The URL can be used to link to this page

Home My WebLink About0600 CRAIGVILLE BEACH ROAD - Health )00 Craigville Beach Road Centerville A= 246—224 10 ' I ® I 5 M E A D I No. 2-153LOR UPC 12534 smead.com • Made in USA Ir�GYC(�0 �J L � CATION W A C E PE RM T NO. I ��tr seey rao& C IrCIe- YIILAGE s _ I N S T A LLER'S N/A ME A AD DRRESS f weelH K t Sr !�/, 154`H s B U I L D E R OR OWNER A< of c ti , ld�s Alo,,A /�4A-,, � Ness DATE PERMIT ISSUED DATE COMPLIANCE ISSUED , , /a�a �T /o�� D �, r �� - � � ,� � �. � i �vt � r � � � 0 � �_ �'� � � �_ n � � �� `.. SP�r s�P4G�o� G/ve%r __ � _o No.. ....� � F11), ............. fJ ` O —THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' .........................................•--... , ' pfiration for Uispniittl Hlorks Tongtrurtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (t_�an Individual Sewage Disposal System at: /✓�trc . � •Sp�s,�Qu�..... C/�C/? ca' - ddress , or. No. i 8 .S CAa!�..l��J.......t e� Vic. -SZ�dH�e��aev•e/rC P ..... •------•.................• --••••••.... �wne � CC�Address ; ��h ........... . .C<.------.............._........... . ..1. �— / /!t K J' '� f _ir/17s !/?/*...^.'. Installer Address dType of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms...........................................................................Expansion Attic Garbage Grinder Other—Type of Building No. of persons.............. Showers Ga YP g -------------•----•-----•-•• P ( ) — Cafeteria ( ) P4Other fixtures ....................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W . WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................•.. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date-....................................... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ V ------------- `---------------:--.----:--_.-- -----:--------------...---•..------------•----------------------------------------- ----------- --------- • xDescriptionof Soil..--------•---. -- ••.............•-• .•••:••••• -----•--•- •-•---••---•--•••-•-•---•••. -•--••---•-••-•-••-•-•-••-•-•---•--••-••••....--- ..--- -------------------------•-----------------•-----•----------------------------•----------------------------------------------------------------------------------------------- ---•--------- W UNature of Repairs or Alterations—Answer when applicable S j,._._../ f1. ...... �... � ................. Agreement � y �--�---------------- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System,in accordance with the provisions of iITi 1E 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has a d b y ..board of ealth. Signed•• --- ......._-••----•----•........•-- ................. Date ApplicationApproved By-•••••----•••--•--•-•----•-•----•-•••-•-•••••.....•-•.....-•---•••••----•--•..................... Date Application Disapproved for the following reasons:-----••..........................•-•-..........---...---------•--------.._....------------------................ -----•---•----------•---•----•....................•--••----•-•--••-........_--•--•-•-.••••-•--•-•--•••••••-•---•-------------••----••••••-•-•--••-•-•----••••-------•-••-••-----••••-•----•••----••••••- Date Permit No.Z_, ........ ..... Z.................. Issued...........................................D ate....... Date No-1 n�.........J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................ ..............OF.......................................................................................... Appfiration for Bisposal Marks Tonstrurtiott VarAft Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ................. ...... ......4..C......................................................................... L I n-Address or lAt-,No. ............................ '.41j ILL . ......... Y_ .............. Owner Address ................................................................. .....V �Z.s ........................ ...... Z.r- ....... Installer Address Type of Building Size Lot............................Sq. feet. Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building ............................. No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width............._.. Diameter.........._..... Depth................. Disposal Trench—No--------------------- Width................_... Total Length...--............._. Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) . Dosing tank ( ) 1.4 1-4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rX4 Test Pit No. 2................minutes per inch Depth of Test Pit................._.. Depth to ground water........................ .............. ........................................................................................................................................... 0 Description of Soil.....- .........................I.............................................................................................................. -----------------------------------------------""""----------------*-------- ..........*'**'**------------------------------------- ------*------------ ----------- --------------- ......................................................................................................................... ...... ........... .....------------- --- All? U Nature of Repairs or Alterations—Answer whenapplicab!l�.....o"o .................... ...... ........... ........7"' ......f> _.. - = �l ..s -��-> Agreement: The undersigned agrees to install the aforedescribed' Individual Sewage Disposal System,in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has i ued b t e bo rd of health.is '2 Signed. . .......... S_ .. .. .: .................. ..z/ Signed.. ........................................ .......................... Date ApplicationApproved By............................... .............................................................. ......................................... Date Application Disapproved for the following reasons:........................................................................................................... ....................................................................................................................................................................................................... P- r q Z Date Permit No.v..�=� Issued.................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... .........OF.......... -—------------------ (Irdifirate of Tomplitturr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by---------------------------------------- .......J�A.�7.0 ... ............................................ ..............................................................I..... ln�.!_ller at... .... . ......C .....24_� . ....r ...... .......... - ------- AZ_J ... Pam? has been installed in 6&ordance :�the provisions of TITLE 5 The State Sanitary Code as described in the application for Disposal Works Construction Permit No.... .......... dated,............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---------------- reZ................................... 1. Inspector....---...------ THE COMMONWEALTH OF MASSACHUSETTS A 2- BOARD OF HEALTH...77_v .z��...........OF....... No .� .............................. .............. Fmc........................ Disposal Marks Tanstrurtiatt frrmit Permissionis hereby granted...... .......A-4.1mo.......................................................................................... .to Construct or Repair a%Individual Sewage Disposal Syste7,/ Sire;i .. at . ............. . ............................... .. as shown on the application for Disposal Works Construction Permit No.6��.. D t d 142 ....................... ............. ........................................................ Board of Health ......................................... DATE....t�....../....... .....A FORM 1255 A. M. SULKIN, INC.. BOSTON