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Home My WebLink About1090 CRAIGVILLE BEACH ROAD - Health f io i o Cra igUi'lit Bea% Kj- - OcAteTvi ate - -- - - S M E A D No.2453LY UPC 12934 smead.com • Made In USA SUSTAINABLE VESTRY INITIATIVE Cordfisd Fd w Scurclq WmLdWwuLwg VT o J 9 TOWN OIL BARNSTA LE � I.0t ATION _ .SEWAGE # (� A. VILLAGE 14 �� h a2G` ASSESSOR'S MAP tit LOT Iol INSTALLER'S NAME & PHONE NO.- C AP6 ! A,t,D SEPTIC Tr1NK CAPACITYN1 42:7m5 z LEACHING FACILITY:(type)`T!1rrLuGJE.$ 9-�L (size) i _ NO. OF BEDROOMS - I'Itiv.�'fE `a1rLL C i 't1 UI BUILDER OR OWNER -732—'L_ P Al 0--rC k- _ DATE PERMIT ISSUED: ' DATE COMPLIANCE ISSUED::__ VARIANCE GRANTED: Yes No r , R ,'� `Y�.. I .9 C� _ I V G��..P :-�� a .�- .x ;-_ ..; . �� 3pp � es` �y�Z 19�511 tr ,_ .. -;- �, �; .: - f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Applutttinn for Disposal Works. (nnnstrurtion jhrmi# Application is hereby made for'a Permit to Construct ( ) or Repair ( i.�an -Individual Sewage Disposal System at: .✓ �►!.1�.�. °5� .- •••-1:-••::�.•••••• ...-....... •.Ci/�{�.u:,�� ................................................. ocation-A'dAdress �d, `� or Lot No ... ...._.._..L {l 'B✓ -� 4�ifti'eT Ye....................................... .................�'�_.Y:Y"�............--.....__ Owner Address `n n a ...:...�� `: ��t L.!�! �??a ...X`::Y......!^c_V.....� Installer Address 2 Type of Building I Size Lot................ q. feet �-, Dwelling—No. of Bedrooms....a.........................I--.----.:-Expansion Attic ( ) Garbage Grinder ( ) of Building ... No. of .04 Other—Type,� g ......................... persons---•---------•--•----------. Showers ( . ) — Cafeteria ( ) QOther fixtures ...................................................................---------------------......--•---•---............................................ W Design Flow.......��--.�?...........................gallons per person per day.-`Total daily flow.....a ..........................gallons. WSeptic Tank Liquid capacityf..t .gallons Length..... Width....`{........ Diameter................ Depth............... x Disposal Trench L No....../........... Width.---.y`........_ Total Length..a.��-.-..• Total leaching area................:.,sq. ft. 3 Seepage Pit No..................... Diameter............:....... Depth below inlet.................._. Total leaching area..........:.......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a . - Percolation Test Results Performed by..............................................••••......••............... Date......................................... • Test Pit-N;. 1............%..minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test'Pit..................... Depth to ground water........................ 0 ................. -:----.......-•------•--• , .............-- ......--...--- Descriptionof Soil...................:_:................... ......................---.................................................................................................... W ----- - -- --------------- ----•............ ....._.....-- ••••--......----•-.....•---.....•..--•-•••--••••----•-•...... ----•••--•--...................._.............._..._...... UNature of Repairs or Alterations—Answer when applicable'-XIM. -1-Alt....l.anb..$e.V. .. ............. a ......... .,C.--l-.... . ................................................................................. Agreement: The undersigned agrees'to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI'11Z- 5 of the State Sanitary Code— The undersigned further agrees not to plaice the system in operation until,a Certificate of Compliance has been issued by he oard of I iealth. Signed...-. .. .. •..... ..•••----------- -- ............................. ..... Date Application Approved By.. ©�_:nj .==...6.7. Date Application Disapproved for the following reasons-----------------------•--•-•--------•------------•- --•-------•----•-•-•-....................................... ................................. .�. .,...... Date s, PermitNo....... ......................... Issued-......................................................... Date 7S_ D Fins THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. ............ ..... .... .. . ................................. Appliration for Disposal Works Tonstrurtion lirrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: .. .... ........ .... ...... ................................................. Location-Address or Lot No. ..................................... ...................... .................................................... ..... —----------- VV__0_ 0,ner Address VAVJ L ................ _V4'4_V3..... kO(o L ..... .. ............. .............................. ......................................................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons.._._....._..__._........._. Showers Cafeteria Ottrfixtures ....................................................................................................................................................... '5'- p ___.__...___..._._.__._.gallons. Design Flow........ .................................gallons per person pe r day. Total daily flow.....aj�tc) Septic Tank- Liquid capacit�.O�.gallons Length..........__. Width..._`.__..... Diameter...............*-----Depth_..._.__......_."'*-"' Disposal Trench Z�No. .....Z........... Width_...`?.......... Total Length...C*.-T`...... Total leaching area....................sq. f t. Seepage Pit No..................... Diameter......_..___.___.... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit..........._____._._ Depth to ground water.._..................__. 4� Test Pit No. 2................minutes per inch Depth of Test Pit..._............__.. Depth to ground water___._...._.._........... 9 el, I- -----------------------------*........----------------------------*------------*--------"---------- --------------------------------------------- 0 Description of Soil........................................................................................................................................................................ W ............................. ................."----------........*------------*"**......*------------------ ..........*--------------*--------*--------------- ---------------------*------------------------------------------------- ..........."---------------------- ------------- U Naturt of Repairs or Alterations Answer when applicable__:4��S!A._t�.... ............. 0 41 5 ....................7......................... ----- . .... ... ------------------------------------ ........................................................ ........... Agf�ernent- .. . ... P The undersigned agrees to install the a1bredescribed I-ndividualSewage Disposal System.in accordance with "ihe pr"0-'V"isio .of ns I "5-of the State Saniiary'C'6de The undersigned further agrees not to place the system in operation until a Certificate of Compliance,"ka -been issued by=the-boar.d of health. Signed.................. .......... ....... .................... ---------7 ........... Date Application.Approved By................ . ......... ..... .. ................................... ....... Date Application Disapproved for the following reasons:............................................................................................................... ......................................................................................................................................................................................................... Permit No....... .. . ... ........................... IssuedL..... .Date ........ Date THE COMMONWEALTH OF MASSACHUSETTS BOAR`DD OF HEALTH �S lf�r2 to—�l vq,v .�'�'`... .....'............OF..................................................... ............................. �rrfifirttt.� laf fanutnlittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (t) G 14 Ly�K{(� co wsT' by-------•-•-----•----•...... ................�l�... ......0 ..._._._.._.._..... In has been installed in accordance with the provisions of TL I'"L: j o 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. q DATE...... -•••••..•-•�.. • --. a 1- �!------------- .--••--.. Inspector........... ' .....-•----•---------------•--•-------••---------•--............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t c'a�. V-- b ..........................................oF..... ----- ......................... No. ...................... FEE... --2.......... Disposal Works Tonstrnrtion f rrmif Permission is hereby granted-----------------G G v4 e<< yj:..5`e � .......................................................... to Construct ( ) or Repair (L-)an In ividual-Se wage Disposal System atIgo..---...---..-d--..-U----------c......`--.= .....----- .................................... ---=r ----------------------------------------------------------------------- Street as shown on the application for Disposal Works Construction Permit No.z.`�.'.ft'-_ Dated.......................................... * ---- DATE. �7- $ C/ uoar l o; xealtl�