The URL can be used to link to this page

Home My WebLink About0169 CRYSTAL LAKE ROAD - Health 169NC;rystal Lake Roam ___.. Osterville�`° ,1.73-007-001-028 i �� I� it �� », w � � CE C 4 i I 1 L0CATION / SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME ADDRESS BUILDER OR OWN R Apt, ' DATE PERMIT ISSUED DAT E C 0 IN P L I A*C. E.,. ISSUED -W -war 00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT Application is hereby made for a Permit to Construct el�) or Repair an Individual Sewage Disposal or Lot No. er d 4 Installer Address 70 M Septic Tank—Liquid capacit' Other Distribution box Dosing tanl:;-,( � _----__._---'--__.—._---._-_------_-___----_--_'_--_'_---_—__--_------_-_— . Agreement: The undersigned ogcece to install the uforedcacr8ed Individual Sewage Disposal Syvternivaccordauce with the provisions of Article XI of the State Sanitary Code The undersigned further agrees not to place the systemio | operation until o Compliance has been issued by h oloap&oealw.,le,-� | � Application Approved Bv_. A | Da3� Application Disapproved for the following reasons:...................................------'_--------.--_-_--........................ � -------------------------------------------------''---'---------------'--'------------------ . "=" � Permit Date ' / THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT . '. OF................, Cam................ Appliration fur. Dhipoiittl Works Totts#.rur#ion Vrrmi# Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at `off aCo� S1. ...... ......------- e.s.s or Lot No. ----- ---4-- --- ow Installer Address Type of Building 3 Size Lot -__'-2-.. _.Q..d.�Sq. feet Dwelling—No. of Bedrooms--_-___-__`''�=-------------------------Expansion Attic ( ) Garbage Grinder 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -----•------•-•---•----------------------------------•-•--•-----•--------------------••-•--------------------•--------------- .................... Design Flow.................................... ......gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid caWtyK gallons - Length________________ IWidth----------.----- Diameter................ Depth---------------- Disposal Trench—N ........ Width• . Total Length--------- ------- SeepageTotal leaching area....................sq. ft. x Pit No.....�......... Diameter..�.Z......... Depth below inlet...!...............� pTotal leaching ared- 1�_..___s4..fs/�.,p Z Other Distribution box ( ) Dosing talk Percolation Test Results Performed by._...__.. ,'/Date f a It ,.-I Test Pit No. 1................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____.____....;........__ W f....__.._...A .: O *-._._ .._�- ..__.�..................................................................................................................... Description of Soil----••-- r- /,l l.��--. ----- --------------• -•---...--- x d c., ------ ------- ----- w UNature of Repairs or Alterations—Answer when applicable._............................:.:___________.__________._______......___...._.r_.__.__-_-_-_-..- ------------------------------------------------------------------------------------=•---------•-------------------------------------------- I--- .'------------- Agreement: ;;,,. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i sue b 3boa o health ' f� . .. `'� f� eate Signed. - ---......................................... ............ Application Approved G -- -- . �•• . •• . •-- �1�C> a ace Application Disapproved for the following reasons---------------------------------------------------------------------------------------------•••--•---------•.-- -----•---------------------------------------------------------------------------•-----•----------------...----------------------------------------------------------------------------------------.----- Date PermitNo......................................................... Issued..........................................:............. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD �HE�V �/`G.............of....... .......� ..... Trr#ifirtt#r of Tourpliattrr THIS T C F ha Indi ' al Sew sp System co ns# ucted `Rep red ( ) by r �� ,% ..... l - / IA �, ..___-- ` to er ..................................� - atF •••••. ••--.... .... been installed in acc rdance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit NO.0....`..fit 0l............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUAR TEE THAT THE SYSTEM WILL FUNCTION ATIS/F�ACTORY. C� DATE �( L I..gd--------------------- Inspector--••_o�� ' THE COMMONWEALTH OF:MASSACHUSETTS BOARD OF HEALT 3Ej ..•-1--�"-.h /2...._.OF..........9. �.........Q��..:�. .................... otl No------------------------ F � Permission is h reb ranted_...._____ '�.1 _G';�G�...._._./. _-. -� _._..!..__ G�'��e ................. Yg to Construct 04 ReA�ir ( ) an IndiviS,e age Disp ,� System c/�. '� 1 /lC at No. -j 5 .. u.:K.dC. f . /. - _:G = -----------v(1. �`'�L.................. Street as shown on the application for Disposal Works Constru ermit No..................... Dated.......................................... ., Board ea th DATE................................. ................ FORM 1255 -HOBBS & WARREN, INC.. PUBLISHERS L d SI�.tGt_E F4MIt..�( - �3 ROOK �' C.ZY5 1.rHL.. L-n.of FOAD aA«� ��aw • Ito � � .3,�i r"__. ._.. S E�Tt G T At.!�L • 3 8t) X 200 4"C.0, j .. %>% SP05AL P1T VWG- t PL Gx . . ARMA -2.-L 6 zF x L. s GoTToM AQeA• ! 113 S F Z4 TOTaa- vo"%6N �0�� .. ►i �( -g� DIST . ._ j • ..' • � t Soo GAu -. '.. 1 � E-Zc o�T to�.l Pr4'TC=` t t u Z MuJ oQ L.565. P UTU r 0.E,. .r� �fIIWMYTi r i JO ,p No. 19334 O P .•. L c)p�0 $` i i t fi FW • tflo'. C..GtA1N� ,¢r�PE ►SvD wv � �uv• g7:� 4"Oo` vtsr. `"" S�ric qb9 ;'•• ThuK. Ilk r lobo _ L.EA►GW A� PIT 0 { w.r,t vrASuW N cYvac C(O 4 ; ; CMR_TIF1aa OI..oT Pt_..AN . 1 ptZo F=t L..� - C I Mn • t G¢tT 1 F•( T"AT r"rr- Gom P&-`(S AwD S T$ACK RE4��¢LME�.aT;� OF TW& Zvvv" \-LAii &-oor' 143 PaGC �. BAxTetz t, u-tr=6 tic. Qs.`tsTt= ZZEIC), Lain 9JtZVWPV-ry TKtS PL&W top' UOT $oSED ou Au t TZOMENT OST KVtt.Lt�. A�tA,SFa• SUCvc( T"r- OFFSIET; •5"0QLD NOT EE USeD gPpL.lGAatT To -PE.T r-zM, L $-OT U W E3. ��U L!-4 LL A. M� 3 LOCATION SEYlI'AGE pERNIIT 0 N -- `u VILLAGE 1N.STA LLER'S NAME ADDRESS I R U I'L D E R. OR. OWNER DAT_E' PERMIT ISSUED iA b i : DA.TE: CO PLIANCE ISS.U,ED - --- __-. r 2 m . a it x a 777�,QM a Rb '� '� Y [ y^r„.✓ s4's .- ru p 'Z. -� {4IIc�il�}5'G�- ... {! i,.xs� N� r� �"""'$ a. .s. e §"� <t 3 ��'�;: rf'� � �•e_{`� gS S �v a .r ?('"r''3A_� a 4. - £ ' du 'da 5 ..,ems ,s.- ar•-§-:w -.•,.+.:t .t+�rs-.q`a�a.y*v + ' h^�` -'o'r^�e, gp t t..fi K - f �L G } f