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HomeMy WebLinkAbout0028 HAYES ROAD - Health Celdery i Ile /// E M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR A SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT10% CerdedFiberSourcing POST-CONSUMER® wwwzflpropramorp 5R012W MADE INUSA GE ORG NIZEDATNMEA L/IN No....lf.`. 6 Finc ........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Applirntion for Uiipnsal Works Tonstrnrtinn 11unfit Application is hereby made for a Permit to Construct ( ) or Repair (%.-)an Individual Sewage Disposal System at: -------------- -- -------- - ••-------s.... •._..._................................... Locati Address or Lot No. ............ . r-i ........!' �`m-..---•-•-----......-•---------- ...........�k N0__4- ........- ner Address . r a ...�.1 ..` N _Ci l�'Sc�r �l�tL r 1r •-• ___ Installer � Address Type of Building •-- Size Lot............................Sq. feet U Dwelling—No. of Bedrooms._3........................ _Expansion Attic ( ) Garbage Grinder ( ) Aa Other—T ype of Building ._.... Other fixtures No. of persons............................ Showers ( ) = Cafeteria ( ) 4 .---......•---- -• ------------------•--•------...-----------------------•--•------•----......---------...------.......----..........------------ W Design Flow...... .........................gallons per person per day. Total daily flow____ ..................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length......._............ Total leaching area....................sq. ft. � C Seepage Pit No-------#------------ Diameter.._..`�'.......... Depth below inlet--_-.�............ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by...:== ................... Date........................................ Test Pit No. 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........................ Ix ---------------------------------------•-------••...----••--•-•-••••-•-•----••-•........_...._............................................................... 0 Description of Soil........................................................................................................................................................................ x U .....--•••-••--------------••-•••.............---•--...••-•-•---•---••----•--••-------••----••-------•----•----------------•----•----•-------------------••--•------------•--------........----••......•. U Nature of Repairs or Alterations—Answer when applicable._.___ .__._..(,�`-�.__t� _ l�_.__(,�'. ......... �..`a._G_,( ......0 �5 ..--ree � �� a�� -------------------------------------------------------••...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Co _prim s been ' suedAb e.board o ealt Signed ... .-.6`'�------------- ...... ............. Dace Application Approved By ..................... ..-.. ......... .......... �i are Application Disapproved for the following reasons- -------------------------------------------------------------------------- -------------------------------------------- ------ . . . ............................................... ............................. . --------- -- ----------------....... ........................................ PermitNo. / �.'..'I....11- ---------------------------- Issued .---....------. ------------.......---- Daw TOWN G BA,RNSTABLE Q LOCATION �� I-)�Y�S � SEWAGE # 9( or `p� VILLAGE ASSESSOR'S MAP & LOTj INSTALLER'S NAME & PHONE NO. C a4 PC- L Amp Sew_ 4, SEPTIC TANK CAPACITY /0211) ,rxt LEACHING FACILITY:(type) / ����►a sr F�cc" (Size) NO. OF BEDROOMS -3 PRIVATE WELL OR UBLIC WAER BUILDER OR OWNER --�,r)a7 "M 5 f4C-e'i 0 DATE PERMIT ISSUED: 1 IqDATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No o ��s'inccJ ►�T{.C� i hC� t4lew i>rr . -- ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirta#ion for Disposal Works Tonstrurtinn Vautit Application is hereby made for a Permit to Construct ( ) or Repair (%- )an Individual Sewage Disposal System at: ........- '.�. -!4 z°5..._ --------------------------------- (r.�:.rc::..: .. " -----•---•----•-••-------- •-•------- - --- Locati n-Address or Lot No. ........... v�.wJ.`a....._.. L'eTC> IL ...............••-...--------- ............-••••.....-� -/....J ✓...l....4--••-•---- •-----....i---9�-•-•-•d-•�?----�•-'if •-•--•----... Address 'H 0V L......................•-•---••----•--`a--•---...................................... ......................�•• .................. Instller Address UType of Building Size Lot............................Sq. feet I—I Dwelling—No. of Bedrooms___3---------------------------------.___Expansion Attic ( ) Garbage Grinder ( ) A4 Other—Type of Building ...P (<<. ___.... No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures .......................'1. 1 i' ____________________ -•--•-----•-----.---------•-- W Design Flow...... _ ______......................gallons per person per day. Total daily flow.------- ........................gallons. WSeptic 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...le............. Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by................................................ Date Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gr.I Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 94 ----•--•••---•----------••-------------••---•-•--•-----••------•--••----••-------••--•••-•-----••--••--••.........-••---•....--•-... --•------------------ 0 Description of Soil......................... x U ..........=............................................................................................................................................................................................. w x -•---•--••••-- ------•-----•-----•••-••----•--••-----------------•---------•---•••--------•-------•-----•-•---------•-----------------•••--••------•----•--•-•----•-•-•--•-•••..-•••----•........_...-- U Nature of Repairs or Alterations—Answer when applicable-•---0)w---.._. _� ..__ Q` x:. 1 l71t/ y ....................... ......................9W L Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has_b_een issued by the-board of,Health. ... ........ ..._.... q' Signed 1.s .:.... ..-C- ....: Date Application Approved By ------------------ " ��. ,.' .................. .... -=---/.......?/..--- Date Application Disapproved for the following reasons- -- ----------------------------- - ----- ----------------- - ----------------------.................................. ---------------- -- -- -- --------- -- ---- --- - ------------ ----------------- --- -------------------- ---------------------......................................................... ---------- - --------------------- . .... Dat e Permit No. ........---�-- --7- �. ............................... Issued -..---------------- .......... ......... ---- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Gralatiance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ��...V . --r-..t.mac -_.-5�... ............................................................ _ Installer has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ........?1.----.I/---g--&... dated --- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE, SYSTEM WILL FUNCTION SATISFACTORY. �/ tt�4! 1 ' 74 DATE.................................... W - ector � '. J .. . ../ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE.. �i��ra��1 nrk,� �lan,��rtinn rruti# Permission is hereby granted........e. to Construct ( ) or Repair ( i )fin Individual, Sewage Disposal System � Street // /��/ as shown on the application for Disposal Works Construction Permit No..7l' o-Dated.......................................... ------------------ ••-•..•..��...................................................... DATE. I,/- /' �� Board of Health FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS 79— UV .Z. � • .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........Town........OF...........urns.tabl e-.............................................. Applirtt#ion for Diopoa al Works Towitrur#ion Urrmit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 28 Hares Rd,___.Centerville. _02632 __ Ed ar inters dress 28 Hares...................,_ _d�Wterville_t .02632 ... .......... ......Yj-.-.... .-.-..---.........-•-•----------.. ..--- Owner Address w A & B Cesspool Service 128 Bishops Terrace, Hyannis , 02601 -•-•------ ........ .... ... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms........... .Ex anion Attic Garbage Grinder ...... Showers —� Other—Type of Building ............................ No. of persons..................4. ( ) Cafeteria ( ) Otherfixtures ...................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 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........................................ Test Pit No. i................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•---•------------------'------•--•---•--•-•----........---•----•--••-•--•------•---•----••-...........-•-•-••------•---------•------------•-•-•••-----..... 0 Description of Soil......Sa11d-----•---------------•-•--------------------------•-----------------------------------•---------------.._.-------------------------•---•-••------•----- x M ----------------- --------- .----- .-_.-..--- ............ ..-------------------------•---------------------------------------------------------------------- ..------- .......------------- -------------- U Nature of Repairs or Alterations—Answer when applicable.__Installation of-a__.. 0 gallon,._. leach.--pit...with...extma...a tone.........................•-•---•---------------------------•-'-•---------- :. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIL 5 of the State Sanitary Code— The undersigned f rt r agrees not to place the system in operation until a Certificate of Compliance has been issued by th o d I g 6 11 Si d- ............. .... ..... /79 t Application Approved By----- ! l!1l1 6�1T179 • - -------------•----- Date Application Disapproved for the following reasons:.*.............................................................................................................. ....................•-•...••-----------•----•-----•----••---•--------------•--'--------••-.....---------- Date Permit No..............Z9�--••---•----•------•-------------.. Issued-----------.....6/1.1/79.................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (� ..................Town............OF....BarnstablE........... (�rr�ifirtt e of Tomplitturr .. THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by._A_.&--B.-C-esspool....Service,._.128_Biehop5_�erra.ce,;Ijyannis._ 02601 at28 Hayes-.Rd. . Cetterville: Ma,. n ... -........ b..��32-__-- Edgar Winters has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code s escr' din the application for Disposal Works Construction Permit No.._......79_'-_^?r.!2-...... dated-............�--�11�9 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 4. /11/79 DATE...............6.............. -....... •-•--------i------------ Inspector.............---------:..... .....•.----.......•----•---•--•-•------------....-- ��, ���r�-ice T� No..7g- 3'J_,sZ, d�R Fly$.......-�--,5.00.... •a •.,COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... .....TOwr..........OF..........-q-c'fix'.'na..t_s1-.,tle............................................... Applira#iou—fear Diipnsal Works Tonstrnrtinn Vamit, Application is herliby,�made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System,at - 28 xa s Ad. t Centerville 02632 .. .. ...-•---------t.... ................... ........................................................... - "" ' Location-Address or Lo No. Egar � fvg, 3 .:' r> rs 29 .�ay __ .�.�...Cne .. �� Q... .. .. � mill 2632- Ow ez Address w A & H s ihol•-Serve cP 123 Bishops Terrag'Q ................ .............................................. s Ii € nn 9 02.601 a Installer Y Address UType ofBi.4iliding., Size Lot............ --------Sq. feet J —No. of Bedrooms......... .......a .........................Expansion Attic ( ) Garbage Grinder ( ) p, xQther,^ Type of Building __?._ .._•.•.....•_.:... No. of persons..................4....... Showers ( ) -.Cafeteria ( ) 3 f, Other fixtures .. -------- --- -•--------- ------- ------------------------------------------------ ...----------------- -.-- •-.._._._.••.. w Design;Flow_,._ ••- ___-_--•_ gallons per person per day. Total daily flow.............................. .........gallons. 04 Septiq j4nk„-Liquid capacity's _..gallons Length................ Width................. Diameter................ Depth................ w Dispgsal,,Trench—:No. ..........._..__.. Width.................... Total Length.................... Total leaching area:.. sq. ft. Seepage Pit .No ....... Diameter ............. Depth below inlet.................... Total leaching area ............sq. ft. Z Othe istriliutiori"box ( ) Dosing tank _( Perc©lat�on$,Test.Results ..i"Performed:bY--•-------- ................................................. Date. ..................... r l rTest� 'it,=No 1.................ininutes per inch Depth of Test Pit.................... Depth to ground water LL, Z`estrPit�aVo 2-__............;minutesper inch. Depth of Test Pit.................... Depth to ground water` .................... `4 ' DDesc "i©nfQf.S011 t:; g€1 .+: ... ..... ........ _ ._.___.-------- ---------- _.-- -............';`,_'! 3 t yFVti --`-... __-_-- ' ......... .... .... ........................................ i _-----••--. UNature ofT Repairs dr Alterations—Answer when applicable--In. tF�l ati-on_._b .s'�_._..6�Od...��o�i...___._. .3 .. ............................................••-••••-•-•--•-,,_.. Agree ient r ,4ty, The 6undersigned agre s to install the aforedescribed Individual Sewage Disposal System in aceordance with theisioiis of TITS` �z p 5 of'the State Sanitary Code The undersigned rt er agrees.not to p1aGethe system in operaaLU ii until a*,Cert icate of.Compliance has been issued by th o r i h. ; }l Si ed _._. �h1/79 at Appl* ion approved. BY ... r.. -... tom. �j7�----•--- Gr!V� ... .......... G as �i Date Application<Dtsapproved for the following reasons:...........................................................'--� k ...--------- Fw ti •* J . --••••.. tax Date 1PIN ' ,tP�a,f emfa�i�trN o .. .............. .............. Date W v , r THE COMMONWEALTH OF MASSACHUSETTS . ..x BOARD OF HEALTH f�' `tx Y° r 1 ......... 'OF...Barn8�'ic'�b�4' x Tin Wn k}+tk w r .................... J.+ a 1f;a of,��unt�r�i�tn�� ., �� rIi � S,Tp CERTIFY, That tTie Individual Sewage Disposal System constructed -( r r Repaired (X ) Eby A I � ,c ©1• S@rViC!?.st_..128 Bishops Terrec � a n..st , Q 6t� ,=a , �_ , , at28' "� � ';ti .C��gvi11e; 1148� ( `' �'�3l Edgar iN]n 9z' x •••••- has bit 11il t tied an accordance with the provisions of TITLE r of The State SanitaryCode s ekcr in the " � p 79 ' Zr fit-, � ������ pp Lion for Disposal Works Construction Permit No............... __.____.._...:_....... dated__..._... , l r h,._.._.____.-_.__... a li f 7 IS -WdE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTi, OIrkMIILL,FUNCTION SATISFACTORY. DAT &,6� 1�79 Inspector. ------------------•-- THE COMMONWEALTH OF'MASSACHUSETTS` BOARD OF HEALTH r t 1 Barnstable ......... ................` Ot . 5.00No7 THEE ................... �, A & B Cesspool. Service 12 Bishops., � P rrnissiori > 'hereby granted______________________ T:..t��e, Hyannis to Coh r ) or pair n Indi al Sea a Di s s em at No �,� y ..: • , ben �erVille — d9 'r �r zri ers JStreet ............................+ 4. as shodvn on the application for Disposal Works Construction nit t- Dated_._61� 1 --------------•- Board of He ` DATESt k ..••••••---•••--•.......---•-•.....................•---........ FORM �SSHOIjB&4WARREN, INC., PUBLISHERS 1, L-b,CATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME & ADDRESS 8 U I L D E R OR OWNER. DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED �' J� ,Y + �' V 4 No'_...a1__��S Fz��... .J...... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEA TH -�.............OF......... ... .. ..... 4 GJ `t' ...1........... Appliratiun -fur Biiipu,ittl Worko Tote trnrtiun Prrniit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location- des + or Lot No. ................. -- 1F 1t W Owner ,address ................................................... A---: _T_5_:1..._._------ '_ ...................... SI utt Installer Addres§ UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.:..........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) d Other fixtures ------•----•-------------------------------•-•------•_-----•--- W Design Flow............................................gallons per person per day. Total daily flow.........................................---gallons. 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_---_.---------------------------------. Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water.........-..--.-.------- �14 Test Pit No. 2......-.........minutes per inch Depth of Test Pit.................... Depth to ground water......-..--.------------ P4 ....................... ----------••---•----------•--•--------------------•--------------------------•------•-------------------------------------------•--- ODescription of Soil---------------------------••--•-•-•--••--•----•---------------•--••--•----•-•--••--•-----------------•------_-...---------------------------•----•-------------------- x V W UNature,o P .airs or Alterations—Apswer wen appli le............. ........... ---------- -, ----------------------------------------- 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 iss d by the board of health. igned. -.. 1, -3 7 -----------•-------------• ---------- Application Approved B --••- .�..`®.D�e--._ PP PP Y / i�-�� ----..-_.. Date Application Disapproved for the following reasons-----------------------------------.............................................................................. ---•---------------------------------•------•--------• .................................................. ---•------------•------•••• ------------------------------ ----------------------------------- Date Permit No......................................................... Issued.-..�...``�... . -- ---•-•-•-- 1 Date A' LOCATION ,E PERMIT UO. \/ILLAGEh ,-of//�, IMST.ALLERS. UNME.. �.- Q.DDRESS BUILDER 5 - Q &V AF-_ �- .ADDRESS DATE PERM, 15SUED DATE COMPLIDXICE ISSUED : /oat, 37� -v Z I 4 4l THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH .T/`Z.,/).�..............OF........ . .. ...C� ., ._.................... Appliration -fur Uhipniitti Workii Tomitrurtion Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: --•---. --...•----------------•-••--•---•-•--•------...._..------ ------••-•----•--------•-- ....... Location;,Address or Lot No. 1 E�.,�_.... ' -------1 ..--!--� ..-C.... ................................ ...T....-------- ------ owner ° _ Address w ll ra ��----�lC---�( --•-•---------•----•-•--•--••-••--------•--•-•--•---•--• ...lit/.Al....t.................! Installer Address Q 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 ( ) dOther fixtures ----- ----------------•--------------------•-----•-•--- --------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 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 ( ) aPercolation Test Results Performed by------- -------------- ----------------------------•-------------••-----• Date--------------------------------------.. Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-------------------- Depth to ground water....__-__-_---_--.-.-- rs, Test Pit No. 2................minutes per inch Depth of Test Pit.__--____-__-_____-_ Depth to ground water__.---._-__--_-_-.------ P4 ---------------------------•------•--------------------------•---------•---------------------------......................................................... 0 Description,of Soil.....................•_...........------•-------•---....---•----•---....--•--•-•------------•------•--•-------•--•-----------------------------------------•------...- x V ----------•--•---------------------------------•-••------...----------------------•-....------•---•-....-•---.....--------•-----•-------.----.-.------•---------------•---------------•--•---------- W UNature of R airs or Alterations—Answer... en appl' ble..________._-. �%-- ---�------J----=_ r _ �. .. - ..r!_. .__i..r__�: - -!- -------------------------------------- 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 is d b the board health. Signed ..... .--•-- •----•--•-•-j::" --�� ' /U-------------------------------- Date - S / _ D7ate 7 Application Approved BY y'. �-1 �.� 1 ./a!!t _ - - --------------- .� --�- - e Date Application Disapproved for the following reasons:---•---•-----•..................••-•----------•-•-••--••-•----------------------.......---• ----••-••-•-------. ................•••---•---•-•---------------------------•---------------..._--•---...._.....-----•--------•-----•---------•---------------------•-.-----•---•------------------------•-•---•-.---.----- 1___D_ Permit No......................................................... Issued..... 2 C J Date THE COMMONWEALTH OF MASSACHUSETTS BOARD Pff HEALTH ... ....... ... 0 F..........K-I./ 4. .............. -- (11krrtifirair of Ttlnmpiianrr ;Ijs I TO "E FY, That the Individual Sewage Disposal System constructed ( ) or Repairedby. -- -• = _•.........•--•--•---- ---- -- ----- -- -•----------------------•-••------------ ��/� Installer, � � at----- try "�/'QrJ E f/�'s = &44 —A...... '!- ------------- .................. has been installed in accordance with the provisions of Article XI of 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 TIME SYSTEM 1NIL-- Fly CTI_QN SATISFACT AX__ ----" z DATE----•-••---•- •--•-••--••-------•----•-•--•..................... Inspector.---_ --------•----------•----•-------...- . ................................ THE COMMONWEALTH OF MASSACHUSETTS i BOARD HEALTH . .. .......... ............OF....... ................... No......................... FEE.,2. Bi V0.6 >�rk n n r rti>Qat rrmit Permission is hereby granted_._ ..�_. ..................................---------------••---- ....---•---...----------- to Const °( ) or R , air Individ Sewage Dispo System ((�� , �} at No. - I - - r a �C� ---------- r Street as shown on the application for Disposal Works Constructio rmit Dated_-� ----:�_.'--___-�-,.._. -- .� •--_-----------------_----_ �^J S`-•-•................................. Board of He th DATE--�--/-•-------------------------• FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS