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Home My WebLink About0038 GREENWOOD AVENUE - Health 38 Greenwood Ave J � Hyannis i ��I No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIppliLation for Disposal *pBtem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(X ❑Complete System ❑Individual Components Location Address or Lot No. 38CjiZ(sM&vcob Mcs Owner's Name,Address,and Tel.No. Assessor's Map/Parcel gagr45 5 ® LAv�® 1 S z Installer's Name,Address,and Tel.14o. Designer's Name,Address,and Tel.No. f 9 N/A Type of Building: Dwelling No.of Bedrooms Lot Size as,<S 1 " sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) /v gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 6�� [� �71 C 5 � Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance.has been issued by this Board of H alth. Signed cz, Date al " a a Application Approved by (O- Date_ S r Application Disapproved by Date for the following reasons Permit No. � �V T Date Issued f t No. ;:: " Y � ,,�* r xi :.xY, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION TOWN O1F BARNSTABLE, MASSACHUSETTS 9pplitation for Mi!'5posal 6pstem Construction 3oermit Application for a Permit to Construct( ) Repair( ) Upgrade( )` Abandon(X ❑Complete System ❑Individual Components Location Address or Lot No. 38(ajZ(5M&J jb AVE Owner's Name,Address,and Tel.No. p Rag t P 3 y iA5 wr4vs�c°�' � Assessor's Ma /Parcel 4"� �� Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. -0-"etx'DE Gh�acsdrg N/i4 S3 Gockacs4tC.t Szr- lk, S�►P ' Type of Building: ,n f Dwelling No.of Bedrooms' l�/ Lot Size 'A j(051 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures A Design Flow(min.required) /utr gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) k�n.�ri1 F Date last inspected: >� Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in " accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of t Compliance has been issued by this Board of Health. Signed -�- _ Date f, '-� • n 4 Application Approved by t-..:��C.i� �• S Date 'S - r Application Disapproved by a Date ,. for the following reasons F Permit No. '40 r® Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( by WEU) D_6.>- CG uTE326' 4454 S at _2 A-V 67 14 1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.-2 61% b').$ dated G Installer (2APsl jtDF GN'TL�7�e�(S Designer Al1A #bedrooms h / Approved design flow All gpd The issuance of this permit shall not be construed as a guarantee that the system will f6c ion,as designed Date r� ��-�f Inspector ---------------------------------- ---------------•------------------------------------------------------------------------------- --- No. Owl r �'� Fee a�-S THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Mispo$al 6pstrm ConStrUttion J)ermit Permission is hereby granted to Construct( ) Repair( ) Upgrade �( ) Abandon System located at .32 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit.�� ✓. � � Date Approved by , CapewidPB.A. ENTERPRISES J.P. Macomber& Son Since 1928 Sewer Connection • A Robert B. Our Co.,Inc. Company"Built on Trust" 153 Commercial Street,Mashpee,MA 02649 ,January 3, 2018 PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME: Diego Baveloni ADDRESS: 38 Greenwood Ave ADDRESS: 43 Winsome Road Hyannis, MA 02601 South Yarmouth, MA 02664 PHONE: 508-360-2551 EMAIL: diegobaveloni@hotmail.com Capewide Enterprises, proposes to furnish all materials and labor necessary to complete site work for a sewer hook-up at 38 Greenwood Ave, Hyannis. Work To Include: • Complete the permitting process and provide a disposal works abandonment permit and a permit for sewer hook-up. • Pump and abandon existing septic system components per Title V regulations. • Trench from existing sewer line exiting rear of house to sewer stub at street. (quote assumes one line exits basement) • Install and connect gravity sewer line from house to sewer stub at street using approved PVC piping. • After Board of Health and Sewer Department inspections the impacted area will be backfilled and graded using onsite material. Phone: 508.477.8877 Sewer Connection Contract,38 Greenwood Ave I/M8 Fax: 508.477.4977 www.CapewideEnterprises.com Initial: Work Not Included: (Unless otherwise noted in above included work) • Any inside plumbing. • Movement of any large sub surface boulders or of any fences, sheds or other obstacles that may be encountered that are not otherwise noted in above included work • Movement of any underground utilities IE water, electric, gas, phone or cable. This work would be performed by Capewide Enterprises for an additional fee. • Any upgrades to electrical service • Any representation at Board of Health or Conservation, i.e., variance The material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner, for the sum of$4,865.00 Payment Schedule $1,600.00 due at signing $2,400.00 due at start of work $865.00 due upon completion NOTE - This proposal may be withdrawn by us if not accepted within 30 days. Any alteration or deviation from above specifications involving extra cost will be executed only upon written order, and will become an extra charge over and above the estimate; payment for the extra is due in full before the change is made. All agreements contingent upon strikes, accidents, or delays beyond our control. In the event that any underground utilities are obstructing; the customer is responsible for the cost of resituating them. We are not responsible for any irrigation lines, trees, bushes, shrubs, or plants unless specified in writing by Capewide. Capewide Enterprises is not responsible for driveway damage due to the weight of equipment/machinery. The customer will be responsible for any additional costs if trench permit and trench protection are needed. *Loam and seed will be spread once; maintenance and guarantee of growth are the homeowners' responsibility. Capewide Enterprises . ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will-be made as outlined,above. Customer Signature(IiJ.,L Date AO t 3 Signature Authorized Cap ide E terprises Representative Sewer Connection Contract,38 Greenwood Ave 1/3118 Initial: Invoice Capewide Enterprises/JP Macomber A Robert B. Our Co.,Inc. Company Date Invoice# 153 Commercial Street Mashpee,MA 02649 1/31/2018 3580 508-477-8877 Bill To Diego Baveloni 43 Winsome Road South Yarmouth,MA 02664 Job No. Terms Due on receipt Quantity Description Rate Amount 1 Septic System Abandonment and Town Sewer Connection at 38 Greenwood Ave, 4,865.00 4,865.00 Hyannis(per contract dated 1/3/18) Sales Tax 6.25% 0.00 Thank you for your business! Please make checks payable to Capewide Enterprises. Total $4,865.00 Payments/Credits -$1,600.00 Balance Due $3,265.00 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IMA L DATA g � Legend x r Parcels Town Boundary Railroad Tracks y4 ;' yk Ragyx 289112 Buildings .. Painted Lines X } 328 Parking Lots Paved ON >y `{Y'"i�k�'i`� •t �'+��;`� k f S}� f�' :c Unpaved Driveways 28999300�t, ; a�t'� �� pax 1a � Paved Unpaved #25 s .._ : Roads M Paved Road Unpaved Road f` Bridge M• ® Paved Median rY �, Streams I s?',YAtS tit I.ii•} rnj" t�u`'7 r5 LT tre 15 q N Marsh xt ,t 'KRY Water Bodies a 289113 #38 289092 a #39 Nk 'm • r. � �., tX .`,. F �,� r �r t -�X �'.��'§k' �::iy�tL","x•°'6'li'�1 (f if ��4. �.�'r ' •+ 2�1��r r t T 'Jt � .r ^t„�a� 4 i. ` 289138 'y,�•,.$s' ' _ t, x. r$*ad 4'= •Y 48 '! � of 7 �� '^.r ��` �. Ma tinted On: 1 O 2018 This ma is for illustration purposes only.It is not Parcel lines shown on this ma are oril a >p,r PP /3 / P P tP Y• P YSl P adequate for legal boundary determination or representations of Assessor's tax parcels.T ;� I C, e l` Feet re ato inte retation.This ma does not re resent not true roe boundaries and do not re ,G a g� rY 1P P P P P rt3 P & 3 °;$ a {�'��a �` t 1 O 21 42 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on ` � ti "-gy ` reflect current conditions,and may contain such as building locations. �r.' b } ° Z 1*1 Approx.Scale: 1inch= 21 feet cartographic errors or omissions, ;�. f Im Town of Barnstable Barnstable .�. Regulatory Services Department BARNSTASM I -- ,_ UAS& - . Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012-1010-0000-2848 -0271 March 28, 2013 CONSTANCE PERKINS 38 GREENWOOD AVE IMPORTANT NOTICE HYANNIS, MA 02601 Map & Parcel: 289- 113 The Department of Public Works informed us that public sewer lines are now available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 38 Greenwood Ave, Hyannis,MA, to public sewer on or before 3/30/2015. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. Failure to comply with this Board of Health Order may result in a complaint against you, in a court of law. For additional information pertaining to the sewer connection, please see the reverse side of this page. PER ORDER OF THE B ARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health Cc: Barbara Childs, WPC/Roger Parsons, Town Engineering, DPW Enc. QASEWER connect\Letters Stewart Creek Sewer Connects\MA1LING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc h Public Health Division March 28, 2013 ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS: SAVINGS AVAILABLE/GRINDER PUMP: A reminder to those of you who need a grinder pump for your connection: Department of Public Works (DPW) sent you a letter in December 2012 stating the town, for a limited time of two years, only from the receipt of the DPW letter, would provide you with the pump at no charge. (This can save you thousands of dollars.) Please note: You must pay the installation cost through your own contractor. Please make your contractor aware of this, if interested. Also be aware: this is a shorter deadline than the Public Health Division's deadline on the reverse side of this page. SAVINGS AVAILABLE/PERMIT FEE: The Town offers a waiver of the residential sewer connection fee of $420.00 for those properties that connect within two years of the receipt of the DPW December 2012 letter. LOANS: For loan(s) available, please see the enclosed brochure, or see the town website: littp://www.town.barnstable.ma.us/cdbg (under the "CDBG Programs", see "Sewer Connection Loan Program). For loan specific questions, you may contact Kathleen Girouard, Growth Management, at 508-862-4702. CONTRACTORS: Information on Licensed Sewer Installers is available on our web site at www.town.bai-nstable.ma.us/PublicWoi-ksTech/sewerinstalIei-s. Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis—contractors, please call Dave Anderson at (508) 790-6244. FOR ANY QUESTIONS /ASSISTANCE: Len Gobeil at the Town Manager's Office is available to provide you with direction you may need in reference to the Stewart Creek Sewer Connections. You may contact him at 508-862-4701. QASEWER connect\Letters Stewart Creek Sewer Connects\MAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc YOU W ISH TO OPEN A BUSUESS? ForYour hfDrm atDn: Business certates (cost$4 0 .0 0 fDr4 dears). A business oertfcate ONLY REGIITERS YOUR NAM E ii town (vahhh�.ou m ustdo byM G L.-kdoes notgae yauperm-bs-bn tD operate.) You must first obtain the necessary signatures on this format 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: //2-7 t 2 FiRh phase: APPLZANTS YOUR NAM E/S: /i Le tY- BUmSSNESS YOUR HOM EADDRESS: dip * TELEPHONE # H om e Tehphone N um ber G 0008 NAM E OF CORPORATDN : ------------------------------------ ---- - -......----- -- -------------------------------------------- ------------- NAM E OFNEW BUSN ESS--PCC�..QL_-e_(2a_ TYPE OF BUSNESS -- \�/�� --- -- ---- ---- - - IS THIS A HOM E OCCUPATDN? YES NO �{ ADDRESS OFBUSNESS M.AP/PARCELNUM BER (�-I ( Ipssesshg) W hen start hg a new bushess there are se%eralthhgs you m ustdo h order to be h com plane w 1h the ruhs and regUhtiDns of the Town of Barnstable. Thy form :is htended iD assst}ou h obtai-Lbg the hfDrm at bn you m ayneed. You M UST GO TO 200 M air St.- (comer of Yarm outh Rd.& M ah Street) to m ake sure ynu have the appropriate perm-s and Menses zequked to 1--gaIlyoperate yuurbushess h the town. 1 . BUILDNG COM M ISSDNERS OFFDE Ths hdirdua]has been hfDrm ed ofanypern_trequaem ents thatpertah to dLb type ofbushess. Authorimd Signature* COM M EN TS: 2 . BOARD OF HEALTH Thh hdi7hua]habeer}' r` /�dnofthe perm krequi-em ents diatpertah to th tAp b e ofbusiaess. Authorimd S#nabure* COM M ENTS: 3 . CONSUM ER AFFAIRS (LrENSNG AUTHORII'Y) Thh hdi7hualhas been hforn ed of the kenshg requ±em ents tiiatpertah w the type ofbushess. Aut hor:i2ed S ignature* COM M ENTS: 4r 4 Date: 71211 ,0oiz TOWN OF BARNSTABLE AE-64 ICr) TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS: ,/15 62t CC, C4 ( Mj;ram BUSINESS LOCATION: ,TOQ IS A Q2 INVENTORY MAILING ADDRESS: C,,-&,Gk, Akfr TOTAL AMOUNT: TELEPHONE NUMBER: 'q-O!R 77(. Ct CONTACT PERSON: a!jf� pfrw� EMERGENCY CONTACT TELEPHONE NUMBER: Sa�' ' le3c� MSDS ON SITE? TYPE OF BUSINESS: t-rv/ z INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: +((nCk Last shipment of hazardous waste: Name of Hauler: Puma ��r1r;;�� L Destination: Waste Product: nneCtfl, 0(I��r;olL•e& Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) ' Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials LOCATION SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME i ADDRESS I U I L D E R OR OWN =T.-/ter �r.r�_i -�'�Z,.✓� DA T E PERMIT ISSUED DATE COMPLIANCE ISSUED �v . _. ._ � . �� I �' � �'�� : ' ,;z, �� ` � ,� _: � ',� .{ ` No..---...SY`.S. .-.. FizBA2...................... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH II �..- ........................OF.-.-..-.�.w1..-Sl �--1c-.......................................... ApplirFation for Disposal Works Toustrurtinn Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( Aran Individual Sewage Disposal System at: I C4_7 V_p ate SAddress r Lot o� ........ - ............................ . __e_ .. ? .. ' - °-----------.........--•---...-•---- Owner I Address S o^v Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Building _______________ No. of ersons_._._._._..____._________ Showers YP g --•--•-----' ------------------------------P --- ( ) — Cafeteria ( ) Q Other fixtures ------------------ ---------•••••-•--....------------- 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.................... 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ................................................... •....... •------------------------ ---------------- ------ -..... •----------------------------- •-------------- ODescription of Soil...........................-............................................................................................................................................ x w x f -------------- ---------------1 ------------ U Nature of Repairs or Alterations—Answer when applicable.____/a_0.° t;_ 1�A�C----`------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in.accordance with the provisions of iITiZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. /��° ---- ------------------------ cif Sign -________ Dat Application Approved By....... .__ ___. ,l0-S '- Date Application Disapproved for the following reasons:............................................................. - ..•••-•.............••-•-•----------•-•-••--•-••-...-----••-..._..-•••••••••----•-•---••---••--•••_.._._..---•••------••--•---•-•••-•-------------•-•--•-------•----••••--------•-----------••....--•-•- Date Permit No................................... —/.Z —7 1 Issued -,�'--"""-'•-----••--••----------••-•-•--- Date } No. _... .... Fps ...."�—................ THE COMMONWEALTH OF MASSACHUSETTS BOARP., OF HEALTH --------- OF.-. ......-.....''� . ......................................... App iratilan for Disposal Works Corm rnrtiun rumit Application is hereby made for a Permit to Construct ( ) or Repair ( kflan Individual Sewage Disposal System at: ....�..�.......__....... ... p ..... ................ __ ..:.------•• ..... ._....--•-•...........••••• -••-- _ anon Address r Lot o .......................................... rtr ! . +P-----------------------._._..N---•- Owner / Address Installer Address Type of Building Size Lot..............._____________Sq. feet Dwelling—No. of Bedrooms___..._. ___________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons....,....................... Showers ( ) — Cafeteria ( ) Otherfixtures -----------------------------------------.--=-•••- . ••--_-•--•-••___-------_... -----_---__--_-- 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.................:...... Test Pit No. 2........._......minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-----_-----•-------------•--•--•-.....••-••_----...._......-----_---_--..._...•••••-•••••--.....-••......................................................... 0 Description of Soil.......................................................................................................................................................................... x ---- ---------------------------------------••------------•--••-----•----------•-----__----•--•_. -- -- U Nature of Repairs or Alterations—Answer when applicable___ e?. . ._.. :+ _ ________. _.t_�r.t.___ ___ f_�_'t!"R�—.t!' _-----•-•..................... -•••_•---••-..................................................... 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 been issued by the board of health. Sign d JJ I Dat, ......... ----------- ------------------------ Application Approved BY. O ----- - Date :_.... Application Disapproved for the following reasons:......................................................................... .................................... •------•...................•-------•-•--.....------•----.._...--=-----.......---=---------•----.....-•------------------------------------------------------------------------•---------------•--•----- {' Date r PermitNo................................................----•--- Issued...... _... ---------•-----•- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I C ................:OF...., 4 .'§�1 ........ �rr�ifirtt#r laf (��ant��i�anr.� 3.4. THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired btr-.--•--•--•--•-- --•--------------------------------------•---.......-•----........._. .. y Inst ler has been installed in accordance with the provisions of 7, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit ______________ dated_-. _-^_, :_ "'.}7___e_........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..---.`,0. ....�-•2...•---7<-.................................. Inspector ,•----�......:-.._... .................................................. THE COMMONWIEALTH'.OF MASSACHUSETTS BOARD OF HEALTH Ilk ./.-- 1. --/:c C."�1................OF..... ....... .s!4_�f'.......................................... ........I.I.X............ FEE.- .......... Disposal r nnr ernuti Perm> siori°`is,hereby granted •.................. ` to Construct ( or Repair ( an Indivldual Sewage Dlspos System at No., 'tr?- !+< _t2..Ica g v ................. eat _ 'i_.._. ......................................--------•-•--...---•-- as shown on the application for Disposal Works mit:,.Construction Per o __ ted �l _ f ........ ..�..... 6 40 Board of Health 7 DATE. •( --•------------- -------........ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - AsBuilt Page 1 of 2 LOCATION SEWAGE PERMIT NO. VILLAGE Ale INSTA LIEN'S NAME i ADDRESS/ II UILD�E�R OR OWN`! DATE PERMIT ISSUED .DATE COMPLIANCE ISSUED n P _--- R O http://issgl2/intranet/propdata/prebuilt.aspx?mappar=289113&seq=1 9/29/2017