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HomeMy WebLinkAbout0112 CAP'N SAMADRUS ROAD - Health 112 Cap'n Samadrus Cotuit F - - - - --- --- - A= 038 —043 j LO•C ATAON �—� SEW G E RMIT NO. VILLAGE m IN.STA LLER'S NAME & ADDRESS JOHN A. AALTO BACKHOE SERVICE street blest,Barnstable, Mass. 02668 BUILDER OR OWNER �-/e s AeWc . V DA T E PERMIT ISSUED ��7 -- DAT E COMPLIANCE ISSUED�� Z,'7� ��/ ,/ ` � �, �� /� ,� . \ � .% i � �/ � /b c�\ �. �\ ,, �; f _J • , . � 1 - __ t � i � � a L 1-7 rj i- 1 - A, 77- III. Ij ti [ I V �4 Y cot TN OC . 1 V y v m— P g 1 �aa1 I A117 d IP7er-vei,� �� lz •_ /� y gq ,I ------ �f4o a����-@�a► ��� 9 I a I ! 1 I f T � tl l l I I Pr+' _ — .-,te.]" I I I I I { II I I I I II �-r �,►„� ( I 1 I � I l i _ �rdv� ,n . 9 r0 Lul cc `5 0 LOT .23 �► SHED rnrn ��4 LIU 1 4`+ Kan is or sr.nnn ann71,e• " *" Zc PC 17nuW "j?Vil This Af(li?"Pf'h(�'�' T}�pCpE'rTTC1T�T ; Lu.:r -� v �, Bank USe Only ---- TOWN: _111T — — — REGISTRY OWNER. _C_NaSS E. lt-2AMC11Jf-A'FD—fff4L---1 DEED REF: s•l� — .� _BUYER: _ I, (�j�a(R.-�- �-_._.. --_- - �-- — D -T E• _ —`7 PLAIC[ FIEF: _r, l.f'HLL,:1 11 r,.�I. I HEREBY CERTIFY TO �' �1ST�11��' 1 .�f r ��--_r.0 m ',. ,r1�i a<' .:.� _A\1KF&' j1RVEY __ _ _ THAT THE BUILDING � �r�4'" a..iat `1���"� rnntcT tT rV AAtma SI-Il W- UN T--riid PLAN is LOCATED ON THE GROUND AS � :��Cl & � y- ,� T- S`""^" CONFORM'RM' 408 SUITE 5) SriV`rrir' nicu 1YitiT ii.i i�v�iaau�+ v%v __-- % �' � r14fi7l1�4�J ��•' . TTs„ 7nkiTLTr, T 4ut 0VTfl•ry oc+nirtioc+ias>Tmc nt~ TTTr. p�� � ix INDUSTRY ROAD av trio c�v:vaary :/%ai9 NL,au�,�ai :,;.�ve:ri�ieLai:.J va a;iu g ,�j�:•` 9. 3 , /,! mnw;r n� _ RdRNS?dRI.F' nND Tu�T ® \';;:\ ��,si. o __ ___ ______:::. , ,.,X.6f 'trr;t1,%r?`� MARSTONS MILLS. MA. 0264B I �_ IT nni S TVOT _ >.IE wrTHtw TWF. Sprr_.1AL FLOOD HAZARD ��y,,•. � TEL: 428-0055 � AREA AS SHOWN ON THE H.U.D. MAP DATED z/2_ FAX 4 0_5553 C'nrraTnuntt� Paned 250001 D018 D r� FROM AN—INSTRUMENT • PA(J L, A hil;t�lll-I F�tY PLS Sv�Vt;Y NCFT TU i31✓ USED FCiR ��GivC1;S �T"' F56a'R59iSSP�. TOWN OF BARNSTABLE LOCATION Q Jr,16 rc -/V SEWAGE # C/ a, VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S.NAME fa PHONE NO. �I�n %}, /� ��� AcIlOF Sere SEPTIC TANK CAPACITY ©0®c LEACHING FACILITY:(type) L s R (size) G 0 NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNE CA Grl�� zf(e C 4W ♦ p DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No o�,� ~� �p n �; �4�° f �� ��' �� � � 6� '� C �, *� y ~ �, � � � � s =� � � � �} _ �. No. .� 3� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal Works Tunitrurtiun 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair (L-1'an Individual Sewage Disposal System at: 1(2 e p ® � ..............._M ...........-•-��'- /" 5� .6t �?t.s.:.�` *... ..... . ..- - ...................�j i Loc do -Address/ r/ r Lot No. A .............. 4/:!letX.L - —���Gt G�7 i// 0✓ SCf�' 9 i-as t d. C�'�c.s^ .--•- .._..... - — ..... ........•. -.._..__.._... a /� � STi z n1 eq_ _ Yiey , 5--- --------------- ------- ..................................•... -- Installer Address Type of Building Size Lot...........:................Sq. feet U Dwelling—No. of Bedrooms----------�0..............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............................ No. of persons--------------------------_ Showers — 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................ 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. 1................mmutes 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........................ x ••••. ----------•• ......•-•-••••. •. ------ ..------. . •-----•. . . ODescription of Soil---------------- .r!r --4----....•...-----•----...........------•----------------------------------------.•...•._....------------------------................ U ..............................................-•••-•••......-----•---•-------------••••••-•-•••-•--•------••-•----•----•-------•-.........••-•-•••---••---•--•----•-•••........-•------••••......-•--••. ----------------------------------------------••• -----------••-••••--••-•----••-•-•-•----•-----•-------•-•----- - Q 2,F ----------------..........................---•-..... ............ Nature of Repairs or Alterations—Answer when applicable 2� � _ T �Oo�_cr_ ' ,f ........... U P PP --- fa---n s......gio_n•-•-•••--••-----•-----•--••-•-••••-•••-•-•-•-•••-•••••----------------------•-... e 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 Comp ' e s been issued by t e board of health. Signed S s/7--90 -----'-- ....-----— ----------..................................................... ................Da[e--------------- Application Approved By --------------------------------------------------------------------------------------------------------------- ..................-......---....- ---------------------------------------- Application Disapproved for the following reasons- ....................................................... ------------------------------------------------ ------------------------- .................. .----.-...-...--..................-..----.---.--------------------.----.-----------------------.------------------------.....------------------------------ ------ ............---. ------------------ .Tate PermitNo. -------------------------------- Issued ------------------------------------------------------------------- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Dispasal Workii Tonotrurnott V.arAft Application is hereby made for a Permit to Construct ( ) or Repair (�--)—an Individual Sewage Disposal System at• 1(2 ,t -------------- _ ....._.0 ---------------------....------------------------._........---------------------- Loc,Zi.nd Lot No. .......................... ---•------ .__...__... Owner Address -/- --•._I.._.. ..................................... -------••----------------•------•----••--•._..... ��........-- - Installer Address Type of Building Size Lot____________________________Sq. feet V g— _____Expansion Attic. age Grinder( ) Garb ( )Dwelling No. of Bedrooms___-_-___` ________________________ — a`� Other—T e of Building No. of ersons____________________________ Showers Other—Type g ---------------------------- P (----)-------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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_______________________. 04 ............................................................................................................................................................. ODescription of Soil.................it?.ar��..........................................=--------------------------------------------------------------------------------------- U ----•----------•--------------•----------------•--••.._...-•---•---•-•-----------------------•-----------••-•------------------=------•---••-----------•--------••--------------•----...---------------- W x ----------------------------------------------------------------------------------------------------------------- a-------------------------------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable-_____ ------teh-g.4�t _�___!O®o-_w1...... .......... < ---•---------•••--••--_-___./a-�Js r qQ">------------------•-----------.-.........•-------------------------------------•-----------------........................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with •100� 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 Compl-an e h been issued�thhoard of health. Signed -------- ............... - -------- ---1/�... ........................................-90 Date ApplicationApproved By .........................................................------------------------------------------------------------------------------------------- ........................................ Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------- --------- ----------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------- Date PermitNo. ------------------------------------------------------------------- Issued -------------------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (9er#tftrate of C�flutplia l<re THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by------------------------------j y......49.......Q 11..-----.......------------------------.............----- ,c R In�iall-e-r, at ........................... S/ - ^`"`..fi C..! .-5.............�...--Cs.lvr --' -- - -- - -- -._.-...-.-..... has been instaled in accordance with the provisions of TITLE 5 of The State Environmental Codes as described in the application for Disposal Works Construction Permit No. -- --= - - --------�.... dated ___.-__�/_._-_ .-__.--..-._......._._... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR 'NTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r -DATE.......... --- 1- ------------------------------------------------------------ Inspector .....-..--- - ------ ----....---- t� u THE COMMONWEALTH OF MASSACHUSETTS t •. ;Vk BOARD OF HEALTH 'TWON OF BARNSTABLE No. �... �7 ¢' �' - t ' FEs_•_3d Permissionis hereby ranted•--- ---•-------•---•--------------------------------------•--------...•-------............._•___•_•_ to Construct ( ) of R pair ( ✓)an Individual Sewage Disposal System at No..... ''� o'er _- �'�,_�_ f --fit{, �" "f- ---------------------------•-------------------------------------------_--______-_-_ .... 0 0� �Jrf Street a s shown on the.application for Disposal Works Construction Permit No._Vj_=/)•!Dated......1-17_-Z 4) _ ..................•-•----•--------•-------Bo� 1f�iEie�� � "` _- -- �� ---.............................................. r FORM 36508 HOBBS R WARREN,INC..PUBLISHERS r' ��vi• 4 No. Fss.... ..-.._....._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratinn for Disposal Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (-%� an Individual Sewage Disposal System at: I I ... ......................... .. ..._..... -------------------------------------------------- ----------------•-•-------..----•--- .... Location-Address �— or t No. ..-�----.2�21.. Qe :.-...5••6 V. _- . . �.....IC1 #t12,.�67e!;Ull-?'-------------------------•--•--••.......------. -----..... �J Owner Add ess aA . n�� . . - so lucc.. c ree E e3� •.r' .......................... Installer Addre Type of Building Size Lot----------------------------Sq. feet U _t Dwelling—No. of Bedrooms------f-------•--__--__--_-----___-__-_Expansion Attic ( ) Garbage Grinder ( ) PLIOther—T e of Building No. of persons............................ Showers — Cafeteria P4 Other fixtures -----------------------......................_ .< --------------------------------------------------------- ......... ••---------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fit Test Pit No. 2................minutes per inch Depth of Test Pit-•-___-_-.--_._.---- Depth to ground water........................ M --•--------------------•-•--------------------------------------------------------------------------......................................................... 0 Description of Soil........................................................................................................................................................................ x U W ----------------------------------------•--•---_.....---•-----------•--••---•----•----•-•-------------•-- -------- ----------- •---- ------••--------------------------- U Nature, of Repairs or Alterations— wer when applicable__ e? ! }-r�b_�a_!n�- -.1' ... *14 ;?�...looP_��X.__. 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 Complianc has been issued by the board of health. Signe ------ - .. .... . ------ --------- ------------------------- -------- �.7----- ---- t-4 l p90---- � Date Application Approved By -- - ----------------- ---- --- . . .. .. ................. ........................................ ..........--.--- ................. Date Application Disapproved for the following ea ns- -----------------------------_.................................................................................................. ---------------------...............................------ ------------........................................."...-------- ---................................... -------- Date Permit No. �}` ... Issued 9h e { f� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tottstrwtuan 1hrutit Application is hereby made for a Permit to Construct ( ) or Repair (­�4 an Individual Sewage Disposal System at: Q...051...................................... ------- -•----------•--------------------------------------•_-----•--__--_--_____........--____------- QQ�� Location-Address n 1 or t No ...'....._..Q:�r...... .•j �ri^ — lCe►1110_! V2,.�6terVl 2----•.....................................---- _.-- Owner Add ess a A4 16---C4?,Rsa................ ------ . 3so l�lQ lu J ire t�....... s Frog .......................... - ---- Installer Addre Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms........ ...--•________________ _Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building ______- No. of persons____________________________ Showers — 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................ 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. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water______-__._______-- -.- LX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •---•-•••---------------=-------------•-------•-••-----••-----------------------•---•-•-....._--••--......................................................... ODescription of Soil........................................................................................................................................................................ x U ............................••........................................................................................................................................................................... w ...................._.:........................................................................................................ ----------------------------------------------------------- ... U Nature of Repairs or Alterations gwer when applicable__ ¢rno�e t-Q�_ an¢ �l-_rese -_,q ��>a �, --- Ioop_ � V 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 been issued by the board of health F - - Signed.. ( rEc -'` - C Dale Application Approved BY ----..... G%f' -- --- --------- Dale Application Disapproved for the following rea ns: .............-----------------------------------------------------------------------------..................................-------- Permit No. � Issued .. �l7 DTHE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (9ex#tftca e of C ompltttttre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( 44. ) by.........................t4 Q.� c, ....................................... -----------........................--------- ----------------- / / '/ '/ '/&s[aller at ........_(V IANA 0....- .-V - ------��;../��1�/ ------_----------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code a,� desc�ed 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 FUN TION SATISFACTORY. DATE G„�. ... _ . - Inspect -------------------------------- A r - — ttu THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No n��F FEE ...... . .... �t��r�a�ttl , nr � ��rn�trttrtUan- rrutit Permission is hereby granted----------------- --- .....(f,�.--•----.....----•-------------......----•---•------•---.._..._..........---•---.....-......---._.... to Construct'4 or Repair (.{� an Individual Sewage Di asal S s at No...........L.A]VI O---------A-V�i a ©S ..(/1 ................, Street - 67 as shown on the application for Disposal Works Construction P •r Noq_!.�.__Q�. Dated.__ _ .../ ..__.... �' ��" ','i 1� Board of Health DATE. 0................................. •---- LE0RW3_6 5O8'HOBBS 6 WARREN.INC..PUBLISHERS THE COMMONWEALTH OF MASSACHUSETTS BOA.RD OF HEALTH Application is hereby made for u Permit to Construct ( ) ( ) an Individual Sewage Disposal System at: I I Ad No Owner nstaller Address v'^ � Type of Building t Size Lot....ZA.,.T0_ .....Sq. feet Dwelling—No. of ocuc000` ............................................Expansion Attic \ / Garbage Grinder ( ) Other—Type of Building ............................ No. ofpers000-------_—' Showers ( ) -- Cafeteria ( ) Other Dry6/o �ay. Total ' Septic Tank--Liquid capacity �*..gallons Length � D�o�ctor---_'-' Depth_. �-_.� Disposal Trench—N� Total Z Other Distribution box \6, / u / V., ' - ~~ �Percolutinu Test Results. Performed by.. j -' Dute--' �------ Text Pit No. l-.-� -- oiootcs per inch Depth of Test Depth to 87ouo6 wuter40.7-'^"AUK Test Pit No. 1:51AWW-zoioutcsper inch Depth of Test Pit.................... Dcpthtogroumiwuter—.--------- -''—' - -------'�----�-'-'-'-......................................................... {� o6So�—'��~'� .-- ----- -�������-�����-- _ __..�.---.—'__.................................................................................................................'........................................................ ----_--'—'--.----_---------._---.—'-_----_----_---.--_-'_—'.''---__—..'---_____- U Nature of Repairs or Alterations--Answer when .—_----.—.---------'__-_--_-__—_-''— � -------_---_-._---_.__—__'_-'----_--_'__'_-._------.---'-_-_---''-----.----_______-. Agreement:� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisionsofTLII11- 5of the State Sanitary Code-- The undersigned further agrees not to place the system io i � Certificate f Compliance 6u b issued b ' �-�_�' t� the board of healt ~ ----' ' ��'_.��.-��-�-- g »*, Application Approved Dy-' __/. .���.��—���,-- ' 8� Date Application Disapproved' for the following reasons:................................................................................................................ ........................................................................................................................................................................................................ Date Permit ° Date kq r` No....... G�:......� FIz$ ........D�.�............ 1 . § THEAONAoEALTH FH TS BOARD 4 . e ay Y ' ApplirFatiun fior Di u atuxkii C�uwuurtwn rrutit Application is hereby made for a Permit to°'Construct ( ) or Repair ( ) an Individual Sewage Disposal f� system at ,� Location:A r s r-Lot N ' Owner G'.1/ . �... L - ------- �jn staller Address Q Type of Building . .' Size Lot.. :....O�_____.Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage,Grinder Other—Type of Building No, of persons.............:.............. Showers Cafeteria Other fieS WDesign Flow..-, .... ... ............. .....gallons per'person er day. Total daily flow..__._. _ _._.:_............gallons. WSeptic Tank.:.?Liquid capacit} ...gallons Length....7......... Width-__---- Diameter---------------- Depth---5......... x Disposal Trench—No..................... Width_.................. Total Length..........__.._.... Total leaching area____ .._.__. sq. ft. Seepage Pit No------- ...... Diameter.:::!�....._..... Depth below inlet.._.® ---- Total leaching area... ....sq. ft. 'Other Distribution box ('!) Dosin tank ( ) , Z ' Percolation--Test•Resu1% Performed b . ,�X{ `. . Date "' I Test Pit No. L_______________mmutes per Inch Depth of Test Pit . f } ...._.. Depth to ground Ovate ____._____ ......._. Test Pit No. 2✓�.�'� _.minutes per inch Depth of Test Pit.........:.: ..... Depth to ground water........................ 1 O Description of Soil.�--M.4...-- Ah? t✓!3SC? '.e C"...TC3� x U �.................................-.......................................... w..............................4-..----•-•-----••----••... W -------------------------------•------.....-•---•--••••......•-- UNature of Repairs or Alterations-Answer when applicable_.._._._ ............................................................... .. ¢;.., Agreement Y The undersigned agrees to install the aforedescribed Individual Sewage Disposal Systermr,in aeoo dance with the provisions of TIT1E 5 of the State Sanitary Code—The;undersigned-further agrees not Iolplace the system in operation until a CertifigLfeof Coippliance has been issued by th'e:board of health. _ 7 ' Signed....... ... =' ............................ O Dat Application Approved BY•- .............................. .. - �!. '------ Date � �f Application Disapproved for the following reasons:-------•---- ... =-•------------------•----------...----•--------------'............................... ...................-.................................-.........................................................---......................................................................................... Date Permit No._.._.---------------- ----------------------------• «" Issued••-- := -=----------••--- r1 Date THE COMMONWEALTH OF MASSACHUSE TS t `p, BOARD OF HEALTH ' r f C.rrtifirFa j of (lump tFanrr TH1 7S TO CE TPFY, That the n ividu ewage Disposal System constructed ( ) or Repaired ( ) by.. G' l u e /l C! {' 4- -.. -- ---._...._.. ..... - �rriw �1V �at ,Gwt. ..O.s_ ....I s 11 +' , has been installed in accordance with the provisions of TI of�he State Sanitary C de d c ed in the PP Works Construction Permit No..-- ................. dated------------------ ---------)-........-•-•••• a licatiori"for Disposal THE'`ISSUANCE OF THIS CERTIFICATE SHALL,TOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM VIIIL,L FUNCTION SATISFACTORY ' DATE.... AG Inspector Y............................... ........ ......:�....? ...................................... I, THE COMMONWEALTH OF MASSACHUSETTS •-• BOARD OF HEALT "� ' ............ .......OF............... L... ...... ? .....................--•--........ �S' No.......... FEE........................ �,i� 7. Permissionfis hereby granted_..:`.�!� ___. /�j� to Constr ( r R � � n I • )q al��;V.a Disposal ,ryste q _ f / f n( j at No..._ ��� � � � .. 5 (._� - _..V G�-ar�+zCa.LT. 'T...-C-••-- tit . Street f '� as shown on the application for Disposal Worlds Construction Permit N'' 'fated.._. . ................ G�t J.tf(- ''f.[ - Board of Health u� .......DATE...... ............. •--............. FORM 1255 HOBARREN. INC.. PUBLISHERS T l S'3o,r fSC % _ 4-95 6.Pb. i � 3 �1�� _fit fT�j- u5E (oc� G 1r,<�:> SF --z 2.Sz 37S Bor Tom aomA= Sd f ► .o _ eo _t'aT,c-t_ IZ>V--St6►j = d2S -T cnTA t_ 'Co h.l L.-( FLo�,k/ = 330 6.PU L-F,'c vL&Tlc-ILJ QATE : to 2AA I W* orz LX--%. t'f u• t + rN L� Q b• •� WocD �, ,• _ per 2Z 3q * N•5oP 39 V I Top Fwa =tao.o LoAM DIST. '^ IW- 6AL. 14-7 pox � �' Tep"►c loon Q3�� INV. t►rv: •i, i - LAN �4o 44,-L I �vIt �A FtT ` SA'Ja Wtru � WAS►•IED Pizo�-1 t✓� L OTU IT +.�, .�J�•�: cni:ry -T�F=' I r-MIZTItz-4 Tti4AT Tt-ZE R2pl'�7Eb ,uo�.,u►.l A ca T>w�Lr�N G "E Kt::pW Gc:�AolkpLgs WIT►-Z TI.1 StII .L(tJf= AWC-> SETUAck V:C-QUIREAAi-: "TS OP-- T"e L.oT 23 -(3wU REGtS�t'c.tZ�U �.At,.�G � 5u2vcYartS TI-1t5 gt_AW t 3 uaT U-'ACyCTJ vaa AW USTE2V11..4C a SASS, AFPPt_I ca.ti..l�r I .C' r;E;� �-`��� TG i7r_1'i��:�i►.t�=. l:.o'Y' t_tW�� rL.1ap�Ll.Ef /yt�� l.�