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HomeMy WebLinkAbout0299 POND STREET - Health 299 Pond S900sterville A= 119-034-003 A 01A q q RINI VIM4.04 Uw �n Iwo Ago two?Eli 4; 4 YJ 41- 0434!� �A Mi 174 14, y '04 ! AM! RA vmw� owl. TROY'.' most 2 loom M g�v VANk ii q -MIMI, --x- A, a; `40 1 M MARION =WNW, ONES N, gp 4,At rIT111111, A '4 -# "qg Mi I",4Z AG Ri, I! q 7 ,Wzvb,jr alt M4 WANQUYU -lap N1 io MV,W 4 MNV'", pf 01 qw�p Aw Is $ITS"wv 4 4.1 AM 82 .0 15 W 4""g, la ITEM ik AWNS 5t, NAUR"', ly M,6 R o�,TV, wizz ­"M Is z4, 11 owl �`NS .0 im 4e,", 116 FEB./�(• 4�0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirutiun for Uiupu ial Worbi Tunitrurttun lirrutit Application is hereby made for a Permit to Constbuct ( ) or Repair ( ) an Individual Sewage Disposal Syst�t .. � .. -_ /--------------- .� . ---- „-naa t or Ioc_N o. .............. a� .r --------------�.. -----........................................................... � ...............A i � Instal er Address U Type of Building Size Lot___-7Y,..a 2_1....Sq. feet Dwelling— No. of Bedrooms........ ---_..._____-_-.-_Expansion Attic (NO) Garbage Grinder (,+o) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------ - qI W Design Flow........................a .. ._.___gallons per person per day. Total daily flow..__._.____.______ ........................ WSeptic Tank—Liquid capacity_1°-��Q,gallons Length_�o'��_`�_ Width_s'_J J`.`'_. Diameter________________ Depth___-______------ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No---P��`._-_.. Diameter-----!.4.._______ Depth below Total leaching area.'©_i�...sq. ft. Z Other Distribution box (X) Dosing tank ( ) '—' Percolation Test Results. Performed by------------ �!.....o�?......./.� 'k.�.'!�3".0. Date........................................J �'I✓� Test Pit No. I........Z....minutes per inch Depth of Test Pit----Oy_°f.... Depth to ground water......... .......... Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.............._......... -------------••--------------•-•--...-----.......-•-•-•--•---•-••---•I•----...-..---.........-----..........._.......-----•--------•-----.........-•---...... S Description of Soil If ..� -°------...--.t—A S; ,1..... s ' `�o` ----------------------•-------------------------------------••------------ .......................................... .r............................. do"/.� '......_. ....... .-----............--------•-------•----•------•-----•-------........---------•---- V W ----• ----•------- ..............................................................................................................................................................................-.••••. UNature of Repairs or Alterations—Answer when applicable...._........................................................................................... ----------------------------------•-•----------------------•------------------------.........--•---.------------------------------------------------------------------------------------...---........•. 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 Compli ce as been ' su by t oard of health. Signed .... ..... ........': . .... ---------::.......V�------------------------------------ -------------------- Daa----------=------ Application Approved By . ........ ------- - -------- - .... .. ................ -- -- ...................................... --------.....-Dace.................. Application Disapproved for the following reasons: ......................... ... ............. ...------------------------------------------------------------ . ......... . ..................... - ----------------------------------------------------------------- ------ ............................ Permit No. � Issued ................ .... Date------ are No.K----4......:-••-- D THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE , pphration for Bi-vivitiat Work.6 Towitrnrtion frrmit Application is hereby made for a Permit to Coristbuct ( ) or Repair ( ) an Individual Sewage Disposal System at• ,� . .. Y L^ac i n-Add ess or Lot No. Address a --------- ! ..................................... a ..................................... Installer Address UType of Building Size Lot------?`1_.....:�--..Sq. feet .. Dwelling— No. of Bedrooms._.._...Fo.`!K---------------_--.Expansion Attic (^/o) Garbage Grinder (wo) a`L4 Other—Type of Building No. of ersons---------------------------- Showers yP g ---------------------------- P ( ) — Cafeteria Otherfixtures -------------------------------------------------------------------------•------------- -----------------•---------------------•-------•.......-•---- W Design Flow........................!, .r..........gallons per person per day. Total daily flow.................../_�__�.__.._...____.gallons. WSeptic Tank—Liquid capacity_1r�4.gallons Length Width_S I_d�. ,.- Diameter_------------- Depth................ x Disposal Trench—No. .................... Width..................... Total Length----- Total leaching area....................sq. ft. 3 Seepage Pit No...`�".�D.---.- Diameter_--_./_Z......... Depth below inlet..-�a_.Q_....... Total leaching area..r.�!..4_..sq. ft. Z -Other Distribution box (X) Dosing tank ( ) Percolation Test Results Performed by---------- ------- Date......._=Z s^ PF ---------------- Test Pit No. I........`- -.__minutes per inch Depth of Test Pit____!y.`l......... Depth to ground water------------------------ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------------••----•----------------------•-----•----•---------•--.....---••---...................................._... ....... ---------- O I. S Description of Soil S® "'. ° �� `I_—_ sc `S` •ro.�_f................................................... 0 ----------------- --------------------If!..t_�./_.l Y........................... _y....1...--•-`f/®�r0,/...-•----••-----••----•----........----........-•-------.......................--- W UNature of Repairs or Alterations=Answer when applicable.............__......_.._...........__........_.____.._......._.............____................ 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 oard of health. Signed `------- --- -- ... .......................'----------------------------------- ---------------------------------:...... Dace Application Approved By ..;'......... 7`T%I1< .......... i /� . ---------------------------------- -�.. .�- ......... ...... .......---------- Dare Application Disapproved for the following reasons- -------------------------------------------------------------------------------------- ------------------------------------------ Permit No. Issued ........... ...------..Dare...-. t �--- ---- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�ez#iti a e of C araptianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ------....._----------------------------- -----------------------------._---------------------------------------------------------------------.----------------------- Insudlrr at .......................................... . ...........---- -----....----------------................._......------------------------------------..-.........------------------------------ has been installed in accordance with the provisions of TITLE 5 ot�The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..:_..`'/..i-�L'." ' .' dated _.....__..__----------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED /CS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. Q DATE............................. ....y l-/ '- .7 - .._..._.. - Inspector ........ Z...................... ................ ......... ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 0 No......................... FEE..40 ...................... Royoiial Workii Tonitrudion rrntit Permission is hereby granted...................... ----------•--------------------•--•-------------------•-•--•--••----•----.....----------------------.................. to Construct ( ) or Repair ( ) an. Individual Sewage Disposal System atNo--------------------------------------------------------------------------------------------------------- ---------- ................................................ Street as shown on the application for Disposal Works Construction Permit No.�._._�_� �_. Dated........................................... --.....-•-----------••-----------------------•-------------------------------------------•----••------•- Board of Health DATE................................................................................ FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE �j[/ 7 (/ LOCATION O/ 3 0��� �oh� S� SEWAGE # ./ 7 r J 7/ VILLAGE OS;��• Q( ' J ASSESSOR'S MAP& LOT/l Y•63 y LL6 INSTALLER'S NAME&PHONE NO. UO� �o ,• Cow5�r✓c do y.2 y- p'.2(� SEPTIC TANK CAPACITY /5Do GtC LEACHING FACILITY: (type) P��� �2� (size) �� xy NO,OF BEDROOM BUILDER OR OWNE �W e•� P)✓kmrrDATE: y COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility sf Feet Private Water Supply Well and Leaching Facility (If any wells exist 1409 on.site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by LC gh f L, L) - TOWN OF BARNSTABLE OP 101(0 b3 (/ 7(/ LOCATION 07� ���o h� S� SEWAGE # 7 / VILLAGE DS l ASSESSOR'S MAP & LOT/17-63Y.16 INSTALLER'S NAME&PHONE NO. �a� Io • Caws�N✓���n� y.2 g�x 4 SEPTIC TANK CAPACITY 15�o Ga C LEACHING FACILITY: (type) (size) NO.OF BEDROOM BUILDER OR OWNE .eA- PERMTTDATE: gAy COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) X)A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by � � w - Q ��� \1 "i k �� � � O � � A � C �1 �.> � � m4 w W V 0........................ FEB..... ..........._...... Li�11' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - vtc�..cl................OF......... i7-a[_ 3� A.VVfar-ation for DaipuaFai Works C iamitrurtintt Prrutit Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal _ System at: Location-Address or Lot No. _l2cslrlrta'Asa....xni.. _Wy.��..................... .."•------.._.. / PN..c _._.s �...----•----._...-----._.._..._.......-------------- Owner ............................................................. .----.---------•••. _. ........................................ Installer Address Type of Building Size Lot... '` -off _......Sq. feet �-� Dwelling—No. of Bedrooms..........:Fnv..........................Expansion Attic W) Garbage Grinder (411) Other—Type of Building No. of persons............................ Showers a YP g •--•--•-------------------•• P ( ) — Cafeteria ( ) Q Other fixtures .. ----------------------------•------------- ............ ---------------_------ W Design Flow.................................�s____gallons per person per day. Total daily flow___......._..._................gallons. Ix W Septic Tank—Liquid capacity.l5.0o.gallons LengthJQ._-C:°... Width_•s�`&.'._ Diameter.... --_. Depth.v`_6.it. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area----------------_...sq. ft. Seepage Pit No.--__?�__-__- Diameter----/z......... Depth below inlet_. r.y_7�._. Total leaching area.... -•_sq. ft. Z Other Distribution box (X ) Dosing tank ( ) '-' Percolation Test Results Performed by..S:.t r:./. i........: '!C- 6• -`5' •-€ &- Date -------------------------. minutes er inch Depth of Test Pit...l_4A``._..... Depth to Test Pit No. 1..._.0�____._. P P p ground water______________________ _ 44 Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground Ovate , - r11k 10s � er ........................................................................................................ ................... O Description of Soil---- may ti', .1� i1__ .. t1aaT.l"•-----------------------------------------------.... x _ W -------------------------------------------•-•--------------------------•---.....-•---------•••--•---...--•------••••-•--------••--•-•-•---•......---------•--........ ..... MIILSON...... t �ri U Nature of Repairs or Alterations—Answer when applicable--------------------------------------........................ -,o- No:30216� 4 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in a or with the rovisions of as' p 5 of the State Sanitary Code—The undersined further agrees not to place the system in operation until a Certificate of Compliance has been issue t be-..oflth Signed----... ----•.•-- ---------- 0/__. -- --...----"-. ---------- Date Application Approved BY --- •• ------. .............. Date Application Disapproved for the following real n .---•---•-•----....-•--------------••----------------•----•••--•----•---•----------••......----••-----------•••-- .......----"--- - ...---- ----------- ate Permit No.... .. Issued----------- ---•------------ ------- D e --THE COMMONWEALTH OF MASSACHUSETTS ` I OARD OF HE LT rOay.OF.... ........ ..../ ! ............. Qrrtif iratr of TautpliFattrr � THIS IS TO CERTIFY, That e Individual Sewage Disposal ystem constructed ( J() or Repaired ( ) / " - ---------- - at 1W has been installed in accordance with the provisidns of T - - ThOjtate Sanitary o e a de•cr'bed in the application for Disposal Works Construction Permit No._0yU-� t------. dated-- � $ ------------------- THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... t No..Z q�_...' IFss..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ., - Appliration for Digpaa al Works Tnnitrurtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...---------•••-•....-•-...-•-••.•••• . . •-•...................••--•-••••--•--• •-••...----•--••-•-......L c>..........-- ....•--•••-•-•••......--•---••--••------- Location-Address or Lot No. 1..!Ct :.1 ....a : .L(�.................... fin J[� r A Owner Address == 1 y Installer Address Type of Building Size Lot--- -Lou- Z-------Sq. feet V 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..................Q!�!f0...............gallons. WSeptic Tank—Liquid capacity.E:10--gallons Length_1Q�-_f:"_._ Width__. .'-_ 3'_ Diameter................ Depth..;'... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area----------_---------sq. ft. Seepage Pit No......-_'.na..... Diameter.....le....._... Depth below inlet....3, ..7 -. Total leaching area.....Y z--sq. ft. Z Other Distribution box (X) Dosing tank ( ) Percolation Test Results Performed by...s_�r1,_l=�r._....._ ` / F �1c•._. Date... .../ .......................... Test Pit No. I._....N�.._...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 wat —_ ................. -'A s O Description of Soil.. �• �a---'w--- --�'`r..... -- `'-........•---------------------------------------------------------- x 3o" W f1 'x,ticp ................................. - ----•----•------•--------------- i- ALLY-Ni LLY-i_-.------- Na C .................._ y_._.... -•----------•••••-••-------------------••-------•••..................---- o WILSON -� U Nature of Repairs or Alt"erations—Answer when applicable--------------------------------------------------------------- �p ...3021s Q 4 IST� �� Agreement: urrL The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in co with the provisions of TIT ,,��. 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 l tbp 7bo r of iealth. Signed ••--••l l/:.c'^ . ~' _ s.: ,�`/ Date Application Approved By- •i/ _.. .. .�! ` Date Application Disapproved for the following reas n -------------------------------------------------------------------------------•----------..Da..e--- -•-•-•-----•--•-•-•-••-••---•••••••-••--•-...•-•.-••-- . -------------•--••-••--•---•--•--••-....---- -•••-•••................. ----••......--•••-•----••....--•--- ------------------- - Date Permit No...�0j-j Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS 0FR F.��-f.il. !. .... . C .............. Cnrrfifiratr of Tnntpliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (�) or Repaired ( ) b - -r Y --- -----••••-.._.-..._.. L /� �j' taller / /f/ at -f----_. Z . -1V�..�-!__0_.)-------d� �C ��rlll_1.�(�, --•---------.............. has been installed in accordance with the provisions of T�T 5 State Sanitary de s desc ibed in the application for Disposal Works Construction Permit No. �4�f �'---•-_-. dated-.ot _��--------------_--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA ANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................•--•--........-•----------•---......--•--•••-•••...--•--_..... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BQA IV No� ..... F L7 1. .................... �/. ti/ FEE. -----••----.... Disposal orkii Cunnstrudion rrmit Permission 's herebyranted .�`'G'_eT.? '.0 cz`!7 ���I-S i��-r1�=�'�J to Constructel Re ( an Individual Sewage Disposal /System at p ...b No...... _ .......I Street as shown on the application for Disposal Works Construction Permit Nq Dated___���...__.��----- ...................................• Board�- - It • Board of Health DATE f ----------�;- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS _ I c �- i io I 43• G,Q a: E, jLc „ O A - I- i I � i ,r G Sz> - � l� 12Psis ga- �� LOCATION SEWAGE PERMIT ON0• NOW o) !VILLAGE I' INS LEW'S NA E. i ADDRESS. G UIL R OR OWNER DATE PERIltIT IS_SYED"N=`° DATE COMPLIANCE ISSUED rQz- ' -X43C No............... z! >. Fns....l,:�1.� 1�! THE COMMONWEALTH OF MASSACHUSAS BOARD OF HEA TH ...........)DcU�...........OF. �,(,f/ L•-•.............................. Appliratiou for Dispaii al Warkii Tomitrurtiura amit Application is hereby made for a Permit to Construct ( ) or Repair 4--)—an Individual Sewage Disposal System ........... '........... ....... -••-----........---- --••----.------------._._.........-----•• cation-Ad .� O er d e .. _ �...._.._. � ...................................... F Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms________________________ _________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building ___________________________ Showers Ga YP g ------------------------•--_ No. of ersons_P ( ) — Cafeteria ( ) Q' Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................ 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........... `-------------- =-------------- a 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------------------------------------------------ w .•.----------••--.••--••------•---------------------------••-•-......_._.__...._. x ------------- -------------------------•-------•- .-•--•----.••-•------- U Nature of Repairs or Alterations—Answer when applicable_________ .... �� __.______ Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of ii' ,;. p 5 of the State Sanitary Code— The undersigned further agreas not to place the system in operation until a Certificate of Compliance has be issued by the oar f health. Signed• AEf� -- - -•---- Date .._..._..._ Application Approved By.._...----•--•---= ,�z��� y...... ------- -� �� ------ Date Application Disapproved for the following reasons:................................................................................................................ ................................................•...-••------......_.......--------.......-------•-•-•••- Date PermitNo.......................................................... Issued..................................................... Date THE COMMONWEALTH OF MASSACHUSE18S ..� . BOARD OF HEALTH ��+ �r' 4 y S,nL. ?r.. OF....ri ; ..a !M.,... ...... J ---------------------------••-•---- ApphrFation for Dhipmal Works Tonstrnrtinn rrnat Application is hereby made for a Permit to Construct ( ) or Repair 4 ►)-=an Individual Sewage Disposal System at x ............ I rr} *fl ...................t Y r -- q{Lo- ------ ---------------- Location-Address t ---------•- No. ' A •---..:`wyl _ _._...:_:..[:3{.d.;' -?: ter!:---�. ..es:�L :' .�• it _..__..... _. ................r ° .� _ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) persons............................ Showers — a Other—Type of Building .....................:...... No. of p ( ) Cafeteria ( ) Otherfixtures ---------------------------------------------------------------------•-•--•-•------------•-•---•--••••-••••---------..........-•-------......._...•--• W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic 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......................................... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ AS -----------••--------------- Descriptionof Soil------•...........................•---.-•-- ,_.. .P...: .... +' x= .................................................. ... W -----•--•••---- --------------------------••----••--•----•----------•-----------------•-•-•--••--•-------------- F U Nature of Repairs or Alterations—Answer when applicable............... ✓F":c = 1':............ .------••---------------•--..--...-•----•-------•-------------------•---......_._,_. , �_.... -= •--•-•----- Agreement: r The undersigned agrees to ,install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of I. :S 5 of the State Sanitary Code— The undersigned further agrels not to place the system in operation until a Certificate of Compliance has/bben issued by they boar of health r Signed �' ,f=r ... f ���"�`y��, r� ,--• r.....u.._a. ! ..... ��/°� Date Application Approved BY .. _; "-��5�... .... �� �-x................. .......... Date Application Disapproved for.the following reasons--------------------------------------------------............................................................ ..........................••--•-••-----••---••-----------•-•------•-•-•---------.........----•----••••---I--•------------------•-----•-•---------••-----•-•--•---•---•---------•••-•---•----•-••-••-_.... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS !} _ BOARD OF HEALTH Trrtifiratr of ToutpliFatta THI.SIS O CERTIFY, That the Individual Sewa&e Disposal System constructed ( ) or Repaired y Y .... /fir / i f '� 1 J!r } b .} .I . . -�. Installer __"�' P ............................................................ f_-...... ........3 ._..____ _.._. has been installed in accordance with the provisions of T h; 5 of The State Sanitary Code as described in the ,application for Disposal Works Construction Permit No.. �_ ..3_l 4------------- dated_............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE DATE..---•-•--•--•--• •-----.----_..7..�..�..�?. 1.e.v........ Inspector................. ` ......�=? .--•----------........ THE COMMONWEALTH OF MASSACHUSETTS j BOAR--.F HEALTH � ,...,.............. .... 2 ¢.. dv fj G " f/.... FEE...'.... Disposal ,og Tomitrudion Pyrutit Permission is hereby granted-..-. ] :' J.t`_ f .. . �,. _t -- ........................ to Construct. ) >~ e aIr )ap Indiv�ualP Sewage Disposal System P at No... =f = `f .._. .�'.:....•....__ . i f 1,' `..: •------------------------------------- - ---�'��'�� i� Street as shown—on the application for Disposal Works Construction Permit No..................... Dated............................................. 110 d-1, •-- _ n Board of Health DATE....:....................... ._. �. .. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS G_o-r 41 /7 n P �3q5 � / 50 ' ;L o H OF O� STEPHEN 'yG '"` +' ProPe�.c51 Wa+er Seruic� a I f`�ALLY; n fCHAR� � -s i / 4C3 WILS^^ viy A. t \\ ,,�,o.3J_ r��/4�� i Q4XfER '. 41 �<* 14M 24040 L,P. 7 10, /0.3 f i7E51GN L4?A . ; LY F l-G�C1 1 1 O k To 13E rno✓�'.!� -F�,IJK' ti Est S two S4L 'PIT T-v U 5E (600 GZ.4(,,. LJ�►CH �I T- h 5 i > W,4 Ll.. �,4 1 3g --51 F, 4' x C.,'a 2 ..w/V Stonc) y 'S� k 2, 5 = 3 46 ..G 1?.b, S P TOTAL V=-S - -, 1 b>V= -.. 9/8 Gam.D, ?'OTAL t4&.ILN trjdyj qqo Cam, RD (0972 _�atc /S_-_¢£3..____T_csi-..by K G= 41,0 Tope / .� �� /�� 114IC t. soil r soo 30"- -97.8 E,oc, - ST. 11.1V' I►„y q7 v 1 GcAI. 4.5 9 W X 47,14 � 47,31 9 51 ['1G WITH t,If - � NV. TANW- a 10 l Yt �� c 44 7 4,44 �j e1 yl{p6HEb '" PLOT FEW 4� T_.3_.�.-p NC7-ST. �a IM4 36.3 1J0 SC.h.LE � 93- ea ' .1.7 1 G�#ZT1 V--1(TNAT T1• Z H OU*E '9- E J F. ,L E , laVPSCiJ COMPL\{S Vi 1714 Tl-alE 51 AaL1 t jE RE �STI EA �.AQb Rv��-MKS �-�4Np SET K 17-EQUkTzee Ae-NTS <DF THa 05TERViL1.J�'�.M�55, Owyc.- {� LOG�.-TL•b 1i111T�*l N THE' *P"11J Tl-A 1 S F1-&�?J t 5 Np-T P660D 0tJ,Q}.1 11J--STR- / ll11 UN1e-Q r SU12.VFFY AtN.b 7- -4ca o r=F5r�T5 {-lbw N THOU L.A kj(:�JT 7SE V SQb To � 15 H Lp-�- L-1 t%jSS, 3 t?