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HomeMy WebLinkAbout0178 CAMMETT WAY - Health 178 Cammett Way, Marstons Mills A= 100-051 l TgWN OF BARNSTABLE 1 OCATION Z 7 C&0110��L!� U14T_ SEWAGE # VILLAGEJ�/>t�� TG� ��5 ASSESSOR'S MAP&LOT 66 -�S1 INSTALLER'S NAME&PHONE NO. /1/./17•e 75'2 46" 77� SEPTIC TANK CAPACITY LEACHING FACILITY: (type)Z /ol// (size) OL E/ NO.OF BEDROOMS BUILDER OR OWNER t:PERMTTDATE: COMPLIANCE DATE: 11ZZ 19Z 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) Feet Edge of Wetland and Leaching Facility(If any wetlands exist. within 300 feet of leaching facility) Feet Furnished by f --- a 'Pa 3i z p � � C) K 6 Fee $5 0 .0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for -Migpool bpeum Conotruction permit Application is hereby made for a Permit to Construct( )or Repair(X )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 4 2 8—0 0 4 5 178 ,q� etrt Way, Marston Mills Jamie Pina 178 Cammett way Assessors ap/Farce Ma r s t on s Mills Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr, Septic Srv. P.O. Box 1089, Centerville, MA Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder( ng Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) We will install a stonepacked pit according to the plans of Eldredge Engineering Co. , Inc. 4� 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 Certifi- cate of Compliance has been issued by 2xd of Health. Signe Date-� Application Approved by g Date Application Disapproved for the following re s Permit No. Date Issued a. - . No. — a Fee $50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zlppftcatton for ;h9pool bpftem Construction Permit Application is hereby made for a Permit to Construct( )or Repair(`X)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 4 2 8—0 0 4 5 ASor's 13 CRRMgt Way, Marston Mills Jamie Pina-, _,,, 178 Cammett way Maratons Mills Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr, Septic Srv. P.O. Box 1089, Centerville, MA Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder(nth Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) We will install a stonepibkhd pit according to the plans of Eldrecjcje Engineering Co. , Inc. 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 Certifi- cate of Compliance has been issued by!WO!WO#of Health. q Signed `V Date Application Approved by _ _ Date r Application Disapproved for the following reas Permit No. '~ Date Issued ———— ——— ————`—————————————— ————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Pina Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( x)on by Installer Wm E Robinson Sr, Septic Srv. at 178 Cammett Marstons Milhs as b en constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Date Inspector - 7 - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. No. Fee $5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Pina 1=t5pooal 6potem Conotruction Permit Permission is hereby granted to Wm E Robinson Sr, Septic Srv. to construct( )repair( x)an On-site Sewage System located at No.# 178 Cammett Way Marstons Mills Street and as described in the above Application for Disposal System Construction Permit. nay The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or specia'condidons. :b All construction must be omplet if in three years of the date below. ' / G Date: � �" / A�proved�by' �, O Board of th F' t TOWN OF BARNSTABLE LOCATION 7� C/f 197�IC17 �ff�— SEWAGE# 6 VILLAGE e� TOl✓ /GL�ASSESSOR'S MAP&LOT -0 S f INSTALL ER'S NAME&PHONE NO. ;;•n' �3 y�V 7S 8 7l SEPTIC TANK CAPACITY LEACHING FACILITY. (type) (size) /i oTiy NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: �l COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottompf Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge,of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by 1£ 1 o e 0 `�sp 7' or 9 /Zs.o� — _...._.. t +S � L� 73 20,oors S,F Soo"/. ♦ RrsA o �0T ILI foo�se r o T 7 y 0 N Lev ror r FA d.� In J T3 rn � -F.u✓ roo• i l � . TH Of CAM Pal C T T WAY Jbbs/is L1// r boy " 1 a LEGEND NALE�4� EXISTIN® SPOT ELEVATION OAO /,�1.`o OF k4 CERTIFIED PLOT PLA1M EX18TING CONTOUR --- �� FINISHED SPOT ELEVATION — � � R08ERT ti Lc 7- 73 C-ANkMF TT WAY FINi$"ED CONTOUR 0�. �gl Er.DREGE o s APPROVED' BOARD OF HEALTH IN S S ARNST,AsLA,�i �. AGENT SCALES 3 0 " DATE 1 3 /2 X9,10 REDe EN rise REOiSTt14E0 EA4STE CLIENT N� I CERTIFY THAT THE p0, $--%, DUILDING •11OWN OM TM PftP O Pt" CIVIL LAND CONFORMS TO T ENGINE DR.SY �,�.! HE ZONING LASS . 712 MAIN 8TREET CH, 0Y, OF SARNGTABLE MASS. HYANNIS, MASS. 3 43y �'� . ... .:_.. SHEETS OF DA E REG. LAND SURVEYOR — 20 P /W//V. /Y077E /I" E'/TiSot�� TMESEPT/C TAAOIK OR /O AT. A9/N. L&�ACAOIO a P/r AN& ADORE rA6/AN /?"BEL0JV aRA PJFO.A "",V1AAgF7-4cR COVCe F7- COI�Ei!' IF,,-Cv /Ot•O CO/VC/t!'Tt 4�P!/C Pmr SMALL AF APAPVtJi FJY7- TO 4MA®F.64,V ArrRA� J'0E.4VY CAST•/'VO V CG►yAffAr STWAL<L d9.E SJSl�� j v C®IDS � T /F 4 a%M/N. ®/NCiCgTE co✓E'R CLEAN SANO As AV 2"LAYS)t M//K o/T�! 'DOO GAL. • e e o � o• QF � v,3/�. SAFAT/C Ti1NK ®® WA SN�'D 57t7NEX ► oIles s o • o • • ►• ; • '•:• millse t► • • a � o ► '�'♦ -• / �2r � � •• .oa WASXEA ETONAC e / • � o • • • e • o 0 1 • 1$$5 x 2•S` = /a�1 ¢s® e a e • ® o �+ e e a I► a t AWECAS rSZft"6Aa-., /JiOd&47 &A&VAT14ovs ? .S x J 0 = 78 e ►�® e • e o ® • e a a �a ® P17 ®R 4V4VIV i ����P.D Lam✓ �1 L? /a � VZx7• AT AW&I /A/6 irr 6 A� t�A" //1/4E TAIC' T.rOeVlt' AeT• _LQ /.►/.AJrP> {SEE TsiAu3r now 4M7LET.KEPT/C 7ANPC /AVi '®/3TINVA ITION ADOW 97 SE�y+AN 4� 'aROuND 014TEi l XA&LZ /AV446'r LEACM/AW ®/7' A7. . yl/�1�iE 01.S~AL SKS71AM LEACf IM40 A2/7 7MWL.ATION D/,VAVV.T/.O/V a 16,_.ArT. Nt/f1oER 8/e���pO/ys �� D/MGNS/ON C �� FT, P'1'"' rm4-ga 6Z.P,*SPOSAL f/NIT SOIL. L®�► TOTAL !•ST/A#YtTED FL #V 33 d SA4.1441r SO/L 7-&ST A►/ SO/,t rFST,*2 SO/L T,ZJT IV4U#W EP 0,W 4E4CRIM4 P/r3 i 4-zov 99. S/®F L1'ACM/M6 AVER PIT / 22f Sa rT f ADATF OF Sol TEST 0_2 RESL/d.TS /TA1/BSSE® BYQ _ .Si S. Acv9 t +40TTOM L6r4CN/A/6 PE1r p/T L0Arr a Suasvf_ AFMCOLAT/UAP RAT/i / r AL LCACVfWCF A q&A 2G7 sQ fY dZ � MNdSIIA Re?EAII�E[.Ei4�'ASOINd AREA 2- l°ERCOIAT/ON RATE 2 A11A,. I VCN r' �H OF �t R09ERT 6;tUCIE 73 CHMMEi7 wAY I''I>aRcroivs �� ELDRE . 3W 4 &L.ORED EEfllKtr/IV,E�J� is E� �� onAt.��"�'� ` �s.cv �7 0 712 AIA/N .sT 1 ASS. . 4i{rp 5�;6y NO® s /+IYANNi�, M,,q SS. AtO�/N® Y134T1"q' �71ICOvs4/TE1e; Y� CL41XAI � Fk D.. IVA7-4--dr AV-AFA.AW Hap ►eve4TE:�RR.sq, JGa )w 4 o t L`E'T�Of l Alt"" dD v 1 i I •- i I'I CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS). I,William E. Rotinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated t ,concerning the property located at 178 Cammett Way, Marstons Mills --meets all of the following criteria: * There are no wetlands within 300 feet of the proposed septic system. * There are no private wells within 150 feet of the proposed septic system. * The obseved groundwater table is 14 feet or greater below the bottom of the leaching facility. * There is no increase in flow and/or change in use proposed. f * There are no variances requested or needed. SIGNED: DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 42 (Attach a sketch plan of the proposed system. Also if the licensed installer proposes a certification plot plan,this plan should be submitted). I I No.$y ail F�$s,1 _.............._ THE COMMONWEALTH OF MASSACHUSETTS BOARD 2F HE C:Y. 0 ... oF.......... ./ N. ...... ........................ Appliration for Biipooal Works Tonotrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewa isposal System .... ..........- ___......_.. ... .......... ......... • - - e,� _ _____/____y__�,-.�--awe..... , ��- . Location-Address or Lot No. Owner ^ Address ..- -...L - 2. -• .... ........ .....0)......��.......40��..........t �s,� ter. Installer Address Type of Building Size Lot_._ O_r .5q. feet V Dwelling—No. of Bedrooms--_.. 3.._ -•---Expansion Attic (� Garbage Grinder ( ) a'� Other—T e of Building No. of persons .. ( ) ( ) Other—Type g ..__ ._ p '�................. Showers — Cafeteria Otherfixtures --------------•--••jr-•-•---••--•------------•------•-•-----•------•-------•---•--------•-••-•---------•-•---..._..........-•-••--•••--------....... W Design Flow......... .......................gallons per person er day. Total daily flow------JwX-.-:Q......................gallons. 1:4 Septic Tank—Liquid capacity_/g allons Length.. _ ......... Width---4........ Diameter................ Depth.............. W Disposal Trench—No..................... Width.................... Total Length..._._._..._ Total leaching area-------------------- q. ft. x Seepage Pit No------/__.......... Diameter.....1#._..... Depth below inlet._...._ .......... Total leaching area...... _ -ft. Z Other Distribution box ( ) Dosing tank ( ) `-� Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1-----n.Z__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........................ Description of Soil......... .-..... �/ --......._. � 'Q1..11/_..4..,............................. UL..—� Z....... e.".„.......---�.� .....-... .......... --------- W --•--------------------------------••------•---•-••••-------------------------------•-••••---•-•---•----•---------.._..-••-••----------•---•--•-•--•••-•---•••-------------••......---•-•.............-- UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: Th a dersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the p vis' ns of i ITIE 5 of the State Sanitary Code—The undersig d further agrees not to place the sys m in ope do til r e f C liance ha en ism by the board Ith. Signed Q. -... •••-• ..................... �---- ---k �....._..._ Date PPad A d By.................-------------•--............................................................... ........................................ Date A 1' tion Disapproved for the following reasons-------------------------------------•-----------------------------------------------------------._........------ --••--......-•--•--•-••---••......--•-•--•••-•--•••••----------•-•-...------•---•-••---•••-----•---...-•---•--••••-••••---------------------•---...•-------••---•-•••---------------------•-•••-------•- Date Permit No.... ........................................ Issued -------- Date ... Date r No.d .r.._....... FEBI$ a ........................... 9 ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...----............ .. ..............OF................-.....-..-.-_.-.......-.---------.----.._......------........-..._------•. Appliration f.ar '%ipmiFal Works Tnnstrtartiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ................_................................................................................ ••--•______......•-••-•................•-•••-••-••••-•---•••--••--._........-----.________....._.. Location-Address or Lot No. ......................___........................................................................ ..........--...................................................................................... Owner Address W a •--•..........................................Install --- ll.e- A r A........._............................... --•-----••------•-........................... -dd •ress...............................••....._..... n PQ UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—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................ 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.............k...... Depth to ground water........................ a ........................................................... Xh ..................................................................D Description of Soil }} y; -----------------------------•----••-•-----•--•-••-----•-----•--- x Nature of Repairs or Alterations—Answer.........................................................-�--when P PPlicable................................................................................................ ...---•------------------•••--•-------•------•••----•-••--•----•••-------------•-•-•....•----------------•....-------- ••...----•--••----•--------...-----•-----•-•-----•--•-----------••••••.....----- Agreement: T u' dersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the p vis' ns of TITL% 5 of the tate Sanitary Code— The undersigned further agrees not to place the Sys m in op atio til e e� f C pliance has been issued by the board of health. ♦ f r Signed........................................................................... ........ 7 ......-- Date pp cat A ed Y.................................................................................................. ........................•.............. Date A pl• tion Disapproved for the following reasons---------------------•-••---...........------•-------•---------------------------•-------•-•-------•--....._••--- ---------------------•-----•-----------------------•---------------------------------------•---------•-----•----•------......---•------------•--------------••----------••----------------•---------.--- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH ...O F............... ...:.....:......::...... ............................. Trrtif iratr of ToutpliFanrr T�S IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by. Installer at.. E' er✓ L Z G='�a 3d - r - ----- ------- ------- -- -•.------ ----- . has been in tailed in accordance with the pP.ermit ns of TITLE 5 of The State Sanitary Co �i ed in the application for Disposal Works Constructio No.____ %--:_�_rl............. dated__-S .... . ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO SATE FACTORY. ��i . . DATE.. Inspector... ---.......•-----•--------------------•-----------••--•...._•--•-.•--•- THE COMMONWEALTH OF MASSACHUSETTS BOARD OFAHEALIU S �! � . . ......OF... ......................... /" ... FEE. ........... Ravo 1 nrkii mit Permission is h eby granted ...------ ---....--.-----•-----••-•----•-----•................. to Constru�ct'y( , r;Re air an I 1 ewage Disposal System at No. l40 `` 7sonstruction Street . -as shown on the application for Disposal �7 P�; ..................... Dated.......................................... / ......-•...:./ .............••------............................................................ DATE .►X - Board of Health --------• --•--- .........................................66--__..-- FORM 1255 A. M. SULKIN, INC., BOSTON �IOA3AbnS ONyi '03H 3 d0 d0 T133HS 'SSVW S I NNVAM. �� !/ 'e =A® 'Ho 133HIS N I V W Z14 $SVW 3,18V1SNtlVB d0 +A8'a0 VOA3Avn 33NION3 SAYI ONINOZ 3H1 Ol ORM0000. � ONV1 1IA10 . 00 * NIf1;�I SIM1; NO NMOMe ON1011t16 'ON GOP HUM 3d311103 4 311 1VH1 Adllli30 1 9N y 1N3110 1100 ON/M33N/9N3 3903&07 ,r n 719YU sf-VYYIT F 131V0 ; 01- �.� � 131VO$ 1N3.0 V 3lVd } d HllV3H d0 aVV06 03AOadd NIV s o 5 r o38013 0 bt101N0O 03HSINIA r• 3onae NOIIVA3'13 lOdS 03NSINIA tiV� 1..L Jw�NI £E -�{. A7 li1313 _-- 0 --- onOIN00 ONILSIX3 NV1d 10'ld 03131,Lb3J y�ssyw io N11���� 010 N011YA3'13 lOdS ONIISIX3 CIN3J3-1 N31tlNp�s poll 4101 W � c y,,� ITV VY .V r`��+,a rp J�;o5l a 2- 'Eh Jo tii�d 6 ��3�dd o — � b6 6 __ _ -- -- — —. —�-66--— -- —— J Iry o Z �+o'SZ/ ro w .ool n*ff�3 g o , p N oo ror n � N O J O J a asodoty v Q Z� ox �NF11 f, 0 � :-In 3W 1 -�ooi ;dv o00'oZ �t li O �J � o7 � ran O NO TF /F E/TNER 7AI e SEPTIC 7 AN.•C OR ♦E,.gCs•//ivG PIT ,4RE MORE TNA.N ja"BELOIV /0 p'T. /N/N. 6;RAOEj A 24' P1AA4E7.ER CONCRIFTL= COYB.R SNALL OF ®AP0v6N7- TO GRAOE.�AI✓ EXTRA Eye /OB CONCRC'Te< 4~PYC P/Pl tiZ-AVY CAST IRON CO�/ER SN.4 L L L3E USEO t COYERS M/N. .a/TCN /F/N DR/VEyV'A Y e /g oER '• / 2% M/N. GNCRLcT.E 111 A f; �_ GiJ�•�oE Co rER CLEAN SAsIYO BA CA.�/L L - UQL//D LEYEL CAST - a" -AYER jRON P/PE- 0 0 0 o o QF 1000 VB -3/8" M/JV O/Tc�r GAL. o • . . . . . • •l4'Peet P7. SEPTIC TANfC D/ST. s ! ! • • . • • ! • • , , yVASHPO SMNE BGX o ! � $ • • • • • .•e • • • • • 3 .. • • o i ;• DEFY: v a e WASYA=Z> STOiYE -'�` i • o• • ! • • • • • ! • ►Sff 5 x 2 S t+71 i eI , • • s • • • • • • op•o� PRECAST SEEfPAGE 7$5x 1 o t 00 • • • • • • • ' a • P/TOR 4VU/V, IAIVACRT`ELFYAT/DNS !/tS . +r FLF-/ /NYERT AT Ql//L1?//VG .�_�FT. 5 49 C�P.D: G JrJ: A/AI�f INN EZ JWP'T/C 7.4/VK` vi F7.' -L4_ FT. O/.4M. �i IC SEE r uC.1TJOiV� DIJTLt�T SgPT/C TANIC �2 �FT.' 1,vA,ET D/S,-,w49!/T/GN 80X FT. OR04VNO 1.C47'ZR TAd,LE SECT/CN OF OvTLETD/STR/SLIT/ON BQx-9-7- 7-FT, SEJVAGE l�ISPO�S�L SY.STIFM L EACHIMG 0/T 7"�I 6l/L..4T/ON DE516N CRlTER/A SCALE : %" = j :o D/MEK.F/ON A _F'T. $ _FT. NllM�Ei� OF�pR00/y►S �; D/MENS/ON C Z4 FT. "Im �R�tGF'DlsPos�s�uw/r o� SOIL LOG SAIL TEST TGTAL EST//rl�tTEG FLA*V 3_3D GAL./0.4V DSO/L TEST At'/ SOIL TES7-*2 ,/UMBER OF A0ACJlINT: ,o/TS 1 ELEK 99•o ELEY, GATE OF SOIL TEST SLOE 4.1-54CHlN6, PER P/T J SC•t PT. RESULTS iV/TNESSED NY -q4 3 RncoB 1 a0r'rO t L.04C UNG PER P/T—$q, An / PERCOLAT/ON RATF�E/ G Z IyJlbr�/INGH L.DAM +S'u asn u MrA4 LEACHING AREA —� y -SQ FT %/ AENCOLAT/pN RATE A MJN.IINCH RE541FJZVELE4C'N//V6AREA SQ. FT ;. % ��js� Meow'-) Saa o a$ �.a Meow'-) li33ER: F �� er+�c► . ►,2 ��� 6RaVE_ Lo-- 73 Cf)MME7--r W)9,, �(-3RsroNs M1�ct SRUCE ELDRED 366 O ; '• C-;' EL PREASE EN&IN"R/AU CO,lIVC. oE,c� ,�`` 7t 1 't- • {S ,�fl�� `�IpNAL0%3 �t EV Sr7 D P MA M .9 y 4YANN/9, MASS: � FD g F t [ NOGROUND A,4r-•R E/VCDUNTEREO CL/ENT: ,9RNsrA3i D.ITE- Q G/�OUNO LV.ATEN AT FL EN. Nowrn�� mHR. 9, i jg�f JOB NO. 8 4 0 2: r SHOT Z ois Z. L CATION L SEWAGE PERMIT NO. L dT q3 CRm1wrT 40tgll 8�1 VILLACE I. //7fi�ieJ TOAJS /77,-4J,S (OINSTA LL R'S NAME & ADDRESS a D Ute e v, •(�d U I L D E R OR OWNER Dogak(/ DATE PERMIT ISSUED DATE COMPLIANCE ISSUED o ` a .A LOCATION L/ SEWAGE PERMIT NO. III L or 73 CArn1,ocr Gvt4y 8 y ,VILLAGE S (blNSTA LL R'S NAME & ADDRESS r , 0 Ule C v tl r . ` ,(Ze U I L D E R OR OWNER 0 DtqcEcl DATE PERMIT ISSUED DATE COMPLIANCE ISSUED o ip a