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Home My WebLink About0105 COLUMBIA AVENUE - Health 105 Columbia Avenue Marstons Mills t A= 103-027 y t TOWN OF BARNSTABLE LOCAT10N 112 S C��i�rll,�a SEWAGE VILLAGE 4t 5 f,qhf "llf ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE SEPTIC TANK CAPACITY ,o-"-'*-, sr LEACHING FACILITY:(type) ,O; (size) 1ZY NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER /✓J� ��,, �, —0 -DATE PERMIT ISSUED: $ - - 3 DATE- COMPLIANCE ISSUED: - q 2> VARIANCE GRANTED: Yes No �� 1 i . i � �` �� t �� i / � � � i, II / �' �,f n� � � �� . i vim' / � � � � ' M� � \ �' r � � G�' L vlji•k,,lei "�4 WN OF BARNSTABLE LOCATION f C3, 6'� EWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. dn %1,4 b '��5 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) �T (size) Q J%3 NO. OF BEDROOMS \ -3 . PRIVATE WELL OR UP(�BjLIC WATER BUILDER OR OWNER /7; �l / �1zi1�-� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No s 30 '/ . e , \ ' f b/93 _64907 No... ...... FEs....(�..�_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE App iratinn for Diri.pwial World, Tontitrnrtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....... ------��'-- ------ a/�1 ----•----------•----------------------------------------------- Lor 6 n-:\ddres- ................. f ror Lot o. �J - =.�e!.!'iteL , �4�C'/'ld+S... ��r. .. ................ ................................................ . 0 -ner Address a ................................. ............................... /....•...-s....�� .fps Installer Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........................... Showers ( ) — Cafeteria ( ) a' 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. 3 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........................ LT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---- 0 Description of Soil---•-----•-------------•--.$-`"-� •----•--......-----••----•---•--------'---.----- ----'-'-------.----.....-----------'............--••--•--.--- W UNature of Repairs or Aterations—Answer when applicable..._._.1?t?�e__._ P*.!;A 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 ee ' sued by the board of health. Signed ............ ... .. .............. ...... �..g.�".. ... Application Approved By . .. .. ..9.......... ....... .. .. Application Disapproved for the following rea o r: ...............................:: .......................................... ............................... ............ ...................................................................................... ........... f Dare Permit No. Issued ........... ................. ....... . . ..... .... ........--. ....... Dace ��..fl.....�-....�•�.-.kn..�....:�.�_. ...�....,-...-w-,T.........- .. _.....�- -.--«rrr..-_.......v^-v.....+.-..L^•.�._.r.r�..•-'"'--..'-�f�-"�t/"/�/J'J.'�/�)+•�--°��-Jr+..-��...r�.:^-w.•..-^-�-...--..:,+--✓�`.�.,,.,rw..-....r-11 No.. .. ......... . Fps... ... THE COMMONWEALTH OF MASSACHUSETTS l BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Ui jpwial lFur1w C owitrurtiou rantit Application is hereby made for a Permit to Coiist uct ( ) or Repair ( ) an Individual Sewage Disposal System at: ----------------------- __... ------------------ / cs Lot_no. L o. ...................CAA.Ftln.... ,4��.r ............................... ....... S C�-�t�I-`-.� ��P 0%ner 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 ( ) dOther fixtures --------------------------------•--.....----------------------------------------------- ---•-----------------------.................---..._....-•---• W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Cv Septic 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........................ a ......................------- -------------------------------------•----•-----------••--....-•----.....-----------•-------•----._.........._...._............ 0 Description of Soil........................... ----------............----•-•------------•-----------------•-----•---•----•-------------•-----------------.....--•-••-•--- V -------------------------------------------•---------------------------------------------.....-----------------------------------------•••-------------------•--•--..................................... W x ................... ................................................................................................................................................................................... U Nature of Repairs or;Alterations—Answer when applicable..._..�as--�____L ��6- �s�------�?."... .................. 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 h een 'issued by the board of health. Signed ........... ... .....`................ .... .................. .......y�)/:s..`�-..7...3--- t Application Approved By .L. l'1.: .......- . !/ � �1�a�1., :,o...��>f. - ....._ Y"!` 7t n_.......................... Application Disapproved for the following reason, ` \ / .............................................. �j^J�---..................................... . ........---......................._......................................._I ........2..... .../!...<._�........Dace.................. Permit N- --------------t_...-......LrM Issued . r 1 Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CITe>!ttftrate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Dis oral System constructed ( ) or Repaired ( vj by ......................... ....._................ ...._._......5��, 1a....f�G.. fd..__.......... . / Ina;dlcr / at . ..................�O..S..... r�../... �- .. �Gr..........; v.{ ....��s. � C�!'?...<.....Iv.�i.1. .s................................................................ has been installed in accordance with the provisions of TITLE�of The Sat. EnyironmentaI Code as described in the application for Disposal Works Construction Permit No. ----- -�_3._...._. . dated ........ ... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE ONSTRUEA AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. p DATE---------------.... .'...._��...._.........._.. .. --------------....._-- Inspector ............_.>. ................_... ... ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ATOWN OF BARNSTABLE. �_.._..._. FEE.... ...... �i��t1 l�r�� >��tl�tr�stilan �rrmit Permission is hereby granted v`- .. . �---------------------------------------•-•------ to Construct ( ) or Repair ��an Ir lividual Sewage DisposalaSystem atNo. � .C'_('. ._.r_• a-a_,,_t, .. __" ___ /1 -/ 1 --•--- ................................................. I v >= �SIr t �./�f „ as shown on the application for Disposal Works Constructi�Permit No..�..�"�__..___.___ tDa ed__________________�__.`,........_........ r -------------- DATE............... .?• -F7A.:3_ ................................. Board of Health FORM 36508 HOBBS fi WARREN.INC..PUBLISHERS r �i3615 TOWN OF BARNSTABLE 4 OFFICE OF BOARD OF HEALTH *63 367 MAIN STREET HYMNS.MASS.02601 March 30, 1993 Peter Sullivan - Baxter & Nye, Inc. 812'Main Street Osterville, MA 02655 IN REi 105 Columbia Avenue You are granted permission, on behalf of your client, Edna Edwards, to construct a one-bedroom apartment at 105 Columbia Avenue, Marstons Mills. This permission is granted because you testified that the existing septic system meets Title V, the State Environmental Code You also testified that the septic system has a capacity of 490 gallons per day. Thus, the septic system will not be required to be upgraded or replaced. Therefore, this request meets the Town Ordinance entitled Regulation of Wastewater Discharge. Very truly yours, ,p 10'Susan .-As ` Chairman Hoard of Health Tovn of Barnstable SGRI be s +y I AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION. )a S C,7`J✓v►�.� SEWAGE # VILLAGE A'k ASSESSOR'S MAP & LOT -�oZ] INSTALLER'S NAME & PHONE NO, SEPTIC TANK CAPACITY LEACHING FACILITY:(type)'_ (size) NO. OF BRDROOMS PRIVATE WELL O PUBLIC WATE BUILDER OR OWNER DATE PERMIT ISSUED.: $ - ?j 3 DATE COMPLIANCE ISSUED; , 9•� VARIANCE GRANTED: Yes No ._j� 11 l 1 IN/ http://issgl2/intranet/propdata/prebuilt.aspx?mappar=103027&seq=1 1/29/2013 THE COMMONWEALTH OF MASSACHUSETTS Ficz BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Uhiposal Works Tomitrnr#iun jhrmit Application is hereby made for a Permit to Construct (k,)"-or Repair ( ) an Individual Sewage Disposal Systmi at: e a __.......- .................. ......... ..••---•••----................._...•------------•----•.._...................._.....-•-- option-Ad or t N Owwnnerin d ress /�/Jr ........................... =B�'1'! L,l..lt��/�!!................ ��t 4'�r:_4..°�_-C.:�.`ld..�t ....-- � Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms---...... -Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.....................--.--.. Showers ( ) — Cafeteria ( ) aOther fixtures --------------------------------------------------------•-----•-•-••-•--. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid'capacity rr .gallons Length---------------- Width---------------- Diameter.---- .......... Depth................ W Disposal Trench—No..................... Width..............-..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....eat'--------- Diameter. l?. .--.---. Depth below inlet................ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit---.--.............. Depth to ground water........................ Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....-.-----..-.----.---. R+ -----------------------------------------------------------------------------------•---•-------•.••.......................................................... 0 Description of Soil......................................................................................................................................................................... W U. ...........................................................-•••-••••••••-•........---•••-•-•-•----••••-•-••-••--•-•••-•.....•--------•-------•••--••••-•------•-•••-•----•-•----•-•.......-•----------•. W ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia c has been issued by the hpard of health. `1 9U Signed . -- ----- ------------------------------------------ ...................-------------------- Dare ApplicationApproved By -------------------------------------------------------- --- --------------------------------------------°---------------------....:------_-- ...................................... Dme Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------------------------------- .....................................'................................................................................................I---------------------------------------------------------------------- ............. Da[e-----------'..... PermitNo- ------ ------------ -------------------------------------------- Issued .....--------------------------------------------------------- -- Dare No;,// ••r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for-Dispooul Works T"ottitrur#iun rami# Application is hereby made for //a Permit to Construct ( J, ,or Repair ( ) an Individual Sewage Disposal . .System at: Io� � a�. � «�ic .. • - _.. ----- -•-•-�--€�•• ........................... • ........... ------------------------.......--- .............................................................. Lo tion-Address or Lot No. ......................--... ' ------------------- 'U./3px /G6llle .E.?-- ✓ -.//a:- Owner F Aildress --.5.O !�/iaaa S l i�rf � { c Installer Address Type of Building ' . Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.....................:.................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtiYres .:`...............:. d -•--'•-•-------•••-••-------••-•--•.-••••--•----•------••----•--•-•-----•---••••••----•...-••-•--•-•-•-••-•-•.....••-••••--•--•--•- WDesign Flow----------------------------------•.-•---__gallons per person per day: Total daily flow............................................gallons. W Septic Tank—Liquid*capacity(?q.gallons 'Length_----_-....._Width................ Diameter................. Depth................ x Disposal Trench—No..................... Width..................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No----�W........ Diameter.._. ?.......... Depth below inlet._..`� ............ Total leaching area..................sq. f0 Z Other Distribution box ( ) Dosing tank.,( ) , a Percolation Test Results Performed bY--•=-•-•--•--•••......-•-••••.--•-- -•-••-••-'--... ... --- --• Date------------••-•---••----=-•-•------ s --" Test Pit No. 1................minutes per inch Depth of Test Pit............_....... Depth to ground water.....:................. r 4 Test Pit No. 2................minutes per inch Depth of Test Pit............:....... Depth to ground water........................ PA --•-•-•••--•••------••-•-•••••-••-•----•-•••••--•••.....•-•••-••-•••--•-••-••••.............................••------••-•-------•-•---•-•••--•••--•-•--•-•••-- Description of Soil - ................. ................................................................., ----- -----------------------------------------------------•---••••-•---••--- V+ , Nature of Repairs or Alterations—Answer`wheri applicable...................................................•__....__.__.._.___._..._______.___.___--- U 7 . . . .<i a r per Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE-5 of ile State Environmental Code The undersigned further agrees not to place the system in operation until a Ceertificdte o mp� liance has teen issued by the blo.ardf health. g --�-- --Sl ned y Rr. i { Date ApplicationApproved BY -------------------------------------------- ................................. } ------ .......`-----` --------------------------------------- .. Application Disapproved for the following reasons: ------------................ ----------------------------------------------------_-_-------------- f/ J Date Permit No. " 1 -T Issued --------------- Date r' 7 fy 'THE COMMONWEALTH OF MASSACHUSETTS fgBOARD OF HEALTH ` TOWN OF BARNSTABLE Certificate of (�IImyiianr, e THIS IS TO CERTIFY, That,the Individual Sewage Disposal System constructed ( '4—)-or Repaired ( r) b ................. �, ,"... ------- _, Installer r at .g.... v�aG....�vf 11/�grf7�iay-s.. s//s...... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ................. ..................... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT RE CONSTRUED,AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.,'. DATEf = ----- Inspector ... ------------------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No...............:... TOWN OF-,BARNSTABLE FEE........ .....:. i Disposal Works Tnns#rur# orrt "pa-mit Permissionis hereby granted...........`.......----------------------•-•-•--••-•••-•-••••-•-•-=.........•--•-•-•-•-•--••............-•---•-•••.............:---_•••--- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No Street as shown on the application for Disposal Works Construction Permit No,;:.... Dated.......................................... •......................................•-------.....--------.....---......_•........••••--•••-----•--••- Board of Health DATE.............................................................................. FORM 3650a HOBBS 3 WARREN.INC..PUBLISHERS *ae ® P THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �Gv. -...................OF...... XX ............................ Appliratuan for Disposal Works Tonstrurttun f erupt Application is hereby made fora Permit to Construct (.�r Repair ( ) an Individual Sewage Disposal System at 63 - -�-�--•-----------------_......._.... •. _...._•. ovation A dyes ..... .•- .... •••.or Lot No. .... . ,�ate, ...... .� .....---•-•-----•........... .....-•-----•....... ............. .---.......--•-------••--.........._.....- -- -- _ ----- --•----- er Address ........................... . ......_........._... ........................... Installer Address Type of Building Size Lot................ q.---- --S feet Dwelling—No. of Bedrooms...........3............................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ............ :.... ------•--------------- WW Design Flow..............._5S..................gallons per person per, day. Total.daily flow.._:..3cg.62.._...... ..... ......................gallons. -. W Septic Tank—Liquid capacity. V.gallons Length--- . ;fit. Width__,�.� . Diameter Depth4'�...._. ... .. x Disposal Trench—No...................... Width.......................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No........./........ Diameter..... Depth below inlet....... ........ Total leaching areaA9,Q,tJ.s*t.GP,D z •Other Distribution box Dosing tank ( ) �•+ LD 64 � .........................�G� a Percolation Test Results Performed by.......--• -•-------( €LC E ./• G -•--_.... Date � -............. ,..a Test Pit No. 1..L.....Z.-...minutes per inch Depth of Test Pit... ... Depth to ground water.!!l?� fi Test Pit No. 2---&.minutes per inch Depth of Test Pit_:l✓ ��.... Depth to ground water.,/Vh/ve.... a .................. ......----------------......----.......'.-----.......................------•--...............-•------............................ 0 Description of Soil......., �E... �-{9.n�__________________ rJ ----•----•----------•---------- •-------------- -•------------------- -------------------------------------------------------------- ---------.------------------.---...... ---•-------- 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 iITL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b ' s ythe boar of health. I/Signed..-- -----•---- /.................... _..__ Date Application Approved BY............. ��• ,c . ...----•---....------------......... ....................-.-..-:. Date............... Application Disapproved for the following reasons:...............>_.__................___.______.____:___.____...........__...__..-...._..._...................._ ..------•----------------------------------•---------•--•---------..:-•---...........•...........----.-_............--------•-•---•--------•............................----.........•---.........---•- Date PermitNo.........2.7..--.q•-,77...................... Issued......................................................_ Date -No: »...,...».... FES»...��' !/� THE COMMONWEALTH`OF MASSACHUSETTS ,�� j�.�►/6 BOARD OF .HEALTH ...... OF.. /P/CJtiS/ i . __.**......................... Appliration for Disposal Works Tonutrixrtion Frrmit Application is hereby made for a Permit to Construct (I/ror Repair ( ) an Individual Sewage Disposal System at: ............ ....... v ?:s -..F'f ,a. `:.....__.....------........_...... _r Location-Address or Lot No. l ............................. ............................................................................----........»........ Owner Address.................................. Installer Address Type of Building _ Size Lot--------------------•--_----Sq. feet Dwelling—No. of Bedrooms.........., ...........................Expansion Attic ( . ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers — Cafeteria a' Other fixtures -•----------------------•-----------..........---• . -- W Design Flow.................QT.................gallons per person per day. Total daily flow....._r.. ........................gallons. Septic Tank—Liquid capacity-.—W.0gallons Length... Width.., �L'... Diameter................ Depth......:"_..... Disposal Trench—No.........:........... Width.................... Total Length................:....Total leaching area...................sq. ft. 3 Seepage Pit No..�...._/.._.,.......... Diameter...._.�Z ..... Depth below inlet.......I......... Total leaching area.'%2t_K..-ft.d;PD Z Other Distribution box ( V Dosing tank ( ) '"' Percolation Test Results Performed by.... ....... .........!.......... Date------------------------•:--- - aa Test Pit No. 1../....Z-:..minutes per inch Depth of Test Pit..-f` '��.. Depth to ground water-..Is,z��f.... Lit Test Pit No. 2...L.Z.—:minutes per inch Depth of Test Pit../;!cE1....... Depth to ground water.;A—/Q/-.T'--.._ x -------- -------------------------------------------- --------- .... - --.._......- O Description of Soil.......I .. .....................................................--................... --••-----•-•-----------------------•---------------------•-•------.....----------•-----•-----•----•----•--•--•---------------------.............--•-•--•-•--••-••-•-•-•-------•---••......--•--------.. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... 1 ........................ -----•.....................•---..........----•----------•----------•--•--•---.....-------------------•-•-•-•-••-------------..................................._............. Agreement: ' The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been-issue ,by the board of health. signed----- -. Date Application Approved B .___ Y { Date Application Disapproved for the following reasons:..................................................;........................................................ ....---•---------------------------------•---•-------.....--------•---.....--------...----............._...........----------•----..........:--••---•--•---•--.....---------------...........-•.......» Date PermitNo.........�--?----Y,... .............__._. Issued....................................................... . Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH wrtif utttr of Tomplinurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.............................................--•--......._..........---------------------------------•-•---........................-----......-_..................---..............._.._........_ Installer at............Z.z.,7 .......L-" _rr..F°:� -----AV--- ----��/,�C li.re s ae!=---�9'f�.......................... �. has been installed in accordance with the provisions,of TITLE 5 oflThe State Sanitary Code as described in-the on for Disp osal Works Construction Permit No._......� 1:�_�f.___.,7_.�. /da4d.--....�x.................................... � 7 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT_,BE CO STRUED�AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. t N r -z t j r� v DATE.................. � c� �� ----�...................................................... Inspector---._;;:.:,.........-------- ..---................................................ THE COMMONWEALTH OF MASSACHUSETTS ►� f 0 0 < v BOARD OF j HEALTH ems - ...........OF...........1,/ :,�: ..4 No FEE..7..,�........... Disposal Works TotnotrWion rrrmit r � - Permission is hereby granted..._ ._C;V_zoe_ _ �. _.......-•----•---------•.......................................•--•-••...................»»» to Construct ( or Repair ( ) an Individual Sewa a Dis oral System at No......... r:.7.._.�i. .,rA.L�'... .l:gin-.t"' !s-----••- � 2- �:, =............ -•-••-•-- ............. ... ---- � Street as shown on the application for Disposal Works Construction Permit No.R7.4z.72. Dated....f I... M't --- ........................................................ / Board of Health DATEf .�------------ ----------•----------••-•-••... �P �o✓niDATIO / .50, 00 SO - g8 <l- 6 43,SS 4tZ 'o j- v� ¢3.8 1 36 s9,/ 30 _ N D TE: EXTEA.10 ALL AFPL/CA45L.E eacis7411,9 9r-ound Pro,Fi/e HO,e/z. _SCALE : /„_ /O' LC C ! 0 T, SCALE : / /O" MAAJ%lOLE C0116RS To l.U/TH/Aj �. o---v---o.....o_ ro osecl rouncJ ra !le VE �2 46.8 rr" r7. %q 'Per 'f�. FLoG�/ 2- /a er of 904 ScHEt�. ¢O P. L:C. o,e cr"In/mum /" per •Poof) 3/e peasfone EQU19L TO SEPTl c P1Pe ro BE d --Tfl/yK•+ p LEVY 4-0 C)O GEVEG D/S /T 'G7 O X vz / washed s- one �: r / ¢48. 4-7/ o /000 GAL. SEPTIC TANK .3 0, LEACH P/ r io,., 8 c)U 6 ....._.- ! 7/8-B 6 ILC) W ANC i v' L Fc 1`,�ic, � ) 3 8 EA,P_ ooM HOUSE OAT E. TEST 8Y g7g ('no disfaos�r WITN E S S:7- ,M, KEEL/, BARn/.STs�f3C.� 8, /...- ` T I_(_,z � ,� T, N z , / F p / 33 a �o ci 4- 0 -T= o \ 65011- L.Ef9CH/NG F],42E/9 K.4q_,9 3 d- / /DC= Wt9LL.: 15o.8 x 2,5 ` 3.77..0 6,P.U. \ �oTToM : . / x 1. 0 - / /3 . / COA(?SE 43,1 SON ro-rigc- 90. 1, Gram.D, SA NP 1 6, 4�s�c N p,7-' b✓/3' O,r a O ` COAA5E SA 1,.ID C / !jA ' O m 3S.l 1560 / �!C) W ATcrc 2 49•I /, CE/2T/rY" -rr'I 7 THE 8U/GD/h!G F„!co✓.vr/s2CD POLE f-.-R 7POSED ON THE G�2oUAJO IqS C,JN CAN TH/S PLAAJ DGE.S c CO&IFO�21"I TO THE BU/LD/IVG �5E7 `j 7-'E -Jr' El�r-7 PL/-1 Ni 8.¢ E, ?C K 2E 0L11F2E ti/TS OF• Th- F_ / r 7OWAlJ OF FOB . LO rS 63/64 -z— P4" aK 157 PG. 97 i GOLU/"It3IA AVE. -4 V./1LL1 /"1ANT1G D1, 1V4- Or As OF as /'i aR 5 7 o N s M l LL S / ��g g7 8 1 F i` GEORG ' ��q r / IG1']AEL �uFFO/V� LOW A9,ARD PREPARED FOR: , o H '4�0� 49,1 Boo. ' L SCALE: AS NOTED DATE:_��,_y /� 8 7 i ;rL L. 0. 00 ex s-/-/ nq ` e)FIE va-/-/on 8_1- D:G. SETBACK o.00 pr-oPoSed c /� vat/or, F�.EQU/�2EMENTS : APPPOVED . " 4r-0n f - . 30 _ �'f• BC��9,2D GF f-lEALTH _.. ..,,._. c� ><!$�'-!n c� cG7nfovrs '7/4 MRIN 5TQEE T S.L cue l� o- o -- loropos�d C0 7-/-ours r'eGLr : l5 , , MA S• YA)e r�ca uTH Pope?" MIAS S . • !_'"" � P�oF�55lQNAL EhlG1N�ER5 � LAND SV21lEYQ,�.S � S G— lS 8 , 1