Loading...
HomeMy WebLinkAbout0092 MAUSHOP AVE - Health aushop Drive .. 0:0 Barnstable i i No. 'go Fee Px) THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitation for Misposal 6pBtem Construction permit Application for a Permit to Construct( ) Repair(v�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. q 9L I'r1 Al(S RoeP A V I✓ Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. 5'09- a 9- 300 Designer's Name,Address,and Tel.No. PA j orals i5ACAV-l7lr�19 TA-v s srr-nl Dn• S o zbo A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building T)W L-ZL-.rr+'is No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) AGPtnc(.- ) D- BOY S ✓,,v0 0/ Suo C)o-rrz 7-41K= Date last inspected: eel lP 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 T4oealth,.- SignedLode to place the system in operation until a Certificate of Compliance has been issued by this Date 7 / Application Approved by Date -� Application Disapproved by Date for the following reasons Permit No. '- Date Issued_ v t IW No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplicati6iff W'Disposal 4- pstrm (Construction permit Application for a Permit to Construct( ) Repair(./Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address br Lot No. q a1- MAUS HoPS A V tr Owner's Name,Address,and Tel.No. r,. PSTASLL Assessor's Map/parcel atCj -61%0 �- Installer's Name,Address,and Tel.No. SnR- 42 Designer's Name,Address,and Tel.No. P{}$rbnL EkGAVATrw' k /cl .TArJ .S E/SASI"r,-,4nJ bA• -.SAr-O wZZ-0 ,1 /t/ A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) t Other Type of Building n w L-CLr,J 6- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) /V gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title t _ Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) , (EPLA (3okc=S A^jA /, 5� �L' Seo3rc TqN� Date last inspected: S E07, 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 Enviro�Code and not to place the system in operation until a Certificate of j Compliance has been issued by this Board of Health. Signed - Date 7/�2 7 Application Approved by Date —/1—/'7 Application Disapproved by Date for the following reasons Permit No. I Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERRRTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by at _. Cf has been constructed in accordance - I with the provisions of Title 5 and d the for Disposal System Construction Permit No "�-7dated ^ f-72 Installer Jl/ Designer It/.4 #bedrooms Approved design flow .t/14 gpd The issuance of this permit shal/�.no a corystrue (aJs a arantee that the system will�fu ction ask-&signed. Date / C Inspector --------------------------------------------------------------------------=--------_----------- -----==--------------------=------------ No. J Fee 0( THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION.-BARNSTABLE, MASSACHUSETTS Misposal bpstem Construction J)Prmit Permission is herebyanted to Construct Repair U Abandon Sr- Upgrade( ) P ( ) P� ( ) ( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. .------'� Provided:Construction must be completed within three years of the date of this perme- Date A roved b O 7 PP Y ,(Lc� E iv,4 E PE Itul f NA- f D E �✓,� Olt. OwItEft TE pf �. #'SS ., IA ANCE suED r f - / .-)o 'f Y - 4 � 1 � EU''All NO. WeE A I L Ate }, ' RJR�R.�q OYI U-1IR.We-11- OR OWNER ry} • I/A d :. RIIRRl�._ YYF D A T E P E R Ml I T !S"S U E D --r DATE Coopk1A'N yI ISSUED �47f • } r - I��: .YA e r Health Department Drop-Off Hours: 8:00 AM —4:30 P.M Town of Barnstable Received by Health OF1HE A Regulatory Services Department on Richard V.Scali,Director • BARNSTABM RAS& r Public Health Division i639. �0 . ATEDN � Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE Property Address: Assessor's Map/Parcel Number: 10 U A licant Name: � � PP �s) Phone: �d� E-Mail: C3�,V Size of Lot: 41 2a. How many bedrooms exist at your property now? Sus 2b. How many bedroom are you planning to add as part of the Accessory Affordable-Apartment Program application? 2c. How many bedrooms total are proposed at this property (including the Accessory unit)? 2e. Is the roposed Accessory Apartment contained within: the main house; OR a detached structure 2f. Submit floor plans for all buildings on the entire property. Show all existing rooms in the dwelling and the proposed accessory apartment. Label each room clearly. Label measured width of all open doorways. Use straight edge for hand drawn plans and be-sure all labeling is legible. , Signed: Date: 1 r ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE FOR STAFF USE ONLY i 1. Is the dwelling connected to Town sewer? ❑ Yes- No 2. Dwelling located ❑ INSIDE ❑ OUTSIDE the Saltwater Estuary Protection Zone 3. Dwelling loc d INSID ���pu is supp y we one o ion 4. Dwelling is connected to ❑ ON-SITE WELL ® PUBLIC WATER 5. Disposal works construction permit on file? VYes ❑ No, 6. If yes, how many bedrooms were allowed by this permit: _�_ bedrooms 7. Were building permits obtained for additional bedrooms? ❑ Yes Q'fJo 8. Engineered septic system plan: a. On file at the Health Division? Q Yes ❑ No b. If proposed accessory unit is detached from principal dwelling, is that plan on file? ❑Yes ❑ No T� P � 9. Existing septic system capacity is bedrooms ^05;V-9�5 For the accessory unit to receive approval from the Health Department the following action must occur: ® Existing system accommodates proposed additional bedroom(s) ❑ Upgrade existing system to accommodate additional bedroom(s) ❑ Must remove a bedroom from the main house ❑Must connect detached structure to the existing septic system ❑ Must install septic system for the detached structure Masi— Prof. �-!' �1✓ISip 1 rpy�FA�� ci ��#►nIS�L4 l2UJti r /� +J�� n.z", Laxw' Is rJ�7Mi +41f nab d�li �.1✓ Signe Date °' 2. i 8/16/2017 HOUSE 2.jpg MAEN HOUSE 2ND FLOOR EX2=EXISTING-REPLACE WITH COMBO I 5�ic Roof x6 Bedroom Deck io'xg' EX2 —. Master L., Bedroom Bedroom 14'x16' 11'x11' All measurements are approximate and not guaranteed.This illustration is provided for marketing and convenience only. All information should be verified independently.©PlanOmatic hftps:Hmail.google.com/mail/u/0/#inbox/15ddbfO8e7b8lfe5?projector-1 1/1 f 8/16(2017 BASMENT.jpg MAIN HOUSE BASMENT EX2-EXISITING=P.EPLACE WITH COMBO Utility Laundry 25'xll' Room Furnace 5�X4� i I Store Finished Room Room 121xio' 9'xio' EX2 All measurements area appr oximate ate and not guaranteed. This Illustration Is provided for marketing and convenience only.All information should be verified independently.©PlanOmatic I https:Hmail.google.com/mail/u/0/#inbox/15ddbfO8e7b81 fe5?projector-1 1/1 8/16/2017 HOUSE.jpg _--" MAIN HOUSE FRIST FLOOR i ALL NEW SMOKE AND CO DETECTORS Deck X1=NEW POSITION- ELECTRICAL SUPPLY RUN REQUIRED -COMBO DETECTOR 9'x16' I EX1=EXISTIWG-REPLACE WITH SMOKE WITH BAIT BACKUP I i • EXl _ Kitchen I Ling r 3 - Garage i � oom �- 'i: FP R . 13'X�3' • Family Breakfast ' Nook/ Room x2 Diiiin 15' ' 3 I XI � g Room 1O'xii X1 ' �waIl mount removed and ' wire run to new combo X1 All measurements are approximate and not guaranteed.This illustration is provided for marketing and convenience only.All information should be verified independently.©PlanOmatic F p. f 4 _ r . https:Hmail.gbogle.com/mail/u/0/#inbox/15ddbf08e7b81 fe5?projector-1 1/1 8/16/2gV APT.jpg • APARTMENT EX2=EXISITING-REPLACE WITH COMBO Bedroom 11'X10 Kitchen i 12X23' FP 6'X2' EX2 _.,_._... ....- Living Room E71 i 116 All measurements are approximate and not guaranteed. This illustration is provided for - https:/Imail.google.com/mail/u/0/#inbox/l 5ddbf08e7b8I fe5?projector-1 1/1 - 1 ro SEWA ERMIT N0. A G E d I N S T A LLER'S NAME & ADDRESS 1,5 Xe) Bft'D'E-R- 0R OWNER DATE PERMIT ISSUED 1-"3y -7Z DATE COMPLIANCE ISSUED �, 3D -79. J � 2 31 , -o G q% :� L THE COMMONWEALTH OF MASSACHUSETTS -BOARD OF HEALTH .............OF..' t ! P8 it V/ AppltrFatuan for DispagFal Works Tonstrurttun Fam 1 Application is here a for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: G ?,C -•-----•--- ?..�..................................................................... ti_ Location• dd or Lot No. .... .a.. _ l�A h . s'�1. ..................•---------........ ..........-,1�'I vs. oho A!�E__.... !.' ...J_`/i�s� ' Ow r T Address t�'C.,�. _ t9 /� .� leE:...-•--•-•-•---.......-•--•-•---- Installer Address Type of Building / Size Lot.R.129-1r.9,�`�....Sq. feet U Dwelling—No. of Bedrooms...............................•...........Expansion Attic (jo) Garbage Grinder (vo) Other—T e of Building No, of persons............................ Showers — Cafeteria Pa Other fixtures W Design Flow.......... /.,0.....................gallons per. per day. Total daily flow...............e2 Z?-._...............gallons. WSeptic Tank—Liquid.capacityl©wat.gallons Length&.'C.-".. Width.Y.&`". Diameter________________ Depth.5�.`e`!. x Disposal Trench—No......... ..... Width.................... Total Length.................... Total leaching area....................sq. ft. p ' ..sq. ft. Seepage Pit No..../............. Diameter.__.. .._..._..._. Depth below inlet__..._._..____.. Total leaching area... . Z Other Distribution box Dosing tank ( ) 0—' Percolation Test Results Performed 5, Date..... ,/_. d.,l .-----__. aTest Pit No. 1._4--'.2 -•_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........................ -•-•------•-•-----------------•-----........----•-••----............------------------------•------•.................-----•---•----------------------------- O Description of Soil-•--a-_t2--'.... ---F--. ......... ...r'4'1-->.......... ze..`...fv 1�rcepl.._-.f�in�.� .��' ntb...--......e.e.= ....... --------------- VNature 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 i IT .;;,. 5 of the State Sanitary Code— The undersign��effdl1 further_agrees not to place the system in operation until a Certificate of Compliance has been sued by boardf health. -- ...�... r I 3J" > ign Date Application Approved By.._.. !��7 r............... { �_-- 0 Application Disapproved for the following reasons:........ ..............................................:......:.................................... --•-•-••.................:.........................•---•-----------------....---••--------...-------•----'---..._.....-•----••--•----•-•-------•/-^J-...•q-------•-•�J-•-----.... ----....--•--- Date Permit No.......... = .............. Issued....!--_.._....: ` .._..._........_..... Date - _ Fizz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - -/L Gt„?-.-IU.....---..._OF..... .�'r....+!1,1:.ra-� ..e.:' ....................... Appliration for Disposal Works Tonstritr#inn Permit Application is hereby made for a Permit to Construct (�'�`) or Repair ( ) an Individual Sewage Disposal System at: -----44021.d.................................................................. •- Location-Address �A"V!' -or Lot No. P! Jdf�'!`Ili dy1. !Z ..................................... ........•- !!!t`�''.....A... ....................................... Owner Ad ....dress __________________b `� Installer Address Type of Building , Size Lot.e2l__�Y3...Sq. feet �., Dwelling—No. of Bedrooms............................................Expansion Attic (vD) Garbage Grinder (j:r) Other—T e of Building No. of persons.................•_.._...... Showers a YP g --------•--..._...--•--•---• P ( ) — Cafeteria ( ) Otherfixtures -------------------------------------•---------••--------•------- d ` d vo ' W Design Flow..........�1j.49............ per .WP,n' per day. Total daily flow............../'`Z,*........_..:_._..gallons. WSeptic Tank—Liquid'capacity/apw.gaRons Lengths..�K". Width.:! Q:". Diameter................ Depth§:...6.f . x Disposal Trench—No..................... Width•................... Total Length.................... Total leaching area........I...........sq. ft. Seepage Pit No.... ............. Diameter....i............ Depth below inlet..... •........... Total leaching area...PZ_�..sq. ft. Z Other Distribution box Dosing tank ( ) aPercolation.Test Results Performed by.. �?. .�Q.�_ ?_.._ 4.-.t � j..ks_ Date..... ........' ....... Test Pit,No. 1.r`_.2.....minutes per inch Depth of Test Pit---- ."s_i_...... Depth to ground ..... fN Test Pit No. 2................minutes per inch Depth of Test Pit...._............... Depth to ground water........................ a ---••••-••••----••--••---•......................•-•-•••.......----,....---.--.._.. -----.._............................................................... O Description of Soil---. _&_at.s.- e---. X ae-- 1�! S'_ra_-t , � .rc�,�a._-_fir 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 T IT I Z 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 hby the-board of health. y .Sign r Date Application Approved By..... ~G�,eYft 2! 7_�---' --•--- °a-�J 7 �.7 ... . Date Application Disapproved for the following reasons____________________ ----------------...__..---•-----------------------_...-------..._.......______ ---------------------------------------------------------------------------------------------------------._...-..---------------------------------------------------------------------------------------- Date PermitNo.......................................................- Issued.-----............................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH t, ...........4............................... r....!" ........�...........OF'.. ............... .................... Tntifiratr of Toutpliattrr THI�IS CERTIFY, That th jndividual Sewage Disposal System constructed ( or Repaired ( ) ,I ..._.., at__..''. �/ ..._6�r`fi: _ ._.i .. ---P�/d!-_-• -- ;-r'F. �..1.� � V...._:._.. /� '1.:._.. t has been installed in accordance with the provisions of,T 5 •f The State Sanitary Cod . as ties rih n the application for Disposal Works Construction Permit -( . .................. dated--------- ~_' - a. __.__._... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G; RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........... c Inspector...-- -------------- ------------ ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH <-✓� .. 17 i ;...................... f OF...... .. .� ........................................ No...............�.... r................. Fi.E......`�................. Disposal Tnntrnrtilan r r' tt `r Permission i�by granted............ - t � .__._____. 4 �...��..................... �... .........._-•__-... to Constr ( or Rep r ) an Individual S . is po stem /� pp p , Street ... .... 7 �,. ated......�..�..'.. �� as shown on the application for Disposal Works Construction Permit oe� � • . . .� . .••... ............... -- •------ DATE. _. ._._.•....•.•______________• Board of Health _.... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS ` AsBuilt Wage_1'of 1 r L � " "rlgN � SEWA � ERMIT N0. L r v M/4 .5 ffo,4 AGE INSTALLER'S NAME i ADDRESS VF /C05 kVttV-E-W OR OWNER DATE PERMIT ISSUED 1-3.47_7 DATE COMPLIANCE ISSUED 1, 3p-7! A:7"t p- G�q7q 31` ?/ http://issgl2/intranet/propdata/prebuilt.aspx?mappar=299080&seq=1 5/19/2017 a, LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME & ADDRESS Vf, lox � �9i2a 5 T/3 c. i= B UI'LDE R OR OWNER DATE PERMIT ISSUED /� 0 DATE COMPLIANCE ISSUED /Yo U5 � (-4k�f&i_. 1 ---- o ® 37 No...... ........ I©.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD/OF HEA TH- ......................... ...... . ..............OF..... �[ G�,✓ Ton Appliration -for J%ipoiial Workii litrurtion Vantit Application is hereby made for a Permit to Construct or Repair an Individual Sewage. Disposal System at: ...................... .................. ........ ............. .....6 "J......................................................... Location Address or Lot No. . ................................. .................6._CL-+M'j............................................................... Owner I t. Address .......... ........... ....................... ...................................I............................................................... Installer Address Type of BuI1,;d1n Size Lot_ PV-...Sq. feet ':.t Garbage Grinder _'R of Bedrooms--- -----------------Expansion Attic Dwellin -----------3......... PL4 Other—Type of Building -------- No. of persons.....6------------------- Showers Cafeteria PL, -Other fixtures ------------------------------------------------------ --------------------------- ...... ------------------------------------------------------------- W Design Flow-- -0 Septic Tan� . ....:......................gallons per person per day.. Total daily flow............3_� _--------------_-gallons. P4 id capacityA -gallons Length____A=� Widtl.............o'.1.:::;_blameter................ Depth..-------------- Disposal Trench—No_ --------------_-_- Width____------__-------- Total Length.................... Total leaching area....................sq. f t. Seepage Pit No_____________________ Diameter..._.._..._....__.__ Depth below inlet_--___ fI otal I aching area....... ----------sq. f t. Other Distribution box Dosing tank .- 7,,/ Percolation Test Results Performed by._"s.... -------------------------------------------------------------- Date---------------------------------------- a Test Pit No. 1................minutes per inch Depth of Test Pit....._.........._... Depth to ground water.-----------------­--- ;3:q Test Pit No. 2................minutes per inch Depth of Test Pit....._._.........._. Depth to ground water--.------_-___----...___ .......................1. .. .... ... ..... ----------------- 0 Description of Soil---- ---- -------- ----------- ------------------- )9me//---- -- A- ----- -------- ---- 41 j----------------------- U ---------------------7 ------&ez----�- ..................... ------------------------------------------- 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. igned .. .. ............ ......!�.......4-1------ 7... ............. ... Date Application Approved By.__...... ----- V jk� 7 / ................. ....L a .;/--�------ Date Application Disapproved for the following reasons:........... . ..................................................................................................... L...................................................................................................................................................................... ------------------------------- Date PermitNo......................................................... Issued........................................................ Date -J6 No.......(l!f1--........ ` Fizz.... ............... THE COMMONWEALTH OF MASSACHUSETTS SBOARD F HEA TH Appliration -for 43h4putittl Works Tutwtrnrtinn Vrrniit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .............................. .......1. "..:�� __ _.____.✓- ................. .....\�C 1/Y _i 7.�.r___.1=�Y........................................................... Location• ddress or Lot No. ^— Owner QQ S .................Address-_...------...................-•--•.....--- i � Installer Address �/ Q Type of Buildingl Size Lot_....lZ .. Q_..Sq. feet U Dwellin No. of Bedrooms_____________ -Expansion Attic Garbage Grinder p-,I Other—Type of Building ---t r. ------ No. of persons......6------------------ Showers (4-+ — Cafeteria ( ) Q' Other fixtures ------------------------------------------------------ W Design Flow.... _____________________ ___gallons per person per day. Total daily flow------------ �.................-gallons. P4 Septic Tanker Ltd capacity-_Y V/_gallons Length-----4----_ Width..........eF�iamete................. Depth-..._-_-.-.--- W Disposal Trench—No. .................... Width-------------------- Total Length------------_----- Total leaching area--------------------sq. ft. x Seepage Pit No--------------------- Diameter-------------------- Depth below inlet...... ____ otal 1 aching area----. --_---_--.sq. ft. z Other Distribution box ( ) Dosing tank( ) - d6- 7` d r //- /q- 7e aPercolation Test Results Performed by._:!!,�.........---------------------------------------------------------- Date---------------------------------------- Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water....----.------.----. -- LL, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water---_-.-..--------------. ----------------- --- ; - --------- - -- / / O Description of Soil-- x 4/ W 7 �` -------------------------------------- -------------------------- x - .sue - � 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. igned. ___ `�..------. Date Application Approved By-------- ------- L% /------ ---- / D t7 Application Disapproved for the following reasons------------ - ------ ----•-----------------------------------------• ............................ --------------------------------------------------------------------------•-••••....._....---...------•.........._...•---•-•-------------------------- -----------------------•------------------------- Date PermitNo--------------------------------------------------------- Issued........................................................ Date I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . . ..............OF......... . .. .. j �G/ ....................... �prtifirate of 01Outpliatta T TO CER" FY, That the Individual Sewage Disposal System constructed (�or Repaired ( ) by-- .....--• "--•- -------------------------------------- ""'L s Install at =' l.. Q d� .--------- has been installed in accordance with the provisions of : `ti le XI of The State 5anitary Code as described in the application for Disposal Works Construction Permit N ._._.-_ �/--------------------- dated-/.;2,-___a_-e).a-_7,�__....._.._. THE ISSUANCE OF THIS CERTIFICATE SHALL, NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------------------------------------------------------- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH // i ................OF.... No......................... FEE ............... Mel_ �rk,� � �tr�trtinn rrntit Permission is hereby granted- y to Co 17) e ior t an�ndividua ewage D posal System 'a x 3 ` Strect as shown on the application for Disposal Works Construction�P�ermo.____ ated��.-.:_!J_'__7 ._._._... --------------------- •-• Board DATE------------------------------------------- ------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �aT TE 5 HOES is �,� J�}IV• 3 C?, /9 79 q P f 9 3a PAUL. MURRAY Z N•5P6 C7'r R . ' ELEV 14.0 k D - . L. m AND t a -3 y�, '{M EDIVM fP S!t'N13 391 / 7 �C7 T f / !D MEIN/Uri 'ormvi S ►D 15 AA o 0.11V6 Ai, .T qQ SFQ li isr8 Iry ;•,c i .� j • Y ,` /a✓, �0 yQ ST { M/A-f/A-Y U/t/l t r L.Di/vG S ETL3�Cam' •eE U/,� ME.�/T5 S C,4 L t / _ 40 , F'20Ao17- J5. Si T2,E4T� P2 zoo SED SE P T/G 5 y5 TE^4. CaA/S T2 UG T/ON SH A-LL G pNF02M TO ✓/ASS . . :DE S/0 Aj r-L O W GAL. DA Y C N V/;e O/l/M G-N T�,( CODE. T/7 -E: Y ,2Et�ISED` 7 7 5AI?1 S7-A01 1-L-: ,A CAI r2ATE T4P OF 'yE.�1 L T.�/ 7z LJG A T/O NS FP 0 1C 0 MAn/NOLE C VE,2 -TO EX.TEnlZD ?p /MpE�V/OUS CO t/E�2 1 T / . TOWI [ D ,a2E VEVT rVG-S. �2oiti 1A4o= T2A7/�t/G S7-owE 15 lL '4 CAsr , 3ox �� Z/"W106 0VL__e /2oN ''' -�--- --� -- = T/GKT N Oi TCf/ FOaT ��"Mt,V / 2" Min/ p T /4" 14"/Foo r .,u �`'� (..z WA Ec7 GA L L Del /iV✓E 2T n'. ,cl=-�-' /N VE2 T. G A PA C./ T y A e 04,) /O E oT/c' TA ti,e - . � I �6 S ("th��c TGTz T/G (T� bV VEfZT } /N VE E?T No GAk-1AGE a. VITION L 2EF�2En/� /V LDT G r$ RE-�/:1 NaLo Al Box EDT .- ' .S /G T<lN. rC� j7/5T1Z/f3UT/ON cs QUTLE7�� AND L�<kG�//iVc'7 .a/T .. TO,2 �, L k3a}��C TO'4E..OF .Tc'E/n/F02CEZ7 C;0 CT�'GTE �z .. i on/c2ETE sT,2�:v5T�-j. 30 `ps- v A t"z m4TH#ash �U / !VJIN __ 20000 bQ 3� .�- �o, boa a�,vG - - �• . ..4 �`/vim Yt',�tY %/QT �co B 'LD -A, r! N?�U f o�i�� ,s-'�-ram^' Un/4 _ nt Z-. CERT tr---y ?'H �7f/WCr �# 1���lf4Z`�` S./Gn/ !��z�/�vG x i `s , LQCfq 7'loN /5 c aR R,E 7" ,err V' DOES ' CaM P4,-1 .�,v I��' 5 -T/3ACK R6-a UlR - . TO(.v/1l QF �i9�N5�•7't?r�G,�" _ ,s ' - '� rCpsT'&.'��� �'�� - .. . f/E,4 L 7.z,/ 4 G�c��c/T i. 21493. 19 t � aceQ I I-z F sw&sal d •/ `,\ � ;� ��, ,.� 4 =6`ML-D,co-au.s� Satyr, x x S 6-7, Flag I %V N /S � � S - '7.�/Z AM�b. GoA.TZ-SE �3 u/Z-D/ArG S ETOAC,rc .2EQui,2E:ME�i7s• ' s ')c',00A1 T / S/ SEPT/C 5YSTa-M • ,3 BE DI20oMS SHA LL GONF�2M 7-lb• MASS . hES/G AJ FL O W, EN.Y/QQn✓MLn/TL�L C00E T/TC.L ]z 3Q0 GAL , Aivo 7-oLuN OF ..'t3.4> �/s ".4 L'C A C A/ 2 A TE //t/GA/ TOP OF AIEALT.y T2�C C-/LA T/ONS o/ f�20.00SEa ' LEACAl q.2EA 270 • Fo uNOAT/ON , Zo.o MAA/14OLE CoV6,2. TO X TE/JD Tp /M•�E..�V/ous Covcze Tom//Al / OF Tiny/5/�E1� ✓4/l/T •c2oti! Z T2AT/�t/6 r D/57. pC45*i2o ,� I BOX �•Z/"W/PC ti!U/tI 3'na.AV JF Z Q 112 - .a/7�1v —F�aw. E e /. /G�r 4 oia. /O LCQ,: A/ ^/ /O"M/N MAN ��TCtL:. T /4" �4 �foo� 2+ Mini /�ircfi ..✓_ P/T �/,¢�_��2 DiA. M/N *"/Fool ^ WA5f/EO 17.0 /O Q O _ _. /N(/ T . STO n/E /NVL�2T GaLLOra /N'V.E�T V $ ALL ca P.4 c/ T y - SE TA A/& , � ELEV. A 00^/O / S .O 8c7TTOtif O� .5 t WATGTzT/GHT.) /NVE,2T T No GA 28AGE G,eIND�,� Z" x 6 S/ TE hL A A/ r LOC<i T/0/V T ,vK ry gd' A, •N,.�✓.� Z34TZNS%y 3 E w.3Z .SEDT/C TA .�� l�/ST;2iBUT/Q�/ .80X �S OC�T,�ETS;) AND LaAG.y/.t/G f�/T /GO,� - ', TO BE .07� .�EiNFO.C�'GED CO.�.lG12ET� CO.yC2ETE Sr,2E.vGr2'/ . 3000 psi M/iv. 20000 H-/O LOADlAjr, w /4 To;e,.Y•LA /� ��� ����� �¢ �,e/VEWAY No.T To BE LocaTED MLa SS• !. RAY ,�t? - O✓Ee 5yST�M UniLE_55 f-/- 20 nE S/GAY L 04 LD/A/G /S USED:�. • 4. --..�'��-',; %��'• �H� Wit' ;�4..�/.z� G��.r� �,,,� �" ` "'_ '=y y ' '�� a w"" ,y. .. a .�,•. , - . - .. .. ". i _ c 4, � �. ,t-