595 Septic application and permit it .
COMMON1 LALTIT Of MASS;ACHUSETIS
Board of Health thri et %')12/'41.1.
CITITICICth OT I OMPrIANCI ."
Description of\4bIIC U Individual Component(s) J Complete System
The undersigned hcrehy CC!rih That the Sewage Disposal S stem, Constrr cued ( }.Repait eci ( tl':Cpgra led ( ).dhan I
in I/1(414a ��r ,�. _,,er� 1 5-;/
FFF
at
has been installed in accordance with the p o- V so f 310 CAM 15.00 (Title i) and the app:
applicant N ll al- y dated el Approved Approved Degn Flow
Installer . i ..
�r •
upd)
sign pl.
>huilt I I- elating
Designer:
The issuance of this permit
No V
Inspect> I ..
a
all not be construed as a guarantee that the system will function as designed.'
COMMON11 UALTII Of MASSACTRISEITSII-
Board a Health r
Board f .1 i.i/i�/
DISPOSAL SYSTEM CONSTRUCTION P-KR yI f
i
Permission is hereby granted to; Construct( ) RepairQ) Upgrade( ) Abandon( )an individual sewage disposal vstein
at
as described in the application for
Disposal System Construction Permit No. V 1 - - ; dated
Provided: Construction shall be completed within three years of the date of this permit. Al!local conditions must be rut
Rem 1255 Rev 516 AMn.satin CO Beebe MA Date 1/ ?!- Board of Health ( /�-. ! /v /
COMMONWEALTH (H 'MASSACHUSETTS
Board of Health. italRi I rO%% , AIA.
TION FOR DISPOSAL SYSTEM CONSTTUCII()N PFRFI]T
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sg e :Name h {"v ish,S..i M cats
Address
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Telephone#
La- A?) S2 R 3 ici i
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TsT -f Building J +- 'n^a.la/ In Size s4 °-
ei g r AA. (
Dwelling-No.of Bedrooms : Garbage gander
Other- of Building No.of persons /U Showers r)e6 'r( 1
Type o
Other Fixtures
Design Flow(min-required) ..,5 0 gpd Calculated design now S ti s% Design flow prodded gpd
Plan: Date / I- !J- o
Title ;I:"rr°'ref> faC hA2Fri,FA-)
Description of Soil(s) 4p.e Ole>—
Soil Es alumni Form No.
N u d
mber of sheets d`- Res Dare /I-/<''
a A (c c*i+J( RQ C ' C AA; 1
Name of Soil Ex ablator Dare of Evaluat
DESCRIPTION OF REPAIRS OR ALTERATIONS
in one i r,.c.A c. 112e).(.b> �,1J
CzllaANNA L)* p wl
Cii<lo.A.Eltf l/SC
CPSZ .iO A, : '1
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health.
SVIedDate
Inspection
No.
;L.ONJ1OINWEAL1
Roof Health.
CLI2TTF Tj-{4 COI\IPLIANCL
Description of Work: :IIndividual Component(s) RCom'leteSfstem
'the undersigned hereby eels&that the Sewage Dispo-. System: Coltsy, r ted ( I.Rep: d ( 7.I'pgtad d ( At 'atoned ( )
bv:
f3 • LASS
at � �
has been installed in am rdance with thtryfe it of 310 CMIR 1300 (Tide 51 and .4W approccd design plans/as-built plans relating to
application No date
Ii smiler
Designer.
The issuance of this permit shall n&bk construed as a guarantee that the system will function as designed.
K
dpproced Design Plow (gpol
Inspector: Date:
110t1>1fNWLA W OF I \SS.ICIII'SLTIS
daonI of Hettm, Att
DISPOSAL STS I D1. OSIIdL'C IIOJ' P� k III
Permission is hereby gran ted t o; Co 9struc5(�Repair( ) grade( ) Abandon( y) an ind duals gedt�p�,el system
at -het as described ikthe a�cauon for
j ,"
Disposal System ctmstrttiction Permit No. _dated (�
Provided: Construction shall be completed within three wars of the clam of this permit All local con diti q u t be met.
HE
Form 1255 Rev 5.96 A.V.stun CD eostor.MA Date Board of I Iealth
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MAGINNIS
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Bond of I ralth.%10Z }t-)IA I
ITS
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TFON LOI? DISPOSAL SYSTLt_ • LILTIOfN ; 1T - --
vucl( 1 Pupal'( U1 '-rdr dbandon( ) - 7 Compete System.
Lmponents "'!` ,•
Type of Building_ SING LE re‘,---, L.
Dwelling-No.or Brdroom. C
Other r-Type of Building No.of persons I,0 • Showers ( Cafeletja ( )
Other Fixtures L
Design Flog (min. required) C 5 G gpd cal, dated design flow S 5 C Dcsign Pine provided !.G a-d
Plan: Dale I - 10-G3 !N nthtofsievs - 3 kewsion Date 4 -.;� Q4
Title l-/d4 f LIIvIC . LC AC fr ID Cr GtD — SCS `< '.Ci rh: o--G111-9 -Al'htJ' ` .= :v , N •
D sd iption of SAN ON •r,L t w aC/3e 0 Or F c- h"7 rt . _.•, '
Soil Eial t Form No. Name.f Soil EuluamON/ (bE D u maw?.Oki rl F
v
(� k' II `
DESCRIPTION OF REP.AIRSOR:UTERal IONS el C_.Nh C:da �Xts t -G I(1tNi YltS��C9� C X�jW xl 5n)
is• ,._I> RIP ) (,e, •ii1 (FLt.=Arc i2 Lt %I (. (3(.- 0 (4“.a 'C X 3( (.,,)v
e
Lot Size
• Garbage gdhiigr{/f
r
The undersigned agrees to install the above described Individual Sewage Digposal System in aodida;r4a the provisions of TITLE 5 and
further agrees to not to place the system in operation until a Certificate off Compliance has been iined by the Board of Health.
Signed 1 w -1.., : ,.. ..,c,.�...a _ -Date 2 b C j
e
Inspet nious
i
local 5 ja„
()DOD- �oAO
o Nair�e P IT DC- W2�
Map,Pan e]#
-1 Id ' "C GLES M EAC.W 20
I ern ei I
9
( r
il plw,e% 413) 5 7 93 i
I,Installers Nance Kr12 S
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O(C,-�A/4-1) I "b
c Name ) rl,y�;n/ VIA je,,, NYS' Q5
Addres iR iV(_tZ 1)Fllt ' 1"AFID�'i vo)i\
Vdd `)c-AAJCAGF-t -F��LSlflfllls(51p).,
Telephone# ( 1--2' rq — 539_11_'
Telephoned (4I� ' S2 ) - Si ' 1
Type of Building_ SING LE re‘,---, L.
Dwelling-No.or Brdroom. C
Other r-Type of Building No.of persons I,0 • Showers ( Cafeletja ( )
Other Fixtures L
Design Flog (min. required) C 5 G gpd cal, dated design flow S 5 C Dcsign Pine provided !.G a-d
Plan: Dale I - 10-G3 !N nthtofsievs - 3 kewsion Date 4 -.;� Q4
Title l-/d4 f LIIvIC . LC AC fr ID Cr GtD — SCS `< '.Ci rh: o--G111-9 -Al'htJ' ` .= :v , N •
D sd iption of SAN ON •r,L t w aC/3e 0 Or F c- h"7 rt . _.•, '
Soil Eial t Form No. Name.f Soil EuluamON/ (bE D u maw?.Oki rl F
v
(� k' II `
DESCRIPTION OF REP.AIRSOR:UTERal IONS el C_.Nh C:da �Xts t -G I(1tNi YltS��C9� C X�jW xl 5n)
is• ,._I> RIP ) (,e, •ii1 (FLt.=Arc i2 Lt %I (. (3(.- 0 (4“.a 'C X 3( (.,,)v
e
Lot Size
• Garbage gdhiigr{/f
r
The undersigned agrees to install the above described Individual Sewage Digposal System in aodida;r4a the provisions of TITLE 5 and
further agrees to not to place the system in operation until a Certificate off Compliance has been iined by the Board of Health.
Signed 1 w -1.., : ,.. ..,c,.�...a _ -Date 2 b C j
e
Inspet nious