173 Title 5 Permits, 1991 No 0.2 �
THE COMMONWEAL ASSACHIJSETTS ifet9 liV
BOARD OF HE TH
OF
/1" Fes
Muwnnut or ku T ntrurtian trrmit
Permission is hereby granted )lt��
to Construct (X) or Repair ) an�[�ri' irIJal�ewag isp SysteJn1/ e,
at No �rC ?f .._..j'=r�c
as shown on the application for/Disposal %V rks Construction Permit 71 /i i?. Dated N. .. Z �%
/G ^ ✓ ��-�vvNe3Bl of Health
DATE lll_}.G Y/
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
\ "FVEVS0 I .
NT lls _._..
---- - "2- o[ The State Sanitary Code as t} rtb}dd in he
at. - __._ // i/
has been installed in accordance wni the provisions No -� S q p dated -
applioetion for Disposal Works Construction Permit o
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT RE COHSTR D AS A 6UA ANTE/S THAT THE
`
SYSTEM WILL NCTION SATISFACTORY. J,� �/y---'
y(�,IMx_c}.0 /”.7_.._ Inspector_....__
DATE.................. /%.J fill! ✓ -
THE COMMONWEALTH OF MASSACHUSETTS CC) %Ili
BOARD OF HEALT
(grrtifiratr of Cnumptian__
e Individual Sewage Disposal System constructed OO or Repaired ( )