Loading...
52 Septic Upgrade Permit 2006 FEE • COMMONWEALLTTH� OF MASSACHUSETTS Board of Healh, ,r,�,an/AA%Pro�i, MA. LICATION/FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT min to Construct[' Repair lfpgrade(<Abandon( - )(Complete System O Individual Components Location 6`u-�o gae_oOA Owner's Name /aQ00A/ Map/Parcel/ 2 A/%TU�ki n p u-P 41,4 /EL[,EA/ Address 32 /W,D)W9 '0J� ��, A/O r///7r.2// ,(/Oen1AM`�rov Lot# pm, YS LOTOia -it Telephone# is-e6 LS/0 Installer's Name Designer's Name/0/L ../f, s s/56t(271/ Address Address 44,53 fr E0 FILIAL tsr I Telephone# M 3 f 7 074/09 /z7- •� Telephone# Type of Building e s/(),Cailri4 t /10/4£ (�tE'r1srmiC Lot Size tx,'sr sq.ft Dwelling-No.of Bedrooms 33i-0%n6'W AX l7'SPO SA6 - Garbage grinder(.46 Other-Type of Building cS/LJ LE //9/1!/GV No.of persons 4, Showers a Cafeteria g1id Other Fixtures FULL-8,447 Design Flow (min..rqrequired)//O -e 9 gpd Calculated design flow 396 Design flow provid-d /S gpd Plan: Date AOK-.i L /0 o%0/6 Number of sheets / Revision Date , ZLYJ Title YEA17C SV(TTfd? £7. S/64/ ,=6/1— F//F•U ,tE4i206u 5-2 /1- 1-01€1,C1 6. Description of Soil(s) �,/ ' f Soil Evaluator Form No. rf Name of Soil Evaluator tT /'/0,S%/f/.O Date of Evaluation /2 -/3 'C)4 • 5-P64/IS 8- 30 -07 DESCRIPTION OF REPAIRS OR ALTERATIONS C nn/JG5 re" SEOr7C Sv5-r- 1 U,d /.441.E ZD 3/O Fo/2 ,E n577416 //o 5E. .4YTAC_/7i/J The dersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to t to place the system in operation until a Certificate of Co Iiance as been issued by the Board of Health. Signed z r1 t« Date ,El i d Inspections Pere Test Witness Pa ent Record �}7 ,,�, /� � Date: 02 / O, Amount: $�J . '�"-e-cei- 4 Property Owner Property Address New Construction Repair_ •cPURVES REARDON 3286 It LLEN D. REARDON 52 AUTUMN DRIVE 51)999 @t19 N' FLORENCE,MA 01062-9720 Y[✓. /3 DLO•., afuxcHI y5Q y/ cl}-� DAIJ NNN ( YIJMIYO L+Gp'f l_� / N/ PI SAVINGS BANK N 1 RJR hZlXi ti.-YYY1/ /�"'� '°c'-_ .0 4e -'.—tom .! p� t t: 2 Y LB7093���`St: 5 20 5 /0 3869' 3 286 h •