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840 Certificate of Compliance BOARD OF HEALTH OFFICE OF THE MkMBERS ROSEMARIE KARPARIS,R.N.,MPH XANTHI SCRIMGEOUR,MHEd,CHES JAY FLEITMAN,M.D. STAFF Ernest J.Mathieu,R.S.,M.S.,C.H.O. Director of Public Health chard Meczywor,R.S.,Sanitary Inspector 'atdcia Abbott,R.N.,Public Health Nurse Madeline Heon,Clerk BOARD OF HEALTH CITY OF NORTHAMPTON MASSACHUSETTS 01060 Board of Health, Northampton 212 MAIN STREET NORTHAMPTON,MA 01060 MA. (413)587-1214 FAX(413)587-1221 CERTIFICATE OF COMPLIANCE Description of Work ❑ Individual Component(s) ® Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed paired Q Upgraded O, Abandoned❑ by `5 . L4. CO 4711- at I ' ,I�� O we ///IfT zi J has been installed in accordance with the provisions of 31 0 CMR 1 5.00(Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Des' ow Installer LN r / ' - .l 106 Date(er Fa / The issuance of this permit shall not be construed as a guarantee that the system will function as designed.