HomeMy WebLinkAboutHealth Permit # 10/21/2003 Commonw6olth Of Massachusetts Map-Block-Lot
Board Of Health 10----aazs-
Pernrit No
P.I.
North �`+ndov�r BHP-2003-0331
F.I. ITg
$250.00
Disposal Works Construction
Permission is hereby granted Peter Breen
to(Construct)an Individual Sewage Disposal System.
at No J-07 CRAY STREET
----- ------
ass own on the application for Disposal Works Construction Permit No BBP-2003-033 - --
- -- __-_ -__ Dated C)ctober2 003
Issued Can: Oct-21-2003 --------------------------------
- _ Board Of Health
.............."°....................................................................................
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: /G CURRENT INSTALLER'S LIC ENS E#
LOCATION:
LICENSED INSTALLER: G
SIGNATURE: � ... � TELEPHONE# K 6
CHECK ONE:
REPAIR: NEW CONSTRUCTION: '
IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
J
,$ 00 Fee Attached? Yes_ No
Foundation As-built? Yes No
Floor plans on file? Yes No
Approval __ Date: _