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Board of Health, Yarmouth, MA Fee
CERTIFICATE OF COMPLIANCE $55.00
Description of Work: Install in septic line for new bathroom. Tie into existing septic tank.
The undersigned hereby certify that the Sewage Disposal System; Expansion
by: CAPE COD SEPTIC SERVICES
at: 189 SILVER LEAF LN, WEST YARMOUTH, MA 02673
Has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved
design plans or as-built plans relating to application No.: BOHDC-22-0102, dated 7-19-22.
Installer: CAPE COD SEPTIC SERVICES
Address:350 ROUTE 28 WEST YARMOUTH, MA Inspector: James G. Gardiner
02673
Designer: NA
/d- / t-a2_
Ia ruce�,. Mur .S., CHO/James G. Gardiner
Health Director/Assistant Health Director
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.