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Home My WebLink About0121 STRAWBERRY HILL ROAD - Health (2) zl- CZ CO f-4 i L _ S No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in cornputer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 3pphtation for Misposal �bpstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System. ( Individual Components Location Address or Lot No. I �� c Ay l Owner's Name,Address,and Tel.No. Assessor's Map/Parcel�� Installer's Na a dres ,and Ted.No. S�yt <c Designs Name,Address,and Tel.No. Type of Building: t—d6 9 3 Dwelling No.of BedroomsY Lot Size �`-', ' O. sq.ft. Garbage Grinder Ak Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures t I Design Flow(min.required) '1 gpd Design flow provided !I q D gpd Plan Date G —_S— f 7 Number of sheets I Revision Date Title LGeUAjAIL01 Apia LAu&o r CA Ak Size of Septic Tank ]ROD Type of S.A.S. Description of Soil S 1!)n/ Nature of Repairs or Alterations(Answer wh n applicable) n /a e c Date last inspected: ` I 17 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental C�p4e and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea I _, -� Signed �i/L� Date Application Approved by Date / — — Application Disapproved by Date for the following reasons Permit No. �c / Date Issued �-- ------------ No. Xi / .r `. y Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in compute Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS , -�s application for ]Disposal 6pstrut Construction.3permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System [M dividual Components Location Address or Lot No: ''`( « ' �3c rl Y i' Owner's Name,Address,and Tel.No. 1 �' "� Assessor's Map/Parcel 9 7 4 1 z- � ,i li pa/T �'"'r !/1 Installer's Name_Address,and,Tel.No. /cam-i� Design 's Name, e,Address,and Tel.No. Type of Building: SU Fj-66 t - , m 0 Dwelling No.of Bedrooms Lot Size `^'� '©O sq.ft. Garbage.Grinder A Other Type of Building No.of Persons Showers( -) Cafeteria( ) 1 Other Fixtures (� Design Flow(min.required) �b gpd Design flow provided / G�O gpd Plan Date (—5— IT Number of sheets Revision Date Title UCO jA( A A &A L,-d!u el,,t CA A k Size of Septic Tank 0o' Type of S.A.S. ; Description of Soil Nature of Repairs or Alterations(Answer when applicable) `] v/,/` �/f��',14 � 1,r{ (• �/r(� y/ CA4V! `!"'r � p { J Date last inspected: ` j 17 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not.to:place the system in operation until a Certificate of Compliance has been issued by this Board of Health. .:. Signed- �. i e '-��'�..,. Date Application Approved by /` Date Application Disapproved by Date for the following reasons. Permit No. / CI Date Issued /."-✓ -- --- -- - -•----- - ----------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY„thattttheme ri s to Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by atIIIS121Z 1Q1 has been constructed in accordance I n with the provisions of Title 5 and the for Disposal System Construction Permit Nor/ -")t��dated Installer ` (- �/% -tAj DOA)1 ST Designer #bedrooms ,r Approved design flow gpd The issuance of this permi-shall'not be construed as a guarantee that the system will fuffe ioiras designed. tit. Date r '�.� ' ~' Inspectors r h.• " -- - No. CC%/ _ j "1 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Nspo8al 6pstent Construction-Vermit Permission is hereby granted to Construct( ) Repair( ) Upgrade k� Abandon( _ ,ry System located at= and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special c onditions. Provided:Construction must be completed within three years of the date of this perna< ; 1 Date . Z � . r �- � Approved by,.