HomeMy WebLinkAbout0082 YACHT CLUB ROAD - Health (3) C--Pa-& -Rd
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No. :2-0 Fee '
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y
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PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
2pplitation for Dispoeiar *pstrm (Construction permit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ndividual Components
Location Address or Lot No. To ��G�-t�`V Owner's Name,Address and Tel.No.
Assessor's Ma /Parcel 1 �
p o�(d 3�
Installer's Name`,Address,and Tel.No. �` �' ®S'S' Designer's Name,Address,and Te o.
Rc� Zn�\k —a .r-G v I
Type of Building: ^
N �Dwelling No.of Bedrooms Lot Size \Ac.r-�sq!ff. Garbage Grinder( )
Other Type of Building No.of Persons Showers{ ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided 10 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) „tam CO
`�.dv�. b —�5%CSC �`G.,�1 1-►b a "Y
Date last inspected:
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.
Si Date
Application Approved by Date '7
Application Disapproved by Date
for the following reasons
Permit No. n ;, !� / — �� Date Issued o Z
No. .2-0 y 3 r..-7 Fee U '
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:_ m
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes �
11pplitation for Nsposal 6pstem Construction Virtu
aC>
Application for a Permit to Construct( )•r Repair(V�Upgrade( ) Abandon( ) [:]Complete System* �ndiiduai Components
Location Address or Lot No. ��G��G{� Owner's Name,Address and Tel.No.
Assessor's Map/Parcel (� �' '� .�/l < �� ��C. •���,�v�\ L ,,.
Installer's Name,Address,and Tel.No. �' "�6''EiC�`�'S Designer's Name,Address,and Tel.,No.
Type of Building: ( ?
Dwelling No.of Bedrooms 1A- rP,3 {�of Size � g ( )'j�c.t��'s . Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures i
Design Flow(min.required) AJ ( gpd Design flow provided `1 gpd
Plan Date Number of sheets Revision Date
Title z .
Size of Septic Tank, Type of S.A.S. ,
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)- .7j.ly
�,'"ty'• C.. �-c1y C�Ga^�,5 i��...V +t,�i tWY�.�e b"'t^ D�-+�.�.�,1a'7''�nC ', t
/^Q. 1+ � �-C c►�� �.N .11 A �Il4Cfl3
r `
Date last inspected:
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. /
Sign€d'-,, �%r ^ --- - Date
Application Approved by ,S Date l+/ -7 /
Application Disapproved by `+J Date f
l
for the following reasons
Permit No. n OL Date Issued I DI-? /
THE COMMONWEALTH OF MASSACHUSETTS
I, x BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CCE�RTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( v< Upgraded
Abandoned( )by �E,,Y, P'..,n C,•;A��A - s.
..ar ��'�ti4 GG�.\ � � c�i 1i� �-�� has been constructed in accordance
with the provisions of Title 5 and tfie for Disposal System Construction Permit No. 20-11-36 7 dated
Installer Designer
#bedrooms Approved design flow''\ gpd
1 T 1 '
The issuance of this permit shall not be construed as a guarantee that the system will f inc)ti``ori as designed.
Date I{ 1 1 Inspector J ,/lJ �i!v �_. P
it v t � _
No. U a 1 R_ (a 1 Fee
s l/ THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
ra J,' u� r
MIstJOsal 6p8tem Construction Permit
Permission is hereby granted to Construct( ) Repair(V ( Upgrade( ) Abandon( )
System located at tom (�\Oi r �-�ti Jy\ J'°Q)
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 conditions.`,..
Provided:Construction must be completed within three years of the date of this permit.
Date f 1 7�? { Approved by rj4-,
! t 4 .