HomeMy WebLinkAbout0165 BAY SHORE ROAD - Health `f
w 165 BAY SHORE ROAD
-HYANNIS'
A,=325 1'63
q.-
a
No. ®3 C� Fee
�
BOARD OF HEALTH f
TOWN OF BARNSTABLE
ZIppYicatiou jor Very Cou5truction 3permit
Application is hereby made for a permit to Construct Alter( ), or Repair( an individual well at: ;
Location-Address Assessors Map and Parcel
Owner Address
Installer-Driller Address
, I
Type of Building /
Dwelling V
1 - .
Other-Type of Building No. of Persons
Type of Well �O �yC. Capacity
gP
i
Purpose of Well
I
Agreement:
The undersigned agrees to install the afore described individual well in accordance with the provisions of the
I
Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the
well in operation until a Certi cate o Compliance has been issued by the Board of Health.
Signed
Date
Application Approved By
Date._ I
i
Application Disapproved for the following reasons:
I
Date i
Permit No.(�2��6 — (� Issued Z.5loo z
d
Date ,
BOARD OF HEALTH
TOWN OF BARNSTABLE
(Certificate of Compliance
I
THIS IS TO CERTIFY,that the individual well Constricted` �), Altered( ), or Repaired( )
by X�)L sy,� W d\ �d'AA i kis t 1 l L ,
Installer'
at b� S�� NAupr nis
has been installed it ccordance with the provi ons of the Town of Barnstable Board of Health Private Well Prote tion
Regulation as described in the application for Well Construction Permit No. Dated 2S
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORILY.
Date Inspector
�,f .. r''1 -,r•w�y t i,`. y 1s..+y�, _ y ... Vim_;' _ x._ }+.• F ,y,�,'„'.-. it v� k .y� .•. �l.r• + ...v f''„ '`!'''' .'�• v2
s•
No. Z _��jC� Fee I
BOARD OF`HEALTH
TOWN OF BARNSTABLE
01ppYication jor Yell Con.5truction Vermit
Application.is hereby made for a permit to Construct A, Alter( ), or Repair( ) an individual well at:
. f(b5 $"
Location-Address J Assessors Map and Parcel
Lac cw ' h��\ Rio B1a��cbeccH�:��a�Pa y Qcac ,M�otaZb
Owner Address {
S S1r na►���` (�ct���Y.st►` 0•�OX Z`7 r�3. (�,cUN IlMA u-6s3
Installer-Driller J Address
Type of Building k
Dwelling
- �--yam.`_`--"---•�� ,
Other-Type of Building No. of Persons,—
Type of Well ° ' Capacity q -.
Purpose of Well
Agreement:
The undersigned agrees to install the afore described individual well in accordance with the provisions of the
ti Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the
well in operation until'a Certificate of Compliance has been issued by the Board of Health.
r.
Signed
Date
Applicatio/&App ved By —( h 5/-�T 0 216
Date
kk �
L'•' Application Disapproved for the following reasons:
�� lld` �j Date
Permit No.vv�� — Y Issued / 2 5
Date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of Compliance
THIS ISSTTO,,CERTIFY,that"the individual well Constructed Za), Altered( ), or Repaired( )
by a S), tsd Vvt\ 1���1�RYA 1�Y1C s� 2
qq ,,pp J Installer ,
at1
has been installed in accordance with the prove is ons of the Town of Barnstable Board of Health Private•`Well Protection
Regulation as described in the application for Well Construction Permit No.[02020 U-3n Dated 2,5 &Q Z4
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL:
SYSTEM WILL FUNCTION SATISFACTORILY.
Date Inspector
BOARD OF HEALTH
TOWN OF BARNSTABLE . __ •��
39ell Congtrucoon Permit S
NoY) 2-()Z() Fee oZo —03d
Permission is hereby granted to Q�SI'Y►Or►d VV Q\� �t�l�l t1,R I'Y�(..
Installer
to (Construct K),'+\_Alter( ), or Repair( ) an individual well at:
.� Street l
as shown on the application for a Well Construction Permit No. LAJ2-o o - 0-19 Dated
Date
Approved By�
1 ��
Y ��F
O,r
464)
0
8 1 U..S CATCH
BASIN
ti MFiyT RIM=9.1:
11.0 t U.7 Cg/DH O,p
FOUND
Op
yq1 pOSr
LAWN y"q�q�OO qND pq�MFNP
70\ 9.8 �OF�
�ry
10.7
REMOIiE STEPS, r� o�v
PA VERS AND
REGRADE 13.1 12. / CATC
R �j3 BASII
10.429 9 RIM=9.
LOT 75 ,`�., � - ,3.9
13.6 p ��
91972f S.F.
4.3 LAWN t REMOVE PA IiEME/1
AND REGRADE
LOAM AND SEED
I P
LAWN _ � Pp�p►� w .. ,0.3
pPpS
% Pao
GF, N PRO
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26.5'
15.4
�F• 1 11.3 32.8' LAWN
R.R. TIE
.LAWN
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21'(20 JVIN.f 13.9