HomeMy WebLinkAbout0147 BRISTOL AVENUE - Health 147 Bristol Ave
-Hyannis
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TOWN OF BARNSTABLE
LOCATION /'4�•7 S -to L Al g' SEWAGE # 97-Y-7-7
VILLAGE 14gASSESSOR'S MAP 6 LOT - .Q
INSTALLER'S NAME & PHONE uj.CRAIG MEDEIROS
78 LINDEN ST.
SEPTIC TANK CAPACITY HYANNIS
dvw a 5'Zn4v�
LEACHING FACILITYAtype) r/ i 2 (size)//x�y33G�.Ya.J.�
Alr X714J2 !t c
NO. OF BEDROOMS 3 PRIVATE WELL W(PUBLIC WATER_
BUILDER OR OWNER �1 u r•Cy Y
DATE PERMIT ISSUED: 2Z! 211 `7
DATE COMPLIANCE ISSUED: V-10117
VARIANCE GRANTED: Yes r No
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No. !� '�� � Fee ��!
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
2pplication for ligpoml *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No./Lf �/s%O V Owner's N��app11��e,Addreess,an el.No. p
Assessor's Map/Parcel �J 7 (1�u13 R,� /7 L' ,
a9/ io ls oybb�
Installer'Name dd ss,aid Tel. o /�i l/Q 7 Designer's ame,Address and Tel.No.
V . �� t C'nn�lT2t�S
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons 3 Showers(✓) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil &A/�l e_yg6t
Nature of Repairs or Alterations(Answer whe ap?licable �� eA PVC %a v a Pwu�P
.tom ' - -WA k1 AA 1 /h,� R" 3 • gi p
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 Certifi-
cate of Compliance has been i ue�-by this Boaz of Health.
Signed / YWU Date
Application Approved by Date f J;g��
Application Disapproved for the following reasons
Permit No. r X . c Date Issued 9'
TOWN OF BARNSTABLE
LOCATION /y -7 Av4' SEWAGE # 97+-Y-7-7
VILLAGE /4/YASSESSOR'S MAP & LOT, - d
INSTALLER'S NAME & PHONE ub.CRAIG MEDEIROS
78 LINDEN ST.
SEPTIC TANK CAPACITY HYANN
orty 5'tnbv�
LEACHING FACILITY:(type �. (size)//�,nr33�kXy�
NO. OF BEDROOMS 3 PRIVATE WELL ORCUBLIC WATER_
BUILDER OR OWNER p
DATE PERMIT ISSUED: 2Z1-1 Q
DATE COMPLIANCE ISSUED d/q
VARIANCE GRANTED: Yes No v.
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No. Fee ( �{
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
�a a
01pprication for �Digogal *pgtem Conmruction Permit
Application for a Permit to Construct( )Repair( -,)Upgrade( )Abandon( ) O Complete System ❑Individual Components
4Location Address or Lot No.�Gf�r, /S�,i Od' V'E Owner's N e,Address an el.No. t
.1 4{,ld (t ."7
Assessor's Map/Parcel 17� / C/ .73 t.< /
4
Installer's Name Add s d Tel.�1 S /fir 7 Designer's Arne,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms ,i3 Lot Size sq. ft. Garbage Grinder( )
Other Type of Building 7. No.of Persons 3 Showers(✓) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank ' `J� Type of S.A.S.
Description of Soil 12 4Q1qVE-L
Nature of Repairs or Alterations(Answer whe app licable �vw�/p � v oL
-;C'.y r �a S n14AL/ M Nd-IM // 'wk 33 Y_ k
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 Certifi-
cate of Compliance has been 4ueoby this-Boar, of Hea th.
OF
Signed VV Or% y Date
Application Approved.by '07 Date'
Application Disapproved for the following reasons
f
Permit No. ` Date Issued
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS T;I -
E TIFY, that the On-site Sewage Disposal System Constructed( )Repaired (✓) Upgraded( )
Abando ed( )by ,G'2. �=G.'/►/I ��/,2 5
at ` -v `1 F 4 N/Vd/y#q has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated 9/L/A 7
Installer - Designer 001
The issuance of this pe t shall not be construed as a guarantee that the syste ill function as designed.
Date - ! 6 Inspector
G��J
——--————————————— ———————————
No. :7/ Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Migogal 6pgtem Congtruction Permit
"YV1,} Permission is hereby gran ed to Construct( )Repair(k1jUpgrade( )Abandon
System located at % /VyT N/yAlwl S c�L6al
`r. and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provi d:Construction must be completed within three ears of the
� p years date of th ermrt.
Dat ._`� il' ~ 7 — Approved b�& /�✓