HomeMy WebLinkAbout0130 CENTER STREET - Health r 30,Center Streets Js Sewer Acct# 1598
Hyannis
A 327 —037
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TOWN OF BARNSTABLE
I;:iCA11ON LL,,L d) �T17e SEWAGE#
VILLAGE A�)L7;6 ASSESSOR'S MAP& LOT Z9 � 41$7
WSTALLER'S NAME&PHONE NO. e¢4/.hl (2nallx . 199-(01-3,l
SWW TAB CAPACITY //1 t) p
LEACHING FACELrrY: (type))n /Illy GUP�7 L'- (size) _
NO.OF BEDROOMS IE W
BUILDER OR OWNER
PERMrrDATE: f O�c�i� C� COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by 4?t �t1 ✓ � =�
Sr-
No S / s Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF RARNSTABLEs MASS CHUSETTS
01pprication for Miq& l 6pgtem Con!Aructiort Permit
Application for a Permit to Construct( )Repair( )Upgrade Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. /2 U jYeu�, 1_ /9� /Arl c /) Owner's Name,Address and Tel.No. &/7_�1—633Z-
J Ggtk /PC0 j sT
Assessor's Ma /Parcel f; a�j�o /�(j)y►,( )etp�rj 5
JJ 11CVJ � � Q43 79
Installer's Name,Address, d Tel.No. Designer's Name,Address and Tel.No.
��A1LI�s e1»nil/ 64g1e,.r Vey/ n � �'7(Tr nee�'o�t.
Sully vu-�• Ad�ld 0h Rk_ (.14 - r auX� �uf Q-
Type of Buil ing: 7173,Qc,,1 3 Pa r
Dwelling No.of Bedrooms Lot Size 9200 sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons 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 6 O00 Type of S.A.S.
Description of Soil e.l
Nature of Repairs or terations(Answer when applicable) f ;tf s, Oennecfl n
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 issued by this Board of Health.
Signed C= - / Date f6
Application Approved by Date
Application Disapproved for the following reasons
Permit No. 91 Date Issued �' '�
r
:No \ Hr Fee On
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
/PUBLIC HEALH`DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
T %
ZIPP
rtcation for/
i!6pogal *,pgtem ,(Eongtruction, erMit '
Application for a Permit to Construct( )Repair( )Upgrade OC)Abandon( )r. O'.Complete System ❑Individual Components
Location Address or Lot No. 2 S, 0,1ner's Name,Address and Tel.No. (� ��_
✓U C'P►r "ir>r►!� � r -M( l
ssessor's.Ma /Parcel
Installer's Name,Address, d Tel.No. Designer's/Name,Address and Tel.No. ��� �� L
/l_s Gt)OZ', Lr4q ,:5_, Qc i�) r7 �1�PP✓lei
)Y1 Suf11 vu c, AQ/ ' �j
Type of Building: %J�� / 3 d a p
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons 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 O l U00 (i Type of S.A.S.
v
Description of Soil W P✓ k)
Nature of Repairs or Alterations(Answer when applicable) / r M. 4S� �lt�/�('C f/n
r Ch 1/vt 2 17
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 issued by this Board of Health.
Signed � `®r [ .e ..r' Date f6
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
———————————————
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliattce /
THIS IS TO CERTIFY, that the On-s' a Sewage Disposal System Constructed ( Y)Repaired ( ) Upgraded( )
Abandoned( )by C
at has been c nstructed in accordance
with the provisions of Title 5 and the for Disposal Syst m Construction Permit No. - 45—Vj,16dated /0 -- 9
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the Sys ill function as d n
Date�� r ,7 Inspector
------------- ----- -------e. ----------NO. 15>r tf::> Fee _
a
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
3Digpo0a1 *pgtem Congtruction Permit
Permission is hereby granted to Construct(�--- pair( )Upgrade( )Abandon( ' ) A Grf a, e � �
-S,s*m located at .^k S
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.
Provided:ConitrRcty'on must be completed within three years of the date of t ermit.
Date: Approved byC