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HomeMy WebLinkAbout0244 GREENWOOD AVENUE - Health 244 Greenwood Ave Hyannis' A =288 — 177 r 1 0 �pp p 4 O I�S o TOWN OF BARNSTABLE LOCATION Z Y H Cj-v e n way Bp 1��rP SEWAGE # VILLAGE ASSESSOR'S MAP & LOTX�'% 1 1 7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 S No. Fee ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppl cation for MispoBAY ,pstpm ConstCUition j3prmit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(X ❑Complete System ❑Individual Components Location Address or Lot No.a q q (yQ e Avg, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel g Po 4 VAL)LA SP AX Installer's Name,Address,and Tel.No. ; (O 8—(�`T7—8q 7fl Designer's Name,Address,and Tel.No. GAPG�IDL C�c�.��lst`• t.C� W 1A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 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) A' AL)DW all s"T,A)& Sat`c Sq S75cl 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 issuedby4his Board of He h gne Date iv Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. Fee THE COMMONWEALTH-OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for Disposal 6pstrnt (Construction Vermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(X ❑Complete System ❑Individual Components Location Address or Lot No.a qy G,q e-v(R. oh Avr Owner's Name;Address,and Tel.No. ZIANG Me-140G:1 I Assessor'sMap/Parcel 14y P•0, oo (4"8 `Ak)1U151>04—"r Installer's Name,Address,and Tel.No. 50 8 q77-8$7f7 Designer's Name,Address,and Tel.No. dA P&W m5 r4-c Pis .�,s N W 1A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil j Nature of Repairs or Alterations(Answer when applicable) At3AQ0a-&J all S"f 10& 5GPD C SV Sit 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 Board of Heait �r gne 1 h Date Application Approved by // i 0 Date Application Disapproved by 4 Date 'K for the following reasons z Permit No. Date Issued ------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) . Abandoned(X)by CA PGw rb iF &- } at a(26� k_)O m A 44 YA0 ,5 has been cons cted i acc r c ' with the provisions of Title 5 and the for Disposal System Construction Permit No e Installer Q 4,4 C— Q)())G c N'7&X PQ1S6T (,LC Designer lV #bedrooms Approved desi fl&,w n gpd The issuance of th' pdrmi;shall not be construed as a guarantee that the system wi'1 fun tion as-desi Date I ( � Inspector (� °v - -- - -- - -� - -- ---- --------=---- -- No. Fee � �� D THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *Pstem Construction J)trmit Permission is hereby granted to Construct( ) Repair( ) Upgrade�( t t)/n. Abandon A) System located at��Q��)C2 67) V 6 tR Ykmc)t 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:Const cti n us b pieted within three years of the date of this permit. Date Approved by *;O ,Da` - %' ', , � AsBuilt Page 1 of 1 ©�15G( TOWN OF BARNSTABLE LOCATION 2-yy CY'CGrlwoedP IyP SEWAGE# VILLAGE ivd-AA L 5 ASSESSOR'S MAP dt LOTIVT 117 INSTALLER'S NAME&PHONE NO. 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