HomeMy WebLinkAbout0014 GREGOIRE CIRCLE - Health 14 GREGOIRE ROAD
Hyannis
A = 273 - 011
I
No. 7
Fee 5
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: CZ I
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for M18poSal 6pstent Construction 30Prinit
Application for a Permit to Construct( ) Repair t,4 Upgrade( ) Abandon( ) ❑Complete System ❑Individual Co ponents
Location Address or Lot No. G/ I Owner's Name,Address,and Tel.No. JC-- o � I
Assessor ss MaplParc � OZ�� ,YY 27 O 1 �t /�� s4p%, {�dIrk k
Installer's Name,Address,and Tel.No. SDrc �/��� Desi er's Name,Address,and el.No
D'Iec�a�0 � �r n 5 �'t,�i�r �.�.-fL
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 Ce 55 6 I Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) &/n L 7-C
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 Dealt
Si Date e—2 ��
Application Approved by Date
Application Disapproved by Date
for the following reasons
ley
Permit No. o — i Date Issued
. `
No. 2- 6 � Fee+.
THE COMMONWEALTH-OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftPlication for Voposal 6pstem (Construction Permit
` Application for a Permit to Construct( ) Repair(dC) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
JAV
Location Address or Lot No. G/e 6 i e !' Owner's Name,Address,and Tel.No t)e > O
Assessor's Map arcel h
Installer's Name,Address,and Tel.No..S0 F Z 6 9-07Fj 9 Desi er's Name,Address,and TA.No.
$JOAS
D^o �6et.)-c/ a.IJ . ,64-
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 / ,p
Size of Septic Tank ( �✓�sja j Type of S.A.S. �-es,S O O
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) tk/i'! �i�t" �/' �C��9G•v'�
i
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 ealth. -,,.�''�
Sian � Date G—,e
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. �Zo Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
p" THIS IS TO CE TIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded(' )
Abandoned )by L o a o Se w-e/
at (coQi/L has been constructed in accordance
1.with the provisions of Title 5 and the for Disposal System Construction Permit No.o%16- �b'7 dated
Installer iLt Oyu,& 5LJ -e-1 4.a11 A112G�'✓� Designer
#bedrooms Approved design flow n /v bOr and
The issuance o this permit shall not be construed as a guarantee that the system will far tion asydesigned.
Date ) ' Inspector !/
'r `!
:. ----------------- _ _
��U�b -------------------- ----�-----------
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6pstem Construction Vermit
Permission is hereby granted to Construct( ) Repair( ue Upgrade( ) Abandon( )
System located at
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 c mpleted within three years of the date of this permitZ:4 '�.
�'
Approved by PP f
Date 7- A Y_5
i
-9
TOWN OF BARNSTABLE �
LOCATION SEWAGE #
VILLAGE . , ASSESSOR'S MAP 6z LOT
INSTALLER'S NAME & PHONE NO.r_ ,'/= P� a o e ec>
i
SEPTIC TANK CAPACITY B -
LEACHING FACILITY:(type) a . / (size) 10FO
NO. OF BEDROOMS-PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
v
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED;
VARIANCE GRANTED: Yes No
3
��`t
�� .�` .
''�.
� I
ti. � !
"�_ �
� s
U� �°
��
I
� .�
_ �
AsBuilt R Page 1 of 1
TOWN OF BARNSTABLE
LOCATION = - f'.1� .7 SEWAGE &
VILLAGE .' �ANJV ►S
- - ASSESSOR'S MAP & LOT
INSTALLER'S NAME G PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) 1 ,� (size) Oem
NO.OF BEDROOMS— PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
r
http://issgl2/intranet/propdata/prebuilt.aspx?mappar=273011&seq=1 6/27/2016