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HomeMy WebLinkAbout0090 HYANNIS AVENUE - Health 90 Hyannis Avenue Hyannis - - - - A = 287 141 r - t �I I I j I i C f 0 �I e TOWN OF BARNSTABLE LOCATION J4 Z A4 e,fI; C' (/r- SEWAGE # 2Q?3GG�Z� VILLAGE ASSESSOR'S MAP & LOT 2-9INSTALLER'S NAME&PHONE NO. 6 11 - y >tZ -C. SEPTIC TANK CAPACITY /oO0 nn L LEACHING FACMrI'Y: (type) Q, OZt bCW-& (size) fhno NO.OF BEDROOMS 3 BUILDER OR OWNER l ►'� 1 PERMITDATE: Co 3 COMPLIANCE DATE: 03 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 we lands exist within 300 feet of leaching fac.;Ety) Feet Furnished by a � L. b C_`R � \S No. LVo ✓e�� Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Miopoal *p5tem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �� /Owner's Name,Address andTel./No. Assessor's Map/Parcel _ f l �►r 5 LG ///��` 1� �/1 7© T/� ��r� °? f q H Yq 1. 1 �,�t ve Installer's Name,Address, Tel. o. Designer's Name,Address and Tel.No. ;qj, e � 0q/ ,,ap 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. face //-.-- Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 the Envijorgrital Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b bard0killih. Signed` Date Application Approved by -� Date Application Disapproved for the following reasons Permit No. Zoo 3—25- Date Issued 4 G 3 No. &0 ✓' 2 Fee / F. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for 10i9;poga1 *pgtem Construction Permit Application for a Permit to Constrict( . )Repair( )Upgrade( )Abandon( ) + ❑Complete System ❑Individual Components Location Address or Lot No. QD 44eo�l _ Owner's Name,Address and Tel.No. Assessor's Map/Parcel // A, z25°�_ r�( I�Y� IV 3 Installer's Name,Address,and-Tel No. Designer's Name,Address and Tel.No. 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title " Size of Septic Tank Type of S.A.S. Cc C //l.P-- Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 Tille�f the Environrt ntal Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by.-th' oard al'th. Signed- Date o3 Application Approved by S Date 4 Application Disapproved forthe following reasons Permit No. Z 00 3 2 s- Date Issued 9 G 3 — ——— -----------------11---------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE MASSACHUSETTS WLACr M'� Certificate of Compliance THIS IS TO CERG I , that the On-site Sewage Disposal System Constructed( )Repaired(UpgradedAbandoned( )by /t ��Y at 6 i has been constructed 'n a9tordance with the provisi ns of Title 5 and the for Disposal System Construction Permit No. Zto 3-2S6 dated to /03 Installer Designer The issuance of this Jermit shall not be construed as a guarantee that the syste act'n as .'L-41gned/�� Date 9 �n 3 Inspector f --——————————————————— ——————————————— No. Fee ' /°. THE COMMONWEALTH OF MASSACHUSETTS MA f N L t o r PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS li5po5ar tem Congtruction hermit Permission is hereby granted to Construct( Repair(k: grade( Abandon( ) System located at cg de, 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. Provided: Cons tr ctio t must be completed within three years of the date of this pe Date:_ G 3 Approved by AsBuilt Page 1 of 1 'IUWN Ur BAK YIABL& LOCATION y4 A�4 d t4,zle P d i4l:_ SEWAGE#1 2zo 3-2-AX VILLAGE l�/ 4,fzldz{S' g9nr Z I ASSESSOR'S MAP//&LOT 2'21-igt INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY h o o /o nn l LEACHING FACILITY:(type) �'. ���,' � (size) —rv�• NO,OF BEDROOMS 3 BUILDER OR OWNER LdAn, PERMITDATE: 6 COMPLIANCE DATE: �3 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feat 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 i C,L ect Y? A ALL � o s o - http://issgl2/intranet/propdata/prebuilt.aspx?mappar=287141&seq=1 8/17/2011