HomeMy WebLinkAbout0624 IYANNOUGH ROAD/RTE 28 - Health 624 Iyannough Road ❑
Hyannis
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. .No. . ZO d 8 ZN 3 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
pplicotiou for Tigponl �§pgtem Con. tructiou permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(r/0 Complete System ❑Individual Components
Location Address or Lo No. tt -- 11 Owner's Name,Address,,and Tel.No.
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Asl�.1'1Map/Par(el 1A,/- C_r../',, N•
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
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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
i
Nature of Repairs or Alterations(Answer when applicable) T� 6.,:6 ( Cr-=" �e 4ru,
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 Bo rd of Health.
Signed Date
Application Approved by Date �9 OE
Application Disapproved by: Date 1
for the following reasons
Permit No. Zo oa-, 2 y3 Date Issued • 9 moo&`
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No. .7 A b E, 2 LI Fee /\
THEj"C:OMMONWEALTH OF MASSACHUSETTS Entered in computer.-
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for �N,5pogar 4p.5tem Cougtruction 'Permit
Application for a Permit to Construct( ) ' Repair( ) Upgrade( ) Abandon(/�❑.Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address,and Tel.No.
�,a�`1>!G. �nd�hl� � to �
Assetl Map/Parcel AyC,7,f "-" ��^•
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
�5<c
Type of Buildin''g: , T
Dwelling 'No.of Bedrooms Lot Size sq. ft. Garbage Grinder
Other Type of Building No.of Persons Showers( •) Cafeteria( )
Othei Fixtures R
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) [_/D-0(� ( ( (��c--Ci(4 �(
Date last inspected:- f .
r�
°} Agreement:
The a g undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
g t
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation unt<i"I l a C'ertificate-of
Compliance has been issued by this Board of Health.
Signed a.._ Date ,
r
Application Approved byy Date ��} Qr✓'
1p
Application Disapproved by:/;/ r ! Date
for the following reasons (/
Permit No. ZO 6$— 2 GI Z Date Issued 6- 9 Y ZOo�j a�
. Ts in��i`rSr" Tferfi .� 'V! s "sw w,••1Vu r.•p.0
THE COMMONWEALTH OF MASSACHUSETTS
✓BARNSTABLE, MASSACHUSETTS
i
Certificate of Compliance �
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( )
Abandoned( yn._f�-l/�_
at _ 1 ( .f -T t has been constructed in accordance
with the provisions of Titl 5 and the for Disposal System Construction Permit No. �( dated
(17
Installer •-(��..�� _ Designer
#bedrooms Approved design flow / .�a ; p kJ gpd
The issuance of this permit shall not be c/onstr ed as a guarantee that the system wifl unction as desig�yned. l` All G !
Date ..n I . r Inspector
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No. Zr7/a 1�l �� Fee 2
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
Migo al 4p!5tem Construction Permit
Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( )
System located at ��;1 L{ �, ns� q y U 2 U t'trn n(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: Construction must be completed within three years of the date of this permit.
Date � "� Zo 01�5 Approved by J
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