HomeMy WebLinkAbout0049 KELLEY ROAD - Health � Q K
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No. ` Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Rp
ry
plication for Misposal *pstem Construction Permit
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Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System 1XIndividual Components
Location Address or Lot No.49 Kfuc-%l ED Owner's Name,Address,and Tel.No. J off O &U aY
.41 1CtctXY e,.
Assessor's Map/Parcel Z9 2. O b I E{
Installer's Name,Address,and Tel.No. detT a- out Designer's Name,Address,and Tel.No.
3c.3 w me-S Perri SbS=4-11- 88-n
Type of Building:
Dwelling No.of Bedrooms QIA— 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 iate
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) L.j Aj L e—a A j Gc- hjemu (s -m> K,
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 theZipvironmental Code an&.not to place the system in operation until a Certificate of
Compliance has been issued by this Board/Ho.
Signed Date / OJO
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. �� � �� Date Issued 7� �l
A
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' No. 1 Fee ` {
t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye /
PUBLIC HEALTH DIVISION -.TOWN OF BARNSTABLE, MASSACHUSETTS
lication for Misposal *pstem Construction Permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) Complete System 1XIndividual Components M
Location Address or Lot No.,49 KFC.t•C k/ F- y A^a Owner's Name,Address,and Tel.No. S o l•I&I 6-(AA`(
�q Kt ccFy Or).
Assessor's Map/Parcel Z9 110 61 N .4 115 QU-01 -
Installer's Name,Address,and Tel.No. go6EeT -a - 0kA2 Designer's Name,Address,and Tel.No.
3G3 W 4 r'rFS PA-z'N 509.4-11- 88'7-► k
yA,R_moL-ACz R.,Ma o 1 L L
Type of Building: A 1
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other TXpe of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision l4aie
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
}
Nature of Repairs or Alterations(Answer when applicable) L C 14 A•n1 G-+L. h-Aae -m Ti4"K.
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 thenvironmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board H
I. ��.. . Signed s' Date �/y !7O �e N
Application Approved by M ftirk Date
Application Disapproved by Date
-^foFthe following reasons t
Permit No. ( �% oc� `� Date Issued •�
----•- -----=-------}---_-----=-----=---=------, ------=�-v---•-��---_- mow.,_---___�.._._..-__------•- ----------.__..----•---------- • ---�-•------, __
a �) ' THE COMMONWEALTH OF MASSACHUSETTS
1 C�rn BARNSTABLE,MASSACHUSETTS
0 C Certificate of Compliance
HIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( )
Abandoned( )by RvP�¢�'C (�, 60 CL CCU
at 4kEa y RD MAVOI C has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit NoA do . (—IMIated
' Installer k4ega D, ovrz Designer N1/4
#bedrooms N/A, Approved design flout, N�14 god
The issuance of this a its III not be construed as a guarantee that the system will n ti Ilon as desi . ed. , QQ
Date Z I Inspector IL_
v
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---__--•----_.__._.__._ Fee` / 121•"''
j THE COMMONWEALTH OF ZSSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Misposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair(�() Upgrade( ) Abandon( )
System located at JCGC�.Q/ R(��(7 t+YA-AjA j m "
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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 completed within three years of the date of this permit.
Date Approved by ,/
TOWN F BARNSTABLE.
�sL OCATION U SEWAGE#
S✓ILLAGE (ti VL- ASSESSOR' M P&PARCEL Z � �
,..
f INSTALLERS NAME&PHONE NO:"�'_ �
SEPTIC TANK CAPACITY �ITa
LEACHING FACILITY:(type) (size) �� /01 "C
NO.OF BEDR MS
OWNER
PERMIT DATE:. -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
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TOWN OF BARNSTABLE
LOCaATION to/& R-)) SEWAGE #
VILLAGE �` C,441S ASSESSOR'S MAP & LOT,2'iZ-O( -7
INSTALLER'S NAME & PHONE NO. 6U,-1v1 17Li 6g1YXo&,r-4ov ��z 8'92t
SEPTIC TANK CAPACITY 4 UW l
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LEACHING FACiLITY:(type) L lwka g (size)
NO. OF BEDROOMS PRIVATE WELL OR CBLIC:W7ATE;D
BUILDER OR OWNER T�e-lqy 6�eaC L�s .�P
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes o
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ASSESSOR'S MAP NO. PARCEL ''
-bL-0CATION SEWAGE PERMIT NO.
+ 49 Kelly Road
µVILLAGE.
Hyannis
N A M E A A D D R E S S INSPECTED BY :
Joseph P . Macomber & Son , Inc . 775-3338
Box 66 , Centervil:ie , Mass . 02632-0066
OWNER
Ricky Harvey
2-6X8 Cesspools +
F .DATE PERMIT ISSUED '
` C INSPECTED 8/4/88
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DAT E COMPLIANCE ISSUED
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