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HomeMy WebLinkAbout0179 LOCUST STREET - Health 179 LOCUST ST. ,Bffli TOWN OF BARNSTABLE LOCATION Qc� Loucus"7 SEWAGE # VILLAGE 14 yA'IUY AS ASSESSOR'S MAP LOT INSTALLER'S NAME & PHONE NO. z)A N A SEPTIC TANK CAPACITY LEACHING FACILITY:(type) size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER OR OWNER SUS I-\T\j M ©eq JS©�\I DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �: �} s� r O— � � ` _- c o �� � � � � J ©� -��' -� �s No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplication for Mid oal *p.5tem Con!Arurtion Permit Application for a Permit to Construct( )Repair( )Upgrade( Abandon( ) Complete System El Individual Components Location Address or Lot No. ? �`j CUS I S 1 Owner's Name,Address and Tel.No. Assessor's Map/Parcel 1-7,0, �a D Installer's Name,Address,and Tel.No. O Designer's Name,Address and Tel.No. 44, Jle 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. Description of Soil Nature of Repairs or Alterations(Answer when applicable) kCLK 610 f n h c_i 11 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 Certifi- cate of Compliance has been issue by t 's Boar Health. c� Signed Date Application Approved by Date If t Application Disapproved for We fol owing reasons Permit No. 79- 7 71,E Date Issued / ;7& Fee y e THE COMMONWEALTH OF.'MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS �Rplicdtiou for Mt.5pogat-*pgtem �(Con5truction Permit `Application for a Permit to Construct( )Repair( )Upgrade( Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. ( —? ( L G G�5 f !, Owner's Name,Address and'lle'.No. Assessor's Map/Parcel 3/0- /� p Installer's Name,Address,and Tel.No. O Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 1 No. of Persons Showers( ) Cafeteria( ) ry -'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. 9Description,of Soil y `... t • Nature.of Repairs or Alterations(Answer when applicable) I-L2 d Date last inspected: emu, 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 Certifi- cate of Compliance has been iss aroy Health. Signed ,G/ Date Application Approved by Date, Application Disapproved for e fol owing reasons f Permit No. 717- 7 76 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate �., VTO tcate of �lComptiattce THIS CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( ) Abandoned(,lby /��t�P L a at t 7 � L- c� c-u�fi if H c1 K bt (3 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.�-77�dated' Installer Designer r ,� The issuance of this e it s��j construed as a guarantee that the�Szw, eunet}'o as e i ned7 � Date Inspector g ��� 'I/C/ � -� :w- Fee _ THE COMMONWEALTH-OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS �Dizpozat *p.5tem Cow6truction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon(`T_ System located at 179 C O S C,d S-F 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: - �/ Approved by