HomeMy WebLinkAbout0044 NORRIS STREET - Health 44 Norris StreetFli
Hyannis
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No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for 10ioogal 6potem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon(X) ❑Complete System ❑Individual Components
Location Add ss or Lqt No. Owner's Name,Address and Tel.No.
y A Oorrl 5 5+ A q 0w I,J 7nt,.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.�Io. 5006)7'76—%ate Designer's Name,Address and Tel.No.
. O
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) nYYUL C4S_ ,ZP401 . co fl u'l �0
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 issued by this Bo d f Health.
Signed A AAA . Date
Application Approved by Date
Application Disapproved for the following reaso
Permit No. Date Issued
No. Fee_C�_S,
THE COMMONWEALTH OF MASSACHUSETTS `Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYication for Mopont *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon(A) ❑Complete System ❑Individual Components
Loca on Address or Lot No. P Owner's Name,_Address and Tel.No.
Assessor's Map/Parcel 30(_039 y4 rbrrj 6 St• �q wi Sl M a
y
Installer's Name,Addre s,and Tel. o -0%) -33� Designer's Name,Address and Tel.No.
S:r'�, t`1'Lcf.lAf1
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) OY)Lt I CS�.�P o P C,on ,G7 �J -6 o 1,
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 issued.by�thifs Board of Health.
Signed �fr 'L� _ Date i l r
Application Approved by �f ° Date
Application Disapproved for the following reaso s
Permit No. 51/ Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired( ) Upgraded
Abandoned( 'Aby .S• . VA10- ombV CUO Son , CQC.
►
at 414 0, r r-l5 S A V C4 vi i 5 . ou I Ah ts P71en constructed in accordance
with the provisions of T*de 5 and the for Disposal System Construction Permit No dated
Installer 80bRj `� Designer ..
The issuance of this permit sh"allll not be construed as a guarantee that the system ill function as designed.
Date I � d�(-� 10L4 Inspector a
No.— ---_T�— =------ — --Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Migpont *pgtem Conmructton Permit
Permission is hereby granted to Construct )Repair( ,)Upgrade( )Abandon( X)
System located at 44 170on 5 S+. U WYVh l5 mo,
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: Con tru tion ust a completed within three years of the date of th0'erm�.M
a�
Q/�
Date: U/ Approved b a'
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