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HomeMy WebLinkAbout0365 OLD COLONY ROAD - Health 365 OLD COLONY RD., HYANNIS A=326-001.001 i i �,,� � No.--- ---------------- Fee------- - -------- \ BOARD OF HEALTH o° TOWN OF BARNSTABLE Application-*rVell Con0ruct ion Permit Ap is he a mad fora erm>t Cons,�ruct (11J, Alter ( ), or Repair ( )an individual Well at: ---------------------------------- -------- ---------- --------- ------- ------ ` Location — Aldless Assessors Map and Parcel �Owner -----____--1-----Address------ yJ — ------------------------ ---- -----—---------------------- nstaller — Driller Address Type of Building Dwelling------------------------------------------------------------ Other - Type of Building --- No. of 1-51 Type of Well -- ---- - — - ---- YP ------- - Capacity----`� �-- Purpose of Well--------------------------------— - — ---— Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well o ct' n egulation — The undersigned further agrees not to . place the well in operation un ' a er ' cateof a e as been issued by the Board of Health. - -- ---- ------------------- ------------------ - �d�at� p/ Application Approve -— ------ -- --- --- -— --� I ©a__ date Application Disapproved for the following reasons:----------------------------------------------------------------__________—__________ -----------— -- ----—-- ------- — ----- - - - - ---------------------- --------------------—_-- -- ddate PermitNo. ----- --------------------------------- Issued-----------�----�----�- --- ------------- - ----------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certif rate ®f Compliance THIS IS C TIFY, That the�I,+ndio' ual Well Constructed (G'j Altered ( ), or Repaired ( ) by- 1'� - ��"' - ---------------------------------------------—------------------------------------------- — — - - —- Installer o at -��___ C - —--' -- ------------------------------------------------------------------------------- has been installed in accordance with the provisions of th6 Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -------------------------Dated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-- ------------------------- — -- Inspector_-------------------------------------------------------------------------- No.-------------------- Fee--------- BOARD OF HEALTH TOWN OF BARNSTABLE oN f' rQ 0(ppCication-*rVe[[ Con5truct ion Permit ,N4 Appli t• n is her by made jor a permit to Const uct ( , Alter ( ), or Repair ( )an individual Well at: - -- ---------- ---------------- ------------------------- Location — A dress_ —— —� Assessors Map and Parcel - - --- ... —....... Owner Address "Installer — Driller — — — — — — ——------------=----------- Address Type of Building Dwelling--------------------------------------------------------- Other - Type of Building------------------------------ No. of Persons------------------------------- -- _ Type of Well- � --- -------- ---- -- - Capacity-- - _ ------------ - --- Purpose of Well------------------------------------------------- 1 Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well P t ctio ulation - The undersigned further agrees not to place the well in operation until a Cterti ' ate as been issued by the Board of Health. f lia , -- ----- --- -------------------------- date p� Application Approved ---- -- --- - -- --- -— -- --�-L�d date ---------- Application Disapproved for the following reasons:--------------_____—__—----------------------------_---- :_______________—__________ ----------------------------------- ------------------------------------------------------------- - ---------------------- =--=-- ,. 1 2� 3 Permit No. _"�'r- --- ---- —— ---- Issued--- -- �� - -— --b---------- date. - ---------------- date ------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE -. Certificate Of Compliance THIS ISTG'CE TIFY hot the Indivi ual Well Constructed ( , Altered ( ), or Repaired ( ) by -- 1/--,�Q -------------------------------------------------------------------------------------------------------- -- Installer at ----------------------------------------------------- has been installed in accordance with the provisions of the own of Barns o table Bard of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ---------------------------Dated-------------------_-_-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE----6Z�p~///- ------------------- =-- - -- Inspector------------ w —----------------------------------------------—--------------� BOARD OF HEALTH TOWN OF BARNSTABLE lVell Con!9truct ion Permit �, - 7 No. ------------------ Fee-------------- Y Permission is hereby granted- ---- ----�------------------------------------------------------------------------ to Construct Alter (/ ), or Repair ( ) an Ind' ideal Well at: No. ----- -, OLC OC¢ur ------------� -! -------------------------------------------------------------------------- as shown on the application for a Well Construction Permit No.-------------V- -,_ -��- -� -- - - ,Date - -�------------------- Board of Health DATE— -- -�- — -- - No.--- --------------- Fee------ ------------- BOARD OF HEALTH / TOWN OF BARNSTABLE ✓ AppIuat ion-*rWell Con0ruct ion permit Application is"he eby made for a perm t to Construct (Alter ( ), or Repair ( )an individual Well at: 5?o2600il co Location -Address Assessors Map and Parcel ----- ---- -------------------------------- ----- Owner a Address --------- ------— Installer — Driller Address Type of Building Dwelling------------------------------------------------------------ Other - Type of Building---------------------------- No. of Persons--------------------- Type of Well Capacity--------------------- - - - - - --— Purpose of Well----- ---�` �y'--------- Agreement: The undersigned agrees to"install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until arqertificate .o mpliance has been issued by the Board of Health. Sign - - - cs-- — --f-- �---- CL � date Application Approved By-)L." - / ------ date Application Disapproved for the following reason -------------------------------- ---- date Permit No.-IVA.1 ® —r� I — Issued— -�°.�-' - - -------------- date ----------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by----- --------— - ------- ------------------- -------------------------------------- Installer at- ----- — -------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ----------Dated----THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE—--- --- Inspector------------------ ---------— Oi = No.--- --- ------------ . Fee---=-- ------------- BOARD ,OF'HEALTH / TOWN OF BARN-STABLE . _ ✓ J c / App[tcation,�or ell Congtructioriermtt W . Applicahon is hereby.made for a permit to Construct( Alter ( ), or Repair:(E' )an individual Well at: Loc'at�on ddress + A'ssessos Map and Parcel ' Owner Address = ----�d d� - � ----fed--��'C------ lG- k"AIgS j //— — installer.- Driller Address Type of Building Dwelling.- --------- Other Type_ of Building = -=- - :No. of Persons---- ---------------- Type --------- of Well- '9��� =_- 1---- - Capacity--- Purpose:of Well _ I Agreement The,undersigned agrees to install the afore'described individual well in accordance with the provisions of The Town of Barnstable Board of Health Private.Well;Protection;Regulation The undersigned further agrees not to place the well.in operation until a Certificate .o Co lianc has been issued by.the Board of Health. Sign — --- - date ----- Application Approved By date if Application Disapproved for 'the following reason , . ----- -=---__ f — s --- -- —-- — -- ---_—date-- ---- j Permit;No. - issued, - i date I :"9e1ka?!e'+!�%a..hb4n3i1iTes.fli!:i,lM!'ie'!!li±i8dlifMA4i! 4ildeil6ii0a1NYsifali!FT�i'N.F�09r/6ili�!!pTi� �iNllits'?bifi'rii�Mdl.Y!!MnR1'�i'd�Y$i9�ft�idYil'i,R�!.�i�.�Al'i1R1MJil,@�Y 4i,:.iSb�w'YV k r ` 'BOARD,OF HEALTH { TOWN . OF: BARNSTABLE erttf tcate�f �Com [iarice THIS IS TO CERTIFY, That'•the:Individual Well Constructed (. ), Altered ( ); or Repaired ( ) J by -- -- -- -- -- —- - -- -. -- - --- - r Installer. has been installed in accordance. at -- -- --- -- with the provisions of the Town of Barnstable Board of:Health Private Well Protection Regulation:as.described in the application for Well Construction Permit No. ---=--==-=Dated-----=- =-- THE ISSUANCE OF THIS,CERTIFICATE.SHALL NOT BE CONSTRUED AS A GUARANTEE.THAT THE WELL .,SYSTEM WILL FUNCTION SATISFACTORY. DATE — Inspector aT.cAogrBCiLYrligil69Gwiwyli�itibipi, ofp'fidil... 7!•iTi92FiiliYFi&GSi9i,®iRiRiK9ilitit�KBf:'Ril,fnliti9iF}ifi�'P!b9i4i•1i4 %],:-aei�/e''�.i�i4f.'+Y'!e'.'li'?..iP9fA!d,°ip?}!jtiaQ'q�y,4NTn4li44?i Sbli!!6�5 ^BOARD-0F HEALTH " TOWN :OF 'BARNNSTA�B.LE i' Ic fie[[ on�tructton ermit No. Fee- Permission is hereby granted- -- _____ _ to Construct. , Alt r ( ); or Repair ( ) an' i u Well at: No.' -- - ''-A °- �` - .........------------- efl street a's shown n tlhe plication.for a We C nstruction Permit No.- --- - Dated- ---- ------- ---- --- T — _ f - ------------------- oar Bd of He DATE