HomeMy WebLinkAbout0014 PAINE AVENUE - Health 14 Pine Ave.
Hyannis:
A—288 144
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
::
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftpliLation for Disposal *pstrm Co. Union permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ❑Complete System ❑Individual Components
Location,Address o rLot No. r-J j;,3•e v Owner's Name,Address,and Tel.No.
7y'i(UNAJ\% (,
Assessor's Map/Parcel 7 �•�
Installer's Name,Address,and Tel.No. Designer's Name,A dress,and Tel.No..
S L_ 7/
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
Nature of Repairs or Alterations(Answer when applicable) A to G,jC)",; c9
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 Board of Health.
Date , J —l 7
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. ,,'--,): 2 Date Issued
%
No
e::: Fee
THE COMMONWEALTH-OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for Misposal 6pstem'Con A union Permit
Application for a Permit to Construct Repair Upgrade Abandon Complete System El individual Components
1-
Location Address or Lot No.I Av,f Owner's Name,Address,and Tel.NO.
Assessor's ap/Parcel 4 At A e
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
I-oc S()8-t[00-7/5-5
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
Nature of Repairs or Alterations(Answer when applicable) A1nc,,c)c2,1
Date last inspected:
AgiTpment:
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 I ras been issued by this Board of Health.
Date
-Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. 7 2 S 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(V/)b, ,es A TfJr
atIL-1 'P.,a r- N,)v- Na,IWVPJ'l<< has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No,Z_-12 dated 4
Installer!Z62s \ob A r Designer
#bedrooms Approved design flow gpd
The issuance of this permit shall note construed as a guarantee that the system( iir- cton a u�siped.
Date Inspector
--------------------------------------------------------------�-----------------------------------------------------------------------
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
. Misposal .4- pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade Abandon( Vill'
System located at'/'-1 726 r- A urj,4j i
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' I t d within three years of the date of this ermit.jornp e e
Date Approved Qby