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Home My WebLink About0054 PINENEEDLE LANE - Health 5.4 Pineneedle Lane Hyannis A= 294 028 � I r LOT NO yADDRESS:-. : OWNERS NAME: SEWAGE PERMIT NO. : NEW: REPAIR: DATE ISSUED: DATE INSTALLED: iNSTALLERS NAME: INSTALLATION OF: 4.Q Q egn, WATER TABLE: FINAL INSPECTION BY: DRAWING 0F INSTALLATION ON REVERSE SIDE: / I �J d TOWN OF BARNSTABLE LOCATION � � �� p � AGE # 91- — VILLAGE ___ ASSESSOR'S MAP & Lo' j INSTALLER'S NAME 6i PHONE NO. � SEPTIC TANK CAPACITY LEACHING FACILITY:(MO (size) '" i a NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER L/ 9 z?Z— DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No No. Fee THE C,PMMGNWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS 01pplication for )Diopozaf 6potem Colt-5trUction Permit Application for a Permit to Construct( )Repair( )Upgrade( bandon(�U omplete System ❑Individual Components Location Address or Lot No.f;41 �j j9�n� r.Gy�j Owner' Name,Ad��ss and Tel.No. �r+��G�Gis�CrY Assessor's Map/Parcel a �/s O,;t Ins tall gr's N e,Address and Te),No. SO$=�j/pT(y fg y Designer's Name,Address and Tel.No. /9�/a►il7 Yo®, / Ir4- Gy 6,rl .Gvi�r°,�v��li JowA , Type of Building: Dwelling No.of Bedrooms Lot Size Q,;22sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore describe on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss obys oBoalth. Signed Date Application Approved by I Date Application Disapproved for the following reaso s Permit No. 24d I—Ll Z Date Issued Zr U --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS4O CERTIFY,that the On-site Se Di o � .(tiw ^;al System Con;tructed( )Repaired( )Upgraded( ) Abandoned(`/)by & E at e42 A&WA 1-c7 . t6AU, has been construwted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.7,4V IUZ dated D Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector �� ,� � - - �i �-� C�� fir;. � •No. � Fee �J�✓t::.•j THE CP.MM'1IWEALTH OF MASSACHUSETTS - Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for Migozal 6potem Construction Permit r � f.,i �' r r s � Application for a Permit to Construct('1. }rl,pai.(� )Upgrade9(�, y,:4b'don(� Complete System ❑Individu`al Components a ff Location Address or Lot No.!�L� �j hf� �.Gbh Owner Name,,Adds and Tel.No.IF- Assessors Map/Par jel e / Installer's Nine,Addressy and Ter No. 5O$=•S/pt p!$ cl Designer's Name,Address and Tel.No. f 1 � CGr fraG>"or, Type of Building: Dwelling No.of Bedrooms Lot Size 042Zsq.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) 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 issyff4 by s Bo Health. Signed .• r Date d / Z� Application Approved by x Date Zr o Application 13 approved for the following reaso s r. Permit No. /y l—y Z/ Date Issued U --------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS O CERTIFY, that the On-site Se a Dis osal §ystem Con tructed( )Repaired( )Upgraded( ) Abandoned( )by 6/9" at 1,2v / dln^ has been constructed in accordance with the provisions of Title 5 and the for Disposal ystem Construction Permit No.TiGll/' Z dated 6� O C Installer Designer The issuance of this permit shall not be'-'.construed as a guarantee that the system will function as designed. ate'- Inspector - . - -- - - No. W`il-7 ZI -------_29T 1�2a --------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi.5poear *p5tem Construction Permit Permission is hereby granted to Construct(/��)Re air( )Upgrade( )Abandon(� System located at 'S� 4-1i i5 e �hti 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:Constructi n �� mpleted within three years of the date of this t. Date: Approved by