HomeMy WebLinkAbout0014 SANDPIPER LANE - Health 14 Sandpiper Lane
A = 258- 180
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No. rc�-c 11 3 9d?— Fee / ®0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
application for ;Dispoeal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. L p7 1 Owner's Name,Address,and Tel.No. n
e�o's�aP c / r` 0 ` G I CA
Installer's Name,Addre s,and Tel.No. i Designer's Name,Address,and Tel.No.
�e .Sr,� %t✓ CvT�t=,
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) e C Coe—e-- v
CCss�� - �.✓�' ?J� Glees�, ov
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.
e Date
Application Approved by Date J2 I
Application Disapproved by Date
for the following reasons
Permit No. 5b n 3`� Date Issued ic
) /
No.
V ' 3 ! 8 Fee /�V
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ZippYication for Misposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Pw
tio 1d ss r Loot.No. Owner's Name,Address,and Tel.No.�or's'Map/Parcel' / �l ' �(��i YI `J 1/I Cn,
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
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. i -7
Description of Soil t _
Nature of Repairs or Alterations(Answer when applicable) Re Coe_ �-
��SS�-z' - G✓� 7`l� C/ems ri ovT
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.
e Date 'l 7
Application Approved bY� Date 7
Application Disapproved — ='Date - - - - -
for the following reasons
Permit No. Date Issued 0 7
------------------------------------ --------------------------------------------------------------------------------------------------
1 1 THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
vb���`�c�'rr' Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( )
Abandoned( )by V:)9" v,_
at t- fit- Z---N a has been constructed in accordance ^� n
with the provisions of Title 5 and the for Disposal System Con(truction Permit N�//—3 l)g dated la � ` '
Installer Designer
#bedrooms Approved design flow n gpd
The issuance of this permit shall not`bl or?s'fru d a /uarantee that the system will functio de 1 d.
Date Inspector
------------- ------------------------------------------- - -
----- ------------------------- ------------- --
No. Der Fee
3g" o�
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
�Disposal 6pstem Construction Permit r�
0 nil"
Permission is hereby granted to Cons ct( Repair( ) Upgrade( Abandon �,a� �
System located at
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:Construct''07 mu�st7b X
leted within three years of the date of this permit.
Date / / Approved by