HomeMy WebLinkAbout0077 SEABROOK ROAD - Health 77 Seabrook Road
Hyannis
A=.307-033
0
No. C�0I3 l LI Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ZippYication for disposal 6pstem Construction Vermit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(x) ❑Complete System ❑Individual Components
Location Address or Lot No. 7-7 50(8 P-QDe- P—� Owner's Name,Address,and Tel.No.
14Y4049S ARa!®c.D.-C- -,tuD1rg GocVM 41✓
Assessor's Map/Parcel 30 3 3 77 S R 64 l S
Installer's Name,Address,and Tel. o.sa$-477—g$Z7 Designer's Name,,Address,and Tel.No.
dAPGvtJVE Etv7' cScS c.�
15--A aW sr
Type of Building:
Dwelling No.of Bedrooms N Lot Size 17�d I 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&�&M ow
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.
Signed Date C o X9—a 0 173
Application Approved by Date 16 — � 13
Application Disapproved by Date
for the following reasons
Permit No. �d�3 N' Date Issued lU' / 7j
No. ;V J ' C I - Fee
Z V
THE COMMONWFALTH-OF.MAPSSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION--TOWN,OF BARNSTABLE,-MASSACHUSETTS
Replication for Misposal�6pstrut Construction Permit
Application for a Permit to Construct( ) Repair O Upgrade( ) Abandon(K) ❑Complete System ❑Individual Components
Location Address or L9t No. 77 5a(a Rtoe tZ Owner's Name,Address,and Tel.No.
l-lWPatS AW L,D* 7'uAtr� GooWi&I
Assessor's Map/Parcel .3Q 7 S 1
Installer's Name,Address,and Tel.No.,509-477-88-77 Designer's Name,Address,and Tel.No.
dAPcc�raE 0/14 ;
Type of Building: Q,
Dwelling No.of Bedrooms A / I Lot Size p 7(a/ sq.ft. Garbage Grinder( )
x 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
i
t -
Nature of Repairs or Alterations(Answer when applicable)
_ Date last inspected:
d 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.
Signed Date (0"'�&
Application Approved by Date 16 ' X f 3
Application Disapproved by Date
t for the following reasons
i
Permit No. r•013 Date Issued
t .
TH E COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
y
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned( �)by AP Gc,c)1 or EQ r21Ss U-C,
at r]r] S P X��. (�D/4 n •14 V#(l)N(S has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No..2013-q 15 dated r G 1 8
Installer Designer 0
#bedrooms /V Approved design flow N4- gpd
The issuance of this permit shall not be construed as a guarantee that the system will funct-� on-'M designed.
/Date / t// -,V Inspector �` •1�_.. —---�
------------------- - 17
.�----- -- ----- - ------ -------_--- - ----------- -------------------------------------------------------
No. o 1 S Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal .6pstem Construction 3permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon(x)
System located at 17�1 SEAagopr- RcAD t4V 4 1Cl 1 G
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 completed within three years of the date of this permit.
Date d a Approved by