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HomeMy WebLinkAbout0294 STEVENS STREET - Health 294 Stevens Street - Hyannis A = 308 - 006 _1 No. 0 .L —0;17 Fef 1� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: L PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplitation for disposal *pstrm Cunst rtiun 3dPrmit (Vie 30,?-oo� Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) Complete System ❑Individual Components s Location Address or Lot No. l Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3 a 4,r' '©d(? S il'v`J a v i L L L Installer'J�' 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 ate Title - Size of Septic Tank y�/� Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) d^ CA InI4 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 thiMBoarHe Date Application Approved by Date 2 Application Disapproved b Date for the following reasons Permit No. Date Issued / 3 t errs _ - ."=------- - -- - ---- ---- --=--= THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance HIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) b d( )by at F.��, has been constructed in accordance with the provisions of Title 5 and the fo Disposal System,Construction Permit No.D-U I)-— 0)-3dated r 1 Z Installer Designer #bedrooms Approved flow gpd The issuance of this permt sha not be construed as a guarantee that the systetdaesi!n nc' es ned. Date / Inspecto �.. - No. !G 1 Z _() Fee 11, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yication for is oral . stem Construction Permit�� � � p � I 3 0� Dv Application for a Permit to Construct( ) Repair( ) Upgradd( Aban�( ) Complete System ❑Individual Components Location Address or Lot No. I Owner's Name,Address,and Tel.No. 5 O F.'77 S-q9 3/ d �sessor's Map/Parcel S©g -O 96 S f,,4 17 0 h S l 4"v% Sf v Aj 6,v111 L I,,,,, Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. L )A_ i Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) t 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 L�J /� Type of S.A.S. P Description of Soil ( _ j' Nature of Repairs or Alterations(Answer when applicable) un , 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 Boar e th. # d Date Application Approved by Date Application Disapproved b Date for the following reasons Permit No. of 0 a Date Issued / i THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance HIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandon ( )by at 2�)V 04 to, r 44iq t—n,'/ has been constructed in accordance . f with the provisions of Title 5 and the lfo Dir' sposal System Construction Permit No.p v - 0-Z 3dated r1l,2- Installer Designer #bedrooms Approved design flow god The issuance of this permit sha l not be construed as a guarantee that the system4lill funs'onus designed. Date J Inspectors No. 0 I -0 Fee (` THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposat 6pstem Construction Permit Permission is hereby granted to Construct( ) Repai ( ) Upgrade( ) Abandon( ) System located at 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. i Provided:Const ction ust be completed within three years of the date of this permit. Date ( Approved by JA A r