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Home My WebLink About0148 THIRD AVENUE (HYANNIS) - Health 148 Third Avenue Hyannis A �-266 010 i TOWN OF BARNSTABLE LOCATION Alice" ��,��sf SEWAGE # 0 03 — dr VILLAGE /��il.•�'✓�J' ASSESSOR'S MAP & LOT 2-Q4 bi® INSTALLER'S NAME&PHONE NO. �� LF'�ccFv/r 97S �70� SEPTIC TANK CAPACITY ✓yo o byy�<, LEACHBvTG FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER CoGGi�J' PERMITDATE: �'—/- '� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) / Feet Furnished by (Tis%, G4�2rO `</F � � o � � Qp �, o � � a. o y e , �o .o ,_ � o a hl O t : s 2 No. —0 > "Ih.3' ' 's. Fee s THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS . 9 t Yicatiot� for i� oar pgtent_ tottaruction,Permit Application is hereby made for a Permit to Construct( )or Repair O an On-site Sewage Disposal System at: Location Address or Lot No. Z;f 10 6141-e Owner's Name,Address and Tel.No. (9 ®t. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. i r"`^+ `�sBo�sir �7 1 >� Type of Building: Dwelling No.of Bedrooms 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 Description of Soil Nature of_Repairs or Alterations(Answer when applicable) ��L�CeF' �-Xi,j�Ti%�✓c ,p—{�o>C s/�"✓7.r« /vc4e - av GX� .iFfL� Ate t 0 ZPI. 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 issued this.B Au1_of Heal Signed Date - I Application Approved by _ O Application Disapproved for the following reasons Permit No. � 3� Date Issued No. 'Q-©r 2-3t (10. � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS. Tipplication for-Oi9pogal 6potem Consstructionjoermit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. 11 i L1 ��j/,/c�.b Ile '' Owner's Name,Address and Tel.No. v c e Lei•-1 & p ) Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. v-/^ Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Ilan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs.or Alterations(Answer when applicable) E °-n 2-14_D L7- 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 issued this Board of Heal _/_o� Signed Date Application Approved by Application Disapproved for the following reasons Permit No. Date Issued O d THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TMCI IFY, the On-si S age Disposal System in ed( )or repaired/replaced(X)on. 1 � � � � for.� � `� �tQ•nni s, has been cons c d)'n ccordance with the provisions of Title d the for Dis System Construction Permit No. oZ�3 3! ( dateA �l ► O Use of this system is co dition o cc 'tb the provisions set forth below• No. 3 cb E r. Fee THE COMMONWEALTH OF ASSAGHUSETTS PUBLIC HEALTH DIVISION - B STABLE, MASSACHUSETTS dig o�ad &pgtem Con2truction Permit. Permission is hereby granted to to construct( )repair an On-site Sewage System located at �r S 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. All construction must be completed ithi two years of the date below. Date: 71 �• Approved b TOWN OF BARNSTABLE j LOCATION �i //!`b i91��' �jY,C•w�J+ SEWAGE # wN�.r VILLAGE //�i'u ASSESSOR'S MAP & LOT 2- INSTALLER'S.NAME&PHONE NO. 07!4 SEPTIC TANK CAPACITY LEACHING FACII.TTY: (type) -2 ©ice"-r (size) NO.OF BEDROOMS -3 , BUILDER OR OWNER CoGGi�J', PERMTTDATE: COMPLIANCE DATE: W—q- 03 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any,.wetlands exist within 300 feet of leaching facility) ```j / Feet Furnished by 0i,06s Gc`Bol-`!/F A E �° a eft/fib /fUl� 4ff52 �fas 0