HomeMy WebLinkAbout0048 WOODBURY AVENUE - Health 48 WOODBURY AVENUE
Hyannis
A = 307 — 232
No. D � Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplitation for MispoBal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon X ❑Complete System ❑Individual Components
Location Address or Lot No. `JS W v v4 6,sr y /pug Owner's Name,Address,and Tel.No. `6jA.,C.e I 1"T
"twnA s
Assessor's Map/Parcel - 0-7 Z Z 3'L
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
C2 Apewl-6 l l— 14 Z 1
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) Aoioay4c� rp} V�leiw.
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.
Si Date
Application Approved by Date "
Application Disapproved by Date
for the following reasons
Permit No. 7 Date Issued
No. _ v! LI '^' — Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2ltlflcatioll for -MispoSal *pstrm ConeitCUrtloll 3perlllit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon ❑Complete System ❑Individual Components
Location Address or Lot No. o a41 to of Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
eAPtwi 10 t' {v$v P Vim— k
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
s
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature
//o+1f Repairs or Alterations(Answer when applicable) I'-t•' r—WN9C p}Z� 5c„��6vr,
' CrV�1M ELF �7 5 Pam)Gam„ 3
5
t
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' 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.
Sign' Date
Application Approved by Date
ti � � ILI
Application Disapproved by Date
for the following reasons _
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned(V)-by_ G��: LL lFyt�- t tQ v i',,c'j U—-
at �-( b 1�1 Jc v!� /�v t, has been constructed in accordance I 1
4
with the provisions of Title 5 and the for Disposal System Construction Permit No.6 ��5 dated � 1 � I '
Installer Designer
#bedrooms / Approved design-flow gpd
The issuance of this permit shall n,'t be_co t�uecVas a guarantee that the system will�nctk'on as designe. . � (�
Date _ Ins ector }
p Apr vp,„
---------------------`--------------- - --------------------------------------------------------------------------`------------------
No. LI Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal &petem Construction permit
Permission is hereby granted
to Construct( ) Repair( ) Upgrade( ) Abandon
System located at _ 0 t.Jo �±t *%>-C
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�c 1Vdithin three years of the date of this permit.
Date Approved b