HomeMy WebLinkAbout0154 GROVE STREET - Health 54 Greve street
Cetuit
A = 228 - 115
No.
2d� r Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
0(ppliLation for Vspo8al *pBtem Construction permit
Application for a Permit to Construct( ) Repair(vJr Upgrade( ) Abandon( ) ❑Complete System [1�Individual Components
Location Address or Lot No. 165 C,ro y,T r,t;,-K— Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel (cA m b (e C) 8- iD �\ T 4 S O n
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Fo 8 f4 G'C I?
Type of Building:
Dwelling No.of Bedrooms A 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) Ii _0_10 Gan � .
J O yam,( /y1 syr P, ff''Q-ex C i 0 of a "
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
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued ��
-2 No. ` ..., Fee`s
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: n
Yes
PUBLIC HEALTH DIVISION,- TOWN OF BARNSTABLE, MASSACHUSETTS
9ppfitation for Dispsal 6pstem Construction Vermit
t Application for a Permit to Construct( ) Repair('/Upgrade( ) Abandon( ) ❑Complete System N1 Individual Components
Location Address or Lot No. $05 rp V G cam,-r _-�" Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel jc�JV(6 —
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
�Zo tiT g. 0-;-'L C4
Type of Building:
Dwelling No.of Bedrooms t " ( Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures 4.
Design Flow(min.required) IV gpd Design flow provided /l✓ gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil f
Nature of Repairs or Alterations(Answer when applicable) �� (a
��0%4 6'-.c.� In 4-1 lit ( C.C ap 0\
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 Boardof Health.
Signed . Date ® 1
Application Approved by Date
Application Disapproved by V T Date
for the following reasons
Permit No. f� 'µ Date Issued
-- - - - -- -
F
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
r� Certificate of Compliance
THIS IS TO CERT-I�FY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded
4
i Abandoned( )by ` C ,�i w>(- C C) .
at. " r `� ��� �' %� C ?t^'t has been construcct�eG}d in accordance ) �p
with.the provisions of Title 5 and the for Disposal System Construction Permit No. d cN I 'T j� dated r r
Installer 1 l..-,c'> � Designer fl( 1
#bedrooms I W Approved design flow ` gpd
The issuance of this ermit haall not be construed as a guarantee that the system will f`nnc b!n as esigned.
Date G 'v ( Inspector ,,,--- --------------------------------------------------------------------- --------------------------- -------- -
No. 0( c �l Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Nsposal 6pstem.-Construction permit
'Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( )
System located at ' la fa Jc �a TJ - } k
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
P Y
Title 5 and the following local provisions or special conditions. 'Z
Provided:Construction must be co_mpI d within three years of the date of this permit.
. Date lJ / f Approved by