HomeMy WebLinkAbout0055 NARROWS WAY - Health 55 Narrows Way, Cotuit �
A= 021-003-008 Lot 24 & 24A
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ASSESSORS MAP NQ
No. 's PARCELNO; JO® v+� Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pp iratton for Mt!6poml�*p5tem Cow5truction Vermtt
Application is hereby made for a Permit to Construct( '�)or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. Owner's Name,Address and Tel.No.
A s� ,� ` ..0 s C912M"4J s
Installer's Name,Address,and Tel.No. Designer's Name,A+1J Add ss and Tel.No.
'4Co 0-alP C.Aw.mC-r1' ail �V1�aS�•�s M�'i5 C`t�L +t
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Type of Building:
Dwelling No.of Bedrooms Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3 gallons per day. Calculated daily flow S�D gallons.
Plan Date Q Number of sheets Z. Revision Date
Title 'l_ Uifb
Description of Soil -Z` 1 ` 2 IJ yj ungvn, SAAb
Nature of Repairs or Alterations(Answer when applicable)
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 issue is Board of Health. - >
Signed Date
Application Approved by
Application Disapproved for the following reasons
Permit No. Date Issued , �� ,
TOWN OF BARNSTABLE
LOCATION �T o2�t- aye SEWAGE # 9l0 "7SS�
viLLAGE�oTU/T 1Z/QL"!l/S wY� ASSESSOR'S MAP & LOT A—' 3 "
INSTALLER'S NAME&PHONE NO. A66b aiGdyhrl*4 112E
SEPTIC TANK CAPACITY
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LEACHING FACILITY: (type) /f_Ln 12 /Uely- (size) /d X is X a d
NO.OF BEDROOMS_y�
BUILDER OR OWNER �NUIIJ 1��'J3t�
PERM PT DATE: 9-19'�lD COMPLIANCE DATE:
Separation Distance Between the: N
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist 2*
�Feet
on site or within 200 feet of leaching facility) J0
Edge of Wetland and Leaching Facility(If any wetlands exist N
within 300 feet of leaching facility) Feet
Furnished by 1-5 X TER 4- ItIyA- 11V6
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THE COMMONWEALTH OF MASSACHUSETTS
_ PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
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Certificate of Compliance /
THIS IS TO DER Y,that the On-site Sewage Disposal System inviled( )or repaired/replaced( )on
b v �O for ` V
Y
as V ' has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. - dated
Use of this system is conditioned on compliance with the provisions set forth below:
No. 0/v-- Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
`igogaY *pztem Construction Permit
Permission is hereby granted to - NCO G744q,
to construct( )repair( )an On-site Sewage System located at V, S �4EE��wS 4/�Y a
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 within two years of the date below.
Date: PC—/- y - -- / Approved b
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No.
+�' Fee 10
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ructi ermtt .
$tC11� �OtY�t Ott
liC�[ti01� for ig 0�OY p�
Application is hereby made for a Permit to Construct( ' or Repair( )an On-site Sewage Disposal System at:
1
Location Address or Lot No. Owner's Name,Address and Tel.No.
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04 333 C.gimnA4 �t
P�L4_4 ,46 0t�,
Installer's Name,Address,and Tel.No. Des' ner's Name,Addr sand T 1.No.
m,,R �AN,o&e 2� r>7ra�Sro.,s r►+ i5 x- 1, f�t{@ �iJ�
B t z- AAA I
LIU -3a6� 05T-EZZ0cam'
Type of Building:
Dwelling _No.of Bedrooms - .J Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow LSD gallons.
Plan Date S t' 4 P IQ Number of sheets Z_ - Revision Date
Title 1 g::) Ror iLA!L) T' 'i '�= `j> V it>
Description of Soil CA.—
�'< 1
Nature of Repairs or Alterations(Answer when applicable) a
s
Date last inspected:
Agreement:
1. 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.byy-this Board of Health.
Signed ' Date
Application Approved by
Application Disapproved for the following reasons
' Permit No. '" Date Issued
TOWN OF BARNSTABLE
LOCATION - 4�rg va t- AV A SEWAGE #
VILLAGE6721r 4//39A0A1J WY. ASSESSOR'S MAP&LOT ! /' .3"'
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILrrY: (type) /F_Gh / Z Nell• r
/_� (size) Id X7.�X,;? —h
NO.OF BEDROOMS
BUILDER OR OWNER Nul b loth 5 38
PERMTTDATE: COMPLIANCE DATE: c:9_16— 97
Separation Distance Between the: N
Maximum Adjusted Groundwater Table and 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) I.Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) _ feet
Furnished by i/��� ��� ��
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