HomeMy WebLinkAbout0034 PONTIAC STREET - Health ri
34 PONTIAC STREET, HYANNIS
5
A=269-184
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TOWN OF BARNSTABLE' fu �l
LOCATION J �i\,4a a SEWAGE # '" r
VILLAGE G'��'�ASSESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE NO. . i vG
SEPTIC TANK CAPACITY /0 P D
LEACHING FACILITY: (type)
, f
NO.OF BEDROOMS '
BUILDER OR OWNER 1-.211. ,I 1^Atr `
t PERMTTDATEf / �'� COMPLIANCE DATE:
Sepaiation Distance.Between the:
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) Feet `
Edge„of Wetland and Leaching Facility(If any wetlands exist
Within 300 feet of leaching facility) Feet , =
Furnished by
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No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Ye
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ZippItcotion for & *p9;tetu Couetruction i3ermit
Application for a Permit to Construct( )Rep (
Upgrade( )Abandon( ) El Complete System El Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
s§esP!07ap cel '1 Y'4wa o �/�
Z 4 Q�cJ b r 164W,0
In er's dress e, d Tel. �y. Designer's Name,Address and Tel.No.
rV C'Tl®�
A� e—
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building'!;=K1fi 1 No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow d i!� gallons per day. Calculated daily flow gallons.
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) iJ e e_I S AV AJ I F'0G4 Ior
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 vironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been' e by t 's It
Signe ` Date /
Application Approved by Date Q
Application Disapproved for the following reasons
Permit No. — Date Issued
4�
No. . Fee
f! j
1-, THE,COMMONWEALTH OF MASSACHUSETTS Entered in computer.-
Yes,
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
ZippYication for Mi a- proem Construction Vermit
Application for a Permit to Construct( )Repai (�)Upgrade( ')Abandon( ) O Complete System El Individual Components
Location Address or Lot No. rye b Owner's Name,Address and Tel.No.
7S ssessPor s Map/p�rcel`_) # ���1•� rv, � P4,
P
Z o rC d l CNN's
InstaHer's acme, dress d Te lCX4 , N Designer's Name,Address and Tel.No.
--5-o.s^4
Type of Building:
Dwelling No.of Bedrooms 1,51 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building P is y Ica No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow p � gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date i
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) io e e. I S ° ai P W_j I 'Al
,,. 4 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 vironmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been ' ue b his;, r �lth.
Signe ` Date /Q^
Application Approved by / 'I'j Date /D
Application Disapproved for the following reasons
Permit No. Date Issued
---------------------------<— -- ------
THE COMMONWEALTH OF MASSACHUSETTS '~
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO C hat he O1site Sew�Diasal System Constructed( )Repaired O Upgraded( )
Abandoned( )b oNS r Pj
at r✓ ANC S b constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
No. i '�� � --------------------------Fee— �Y
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Migogaf bpgtem Construction Vermit
Permission is hereby grant d to nstruyt�( )Repair(()Upgrade(, )Abandon( )
System located at �f ��V r C /Ow A/e 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.
Provided: Cons ction ust b completed within three years of the date of th' e461
Date: �� Approved by J �' .
TOWN OE,BARNSTABLE �-
LOCATION.� PD A ArAr ��.- SEWAGE #
VILLAGE )—ske,nS7a l I ASSESSOR'S//MAP&LOT
INST.ALLER'S NAME&PHONE NO. f y
::;SEPTIC TANK CAPACITY
GEACHING'EACILTTY (type) �.C'. GAec ��i�,r.5(size) `-
i. :.'NO:.OF BEDROOMS
?B:UII DER OR OWNER A4 A r
>PERMTTDATE: COMPLIANCE DATE:
Separation Distance Between the: �: a
Maximum Adjusted Groundwater Table.and Bottom of Leaching Facility Feet
S:
sPtii`e8te Water Supply Well and Leaching Facility (If any wells exist
<`.%onsite or within 200feet of leaching facility) Feet t
Edge of Wetland and Leaching Facility(If any wetlands exist
;;.•within 300:feet of leaching facility) Feet
� ''Iuriished by J