HomeMy WebLinkAbout0145 STEVENS STREET - Health 145 Stevens St
309-238 Hyannis
No. Fee
/
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
ZippYication for Migogal *pgtem Congtruction permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon(t/) O Complete System ❑Individual Components
Location Address or Lot No. l ,f 1 ri r Af 6 P Owner's Name,Addre sand Tel.No.
Assessor's Map/Parcel 30 f�—2j13� f1`' `�
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
,�®lam L��`j �✓'�`�j`
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 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 Alteratio (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 t ' ar f He
Signed �' Date �/�✓a�9�
Application Approved by Date 3 _/tJ-9 7
Application Disapproved for theVollowiW reasons
Permit No. 7 d Date Issued
No. / 0 Fee
1
I` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
I,
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
ZIppfication for �Ditpotal *pztem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon(V/) YJ Complete System ❑Individual Components
Location Addressor Lot No: l/�°!9w 07. Owner's)lame,Addre sand Tel.No.
Assessor's_Map/Parcel y3�q-2-3
Installer's Name,Address;and Tel.No. Designer's Name,Address and Tel.No.
f. 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 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
fJ d`I Sz'��`7G:S Gr�das
Nature of Repairs orAlteratio s IA pswer 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 aCertifi-
cate of Compliance has been issu t r oar. f Hea /
�
Signed Date
Application Approved by Date
Application Disapproved for the following reasons
Permit.No. 7- I ;?- o Date Issued f
————————— —— ——— ———————————————————
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS I$40 CERTIFY, that the On- ite Sewage Disposal System Constructed( )Repaired( )Upgraded( )
Abandoned(V)by //Dr�� d f CBh,5
at 1 y ✓� �-6J" ✓�' T has been construct Fd in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 7,7-/J.d dated
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the syste will function as designed.
Date InspectorT
No. ----------------- d Fee 3 .
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS
Migotaf *ps�tem Congtruction Ve it
Permission is hereby granted to Construct( )Reeair( )Upgrade( )Abandon(
System located at
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:Construction must be completed within three years of the date of this permit.
Date: ' y / Approved by
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