HomeMy WebLinkAbout0048 PARKER ROAD - Health 7
: TOWN OF BARNSTABLE
LOCATION if /ARkex {Zd SEWAGE #
VILLAGE OSre-R✓/G 4 e ASSESSOR'S MAP Cz LOT �147�ff/j
k INSTALLER'S NAME & PHONE NO. Alf c e M/I e e f SdAI
SEPTIC TANK CAPACITY / o O O
LEACHING FACILITY:(type) A'/ (size) love
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BARtUER OR OWNER „6
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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TOWN OF BARNSTABLE
LOGATION SEWAGE #
VILLAGE Ad�P ee_. ASSESSOR'S MAP & LOT Q-- 0
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY �D
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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TOWN OF BARNSTABLE
'UNDERGROUND FUEL AND CHEMICAL STORAGE-SYSTEMS VA luti W�/
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ASSESSORS MAP'N0. PARCEL NO.
ADDRESS; ydF � VILLAGE; Sew v I yta 5 S oZ6 SS
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NAME, C®Y1 " ... . .... to h 4 c'f . .Cc Hie.
CONTACT:PERSON . : ,. ;. o P PHONE NUMBER 2-0 O
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL.. AGE: TYPE: LEAK
OR CHEMICAL: l DETECTION
SYSTEM!
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DATE OF PURCHASE OF. EACH:. . 1. 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING- CERTIFICATION SUBMITTED: PASSED DID NOT PASS
.`PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. �j
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PERMIT FOR-STORAGE
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t' �- 'a` 4 y •.p 1 .rx:Y y,s �• s,r s 4 .�<` J.:. y t A
tt f r, In accordance with provisions'of Chapter 148, C3 L•,.,`and Regulatioto ,ns * g.
made under authority thereof.., }�� ,y,�;�_� ,� r�� ���r ��r• r t � r• �s �'�
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.. . . ., � � ,no '8! 0 X}rName C •Name b
(owner or occupant) ... • ..... 4 t
¢ Ir.-.1' •.., � ds Vr4. , r� 1srd,�,,f,e r a ., Oug1'° l nV. VAddress 'Address 18 . TY..n •r,{t�r*.. rJ!t�,Lq•s?: Y�e y: �'s!`�a ����'m ` r.�d�` is f 4 '''y Burner , �� :�r � t� Y �' Storage : }in �y t ut�t�aP
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. ! Ma del No,m'',Size W1, T4', ° r location Under Y`ound
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t t't, re .rPermlt Issued: \ \• rr..•. .. ...J .3 .� � � O Y �� 4. t ��+�
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