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HomeMy WebLinkAbout0086 REBECCA LANE - Health 86 Rebecca Lane . Osterville A= 146-037 s a - I q.� ®I(` 2�� -00 No. gee /CD THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes TippYicatiou for Digoal 6p5tem (fou.5tructiou Perron Application for a Permit to Construct( ) Repair>6 Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.96 9A� C<A Ira Owner's,Name,Address,and Tel.No. 65 rzry �o.Vy &/ Assessor's Map/Parcel 'y14 637 A, 12eA3Ech A, 0 sraw(u-4g Sag 1/77-X$77 Installer's Name,Address,and Tel.No. _ Designer's Name,Address and Tel.No. St Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 'EKS i—AM S C..1i+6-ry TpR )N-%— �T 1P_11A cat Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date // Application Disapproved by,/ Date for the following reasons Permit No. Date Issued days `-- LOCATION : SEWo,G ERMIT UO. �GT3 b — —. IWST LLERS ► &NAE ADDRESS 10 ,;P2 — BUILDER 5 A&VAE A DRESS DN-TE PERMIT ISSUED �D ATE COMPLI &MCE ISSUED : — = � \J e � h 1 � � ,/t �.�' .A-- „�" I ^ to" . No. Q t �V t Fee ��•00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ,t Application for Dioq!6al *p.5tem Congtruction Permit Application for a Permit to Construct 11( ) Repair Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.${p �2rY�Q C� l_0.��. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel g(, Rek3.-WId, ©SreWIL 49 ° Installer's Name,Address,and Tel.No.S Cog �� �g 7 Designer's Name,Address and Tel.No. 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(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) .�fn S a��( S C,.n �a`y eq. Date last inspected: a') 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 r, Date 1 o _ Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 00 r/ 218 Date Issued 914 Z O/I THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE;.MASSACHUSETTS Certificate of ,Comvliance THIS IS TO CERTIFY,that the On-site.Sewage Disposal'System Constructed Repaired ( ) Upgraded ( ) i Abandoned b( ) Y s.�✓ at �Qlp e�ccs� L giy.sZ Q S ¢r ✓�\�� _y ;,t has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2Oil- ?T8 dated G /8 zo// . Installer ea Q ��j i�2 t✓1r2r g '', #bedrooms Appr?yed design'flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as"d'esigned. Date _'Inspector No. U�( 2. J FeelW. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS .; 'Wi5po5a[ *p0tem Con5truction Permit Permission is hereby granted to Construct ( ) Repair (V/) Upgrade ( ) Abandon ( ) System located at �2�pccc� (�S`�Q r Y and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this sppermit. / Date 60,, 12-0!/ Approved by -� !