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HomeMy WebLinkAbout0151 SEAPUIT ROAD - Health 1.51 Seapuit Road Osterville A = 118 - 124 - 003 ,: No. �!" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 9pplitation for Dismal *pstrm ConstCULtion Permit Application for a Permit to Construct( ) Repair ) Upgrade( ) Abandon( ) ❑Complete System f AIndividual Components Location Address or Lot No. 51 SGA PU17- P, Owner's Name,Address and Tel.No. R a�SL-r W4 d 6k§kJ Assessor's Map/Parcel I�4 003 05T ( SOS-A <Jc'T— P� 0�?' Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 15.3 Co -z— M 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) .57Q1SIr 1-Jax�) R—;to n—609,, AND PJ.5M 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 Hea e Date \ Application Approved by Date � 1 Application Disapproved by Date for the following reasons Permit No. �c3��� ^ ® Date Issued .f ,4•l-.+a;_,. . ,t �-,z,',o, .:.-r�.:.r.t7^ --.:k;:--..•,^=t%^„-,^T"«*sr._:.:,:y. -�'.,^�....'^''4., !`"Kti.�'�A-.�'--x•":..-...".'.e•�. ... Y:.;i�-,x ➢„+''.s-:.,-.�.'k,,.'�:r'„7,r�. .:.. -• � , - - No. /" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpliLatibn for Disposal 6pstem Construction Permit Application for a Permit to Construct Repair)( Upgrade Abandon complete System Individual Components PP ( ) P � PPS' ( ) , ( ) ❑ P y � P Location Address or Lot No. 51 5 C-'A P rr Pb Owner's Name,Address and Tel No. Assessor's Map/Parcel I Wa7 dQ. (` Ste}j7cJt 7- PLT QST �G.CE„S Installer's Name,Address,and Tel.No. SC$d--yT7--$$'i't 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) _ &)S7'�_ AJ6Xj F4^;tO D bOX ANb PJ57 M. 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 Hea :h. gnf ed ' Date ` Application Approved by — Date t 74 Application Disapproved by Date for the following reasons ' Permit No. 1Ss- — 10 Date Issued 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(�) Upgraded( ) Abandoned( )by AC-Wl-S g =C1jT&('t9E3/Ago . at S 1 s c-Ou!-r Ab - o.6 7- has been constructed in accordance with the provisions of Title 5 and the for Disposal Sy e Construction Permit No.�31'? --D/0dated l 1 Installer 0,4VE c,A/DiE EA)7Z@Q%G Designer AJIA bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will fundio designed` ' Date �� M . ff� Inspector --f='--------------------------------------------- =-- _ ____________ -=--=---------- ------ No. go` ~'`�` Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit' Permission is hereby granted to Construct( w) Repair O Upgrade( ) . Abandon( ) System located at 51 S'&¢PU l j- P a*:b ®S=MXvIz dC-45r and as-described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be/coo jpleted within three years of the date of this permit. �. Date ! ` Approved by` _ ems_, �. • . -, - .< _..