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HomeMy WebLinkAbout0015 RASPBERRY LANE - Health �.� Lc�,Y1C� t� ►���g �r�,�S i i No. (/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliration for ]Disposal Opstem Construction permit Application for a Permit to Construct( ) Repair lA Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. 1.5 'RPtSP BE RRy W . Owner's Name,Address,and Tel.No. Assessor's Map/Parcel �0 O 19 I M(6 l u E N H I S L—A TO lE� Installer's Name,Address,and Tel.No.S21B " y 7 7" I I Designer's Name,Address,and Tel.No. 3 3 ia�VU f Arr14 S. `4h-A.Nn—z ilk C 2- G y Type of Building: Dwelling No.of Bedrooms IV 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) n �a 3 N 2� $flx (� l 1�►a e co" "/ a w q t o5 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 Environmen ode and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He j� Signed (/(, Date Application Approved by Date — r Application Disapproved by Date for the following reasons Permit No. �'' ` Date Issued '� No. U 1 r F Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: , Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYitation for ]Disposal *pstem Construction APrmit ,` f C> Application for a Permit to Construct( ) Repair`,A Upgrade( ) Abandon( ) E]Complete System ®•Individual Comp'o ents -r� Location Address or Lot No. IS' h 5 r'G �! Owner's Name,Address,and Tel.No. ! + p ,�q+ ,An 1• ��4 r,,r�+ i s t,...R Tc 1� R co Assessors Ma /Parcel 10 7- a 7`� t+�+ Installer.'s Name,Address,and Tel.No.��' ' �/7 7 - 18 1 Designer's Name,Address,and Tel.No. v �^vl:Ei�fi !3 0%jc. ,1 3 Lzt.:.,. jcs 'F,t1J4/ 5, zLG 4 Type of Building: Dwelling No.of Bedrooms !V Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures A Design Flow(min.required) J gpd Design flow provided J 1 1 gpd Plan Date ' Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. i. Description of Soil h Nature of Repairs or Alterations(Answer when applicable) 01.-,�< li 1\r�. �0X CA: / 12�,ScoZ t'c�crc �ur� a 1 i�bE 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 t' Compliance has been issued by this Board of He/alt/h_: X r Signed ti // �'C /Vdim`f /.rr Date 1-�` Application Approved by `Y Date 7- Application Disapproved by Date for the following reasons Permit No. �}�� � Z Date Issued f -L _. �—, THE COMMONWEALTH OF MASSACHUSETTS C 6V BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by r at ) `Z �" -yV\,_, has been constructed in accordance c f with the provisions of Title 5 and the for Disposal System Construction Permit No.2 t)d 9�� dated Installer r Designer / #bedrooms N / Approved design flow gpd The issuance of this erm�t shall not be construed as a guarantee that the system will Ifunctipti as designeA. Date l�� Z Inspector '4,/ ---------- ------ ----------- ------------ - - _ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction Vermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at 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 completed within three years of the date of this permit Date �' Approved by ""` Cl:) ' L0 �©TION I� SEWAG P��! N0. VILLAGE 126 CA A V A A/E M6,d4OR �/5 M - J e-s INSTA LLER'S NAME i ADDRESS JOHN A. AAI.TO BACKHOE SERVI West 8arnstablei, Mass, 02660 BUILDER OR OWNER DATE PERMIT ISSUED 2f DAT E COMPLIANCE ISSUED r 3®1� ijj'' ,a "" rC' .k F . • ' .. .. ....^iv!;s-z k�a�.n.w,v:,meya?"_. --+n .=.-,awe .. .. ... .-.,. , l0 CAT 1 S . IY PE t NO. VI I,L#6.E Y 1N3T# L 1E ShE , #D,DRESi 10HN 71.`MLTO OE SE,1A �lllat Mess. , , u I t a F n OR OwNtR DATE PERMIT ISSUED7,9 DATE COMPLIANCE ISSUED 3 e ors- - W i d I 1 II I