HomeMy WebLinkAbout0010 ANGELA WAY - Health 10 ANGELA WAY
WEST BARNSTABLE _
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TOWN OF BARNSTABLE �'
LOCATION �t� �,. e P �L�a4 SEWAGE #
VILLAGE S VlArAJ 4 de ASSESSOR'S MAP & LOT I?3 0605
INSTALLER'S NAME&PHONE NO. vC a u1 a=
SEPTIC TANK CAPACITY ® 2 ,4/
LEACHING FACILITY: (type) P (size) _ dJ��
NO.OF BEDROOMS -3
BUILDER OR OWNER ?fe' r° L a a4e�
PERMITDATE: _I s Q� COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjtisted,Gundwater Table to the Bottom of Leaching'Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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No.74 Fee J I t
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: --A—/ -
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
0[ppYication for 3Di2;pooa1 *proem Com5truction i3ermit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. /Q #1"6?� � _Owner's FAe-v- J Uarne,Address and Tel.No.
�5�Assessor'sMap/Parcel ! / ® �,7 C,
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Installer's Name,A ress,and Tel.N v"J` );An S esigner's Name,Address and Tel.No.
CO�� dvC � o "�L�✓C Sf}
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 o Repai or A erations(Answer All W
iLjrwh applicable) P_/J 4 C e I p"D kle#V
'37 — /'0
Date last inspected:
Agreement:
The undersigned agre constructi and maintena a the afore described on-site sewage disposal system
in accordance with the ovisions of Title 5 i nme Co nd not to he system in operation until a ifi-
cate of Compliance h be n issued b 's o f al _
SI ed Date &-Aidl
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
No. W V - Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
r Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
i
01 pYication for Migogar *p!tem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System O Individual Components
Locaiion Address or Lot No. Owner's ICI a Address and Tel.No.
r C /
Assessor's Map/Parcel (/ G —✓ /�o �.� � P
1 0 r
J% Installer's Name,Address,and Tel.N 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 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 oa�f//Repairs or Alterations(Answer whep applicable) a 1�e at7 14 C. C. �V-0 ee ou
U
Date last inspected:
Agreement:
The undersigned agre�4-o-ensure-t constructio and maintenance f the afore described on-site sewage disposal system
in accordance with the provisions of Title 5)ff/�e ironme Cod nd not to . ace-the system in operation until a fi-
cate of Compliance has been issued b , Boar 0�H�alth � �
Sig 'ZZ
ned Date s ��
r i
Application Approved by Date
Application Disapproved for the following reason
Permit No. Date Issued
--------------------------- ---
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CER32gy,that he O -site Sewa a,Disposal System Constructed( )Repaired( �)Upgraded( )
Abandoned( )by 4 t d a/ r— c % G" '
at r-e f has_been constructed in accordance
with theprovis' ns o, itle and the r Disj°sol Syst m Construction Permit No. dated
Installer rd U /u C"1` r fT Aj Designer .
The issuance of this pe i shall not be construed as a guarantee that the syste : 1 fu etip 54 design
Date y Z6t9/ Inspector /
No. � rr --------------------------Fee
l7 THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Migosar 6pstem Construction Permit
Permission is hereby granted to Construct( )Repair O Upgrade( )Abandon )
System located at gor/ U .4� e I 1-�- i� ✓ , �/
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 Tust be completed within three years of the date of this p it.
Date: S/-� Approved by ,t _ A % _ (�-J
f� F"
O`C,A T 10 N �i%'�e! �'` ` 5 E W A 6 E PERMIT NO.
V L L A C E
,. 1-fdST A LLER'S NAME A ADDRESS
S UILDER 0R OWNER
DATE PERMIT ISSUED
D A T E COMPLIANCE ISSUED .� 31
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TOWN OF BARNSTABLE
LOCATION '-�,
�4 et,�f,[y ��/A SEWAGE # zt/y l
VII.LAGEf(JA.�F/,u_ s7�Lf L,(e ASSESSOR'S MAP & LOT l 17 —065—
I'NSTALL:ER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
I . NO. OF BEDROOMS —3
PFP,.:QR::OWNER
OR:O:
•
PERMITDATE:���/ COMPLIANCE DATE:
Separation Distance:Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water,Supply Well and Leaching Facility (If any wells_east.,_,.:
on site,or within"200 feet of-leaching facility) Feet
Edge of Wetland and Leaching Facility (If`any wetlands exist
"within.300 feetof leaching facility
:Feet
Furiushed'by
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