HomeMy WebLinkAbout0000 LOTHROP'S LANE - Health 's Lane
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No. 1,W16 --0 '.� Fee
BOARD OF HEALTH
TOWN OF BARNSTABLE
ZIpplicatiou _for Yell Couttructiou Permit
Application is hereby made for a permit to Construct( ), Alter( ), or Repair( ) an individual well at:
Location-Address e`s�c�rs Map and Parcel
Owner Address
Ca( ,F, .10Q— J -(( om! 2—C, -)�)I�r2 l.0 Ist'O_y
In ller-Driller Address
Type of Building
Dwelling
Other-Type of Building No. of Persons
Type of Well___ "4 1, -P V c, Capacity
Purpose of Well 1_ YVi 0;1C�'iz,�.
Agreement:
The undersigned agrees to install the afore described individual well in accordance with the provisions of the
Town of Barnstable Board of Health Private Well ro ction Regulation-The undersigned further agrees not to place the
well in operation until a Certificate o s been issued by the Board of Health.
Signed
Date
Application Approved B
Date
Application Disapproved for the following reasons:
Date
Permit No.<-JCd)P-)/6 — Issued !6 h3h ,�
Date
-------------------------------------------------------------------------- --------------------------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of Compliance
THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired( )
by cxtl 1
Installer r/
no INC-Z r-A LC. N
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Pr—iv e Well Protection
Regulation as described in the application for Well Construction Permit No.► be 1 Dated IC Il
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORILY.
Date Inspector
No. /n 7a'01f --10 aq Fee
S
BOARD OF HEALTH
TOWN OF BARNSTABLE
Rpplication _for Veil Construction joermit
Application is hereby made for a permit to Construct( ), Alter( ), or Repair( ) an individual well at:
(I -'M4An-esh AV+4 rK- pot V%St. la � 1 n25 C-)
Location-Address '9xseSrs Map and Parcel
Owner Address
��.kl �(„vim ,l)g -1 (
In Iler-Driller Address
I
Type of Building
Dwelling
Other-Type of Building ; No. of Persons
Type of Well 't-� 1�V �Y C#acity
Purpose of Well i V v
Agreement:
The undersigned agrees to install the afore described individual well in accordance with the provisions of the
Town of Barnstable Board of Health Private Well r�ection Regulation-The undersigned further agrees not to place the
well in operation until a Certificate-,o Co pRa e has been issued by the Board of Health.
Signed ' t
Date
1 /-
Application Approved Bye /0,/�,3
Date
Application Disapproved for fae following reasons:
Date
Permit No. W lCo —(���--'J Issued /�✓ / 3h (�
Date
BOARD OF HEALTH
TOWN[ OF BARNSTABLE
Certificate of Compliance
THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired( )
by �' kl CA 1 C:
'�. � Installer
at AN w. ryN h �r v P, Cc v�, r if g , �0
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Pri ate Well Protection
Regulation as described in the application for Well Construction Permit Noar-�'Xi I J G:5" Dated �G�(.3 /
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION'SATISFACTORILY.
Date Inspector
BOARD OF HEALTH
TOWN OF BARNSTABLE
rr Veil Conotruction Permit
No. �� to 'G C—)� Fee
Permission is hereby granted to n.-P,
Installer
to Construct( ), Alters( ), or Repair( an individual well at:
�Z� "
u✓1
No. (- �} 1 C \ ! � 0 , + Vec" PaviS(,
Street A C V rJ
as shown on the application for a Well Construction Permit No. (^ 1- 1 L `0,31 Dated 1r/3
Date /d /1 ! ! �i Approved B,y �n C)�A
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