HomeMy WebLinkAbout2320 MEETINGHOUSE WAY/RTE 149 - Health 2 3 2 .'1V 6ting§buS'6 Way
is West Barnstable
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F
r T TO WN OF B4NSTABELE 0
L09ATION �o�. �e� ���P SEWAGE #4�-/9.3
j VILLAGE bf- J 7— ASSESSOR'S MAP & LOT
INSTALLERS NAME&PHONE NO.`�Dc::c-� 1 t= ��
SEPTIC TANK CAPACITY _//C)00
LEACHING FACILITY: (type) ItAe(T k (size)
NO.OF BEDROOMS A L
BUILDER OR OWNER y r 1 e
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 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. ekU i U Fee 6 uy
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETT
0(pprication for Migpooal *pgtem Con.Wuction Perm t IS5-032-
Application for a Permit to Construct( . )Repair((K)Upgrade( )Abandon( ) O Complete System F1 Individu omponents Ob/
Location Address or Lot No. ,2-3,20 M to i u��D d"tny Owner's Name,Address and Tel.No.
was
Assessor'sMap/Parcel u�k IS� off�_ OD Q
Installer's Name,Address,and Tel. ot Designer's Name,Address and Tel.No.
gcwC� �Clz %
Type of Building:
Dwelling No.of Bedrooms 9c'm — B ANtSvimze sq.ft. Garbage Gnnder( )
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 of Repairs or Alterat' ns(Answer when applicable) R/ 4 3
f
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 o and not to place the system in operation until a Certifi-
cate of Compliance has been issu y this B and ealth.
Signed - Date�~ 0 S
Application Approved by \ VV. Rd Date
Application Disapproved fo the following reasons
Permit No. G��� �� Date Issued
No. (Jv — ' ', f J / - . Fee V
THE'.COMMONWEALTH OF MASSACHUSETTS Entered in computer.
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ZippYication for 301gpool *pgtem �Con!5truction Perlu t /.�S 03�-
fr
Application for a Permit to Construct( )Repai r(K)Upgrade( )Abandon( ) O Complete System ❑Individu ,Components 00/
Location Address or Lot No. 2 3?d M teal r% N uujp ti,p y Owner's Name,Address and Tel.No.
Assessor's Map/Parcel B U(' �
l S - l�1i
Installer's Name,Address,and Tel No. Designer's Name,Address and Tel.No. jr�I
I�b^ SZ.
Type of Building: Q.of.Bedrooin !�G�✓-YI 4,01t-ZSr)iAZe1s ,:ft. Garbage GrinderOtherIype of B u o. o Persons
ilding Nf SDwelling Nohowers( ) Cafeteria
Other Fixtures _ y
�Wk6
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 of Repairs or Alterat�'°ns(Answer when applicable)
a t l
1_7C
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 Certifi-
cate of Compliance has been issue by this Board of ealth.
_ d Signed �XvDate
Application Approved by - Date . .
Application-Disapproved for the following:reasons
Permit No. 6o�" �7 Date Issued _
Y
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( ) Repaired < )Upgraded( )
Abandoned( )byQat U A , / has been constructed Z accordance
with the provisions of Title and the for Disposal System onstruction Permit No. fcu ?dated 1-2
Installer 1,. ► . r,, ��,,;:�- Designer
The issuance of this permit shall not be construed as a guarantee that the,system will function as designed.
Date (0 A4 r)M4, Inspector I N �\
———————————————————---———— -- ----- --- --- -
No. 9 as Fee A0
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Migpozaf *pztem (Construction Permit
Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( )
System located at ? o ✓1'I et � %
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:Construct n must be completed within three years of the date of th,spermi.
Date: Approved by / t/i n
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933
I O C A T ION 3 AGE PERMIT NO.
��V �
�YIL LAC E
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INSTALLER'S NAME R ADDRESS
t U I L D E R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED ®-®5 �
L
11/2/21,2:52 PM ShowAsbuilt(1700x2800)
LOCATION O dt SEWAGE Y,266T'/83
1 VII LAGS F -r' .D ASSESSOR'S MAP&LOT AQO
INSTALLER'S NAME&PHONE'NO. 7� (t':Slc�" �{�B:SSdq
SEPTIC TANK CAPACITY '%od o 6PyL. %A,szs
LEACHING FACILMY:(type �CAt a�t-i (sue) li000 lief
NO,OF BEDROOMS_&�—A- �2
BVIIAEROROWNER
PERNMI)ATE: \,s ol'OS' COMPLIANCE DATE:
Separation Distance Between the: ..
Maximum Adjusted GroundwaterTable to the Bottom ofLeaching 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 fat of leaching facility) Feet _
Furnished by
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