HomeMy WebLinkAbout0000 MEETINGHOUSE WAY/RTE 149 - Health 0 Meetinghouse Road
West Barnstable
A= 155-034
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VV 2 ooq- 0 2 7
No.-------------------- Fee---------------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
0Ipplicat ion-*r V ell Con5trutt ion Permit
Application is hereby made for permit to Construct (� Alter or Re air a individual Well at:
Y P ( ). ( )PP , P
Location — Address Assessors Map and Parcel _---
Owner Address
-----------------------------------------------------------------------------
Installer — Driller 0 Address
Type of Building
Dwelling----- ---------------------------------------------
Other - Type of Building---—------------------------- No. of Persons------------------------------_---___-__
7
Type of We11
Purpose of Well-----
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.
Signed ------------------ — - a L-6�`----
date
Application Approved Bf--- - 12"S ' --------- --/6�z6 ____
PP PProveY— - --�----------------
Application Disapproved for a following reasons:-------------------------------------------------------------------------date
-------------------- ----------- --------------------------------------------------------------------------------
date
Permit No. - ------ — 1 ---- Issued----- -�� - (�' —— --
-�------------ date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f Comphante
THIS IS TO CERTIFY, T at the Individual Well Constructed (�), Altered ( ), or Repaired ( )
by- Qe v- �lf // i✓ --- ---------------------------------------------------------------------------------------------------
V Installer
r ---------------------------------------------------------
---------------------------------
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. ----------------_-------Dated------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE- --- --—— -- ------------- ----- Inspector--- - —-----------------------
-- - - ---------
------------------
i
r
P V
No W 2 DO R---O - Fee---- -------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
App[icat ion-*r V ell Cootruct ion Permit
Application is hereby made for a permit to Construct (e/,, Alter ( ), or Repair ( )a individual Well at:
gy
Location — Address Assessors Map and Parcel
------- -------------- ------------------------------------- ------------
Owner Address
r � /
--------------------------------- --
Installer — Driller rJ Address
Type of Building
Dwelling --------------------—----------
' Other - Type of Building —------------------- No. of Persons-------------------------___—__________
Typeof Well ------------------------—---- Capacity--------------------- --- ----------------------- —
Purpose of Well---�!�'r{-='-- -Q--------- -
Iz J
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with-the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.
'i Signed /
--------------------- --
date
I
Application Approved By— �-------
Application Disapproved forte following reasons:---------------------------------________________—---—----
----------—-- ------ -------- — ------ - --- -- -- --- —
I`
-----------------------------------
date
H
Permit No. - �O _�OZ 1 �;. ', Issued L`-------------------- — -----date
.. \
�I--------------------------------------------------------------------------------------------------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
�I
Certificate Of Compliance
i�
THIS IS/�TO CERTIFY, That the Individual Well Constructed (v) Altered ( ), or Repaired ( )
r LJ� Y zT/, i /, ..�!'I r✓!L/-Y'--------------------------------------------------------------------------------------------------
______
r
/ n / / / Installers
at
>`,1 ( � , /-t/-F -L- i'V l f f�'/;:ri/r.-1 /gyp
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. -------------------------Dated-----------------------
i
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-------------------—--------—---------------------------- — -- Inspector---------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------®=
i
i BOARD OF HEALTH
TOWN OF BARNSTABLE
i
Vell Construct ion permit
No. ----- -=- 0 2 1 Fee---`— —/
'! Permission is hereby granted-- -- - -- —-- ---- - — -- --- - —-to Construct (/), Alter ( ), or Repair ( ) an Individual Well at:
No.
Street
as shown on the application rfor a Well Construction Permit
No. - - -- --. -- G --- -
li��^ -- — - Dated---- - r° -� --
i�
Board of Health
DATE— -- — - —— —' --
Town of Barnstable Geographic Information System October 2, 2009
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DISCLAIMERS:This map is for planning purposes only. It Is not adequate for legal Map:155 Parcel:034 - N
boundary determination or regulatory Interpretation. Enlargements beyond a scale of Selected Parcel
Owner:BARNSTABLE,TOWN OF(CEM) Total Assessed Value:$669000
1"=100'may not meet established map accuracy standards. The parcel lines on this map 1
are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner - Acreage:5.03 acres Abutters
boundaries and do not represent accurate relationships to physical features on the map Location:0 MEETINGHOUSE WAY/RTE 149 /�{
such as building locations. Buffer {r,,rr
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DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:155 Parcel:034 N
boundary determination or regulatory Interpretation. Enlargements beyond a scale of Owner:BARNSTABLE,TOWN OF(CEM) Total Assessed Value:$669000 Selected Parcel
1"=100'may not meet established map accuracy standards. The parcel lines on this map
are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:5.03 acres Abutters
boundaries and do not represent accurate relationships to physical features on the map Location:0 MEETINGHOUSE WAY/RTE 149 j/ff
such as building locations. Buffer '✓'r
Aerial Photos Taken April 28,2001