HomeMy WebLinkAbout1730 OST.-W.BARN. RD - Health QCfe/vi/fie 'bJ• Berns*ble
TOWN OF BARNSTABLE
LOCATION 17.`,1 4s7 ,a&LE- SEWAGE #
VILLAGE/✓, ASSESSOR'S MAP 6z LOT8' di
INSTALLER'S NAME & PHONE NO. '
SEPTIC TANK CAPACITY I0Ma s
LEACHING FACILITY:(type) P (size).
12 PRIVATE WELL OR PUBLIC WATER l,��ct_
NO. OF BEDROOMS
BUILDER OR OWNER l'Z� �� S.tii:H �a/LS I�/7�2/J;�✓A•04VIl_otff"al0'lff�
DATE PERMIT ISSUED: i9'12
DATE COMPLIANCE ISSUED:
'VARIANCE GRANTED: Yes No
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No./Y----------------- MEMO.O. Fee---------------------
BOARD OF HEALTH
TOWN[ OF BARNISTABLE
2ppricat ion for Vefi Con5tructionpermit
Application is hereby made for a permit to ConstructXj, Alter ( ), or Repair ( )an individual Well at:.
1730 Ost. W Barnstable Rd.
----------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------
Location — Address Assessors Map and Parcel
Adrian White -_ ____1730 O s t W Barn_._-_R d._-,----hi-.-___B-a-rns_t a b 1 e
- ------------------------------------------
Owner Address
Meehan Weil Drilling 338 Rte 130, Sandwich, MA 02563
Installer — Driller' Address
Type of Building
Dwelling---------�----------------------------------------------------
Other - Type of Building -------------------- No. of Persons---------------------------------=-----------_----------
Wate ----------------------------
Type of Well--------------------r ------------------------------------------ Capacity------------------=--------
---------------------
Purpose of Well-----rep 1 a ceme n t ...........................
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�i�h '�t/�^e __ Al-,*r/ / - y�
-------------------------- ------------------- -----------------------------------
date
Application Approved By = eta `-- ` -
date
Application Disapproved for the following reasons:--------------------------------------------------------------------------- ---------___
------------------------------------------------------------------------------------
Permit N
' o. Issued
� �'✓�
- -!�-- - - - - -' -
-------------------------
date
BOARD OF HEALTH
TOWN OF BARNISTABLE
Certificate (Of Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed (X), Altered ( ), or Repairedxx)
Meehan Well Drilling
------------------------------------------------------------------
--------------------
Installer
1730 Ost. W. Barnstable Rd. , W. Barnstable
at---------------------------------------------------------------- - - - - - --
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 1`ly fe7t�� 1.: Dated'---a--- jam.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
' `J ------------------------------ -
DATE--- ---�-------------------------�------
BOARD OF HEALTH
TOWN OF BARNSTABLE
U)rll Con5truction3permit
__. z .�
No. - - - ---- / Fee------------2'' 7J
Permission is herebyranted--------1)1"0="'_'4__'k41'1------���----------------------------------------------------------------
g �/
to Cons r ct ), Alt-------er , ), or Repair (4) an 'vidual Well:
Z- 016
Street
as shown on the ap licatio for a Well Construction Permit
...
3
�
No. �-_------ ------ ------------------------------ Dated------ - ---------- ----------'-�-- -------------------
Board of Health
DATE---- — - 9-1-1
-----------------------------
m
,1
No.��---- --------- Fee--------------------
, R c BOARD OF HEALTH
TOWN OF BARNSTABLE
Zpplitation-*rIftl Con.5tructionpermit
Application is hereby made for a permit to Construct (<X), Alter ( ), or Repair ( )an individual Well at:
1730 Ost. W Barnstabl-e Rd.
Location — Address Assessors Map and Parcel
-Adrian White -- - - -- - -- - - - --1-730Qst_W-Byrn .--�cl__� -��T= Rja- rr,ct_able
Owner Address
Meehan Well Drilling 338 Rte 130, Sandwich, MA 02563
Installer — Driller \ Address
Type of Building
Dwelling--------- "----------------------------- -�-
Other - Type of Building----------------------- ------ No. of Persons----------------- - - -- -- --
Type of Well-_Wai_=Pr ------------------------------------------------ Capacity----------------------------------------------------
-----------------------------
Purpose of Well-----r p.c l a c em a n t-----------=------""--------
Agreement: 4
�, �
The undersigned agrees to install.the aforederibed individual well in accordance with the provisions of The
Town of Barnstable Board of Healthsc
Private Well Protection Regulation - The undersigned further agrees not to
place the well in operationluntil-,a`Gertificate of Compliance has been issued by the Board of Health.
Signed . �� �J-/� 'P.�i -'� —- — - lVd V
date
Application Approved By ---?---
�. V
date
Application Disapproved for the following reasons:------------------------------------------------------------------------------------ -----------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
date
Permit No.- -//L�__'"'-/ "'- --------------- Issued-----------f------
------_-_-
date
BOARD-6F HEALTH -
TOWN OF BARNSTABLE
Certificate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( x), Altered ( ), or Repaired 7(X)
Meehan Well Drilling
bY— — — — - --- -- - - --— - - -- - -------------------------------------------------------------
Installer
1730 Ost . W. Barnstable Rd. , W. Barnstable
at - - ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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 NV �� Dated; ����- ��
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-- !r^ f Inspe 4tor - .?.?c,.G' \1 •_--- --- " - ,'---
BOARD OF HEALTH
" TOWN OF -BARNSTAB LE
Yell Con5truct ion Permit
No.-AP'-'---.�•?a Fee-
Permission is hereby granted ------�:------ �;- �
to Construct ( ), Alter ( ), or Repair (A) an Individual Well at:
• ---1-7- �---------s- ---- -------------yztz---------�---------Street-- -- - - - �- - -= -r• -r-- - -- c
00'
as shown on the application,for a Well Construction Permit
No.------ -�i"--- i---
.----------=/`� Dated--- � -'------�-----------
-� Board of Health
DATE -/—-- - -, - ------------
* 1
fl, -7
TOWN OF BARNSTABLE
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
NAME I L .,��� �� AL j !s
ADDRESS VILLAGE -
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE:
OR CHEMICAL
(Give same information for any additional tanks on reverse side of card)
DATE OF PURCHASE OF EACH: 1. y� 2. 3. 4.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED:
PASSED DID NOT PASS
A P P R O V E D
Barnstable Conservation Commission
le .d
igned a s