HomeMy WebLinkAbout0240 PARKER ROAD - Health (2) 240 Parker Road
W. Barnstable
A = 176 015
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Fee-���" ------
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BOARD OF HEALTH
TOWN OF BARNSTABLE
Appricatiouffor'Vell Cootruct ion Permit
Application is hereby made for a pe it to Construct Alter ( ), or Repair (�n individual Well at:
Location — Address Assessors Map an arcel /
caner Address
Installer — Driller -- Address
Type of Building
Dwelling
Other - Type of Building-- ------ No. of Persons----------- -----------
Type of Well Ca acit �Q`-'W --
YP -- Capacity— — — —�
Purpose of Well OT --
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 CertificatAof Compliance has been issued by the Board of Health.
Signed —
dale
Application Approved By � —— __—___— 2-7- 3
die
Application Disapproved for the following reasons: --------------- ----- ----------
date
Permit No. "" -- Issued---- -Z b date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f Compliance
THIS TO CERTIFY, That the Individual Well Constructed (A,��Altered ( ), or Repaired ( )
I Iler
ato �' ----___ -- --------------
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Frote9lion
Regulation as described in the application for Well Construction Permit NoN!!3=?—&—Dated U
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE- --- - -- Inspector-- —__—-- -- ------------
4 , ,w 2oo3-° ( '�7 - �'�_" ------
Fee
k I
#; BOARD OF HEALTH.
'¢ 'TOWN OF BARNSTABLE
z
-
01ppYicat ion-*rVefr Congtructionpermit
Application is hereby made for a pe it to Construct ( '- Alter ( ), or RepaV( n individual Well at:
Location — Address � — A rs Map and-ParceleeIV6
wner Address
ok� - "�o
Installer — Driller Address
Type of Building v—
Dwelling _—--- --- -------------
Other - Type of Building----------------- No. of Persons----------------------------------
T /0�U�
Type of Well -- -- Capacity---- — --J-- --- ---
Purpose of Well-- 0-7 q'& L
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 3"Certific�.ofcompliance has been issued by the Board of Health.
Signed U
T Q da e
Z
J�-s S` 2 0 3
Application Approved By ------- -----
d e
Application Disapproved for the following reasons: ----- --- - ----------- --
_--__—_—date ---
Permit No. _- Issued----��- Z 2 G ---------
date
�F
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certifitate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( 41'"'`Altered ( ), or Repairedby
( )
1 staller
at—
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well rote Pion
22
Regulation as described in the application for Well Construction Permit No.'J2oo3-0(q-------------Dated--- -----3
---
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----- --- Inspector--------------- -_ —_ --__
BOARD OF HEALTH
TOWN OF BARNSTABLE
Ivell construct ion Permit
No. WZ003-01q Fee_ ------_
Permission is hereby granted - ------�-----
to Construct ( ,4; All, ( ), or Repair ( ) an Individua�r yell at:
No. � 7/ G���Ct� /�� jC//� a� 4�r� --C_ —--- - ---------------------------- -
street
as shown on the application for a Well Construction Permit
No._ �''J 2oU3-Old Dated 2 Z a�
---- --- /�—c-----------------------
- --
/L J
DAT E 2 2 10 ------ Board of Health
__
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RTE BA .,
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LOCUS
go
CHURCH C+�
LOCATION MAP NO SCALE
LOT AREA
2
ASSESSORS MAP 176 PARCEL 1
53,897t SO. FT.
1.24f ACRES
\ ,--EXIST. LEACHING AREA LEGEND
i LP EXIST, LEACH PIT
+ EXIST. CESSPOOL o p EXIST. SEPTIC TANK
(ACTING AS "SEPTIC TANK")
W
W 7 CB/DH CONCRETE BOUND
EXIST. FAILED WELL (TO
BE ABANDONED)
"So
EXIST. DWELL -
L
+ EXIST. LEACH TRENCH
N �51
.P
EXISTING LEACH PIT O ( O P
..AND SEPTIC TANK O
LP
EXISTING WELL
EXIST. DWELL. CDR ( EXIST DWELL
� T _
a
Y
CDR PROPOSED WELL PROPONED WELL PLAN
CB/DH
- -
_
ER. ROAD
'' st "1'tD1 ,.
wH,: ...w:w..:.,»,,......a..,y.:..'•:-.+'-n....«i....>..,.�.w.cuY,...+............. �:c..,.,...4..w,.+..C.:«.+.w..,..�.1,..:G....- +Giw``.r.. ..P..:nYtl..._sA..:a�.._ °�"�CL_.�..� .......-.....-......r......-.-..-..n......u...,,.....�...,....rum..... ... .s.....
�.,. PREPARED F
RENE LAMPI
BOARD OF HEALTH
30 0 30 60 90
MA
` APPROVED DATE
SCALE: 1., = 30' DATE:, MAY 12, 2003
off M-362-4541 i
fcx 508 362-9880
do wn cope engineering, inc.
AR NE cyG�
CIVIL ENGINEERS
LAND SURVEYORS s OJALA
No. 6
939 thin st. yarmouth, Ma 02675
03— 107 ARN H. MLA, P.E., .L.S. DA E
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