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HomeMy WebLinkAbout0240 PARKER ROAD - Health (2) 240 Parker Road W. Barnstable A = 176 015 i f j; Fee-���" ------ f1o.— -- 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 __ a RTE BA ., ?Q 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 r