HomeMy WebLinkAbout0032 MAIN STREET (COTUIT) - Health (2) �13� fay
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BOARD OF HEALTH
TOWN OF BARNSTABLE
01ppYication _for Yell Construction Permit
Application is hereby made for a permit to Construct(+%- Alter( ), or Repair( ) an individual well at:
J�) Mai. sT ca7lteT
Location-Address Assessors Map and Parcel
Qa r l�..,e �o C� '� /uU(PU ST Co!k,�T M 4
Owner Address
(J�NNlS SCG,vivC l+/ Oe6raS,3 /Z � MC,I rOce
Installer-Driller Address
lter )S!� ^AC S77- N e7
Type of Building S-C,
Dwelling
Other-Type of Building No. of Persons
Type of Well Capacity
Purpose of Well /✓/ �6aTa a p,,,�y
Agreement:
The undersigned agrees to install the afore described 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 ComUianchas been issued by the Board of Health.Signed
Date
Application Disapproved for the following reasons:
Date
Permit No. Issued
Date
--------------------------------------------------------------------------------------------------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of Compliance
THIS IS TO CERTIFY,that the individual well Constructed(A- Altered( ), or Repaired( )
by DeN Nt s ,S'Cow,,,c jl
Installer
at 2,2 MCx l N S! Cep/T
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private veil er¢te�
Regulation as described in the application for Well Construction Permit No. Dated r
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORILY.
Date Inspector
No. Fee
° BOARD OF HEALTH
� r�T,OW-IV OF BARNJS�TABLE
01ppYicactfon jor Yell Cott5truction Permit S
Application is hereby made for e Construct(t) Alter( ), or Repair( an individual well at & ;
PP � Y permit to r
z"':.�4H, Y}-.. r�..t ! ,y � ke.�K�y„�-,w,.�,�;..... �r+�-.��� w.� :. s-"`';;• ..,y,u:1�.
�`'�a,:r_�_..y/�^''
S /
Location-Address Assessors Map and Parcel +%
fk�tle...,c He11 3J /140,rn. S? cjc-tI7M4,
Owner tc, ^— :'. , ,rr> "r .' .' s., a .. •Address •. T -._
}
�P�y,viS ue DebtGSS R riAC'3i�y6re
Installer-Driller Address
(//,r T. N e 7
Type of Building
Dwelling
Other Type of Building `. No. of Persons
Type of Well "/ y C Capacity
Purpose of Well /✓/ I J-/6
Agreement:
The undersigned agrees to install the afore described 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 UPN � • ( `�r(�
Date
- �.. - _ -="�"�"•"a
Date
Application Disapproved for the following reasons:
Date
t '
i
Permit No. Issued
'E Date
.a4 -----ma—asp---.°veep—eed4vee<
E BOARD OF HEALTH
TOWN OF BARNSTABLE
rYa ,;-o •+ ` , -` "4 .. F :,. r, ,.. .: ,__ ,,,:. ay'
erttftcate of writ ttance
THIS IS TO CERTIFY,that the individual well Constructed Altered( ), or Repaired(
w by
Installer
at MU l CvTu I T
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. [A)202? —0I j Dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL _
SYSTEMWILL FUNCTION:SATISFACTORILY
Date "` Inspector
-------- ---- .,..---.e--A«:.�..,..
BOARD OF HEALTH
TOWN OF BARNSTABLE
Well Cougtruction Permit
0.
Fee
.. .. '.. / _ , ,_a, try ..�4 .:.. a. u.'-3•
Permission is hereby granted to et'jtil S Sc,,.i
Y Installer
to Construct(0; Alter'( ), or Repair O an individual well at:
t Street ' 20- -_ f,1 ,
as shown on the application for a Well Construction Permit No. L,�f (J __ r�1Dated
Date / ( ^ Approved By �� ,
SYSTEM PROFILE NOTFS
_-Rat
20 1 ll� 10 Pt -TER—T
10 lu-0,
FM�C ISTEV M SOk 40.4'PC.
.31 m at
(2D
NE.,
. _ I t
10 V dTWIXR 9UyL U, Fm
LOCUS MAP
F_J_
FAWN RE 's
D'RO. .2' LFAfHMVG 04�� ASSESSORS MAP 23 PARCEL 3
:OC�Atrl 11 "LOCUS M THIN EEMA FLOOD ZONE X
-�E !j 3F
j14-MLS AND 11;Wa! 'ql_.R W.,�1 AND'I�E IAV.'N� (AREA Cr UNWAL FLOW KAZARD)AS
�RD4 Sk�ON COMMLkW.TY PANEL 125001co5s9i
KRICN OF;EPV,E�"E. DATED 7/)6/2014
LEGEND
N
I "Z
SYSTEM DESIGN:
GARBAGE VFPOSER M NOT"!q
DES FLON 3 BEDROOMS 0 110 GPD 33D GPD
USE A?�q GPO OlWA FLOW
SEPTIC T�!330 f�PO(2)-660
TEST HOLE LOGS SEPW TAW USE A 15M GAL
ENGUCER:MC i FF. LEACHW:
NTN.SS
SAES: 2J25._12.83)2 J.74)-m,GF0
BOTTOM 25vl2tWl(.74)�-,237coo
TOTAL' 472 S.F. 9 GPD
PEK.RATE W 0
62 a USE(2)500 GAL.LA ROUND (ACME OR EQUAL)
�9
CLASS. SOU Pi NTH 4'STONE ALL AROUND
tLEV. ELEV.
59.6' 9. SOX
74' 4/2 APPROVED DATE BOARD OF KEW.
4cta TITLE 5 SITE PLAN
rsk
2.51 5/- _P7 57-9.
36* 56.6 32 MAIN STREET
C; BE, COTUIT, MA
fss TOP OF aox
36 2 Sv V.
NA.-as PRE�FOR
./c, �Z BORTOLOTTI-CONSTRUCTION
U/Cs
WE.omGBEN 26.MIS
IOIR 7!
132 1486 IM'1 481 deiro Coe
NO CMAtMATER ENCOUNTCREO Ctvll �gyoif�rs
m
/and sr"
DUE — . 51—e�'. ea)
DAREL A. A.PE.. 7cr dIA 0767s