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HomeMy WebLinkAbout0135 PUTNAM AVENUE - Health c a;�U .�//iice�, o�� _�=_ __.___ No. r v�1/Z' y� Fee BOARD OF HEALTH TOWN OF BARNSTABLE 01ppYicatiou ff or Yell Cougtructiou Permit Application is hereby made for a permit to Construct( Alter( ), or Repair( an individual well at: l3 5 PPr, dfn fiYe , 6D f u i f © 3 G /04� do I Location-Address Assessors Map and Parcel LLG q 002 o (D� Ave T -7 5 aas �a�es 1�arm � x y owner T Address bOJ Wj_\61 W1wn br � PU 6OX Q'7Q✓ / Yu�lM A- 0 2�93 Installer-Driller Address Type of Building Dwelling Other-Type of Building �r No. of Persons Type of Well `1 Lj(, � 1'VL Capacity Purpose of Well- � 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 Certi ate of Compliance has been issued by the Board of Health. Signed ate Application Approved By �Pz-- Date Application Disapproved for owing reasons: Date Permit No. �%� Issued /I/, -L-- Date -------- ----•-------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed 167, Altered( ), or Repaired( ) by �_I Installer at I ?y 5 �1111'lG.l Y] �I'V� 6x?Lu t- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private We Pro ection ..Regulation as described in the application for Well Construction Permit No. LJ2,a2?, Cd 1 Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector - l - No. ,VZ '' DI� Fee `7 BOARD OF HEALTH TOWN OF BARNSTABLE Ln Zipprication ,for Vern Cow6truction Permit Application is hereby made for a permit to Construct(x5f- Alter( ), or Repair( ) an individual well at: 6D D Location Address Assessors Map and Parcel B PS Farrr> LLG q 002- C)ou,cj to- S Av_ ,bRAC�S Tjc `7Owner rpor�d well br,l(i m , l h( , �o eox a7�" ()t' �d,dress y,,< lk 1t 02G 93 Installer-Driller Address Type of Building ;, Dwelling y Other-Type of Building No. of Persons TYPe of Well ' ► 5t fl ' Capacity 7 _ Purpose of Well y I lno i c\yl J r,✓ 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. !. SignedJ� �L1Z4ZZ 4 Date Application Approved By � Date Application Disapproved for Cefo1lowm reasons: 1 / Date Permit No. �D) Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed L), Altered( ), or Repaired( ) by kr�h l l - 1 Installer at 13 5 Pu f r7a m 4-V� . (-' I-Lt r � has beer!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. MxVt p: Dated q17,/1 l - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL x SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE C 39ell Congtruction Permit (.� . No. r Fee ` J — Permission.is hereby granted to n cf t-lJ� ( I b r t lit I)G, IV)C. Installer ` to Construct(X), Alter( ), or Repair O an individual well at: 3 No. 13 7 Street + as shown on the application for a Well Construction Permit No. i''-1 Dated Date "l 7. 1 ) Approved By (_,�% R=59.J4 70.26 d.h. C.B ci �• g.AO2 8 V ot d.h. �! of / 3 let a AW 00 d.h. `' '' `'► '�'cs ` ' .,. (20.00 Wide) � dh. C.S. ! N33oji'15"W 46. 12— 43 f SUBDIVISION PLAN OF LAND IN BARNSTABLE 42j5 D CapeSurv, Surveyors ~ April 22, 2015 R�39.54 a• l ro.�s ca 0) tJd}��e dh.S<Nk8 a,95'4 n g e try 8� �5p�y0• 0' •,� $�� �. Easement �' iLLhii y dh. , `�`:� (20.00 wide) P. N4J3175-W4dU j o LGB�4,r t o 5 v so .i Sa ', f j 0 14 g fo 15 Ob � 3 , m p , A O GB. 16 dh.GB. w � 6l seabroz� i ® h ?I�RT r;e t\, 1.1.. �T?,6gij��. i dh.GB. ram- .i' •���_•� toDAIL Subdivision of the Remainder of Land and Lot 1 �� Not to$,a/, Shown on Plans 4235-A and 4235-C ��� 6 ~- Filed with Cert. of Title Nos. 136 and 19327 Registry District of Barnstable County ,'-'� _ _ •'�� Seporote certificates of We moy be Issued for land Abutters are shown as shown hereon as lots 2 and 3 on original decree plan. By the Court. /�� caoy a W r P1- ••• LAND RoISM770N OFROF December 16, 20t5 Recorder Dec, M 2015 Scde or w#p1w,200 test to on Inch 5JK-OBLX ra ftarond,fnikeer for Covrt.te