HomeMy WebLinkAbout0044 NEWPORT LANE - Health (2) :,,=Tangy lfii A_CT.,.,�1�i� 1C.� 1
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No. �' 1 0 J Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplifation for Disposal 6pstPm Construction VPrtnit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System El Individual Components
Location Address or Lot No. L P✓ Owner's Name,Address,and Tel.No.
Asseo� P
r `Iap/Parcel 16(E
Installer's Name,Address,and Te.No. Designer's Name,Address,and Tel.No..
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Type of Buildings
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder{ )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 1 a A/ r�} gpd Design flow provided 1" gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 7,4e-ob;-e c_ —/,--/Y
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Boa ealth.
Signed Date _a 2
Application Approved by ' Date
Application Disapproved by V Date
for the following reasons
Permit No. a u d Date Issued ( `�
F
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No. )W 2 I O y Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
" Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for Disposal bpstem Construction permit
Application for a Permit to Construct( ) Repair(v-)�Upgrade( ) Abandon( ) ❑Complete System Individual Componen q
Location Address or Lot No. q IA)f_1 Jrv/f L N Owner's Name,Address,and Tel.No.
Os�c✓���1 e riZ
Assessor's Map/Parcel (� o,? 4 A D C
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
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Type of Building:
Dwelling No.of Bedrooms N/+F7� Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) hi LA gpd Design flow provided IUD 44— gpd
rW �
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
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t
Nature of epairs or Alterations(Answer when applicable) 74 c#a,A GC I &/ Z? -ZW Y
Date last inspected:
Agreement:I
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Bond o ealth.
Signed Date ?j-a 6'2 2
Application Approved by to C). I Date 7
Application Disapproved by V �. Date
for the following reasons
Permit No. `") a — Ju d Date Issued . 3—a
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
�v Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned( )by�, A _: ((x))I\) 7,,►�
at L4 Ll A )%60 t 1,IJ �P f j e has been constructed in accordance
with the provisions of
Title 5 and the for Disposal System Construction Permit No. 7d 0 J`�t<v dated 7' ) C7
Installer U A ,`- t oxm,J T h>C. Designer p`I
#bedrooms F, .(1- Approved design flow n v f'4 gpd
The issuance of this permit shall not be construed as a guarantee that the system will function asdesigned.
Date l°� r Inspector �( 12
1 f v v
-------------------- ------------------------------------------------------------------------------------
No. d;;� -/cJ v Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Disposal *pstem Construction joermit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( Y.
System located at LI /�PC �r/.k"X t�S kP✓� '
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three ears of the date of this permit.
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Date �j l,)�I ! Approved by �'��
Z 548 6.59 959
Receipt for
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STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
`CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front).
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address 12
leaving the receipt attached and present the article at a post office service window or hand it to
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2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return Cl)
address of the article,date,detach and retain the receipt,and mail the article. rn
3. If you want a return receipt,write the certified mail number and your name and address on a 02
return receipt card,Form 3811,and attach it to the front of the article by means of the gummed m
ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT
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4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, 0
endorse RESTRICTED DELIVERY on the front of the article.
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5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL
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TOTAL Postage
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Postmark or Date
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STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front).
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address
leaving the receipt attached and present the article at a post office service window or hand it to j
your rural carrier too extra charge).
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return C.)
address of the article,date,detach and retain the receipt,and mail the article.
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3. If you want a return receipt,write the certified mail number and your name and address on a
return receipt card,Form 3811,and attach it to the front of the article by means of the gummed
ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT
REQUESTED adjacent to the number. co
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4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M
endorse RESTRICTED DELIVERY on the front of the article. E
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5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL
return receipt is requested,check the applicable blocks in item 1 of Form 3811. !W
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6. Save this receipt and present it if you make inquiry. 105603-93-B-0218
Z 348 659 960
Receipt for
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to Whom&Date Delivered
Return Receipt Showing to Whom,
Date,and Addressee's Address
TOTAL Postage
' &Fees
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Postmark or Date
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front).
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address
Mleaving the receipt attached and present the article at a post office service window or hand it to
your rural carrier(no extra charge).
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2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return Cl)
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address of the article,date,detach and retain the receipt,and mail the article.
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3. If you want a return receipt,write the certified mail number and your name and address on a
return receipt card,Form 3811,and attach it to the front-of the,article by means of the gummed
ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT
REQUESTED adjacent to the number. co
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4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M
endorse RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested in the appropriate spaces on the.front of this receipt.If
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return receipt is requested,check the applicable blocks in item i of Form 3811. d
6. Save this+,ctcipt anApresent it if you make inquiry. 105'603.93-B-O2.6
;o SENDER: I also wish to receive the
■Complete items 1 and/or 2 for additional services.
ei ■Complete items 3,4a,and 4b. following services(for an
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■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you. ev
■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address
4) permit.
d ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery
■The Return Receipt will show to whom the article was delivered and the date a
delivered. Consult postmaster for fee.
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PS Form 3811, De ember 19k Domestic Return Receipt
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UNITED STATES POSTAL SERVICE 0P PM
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®epadtae .. �..
owr of Bamsbble
Box 534
-��artnis Massachusetts fn6
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Town of Barnstable
• � Department of Health, Safety, and Environmental Services
RA Public Health Division
it 367 Main Street, Hyannis MA 02601
Office: 508-790-6265 Thomas A McKean
FAX: 508-775-3344 Director of Public Health
December 2, 1996
Chairman of Trustees
Village Square Condominiums
39 Tower Hill Road
Osterville, MA 02655
According to Title 5, the State Environmental Code, Section 15.30(3), all septic systems
connected to condominium units shall be inspected before December 1, 1996 and at least
once every three years thereafter.
You may not have been aware of this requirement until now, therefore, please feel free to
give me a call at 790-6265 if you should have any questions. In the meantime, please
make the necessary arrangements to have the septic system(s) inspected. Attached is a
listing of DEP certified septic system inspectors.
Sincerely yours,
Thomas A. McKean
Director of Public Health