HomeMy WebLinkAbout0039 LAKEWOOD DRIVE - Health (3) _ _ -- - —- - --__ - . _ �' ��..�-ems �--GLP
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No. (' v` :rC I Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in compu er.
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es
9ppliLatlon for BispoBaf 6pBtpm Construction 3pPrmit
Application for a Permit to Construct( ) Repair(,/) Upgrade( ) Abandon( ) ❑Complete System /Individual Components
Location Address or Lot No. 3 G�k�,�.i✓��d �( Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's N Address,and Tel �1 Designer's Name,Address,and Tel.No.
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�d-Kr'unli( 113 d l Xa l
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Type of Building: 06w
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) gpd Design flow provided 1) A- gpd
Plan Date Number of sheets Revision Date
Title f
Size of Septic Tank?X t S J 1006 Type of S.A.S. e X 1 S' (o X(. Lec,c_ ,_ t
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) �C, r\,Q Ec6r- '� C J\V,—
bk , Can\a LA- n a 6 k 141 o
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 Board ealth. �i
Sig Date 0 02
Application Approved by Agthj c4R Wf Date G -
Application Disapproved by Date
for the following reasons
Permit NO. 2.2 — (�`� Date Issued 3 y
No. d C7 1 Fee�1
THE COMMONWEALTH OF MASSACHUSETTS Enteredincomputr:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
s
01pplicatlou for Disposal 6psteta Construction 3permit
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Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ®Individual Components ��.
Location Address or Lot No. q w p (� t.�s Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel "���... �')()5( C ,� t ��
t' c•,n� f sum
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
H VC,N
Type of Building: d') 5 k4 00(v
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) }f Q gpd Design flow provided /a-'• gpd
!—
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank r_>V't c,� 1006 Type of S.A.S. P X 1 A (o X k- L P G(.`�. P i A
Description of Soil ,
Nature of Repairs or Alterations(Answer when applicable) QP n` C P V r v f(-^VC ►tJ
14 1 IN A QP M G L( � i n n Cl (Z 6 .:`P r ,�
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 provis t ns 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 Board QfHealth.
4 j Siged_1 ` Date
Application Approved by i Date *?AL b?-
Application Disapproved by Date
for the following reasons
Permit No. Date Issued 3/1/ - �
- ---- ------
.
dr b THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE;MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V Upgraded( )
Abandoned( )by C C (-I yC C J�,V\
at 7 Ci I_ 1/a . c6(I [Nr e U has been constructed in accordance f
with the provisions of Title 5�^and the for Disposal System Construction Permit No. 9.✓ ;0/9 dated JA Z
Installer Designer
#bedrooms Approved design flow fU f 4- gpd
The issuance of this permit.shall not be construed as a guarantee that the system willlfnnctionflis designed.
Date U/t /c} ;�_ Inspector
- - --- _ - - - --------------------- -- ---- --------------------- -- - - ---------------
No. r,d 9 1 — ()6 1 Fee S
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
r Misposal ,4pst m (construction Permit
Permission is hereby granteed}to Construct( ) Repair( {� Upgrade( ) Abandon( ) .
System located at Cr VR_.0 (,)o eJ r` . C- y
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.
x.
Provided:Construction must be completed within three years of the date of this permit.
Date 31(V d Z- Approved by � t