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HomeMy WebLinkAbout0014 MOCO ROAD - Health 14 Moco Rd.., W. Barnstable TOWN OF BARNSTABLE LOCATION 1'I NQCo RUQJ SEWAGE # VILLAGE n� la ASSESSOR'S MAP & LOT 21 5 '©lD INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY . o C)n LEACHING FACILITY: (type) (size) NO.OF BEDROOMS i BUILDER OR OWNER �.�o 11i�_ QQu lxw. PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ve. L j I Ili -��le M 2��P Y, No.P-2 1---A-1 2— Fee- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rlftl Con5truction Permit Application is hereby made for a permit to Construct Alter or Repair ( )an individual Well at: j '_i --rv.�0 6- --------------- ------------ Location Address Assessors Map and Parcel Owner Address --------------------------- ------------------ ---------- Type of Building Installer - Driller Address Dwelling------ ---S- ----------- Other - Type of Building------------------------------- No. of Persons---------------------------_--____________// Type of Well Capacity------------------- Purpose of Well--------- 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 a Certificate .of Compliance has been issued by the Board of Health. SignedJ&- ------- -------------------------- date Application Approved By --la-ft -11 date Application Disapproved for the following reasons: —--------------------- ----------- ----------------------------------------------------- ------------------------------------------- date Permit No. Issued o-7 -----------—------------------- date -------------------- ----- - ---- - - -- - ---- ---------------------------- ------ -- - ----- ------- ----I---------- - - --- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed Altered ( ), or Repaired by-------Z'�nW A4---------- ----------------- -------------------------------------------- Installer at--------- I P- -2�------------ ------------------ --------------------------------- 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.W- --Q0----0----- ated -U ? THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------- ----------------------- Inspector--------------------------------------------------------------------------- - ------------- r I - -��- * BOARD OF HEALTH No. � Fee----- TOWN OF BARNSTABLE Application,for lDe[Y Construct ion Permit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel ;-------- �_ �--� _______ _! 'S= -�_sa ---- =- r -------- Owner Address Installer — Dri ler Address Type of Building Dwelling---- --------------------- Other - Type of Building-------------------------------- No. of Persons------------------------------— —- Type of Well----------�<-- —--- - Capacity---------------------- - - - - -—— -___— Purpose of Well----------.�-�`--i-�: ----------------------------- i I 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 a Certificate .of Compliance has been issued by the Board of Health. i Signed date Application Approved By date i Application Disapproved for the following reasons:--------------------------------------------------------------------------------------_--____-- -----------— - -- — -- ----------------- -------------------------------------------------------------------------------------------- date Permit No. ----- - Issued date I-------------------------------------------------------------------------------------------------------1 BOARD OF HEALTH TOWN OF BARNSTABLE ! Certificate ®f Compliance _ THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) i by--------4_ee�l------001 �' --------- � �- ------------------ =- - - - -- - ---------------------------- Installer pp�� at --------1 -- p--------�"� -- - — w.-tz_°t f------------------------------------------------- - i� has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection i I Regulation as described in the application for Well Construction Permit No. tz,-� - a_7___�3aDated t--=-U f THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE----------------------------—--------------------- ---— - -- Inspector----------------------------------------------------------------------------- i -------------------------------------------------------------------------------------------------------- I BOARD OF HEALTH TOWN OF BARNSTABLE - - Vell Conoruct ion Permit t w a ov-7- 0 3 2 �. No. ------------------- Fee--- Permission is hereby granted— � - — --------- �-- ------------------------------------------------------------------------------------------ !' E to Construct ( ), Alter ( ��, gr Repair (V a Individual Well at: L Street as shown on the application for a Well Construction Permit No. -------------------------------------- Dated-- ------------------------------------ ----------------___ __-- � _a_------ Board of Health DATE----��-�---�-�---�--� �----------------------- - - 3 eral �i ifs S,o 1 ,V V d'o14Ls Lod � Ad V J� Ul (All p tqiv �= �• k :. - September F 2 2, ;1978 Lrnest,Ewing `32 Sidlaw Road Brighton;, -`Massachusetts •02135 , Res` Your property. at. 12 Moco -Road, West` Barnstable,' Dear: Mr. Ewing: You are granted 'a variance,,to locate your -well` '145' fe' etl,from your•'.sewage leaching area. and 104 feet .from .your neighbor's { sewage Leaching area in,.-lieu- of the. required 150 €eet.;; This variance ',is conditional.,based upon our,"approval of :engi _ nearing plans of`your':eept :c: system',, percolation aests; etc. All other regulations contained In-*Title..5' Hof the State r; Environmental Code, and Town -of Regulations . must -be "complied with. ` " This variance oxpirea November l,. L979.. - Very +truly yours, , w .Anon- J baugh, Chairman .` Bober L. x s A. Mandelstam, D. BOARD OF HEALTH r TOWN OF BARNSTABLE. 32 Sidlaw Road Brighton, MA 02135 September, 18, 1978 r Town of Barnstable Board of Health s REQUEST FOR VARIANCE Dear .Sirs: On my lot ' (#12 Moco Road, West 'Barnstable) I have not1 been able to neet ,the-requirements of the Town of Barn— stable in locating my "well 150 feet from the closest existing sanitation systems. As shown,on 'the attached map, please note°that the dis- tance to my.own proposed sanitation system is 145 feet. The distance from the well to the sanitation system of my neighbor (Mr. Jedrey) is 104 feet. (I believe this to be the measurement taken by Mr. Murray of the Barn- stable Board of Health. I, therefore., respectfully request a variance, Si. cerely, C. Ernest Ewing Enclosure (1). 7 . 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