HomeMy WebLinkAbout3385 MAIN ST./RTE 6A(BARN.) - Health 3385 Main Street
_ Barnstable
A=299-044 - 002
JUL-21-2004 WED _09:21 AM NORTHERN, SEALCOATING 5083940955 P. 02
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PERMIT NO:j2-q 2-11
C ABANDONMENT PERMIT TOWN OF BARNSTABLE f
SEPTIC �r�/
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OBTAINED FROM HEALTH DEPT.
SEWER CONNECTION PERMIT
Abandonment Permit Not
Required OFFICIAL USE ONLY
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PROJECT CONTACTS
PROPERTY OWNER(Mailing Address SEWER INSTALLER _
Name: �Gn//2A-� (ii1A7SDn/ Name: o�+l�i�•�/v ��{�,n�-
Address: Address:
Phone: Phone: .�;D 5 3 5 5— �r �—
License No:
OWNER'S AGENVENGINEER
Name: /yA-t>4•-45w„i /�1./w Address: 2t3 ..�.a( c`Gu i L n G�ry
Phones: 3 5° - g 4 7 y 6IL-' ,L L
PROJECT DESCRIPTION REGULATORY REQUIREMENTS
ENO
`,,1 A •w>i.,t. v;�,:.,�:i ,r;C�' ou¢< >)r.: '..q .i,,c?•: ;5$r lr�+kY •v�i:}..' .:iy'�,::i•�:�'+CC�� A Ttie IflStallati011 Of 8a SeYV@f f%'r,..?a�{,>.>,.+?V n3,kh°cy'•::io'rty.V�':•<i' , .,Su;r...•.: .�:.:...��kin%:.�•�`• 11'• r:�:,;:�.;.., <-.:;•.x•.. ' .::. .�... connections must be done In accordance with the
provisions of Article XXXVI, Town of Barnstable , Generat By-laws and
RESIDENTIAL regulations Issued by the Department of Public Works. Before excavating
within a Town Way the sewer Installer must also obtain a Road Opening
COMMERCIAL permit and comply with the Construction Standard-; and Specifications
outlined therein. At least 48 hours prior to the instanation,tha applicant must
RESTAURANT notify the Department of Public Works,Engineering Division for the purpose
of inspecting the Installation. The Inspector will comiAde the Compliance
INDUSTRIAL Sketch locating the installed lines and connection. By signing the Application,
the applicant acknowledges and understands the regulatory requirements and
STANDARD INDUSTRIAL CLASSIFICATION NO. understands that failure to comply with them shall be grounds for revocation
of the Sewer Connection Permit and the denial of any future application.
NO.OF BUILDINGS NO.OF BEDROOMS
SIZE OF PARCEL ACRES
ESTIMATED DAILY SEWAGE GALLONS
PIPING:LENGTH DIAMETER
EXPECTED INSTALLATION DATE
SIGNATURE(INSTALLER/AG DATE LT UZ—
SIGNATURE(DPW APPROVAL DATE