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HomeMy WebLinkAbout0020 BELL ROAD - Health Hyannis F/R � 1 223 i 2 5 ( 5 ,per FAILED INSPECTION -\ COMMONWEALTH OF KNSSACHLJSETTS EXECUTIVE OFFICE,OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION R CZEiVED AP: ;PARCEL- 2 2 3 w Novo 3 2004 TOWN OF BARNSTABLE HEALTH DEPT, = ,•.:TITLE-5 - OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Q.oA D . Property P Y Address: 2o Owner's Name: � tyX1�PQ�CI� ' Owne'r's Address: �,f [ � Date of Inspection: io •-y Name of Inspector: (please print) �o C1 P y l`fO�I4 Company Name: !"Ope in)%S.e Cnt2Cp{`►Se .t- Mailing Address:' Pd-Tyi-A �h3 - �"P n+P(I;� r Telephone Number; s0R — �i'�•�'i CERTIFICATION STATEMENT. I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time,of the inspection:The inspection was performed based on my " training and experience in the proper function and maintenance of on site sewage disposal systems..I am a DEP , approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes r Needs Further'Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: io/A!gJ o-{ The system inspector shall submit'a copy of this inspection report to the Approving Authority(Board of Health or z DEP)within 30 days of completing this inspection:If the'system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall.submit the report to.the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments . ****This report only describes conditions at the time of inspection and under the conditions of use at that .. time. This inspection does not address how the system will perform in the future under the same or different conditions'of use. z Title 5 Inspection Form 6/15/2000 page I Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL`SYSTEM INSPECTION FORM' PART A CERTIFICATION (continued) Property Address: ')-,o R e_II ri i)C: Owner: Uc T_Qi3(l�il lll— Date of Ins ection: r P _ic) ie�,q 1ntl Inspection Summary: Check A,B,C,D or E.lALWAYS complete all of Section D • , C A. System Passes: . _ I have-not found any information which indicates'that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluate d ed are indicated below. Comments: B. System Conditionally Passes: y ,-f--ft_ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair,'as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the, foi the followingstatements. If"not determined"please explain. The septic tank'is metal and over 20 years'old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is'imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certifcate of Compliance indicating that the tank is less than 20_years old is available. ND explain: Observation of sewage backup or break out or fiigh static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken;settled or uneven distribution box.System will.pass inspection if(with.• approval of Board of Health): r broken pipes}air-replaced _ obstruction is removed distribution box is leveled or.replaced ' AND explain: ` n =The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 -OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS t( SUBSURFACE SEWAGE DISPOSAL:SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:'`a n Owner Date of Inspection C. Further Evaluation is Required by the Board of Health: -A-R Conditions exist which require further'evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not•functioning in a manner which will protect public health,safety and the environment: . Cesspool or privy is within 50 feet of a surface water ' Cesspool or privy is'within 50 feet of a bordering vegetated wetland or a salt marsh r 2. System will fail unless the Board of Health'(and Public Water Supplier, if any)determines that the system is functioning in a•manner that protects the public health,safety and environment: The system has a septic tank and soil absorption'system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. - The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the:SAS'is less than 100 feet but 50 feet or more from a private water_supply well**.Method used to determine distance *.*This system passes if the,well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate-nitrogen is equal to or less.than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: x Page 4 of 11 OFFICIAL INSPECTION FORM--NOT-FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE D.FSPONAL"SYSTEM INSPECTION FORM PARTA. CERTIFICATION(continued) + Property Address: ,Ao 1�(.i111 i'n�; f(lal Owner: �(`�� �imPtliCtl Date of Inspection: 10 j'Jq D. System Failure Criteria applicable to all'systems: You must indicate"yes"or"no to each of the following for all inspections: Yes No & Backup of sewage•into facility or system component due to overloaded or clogged SAS or cesspool 4 X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool i Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than b"below invert or available volume is less than'/z day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped 'Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. A Any portion of a cesspool or privy is within a Zone,I of a,public well. Any portion of a cesspool or privy is within 50 feet of a private`.water supply well. An portion of a cesspool ,X. i � le ' t e or r is less than 100 feet but eater a e than 50 feet from a private — t water YP P �'3' greater— P supply well with no acceptable water quality analysis.(This system passes if the well water-analysis, performed at a DEP certified laboratory;for coliform bacteria and volatile organic.'compounds indicates that well is free from pollution from that facility'and the presence of ammonia nitrogen and nitrate nitrogen is.equalto or less than 5 ppm,provided that no other:.failure criteria . are triggered.A copy of the analysis must be attached to this form.] . (Yes/No)The system fails. I have determined that one,or more of the above failure criteria exist$s described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve.it facility with it design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems.in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply , X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered i. "yes"in Section D above the large system has failed.The owner or operator of any large system considered a . significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM,-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: _ CA M\I mu Owner: T2•��'c'e�i P�rnec��al_ . . Date of Inspectsi Check if the following have been done. You-must,indicate,yes"or"no"as to each of the following: Yes No t r. Pumping information was provided,by the owner,occupant, or Board of Health Were any of the system components pumped out in the previous two weeks Has the system received normal flows iri the previous two week period ? Have large volumes of water been introduced to'xhe system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) . _ Was the facility.or dwelling inspected for signs of sewageback up? I _ Was the site inspected for signs of breakout? Were all system,components,excluding the SAS;located on site'? Were,the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction;.'dimensions,depth of liquid,depth of sludge and depth of scum? t Was the facility owner(and occupants if different from owner).provided with information on the proper maintenance of subsurface sewage disposal'systems.?' The size and location of the Soil Absorption.System(SAS)on the site has been determined based on: . Yes 'no .s ; .Existing information. For example,a-plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 MR, 15.302(3)(b)] i" Page 6 of 11, t x OFFICIAL.INSPECTION FORM—'NOT FOR-VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE:DISPOSAL SYSTEM INSPECTION FORM PART C SYSTE]VIINFORMATION' ` Property Address: �,Q ( r'itYn • e Owner: .? r-cv P►m e.r�cci Date of Inspection; FLOW CONDITIONS RESIDENTIAL f` Number of bedrooms(design) ,' Number ofbedrooms(actual). 3 - DESIGN flow based on`310 CMR 15.203 (for exampleA 10 gpd x#of bedrooms): 3Cy Number of current residents: , ` Does residence have a garbage grinder(yes or no):no Is laundry on a separate sewage system(yes or no):,fD [ifyes separate inspection required] Laundry system inspected(yes or no):J * Seasonal,use: (yes or no): E ` Water meter readings,if available`(last 2 years usage{(gpd)); Sump Pump(Yes or no): j *, Last date of occupancy: ' ,;. COMMERCIAL/INDUSTRIAL g ' Type of establishment. Design flow(based'on 310£MR-15.203). _ gpd 3 Basis of design flow(seats/persons/sgft,etc.): - Grease trap present(yes or no) f Industrial waste holding tank present,(yes or no) Non-sanitary waste discharged to the Title 5'system(yes or no) Water meter`readings,if available: Last date ofoccupancy/use: , OTHER(describe): v _ -i` t.. -f a .•.. - . GENERAL INFORMATION Pumping Records Source of information ' < Was s•stem' um ed as part of the'inspection es or no : s If•yes,'volume pumped:_gallons-=How was quantity pumped determined? ` Reason for pumping: „• TYPE OF SYSTEM ;. Septic tank,distribution box,soil absorption system , Single cesspool _Overflow cesspool ,. Privy - a Shared system(yes or no)(if yes,attach previous inspection records;if any) •Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be '" obtained from system owner) Tight:tank Attach a copy of the DEP approval - Other(describe): , Approximate age of all components,date installed(if known)and source of information: �r1v 1d� i, Were sewage odors detected when arriving at the site(yes or no): Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS �i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: 3n Date of Inspection: BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron 40 PVC other(explam) Distance from private water supply well or,suction line:• Comments (on condition of joints;'venting,evidence of leakage,etc.): SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction: concrete_metal_fiberglass__�_polyethylene—other(explain). If tank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle:, qlj'`` Scum thickness: Q Distance from top of scum to top of outlet tee or baffle:'_ Distance from bottom of scum to bottom of dutlet:tee or baffle: How were dimensions determined: eirinq In Comments(on pump ing'recommendations, inlet an utlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage;etc.): a, , -2 -��n� sino�i�;i b;e a�moe c�t�� c�.� �► . G�� m ►'���c.nc�e... . GREASE TRAP• ' .I�LF}(locate on site plan)`'_ • -� y a Depth below grade:_ " Material of construction:_concrete metal' fiberglass polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage, etc.): Page 8 of 11 , OFFICIAL INSPECTION FORM'=NOT'FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL-SYSTEM INSPECTION FORM PART C € SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: (tank must be pumped at time of inspection)(locate on site plan TIGHT or HOLDING TANK:Y]_r7 ) Depth below grade.- Material of construction: concrete metal fiberglass_polyethylene _ other(explain): Dimensions: Capacity: _ gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: ; Comments(condition of alarm and float switches,etc.): f DISTRIBUTION BOX: (if present must be opened)(locate on site plan) ; Depth of liquid level above out I et'invert:611, Comments(note if.box is level and'distribution to outlets equal,any evidence'of solids carryover, any evidence of leakage into or out of box,etc.): . r 0 ii'mp- C,t-I'd n ( of, 4.C.cj ctInt PUMP CHAMBER: F} (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances,etc:): g •' Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM-INFORMATION(continued) Property Address: all {1, ' Owner: ��c��� Date of Inspection: j-�q i SOIL ABSORPTION SYSTEM(SAS): (locate on site'plan, excavation not required) If SAS not located explain why: Type (B leaching pits,number: I chambers,num er: leaching galleries,number: leaching trenches,number,length: s leaching fields,number,dimensions: " overflow cesspool;number: innovative%alternative system Type/name of technology: ` Comments(note condition of soil;signs of hydraulic failure, level of ponding,damp soil, condition of vegetation; etc.): . crt T� m e; o fin.``'Q, t N x CESSPOOLS: nCA_(cesspool must bepumped as'part of inspection)(locate on site plan) Number and configuration: ' Depth—top of liquid to inlet invert` Depth of solids layer: Depth of scum layer: _ z Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): ' Comments(note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation, etc.): PRIVY:aj(�_(locate on site plan) Materials of construction- Dimensions: Depth of solids: ' Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation,etc.): Page 10 of 1 I OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_20 dell.�O H n Ny xnni�; m—�V Owner: 5.2+kC_ _� ►�R� Date of Inspection:_10 I-.ct lU a . SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including-ties to at least two permanent reference landmarks or benchmarks. Lc cate all wells within 100 feet. Locate where public water supply enters the bui ding. 3 � Page 11 of 11 - OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS V SUBSURFACE SEWAGE,DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 9 Co Owner: .. � Date of Inspection: SITE EXAM _ Slope Surface water Check cellar r r 4 Shallow wells Estimated depth to ground water"j5tfeet -, Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) --;&_Accessed USGS database-explain You must describe how you established the high ground water elevation: uS�>S ma�A hcxt > 11 ' TOWN OF BAR' P.: �> C d,iOCATIGN 20 Z 11 SO SEWAGE # V rl LAGr 14,4cT n n iA 1'�11 a _ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. i°�1,�t� SEPTIC TANK CAPACITY loan LlrG ,J-EACHING FACILITY: (type) '7 ,T_n6 ,+ro h2r (size) H&J-X JI-'O � IQ N0. OF BEDROOMS -Ti3UILDER OR OWNER PERMTTDATE: 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 ya w 5 � r 1 C". - No. G� —� I �;- � , ^: ,t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i'es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pphration for 30i5pogaf OpOem Construction permit Application fora Permit to Construct( . )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. av &-1i Owner's Name,Address and Tel.No. Road l-1Yr�-nni S Te.FFr ey Pi,""rAL Assessor's Map/ParcelCj Z `a. 3 Zoe ,/ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. j a 8 9 c�G, cj z � ;c�.gcd C�pe�7 — �e��P�✓l�c�1' Gs„fie✓�rr tg 0✓fQ4.K r,11 eeoeinq Type of Building: Dwelling No.of Bedrooms Lot Size a 5, S I J sq.ft. Garbage GrinderA— ( ) h w Other Type of Building A. Flr/�.:�� No.of Persons S o ers( ) Cafeteria( ) Other Fixtures Design.Flow '1116 gallons per day. Calculated daily flow `�`�a gallons. Plan Date ///z c zo oy Number of sheets / Revision Date Title SLVnz 57fr -1 dk e. k go f32/I 14:,M Size of Septic Tank /®oQ Type of S.A.S. Tn-'-i I74r4.-S Description of Soil; A- Goa+at r Sgrd /o v2 -� /0 y2 XY C � Coarse. �4►d �� y�e �/� Nature of Repairs or Alterations(Answer when applicable) 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 Certifi- cate of Compliance has been issued by this Board of Health. Sig, ig Date /ZrZ-200 Application Approved byd2�� Date Application Disapproved for the following reasons Permit Permit Na. F )ate Issues OG Fee THE COMMONWEALTH OF MASSACHUSETTS (j!Entered in computer; es PUBLIC HEALLH,D VISION -ITOWN OF BARNSTABLE,MASSACHUSETTS Zipplication for ]0i2; ogal * otem Construction Permit� Application fora Permit to Construct( , )Repair(4pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name Address and Tel.No. t. a.0 Be.11 Pogo- Assessor's Map/Parcel oZ 9 2. 2 Z 3 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �-p 8 9 N4 S'2--4 PD,&,, 7163 CCH1{��;(1� 5 �SY2$ �/oZ8 /r�� kJrs;(�ra�� Si, /`tJ•"c(c�%%�oio Type of Building: Dwelling No.of Bedrooms Lot Size aa, sal�" sq.ft. Garbage Grinder( ) Other Type of Building C;y</.`M;�„ No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1-14/o gallons per day. Calculated daily flow- gallons. Plan Date ///Z L/ o dy Number of sheets / Revision Date �. Title SWT-- S 7 f r ze.." /Lr,9 jo;%! Z o t3p l i /Zv A(A Size of Septic Tank /00 o Type of S.A.S. -in F; I r6a Aj.� Description of Soil A- Ca4,h r 5-?nd /o yA 7� Iva �Y ( /o S� c !C ..Arm e_ d i / 7/� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: r; Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system ,4 in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi= Cate of Compliance has been issued by this Board of Health. - + Sig ed Date `-1 Z-.--Z'Zoo ' Application Approved by Date az d c-/ Application Disapproved for the following reasons I Permit No. oZ�Y '—�f-1 Date Issued ( 'a. (n.&L.1 ------------------------------- ------ �.. �_u THE COMMONWEALTH OF MASSACHUSETTS x BARNSTABLE, MASSACHUSETTS •t Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( ) Repaired(✓)Upgraded( ) Abandoned( )by at I I �? Gc� /-��� has been constructed in accordance with the provisions of Title 5 and td for Disposal System Construction Permit No. )00 L/-lo r9 dated 1'a Installer Designer l The issuance of s permit shall not be construed as a guarantee that the s s e�/w 11 functi�n as designed. Date ��1�7dy Inspector_ 11 � 12 r - 1 / -- r No.1�p CJC."y —(0 7 6 Fee 60 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Dizpozat *pztem 'on5truction Permit Permission is hereby granted to Construct( Repair( Upgrade( )Abandon( ) System located at _ n ,\,\ c t � J and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construct' mu t be completed within three years of the�a �tfli Date: G Al. ie2i �� FROM FAX NO. Jul. 17 2003 12:52AM P2 iziva1zuu4 rna bua IkV .egs,� ':' _. _.�.____ W ___,_. ..__....^_.._�_.. ` %Nuui t:[:ari FHx, Ad 1f, 2,003 01:49AM P1. 'Fawn of Barnstable Regulatory Services $ a 8 ;E'howks F.Geller,Director Public Health nfivision ',Thomas McKean,Director 200 Buhl Street,S'ysnnis,MA 02601 Office: 508-862-4644 Fox.: 508-79f,D--6104 Date: Designer. ✓'!'"? car. o► �� .r_►� _I r✓G Installer: Address: �w r:� .. '..b ��:. Address: ...Q: by, 7 k Tn Its' On- wa.`+issued a pernlll:to install w, ®tsLler,5 sepfc system at L _ rased on a desl,gn drawn by �._.. aldress Q V'S�AC.I� C+—�t i h► �,ZPt dated, _ !1 "L4--10 -_..._.� . I ceiti;fy that the a�:l�tic :��s;toiti refc;rc�noecl sab<►ve was i►.stalled ,�ubst�.►.titIlly a mordut to _ the desip, which may inolude minor approved obanges such as lateral relocation of the disc iNition box and/or septic,tank. I certify that 'the septic system referenced above wu installed with InjOr ahemges (Le, ema.ter than 10' lateral relocation.of the SAS or any vertical relocation of any emmpoue0t of the septic system)but i0 aeeordmwa with State& Local keguladons. Plan revision or certiii.ed as-built by designer to tbllow. DAVUK NO �16488 r Ai «� ti- ISM Q:HealtWseptiwDsAis m-Ce=lii9caftn.Fa Town of Barnstable , NP�O�1NE Tpp Regulatory Services . Thomas F. Geiler,Director a �' , CAM Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02401 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Forth Date: Designer: Installer: _Fic,haI-J Cggs�„ Address: Address: P o e 763 e,Llfe,(%�.Ae MA- oz G3z On Z-(, -t o�y ��,"J, C,p.Qej,, was issued a permit to install a (date) (installer) septic system at Za c3e- 1 12,1AJ based on a design drawn by (address) dated (designer) y I certify that-the septic'system referenced above was.installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical.relocation of any component of the septic system)but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. . a (InI taper's Signature) (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBSLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE P LIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiper Certification Form TOWN OF BARNSTABLE '' LOCATION '1 � SEWAGE # � VILLAGE N-in,—n i ASSESSOR'S MAP & LOT 2 9.2 )R 3 INSTALLER S NAME&PHONE NO. 3 lople, L-1o�l�erv(-% O.s l.t_G SEPTIC TANK CAPACITY 10 I IM�1 LEACHING FACILITY: (ty ) (size) fe'L jl'i..D f. I64 NO.OF BEDROOMS LI BUILDER OR OWNER PERMTrDATE: M I G I 0 COMPLIANCE DATE: 1 v 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 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by j ".4U 0:3 4 TOWN.OF BARNSTABLE. LOCATION Gd' i��• `/' SWAGE # ?r VILLAGE /�y,�n.�/ S ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 4//0 ki / LEACHING FACILITY:(type) r 000 �',4/ / �" (size) t� 6 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILISER OR OWNER DATE PERMIT ISSUED: "'! DATE COMPLIANCE ISSUED: C/® �— QS' VARI# CE GRANTED: Yes• No 91Rv Q c/` y3 yq J TOWN OF BARNSTABLE. LOCATION, s el� .T;Z EWAGE # r- VILLAGE .f V�.-�n� SL ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. �4n..60 ?`7S- 07,5"00 SEPTIC TANK CAPACITY l 69®64llOn i, LEA:CHING FACILITY:(type) ! d CAI,. al'/ (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER .DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: . VARIANCE GRANTED: Yes No �/. Oof�, m T� i W �e L - ASSESSORS MAP NO- PARCEL - FizB THE COMNo !!' BOARD OF HEALTH 0?� � TOWN OF BARNSTABLE Appliration for Diripwi l Marks.rks ( outitrurtion. rrutit Application is hereby made fora Permit to Construct ( ) or Repair ( �anndividual Sewage Disposal tem Sys c t.. r l/.....12 ­4�...... /� � � � �✓ --- �, oc;ttion. ld"ss - 1 t 0.� o,ler Address Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms....--.--..- ---------------_---...Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length----------- ---- Width--..-..--------. Diameter---.------------ Depth................ Disposal Trench-- No- -------------------- Width-.-.----- .......... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter--.-.--------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date------------------...................... Test Pit No. 1................minutes per inch Depth of Test Pit---------------..... Depth to ground water........................ G% Test Pit No. 2................minutes per inch Depth of Test Pit.-.---.----.--..---. Depth to ground water........................ R+ •----------------------------------•-----•----------------------•-•------------------........_------................................. •----..-------------- - Descriptionof Soil........................................................................................................................................................................ W x ----------------------- X------...--------.....--------------------------.......--------------------- .............. U Natur of epairs o Alterations— nswer when applicable...�C1S. k��..-.-.- .'.��3QO...S-. -.�....< 1�......�'i�0.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en iss b e board of health. Signed ----------------------- ..... ... . Dace Application Approved By r,,,�' r'1i .. ........ .. .. ...................... ......... r, �� w✓ Dare Application Disapproved for the following reasons: . ..... ...................................................................... . ......................... ........................................................•......................... ...... .................. .................................. . .. .................................. ... . ................................ Da Permit No. .... ........'.........4�5 jg... Issued .....C ------- ----�-- :e-----i`�........... Daze '�'Vtiw.ti'.�Yri^'�.F+`-�. \^,I�f\rr_;.���. :�'...-�yv`:'�....�'Y..-��:i-�_. `T.4 M' . -� �. �/V�....__ - r�._.._. __._. 1_ wy 1 �rV✓- _� a V w_ .. _, . y t:e THE COMMONWEALTH OF MASSACHU-SETTS• BOARD OF HEALTH C;q? TOWN OF BARNSTABLE Appliration for Difipwial Wark,6 Cfontitrurtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: ------•--••• r Deaf ion-:\ddrrss - '-- •• 'o o--= .................................. Lot Igo. Owner Address a •-•------• ✓ .f3 - -------------------------•-•- Installer Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms------------fit,- ........-------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons __-_-----.-------_.-.-. Showers ( ) — Cafeteria ( ) d Other fixtures ----------------•--------------•----•----------------- w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W - Septic Tank—Liquid capacity------------gallons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No---------_---_----- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1­4 Percolation Test Results Performed by.......................................................................... Date...................................... 1.4 Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0-4 44 Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................ 9 ........•-••----------------••--•-••••--•------------•••----••-•••----•-••--.....---•--------•-----.......................................................... 0 Description of Soil......................................................................................................................................................................... x w UNature of Repairs or Alterations—Answer when applicable._._rt?_ _ A/1.____._-�_.'.b ... .rA I:...4_� %...?t:. >.- Agreement: r The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued bPPe board of health. Signed ---------------------- �!....� .....�-..� ...n`.......................... ......a..: Irate Application Approved By ...:......��� ........ V ..............-�.��--�.7 Application Disapproved for the following reasons: ............................. . . ........... .......................................... ` .....`` ...................................................` ` ................................................... ` ... `. ` ..... .. ...... ........................ .--------------------------------------- Permit No. ......... ......... `.... �,�.----..... Issued ..... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by--------- .---------------�'c...0.............................................................._....._..------ --------------------------------`---- at .........._ n..//. � 1/--......... ..... .. .. ... ` ` ............. ` has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. -��-7 "�'�... ��. dated '_r ..: .......G THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT T-- E-� SYSTEM WILL FUNCTION SATISFACTORY. �- ... Inspect......... r . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE -3a No........................ //� FEE........................ Uisplaiial Workv Tonitrurtinn lermit Permission is hereby granted.------... --------- ----------------------------------------------------------------------------•---•------•--. to Construct ( ) or Repair (,,)an Individual Sewage Disposal System atNo..:�............./ >. ......�; /,� -----`'" -- ....................................................---------------------............. 6� Street as shown on the application for Disposal Works Construction Permit�No jBoard of Health DATE....... -------•--................. FORM 36308 HOBBS♦!e WARREN.INC..PUBLISHERS /000 f r. BENCH MARK: TOP-'OF FND. ELE.=.5 r, 2 O 1• SAS PCT°gas 0oRT� . (SAS) SHALL BE THOFMgs 'O Q R,OAO J -' MANHOLE COVERS TO EXTEND TO ` 45.75' LONG ��� sq�y ,~ f3E�� 7 WITHIN 6' OF FINISH GRADE . 11.0' WIDE JAAMES A. G� z ! 10' DEEP CIVIL. � �� Q 2X BAFFLE REO'D No 36488 (o•Z O t7� `1 St 730, EL-. 9FGlST 6 9t. LOCUS MAP ExryT. '� p•g, 2• PEASTONE TOPPING GENERAL NOTES: I1000 GAL AL 5 9t. fit. _- t- __ -_ - CAP — ELEVATIONS SHOWN BASED ON U.S.G.S. DATUM. TA a K _ _ _ -_' _ ENDSSYSTEM PIPE SHALL BE EITHER C.I. OR �• $ 6• 3 4' DOUBLE WASHED SCHEDULE 40 P.V.C. EL=`rj-tl 7 b S�ONE ALL AROUND — THE BOARD OF HEALTH SHALL BE NOTIFIED 10'—� PRIOR TO BACKFIWNG OF SEPTIC SYSTEM. — SEPTIC SYSTEM STRUCTURAL COMPONENTS 20' MIN. 1.0 43.75 .0 SHALL BE CAPABLE OF WITHSIXNDING A WL 1W ioa a H-10 LAADINb. UNLESS SPECIFIED OTHERWISE PVC RACE-< 2 MIN" USE SEVEN (7) INFILTRATORS ' — SEPTIC SYSTEM UNDER DRIVEWAYS SHALL PROPOSED SEPTIC SYSTEM WITH 4.0' OF STONE O SIDES (o '3 COMPLY WITH A H-20 LOADING. NO SCALE & 1.0' OF STONE O ENDS —THE DESIGN AND COMPONENTS OF THE SEPTIC NO STONE AT BOTTOM DEPTHO ELEV.- S7.4A i� �� 7/ 7. 0 SYSTEM SHALL BE IN COMPLIANCE WITH THE IS` A ' LoAA SAAO I ����i<yvt L = 4 STATE OF MASSACHUSETTS SANITARY CODt Pepe, a to AN y SRaO t 0 y& �I¢ ON oW AMA; 0 3 C-X Ve P THE ITLE VLOCAL BOARD OF HEALTH. AND SHALL BE IN M ULESCAND� l: $¢•� REGULATIONS. —THE CONTRACTOR SHALL BE RESPONSIBLE FOR 3� c APSE SPA LOCATION OF ALL UNDERGROUND UTIUTIES AND 1 y0. 7I b — — L�j (� ._ SHALL NOTIFY DIG - SAFE PRIOR TO 12d t *7•QO (✓ yT. ¢ CONSTRUCTION. SOIL TEST CONDUCTED ON 11 I Z3}04 0 N / — NO GARBAGE GRINDER Q/, 7. 1�AVt►rt, (fie, + a DESIGN CRITERIA: DESIGN FLOW 00 VS ATEit OT3SERVEp � ► 20" ' I I MS AT 110 G.P.B. / DAY 440 G.P.D. t M N REQUIRED SEPTIC TANK: 1 =; 1�4NK. LEGEND: SEPTIC TANK PRCMDED DUSTING CONTOUR ——— —— ` 0 0 1 ( } DESIGN PERC RATE <2 MIN/INCH WTI —W—YIF— \ , ) r oT• __._ SIZE OF REQ D (SAS) AREA - 440/0.74 595 S.F. HOLEr J D W Eu'►J� 'S 7.Z o 0 r. _. 57.$o -� _ GAS SERVICE —G-6 SIDEWALL 2 0.83)) 45.75)+(2)(0.83)(11 = 94.2 S.F. BENCH MARK OEM . U- \ �O t,O,F --!'�� Q BOTTOM t�11�(45.75) = 503.25 S.F. 5$.20 SL,Aej r 't SIZE OF LEACHING FACIUTY PROVIDED: 503.25 S.F. + 94.2 S.F. = 597.45 S.F. = 442.1 GP NOTE: L PRIlOR TO INSTALLING THE NEW (SAS) THE \ ` S• ` _ t r -; - EFFECTIVE DEPTH: 10'- . CONTRACTOR SHAM PUMPOUT ALL LEALNV TS `, EFFECTIVE LENGTH: 45,75 AND BACK FILL WITH CLEAN MEDIUM SAND R 56 IFLEAcA P ITS ARE ENCOUNTERED W THE ` = _ `' s tom-: EFFECTIVE WIDTH: 1'1.0''- (SAS) AREA THE SHALL BE REMOVED �N W - y = OUTBACK ENGINEERING r k4 ` 106 WEST GROVE STREET •/ MIDDLEBORO. MA 02346 o , (WS) 946-9231 + _ PROJECT: SEPTIC SYSTEM REPAIR ZO FOR I t RoA0 PL'A � � As sHowN � �.� �o m Id Lf 1,041 MAPaZ?d.c LOT ;La. — — — OWN It ?r't✓F2C`/ piMENTAL O Zo 3ef-t- AL0A0 v�P4N kA 0 2(po 1 • j la • 1 I e Pennd+#ion VenF winJaws L a,t 1 m•os. n n - •map:?m 1a•n uoSN'N,ed •� Im vb O+a�— �� f� \ S a • • p o I - a. o - E 1 �• _ I T s xb'• 9 �L _..I �1 m•es. � ))• b 4 T ox ml �, - Powd+hien Jer:F wmd9wa 1] p •M•WM4-A-4xrwx+d � 1 m•v D' ltit a—"— o �v y 0 � � V , • q O , copyriynto2oo4bylcenru:cni"'. mernszoueees. o ThaepMsereprotectederPedde q PROIECT• family room/Office addid'ion �w�Feel�Dh ^' eopyrIght t.ews.The orI4rtmIchaser Of this P' 1 J 0 v ]' plan is euthorized to torotoneand only - ���eT one lwmeu5lI ehla pum atton or ,1 1t4L�G�ri� 1 �1 .C+• -AL- .us. •f reuse le prohibited without exprespwrltten JL.et 1 I.i V m permission Of the Des( en _ Myeletrepm4n anwa anNer em1:7 ~ •V __I. .._i { arawme—. ia enneth�adl er p.vseoiai'e�t'- LOCATION: ��as a R y REVISIONS: ba wttener^nar -�. .. i'-• ��yy♦♦ - M10 Dexl,)xer mt2 O f�•'gfed•t-j prQfessi4nOl buliding design �'—'e ' nni� anem�mmerclal�rHya crapanaaetNq em slom> Ga�sfrucYwn Pt.n.: Oe/Os/a 00+ 1 , : , becema Slim respo IbAlty as the Gan+tr.wetpn Plwn+: I P.O.Box 7749•Nyannla,MA 02607.908.T90.9922 GfdlalllgeonVeetor. __..i._.tksedlereksadeNgn:com.wwwkaadeelgmiom--j__i._.t. 4 , Y¢ ar mg •e o r 0 a 4 a ' Q � S i m •. a A ' a' Q � � 0 w ----- -----�'---•-*----- � r d+ , q Anderssr�[TIT'A l 01 0 0 w a u .9Ano/s . 9 AndarsenePWG momBL - a � AndersenaNnrraGnese,m � �� Ander,enmlLrraf exb,m � a r.o.x-lo 1/e y,•-e-1/, �� ,@-? rc.x'-lo 1/b•.,'-e 1/,• a 0 � J s • ---------- Andtrsena'Na'rolinexe,m e ' A�d�rKnm Nnrrdine ib,m __;____ J a 9 serso)�/B' S � s . .n eopiy9gnteno0a by penneth seiner assoUetos: - - PRAWN BY: Those plans are protected under Federal - PRO ECT: copyrlght Lem Th.orlginal pLr Chew OF thla Plea#_ 1590 —I— - Family room/Office addition t�,h Fe���l�oh Pen is authorized to construct one and only AncHirEer - t Z ,one home ashy this plan.Modflcsilon or T reusels pr.,.Itep uathout express tten �{,►I F�E/ L. plM��r L - - .'.� permiSSlon of the Designer. ® ,. - • Any 41 i pa Gea,e Nrrors and/oraml alone note!,dlmenelona and/o n _ %�enna}h yadler hssoGia}es i LOCATION: draw f,W tshodonthe-doaan to REVISIONS: . t - stlenb bra httotheattendon F O Prdnniv ype„nry o�::m/xoa, professlvnel building design,- T 2 �611 �d. t�oideo 9tw on P u`am`nmtn nt g evwsd Desinq: - O'1/xm/x001 i i i caaatr.ran cons[Ituteatne akeptanoe commercial•reawahfaf'_i' i"' Hydnnls air( h of these doeamente end any Gana}r•ucYmn Finn,: ob/o9/x oo, r A6yAG U52•}''{"4 : : : : ': _..j.._ - dieerepnnUee.error end/ar a t elope Gons#ruaFton Finns:. Ob/Im/a 00, P.O.�Box 11,9•Hyennla,MA o1601.9Ob.190.OR22 I become the respoltalblllty of the _ _}kaadlerokeadedgncom•wwwksadeM�n.camy_..a.._.}... bull®ng cpneractor. , i 1� ti i r Q ,t a N ' 0 ---------------------- ------------------------------------- -------------------------------- b ------------------------------------------------- 4-& 0 sp , „ yy J a 0 N __- _ a 3'i + -AndarsanaA 9 1 e i ' .b,fB 1/f�/OBI/f• Cy : gy, -- -- --. EE •-•i 9/�' y`-:• I no.9••O I//•a 1`-'i l/z• 0 _ 'b: 5 N - a A AIdaY3{� 9 1 m N Q I Q i o , i ' I I -0adar,ana YSB9e �, 0 .________' � S/bSb/b „ r .tB 1/4'SOB 1/2• N a I r.a.9`-01/!•f 1'-71/t• _ I w •-o /:•z l•-4 11/:• 0 ' I �O ' J - I � 0 ' r-• o„ 0 o a 4'-cs 1/S• P'-G 1/S ' CoWght•2004 by-Kenneth Sadler ASsoGates: L PRAWN BYt •� Ths PI9llsareplA.Oted under Paderal ' PROJECT: FGimily room/Off ice addiT ion L-01*� •�e1��h ' Copyright LAW The omginm purUeScr of th(a , Flan# 1530. O plan(a mrthorized tO LOM"Ct ogre and only ARCHITECT one home us mgthleplan,MOGHc=:,r J�:FF�.Fiv 1... 1 At reu3e Is prohblted without e%pressurrltten ) l' Nl pem(sslon of the Designer. m1 dlsoepancj more and/or om ssl n y menoc.`ea en3lonaanad. LOCATION: An O > LR7EVISIONS- - _ .ILennee}h l�adllet'd�ssoGia}es? 2 O P� �. ashao beinw�rrglh�tome acc nibnnort?3 O 01/f d,/2009 -' 'I-"i'nnr4fesSlvnel bulldln (�CSIr1A .._i i o�oilrdProcea gudtheamenc ny Oy/tdr/4004 .Y08 tal3tltltdsthe acceptance eommerelal%re3klentlaf" ostu3edocumentoandam Pl— 0&/09/2004 ! Hyannis....1.. nand—emaaloea Pl.aw OB/Im/z004 P.C.Box 114E•Hyannis.MA O2b01.S08.'190.3921' I become thereW—lblllty of the ...:._.L._.keedlereksadeslgncan.wwwksadealgl.can-.. .._.r... bolding dolltractor. Y • a E • � •tea G � 0 e cP S a $ •g £ � i R f` 0 � N - r a Z a p Q F S a � o P i S Q pe J s ° z O ro x � 9 x � e � a i M a t: trl y , • -.. • GopyHght o2OO4 by Kenneth Hndler A—J.Les� - - ThmapmismTheCrUctMunearPaoere PROTECT• Famil roam/Office addi4-ion DRAWN BY: p1m ICON w Lora.d t orlglnni pwcheser of t 1 Flan 15 9 Ll)I�o P EI Oh qnn Is eu[horized to construct one end only one home using this pkn ModiRcntJon ar ARCHITECT j revaelsprohlbl[ad ftheCexpreeawrl[ten Jf�FF�-i✓� L. pilv(Et�T�kL permtsslonof the Oeslgilr. •, •. ' _ Any Rscrepandea errata anNor anls9one O i LOCATION: a nenxea almens ana,anNer REWSIONSt •anne}h yAdlar ft4soGia}es drawls tdfinedan Mesednc I,, 4 ^� shop be tw- eo Ne attentlon of 'Pra(nninvy O..inq: O]/x m/x 004 prsfessienal building design ?-T'- �O ��I' 1`�• ene vedgner pt to a he carmen o—, ;. �.vi.M Owemy o]/2m/200+ y __ _ of—ta tlan.Proceemngw1th Goasfrw:}'ion P{+nc oe/00/x00+ {- I"1 T'eommeretal�resklentiaf '--." I H aoaavucuta cw„ut.zaatneauepcae<e -,..{._.i , i i rlyannis ,M6lyyAGhUse•h•hs of thesedocumans 4.y GonNruNion Plwn« Opilm/s 00+ -�'- mwe—d-r—Nor omla — { P.O.POHOx 1149•HyannfC MA o260[•90H.Y90.9972 { " �.._.y._.F.keedlerakeadeelgrtcom•www.ksedeolgncom-'__{.__+... beco°a the responalb10y oP the � bMmng eanGactar. nY t• o d `4 `./ V-4 f a a C\ F b D \ X\ A a �v Y El N Y s @ m! 13 + + 91 + �2 F ropyrlght 02004 by Kenneth 9e Sr/.esoUetes: � - PRAWN BY: F TlteseplensereprotecteAunderPCdeR1l pttp qq PRO ECT• (� copyright LBWS Theorlginm pWebaser of this PIU11,# I JJO. � Family room/Office addi'�-ion LUt�pt .(Zet oh �; plenb authartzed to u+nstructane and only U 3 ` p7 one home"19 this plait Wdifl6etim OrW ARCHITECT reuselsprohibited wi[houteOW.WrltLen �ti/FI F L•.• F"IMCNrA�w � pemesslon oP theDgier. .}l __l. ._I i i ` i i E i i �, Mydl�uepentleA errasanNor aniz�lona O e enneljt Sadler Passoaistes! LOCATION: moaneceadlmetilon>and ar REVLSIONS: - erwnq—tdned on these docunenta 9 In IS, tof a /7 �„� - Pr4lmfa.rr vsainq: 07/zm/4004 _ 2 0 • the ervv pry to the ctommelncement proPessivnal building deli n i i�ell �d: p.avisad vs.lnq: o>•/za./eoo4 ,j_ t g ofconscrucaon Prowding w[h Gondroc}i—pi— oeroo/soo4 ' 1 `i-I-' i eommere!al�resldentlaI - L �axr�,cuon we,nttrt�ethe.ocepranee Gan#ruNloa Plma oe./Im/xoo4 .._i.-i i , i _.}._ �"I�a111115 ,Ma�s�aalil1u�se'1 s m,c.e ftch`ixdoc—m—dan�s�lone 1 P.0.60X 1744•Hyannis,MA 02601.5D8.190.99Z2 I - - Pan became the reeponsibAlty of the I.—.i._}k9adleraksedetlgncam.unaW.Keade�igrtaOmy_y.—.a. Whding eantroctd. f 4 a .p s 0 I -------------------- 0 S � rn � YFm El O .I -- r-- } r eopyrlglt®�004byKenneenSadlerAs9oUetae� - DRAWN BY: mesep MS ereprotectedunder Federe PRO ECT: „ o coNrlohtLamneorigi. uren.9.i-15 Plan# i 590 —�— Family room/Office addi�-ion �V,hF��g,�py -1' ARGHITEGT plChe euthorizedthl eon9eructoneandor —AL one hemeu9ingthl9p_M0.Flcatlon or V• reusels prohRHced ad . eXpressu rtcten J�j��Gr� L• permisslon of Ne De9lgler. 1 t_ 9 Mydlarrepeneleq errw9 anNor aml9Noha C t -J 1 ' LOCATION: In the notee.dlmm9lana and/or p ennetlt hAciieY A�aOGiai e�! drauan eontahedontl—docunmea A o REVISIONS: :- shave brauyht to the ettenclon of y� J °-a 2 O 1!.)cQ r—A• the ved er pdeN cothe eammencemenc - Pr.rno—a —inr„ o,/:m/:oo� r•-i-Pl, ieSslanelbuildingdesign"— ' - - w�a�nat.ucemn.r.ouamnywen R.aiaad f7«inq: O11 .00� i ; i . . . ...1 conatruodan conatltutea the aceeptenee ......_..._._. i Gona#ruek'w:Plans: oe/oe/aoo, —1._.� 1 I' tcammereial•reHidentiar'-i—"i" 1 I4yannl5 ,r"�assAGhUSe•1'�y afehese dawmenes one any : i i : : : : : : ...1.-- Ra be—.the errwa�d/w o the 1 Ganshrastion Pl.mx OD/t m:S'00•t --�--P.O.BOX 11 i9•Hyannl9,MA D2H01•SOH.190- 9 I 'became the reap- Iblllty of the _ikeamereK9ade91gncam•uauwk9adeslgrtcan-i-.-j._.r... bullding contractor. r r 1 , , i S s ^ 0 �_ rN \ rn -------------- ----- LO Q -T EH=EH l- 1 lY� a , S u7 Gopyrlt�LO]004 by h:enneth 5ddler Asa'' as - -' • - rhesepmsareprotecceduMerPeeere PROIECT• i�amil room/Office acldi}-ion ow>wNSY: •� Gopyrfght laws The drlgfnal pimchaxr of this + plan is authorised to construct otm end only PIQfl# 1590 Y Lt31yF �BI�Oh n tp one home using this plen.MadiFicetlon or - ARGHIT2GT v �.3: reuselepromblted withoutefpresswrltten JG+F'���iV �• �j' ✓�✓ �11.1 O R perml ton of the Deslg,er. i AI _� �.... MydUerepandeA errore anNor omUdon, ° LOCATION: m the not,t dlmrndoeq rnd/or " enn�th�adl�r istssoaiatez I ^ REVISIONS: - reWngs corltelned on thexdocttnents 1 1 Mal be brought to the attention of PreWau Des7ry O'//Zm/9 OOa _.._.�... 2© �ef� . the Oedgner prior to the eommenument r�-pr9fessitmal building design weonse aeda �, m Wd p-w:sad D...my. oT/am/aood _ i . . i 9 , - "- -- nT1 ewu—don—afti6eethe ace loon Gonshrm,Fion Pon« os/oo/soo4 1 T"'I—T- IGommerGlal•reeldentiaf I ':--T- W a Is MaSSaGhuye•r'�'y of ehaxdaevmen eaneany Gonstrue4'.on Pl•m« OB/Im/1004 ---1--"P.0.�f3ox 7749•Hyennla.MAo7601.906.�90.392Z i� r die beWme th�eaponelbllfty of the ._!._..i._.i.keae0erskaodGdgnean•wwwkandeafgn.eom--j---I" 4-- buAding edneractar. i