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Home My WebLink About0054 HYANNIS AVENUE - Health r 54 H 'ar�� i :.Av . 4 SFS Y:. , V 287 125 ' t Hyannisport r 0 I r. COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION c , TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A a ry — /.z 5 CERTIFICATION Property Address: . 54 Hyannis Avenue Hyannisport Owner's Name: David Roache Owner's Address: Date of Inspection: 10/24/2006 Name of Inspector: (please print) Patrick T. Sullivan Company Name: Ready Rooter Mailing Address: P.O.Box 371 Sandwich,MA 02563 Telephone Number: (508)888-6055 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: —ZPasses Conditionally Passes Needs Further Evaluation by the Local Authority Fails Inspector's Signature: e � Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or 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 S iS o A 10, ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does notffMW oiv fhe` ys4.e'ri will perform in the future under the same or different conditions of use. Y { Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D 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 evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional ss"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as ,�pproved by the Board of Health,will pass. r Answer yes,no or not determined (Y,N,ND)in the for the,f`ollowing statements. If"not determined"please explain. ; i� The septic tank is metal and over 20 years old*or the-,'eptic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or�4nk 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 Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: J Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled of uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced .'obstruction is removed ;'distribution box is leveled or replaced ND explain: 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 r` obstruction is removed r ND explain: /, I Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 C. Further Evaluation is Required by the Board of Health-, Conditions exist which require further evaluation b the Board of Health in order to determine if the system is failing to protect public health,safety or the enviro nt. 1. System will pass unless Board of /ofa rmines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manwill protect public health,safety and the environment: _Cesspool or privy is within 50 ace water _Cesspool or privy is within 50 dering vegetated wetland or a salt marsh 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 sy t/ (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water su ly. The system has a septic tank and SAS and th7_� AS is within a Zone 1 of a public water supply. _The system has a septic tank and SA/tdetermine AS is within 50 feet of a private water supply well. —The system has aseptic tank and SAe SAS is less than 100 feet but 50 feet or more from a private water supply well". Method use distance "This system passes if the well water , erformed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds incates that the well is free from pollution from that facility and the presence of ammonia nitrogen and ni to nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of e analysis must be attached to this form. 3. Other: / ' r Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _ _Z Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ __v/ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _V- Static liquid level in the distribution box above outlet invert due to and overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"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. V Any portion of a cesspool or privy is within a Zone 1 of a public well. _ Any portion of a cesspool or privy is 50 feet of a private water supply well. �[ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water 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 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.] (Yes/No)The system fails. I have determined that one or more of the above criteria exist as 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 a facility w' a 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 th criteria above) yes no ' — _the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary,:fo a surface drinking water supply 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 "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 f 'led under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should co tact 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: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No _/ _ Pumping information was provided by the owner,occupant,or Board of Health _ -Z Were any of the system components pumped out in the previous two weeks? _ Has the system received normal flows in the previous two week period? _ Have large volumes of water been introduced to the 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 sewage back up? Was the site inspected for signs of break out? _ 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? _Z _ Was the facility owner(and occupants if different than 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 _ Existing information. For example,a plan at the Board of Health. -Z_ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): -7 Number of bedrooms(actual): �7 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no):,,�[if yes separate inspection required] Laundry system inspected(yes or no):= � Seasonal use:(yes or no): s <='e- = 3 ( P, 0Water meter readings, if available(last 2 years usage(gpd)): �- 55n - ,r,(, r . Sump Pump(yes or no):1,:)p Last date of occupancy: COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203 Qpd Basis of design flow(seats/persons/sq. etc.): Grease trap present(yes or no Industrial waste holding tank pres t(yes or no): Non-sanitary waste discharged t the Title 5 system(yes or no):_ Water meter readings, if avail le: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION. Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):ti If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: T�OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool —Privy _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 roximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):, Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 BUILDING SEWER(locate on site plan) Depth below grade: Q ' t " Materials of construction:_cast iron�0 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:3zoocate on site plan) Depth below grade: i Q" 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: ~Q +� Distance from the top of sludge to bottom of outlet tee or baffle: :3 Scum thickness: ► 'r Z ` Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined.\, ,.e Comments(on pumping recommendation ,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): a� �c�y1r��, '•„�,,��+-`:. Grb�<a.�-5 c ��,..'y., �" � �. �-5�,� � :mac"f-S i GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete metal," fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outl `t tee or baffle: • Distance from bottom of scum to bolt of outlet tee or baffle: Date of last pumping: Comments(on pumping recommer} ations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,eviden a of leakage,etc.): Page 8of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 TIGHT or HOLDING TANK: (tank must pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): Dimensions: Capacity: gall'ns Design Flow: g41lons/day Alarm present(yes or no): Alarm level: AlarVA working order(yes or no): Date of last pumping: Comments(condition of =and float switches,etc.): DISTRIBUTION BOX:—Z(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0„ Comments(not if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): w/ —2C''-,1 � i.)C-) ` ` � 5 r� tie s (moo .T'"14 PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chambe ,condition of pumps and appurtenances,etc.): r Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 SOIL ABSORPTION SYSTEM(SAS):__%Z(locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: /leaching trenches,number, length: Q 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.): S �"' V^.��=-Q�t-d.{J\ �'� .•.� \J r�. : J V .r yw A\ LAt S c��'ST O•��, C'`�'L`2.r' CESSPOOLS: (cesspool must be pumped as 1 91 1 of inspection)(locate on site plan) Number and configuration: jf Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow es or no): Comments(note condition of so' ,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: i Depth of solids: Comments(note condition of soil,signs f hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. - I t 1 n� 1- O ` 6 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 54 Hyannis Avenue Hyannisport Owner: David Roache Date of Inspection: 10/24/2006 SITE EXAM Slope Surface water✓ Check cellar ✓ Shallow wells k3--, Estimated depth to ground watery feet 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 properly/observation hole within 150 feet of SAS) Checked with the 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: �r �QI - '�.�=� 5 (�h L._'C'� w-.i 4 l.-d �4 %� �v a- / TOWN OF BARNSTABLE LO CATION L 42 SEWAGE # �� 3.5-- ViLLAGE �1y��1i�i.5. 1'l' ASSESSOR'S MAP & LOT Jf INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY nnxv LEACHING FACILITY: (type)La��'4ly�o-3 C—(size) NO.OF BEDROOMS _ BUILDER O OR�WNER PERMIT DATE: 2,— 21 � �OMPLIANCE DATE: L' Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 7 f e _ . � ' ' w W O O A� C . - � 'r a. �aaa �a <�� + i TOWN OF BARNSTABLE LOCATION Je—�{ ,�..4„�,a,; ��. SEWAGE#9�4_ VILLAGE ASSESSOR'S.MAP&PARCEL INSTALLERS NAME&PHONE NO. �rb`a '� ��.3�. 7 7j ( SEPTIC TANK CAPACITY 'Q(Z%ZD=> LEACHING FACILITY: (type)��.�,,�s�i"a�. &:P (size) -r' x An" NO.OF BEDROOMS OWNER V•�� "PERMIT DATE:.96!c COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility > `J' 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 !'mil maw C6 ;P/C>�; li 9 �' 0 fie. �� \ ; 6S` fLA K Q �t 3 � 4 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for Migoml bpztem Cow6truction Permit Application is hereby made for a Permit to Construct( )or Repair(4-<an On-site Sewage Disposal System at: Location Address or Lot No. v Own is Name,Add re and Tel No. Assessor's Map/Parcel Ins ler's Name,Address,and Tel.No. / Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder(�l� Other Type of Building PeCe No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 7,y gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs or terations(Answer when applicable � 70NJ d✓P 1 LSO e 48C 7' LtS/0 12 Zd Date last inspected: Agreement: The undersigned agrees to ensure the construction 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 issu s do Health. Signed Date M Application Approved by ' Date ';r � -� Application Disapproved for the following reasons Permit No. a! — Date Issued 4J ' 70 t. 2 I Fee. - 1 THE COMMONWEALTH OF MASSACHUSETTS r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for ]3igpoga1 *pgtem Construction Permit Application is hereby made fora Permit to Construct( )or Repair(v�a'n On-site Sewage Disposal System at: F { Location Address or Lot No. Owner's Name,Address and Tel.No. !+ Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder(/fiY6 Other Type of Building o p No.of Persons 5. Showers( ) Cafeteria( ) Other Fixtures " Design Flow /A gallons per day;Calculated daily flow 7- gallons. Plan Date Number of sheets Revision Date Title Description of Soil hx r Nature of Repairs or lterations(An&wer when applicable) , f�7`D/� 2 OlIIJ g2� /rJ T4i9 J )Owe ' ' Date last inspected: ` Agreement: . s The undersigned agrees to ensurejhe construction 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 is Board of Health._ Signed 7 Date Application Approved by r %' Date Application Disapproved for the following reasons Permit No. Date Issued - ✓� ' �� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance r THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(�n by Installer A,7;7�1 Z,-, f i /pia 5 at r v7 has been constructed in accordance with the provisio s of Title 5 and the for Disposal System Cons ctio rmit No. . dated rr--� ' 4t5t Date r�'1 Inspector tl THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. No. / !y -------------- Fee— ^«°' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ' Migoar *pgtem Con!trurtion Permit Permission is hereby granted to D!&42 Zei Z�dl'5X: to construct( )repair( Aan On-site Sewage System located at No.#Z/7W�JJ1�9/S 4LJ� i and as described in the above Application for Disposal System Construction Permit. W. Dam The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. i All construction must be completed within three years of the date below. 1 Date: GS' Approved by Bo d of Health a, a c-- CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONS'TRUCTION 1'I;RMI T OVTT1IVU'1' DESIGNED PLANS) n ~ 1,.. ~ ,. � r�D/ hereby certify that the.appiication for disposal works construction signed ned by me dated ��z�C�6 , concerning the p B property located at �O /�',��i�s�% �v� �'l/lr'%�SA�/°r meets all of the following criteria: Xicrer n nvcllands within 30Q (ect of the r sed se is system ire o proposed I� / licre arc no privite veils within 150 rec! of the proposed septic system "he obsened ground«•ater labie is i 3 rcce or greater below the bottom of the leaching facility Them is no increase in glow and/or chance in use proposed p . /There are no variances requested or needed. SIGNED : DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER IAu1ch a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submilledl. t; r r V p f I � � L C o w� o � 0 Mrn 'b �4 r M AsBuilt Page 1 of 1 TOWN OF BARNSTABLE / LOCATION 60 YQYJ/9IS SEWAGE # � 7 VILLAGE Z6d9 ,4149 'T" ASSESSOR'S MAP&LOT 4757-/ZS INSTALLER'S NAME&PHONE NO. l SEPTIC TANK CAPACITY Z&V 95:4 L LEACHING FACILITY: (type)l44441-3 (/g� (sue) 7 ;c 60'A / NO.OF BEDROOMS BUILDER 0 OWNER ��4r PERMTTDATE: ! ® OMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility f 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 7 Z R O 0-sf, q4'~7, rS3'g!. YJ a y 6 y- http://issgl2/intranet/propdata/prebuilt.aspx?mappar=287125&seq=1 11/15/2011 i ,a> i O--N I�s cn t � co 77 Cl W k < f" v J A: t J b -9 /V)f � 10 � �y N �. fvl 777 32'-10" NOTE: CONCEPTUAL PLANS ONLY, NOT FOR CONSTRUCTION. r. FIELD VERIFY ALL DIMENSIONS AND EXISTING 4'-3i4" 2'-6" 4'-03/" 2'-10%" 8'-105/4 9'-11" PRIOR TO FINALDESIGNNS If AND CONSTRUCTION. 4 x 5'-O" 8'-10�4" INTERIOR FURNISHINGS -- --- -- . ---- ---- --- SHAY Electrical ' ITV - SUMMER 5ervlce/ I Isom st In Meter I` o IL RESIDENCE LAUNDRY 54 Hyannis Ave. Hyannispo.rt, MA �n I cn x r - I Add new wall, — �cV door and hooks. O r (P tn\* _ 3'-6" R i L—i Lori - PROPOSED - ------------------- Kitchen Mudroom O New Eench KITCHEN Mirror �Q x Seat: open LaffpI I I = - � N j Ater L I 0_ 0 ' — — _ m Meter 0 �m Pantry Pantry Pantry� m Closet Closet Closet P 2,_8N -. NB Interior Design, Inc. _ ,Q Door -- 4'-10" x 3'-2 4" Door „ ? „ " 94 Pleasant Street g -10 1 4 -10 g -O Northborough, MA 01532 T.• 508-393-3866 F. 508-393-9648 i ORAWING: OAT_ tt� 4/6/08 Y REV DRAM BY: 1l4 1 0 PNB r C _ OJ i 77 . ��. i 1-15 ZN b f {