HomeMy WebLinkAbout0023 MARSTON TERRACE - Health 23 Marston Terrace
Hyannis ~=-P
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �
Map Parcel _ Permit#
Health Division n ; Date Issued �3 0
onservation Division 7A Z Application Feeod
Tax Collector Permit Feel f O
Treasurer O� SEPTIC SYSTEM MUST OE
Planning Dept._ � 1�-- . ._..INSTALICWITH mOM 5LIANCE
LE 7TRONMENTAL CODE AND
Date Definitive Plan Approved by Planning Board P "^'� OWN REGULATIONS
Historic-OKH Preservation/Hyannis ►�„ N�w f �r���S
Project Street Address
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Village
Owner Address /4 W Md OWE w4wd w
Telephone Q
Permit Request ft,%J(A mm 4b r(ci rm.-o-- QA Dc t l sl r ,L n- dft -� A4J,.1D(Lc� 00 r
� fl i'- fZ L ,1�1 I a� ?c f S�?AJ 4- <b t�� Lg.,L�'
Square feet: 1st floor:existing proposed 2nd floor: existing � proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 49 AM -aConstruction Type
Lot Size .7(0 Grandfathered: ❑Yes ❑No If yes,attach supporting documentation.
Dwelling Type: Single Family fib Two Family ❑ Multi-Family #units e
( )
Age of Existing Structure L w Historic House: ElYes d(No On Old King's Highway: ElYes ❑No
Basement Type: ❑Full 9'6
q�rawI ❑Walkout O Other A A E SLPr6 od Cam"
Basement Finished Area(sq.ft.) o Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half:existing i° new
Number of Bedrooms: existing_ new Q
Total Room Count(not including baths):existing 61 new ® First Floor Room Count t�
Heat Type and Fue: MGas ❑Oil Electric ❑Other �
_ Wo! T — 0,� tc-
Central Air: lYes ❑No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes ®Tlo
Detached garage:❑existing ,❑new size Pool:O existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name L(Js 'Da CQ/,drRdcT S/<II�'elephone Number
Address -eta, I%X Ipco License#=2--
A4RO-40) Iq(U-3j &I OZ-J Home Improvement Contractor#
Worker's Compensation# 0000003 3 9L
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO S&&LA C(I 91 %SS'-1h2-�`
SIGNATURE DATE sl a
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1„05'6 X Kf 11'-5" 1„05'6 x
M.ZE M„LE
4 ft.A lic
3-pc Shov
Proposed
Second Floor
Bathroom
,.a. Ca Unen
,a Closet /7
k a
Existing Storage /b
_ ---------- Proposed
----------- ---- - Walk-in
Existing " ;� 3'x a!a c; Closet/Storage
Office/Guest Bedroom /
Existing
Office/Guest Bedroom
a
Open Shelving
Existing Second Proposed Second
Floor Storage Scale: 1/4"-V-0" Floor Renovation
McCormick Residence Drawn by A. Liss
23 Marston Terrace Construction Services
H annis ort MA 02647 Date: 1/19/04 Revised: 2/23/04
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COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
RECEIVE®
JUL 3 12002
TOWN OF ARNSTABLE
HEALTH DEPT.
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS'
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION -:z A
Property Address: 23 Marston Terrace Hyannisport
Owner's Name:Steve Celleta
Owner's Address:Same �— ' `
Date of Inspection: 7/17/02
MAP Z,$`
PARCEL
Name of Inspector: Timothy Lovell
Company Name:Accurate Inspections LOT
Mailing Address:550 Willow Street
W.Yarmouth,MA.
Telephone Number:508-771-3700
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.sowage..:disposal systems.I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(31e6R 15:000). The system:
X, Passes
= Conditionally Passes v
Needs Further Evaluation by the Local Approving Authority
Fails
Inspector's Signature: 6 Date:7/17/02
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
****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.
l
Page 2 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
_X_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:
_N/A 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 for the following statements. If not determined please
explain.
_N/A 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 infiltration 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 Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
N/A 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 or 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:
N/A_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
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date'of Inspection: 7/17/02
C. Further Evaluation is Required by the Board of Health:
_N/A 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:
_N/A_Cesspool or privy is within 50 feet of surface water
_N/A Cesspool or privy is within 50 feet of a bordering 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:
_n/a_ 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..
_n/a The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
_n/a The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_n/a_ 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:
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
_x_Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
_x_Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
_x_Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
_n/a _Liquid depth in cesspool is less than 6"below invert or available volume is less than''/z day flow
- _x_Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
of times pumped
T _x_Any portion of the SAS,cesspool or privy is below high ground water elevation.
—x_Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
_x_Any portion of a cesspool or privy is within a Zone I of a public well.
_ —x_Any portion of a cesspool or privy is within 50 feet of a private water supply well.
_x_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.]
No_(Yes/No)The system fails.I have determined that one or more of the above failure 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: N/A
To be considered a large system the system must serve a facility with 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 the 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 to a surface drinking water supply
The system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone H 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 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:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
Check if the following have been done.You must indicate`yes"or"no"as to each of the following:
Yes No
_x _Pumping information was provided by the owner,occupant,or Board of Health
x Were any of the system components pumped out in the previous two weeks?
_x _Has the system received normal flows in the previous two-week period?
x Have large volumes of water been introduced to the system recently or as part of this inspection?
_n/a _Were as built plans of the system obtained and examined?(If they were not available note as N/A)
_x _Was the facility or dwelling inspected for signs of sewage back up?
_x _Was the site inspected for signs of break out?
x Were all system components,excluding the SAS,located on site?
x_ _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?
_x_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
n/a_Existing information.For example,a plan at the Board of Health.
_x_ _Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)1310 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:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):_4_Number of bedrooms(actual): 4_
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):_440
Number of current residents:_1
Does residence have a garbage grinder(yes or no):_no_
Is laundry on a separate sewage system(yes or no):_no [if yes separate inspection required]
Laundry system inspected(yes or no):_n/a
Seasonal use: (yes or no):_no_
Water meter readings,if available(last 2 years usage(gpd)):Yr 2001(52500gals)Yr 2000(53000gals)
Sump pump(yes or no):_no_
Last date of occupancy:_current
COMIKERCIALANDUSTRIAL n/a
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_
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 of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: Owner 2000
Was system pumped as part of the inspection(yes or no):_no
If yes,volume pumped:_____gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
_x 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 age of all components,date installed(if known)and source of information: „
upgraded 1988
Were sewage odors detected when arriving at the site(yes or no):_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: 23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
BUILDING SEWER(locate on site plan)
Depth below grade: 16"_
Materials of construction:_cast iron _x_40 PVC_other(explain):
Distance from private water supply well or suction line: 75'
Comments(on condition of joints,venting,evidence of leakage,etc.):
No evidence of leakage,Joints look tight venting ok
SEPTIC TANK:_x_(locate on site plan)
Depth below grade:_10"_
Material of construction:_x_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: 1000 Gallons
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness:_3"
Distance from top of scum to top of outlet tee or baffle:_6"
Distance from bottom of scum to bottom of outlet tee or baffle:_15"_
How were dimensions determined: in the field tape measurements
Comments(on pumping recommendations,inlet and outlet tee or bale condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
Tank looks to be in good condition at time of inspection no evidence of leakage liquid levels are at invert out,
bales are in place and look fine
GREASE TRAP:_n/a (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 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:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
TIGHT or HOLDING TANK:_n/a (tank must be pumped at time of inspection)(locate on site plan)
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.):
DISTRIBUTION BOX:_x (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:_0"
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.):
Distribution box looks fine at time of inspection liquid levels are at inverts out and equal so no evidence of solid
carry over 20 to top of cover.
PUMP CHAMBER: n/a (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.):
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
SOIL ABSORPTION SYSTEM(SAS): (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:
_x Leaching fields,number,dimensions: 20x30
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.):no evidence of hydraulic failure no pondin or soil vegetation is normal I excavated test hole at end of
field and found system seems to be working fine at time of inspection
CESSPOOLS: n/a(cesspool must be pumped 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:
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:_n/a (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.):
I�i
Page 10 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
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.
Back of
Home
23.6
22.5 26.5
31.5
30' x20'Leachfiel)
Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:23 Marston Terrace Hyannisport
Owner: Steve Celetta
Date of Inspection: 7/17/02
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water_9 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 property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
Checked with local excavators,installers-(attach documentation)
_x Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Information provided by Cape Cod Commission well Data Well#M1W-29 indicates water elevation adjusted is at
8.68 July 2002 report Approx bottom of leaching field is at 15.0 separation is approximately 6.5 ft Map#Plate 2
`��� TOrW�IV OF BARNSTABLE
LOCATION "�'3 SEWAGE #
VILLAGE ASSESSOR'S MAP& LOT
INSTALLER'S NAM4 PYONE NO.
SEPTIC TANK CAPACITY
I
LEACHING.FACILITY: (type) (size)
1
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
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 4
within 300 feet of leaching facility) Feet-"-
Furnished by
Back of
Home _
23.6
22.5 26.5
31.5
30'x20'LeachfielO
TOWN OF BARNSTABLE
LC`CATIONy �•��/�/�-�510<1 /I?fMC SEWAGE # Q
V` LAGE 11VVZ1717C fi,S 42r ASSESSOR'S MAP & LO 0 S
�--ER'S NAME&PHONE NO.At-71Ju,.+- '�, � i�%•� 7�/-3�d
SEPTIC TANK CAPACITY
4 LEACHING FACIL=: (type) Zt46k 194Y /W (size) ;?o dr-0
NO. OF BEDROOMS G
BUILDER OR OWNER 5kut. o,P— / i2
PERMITDATE:. COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 91 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
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DATE PERMIT ISSUED �1�76r
DATE COMPLIANCE ISSUED _.
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South Wing South Wing Renovation
McCormick Residence ,
. Drawn by A. Liss scale: 1/4 --7 -o
23 Marston Terrace Construction services
Hyannis Ort, MA 02647 .� Date:, 1/19/04 Revised: 2/05/04
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