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HomeMy WebLinkAbout0033 MAYWOOD AVENUE - Health 33 Maywood Avenue Qy- ) Hyannis A = 287 129 r� V i i 04/26/201 09 : 22 TOWN OF BARNSTABLE PG 1 health (APPLICATION PROFILE Ipiappent ' GENERAL APPLICATION - - - - -- - - - - - - - -- - --- Application ref 200905106 Fee Effective Dt 10/23/2009 Department BUILDING DEPARTMENT Location 33 MAYWOOD AVENUE Parcel 287129 Cross streets Add' l loc desc LOT 2 , 2 Municipality HYANNIS Subdivision Lot 0 Existing use SINGLE FAMILY HOME memo Current Zoning RESIDENCE F-1 DISTRICT Flood zone Applicant PROPERTY OWNER Proj /Activity GARAGE DETACHED RESIDENTIAL Class of work ADDITION/ALTERATION Description BUILD 23 X 26 . 6 FREE STANDING GARAGE WITH LIVING . SPACE GREAT ROOM, BEDROOM, SITTING AREA AND 1 1/2 BATH. Proposed use SINGLE FAMILY HOME memo Proposed zoning RESIDENCE F-1 DISTRICT Flood zone Non-conforming N Applic received 10/23/09 Estimated cost 100 , 000 Estim start/end Actual start/end Impervious Surf...-- Assigned to "`T--- Status ( ACTIVE Status code e .c INELIGIBLE " Multiple submissions N Next action Government owned N memo ---- -- Ordinance ref Reason for app Parent app Point in time fee effective date Fee expiration date ROLES/NAMES Role Name/Address PROPERTY OWNER THE 33 MAYWOOD AVENUE LLC CID 305439 2 SEAPORT LN STE 1100 BOSTON, MA 02210 GENERAL CONTRACTOR PROPERTY OWNER CID : 813776 , Phone : (000) 000-0000. Tradesman Name Lic Type License number Class Expires PROPERTY OWNER OWNER 04/26/2010 09 : 22 TOWN OF BARNSTABLE PG 2 health (APPLICATION PROFILE 1piappent Application ref : 200905106 (continued) GAS CONTRACTOR LECLERC, DEREK CID : 812757 PO BOX 1248 Phone : 5082927249 FORESTDALE, MA Tradesman Name Lic Type License number Class Expires LECLERC, DEREK JNMAN PLUM 26022 05/01/10 PLUMBING CONTRACTOR LECLERC, DEREK CID : 812757 PO BOX 1248 Phone : 5082927249 FORESTDALE, MA Tradesman Name Lic Type License number Class Expires LECLERC, DEREK JNMAN PLUM 26022 05/01/10 RESTRICTIONS/HAZARDS - - ---------------- - Restrct/Hazard Hold Comments RST BARN H IST PREREQUISITES -- ----------- Prereq Action Dept Needed By Approved By Status CONSERV APPROVAL 6701 10/23/09 DKAR APPR 10/23/2009 approved under DA-09008 01/07/09 HIST BARNS APPROVAL 4201 10/23/09 MFAI APPR 10/23/2009 N/A HEALTH APPROVAL 6500 10/23/09 `" DDES APPR 11 bedrooms 2009069 is for Septic tank installation to add garage and living space . Permit 99-326 was approved for 11 bedrooms . The garage brings them up to capacity. TAX APPROVAL 6300 10/26/09 DBAR APPR WORK COMP SUBMISSION 6300 10/26/09 DBAR APPR PERMITS Type Permit Number Status Issued Fee Unpaid Amt RES APP FE ISSUED 10/23/09 100 . 00 . 00 ELEC ACCES REVIEW 30 . 00 30 . 00 RES GAS 20100347 ISSUED 04/23/10 76 . 00 . 00 RES PLUMBI 20100319 ISSUED 04/23/10 148 . 00 . 00 RESADD/ALT . 20100017 ISSUED O1/07/10 510 . 00 . 00 TOTAL: 864 . 00 30 . 00 INSPECTIONS Type Requested Scheduled Insptr Permformd Results Bal Due BLDG. FIN 1 . 00 EFINAL #1 . 00 EROUGH 1 . 00 FOUND 1 PROM 02/02/10 PASS . 00 04/26/2010 09 : 22 TOWN OF BARNSTABLE PG 3 health APPLICATION PROFILE 1piappent Application ref : 200905106 (continued) FRAME 1 PROM 03/31/10 PASS . 00 INS INSP 1 . 00 TOTAL: . 00 AUDIT HISTORY -------- ---- - Department Action Source Created by Date Comments BUILDING DEPARTMENT Permit issued APP permit 04/23/10 Permit no 20100319 - RES PLUMBI , PAID BUILDING DEPARTMENT Permit payment collected APP permit 04/23/10 Payment collected on permit RES PLUMBING PERMIT P BUILDING DEPARTMENT Permit issued APP permit 04/23/10 Permit no 20100347 - RES GAS, PAID BUILDING DEPARTMENT Permit payment collected APP permit 04/23/10 Payment collected on permit RES GAS PERMIT G BUILDING. DEPARTMENT Permit payment collected APP permit 01/08/10 Payment collected on permit RES ADD/ALT BUILDING PERMIT B201 BUILDING DEPARTMENT Permit issued APP romap 01/07/10 Permit no 20100017 - RESADD/ALT, UNPAID BUILDING DEPARTMENT Application reactivated APP romap 12/15/09 Reactivated on 11/13/09 - Status was DENIED BUILDING DEPARTMENT EXCEL 1JAN09 - 11DEC09 APP finchn 12/11/09 BUILDING DEPARTMENT EXCEL >31mar09 APP finchn 12/10/09 BUILDING DEPARTMENT EXCEL 2009ALL APP finchn 12/02/09 BUILDING DEPARTMENT EXCEL 30JUN09 2DEC09 APP finchn 12/02/09 BUILDING DEPARTMENT EXCEL TestPermits APP rudziakj 12/02/09 Application status change APP romap 11/13/09 See text BUILDING DEPARTMENT Permit payment collected APP permit 10/26/09 Payment collected on permit RESIDENTIAL APPLICATION FEE B BUILDING DEPARTMENT Prerequisite approved APP permit 10/26/09 WORK COMP on 10/26/09 BUILDING DEPARTMENT Prerequisite approved APP permit 10/26/09 TAX on 10/26/09 BUILDING DEPARTMENT Prerequisite approved APP fairm 10/23/09 HIST BARNS on 10/23/09 BUILDING DEPARTMENT Prerequisite approved APP desmarad 10/23/09 HEALTH on 10/23/09 BUILDING DEPARTMENT Prerequisite approved APP karled 10/23/09 CONSERV on 10/23/09 BUILDING DEPARTMENT Application entered. APP permit 10/23/09 ** END OF REPORT - Generated by Health Counter User ** TOWN OF BARNSTABLE LOCATION l-Y7/4 64/0oc/" ►//�4/G/1�5 SEWAGE # 200 9—0 G`I VILLAGE ASSESSOR'S MAP & LOT 287-/2q INSTALLER'S NAME&PHONE NO ��SD�- SEPTIC TANK CAPACITY ,�I�STI���/ /5�00 �q� T�r/� H-20 620161 LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER JDs rv1'4 Ja-544 /�1411an PERMITDATE: 3— :�7— 0 ' 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-- . �� ,® /� oZ ,/� } OOd 1 N O'./J ' I - _ i �, 7-I�Y�IAYA� • e i j � i No. -V Fee HE COMMONWEALTH OF MASSACHUSETTS Entered in computer:!=/F PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpIicatiotl for 39isposar *pstem Construction,Vermit Application for a Permit to Construct(--I' Repair( ) Upgrade( ) Abandon( ) ❑Complete System [ hdividual Components Location Address or Lot No.33 McqY.vaek,Avg Owner's Name,Address,and Tel.No. il\c 3 5 A} et iLc_L y s lvtct- Assessor's Map/Parcel U7 IZcl 3^ G Installer's ame,Address and Tel.No.S0,?—,Y20-973 8 Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 1 f a c Lot Size I xI A�ec> sq-ft. Garbage Grinderlpo) Other Type of Building C`I No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date 1 1 71 cue( Number of sheets Revision Date Title 51\C Size of Septic Tank 1,134ab 6�k• Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ; o c G Date.last inspected: c` ►_ C ' Agreement: Z�'lc� Or 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 Certificate of Compliance has been issued by this Board of Health. i � Application Approved by Date Date Application Disapproved by Date for the following reasons Permit No. Date Issued " Noy' �/v 61HE Fee COMMONWEALTH OF'MASSACHUSETTS Entered;n conpguter: i PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS - Yes appYicatiott.for Disposal *pstem Constructio%3ertfrit Application for a Permit to Construct pp Repair( ) Upgrade_,( ) Abandon( ) ❑Complete System 9-Individual Components Location Address or Lot No.33 Muy n„ol NvC ,Ny,,rW\,5jbA Owner's Name,Address,and Tel.No. IhC 330\, yL•rrvot / Lut cfo lvk� r.vl—(.,3.L.L.— Assessor's Map/Parcel Z$ _j Zq z SQ,po�V Lr C a it hua Installer's Name,Address,and Tel.No. esigner's Name,Address,and Tel.No. I ,\ X Type of Building: 5 Dwelling No.of Bedrooms ?}rwva,e-j Lot Size 1,4-s 4 ec'> sq--ft. Garbage Grinder,06) Other Type C� rx>5�`^S� e yp g � No.of Persons Showers( Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date ►L71 oe( Number of sheets Revision Date r Title ,1t �� .� 7cuov5c'� - Size of Septic Tank ;pp 6,.k Type of S.A.S. vt.�-'Description of Soil 7`{a Nature of Repairs or Alterations(Answer when applicable() -. Date last inspected: �� „�,�.� �__ .rh•� i ' Agreement: {<� ��� Z�`Icy vtACk Thedersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accor&a ce with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compl ante has been issued by this Board of Health. .----. , /f , ~ t ed.- � Z / /0 t Date Application Approved by r / Date f Application Disapproved by Date for the following reasons ` a ?: Permit No. t, Date Issued ; t177 - --- ---------- ---------- 13 t P Jd o THE COMMONWEALTH OF MASSACHUSETTS ;�- , v+r llpc �� BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(i}' Re aired,( Upgraded Abandoned( )by -T 1-1 Q. 2,3 M A zj t.,v v 0 A vat L 1. C— at �'z� M�ti�r„rl P 1� �_�f has been cons cted m acccjo ' ce with the provisions of Title 5 and the for Disposal System Construction Permit No. �"(/ ted Installer ^ -' ' c Designer #bedrooms Approved design flow gpd The issuance of is permit shall not be construed as a guarantee that the system wil ctio as desig/ned. r Date r �o Inspector -� a. y No. "' �7 C'/ Fee �U THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION T BARNSTABLE,MASSACHUSETTS Zisposal 6pstem Construction J)ermit Permission is hereby granted to Construct( /) Repair( ) Upgrade( ) Abandon( ) System located at ' ,�} A.,4-nnrl (fit — �\�� pit„2 s- �.Y and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. i Provided:Cons ust be completed within three years of the date of this permit. f Date 2tru 1tion 20 /O Approved by 1 _ I r _ Town of Barnstable oF1HE' Regul`atory Services Thomas F. Geiler,Director 'QB' AM. E M Public Health Division 9Q 1639. `fig O'°tEoii,p�A Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: Sewage,Permit# Z00 0 ° Assessor's Map/Parcel Zg Installer& Designer Certification Form Designer: 6$kjgxr .*�wC�._ Installer: b A4 J)z Id � — J - — _Address: 1�.0, �Sd Address: D Z14wsye On � yry�o was issued a permit to install a (date) (installer) septic system at 33 ih Uao e- % �c� based on a design drawn by (addrbsgy s4N t eAr dated /7/0� (d igner) 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. Strip out (if required) was inspected and the soils were found satisfactory. - 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. Stripout (if requir nspected.and the soils were found satisfactory. VV OFM480, U (Installer's Signature) 43168 90F FGISTLR�� FSSIONAL esigner's Signature) (Affix Designers Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercertification form.doc .i TI iF SA I m x3 II h r =, LL uk ro ZE LO 94 r 1, m U ' v N H � N W D� T Wm I X nN=FL I _ � ru ® _ J I i o � f TTI �0 \ Fl ------------ �I f Ire sl i I I I J 4 ' i , TOWN OF N T L i Q R � �:.I R `'t All F c° rr** t c M: �c� f 42'-0' _ b'-O" 3'-0' II'-O' 12'-6" 9 EP q c j FUTURE HID O' a - W/ Q Q a HALL KI -4' b'-O Y 6'-S' BEDROOM #1rITER Q P 3 a J . Q9 FUTURE 10 Z KINK b REF Oy ® O O N DATH Q Z a O O BEDROOM #3 04 n 3'-5' 4'-T w b COVERED PORCH 3'-W b'-b' 3'-9" 12 # Q BEDROOM 2 O . � Q in Q Q Y A O m E -i al 14'-O' DN Q ❑❑ ❑❑ Z } IILUEOTONE STEPS _ W - STONE WALL x ' Y S F R UP 3'-0' IS'-d W-O' 12'-0' _ SHEET 00 N A 4 FIRST FL R PLAJOB,N q90.7 SCALE, 1/4" a 1'-0" DRAWN BTU KW DATE, 5/7/99 i 42'_O. 12'-0' dD b ----_--- ---- NBAT" DT] m ISy HALL i i i NOOK IEEE ALI. 0 E Q OPEN TO BDRM qi BELOW RAIL o LINE OF �a OD > _ RIDGE ABOVE L- IO Z RAIL - LINEN •Vt L f SL EPlqQ LOFT E LINE OF Q B _ I RIDGE ABODE 11 = Z _o 0 Z ' DECK ' O BETOOM #4 u l m — � v n Z n � I 1 L a _ o e 2 � - M BALCONY Z t SECOND FLOOR PLAN $F ° SCALE I-O" Y � WINDOYV SCHEDULEQ KEY OTT. ESCRI TI R DOORO SCE14NEDULEMFR✓MODEL'`p/�/ KEY OTT. DESCRIPTION ROUGH OPENING MANUFACTU /M RERODEL �I A II DOUBLE HUNG 3'-2 1/B"x B'-A 1/4' ANDER9EN 309i 1 4 EXT.FRE4O4 DOOR 6'-0'x L'-e' ANDERSEN FhUF06BAPLR B 2 DOUBLE HUNG 1'-i 1/0"x 4'-B I/4' AN 2442 2 3 VT.FRENCH DOOR 2'-10 I/2'x 6'-10 I/2' ANDERSEN FWH29LB �'/ ( ,,,���///��� i` C 4 TRANS 2'-6 1/0'x 1'-0 1/4' ANDERSEN TR2410 0 0 2666 SCREEN DOOR 'V�'/� ��((��,, D 4 AWNING 3'-0 1/2"x 2'-4 1/6' ANDER9EN AMOI 4 9 2066 SCREEN DOOR F �L/./V'/ �/W\ E 2 FOUNDATIOWCEDAR 6 0 2060 SCREEN DOOR \,J SHEET i 0 2666 INTERIOR 2'-0 V2 x 6'-e 1/1' ' 7 1 3066 INTERIOR COL W-2 1/2 x 6'-0 1/2 A 0 1 6466 INTERIOR oBL 6'-i 1/2'x L'-0 I/2' 9 2 2ou INTERIOR 2'-1 I/2 ,I1f.,I111V\/'1 10 2 I666 INTERIOR 1'-0 1/2'x V-0 112" 11 2 2466 INTERIOR 2'-6 1/2 x V-0 1/2' .KJBr 9907 t2 I IXT.FRENCH DOOR W-O'x V-0' ANDERSEN FWH506BS9 •TEMPERED GLASS BELOW IB'O.F.F. DRAWN BY, KW •G.C.TO VEWINDOWSY ALLL SIZE 6 QUANTITY PRIOR TO ORDERING WINDOWS •G.C.TO VERIFY ALL SIZE 6 QUANTITY PRIOR TO ORDERING DOORS DATES 6/7/99 Page 1 of 1 Miorandi, Donna ...... From: John O'Dea [John@sullivanengin.com] Sent: Wednesday, May 05, 2010 2:29 PM To: Miorandi, Donna Subject: FW: Fallon Garage Agreement Permit No. 2009-069/ Maywood Ave Donna, I was in last week erasing a proposed septic tank because the building department didn't want a "kitchen", and the owner really didn't care. When the building inspector said they were not even going to allow a sink we decided to reevaluate. Based on the attached, which I just received, the building commissioner is going to allow a wet bar or kitchenette. The attached also specifies how the garage will be used. With this agreement(which specifies the use) is one tank ok, or do we need to go back to 2? I'll be in to close the loop someday soon, and make whatever changes necessary to the permit and plans. John 5/5/2010 II AGREEMENT FOR USE OF GARAGE f 33 MAYWOOD AVENUE LLC, a Massachusetts limited liability company,c/o The Fallon Company LLC,Two Seaport Lane, Suite 1100, Boston, MA 02210,being the owner of property situated at 33 Maywood Avenue, Hyannisport,MA,described in Certificate of Title No. 183480,being Lot 2 on Land Court Plan 15903-B, Lot 1 on Land Court Plan 33385-B and Lot 2 on Land Court Plan 14065-B, being shown on Assessors Map 287 as Parcel 129, hereby agree,certify,warrant and represent to the Town of Barnstable that the accessory garage building to the residence located on the same parcel as above-described,which accessory garage building contains a wet bar and kitchenette facilities,is not intended for and shall not be used as a permanent, separate apartment for year round or summer occupancy,for rent in any fashion. The intended and authorized use is for the occasional guests associated with the residential use on the same premises.The accessory garage building shall not be used for a"Family Apartment"(as defined in the Zoning Ordinances)which would require application and approval of a.special permit and compliance with the Family Apartment Rules and Regulations. The accessory garage building shall not be rented as an apartment or as a single room, or in any,fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. This Agreement shall'be duly filed with the Barnstable Registry District of the Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as'herein stated,which Agreement shall run with the land and be binding on future owners. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. Executed as a sealed instrument this . day of May,2010. TOWN OF BARNSTABLE'I OWNER(S) By: Building Commissioner; 33 a oo ve e, LC By.Jos F. to Member' t COMMONWEALTH OF MASSACHUSETTS r Barnstable County;ss. On this of May,2010,before me,the undersigned notary public, personally appeared Joseph F. Fallon, as aforesaid,and proved to me through satisfactory ' evidence of identification,which was personal knowledge to be the person whose name is 'y. r signed on the preceding or attached document, and who acknowledged tome that he signed it voluntarily for its stated purpose, + Notary Public My Commission Expires: 14ACCANN VIMAMV * Notary Pubile Commonwealgi of Massachusetts My Commission Expires AUGUST 25,2011 • �o/d MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town:l MA. Date: �3 ID ermit# -- - — Building LocationJ j-3 M lwloOC�1 V � Owners Name: Type o7Afte ncy: Commercial 1 Educational� Industrial 0 Institutional L] Residential New: �i ration:0Renovation:lj Replacement: Plans Submitted: Yes' o p 0<C FIXTURES z z rn 0 z U . (n W Cn co jQ J 2 H W i Z W _ Y m Q Q to 0 v Z rn ? 1-- rn Z W x t n. w CO F- w u) Y co a X a z CO U a �^ O m Q Cn Q W W to J coJ z v 'N Q Y x O 0 I— x z Q u- �: o. Y Q x W W. W WQCnCnO Q = Q00 ° . Q `Q Q J O 0 x W Q F Q m m ❑ o u. O x Y ._j m m j- ❑ O SUB BSMT. ` BASEMENT 1 FLOOR J 2 N LFLOOR 1 3 FLOOR 4 FLOOR 5 FLOOR WH FLOOR 7 FLOOR 8 FLOOR Check One Only Certificate# Installing Company Namedl� )L t.�rvtg>✓i�1G A?Z>�1rJ J- Corporation —� Address: City/Town , 2�. i��,estate: MA Part ship Business Tel: /-5-b9-Z5z z�tS . Fax: ana .. .e � - _ Firm/Company Name of Licensed Plumber: , ccC INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes NoD If you have checked Yes,please Indic the type of coverage by checking the appropriate box below. A liability insurance policy j xl Other type of indemnity L Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 742 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement., 1+ Check One Only Owner z Agent Signature of Owner or Owner's Agent I hereby certify that all of the details and information 1 have submitted(or entered)regarding this application are true and accurate to the best of my . Knowledge and that all plumbing work and Installations performed under the permit' sued for this apnlication will be 10 compliana- ith ►1. Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 a Gen I By �.------.-- Type of License:. Title( { ✓ S n ure o Licensed Plumber f Plumber (. ..; Master 1,�_� City/TownL_ _ _ journeyman r License Number: APPROVED OFFICE USE ONLY _. s STABLE Alp. 26. AM 9: 13 .V_f-T �s I 1"-n-_ I POOL #01& �' -�� No. S9 3 Fee ,� Entered,n computer: THE COMMONWEALTH O MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS VY Rpplication for �Di5po5a[ �&pe;tetu Con0tructiou Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components : Location Address or Lot No. 3 3 ✓Yl� wda 1� /� Owner's Name,Address;and Tel.No. /Ty`,ki Kt 1 pc�t r' Assessor'sMap/Parcel X1 Jose pN t�e,ll n/ F�I Installer's Name,Address,and Tel.No. ��� �77Sz Designer's Name,Address and Tel.No. ur 19 aL/ t/CJ r3 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building Poo L Hy lj e No.of Persons Showers( / ) Cafeteria(fd) Other Fixtures Z YL ai P'b s Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 2 A-r7 <,— S r-, So i r f f�vh 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 t place the system in operation until a Certificate of Compliance has been issued by this Bo of Health. Sig i ate Application Approved by &!)���� ate Application Disapproved y: Date for the following reasons i Permit No. Date Issued —————— ——————————————————--——— ———————————- _ `x„�•.+.-......�,• _,i-ar—ti.•-,.an,�.W .��:'�A. �... )e..y�..4 �a ...rC"r �.��� rlf j�,,, �i b.r..l°�"tw,. - /il-C.�tT(�yJT'."..C�,Q-� r No. �-/ - e� Fee -� THE COMMONWEALTH 0 M SSACHUSETTS Entered in computer: VYe PUBLIC. HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Mi9;po.5a1-*pgtem Con0truction Permit Application for a Permit to Construct( ) Repair{ ) Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. 3 3 ✓IA-y w vo ?� 2d Owner's Name,Address,and Tel.No. /(ye,h Nt i J>v-,tT Assessor's Map/Parcel Zbo 7 /a-1 FL?se pH j lam✓ do g t" 2 Installer's Name,Address,and Tel.No. ' /` Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building- ;Poo L Ho✓J ec- No.of Persons Showers( / ) Cafeteria()0) Other Fixtures 7 �4-r-1► S ry Design Flow(min.required) gpd Design flow provided gpd Plan Date 4` Number of sheets Revision Date Title �� Size of Septic Tank o Type of S.A.S. .. Description of Soil !j Nature of Repairs or Alterations(Answer when applicable) TIC NTo is i S T Sri r A v i 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 Cod and not place the system in operation until a Certificate of Compliance has been issued by this Bo f Health. r Sign -' ate u Application Approved by V ' Date I v - Application Disapproved by: - Date / for the following reasons t !'Permit:No. Date Issued ® y,�' THE COMMONWEALTH OF MASSACHUSETTS 1 0 BARNSTABLE, MASSACHUSETTS ,' V1 Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by To se4iS at 33 Mr^to JA1de 6l ' ha been constructed' accordance r with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer #bedrooms Approved design flow gpd The issuance o this permit shall not be construed as a guarantee that the system will functionX, esigned. Date ( ((1 Inspector / — --- ------------------ ------ -- ; 3 No. 409q_L_ Fee L� ✓f THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS ig ogal Stem Con9truction Permit Permission is hereby granted t,,;Constru t ( ) Repair ( Upgrade ( ) Abandon ( ) System'located at . , o I j and as described in the above Application for Disposal System Construction Permit.Th appl' apt recognizes his/her duty to comply with Title S and the following local provisions or special condi ' r Provided: Construction must be ompledd�within three years of the date of this pe t. Date `1 Approved b f - COMMONWEALTH OF MASSACHUSETTS EXECUT.VE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM FORM PART A / CERTIFICATION Property Address: 33 Maywood Avenue Cn.. Hyannis Port, MA 02647 Owner's Name: _ Max c& Vicki Kennedy 1 �' Owner's Address: 14203 West Suhset Boulevard ; c-1 Pacif&Palisades: CA 90272 57-1 Date of Inspection: December 1, 2006 1 t Name of Inspector: (Please Print) James M. Ford Company Name: . James M. Ford co r� Mailing Address: P.O.Box 49 Ostervft MA 02655-0049 Telephone Number: (508)862-9400 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 Ne s Further Evaluation by the Local Approving Authority F is Inspector's Signature: Date: December 6. 2006 The system inspector shall sub 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 1.0,000 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. Title 5 Inspection Form 6/15/2000 page 1 i Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 33 Maywood Avenue Hyannis Port, MA Owner: Max& Vicki Kennedy Date of Inspection: December I. 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 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. 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 Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: 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: 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- 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 33 Maywood Avenue Hyannis Port. MA Owner: Max& Vicki Kennedy Date of Inspection: December 1,2006 C. Further Evaluation is Required by the Board of Health: 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 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: 3 f Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 33 Maywood Avenue Hyannis Port, MA Owner: _Max& Vicki Kennedv Date of Inspection: December I. 2006 D. System Failure Criteria applicable to all systems: You must indicate either"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 ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ ✓ 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 6"below invert or available volume is less than '/2 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. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 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.] 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. 1. E. Large System: 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 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 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 33 Maywood Avenue Hyannis Port MA Owner: Max& Vicki Kennedy Date of Inspection: December 1, 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 ✓ 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? ✓ - 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 ✓ — Existing information. For example, a plan at the Board of Health. ✓ _ Detennined 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)]. 5 I Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 33 Maywood Avenue _ Hyannis Port MA Owner: Max& Vicki Kennedy Date of Inspection: December 1 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): 770 Number of current residents: 0 Does residence have a garbage grinder(yes or no): n1a Is laundry on a separate sewage system(yes or no): n1a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Weekend use COMMERCIAL/INDUSTRIAL 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: Unavailable 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 ✓ 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: Installed on 6126100-ner as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 33 Maywood Avenue _ Hyannis Port MA Owner: Max& Vicki Kennedy Date of Inspection: December 1 2006 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): 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: 2" 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: 2000 awl_ Sludge depth: 2" 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: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.). Tees were Present. The liquid level was even with the outlet invert There did not appear to be anv signs of leakage GREASE TRAP: None (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 recommmendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels . as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 33 Mavwood Avenue Hyannis Port MA Owner: Max& Vicki Kennedy Date of Inspection: December.1 2006 TIGHT or HOLDING TANK: None (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: allons Design Flow: Prallons/day Alarm present(yes or no): Alarn level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarns in working order(yes or no) Connnents(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 ♦ Page 9 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 33 Maywood Avenue Hyannis Port MA Owner: Max& Vicki Kennedy Date of Inspection: December 1 2006 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: ✓ leaching fields,number, dimensions: _2- 10'z 82'(ner as built card overflow cesspool,number: Innovative/alternative system Type/name of technology: Conunents(note condition of soil,signs of hydraulic failure, level of ponding,damp soil, condition of vegetation,etc.): _The fields were dry and clean There did not appear to be any signs of failure. CESSPOOLS: None (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): Conunents (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (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 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 33 Maywood Avenue Hyannis Port, MA Owner: Max& Vicki Kennedy Date of Inspection: December 1. 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: A Q 6 �k a �3 o i y, aY �. Yq are 3 i0 Page 11 of. 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 33 Mavwood Avenue Hyannis Port MA Owner: Max& Vicki Kennedy Date of Inspection: December 1, 2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 15 +/- 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: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps the maps were showing gpproximately IS'+/ to ground water at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 TOWN OF BARNSTABLE LOCATION J.7 M wo,2 Me, SEWAGE# V,,ILLAGE ��' PO fI ASSESSOR'S MAP&PARCEL oT7' , INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY Q QUO LEACHING FACILITY: (G(type) 'CJ (size).. 10 x NO. OF BEDROOMS OWNER PERMIT DATE: 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 -row 11)/1 �"� Fp r yq IC � 3 3 S8� ya f 1 . �3 TOWN OF BARNSTABLE LO-CATION O1A � SEWAGE # VILLAGE 1'�I�1ifZ <11z 0'��1�� ASSESSOR'S MAP'& IMMLLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY c LEACHING FACILITY: (type) .4a . ` (size) 14 pA" NO.OF BEDROOMS__-��rTrKr PTO r (' NI/�^J -}D�„1Dj BUILDER OR OWNER Orly/ PERMITDATE: �`` �' COMPLIANCE DATE: 41!rf 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 facilitD, Feet Furnished by C� � 'd � !�✓. _ . �� ..� / ,� t ,J ' .�.. �a_ �_ --` d 1 , � .. ��-� � � s, �. o �_ �� ' ��� �. �� �` �, Fee THE COMMONWEAL H OF MASSACHUSETTS , Entered in computer: - es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS A 01pplication for �Digogaf *pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Loc�' ion Address or Lot No. 4 M►�Y w�oo o Av£ Owner's Name,Address and Tel.No. Asses s Map/Parcel V4YA""l5 Fb e.T K AK x v I c"-< L/E n1 to mV Y 28"1 ! 12ej 2 SE-eY—LG-( S•r CA, ba\DA G 02%3g Installer's Name,Address,and Tel.Rio E Designer's Name,Address and Tel.No. ?CIEQ CJtlLL.\VA/.� P6 e ee. efl p5r r--e_-VI L L 6 Type of Building: 4 Pao WsEO DwellingNo.of Bedroom 7 Fr-1 t�.k,e� of Size �-43 sq.fit. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1210 gallons per day. Calculated daily flow lZ I gallons. Plan Date QiwE Z. 99 Number of sheets Z Revision Date A oy E Title S I t� 4��-K1�.A I� `EOTI.G Sys tom. yyl Size of Septic Tank I SOp C-ALU5US -46We� Type of S.A.S. �°M p`�'� µ�Y z o00 6w+.cam s - 7 $E-09- t o Description of Soil r E &j %M rco D ny&wrap ip E L t 7 C S/13199� 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 issu th is Bo of Signed vt: Date Application Approved by Date 2 Application Disapproved for the following reasons Permit No. Date Issued ^ — THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( ) Upgraded( ) Abandoned( )by at 4 C. y u,LAIS has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No 1�� a2, dated Installer Designer !yG Tie. S UL.LWAKJ The issua a of this permit shall not be coo trued as a guarantee that the sypoft will function desigged. Inspector J. Fee ��f x. '�THE'COMMONWEALTH OF'MASSACHUfETTS' '�t �- ered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yicatfon'forioogaY *pgtetn Con!5tructionerYnit i Application for a Permit to Construct( ,),Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Lotion Address or Lot No. �{ 1 /l I�`�\lJ 60 O /w c Owner's Name,Address and Tel.No. Asses o s Map/Parcel 1 Installer's Name,Address,and Tel. vote"-'' Designer's Name,Address and Tel.No. rt n e7F_e- 'S U L L\V A / 1 ';�24\e E2 Q.D DS i 1 LL E, Type of Building: � A Drzo VssEZ 5 Dwelling No.of Bed oom , 7 i-z`S of Size sq.t. Garbage Grinder { Other ,Type of Building No. of Persons Showers( ) Cafeteria( ) •- Other Fixtures Design Flow 1 Z 10 gallons per day. Calculated daily flow 12 t gallons. Plan Date J ti L Z, IDD§ Number of sheets 2 Revision Date h4 o u C Title Size of Septic Tank 1 5 OD 6,4,t-LG uk, -4(btb e v..t Type of S.A.S. f_M"^ A�Zt� t.L L1 '( 2000 &A�.LJN 7 ZEoe" �e �. �2 Description of Soil CC-A,-,...t V\A�r� 5 o.tis Z2 &A 2 C-a L L 7 t 5/13/99) Nature of Repairs or Alterations(Answer when applicable) Date last inspected: ,. Agreement: w 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=ssu this Bo d of 4V� - Signed ' Date 1 l Application Approved by Date OA Z, Application Disapproved for the following reasons \ Permit No. Date Issued a THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed;( )Repaired( )Upgraded( ) Abandoned( )by - at A M/�`( \/J Dos7 /•fit) Z �_A t S e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit Nog s < dated v Installer Designer fp4=TEZ S UL L-\V A 1,_k The issua ce of this permit shall not..1Ze•cc strued as a guarantee that the s s>e" will function s dest ed. Date ^ i b' 1�r *�' Inspector ✓ . No. Fee Z� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migoar *p!gtem Cl'Afgtructio.n permit Permission is herebyranted to Construct Repair )Up" g ( ) P ( )U,grade(�) ).Abandpn.(... ) System located at 4 MAy W CDD Av E RYAh-l'KI tS' �T`Kf r J and as described in the above Application for Disposal Systed ConstructiofiTPei�. The applicant recognizes his/her duty to 1-1 comply with Title 5 and the following local provisions or speci&4 conditions: Provided:Construction must be completed within threeyears_of the date of,thiss permid Date: � 0 d /-/Apprroved by7 t d N p 7-1 w Eo r J L � - 7 tAT VI - f o� IL o tl _ 1' { o r i I i v t� 11 1 tl E AT n � ZZ r go Z f F.; > J +�+ `' _ F _ ao v � g �� M � �, 3 � - � � r � j � \, � - t - k 1�j� .�/ � o L` v ��'�„jjyy"((�� i f S �. � d >- � � � � . (� ;� I' - ' ._ '� ii a �1 J� �� 1 I! �3 � / � h '� � , � ., ;. � �: r � I � dl� LL �_ •� � � - �' •� � ��-�,� � 1 -� _._ _ � I - - fi ''� �� � J p - ,� �V� y i � I( I %��� F ��--�( .v.- W _ _ I� p _ �. 7 �u � ,i ;a '� � - - � . . \ � - 140 N M � 4 r F of 1 y r . 1 O I� ,I r t i TJ Ed I IrP r Falm 0 IL J r - o � �s]r�a� � . n TOWN OF BARNSTABLE �£ LOCATION A1�L-J gt ,2 AUe-. SEWAGE# i VILLAGE kl' f p O f-1 ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE,NO. SEPTIC TANK CAPACITY Q1JrJ _ LEACHING FACILITY:(type) C4 ` 14 (size) X �� NO.OF BEDROOMS 1 OWNER i PERMIT DATE: _ COMPLIANCE DATE: Separation Distance Between the- j 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 lea_.'. ) J Feet FURNISHED BY �/1,c Q G o/ C Ag � a4k a f3 o I y/ act ca yq are 3 � � 3 ss qc f.� 8-16-00; 7: 15AM;MIILOII ACad Fa= DePt 16178981702 tt 5 TOWN OF BARNSTABLE LOCATION SEWAGE M 29 VILLAGE ASSESSOR'S MAP& LOT iV_7_ /1g INSTALLER'S NAME&PHONE NO. Cto '77 t - V!Z$ SEPTIC TANK CAPACITY - LEACHING FACILITY: (type) 'tie 1.. _(size) /a X NO.OF BEDROOMS BUILDER O n n dc�y PERMITDATE:, gt/�_COMPLIANCE DATE: l-0� 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) Fee! Edge of Wedand and Leaching Facility(If any wetlands exist within 300 feet o c ng facility) Feet Furnished by_ • �ty N 0 0 0 e, TOWN OF BARNSTABLE p - LOCATION 4 OFI: 4,.-41y4� SEWAGE # L VILLAGE ft61.�R1�a 42`7' ASSESSOR'S MAP &&—LOP "f INSTALLER'S NAME&PHONE NO. /9'V�,' `�- � 6j SEPTIC TANK CAPACITY " LEACHING FACILITY: (type) t (size) f fer : l 'NO.OF BEDROOMS/ BUILDER OR OWNERA, I PERMITDATE: �`` COMPLIANCE DATE: Separation Distance Between the: i . Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet I 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 leachin facilityL.. Feet g �, Furnished 6y L-tr 1�' � � i wv,f U _ ! C c. � o a m r � d i Iq Tii {1 i i i iI =r ti r � TI � i i p \ � i L T R i 1 i� 26. I tl I— i i � I I ❑ L—. a4 °o .•o 0 t O C zx"' ?"DOS per yz,. -c"MIC. ell IL IS C,14 F­l�rl..S 1N C.CI-L Flo C)LID t-lulele, pes ---------- �1' s-m Uzi t.tl nJCv3 FLoOL T.a ✓">DMOM Ur -2..1 a 7-;K I Im,rLoqk MLne%rlr� r C:V%,�-n N6 . _CILIN6 % w.11 MOT II IM2.5 Tb9t',H FFLL.N r I� t 3td 71 A I' It i -- M. J..- 1 i-- - - Y J ,,• , 3 N I � I i3 3 9 _ f � � n � z o � T f r 8-16-00; 7= 75AM;M1 Iton A.--ad Fa;-- Dept ; 151789817r_,2 3 TOWN OF BARNSTABLE LOCATION 4 MP+V'*oa �Je SEWAGE g - va.LAGE ASSESSOR'S MAP& LOT,9A7 /9_ INSTALLER'S NAME&PHONE NO._�te�T enjY SEPTIC TANK CAPACITY Ah o LEACHING FACILITY: (type) e fit. (size) /a X 81 NO.OF BEDROOMS It aek..l BUILDER O know i e a a ex�v PERMITDATE: art.A16 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 o c ng facility) Feet Furnished by � �� z O O ` 4 o Q - 5 Parcel 127 \ \\ �� \ �� \ I ► �44+►8',\ 24.90 MSL Concrete Bound ► 1 �� \ \ ( \ �� j �o i .f h3 a t ► ► 1. 1 t14 / /Fw ti . . , , - o:�s' .o • o f l 1 Parcel 120 o O \ ,IT rmy / v v . IV Cal ago It 60 9 z. \ \gLd. \ , It . fir i e3 ,\,. �• d Cp -ram• V \ / . •.'/r���ter... PRIVMT .— r Genetaf Notes: 19 -- ` `\ \ yJP/// % ' t .Existing septic syster rn 2.For EXistIng Pool See m 79M E7-15.82 MSL o To of Concrete Bound a \ i f�'�-r..- �.�� ,-5 p NOTES: FEMA The proposed dwellll '�r = i�%= _ f �- f shown on FIRM Car � 2. The are 1,470 squar, _ --4— NGVD. Thisspacek FE r f exterior wails by allot 3. Flood waters are ailo / minimum of 2openh. w / �Z 7' µ,,/,, total area of 12squa AM) E) +� minimum net area of >>' _• — — „�r�/se Aft �' PLAN VIEW area. rhA butt m of i TROY WILLIAMS SEPTIC INSPECTIONS so Certified by MA Department of Environmental Protection ". Tp ��JT " 8) 385-1300 wN0�g. 19 Hummel Drive N 4(ryoftTAeu, N South Dennis, MA 02660 COMMONWEALTH OF MASSACHUSETTS �� r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFA DEPARTMENT OF ENVIRONMENTAL PROTECTION �o u ONE WINTER STREET. BOSTON, MA 02108 617-292-5500 WILLIAM F.WELD TRUDY CORE Governor Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A [� CERTIFICATION Property Address: J /NO Y wuu �y ah n:J12 Address of Owner: . Mr. + Mrs �/`l 1 f'�'"*� Gull ;✓er Date of Inspection- //9 7 (If different) Name of Inspector: Troy Williams 3y Grc�f /�oc 2� I am a DEP approved s tem inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) JJ U 7 7 U Company Name: Troy Wirliams Septic Inspections SGt Gr�o�'h/ M Mailing Address: 19 Hummel Drive_. South Dpnnis , MA 02660 Telephone Number: , (508) 3.8-5=1-3.0-0 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 inspection: The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: asses _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: S111 /N� Date: 6 X, The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. INSPECTION SUMMARY: Check A, 8, C, or D: AI SYST M PASSES: 7I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR IS.303. Any failure criteria not evaluated are indicated below. COMMENTS: BI SYSTEM CONDITIONALLY PASSES: IVII19 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. Indicate yes, no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. - (rwiaed 04/2S/97) Payer 1 of 10 DEP on the World Wde Web: httpJhy*tw.magneL state.rna.us/dep r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A / A CERTIFICATION (continued) L Property Address: 7 If "y !'�'0 lqJ e Owner: �' v III' u G✓ Date of Inspection: 6 �a / 9 7 A BJ SYSTEM CONDITIONALLY PASSES (continued) /l4/1-7 Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: y 10 l a.y (,J o o /9 e Owner: G v f/; ve/#,- Date of Inspection: 6/.2/5 7 D] SYSTEM FAILS: 11//19 You must indicate ei;,,er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. 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 6" below invert or available volume is less than 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 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. Any portion of a cesspool or privy is less than 100 feet but greater than SO.-feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Pago 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: I/; v z;r Date of Inspection: Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. // c cr _ None of the system components have been pumped for at least two weeks and the system has c,C V k. been receiving normal flow rates. during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. N/9 As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. /11A The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material-of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] (revised 04/25/97) Page 4 of 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner, ( � Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: 7 7 O p.d./bedroom for S.A.S. Number of bedrooms: 7 Number of current residents: 6 Garbage grinder (yes or no): IVO Laundry connected to system (yes or no): J�S Seasonal use (yes or no):�F S Water meter readings, if available (last two (2)year usage (gpd): /� ��r s / / A Sump Pump (yes or no): Last date of occupancy: o< G c, / �t r. COMMERCIAUINDUSTRIAL• N �� Type of establishment: Design flow: aallons/day 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: / // J 1 /YU „ �� . ✓J 1.� G in TO �^✓.�. �G to /t c l System pumped as part of inspection: (yes or no)/[a If yes, volume pumped: eallons Reason for pumping: TYPE 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: -�� s S r�o / s P,' T,9�ou Sewage odors detected when arriving at the site: (yes or no) /V O (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: G ( c Date of Inspection: BUILDING SEWER: A1/4 (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _other(explain) Distance from private water supply well or suction line Diameter Comments: (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 Certificate of Compliance _(Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: ` How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP:, (locate on site plan) Depth below grade: Material of construction: concrete _metal _F-iberglass _Polyethylene --other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: 3 Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: NJ"L,- ✓N.p*� -Comments: - — f m ' (recommendation or pu pmg, condi}pn of tnlet�ar d outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) ,w 5. c S«-,4-. o S i r a c K v v ^n S y .t .e ; S e C.-v o h i t W d r-AC'/ I- (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C L/ SYSTEM INFORMATION (continued) Property Address: 7 114 W °`' � � e— ' Owner: G ( 'i'�e4-� Date of Inspection: / ( a /7 2 TIGHT OR HOLDING TANK!V/(Tank must be pumped prior to, or 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 level: Alarm in working order_Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX. (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER::49 (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.) (revised 04/25/97) Page 7 of 10 L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C L/ �w SYSTEM INFORMATION (continued) Property Address: Owner: G j v e-✓ Date of Inspection: G /Z /1l 7 SOIL ABSORPTION SYSTEM (SAS):_✓/ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: p m-- 6 X 6 0 7 7- Alternative system: Name of Technology: Comments: (note condition of soil, 'gns of hydraulic failure, level of ponding, condition of vege lion, etc.) so wss ✓ h c'A S�hdl due✓ r/ Jk a�.✓ c.r J e--ti S,i a f �✓ uv c .r✓ �. Gt.-S � CESSPOOLS: (locate on site plan) Number and configuration:- a L-, c Depth-top of liquid to inlet invert: Depth of solids layer: .S Depth of scum layer: A/6/V . Dimensions of cesspool: S 'tra Materials of construction: 0--c.5 S ,o 0 o Indication of groundwater: i✓v�/G /� inflow(cesspool must be pumped as part of insPection) OU C-� T`�o GC r H a L.. Comments: �te condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) .�rL o law. .� �/'�•✓��c PRIVY: I /4 (locate on site plan) Materials of construction: Depth of solids: _ Dimensions: Comments: - - (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C �J ^n SYSTEM INFORMATION (continued) Property Address: / 11 c` y W,>o / - -e- Owner: ✓ ( � u r Date of Inspection: /a/ ,7/ SOIL ABSORPTION SYSTEM (SAS)::t4 -3 (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool; number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) CESSPOOLS: Cis shoo ✓ (locate on site plan) / Number and configuration: S i n ( �- C c SS o o Depth-top of liquid to inlet invert: Is G(r Depth of solids layer: / Depth of scum layer: n/o/V,( Dimensions of cesspool: S c.o X : �►ti, , _. Materials of construction: S C r7o G / 6/ k Indication of groundwater- inflow (cesspool must be pumped as part of inspection)_ CGS s�o a a Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condi ,ion of vegetation etc.) 0 , 1 w w s ti .� 4- s s � Ci a lcr,. �. c r . l-y c-c s s a o PRIVY: /V//? (locate on site plan) Materials of construction: Depth of solids: Dimensions: _ Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Paget of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: VJ o o i4✓c Owner: �' u ( v ✓ Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) i3u�K 33 1W to LID D,- A4 w t \ K ya , y / cis SPoo 1 . C'-sy��° � (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C U SYSTEM INFORMATION (continued) Property Address: l M`7 w°" /4V e- ' Owner: �j u / ✓c✓ Date of Inspection: 6 7 7 Depth to Groundwater ^ Feet adjusted high groundwater level Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. Must be completed) PeA-H ak O-l/ 0-I/r- CA b IC, <-t-�-�-.T 7' -C e---S S�CSC ok //, V Lj /9 r / S 7 C, •, &A. C t S 5 ',0 D I S 4- lb L Ga T� / .!r.J (i-�CA--f L� �S / b �.--5 Y� �J GJ J �'S 6 G."�`- � G v.al C L 5 S� 1 1 '1 ro V✓. c� . (revised 04/2S/97) Page 10 o1 10 2410 Opening Above For M.H1 F.G. 17.0 F.G.14.0 F.G.11.0 I&ID Gatti.Pipe Fbr Frame 5 Cover. Float Support 14.5 �•1 Inv.12.5 Inv.9.5 !' To D-Box 13.7 2000 Gallon o Pump To- 13.5 Cables Installed in Accordance Septic Tank I29 B a Bot.E1.9.0 g 1 O With-Local Insta le 9 Elec.Codes. 1 �` / +• ,j Bedding as Per Title 5 10.3� 7.3 -v s 4"0 From.Septic Precast Pump I I Q, I0� Tank.Sch.40 PVC Chamber '1 8,-2., L. a I � ° Ground Water at Eiev.1.7 r,.r 1 By S.E.I. 5/13/99- j PLAN Main House i DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM F i Not to Scale s EG.9.5 1 d0 Sch.40 PVC Finished i From Septic Tank Grade 1500.Gallon 65 pump To D-Box Septic To Chamber Conduit Thru Chamber 6.7 Galy. Fo►Power 6 Float . To D-Box 6.3 Emergency Storage ; Cables. 11 Chain a; Min.2'Cover «y �x Vol.475 Gal. loam on El. ° 2*'0 Sch.40 PVC ( Bedding-as Pump on El.4.2 Mercury Float x Threaded Pip Per Title 5 t Switct>s-3Regb f Accessary Budding Pum off El 3.2 Check Valle 1 Secure Pipe at Top a DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM Bottom EL2.2 Bottom of Chamber I 6"Wad,E\,, Not to Scale •:; • ': 'u one Min. Finish SECTION �- Grade 1000 Gallon PUMP CHAMBER DETAIL Filter Not to Scale Wmpoeted Flll 3�MaximumJPe Fabric a: N Ve"-I/2» Poo Starve ; ' i o 4 » EIS s , 3/4-I V2 DouNe I _ m P Wadvid ! SULL33 j�{�� ?ra IS SJ01 -CROSS SECTION OF LEACHING BED Y DESIGN DATA Not.to Scale Accessory Structure-4Bedroom NOTES With no Garbage Grinder Doily Flow:I I O x 4=440 GPD L dilater Supply FarThis Lot is Municipal Wafer. Septic Tank:440 GPD x 200%=880 GPD IL L.oii atlon olUtiirdift Shown on This M--t Are Appeoac use a 1500 Gallon Septic Tank M At st 72 Hours Prior to Any Excavation ForThis Single Famil 7 Bedroom s Prorscr Tt c Csa!r^rt�Sh-o!!Mak•The Required Y- +•e With Na Garcaae Grinder Motif icationtoDig safe it Daily Flow:liGx7=TT0 3 The Contractor is Required to Secure Appropflater Septic Tank:770 GPD x 200%=1540 GPD ' Permits From Town Agencies For Construction Use a 2000 Galion Septic Tank Defined byThis Plot. t 4 Install Risers as Required to Within 12a LEACHING_AREA of I There are no wetlands within 100 feet of the proposed �;�:eaching facility. �- I Finished Grade. 1210 GPD/.74=1636 SF Reqired Use Bottom Area OnIy There are no private potable wells within 150 feet of th!r proposed septic SHEET 2 of 2 T 5.All Structures Buried Four Feet or More or Subject Bottom A►ea=10'x 164'=1640SF Provided to vehicular TraffictobH-20Loading. system. MAXWELL T. KENNEDY e G,Septic System tobe installed in Accordance With LEACHING BED DESIGN The design of the system is based on bottom area only. . 4MAYWOOD AVE. 310 CMR 15.00 Latest,Revision And The Town of Al Pipes to be Schedule40 PVC HYANNI SPORT,MASS. BomstobleBoard ot Health Regulations. Perforated With Capped Ends.Uge3 4'0 ,' There is an increase in flow and/or change in use. SULLIVAN ENGINEERING INC Distribution Lines in 2-10 x 82 Washed - OST E R V I LL E,M AS S 7All Piping to be Sch40 PVC Stone Fields as Shown. Boom- 1 -7 o 9 a�5 — CD I n uz n -1i N z CD I� N e I N W _ v � fl c E 6 f i B z o c '�1 m i �a G t , n F I T-1 I ' to DO IT ^j r N � _ e^ r30 2 A � � � Im-Imlalm_I n L a N. i I I N J•• g I I i (5)^ I 0 -• z I I' L ; DIRECTIONS: OVERLAY DISTRIC., i AP — Aquifer Protection Distric From Hyannis — Follow Main Street to West I f I c er ra N 7 End Rotary, and.then take Scudder Avenue ,;a off of the Rotary, Take a left onto Greenwood n ZONE A f� Avenue; and then a left onto Maywood Avenue; Site is at the end, 1133. RF-1 Area (min) .43,566 Frontage (min) 20 r Width (mrn) 125 t3cEA Setbacks: Front 30 Side 15' Rear 15' fitl�a� OCtIS "t`•h0g !Z FLOOD ZONE: a �, xYANNr Zones A10(el=15), 05 "' LOCATION MAP: Community P u" Panel o. 0001 0006 D July 2,. 1992 - . Scale .1„ 2000'f . ASSESSORS REF Parcel 126 o° Map 287, .Parcel 129 ry Se`Tt>A P Oa. P `per' Xo. z .. .. Syr Q Yo R -� yF� 0 .\ CB/DH y' ) FND' B/OH / f `? / 1. D r / / �ryh ^b6 % 0 ?/VO Parcel j29 O 1.43 'f Acres Parcel 127' TBM EI-24.90' MSL c°a aac4 stage wall Top of Concrete Bound g�p t Nea9e ,_. ,,SHELL .� ./ =DRIVEWAY Jcy 4g oh �0'� FNoH N8 �f 9 '54'E '90.26 Oo 1 A Parcel 120 i p T� -- --- ----� / N p Batter ....... MIN i ^h ry i: PRRIE i ti CI po ROB yo�4 N E s¢y EX EpLP L Parcel 156 FND % tl om l, '.'' y�if l/ Cb PROJJT f)05 . o gaffe w iN PpDi 'I'F 9i I. 5a• r _ \o PROP9RESN�EME Ftt) : ENHP(25O 5' i 7 Z arL PREP TBM EI=15.82' MSL (f` / To Of oeMed �• Top of Concrete Bound i Coastal BonkG na / a I / // Paia J AMP Zang V10 ' e ct�e , EI Z' /yr ' AM) 7 W�ock Lin. Lost j'oj i a li. I; Nar bar OF Mgss JO �I� a TITLE PREPARED BY' PREPARED FOR: - NOTES: Site Plan ; 1.) The property line information shown was Proposed Addition Sullivan Engineering,Inc: CapeSury Joseph F &. Susan G Fallon compiled from available_record information Po Box 659 _ 7 Parker Road At osterville, MA 02655 Osterville MA 02655 124 Wellesley Road 12.) The topographic information was obtained 33 Ma wood Avenue (5asl.ra-J°„(sae„ze-Ji15 i°x t509)12a-399I(50H)110 J995 °. Bemont MA 0247E from an on the ground survey performed on } {, =wsu acea<°ce.ae or between 021FE8107 and 21/FEB/07 & held O,a�nslaAl�Q edits on DEC/08 & JAN112'to approx. reflect o O e (Hymnlsport) MASS. Draft: J00 Field: WHK/OWE 40 0 20 40 work performed under DA-07035 & 09008 DATE- SCALE l7ev/ew: 70PS _ Comp.: RRL 3.) The datum used is based on Mean Sea Level February 17, 2012 1" = 40' Project�: 201 Drawing 8 c268_2x1 i OVERLAY DISTRICT. ' DIRECTIONS: ,. , AP - Aquifer Protection District From Hyannis` — Follow Main Street to West . z t s End Rotary, and then take Scudder Avenue off of the Rotary, Take a left onto Greenwood ZONE + t§; Avenue, and then a left onto Maywood Avenue; � r Site is at the end, #33. RF-1 Area (min.) 43,560 rG„wcwti) Frontage (min)'20, Width (min) 125' 3 =A x Setbacks: , , �.... ,�. Fron t 30' k ., Side 15' a rasa Rear 15 y rC� pCUg ? 1� FLOOD ZONE: ; 4 r h , 1 SAS f .... € `pt : .. HYA11► I 10'9e rme Lir W a re• �- 14•er•. .�•. ;,; �;,; Zones A10(e1=15), w c_e•ne V10(el.=15),& C ZIFUFUUM -� Community Panel No. #250001 0006 D LOCATION MAP: o July 2, 1992 Perms;-1 Developed Profile of Proposed Septic Tank Scale: 1 = 2000'f Not to Scale ; ASSESSORS REF.: Parcel 126 Map 287, Parcel 129 ICL- SyFO + \ V A \ ��N y tAD Exist Septic Pamft Na 99-3T8\�\� O / \ Parcel 129 Parcel 127 i 11.43 f Acres,- PROPOSED SEP71C TANK O \ \ \ /�. �P13 v TOM E1=24.90' MSLg stone wan m \ TO �MpI B \\ Pa"�c,y. ?� \ Top of"Concrete Bound =���m ;= \ FFIp OHO J4"A\ "edge / \ OPOED\ �,' \ \ _ -'!�. ....y Q s. \ \............ 41 �t .\ D�;,�VEW\ YF�0 $ � N 892154'E I 90.26 . ... \\ Q�y Parcel 120 190* --shill.Ilriw- �,.'•'' \ \ \..�, 3 \t \\ \ / \ -f--r ----_----� \ ° \ rn . \ t • 1 IV .Tp. r .... � � t `t y tit-•\ Parcel 156 FNDFND ; ZIP fW /1, s _20— / TBM E1=15.82'MSL Flag T�°Oet �of . —VI / 5') / Top of Concrete Bound _, y _ e VI0 (el 1 � N / 98 AMA din E1,2•T' Permit History: ''L e (13�F�g/ 07114198 - DA-98060 Kennedy - Shower, Sheds, Landscape / t Tidal W( 09123198 DA-98078 IKennejy Landscaping �p5 Viol998051 -(Kennedy .- Activ. Beyond RDA 02101199 - SE3-3351 Kennedy Pool, Patio, Porch, Stairs 11/07/97 - DA97082 -I Gulliver - 2nd Storey Deck, Enlarge Kitchen 08/18/92 - SE3-2442 Gulliver Revetment Returns 03127187 = SE3-1723 ..Gulliver - Stone Wall 10/11/89 - SE3-2007 Gulliver - AsBuit Stairs $ V1019980211-i Kennedy- Clearing Flood Zone 01/12/99 - SE3-3424 ,Kennedy - Accessory Dwelling NaCbOf 09107199 - SE3-3511 - Kennedy - Addition, Remodel, Porch 06111103 - DA03024 -! Kennedy Fence 04/21/04 - DA03024 - Kennedy - Sheds 03117104 - SE3-4216 T Kennedy - Pier an V102005022 I Kennedy - Cutting J V102005050 - [Kennedy - Mitigation V102005051 !Kennedy - Violation of Order 05123107 - DA-07035 i— 'Fallon - Landscaping 01111108 - DA-08005 - Fallon - Pier Modifications DIIE - PREPARED BY: PREPARED FOR: NORM- Site Plan 1.) The property line information shown was Proposed Accessory Structure . Sullivan Engineering,Inc. CapeSury Joseph F & Susan G Fallon compiled from available record information m At Pa Bax 0 Ostervnle MA oz655 124 Wellesley Road ) topographicrt Osterville, MA 02655 2. The information was obtained 33 Ma At Avenue (5WH28--M44(5OW2e-n1s m. (�)420--JM(sae)4�J995 h. Belmont MA 02478 from an on the ground survey performed on e�ea o�eem°e1 or between 02/FEB/07 and 21/PEB/07& fielBarnstable (Nyannisport) Mass. woo edited 30/bnder to 7035.. reflect Drag: ,)OD Field., -K/OWB 40 a 20 +0 work performed under DA-07035. DA 7E SCALE Review., PS Comp.: RRL 3.) The datum used is based on Mean Sea Level V January 7, 2009 1 = 40' pro' t LZI01 Drawing c266-2X1 ZONE: ASSESSORS REF.: RF-1 Area (min.) 43,560 Map 287, Parcel 129 Frontage (min) 20' Width (min) 125' Setbacks: Fron t 30' Side 15' OVERLAY DISTRICT: Rear 15' s. AP — Aquifer Protection District FLOOD ZONE: Zones A10(e1=15), V10(el.=15),& C W Community Panel No. 03 J250001 0006 D LOCATION MAP: July 2, 1992 Scale: 1" = 2000'.t CB/Dfj D Parcel 121 a / Parcel 126 � ee��ryryo° IV e s FND k-1 �\ Parcel 129 2.9 \\ 1.43 t Acres \ -r - I �p Parcel 127IN sat / TBM EI=24.90' MSL stone wa►i i\L°°°rO" Peek Top of Concrete Bound \ �� As- E ?O• / \ \ \ \14 ......... Nax1'54" E 90.26 O ........... c \�E- / \ \ � •.\..... ` \. Parcel 120 O`L O h co o J � � �iD��� _ SEAR \ i\ \ \\ \\ � o PR POSED t POOL o 1 / f N$ ? t. . F�20.0' \ \ \ \I 1� 1' \ `'O'er ash goo ........... oo�o l \ I I ;.. .... 4................. Parcel 156 Flv0/3 \�� °ova � � \ .�. I ! / •� /� �, Buffs / ca Y.- wow c} // T5 ate Town o TBM EI=15.82' MSL �'� / coastal Bank �, i / Top of Concrete Bound ?�r� O-� Cos C Flog\ — tons 0 / �p� I , /• .�, i Pole — —= .. MA � allc (13%FE6�98 Le end. Line Deciduous Tree Coniferous Tree / a Qs Sewer Manhole o Light Post a b © Water Gate (round) ���" sq� o CB/DH — Concrete Bound PETER Guy s�, SULLIVAN N -C- Utility Pole .1V1733 _____ E ..___. Underground Utility Line a No.zs 9 y �FGIST Ea� ohw Overhead Wires IONA 25 Elevation Contour 7171E. Site Plan PREPARED BY PREPARED FOR. N07E&- Proposed Improvements Sullivan Engineering, Inc. CapeSUry Joseph F & Susan G Fallon 1.) The property line Information shown was PO Box 659 7 Parker Road At Osteralle, MA 02655 OsterAle MA 02655 124 Wellesley Road compiled from available record information (=)428-sus(sos)i2e-.ma ft 150e)szo-,use+lsoe)41ass95 Belmont MA 02478 2.) The topographic information was obtained V 33 Ma ood Avenue �.w^ M► from an on the ground survey performed on Bamstab e, (Hyannisport) Mass. Draft: JOD Field: µ 4K/DWB 30 0 15 30 60 or between 02/FEB/07 and 21/FEB/07 DAIF: SCALE: » , Revfew: PS Comp.: RRL 3.) The datum used is based on Mean Sea Level V November 15, 2007 1 = 30 Project P. 27001 Drawing C268-2xl ZONE. ASSESSORS REF.: RF Area (min.) 43,560 Map 287, Parcel 129 Fronta e (min) 20' DO C -- Width (min) 125' ! Setbacks: Front 30' Side 15' r OVERLAY DISTRICT: Rear 15' ✓ AP — Aquifer Protection District FLOOD ZONE: Zones A10(el=15), V10(el.=15);& C Community Panel No. o #250001 0006 D LOCATION MAP: July 2, 1992 Scale: 1" = 2000'f C91DFVD Parcel 121 Qj J ° a Parcel 126 m / S`s¢ r Qv � ti / ��\ \• F C8/DH FNO rrv0 Parcel 129 1.43 t Acres Parcel 127 \ / i TBM EI=24.90' MSL Stone WON \ / \Loco Pe Top of Concrete Bound \ 4V Hed e �\ FWD H N 897f 54" E so.2s o \ ` \ �..................`.. t `` Qoy Parcel 120 �r t Shell - - $�------- p POSED.t 2 0 tcvs , ti of Poo HOUSE ...... .......... 20 O t j OF. , A t ......... . ............... ? op O /.... ........ Parcel 156 rrlD j� l°Do�V 5.31' r- ��4° w20— / \ �• Tst to Defined '— /i TBM E1=15.82' MSL Coostol '= 5, Top of Concrete Bound no V1 el �°� / Pole A Zp{1s 0 / 4�r r _"AM) E�Z•� Le end: ill. �/ w _.._-.•-.-I Wrack Une / Deciduous Tree / Coniferous Tree C7s Sewer Manhole O Light Post 9 a4 Water Gate round 0 CB/DH — Concrete Bound Guy n -O- Utility Pole n a E - Underground Utility Line ohw Overhead Wires DRA T T- 25 Elevation Contour lAsodify Pool House Footprint & Location 101 29 08 REVISION:Shift Pro osed Poo! House 9 South 101 16 08 TITLE. Sit Plan PREPARED BY- PREPARED FOR., NOTES. Proposed Improvements Sullivan Engineering, Inc. CapeSUry Joseph F & Susan G Fallon 1•) The property line information shown was PO Box 659 7 Parker Road compiled from available record Information At Osterville, MA 02655 Osterville MA 02655 124 Wellesley Road 33 Maywood Avenue (5oe)428-M"(W8Y28-3115 fax (We)42o-.9ss�(5oel �rtx Belmont, MA 02478 2•) The topographic information was obtained 'j from an on the ground survey performed on Barnstable, (Hyannisport) MaSS. Draft., JOD Field., INHK/DWB 30 0 15 30 60 or between 02/FEB/07 and 21IFEB107 DATE: SCALE , Review. PS Comp.: RRL 3.) The datum used is based on Mean Sea Level •� November 15, 2007 1 = 30 Project A 27001 Drawing # . C268-2xi - - ------ - --- --- --.- -- ---- --- - -. - ---_ - --.. - - --- - _ - ---- - ---- ---- - --- --- - -- - - - --- -- - -a IFRI . 1 i I --. ILE, EB EX 1ST. H OUs t :5v5enH SU...A-N P-A-LLON SCALE: \ tl 2V.� APPROVED BY: DRAWN BY DATE: Z REVISED rry DRAWING NUMBER Me The proposed accessory structure shown hereon complies with the sideline and 3 Sr sow r _ \� \ `setback requirements of the Town of Barnstable and is located within the 100 year a FAD \ \ floodplain. Parcel 126 — \ s \ \ \ O \, \ e oc. LOCUS Job H YA.NNI 1 1 1 Parcel 9 \ \ \ ceir LOCUS PLAN \ , FM ,N J' \ `x�>� 1. 3 f1 Acre \ pop \ " \ i Scale: I = 2000 V,q 1 \ � Assessors Map 287 �, \\ \ J' I ' \ t '�' i 's\ Parcel I29 1 \\. \ \ I \ \ \ \ \ FND Ck/�A 0 Parcel 127 \ \ \ A le oo i TBM E1=24.90' MSL �JD Top of Concrete Bound I I I 1 \ \ \ qj I. I .bA ti CB/°H / N P972ll'54 I EQ) FWD ' I csAl►t+ /y�P� \ \ I I I I I I\ 3x2`\ O ���� Parcel 120 \c �o� T `y�Q�+ 90.I26' I \ �''`'' I I�i I \ \ \ I/ ' i .--4o :ioT 'f" co 020.0 � I 1 \ \ — — � , , � - 8 � � \ C F y \_ � -- -� — 2t Parcel156 N \\ \ \\1FL,\ i .10 \ \ to G al fk ,.i /// /.� 7BM E1=15.82' MSL \ v o - Top of Concrete Bound of TO NOTES �FCM><t �Ot __ — I. Existing Septic System to be Removed. 2. For Exist. Pool See Conservation Commission Filing SE3-3351 For Approval 81 Notes. e, — ' PLAN VIEW r itlFEB/ g - h ( 3 Scale: 1 = 30 ' 0M t rdd► (,� r a Pi:rER Los5 SULLIVAN nI 1'49.29733 CIVIC. an H y Title: PREPARED BY.- PREPARED FOR: Notes/Revision: SITE PLAN - ' C��pc����I • Maxwell T. Kennedy Cb PROPOSED SEPTIC SYSTEM Sullivan Engineering, Inc. p o Bax 71s 4 Maywood Ave. 4 M AYW 00 D AVENUE Po eax sss Ostervllle, MA 02655 Hyvnnls MA 02601-0718 Hyann/SpOrt, MOSS. (5os)42s-3344 (5o8)42s-3115 fox (50e)790-790s soe)�so-�sos �x H YA N N I S PO R T, MASS • PsullPEdbol.com (►� � t - o 30 b 15 30 60 120 Field: Draft: IV Date: Scale: Comp.: Review: J U N E 2 , 1999 AS SHOWN Proj # Drawing # �.