HomeMy WebLinkAbout0083 OAKVIEW TERRACE - Health 83 oakview Terrace----
A= 268-288
Hyannis
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TOWN OF BARNSTABLE
LOCATION �.� ®/�i��/�"� ��'� SEWAGE#
= II;-AGE/1yi�i��''l.I� ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY " !'i iti 6: /0 0 0
LEACHING FACILITY: (type) (size'.
NO. OF BEDROOMS
OWNER Z-e,-,fZeee�e
PERMIT DATE: 9—,3 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) �C J Feet
FURNISHED BY
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Town of Barnstable
Department of Regulatory Services 112J�SrABM Public Health Division Date p
MA8a4
019. �� 200 Main Street,Hyannis MA 02601
rfD M�A
Date Scheduled_
Time I I Fee Pd. V
Soil Suitability Assessment or Se e I�ispo�al
Performed By: Witnessed By: t ��
LOCATION 8 GENERAL INFORMATION
Location Address '��' Owner's Nameri�'�.F��Z
�y Address
e V ' �� �iCvGt/�1,,s..3lG��J�°CJYzoX
Assessor's Map/Parcel: Engineer's Name� � 19�����761,�&S
NEW CONSTRUCTION REPAIR ` Telephone# 7 ��vF
Land Use Slopes(%) V ' �� Surface Stones >�P'i`_ 0707
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way ft Property Line 10 ft Other {t
SKETCH:(Street nnaame,,4imensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
--4
Parent material(geologic) ct,( Depth to bedrock
Depth to Groundwater•. Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: In, Depth to sell mottles: ln.
Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj,factor g Adj,Groundwater Level v
PERCOLATION ']ES�C' Date
Time. oQ 0
Observation
Hole# Time at 9" f
Depth of Pere Time at G'
Start Pre-soak Time @. 'Pima(9"-6")
T�
End Pre-soak.
Rate Min./Inch .1••'/� 1�4'
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1) week prior to beginning.
Q:\S EPTICU'ERCFORM.DOC
f
DEEP-OBSERVATION.HOLE LOG Hole#40th:.—r
Depth from Soil Horizon Soil TextureSoil Color Soil
Surface(in.) (USDA) (Munsell Mottling
) g (Structure,Stones;Boulders.
o sis! tency %Gravel)
LS Q f$Z tid A,
f� Miff 9 0
7 d
DEEP OBSERVATION DOLE LOG -Hole#
Depth from Soil Horizon Soil Texture Soil Color 'r'Soil` Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsisten %Gravel)
LS CO
i
DEEP OBSERVATION HOLE LOG -l$~ #
Depth from Soil Horizon Soil Texture Soil Color Soil"' , ' ; Other
Surface(in.) (USDA) (Munsell) Mottling•'.:)(Siructure,Stones,Boulders.
Con i to c O
DEEP OBSERVATION HOLE LOG Mole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
consistency,
Flood Insurance Rate Map:
JA
Above 500 year flood boundary No--k Yes J&
Within 500 year boundary No, Yes
Within 100 year flood boundary No. , Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
• If not,what is the depth of naturally occurring pe ious material?
Certification
I certify that on /I IZ WZ (date)I have passed the soil evaluator examination approved by the
Department of Environi6ntal Protection and that the above analysis was performed by me consistent with .
the required trai ' 'g,experti and ex erie a described in 3 10 CMR 15.017.
Signature Date
Q:4SEPTICU'ERCFOKM.DOC
No.
THE COMMONWEALTH OF MASSACHUSETTS Entered incom ter:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
0 Jplitatlon for Disposal 6pstem ConstrUttion Permit
Application for a Permit to Construct(Repair( ) Upgrade( ) Abandon( ) ❑Complete System Individual Components
Location Address or Lot No,?—? p�J��/��!/�� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building 4F40kP No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 � gpd Design flow provided 9 gpd
Plan Date Number of sheets J Revision Date
Title
Size of Septic Tank �j�/�%�^'(r�Oa 0.�' Pe of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) ��L��"'��l✓�
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 Certificate of
Compliance has been issuAby *soard of th.
Date
9 � �
Application Approved by 0 Date
Application Disapproved Date
for the following reasons
Permit No. Date Issued
w\ f
No. / Fee
#4 Entered in computer.
THE COMMONWEALTH OF MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pplication for Disposal Ops�tem Construction Permit
Application for a Permit to Construct(1<"Repair( ) Upgrade( ) Abandon( ) ❑Complete System ndividual Components
i
Location Address or Lot Noe �+ Owner's Name,Address,and Tel.No.
O . �G
Assessor's Map/Parcel _ (JPOO �� '� �� 10�
Installer.'s Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
1— o
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
i
Other Type of Building P. No.of Persons Showers( ) Cafeteria( )
Other Fixtures
3' S%
Design Flow(min.required) 3 ® gpd Design flow provided gpd
Plan Date 6 /i Number of sheets Revision Date
Title
Size of Septic Tank. r�� �;� .a®ri' Ae of S.A.S. ,, ., ,mac co.'�� _.�.�4'�//f stVrJ'
Description of Soil 'r,eta-
r< Nature of Repairs or Alterations(Answer when applicable) J'jgtdt- t, 0-z ,✓P
j
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 Certificate of
Compliance has been issued by this Board of lth.
gne Date 31 1 c
r
Application Approved by %A/ j® '1' Date
' V r v [� r'ry, �
Application Disapproved bjVV Date
i
for the following reasons "
Permit No. Date Issued
TIf J COMMONWEALTH OF MASSACHUSETTS '
BARNSTABLE,MASSACHUSETTS
Certificate of (Compliance
i THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( Repaired( ) Upgraded( `
Abandoned( )by /fie- p�t��¢' n�^ -/C ,/''!rC
at p � ���j po has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer �Ti yh e45 e g;e&t c ' Designer �j�/,./dJ A??, 0"P_a w 11r✓' 1 '/
#bedrooms Approved design flow 3 � gpd
The issuance of this permit shall not be c'nstrue as a guarantee that the system will, notion as designed.
k
Date h Inspector
LA I Lr
-
----------------------f- ---------- -_ - - - - -- --------- -----
"
No. I. " .. ._ _ . _ -- - - -. .. _ -____ . _ � --Fee
�� THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Dispos 16p$trm (Construction Permit
Permission is hereby granted to Construct(7Repair( ) Upgrade( Abandon( )
System located at
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.
Provided:Constru ion musibe completed within three years of the date of this permit.
r
Date Approved by
SEP/08/2014/MON 12:08 PM FAX No. P, 001/001
Town of Barnstable
Regulatory Services
Richard V.Scali,Interim Director
3 UARNWAHLE.
AMI: Public Health Division
165
M a Thomas McKean,Di rectoe
200 Maio Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer &Designer Certification Form.
Date: i4/� W
Sewage Permit#c®W�`3/F Assessor's MaplParcel
Designer: Installer: t1+4LfTba
Address: 0P " Address: l-(I<,-="
Al
On 3�1 �! �e�4e4/_`�was issued a permit to install a
(date) (installer)
septic system at I based on a design drawn by
(address)
#Lj7 dated 3;' 07
(designer)
ZI certify that the septic system referenced above was installed substantially according to
� Y Y g
the design, which may include minor approved changes such as lateral relocations 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, Flan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed ce with the terms
of the AA approval letters(if applicable) -,,N OF 41,
DAVIT �y
Izn er'sMftnatu:e)
iNASOleer
ITA
Des ear's (Affix Desi p 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.
Q:1Sepfic\De*iper Certific4ofi Form Rev 8-14-13.doe
L"O'C AT ION SEWAGE PERMIT NO.
V I-L LAG E
INSTALLER'S NAM i ADDRESS
��
® lcx He
I U I L D E R OR OWNER
DATE PERMIT ISSUED ,
DATE COMPLIANCE ISSUED 9
h O
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No..8.12_-...3.8-4 "= _�,' Fps
THE
F Ts
,BOARD O� HEALTH y
oOF
c
D
Appliration for Dtap.aaal Works Tomitrnrtinn ramit
Application is hereby made for a Permit to Construct ( Lor Repair ( ) an Individual Sewage Disposal
S stem at
.._ ...........-__...._. _...... .... --
9 ion- ess or Lot No.
W Owner y , Address
(� ...............••-••--
Installer Address
Type of Building Size Lot.�U.................... feet
Dwelling—No. of Bedrooms........... ..... .................Expansion Attic ( ) Garbage Grinder (�N(�
p., Other—Type of Buildin _��______g o. of persons____________________________ Showers ( ) — Cafeteria ( )
a' Other fixtures ......................................................
Design Flow.........-S__S....................:.....gallons per person per day. Total daily flow____________-3.3 Q....................gallons.
WSeptic Tank—Liquid capacity`D�_.gallons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft.
Seepage Pit No........./--------- Diameter....... .(2....... Depth below inlet---6_1.......... Total leaching area�......sq. ft.
Z ( ) " g-.
'-' Percolation Test Results Performed by.._._-.;�_e }
Other Distribution box Dosing
t _
` - "-•`--��7.--------- Date_! ��J �---
a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 ----•-------------- ......--........................ ...... .............................................................
O Description of Soil ?=' ;, a '... ---------------
-- ..._._.. -�
c.� �-"� ------------------------••-•---•--•---..--------•---•-
- ----- -------------
---------------------------------------- -=l Gcrr.�-1, ,Q
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
•-------------------------------------------------------------------•---------------........•---•-•--•••----.-•••••-••••••••--••••--•-••-••-•••••••-••••••-•---••---•••--••••-•••••-••---•---.........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITL12 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b en issued by he b rd of
Signed...... "'- l_.:- .... le-1
Application Approved By........
0 ---•-------••--•-••---•---•-- ¢2te.e.�
_D ------
Application Disapproved for the following reasons-----------------1------------------------------------------------•--------------•-----------------------------...
..........................•-•-------•-----------.....------------•----------------------------------•--•-•-----------••--••••---••------•-•••---••--••••-•-----••-••••••--
/� Date
Permit No........................................................ Issued----7�.
Date
No. ..-... ,: ..........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.....OF.............. /fT // J / - L"C..
Apptiration for Biopos of Works Tontrnrtion Vamit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at
__. .... .......................... ----•--------------- - - ..................................
'on
- 'tl"dress or Lot•No.
�✓��j' 'r'� '- ' ,� '-7 �. ... �r�� --------------------------------•- •-----------...... .......
L
................Installer �'f---•r'--.... or
...._.... .. ............---
af..— 'C/ kL Address
- //'�� Owner
` < /
-•--- ----- — ---•--
Address
UType of Building Size Lot..........................Sq. feet
Dwelling—No. of Bedrooms............: :..........................Expansion Attic ( ) Garbage Grinder (Vv
aOther—Type of Building��Q�1PA o. of persons---------------------------- Showers ( ) — Cafeteria ( )?
Other fixtures ------------------------------------------------=--
W Design Flow..:.......S_G..........................gallons per person per day. Total daily flow..........__.3.1 o...................gallons.
WSeptic Tank—Liquid capacityl. ..gallons Length................ Width................ Diameter................ D-epth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....1..............sq. ft.
Seepage Pit No---------/--------- Diameter......./.Q........ Depth below inlet.._;............. Total leaching are .00._....sq. ft.
Z Other Distribution box ( ) . Dosing t4nk ).
'-' Percolation Test Results Performed by._....... / ._ �7 �-
...... Date .............
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
GZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-___-------------- ___.
a •---•--- ----- ..............................
O ., C.--------------------' �escr Description of Soil......----.0- � ._ . .....mnn..�'
= U
UW -----------------------------------------`�= 410.-------- - ---------------------------------------------------------.--------------------.------.--------
Nature of Repairs or Alterations—Answer when applicable...............................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIT IS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ben iss ed by. he board of.` .
Signed----- ..: . .... ..... :.......... %G_s ''
�r• Date
Application Approved By-------- 724 f ...al �---- /2 _01------
Date
Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------•-••-.
--.........-••------•-------••---•-•---------------------------------------------•------•-•---------•---------------------------------------------------------------------- ............................
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
... ....,0........,r................OF...........i�.`�. A.�/�5.�����"
Trrtif iratr of TomlifaFatta
THIS IS TO CE IF Y That tk Indiv'duaal Sevva e Di s osal System constructed or Repaired ( )
by................................ .................... = �
Installer 9
at-------Z.-al------- - : !t'_ S ---------- 6V_N .'-----------------------------------------------------------
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No________________________________________ dated------------------------------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SAV. SFACTORY.
DATE................. ` - Inspector.------. .............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD��OF HEA TH
FEE..3.0..............
Disposal Vorkg C�ontrnr#ion rrmit
Permission is hereby granted.........AZ-11 a =- ............... ------.....---------------.......------.....-•----................----
to Construct (�) or Repair ( ) an Individual Sewage Disposal System
atNo........1-6.r......-f ......... ......... Ia'' ------------- ---------------------------------------------•---
Street
as shown on the application for Disposal Works Constructi ermit No..................... Dated..........................................
.a
B of Health
DATE................................................................................ +-
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
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XiS'TING . SPOT ELEVATION Oa0 CERTIFIED PLQT.,";`4,-p •�
EXtSTING CONTOUR '- = - 0 __ �oT �f�� �K✓% �i° �� J
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F '04PEDGE: ENGINEERING CO INC
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PER —r. SEPTIC TANK D157. o o A I . • . . . •- • • 1 1 • u a WASHED S727NE
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v o 1 1 • • • • • I 1 1 ' a c P/T DR EQL!/V.
NVeKT EL EVAT/ON S L=L P --� AD
INVERT AT BUILD/NG 97,0 FT. D SEE TABULATJON
INLET SEPTIC TANK 96,5 FT• �- FT. O/.4/+�1. y _, Ii C
OUTLET SEPTIC TANK AFT. --
INLET D/STi4/19UT/ON BOX q 61 -0 FT• SECT/ON OF GROUND WA7-ER TABLE
Oc�,TLETD/STR/BlITIZINBOX_�-��FT. SEN/AGE DISPOSAL SYSTE/►? �I
INLET LEA CH/NG..F'/7- --Fr TAIBUlLATID/V . F
LEACN/IVG PIT ! j 4
T.
DES/GN CRITERIA srAtE : %4" _ /`- o" v/MENs% N 3 F/ el 6- T
D/lyIENS i
NUMBER OF BEDROOMS _,� _
D/MEND/ON C FT.,41
I
GfARQAGED/SPOSAL UNIT_ SD/L LOG sp;%L TEST
TOTAL EST/MATED FLOW 330 G.44.1DAY SO/L. 7"EST #/ SOIL TEST#2
JVUMBER OF EACNINGi PITS I f^E'LEY. �j7. �-ELEY. ,DATE OF so.,,6 TEST -7�
S/DE LEACHING PER P/T �� SQ, FT. O a_ RESULTS W17-MESSED BY /7, F-I
F BOTTOM LAG ACHING PER FT. L v R"� PL`/ZCOLAT/ON RATE / � E� !rJ//V /NCH
TOTAL LEACHING AREA Z n J U J3 5;i i L• _,1�,
SQ. FT, t PERCOLA►T/ON RATE'fk2 MIN. H
INC
"7 RESERVE L .ACN/JVG AREA 2• b SQ. FT. C co
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ASSESSORS MAP :
Lk), ASSESSORS HOLE LOGS -
�►� PARCEL : 7 �> I) The inslallalion shall ca►�i.;, with"I'itic V anal 'I'owu oHIW� }�'���d of
FLOOD ZONE : 1\,107- A F�69 S01 L EVALUATOR: � � , ��. I lealth Itegulations.
WITNESS : LW '�� 2) The installer shall verify the location of utilities, sewer inverts and septic
REFERENCE : � � 1�� �(�� _ DATE: k-)Eg— � I 't I
components prior to installation ,nd selling base elevations.
PERCOLAT I 0 RATE: -< Z \A- Ikk t 6 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per Ii�oL 'I'I►e first
rytwo feet out of the d-box to the leaching shall be level.
L Nllyv I ► 9q, Ll IV 4) This plan is not to be utilized for properly line determination nor any other
TFi- I I TH-2 purpose other than the proposed system installation.
5) All septic components must meet Title V specifications.
�p e2�. D � 6) Parking shall not be constructed over 1110 septic components.
qv 'G 3
/ q 7) The property is bounded by property corners and property lines.
lQj �j 8) The property owner sliall review design considerations to approve of total
��� design flow and number of bedrooms to be considered for design. Receipt
LOCATION MAP�-�) of payment for the plan and installation based on the plan shall be deemed
Gj ��j�-�t� approval of the design flow by the owner.
I 9) The existing leaching or cesspools shall be pumped and filled with material
7� per Title V abandonment procedures. Those within the proposed SAS shall
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be removed along,with contaminated soil and replaced with clean sand per
Title V specs.
,� r 10)System components to be 10 feet from water line. Sewer lines crossing the
l water line shall be sleeved with 4 inch SCI 140 PVC with ends grouted if
applicable. "file proposed SAS is being installed below the water service
line. The line is to be sleeved as aforementioned and maintained in place.
I 11) If a garbage grinder exists it is to be removed and is the responsibility of the
SEPTIC SYSTEM DESIGN
owner to ensure such.
12)The installer is to lake caution in excavation around the gas line if such
FLOW ESTIMATE 1 exists.
►� ---- ------�; I 13 The installer shall verify the location, quantity and elevation of the sewer
BEDROOMS AT ID !GAL/DAY/BEDROOM +��GAL/DAY lines exiting the dwelling"rior to the installation.
Ij I Lftf! z 4 , , zs'.:r '�� ; 14)This plan is representative only that a system can fit on a property meeting
SEPTIC TANK Title V requirements.
I =c ��GAL/DAY x 2 DA IS -L''�-� GAL
USEZD�ALLON SEPTIC TANK 5n
toy o hABSORPTION SYSTEM
O N
3 yr Z 'ebb �G�w-��ow ��' ti\ P�,(t1 aF1!7yS .
7� '`- MASON 'JfruT;
. � .�, SIDE AREA: No 1066
BOTTOM AREA: ,o—� k :r7 ' Z�7'�� _ J ��G STEP �y
-PAC SYSTEM SECTION
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SEPTIC TANK �U 1, iVla�� ' 3 I'/�-Dav�t (� �tDwP
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SITE AND SEWAGE PLAN
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LOCATION : g 0 �yl UJ
PREPARED FOR : \J-7X( Lti DDF �
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DAV I D B . MASON,PS DATE:
° DBC ENVIRONMENTAL DESIGNS
5
W EAST SANDWICH . MA
DATE HEALTH AGENT
W ( 508 ) 833- 2177
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