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HomeMy WebLinkAbout0142 WAYLAND ROAD - Health 14Z Wayland Road Hyannis A=271 205 L'OMMONWEALTH OF MASSACHUSETTS VM EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ExvlgpN ' MENTAL PROTECTION OFFICIAL INSPECTION FORM N TE 5 SUBSURFACE SEWAGE DISPOST FOR AL SYSTEM ASSESSMENTS PART A M FORM CERTIFICATION 907/ �'operty Address:j � Owner's Name: Owner's Address: Date of Inapectloaa Name of Inspector• le e p t p Company Names Ma1 ing Address: Telephone Nnmbes; CERTIFICATION STATEMENT beloe *w is that I have personally inspected the sewage sal s true,accurate and complete as of the ' ° Ystem at this address and that the information reported experience is the time of the' inspection wan training and Proper ff unction and inspection.The ' perfo coed based on 4" approved system Inspector maintenance of on site sewage disposals tiema.I pursuant to section 15.340 otTldo S 310 sin a DEp CMR 15.000j. T1uaystem: �_ Passes ry Conditionally Passes Needs Further Evaffsaluation b -_ -� -"—' Y the Local A 4"` pproving Authority'1, Inspector's Signatn � Date: f1 `[ (3 rn The system in spector shall submit a copy of this inspection report DEP)within 30 days of completing this ' to the Approving Authority oard of Health or gpd or greater,the ' inspection.If the system is a shared system or has a design flow of 0,000 DEP.The originalinspector and the system owner shall submit the report to the appropriate regional office of the should be sent to the system owner and copies sent to the buyer,it applicable,and the approving ' authority. r ` QM. Notes and Comments �CL.c=LS S �\C�C 1 05� 5 'T Drm 'SAS S_�C , v\, v , VL 0 -rYl� i'� ►n+e� **.. � nce seed P�: Th1s report only describes conditions at the time Of Inspection and under the conditions o time.This inspection does not address how the system will perform Ia the future under th conditions of use. lose at that e same or different I� Title 5 Inspection Form 6/15/2000 page 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSES SUBSURFACE SEWAGE DISPOS ASSESSMENTS AL SYSTEM INSPE CTION FORM PART A CERTIFICATION(continued) Property Address: Z tw Owner: 1 Data of Inspection: 2 Inspection Summary: Check AAC,D or E/AL—L complete A of Section D A. System Passes _111 I have not found any informahon which indicates that anyof the�e 15.303 cr in 310 C11t3115.304 exist.Any failure criteria not �described in 310 CM evaluated are indicated below Comments: B. System Conditionally Passes: or morn system components as described in the"Conditional Pass"section need to repaired. sYs�4 upon completion of the replacement or repsdr,as by laced or Health,will pass. iAnswer yes,no or determined(YAND)in tho for te followiag attn . ..not determined-please The septic task is me and over 20 years old' or the tic tank unsound,exhibits substantial' ( metal or not)is structurally, a or exfiltratioa or tank failure in.. . existing tank is replaced with a co lying septic teak as approved by Board of Hsystem e�p�inspection if the *'�ID°�septic tack will Paso inspec n if it is structural) indicating that the task is less than 20 ye old is available t leaking and if a Certificate of Compliance ND explain: Observation of sewage backup or break o 0 obstructed pipe(s)or due to a brok .�static water level is the distribution box due to broken or approval of Board of Health): settled tributioa box.System will pass inspection if(with b on pipes)are replac obstruction is removed distribution box is leveled or r ced ND explain: The syste quired pumping more than 4 times a year due to broken or structed pipe(s).The system will pass inspection' with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed STD explain: Titles i inana�tinn)97—m Aii crnnnn 2 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A , CC CERTIFICATION(continued) erty Prop Address: W Owner: Date of Inspection: C. Further Evaluation Is Required by the Board of Health: exist which require Bather evaluation by the Board of Health in order to determine if the system is failing test public health.safety at the environment. 1. System In pass unless Board otHsalth determines In accordance with 310 CbM is 1 the system is tbnetioniag Ina manner which will protect public health,sat )thateh►and environment: _ Cesspool is within 50 feet of a surRce water _ Cesspool or is within 50 feat of a bordering vegetated wedand or a h L System will fail unless the Board Health(and Public We system Is llmetioning in a manner that p teets the public he safety and, environment:d nes that the _ The system has a septic tank and soil lion (SAS)and the SAS is within 100 feet of a surface water supply or tn'butary to a surface ter ly. _ The system has It septic tank and SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and and the S • within 50 feet of private water supply well. The system has a septic teak SAS and the SAS is I than 100 feet but 50 feet or more gom a private water supply well**.Me used to determine dig **'Phis system passes if the ell water analysis,performed at a D ertified labors bacteria and volatile laboratory,for coliform mg compounds indicates that the well is free m pollution from that facility and the presence of ammo nitrogen and nitrate nitrogen is equal to or less 5 ppn36 provided that no other failure criteria are ered.A copy of the analysis must be attached to this rm. 3. Other: Ti►1� fn.n�r►inn Rnnti!i1;mnnn 3 ,• •a�v�ul ll OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY AS: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOMENTS PART A FORM CERTIFICATION(continued) Property Address: Owner. Date of hupection: D. System Failure Criteria applicable to all systems: You=4 indicate"YW or'bo"to eacb of the following for >lQ.inspectiona: Yes N ._ Backup of sewage into facility or system component Discharge or pondiog of effluent to the surface of due so overloaded or clogged SA3 or cesspool SAS or cesspool ground or swfts waters due to an overloaded or — �[. static liquid level in the distribution box above outlet. cesspool nmit due to anoverloaded or clogged g or Liquid Reqnfied depth in�l is less than 6"below invert or available volrme is leas than% of time pu than 4 tunes in the last year 2=due to clogged day flow obs<ticdad pipe(s).Number Any pardon f the SAS,cesspool or Privy is below high ground water eleva Ater� cesspool or privy is within 100 lbet of a 5MAce water supply _ �Y a surbce Any pardon of a cesspool or privy is within a Zone I of a public wen. — Any Pardon of a cesspool or Privy is within SO feet of a private water _. Any pardon of a cesspool or privy is less than 100 feet but fe wen' supply well with no acceptable water quality analysis, (Thls thus Passes feet il"osn a private water performed at a DEP certified laboratory,for collform b sY+�m p�cew'st flu well water anaty o indicates that the well is"a&am popndon from that lacWty anand �Ville organs compounds nitrogen and nitrate nitrogen to equal to or less than S ppm,provided thatOM@ of no otter flap ours criteria ^ are triggered.A copy of the analysis must be attached to this form.] f y (yes/No)The system h.I have determined that dumbed is 310 Cl1Dt 15.303, therefore the a one or�°of the above faihae criteria exist as Health tv determine what win be ystem fails.The system owner should contact the Board of necessary to correct the failure. E. Large Systems: To be considered a large system the system must s gPd. erve a facility with a design flow of 10,000 gpd to 1S,000 You must 'cate either"yes"or"no"to each of the following; (The following aria apply to large systems in addition to the criteria above) yes no _ — the system is within 400 f a surface drinking water Y the system is within 200 feet of a tribu ace drinking water supply _ the system is located in a nitrogen hive area In Zone H of a public water supp Well ( Wellhead Protection Area—IyVpq)or a mapped If you have answered"yes"to an uestion in Section E the system is considere "yes"is Section D above the ge system has failed.The owner or operator of an Iar ficant threat,or answered significant threat under S on E or failed under Section D Y sys8 stem considered a 15.304.The system owner should contact the appropriate regional office of the p m m accor a with 3 l0 CMR Department. T41a S fnanai►inn cn^",cii<��nnn a vs.,.0 va a a OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address2 CAY C�J. Owner: hA Date of Inspeedons Check if the followirin have been done.You must indicate "Of"no"ar to each of the followin ic Y No Pumping information was provided by the owner,occupant,or Board of Health _ L Were any of the system OmWonents pumped out in the previous two weeks? _ I Has the system received normal flows in the previous two week period? Have large vohunes 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) J _ Was the facility or dwelling inspected for signs of sewage back up? J _ Was the site inspected for signs ofbreak out? J _ Were all system components,eluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected of the baffles or tees,material of construction,dimensions,depth of liquid,depth of slud ge depth of scum? of the condition J _ Was the facility owner(and occupants if different from owner)provided with information on maintenance of subsurface sewage disposal systems? the proper The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Y no _ Existing information.For example,a plan at the Board of Health _ Determined in the field(if any of the failure criteria related nac le)P 10 CMR 15.302(3)(b)] to Part C is at issue approximation of distance >,uceptab TiN� i fnon�n/in" Rn.,. �cii cnnnn 5 co�vvua as OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Z Cx d . Y Owner. Date of Inspeetion: FLOW CONDITIONS RESID1i T1AL Number of bedrooms(design): Number of bedrooms(actual).. DESIGN flow based on 310 ISM(far example: 110 gpd a#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no): Y1 t) Is laundry on a separate sewage systeem�yyea or no): [if yes separate inspection required] L nft 01� ZE no):YCD Seasonal use:(yes or no):Wd w me" read ngs.ifsble(last 2 years usage(gpd)): Sump rmw L"s or no). 0 Last data ofocoupency: e / S Qmi�er 06 C RCIALIMUSTRL4L tablishrneu� Design Bow 310 CUR 15.203): and Hasis of dedp now(ae agtt etc.).. _l— e3rease trap present(yes at no - Industrial waste holding tank present(yea Non-sanitary waste discharged to the T' ,m no): Water meter readings,if a ' Last date of occupant O eserrbe): Pumping Records GENERAL INFORMATION Source of information: n w V,\-Q� Was system pumped as part of the inspection(yes or no)18D If yes,volume pumped_gallons— ow was quand pumped det d? Reason for pumping:Jp_Q M o; W T�PE OF SYSTEM �I Septic tank,distnbution box,soil absorption system _Single cesspool _Overflow cesspool —Privy _Shared system(yea 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 onents, ed(if lmo� )an source of info lion: Were sewage odors detected when arriving at the site(yes or no):JW Ti110 Tnenarlinn T:nnw 411 6 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Addresst 4Z V IUAC 1 . Owner: (— Date of Inapectlon: 0-7 WELDING SEWER(locate on site plan) t 1 Depth below grade: Materials of construction: cant ir=i 44A PVC_otter(explain).- Distance Dom Private water supply well or snctioa line: Comments(on 'tioa jo venft&evidePco o!Mmew c` �41 SEPTIC TANKS_(locate on site plan) Depth below grade: Material of construction:Zoncrete metal—fiberglass_polyethylene omer(eMVlain) if tank is mew list age:f Is age confirmed by a Cart Cate of Compliance(yes or no):_(ate a copy of sludge Distance from top of sled ato bottom of outlet tee or bade: Scuts thickness: Distance fiom of scum to�p top of outlet tee or baffle: � _ o� ` to re�'s Distance from bottom of scum to bottom of flat or baffle: `' How were dimensions determined: M I Conmtenta(on pumping ..;Peons,inlet and outlet tee or baffle conditi as related tq outlet. avid a of 1 e etc.). on'structural integrity,liquid levels GREASE TRAP:_(locate on site plan) Dep _ Material of cons ___,concrete_metal_fiberglass_polyethylene other (explain): Dimensions• Scum thickness: Distance from top of scum to top of outlet tee or ba e: Distance from bottom of scum to bottom of ou or aflle: Date of last pumping: Comments(on pumpin ndations,inlet and outlet tee or baffle condition, as related to o veM evidence of leakage, etc.): tural integrity,liquid levels . T41a 4 lnenanfinn i.nrrn Ail;1jnnn 7 rage 0 oI 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 2 Qn Owner. Date of pectlont TIGHT or HOLDING TANK: (tank mist be pumped at time of >mpectionKlocate on site plan) Depth be butmial of concrete metal fiberglasa_polyethylene o 1eKexplain): Dimensions: CAP'Scitr gallons Design Floor: aallom/da Alarm le (yes�no): i Al order(yes or no): Date of Lot Co�enm(c a of Warm and float switches,etc.): DISTRIBUTION BOX: (ifpresent must be opened)(locate on site plan) Depth of liquid quid level above outlet invert: C013m mts(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or�It of ex,etc. CJ - fig 'e c � � n OF P CHAMBER: (locate on site plan) Pumps in working or Alarms in working order(yes or no): Comments(note condition of pump chamber,conditi a purtensnces,etc.): ni- Tide i fnanar�inn Rn►.n All IMAM 8 r>st;v y 0I 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM�EMRMATION(continued) Propertp Address: 1 H Z lS�, 1`d CA At< Owner: Data of Inspecdon: S0111.ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Tvha ^number: leaching chamba%number: leaching gallaiae,number lesohiog tenches,number.length: leschioi flelds,number,dimensions: overflow cesspool.number: irmovstive/aiternative system T ype/name of technology: Cow(note condition of soil,signs of hydraulic failure,level of etc.): pow&damp soil.condition of vegetation, Ve-- o ��0A 1 VLO c;\ CESSPOOLS: (cesspool must be pumped as part of inspectionxlocate on site plan) Number configuration: Depth—top 'quid to inlet invert: Depth of solicL Depth of scum layer. Dimensions of cesspool: Materials of construction: Indication of groundwater inflow( no): Comments(note condition of soil,signs draulic failure,level of po condition of vegetation,etc.): PRIVY: (locate on site plan Materials of constructio Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,conditio f vegetation, etc.): Ti►I. C inon.n�inn Fn►.n b/1;1,iAnn 9 . Page 10 of l 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(connaued) Property Addresst owner: Date of Iaspecdoin OD SIMCS OF SEWAGS DISPOSAL SYSTEM Provide a skoub of the sewage disposal system including ties to at leant two permanent rafereace landmarks or benchmarks.I.aate all wells wfthin,100 feet Locate where public water supply enters the budding. . A D EC-Lc- ) pl — LIS Britt oy-lt�-5 coin lo-e F�3 ' S B 3 — 41 s in OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Addresu Z— o Owneet Dots of Iwpectioa: Z SITE EXAM Slope svr&ce water Check cellar Shallow weal Estimated depth to ground water feet Plane iodk s(ebeck)all methods used to determine the high ground water elevation: Obtained ftom system design plans on record-Mchecked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 fleet of SAS) Checked with local Board of Health-evisin: Chocked with local excavators hZdoccutpents���� 0 , f ` Accessed vs0S dambase-explain: IV.J 3U J � `�'� Y must be how you establishedthlg�gound wa elev tl 77+ ANY-0 i • - e------------------------ f , a O a o b 12F�- nod T;fla C inonar►inn Rnrm 4/1 Nunn !i � > LO CAT 10 SEWAGE PERMIT NO. MtLLAGE INST- A LLER'S NA I E i ADDRESS k � � �/ iUIL D ER OR OWN //ZLI- 7R ew­ i^ Cl e DA T E PERMIT ISS_V E O DAT_C- C0NtPL1ANCE ISSUED ��/9� ir � n► +eNO M M p 1 s .... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ................Town..------......OF.......Barns.table Kl Allp iratiou for UhipmFal Works C umarurtioaa ramit t'" Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal " System at ..... •Lot.. ... J. �...:: ( .� �c._� ,�„- ...........HyAnn .S,�...A. a®6-- Location-Addre s or Lot No. ....--•Capricorn- Realty....Treat--•------•-•-•-••-••-•-•••. ...7.6.5.._�a,1moUth..Raada...11Y.a lxlia.................... W Steve Lebel Owner Address Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.....3....................................Expansion Attic ( ) Garbage Grinder ( ) per., Other—Type of Building ranch.............. No. of persons............................ Showers ( 2) — Cafeteria ( ) W Other fixtures ------------------------- ----•- . W Design Flow...............•.........5-5-------------gallons per person per day. Total daily flow-__.-------_--�3.0_............•....gallons. Gd Septic Tank—Liquid"capacityl D0_.gallons Length. '.6"_._ Width. .'.10.". Diameter________________ Depth.-.)''.'.$".... Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------1........... Diameter..........6....... Depth below inlet......6........... Total leaching area....266.....sq. ft. z • Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.....Z' dxedge...ZI zin.e-ar-iXIg:.......... Date..... 1•-25-$1--_---_---. Test Pit No. 1K2.j Q....minutes per inch Depth of Test Pit----- 2.!........ Depth to ground waterxl. lae...enC.Ounted Test Pit No. 2-VA......minutes per inch Depth of Test Pit.N/A.._.____.. Depth to ground water.N/A............... ---•---- ......... -•-•••••••......-• ---•-•...... .................••--•. ........................................................ - -2-.......... o:gm...&...tapao i I--------------=--------- Description of Soil.................. --...------------------...--------------------.....----- x 2 ' - 10-' medium..Y.ellow sand ...............................................1.Q - 1 med......While...Sand./trace-s...af---grava.1/m...viatar---at 12 ' 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 i`:C"i. p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en is ed y the rd of health Application Approved By- `G..........1.............................................................. .... t-��.._. ate Application Disapproved f t following reasons-----------------------------------------------------------------------•------------------------------------_.... -------------------------------------------------------------------------------------•••••-••---•-•••- Date Permit No......................................................... Issued_.................................. ..................... Date - _ ....................... �.. Fxs THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................`IoQ M............OF.........Barnstable................................................ �" ,���1tr�ttion fox �i��oo�af oxk� Cnonotrttrtion rrntit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: ................--Tjat...4 .l-.... f ... ............Hyannl%,---MA...................................................... ca Lotion-Addr s or Lot No. .........Cepriao=) _Rea.lty..Trust.......................... 7.6----Falmouth-- Qac Hyann.IG------------------- Owner Addres - a --•-....S .4Ve...Le e1---•-------•-----•.......................................................... .................................................................................................. Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms......3L...................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ................................. W Design Flow..........................5.5............gallons per person per day. Total daily flow.................�3©...................gallons. WSeptic Tank—Liquid*capacity 000.gallons Length__a!6.... Width--0.1—all Diameter................ Depth__ .8.t... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No......... ...... Diameter...........( Depth below inlet.......6......... Total leaching area.....2,66.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by......Eldredge...Engineering.......... Date..... ............ Test Pit No. IX2..Q...minutes per inch Depth of Test Pit.....12......... Depth to ground water.nOng...6nCOunte — ( , Test Pit No. 2JVA......minutes per inch Depth of Test Pit...NIA......... Depth to ground water-N,,A,............... e 04 ---•-----------------------------------------------•----....-.....---•-•-.---•-.---••--•-----...--....---.-......--•.---------------•--••---------------••••- O Description of Soil........... 0.1.......21.........loam...&...topsail---------------•--------------------------------------------•--•--•------------- x --•----------------------•---.....2! - 1 ' m u1r, Y llO v..�and. U ....................................... --------med.._.white---sandltraces...8f..., vel/na--wa-ter----at 12' 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'TTILS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Id Date Application Approved B ..:f -------------------------------•---•--.........--------•-------- A Date Application Disapproved or�he following reasons:................................................................................................................ Date PermitNo......................................................... Issued....................•------.....--•...._..---------••--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... own...............OF......B4; its ta:ble.............................................. Trrtifiratr of Tontlifiatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed' ( X) or Repaired ( ) bySteve LebAl-------------------------------------------------------------------------------------------------------------------------- at LO t.. f .L� > Installer ----------- has been installed in accordance with the provisions of TITLE: 5 of The State Sanitary Codefas -cribed in the application for Disposal Works Construction Permit No .. ., _%.................. da.ted_«V�UARANTEE t.S�.. _ "_................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A THAT THE SYSTEM WILL FUNCTION SATIS ACTORY. J � ��j' : DATE...........................................�- •--� ............ l1�- . ........ Inspector...................................... .- ----- ........-•-------•------------•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......l own OF.........Barnstable ................... .......---...-----.....-•------•-•-•....................--•. F�,��- N .'�....' ?.,t....... ....--•---......... Disposal orkii Tonntrnrtion rrntit Permission is hereby granted...................'.Steve Leb@1. to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at No.••LOt �j L� /=1 f == l .iV"' ..... H X>1 . � •-� �-----•-----•--•-•-- Street as shown on the application for Disposal Works Construction Permit 142-2-?---.--. Dated5.'-�/�.,I ;"................ ........................•--------.....--•---.....-----------------•--•-----•••••---------•----•...-••--- / . .....-_• Board of Health DATE......... ------------------------••----•- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 0f �o SUS n 6`J,U .b ' • O 2 o-r�, � I b �. � ZCA N.. J o s IN PIT io w o �2A oo � - Al- 7S� •t.EGEND CERTIFIED PLOT PLAN 'EltfBtlN® 'SPOT ELEVATION OnO . ����� of Moss EXISTING CONTOUR --- 0 'cy �oT -�.r<<.. :. D FINISHED- SPOT ELEVATIONIo ALBERT, N FIM �HED CONTOUR. -- p o A. Rco No.10951 O IN AMOVED 1 BOARD OF HEALTH A90Fs GlSTE � S/ONM.E DATE AGENT SCALE� / '!:. 3 o ' DATE � REDSE -ENOINEERINQ CQ CLIENT LEA I CERTIFY THAT THE PROPOSED taiSTE11to REGISTMED JO® NO, S l BUILDING SHOWN ON THIS PLAN CIVIL I LAND DN.iY� CONFORMS TO THE ZONING LAWS V - OF ®ARNSTA E ASS. 7I2 MAl It STREET CH. By' , �_�...��..HYANN,iS,, .MA*3. os { SHEETJ_OF A E 0. LAND SURVEYOR n I1lOTF /F E/TNER Ts/E SEPTIC T41V- < OR _ 20FT. M/N. -� � _EAC.�//NG PIT A�tE MORE TH.9:`/ /2BELOyV /Q f7 M/N 1,4.�1OE, f� 24 'O%AM ETER CaNCRETE COVER I S.S+AGL BE BQOUGHT TO GftAoE- GGNCR�TE i 4�PY� P/PE t�EAVy CAST /RON COVER SN,4LL �3� USEJ � M/N. P/TCN �, /F/N DR/✓E.N.4 Y 92.5 COYE/GS� - UQU/O LEVEL z I •; :: /R0N /PE U C? D a a o T ° NJ Al.P/TCN GAL. • e • w • • • .. • • ►a o .4 D/S7 o WA5HPO 57�,NE Pe/s PT S.EPT/C TA/V/C , • . •i • • • ,•S • , :-,.�. 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Sv6,-v L PEt'COLAT/ON RATE Jk2 '4'�MJN.�INCH 14E5ERNE4,ffACN/IV6rARE^ 2-6 b SQ. FT. Z l_ �Z 2, o a; OF Mass, C e?sF-R.S U T �4 / y L�t�i v /� MORSE " p No-095�0�� o' �L DREDGE ENG/NEFRMIG CO,INC. _ 4@/�gPc��Q� iOqo Fc�sTEP �� c-Le:.v. 7Fl; 7/2 MAIN ST. , HYANAlt ,; i�.rgss. .y h� SUtn� A�E�� NOGRovwv y�ATCR ENG'OCNTEREo CL/ENT: z//� GM 0 U/VO PVA TER A 7- EL, N ��✓C O DRTE S� JOB NO,' l Z 0 SHEET?OF z-