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1345 MAIN STREET (COTUIT) - Health
1345 MAIN'STREET,'COTUIT A=018.069 �i i No......��...S.S FEs..........�s...., . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ----.-Town.....................OF........Barnstable. Appliratilan for Uiipug al varku Ton.6trurtinn rrutit 1 Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 1345 Main Street Cotuit, MA02635 ................__.................•••-••-•---•-•----......---....---......-••--------------•--- --•-•••...-•-----•------•-...-----•----•------•-•-•••••...........--------.............._......--- Location-Address or Lot No. ....B................ Sruszta,t? ..........-................................... o3 5...Ya n?.. ............ Owner Address a A & B Cesspool Service �28 Bis .ohs •y ]� Q (Q1 $4 Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ............................ No. of ersons.......__.__._....__...._... Showers — yp g p ( ) Cafeteria ( ) a' Other fixtures ............................ . W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity............gallons Length.......:........ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 14 Test Pit No. I----------------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........................ a' ----•----•------••-----------•-•--••-•••-••-•-•------•-•--.......•••..............•----..._-•_•--••......................................................... 0 Description of Soil......................................................................................................................................................................... x w ------ V Nature of Repairs or Alterations—Answer when applicable_.__-�000 gallon stoned packed over flow. -•-••--••-•-•-•-••--•••••••••-----•••-•••-----•••••---•---•-••-•-•------•--••-•••-----•--------------•---••••-•----•-------•-----•--•-------•-••--•-•----------•--•--•----•-•••-----••-•-•--•-•-••••-•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIS 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ssued b'n operation until a Certificate of Compliance has e � P P p, �•'� Y t ard of health. Ah �vU�u'1 o Application Approved BY . •... -----••-•---......•••......----••---••---•--- -------•-•--6--(ID ........... D to Application Disapproved for t e f o lowing reasons:----••-------------------------------------------------•------------------------------ .......................................................• •...............----•-.......••---•---....••••----••-•-•••••-•••........................•........................I......Dau... PermitNo......................................................... Issued....................................................... Date -- - - --- ---- ," _ -- - ----_ — - - - --- - ---- --_ ---a- - - -- - - No......................... FEs........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 'pawn......................OF.......M=table.... Appliration for Disposal Works Tonotrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .....1 .Main street Cotui t, P�iA026S............... ..- - ----------- .........._::--• Location-Address or Lot No. -Sr)srv*,a i. ' r i;»s-- . eft �o Uit n"a•- .026 ,...... _-. --•-------•-------------- 3 _�-- -- T = 3- Owner Address A.Z.-r CesS.Poa1 _Sevvtos---------------------------------------- 42401__R.'s1 15}�ss-=� car••�13ranr�9.s r?�...A2b01 Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( „) w Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ---------------------------------------------------------•------------------ ----------------- W Design Flow............................................gallons per person per day. Total daily flow..........._................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.....................sq. ft. r Seepage Pit No...............:..... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................... ----•-----•---............................... Date......................................14 .. Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water................... r14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water................ ...... P4 •--•---•-------------------•--------••----•---•---•----.....--•-------......_...__.._....--•_______......................................................... 0 Description of Soil........................................................................................................................................................................ x U -•--•-•-•------•-•••---••••--------•--•------•------------•--•-------•--•--------••---------------•----------•-----•........----------•-------....•-•-•-----.....--•-----...._---•------•-•----•-•--••. w . -•-•-•-•-----------•--------------------•-•-•---•--••-•---------•--••-•--••--------_...-••----------•-•--•-•--------•-------------•-------•---•--•----•------•-•--•-----•--••--•-----...----------•- U Nature of Repairs or Alterations 1000a11on stoned acked over Flow. ions—Answer when applicable.-................ ._._..................__.__......_._._.. ...........-............................................................................................................................................................................................ Agreement: The undersigned agrees to install,the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 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 t e oard of health Sig d. �I `e -------•-•• ................................. Date \ Application Approved By..... ... -•-•-- ------ �•....... . to------------- Date Application Disapproved for t e f' owing reasons-..............-...............--------------------------------------------------------•.......................... .................................................... •-- ------........_..•-----•_.__..-------•----•-----......------•-•---•• ................................................... :.. Date i PermitNo.......................................................... Issued....................................................... Date \ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r........�m....................OF..........R=At4ble................................................ Trr#if irtttle of ( omplianrr THIS IS TO CERTIFY hat the I dividual Sewa Disposal System constructed' ( ) or, Rep i ( ) by_______•-___ A & B Cessf ) 1 Sery ce, Inc. t Bishops Terrace Hyannis, i1A �2�OI 13 5 �dPaSn Street, Cotuit, MA 02635 Install; at... Srusztajer has been installed in accordance with the provisions of TITLE I of The State Sanitary Co e as escribed in the application for Disposal Works Construction.Permit No._S--- _ S ............ dated-__.._ ��. THE$ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO TRUE® AS A G ARA TEE THAT THE SYSTEM WILL FUN TION SATISFACTORY. DATE................... a(.�_. ................................... Inspector........... - ....._.. 1 -.r THE COMMONWEALTH OF MASSACHUSETTS � 4 BOARD OF HEALTH ,z Town...................OF............Barnstable No........ FEE........................ g . 5c - Disposal Works Tonstrudion rrrmit Permission is hereby granted -- -- A & Cesspool Service, 123. Bishops Terrace, Hyannis, MA 02601 --•-- .... to Const> t ( ) or Repair ( an Individual Se �a e Disposal System at No. 5 ?4ain Street, otuit, MA OiZ�`3�._...- B. S msztajer Street G as shown.on the application for Disposal Works Construction Permit No..................... Dated.......__-�d_ . ..J SS r i Board of 3 DATE.....................IL ................................................ ,- FORM 1255 A.La 'I .MBOSTON tr TOWN OF BARNSTABLE ''// LOCATION 3� 14 4/Aj .5-' ( REAR) SEWAGE# � o `t'''(® VILLAGE COTvt T ASSESSOR'S MAP&PARCEL 0 b(o INSTALLER'S NAME&PHONE NO. CA P Ew h'D c— &,rr&AP4,,5G13 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF BEDROOMS L(NG GHAMdzE 1—I,DvSC OWNER 70 HAmi PERMIT DATE: 0 17 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 L./ET�rD6 Nr&W�s°sS 1 A- 2= 27 CIS • DECK ti g �ttoNT , No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitation for Misposal 6pstem Construttion 3pPrmit Application for a Permit to Construct( ) Repair�t Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1345 HAW S'! NvTurT Owner's Name,Address,and Tel.No. C_U5aS6T,r4 F Q5-z.-rATeA TYG- Assessor's Map/Parcel 5 ! i C� l (3 M�4-nP�r C�'cs T t"lA Installer's Name,Address,and Tel.do. 5502 "7- Designer's Name,Address,and Tel.No. �4p�fc� fir(- lsr 77 153 4604P&%:::� �J/A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures 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) C H ' mp-!j ti"6 EW)( -7b C_E�;5'10ecc_ Qj e'tZt �lCt� L� c5�4b.J ZiG��� T�4E7 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 H alth. e Date Application Approved by 12 Date Application Disapproved by Date for the following reasons Permit No. Date Issued :_ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes f 01pplitation for MispoBal,*pstem Construction.3permit, Application fora Permit to Construct,( ) Repair( Upgrade( ) Abandon( ) Q Complete System El Individual Components Location Address or Lot No. INS f'At O ST,C'C)_rU Owner's Name,Address,and Tel.No. F'RuSz-rATeA TYe Assessor's Map/Parcel. 1345 MA-mi 57"'. (ZoTUr7- MA • Installer's Name,Address,and Tel.Nt. gyp$ 477-89'7 7 Designer's Name,Address,and Tel.No.. Nl� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grindei( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) / Other Fixtures 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 I Nature of Repairs or Alterations(Answer when applicable) d— G� F 4441 lJ U&)6 P?2-N-4 TU cSSPa cep r zbt _r Date last inspected: a Agreement: �l The undersigned agrees to ensure the construction'and maintenance of the afore described on-site sewage disposal system in 1 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 ben issued by this Board of Health. , S' � kl Date Z` ?_ 77 r Application Approved by D'ate.,' Application Disapproved by $ Date for the following reasons � ¢ tie .,• ' r Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS, BARNSTABLE,MASSACHUSETTS s • Certificate of Compliance THIS IS TO CERTIFY,that the On-sites Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by CA pe ujt b& G uTnwa-Sef at 34 15 has been construct d' ado dad e with the provisions of Title 5 and the for Disposal System Construction Permit No. � �(datd Installer &t)t & �PT(SI pQ(,6"'� Designer #bedroomsAI Approved design flow gpd Mr The issuance of this permit shall riot be construed asa guarantee that the system will function,s5des-Z' ne� . 7 /a ;� ) 1 ! ' Inspector_ Date f_:___________________________ No. U Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem ConBtrUctiDtt permit Permission is-hereby granted to Construct( ) Repair( Upgrade( ) Abandon System located at 13 MA-W Co—i(__.7r— " 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 tin /sbe compl, e within three years of the date of•this permit. Date Approved by X)z t ;. J � . � I � I 6 1 t � I Gr r R E d)e to i o � TOWN OF BARNSTABLE !!//// LOCATIONA I Al � l RE'AR� SEWAGE# a O t-1 `f'�P VILLAGE COTi-t" ASSESSOR'S MAP&PARCEL 10 btc INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO.OF BEDROOMS LI NC. 6f4ANEE 14-DUSK, OWNER 'ro MA ld� dc--SS POOL PERMIT DATE: © 17 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 � Q&,yrD6 GN�I�0JSEC 130n1K House 4 RA pEcK y g FRoN +— it TOWN OF BARNSTABLE LOCATION SEWAGE# -VILLAGEr,,P, ASSESSOR'S MAP&PARCEL /� 6 INSTALLER'S NAME&PHONE NO. $o,,„Jw, Lrn-feIprYS-eS L-G•S� a77� t77. SEPTIC TANK CAPACITY �u�l9ij� LEACHING FACILITY:(type) rJ'®�q 3ti Ph�JIIG1� (size) 31 NO.OF BEDROOMS �OWNER, riS - �1 g6:� Frxisz+4 isr t kaujrens-e s.. 1ye- PERMIT DATE: 1. k 2, COMPLIANCE DATE: 6 `0 lict Separation Distance Between their wK+e Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility "`�" p' Rt Feet Private Water Supply Well and Leaching Facility(If any wells exist on w/ site or within 200 feet of leaching facility) ✓r 1q Feet Edge of Wetland and Leaching Facility(If any wetlands exist within ,g/ �J 300 feet of leaching facility) ✓ !7 Feet FURNISHED BY 'o�•` �Qf �C. �L i I L I .. A-s 4 �ac k cr l e e��+Aa3 w+�Q 3d C D 8-at=33:i °' y 8-4 3i.7" v� Nl ��1, . \ d N, wt re �\ G-gL=50,6 No.00 12-- Fe THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOLN__t4 OF BARNSTABLE, MASSACHUSETTS Yes application for Mispo8al bpstem Construction Permit Application for a Permit to Construct( ) Repair A) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.1 S4 5 M tA i 0 5T p ju i T Owner's Name,Address,and Tel.No. L.41M'4 TYC it i5uS 6C-Tj4 rP_d Z:fATC-V- Assessor's Map/Parcel j S (pQ , "gy� Ley4y,&7W.MA Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 50$ -:13--Q,:n"7 e_4Qe-c cow- sec ccv�c2s�C�� e 1'573 Sr C, WAME-GWA44 Type of Building: Dwelling No.of Bedrooms Lot Size 1 O q 1 sq.ft. Garbage Grinder( ) Other T e of Buildin Yp g (ZC-5 L�7L�1.. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 5501 gpd Design flow provided of f.3 gpd Plan Date —aQ c1O i X Number of sheets ( Revision Date Title i3'4tj MAIL) Size of Septic Tank 1500 "LL-ow Type of S.A.S. At 36 CNo¢eetadp2S -kd I eaup(Z , ow Description of Soil i;i pi x4em i L)m 6AOb m`fo tt � 56& 'P4AA1 t Nature of Repairs or Alterations(Answer when applicable) ti sjEPS To vet 1500 04u,d v 6EPT6Ci Z*y k— ?b !J� ©s 80Y— °r'n 30 ARC 3G Dt 010WEL60 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 Health. Signed Date 10 Application Approved by Date Lb 4/ ?of Z Application Disapproved Date for the following reasons I Permit No. Date Issued -------- -�--------- -- -- :r ------ -- �O/ No.20 I Z 30 q Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' Yes PUBLIC HEALTH DIVISION,- O. N,OF BARNSTABLE, MASSACHUSETTS 9pplitatlon for Disposal 6pstem Construction Permit Application for a Permit to Construct( )' Repair Upgrade( ) Abandon( ) ❑Complete System ❑Indivi'dual Components Location Address or Lot No.134 5 M(A 14 5T C 0-Tu 1 T Ot.ARw er's Name,Address,and Tel.No. K�t TYc s 4Fu5rk8tM4 F9-US ZT'A?�- Assessor's Map/Parcel 1 $((pq a(o F„IAMY ',S,y. L e jj,&7W I MA Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 50g"X73.OZ7'7 e-APe j(bC- c-NT6YLPRtSE s :C 1-53 Gownwoeem-(- ST Type of Building: Dwelling No.of Bedrooms Lot Size 441 r O Q 1 t sq.ft. Garbage Grinder( ) 4 Other Type of Building C 5 I (A L w No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 55a 43 gpd Plan Date g"M•a0 I X Number of sheets Revision Date Title 1'645 MAI IJ SSQe&-T doTV I T / Size of Septic Tank 1500 1SmAt,6.OW Type of S.A.S. 30 QROL 3(2 COAW69(S t<J/ 000P(-Gq? W Description of Soil P[ .00 - AWP I UM SA*1b (P qQ�t '` 5t G p4AIJ Nature of Repairs or Alterations(Answer when applicable) e-0Q#.II'r—Y '"iy'*+ i w&-S 6i (TlI-)Cw kh:)L+LStr% TO VeJ 1500 G�W 6 a T(Co, TAat.,k— -M 0 0Q O-60Y- T"z) 3 o Alta 3f 2 C3[Oi rE�wa24- VJI-W 1 4.0sJV(4K C-AC44 Rout I" A V I 6-Lb C01L*(C-.00A-V1)Q 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 Health. Signed Date 10, -4f-ao6a Application Approved by Date Cb V Zo/Z Application Disapproved y '` Date for the following reasons Permit No. Date Issued + '4 --------------------------------_------_-.---.--_.-_.__.__-.__,--_-_-,_---_._-___.-.-.--._-._-._-_._-_._.__._._._.-_._-----_._.-----_.-_.------------------------_-__._________________________ •+ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(k Upgraded( ) Abandoned( )by (10"Fewl-06 6NTSRpu5m (,C. at 1345 M Od W S"f (0 T(?(-r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.?,Om— 307 dated (0 Installer CAP&WCDE t IVT1QRi$ES LLC Designer :3 4L EQG~t 0 G6P4 EGG Sod #bedrooms g Approved de flow SStO gpd The issuance of this permit shall no /e const ed as a guarantee that the system," will Date / // Inspector �A W -------------------------- - - -•- - - - - - - = No. Zo 1--2— Fee( 00 00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Vermit Permission is hereby granted to Construct( ) Repair(x) Upgrade( ) Abandon( ) System located at 13 q-5 MAW :5-r <IoTo l 'r and as described in the above Application for Disposal System Construction Permit. The applicant recognized his r-Ekut3 o comply with Title 5 and the following local provisions or special conditions. Provided:Constru ion must be completed within three years of the date of this pe Date Approved b i TOWN OF BARNSTABLE 3CATION 3 5�r /yJ/�/� s 7 SEWAGE # 1n 9'.6 9 9 VILLAG7, C'Q I�t� ASSESSOR'S MAP&LOT !Ll'- 0 INSTALLER'S NAME&PHONE NO. A U vc& 3 T . w 9�.e SEPTIC*TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 10_-90-fl' 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 R £AR cra 3�' '32 4 LOCATION V SEWAGE PERMIT NO. VILLAGE A & B' CESSPOOL SERVICE 128 BISHOPS TERRACE,, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED RE (� No. 7 Fee J" THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIpprication for j0igoga1 *pgtem Construction Vermit Application is hereby made for a Permit to Construct( )or Repair(Y)an On-site Sewage Disposal System at: Location Address Of Lot N /Q —(� Owner's Name,Address and Tel.No. C 07-u or z/7 9- 0-55- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 14 d$ C°,41vc0 3 ff ^0141 S r,✓'y�'� 7�s•a�o� Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil 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 issued-by this Board of Health Signed / 4 Date %CJ Application Approved by 4 Application Disapproved for the following reasons Permit No. l�'6 2 Date Issued No. Fee � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,. MASSACHUSETTS w 2pprication for jDi9;poga1 *pgtem Con0ruction Permit Application is hereby made for a Permit to Construct( )or Repair(Y)an On-site Sewage Disposal System at: Location Address o Lot N 0/ Q - O 6 -Owner's Name,Address and Tel.No. c�T 6 T Installer's Name,Address,and Tel:No. Designer's Name,Address and Tel.No. 7S- Boy' Type of Building: Dwelling No.of Bedrooms Garbage Grande ( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow, gallons. Plan Date Number of sheets Revision Date ' Title Description of Soil -' r d Nature of Repairs br.Alterations(Answer when applicable) rIlAyAf 1 Date last inspected: P 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 issue by this Board of Health/1 Signed / - Date /U r;a Ar Application Approved by Application Disapproved for the following reasons ' Permit No. /�'G 7 / Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS r` Certificate of Compliance _ THIS IS TO CERTIFY,that the On-site Sewage Disposa� teg►installed( )or repaired/replaced(JIB )on /D-;-O-f` by h/ /l/CO 3'f a .��0/�/Sr G%u/I -C/9 S Ij IV asN 5 7- CM/T has been constructed in accord nce with the provisions of Title 5 and the for Disposal System Construction Permit No.�/�"�7 dated '/a -LO Use of this system is conditioned on compliance with the provisions set forth below: ---,_.. No. / O f(J / `� N � �t4� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS t" Ifi5pogar *pgtem Congtruction Permit Permission is hereby granted to 8 owtiC O 5! X_ to construct( )repair( 1!)an On-site Sewage System located at / 3 Jl f .S/'" ('�_7Z;-,,7- and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. Date: _ 2 U Approved by f Town of,Barnstable P# 1►IE ti Department of Regulatory Services BAMSTABM Public:Health Division Date aM6 q 2 0 Main Street,Hyannis MAr02601' EG Mph ` Date Scheduled 3r r Time Fee Pd. Soil Suitability 1 Assessment for Se e Disposal Performed By: grajLq. l ��r �lQ �rJ�S Witnessed By : � LO�;C/1ATIONq&"GENERAL INFORMATION p/_ f- Location Address i3 (f S 'r Ill t� STr e�� Owner's Name c S Q/�yY1 J7V SZ a-( �1- C aW✓C&I U T y eJ Co i Address 9la l�✓a i� Slt t&/�I, Assessor's Map/Parcel O 0 U / Engineer's Name, ;ft_• t t ,rl) r NEW CONSTRUCTION REPAIR L_Z r, Telephone# �J IBCdidk l 3b Surface Stones " bill Land Use i�l �Gt � i Slopes(%) ,nl Distances from: Open Water Body > 1 0 Q ft Possible Wet Area ' !00 ft Drinking Water Well 7I OL ft Drainage Way > 160 ft Property Line > ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) al• Sore Priv-t l Parent material,(geologic) �/ihTli✓�Sh Depth to Bedrock - Depth to Groundwater: Standing Water in Hole: /�l U i'�e. Weeping from Pit Face floo Estimated Seasonal High Groundwater DETERMINATION FOR•SEASONAL HIGH WATER TABLE ` Method Used: Depth Observed standing in obs.hole: ,' in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ e PER.-CO AT1 �F -Date` !. ! . 7'i ne fl'•�4.�i'tt_-r=— - Observation j Hole# w + Time at 9" �` tl Depth of Perc ��a Time at 6" Start Pre-soak Time ci a I Time(9"-6") End Pre-soak W 3 9 Rate Min./Inch �/ �I�►1 In 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:\SEPTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole#'_JL_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel sy1,I3 DEEP OBSERVATION-HOLE LOG B #ole .. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) _ (Munsell)_ Mottling (Structum,Stones ao.dders. 0-1 , ' Consistency,%Gravel) l9- 2y �l.r LS Y10%,3J9 q—go ZS toyp,06 qo-P S144 a S"i'dl .DEEP'OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ' Consistenc %Gravel ,; DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel ii Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes X Within 500 year boundary No D( Yes Within 100 year flood boundary No Yes— Death of Naturally Occurring Pervious Material " Does at least four feet of naturally occurring pervi us material exist in all areas observed throughout the area proposed for the soil absorption system. f If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the.required training,expertise and experience described in 310 CMR 15.017. Signature �J�� %�- �. Date Q:\SEPTIC\PERCFORM.DOC a r Town of Barnstable tegulatory Services 4 Thomas F.Geiler,Director ` �""►, Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 308-862-4644 Fax: 508-790-6304 Date: I 0-11-1 Z„ Sewage Permit# 2'012` a3C97 Assessor's Map/Parcel 18 61 Installer&Designer Certification Forth Designer: SC En_ykneecc,n5 Tic. Installer: Ca(�Cwidc enl•er fcfse s Address: 2 t.'5 4 C cw oerr% NrSMwoy Address: C-a-A Warclnom. rtA 02,538 ;'VNvl- C"L`t Sob-273•0377 - On I I-C&f - 64-t P4scl was issued a permit to install a (date) (installer) septic system at VI Li�5 H acn Skcee t based on a design drawn by (address) C En 5toee:rc�n , The_ dated Aua�st 2-9, 2-0 t 2 (designer) - I 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. Stripout (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 an vertical relocation of the septic stem but in accordance w• y rt I r 1 atton of any component p system) dan with State& Local Regulations, Plan revision or certified as-built by designer to follow. Stripout(if required) ected and the soils were found satisfactory. JOHN I. CMURCURCH1IIII ( ler's Signiature L 4ISO esigner s SignaturrARNSTABLE (Affix De I Here) P ASE RETURN TO PUBLIC HEAL DIVISION. CERTIFICATE OF COMPLIANCE WILL. NOT BE ISSUE NM BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBL IC HEALTH DIVISION. HAN TK YOU. ciAuffice forms%dosignercertification form,doc R FAR 1, TOWN OF BAMSTABLE LOCATION SEWAGE # VII.LAGE ASSESSOR'S MAP & LOT 0/r )6 7 INSTALLER'S NAME&PHONE NO. e4A-C V 3 5-v r Gv if®9P SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: t G-96-9 r COMPLIANCE DATE: 40" a-,f ls' 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 ROVIDE EXTENSION RISER WITH PROVIDE EXTENSION RISER WITH FINISH GRADE OVER D-BOX= 15.3' 4"SCHEDULE 40 PVC MIN.SLOPE 1% GENERAL NOTE BASEMENT SLAB= 17.3 ± WATERTIGHT COVER TO WITHIN 6" WATERTIGHT LOCKING COVER TO FINISHED GRADE OVER BIODIFFUSERS= 15.3' - 16 S OF GRADE OVER INLET COVER GRADE OVER OUTLET COVER REMOVABLE WATERTIGHT COVER SLOPE @ 2% MIN. TO WITHIN 6"OF FINISHED GRADE INSPECTION PORT WITH 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS FINISHED GRADE � ACCESS BOX TO WITHIN 3" FOUNDATION= 16.T± FINISH GRADE OVER TANK EL.= 15.8' S"DIA. OUTLETS) SIDEPORT COUPLER OF FINISHED GRADE SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND 20"MIN.ACCESS COVER 9 MIN. t THE DESIGN ENGINEER. 36 MAX. 9"MIN. 3. 4"SCHEDULE 40 PVC PIPE WITH WATERTIGHT JOINTS SHALL BE USED IN DISPOSAL r PROPOSED 4" (TYPICAL FOR 3) 36"MAX. 36"MAX. TOP OF SAS/B.O. = 13.16' I SYSTEM UNLESS SCHEDULE 40 PVC U ESS OTHERWISE RW SE NOTED. r'� 4. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN MIN.SLOPES 1% 6" 3" 2„DROP MIN. 3" 9° L=24' PROVIDE WATERTIGHT ELEVATION=BREAKOUT, FOR A DISTANCE ' DINTS(TYP.) CE OF 15 AROUND THE PERIMETER OF THE SAS. UNLESS !� 0 3 DROP MAX. k 4"PVC IN FROM , A 40 MIL GEOMEMBRANE LINER IS PLACE AT�3.4 _. � J 1.08 LEAST FIVE FEET FROM S.A.S.AND THE TOP OF (AT CESSPOOL) 14" 13.15' SEPTIC TANK 4 PVC OUT TO (TYP.) 1 THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. LEACHING FACILITY. 0•59� 7.13"+(TYP) 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. " " 13.4' " OUTLET TEE 12.9� MIN. 6 12.73' 12.67� 12.08' 2.875'(34.5") t, 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 48 1.1 5.0' (TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 12.3' 6"CRUSHED STONE (TYP.) 5'MIN. FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS 22"ZABEL FILTER MODEL#A1801-4X22 OVER MECHANICALLY14.4 (5 ROWS) COMPACTED BASE REQ'D NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 31.1' AND DESIGN ENGINEER. 6"CRUSHED STONE 5 OUTLET DISTRIBUTION BOX OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE - 8 A TREE ELEVATIONS SHOWN ON PLAN. DATUM OF 16.11 N.G.V.D. OBTAINED FROM A NAIL SET IN . GROUND WATER ELEV.= <$,0' COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET PROPOSED 1500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. ARC 36 CHAMBER (PROFILE) ARC 36 CHAMBER END VIEW 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR DIMENSION As PER ( ) OR TO CONSTRUCTION LENGTH 10.5' WIIDTH 5.67' DEPTH 5.67' WIGGIN PRECAST CORP. CROSS SECTI[O�(N''��VIEW * THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT SEPTIC TANK PROFILE 79 BARLOWS LANDING RD. DISTRIBUTION BOX DETAIL ARC �� 7T��� � CHAMBER 1-88$-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES I POCASSET,MA NOT TO SCALE (800)564-6774 NOT TO SCALE 11 TO THE DESIGN ENGINEER. NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE STRUCTURES SHALL BE MADE WATERTIGHT. h TEST PIT DATA NOTES: � ,�� ���`� � � y • � 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING k r PERC NO. 13690 REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM 1. MAGNETIC MARKING TAPE SHALL BE PLACED 'f APPROPRIATE AUTHORITY. . INSPECTOR: Donald Desmarais, R.S. ALONG THE TOP EDGE OF EACH SYSTEMz ` . ' � EVALUATOR: Bradley Bertolo, E.I.T. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESSLOCATED COMPONENT. DESCRIPTION HC 1 HC 2 GC 3 _ C D C.S.E.APPROVAL DATE: 7/29/03 UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND 2. ENTIRE PARCEL NOT LOCATED WITHIN A DEPk :t •w .. APPROVED ZONE IL SEPTIC TANK INLET(1) 15.1 30.5 61.5 � � n � ��;�� � �. � w � H-20 LOADING. r ;. fih ' . ;,,, DATE: July 19,2012 SEPTIC TANK OUTLET 2 22.0 34.1 53.8 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. 3. NO WELLS WITHIN 100' OF PROPOSED SEPTIC O � � � � r �. � "' � .,•:.Q. ,•i' TEST PIT#: � 1 SYSTEM. LEACHING CORNER 3 27.3' 18.7' 56.4' 14 O #H REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE ELEV TOP 16.0 WHERE`' � `' �� ELEV WATER= <6.0' MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, LEACHING CORNER (4) 40.9 32.3 45.8 � � �� r �" � * � �, � . � M w . PERC RATE_ <2 min./inch FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). LEACHING CORNER (5) 57.5' 39.0' 72.1' :� . =� � �� r ,' ` .� � t � i �� , ,� ,f # LEACHING CORNER (6) 48.8' 28.8' 79.2' DEPTH OF PERC=i 54"-72" 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN h `wt SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. 4 TEXTURAL CLASS: 1 ' ♦ 16. PROPOSED PROJECT IS LOCATED WITHIN: v � ��� n,; � • Ski r 0" 16.0, ASSESSORS MAP# 18 LOT# 69 Fill FLOOD ZONE C AS SHOWN ON PANEL #250001 0021 D w , 5 10 15.17 .$ 4 N Loamy Sand (30)ARC 36 STANDARD � A/E 17. OWNER OF RECORD: ELISABETH FRUSZTAJER& CHAMBERS WITH (1) 1.1' �'� b f � �� 3r 10YR 3/2 B.M. 26" 13.83' ADDRESS: LAWRENCE S.TYE COUPLER EACH ROW Nail in Treece Alice " x B Loamy Sand 26 GRANT STREET Elev. = 16.11 -� B.M. 10YR 5/6 LEXINGTON, MA 02420 �- _dR R N.G.V.D.29 Top of StklTk ryl 7{ it j E -8--� --� _ - .. �� i g 11 18. DEED REFERENCE: DEED BOOK 24108 PAGE 319 Elev. - 17.32 14y x x t 1 54" .5' -6 0 °E / �. N.G.V:D.29 ' t 4 � 3s° 773 ;: PLAN REFERENCE: LA BOOK 284, PAGE 14 E CF: PLAN x �3 13 20 � J � Perc �; 0 . ,r: ,:., N F-M Sand , 6.0 x� n _ 2.5Y 6/3 5 10, p i 12 STS°S2, "� � GASH o LOCUS PLAN TP2z _GAS GAS 5 \ SCALE. 1 = 1000 120 6.0 J \ �� ) INSPECTION PORT �s /6 A� \ GC 3 1_ R`v�WP� �S 3'�' \fir\ oRsroN � GasS�ON,E�S/�' •. (6) FLAGSTONE WALKWAY DESIGN DATA TEST PIT DATA LEGEND °�` ws--�--GAS` �cas ` '� s�4) CLEANOUTTO WITHIN 3" \ / EXISTING CONTOURS �. W /� GAS GAS . GAS-GAS • �� cps ,r.-- �-- -'( \ \. � •--". 5 3 , � OF FINISHED GRADE \ .\ _� PERC NO. 13690 - 50 � l � \ �� NUMBER OF BEDROOMS 5 INSPECTOR: Donald Desmarais, R.S. DESIGN FLOW 110 GAUDAY/BEDROOM PROPOSED CONTOURS \ C� �6 TOTAL DESIGN FLOW 550 GAUDAY EVALUATOR: Bradley Bertolo, E.I.T. STONE / \ \ 0 p DRIVEWAY 'n / DESIGN FLOW X 200 % = 1100 GAUDAY 7/29/03 C.S.E.APPROVAL DATE: w W EXISTING WATERLINE / TP1 USE PROPOSED 1500-GALLON SEPTIC TANK DATE: July . , 2012 \ a TNN C X0 ®(G p�`.,� _ \ 2 E/T/C EXISTING UNDERGROUND UTILITIES q�GFFc`�ge ` � TEST PIT#� , tiki / coo eFj�E9 OVF ®•� \� ELEV TOP- 16.0 GAS GAS EXISTING GASLINE �� (2) He 2 rtip \ INSTALL (30) ARC36 CHAMBERS WITH ELEV WATER= <6.0' ti w (1) 3' Fo49 ,/ J 1 SIDEPORT COUPLER EACH _ TEST PIT LOCATION `l q�k� ,moo �Q EXISTING j xp ( ) C ROW PERC RATE- �� 5-BEDROOM MAP 18 �- ' HC 1 DWELLING L T oo�, / . j- DEPTH OF PERC O O O PROPOSED 1500 GALLON SEPTIC TANk EXISTING J o ss SYSTEM CAPACITY _ C� 4-BEDROOM SLAB=17.3'± 41,091 S.F. K ti / S� (TOTAL LENGTH)(4.80 SF/LF)(.74.GPD/SQ.FT.)=GPD TEXTURAL CLASS: 1 DWELLINGXISTING CES POOL kY ►��' 155.5' 4. p TO BE =PED (DWELLING TO •Z � � ( )( 80 SF/LF)(.74 GAUSQ.FT.)'= 552.3 GAL/DAY4"SOLID SCHEDULE 40 PVC PIPE (TO REMAIN AS IS) - C AND FILLWITH / ��b� - BE REMODELED) B.M. , Q` " , --- BAN SAND / s' TOTALS: 0 16.0 Hyd. Bonnet Bolt ❑ DISTRIBUTION BOX �C. INV'S-13A'±) Elev. =25.82' / TOTAL NUMBER OF CHAMBERS: 30 Fill / N.G.V.D. 29 , �J� TOTAL LEACHING AREA: 746.4 SQ.FT. 12" 15.0' ` ARC 36(#3613)CHAMBER G TOTAL LEACHING CAPACITY: 552.3 GAL./DAY A/E Loamy Sand E/r/c '� / 10YR 3/2 7/ /C E/r/c 6 , N / 24" 14.0' e/r/c B Loamy Sand Eir/c \� /�42 10YR 5/6 Eir/c \ �., *NOTE: " , S79°16�50"f; f/roc E�r�c �� EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM 40 12.67 ' 291.76, `F�/c STONE�� THE "MODIFIED APPROVAL FOR GENERAL USE FOR REV. DATE BY APP D. DESCRIPTION DRIVEWAY /q0 INFILTRATOR SYSTEMS, INC." ISSUED OCTOBER 3,2003, PROPOSED SEPTIC SYSTEM UPGRADE 1500 GALLON '� \ _ ,<v MODIFIED THROUGH MARCH 14, 2012 BY THE COMMONWEALTH F-M and SEPTIC TANK e.,c\ OF MASSACHUSETTS EXECUTIVE OFFICE OF ENERGY& 2.5Y 6/3 PREPARED FOR: ENVIRONMENTAL AFFAIRS, DEPARTMENT OF ENVIRONMENTAL er �\ C1 ROBERT REA PROTECTION, TRANSMITTAL NUMBER:X235253. LOCATED AT 1345 MAIN STREET 120" 6.0' COTU IT, MA RESERVED FOR BOARD OF HEALTH USE SCALE: 1 INCH = 20 FT. DATE: AUGUST 29,2012 0 10 20 40 80 FEET 4� _`TH OF` s�, r �P` Pul�ssycNNW JOHN 1. PREPARED BY: CHURCHILL JR. = JC ENGINEERING, INC. clwl 2854 CRANBERRY HIGHWAY :�,,$. N0. 18 7 a �F srE o EAST WAREHAM, MA 02538 SITE PLAN- ,N 508.273.0377 SCALE: 1"=20' Drawn By: BMB Designed By:BMB Checked By:JLC JOB No.2262