Loading...
HomeMy WebLinkAbout0058 SOUTH STREET - Health 58 South StAect' 1 i Osterville \ r A_= 118 044 - F/R CL l J k D 4 a o a 0 No.— Fee--!! / BOARD OF HEALTH /// TOWN OF BARNSTABLE ; 6 2pp[icat ion,forVeil Construct ion Permit Application is hereby made for a p rmit to Construct ( ), Alter ( ), or Repair ( ' an individual Well at: Location Address Assessors Map and Parcel Owner / Address ------------------------------------- -- --- - - - Installer — Driller Address Type of Building ` Dwelling— ram 1---- ------------ Other - Type of Building------------------ No. of Persons---------------------------- Type of Well pre-,_ --- --- Purpose of Well ------ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate .of Compliance- has been issued by the Board of Health. Si ate Application Approved By --—— --——— �o -� date Application Disapproved for the following reasons:------------ - - --- -——----- — date It 0Permit No. 5 - 3 -— Issued-------------- ---------------- -------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certifitate ®f COMPliance THIS IS TO CERTIFY, That the I,z�dividual Well Const.ucted ( ), Altered ( ), or Repaired -1— -- - - --Inser - ---------------- - ----- - at ------------- --------- ---- --- has been installed in accordance 'th the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -------------------Dated---- ------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-----------_—-- -- - -- Inspector-- - —-------------------- —------ - i 03 BOARD OF HEALTH Fee—�-------- - ----,'�� TOWN OF BARNSTABLE AppricationArVell CongtructionVermit � Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( an individual Well at: mo — �.. .i:Locations Address Assessors Map and Parcel 4fir i4t ,1 Owner Address /(%Pe<J -------- ------- ----— --- i! Installer - Driller Address Type of Building If Dwelling- �� -1= -- ——---— _ Other - Type of Building— ---------------- No. of Persons-------------------- ` Type of Well ��=—`�--- -- — Capacity------------------- --- Purpose of Well.---�?�r_ic,7.a_ii v-✓ --- -- i Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further,agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.P)ate t Application Approved Bydate — ——— —--—— --- Application Disapproved for the following reasons:' ----- ------ ------ i ----------- date Permit No. r 5 3 --- Issued-------——-- ---- ----- - - date i i BOARD OF HEALTH TOWN OF BARNSTABLE (certificate Of (Compliance THIS IS TO CERTIFY, That the I dividual Well Const cted ( ), Altered ( ), or Repaired CC ` ----------- Inst4l er has been installed in accordance:with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -----------------Dated----- ------- ` THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. jDATE—---- ---- —-- - — Inspector---- —-- -- ------------ BOARD OF HEALTH TOWN OF BARNSTABLE Yell con5tructionj3ermit 5 G 3 No. ----------_-- Fee— - -- Permission is hereby granted — r — to Construct ( ), Alter ( ), or Repair (L,an Individual We at: No. —_ 0—sc-"i,_/A/�V --------------------- Street as shown on the application for a Well Construction Permit iNo.-- — — ted-- -------- - ------------------- —-- - — =----.-- ------------------------ Board of Health ! DATE -- f i . _ a - TOWN OF BAKNSTABLE G C LOCATION SOS//) S/` //t/�01#10V-q_ SEWAGE # V LLAGE C erv;l(z ASSESSOR'S MAP & LOT t INSTALLER'S NAME&PHONE NO."-Z, SEPTIC TANK CAPACITY I/�®��� 'X J 1 r r LEACHING FACILITY: (type) S-0062 �' :1�i G�c��i �o�l (size) 3 X aS n��� SOor-��S NO.OF BEDROOMS 3 —? � �(e�Cf�n\��� BUII.DER OR OWNER t PERMIT DATE: �'1 roc c i OZ COMPLIANCE DATE: 3 d I=0 2- ui Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom ofZeaching 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 L Furnished by i, U 6 3 t c � s O N' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppYication for ]Diooml *rztem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(✓)Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. : 8 S067 57, Owner's Name,Address and Tel.No. o 6%er P-dl e �Pe.7c—He/d,,an a Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. "c3 -ce ce�ll:s«� 474voAr DaT.& 4S50C, Sock -o 5_ . sog- e?•a.'Soa SSLS 56"s4 /44Y (2)S k--r--.«c V—,A. 6-SS yd -8-55- /v,F9/fnzvl7_L, H-9- 6 'o25?If Type of Building: Dwr ellin�g No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow `33� gallons per day. Calculated daily flow gallons. Plan Date Fc •8 o0a Number of sheets Revision Date Title Size of Septic Tank IFOO C 2e17 Type of S.A.S. a-5006,j -Dr-Z wcl%s Description of Soil O 9'q sgno JoAM -3y4= 16,4P! q o k, 7 loom C jj- i '154- 139 k- )4c0tvrn .5iand Nature of Repairs or Alterations(Answer when applicable) 19.0n Dts%rA-%ttZn t- .4 A2 io' x Q 5- (Fc% w> ti T ! I- ` A 5 �uz°r,D t� - C�C'9n SAm To he rv�,hT I n (cZ L'Cn l�hDeriio�� MR�er�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 Certifi- cate of Compliance has been iss d by this B and of e lth. Signed Date Fh-8.07.5`6 a Application Approved by Date Application Disapproved for the following reaso Permit No Date Issued -.�� - 1 .;�,a,No. � ,."``~,'. Fee ~ }4 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye • ;PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ' ZIPprication for Migogar *p5ftm Cougtructiott permit Application for a Permit to Construct( )Repair( )Upgrade(P-�j Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 5 8 Sov7)/ S T. Owner's Name,Address and Tel.No. p5Ter-p-;Ile Pic /�telcl,f,+.,a Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Ll,�/c ")5JOc. 'P•O.-E,X 55�5- 563- l r'al,�%��il� !`iA. 6 o2S74/ 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 330 gallons per day. Calculated daily flow gallons. Plan Date F(-•8-Q oo 9, Number of sheets / Revision Date Title Size of Septic Tank /sop 6A//6�3 Type of S.A.S. _�- 5606,91, Description of Soil 0 ` g S� '- ��.t M �i f'-39`' l���n�rs«:,��,„.l r�a�s ` ca' �`z �Orif)J w,T/I ��N, ��Cli�'TS J I.7C7 f /Jcoi rj f Nature of Repairs or Alterations(Answer when applicable)- A or) l7r-3 i,u,, 13,it — 1 - 300 i,r L,W 0( , 01 .A '9 /t7f 7� �5 // ,cV7L�/,j/1 a �j nUl� U!� 1 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 He th. Signed Date a 5'-o a Application Approved by o �� Date Application Disapproved for the following reasons�� / 1 Permit Nov Date Issued t �� r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(A -) Abandoned( )by Sk% Co,x;'�, i at S has b� constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer -LSt�c� \�ce_t�;5 i� Designer The issuance of this ermit shall not be construed as a guarantee that the sys e illrf �ct""io��n as esigned. Date — "` ® � Inspector - _N _- ———— — ——--————————————— ———— No. �" (./ � i Fee � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migpogar *pgtem Cougtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade Abandon( ) System located at �S 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. Provided:Cons u ion �t be completed within three years of the date of t.is at. /p a /6 Date: � Approved by F TOWN OF BARNS'I'ABLE LOCATION NA Z tA",Z SEWAGE # VILLAGE_ �S t erv�l(z ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.—Z. SEPTIC TANK CAPACITY l00 U,101 ,f j,�, LEACHING FACILITY: (type) (size) '' I,c,� NO.OF BEDROOMS 3 c' BUILDER OR OWNER _ PERMIT DATE: h�� <;:: COMPLIANCE DATE: •1- Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by /P so�r� 11L 0 A 3 19, 8 ° w � - COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS - t DEPARTMENT OF ENVIRONMENTAL PROTECTION F , TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 58 South Street (System for In-Law Apartment) Osterville, MA 02655 Owner's Name: Pete Melchiono Owner's Address: Same Date of Inspection: December 21, 2001E. REGEIVED " Name of Inspector:(Please Print) James M. Ford o �Company Name: James M. Ford ap: 118 Mailing Address: P.O. Box 49 �ree-VRQ�ABLEOsterville,MA 02655-0049 LTH DEP . 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(316 CMR 15.000). The system: ' ✓ Passes Conditionally Passes Needs urther Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: December 26, 2001 The system inspector shall subm a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the,system owner and copies sent to the buyer, if applicable, and the approving . authority. . Notes and Comments ` ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A - I CERTIFICATION (continued) Property Address: 58 South Street Osterville, AM Owner: Pete Melchiono Date of Inspection: December 21, 2001 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. f 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: 58 South Street Osterville, AM Owner: Pete Melchiono Date of Inspection: December 21, 2001 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 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ,CERTIFICATION (continued) Property Address: 58 South Street Osterville, MA Owner: Pete Melchiono Date of Inspection: December 21, 2001 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 fied laboratory,ry,for coliform bacteria a and volatile organic compounds. , indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or.less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes(No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large 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 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 11 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 316 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: 58 South Street Osterville, MA Owner: Pete Melchiono Date of Inspection: December 21, 2001 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. ✓ Determined 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)J. 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 58 South Street Osterville, M4 Owner: Pete Melchiono Date of Inspection: December 21, 2001 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): I i DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system (yes or no): No [if yes_separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): 2001 - 76,000 gals.; 2000-89,000 gals. (total house) Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: " Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,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: Pumped on Oct: 6197-per treatment plant Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _gallons--How wa`s 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: May 29192-per 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: 58 South Street Osterville, AM Owner: Pete Melchiono Date of Inspection: December 21, 2001 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: 10" 1 Material of construction: ✓ concrete meta fiberglass g __polyethylene _other(explain) — If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 12" 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 were no 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 recommendations, 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: 58 South Street Osterville, AM Owner: Pete Melchiono Date of Inspection: December 21, 2001 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: gallons Design Flow: gallons/day ' Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): „ DISTRIBUTION-BOX: ✓ (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. There were no signs ofleakage or solids. There were no signs of backup from the leach field The outlet invert was 30"below grade. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) F Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): 8 Page 9 of 11 OFFICIAL INSPECTIONFORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: SS South Street Osterville, MA Owner: Pete Melchiono Date of Inspection: December 21, 2001 _ 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: 3 infiltrators.(18'x 3'x 2'stone) leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): The infiltrators were located but not dug up. There were no signs of failure or backup in the D-box.•The bottom to grade was approximately 4. 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): Comments (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.): Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) • Property Address: 58 South Street - Osterville, MA Owner: Pete Melchiono Date of Inspection: December 21, 2001 Map: 118' Parcel: 044 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. -bb { Q-e n F 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 58 South Street Osterville, MA Owner: Pete Melchiono ' Date of Inspection:. - December 21, 2001 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 35' +/- feet (Adjusted High Ground Water Level:29.5) 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: . The bottom_of the leach pit to grade was approximately 4'. Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately 35'+/-to ground water at this site. Using the Cape Cod Commission Technical Bulletin, the high ground water adjustment for this site(MI W 29, Zone C, 11/01)was 5.5'. i This report has been prepared and the system 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 system, the inspection and/or this report. I1 - - " x Ge-A d�. -6n 1C) rovA LvAfe" leve 3 S o G ro un(�WA7C r l eve I TOWN OF BARNSTABLE LOCATION S" ,d sz SEWAGE # C?3-14/1 VILLAG Ile ASSESSOR'S MAP & LOT D Yy INSTALLERS NAME & PHONE NO. 6Cro„ C'e"e.-t,, 1 �Qg-,5'-6-90 SEPTIC TANK CAPACITY 00,0 6,4 LEACHING FACILITY:(type) 3 `2�L/%47-2 r (size)/u' X3`-0 IJ7a-,c NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER f�'ele r DATE PERMIT ISSUED: 9C2 DATE COMPLIANCE ISSUED: . d�7 -'� - VARIANCE GRANTED: Yes No �/ F-v.T 01 ICVT : o � J r1 I AwP-r sy sreA OF BARNSTABLE I:OCA7riON � SUtJOWN - SEWAGE # VfLLAGE 05/-;N.-1k ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE,NO. 2CC'AA Gentr.4 SEPTIC TANK CAPACITY IOVD GA LEACHING FACILITY: (type) 1 it�'II 1-4 uis (size) (-;t , 0 ST NO. OF BEDROOMS 3 BUILDER OR OWNER - _ e 2'Cj�1An6 PERMITDATE: 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 le ping facility ll Feet Furnished bs�spe. idn �O(C qa- aO sa- t �B A3- aa.co a3- .A O 3 y ASSESSORS MAP NO: - .�� �." .� _�'�--PARCEL NO: y No.... Fss...... 0..:-' THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH y � TOWN OF BARNSTABLE nr ispoiiai Workii Tonstrnstiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .....,Ta_:�S2i 7:....-5 --------------------------------------------------- •-----.. ...----------.....-••-------..........------. /� / ovation-Address or Lot No. �rz Own r dress FWj .. l3 ll X....-.`�%d •Osl!�'cZ U!- ............ Installer ress Type of Building 3 Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------------------- ------- ------------------------•-------------------------•---------•...•-•••..•---- 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ a -------------------------------------------•--------------•----•----...........-----•......---------......................................................... 0 Description of Soil............................................................................... ....................................................................................... V ..........................................................•----....-•--------------•------......------------------------------------------------------------............................................ -------------------------------------------------------------------------------------------------------------------------------------------- -.................. U Nature of Repairs or Alterations—Answer when applicable.-.../006)...._. . --_.'_._, F�J�!__`__'__, .__LN �� 1I�16a S -----------------------------------------------------------•-------•--------------------...._.••------------...------------.....J�------------...................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia e has Peen issue the board of health. Signed . ......-. ��'i......... ......... Jr�....� Application Approved By ............. o ,�...�.c•-� -� v c1 - �f" �~Z...... Dace Application Disapproved for the following reasons- ------------------- --- -- ----------------------------- -------------------------------------------------- -- --------- ----------------------- ----------- ---------------------------------------------------------- .----------------------------------------------- ------------------- . --........... -------------------------------------- Permit No. -------9a3L..----]�/............................... Issued -------- ----. ------------......-- ------------.Dace........... Dace No......% _. _�y y F�$.......3..0.. .. THE COMMONWEALTH«OF MASSACHUSETTS BOARD OF HEALTH ,(,�.,� y 9 f(/�/� TOWN OF BARNSTABLE / / id App iratilan for Disposal Works Tonstrnrtiun Prrutit Application is hereby made for a Permit'to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: / ... .................•-•--•---•--.......----------- ..:..: e............................................. c�tion-Address or Lot No. Own Address ----------- Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......... _ __...Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No, of persons............................ Showers YP g ----------------•----------- P (---->---•---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. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) 1 PercolationI Performed pe suits d Test Pit No. r inch Depth of Test Pit.................... Depth to ground water........................ f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Wti.......................................................................................... .... ...........................................................---...... 0 Description of Soil----••---•------------------••-•-----.....-•-•-•------------......-•---••--••-----••-•-•••......••-- ..----------------•-------•-----------------......----•--•-- . x tM ................ ..............................................................•--•-•--------•--------•---....------..................--•--... -•----t`........t............_._•...•..� }� U Nature of Repairs or Alterations—Answer when applicable.-____-1.12(f/,)--_-. _;L_!-.. ._.S£ ��_ ifl.�,?�S76RS ,J i -------------------------------•---------------•-------•--•----------------------------------------- ............................ Agreement: The undersigned agrees to install the-aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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. Signed ------------- - - -- ------- - ..-----------_--- ..�n.�...... - ApplicationApproved B ....... ...�.-- ........... -------- -------------------........-....................................... --��>�te................. Application Disapproved for the following reasons.•- ...........................------------------------------------------------------------------------------------------------------------- r Date �a Permit No- --------- - ---- Y�- -................................. Issued `. Dale THE COMMONWEALTH OF MASSACHUSETTS' BOARD OF HEALTH TOWN OF BARNSTABLE TertifiratE of V IIntyli ante THIS IS 0 CERTIFYThat the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by............ ................................ --------------.......---... .... ..........--------------............................................... ............ ---------------------................. .......... at � � � �r� Installer ....lJ....................................................................................................................................................................................................................................... has been installed in accordance with the provisions of TITLE 5 o�The State Environmental Code as described in the application for Disposal Works Construction Permit No.. ...............off-...."....1..�f./....... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. -�-� DATE -- c ........................................ Inspector ...... .1_1-----.....---------.........------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��_�y( TOWN OF BARNSTABLE No.................... FEE.—... Disposal n k� Wnn��rnnr#Uan rrntit Permissionis hereby granted.......... ............................ ----......----------•................................................................... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo............................................................................................................................................................................................... J Street �y r. ,/./ as shown on the application for Disposal Works Construction Permit No.`_.o_(_..__.._y....___ Dated.......................................... '. -------------------------•--•-•-•---••------••-••..._ Board of Health DATE..................... ......................................................... FORM 36508 HOBBS&WARREN,INC..PUBLISHERS .ASSESSOR'S MAP NO. ' o PARCEL. L 0 C A'T ION S E W'A G E PE R M I T N0.i VILLAGE INSTAJLLER'S NAME ADDRESS / S UU ILL-DER OR OWNER DATE PERMIT ISSUED ��/ � DATE CO'MPLIANCE ISSUED /4wN, �G o -Jqf THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEA T c h of ....-..-04 S -- l- ' -�... 6 ApplirFation for Uiopootal Works Tonitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal stein `-r��1• ..... _.. ... ................................................... ....... ..�. , rc ................................... ..... .. - n-A�rdress/ or Lot No. .....�•• 4 W r.- ...--• ,lo..<. ._�1..1....46? ...................... .----------•--•---•----•----._._.....--•-------......--- / ner C Add4e a _ .._ C /_•- ------------------- -------------�S-�'..'..v !.�f._------....---------------•----------- Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-------_ ......... ......_.........Expansion Attic ( ) Garbage Grinder ( ) �a Other—Type e of Building ____ No. of ersons__________________________ Showers yP g --------•--.:._..--•---- P -- ( ) — Cafeteria ( ) Otherfixtures.------------------------------------------------------••----•----------•-•--•---•-•-•---•----•--••----•------....................................... 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........................................ Test Pit No. 1.................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ------------------------------------•----------•-------------------.••--------------------------------•---------------------------------------------------- 0 Description of Soil......................................................................................................................................................................... U •----•---------------•----•----•....•-•-----••-••--------------------•-••--•---------•---•-----•-----•-----------•----------------•--•-•---•-•---••--•-••------------------ -••-•••-•-----------•----- -------------------------- - --------•-------- ---------•-------•---•--------•-•------------•--••--•-••••••-- ---------------- U Nature of Re airs or Alterations A n a plicable._------��" .----•.._. .4 ._S_ C __ --- ------ Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 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 oard of healt Signed.-- - - -•- -- . ... .. .- ----=-�%:_l.�_.._'.� - ' D to Application Approved By.......... --••_ ----.... ----------- . .. ......... ate Application Disapproved for the following reasons---------------------•-------•-------•----------............... ............................................... ..-•-------------------------•---...-•-------------...--------------------•----------•------•--._...------------------------•-----------•--•-•-----•------•--•----------•---••------••••••----•--------- C Date PermitNo......................................................... Issued_....................................................... Date ....<"�...7 FPS . .. THE COMMONWEALTH OF MASSACHUSETTS t---E--� BOARD- OF H EA LTZ __..-..._................oF. ........... ..................... 1-- - --..................... ApplirFation for Uiopooaal Works Tonotrurtion ratnni# Application is hereby made for a Permit to Construct ( ) or Repair (e/ ?an Individual Sewage Disposal System at: _/.. �t ocat' n- dress/ ........... f or Iot No. ^...................... r _ ....._...._...-- ZZAddreisf ,c _ ._d .................................. ._.. Installer Address Type of Building �; Size Lot............................Sq. feet g— ....................................Expansion Attic ( ) Garbage Grinder ( ) Dwelling No. of Bedrooms.:..... a`4 Other—T e of Building .............. No. of ersons......................_.___. Showers —Type g -----:---=---- p ( ) — Cafeteria Other fixtures ------•-------------------------------------------••---------•-•-.••••. ( ) WDesign Flow.....................:..................:...gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.......7....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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 --•-----•--•--•-•--•-••-----•-----••••------------------•-----------•-•-------•--••-•--------............................................................... 0 Description of Soil........................................................................................................................................................................ x U .............................................. -••------------•-------------------------------------------••----------------•---............. .......................................................... --------------------------------------- ------ --•-------------------•---•------••---•--•----------•---- V Nature of Repairs or Alterations/—Answer-when applicable____..._ �� ��� . � � � '� ` ` r_ < ... >�' - t`J '......_.. ..� _ l lam' 't`r� J1 emu. -- rt ._. 1 - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of L I T L E 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. Idg , ..... xk- Application Approved B __...... .:. _ -----._. .��/sD{ .......... � ate Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- ...........................................................••-----------------------...------------_--------------------------------------•------•------------------------------------------------------ _ _ „2 Date fs Permit No.._---------•---- ..... Issued. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ; ....... ,f...i;:".'e7:r':�.. .......OF...... ....,f,,,,;,`,.........�..!�.... .............................................. Trrfifiratr of Tomplitanrr THIS IS TO CERTIFY, That the IAdividual .Sewage Disposal System constructed ( ) or Repaired (e�_. Y---•---•r! t Installer provisions ;T r 5 of The State Sanitary Co� as d abed in the application for Disposal Works Construction Permit No.___... r _ `` as been installed m accordance wrtn the rovlslons of T� PP P -- �---�--�--•--- dated-----�---�--- -------- ---------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION ATISFACTORY. DATE 7./ Z%l :CP. Inspector...... THE COMMONWEALTH OF MASSACHUSETTS BOARD�.OF HEALTH f. t ! .............OF...... '!. 1... ?...... ..r�.-._.r...................... K� FEE..../.....r.... • i Ropos al 1pprkn Cono elan rruni ` =`` ` :�•....''---. .._. .�--•• ...................................................... Permission is hereby granted...._..._ -:.'___.__..!..._. .. to Construct ( ) or Repair -a ...I • dual Sewa e Disposal System atNo............ .r 3 { .................. Street '�n / as shown on the application for Disposal Works Construction—Per-I•r-rit Now.r_._�`_ Dated..... ___� 1 •----._.. Z- r Board of Health ` DATE.............. = --•••--------- ... j cI `...... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - EL tGYJ 2 _ 5 L S MA __9 M h!. _ovc,P A 3�"MAX. /sT. A OX W 4 SuMP P• A ,B • %vv.3*57 G MAX• „ ► ► ° S,9xby 40AM 2 M/N, /NNH4 rNEf,/S�ieE p /� /a sroN� 9 . L . 2 coves, F . 4 'C _ 4 PVc ScH. 40 ,�vc LO M �,puL� , �w� scN:4o Pvc' 7.5 YR 4 /9 y g Io MIN. 14 /NY. 4. e 3 89 Iivv.34�z '. 3 •= � «s>- . , � • R 7^5 37�0 35•6} 3S,/9 ¢ 5 �.., © .. 3 • P G BED OF ,.,,�__. STONE STONE ' ¢ co (2} .�ODG,[ ACN C HAMBE4S 2 EFF. DEPTH ; `(' CRuSHE.v sin eke oa o- • L= C� d e p STONE O oy , , e e o GOA .. • -:. 5f1.S7'1NC- JDOD 6AL.. pRECA SEPT/G T�'JNK 410 't` S� C, S^T `�- -�`—' CLAY 4P/'90YE,0 SY T/TGE FIVE /NSPEC7-0R, 70 IZ'16 . •focrETs 807 MM of -M T P)T. 25' N07" : _CONTRACTOR SHALL REMOVE Aid- /A010CV/OL45 M,47ee/AL JV1 D/U/►' W MWIV THE S. 4-S- AREA AND S-' LA725R91-1-y !bOWN TD 77/E j o YR 8�4 SAn� c2 "SAN.b LAyE,C AT AORROX, �L. ZR 9 ANC 9EPL-4CE wzy Gz-EAI1/ WASHED. STONE , 4' C 4N C/L.4R `54ND IN 9ccogb W/TH 310 CM /s:2sS(3). Z l0 q [2) 500E AMBERS -4 13$•• LcL. ZS.S _ G.W- l 0 7' 6Vr��C -L> . SO%<S TES T 4 ATE -' Z-/Z-OZ S LS EVAL UATD �/o �v L.,E N .doY -. A I/fI D O� /�� PEA" V/EW of 5.A.s, EXG 1' �° N THS I-4N,,4 eeM,5 �f, PERC, /QATE 2 M/A/, PE,C /NGh! SCAT-C- J0' 1-5 TEX7?/ AL CLASS E PC AC So/ R ON y FL E Y, = 4/ _53 5011- 96MOML AREA SEWAGE sYs78M b6S/CtJ eAl-CG/LAT/OnIS �OC/7-mac- 28 PR®PosEA zs �/ s,,9• s. //O GPn 6� X -3 9-A MS. " 330 6l°h P M' -� 2. 1t'EhU/,ZF.b /NF/L Tif'ATYDN A�E,4 • �c ao �,risr/ �o 3 3 u 9?.D O. !¢ O/s F�G�9Y = 4-f6 S.F. ;f-P. _-3L o �� R/ N C, PREC l ST LEACH CNAMBE�PS --- q 3, USE TWO 2 SDO a -x--T---ems- ." ' - 38 W/TN 4' OF bOOBLC- WASHED STONE AeMlND.` X/ T 6°X /voo 4. /MF/GTRAVON A96 4 PRO✓/,'l aN - 20 SEPT/c 7-,fN I � a S/DES=�25'. (.G tSo)x SF �o X ' v . o M Al o � '� EX/sT/�YG .DEcK ..-' \ Q uiEsr SA y FlAl.AZ Ile, E�E1/ 44 Z 2 ti UI / Wiv_•. N PA /YCEL ltE9ERMn1, -• W ' Mo•23g71 "' /7, 77S N � e � �orf.�ECIS1 ER�•� E�� g S h ss�CHAI EN��� SE).t/�!G E SYSTEM UPGR.�! D E PL-gN W 3 ' PREPA�'E1� �iP wc,,� JOHN �-+ �^ bOYL'E.f{f .� �EDrf o0/vl 0lGs A,B�SO.�PT/ON SY 12 NI U DU7/� STiREE"T U No.33589 4 ' l% �9SsE5sD.es MAP //8 Pf�RCEL 44- _ ly��FCISTER�� �° SURD SB .S ZI7y .S TjQEE T 8A>�iVs T.9 BL E , MA - VT - rG��,g2 y sty LorZ S-CAGE-/"= ZO' FEBR�/AXY 8 , ZDDZ se'41.E /N FEET P o. BOX SYS W-F9�MOd77:1, M�9- oZ 57-¢