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Home My WebLink About0052 CAPTAIN STUDLEY ROAD - Health 52 Captain Studley Road Mdmtons Mills A 126 049 E - TOWN OF BARNSTABLE LOCATION SEWAGE # 3—13 VILLAGE In r ASSESSOR'S MAP & LOT_f 2-1-0V 9 INSTALLER'S NAME&PHONE NO. �- S SEPTIC TANK CAPACITY I LEACHING FACILITY: (type) (�Cktr r� (size) PT'Y2 k-2 I NO.OF BEDROOMS { BLUDER OR OWNER G L VIA PERMIT DATE: COMPLIANCE DATE: 13h3 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) y" Feet Edge of-Wetlan j and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by s/oOJ1o.f(S /d /l C� S�t� �CJa�j'�j•W} �g d I Z-q BOA A �► L? ,33 cel r� No. 2oa �` �J THE COMMONWEALTH OF MASSACHUSETTS r FEE BOARD OF HEALTH ` ff1wN CIF MA-2fro.yl M��i t �g.¢.t iv1T.¢P,LN� APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade Abandon ( ) - [-]Complete System Individual Components 5�L c�rs,q s764ey lt,06C-.A-7 6:44ff, Location Owner's Name Map/Parcel# _ ( Address Lot# Telephone# Wirc-��J--t /1.0- /e_Z- 10 f*4jroN Installer's Name Designer's Name $09 tN s�I S,;r6 0t1--,—x_gnL0 Address Address �soe��6s-,79 t3 ��°B) 4��-t 9 4 Telephone# Telephone# Type of Building: ILCiipev r/.l L Lot Size Sq.feet Dwelling—No.of Bedrooms 3 eY.tJ 7 Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) 0 gpd Calculated design flow gpd Design flow provided3 3�4J gpd Plan: Date `� 3 Number of sheets Revision Date Title -t-.)6S�"FA- C "` VC oif/Oj-o-L S 1�I7 Description of Soil(s) d'-"da e e r•,-"-` Soil Evaluator Form No. Name of Soil Evaluator ,0-Ja h'''s z" Date of Evaluation >/ DESCRIPTION OF REPAIRS OR ALTERATIONS �'0�'f LEe�ffitt(i ,7 0- The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to Or the system in operation until a Certificate of Compliance has been issued by the Board of Health. / ) Signed (�✓° C. Date �'t= 9aH , Gw y�� Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM S/96 LL t No. Dd 3 "1 J3 THE COMMONWEALTH OF MASSACHUSETTS + FeE / BOARD .OF HEALTH r~ TDw1�°• OF M42Irv.vl M�cc.t ��¢�nf1T, I+4�� APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION,;PERMIT Application for a Permit to Construct ( ),Pepa r ( ) Upgrade (A Abandon ( ) - ❑Complete System ®.Individual Components frt [�ppTA/nf ST/1SLE y �,.d//�F+f/YIyrJ �"/Lt,j /Ly 6 E�t.T G.[-�'f HM 6 Locati1� �5�•� Owner's Name 7 ) Map/Parcel# Address Lot# Telephone# 6.J'cc./•4�"+ s/.o cvEY LY¢nt/F� Jo/ ;NtoN Installer's Name Desiggei=s Name 801 &41A1 ST s.�rE of 0 LC Address Address roe 26s-,7183 (,�°e) ?1-0-t904 Telephone# Telephone# Type of Building: C)IIJeN r14L Lot Size Sq.feet Dwelling—No.of Bedrooms 3 E7.td 7 Garbage Grinder ( ) Other-Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required)J10 gpd Calculated design flow gpd Design flow provided-7 34S gpd Plan: Date 41-)/a 3 Number of sheets / Revision Date Title 1-a6S.+o%i.4 t e' S'r —+I-e 4011/0f tl f 11re— pp Description of Soil(s) d�;t•f49t ° A4 o —lam'a i Soil Evaluator Form No. Name of Soil Evaluator b Jo ff''s a N Date of Evaluation /o/o2 DESCRIPTION OF REPAIRS OR ALTERATIONS L'f Cz 6o-�ffiw'G . OF The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the Board of Health. Q�T Signed lam✓ 4_%, Date Inspections 43 1f 1 FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 __._- —NO Ut) r,— —_,..----__-- _—..,..— >,y,.. ---— —L-.— -,— _— __- — ... — --- --- �� THE COMMONWEALTH FEE ,WEALTH OF MASSACHUSETTS ✓(`7 9C� ^/fi 6 BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: ve at r c- (PU has been installed 'n accordance wit the provisions of 3 JO MR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No.')063 dated Approved Design Flow (gpd) Installer II 14 li!'vL� Designer: �)CA^ :�v �/I r? Inspector .5 Date 03 J 3 IF The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No. �VU 3 r19 THE COMMONWEALTH OF MASSACHUSETTS FEE 1JF��fyUJp BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at C /VI m.; as described in the application for Disposal System Construction Permit N0. dao-0? dated Provided: Construction shall be completed within three years of the date of this permit.All local c nd' ton must be met. Date l Board of Health A^'/ FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) SW HOBBS&WARREN rM PUBLISHERS- BOSTON r TOWN OF BARNSTABLE LOCATION 5 C0 P 4,10 c( e SEWAGE # 2Q 3 IV 3 VELLAGE--g=" di��/ ASSESSOR'S MAP&MT -0 INSTALLS!NAME&PHONE NO. S SEPTIC TANK CAPACITY. LEACHING FACILrI'Y: (type) U 6 t ki-40 (size) aS-X/2 k2 NO.OF BEDROOMS BUILDER OR OWNER �✓��wt PERMTTDATE: COMPLIANCE DATE: 13 03 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-Wed-aW and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I AC-3 ® &B j C,4 aJ i .� o 0 • STLS/Ol NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM hereby certify that the engineered plan signed by me dated 9 1-4,03 concerning the property located at 5,1 6s PrafN sruoLey /tO, ;4'�7-0-Vi f" cCLJ meets all of the • - following criteria: — • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as.CLASS I and the percolation raie is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable)* Please complete the following: A) Top of Ground Surface Elevation (using GIS information) B) G.W. Elevation eft y adjustment for high G.W. 0 6114*1 - q _ DIFFERENCE BETW ZN-A and B a1 ec F"=i` sv ( /ZIT' 3 4�, tcg✓Yt� SIGNED : DATE: NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. o- q:health folder:perceunp L^O CATION v� S E W APE RMIT NO. t 306 All �s VILLAGE c7�� INSTA LLER'S NAV i AD.0R,ESS JOH.N A. fit== ,BAW20E StrN►Lc 1.7{''�A/'+Trtitlfi�Yno West Ba BUILDER OR OWNER rd vH Sz s14 1 DATE PERMIT I5rSUED DATE COMPLIANCE ISSUED ��- � � b , ��y �'� " � y_ `�� - H \ � 6 4 \ `® � �.�. � � � �, �, � 3� 1/3 No..46 298- v Fi&$..........6....�'.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HF=ALTH a .--------�'PL?� !?1-------------OF...... iyh ;F ..1. Appliration for Eli4pos al Works Tomitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at S _ ._.. .....- ................--........-----.....---L -- ... ......... ----------- oca nAs ---C .................................... ....... or O ner Address ................................... - w � ••••--••---•---•.............. s • .. Installer Address �/ Dof� Type of Building Size Lot-----__.__�____________----Sq. feet U Dwelling—No. of Bedrooms......... ...................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons___-___._•__•__--_•-___-___- Showers — Cafeteria Q' Other fixtures ...................................................... 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GTq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------------ ....... ............................••••• -f--------- ------------------------------------------------------------ 0 Description of Soil...........................'#x� jCr�r- tt/c?� 1. - ----------------•---------------------------.............--- V ---•••----•- }` ------------------------------------------------------------------------------------------ ,- ee U Nature of Repairs or Alterations—Answer when applicable______/fit 3____�j__ty_!✓ _j"_ . ® __... ...... . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be iss d by the bardkolicalth. Signed-----•-• • •....--••• --- -------------------------.................. � -"..3� �"....... . Date Application Approved BY = '� `..... ---. ....... Date Application Disapproved for the following reasons:---•----------------------------------------• ------....--------------------------------------..._._....._------ •••••••••---•••-•-•-••••••--••••.....••••...--••-•••-•--••••••-••••-•••••••-••-•--••------•-•••-••-------•-••-•••--•••--••••-----•••------••----...................................................... Date PermitNo......................................................... Issued_....................................................... Date No..* a:: ?$... �. Fims.......... 1........... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........7Q.911--.44.............OF...... ��'. .5..!�,? .+�'........................................ Appliration for Disposal Works Tonstrnrtion Prrmit Application is hereby made four.a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 5-2 Ce ?_� s/c, 1 - .... �L�oca.t n-Address or.. K..s..%°.........................•••-•-•---•... ..._... O er Add ress Ifar j5 T�l,� Installer Address Type of Building Size Lot.....-_l�l 004-)----Sq. feet Dwelling—No. of Bedrooms.........'."..............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' 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........................................ 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........................ .................................................. ......_.._.......---• -- ........................................................................ Description of Soil........................... �t�(j. i4AO !_ ^'----------•---•---.....--------------------------------------- V ..................••-••----•••--•--........-•--•-•------------•--•..............................••---•--------------------•---••-•--••-------•-•---•-••-•----•----•----.........-•------•••-------•..... W ............................................................................................ ---.....� !..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITiL- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee iss d by the bo rd o health. u Signed........ ............... -.....................--..................... .......................... y�✓'� Date Application Approved BY -----�_- ._ . �_.. ' ,:y4 ............................. .... ....... Date Application Disapproved for the following reasons: ---------------------------------------------------------------------------••-•----•--_..._ -•-------------------------------•-----------•-................--•-•----.....---.......---...-------•-•--•........------•.------------------------------------------------•--•-------•--•••-•---------- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trrtifiratr of Tomplianrr THIS I TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY -<...... -------------------------------------------------------------------------------------------------------=-------------------------------- _ y Installe has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..---.-. 79--------- dated--............................................... THE ISSUA E OF THIS CERTIFICATE SHALL NOT BE CONST D AS A GUARANTEE THAT THE SYSTEM WILL U CTION SATISFACTORY. DATE...... ...'..�..:.....v----------------•--•-•----•------•---....------ Inspector ------. THE COMMONWEALTH O CHUSEtTTS BOARD OF HEALTH OF.........................................................................;.......... No....�: :.>.2.f0 FEE....................... Disposal Works Tonstrnrtion Uprrmit Permission is h reby granted............Rividual ....... -- ............................... to Construct ( Vr Repair ( ) an I Sewag Disposal System - at No. � S' Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... BoariJ��Flea']th - DATE----•-------------------------.e" _-- 7,5 - ................... FORM` 1255 HOBBS & WARREN. INC.. PUBLISHERS I.W . JiL IF _e� �� No � ............... O SSATHE C HUSETTS BOARD 9F HEALTH ,,, I _... ... . ............OF....... -. a,."". ,G/.....'--......................... Applirotion -for 43i,spoottl Works Tonotrurtion Vrrntit . Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location- ress or No. 6 comer Address t .......................................................... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms....:-------Z----------------------------Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. •of persons-------�---------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ____________________________ W Design Flow..... ?_................................gallons per peison�yr d�Py. Total d�ily f�ow...._.__.__ _®®___________-_---_-_--g`llo s. WSeptic Tank—Liquid capacity. 00-0_gallons Length__ ___"6_ _ Width_ e._.. Diameter________________ Depth_�4_- 7`1 x Disposal Trench—No- ___________________ Width.................... Total Length------- __.____-- Total leaching area--------------------sq. ft. Seepage Pit No......./___.__.____ iameter._._..F.......... Depth below inlet.... Total leaching area-_ � _____sq. it. z Other Distribution box (I/� Dosing tank ( ) ` Percolation Test Results Performed by._f�__ V 4__-__Z_4�_94A7f____________________________________ Date..._.4-1— __-_-_______---.. a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water---------............... �14 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water.........-..------------ W ------_-•--•----- ------------ _._ . O Description of Soil.....S��_____-_�`L - ----- T V --•------------------------•-------------------------••-•--•-----•--•-•----•------------••------•----•-••-•----•-••--•-------•••--------•----------•----•---------------•--•---•------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 Article NI of the State Sanitary Code— The undol7igned further agrees not to place the system in operation until a Certificate of Compliance has been • e rd of health. igned--- •�- - ••--•- •--------••-•••----•----------•--------•-------• --------- %-- -- Dat ` Application Approved By------------� ------- 7- Application 5 — 7 Application Disapproved for the following reasons:------------------------------------------------------------•--------------------------__ Date_-_____------- ---------------------------------------------------------------------------------•---•------------------------------------------------------=----------------------------------------------------------- Date PermitNo......................................................... Issued........... ............................................ Date •••......•.•••......•.•..........r....•...•........................................•...........•..• ...••••.••..•.....•...-.< THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT .......� 2.........O F......... Trrtifiratr of (I'ontpliatta TH I TO C RTIFY, That the Individual Sewage Disposal System constructed ( Repaired ( ) by1.. -or-- -- ------- -- -------------------- ---------- ----------•--------------- ,y In a er _ ---- -•-------- --- has been installed in accordance with'the ovisions of Artilp� I of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._."_.___...._- Q..�r_._.___.__. dated-.�___ .`1 �/.:7/X7:.7_C................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... ............................................................................................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 3 Q (o ...........OF.......... .. .... ...................... No......................... FEE•Id Bi-spolitt rk notrurtion Vamit Permission is hereby granted__'_... _ _�- _.1�---`-------------------------------- - ------------------------------ to Con str t �or R it ( ) iv al Se Dis oral st - at Street as shown on the application for Disposal Wor s Construction Permit No..................... Dated----:771 7 ______________ -------------------------------------------------------------------------------------------------------_ Board of Health DATE................................................................................ FORM 1255 H0813S & WARREN. INC.. PUBLISHERS No.. .. Flzs......,......... ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ...G`7�/1.. ._.-.....OF......... .......................... Appliration -for Ui.tipoottl Works Tonitrnrtion Prrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: � r �---••.......-TrJ/b J ✓�ex_r........... �.�_ �_!.:__�LL_LLS_.......----•-. /✓ Location dress or Lo>N�. _ - a /� T-'QU� yK+erAddress ............ ............•-----............------•••-----•-- .... .. r ......................................................... Installer Address Q Type of Building Size Lot____________________________Sq. feet U Dwelling No. of Bedrooms............: .Expansion Attic Garbage Grinder aOther—Type of Building ____________________________ No. of persons.-_-----�?/--------------- Showers ( ) — Cafeteria ( ) Otherfixtures -----------------------••-----------•------•--------------------------------------------------------------------------------•-----------•---------•- W Design Flow..... ?-------------------------------gallons per person �r d y. Total dailye ow.....__.__._�00........___..____.__gallons. ep WSeptic Tank—Liquid capacity-AQ0v_gallons Length__E_`__-X___. Width:_.. ....... Diameter................ _ area-. x Disposal Trench—No_ ___________________ Width._.........__.__.... Total Length___-____- ____._.. Total leaching area-............__._...sq. ft. Seepage Pit No--------1........... Diameter...... Depth below inlet____________________ Total leaching area...-�.._.sq. ft. Z Other Distribution box ( k< Dosing tank ( / ~" Percolation Test Results Performed by. ................................... Date-___. 1-G :7C Test Pit No. 1................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water _.-____-_ G14 Test Pit No. 2........:.......minutes per inch Depth of Test Pit.................... Depth to ground water..............-.-_-_-._. 94 ---------------------------------i- O Description of Soil__.... �C_.____.75_T__ T"_._.. U W x •••------------ ------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------- V 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 Article XI of the State Sanitary Code— The under- •gned further agrees not to place the system in i ed operation until a Certificate of Compliance has been th" and of health. g ------ / J q Date Application Approved By.__._...V.r' _........ .�l 7- S'-7G �� - u 7-------------- --------------------- ----- - -- Date Application Disapproved for the following reasons-...................................=-------------------------------------------------------------•---•-••---••_.. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........71. . .........OF......... ... .. .. �...� ..........'................ Trrtif irate of Tontphattrr THIS IS TO CEWTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) y-- Z2V.0 Jk Z.) - -- -------- Instal r / [/f /// at-.-,:�i•l ---�° --- U ----_---•- tcG---- � ��I- � s��`=� <:�arc-�4 �i r..... !ll��'..�..------ has been installed in accordance with the provisions of Arti G II of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.-. 0-.3,)- ;....._.._.. dated-- --•�- �� C THE ISSUANCE OF THIS CERTIFICATE SHALL PLOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................................_-- Inspector------------------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS d BOARD OF HEALTH C' � ........ OF D ....... e � -9---_--------- No.-•--......................... FEE---/ ------•---- DinVo. ttl , or�kry T{{ omitr urtion rrmit Permission is hereby granted........ �c _-__ _ ---------------------- to Constr et P7, -- s ) or Re,•air / an I divkfual Sewu �Disp sal y to l `� �` 7 P� ( /) f g r at No._r-�_ 4, �3......C%..... .--•-- t G ff G1, �i - - ----•-- �- ---r•'-- - Street ,� as shown on the application for Disposal Works Construction Permit No--------------------- Dated_-_.7 ,=� .";L�1_._._........ ---------------------------------------------•---------------------------------------------------------- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 1 j /30 07 T /,3 � N v Fov.JoATi o� p i O I v N w N J tq �. /P= .32 03 D • 00 G- 3S u1 C � P 7 s 7- 41 ,0 CERTI FLED PLOT PLAN LOCATION' 0 /?spZo ,5 WI,4 5CALE: � = 30 DATE-V -421C -dxl-9 V' REFERENCE: .Ok-/,04 .407- 1.3 9,5 �/ c9 >,v o,v ems■A.c� �ooif z7y f�A� F 3 Irk- c ozo E-,v A y ,a A,fx) 437w a,4 6 R'kz;is rIrr D A E I HEREBY CERTIFY THAT THE BUILDING REG. LAND SURvE OR SHOWN ON THIS PLAN 15 LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT �1-20A7 � CONFORM TO THE `NofM,�ss' ZONING BY - LAWS OF THE TOWN OF ;7-- WHEN CONSTRUCTED. �^ b L JOSEPH M. .. MONAHAN,JR. BARNSTABLE SURVEY CONSULTANTS, INC. WEST YARMOUTH MASS . CpN� SURv�y 4 f j 1,3 0 7 i .� 0 7" 3 v �OU.JDAT/ o� ' v ti 14 N 7015f % N y�a� p>r D O - -� CERTIFIED�� PLOT PLAN L-O C A T 1 O N- A4/I^/7 ,5-rO Z.4 L -� SCALE: . / ,z 3O" DATE REFERENCE: .407" /3 FIBS �yOuJ,v oAv IVARAI ,800/f z7f PA4 A4." 3'y C o2,o ,F-A A 7- ,Q?9RN 37W AS A G /.S Tl?r QL � ED� • ��r� D ATE i HEREBY CERTIFY THAT THE BUILDING REG. LAND SURVE ( OR SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT .,r2tog5 CONFORM TO THE OFM�ss�cyG ZONING 6Y= LAWS OF THE TOWN OF gh,?,U s f&CgA E-W H E INC 0 N 5 T R U C T F D. JOSEPH M. j MONAHAN,Jet. y BARNSTABLE SURVEY CONSULTANTS, INC . /<C01STE�yo� WEST YARMOUTH4 MASS . N� SUR��'