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HomeMy WebLinkAbout0065 ALTHEA DRIVE - Health t z c , '4, J •. - � , '. a � s.q. ,. ? .. . a - d J r n r d _ i �► - 333 FFB 2 1999 A 5— TROY WILLIAMS L - 2 SEPTIC INSPECTIONS Certified by MA Department of Environmental Protection (508) 385-1300 19 Hummel Drive South Dennis, MA 02660 OF%, COMMONWEALTH OF MASSACHUSETTS j EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292-5500 TRUDY CORE Secretary ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property 6 5 'q1 t4 eo, D11,Pr Address: Name of owner -I"y v'c!� �`^. Address of Owner: P.D. (3 oX 43� Date of Inspection: / /a 8/' 9 Gv „H y u r IL/ /.4 CA . Name of Inspector:(Please Print) Troy )Mlliamc / 02 G 3 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: Trny wiliame Septic Inspections Maaing Address: 19 Hummel Drive So Dennis MA 02660 Telephone Number: (508) 385-1300 CERTIFICATION STATEMENT I certify that 1 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspectors Signatures _.�/rray �.r-G C c.Gvwl, Date: la e The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS revs ;r j q SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (contirx+©d) Owner:Prop Y Add�eSs. 65 Althea Drive, Cummaquid,MA Date of Inspection: Keith Parsons January 28, 1999 INSPECTION SUMMARY: Chock A, B, C, or D: A. SYSTEM PASSES: have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 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 re ced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass. Indicate yes, no,or not determined(Y, N, or NO). Describe basis of determination in all instan s. If "not determined", explain why not. The septic tank is metal,unless the owner or operator has provided the stem inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within t my(20) years prior to the date of the inspection;or the septic tank, whether or not metal, is cracked,structurally uns nd, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the exi ng septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static wa level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distri tion box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s)ar replaced obstruction i emoved distributio ox is levelled or replaced The system required p ping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with proval of the Board of Health): broken pipe(s) are replaced obstruction is removed revised 9/2 /98 I'agc2ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 65 Althea Drive, Cummaquid,MA Owner: Keith Parsons Date of t—p—ti(n: January 28, 1999 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 ' the system is failing to protect the public health, safety and the environment. 1) SYSTEM W1LL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEAL AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetl d or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF EALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PRO CTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic to and soil absorption system(SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface w er supply. The system has a se c tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a ptic tank and soil absorption system and the SAS is within 50 feet of a private•water supply well. The system has septic tank and soil absorption system and'the SAS is less than 100 feet but 50 feet or more from a private water upply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is fre rom pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 m. Method used to determine distance (approximation not valid). 3) OTHER revised i 4g Page I of I I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 65 Althea Drive, Cummaquid, MA Property Addres:: Keith Parsons Owner: January 28, 1999 Date of Inspection: D. SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: have determined that one or more of the following failure conditions exist as describe in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to deter ine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due-to an ov oaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the groun or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outl invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below nvert or available volume is less than 1/2 day flow. Required pumping more than 4 times in a last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorp 'on System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspo .or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a c spool or privy is within a Zone I of a public well. Any portion a cesspool or privy is within 50 feet of a private water supply well. Any p on of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acc table water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for iform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria abov The system serves a facility with a design flow of 10,000 gpd or gr er(Large System) and the system is a significant threat to public health and safety and the environment because one or more of th following conditions exist: Yes No the system is within 400 feet of a surface d king water supply the system is within 200 feet of a trib ary to a surface drinking water supply the system is located in a nitro n sensitive area (Interim Wellhead Protection Area=IWPA)or a mapped Zone 11 of a public water supply well) The owner or operator of any such syste hall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further inf mation. revised 9/2/98 Page 4ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 65 Althea Drive, Cummaquid;MA owner: Keith Parsons Date of Irupection: January 28, 1999 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yesy No �/ Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped-for-al least two weeks and-the system has been•receivingnormal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. yC _ The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: Existing information. For example, Plan at B.O.H. _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 115.302(3)(b)) V/- _ The facility owner(and occupants,if differeni from owner) were.provided with information on the.properinaintenaace-of Subsurface Disposal Systems. revised 9/2/98 Page 5of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: 65 Althea Drive, Cummaquid,MA Date of Inspection: Keith Parsons January 28, 1999 FLOW CONDITIONSRESIDENTIAL: Design flow: //Q g,p,d./bedroom. Number of bedrooms(design): 3 Number of bedrooms (actual):3 Total DESIGN flow 330 — Number of current residents: Garbage grinder(yes or no): ND Laundry(separate system) (yes or no):Ak); If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use (yes or no):_&U. Water meter readings,if available(last two year's usage(gpd): / = 76,00d C dOO"� r //cr-.S Sump Pump (yes or no): jVo Last date of occupancy:_ l�7, COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: apd ( Based on 15.203) Basis of design flow Grease trap present:(yes or no)_ Industrial Waste Holding Tank present: (yes or not_ Non-sanitary waste discharged to the Title..5 system: (yes or no) -��Z Water meter readings,if available: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of inforlmation: �0 a�v�- .7 na n System pumped as part of inspection:(yes or no)_Nv If yes, volume pumped: gallons 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) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed W known) and source of information: � s �c_ //�cA Sewage odors detected when arriving at the site: (yes or no) A'O revised 9/2/98 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(contimsed) Property Address: Ownef: 65 Althea Drive, Cummaquid, MA Date of Inspection: Keith Parsons January 28, 1999 BUILDING SEWER: (Locate on site plan) 8 /r Depth below grade:_ Material of construction:_cast iron/40 PVC_other(explain) Distance fromprivate water supply well or suction line AJ // Diameter Comments: (condition of joints, venting, evidence of leakage,etc.) All .o S v Crt. /� c-(u' 4i ah i o SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction:-t/concrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age ls.age confirmed by Certificate of Compliance—(Yes/No) Dimensions:_ S g .)e/ Sludge depth: !' Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: ND/t/t -ft -/­�.., l�7-r• Distance from top of scum to top of outlet tee or baffle: 6 Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: Pr%,h e Comments: (recommendation for pumpin condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structureF-irttegrity, evidence of leakage,etc.) -..e-* fit` y p,_ e� /, w: T 7.Q h,A L s, w'o r�-c ti S u re�ee� /t7 c or,� way/.( 5 6 7c C� �-•• oL_ 6� ✓� `p c� /VO T / !�d I7n 4 6 .t- --Tz", k— G.JQ S h c) 4- GREASE°TRAP: (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass _Polyethylene o er(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: (recommendation for pumping, condition of inlet a outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of'leakage, etc.) revised 9/2/98 Page 7of II SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (corrtirwed) Property Address: Owner; 65 Althea Drive, Cummaquid,MA Dace of Inspection: Keith Parsons January 28, 1999 TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass_Polyethylene_other(ex in) Dimension • Capacity; gallons Design flow: gallons/day Alarm present Alarm level: Alarm in working order:Yes No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float itches,etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: /� Comments: (no -if level and j isIdbutio n Is equal, evidence of solids carryover, evidence of leakage into or out of box; etc.) — b SA 0 AL ✓ o a✓ cr, V A .N S�/JA��CJN r PUMP CHAMBER:_ (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order(Yes or No) Comments: (note condition of pump chamber,condition of pumps and ap4s. etc.) revised 9/2/98 Pnge8ofII i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) O Prop"f: Address: 65 Althea Drive, Cummaquid,MA Date of kispection- Keith Parsons January 28, 1999 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible: excavation not required, location may be approximated by non-intrusive methods) If not located,explain: Type: / 1 leaching pits, number:-c . leaching chambers,number:_ leaching galleries,number:_ leaching trenches,number,length: leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note cQ/ndition of soil, signs of by raulic failure,level of ponding, damp soil, condition of vegetation, )etc.) L• l !-.( —u J ti Ti+ .� Ca..-�.c� Gi,n o+� ..:5�Lr C. L.t ti L r. r w4 'A v CESSPOOLS:_ (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic;failure,Zlevelponding,=conditionof n, etc.) PRIVY:_ (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, c dition'of vegetation, etc.) revised 9/2/98 P2ge9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(corttirued) Property Address: Owrwf: 65 Althea Drive, Cummaquid, MA Date of'pe —: Keith Parsons January 28, 1999 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) f•Jo-->t w � H� T Pee- K �;DUy.�IIoN Tu,•.4C 3 3" yy" s3 'Cl,, a-r3ox revised 9/2/98 Puge 10 of I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(con&,,ed) Prop"Address- Owner: 65 Althea Drive, Cummaquid,MA Date of Inspection: Keith Parsons January 28, 1999 NRCS Report name IV1119 Soil Type_ Typical depth to groundwater USGS Date website visited A/W.1 Observation Wells checked 2 amr C- Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater.?q Feet Please indicate all the methods used to determine High Groundwater Elevation: ` Obtained from Design Plans on record Observed Site'(Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps .f Checked pumping records Checked local excavators,installers VUsed USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) ) Yt D 1�0.�<.✓ T".r�.. �Ta,^v.i i S c�. t S C�r0.�h. Gam. H.. In Nn./ I^-, -G�✓v/o c h 9 YA.c�.s, O/e /6 4- 4-It r.�, /J � � (� c��,-o,� r df W N-f t✓ �t-.:J t I l�/✓�v'r._vl w1 w:?�G/✓ /v�-�s S /i o� w.. J s✓ GtpiP ✓a k 7. Q r. Gi r G�-- .'7/ S o T e S ��7 Sc /f w � �dct/�✓- G7 revised 9/2/98 Pdgr II of II TOWN OF BARNSTABLE J�J' LOCATION C2 �Q/�"/ IM a� SEWAGE # ( — VILLAGE ASSESSOR'S MAP & LOI;J`�a0z) INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size)000 NO. OF BEDROOMS PRIYA,,TE WELL OR PUBLIC WATER BUILDER OR OWNER All vs 06 DATE PERMIT ISSUED: pZ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No II Lp �T Grl- �� � - A N �, o. Fps. .. -.............. - �� THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOARD OF H E A LT Hoarnstable Cons etioon o� apartment .............. - ...-....oF............. �i � 1T..Aa Appliration for Diipnsal loorks Tonutr .r rrm Application is hereby made for a Permit to Construct ( L*10"or Repair ( ) an Individual Sewage Disposal System at• to 5, Z� ......... .....__....A :t:��- ...... .ax...... -v?vin ........--------------------•-------------.. .....--••------....................... Location-Address or Lot No. .......�y.. .t.� .......................... ...._._.._.._..._.._......._.._ Owner Address W Installer Address 43 6 0 r Type of Building Size Lot.-_.___._w.................Sq. feet Dwelling—No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures .......................................... W Design Flow_____________________ .._.........__--gallons per person per day. Total daily flow.........................3 ........gallons. WSeptic Tank—Liquid capacity/00--gallons Length---------------- Width................ Diameter................ Depth................ Disposal Trench—No..................... Width............. Total Length.................... Total leaching area........ _ s ft. --- -Seepage Pit No----------- ------- iameter......... -_..-. Depth below inlet........6........ Total leaching area..... _._.__ ..sq. ft. z Other Distribution box ( Dosing tank ( ) Percolation Test Results Performed by.... � ___�`_____________________ ................ Date-_-________..__ _.�/ Y �P aj Test Pit No. 1........ .......minutes per inch Depth of Test Pit.....��_______. Depth to ground water.........._......... G14 Test Pit No. 2................minutes per inch Depth of Test Pit................. Depth to ground water........................ .-- --------- ------ - Descriptionof Soil-------------------------------------------- -------•- At'-�- ............................................................ x /D ?� f?9 .....FAJ�S..................................... UW - --------------------------------------------------------------------------/l/' ---------- M �i�cl -----�. ........................................ 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance as be iss d by the board of health. J Signed .. ...... - .. I -------------- ------- ------ -------..---------..... -------�f °dam . f _ Application Approved B Da[e Application Disapproved for the following reason ..---.---_----.I....--....-- -. Date Permit No. .. ....... Issued J Date No.. .... �-.__ --•`� Fps. �_.............. THE COMMONWEALTH OF MASSACHUSETTS _BOARD OF HEALTH ................... ?dUl ........OF.............. ra.l�ST.!, .(F........----------.................... Allp iratiun for UtipusFal Works Tonotrur#tun rrmit Application is hereby made for a Permit to Construct ( L_j'/or Repair ( ) an Individual Sewage Disposal System at• , .........................4:1.1� :... ?i �YV{MAQ1••(A Z j • .......... ........... ........ ............. ...............�..................- .... !a fi>,{ 1 ) �.Location-Address or Lot No. 1. .......f_t... .... - . ................ Owner Address Installer Address (� / �j Q Type of Building Size Lot....`_.__i_____________....Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures W Design Flow....................5.........r......._..gallons per person per day. Total daily flow.............__.........3•3P.........gallons. WSeptic Tank—Liquid capacity....?..gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leachingarea........ _..._ ,'sq. ft. x . P Seepage Pit No----------- Iameter.........�Z Depth below inlet_._..._........ Total leaching area..... J.... -.sq. ft. Z Other Distribution box ( ") Dosing tank ( ) &.)-V ;20...mac-. ��'G.GL� Date----••......•..- /�—�G Percolation Test Results Performed by................. .. -._-----.--_ _ �`.._._____.___..__.. i.•..- 77 ,.� Test Pit No. I...............minutes per inch Depth of Test Pit_.... ......_. Depth to ground water..._...............___.. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------------------------- -------• r . --- ------- ---••--------------------------------------.-- 0 Description of Soil................................................. � - --�••-�l1!..----------------••---------•-----------------------•-.---•- V ` ..........................-...................................................Z�.'_..2z- 1.... YD T�IJL ,o ud 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h1as been,issued by the board of health. Signed —�4u ...A/z ,)n<-'s' i- �.------- -------------- ---- -------------------- Application ( � t Dace Approved B /.fi............................... - �.... ''-'�---=---= ------------------ pP Y = l • Date Application Disapproved for the following r asonLl-------------------- --------------------------- �.. ............................................... T, -------------------------------------------------------- r ) �� .�•� / f Dare Permit No. --. ..-C---------------- �/-------- ......... Issued ..--------1 1-�`.. E --------------------- Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH vz"-I OF ;Jr,,���at ..................................... ---------------------------------------------------------------------------------------- C�e>`#t�t�ett#P u� C�o�t�Itttnce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed.( or Repaired ( ) bti..i 3 li• i. .. -------..................... ------....------........................................ Y , Installer at ........................................ . -------- ........ ............................................................ .. ------------t--- ------........... --- has been installed in accordance with the provisions of TITLE 5,0f The Stat yironmental d es4ped the application for Disposal Works Construction Permit No. �_ 1.. ._�..----_-_. dated ...C - ---U-I y:, THE ISSUANCE OF THI CERTIFICATE SHALL NOT BE CdNSTRUE Ar UARANTEE, HAT THE SYSTEM WILL FUNCTIO S IS y CT Y. DATE---------------------------------------- ----- ----- ............ ----------------------- Inspector ..................--------...------. ---------------------------- THE COMMONWEALTH OF MASSACHUSETTS L; ,�J ........'.............................BOARD ®F HEALTH r_ 1 /1 No... .-'•� ...... FEE.J ......a........... Disposal Works Tuns#rnrtiun amit Permission is hereby granted......... ......CX1,`'. `. to Construct or Repair ( ) an Individual Sewage Disposal System i at No.... • •...... �... ,.................t..... +� �'t �� c�i;, . C.u rb1 VL n �, , I .. ...............•......---.....--.-•-----•--... >-: Street i�j__j as shown on the application for Disposal Works Construction Permit No..,.-,,,S __% fDated.......................................... ---------------------------••-••••••••• •-- - .............................................. oar of Health DATE `3 --. . ----� ...................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS f . `5�161-� F=�ti1iLY 3 - BE��t✓t� _ r No. 6A05AC,E 61?ltJDETZ SEPTIC TAtJV- 310XISDWq 49S IP - - I o 06 G,A tr4 or. SEA P F DISPo;A _ PIT loon h,4(,�3�SToNt: 51DEVJdc L. ReA .22� sF LOT zq eA T,)tz.1\/E 'OOTTOM A = 113 SF CUM wt A QUrT':� TOTAL VE616u. = 546 , 'TOTAL DAILY! rLov -----...__.'PEP_ca[,AT7oN �_eATE:;-I"IrJ:4�It►J.��L�SS_ _.._ . .. .'.: . .: ._ ._ __. :.... c t A n PETER SULLIVAN No.t '29733. E . ;� E�OLtr': Z /1-86 TF _. ; 77, 7-77T.777 --�. rI _ �qOd. 4 2 [fit;: GQL 97 r - L' - 1'1 j -- sTo�lE CErc�TIT—I© PLOT- PLd� �fo:lf/A � �� `� ..PLAN_ , ���RF.�JCE• 1 c F12TI c�AowN kE,2-eorJ _c.o :1JIT14 7-F-- TnJE :`MWN o f i3TJ2tJS7'AP g� �` �✓A X'�Ei� �• N��E (I� FLA - pSS�orJd� tAu�-5uev��oz5 -T�IIS � IS NOT �3A�i© SuRalc`f;- A►JD TNT o ,ei"S DI. AN .(t .M 1. Et1T 4tv..0La> L RE E+JGI N EE 5$ � 5T`zvtu ti ,USC-13 To ESTABU =RzopE27y NCS r APPLIC.A"T" �a�s f�vlCbilJ(, • A - 1 log 4 L 14, 'i - _ v 1 L t°1 _ 02 TAN 98 . 1 too , N zz I o. Z + p PETER Act. 2-0733 + j 00 : �/ r cE,e7-i �Eo3Z-07- - __ / T%cY 7-A,�A7 - SNoWit/7 ' . • �- _�. -SET8.4 G -_ 50 0--� 9 f .2E�'E.E�� A�VX /S Nor Lot00 zq - .. XT.EE�tlYE /it/C. 7".�//S�F�.C.fly/S rt/aT B,4SEO dit/:4i!/ i2_EG/STE.2EO •L.Qit/!� SU.eI�E�ar� Al.4Ss. Y/.S_EI� •7"a /VT" J f' TOWN OF BARNSTABLE 15-0"H-FIELD MEASURE ------- 12"DIAMETER CONC.'� I PIER i0 a r.E67wf s OODIG D I 7,1 .N W3x21 m AEW3 la-CONIC MIMS/E8 FT ' . L 6-4- 1 6 4 I AI.IL'N I AlJ0F1 AEW31VCFRIWSTEELCOC.— m CHECK TEE I ; FACE OF CONCRETE L TO THE KI LING ESD.G BULKHEAD FGUNDAD `! TNIS LOCATION f 12'-8- 9'-0- I ' Exrsl3w«3r_Taraavgav R I // / 14'1 14'-6- 1 EKISi1N0 FoonNcs� / New Structural Steel FOUNDATION PLAN Scale: 1/4"= 1'-0" Scale: 1/4"= 1'-0" Francs Sullivan MA Arch 18982 .,A COLLAR BEAMS ABOVE _.—.—.—.—.—.— 5kto to ' iAq=- J slap tc Patio miming -_--- - L-----_I -- --' NEW PATIO • 12'JWOERSE ' GIJ—C DOD SERIES ' _ `. -t 1/2- 9-11"FIELD KRIFY 3�8 6 SO" — � ONE STEP GOWN W s m MNDOW -�L � o � Columns flank oP<nnq JU into new Dlnin`Room/ 36"REFRIG. OBL OVEx Match liv. olumna KITCHEN$ 3'-D- S-6- a e'-11- .___._____._ h o _ - o DINING W < § 9 a - sw. > _ w�xsoow GARAGE ;� EDCE Pr cou ERA Q Us E r __________________1 E.STEL C�1.. xEw eaxEo our srtn cauMN �. aal:xu n+srAu.wRals�rnsRSMr CC 1 �° AULW G Cp.uwN mow J 3'-6-roa'WALL w DfA55 PAN�I W iOP 2.D. IlIN_I DESK U I I NSI I - - I I Fl o 1 � -- --- ENTERTAINMENT LIVING -�- -,l Elusnxc srAl uP OATE:8/19/13 xaow w ur REVISIONS: yr KS Ew BOx`OLUaea 10/12/17 • , soar L 4 FxT. x � ' PROJECT NUMBER' ' EwsrINC EATS RND El(ISRNC E%ISDNc i wxoow wxoow wxoow wnoow W4r First Floor Plan 10RAVkIN6NUMBER. Scale: 1/4"-1•-0" A-1 Bathroom • § laset � • Attc Storage ; BEDROOM BEDROOM 4 i MMraeov� Isoarweow: W-4r 4 Attic Storage Existinig SecondFloor'Plan Scale: 1/4 1,-0., u� as - - - DECK ; a o , Laund. KITCHEN DINING O Q 0 w < o § 00 > GARAGE (0 --------------- --------- ---- ------- - ---- = Q r--------------.-----------------r J xx U { BATHRM. y- BEDROOM - LIVING DATE:8/19/13 ` REVISIONS' W4r ` -i - � PROJE�i NUMBER Existlnlg First Floor Plan - DRawIRC(N—RER Scale: 1/4•'=:1•-0" . .E V. . -