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HomeMy WebLinkAbout0277 OLD JAIL LANE - Health l277 Old Jail Lane Bamstable - 1 1 -- 71 TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE ASSESSOR'S MAP&LOT 2:77rI10 INSTALLER'S NAME&PHONE NO. ��//17��y7riy Scpiic �r-rcr SEPTIC TANK CAPACITY Q LEACHING FACILITY.(type) /%moo C rllsr �3S" (size)f1,7,9:7 ',r S/„r X 2 NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: /y`/f//d COMPLIANCE DATE: 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) 'l�� Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r" t r � a s Gp s � S � O -P r 1 q i t ' 4 O, �e 1 l Fee Cd'� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipplitation for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair((✓Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.-777 01 tea'I G`V. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Z 77_ -,-?© .S Installer's Name,Address,and Tel.No.3 00"` 7 �s Designer's Name,Address,and Tel.No. C<l i�G C%el SG^s�`t<l.✓ SGCIiI'°Ge,�' .Da+G9- C'��� �a-yrh�C o'/.f' Type of Building: Dwelling No.of Bedrooms >� Lot Size g:jgS K,3'r sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ,r-,3-D gpd Design flow provided 5_6-® gpd Plan Date � f /y Number of sheets l Revision Date Title Size of Septic Tank o,moo Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. gned Date o Application Approved by Date Application Disapproved by Date for the following reasons Permit No. — Date Issued 46 ,1 �— Ax vr.._n• ... S..s•�" .^ �,# r 'r Ns� fi .. AIA" y' -aj,•,..:.�.. a,,...4,.4. .`''-`•A'.,f:.,y ,.,.,'•`JT MJ'F:vA'r^ { Fee X.. THE C MMONWEAL H OF MASSACHUSETTS Entered in computer: �✓' : PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for,* isp6sal 6pstaft "Construrtion 3ermit Application for a Permit to Construct( ) Repair((i/Upgrade( ) Abandon O 'Complete'System ❑Individual Components Location Address or Lot No.Z7,7.d/��'a#'� G `Owner's Name,Address;and Tel:No.. /�'•�.r,J�48fi& `�;iv Jr'�'11i. ..I!./ii".lreeel Assessor's Map/Parcel '� Installer's Name;Address,and Tel.No.s off- 7 = a'�`'g Designer's Name,Address,-arid Tel No. Y/ o-C4/e Cir/ ScaY�� S"�r6rr'crS ,1�v4.•� Ca.✓Q �t.9v3,ae%-r`.r �;",. � : N'T. & k '"-.•cam✓ �_�._.�/ t�.:r f�: t/c,,.sA.,..�l,C <a....a-- Type of Building: Dwelling No.of Bedrooms'- Lot Size ej?-; rs"Q sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures D'e"s u Flow(min.required) gpd Design flow provided gpd Plan Date ;",p/ • Number of sheets y/ Revision Datet, m Title Size of Septic Tank -~? Type of S A:S". Description of Soil,_,, /, �i- .T._a sue• S � �? s1,� �F/y� ,•,,� , � . � `{,� �.�,'i�rY , S.d'�• $ t ✓.'sa.�M_'. S�f •'trrr'..�N�'4""Ij✓� , Nature of Repairs or Alterations(Answer when applicable ;.R!/ Ala ,I.7��-.1". �.ls�i�l� i"'- �r-drs �j,.✓ c G+.rs,p.....�....� ra- `1'! _S'�....,s7..� _ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in. "' accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until.a Certificate of Compliance has been issued by this Board of Health. SI gned Date Application Approved by` Date /.h/ AX0 Application Disapproved by Date for the following reasonsy, Permit No. ( c Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by . _ .✓ secrFs�,�.4. . /'�.J �S�«.�c, S.�".,x:-�- at� p►�- d f� �/ Lam, has-been constructed in accordance with the provisions of Title 5,and the for Disposal System Construction Permit No. dated Installer ,, --_-` r-=� Designer #bedrooms Approved design flow �, ^,� gpd The issuance of this permit s 1 all not be construed as a guarantee that the system wil;YuriItji Q as designed.~ F Date Z Inspector / `I;�) S No. �� ...,.- � _.:-_- --,-�-.-;-_.;:,_-.-.�.,.�.,-�.---ammo-.:_>•-.._;�;_---,-=-.=1-=-..- ..Fee�/0 V THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS l ' p"�` ,,\ Misposal ,pstrm (Construction 3perntit Permission is hereby granted to Construct( ) Repair Upgrade( .) Abandon System located at -�7?7, 46. �.. and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must/be compl ted within three years of the date of hi' sperm' . - < . . Date I % �-� Approved by Town of Barnstable Op3NE ' -Inspectional'Serv'ices ; i s Public Health.Division j � "t"91 Thomas Mckean,Director 1619. rFD MA'S A 200.-Main Street,Hyannis;MA 01601 ; Office:: 508-861 4644. Fav 508-790-6304 Installer &Designer Certification Form i • Date: Sewage Permit#,,-0_--0 -7, Assessor's MAPCP'Amel Designer: Down Caper Engineering, Inc. Installer: C'AP `C® e y Address: 939 Route 6A, Address: Yarmouth Port, MA 02675 -� � ,�y g,4r o�G On 3%=��/ /©�/:_ �di� ,was issued a permit to install a, (date) (installer) q septic stern at (1GD JAIL M ACLld, (' p y 2'j based on a,design drawn by (address) Daniel A. Ojala,PE,PLS dated tAA- q, 2-0 f (designer) . 1 I certifythat the se tics stem referenced above was installed substantially according to p .. y y g �• the design, which may:include minor approved changes such as lateral relocation of the l distribution box and/or septic tank. Strip out (if required)` was inspected and the .soil's ' were found satisfactory. 4 l I certify" ertify that the septic system referenced above was installed with,major changes (i.e; .greater than 10'.�later'al relocation;of the SAS or any vertical relocation of any component; ` of the septic system)but in accordance with State & Local Regulations. Plan,revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils - were found satisfactory: I certify'that the system referenced above was:constructed to Corn 4, tice withthel terms of. the IAA approval letters(if applicable) L?A€311 I A — WALA a (Installer's Signature)- "' Nc; f1,(J7, i � � 73 ,1 �..t .ZZ: T (Designers Signature) (Affix Designer s,Stamp Here), 1- PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. g \\toa\depts\IiEALTMSEWERconnect\SEPTIC\DesignerCertification Form Rev&14-13,DQC i - i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. Cityfrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out \ f '[P—�forms on the J computer,use 1. Inspector: only the tab key to move your Michael Kellett cursor-do not Name of Inspector use the return key. Aardvark Environmental Inspection Company Name P.O. Box 896 Company Address East Dennis MA 02641 City/Town State Zip Code 508-385-7608 S13742 Telephone Number License Number B. Certification b Q certify that I have personally inspected the sewage disposal system at this 00 ress and-that ti* information reported below is true, accurate and complete as of the time of the: Ihspectiorj�The pection was performed based on my training and experience in the proper function and maintenance oft site sewage disposal systems. I am a DEP approved system inspector pursuant to Sectie, 15.M of W Title 5(310 CMR 15.000).The system: ❑ Passes - ® Conditionally Passes ❑ ails o, rm— ❑ Needs Further Evaluation by the Local Approving Authority l /ClµJt 09/25/09 Inspector's Signature Date The system inspector shall submit 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. **"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. I A 0.1 USGS•12/07 Title 5 Official Inspection Fonn:Subsurface Sews(a Disposal Systam•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yg 277 Old Jail Lane Property Address - Carl Carlson Owner Owner's Name information is.required for Batnstable MA 02630 09/21/09 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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. 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 USGS-12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. City/town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ® 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: The outlet Tee needs to be replaced 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 100feet 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. USGS•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M '< 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 indicates absent 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: D) System Failure Criteria Applicable to All Systems: You must indicate"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 %day flow w ❑ ® 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. USGS•12107 Tice 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ ® 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 laboratory,for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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 Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following,.in addition to the questions in Section D. II Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a 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 II 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 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. USGS•12107 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 5 of 15 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. City/Town State Zip Code Date of Inspection C. Checklist 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: ® ❑ 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(5)] i USGS•12(07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 or 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,• 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® .No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): USGS•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was 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: 01/09/01 per BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No i USGS•12107 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 II , Commonwealth of Massachusetts Title. 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 277 Old Jail Lane Property Address Carl Carlson Owner Owners Name information is required for Batnstable MA 02630 09/21/09 every page. Cityrrown State Zip Code Date of Inspection D. System Information y (cont.) Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ❑ cast iron ® 40 PVC ❑other(explain): Distance from private water supply well or•suction line- feet Comments(on condition of joints, venting, evidence of leakage; etc:): Septic Tank(locate on site plan): Depth below grade: 2.1 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000 gal 4" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 2811 Scum thickness Distance from top of scum to top of outlet tee or baffle 61 Distance from bottom of scum to bottom of outlet tee or baffle 151' How were dimensions determined? measured USGS•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for gatnstable MA 02630 09/21/09 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was sound and tight. The tee on the outlet end broke of when I tried to clear the roots. Liquid was at outlet invert. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): r 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: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: _ Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): USGS•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for gatnstable MA 02630 09/21/09 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 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 box was level and tight with no sign of carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No. Alarms in working order: ❑ Yes ❑ No USGS•12/07 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for gatnstable MA 02630 09/21/09 every page. Cityrrown State Zip Code.. Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS)(locate on site plan, excavation not required):. If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries , number: ❑ leaching trenches number, length: ❑ 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 system has two five hundred gallon drywells surrounded by three feet of stone. There was no sign of ponding or failure. USGS•12/07 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 277 Old Jail Lane Property Address Carl Carlson Owner Owner's Name information is required for Batnstable MA 02630 09/21/09 every page. CityrTown State Zip Code Date of Inspection. D. System Information (cont.) Cesspools (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 ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, 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, condition of vegetation, etc.): USES-12107 Idle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Foam Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 277 Old Jail Lane Property Address Carl Carlson Owner Owners Name information is Batnstable . MA 02630 09/21/09 required for State zip Code Date of Inspection every page. Cityrt,own D. System Information (cont.) 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. 3 Too b om"ram^rWM SubWlece USGS-i2W Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 277 Old Jail Lane Property Address Carl Carlson Owner Owners Name information is required for Batnstable MA 02630 09/21/09 every page. City/Town State Zip Code Date of Inspection D. System Information (coot.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain:. ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS maps show an elevation of over twenty feet. USGS•12/07 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 VW Town of Barnstable Barnstable Regulatory Services Department °' "'caC " • skaprsras;r:E, i Public Health Division m 200 Main Street; Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 " Thomas A.McKean,CHO October 9, 2009 Carl Carlson PO Box 184 Barnstable, MA 02630 ORDER TO.COMPLY WITH STATE ENVIRONMENTAL'CODE,TITLE 5 The septic system located at 277 Old Jail-Lane; Barstable MA was last inspected on September 21;2009,by Michael Kellett,a certified septic inspector,for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (310 CMR 15.60) due to the following: 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; Outlet Tee needs to be replaced. You are ordered to repair or replace the septic system within two(2).years from the date . you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF TH BOARD OF HEALTH l.� nD r Cal 0 as. cKean, R.S., CHO- Agent of the Board of Health CERTIFIED MAIL#70081830000205009151 Q:\SEPTIC\conditionally passed\277 Old Jail Lane.doc TOWN OF BIlARNSTAB'LE �G I,:OCATION Z 7 SEWAGE # VILLAGE IIQ/dI57`Q't�1is ASSESSOR'S MAP & LOT 2 7 7-O� INSTALLER'S NAME&PHONE NO. M. SEPTIC TANK CAPACITY /®a o G6rL LEACHING FACEL=: (type) Soo 60[ 6wf (size)/�•� S� ' NO.OF BEDROOMS 3 BUILDER O OWNER�41,lgh p PERMIT DATE: I-$-d/ COMPLIANCE DATE: / t � 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) a00 -74 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ,U Feet Furnished by /f 497 ` AP/rah. LOetho✓ : - .4 No. /_00' — IJIJ / `y Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS application for Zi5 poear *pgtemc Construction Permit Application for a Permit to Construct( )Repair( 4pgrade( )Abandon( ) ❑Complete System 1?11<ividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel 47Ale 0 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. N �'� � np / -913�ya Type of Building: Dwelling No.of Bedrooms�17 Lot Size sq.ft. Garbage Grinder( Other Type of Building fz:�'eNo.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 'IVei, gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank l®®� �'sl`f� Type of S.A.S. Description of Soil r Nature of Repairs or Alterations(Answer when applicable) ri Ale, 4X&Aopll 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 this o of 11galth. Signed � Date Application Approved by VADAAA4 SC.lti.t c J Date ► . Application Disapproved for the following reasons Permit No. SOD I — 0 0__1 Date Issued g D I o- f� GY y' No. 700 I "' C �� Fee �THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: " Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Miqogal *pgtem Congtruction Verntit ~ Application for a Permit to Construct( )Repair( Cl/Upgrade( )Abandon( ) ❑Complete System I1jndividual Components Location Address or Lot No. 7 , J� / `j Owner's Name,Address and Tel.No. Assessor's Map/Parcel /3we.5 Ia /�k/& ��� '✓/a�dl�'�l i G Installer's Name,Address,and Tel.No. ,Designer's Name,'Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( � Other Type of Building — G�/1G�No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated.daily flow .353� gallons. Plan Date Number of sheets ? -` Revision Date Title Size of Septic Tank le�OO �✓ � /=X/�7`�''S% Type of S.A.S. Description of Soil °" e /9 .._Nature of Repairs or Alterations(Answer when applicable) e 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 b this oard of H alth. Signed Date Application Approved by Date f U Application Disapproved for the following reasons Permit No. c_�)OU i U y_� Date Issued v. THE COMMONWEALTH OF MASSACHUSETTS 2 77 n BARNSTABLE, MASSACHUSETTS ertificate of Compliance � THIS IS TO CERTIFY, that,th On-site Sewage Disposal System Constructed( )Repaired( Upgraded( ) Abandoned )by ®L c� ` C lJ' S at 2 � 7 O/ �`Cj,�Z /", , has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a U 0 I - OtJ�dated_T� Installer Designer n, The issuance of this pe t sh not be construed as a guarantee that the system wil functtio�n a designed�� Date Inspector st 1/4 i W!V A —�---------------------�—7„ No. 700I ©ZO Fee Sc) ._' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpogar *pgtem Congtruction permit Permission is hereby granted to Constryct Repair( V�u )grade( )Aba don System located at 7.- 7 � �T / //I. �o57Y l 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:Construction must be completed within three years of the date of this permit. Date: 1 o 0} Approved by to " NOTICE: This Form Is To Be'Used For the Re air Of ' Se `tic Systems. Only. P wiled CERTIFICATION OF SKETCH UCTION PERAND APPLICATION FOR A DISP05AL WORKS CONS _ NTT OUT DESIGNED PLANS hereby certify that the application for disposal works construction permit signed by me dated concerning the property located.at Z 7 7 �J� % ��, krlr J meets all of the . following criteria:. The failed � R •, system is conne=cd to a residennal dwelling oniv. There are no commercial or business es associated with the dwelling. 2 1 /ihe soil.is c?assined as CLASS I and the cemoiation mte is less than or equai :o minutes der inc2 '•//There are no wetlands within too eet s of he l �raDo ed seoric s�ste:n iaere are no p•:vate weir within.1:0 feet of the proposed semic srrem. :sere is no inc.--se in flow and/or caan;e in se proposed.. here are no vaarianc=.requested or needed Y The bottom of the proposed leachingfaclity will not of be located less than Lve feet above the maeim=adjusted groundwater table elevation. [Adjust the groundwater table using the�rim method when applicable] ntor , /if'the S.A.S. ^ " _ 4.S. will be located with 250 feet of any vegetated wetlands. the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the ma=um adjust ,groundwater table elevation, Please complete the following: z A) Top of Ground Surface Elevation(using GIS information) ` -7. r B) G.W.Elevation + L' ' the MAX High G.W. Adjustment., ?� DIFFERx24CE BETWEEN A and B �( � SIGNED DATE: (Sketch proposed Plaa.of system on bad]. ¢haute hider bet r • - i TOWN OF BARNSTABLE LOCATION 2- 7 n. SEWAGE # Z!:5),:P/'�7 VILLAGE J041�'l57`a��1� ASSESSOR'S MAP & LOT 2 7 INSTALLER'S NAME&PHONE NO. 1 SEPTIC TANK CAPACITY o,6^— LEACHING FACILITY: (type) Soo Cwt (size). NO.OF BEDROOMS. BUILDER Oil OWNER i 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? a0U '� Feet . Edge�of Wdtland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) �� Feet f Furnished by : i j'• 7ff 9 t16 ; sL o---J LL 4 TOWN OF BARNSTABLE LOCATION / SEWAGE # - � - VILLAGE . - ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. IL �.� SEPTIC TANK CAPACITY /0 00 ✓J LEACHING FACILITY:(type) ''r (size) ®tee) NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: r'f DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes A nNo 41 . a v r I. tor 7 No.-I.... ....._....... Fizic v.0......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirallatt for Diripatial Vorkii Tnnitrnrtinn ramie Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ..................%.......2... . .............. ...81W14 ............................."` Locc n dress or Lot No. .......... -- ..... ........... ....... . ... . _ .... ....... ON crA.': ....... .................. Ad In ler Address UT of Building Size Lot............................Sq. feet r. Dwelling—No. of Bedrooms---------.3----------------------------..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-----..--------.------------ Showers ( ) — Cafeteria ( ) dOther fixtures --------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow...............--.....--.---...--...........gallons. WSeptic Tank—Liquid capacity........---.gallons Length--_-..---.---. Width..-- ...... Diameter................. Depth................ x Disposal Trench—No. ------------........ Width.................... Total Length.................... Total leaching area....................sq. ft. 3 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. 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..--.................... 9 ----------------------------------------------••---------------•--••---------..............--------...------------..........---........---._.......•••.....•. 0 Description of Soil...................................................................................... -----------•---------....------------------------------------•-----.............. UW .................................................................................................................. ....... y�a ........... Nature of Repairs or Alterations—Answer when applicable.---- - % � /D�'D .rY.-._::............ -----------------------•....------...........---•--•----•--•----•--------•--••-------------.........--------•-••...-•--------•-•------•--------•---•--•----•-•-------•-----•----------•-•._............. 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 Compiianc as been 'ssued by the board o health. Signed ......... ..._... ..... ... o .. ........................ ` ....:/.. 74 Application Approved By .... .... ._�...... - ---0--- Da Application Disapproved for the following rear ....................... ... ... ............... .. . .. .. -- ..... .: .................................... . ........................................ !� Dare Permit No. .............. v _.... Issued Dace a a 0 No.. _....._. Fas....` ................. Y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , TOWN OF BARNSTABLE Appliratioit for Diripooal lVork,i Tonotrnr#ion Permit Application is hereby made for a Permit to Const uct ( ) or Repair ( ) an Individual Sewage Disposal System at -2....a��. _ o W .................................................................................dress or Lot No. - Loc-�•tioa. .......... ... .........................•-=----- ....... ............................... .. ...-- -- ---- -----------_...... Ow cr Add cs ..............�--------- ....... .. ... ............ S 7 S l y -----•-- ------------ Ins' ler Address go U T of Building Size Lot............................Sq. feet .-t Dwelling— No. of Bedrooms......... ..............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ...................... ..... No. of persons.----___-___--_-____--_-_ Showers ( ) — Cafeteria ( ) dOther fixtures ----------------------------------------------------------------•-......------....----- ---------•------•--••-••-••---•.........•••-••.........•--••- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 94 Septic Tank—Liquid capacity------------gallons Length---------------- Width-_---._._--.._- Diameter................ Depth................, - 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 ( ) i a Percolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----•--••--•-----------•-----•-••--•-•••........•-•-•----....••••••.......-••••--•-••........................................................................ ODescription of Soil........................................................................................................................................................................ x ------------------------------•----•..........----------....-•-------------•••.--•----•---------- ---- --...- . U Nature of Repairs or Alterations—Answer when applicable. - --------- -- ......................................... oQ ..�........._.. ..--•..................•----...••-•-•--•--•-•-•-•-•-••••-•-•••-•-•-•---••------••--•-•-••-•.........---•••--•-•-----------------•-........-------••----•---------••....•..........•-•-•......_.......... 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 f health. Signed .........(�`......... ........ /.. � . ... ��...��...`...` A lication Approved B i/ -:...... ...:©.... .....�%rV_ --/%��._� ....c / � PP PP Y ....., ,..... Date Application Disapproved for the following rear , .. ......................'. ...... ff �........ . . ............... ...... ................................ . .......... .......... ........................ /.�......1. f y ... Dare Permit No. I.P ... (s//-�....V..)....... .......... Issued .....................................- .....---.............. Dare ---.... --. —_.—, --v.—.._.--os.a ——————c.z.ss-_s=..--w'.._a.—u.-...,.—.�_.�>�..��rd-r.a. i sr.w tears r-a—.-->w v.�.� -.?-- .`.ya�.� ..`..�_...�...._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Olertifiratr of Contlati? ace THIS IS TO CERTIFY That the Individual,Sewage Disposal System construe ed ( ) or Repaired ( ) by ....................... -- /� f/ Sr ---.140...... c am! S 7 S. ..e�o�••_ Z. ��6�rLr, ...................................... at ................c�f.7.7[/..® ..t i�aL lauallcr has been installed in accordance with the provisions of TITLE 5 f The S�tate�.Environ men taI Code as described in the application for Disposal Works Construction Permit No. ....1.•�._Lr'�."". 7.•5:::� "dated ........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. . 9_`---.` .` ..._.............................. __ Inspector .........__....-_C ...1...... .. ....... ----- ......... -- -_- -- --„-_,, _ - -e__.-_.- -...._. -.M-._,-- -_ ----- -,__ - ---__--_------,--- THE COMMONWEALTH OF. MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE.S.,?_ i R11111Q1itt1 FgrhiiTvnstr4u1jvn Permit' Permission is hereb ranted.._../_ v� -_ .....���.. .3oUS� to Construct ( ) or Repair, (✓) a(n/Individual Sewage Disposal System at No....... p -rr PP' p r Street V1 �r as shown on the application for Disposal Works Construction)Permit No--___.-__-- ated--- ............. Su � . . i ---' ........-i••C-•.............•........'� �.`.. ._, Board ofHcalth DATE.............t>;!•......................................................... FORM 36508 HOODS h WARREN.INC..PUBLISHERS 4 ,q0....... Fiva...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................... ....................OF................................... ......................... yfirativit-ftir Bhipasal Worko Tumitrurtion "amit Ap plidifidn- is hereby made for a Permit to Construct or Repair an Individual Se*dge`3Disposal System at: OT W�7 ........... ......LAr. .........................Cr ..... ............ ........... Location-Addrest ..... ........... ...........0..............or.-ot.No........... ........................ ... -ran.__... ........ ... .............................................. ....... ner Addrel-r , ......0��e: ...................................... ................................I..........A.,............................................... Installer Address Type of Building Size Lot.._ 0....Sq. feet U Dwelling—No. of Bedrooms.............�>--_-------------_-------Expansion Attic Garbage Grinder a Other—Type of Building ---------------------------- No. of persons........_.__.__._._.._..._.. Showers Cafeteria Other fia res .............................. .................................................................................. -------- ------------------------------ Design Flow............S.-)...........................gallons per person per day. Total daily flow__3.yAP...=3111........gallons. 9 Septic Tank—Liquid capacityio_o_R_gallons Length................ Width-------_------ Diameter_____-______.._- Depth.......-....___. Disposal Trench—No. .................... Width.....________..... Total Length___......__.(...... Total leaching area....................sq. f t. Seepage Pit No-----------/------- Diameter.__......._..__. Depth below inlet.....Z............ Total leaching area..4/0.;2.,_ .._sq. ft. Z Other Distribution box �) Dosing tank ( ) Percolation Test Results Per-formed by---------- HAj�'5..... Date..... Ir......... 1.4 7--------------------- ... Test Pit No. J-3.k-2--minutes per inch Depth of Test Pit-----1_3...6."Depth to ground water_.__...to ki e- ----------­----- rX4 Test Pit No. 2................minutes per inch Depth of Test Pit____............__.. Depth to ground water---C..q, P4 ..............................I............................... .......... ................................................................................. 0 Description of Soil.......................U.•_1�.........Z;�--- ....I S I -------- ------------------------------------------------ T" ------- �4 I-------------- I................................................... �........... U ... --------------------V----- .........F WI_V....................... --------------------------------------------------------------------------------------------------------------------------------------------;---------------*.........................:................. 4 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'TTIE 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be i ued by the,koar bDard iealth. ....... . . ... .... Signed. rDate Application Approved By............... ........ ...................................... .............. ... ......... Date Application Disapproved for the follbiving reasons: .................................................. ........................................................... ........... ..........................................................T.?............................................. ............................ .................................................. Date Permit No.....� f. ..........e�-/-.;I................. Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ..............OF....... .................................... THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by................A,,.; ..............0.1-ex............................................................................................................................................. Installer *at...............41-2n:......7;............ ......= �?'/.......... ........ ......................................................... has been installed in accordance with the provisions of 5 o' The State Sanitary Code as described in the -T1 t application for Disposal Works Construction Permit,.No-------- -------;� Z.--4......... dated--..._ __ I-----/ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. n i DATE............ ............................ Inspector.......... ................................ ............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. ............OF.......... . ......................................... ........................ Permission is hereby granted...................... k............................................................................. to Construct or Repair an Individual Sewage Disposal System at No...-- - " MW . ...... Street as shown on the application for Disposal"�"or!ks F'onstruction';lPeftnit Dated------ - W, ........... ........................................................................................................... Board of Health 0 -DATE........................................................... .......... W FORM 12-55 HOBBS & WARREN. INC.. PUBLISHERS* e LOCATION ' / � SEWAGE PERMIT NO. Lo T 7 ow Jeat_UdVSC-W Sid 21Z VILLAGE INSTA LLER'S NAME i ADDRESS R-06Ce - 9. atAt 40 14 C- IUILDER OR OWNER CA4Y Nei smote W• " 1�M MA DATE PERMIT ISSUED OMPLIANCE ISSUED DATE C ti V i U jj 4h �1 f No...............�....... Fps................... .- -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH D. . .-•.--•...OF. .n�t ea. ............................................... .... Applirutiou for Disposat Works Tonstrur#ion Prrutit Application is hereby made for a Permit to Construct (u) or Repair ( ) an Individual Sewage Disposal System at P ......... ............................................................ /? � ...... •. ---• vfi----.. _. -- 1.. rrr Location-Address/ or LQt No. vS 2 _ � _........� Owner Addr ss .laces........................ ... --•- Cerwdc� Installer r Address U Type of Building Size Lot.10,L.n U.....Sq. feet Dwelling—No. of Bedrooms-------3...............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria W Other f Oures .----•-•---••----------••-----•. • . .......-.gallons per person per day. Total daily flow '_/Iv_.=... 3d..........gallons. W Design Flow.......S.5................... g P P P Y• Y � W Septic Tank—Liquid' capacity/Q,;Lu..gallons Length................ Width................ Diameter.-..-.-------.-. Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------I----------- Diameter.........9........ Depth below inlet.....4_............ Total leaching area...E/.4........sq. ft. Z Other Distribution box ()() Dosing tank ( ) Percolation Test Results Performed by--------- t�O * .._.. !lA S.............................. Date.... ............... Test Pit No. 73.L.; --._minutes per inch Depth of Test Pit-./1-.`....--.. Depth to ground water._✓1a!1�__.... / Gr[4 Test Pit No. 2................minutes per inch Depth of Test Pit...---.............. Depth to ground water-cr�tovw i� V ^ .................................T...........•.......---`----------......--•---•--•---•----•-•-•-----••---•--............................................... 0 Description of Soil------ ".3 ��------7V..)----5� o.!-.!._..... .............................................. y. V ----------------------------------7�,1I 'lb:� M � Jr�Av / �'�!c s °f -�i5 W UNature 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 iITL% 5 of the State Sanitary Cod — The undersigne further agrees not to place the system in o ration til a Certificate of Compliance has b ' ued by the, r iealth. Signed•-- --. ........................ .••-----------• -•---•------ �- - Date plicatio Approved BY � ........................................' Date Application Disapproved for the following reasons----------- -------------------------------------------------------------------------------------•-----•----•-•-- ........................................................ ..............................................................•---•----------- --•----•-•---------•---•------•------••-------•-----••-•--•--- Permit No. = Y L5 ..-.:... /� Issud.........._.. Date -•....... . ---- ----- Date LOCATION L�� _ NO. VILLAGE DATE Y ' APPLICANT h " FEE j k �Nonndable ADDRESS ram '"F _ , �Y�� � -%` ��':. ��� TELEPHONE NO. �...��Fa x�.,'�..��c� r.,.: aY;,s",iy; » a,�a `.".�,. b ';✓.° l t ';'. -'` ^'i .•-h w_d"�b^ '''' M:_ ,F.`M "> '"7 •.�kk ` s _. .ENGINEER zz, ,� ¢I ,�� :'TELEPH E NO DATE SCHEDULED �_,«`;8` .x°.r ..'+a`" z� .. :* �e�?ro•x.. ... -.F'- ;'� fr x s yn�£. ,. a, *wear'S?e c + �Ap leantl s.r�.r s4'., "slY , 4 ��' �'r-' '�C �_ y ': �r�y, •e s � �a€-'t�* t,�;C" Y . - (�nature) a,�• • • ►• '`". t`` ` ry �'"L O O O . x• O • • • O • • O •O • �• O• • O • • • • • tom' '•4r. .s;. 3R!- :• - - .sn-x+-,d*«+.� ar' N":y7 .�".+*.'.k': C',x<;L"€5`.ca�, r 'n. N'k it ' Ciw 3;a ...n. - \^f'""z.7y-. r- F we d`A.�" j:.,.,rr''^.,.'_`M4^s•" ...a:^..r,�l, + ';�l k 5r '"�. t ,_ >r,. _. -... __- ..c. -_ -x � `.•. `r >�' -: .�'�,• ;'' g, c"" a .t<.� - ^ `".i ✓^I y,.ray: "A .e,r '� � "i r S.•; fir'\ .M'1...,�$, r;,•. ,ti ,i�i ' "`" d^j.! T ,TIME SUB DIVISION NAME � .'-DATE / `® EXP,j�NSION AREA: AYES• NO r. TOWN,WATER PRIVATE WELL �' .r. ' 'BOARD OF HEAL•Tl EXCAVATOR - .�-ter _� . : .: �. • SKETCHY (Streea �name,_etc. dimensions_of _lot, ---exact lo of ,test holes and : _ , y , percolation tests'. locate--wetlands in proximity to 'tesf holes) .NOTES : x - 17- n s r RCOLA-T ION--RATE-: ZM�c� rr� TEST -HOLE -NO: - -ELEVAT--ION: =- -• --TEST- HOLE NO: -ELEVATION: 2 s a3as� . 2 3 ♦r 3 �. 4 4 - 5 T�1ryD, S,�;v 5 r*v' 9 �' f! 1'�'Z�?ems;a•" - -6 _-.. i 7 7 g 8 . 10 10 t if 12 . 12 - 13 13 j 14 _ � 14 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS "LEACHING` •' LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON C TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P, E, AND RETURNED TO' BOARD OF HEALTH COPY: RETAINED BY APPLICANT' I l �f : yam,S�E�C ..i ,•j„7 t 7 > r \ � [G s .. - ... ) .. x • F f 7 1 RT _ w.-+? '' "-3' ° > 5 r �� � i •�:, &s4 �'N ,tt n��, s Jk �k�1 �-. ] � f: ,. z - �� I✓ J � _. 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Fee--------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Application- orVell Cootruct ion Permit Application is hereby made for a permit to Construct ( ), Alter ), or Re air ( )an individual Well at: - c — ---- —-------- I- tion — Address / Assessors Map and Parcel allege , Owner Address �� - %Y_ __�t°ll. pia ---s� �ulr� - - ----------------------------- - ------- Installer — Driller Address Type of Building Dwelling -— -- - Other - Type of Building-------------------------------- No. of Persons---------------------- Type -------_—_______ of Well—��`� ------- Purpose --————- --- -- - -- - - r Capacity of Well----- e�1 -- f` -__1 �� \ 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 as Certificate ,.00 Compliance has been issued by the Board of Health. pp Signed _ ate Application Approved By ` - _—�= r Z date Application Disapproved for the following reasons: --------------------------------�__--_______ — —--— --- date Permit No. — ---— Issued----- -- - - — ---- ---- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS.TO CERTIFY, That the Indi ' ual Well Constructed ( , Altered ( ), or Repaired ( ) _ Installer 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. --1_ -I__Dated�'2� _/__� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE---- —- -- Inspector---------------------------- ---------—- I 01S-- No. 9 '- ---- ------------------ -- r . Fee BOARD :OF. HEALTH . TOWN OF. BARNSTABLE rication; For Well �ongtruct conerrttit Application is hereby made for a permit Construct ('., ) Alter.( ) or Repair(� an individual'Well atc a 7 ��t l Loc hon Address 3 Assessors Map and Parcel : f f, Owner Address t installer -Dnller' 7 Address _ Type of Building Dwelling S <, Other -.TYPe of Building'=- — -- No.'of Persons---- --------- ------ -- I, Type of Well Purpose of Well - ft Q_Lq f Agreements The unders<gned agrees to install the aforedescribed individual well to accordance with the provisions of The 4 Town of,Barnstable Board of Health Private Well Protection Regulation ,,:The undersigned further agrees not to,,: place the well., operation until a 'ertifieate .of Co pliance has been issued by the Board of He/alth Signed - if .3 Z� � — gate ` Application.Approved By — ------ 3. I date Application. Disapproved for the following reasons: date Permit No.. _ ----- Issued------ - - - -- -- ---— - date a.:d+:.C:eeu.uTelAn,9m#}siTe4ti's++«!¢u6000'^$9e.EbSo9'.o!ae!6�ddFiP.aia#c:e'c�cem!tmS{i!®T6ec-�olSp.«tvC!bee CaYiL•n�39Af!aeWJin!mlEaB�•Veil:le?'e�.ili9i?BJ2NLOvRpOeee!.6e aaeesir6eie.Yr�iEdie.Fsiraa�iec�i.T.. BOARD. OF HEALTH TOWN OF BARNSTABLE C ertf icate Of Compliance THIS IS Tg CERTIFY That the'I al W 11 Constructed ( , Altered,,(; ), or Repairedby ---=- --=------- ----- - - - --- ---- ---- --- - -- - --- - Installe cr — 1 at------ Y 1 has been installed in accordance with the provisions of the Town of Barnstable Board of Health jPrivate.Well Protection . Regulation as described in'the application for Well Construction Permit No. -�9- - 7=Dated: �� ------ THE ISSUANCE.OF=THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE,THAT THE:WELL SYSTEM WILL FUNCTIONQSATISFACTORY DATE- Inspector:------ -- -- ---- - — - �do!'e?sa'!iPiPiei.W e]�Sp!Lei!!iVti�ie?fAQiei:liR6ShYK�iTA 94eGli4wkSli00eeV$iiTiliRli�il'f�+YJY@G7iliY.9ie8K4isi}Ii1!1.h1:PY�.Y.i_.r!��ii'ti@U+'iEi�i.i.iYirtiili!ii•.sRi�i��i.�i�0.a-G^v!i�GMT« 1 BOARD'OF,HEALTH ' TOWN OF BARNSTABLE ' Well eoBtruct ion 3permit f No. Fee- 7 ,S co Permission is he by granted. to.Construct ( , Ale ( ), or Repair ( ) an I ividual Well at: t e No. -�'7 G G+.� L yt 4zV'- =f--fJ- -------- --- - ----------- - -. Street 1 as shown on the application for a Well Construction Permit c tJ '7 -7 _�—_No.- Dated F ---------- Slis Board of Health DATE -- -- SYSTEM DESIGN: TEST HOLE LOGS NOTES SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE NAVD 88 MARKED WITH MAGNETIC TAPE OR 1. DATUM IS (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. GARBAGE DISPOSER IS NOT ALLOWED ENGINEER: DANIEL E. GONSALVES, SE #13587 �ou�e 2. MUNICIPAL WATER IS NOT AVAILABLE ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE WITNESS: DAVID STANTON RS 'QOi/, 6q TOP FOUND. EL. 75.55' FILTER FABRIC OVER STONE PROPSOED 5 BEDROOM DWELLING 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. °Qd \ DESIGN FLOW: 5 BEDROOMS ® 110 GPD = 550 GPD DATE: 2/28/17 I 74.5' MINIMUM .75' OF COVER OVER PRECAST 21i SLOPE REQUIRED OVER SYSTEM 69.0' _ 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS PRECAST H_,o WATERTEST D'BOX FOR LEVELNESS BLOCKS OR USE A 550 GPD DESIGN FLOW PERC. RATE _ < 5 MIN/INCH To BE AASHo H-2Q PRECAST RISERS 5. PIPE JOINTS TO BE MADE WATERTIGHT. RISERS (TYP.) 2'0 72 58' 4"0SCH40 PVC MORTAR ALL INVERT IN 65.20' CLASS I SOILS P# 15280 �°LEVEL 1ST 2 COMP 6 MIN. SUMP PIPES ' .� 12" MIN. INT. DIM. ENDS (rn'') SIDES 66.2' SEPTIC TANK: 550 GPD (2) - 1100 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH V o� � 0,0 0� ' ➢oo�oo 310 CMR 15.000 (TITLE 5.) LOC S %' 10" 14" ° ° ° ° **RE-USE EXISTING 1500 GAL. SEPTIC TANK TEE **EXISITNG TEE * ®®® ® m®®®- n ® o 0 0 , ^ ELEV. ELEV. ELEV. ELEV. SEPTIC TANK 71.18' , o 0 0'0 00000000 . ®®B ®�®� ® ®®®® ® ;og000010 L�1,.1 , \ l�ii�l L�4�J 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO g 00000000000o O 'o°o°o°o° ® ® ®®® �I o 0 0 0 t/ \/ v S ?.0o�o�o�a� o°o°o°o° °°°°°°°° p" 68.5 p" 68.5 p" 68.0 p" 69.0 BE USED FOR LOT LINE STAKING OR ANY OTHER �� C`� Bf dg GAS BAFFLE 000 o ° o ° ® ®® ®® ®® p® ® ° ° o ° o°o°o°°0 ® ®®®�®®®®® B�®®®®®®�® °oo°o°°o LEACHING: 65.52' 65.35' °°°°°000 `o °° 63.2' _ PURPOSE. Lane ° ° ° ° SIDES: 2 (42 + 12.83) 2 (.74) = 162 GPD A A A A ° o 0 o `H-20 500 GAL. LEACHING CHAMBERS BY ACME PRECAST OR EQUAL BOTTOM 42 X 12.83 (.74) = 398 GPD SL SL SL SL 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 3/4"-1-1/2- DOUBLE WASHED STONE 4' MIN. (4) UNITS REQUIRED 10YR 4/2 1 OYR 4/2 1OYR 4/2 1 OYR 4/2 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALEDALL �OUte 6 (J PRECAST STRUCTURES 6" CRUSHED STONE OR MECHANICAL OVERALLOUND DIMENSIONS TO OUTSIDE OF STONE: 42.00' X 12.83' TOTAL: 756 S.F. 560 GPD 1811 16" 20" 6" WITHOUT INSPECTION BY BOARD OF HEALTH AND COMPACTION. (15.221 [23) 114 B B B B PERMISSION OBTAINED FROM BOARD OF HEALTH. ( 7 SLOPE) ( 1 SLOPE) USE (4) 500 GAL. LEACHING CHAMBERS 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING (ACME OR EQUAL) WITH 4' STONE ALL AROUND SL SL SL SL DIGSAFE (1-888-344-7233) AND VERIFYING THE or LEACHING LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES LOCUS MAP FOUNDATION- EXIST SEPTIC TANK 76' D' BOX 17' FACILITY r57.0' 7 GROUNDWATER FOUND 36„ 1 OYR 5/6 65.5' 1 OYR 5/6 1 OYR 5/4 34" 1 OYR 5/4 66 2' PRIOR TO COMMENCEMENT OF WORK. 32 65.8 38 64.8 SCALE 1"=2000't 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 277 PARCEL 20 *THE INSTALLER SHALL VERIFY THE **INSTALLER SHALL CONFIRM MINIMUM SEPTIC REMOVED BENEATH AND 5' AROUND THE PROPOSED LOCATIONS OF ALL UTILITIES AND ALL TANK SIZE AT 1500 GALLONS AND ITS SUITABILITY LEACHING FACILITY. BUILDING SEWER OUTLETS AND FOR RE-USE. REPLACE WITH 1500 GALLON C C C C 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AN ELEVATIONS PRIOR TO INSTALLING ANY SEPTIC TANK APPROPRIATE TO SITE CONDITIONS IF PERC PERC PORTION OF SEPTIC SYSTEM NOT SUITABLE REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. M FS M FS M FS M FS 13. NO POTABLE WATER WELLS EXIST WITHIN /50' OF PROPOSED SEPTIC SYSTEM. 2.5Y 6/6 2.5Y 6/6 2.5Y 7/6 2.5Y 7/6 76 O� j N I I �Q �3 N86'47'33"W o \ 138" 57.0' 138" 57.0' 120" 58.0' 120" 59 ' B/DH 177.000 82 BENCHMARK: \ .0 � I, CEMENT BOUND \ = 82.8' NAVD88 \ � 72 � 80 8 \ � NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED W R=4 I I I I I I I I I I I 9 , I EXISTING v GARAGE 03 I 1 , 69 69 EWELL G 150.0F I ' 11 11 v • PROPOSED \ ZONING SUMMARY Q ADDITION ZONING DISTRICT: RG RESIDENTIAL DISTRICT 1 1 MIN. LOT SIZE 65,000 S.F. MIN. LOT FRONTAGE 20' j , r 8\\� ,-` _ ti TM.._.,.LOT:WU©TN _ _ 200' MIN. FRONT SETBACK _30' EXIST. DWELLING 8s \ MIN. SIDE SETBACK 15' "1 Lot 11 GRAVEL E TOP OF FNDN \\�84 , �"��` �� MIN. REAR SETBACK 15' DRIVE �--- EL. 75.55 � �83 $84 �_e2 SITE IS LOCATED WITHIN THE 55;659 Sq. ft. E \� AQUIFER PROTECTION OVERLAY DISTRICT v 1 .97 .pereS / �l ado 82 ONSITE WELLS IN AREA DECK OWNER OF RECORD �Q >> 80 JEFFREY M. CANNON & KIMBERLY A. MICHAEL277 OLD JAIL LANE BARNSTABLE, MA 02630 _72 Iv) REFERENCES \ Z N LAND COURT CERTIFICATE 189785 LAND COURT PLAN 39072-C CAUTIO E 9' GAS At;;, >s AREA 2OF p3•, - - - -- H4 Op 6-9 3 � TITLL o SITE PLAN CB H _FND " N #277 OLD JAIL LANE \ EXISTING 68 71 BARN / TH` BARNSTABLE MA \ - - - - - - - - - \ PREPARED FOR �, o 8 KIMBERLY MICHAEL \ ` DATE: MAY 9, 2017 LEGEND , \ \ � Scale: 1"= 20' 99 - EXISTING CONTOUR9, �jy OFMgSo' /��HOFM4S' \ e �. � V �a� c�;_, 0 10 20 30 40 50 FEET X 9-91 EXIST. SPOT ELEV. �o > > II a jo OJALA A. s� DANIFLA. 9 o DANIEL G � I 2 I _ 4 sg mod" CIVIL �,� �� OJALA -[99]- PROPOSED CONTOUR 3 No, 46502 off 508-362-4541 \ 5 00 BENCHMARK: No [98.4] PROPOSED SPOT EL. `68 I I R� ��'/sTe�``� �0 ss�(0 s fax 508-362-9880 TH 1 'Eg I = 70.4 NAVD88 p O 69 SURVEY SPIKE �Cssi nG, <> ✓ e " '` downca e.com I I �'� ��N of Mgss • • TEST HOLE I I 72 � �ZNO�MgsS9 y�� qC down cape engineer/ng, 117c. 0 DANIEL ti� >> ��' DANIFLA. A. __ 2%. SLOPE OF GROUND I OJALA � 70 OJ;j1d A IVIL con 98 civil engineers 71) UTILITY POLE -6 I No.4uy&0 I -6 No.. � ,p _6s I 4, �o �, oFF land surveyors FIRE HYDRANT , 061 i \ 5�-�� �SS�pN T �ENG�R/ N ` r" �` 939 Main Street R to 6.�1 NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING �� I I s8 LICE ?,-038 DATE DANIEL A. OJALA, P.E., P.L.S. YARMOU THPOR T MA 02675 # 1 o KI f ---- - ` ; �' 1 `^--''•I��.i�7. i � � � FL toe. U All, 3 -' tvv 1, EL 6, 1 30" , C• ��►�.D kr" W1T1-i WI C ; !T!a L TEE E -- .M TQ.ACES f _ - l ` ! E a FItJE 1 ( �, -•' + _ 4 , ` .� \ a ��v-'i` ,T`, � �� �..« `a . -.a i f V ��l f. G�- f/ � �'S �._. . C 1. �G � �b�• �,,... -..,�.IT�.. Woe � G / /4� + v 1y'; \`• 1 J ^y .3s Ot �1 i,_'!r`, - �°t`� ` �a f re ' •'``1 C �'�Al w a1 N / f e" �► / ' t,+ Ot's, ( 1G • s /' � �i A"1.�7►-'( 1:=G,b? La%t t 1, +,tJf �"� -� . ' � l _lok woo g -45 1 . i` .. \ ,. y ,•" ,J J '�< ^"'"e�sR� '°s"s+-�?r�re'ail!'+:sz.S�.S ;r yo �9� J / VVt�t��l E N�`Nr I(� ..� r .tee!..#SR TO F. 1 �N� �"'Ac k R+l� CA r f QjL y/+y7, v 'M i RANK {3 � MA. CO" t 4 Per YtC�►.� 5DYE - /• N �oX ST2 LE�f#L PR ErlN T aF►t.tf 5 f' M Pr2ia -- �cnr�i_ _.__ 1 !r�>FI L3UAllj kA E- � ...` �•,(� `... '+.. *^Ta l4 _. ` 'tea / ..+L.w•-� _ / � , � V'�+ T •.-• t.--. l ��. _� M,.+. • ---.... •-. . � A, ,✓ � W'"IWN. fF`�iiT' �" : --let � it oc R • • �� -� t c. i Mtt,1 1 > c.�11), - .oo E __.. ©,ese� •t-y 4"Po L %,�, /°►� , _ 20 mlw. 5eP-TI G 5V6 reM CON 5TP UC-'noN • I CONFORM -rb -rl � nn . Nunn15fg OF i5so aoomr> � RCai�tM T GODS -rITI.E Y en, CA F1Low • 3 t .._. _ ^ :. �1GV 1 gED -j-"l7 THE Tb'K/N � .. s = - Pgr.r EX1 T '�, ! . I0v i . �OAfZO O¢ WF�►fr-'�4 IZ95r4 �I�A'flald5 { LEAGI-��1�,ICa RATE 5 E ell c.'CAN IC, o I STIR I 1 ?i o r,1 2�0 F2 Q `V. GF.AGI- . Gl-kQA G 4 Tl� � - AN v t-EAcwa rN + PIT To a of c G s�v �, r` Ra✓�r.1F•©,I'�,cA �v,��r ca cR`,rr� 3oaoP5 PRo9a5av � AWN . �� �t� • ��4#G tf�1 G Nvi� �,,, � K. rT x � �, r., , � r�•y W'l� .1 1 T i 1/ t V �� 2DraaC)PSI - �•• r�:, � �. -POT EL. 10 LOAE)lp4cq �,71�1�- wra� C v ' �I k: � pt2�lF..*Ay f�IOT' -r'o OF. LOt.•,D►''(�L� z ALfv -7 ��.( �F-'�� � ���.-���w ►sty,,.. � �T� Tb RN9• R�Eta, of iD' ► _ ENGINEERING C.R.�. -ki- -r�R DESIGNING BUILDING ....._ .... ... _ INC. 385 DE OT 0 0! M I