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HomeMy WebLinkAbout0256 HOLLY POINT ROAD - Health 256 Holly Point Road Centerville A=232-031 M E A►De No.2-153LOR UPC 12534 smead.com • Made in USA Ac C4 d No- 'of U — l 3 Fee !0O — THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS YeS 5 ZIPPlitation for Mi5p0al �&p!tem COY 5ttruction Permit Application for a Permit to Construct( ) Repair(. Upgrade( ) Abandon( ) 5✓ Complete System ❑Individual Components Location Address or Lot No. 2_5 6 ND l ky Point go Owner's Name,Addre s,and Tel.No. 417 &_niery t i l t Wl I li Ct i'6 Evc n 1 lel Assessor's Map/Parcel Q3z t1�U r c'_L l 3 l 25(o N°ply-P°I k\4T In taller's N e,Address,and Tel.No. 568 -477-0663 Designer's Name,Address and Tel.No. G�L3r XcavaflOn t Sawn ape_Fn i.nee rt a� t Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building_1k6!dAnj_A, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 0 gpd Design flow provided 7q gpd Plan Date 10/1 q I 1 0 Number of sheets Revision Date i✓/�- Title Size of Septic Tank Type of S.A.S. Description of Soil , ( ,� m Nature of Repairs or Alterations(Answer when applicable) Date last inspected: .5-11 Y1,101.4 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by /e r, Date B v Application Disapproved by. Date for the following reasons Permit No. P-0 1.4 Date Issued /U „4� e �rrar�— -- —_-- — — -- — ----- —_--- — --i--_------- ———— No. ¢ ()fp 'ot Ll1 ri Fee /0U r if - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: "PUBLIC HEALTH'DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes `T[ppYication for Mizpogal *pgtem Cou5truction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) U Complete System ❑Individual Components Location Address or Lot No. 2,54 f 1U 1 VO i of E O Owner's Name,Address,and Tel.No. �.�7 9— 1,U U �Ctl-if'_-ty; 11e VVIIt Incr\ c�vclC,lle Assessor's Map/Parcel 'z�z I`CI f C J ( 2 5 (c �1 U L L\-j�U l l\1 1 J Dj (,'C((i l i C-t'V t(1 t'. 'I ' Installer's Name,Address,and Tel.No. 5 08 9 7 7 666 Designer's Name,Address and Tel.No. 6l� 3 f 12 x(n\)a1Ic)o �Uw�� (O-P-e 6)c 1,,(CI L. l Ten hp( ( \Lim fl,1E'S1tIc�LO MA 53 a f „ �/Tf -o ,U-tt ci t Type of Building: { Dwelling No.of Bedrooms_-3 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Buildings l C� ,(j [R .. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ,3� gpd Plan,Date j 0' Number of sheets I Revision Date I � a Title ) f IL Size of Septic Tank f Type of S.A.S. r Description of Soil iz3 , # Nature of Repairs or Alterations(Answer when applicable) 1 i Date last inspected: ; 4 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed - _ Date Application Approved by l Date Application Disapproved by. Date for the following reasons Permit No. a 0/D 7 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 -T�1 LR F x( T I ya i I&n at ��(�` �;�G 1 i�n r: ,t / �i Cj � �'� }� �f V I 1 � f? has been constructed in accordance i � with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 0/0'y/3 y dated ( ��/O. Installer��Ohe LT (I I L r 04 Designer rJ J i l l j� f n r ; , n('r f #bedrooms 3 Approved design flo 3 , pd The issuance of this pe it shall not be construed as a guarantee that the system wi; function as desi.bed. Date 1/0 Inspector l No. —?C)0O "t j Fee ! 00 r THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS Di5p0al Aqpp5tem Cou$truction Permit Permission is hereby granted to Construct_ ) Repair ( y� Upgrade ( ) Abandon I System located at (p 1 U L L\� Pb IJ-i ll re- -System and as described in the above Application for Disposa Construction'Perm`it.The applicant recognizes his/her duty to comply with Title 5 and the following•local provisions or special conditions. J. > C I Provided: Construction must be completed within three years of the'date'of this pe• it. Date /Ola /rf Approved by (� (ej -' FROM :down cape engineering inc FAX NO. :15083629880 Nov. 05 2010 09:22AM P1 I /0 -V iA C FT132,6 0 R71 Se Thumm ?. (' igm-, STABLr, WASK (,N Thom' 'cm, ncitn,os Mc-ka 'M r 201) h1lain Alviumis.,M-A 02601 Fax: 508--790-63016 N�Omw Cerfific afi.ou Form. DRte: Sm,k1grPer1Il'6fthV Assessar'� DWap\Pm-cel 2,3 Des gupx* o 1W 11 C 0-,Jatl 0 A Addrpss- 0 1 P) Addreqg- Ll 1�A ni 0D. )012-91 r-) jija�jo() was issued a pen-nit to j_U,3fiq J1 q (date) ust, (--T.) septic;sysitm all 1 ktscd on a design draw)).by (a dress cLated I (,eAi('y that Lhu ~),stem refelelacod above. wail iMS"Lalled substantially accordjnfi, to the design, which may include mbio-J'- ,IpprUved chwiges such as lateral.re(ocation of the distribution box and/oi septic tank. 61WO-r"* e,,d, Ju r. cer-hf y tbX. the septic systel-0-ref0iuncud above was installed with i,iLi,9jor changcs (ix, , g ratc, " or any wrtkal rolocation oJ*aiiy COMP(Me.11t i .r than 10:, latc..'ral roluation of Jit S'AS o of the (I(; systmrj) but In accoi-dance with State &, Local RugLILLIMIX- PhIn TeViSiU. 07 ceft-i Red u-built by designer to fbffow. v\OF Afjyam' S; &2a 17ANIE1 A 0JAL (111st"t1lor,". siguk-u .) I civil. NO'46502 $1()N L i-- gT1Li[L1TP,',) (Affix D,Nmgntr'ti Stamp .Uere) PLEAR RETURN TO fi.43RNSI'A o Ly PUBLIC .j .f D.kVjl.,NJOJS, CE ilTIVICAIT UY CONTLUNCE WiLi, NOT j3l; '16SUED UT WATT, B07iTj J`)gy�' j,'().KIM tplN'D AS-BUILT CARD ARE Town of Barnstable �19E Department of Regulatory Services y ���e Public Health Divis10ll]l Date a' 200 Main Street,)Hyannis MA 02601 tgya ,� rtl Yr Date Scheduled_ U v Time Fee Pd. ` \lac D D Foil Suitability Assessmentfor Sopage Disposal Perfonned.By: QiVI'P• Witnessed By: 1/1 i ]LOC 4 T1ON-& GENERAL IN O)[�Iv1i MON Location Address a6 G r�0l� 1 p 1 'It ILK Owner's Name �� (/t C. Address J Assessor's Map/Parcel: Engineer's Narttc .�0 GayC NEW CONSTRUCTION REPAIR Telephone it 36 a T ST r land Use. "A'�'p Slopes(9:0) 6' Surface Stones Distances from: Open Water Body It Possible Wet Area ft Dtinking Water Well ft Drainage Way ft Property Line ft Otlier ft SKETCH., (Street ua e,dimensions of lot,exact locations of lest holes&perc tests,locate wetlands in pratinuly to holes) 1� 10 fig— D J -� �� �! �t� hl � 2 � SEF Y 7 REC'D ' �� �c4 By - Parent material(geologic) � « ' Depth to Bedrock Depth to Groundwater: Standing Water in Hole; Z UV— �� D Weeping I'ra!tl Pit Ptlt a 1t�IV Estimated Seasonal High Groundwater - 16— t D]ETERAUNATION FOR SEASONAL 11101-1 WAFER TABLE Method Used: Depth Observed standing in obs.bole: In, Depth to 5pll ImAtIgs: In, Depth to weeping from side of obs.hole: I!L Groundwater.Adjuslment e ft. Index Well It Reading Date: Index Well level _ AdJ,f:.letw, A41,flruuntlwuter Level _4 Observation /' Ii/' Hole## Time at 9" � � Depth of Perc 1i Tbnr at 6" 4 Z'vo I -1100 Start Pre-soak Time @ /l.07 _ Time(9"-6") End Pre-soak Rate Min./Inch X,',, /N Gl Sile Suitability Assessment: Site Passed_r N Silg-Failed: Additional Testing Needed(YIN) Original: Public Health Divi:,ion Observation Hole Data To Be Completed on Back-4 ***If percolation testis to be coeiducted within 100' of wetland, you must first Uotify tile. Barnstable Conservation Dlvlslon at least one (1) week prior to beginning. QAS EPTIC\PER CFORM.DOC _ R1 D lEROBS RVATION FILE LOG Depth from E Soil Horizon Soil Texture Hole Surface(in.) Soil Color Soil- Other (USDA). (Munsell) Mottling (structure,Stones;Boulders, Con istenc % ravel Depth from DEEP OpSERVATION HOLD LOG Soil Horizon Soil Texture +e# _ Surface(in.) Soil Color (USDA) SO1I Other (Munsell) Mottling (Structure,Stones, Boulders, _ 20 �iLL. Consisenc %Gravel D E]EP ®BSERVATTO I3®I,� Depth from Soil Horizon ®� Hole#_ Surface(in.} Soil Texture Soil Color Soil (USDA) (Munsell) Mottling (Structuree,Other Stones,Boulders. C_onsisteney 90 t3nvell 74 DIi;RP OES]ERVATIGNROLE LOGHole# _ Depth from Soil Horizon Surface(in.) Soil Texture Soil Color Soil (USDA) ,. Other (Munsell) Mottling (Structure,Stones;Boulders, Consisteney------------ --T--� - to G /.6 Mood Insurance Rate Malmo Abovc 500 year flood boundary No Yes Within 500 year boundary No_ Yes. Within 100 year flood boundary No yes _ Il�a;ia h o� Nyturally_Oceu¢rrunu]�eirvious 1Vgaterit�] Does at least`four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the'soil,absorp '— system? If not, what is the depth of KRUirally occurring pervious material? -.- tCe�t>I�caHan I certify that on (date)I have passed the Soil evaluator examination approved by the Department of Environmental.Protection and that the above analy.-is was performed by'me consistent with Ole required training, expertise and experience described in 10 CMR 15.017. Signature_._.. " Q:\S.EPTIC\PERCEORM.DOC Town of Barnstable Barnstable. Regulatory Services Department 9t� SS, i Public Health Division \�A�i6�9/ a` 2007 vmod 200Main Street, Hyannis MA 02601 Thomas F.Geiler,Director Office: 508-862-4644 Thomas A.McKean,CHO PAX: 508-790-6304 CERTIFIED MAIL# 70081830000205009472 6/14/2010 William Budailey 256 Holly Point Road , Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located 256 Holly Point Road, Centerville MA was last inspected on May 26, 2010,by Sean Jones, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Any portion of the SAS, cesspool or privy is below high ground water elevation You are ordered to repair or replace the septic system within One (1) year from the date you receive this notification. Failure to repair/replace the septic system within,the deadline period will result in future enforcement action. OF THE - ARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health rrC1C�aply Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments s 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Citylrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information I - on the computer, use only the tab 1. Inspector: key to move your cursor-do not Ricky L. Wright use the return Name of Inspector key. B & B Excavation, Inc. 116 Company Name 14 Teaberry Lane Company Address B Forestdale MA 02644 Cityrrown State Zip Code 508-477-0653 S14595 Telephone Number License Number -; t C-D B. Certificationa I certify that I have personally inspected the sewage disposal system at this addresszand thatthe information reported below is true, accurate and complete as of the time of the inspection. The,,inspec ion was performed based on my training and experience in the proper function and maintenance of_on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 oP Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 5/19/10 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 t the same or different conditions of use. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 t Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 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. Check the box for"yes", "no" or"not determined" (Y, N, ND)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. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria 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 '/z day flow t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ® ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified 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. 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. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Cityrrown 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)] 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 l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M z 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 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 ears usage d n/a 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date Commerciallindustrial 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: t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): cesspool in line with 6x4short pit for overflow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 256 Holly Point Road �M Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 25 years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: greater than 20' feet Comments (on condition of joints, venting, evidence of leakage, etc.): At time of inspection building sewer appears to be in good shape ,no sighns of leakage or blockage Septic Tank (locate on site plan): Depth below grade: 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: Sludge depth: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 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.): 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): 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 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert n/a 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.): no d box Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 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: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 256 Holly Point Road Property Address William Budailey _ Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: (1)6x4 ❑ leaching chambers number: ❑ 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.): At time of inspection leaching showed no signs of hydraulic failure but bottom of leach pit is in ground water Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 in line with pit Depth—top of liquid to inlet invert 6' Depth of solids layer 0 Depth of scum layer 0 Dimensions of cesspool 5x6 Materials of construction block Indication of groundwater inflow ® Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ��M s 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): At time of inspection cesspool apeared to be structally sound no sign of hydraulic failure but bottom of cesspool 4" in ground water 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.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 256 Holly Point Road Property Address William Budaile Y Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. City[Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately Cl 'a t5ins•09108 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 15 of 17 . 1- e Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 8 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: could see ground water in bottom of cesspool and pit Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Y Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 256 Holly Point Road Property Address William Budailey Owner Owner's Name information is required for every Centerville Ma 02632 5/19/10 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 1 .q COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A �CERTIFII�CATION Property Address: S� 1 o� t t�i.J Owner's Name: Owner's Address: 25% /y o n/-' Re>AO Date of Inspection: / < � 5 Po 17<Z A Name of Inspector: (plea a pri t) ��w9R� sTGG.✓Gr �oZ -- 031 Company Name: � S �/ Mailing Address: 729 39/ g Telephone Number: �5w,!q — / CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my rraining and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: V Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority., ails _- Inspector's Signatu - Date: 9-p-i6G The system inspector shall submit a copy of this in pection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. , Notes and Comments ran / / ""This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address hoNs the system will perform in the future under the same or different conditions of use. I itic � Insrcc[!on. Form 6;1 i%?000 ha"e I Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property address: il-2�'t// d r-!/ Owner: Date of Inspection: 9 8—aG Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D :y%ste.5,1asses: v a 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: dU�� Ol^ ✓ B. Sys Conditionally Passes: One or in e system components as described in the"Conditional Pass"section need to be replaced or repaired.The syste , upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not dete i ed(Y,N,ND) in the for the following statements. If"not determined"please explain. The septic tank is metal and ov 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying s tic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it i tructurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is vailable. ND explain: Observation of sewage backup or break out or high s tic water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distrib 'on box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructe ipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 i I'age 3 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) 1�Property Address: zSG `el' ld �-�7 Pvvi Owner: Date of Inspection: C. Further Evaluation is Required by the Board of Health: Co itions exist which require further evaluation by the Board of Health in order to determine if the system is failing to otect public health, safety or the environment. 1. System *11 pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is n t functioning in a manner which will protect public health,safety and the environment: Cesspool privy is within 50 feet of a surface water Cesspool or rivy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the oard of Health (and Public Water Supplier, if any)determines that the system is functioning in a mann that protects the public health,safety and environment: _ The system has a septic tank d soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to surface water supply. The system has a septic tank and S and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS d the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and t SAS is less than 100 feet but 50 feet or more froth a private water supply well". Method used to dete ' e distance "This system passes if the well water analysis,perfo d at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the ell is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equ to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be att hed to this form. 3. Other: i 3 Page 4 of I 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: AO(7I v. Owner: Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No L-4ackup 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 ogged SAS or cesspool .y/ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or ,,cesspool widd epth in cesspool is less than 6"below invert or available volume is less than '/z day flow �°% .5 n 4 Te. ired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number imes pumped y 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 ,jater supply. y portion of a cesspool or privy is within a Zone I of a public well. y 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria ^,,// are triggered.A copy of the analysis must be attached to this form.] -r0 (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Systems: To be consi a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either "or"no"to each of the following: (The following criteria apply to stems in addition to the criteria above) yes no the system is within 400 feet of a surface g water supply the system is within 200 feet of a tributary to a surface ' ing water supply _ the system is located in a nitrogen sensitive area(Interim Wellhea tection Area—I WPA)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 at,or answered "yes" in Section D above the large system has failed.The owner or operator of any large system con *red a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 3 MR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: ✓ a Date of Inspection: �06 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes 0 Pumping information was provided by t o er ccupant, 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 ? V 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 ? V Was the site inspected for signs of break out ? (nl��v�tny Were all system components, the SAS, located on site ? / 411Tir.14 45 77arVk ✓ _ Were theih�PLZ5 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: Ye�L — / Existing information.For example,a plan at the Board of Health. V — Determined in the field(if any of the failure crit ria related to Part C is at issue ap roximation of distance is unacceptable)[310 CMR 15.302(3)(b)] G �SfOvas cdyv���.J Lees% /% �.�>/1✓�7jf ✓•ASP, 5 Page 6 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: ZS4. (-���Y PO« iZd Owner: ?2aT r- Date of Inspection: 9- FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 1 10 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no): Ye 5 Is laundry on a separate sewage system(yes or no): ;J:v [if yes separate inspection required] Laundry system inspected(yes or no):A/A. Seasonal use: (yes or no): No z oaC_ z(.vuo q 31 t' z�S I�G,a�o_ 371 k Water meter readings, if available(last 2 years usage(gpd)): t 3r 3�s' Y Sump pump(yes or no): Last date of occupancy: Cy{�Yeyjf �i�roNf/isl`���, A114t_COM RCIAL/INDUSTRIAL Type of es ta ' hment: Design flow(base 310 CMR 15.203): gpd Basis of design flow(seats ons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(ye no):_ Non-sanitary waste discharged to the Title 5 sy (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: d�' ''L ��/ � ��}fI — " ��cT Was system pumped as part of the inspection(yes or no): If yes, volume pumped: W llons—H w was quantity umpgd determined? s� Reason for pumping: �� ocY /il ad r e-{ /ry 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 :)tOther(describe): �SS DU ddl� d5 y r � ��z w1/ Ap roxima age of all componen s,dat to cif known) d source of information: 9/-/9 a ( .>ti► � /ice S-�s 9 ✓�rsQ�.� `e��°� Were sewage odors detected when arriving at the site(yes or no): 1410 AP 6 Page 7 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INF/Of/RMATION (continued) Property Address: 25G / v(fl Owner: raff— Date of Inspection: BUILDING SEWER(locate on site plan) Depth below grade: 12//� , Materials of construction: mast iron �40 PVC_other(explain): Distance from private water supply well or suction line: 7-✓0 6r14 770 'Fx c c- 'f/-/4V-'v t pa A— /(p Comments(on con 'tipn o joints,venting, evidence,of leakage,etc.) /G�/�/� i.,T are A, SEPTIC TANK: /(locate on site plan) jL S�-t (PSS(.7 —�,t De h below grade: Mate ' I of construction:_concrete_metal_fiberglass polyethylene _other a ain) If tank is metal ' age:_ Is age confirmed by a Certificate of Compliance(yes or no): _(attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to ttom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of out e or baffle: Distance from bottom of scum to bottom of ou ee or baffle: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or condition, structural integrity, liquid levels as related to outlet invert, evidence of.leakage,etc.): .bl GREASE T locate on site plan) Depth below grade:_ Material of construction:_concrete_me fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,struc I integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / /SYSTEM INFORMATION(continued) Property Address: 1y�G ftr/a� �14 f r� 4 vI e Owner: ye t Date of Inspection: - 9- O C TIGHT qr HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below�gr?au�- ccMaterial of cncrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): All DISTRIBTI (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets any evidence of solids carryover,any evidence of leakage into or out of box,etc.): p/ PUMP (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 app ances,etc.): 0 Page 9 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ''// //SYS,TTEM INFORMATION(continued) Property Address: z56 /`7�1 O'o/,I/ Q Owner: Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) ,{ SAS W located p<OaM i6*: 6-12 Type PY¢ras a Is 1,00' leaching pits,number:_AVZ-'- Z h tZ"a�t p,(• --� �iP�� ,,•,,� _ ►� / leaching chambers,number: �� " e 6, t n, A,�+ leaching galleries,number: o a e I �/&v RZO leaching trenches,number, length: o a Ut leaching fields,number,dimensions: o " I Gc�he%e iT overflow cesspool,number: innovative/alternative system Type/name of technology: Comments of condition of soil,signs o draulic failure, level of ponding, damp�Sol l,con ition vegetation, etc.): / d/�yr/l �l/oK�) ( °h� /ar✓v� —46P--d/ b/ �- G 17" n CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site pI C4�1� TWO etocv- fNumber and configuration: ��� c & z i� e�� Depth-top of liquid to inlet invert: 2�" ✓a1 rj� Depth of solids layer: 5t H Tlo ¢`l Depth of scum layer: P`t 61Tt Dimensions of cesspool: �/ 53�� Corc Materials of construction: elcA,< 6 c,'4a cons f' t &<1k Indication of groundwater inflow(yes or no): o Cory Comments(not gnditio of Sol] i$ s of ydr ulic failure, level of ponding,condition of vegetation,etc.): aY /!�/lT �l/d.✓Ls" /l�.�r! A w d.K O fd rri� Vt+ PR locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments (note condition of soil, signs of hydra failure, level of ponding, condition of vegetation, etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ' SYSTEM INFORMATION(continued) Property Address: 256 y Poll', Owner: Date of Inspection: 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 ' s � c water supply enters the buildin . 42it—TWuc/w/.ara+t 'q/ �C hHdozif�Gc� S ASSeX, O5 31 Ol �23G 8 J� b M rwk L+recv� -- Gt�a�c/ t .R<ocK o l rj4- 10 Page 1 1 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) zs / Property Address: 17e— Owner: 4 r� Date of Inspection: 9 -66 SITE EXAM Slope / % - L Surface water Lf/�G � Y� ��✓�G✓Q� Ue� /Sv-i~ �o < o�riF�'-`�`Gl Check cellar dv�� Shallow wells 0,,, clhy �1✓17�.1���✓ Estimated depth to groundwater /D feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Chec with local Board of Health-explain: ecked with local excavators, installers-(a ch documentation) y g Accessed USGS database-explain: Sii c PvY� You must describe how u estab •s ed the igh group water e evatio l�s� �I� z9_ 71�-• C ,.,�.�y►�l'�'- -�Q Ik,�(yid.1N� 4— fprQc,,,,4- VJ LW 1e� PL S ��� 3�•� qrd j i-e� AY 11 TOWN OF BARNSTABLE LOCATION y SEWAGE # ('91 �9s> VILLAGE,.- C-e-V711 ,11- _ ASSE SOR'S MAP & LOT 23Z-3/ TALLER'S &PHONE Nol /15— G�CY/12�e-'Y o '5 '141 W��`�'AS1�C EI=TIC CAPACITY d�U � � �ttc� Onsf 1< LEACHING FACILITY: (type) CQLC/ �ZU�otG d r (size) Ord 4 Nl�'OF BEDROOMS{ 3, - /Z BU//II,DER��JJOR WNER yvdar PERMIITb 9 e-o� COMPLIANCE DATE: S is Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 1. 3 Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) eet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachi�g faci 'ty) / I- Feet Furnished by /- - ftx)e g �4S {Sys J /Z 23 -,6 p.C . SJ > / c 1 _ TOWN OF BARNSTABLE ° LOCATION �� oC.GY �iNr SEWAGE # VILLAGE ASSESSOR'S MAP & LOTcAl. ---oaj INSTALLER'S NAME & PHONE NO.,&04rVWW7 e,0&97- S6TIC TANK CAPACITY LEACHING FACILITY:(tVpe) (size) NO. OF BEDROOMS PRIVATE WELL O LIC WATER BUILDER OR OWNER A::�-pojo%w DATE PERMIT ISSUED: IS7,41, 9/ DATE COMPLIANCE ISSUED: -/ e� AK VARIANCE GRANTED: Yes S a / t ` ! k �VGrW ��.DPiz- C�S.SS f'�GL l0/c3 Si73A1� No... ,f` Fss............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilan for Disposal Workg Tonstrnrtinn Jkrufit Application is hereby made for a Permit to Construct ( ) or Repair (b< an Individual Sewage Disposal System at: --------..�....� ...•... t Y_�� �..... G�.•�; tic. L ation,Add r c� 5 / or Lot No. .......--•- -•-- Owner A dress Installer Address U Type of Building Size Lo w A4V-=::...Sq. feet Dwelling—No. of Bedrooms.............Q.2----------------------Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type of Building ......eZF�'----------- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ---------------=--------------- . W Design Flow.................... ..............gallons per person per day. Total daily flow------------ ..................gallons. WSeptic Tank—Liquid capacity.:.........gallons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ►-' Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.......--...........,-.. 4q Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ -------------------------------•--•-•---••-•-----•-•---•---•-------•-••---------••-•---••---•---•---•..... •---•......-----•-------------•-------•-•-•------ O Description of Soil...........J.:7....�—'4 ----�.s�..�._�...... -'` U ---•----------- .............................................................................................................................................................. -----------------------------•------.....----------•------------------------•-------------------------------------------------------------------------------- UW -------------------------------------------------------------------------------------------------------------------'---------------------------------------------------------------- ..... Nature of Repairs or Alterations—Answer when applicable----- ........ta.D.4 �..... tf-.......rr. -----------�17V E-------------.2.3---------��--.v--- 2 � '�' ..................................................... 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 been issue by t board of health. Signed ......... --- . -- ----- ------- - ----- -------- ............... Date �`--.---. Application Approved By ----------------- _- -- --- ---......... ---� -�Fj Application Disapproved for the following reasons- ------------------------------------------------------------ ---------------------------------------------------------------------- ----------------------------------------------------- ......................... ---------------------------------------- PermitNo. ........ -1--- eJ--------------------------- Issued .-----------------------------------------------to------ Date qq No...!.� /?.!S I Fim.� ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uiigvosal Works Tonstrnrtinn Famit Application is hereby made for a Permit to Construct ( ) or Repair (b< an Individual Sewage Disposal System at: -�S -----• •.... ............. ---------------------------------------- � e�� Lo ation-Addre s or Lot No. W ............ .-Q-._a.. -.- ............ Owner Address -•--c a.� -... rs> 7.��....�-�L�Y 2?4 .......................... Installer Address Type of Building Size Lot- �1%1� .Sq. feet U ----- DwellingNo. of Bedrooms......_.....�. ......•...............Ex anion Attic a — p ( ) Garbage Grinder ( ) aOther—Type of Building -----r Z�ES........... No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ........-••-•-. ••-•--••-••••---•••------•----•._.....•-------•--•••-•---••-•••-----••---•••---••••....•----•••---•---•-•..................•---•.---• W Design Flow................... 4 ............gallons per person per day. Total daily flow-..........6._:5LR4'�..................gallons. WSeptic Tank—Liquid*capacity._..........gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. > Seepage Pit No............... Diameter............---..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.--................. Depth to ground-water..---.-.-.-.--.._----.-. 4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........--..........--.. P4 -•-••••--•---•----------••---•----••----....---•.....-••--•-•---•...............•---•---------•-----......................................................... Description of Soil `.. ?-F..!1... `_r'Q Vx ...e .......................... .....................•-------......_.................. W U Nature of Repairs or Alterations—Answer when applicabl -----'4140------.��.106_r-�_/�__Z.f�e. ---------------- --------- 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 It c board of health. Signed........ c s t 1.. ...�1: ...t. -Q -- 5 t, ,. i • ' '. s � Date Application A' roved B ` PP PP Y ................�� \�--. ...t., ,- z t f Application Disapproved for the following reasons: ............................................................................... ......................... ------------------------- --------------------------------------I---------....-----....---------..........--------.......................----------------....---------------------------------------------------------------.-..... ....................................... Bar PermitNo. .------�7/,t--... Issued ------------------------------------------------------------------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Terttfirate of �L��ant Xtir nce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by---------------------------------................................ ��D �1 -----------c'w^1 s loe -ram .............................................. .............-- Installer at .....................................................��s 1�......... eo.................... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......................................_........ dated -.....------------ .-----------------.---------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-.. - Inspector ........ �~ ----------------------- THE � COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No...;. � ........ Disposal Works 0.111nstrwtiun P.rrmit Permission is hereby granted..................�/).a-72JI .i�h........f .............................. to Construct ( ) or Repair K) an Individual Sewage Disposal System at No...............••---................_.<-- ._.,. �?�_/:` _.�l!��,! `...., �'---=---... �l�lll. Street as shown on the application for Disposal Works Construction Permit No 9 _Dated........................................... .............•-----•-...... .�. -T� '� ----•-•--................................ , Board of Health DATE ..S; 7............................. FORM 3850E HOBBS h WARREN.INC..PUBLISHERS ' TOWN OF BARNSTABLE LOCATION o 54 l/o//W Po;na Po, SEWAGE# - q34/ VILLAGE 0 c n4c r jj,'/Jr- ASSESSOR'S MAP&PARCEL 3Q - 3 INSTALLER'S NAME&PHONE NO. R EX e a v ct-4; O f\ SEPTIC TANK CAPACITY IS'OO LEACHING FACILITY.(type) Tr Incl.e S (size) a X 3 X 3 Q NO.OF BEDROOMS 3 OWNER- (3;1 1 ZUdGt;/Gy PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility). Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Ai- as ' Sit - 30' A2.30 o 132• 0 " V A3 - 39 ' A Ay - ,v-/Z 00 T � a � cri As AG• y� " 314 Not1y PoIf",% Rd. " .LIE 28,2014 ATE MU DRAWN BY: DEY - '''. . . NaRa!!a°Ymmlma Ymalwrm 'mn wu��a�'a"'mM`w�amNnmo ,. - ,. wllY.Pw.:®YmlPelaNQNY°,w,xeaRw.NPw desi9n.Go contact®hpa m . - - >IoneNuwxmnweaPUA.uxoNve.avb¢�,an - . 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I-- _-__-___________ , em°' XYl XF2AlQMOe N0¢4llmlllolne®N4xNGanT1tY.Pb "0.¢oOIWxOaPRMaWIYMAl10["MpaNrtlla lYILOTVCRIa@fN¢® I I - - - - ♦wxoa<.malwAx><zlm,..awlxlfP..lam,v�A °mr.PoeP � -1 !Nv1YaAx'a1xmA9"M®lBN5.91eb1®IeWMSRIe!tmA111P�0MN161e6 I -----_------ I iv �roPwvmra rw.emAcalomlr.mMn.IxlxnmwmNUNen J ro•KaDE GONG.KALE I - !d 20 KEYMY INTO I 1 24•KADE x I2'D�ES�mV 1 I GOM)NUah COIY..PWTIN( Lm®tND0.YleWle®NMmNPILTm¢IB°lbflBN:fMAWf1PN�l®¢XTJ a(L�J �LI' I 1 a'R NIN BHOHNWI RwSN® 81 I e� - - STMTURAL/FRAMING NOTES �'� A SOIL CONDITIONS AND S1RllG'NRAL FILL - - �,rrcl {,...I z I 1 6RADEONUIDISFIN%IE it5K I m Ai¢ix uoev+1.�eeixulvnJ.w"mv�.oarwrNsminw.Mxc ' Uj . SIM-6RADE.(IYPICALJ u �xmwa�mMA�ramrtaa�H n»'�ea¢mNo�®are�Piarwiwm�QNo . I I Jumm�PPexa:av!® aseexaa�N¢Nxu larallNciwN.sNvumNTP«mAlmNwwoebor�rnva�xines�vu Note: The exterior walls meet the prescriptive C) 1 _ MMR1GIxxR bTBNDRBE. xlem®Naaww welHaP�WiIDROPP.e61B4PEItID aVRfl . �116EnN A11LK�NE6�MroM IT�W eme®2�MbTMNp.IM Q maePmeamlavu �AJlwxmwlewselrarlaeweaxY - � ���,� ae Q mnavural:RNmunlAminxxvuxlmlbela I intent of the Massachusetts State Building Code N nxuaumxmxu°rcxNR roMN x ° � �� =per xNemM� %n o i I APQnanxr4lmw+rn.er ew. n Nvwm snenvu»NmanxaNxMNmaawmerxxuNl.u�axro wms,xxum aaai>alam a iu®!¢�sataxuexn¢w®auvNum. ' MmAaimMrg111rLm9Rp¢06 Blr1mRl Mi0il. (� n� I I a srxErmiaraiflvuB? au:nbavNvwlQeemmQ®®e�Ava.NQwua? 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FIBERG ROOF SHINGLES PATR 6./- .. .. 6N- - ICE!HATER ROOF SNIN6l8 - - 2013 ME. .. ... ... ........ �HE. - `--_�______________�______--__ 5Ax FELT TING HOUSE 20130118_MOORE - ................ _______-__ - .. .. .. _ ... .. _ .. .. iaP�ATE - I/2°GDX PLYWOOD SHEATHING V*TER SHIELD TOPIPLATE .. .... .... 15FM6:€K -. .. " . .—. I —. ROOF WRAFTERS IDE ICE a(SEE FRAMING PLANS) 20140178C,D5 . .. - SCALE SEE DRAWING'. .............. .... - 2°MIN.AIR SPACE - �NBIONB: .. D e DATE DESC q p / \ /-£NSTIWS NpF.E _P - TOP OF PLATE ALUM.DRIP EDGE -O 6T/14 Ix FOR COPSTRI.rTON F b d 9pB0 ADS GYPSUM D.ON Ix FA5GIA BOARD(ME) AS SELECTED KkT ZABLEHATCH - - Ix3 STRAPPING®Ib"O.G. ALUM.GUTTER �y OMIIR UUF5EE TOL. _._. TDL - 2,2x6 TOP PLATE 2"CONTINUOUS SCREENED ' STOFE VB�L MATCH ;Q ALUMINUM SOFFIT VENTS. Ix SOFFIT E. i SOTXONC L ---- ------------ - --J L---- -- ----- --- --- ---------- -----i BOT/CON6 `� MIDINS EXISTING r SHEAR HALT-TYPE°A' 'TYVEK"AIR INFIL.BARRIER /2"PLYWOOD SHEATHING HPA Des 1111%hIC FRONT ELEVATION RIGHT ELEVATION 2xb 51LD5®Ib"O.G. WATERTABLE - MATCH EXI5TING Zoo Stonewall Blvd.SLMo 5 1/4" = 1' 1/4" = 1' (e2xxb SILL TOP/GONGRETE PRE55URE TREATED) WTantnenl `�� TRIM SNAIL MATCH - 5/8'DIA.x 17'ANCHOR BMT5 II H/PLATE 1/4'X3'X3' 508964,6898 fll DaNA L MATCH HaM5E - - f e 3'-O'OL.a I'-O'a wRNBt5 . - B'MIN BENT 6OLS84MM M bf J� J� bi- Flee+vux wale wart a<.... `p RADE(VARIES) ME✓ v ME RA7F SHIN61$ ICE l w,Tac GARAGE SLAB :°• `. �•..` ",,.. owtm ahaadssi�am r SHIEID STONE VENEER -------------------------µ---------------- - MATCH EXISTING HOUSE -.-._ - - - _ - - - - 7oPiPlnTE - TOPRIATE DAMR200FING www.HPAdealpican - - - BELOW GRADE - . _ Z 10"WIDE CONCRETE . Q FOUNDATION WALL SIDING,MATCM ' Ex5Tw6 HCI15E - - - `P ® �SIOM,EM-nN Har ® Q rONr "PERIMETER F.. $ / \ IX5T1NG HOIFE� / \ - `r CONCRETE FOOTING wAiatrpgL�,MATCH - 4'PVC PERIMTER FOOTING ATCH DWD ENGINEERING, INC. EXISTING IY7115E R - MATERTgqB�LEE,,MATCH NOT REQUIRED IF 5 MICHAEL ROAD, E. BRIDGEWATER TD 'D tb5TR16 H011 TYPE 1501L Tel. (508) 376-9602 — STOIdiVB✓�t,MATLH - _ TDL. - STQEVB✓�ZIMTGI — - IIIIIIIIIII : I IIIIII . EXIS7IN6 - Fax. (508).378-2922 _ �B _ IIIIIIIIIIIIIIIIIIIIIII III III III III IIII f11 �is,vRBED SOIL I I = � � � II III III III III III III.III III III III - � � i I I ---- ----------------- 4 --------- WALL SECTION eor/cONC v rl-----------.- --------------- , - L----- -----------------J BOTxoeO 3/4 = 11 n REAR ELEVATION n LEFT ELEVATION �`` v 1/4-. = 1' 1/4" = 1' V o w � 0 z LLI E e06SEE )SHOMN O l i v rum 1@ N 11N� n� CEIL 15T5(5ff. - FRAMN6J AS 1.J SH" d N NE� � �I ME qH ME. ry ------ - 1 NISSET� O I ZO 0. TOP/PLATE .L71575 R7MLM6 I TOPiRATE J01'i15 FRANRK _ - _ e T.- Lu ._.- -.-. _ I I 50fflT I - I I I FTWfiNz aw'OC I*FASCIA Q 0 GARAGE 6ARA6E i TR�tt J .. �0 W DD- I I IX 50FRT TDL -._. -I. L.- _ _ FYPON -4'SONG.SLAB I I .. BKTI6X16 OR -Q SAB Pi7LHED TO DOOR - - -°`P SLAB MTU®TO Do�GRR I 1 - - - _ AS SELECTED I I BOTKZNC BOT/COIF I I ' r F ROOF OVERHANG DETAIL - .1eOnnir.�uu,m,e o.•�.v»4 - � � n"eee w nn waawee loiapa.R>we HIM 1. - 1 rQr n.n P ,a° �Ow oAy oao�oe SECTION SECTION SHEET.• F 1/4. = 1• 1/4' = 1' of JOB NO. 201301'f2 RENOVATIONS TO EUDAILEY E�CE 256 HOLLY POINT O B;0--�NING / o BACK PORCH o CENTERVILLE, A - -V- 03 _ II INFlLL LAUNDRY MUOROOM REMOVE DOOR 11 NEW SI / AT FENLAR D OPENING -MATCH a� AND CASINGS REMOVE WINDOW I 1 W/NEW HEADER AND ENlAR1 -2-2x8 W/PLYWOOD ���AAA OPENING FOR NEW - --'- SPACER Q WINDOWS �\\vlI 1\v I ` A �--.L----� Leonard�J. Staffa 3 N o I REMOVE DOORS I C TECT�1 ( GUEST BEDROOM GARAGE . I KITCHEN BSEARSROAD _ I KITCHEN TD BE GUEST BEDROOM I I MILTON,-W-2186 327 I REMOVE ALL 817 896 7795 L� FANTFY 3� I �BINETRY; I I 817-898-2327 IOWO I �] AE9WC REMOVE REMOVE FLOORING w L------------ / rew xlw 1 —.. 8m.r--m BMT-N -- j`---- � / < tl PAR7ti►ON TYPE LEDENO REMOVE WINDOW TOSTING REMAINAR77710N NEW ENTRY DOOR W/ C N I I I I I OPERA77NG SDEUIE , REMOVE BEARING -TO BE REPLACED _------ PARTITION TO WINSTALL NEW BEAM ALLI II <\ i ------- BE REMOVED 6x6 POST WRAPPED I I \ 'm I I II REMOVE DOORS WITH 10-TURNCRAFT 11 \ I REMOVE CLOSET I I I / WOOD COLUMN, NEW PAR71110N TYPICAL SNEW BEAM ABOVEEE FRAMING PLAN I REMOVE DOORS I I 1 REMOVE BRICK REMOVE DOOR AND JJ-HALF WALL W/ I 1 I Sip —�1 II ENLARGE OPENING WOOD CAP AND III i I 11 -NON BEARING COLUMNS, TYPICAL -INOVIF BEARING INSTALL N£WPOSTS AND BEAM - -'I Jai NOTE: ALL DIMENSION ARE FACE OF STUD TO I I I p FACE OF STUD IN NEW WORK, �SU00 VV NGOOM g I I ii LIVING ROOM ry AND FACE OF WALL IN RENOVATION WORK: NEW WOOD FRAMED Ili N j 11 — FLOOR STRUCTURE I I \�i i I 11 tl W/OAK FLOORING I 3 a µ -SEE FRAMING PLAN I I REMOVE WOOD I fN I I T., o _ ( STEPS I 11 -REMOVE WINDOW tl -TO 8E REPLACED �S w.I.raw MR Oae� E?OS77NG DOORS i II LS B-1i-07 II Ivmmilm Ab Has I 1 1 TO REMAIN i (I U AS NOTED EUDAILEY-AI 0713._ 6x6 POST WRAPPED WITH 10'NRNCRAFT I I J REMOVE BEARING WALL i n WOOD COLUMN, -INSTALL NEW POSTS TYPICAL AND BEAM I I I JJ-HALF WALL W/ WOOD CAP AND COLUMNS, TYPICAL I I I NEW FRONT WINDOWS I I II N ENLARGED OPENING /NEW HEADER II REMOVE WINDOW vi� W/ 11 NEW SLIDER IN CiQ -2-2x8 W/PLYWOOD II I � �--AND ENLARGE EMSTI G OPENING PE IW'G8088 of SPACER II I OPENING FOR NEW rz I I WINDOWS LS MA. T BEDROOM- yQ II MAST DROOM m Ll I o 3= �q I r k I II 8N I II 0110 o 10 ® ® t ® ® \S.r,ERED ARi l DEMOLITION PLAN D STq��1A NEW FIRST FLOOR * PLAN ® o Na_6650 cn � MILTON. A am WIN J I or 2 H PS�PC1 war Ma A. 1 NEW FIRS �T FLOOR P N FIRST FLOOR DEMOLITION , UN NEW FINISH APPLIED 1X2 TI?IM,PTD RENOVATIONS TO EUDAILEY RESIDENCE I I 10'RD. I I I I f0'RD. I I I I TUSCON I i I I TUSCON I I COLUMNS I I I I COLUMNS 256 HOLLY POINT ROAD I I AROUND SR I I I I AROUND SR I I COLUMNS I I I I COLUMNS CENTERVILLE,MA I I I I I I I I I I I I I I I I 1 INnU DOOR OPENING NEW SOUND TO 1 I I 1 1 I I MATCH EXISTING - f m _ Leonard J. Staffa I I } 1/2' a I I I I 1 112' N I I Ash ARCHITECT] 5 SEARS ROAD Li BASEBOARD 13 MILTON,MA 02188 INTERIOR ELEVATION --LIVING ROOM ,-'-- _ GARAGEa ' ' not to Boob 6r4 POST AT EACH END OF BEAM 'NEW BEAM , Lvt PARTITION TYPE LEGEND Liu EXISTING PARTITION TO REMAIN _--___- PARTITION TO BE REMOVED 6xB POST— NEW PARTITION •AT EACH END OF •BEAM •`^ in �r-NEW 2X10 FLR .� JOISTS 16"O,G EXISTING ROOF ®® STRUCTURE e' NOTE. �.,. ------ ----- ALL DIMENSION ARE FACE OF STUD TO ' o - FACE OF STUD IN NEW WORK. AND FACE OF WALL IN RENOVATION WORK. Illm"tv dhoold bp Dow LS LS 9-17-01 ✓o" do me AS NOTED EUONLEY-A2 0713 NEW INTERIOR _ J FINISH DOS77NURf� w NEW WOOD TRIM EXISTING ROOF W/FURRING STRUCTURE 6x6 POST AT EACH END OF NEW J-LVL BEAM BEAM J'SOD WO _ OOR Li ILI PLYWOOD t OOR Q 2x10 FLOOR JOISTS, 16'O.0 m EXISTING SUN ROOM ( EXISTING LIVING ROOM NEW FINISH fL00R TO ALIGN W/ I � EXISTING MASTER IQR00_M it .` t ya�3 L SI��gg yc - --- EXISTING FLOOR' STRUC7URE- NEW S'BATT �rRQ INSULATION REMOVE BRICK R-� STEP EXISTING OOflCRETE —ry.--y-- FOUNDA7100 WALL I• NEW 6 MIL. VAPOR BARRIER NEW PRES. TRTD. FRAMING PLAN TEXISIWGV-48014 2X6 PLATES EACH SIDE EX151ING BASEMENT ,. ElSERE�AR GRADE AASREREOUIRED TO LEVEL �G\S RQ J � WALL SECTION oar* 8.q" � ELEVATION N0,6650 9 ,�► Oft MI NTON. 2 a: OWALL SECTION AT FAMILY ROOM FRAMING PLAN2 , A2 G • h OF MPsr'P _ 'x:.*i 1 47 r. ao�eee r aernorm wn owcm,�smur wasxw�o wepm Sr,+!s�et�v+nrunr«ara: ,auavYm�x uHntwxearwaw+rv. ,ruse,w:nww.mrd�w+r+wrwwwrwxe.mww.u..rv.,.rr+..rwrrw.a ` .. .. ,. ,..:: ... ,. .. .,. ,..... ...�...._ ... __,... ... ...._.. _._,.....__.__... „-....._............. ..,.,......._...,_._....,,.......u...,..,w.,,,-....,..,...ww...,...___.......w..w,..,.,.,r..............r,».«,_........«�..r.. .._..... rr� 04 TOP Caf.. F..0 UNDA'1'1()N EL EV. `? � . _ �_. Ct..E:AN SAND 4'" S(.,HE.DUL_E: 40 PVC PIPE 0: +111hd. P11011 I/8" PER FT. �� � ` ?" LAYER OF WASHED STONE 4 CAST IRON PIPE c OR f-QUAL MINIMILIV 1 PITCH 1/4* 1'I;R FT, FLEV.— NUMBER I._ � `�I �N CAC I 11 � OF BEDROOMS FLOW I -- 1�tE1Aty La SAL I UNIT w_ Y S TOTAL ES`11fviA1`kU FLOW r I" V. , _'�! .?� a I I _ 1 F? E 1.EV. ELE:V. :... 11 Ck1-5x tD _ _ ___,.._w"` _.w_� . C?A ./B ./D _ X GAL_. C)AY g_ . ._ r AYfit) / r REQUIRED SEPTIC TANK CAPACITY -; i+;t GAI di I. V ELI Vr C 5 ACTUAL 631Z SEPTIC 'TANK (' a E CIF" GAL, ELEV. 37.7�, SUMP � ELEV. 4= �1 »�' _. ° ° �, C} �___._. p_� � _ _�_. �.�._ _�- a AREA REQUIREMENTS w o o p I.,EACkfINC' �- {� l w o u ° o o v o o v 12" V `SIUF.WALL_ AREA (� IF3 3 GAL./S.F. ` ' t ^ ! we ' B V I O �E ._.. _a _ . . LE .._ -.r ... BOTTOM M r'(_'A ,...,�.:wQ S. . 1 LEACHING CAPACITY BOT�IOM �+- SIDE:WAL_L) 35£.Cf CrAL../DAY �.:' 1500 GAII.—I~ ON P u m P TO 'iF: WATER TESrf.:D 8' X 20' X 2' I � � RESFRVF I.,FACMING CAPACITY w356.0 _,... GAL./DAY 2 N A _ PALARM ONI EL...UMP On„j /4 To 1 1/._"- 7.0 • WASHED STUNL: fir_. f::L — _ 7 -�(, �-1 Y PC�°IN � c(,, A PUMPOFFIrc_.� ���. �_ MAXIMUM POND ELEVATION (F ROV DNR) - ,,,�4�Q__� SEWAGE ISPOSAI—,. YS tT�EM OF1�_.F OBSERVED WATER TABI—E ( 11/ 27/92 f_LEV. - ��w l.-EGEND: NOT TO SCALF: EXISTING STING SPAT ELEVATION C OxO .L EXISTING CONTOUR -.,.,w_.. 00 _ 6 11 • �U T M Fdd� T C?Iry' f''OUNDA"1C�N a�' � ,_ww...w__,. .-._._..w..,_.__,..__.__...._.w.__�...._...._..._,....,__.,,......._.._._......_.._.._,._......:. F'INA, ELEVATION �t h;1] ' F It+EdMUM4 L ,�I'0'r >t 1 R + 10 T "�ICNIP»;ttivS ..+ L CON TOUR 'r�� I , V. r .,,r _ _ww.w ,,... ._.__ L"E.1:.A3I SAND SOIL TI.s�T LOCATION . .. tid �VLW1 s CONCRETE TE UTILITY POLE C)- . .._,.»� , .. ... Covt.:R ; TOWN WATER bV _____.._.._. ....w_. , 4" SCHEDULE. 4.0 PVC PIPE. CATCH C H BASIN V-114. PITCH 1/8" PER FT.. � � 2" LAYER OF I` TOP OF $LA 8- TO 1/2" WAiHED *roJ ^ w 7 ' 1 rAs!, !RON r" ELEV. r A .,. .. r-..,.�. r r• r;' .A , e .':. i• •,.Aw....._w.,."�:. ..Cn,a�i.,�0�....«_�..tt �� R � ) .r .T"' ^_......... f( � (�`'W^I1[j ,,�{1 V f 1�..C Y ,(/.�� wl (^)!�w\I DROOMS {,,,, MJ �n,.S! '1 tl LI I L/1 �I S f , «_ t 7 L«.krh�..:r.. NUMn u. _ .,._ ..w.u... � ELEV.- FLOW LINE t1 � y � �._�.. _ _�_ i�f EC7. UNIT G:AI?I,�A Ol) ._�. _.. _ .. _.. -- -- ,I Gfl` I` GaAI I + iF E LE:V.� _ �,w.w� x�i_, -_. �- 1` IAL. I-.'a IMATED FLOW �E E,4 ,. ..._ _. '« ._.. . c.G f ] , ELEV. _.»: .__,.. }( ._:?,' . '-f,,�,1 B DAY X _ __ 6R. X 1. 1 f ry ) t r b , L_. �:-_ CA C-1 — ° 5 - CAA ./DAY w. ', ' C) Ftl.1t IJ 110 ^ ITY - �.�� _:. G l . � LI VF. p r� r `` f I cw �: 7 V. _. �, d C AC _ I t • 1_ _. _ _ I L _ ' _ ACIUA:. al. ! Of- SEW T C TANK _ . Lts GAL. y� �rL r ytp I l ELEV. r , 1 ' .+ 'SuY'tt ......ti?»FW'4 4 V •J tJ`N'.P ELEV T "t1.s1 `p O W../"t�l�fll�i�x w.,.:�.-�.. I ELEV. _ AREA REQUIREMENTS , _ _..,r �,. _ �? REME N�TS ® o m p o c� ' ��,����I \ I �I ��f ����3� � � p O� O C7 A � � � '� 1 11� :��.L..L AR FA r„4 „.,, 1.YAL../'7.F. ' n � v� � ... I A f d A4 r.d �._. � , _.�._...�.�_ _ ...___ _ ..._. �..._ — u __. LAC �. ,.f; a _ ._ GAl_ /s. . , r O c. J i AR ILA w ,� LEA('J lN,' CAPACITY (� EWAL ) ?.q _��. , CA ,/DAY ttJ'1TOM + SID L 1 O ., L. i X I 2x((1� „. f N I _.- ,O 91.- WATER TESTED 7 ., � � I I 000 C�,L N �� �.�?�( � � 2---10' X 30' X ' _ _ RFSE VI' LEACHING CAPACITY AY , ,_,��,_- TIC TANK C"'r ,A M LBE'R 5,5 k VAIN HOUSE �UMP ,, A'SHEf� TC�NI:' PUMP Of INT ROAD r _ � - w MAXIMUM POND �_ r � � � M f ELEVATION (FRC}!r� 17h±T�.. ,t r� DATE SEWAGE I C � S YS � �O L OEISEF�'`< wD WATFR TABLE ( 11/ 27/92 ) E_CV. 0�"E S• NOT TO SCAM: I. ALL. WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. ., �. �: .�.� ��� I "$`ITS 5 AND '1l•IF,r,` TOWN OF' A.R�NSTABL.E RUU-S AND FOR Rlri�aLATZo -o "'HE SCr SU1 1~AC;E I S o AL o I.�EWAG . SOIL TEST GATE OF" SOIL `TEST N ?V. 27, 1992 > w ' `�,: �Sy 'tV90N' �l pi-i- ;r ON r �R.a ALL VZ.Ji .0 .•w+ TO SANITARY Lp�i�41T.?' SH/'�.+b..Mw tt+. BROUGHT 6+d h :.,.....M-,•...,....w .-.._. .... .._.....,_»,•...._._..«.w,., ..... ..........., .. WITHIN 12" p F1i�1` d GRADE. v+llTtvES,`:}I t ElY �� DUN viNC ,. r F�IERCOLATION RATE~ 3. (EXISTING AND FINAL G AIr���S ��"E-.ALt REMAIN ESSENTIALLY 1�I'E SAME. � '1: _ __MIN./INCH. s r I: .' ,� 4. r L, + .OMI ("NL'NTS C THE SANITARY SY51T_M %iAL,L SE CA. Af�l,_ . .,.1 ' ,`�`�'l :I"ANDIN� I-��•�c� �.oA�0��f0 �N�. : � THEY A�� �It��� WR o1� WI>1-�1��� .., _. � . , 1 ! E"'' " ' IVY S OR PARKING EA +,r C) LOADING E G� , _ f� ._ V. .7 _ ,__,.... ►__- � I " . a., ' ,I a AR «- S I~ LEV. � ° � a �. �,A �e � w w ` ... _�wTwl� ,� € { IdE f o � IDS AR O 0, ...... .._ _ ,.EO' UPI R' �� 11�414 1 F I'. F RIV OR W KING R AS. ASON TOP' AND , �' . �jf�Col' ` , #Y Ad1 ARY I.�N$T' U.. O IfOR1NC� C;C)VI RS To GRADE aIIfISta11_ SUBSOIL �C BE MORTARED IN PLACL. !" f I� a � ,. ..,, li!_ L,AND `'URVEYOR 6. 1,4 DETE WItNAfl% HAS BEEN MADE AS TO COMPLIANCE WITH — 4' 4' 2O;i r A T'�+t;1y E"7` ROAD � I F.E( €:.D OFF ZC:NI RE LA'nONS. C� r"�"T APPLICANT IS T-C� ,_.._.. w_. 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