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HomeMy WebLinkAbout0028 KALMIA WAY - Health 28 Kalmia Way 188-049—001 Centerville p a id Fi A i i F w x n A 4 6 No. ,W/-A 5 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppliLation for Disposal �bpstrm Construction Permit Application for a Permit to Construct( ) Repair()() Upgrade( ) Abandon( ) ❑Complete System NJ Individual Components Location Address or Lot No.as 1K QN Owner's Name,Address,and Tel.No.`� Assessor's Map/Parcel �� �y Installer's Name,Address,and Tel.No. jZAn/(Y`R. (d AIJ T, Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms �'� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons 2 Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '-!Y O gpd Design flow provided 4q 0 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i 1 Nature of Repairs or Alterations(Answer when applicable) &_?Ql_.t' �in g_ �.MOl ©k4t4+ oG 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. <1 1 Signed Date Application Approved by Date / O Application Disapproved by Date for the following reasons Permit No. � p� \_ Date Issued "74— No. e �C Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for DisposaY bpstrm Construction Vermit Application for a Permit to Construct( ) Repair 0 Upgrade( ) Abandon( ) ❑Complete System X❑Individual Components Location Address or Lot No. ,Address,and Tel.No. �� �C\ ,)1(C� V A� ) a� Assessor's Map/Parcel ' - 2�b Installer's Name,Address,and Teel.No. 12AAIC L1? N) I . Designer's Name,Address,and Tel.No. 1y'pe of Building: J C T, _. Dwelling No.of Bedrooms L� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons 2 Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 0 gpd Plan Date Number of sheets Revision Date Title " c Size of Septic Tank �'� Type of S.A.S. I Description of Soil Nature of Repairs or Alterations(Answer when applicable) ��,C`rcl E' z." 7 0 Q -50-x Lc alc i c•t Tl�r.,� L r��fi� t \ t'R11�If� 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 c Compliance has been issued by Board of Health. _re l U�IrZ Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. � 5 (�— Date Issued TH E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired Upgraded Abandoned( )by LA n/({ Il (0y i?;. ( �!iOA at 'Z--6 kr� k ,01-1 r-\ t.0 G l( has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.6cJa 3 5:�:,dated ( � ' �--- Installer Designer #bedrooms L, Approved design flow gpd The issuance of this permit shnot b" construed as a guarantee that the system will"function as{�des�igned. Date 117� ) Inspector ----------------�,----r--------------------------------------------------------------------------------------------------------------------- No., / _ I U 3�G�-- " Fee�— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal bpstent Construction Permit Permission is hereby granted to Construct( ) Repair()() Upgrade( ) Abandon( ) System located at �`b kr�(1,0 k 0" U)()A I C9 I 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 in st be co pleted within three years of the date of this permit. Date t t �� Approved by i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. City/Town 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. ImpoWhen A. General Information When filling out forms on the / computer,use 1. Inspector: -=' only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. DOUGLAS A BROWN INC Company Name r� P.O. BOX 145 Company Address CENTERVILLE MA 02632 City/Town State Zip Code 5084204534 S 14297 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: 71 t y ® Passes ❑ Conditionally Passes Fails ca ❑ Needs Further Evaluation by the Local Approving Authority 2/10/12 w Aspelotignature Datern 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. t5ins•09/08 Title 5 Official Inserms.bsur.rcesi. osal System AN 1 of 17 Commonwealth of Massachusetts s Title 5 official Inspection form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �. 28 KALMIA WAY Property Address MILLER owner owner's Name information is required for CENTERVILLE MA 02632 2/10/12 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: THE SEPTIC PLAN WAS REVIEWED AT THE BOARD OF HEALTH ON 2/8/12 THE AS-BUILT CARD THAT THE TOWN HAS WAS TURNED IN WITH NO TIES TO THE HOUSE SO LOCATING EVERYTHING WAS IMPOSSIBLE WITHOUT TEARING UP THE ENTIRE YARD. I LOCATED THE SEPTIC TANK AND FOUND THE D-BOX WITH A CAMERA. NOTE: HIGH WATER USAGE PROBABLY DUE TO POOL AND IRRIGATION 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•09108 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 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cunt.): ❑ 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 Lt5in. 0901 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments „ 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every 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 El ® 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 Lt5ins-09108 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Cityrrown 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Citylrown 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): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is CENTERVILLE MA 02632 2/10/12 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: ACCORDING TO THE AS-BUILT CARD SYSTEM CONSISTS OF A 1500 GALLON TANK D-BOX AND 6 INFILTRATORS IN A 10.78X44 FT AREA Number of current residents: 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)): Detail: 2010 742 2011 1065 GIRD ( HOUSE HAS A LARGE IRRIGATED LAWN AND IN GROUND POOL) Sump pump? ❑ Yes ❑ No Last date of occupancy: CURRENTDate 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: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 . every 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): t5ins-09108 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 28 KALMIA WAY ,p — Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: SYSTEM INSTALLED IN 2007 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 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: .5feet 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Citylrown 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 MODERATE 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.): TANK LOOKS LIKE IT COULD USE PUMPING 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•09= Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Cityrrown 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 t5ms-09l08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): offDepth of liquid level above outlet invert 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.): BOX WAS LOCATED WITH A CAMERA AND SHOWED NO SIGNS OF FAILURE 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: AS-BUILT CARD FROM BOARD OF HEALTH SHOWS NO TIES TO THE HOUSE t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 6 INFILTRATORS ❑ 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.): THERE WERE NO SIGNS OF DAMP SOILS IN THE SEPTIC AREA AT TIME OF INSPECTION :NOTE : VERY HIGH WATER READINGS 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 t5ins•0901 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts ARXf Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 28 KALM IA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Cityrrown 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.): 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 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every page. Cityrrown 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 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is required for CENTERVILLE MA 02632 2/10/12 every 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: 5.37 FT 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: 2/8/12 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: r ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: OFF DESIGN PLAN Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 28 KALMIA WAY Property Address MILLER Owner Owner's Name information is CENTERVILLE MA 02632 2/10/12 required for every 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE LOCATION l ►��✓ EWAGE t rT- , VILLAGE S MAP&PARCEL —/c — ,yI� INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY s" LEACHING FACILITY: (type) r/A/',r,;r/ A �9 C (size) NO.OF BEDROOMS OWNER 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 I Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY I - I i ICA !� ' b.. `Town of Barnstable pF�HE Top, Regulatory Services Thomas F. Geiler, Director B">MASS. Public Health Division 9Q i6 ,fig' vATF039. A Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 5ZPT�o 46 44 Fax: 508-790-6304 Date: Sewage Permit# A�O#nV�Assessor s Map/Parcel —"0 ?-00 Installer& Designer Certification Form Designer: LP QkCaE 1� # Installer: W 1a,11JIVID nWG,6e e c Address: 3 7 J�� � Address: ��� � n On as issued a permit to install a date) (insta er) O septic system at , , �u� l /jMy�— ased on a design drawn by (address) LA Mk�� dated (designer) 4/I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral 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. Stripout (if required) was inspected and the soils were found satisfactory. (Installer's Signature) (Designer's Signature) (Affix Designer's Stamp Here) 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. gAoffice formsWesignercertification form.doc JIJN-1' -2l`. 16:31 LABARGE ENG I N. and CONTR. 508 432 6792 P.E12 Town of Barnstable "19 Regulatory Services Thomas P. Geiler,Director t, m;' MAW& Public Health Division UAW, Thomas MrKean,Director 200 Main Street, Hyalanas,MA 02601 ®>'.iiss: 508-86 �644 Pax: 508-790-6304 ® Sewage Permit## Assessor's Wp/Parcel Yngtal ec A Deft er Certif calf k EU- I ,/ /U6installer: AA1 Address: O2G7/ was issued a permit to install a (date) (itaLtall)watern,at 6 ' based on a design drawn by ($dss) i INC dated (designer) C / 67 I certify that the septic system referenced above was installed subst tially according to _..-..._.•__ the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic. tank. Stripout (if required) was inspected and the soils /were found satisfactory. 4 I certify that the septic system referenced above was installed with m�®r changes (i.e. - � greater than 10' lateral relocation of the SAS or any vertical relocation of any coraponmt of the septic system) but in accordance with State & Lord Itegul4ons. Plan revision or eeztified as-built by designer to follow. Stripout (if require ected and the soils were found satisfactory. s�`aF�OQs�, .v Todd A_ (installer's Signature) _._... .� (lei sgr�ature) (Affix Desi amp Here »411,a:ia, :ELD TUB TO 9 A�L� PUDLIC IIEA►I.�' DI�TI I®1�. CE�T� ICAT]E;l t � TCl� LL 1vT0 E ISl9UED Ul�'TIL �0 0 P'®�'1 A l7 �T C A ItECETV$D$Y TI��B�RNST�i,BLE PUBLIC'TJEI DI�9IO�I,; e°L'.,fl'icd��161�e5i�creefti�aeaRo81 ferrro,d�� TOTAL P.02 JlJhl-11-� iEE1 13:25 LABARGE ENGIN. and CONTR. 508 432 6792 P.Ell + t i Design ® Build 0 Maintedri :237 M ain Street 'West Harwich, M.A 02671 1"hone: 508-432-6360 ?I:'axy : 508-432-6792 VVIVW.Jalb argereallestate.e oats From- -79 0 -- Pages: including cover sheet) U ililQi&'i�: Date: M Notes/Comments: CI CQ i 5 rb Ck,;1 CAA ��o) C'.aw\ 5 tk( �r �,: `i✓� ' ,lip .`CA C, T-- UV7 L') Cr V This message is considered confidential and intended for the addressee only. If you receive this I,�`,�;ssage in error, please contact sender at phone (508)432-6360. T J�1-11-' JL 1, 13:215 LABARGE ENGIN. and CONTR. 50e 432 6792 P.02 Ltbarge Engineering&Contracting,Inc. LOCUS: LOT 2 KALMIA WAY 237 Mairl St.Rt.28 CENTERVILLE West,Harwich,MA 02671 6/18,'07 SEPTIC SYSTEM AS BUILT ELEVATIONS DiOT 76=/18/07 8ENC.-FMARK DESC: TOP OF EXISTING FOUNDATION 27.62 !:)T,US!;+�tOT 1.96 HI'.rN:3)TRUINENT 29.58 MINUS SHOTS TOP OF PIPE DEPTH OF PIPE INVERT PLAN DIFF 1-'1>1 11)ATION 1.961 27.62 27.62 JN TO BE INSTALLED BY PLUI 0.35 25.50 je►Nj<IN 3.96 25.62 0.35 25.27 25,30 -0.03 4.11 25.47 0.35 25.12 25.05 0-07 TKNK OUT D13;T14 4.46 25.12 0.35 24.77 24.87 DBOI.T 4.65 24.93 0.35 24.58 24.70 -0.12 1320"U"'T 0.35 W. D1301-IT 0.35 MOUT D 11 3 0' r 4.65 24.93 035 24,58 24.60 -0,02, 0.35 SAS SAS 1-INK) 0.35 OTHER MEASUREMENTS AND COMMENTS LEN(3T. 44 10.78 INLE"i""A"E 10 INCHES 011 Ti- r T Z E 14 INCHES To the best of my knowledge,information,and belief the system is in substantial compliance with 3 1 OCMR 15 and the approved plan. TOTAL P.02 No. a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYtcatton for Mtopooal *pgtem Conelructton Permit Application for a Permit to Constru air( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No. Z/pr 4`4Z' i f d✓i9 Owner's Name,Address and Tel.No. Q�jl/ lil/bGa 6�'F/Vlr1-Z111 - h1i6- e G3.,L 39 Assessor's Map/Parcel y Installer's Name,Address,and Tel. Designer's Name,Address and Tel.No. L!9' �N�//✓� �iNe rn�iN sT 8 - (oB6 --0 (4/ 5Z,9 -y3A-Z,_;,o Type of Build' Dwelling No.of Bedrooms_ Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. i 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 ar`d not to place the system in operation until a Certifi- cate of Compliance has been issued b t ' B o Health.Shme 4 Date Application Approved by ® Date Application Disapproved Ar the following re o Permit No. Date Issued TOWN OF BARNSTABLE LOCATIO d EWAGE VILLAGEQ_:� � , ASSESSOR S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) V (size) � � �// NO. OF BEDROOMS OWNER _ r= 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(Ifany 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 Al � A-3 -- A-� CA s No. a " (( r Fee 4HE'COM NWEALTH OF MASSACHUSETTS Entered in computer: s � PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Apprfcati-67 for 33fgpoor, *pfstem Cott.5tructfon Permit Application for a Permit to Constcu j epair( )Upgrade( )Abandon( ) , Complete System E-Individual Components Location Address or Lot No.Zi r W4k1- Owner's Name,Address and Tel.No.0,1FIV Gt�Lyp� 3 8C��v2-acv�ccz- ssessor's Map/Fazcel --> _ C� 11V Installer's Name,Address,and Tel. Designer's Name,Address and Tel.No. �/Nlj/�✓EG,eiivs mysN sr h✓3.�i.✓icff yh� . Type of Build' g: Dwelling No.of Bedrooms _ Lot Size sq.ft. r> Garbage Grinder 6 - Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other-Fixtures r Design Flow 3 gallons per day. Calculated daily flow t gallons. Plan Date Number of sheets Revision Date Title ;r•. Size of Septic Tank 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 apd not to place the system in operation until a Certifi- cate of Compliance has been issued by is Board,of HHealth. f. r-, Date ¢' Application Approved by' %f// f i D ' �� C�~> Date Application Disapprovedfor the following re sons ( a 5 Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY, that the On-site Sewage Disposal, ystem Constructed ( )Repaired ( )Upgraded( ) Abandoned( )by at e_ 27- ha en constructed in accordance with the provisions of Title 5 and the for Disposal Sy em Construction Permit No. ) ed Installer [�T//�.0/. r 7�//��,�- D IL _ The issuance of this e t shall not be construed as a guarantee that the system will function as desi� nedd Date U Inspector : _,Y)/v"""i c �y lll_vv ` J J No. ! ----- —• ---------------------- ice 67 �- -S THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Miopogaf 6 item Cougtruction Permit Permission is hereby granted to Construct Repair( )Upgrade( )Abandon( ) System located at _Z�97 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 {ConstructioJn must be completed within three years of the date of this pe :'t Date:_ 1 C1 Approved by. �r s V ff k. Town of Barnstable P# Department of Regulatory services : .Anxsn+su, Public Health Division Date �Ar 16J 9.�,eg 200 Main Street,Hyannis MA 02601 Enµ►. us 6Su L M Date Scheduled Time�� . Fee Pd. _{ ,�J V,Am"" ' Soil Suitability Assessment for Sewage isposal D` Performed By. /-�;21✓h 2J �o(�ylt Witnessed By: LOCATION& GENERAL INFORMATION Location Address LtJA� Owner's Name Address Assessor's Ma /Parcel.• (/ Engineer's Name,/A p i Fly U 1 F NEW CONSTRUCTION � REPAIR Telephone# J Zi Land Use /�G'N��Q Slopes(%) 3 Surface Stones Distances from: Open Water Body 7 /O U ft Possible Wet Area y �� ft Drinking Water Well Drainage Way '7?' ft Property Line 7/O ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes). Zy�I bb�6 fib O6/ Parent material(geologic) IO&VfMIT62 �' Depth to Bedrock B Depth to Groundwater Standing Water in Hole:" gb y Z 7 a y OWeeping from Pit Face N J Estimated Seasonal High Groundwater CL Z J &7 e ) T� v DETERNUNAT?IPN FOR SEASONAL HIGH WATER TABLE Method Used: 47D C2. 6ZG� A Depth Observed standing in obs.hole: _ In. Depth to Soil mottles: ttt• Depth to weeping from side of obs.hole: in, Groundwater Adjustment $• ; Index Well# Reading Date:` Index Well level,,,�,.:,.. Adj.factor.-„ Adj.Groundwater level is PERCOLATION TEST Observation Hole# / 7� Time at 9" Depth of Perc 30— 11 7,- z/- (J Time at 6" Start Pre-soak Time @ O� .Ti ("'-6") 0,q,�, 6: End Pre-soak 271 Rate Min./Inch ,:f Z GZ 3�0 G/�1l/ . /U slG71 Site Suitability Assessment: Site Passed Site Failed. Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- I ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICIPERCFORM.DOC � I DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc % ravel DEEP OBSERVATION HOLE LOG Hole#_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel Z�12 6A s, /o y2 `/0 C5 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel k } DEEP OBSERVATIO14 HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, ravel Flood Insurance Rate May: Above 500 year flood boundary No_. YeSX_ Within 500 year boundary No N Yes Within 100 year flood boundary No - Yes l� Depth of Naturally Occurri iiyervious.Mnterial Does at least four,feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material' Certification I certify that on ��—1c� (date)I have passed the soil evaluator examination approved by the a ' Department of Environmental Protection and that the above analysis was performed by me consistent with 'the required training,expertise and experience described in 310 CMR 15.017. Signature Date �o` Q:\SEPTl0PERCFORM.DOC � TOWN OF BARNSTABLE LOCATION �8 T�����r,.�2 �--�. SEWAGE # VILLAGE "Ile ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 170 1,n P. Ae, /fo SEPTIC TANK CAPACITY J 5-00� LEACHING FACILITY:(type) X f� ^',19�� (size) /0009 NO. OF BEDROOMS ,3 PRIVATE WELL OR UBLIC WA E BUILDER OR OWNER DATE PERMIT ISSUED: �- DATE COMPLIANCE ISSUED: l��g VARIANCE GRANTED: Yes No �� PY�.�e �� .',; , �,. r ice, ��,� ;� 3 % �� 0 � �sa "�^ �' �1 i � .D I � / � � � � ��� � � ,S' `.� � � y- � - wr — � _ .,� p No._ FE/10 THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOARD OF HEALTH edlnstable Conservation Department TOWN OF BARNSTABLE � 6 —frQ3 sl led �.�ltr �t���an��al �nxl�� Cnngt�#rnr#inn Prriti# . Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System QQ at: / Location-Address or Lot No. OwTicr Address ------------------------- ------. --• ---"---• " ----"-------"-•--.-..-".... . Installer Address Type of Building Size Lot............................Sq. feet U Dwelling— No. of Bedrooms___________ _____________________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................... . . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter._-..._-_--__-__ Depth................ x Disposal Trench-- No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------------ ------ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---------'................•------•----.....--------------•--..._..•----•.. Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------------------------------------•----------•--------------..............---"""-_.""-......................................................... O Description of Soil.................. rv/ ------------ .-------- W --•--•--•------•---------•"-----•--•-•---------"-"---•-----------"---------"------••-•------"-"-----•----------•--•---------•-------------"•-•-------•--•--•---------"-"...""-"--""..................... W ---- ----- U Nature of Repairs or Alterations—Answer when applicable.______ __----- 4............ ! moo .......... / ..............h.o_�.�.._._._.0 c�uti--------- .f�1'c -----..''?"'f�_ _..(PA,t. 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 Complian has been issued by the board of health. Signed ..----- .�'�. ......6_ le_aid Dare re................. Application Approved By ............. .. Dace Application Disapproved for the following reasons: ...... ' ........... .... ' ............................ ..........................'"" ........................ .... ...........................................................................�✓... ............. ... ' ........................................................ I....................................... Permit No. ...... ..-..... �J... ................. Issued .................... .......................................ate _ Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE r Certificate of Compliance t THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ................................................................................................................................................------.------------ -----------....._..................---------------------------------------- at ..... .............. ... ...................... .......................... ........... ....... ...................---------------............-------------------------------- -----------------------------------------.._ 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 pp TOWN OF BARNSTABLE FEE..... ...... Dispaasal Workii Ton #nu#uan " a mit Permission is hereby granted------.....N' ...... ------------------------------------------------------ ....... to Construct ( ) or Repair (X') an Mclividual Sewage Disposal System Street 4 as shown on the application for Disposal Works Construction Permit No.. Dated Dated........................................... -•-•..........-•--•-..../ .f ' DATE---........�--�-y-:..��__ � .......................................... Board of Health FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS �..7- 8 • C��fS 93-z5 �6© THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE t! 3 Appliratiott for Diripoiul Vorkii Tomitriartion Errant Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: b .. ...... 'g T/� h,C{v ... /2d /�.-------- -•---••----•------....................•.�----�-•----•-----..�..........--------........ ..... Location-Address or Lot No. / C S.4__Dv211' E ......................_.......................................................................... ••-•--••-•--•----•-•••-•-•----•----••-----•---•----------------•••----------...................--- Owner Address a ••••--••----•-Sdiy�v /�:_....._ AST \ L✓fln./i T �� .T:.._..._. lnstalter Address VType of Building Size Lot...........................S q. feet t..t Dwelling—No. of Bedrooms___________---------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building -_-------.--_------------- No. of persons---------------------------- Showers. ( ) — Cafeteria ( ) Q' Other fixtures ------------------------- --------------------- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W 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 ( ) ~" Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-••-•-•-••--•--------------•••••----•-•--•-•----•••-•••.....--•----•••-••--•---•---......-----...........................--•---------•---------------------- ODescription of Soil...................-_.—/P.Z............ ----------•-------------.._...---••-....---------••---••-----...........................1 W UNature of Repairs or Alterations—Answer when applicable_----- ............ ...................... ........... /�..............Z_.2.e..r{'__._..'C�Lf'G!� f'iL�?'.0 C.....__. '_ ^ ... ................................. 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 Complian has been issued by the board of health. Signed ------- .... ..........�........ .. .................................�3 Dace Application Approved By ............. �, ............ ....'------------------•-----....-..---'----...--.................... ................. .--...-........Date.................. Application Disapproved for the following reasons: ....--.... .................................................................... .................. ........................ ---... ................................... ........................................ PermitNo. .. ; ........ ...... ................. Issued�, ..................................._...-.....-.........Dare Dare No._E7 .StK?1 Fins....�. . .......... THE COMMONWEALTH OF MASSACHUSETTS- BOARD OF HEALTH .F 1 -•.......... .........................OF..........................................._.............-- App iratilan for Dist sal Warks Toustrnrtinn amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: a .........Z$.....l.......................................................�a ......... ----------------------------------------- ........................................... Locat'on�-�Address Ato or Lot No. CF'N 7_.? !�G ..Moir:.. ..1a Rik�?t� ........... ...................................... r.. 66 - ------------•----•--••--•-••••--• •-•...... ..z...,�s=�...•-. - Owner ,, i, .,..Address .z..:. c -------------------- --- - Installer Address Type of Building Size Lot............................Sq. feet ,. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building ............................ 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 tank0-4 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------------------------------- 0 Description of Soil.................................1AQ .... ! ........••------•---••••-•••-•--•-•-•-----•••--•--•••-.------•••--•---•••--.......•------- W V ---••-•••••••••----•-•-----•-•••••-•---------•--•------•-------•-•••-•••-•---------------------•-•---••-----•--•-•--•-•.....•---••-••-•------•••--••---•-••-------------•-------------•-•-•---••---•--•- W ----------------------------••---•-••......---•••--••-•......------••---•--•--•••-••-•----••-•--•••....----••••---------------•------••---•---•----••••------••••--•••••--•--•-•......•-•----•----...... 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 i IME 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by the board of health. Signed.-.... .. ...F.l--------------------------------------------- r�� Date Application Approved By............ .-- .:-•--TxeG- ........................................ ...... E 1 Date Application Disapproved for the following reasons:.................................................................................----........................... -----------------------•-----•---------•--•----------•••-••-----------•--•...-•-------........-----------••-----------•---••-•--••-•--------•----•-•--••-•-•-••--••-•--•••-•-•••-•------•••---•-........ Date PermitNo......................................................... Issued....................................................... Date , LOCATION SEWAGE PERMIT NO. { VILLAGE o�m-lek v "'oe e 1 INS,TA LLER'S NAME i ADDRESS 8 U UL D E R OR OWN ER DATE PERMIT ISSUED ' .. N DATE COMPLIANCE ISSUED ANC i � 0 hl�u/ 1b ��'� Poo L THE COMMONWEALTH OF "S'SACHUSE 7 BOARD OF HEALTH ..........................................OF..................................................................................... C9rdifiratr of Toutphattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or7Reppairedd ( ) by.............. ,°..... ............................•----••-----•-------•----------.........--•---•--•---•--•---...--•-----•--•---................--•-••----.....-•-----•--- . Installer y PP P with the provisions of TITER of The State Sanitary -ode s described in the application location for Disposalo alcWorkseConstru Construction Permit No .-_- ......... dated-- __------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTIKIUED AS A ARANTEE THAT THE SYSTEM WILL FUNC ION ATISFACTORY. DATE----------------- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF........ No..._. - FEE.... .............. 0hipnsa1 Works Tonotrndion Uvrrmit Permission is hereby granted..----- e� :A �A�.................---.•.._..... .... ................ to Construct ) or Repair ( ) an-Individual Sewage Disposal System, -------------------------•-----------------------•---•-----------------------------------.... Street "as shown on the application for Disposal Works..Construction Permit No.__��.... Dated__ _t _.��'!`'� - _ .......... l yBoard of Health -4Q,�Ea - .................................... f IT A. M• SULKIN, INC., BOSTON n No. t,�?� Fxs.. - a ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.......................... ._........ Applira#iun for Diipusal Warks Toustrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ........................ ► oca ion-Address or Lot No. ' a Owner !Address .............. ...... a m.ts....•....._...K-0.`�:................... ................._•.•--•-•.•--•-•---•-.--•- ......----...........--•-•----•-------••--- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fuel!, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W ........................................ ..e ................................................... 0 Description of Soil.................................&0..Q.. !....-----------•--•---------------------------------....------•.----------.--------....-------- V ....-----••----••---•-....-•••---•----•.....----•-......•--•------------------•-••••------•---•-----•-...-------••••---------•-••---------•••-----•-••....-----••-•-•-•--•......---•-•..........._.----- W ------------------------------------------•--...--------------------------------------•--•-------------------------------------------•--------------------•--------•--------------------•••---------- U Nature of Repairs or Alterations-Answer when applicable................................................................................................ ---------------••----------...--------....----------------------•--------------•----------------...----------------..._.__......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by the board of health Signed. --- .-•-- .. �+ .s � Date Application Approved By---------..,_J ._` .�.k .�!_: ,�, --- Date Application Disapproved for the following reasons-------------------------------------•------------------•------------------................................... --......-•-•--••-------------•--------------•---•--•--------•-------------...------------•-----....-----------•-••-••-••------------•---•-••----------•------------••---............................... Date PermitNo......................................................... Issued....................................................... Date STAMP: - NO U3a N O _ LU as - aaoa - _ i 7 oZ. m 3cd a THE MILLER RESIDENCE w KALMIA WAY z CENTERVILLE MA. o Q U) L1 GENERAL NOTES (See also Project Specifications): a.Existing surfaces disturbed during the course of the Work ah ll be recenstrueted and ABBRE IATIONS SYMBOLS SCHEDULE OF DRAWINGS Q finished to match adjoining surfaces. Patched arum shall be finished In such a meaner ,{-� eG as to provide visual and structural continuity across the entire effected surface. - ea .scene&aT n roDrr 8/ 1 \ A-1 TITLE SHEET w I J.W uP.. e.aTR mom rlooe uo us sea q\`-fIF'-/f i Sam sego► 1,The General Conditions state tbat the Contract Documents are complimentary. S.All voids created or surfaces disturbed resulting from cutting,removal or Installation of �T ��� UV. _ A-2 FOUNDATION PLAN _ -f (..._. 2.Provide the eanvlcea of a Massachusetts Registered Surveyor to!spout structure on site elements as part of the Work.ball be filled and finished to match adjoining construction. :w eRo® L LEMOrs` A-3 FIRST FLOOR PLAN SCHEDULES 'J R[cMx emv&m.-uTus m SOP (N C w Rod establish existing elevations. Elevation of finished floor shell be established b 10. Except m provided in the Documents,no structural member or element shall be cut aemw June o MA ae�aoaer a�omna a"or O na OMMMU a Ten A-4 SECOND FLOOR PLAN G y p p aw mnnmmue w.T. aeTssw ePRmlc mcras. T�"any A-5 ELEVATIONS LL JJ Architect with elevation information provided by Surveyor. without written approval of the Architect. The General Contractor shall coordinate all Bu RUM sex wemma A-e ALm USS T m TTu 8O1iOR eeTP A-S ELEVATIONS . - - cutting and shall advise the Architect of any potential conflicts with saw'or existing nano sham+ ass. amTrrT�tee aWa.ao. . 3.The General Coatraaer Is reap-Hiblo for OD the work. - - sort Borrow IG+. Immma .4as MW SPOT Ruvuma A-7 CROSS SECTIONS = A.Build and mail!parts of the Work level,plumb,square and in correct position. structure. B.O.W. �, cep BOTTOM Or , MOUNTED _ B. hake joint.tight and mat. It such In impossible.apply moldings, sealant or other 11.Demolition work shall only be carried out once all temporary shoring and bracing is in RK BLUI I aar � '�" 4a.a COMING SPOT oevefrax A_8 FIRST FLOOR FRAMING PLAN Joint treatment an directed by Architect. place. Removal of eu temporary support.shall be completed only attar sew work is eecura M _ .xA N' m coxmrtt �' �'1°a:all Ro®Wa°OpT - A-9 ' SECOND.FLOOR FRAMING PLAN sTg ""'°ac'Ix SCHEDULES C. Under potentially damp conditions.provide galvanic Insulation between different _ and complete. C r&mx(pc) o.e. m TO Sx 101 Soda.ulmsa A-10 metals which are at adjacent on.the galvanic scale. as ammo all °••"`tea O Goes Rules _ - 12.AD material.,equipment and workmanship°hall conform to the requirements of CUM carer oP.a. or,.:mta ) D.Apply protective finish to parts of the Work before concealing them. For exempt., authorities having Jurisdiction of the Work. cot muses ' P•.•e Oq WwDos TTPR - _ paint door tape, bottoms,glazing stops,glazing rebates, and hardware cutouts hot- rasa aaswsn ! ^a Plii'� hanging doors,and paint corrodible mounting plains before installingparts over them. 13.AB materiels and equipment shall comply with the Occupational Safety and Health Act, rsn CotlCBara YeBO1mT ulot PIS' Puna, . E. Where accessories are required in order to install parts of the Work in usable form Including all amendments. _ .. wsarrunmq Pees. rnaTTTms �O WALL TYPe Dare. coWm:,vus PL P:.:Te ) . u mar•.aymema lo.rt Pue. rearas RMIGa Wash and teacake the Work perform properly,provide each accessories. 11 special tools � 14. AD materials and ogWpman!shall conform to the requirements of authorities having cta< mr•.;�.yxaolo� - plot tuaTm t&Imua era required to maintain,adjust and repair products, provide them. net. art..::. PTm. nylamla msmm PARnTWx F. Follov manWecturer s Imtructiom for assembling,install',g and_adjusting produce. jurisdiction regarding not wing or installing mbnstee or mbaetea-contelaing maerlale, me an,_...M I vtTWB mr o TITLE: Do eat inawll products in a man,ar contrary to the msnufmturee.instructions 16.AD pain!mad-all products and msembliea shall...to-W'A.N.S.I.Z66.1, P.T. P®see tosetm IOW P�[aa unless authorized In writing by the Architect. Specifications for Points and Coatings Accessible to Children to 1linimlza Film Toxicity. OR mmnaaa.a 4r aoensr Tax Dry y. Rwv exovmm amTma rsa WALL G.Adjust and operate all items of equipment,leaving them fully ready for me. �R � ® aRvauts K The division of the Documents fate Architectural,Structural,Electrical, Yschanlcal. 18.ALL warrmtins,guarantees and service maintenance agreements shall comes-oe on the male) Gen.apa(e) I - 2, Most � ma®eTs-Pus ns®clmx date of Substantial Completion of the Work or of the ism be guaranteed,whichever is oo aeun.9w n e ems " Plumbing and Civil components to not Intended as division of the Work by trade or p m mmmAL® ® Room Dram eels-PI&Tm ns nscmem otherwise later,so that the Owner may receive full me of the Item[or the guarantee or warranty Roc. YnvacWl eat mall �`t' TITS SHEET a cEMIUR Ira ame" oPIIla(a ® caxaxts mya PIJNB ns asc. L Provide utility installations from lot line a house Including underground electrical, period. - Rev, nL+am. star. erclmN v water,telephone and CATV to comply with all local codes and requirements. 17.GENERAL WORK TO BE PERFORI�D AS PART OF THE GENERAL CONSTRUCTION: RRm Rmr�cra. PtTWooG ' P P y ra4 s t4au, � sPG eP[mlf&wme 1.Concrete shalt have compresaive strength of 3000 psi• 26 day.for walls and A.Seal cracks and openings to make the exterior skin of the building light to water and Rear. UL.ma at memn+as-T ® STUL,LABOR eelsM. 3500 pat®alab work and reinforcing rode&woven wire fabric(WWF) per drawings. air-try. it ens.' m: RUNT T ear sHZ)APm N •a ® ROUGH LOI . Where noted,provide herd steal!rowel tlnlah oa elaba B. Provide ndegnste blooldng,bracing, nallara,/mteniuge and other supports a lastaD W RTr,:1II1 I an STEM. ® moos umm :4 Dampprootlog shell be factory manufactured semi-mastic c...I tancy from asphalts parts of the work securely. Blocking,bracing,nallere,feateninge and other supports RN' rOGMZa Tax' ..a and mineral fibere, and Installed on all walks and footings. shall be of a type not subject to deterioration or weakening m the result of n ruse AL.mn Tas ToPaeorros Omf11&1[m-mGm i DATE ISSt7ED: ran nrex®ISD m ovKM T&a TOlimlr&®omR ® amaunn-act GZ 0r�e Piers for docks ehA11 he concrete filled Somtube forme. environmental conditions or aging. - n roc sxmmv� T.O.T. TOP or roalmATms - '-^- C. Perform cutting and patching for all trades. Patch holes where duals,conduit,pipes It rtmR(mG) TAW. TOP OF WALL seam ' 4.The General Contractor shall verity all dimensions at the site and shall notify the Fume rUGORSO rT T TRW •• REVLVM:' Architect of any discrepancies before proceeding with the Work or purchasing materials and other products pass through or we being removed from existing Cher construction. rr root TYP.Uxv UNTRIMMED maecr aBevd ..._........_._.. _ D. Provide ahmea, furred spaces, trenches, covers,pils, foundations and other ran. wmma mop, mat® N or agulining Verify u critical dimensions 1s the field before fabricating items which most non. rommame vat. vt®r m racy +,-._.•- Wnnm rest!cent fit adjoining construction. construction required to conjunction with the Work. If each construction ls not rues ruRem(ma)� ('a - shown on the Drawings, coordinate with Architect for sizes and placement. a sea j � vvnm mlmasmam Tax, PROPIUM mID cuv. ratans® 5.All details are typical union otherwise noted and ere not necessarily shown In the E. Provide and coordinate arrass doors and panels as required for access W equipment ¢ ent®et casnums orc vnrvl.Wee,covxepo teens ma Documenls at all locations where they occur. requiring adjustment,inspection, maintenance or other access and as required for access ct coca/ We safes maser Wmx/Wmre te spaces not otharwlae accessible. such m attire and crawl spaces. aGVZD / Wtm 8.The Archfeaturat Documents govern the location of all Electrical and Yechnaical Items Ra�a W/o WTmoOr Installed m t pert o!the Work. F.Check Drewinge and manufacturers' Rternturo for requlcomanls far buses,pads, and Roan R®Bolles I WWy. Wonm Was!cent other supporting structures. Provide ouch structures. Remove supporting atructuree ®tea ae®W000 WD WooO 7.Existing items which are not to be removed and are damaged or removed in the course associated with removed equipment and patch remaining surface.. MM a�Tanaamma°���noga000&�a' of the Work shell be repaired and replaced in like now condition without cost. G.As part of a year warranty specified in the General Condition,repair crneke and ®tie aeeasess likexe other damage which occur as a result of sattlemout and shrinkage during the first year a"it � om i DRAWN BY. "- after Substantial Completion- _ Omen. Gmul'"M N . DRAWINGS ARE W. PROJECT : nice 16.AD work shall conform to the applicable aections of the Ymeaehmetls State Building a JODw REPRESENTATIONAL ONLY -- -Code,Sixth Edition. For residential projects,particular attention shall be paid to Chapter 36 -One&Two Family Dwellings, especially Table 3606.2.3•Fastener Schedule far Structural - DRAWING NO.: Y.mbere. DO NOT f SCALE �� i DRAWINGS r STAMP: , 23'-4° 6'-8" 58'-0' . OUTLINE OF DECK,ABOVE ---' i 2-P.T. 2x8 GIRT - B' DIA. CONC. g SONOTUBE, TYP. O M o 2-o CUT OUT EX. FND " FOR NEW 36" DOOR 42' HIGH WALL CONTINUOUS ' 2x6 P.T. SILL FLA E/SILL INSUL. w/1/2' DIA GALV. B. O 6'-0" O.G. MAX r'----- -----'''--------------------------------------------------- ---- — - o ----- ---- I . z FULL HT WALL ---------------------------------- --- ---- ------------------ I co 0 3 0 2 �z r ----- ---- -- --- • ------- --- J 1 _ IB'-10" r--1 r- DROP WALL 48"' 1 I o Cd a I r— ------ r-- -- - I I I I r 3 1/2 C. FILLED I I STEEL-LAILY COLUM ON L-�—J Q� CONTINUOUS 2x6 P.T. SILL PLATE/51LL - 1 I 8'x4'-O" CONC. WALL 1�n ON 16'x10" CONC. FTG. I 1 L J CONE. FTG. TYP. I m J INSUL. w/I/2° DIA GALV. A.B. O 6'-O' I I I I ' m j O.G. MAX I I I I I r—I— I I I 1 1. ( - I t; I�1 ONx O'��O'''GON_- FTG. I 13, GABAG L _-1 m w/2 xo° CONC. KEY4" CONC. SLAB w/ I - - r ----------- ------------------------- - I 16°x6° 10/10 WWM ON I m Q i m - 1 I I 6° COMPACTED GRAVEL I I I f` i I I r I ———--————————————————————— U I - I xH I W I I P1 I I r — v� L J Q°C I I o I I I I j i > m, I I O m Q L_I_J h,' I m-1 iv I o U3 W w 1 _J o W , J I I o I j 9 m � I 30'-0" W W I I DROP r W U I I ' Y = 3 I/2" CONC. SLAB OVER \\ \ _ 1=-• _ i -__---___ -- - J _ 1 /_�� 6 MIL POLY VAPORBARRIER \ __---_ ___ -_--'-----"--- ------ ------ ------'--------- I� � � OVER 6" COMPACT D GRAVEL I _ \\ \\ L__ __________________________ I I co \\ — I I 8' DIA. CONC. _ I I I rT-I QK I I - SONOTUBE, TYP. O I I I I I to I I m I I L_I_J ' L_�_J Aj 2-P.T. 2x8 GIRT I -O/"/ T;, �- I ril- F--_—_ ______ FOUNDATION PLAN 4° 2-P.T. 2 10 GIRT1 DATE ISSUED: L J L J L J L REVISIONS: 8 24'-0° 6'-0° 31_4" 4'_811 2i-pa 12" DIA. CONC. SONOTUBE ON 24'x24'x12" CONC. FTG. " DRAWN BY: FOUNDATION PLAN PROJECT#: + DRAWING NO.: A2 r STAMP: 55'-0" 5'-4 1/2" W-O" 5'-On 16,-0.. 14'-6" DECK COMPOSITE DECKING v - - o Z o � o w �Ct w z It z to BREAKFAST cl 1 , , i 1 _ O11Ip i 1 M. BEDROOM I e e TRAY CLG. O . ----- ---__------ ---------- ' aLLA O B" DIcoL-TYP I Qivi- ---------------- -� ni o �+Et u0. IZ_61, c.o. ------ LINE LINEN" QU Q g2 4' 9' O° Cn W W -J GARAGE I ------ a so+ter+sNowee i g J o c • W fi e acl�r+e W 1 CL. , ere•TYPE+x+am . I I :-- allowele NEAO6 J A cv 15'-O"S / DI N I N m a J J H eOFFl DIS O O O i0 Lu . O r e • Q U W-4° 12-b C.O. 1 � 1 N. B" DIA. COL.-T 11 . 4 m W. SOFFIT o - i ROOM iv 13 0 � I ' - FIRST FLOOR o ' I O u I m I I , o O O � m DATE ISSUED: O O OS/06JOB REVISIONS: COVERED OORCH b m COMPOSITE MECKING 2' O+ xB DECO ATI E OL's. TY . yl_on 9'_O" 4'-0" 4'-6" 9'-6" 9'-6 41_6" DRAWN BY:IF - y_O+ 281-0" 3'_4° ,yl_5, PROJECT#: - 241-0" DRAWING NO.: FIRST RS FLOOR PLAN A3 Qg r i . STAMP: R 7'-0.. O O O Z o � N BATH zd U V.I.P.WMVOW(LOCATION m U i r3 o ------- -- - �+ BEDROOM cl ACCM9 PANEL '0O 1 . _ UP C1 �^ / OA T m C/o W U .1/rL-lR w W 0 ----- - — ENCGOB- -DN_. cn c � gJ > ��" AOGE98 +r c .p PANEL O .. t, ; W S C J H W m i - co)t W U r I.D. I m � �\ le � 1 o -- 9• s DN. �: is HEDROOM 5ATH o TITLE: 0 2'-e' O SECOND FLOOR Uil PLAN © O DATE ISSUED: 05 D6/08 REVISIONS: 9'-6° 24'-0" b'-O" 2B'-0° SECOND FLOOR PLAN p DRAWN BY: - - i PROJECT#: DRAWING NO.: A4 ®eg r STAMP: 8° SOXOUT RAKES 12 Ix4 ON Ix8 RAKE BD5 101 O w/Ix6 SU5-FRIEZE CONT. RIDGE VENT i 12 3+ - COPPER FL. ON 2x2 R.C. HEAD CONT. RIDGE VENT —14 — GAP / ®� ASPHALT SHINGLES 15# FELT PAPER 0 ® ? z _ s o COPPER FL. ON j { ALUM. GUTTERS ON vj p GROWN HEAD Ix8 FASCIA BDS.. o= xg ❑�❑� I Ix6 CORNER BDS. 3 a0 a — R.C. CLAPBOARDS _ i 4" EXPOSURE 00 n no a _ ON TYVEK HOUSEWF 1 W 5x8 DECORATIVE U COL's. TYP. Z W } 0cn Q LLJ FRONT ELEVATION w LU 12 e LU U Io 12 i 1 - ELEVATIONS RAILING j NOT SHOWN - FOR — ® _ DATE ISSUED: 3. ---- - CLARITY,, ® -- -- s 05/06/08 ' '� ► — - -- -- REVISIONS: -----------J-E- ---------------- ---------- ------- DRAWN BY. '�� i �'-`T° 6'-e° T-O" T-O" b'-4 I/2• g'_4:��r �e� PROJECT#: --- n DRAWING NO.: i of Oj REAR ELEVATION STAMP: CONT. RIDGE VENT ai _ iA J ffTn o= �Q IIFMI i 3ra Lu U 3'-40 I Q } RIGHT SIDE ELEVATION c Lu Lu cd YYY W W U CONT. RIDGE VENT 12 10� WLE: 12 's M1 a ELEVATIONS f 1 ®� DATE ISSUED: OSr06/08 REVISIONS: . DRAWN BY. PROJECT#: DRAWING NO.: d LEFT SIDE ELEVATION { A6 STAMP: r ' COI'T RIDGE VENT 2.12 RIDGE BD. TYPICAL ROOF CANSTR TICN ASPHALT SHINGLEs ON ISO BUILDING PELT ON I U2'CDX PLYWO. . PROP-A-VENT BAFFLE 2.10 RAFTERS•16'OZ.W CON'T RIDGE VENT SIMPSON 5 CLAPS•I O.C. 9'(R-SO)FIBERGLASS BATT 2.0 16'O.C. KRAFT PACED INSUL. 2.12 RIDGE BD. 10 11 1 12 it It TYPICAL ROOF CONSTRUCTION 3+/-F - ASPHALT SHINGLES ON 0 III u I I ID>•BUILDING PELT ON I x 3 STRAPPING AT Ii'O.G. 1/2'BUILDING ING FELT , 'BLUEBOARD WITH 2.10 RAFTERS I6.O.C.w/ 12 / I ' \ BKIMCOAT PLASTER-SMOOTH SIMPSON 142.4 CUPS O Ib'O.G. / !2rs 16 O.C. \ \ 10 r—//�,� \\ Y o WALL SOL D BLOCK TYP.2 W FLOOR CONSTRUCTION N N O /1•�t ///// P' - AB NEEDED G7ED 4 NIO �o SU it UU /S'TJI's S 1 9/4'TlG PLYWD OUBFO FLOOR GOIBTiUCTION i'OVER O.G. WW uu n Z 1.9 STRAPPING AT li•O.G. (qJ (���u WI2f,�E 8T.SM. SKJMKOATT PLADTERTU SMOOTH - Q 8 5 1.3 STRAPS•16'O.G. tn9 Tvn�nL ue_r S/S'TYPE•x'G.W.B. - � W-C.SHINGLES i e WALL CONSTRUCTION— ON WAL19 l CIF. W.C.SHINGLC9 S'EXPOSURE + L/INSTRL=.ION a" TYVEK HOUSEWR TYVEK HW86IRAP �D 2.4 GOx PL;T I/2 COX PLYWOOD G/4'T!G IL0 SUBPLOOR 2W STUDS•16• 2.4 COXSTU P•I6'O.G. m GLUED l NAIIlD OVER S 1/2'RA UNPA< GARAGE 11 7/S'TJI'r•IL'O.C. GATT INSULATION r b'(Ri9)FIBERGLASS BATT INSULATION 1/2'OWE BOARI 4'CONC.SLAB w/ u✓VEN.PLASTE i'.b'10/M WHIM ON - 6'COMPACTED GRAVEL k. III IUI - - LIJ FOUNDATION, •� BITUMINOUS OAMPPF WFiNG - ' ON 10'CONC. @AQEMENT FLOORS - Q FOUNDATION WALL S 1/2'CONIC.BLAB OVER . ON 20'x10'DEEP b MIL POLY VAPOR BARRIER KEYED CONIC.FOOTINGSECTION ON b'COMPACTED GRAVEL Lu J A CROSS _ sca�sla=ry 0y I ; Lu Lu CROSS SECTION w U "' scA�sla•=ra � TYPICAL ROOF CONSTRUCTION ASPHALT SHINGLES ON ISO BUILDING FELT ON 1/2'CDX PLYWD. 2.6 RAFTERS•16'O.C.w/ SIMPSON 142.5 CLIPS•16'O.C. COPPER PAN FLASHING AT DOOR LOCATIONS TIT: 1.4 PVC TM I ! CENTER SD.ON FIRST FLOOR - - 2.6•16'O.C. FABIR FLASHING SUHFLOOR t STRUCTURAL _ S.S DECORATIVE 1.6 COMFOSITE DECKING CROSS SECTIONS COL'..TYP. e COMPOSITE DECKING ON P.T.FRAME Ix3 ON Ix RED CEDAR _P.T. 2X8 4 16" O. PAINTED II'' DATE ISSUED: P.T.GIRT _ 11; :C 05/041DI i GALV. II` REVISIONS. JOIST HANGERS .\� P.T. 2X8 GIRT P.T. 2x5 LEDGER w/ 5/6' P.T. SPACER W/ 5/8" DIA. GALV. LAG BOLTS O 16' O.G. STAGGERED H--1—SIMf-5ON CB" �� • CONC. SONOTLIBE _ DRAWN BY: —--- PROJECT#: CROSS SECTION Al SCALE:114'=v-0' DRAWWGNO.: .. DECK D TAIL A7 i� s4 r • STAMP: - P.T. 2x& O 16' O.G. 2-P T. 2xb GIRT 5EIAW i FF=F:1==F::f-_=F= =::P1=P=F=F=4=F=F=1 =4==F=H IIIIIIIIIIIIIIIIIIIIIII 1 1- I 1 1 � I 1 1 - IIIIIII1111111111111111 � . II '' i II 1 1 I I1 I f II I I III IIIIILIIIIIIIIIIIIIIIII Illilllllllllllllllllll Z �O In _ _ . - ul 1 1 I 1 1 1 1 1 I 1 1 \ ------------ 6 - I \\ - ----------- 1 _ ------ 31II1IIIIIIII11 I 1- I 11 �" TJI'e (360 SERIES) T- -- r: II 11.TJI'e (360 SERIES) O 16" O.C. ^�-------- --- --11 w I . - - r- --IOJ--- -mJ ____ -- + -'- 1 I I I xm- --xm--- '---- -- _ Lu Q . W i _�1 -_-- - --=------ -- �. N 1 1 WlJu L W Lu - ----------- 1 2-P.T. 2x8 41RT -_ ��`� � .1 Y P.T. 2x6 O 16' O.C. ----------- -- '----u —� r TIRE.it --- -- r - __- - FIRST FLOOR -------- ------------ GONT. 11 7/8' wL FRAMING PLAN RIM J015T . FIRST FLOOR FRAMING PLAN TrTT7 TT f TT TTT - - DATE ISSUED. I I � ILL�� I LL��I $�w -�, -L�_ L _I_I REVISIONS: NOTE: FLOOR TRUSSES TO BE ENGINEERED BY TRUSS MANUFACTURER. STEEL BEAMS TO BE ENGINEERED BY 2-P.T. 2x10 GIRT STRUCTURAL ENGINEER. g� P.T. 2x9 O 9 DRAWN BY: _ _..-. PROJECT#E: DRAWING NO.: A8 ®g r , STAW: o n O - W r V I\. ------ 3 C Ci —_ _FL FR. -11 7/8°-LVL II IN ---- - FL FR. 4-11 7/B' LL LU SERIES) O 16, O.G. I I . . IL�----'— - - ----- / T--------- `, ------ -- -- ----- z -- ---_ --------- I I _—_— — -- - o ----- 1 r:1 I — `� L_ �c w ----- wJ-I WI4z30 STEEL 9M. BELOW1 ---- - I - -- V ---- - ----- z it _ _--_ _ I� --- II --- ---- I-----� FL-FR Il 3 - / LV -—' 3-II VIE" LVL BELOW .• 1 TIME u I ,. SECOND FLOOR / n -.-- ---- ------ — - FRAMING PLAN SECOND FLOOR FRAMING PLAN CONT. II 7B" LVL RIM JOIST DATE ISSUED: ON04M, REVISIONS: _ DRAWN BY. PROJEC T#: DRAWING NO.: A9 r a STAMP: DOOR SCHEDULE s.G. - SOLID CORE "` - "°`I°W `°RZ WINDOW SCHEDULE SYM. MFWS UNIT WIDTH HEIGHT THKNESS CORE PANEL REMARKS SYM. MANUFA RER'S UNIT ROUGH OPENING REMARKS XI S. 6'-B' 1 5/6 S.C. 6 PANEL wA2' H. TRANSOM A ANDERSEN TW21052 5'-0 1/6'x5'-4 7/8' X2 2'-B- 6'-8' 1 5/6 S.C. q LT. B. ANDERS TW2446 2'-6 WxW-8 7/B' X9 ANDERSEN FWG 8068 S'-O' 6'-B' _ C ANDERS G65 6'-0'x5'-0' X4 ANDERSEN FWG &0" 8'-0' b'-B' D ANDERS 76 c- s W-0 1/2'x9'-5 7/B' . X4 ANDERSEN FWH 9168 5'-I' 6'-8' E ANDERSEI TW2442 2'-6 1/8'x4'-4 7/8' X6 2'-8' b'-8'. 1 5/8 S.G. q LT. F ANDERSM T1421046 9'-0 1/8'x4'-8 7/6' X7 q'-0. 7'-0. G ANDERS AZI Z'-O 6/8'4Q'-0 5/8' - o q.-O. 7'_0' wA2' H. 14 LT TRANSOM - Z c H AND 2817 2'-6 I/8'xl'-7 1/4' BASEMENT SASH C9 0 V5 J ANDERSEP AW31 3'-0 1/2'x2'-4 7/8' ] WU NOTE 1, ig z I SEE ELEVATIONS FOR GRILLE PATTERNS. r g O I 2'-6' W-8' EXTERIOR GRILLES TO BE DETERMINED BY OWNER 13/8 S.G. PROVIDE INSECT SCREENS 2 2'-6' 1 3/8 S.C. - - HARDWARE TO BE SELECTED BY OWNER 1 3/6 S.C. 4 FAIR) 6'-8. 1 3/B S.C. 15 LT DOORS 5 2'-1' 6'-8' 1 3/8 S.C. 6 4'-0' W-8' 1 5/6 S.C. BY-FOLD' - 7 2'-8' 6'-8' 1 5/5 S.C. LLJ 8 2'-8' 6'-6. 1 3/8 S.C. q 4'-0' W-S' 1 3/6 S.C. BY-FOLD W 10 2'-6' 6'-8' 1 3/0 S.C. - } II 2'-6' b'-8` 1 3/B S.C. L W J � QS 12 2'-6' b'-8' 1 3/6 S.G. W - ' LLI 15 2'-8' 6'-8' 1 3/5 S.C. 14 2'-b' 6'-8' 13/8 S.C. G W 15 2'-6- 6'-8' 1 3/8 S.C. - W U 16 5'-0. 6'-8- 1 3/8 S.C. BY-FOLD ~ 17 2'-6' b'-a. 1 3/8 B.C. -IS 5'-O' 6'-8' 1 5/8 B.G. BY-FOLD - - - Iq 2'-8- 6'-B- 1 3/5 S.C. - 20 2'-6- 6'-B' 1 3/8 B.C. - 21 2'-6' 6'-W 1 3/6 S.C. - TITLE: 22 5'-0. W-a. 1 5/6 S.G. BY-FOLD s 23 2'-6' b'-B' 1 3/8 S.C. NOTE, SCHEDULES I. SEE ELEVATIONS FOR GRILLE PATTERNS ON ANDERSEN DOORS 2. INTERIOR DOOR MFR TO BE SELECTED BY OWNER S. DOOR HARDWARE TO BE SELECTED BY OWNER - DATE ISSUED: 05/04l08 REVISIONS: Q DRAWN BY: PROJECT#: pp DRAWING NO.: a8 Al 0 SEPTIC SYSTEM PROFILE NORTH ALTERNATE BENCHMARK NOT TO SCALE ¢ '�s TOP OF FOUNDATION SOIL TEST P# 10805 � AS--BUIILT 27.62 DATE OF SOIL TEST 09--23--04 z WITNESSED BY DAVE 7l� 'G�" r 6 MAX SOIL EVALIUATC)R B=RNII UNG R PERCOLATION RATE <2 MIN. INCH.INSPE 9" MIN, 136" MAX LEVEL 2' MIN �*-- PORT t,T101 1.00' MIN, 3.00' MAX 2.12 RISER IREQ D °' F 0.17 3" SEEDED TOPSOIL, W/STEEIL OF SE'RVATION HOLE I 1.25 Lin L ' ` 2% SLOPE MESSENGER - 2" PEASTONE 0.33 f -� ELEV>= 23.4C1 6.10 MIN ELEV. DEPTH HORIZ SOIL TEXTURE COLOR MOTTLING � 25.50 - :1.17- 28.1 Q M A7C 5.3 0.2525.05 .- _u ',;•,:�;<<:,°.:: �,;.;4. ....X.;: _ � n. 25 73 -� A LOAMY SAND 1 3 f2 N tf:;•. ;..... .. ,. wr _ ;,ri: ,> ?4.57 2-16 Bw LOAMY SAf�JD 24,87 :;r;:� :,,k. 3 4 TO 1-1 2 DOtJ LE �. ::4j' rT..,;�.:... - I OYR4 3 0 4.00 / Q.83 r �:_ ,,, �°�, ,.>: •�:.: lf B .:; :,,,:;.. > ,. Y;r w. .:, 1.19 -. _ ==:= �. �° °' WASHED STONE 17.40 16-102 C COARSE SANG) 24.6Q ..., . -23.41 O •,•,.,. d.a:. w�'V* ...+`,: rtc br 1I0YR5/6 N IHIGH CAP INFIL -3,2'5 ENDS ;: 8 2.7 ._... -�---�•_-�-=�'.. .. .., . T A ORS 37.50' SET N (�.86 , - : .. ..•,:.:. .:; :: ;�` •:: ,,. �» COARSE AGGREGATEi.37 4.00 -�► 1500 GALLON SEPTIC TANK �` --- 44.00 --- ------ 10.78 -4----�- LOCUS MAP 16.23 AS FOUND 09-23-04 ST-1500-H-10 DISTRIBUTION BOX GROUNDWATER MEASURED NOT 'TO SCALE BOG EL 17.62 DB-3 OR D85 H-10 06-14t-07: 18.04 - 18,t - AS FOUND 06-14- 6 GRAVEL ON NATIVE SOIL OR' - � �� MECHANICALLY COMPACTED BASE, Tl'P NOTES PERCOLATION TEST DONE AT A DEPTH OF 30"--42" )GENERAL ALL WORKMANSHIP AND MATERIALS SHALL CONFORM WATER ENCOUNTERED @ 86", EL 16.23 TO 310CMR15.00 THE STATE ENVIRONMENTAL 'CODE TITLE V. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL. OF SANITARY SEWAGE, AVAILABLE FROM STATE OBS.ERVATTON HOLE 2 HOUSE BOOKSTORE 1-617-727--2834, AND TOWN OF BARNSTABI-E RULES AND REGULATIONS FOR THE ELEV.= 22,20 _ _ SUBSURFACE DISPOSAL OF SANITARY SEWAGE. ELEV. DEPTH HORIZ SOIL TEXTURE COLOR MOTTLING 2) CONTRACTOR SHALL VERIFY LOCATION OF EXISTING T� 10 " 25.13 0-2 - A LOAMY SAND UTILITIES. CONTACT DIG-SAFE AND LOCAL WATER `'`�� 10YR3/2 N DEPARTMENT 3 BUSINESS DAYS BEFORE BEGINNING 24.30 2-12 Bw LOAMY SAND 11 QYR5/4 0 CONSTRUCTION. 17.80 12--90 C COARSE SAND 11 QYR6/6 N 3) CONTRACTOR RESPONSIBLE ,FOR OBTAINING ADEQUATE HORIZONTAL AND VERTICAL CONTROL. 4) CONTRAACTOR SHALL VERIFY ALL PLUMBING FLOWS 'TO •00„ PROPOSED SEPTIC TANK, AND SHALL LOCATE ALL OTHER BOG ELEV/ 17.62 a°� �P EXISTING SANITARY FACILITIES ON PREMISES NO LONGER YVATE'R ELE1/ 1 .69 9� USED AND PUMP, AND FILL OR ,REMOVE SAME IN o ACCORDANCE WITH LOCAL REQUIREMENTS. 11-03-04 r � ,✓ 5) ALL COVERS OF SANITARY UNITS SHALL BE BROUGHT e �, + , TO WITHIN 6" OF FINISHED GRADE. ALL MASONRY UNITS 1 QQ FROM ISOLATED4 ��/� 0� ` „ TO BE MORTARED IN PLACE. ALL PVC PIPE TO BE WETLAND ,AND WORK LIMIT 23.a'�9. �6kx , PERCOLATION TEST DONE AT A DEPTH OF 28 -40 SOLVENT WELDED. ? 4 rs ucs WATER ENCOUNTERED (5) 78 , EL 15.70 6) UNLESS OTHERWISE SPEOIFIED, EXISTING AND FINAL ?e O 1041 9 GRADES SHALL REMAIN ESSENTIALLY UNCHANGED. & ' 7) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING RESTRICTIONS tax ' AND/OR REGULATIONS. OWNER/APPLICANT MUST OBTAIN SUCH DETERMINATiON FROM APPROPRIATE AUTHORITY. 8) EXCAVATE AND REMOVE UNSUITABLE MATERIAL BELOW THE LEACHING INVERT ELEVATION FOR 5' AROUND r LEACHING SYSTEM AND REPLACE WITH CLEAN SAND. 9) IF ANY DETAIL OF THIS PLAN IS NOT UNDERSTOOD, } r 20.00 t}}�� 9 a 'r 0 CONTACT DESIGN ENGINEER AT 432-6360. EXISTING o �!J r ��/ 10) 48 HOUR NOTICE IS REQUIRED FOR ,ANY INSPECTION FOUNDATION c9 05 OR CERTIFICATION REQUIRED. 0 r ,00 FROM IRK LIMIT '� 11) SITE LIES WITHIN FLOOD ZONE C AS SHOWN ON MAP FUTURE ELEV 27.62 \ . . , 1 WETLAND AND WORK 6.IMIT � ;�3, � P POOL IP 2�0001 0016 D DATED 07-02 2. , 0 10.00 -� 44,00 ROM AU 100* FTO BOGOP OF BANK A,�� S`j 0) 2.20 \ i' GW 15.i'0 RESER ,� 2� J p \ EX STING 20.00 FOUNDATION FUITURE yyf 'S�. I5 6. `"�I POOL. B�10.002 CIO C�7 �! `v�► 2.20 4 12.45 10.78 I � cw 1e3.7o �� r � \� ?� ST � °a� �\ 0 22> 23 Q - `�, LOT 2 .-- ' �� `� OD z --•-- 0.7 W 116 -�- 63 A • �`�� ( � GWT 4 12.45 f 10.78 LOT 2 2 �`` VWETLAN D=0. 1 O AC. ,� 38.00 �`.,�, `�, 11 BETPiAANN - A"'. �ca i3 2r 36.0 0 � `"\ Tt7T11L-,.73 AG. c> TOTAL- 1 .73 AC. ✓ � DRIVE DRIVE l I A. / CIVIL hJ RESERVE APPROVAL EN(6 E TAMP DESIGN CALCIULATIONSLl�,� / / - SEPTIC DESIGN BJY „�--- `` 07 �ELEVATIONS, �, -� 16 14 NUMBER OF BEDROOMS 4 : ,, � GARBAGE DISPOSAL UNIT NOT ALLOWED DESIGN FLOW \ o t. 11/03/I04 HOUSE SITING AND SEPTIC DESIGN BJY - o c ,� • .� � ®ate DESCRIPTION Drawn Checked. 4 BEDROOMS x 110 GAL./(BR--DA)=440 _QED. � / �?a3 �� � - BENCHMARK R E V I S 1 0 N S - REQUIRED 'SEPTIC TANK CAPACITY 15 0 GAL (MIN), 4,, �' TOP TAB BOLT ON - - ACTUAIL SEPTIC TANK CAPACITY 150 3AL f ' l HYDRANT9' PROPOSED SITE PLAN SEPTIC IC AREA REQUIREMENTS ,r �`*. `,� APPROX. NGVD LEACHING w � � ----BOTTOM 0�.74 G,AL/(SF-DA) w , �, j► SYSTEM EIS ---SIDE Q.74 GAL/(SF-DA) e LEACHING CAPACITY �� LOT 2 KALMIA WAY" �((44'x10.78') + 2x(44'+10.78')x1.19') '�j' ce�a�"" IN x0.74 GAL/(SF-DAY)= 447 GPD RESERVE 447 GPD CE NTERVILLE NOTE: TOPOGRAPHIC SCALE: NOTED DATE: OCT 26, 2004 _.. INFORMATION TAKEN FROM LA BARGE 20 -�0 20 40 60 TOWN OF BARINSTABLE SCALE: I"=:40' ENGINEERING & COIS UCTING,INC. BASE MAPS AS 237 MAIN ST. -ROUTE 28 SITE PLAN N OT ES a SUPPLEMENTED BY ON THE VVESTHARWICH, W671 e> � 1 .2iG 1 . LOCUS REF: D.B. 2114/239; P.B. 568/`6,8 LOT 2 GROUND SURVEY. (508)432-6360 1Q o Q 2 - (, 2. ASSESSOR'S MAP: 188 PARCEL 49 DRAWN BY: BJ•Y CHECKED BY: TAL SHEET 1 OF 1