HomeMy WebLinkAbout0039 LAWRENCE LANE - Health 39 LAWRENCE LANE, CENTERVILLE
A= 190 253
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DEED RESTRICTION
WHEREAS, _h7i �Cf C 0 �-,' i ��S �J of
(owner's name)
✓L C N`L <C f IyT ;Evl c,l L MA
(address)
is the owner of ,.S.gI L 19W f."Y c C L Alvi located
(address).
at �' y'f,C✓-c
MA (hereinafter referred to as
and being shown on a plan entitled "Subdivision of Land in c
666Wfollf MA, Property off-z,:c y 64FIv XFtL<q i(?L/
et aI, duly recorded in Barnstable County Registry
of
Deeds in Plan Book _ - " Page �f ;
Or on Land Court Plan Number
WHEREAS, as the owner of said lot has
(owner's name)
agreed with the Town of Barnstable Board of Health to a restriction as to the
number of bedrooms which can be included. in any home built on said lot as a
pre-condition to obtaining a disposal works construction permit in compliance
with 310 CMR 15.000 State Environmental Code, Title V, 'Minimum
Requirements for the Subsurface Disposal of Sanitary Sewage;
'max.,ry" i E-{EREAS, the Town of Barnstable Board of Health, as a precondition to
r `1�F,
-gran ipg a disposal works construction permit for a septic system in compliance
whh 31 0 CMR 15.200, State Environmental Code, Title V, Minimum
K6q_urrements for the Subsurface Disposal of Sanitary Sewage, and authorizing
th�jSissuance of a building permit for the construction of a-single.family home on
this property, is requiring that the agreement for the'restriction on the number of
bedrooms in any house constructed on the lot be put on record with the
Barnstable Dounty Registry of Deeds by recording this document,
&cdr
following restriction,.on his above-referenced land in accordance with his
agreement wifh the Tr)wQ of Rarmgt2bfa R-nard of H& . , .t, .c. . stFi(.rion .ha[I
run with the-land and be binding upon all,successors in title:
may have constructed
(address)
upon the lot a house containing no more than %. FC (g) bedrooms.
fin kcitc, ddKL,5"A agrees that this shall be permanent deed
(owner's n me)
restriction affectingK-cPe,,e located on Q'Vr',c;fi.zi.0 MA, and .
being shown on the plan recorded in Plan Book.- '_ , Paged
Or on Land Court Plan
For title of �nr G' '�/' see the following deed: Book27-� 9 , Page
13 Or Land Court Certificate of Title"Number
Executed as a sealed instrument �� day of t?7f�.a re.
Ow�ne n ure
Owner's signature
Owner's signature
COMMONWEALTH OF MASSACHUSETTS
(vs--fl4y�� c f , ss
20
Then personal[YPP a eared the above-named
AA&G� L r,qr r, s p gF -
known to me to be the person who executed the foregoing P
p g g instrument and �`Exwna� ooy :
acknowledged oee g Ts
the same to be U1J free act and deed, before me,
{4
U t Notary 7� cow►v'+
Public
My commission expires: i
= &M4V/,, OY 0�or9
BARNSTABLE REGISTRY OF DEEDS (( e)
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No. �of ,?� 5
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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01ppYication for Nsposal .pstem Construction permit
Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 3q LAWRCt.�_ C.*WG Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel CIO L'V I r.CG s ANoDGRA Boo 06
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
G"GWIDG GW_r Pk1SE_S LL4J--
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Type of Building: /
Dwelling No.of Bedrooms 6 Lot Size .��1 kk4zS s+-A- Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
�GPL 4<C �2— COX
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.
Sin I
Date -2
Application Approved by Date .2-,';L— /3
Application Disapproved by Date
for the following reasons
Permit No. 13 6 s Date Issued '�
No. 0 1 / Fee 1'
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Zipplication for Disposal *pstrm Construction i3Prmit
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) El Complete System El Individual Components
t r - Location Address or Lot No. 39 LAkJRC_LIZG ENE Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel V(tom- 5 A1\JQGRA 800VA
Installer's Name,Address,and Tel.NJ- _ Designer's Name,Address,and Tel.No.
G40swtpE G7 7WPXlSES L4-1G-
i L4 0 —
Type of Building:
Dwelling No.of Bedrooms Lot Size Ac.crc sq,2� Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
s
Design Flow(min.required) gpd Design flow provided gpd
fj Plan Date Number of sheets Revision Date
4 Title
F
Size of Septic Tank Type of S.A.S. '
Description of Soil
ti
I.
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
4 - <
I! Permit No. go t3- 659 Date Issued �" � 2 — f /
i
-------------------------------------------- ---
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(K) Upgraded( )
Abandoned( )by_CAC—wt4� C.►c1T�Lt� �tcS LC.0
at 31 (..4te)2�1.)��C1�� C!�11 ((� � has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.aG 13- G S9'dated
Installer — Designer
#bedrooms N Approved des' nrflo gpd
The issuance of this permit shal not be const��ed as a guarantee that the system tll functioqe
i Date �c 8^// Inspector
-------- ---- ------------------ ---- -------- ----------- ---------- -------------------------------------------
No.go 1 �� —C>159 Fee (�
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
I
Misposal 6pstem Construction permit
Permission is hereby granted to Construct( ) Repair(A) Upgrade( ) Abandon( )
System located at L WFf= !.1-r_ (_AQ _ GG* =V j L LJ
14 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
ction must be completed within three years of the date of this permit__—C��L Cam`
Date _r Approved by F)
I
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own of Barnstable Barnstable
SHE 1p�
Regulatory Services Department AHnmdcaCfiv
r r I
Public Health Division
200 Main Street, Hyannis MA 02601 200�
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL #7012 1010 0000 2843 2041
February 21, 2013
Ms. Sandera Booth
39 Lawrence Lane
Centerville, MA 02632
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 39 Lawrence Lane, Centerville, MA was last
inspected on 2/0512013, by James D. Sears, a certified septic inspector for the
State of Massachusetts.
i
The inspection of the septic system showed that the system "Conditionally
Passes" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the
following:
• The distribution box needs to be replaced.
You are ordered to repair or replace the septic system within two (2) years from
the date you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in
future enforcement action.
PER ORDER OF THE BOARD OF HEALTH
s McKean, R.S. CHO
Agent of the Board of Health
•
QASEPTIC\conditionally passedl39 Lawrence Ln Cent Feb 2013.doc
Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13323
ey
Logged In As: Parcel Detail Wednesday,February 20 2013
Parcel lookup
Parcel Info
Parcel ID 190-253I Developer i LOT 8A �I
Lotl
Location 139 LAWRENCE LANE Pri Frontage 134Se
I
Sec Road ISHOOTFLYING HILL RD I Frontage - -
Village CENTERVILLE Fire District C-O-MM ___
Town sewer exists at this address I No I Road Index 10876
Asbuilt Septic Scan: Interactive �
190253_1 Map _ l =
Owner Info
Owner BOOTH, SANDERA J Co-Owner F_
Streetl 139 LAWRENCE LN ) Street2I
City ICENTERVILLE state AMA zip 0266332�� Country _ J
Land Info
Acres 0.39 use Single Fam MDL-01 I zoning[R-67-1 Nghbd 0105
Topography I Level ( Road[Paved — -
utilities Public Water,Gas,Septic I Location
Construction Info
Building 1 of 1
Year 1980I Roof Gable/Hip Ext lVVood Shingle I
Built 1 Struct Wall i
Living 1954 Roof Asph/F GIs/Cmp ( AC(None —1 4
Area Cover Type -
Style Cape Cod Wall Drywall I Rooms c1F3 Bedrooms
Model Residential Int Carpet I ores 13 F II
Floor Rooms( �
Heat Total �A.
Grade Average Hot Water ( 18 Rooms
Type RoomsHeat 44
M
Stories 11 1/2 Stories I Fuel Gas I Found-ation,Po ru ed Conc.
"-FAHh
Gross 8
Area 1 �(456..____._...._. _I
Permit History
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13323 2/20/2013
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
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.
Important:When filling out forms A. General Information
p��aunufnu�/
on the computer, OF MgS,soi,��
use onlythe tab
1. Inspector:
o
-
key to move your p
cursor-do not James D.Sears JAM ES
use the return Name of Inspector = ;r„
key. ;,�
CapewideEnterprises, LLC .•c„ o
5�� .
,y Company Name ., ' •
153 Commercial St. Tp�G\``\`p
Company Address
Mashpee MA 02649
City/Town State Zip Code
508-477-8877 S1623
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,;inspp4ion
was performed based on my training and experience in the proper function and r>sj,tenanceW on g
sewage disposal systems. I am a DEP approved system inspector pursuant to.$a ction 15, 40 of--
Title 5(310 CMR 15.000).The system: e, a
❑ Passes ® Conditionally Passes ❑ Fails tint
❑ Needs Further Evaluation by the Local Approving Authority
2-6-13
1 ector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
""This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use. �J
t5ins•11/10 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 1 of 17
t J}
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM z 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is Centerville MA 02632 2-5-13
required for every
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
❑ I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
® One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
_ r Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M ,.•''r 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. Cityrrown 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):
Need to replace D Box
❑ 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•11/10 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
M 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
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 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 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 eesd is less than 6" below invert or available volume is less
than %day flow,LE.4C#tAvG
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
c'I
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. Citylrown 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-11f10 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
M 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
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
t5ins•11/10 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
w 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
The system is a 1000 Gal precast tank D Box, Pit and two 500 Gal Chambers.
Number of current residents: 1
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)): 2011-37,000Gais
2012-40,000GaI s
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: Present
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-11/10 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
39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. Cityrrown 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: 6-3-11
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•11/10 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
M 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
Around 1980 New Leaching 2000 Permit 00-004
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 28"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.):
Pipeing is 4" PVC SCH 40
Septic Tank(locate on site plan):
Depth below grade: 20"feet
Material of construction:
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 Gal Precast
Sludge depth:
2" I
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
4 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. City/Town 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
28"
Scum thickness
1"
Distance from top of scum to top of outlet tee or baffle
12"
Distance from bottom of scum to bottom of outlet tee or baffle
17"
How were dimensions determined?
Asbuilt-Tape
Sludge Judge
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 at working level, Tank and cover's at 20" Below grade w/outlet baffle, No sign of Leakage or
over loading.
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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
a Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
'< 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owners Name
information is required for every Centerville MA 02632 2-5-13
page. Citylrown 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•11/10 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
M 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
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 0
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.):
D Box is 16"x 21"-29" below grade w/two lines out.Wall's are one. Need to replace D Box.
9 9 P
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•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number: 1
® leaching chambers number: 2
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Older leaching pit, Pit at 30" below grade w/cover at 8"20"water, Newer Leaching, two 500 gal
dry well chambers w/4' stone. Chambers are wet and clean. No sign of over loading or solid carry
over.
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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
-t Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
a 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
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
EAR
A o
r o
O ❑aL
3
Ivl
u
14-a:ol
la�a � 3r�
0q-3 = °
- 3y
-y= 3 g,
t5ins•11110 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
�M y 39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells Nv
Estimated depth to high ground water: 12+'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: 7-31-80
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:
T.H. on Design plan 7-31-80 No G.W. at 12' Bottom of chambers at 6' Bottom of Chambers at
6' above T.H. Depth
I
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
39 Lawrence Lane
Property Address
Sandy Booth
Owner Owner's Name
information is required for every Centerville MA 02632 2-5-13
page. Cityrrown 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
i
TOWN OF BARNSTABLE
LOCATION 9 L sa Lat P e � G' L
A Ale SEWAGE # L) 7 - U U
VILLAGEC ?Al fg ;�> fir' p- ASSESSOR'S MAP & LOT ^�
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY f.
LEACHING FACILITY: (type),Z
P1 G� (size) SO G A.L
NO.OF BEDROOMS_ 3
j BUILDER OR OWNE
PERMITDATE:
��COM�PLILAAN�CEDA�T7E:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility)
Edge of Wetland and Leaching Facility(If any wetlands exist Feet
within 300 feet of leaching facility)
Furnished by Feet
i
j
I
N
s 3�
r
}
TOWN OF BARNSTABLE
LOCATION 37 /— .4 ul it -e-Al e e 4 A Ate SEWAGE # 0 0 � ��
-V-ILLAGE C eAl-re A JZd ASSESSOR'S MAP & LOT '
INSTALLER'S NAME&PHONE NO. m am deg. (9w
SEPTIC TANK CAPACITY 0,0 -- �,�T o C.y
LEACHING FACILITY: (type);,-�,Z'C W C ,A/4AGO.f'5 (size) -5-00 6 AL
NO.OF BEDROOMS
BUILDER OR OWNER ►
PERMITDATE: oo COMPLIANCE DATE:
— 120
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
.`Furnished by
__ _ _ —�
� .
,,c
''� ,
� h ,
� � � ,
� .
E t
., �',
� � �_��
�� :,�'
'�
. }
J �
No. A0" 1�1 Fee $ 50. 00
THE COMMONWEALTH OF MASSACH'USETTS Entered in computer: —Ke,
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pprication for �Digoe;ar *p�tem Cow5tructiou 'Permit r
Application for a Permit to Construct( )Repair(X j Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 39 Lawrence Lane Owner's Name,Address and Tel.No. 7 7 5—4 8 7 1
Centerville ,Mass . 02632 S . Booth
Assessor'sMap/Parcel 170 -1- S 3 39 Lawrence Lane Centerville ,Mass .
Installer's Name,Address,and Tel.No. 5 0 8-7 7 5-3 3 38 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8
J.P.Macomber & Son Inc . J.P.Macomber & Son Inc .
Box 66 Centerville ,Mass . 02632 Box 66 Centerville ,Mass . 02632
Type of Building:
Dwelling X X Fo.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 355 gallons per day. Calculated daily flow 3 x 110=3 3 0 gallons.
Plan Date Number of sheets Revision Date
• Title
Size of Septic Tank /� L�J Type of S.A.S.
Description of Soil Loamy b o n e y sand to medium fine sand .
Nature of Repairs or Alterations(Answer when applicable) A d d i n g t w o 5 0 0 g a 11 o n l e a c h i n g
chambers packed in 4 ' of stone .
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued y this Boatd of Health.
Signed Date 1/4/0 0
Application Approved by Date l-'
Application Disapproved for the following reasons
Permit No. "_10 �� Date Issued �''`
No. Fee$ 5 0.Q Q
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Z '
es
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Apprication for Migpogar *pgtem Congtruction Vermit -
'y .
Application for a Permit to Construct( )Repair(X I Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 39 Lawrence Lane Owner's Name,Address and Tel.No. 7 7 5—4 8 71
Centerville ,Mass, 02632 S. Booth •
Assessor'sMap/Parcel , O S-3 39 Lawrence Lane Centerville,Mass .
Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8-7 7 5—3 3 3 8
J.P.Macomber & Son Inc . J.P.Macomber & Son Inc.
Box 66 Centerville ,Mass. 02632 Box 66 Centerville ,Mass . 02632
Type of Building:
Dwelling-XXNi o.of Bedrooms 3' Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 355 gallons per day. Calculated daily flow 3 x 1 10=3 3 0 gallons.
Plan Date Number of sheets Revision Date
Title
�y Size of Septic Tank A0 Type of S.A.S.
Description of Soil Loamy boney sand to medium fine sand .
Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon l e a c k i n g
chambers packed in 4 ' of stone .
Date last inspected:
"Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the,Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued y this)3o d'of Health.
r
Signed t— Date 1/4/0 0 L "--•
Application Approved by Date 61 �J!J
Application Disapproved for the following reasons
Permit No. GAD 04W Date Issued
----------,--_-----------------.—_—_-------.—
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Comphanre'. x .
THIS IS TO CERTIFY,that the Od--life Sewage Disposal System Constructed( )Repaired(X X)Upgraded( )
Abandoned( )by J.P.Macomber & Son Inc .
at 39 Lawrence Lane Centerville ,Mass . has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. -,®f dated_ /,,�* �f 4516.
Installer J.P.Macomber & Son Inc. Designer J.P.Macomber & Son J�n,c .
The issuance of this permi shall n tube nstrued as a guarantee that the sys em wii uunctii1on as des`r ned.
Date Inspector �"/� i�'y1 �,� �I ��� `f U� 1
No. Ill�.r, Qy h✓ — ————————Fee $ 50. 00
P
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS
Migpogal *pgtem Congtruction Vermtt I
Permission is hereby granted to Construct( )Repair X�Upgrade( )Abandon( )
Systemlocatedat 39 Lawrence Lane Centerville ,Mass.
i
and`as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of thi t.
Date: /,-7 -- Approved ✓
1/6/99
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (W=0UT DESIGNED PLANS)
I, Jose ph P.Macomber-Jr _ hereby certify that the application for disposal works
construction permit signed by me dated 1/4/0 0 concerning the
property located at 39 Lawrence Lane Centerville ,Mass meets all of the
following criteria: t
1f The failed system is connected to a residential dwelling only. There are no commercial or business
/ uses associated with the dwelling.
•� The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
✓ There are no wetlands within 100 feet of the proposed septic system
•✓ There are no private wells within 150 feet of the proposed septic system
•� There is no increase in flow and/or change in use proposed
•� There are no variances requested or needed.
JThe bottom of the proposed leaching facility will Abe located less than five feet above the
maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor
method when applicable)
If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed
leaching facility will M be located less than fourteen(14)feet above the maximum adjusted
groundwater table elevation,
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information)
B) G.W. Elevation -' +the MAX. High G.W. Adjustment. 17, _ ✓� 2
DIFFERENCE BETWEEN A and B 3('
SIGNED DATE: 1/4/0 0
(Sketch pr sed plan of system on back].
Q:health folder ccn
y
r
i
J
•
DATE._ .... ..; ...,
PROPERTY ADDRESS:_':. 39 -Lawrenc'e Lane RECEIVED
Igo Centerville ,Mass . AUG 2 1995
02632 HEALTH D,EPT.
_ . .---- TOM OF BARNSTABLE
On the above date I Insp
ected the septic system at the above address.
This system consists of the following:
1 . I-1000 gallon septic tank.
2 . f—distribution box.
3. 1:-1000 gallon leaching pit .
Based on my Instaction, I certify the following conditions:
1 . This is a title five septic systein. ( 78 Code )
2. The ;yst•em' is in proper working order•at
the present time .
51GNATUR!7-: /, .
`
Name: J. P .M'acomber Jr.,
Company: J. P •Macor4ber & Son 'Inc
------- •------=----
Address:_$ex—bb-----= -- --
Centerville Aq_ps__02-632 `
Phone:-- ------- -- 1
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY
W, W- 2ran
JOSEPH P. MACOMBER & SON, INC.
Tanks-Ceupools-Leachfields
Pumped L Installed
Town Sewer Connactlons
P.O. Box 66' Centerville, MA 02632-0066
775-3338 775-6412
..^_E SE ACE DISPOSAL SYSTEM 12;L"^
Aodress Of Propert.yy, 36 Lawrence Lane Centerville ,Mass.. 02632
Owner ' s name Ken Johnson c/o Scott Leforge
Date of Inspection 8/9/95
PART A
CHECKLIST
Check if the following have been done:
Pumping information was requested of the owner, occupant, and Board of
Health.
None of the system components have been pumped for at least two weeks
and the system has been receiving normal flow rates during that
period. Large volumes of water have not been introduced into the
system recently or as part of this inspection.
As built plans have been obtained and examined. Note if they are not
available with N/A.
The facility or dwelling was inspected for signs of sewage back-up-
The site was inspected for signs of breakout..
V All system components, *�wcluding the SAS , have been located on the
site.
V The septic tank manholes were uncovered, opened, and the interior of
the septic tank was inspected for condition of baffles or tees,
material of construction, dimensions, ,depth of liquid, depth of
p q p
sludge, depth of scum.
The size and location of the SAS on the site has been determined based
on existing information or approximated by non-intrusive methods.
The facility owner (and occupants, if different from owner) were
provided with information on the proper maintenance -.of SSDS.'
Recommendations
1 . Roots entering tank at inlet . Must be removed and pipe reset
in concrete . This will omit root intrusion.
2 . Septic tank heavy with solids . Must be pumped. Last done 198,
3 . Pit cover must be raised to within 6" of grade . 2-dollars .
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION
FLOW CONDITIONS.-
If residential
,3 number of bedrooms
number of current residents
garbage grinder, yes or no
. laundry connected to system, yes or no '
seasonal use, yes or no
If nonresidential , calculated flow:
Water meter readings, if available: 1993-75 , 000' gallons =20.5. 48 GPD
1994=67 , 000 gallons=183. 57 GPD
Last date of occupancy
GENERAL INFORMATION
Pumpin ec Is and ourc f informatio
1 ,, ' T
System pumped as part of inspection, yes or no
if yes, volume pumped
Reason or pupping,
-7 T �S
Type of system
Septic tank/d.istribution box/soil-absorption system .
Single cesspool
Overflow cesspool
Privy •
Shared system (yes or no) (if yes, attach previous inspection
records, if any)
fur, Other (explain)
Approximate age of all components. Date installed, if known. Source of
information:.
�N
Sewage odors detected when arriving at the site, yes or no
9
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION coatiaued .
SEPTIC TA1:K: 1000 gallon tank .
(locate on site plan)
depth below grade: 16"
material of construction: XXXX concrete metal _FRP other(explain)
dimensions:_ 816" Lnno 4110" Wide 517" high
18" sludge depth
distance from top of sludge to bottom of outlet tee or baffle
23" scum thickness
8" distance frog, top of scum to top of nutlet tee or baffle
_ h„ distance from bottom of scum to bottom of .outlet tee or baffle
Comments :
(recommendation for pumping, condition of inlet and outlet tees or baffles,
depth of liquid level in relation to outlet invert, structural integrity,
evidence of leakage, recommendations for repairs, etc. )
Septic tank musL be umppd _ Rant i ntriici nn nt the -i nl et n f t3r�k
Roots must a remove and joint recemented . The tank is structu a
lly sound .
DISTRIBUTION BOX: XXXX
(locate on site plan)
_T40 depth of liquid level above outlet invert
Comments:
(note if level and distribution is equal, evidence of 'solids carryover,
evidence of leakage into or out of box, recommendation .for repairs, etc.)
niRtrihntinn hnv ; ,_ level with equal diS iblltinn Nn 1PakagP
into or out of the box . No solid waste carry nvar
PUMP CHAMBER: NONE
(locate on site plan)
NONE pumps in working order, . yes or no
Comments:
(note condition of pump chamber, condition of pumps and appurtenances,
recommendations for maintenance or repairs,etc. )
NONE
-------------
SUBSURFACE SEWAGE DISPOSAL SYSTEM. I
PART 8 NSpECTZON ?ORM
SYSTEM INYORKATION continued
SOIL ABSORPTION SYSTEM (SAS) .XXXX
(locate on site plan, if possible; -excavation not required, but 'may -be
approximated by non-intrusive methods)
If not determined to be present, explain:
Type
leaching pits and number 1-6 ' x7 ' precast leach pit
leaching chambers and number
leaching galleries and number
leaching trenches, number, length
leaching fields, number, dimensions
overflow cesspool , number
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding.,
condition of vegetation, recommendations for maintena ce or repairs etc.
sand , No signs hydraulic ailure oPe E14,148 �
Cover must raise y a ing LWO
CESSPOOLS (locate on site plan) :
number and configuration
depth-top of liquid to inlet invert NONE
depth of solids layer
depth of scum layer
dimensions of cesspool
materials of construction
indication of groundwater
inflow (cesspool must be pumped as
part of inspection)
Comments:
(note condition of soil, signs of hydraulic failure, level *of ponding,
condition of vegetation., recommendations for maintenance or repairs,etc.)
PRIVY: NONE
(locate on site plan)
materials of construction NQNF
dimensions
depth of solids
---------------
Comments:
(note condition of soil, signs of hydraulic failure, - level of"ponding,
condition of vegetation, recommendations for maintenance or repairs,r'
NONE _ v
11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION •FORM
PART B
SYSTEM INFORMATION continued
SKETCH OF SEWAGE L:SPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within loo ' Town Water
Alit,
r .
I �
i
l '
DEPTH TO GROUNDWATER
201+ depth to groundwater '
method of determination or approximation: `
Se-e attached 11A Lot 8 Plan Book 333 Page 54
4 q C 4 P D.
k O0 -3 CAL--
(Ocx-) A,5. UX-Al,/ALJ— AIZE-A (50 o
r-"C:) .n;r PC 2.5 7
u4rrrom rap,
r A44 .. ,.1. k.,-4' *
C�o
TorrA L -D eS16W r dt2c-->
-T OT&t- F:-L.,o W 6.F-D. X
toEW-C-OL&TtoLi V%TL CIO A A i w' or, U6<,.
r
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V
oca. 5;!p Tor l7wo lo C..
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-Boy,
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000 >dlfiNv. IW.
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GAL- 9G 9G JF
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LOCATIC)"
G C A L 5-1; r 72 A.*T n- -7/---31
NO W,� re e-
CMIZTIJ=-{ Tt-(AT- TW--L �Odl)ATIOIJ .5wovio O-E I j CC--
t411.tZiaoi,i �k/ I TI-A Tk-A�-- -,I I)E-' Ll -7-- eq'
AWL- :.C-Tl*f.AC.V-
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EN A.)(T El fz� U
LIOT U.b."AIT? C)" w
12
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM f
PART C f
FAILURE CRITERIA
Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of
determination in all instances. If "not determined", explain why not)
_AM Backup of sewage into facility?
Discharge or ponding of effluent to the surface. of the ground or
surface waters?
_A/6 Static liquid level in the distribution box above outlet invert?
�S Liquid depth in Ar
9 P �:esapaal <6" below invert or available volume< 1/2 day
flow?
_hba Required pumping 4 times or more in the last year7
number of times pumped 0 aN;lrnvky lye,
Septic tank is metal? cracked? structurally unsound? substantial
infiltration? substantial exfiltration? tank failure imminent?
Is any portion of the SAS, cesspool or privy:
At below the high groundwater elevation?
V within 50 feet of a surface water?
1l� within 100 feet of a surface water supply or tributary to a surface
water supply?
within a zone I of a' public well?
�Q within 50 feet of a bordering vegetated wetland or salt marsh-
(cesspools and .privies only, not the SAS) ?
. M7 within 50 feet of a private water supply well?
/V(l less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis? If the well
has been analyzed to be acceptable, attach copy of well water anal,
.for coliform bacteria.,_ volatile organic compounds, ammonia nitrogeri
and nitrate nitrogen.
...........................
TOWN OF Barnstable WARD OF HEALTH
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D .- CERTIFICATION
....... .....
-TYPE OR PRINT CLEARLY-
PROPERTY INSPECTED
STREET ADDRESS 39 Lawrence Lana Mq-qq - Q26*19
ASSESSORS MAP, BLOCK AND PARCEL
OWNER' s NAMEKenneth Jihnson
PART D - CERTIFICATION
NAME OF INSPECTOR Joseph P.Macomber Jr .
COMPANY NAME J. P.Macomber & Son Inc .
COMPANY ADDRESS Box 66- Centerville ,Mass . 02632
Street Town or City State LIP
COMPANY TELEPHONE (508 775 3338 FAX (790 1578
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at
this address and that the information reported is true , accurate, and
complete as of the time ,of inspection . The inspection was ,performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
w itli my training and experience in the proper function and maintenance of on-
site sewage disposal systems.
Check one:
XXXX System PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
health or the environment as defined in 310 CMR 15 - 303 . Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form.
System FAILED
The inspection which. I have conducted has found that the system fails to
protect the public health and the environment in accordance with Title
5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form.
r.4
Inspector Signatur /MJN-4m .— Date 8/10*/95
this One copy of h is Wtification must be provided to the OWNER, the BUYER.
( where applicable) and the BOARD OF HEALTH.
If the inspection FAILED., th',-- owner or"1'O""p e rator shall upgrade ' the system
within one year of the date of the inspection, unless allowed or required
otherwise as provided in 310 CMR 15 . 305 .
partd.doc
TOWN OF BARNSTABLE
LCAGN � ®SEWAGE #
VILLAGE _ ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (SIB)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COZI LIA.NCE ISSUED:
p,
i_p
of
LOCATION - 3� SEWAGE PERMIT NO.
La -117 c� �-a z-, -� 4e / 2-0
VILLAGE
r
INSTA LLER'S NAME i ADDRESS
U I L D E R OR OWNER r `//�
a v r. .
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
p rn� S UAI YAM
lot
...........................
THE COMMONWEALTH.OF MASSACHUSETTS
BOARD F HEALTH
3� Appilration for Bhipoiiai ,ark !iinstrurffottApplication is hereby made for a Permit to Construct ( ) orepair ( ) an Individual Sewage Disposal
Sy tem at: / n
. ( ...................................................................... .4--------------,---------------.------------ --------------
7 Locat on- dress or No. ........................................C� ��b.............�`�: r.:. ......
/ dress
Installer Address f /
Type of Building Size Lot.___.._f_________________.._Sq. feet
., Dwelling—No. of Bedrooms....................................Expansion Attic ( ) Garbage Grinder
Other—T e of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures ...........................
W Design Flow.......^., ...... gallons per person per day. Total daily flow..........3.3.0.................gallons.
WSeptic Tank—Liquid capacity! BQ_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 ( )
a
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a+ •---•----------------------•-•-•--...... .
P =
Description of Soil...C.-�_ •(.E3/ try( ` u.��UJ1.. eZ .............. ... � U
------------- ..._..._..
U
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 TITI1 5 of the State Sanitary C de The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be ued by e board of health.
13� ^ ���d
ed----- ------------- ........................................
Application Approved BY------- .®='=''..f ..................... ............................
9111PA
Date
Application Disapproved for the following reasons----------------•---------------------------------------•------•-------------------------------------------..._..
...............................•--•--•--......------------------•---------••-------------•---------••-----•---------..........---•---------••------------••-•---•-----•--•-••-•--------------------
(� _) Date
Permit No................. ---••--•------- Issued--------- f 3'`j�/
_...••-D�--------••--------•--••-••----
4
J,
_ FEB.............................
4
THE COMMONWEALTH OF MASSACHUSETTS
-^ BOARD/OF HEALTH
-• -tc✓. OF.....
i
Appliratiou for UhipaaFal Work Toulitrurtion �mit
Application is hereby made for a Permit to
y� Construct ( ) or Repair ( ) an Individual"Sewage Disposal
Sy ep/♦m,,)) at
.. ............... ......... ...TF.................
.... ......._ ..........7. 11 4...............................�.....�.. ..........._..............................___
Loc ti dress Es No
-dress
Installer Address �� �� ,x
Type of Building Size Lot_._.___�...................Sq. feet
Dwelling—No. of Bedrooms-__- _---------------•-.__.........Expansion Attic ( ) Garbage Grinder (�
�a Other—Type of Building
yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures -------------------------------------------------------------•-----------------------------------•------------•----•---------•-•-•-------------------
W Design Flow......1y--------_----_-/I•.........gallons per person per day. Total daily flow.......... ._10.................gallons.
WSeptic Tank—Liquid capacity/!P 40gallons 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.....7.✓4./.sq. ft.
z Other Distribution box ( ) Dosing tank ( ) 3
aPercolation Test Results Performed by............................................................. -------•---- Date........................................
,.� Test Pit No. I................minutes per inch Depth of Test Pit..................... to ground water........................
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
cx -----•-•-••-.
0 Description of Soil...0:` .. C f�c!� .4 1.+ -- ��- a' -`��-- �
VW
� .......................................U...Gi� Q ---------------•-----------------------------.----
�
---- r� -k ------------ ----- -- -----------....-•---------------------------------------------------------------------......................................
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 TITIE 5 of the State Sanitary de— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be ued by" e board of health.
ed-
�
Application Approved B 1..._. ._... ----- ..'.� b-------------
PP PP Y........ :....�_
Date
Application Disapproved for the following reasons:...............................................................
........................... -----__....._
.............................................•------•-•---....-------•---......-•--------••-------------•------------•--••---••-.--------------------------------------•-----•-------•--•----------...
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARDepF HEALTH
.. ................OF.....4C ........................
(Irtif iratr of Tomphaurr
y ,t ,TO CERTIFY,- ._. !�► hat the divi�lual Sewage Disposal System constructed ( ) or Repaired ( )
b .THI I S ---- T "
/ /, I Ir ���_ ter... jJj�� ...--...._
at ..`""!! i_._.'".-. 4IV/ �..�. .... + t" '--K.11�9IiaC_................................................................
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.___d~'''���.................... dated------
.__ ._
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST ® AS G A ANTEE THAT THE
SYSTEM W L FUNCTION SA ISFACTORY.
_��
DATE--•-------- ------- ------ - ._.......------------------------ .Inspector.---...Ale--------••-----........................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR OF HEALTH
No. df/ !.......................OF....Z.A?Z� _ ,r�!'..................... }
FEE 4V .' .
Permission is ereb ranted.... ___ '.d. ff*'�f ..__ A _! ` a
Y g ........................................
to Const,�uc6t or,rR�e��pair ) an Indivi S Wage Disposal�ystem'
at No....� �f-- 1 . 'C" c.-/ fv� 'V
................................................
Street
as shown on the application for Disposal Works Constructi rmit No....�.................. Datpd..........................................
�. al -------••------••--------------•--------
DATE--- u' ............................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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"VI COMPLETE 6 BUHL'fIT 9I1'H''PEIttQT At?TLTCATiON ,41'VC Guide ra Aydod Cn _ at.P•�Ia(!t�rr/Arkris;llO tort Wind Zone nrra.Massachusetts
resaklist u. AWC Guide to Wood COnstruc(lon to grgh�rxdAre¢s:IlO mph Wind Zane
ArPLICANT T° FR."'aFr,rr�.ea.".Irus,,nit) riizPa� "� t fog C<,tn llance:7 Massachusetts ChecklistfdrCompliance(7sotam153DI11.I)1, Massachusetts Checklist forCompliance(7socrrm53oI31.I)L ..
Massachusetts.- fi'ecltiis p (sacmie5sgl.Lt_Ij' 4
A.4VC Guide Ln 14unr(Lunar;uct r r , - - •. •. d Building Aspect", .
h'4c1(I(stforGyniptiAtCpe7Rncn+,r;clgl.z.3,1) Dane�a gWReonedi �rablea] a,
i14RSSfi Cj1 USCCYS C' '.' Q cbyk :Later I(o.0 7Ld moneil5) .._. R._.__ -- --Sz ito..J� .•..Z_ ,� From Tables 10 and 11 and location of well sheathing and ding dery lydne Percent FUIFHelght
compr>an,<. vody:c ads nd'Wau co dlo - .
_.�...-...._.. and
''lateral(o o(16d wrj)m nails (Tabl:� - � � b. e�l be.d vMh strength ass o17/16'-end be m led as owe.
VI :Dad ee li 9 W,li'Ope i 9 (+'9 rd( a mg but pIi �7nNe 9) --
sCCPE ......:..............: .... 110-mPM1 -Header Spans: -- HI panels she o member of the-double
" ..
.._.._.......... x
-+h Dh ekag P 1 9 f c WoodS Panels
�I sgel lW tell u.remeNs ngl azis Dereilei to ewtls std �
shelf occurand be
_' .... �L __ ......-_..- ��ta 9j 77R s 1 i' u On single story tanNiiUttlon,Pan De&etlSrhea b b Itompletes and lop memhe
•.V M d(3 - -9 t) .......... .... .. 'B Slfl PI t SDe¢s' ----. -
e9er ...
oV _Ga,owre C J, , Full Height swe�(. ( suds)-.....- en W�9 Da ng9(D cored tn..-^Tab B
to ate.
fll D PI
ad a slo Z•stori s 52 -LDad e a g W fl OP .Ings(ecord largest opening(T EIS 9) II o ... 2c,'-In.c 12' '
:.2 APPL LABILITY easain l2 slope,SM1all De,cdnsttlal ry) .a sl2tlr ` FI'e d-rSPans:.; ••'�- _ -
or Anicn axes % _................_._..._.......-....--(Table 9)- ... 2.G_In.s t2' _,�
W.�On two story construction upper Denel snail be attached to the taD m mb r of the upper double toD
- __._-_...-._._ bottom olyl I Its et first attachment lower panel be made M band
rvemoer of Stones(a o ,p,,h ll be 26nsl. ... ..... ... .�... __.. .........-_. _. y
.R.s 3"' - gi orHalg Spends.-....._......._._......-._.._._._..._......_ __ - ._. ......
Rm P•cn ....... .. ,.:....(F'g 27 ........ "�• - n econ Den w"""""'- - R 5,60" _t). Full'1-I Ight Stdtls(nD:o(slude)_-_---•---- "�(Table B} _, - _ t 6 balD o g erm
rt n Fool Helghl ...... .. ..(Fig 3)...... g0
n -,-, g,580 -� Eztarlp7W 11 ShNing'm Redid Uplift and Shear SimUlmnaoualy
Eu _Moll. ..:. ..: ....... :(Fig 3)..................'..........._... 1
.........: l-o a� a' sill mtsn Bu((dtn9 Dimension W' z A-6t s-S
Buic ig LengN L ._ g- i ............._._._........_._- .... .... -.. ,.(Fig 4). N urinal Hd ht of Taliesf ODisn rg (note 6}._
.'� entl lower enedanenl road old�4 p a floor fra g
Homm�tal nag spacing et doub6lr. Pi unes;bel joists,elxlgll:dem shelf behieing row of ad
Bu:Iu:nc Asp<t RaJo(VW).... .. ........ Fi 4 Z'vs 6'8• _]� .. _ -.._.....-......._..... -._ - - .r
.......-.( 8 ).....: Sheathing 1•pa...... (Teblo 10 or note 4If less)_... �-In-
.sta entl 9I 31 er}fenfg Venlcal end H rlxontet+NaNn for P I Attachment 1
i
::eminal Mei9M1t cf Tallest Opening ...Nall S ._...-._.- ...-. .
't� FleiI3A•la,H 5poadr,g___. ... ._._ - _...-__.__- .
I
1.3 FPf;AING CONNECTIONS .... ._..:................................ - SM1eaf.Gann c0on4nb.ofted Dpnunpn
coons .(Tabla2)...... _ neUsab 10 ._...
G )10)
3o-arPl compliance th framing tonne 'Percent FunNeight Sheathing-"""'-"._.(Tebi910) .
. bSi AtltllHonat 9heeddng for WaB with Open(9 68(DeslpnTdri pis)...._..>�..._. •' _
2.1, M.
FOUNDATION .-..,.--- �� fvladM 9 ildiilg OUn oR.L gg _ k .
Foincv lion Walls meeting regu,rements of780 G. 1041 ..`.x..-..-.. -.- _ --,•-,,,
... N 5mn'K(eight fTad•t Opedngx•- ........... 4
:........... 0
concrete......... .. _ ..._.
Cuncrd<Masanry... ........................ Sh eNln`9 T7va .._.-._.__._-.........
(Table 1 -IR•-
Edg9 Nail$P,. n9....-._........._. (Table 71) � _ �iR � " �usuc� u .
. 1 Fl Yd Ned S d '-"'._.- ,,•..
GE TO FOt)NDATfON''a nchors es an ahem stave in»n t pe cm..__..-...-..__ommon nails _ _ _ -
,
/ of tedmmmon nails)(Tebb 77)_.. _ - -4 IIT g .��.
=:2 5/8-ProPnelary hlechan,mLA - ire -L
cwiN
heal:ConneWon(o. •
P r en't Full-FleigntSheag+in9- --•^-((�1e 71}_ Zl�•
3c',EPaoln9 f d/ [of plate ...... ''�n a T' -J_ AatliHon Shealhln (or ODDNng>fi'8-
Well GletltlNg
BuI;Fm Dedment-concrete........ _ ._.. ---- - _ -
.. Ind S sad?__.-..-._.__...... -- ....._.._.-.__......._..___. -
iictt f2s(ed for WI P ..
5.1 ROQFS. foi Rafters use AWL--Roan.TPotr sea 9aRS Websttd) - V
2
......... `- rtodlf 9 berspans chedied?.....-..__. --'y/-/
„(Put 780 CMR chariot 55)... •517 ..F(qu(a-19)-...____ ..ssmallefoP2'orl/3 _ for Pa
I I Por�Ea4a['""
/ ® I g ;( Detallo
' � � _a i Vertical and IAfmohmen��
cneekaa _.... ...... - t
surd p ,(Fig:6)... ..
i .tit 9 r OP g D .ensicn .... - .. �� -
:. -less Nar 2'lrom:xlcdof Wall(R96) ................ :R�Ofw ft -Co edl tLoadbearmgW -
Fv SI d lFl Openings P Pneiouwt tt .
o rIc t6C[Daoks /R sd' p
911a
_.........
eanng'Wallt or Gneav+all..... ;FS]) ........... .... ._ / - Lateral .._. _------._ ._.... ........_.....
v (Tabl 72).... U Pir
SJPPen ng.Loatlb , (e b' 1.2)...e13)_. S ..:.Pif � _
% nt levered."6 Jo'1 /'R >-+- Sh - -- -
SLp Iing LoadJearing tA'elis or Shean"ai4 ... ) S ter ,•
..(F 9 B)- ........ ......... Ridg na h r of�'ZLl2r
- at E tl ails.. _• (per]80 GMR Chapter 55)..'...._ =� Gabe RaiFe(�ut(Ooke mod- pe(Figure _-_-_ .
FI-e tires n9 ....'..
... 'n.
lrbfl H n t De :(T(Table t3)'
FI.o Snezln ng TYP """ ,(per 780 CMR ChaPt -P - _ Wre _el SS f
... y�,in,edee/'fa In YIHIH .:T!tlds
Rafter Cori': U IN 1 adbea ng Wel
14
Face:Sheathing Th,ckners ..-........ - Pro etaryCo ec ......-_.-_` _ - ..
..:..............(Table 2)..�d Teas of' -� '" .. E
20 .ft Ile
e
UQWL._.._..-... I(TOble(� - ......cord.- Dee Ceta on Nari pegs
�, -Hoot Sh thi g TYP _. - y_ -.. P _
CMR S8 @ d
tv hit .(Fig tO and Table S)- Z Fj- n J." -Roo(Sh al(i19Tn ck- •- S"C - .
(Fg fq dTa6le T fD•`_ft s120 ,- -(.Sheathing Fe t-'; -.-. .____ ((stile 2). .._._ .. ._ for pznel A(fach
- .... e 1
--�bazimag vrL4! -........... ... F 10 dTeble S). by IR R• - .- 1 27/1G WS .
sp..ir5 " "" (,rgs 7 8 8i -• -"' ;oUTMa he kl5tshell be m tt ,rs entire exduding hie fit 1lcePt n noted In 2/ m ly Wih the m utremenls of -
s 24,o.0
R` qq p
...........
' - - J. Too CMR 5301:21.11tem L if the ehsddist Lt metY Its entiretylhen the f011bw4g M taI slraVs and hold dawns arenol
_ e an.: _rlZon a Wiling
menf'
- _: rsQulred pe th WF!CM110mph'Gulde.
12:? ORY/ALES' �/, to PsP 9Fl _ .
13 .rt:: ✓T: - 0 Sea a 9
....... :11'
d n9 II -. _... ........ .(Table$). 1 _ Up 4' b "lR fftrsStra Ds Rg 1
- ... ..... „}� d AB Pao pFg 17 -
d IN 11 B S (.erg t01 - / `V Co SNd Ho15D :Per Figure19 add Figure tab _
H 9nl II S[d R2W3 Slcep(lo Opening heights fup to'eh- hI be Permldedwhen 5A 1_added to P [(114r
(Fg it)' _. 1 Ne a hfs eaNin
1 JSF,,.•ic FI L 9t - -' ) 7ft2@.BN' / requrremenis shown in Tebl s 10 'ntl fY - °
Gyzs..m Cell gLeng,n(,WSP t'5dd?..- (-91t .'✓ L Thabo+bmaHl plot.fn:aYddfl waits shad be rninlmum 2 aL nominall if, sspreavre tree led g2�ede. _
and 2 x 4 Conlmuous Lateral B @6(<o.c (Fig 111 _
or 1 z 3 ce ring furring strips(�1G Spacing ni n vrtN 2 x4 Dlocking,(E'4 R spa.,inc in end joist ortruss beyc-i
Plate .(Fig 13@nd Table 6)_:............
._ ........... ""-'-
SPI ce Length ... ......_-._. __.... Yable .................. ........ 8_ >.�G' ...
e(tfid common na Is) ( ---'
SPIceConnection(no """ -
DOUBLE TOP PLATE\ .-
llo.mPH E);PO$URE B WIND ZONE
Table 2. GenereliVelling Schedule. -
- .JOINT DESCRIPTION Numberof Number of .Nall.Svacinsf
. - - RPbf Framing. mOrt. xlNai s Com Nalls. Bo
DOUBLE HEADER Il
- Blockingto Rafter(Toe-nalled) 2.8d ` 2-10d each end -
- _ Rim Soard'to Rafteh:(End nailed)- - 2-1&1. _ 3-16d each end'
Wall Framing - '' / FULL. -REDUIRENENTB At EACHENR OF.HEADER -
i _ top Plates aFlnter@actions(Face-nailed) -- 4 18d -. z- :Z Joints HEIGHT. •.MINIMUM
- _ - Stud to Shtd(Fae@;nelled) 2 1 d -'16d. o.c. STUD HEADER:SPAR HEADER 1--NUMBER Q UPLIFT -
( ide ..1,6d 16"o.g-alongedges WLL-HFIGNT TE
i � -� •A,' :.: --'- HeatlerWHeadeF Header-( ' - 81� �• LALB.J�� -
1_;1 f, STUDS
OIIHLE JACK OTUD 1'
•e• Floor Framing '1
p",l \iraH PXTI?IDN7?DER Joist to581,'rop Plate orGirder(Toe-Nalied)(Mg.14) ` 4-8d 4-10d 1 perjoist - 2 '2�2X4'.' i 27T .132
- To KING STUD 2"8d 2 10d each end WINDOW 81LL PLATE .. -
r'solo ng .''-''. •. .Blocking to Jalst(Tolinailed) 3 2,2X4 - 416 19p
-,yn mend ,:'.: 3-08d 4-16d _each block'
b, -Blockino1c,Sill arTtiP`TPhda(Yoe-nailed)
v•.
roF Strip toEeatn:or Girder(Few-mileo) 3-18d 4-18d each Joist. - -_-.
Jo let on LsdgentoAeam(r;a-Nalled) 3-SE 3-10d perjolat - "-_ _- - - --- __-
.•'P% ( - : 3°16d . 4°16d 1larjolsl ---- 2 X" 3 693- 330 -
Eis, Bend Matto Jolst`(End°nalled)(Flp.14) _
A -3 (ld `-yer.toot _. ,"/ ___
�... . ' 1
5
,I 1
6� 2:2M6 <3 831 396
r fi yr' _ ,• �B Sheathlnp of TOR Plate(Toe-nailed)(Fig.14) 2-16 4-21G8 3 9l0 462
W _e5tr»i)mal Panels - 1 12
526
-
)' - NA)L TOP PLATE. -
a'.1 -To uF_AIDER WITH rs ortmsaes:spaced up to l6 o.o. ad tOd'. '6°etlgel B"Bald __ ------------------------
NA _ ________ _ ____r
IL BGNFD :;' ^ Two Rows of - --.Rafters or hussess weed over 16"oF., - r Bd J 108 .4"@dge/4"fleitl14
9' 10 3 1,248 '' 534:
ad Conn x( -Sd Gable andwall rekt or rake truss w/o gable ovathang' 8d; 10d '8°edgel8°field -101• ::�.3-2X(2 4 1,385 660
••. 1 •:1';;'i' NAIL$AT 3"O.G. . :
AT S°o.c •Go`bi endwell rakew rake truss w/structural out lookers ad
10d 6'edge,6°field 4 . a <d•:•:' - ,Gable Andwell rekd'or'rake truss w/lookout blocks ad' 10ii' 4°iedgeJ 4°field a c .46 D•P .40•0 d: d A �an ;b•a ,4 a A,4 d•$
lt' A,�ACID4. 1,524. �26
CeIling Sheathing (. a a It °• o•!e.a•! e,•° ° A' ° ° •✓�
F11
• Noll adtedule �(
' edcomm.l - GypsumWeilb'Od tars Tedge/1D'fbW .464 04{:°o•a ..d•a .°d•• °Ay ),..
- :..-..:•._ ...-. o TYP NCHOR 13 ^�. N
1 •�• A t°. n .°. a �JLTB A D•e •° a!
:� EXTERIOR ( - • - °.••4 °,:4 9>53'SCI%4 PLATE WASHER". p ,(
5d co �.(� �H.i�
VIEW a Wan sheau lee ° '4 I LOADBEAR'NC� WALL S
Wood Structuml Panels' el d•A•4a•A•.40•0 d•o aA. :0.4 oa'.'d•a G'a .40::•:
X ens is z aFiberboard i Fane(a d(`1) ad9� _
f t8 3' C'fieidd/ e, a 11."a ° > °.'a °.°° '°••. ° o• > c••.a ..
5d - -7itllliL10"field as°.d•A•.040' .qbe 0: .4d•a 4d•a dA a 0.O•"a•a IV
' § shemh ng W Gypsum Wallboard .
�' .
lad
coolers
I
, I .•< - Floor Sheathing '. .. .4 4 .'4 e
od r 'Wogd SlructuralPanela 4 a•n4,;'. °an . b'e Da . a d• 4 a
elf 10d 8'edge)I--field.
1°or less 10d lad 6'edg-1 S'i(eid -
;Y Greater Ilan 1'. t - - - -
pR
t{��• �1 pare=. \ N d s cadets {!1).Corrosion resistant 1.1 gage nails and 16 gage staples'are permitted;-d1@ck IBC foredtlPoonel requirements. '
a - mid ha,gni 6d common
Nail:Unless othe6wisastaled,sties gNen for nails era eonlm@n on s,°e.Box and pheuma8cna8s of equivalsilt ...
s e, diameter and squat 9rgreater Ieftgth'totha speo)fied borint nalls maybe substituted unless otmr dsa'
prohibited. .. ... -
.. '. n 4..
a�5 P�1; S�LJyri(ZrxvZ ZOrDT 1"otQ C s 5�Rt
3 a� ,c( : fzJ_wt t 'C�t�tYivLG
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