HomeMy WebLinkAbout0104 LIAM LANE - Health 104 LIAM LANE, CENTERVILLE
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BARNSTABLE LAND COURT REGISTRY
DEED RESTRICTION
On&
WHEREAS, Deul L-i • -f- 7~/2 �-C /�lc� > !S of
(owners name)
MA
(address)
is the owner of l 0 �z J ;`u ��, to i - located
(address)
at E'�.1 TPd��1`%/��
MA (hereinafter referred to as
and being shown on a plan entitled "Subdivision of Land in
C f•tU I-feuxzz. MA, Property of la4.,k,1,
et al,
duly recorded in Barnstable County Registry
of
Deeds in Plan Book ; Page
Or on Land Court Plan Nuraber .
WHEREAS, _�]r (41' tc tf d Z q, S as the owner of said lot has
(owners 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;
WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to
granting a disposal works construction permit for a septic system in compliance
with 310 CMR 15.200, State Environmental Code, Title V, Minimum
Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing
the issuance 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'record4it h�•h'' i
p e ,
Barnstable County Registry of Deeds by recording this document, '
On Lr
NOW, THEREFORE, Out .rn'r'� ��n� fs does hereby place the
(owner's name)
following restriction on his above-referenced land in accordance with his
agreement.with thp:.Towa. Health, whiehfPstrietion shat}
run with the land and be binding upon all.successors in title:
• l 0�j L i U $OA Lu-1 e K IV7 r r• //,p may have constructed
(address)
upon Wf-
- lg)house containing no more than (�) bedrboms.
-/? s "P/7 S agrees that this shall be permanent deed
(owner's name)
restriction affecting located on MA, and
being shown on the plan recorded in Plan Book , Paged
Or on Land Court Plan
For title of see the following deed: Book , Page
. Or Land Court Certificate of Title Number
Executed as a sealed instrument day of
L .
Owner's,S' n ur `
Ow s sign ture
Owner's signature
COMMONWEALTH OF MASSACHUSEYfs
yi ✓S �� _ . ss
, 20
Then personally appeared the above-named
known to me to be the person who executed the foregoing instrument and
acknowledged
the same to be free act and deed, before me,
Notary
Public 1 .
a31S103d'30d31N'd NHOr MY co .�IOMI�
1S311d'1kd00 3(ui v i ,: ® biic"
S0330:10 Ad1S103d �:.. r ttey
I.1Nno0 318`d1SNdb8
deedr LE REGISTRY OF DEEDS tnAft Is,2M2 � jjx
I
Commonwealth of Massachusetts 611
Title 5 OfficialInspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
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.
Important: A. General Information
When filling out
forms on the
computer,use 1. Inspector:
only the tab key
to move your Patrick M. O'Connell
cursor-do not Name of Inspector
use the return -
key. Septic Inspection Services Co.
Company Name.
ne 189 Cammett Road
Company Address
Marstons Mills MA 02648
�mm City/Town State Zip Code
508-428-1779 SI 12855
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:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the L cal Approving Authority
December 15, 2009
In4pector'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.
09-275 Quirk.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15
f1
t
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is Centerville MA 02632 December 15 2009
required for �.
every page. CitylTown 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:
® 1 have not found any information which indicates that any of the failbre criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
Tank is not in need of pumping at this time, leaching pit shows no signs of surcharge or hydraulic
failure.
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
_ Answer yes, no or not determined (Y, N, ND)in the ❑.for the following statements. If"not
determined," please explain.
❑ The septic,tank is metal and over 20 years old*or the septic tank(whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.
System will pass inspection if the existing tank is replaced with a complying septic tank as
approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if.a Certificate
of Compliance indicating that the tank is less than 20 years old is available.
ND Explain:
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced
❑ obstruction is removed
09-275 Quirk.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�M 104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15 2009
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ distribution box is leveled or replaced
ND Explain:
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced
❑ obstruction is removed
ND Explain:
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
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.
09-275 Quirk.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15
E Commonwealth of Massachusetts
Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°wM 104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cont.):_
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No" to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than_day flow
El ® 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.
El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
09-275 Quirk.doc•08/06 ` Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
° 104 Liam Lane
M
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15 2009
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems (cont.):
Yes No
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply
well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory, for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CM 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.
09-275 Quirk.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15 2009
every page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (if they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage backup?
® ❑ 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)]
r
09-275 Ouirk.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°wM 104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
every page. Citylrown State Zip Code Date of Inspection
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)): N/A Irrigation&
pool
Sump pump? ❑ Yes ® No
Last date of occupancy: Two years prior
to inspection.
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203):
Gallons per day(gpd)
Basis of design flow (seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
Last date of occupancy/use: Date
Other(describe):
09-275 Quirk.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15
I�
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
General Information
Pumping Records:
Source of information: None available
Was system pumped as part of the inspection? ❑ Yes ® .No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (if known) and source of information:
Compliance date: 5/20/83
Were sewage odors detected when arriving at the site? ❑ Yes ® No
09-275 Quirk,doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
104 Liam Lane
�M
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Building Sewer(locate on site plan):
Depth below grade: 6
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):
6'
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene. ❑ other(explain)
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
--------------------------------------------------------------------------------------------------------------------------
Dimensions: 10.5' long x 5.8'wide- 1500 gal.
• 211
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle
30"
Scum thickness Trace
Distance from top of scum to top of outlet tee or baffle 6„
Distance from bottom of scum to bottom of outlet tee or baffle
13"
How were dimensions determined? Measured
09-275 Quirk.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15 2009
every page. City/Town 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.):
Liquid level was found at bottom of outlet invert, tees were intact and clear. Tank is not in need of
pumping at this time.
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
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):
09-275 Quirk.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15
i
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal,System Form - Not for Voluntary Assessments
L'M 104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15 2009
every page. Cityfrown .State Zip Code Date of Inspection
D. System Information (cont.)
Tight or Holding Tank (cont.)
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
Distribution Box (if present must be opened) (locate on site plan):
0.1
Depth 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.):
No solids or high stains present, liquid level was at bottom of single outlet pipe.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
09-275 Quirk.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�M 104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15 2009
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
Type:
® leaching pits number: One 6x6 pit.
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level.of ponding, damp soil, condition of
vegetation, etc.):
Leaching pit was too deep to excavate, pit shows no evidence of of hydraulic failure.
09-275 Quirk.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15
Commonwealth of Massachusetts '
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t
09-275 Quirk.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15
'I
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
104 Liam Lane
Property Address
Paul Quirk _
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
every page, City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System:,Provide a sketch of the sewage disposal system including ties
to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet.
Locate where public water supply enters the building.
38
20
I
39 28
2
49
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l
' Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
;M 104 Liam Lane
Property Address
Paul Quirk
Owner Owner's Name
information is required for Centerville MA 02632 December 15, 2009
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to ground water: 30'
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Marsh abutting property is considerably lower than SAS.
09-275 Quirk.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15
LOCATION C � l SEWAGE PERMIT ' N0.
Lot 9
w-1LLAGE
�y
- o
INSTA LLER'S NAME i ADDRESS
,D He uj �S
BUILDER OR OWNER
� qLerf
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED a-Q ��
41
t t/``��;r�
Vt
k
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Fimii...Jls............
Nolas� d
T E C MM NWEALTH OF. MAS HUS
EALTH
.................. ................... F.........................................................................................
AvOration for Eli-sposat Mork.5 Tomitrurtion Vamit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
Sys lern
orLot No.Locgri—on•-Ad . ......................... ................................................................................................
............ ...... . ......*-------------------------------------------"-----------------------------------------------
OwnJ Address
.................................................................................................. ..................................................................................................
Installer Address
Type of Building Size Lot-----_-----------_-------Sq. feet
U -----3 Dwelling—No. of Bedrooms ............................ .Expansion Attic Garbage Grinder (t)
Pq Other—Type of Building ............................. No. of persons............................ Showers Cafeteria
P4 Ot re ...................................................................................................M
el s --------------*-------
Desig"n, Flow_______ZA—).........----- ..gallons per person per day. Total daily flow_._..._ ............gallons.
04, Septic Tank—Liquid capacit/Q ..gallons Length________________ Width................ Diameter__-____..._..... Depth................
Disposal Trenches No..................... Width--- --------------- Total Length.....__... ..----- Total leaching area---................sq. ft.
Seepage Pit No.4"��------*-------- Diameter---/d----------- Depth below inlet.......W.......... Total leaching area.x.-2.40...sq. f t.
Other Distribution box (' ) Dosin tkk
Percolation Test Results Performed by.zsh. --- V]. ............................................. Date..��2C�........
Test Pit No. I----------------minutesperinch Depth of Test Pit.................... Depth to ground water...._..__.............._
Test Pit No. 2................minutes per inch Depth of Test Pit.____._............. Depth to ground water...................._.._
0 Description of Soil..........
......................................................................................... -------------*-----------------------*---------............
----*-----------------
----------------------*................;:�-
---------------------------------------------------------- ------------------------- ..........---------------------------------------------------------------------------------------...............
UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------
........................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TL ITI 1,1j: . 5 of the State Sanitary Code N The undersi ed further agrees not to place the system in
has b@en issAe�operation until a Certificate of Compliance h, _ � by the b__r of kalth.
Sid._--,_A1P\kQr1............ ........................................ ............
Application Approved By.. .... ......... ........................................................................... ....
----------
Date
ers, ed further of , 't,
Sig ...... .............
. . . ...... .......
Application Disapproved for the following reasons:................................................................................................................
........................................................................I...............................................................................................................................
Date
PermitNo......................................................... Issued.......................................................
Date
r
F
:•.!1 A. .
!....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........................................O F...........................---------...------------------.......------------..............
Appliration for Digpoii al Works Toamtrur#ion Prrmit
Application is hereby made for a Permit too Construct ( ) or Repair ( ) an Individual Sewage Disposal
Sys ) h l ,h•► �in • i� t U1���
Loc n •••••••---•..••--••-•--_-•...• ..........
or Lot No.
.. � . .,� . ........ --•---------------------------------------------------
Owneri Address
W
Installer Address
Type of Building Size Lot............................Sq. feet
.a Dwelling—No. of Bedrooms_._.. -------------------------------Expansion Attic ( ) Garbage Grinder (J))
'1 Other—Type T e of Building No. of persons............................ Showers
W YP g ---------------•------------ P ( ) — Cafeteria ( )
Q4 Oth ffiMures ............. 4
W _ Design Flow.......66........................ gallons per person per day. Total daily flow....... .d.......................gallons.
WSeptic Tank—Liqul&, ppari�t,.,... .._gallons Length................ Width................ Diameter................ Depth.............
x Disposal Trench—No. ................" Widtla_..�, ........_ Total Length___......_... Total leaching area_-__-_..__._....._sq.•ft.
Seepage Pit No./....___, :. _.. Diameter.../0___.__:_.. Depth below'�inlet �..... Total leaching area..r�....6...sq. ft.
Z Other Distribution box (t�") � Do�in(tiik ( . ....... ^� ,.... .__. Date..5 - .�../
'-' Percolation Test Results Performed�by'�I_ _f_._ •/ �
14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground-water.......................
Gx Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
O h S --••-
Description of Soil `�� ...®� 1-11 -------------------------------------------------------
..
_._ ------------------•------------•----•-----••--•-.............•---•.......-•--•-
W ----------------------------------------- ,r
U 1 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 underIrd
ed furtlierlagrees'not to place the syste4r�in
operation until a Certificate of'Compliance has"b" n is" mod,byhe b of health. ` .
Sig d........
........ =-aWl-------------
Application D/a�t
Approved B ........ .. -........................... ......_.. � "f '�r� �� `°
PP Yl �s , Date
Application DisapprovedA or. the fallozqgr.'easons:a_ ._` s�;'...;_._�,_
•--• •--••••-•--•••---••-•------------------•-•----•---••--••------.....----
I *: i
Date
PermitNo......................................................... Issued...------....--........................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF �EL
rT
e.<s.............................OF... =' r•:�. s�.. ...:. ............................................°
��� (O afiratr of Tout rliFaurr
T= IS ERTI ?Th t the Individual Sewage Disposal System constructed (� »-or Repaired ( )
by '= - ... .........................................
Installer
• .
at .fie r......-- f'" r�. Z ...: ... {
has been installed in accordance with the provisions of TL T .R, S f The State Sanitary Code a%des Aed in the
application for Disposal Works Construction Permit No.. ..._------va..._. ............ da.ted_....1f�t,.l�..�f,./.�''�..............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM,,VYILL F SATISFACTORY.
t" ` t..ii
ION
DATE.....= e 3 Inspector
....
THE COMMONWEALTH OF MASSACHUSETTS
BOAR OF E H
�`, .- / �...ter.E........�...............OF... . -s'
O.y
......
FEE.- ..l................
�ioIIaa��!t for �oai #raion remit
Permission is hereby granted......! ,,te r =�t....-•----..
to Construct . or Re air ) an Individual Sewage Disposal System
atNo......s", ...f {t:---...., � ..._.-------•------------.
Street
as shown on the application for Disposal Works Construction Permit No..................... Dat ^r_, .'",:._.... .............
...............•••......
,Board o 'Health
DATE................................................................................ �'j`
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINALS)
I M ^C&L
DATA
rJdl' ,ALL IJAiU0 COnv rr L-) �"( /.IAI 4 .sN bl�_
ICO .F&M EGCE .nF \ DL.Atilf_" UWLE''z:S A
`l} IM-EWT IS FLED Pck- `_.!AFE Ust:`icA;.iDS !'cT-
,. �.
c
OF MSS
Q o 7.
I°/ ti� / / raoD 4AL• 1 ` J ='f;i OF \!,
1L5 ( /�.��• s6r�T�C {I'L", 1 V' ( / cb ��y� MIs''.�v.
" ,a �rrr
Its .22.s
MORSE
l / b is TOP 3(�,0 / /1 0 'IV
r r y No. 10951 ,Q
L S �..r..
.41
i
_ h
' k CERTIFIED PLOT PLAN
27
/ IN
10
q.
/ SCALE, / = SO r DATE, /0
EN!2NEcf?l,NG CQ./6YC� ENG��",�7� :' sr� i CERTIFY THAT THE
E ER D t�LOlSTI; CLIEN'P .,-,,,,,, SHOWN ON THIS PLAN
joll
-' q aE
r'L LAND "'""''°""!`'' CONFORMS TO THE ZONING LAW
'EER SURVEYOR e: A'.A:'' t,
DR. ,� ;� a��. OF BARNSTA®. E , �S3.
712 MAIN STREET CN.�Y�.'u�,.,,....,,..,, l I o(o 62
H YA N R I S, MASS, 3NI[9T..4.0tr Z,, krt" "'` F DATE R 0. LAND BURYEY(
77 C:.11r*f' ..
, . +- . rt r .. j.. . . n$JMR.4Y.fs Mi{ ~. .. l' r.2 n. .._.. • , -
r:
�E: EACHrNGRP/7 ARE Jy0RE TN.q;°/ /Z BELDxr
` Q"PYC P/P� SIVAGL B �R006R7 TO 6l7AOE.��-;N EXTRA
CONCRerz M/N. P/TCN h'EAVy C.IST IRON C0i1ER SIY,41-L_ 3E USEO
♦•. EL r 3 G D CO �9",ozw T IF//V ZW, EWA Y
' 2 'J. M/ . CONCRETE
C Z.EA/V .SA/V O
- UQU/D LEVEL . '��� � ' • li'
4r, 4'CAST� - - \Cbr�C� V '�1-r�r� 2•LAYER
IRON /PIPE
Q VOAL. 0 •v o C-FIMAIEY �. a a o G}� //g _'��B
,,4J PE SEPT/C TA/VEC
•
DIST, • • • • • • • f f �s•4 YYASHED ST27NE
":: BOX 6 f • t_ • • ,
o r e • • �1R • • • • •40
!N!/CRT �LEfVATYDNS ,l a •• r • • s • • off e o P/7 DR EQU/1!
RlY �p^C17y .54 GAL/dAy . • tr EL 'LO.O
/NYERT AT Q!//LD/NG 3 3 0Pr 'F
INLET SEPTIC -r4/VK 3 z.0 FT / C, O/Allot.� SEE Tf18UL.4 70N>
OUTLET SEPTI C TANK
/NL.ET DJSTRAOUT/ON BOX 3 1.;D 4C SECT/ON OF GROu'',/0 1447,Clr TAaLE
OC/TLETDJSTR/$t1T/4JVBOX 3.0•gFi:..
/Nl6T LEACHING PIT 26.o FT. SFh/AG� O/SPO<TAL SYST�h9 +;
LEACH//VG j0/T Ti4dULATIDN
D.ES/GJV ('R/TER/A SCALRE : %" a /=O'er DlMEl1/.S/ON A -3 F r
NUMBER OF BEDROOMS 3 4= DlMENS/ON CO-FT.
GARQAGED/5P0-5-41. UNIT SOIL LOG :
TOTAL e37I/►?,4-TEO FLortl 3 3 o 0.44.1DAY SO/L. TEST#/ $OJL 7.E:S7-,*2 6W L ?=ST
NUMBER QF LEACHING" P/rS / Et�Y. 20 E Y L1� , p TE OF TEST � Z7 �-
SIDE L�ACH/IVG PER P/T /s'Ff SC,� PT. f F -SO/4.
RESULTS iV/TNESSFD jr✓9,E 1:i/��`"o
COTTOM LEACM/IVG PER P/T 7� ,SQ.` AT. R.gTE#/ �'�Ss M/N INCH
TOTAL LEACH/NG AREA 2 �' .S'Q. FT. .- ., F7." COLA7'/oN RATE' 2 '-'"g'=` `
RESERVELEACNIM6AREA ZU SQ. FT. ` 2 MIN./ INCH
OF
j"k OF
AL
IVrORSE y,��' i
37� O No. 10951 ® FF;'d�
�Q/ pF �`� ,�; r i EL OR�OGE ENlr/N. R/NG CG,Il NC,.
h ,aT 9o�F G/STEy LEY. �• - y�. 7/2 MAIN ST. MASS.
su
Ss�pN,�tF' ` NO GROUlVO yY�4TER ENCOUNTERED
Q GRO uNO Lv-4 TER AT ELEf/ .SHEET=i�F
,� _ - `,,
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
kddress of property ( a L{ L-«P--, L---4/ve Ce--#V v
Owner' s name
Date of Inspection SAP '7i g
PART A
®►t'• 01b 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.
c'�' The facility or dwelling was inspected for signs of sewage back-up'.
i
_1.,__�he site was inspected for signs of breakout.
All system components, excluding the SAS, have been located on the
site.
...._ ._�._. he septic tank manholes were uncovered, opened, and the interior of
the septic tank was inspected for condition of baffles or tees,
material of construction, dimensions, depth of liquid, depth of
sludge, depth of scum.
The size and location of the SAS on the site has been determined based
m,M �..... .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.
RECEIlEO
SEP 3. 2 1995
�r� ►&THDEn W
N6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B 1
SYSTEM INFORMATION J
FLOW CONDITIONS
If residential
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:
e yl?-4 ,e.*u4- Last date of occupancy
GENERAL INFORMATION
Pumping record and source of information:
System pumped . as part of inspection, yes~ ,or:no
if yes, volume pumped
Reason for pumping:
..Type of system
L Septic tank/distribution box/soil absorption system _ , . .
Single cesspool
`4 Overflow cesspool
Privy
Shared system (yes or no) (if yes, attach previous inspection
records; if any)
OtherE( 'explain)
Approximate agerof all components. Date installed, if known. S.ource .of .
information:
Sewage odors detected when arriving at the site, yes or no
-ai
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued
SEPTIC TANK
(locate on site plan)
depth below grade:_� f�
material of construction: C-'�concrete metal FRP other(explain)
dimensions• y� , JAL SC lir/ I- �
sludge depth
' distance from top of sludge to bottom of outlet tee or baffle
,4 4• scum thickness
74"A4V1 distance from top of scum to top of outlet tee or- baffle
1_g'_'_ distance from bottom of scum to bottom of outl�� 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, recommendoations for repairs, etc
DISTRIBUTION BOX: v
(locate on site plan)
depth of liquid level above outlet invert
Comments:
(note if level and distribution is equal, evidence of solids carryover,
evidence of eakageintq or out of box, recommendation for repairs, etc. )
PUMP CHAMBER:
�- -(locate on site n)
pumps in work g order, yes or no
Comments:
(note condition of pump cha 1S condition of pumps and appurtenances,
recommendations for mai nance or xepairs,etc. )
S�
1(
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORDS
PART B
SYSTEM INFORMATION continued
SOIL SAS SYSTEM ABSORPTION :
I (SAS) :
(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
leaching chambers and number
leaching galleries and number
leaching trenches, number, length
leaching fields, number, dimensions
ij overflow cesspool , number
! Comments:
(note condition of soil , signs of hydraulic failure, level of ponding,
condition of vegetati n, rec mmendations 4or maintenance or repairs,etc. )
j
CESSPOOLS (locate on site plan) :
i
number and configuration
depth-top of liquid to inlet invert
depth of solids 1
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:
(locate on site an)
materials of construc Ton
dimensions
~~ depth of solids
Comments: _.
- -- (note condit ' of soil , signs of h raulic failure, level of ponding,
condit of vegetation, recommendatio for maintenance or repairs,etc. )
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION .FORM
PART B
SYSTEM INFORMATION continued
SKETCH OF SEWAGE - =SPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100 '
G �
CF
a •
DEPTH TO GROUNDWATER
f- i9epth "to groundwater
k; - . 1 •=
method of determination or ap roxim t-1on:
„ w _
r
' 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
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)
C/Backup of sewage into facility?
Discharge or ponding of effluent to the surface of the ground or
surface waters?
f�Sta is liq%,K'-o level in the distribution box above outlet invert?
Liquid depth in cesspool <6" below invert or available volume< 1/2 da
flow?
Required pumping 4 times or more in the last year?
number of times pumped
/ v Septic tank is metal? cracked? structurally unsound? .substantial
` infiltration? substantial exfiltration? tank failure -imminent?
Is any portion of the SAS, cesspool or privy:--
below the high groundwater elevation?
within 50 feet of a surface water? a
Af
within 100 feet of a sur water supply or "tributary to a surface
water supply? 110
within a Zone I of a public well? 70-wir/ A4 s
within 50 feet of a bordering vegetated wetla d or:' salt marsh,
(cesspools and privies only, not the SAS) ?A/ '{7,
within 50 feet of a,.private water supply wei!?
-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 ana
for "coliform bacteria, volatile "organic compounds;`ammonia 'nitrog
and nitrate nitrogen.
h TOWN OF Gz Kl S l-e BOARD OF HEALTH
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION
-TYPE OR PRINT CLEARLY-
PROPERTY INSPECTED /
STREET ADDRESS (D Y L� ('A-m
ASSESSORS MAP, BLOCK AND PARCEL # 4414,0 IG -�6/60l y
OWNER' s NAME �h2 I h
PART D - CERTIFICATION
NAME OF INSPECTOR
COMPANY NAME U e VqQ I2 rJ cS e- r c_ S
COMPANY ADDRESS `7 S� � 1�.4 ���� _61 dX3c.'
Street Town or City State EI"
COMPANY TELEPHONE 36 Co U FAX
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system
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
with my training and experience in the proper .function and maintenance of o
site sewage disposal systems.
Check
�one:
C/ 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 o
this form.
System FAILED*
The inspection which I have conducted has found that the system fails
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 inspe ' on form.
Inspector Signature Date
One copy of this certifica ion must be provided to the OWNER, the BUYER
(where applicable) and the BOARD OF HEALTH.
* If the inspection FAILED", the owner or operator 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.dc
1
C
C •0
1/
u
0
g
.A e
ti
4
-- -- ------- TOWN OF BARN,43 TABLE 77
------ i 1 "II I II
II I II
y
GEXIST.2.12•16'O.c TYPICAL NOTES:
F`tFF�P{t J1'
�-•d Zi.„;+ "': •# STRUCTURAL ENGINEER/DESIGNER TO PERFORM FRAMING INSPSECTION
LUMEN FRAMING 19 COMPLETE AND PRIOR TO ENCLOSURE BY INTERIOR
WALL PLASTER BOARD/FINISW.
CONTRACTOR SMALL 9CNEDULe AND pRp�ECT FORM WEATHER ALL
EXISTING MOUSE COMPONENRTyS AND INTERIORS DURING COINBTRUGTION
NE P�RY�O II�pURE�SUCN PROTW1 N�ENCLO9URE9 A9 MA7 Be Q
O
ORA CDTEO9 RCPRREIOPRALL NTCOIE BA NADN DD/UORRIN CGW CAONGNSETBR TUNCATTIO NM A.4YN EUNO DOD
DESIGNER
NTERED. w
CONTRACTOR SMALL CONSTRUCT AND MAINTAIN TEMPORARY WALLS/ �j-% jux
SMORING 9TC.TO MAINTAIN/PROTECT EXISTING WOUSE AND STRUCTURAL H Q$
INTEGRITY OF EXISTING MOUSE. 3 z`z
1 1 CONTRACTOR 8WAL1.917E INSPECT/VERIFY ALL EXISTING VS. PROPOSED z
1 1 CONDITIONS PiN10R TO AND DURING CONSTRUCTION AND MAKE ADJUSTMENTS � $az
1 AS NE FIWF Y TO INSURE COMPLIANCE KITN DESIGN PARAMETERS AS �yt ZLL
LOSS z LG+
1 SPACE FNiOGRea9E9
!9 pN�m
BASEMENT NOTES: a =� �
Tp a u =.$i�
• • ti BOTTOM RES MAIN T�OUNDA LION ON I� STRIP FCOOCI W/���T� p
FULL E wlA°r PROVIDe Ib'Zs v�eR�r coMrINUO:9aAy o4/S °ZIE7cr--- ig
p8
PBASEMENT 'ea`rs i%�CE.rux nIN i°•T a i'r°Iw'9'x9•xl/A 4�PLATE WAS14ER w
2.ALL STRUCTURAL STEEL COLUMNS TO BE S 1/2'CONCRETE FILLED LALLY Q gig
RO✓E/REPLACE EXISTING COLUMNS TO EXTEND TO FOOTING BELOW.PROVIDE 6'.B•.5/B'CAP PLATE
2'9e'LeDGLR ORD. K/ [2�,Q*BEAM WITW NEW •7•xl2'x9/4•BASEPLATE W/a S/4' VIA.BOLTS.WELD ALL CONNECTIONS �;1/2'LAG BOLTS a ,'X l V LVL 4 FOOTTINGS TO BE%'.%'.12'SQUARE CONCRETE W/B 09 BARS EACH WAY. U g
W/KASMERS•12'..e, (o
A 2 ROWS STAGGERED 8. DOUBLE FLOOR JOISTS UNDER ALL PARALLEL PARTITIONS. �
4.CONCRETE SLAB TO BE 4'POURED CONC.ON COMPACTED PILL
A5 S'-O. CUT JOINTS ALONG WALLS AND SEAM COLUMN LINES.
--- ---� -- ®r_=_— - --- -�--� PROVIDED DIAM.SONOfUBE
1 t - B. CONTRACTOR TO PROVIDE BASEMENT VENT CATION A9
I I FOR
2O�'BTIGFO FOOTTIINGe
_ F-----J REQUIRED BY CODE WINDOWS OR MECHANICAL
EW 1. I NEW 2.5. I I DHL. FOR COLUMN SUPPORT ABOVE �o
6 I L-----� 41 CONTRACTMINIMS ENSURE THAT ALL FOUNDATION WALLS MAINTAIN
IX19T.9 I/2'CONC.FILLED 7.PROVIDE WEB STIFFENING PLATES AT ENDS Or STEEL BEAMS, TYP. Z1�
STL LALLY COLUMN I Ip LQ 4„
1 —— TO REMAIN --. -_ i Y S.BEE STRUCTURAL DRAWINGS FOR LOCATIONS OF ALL STRUCTURAL COLUMNS.
4'%B'.B•PARTION BLOCKS L J - ° ^�
P 9 CONTRACTOR 8FL4LL NOT SCALE DRAWINGS POR DIMEN910N8. ANY MISSING, e�
Y F It3CORRECT OR OlEST1ONABLE DIMEN910N9 NOT BROUGWT TO THE 4TTENTION
P, OP THE DEtIGNER BECOME THE RE9PON91BILITY OF TWE CONTRACTOR.
II'-9' - s a • 10. INTENT OF DESIGN 19 TO ALIGN NEW FIRST FLOOR SPACES W/EXISTING
QRST FLOOR. CONTRACTOR SMALL ADJUST TOP OF FOUNDATION WALL AS
4.9TEELTUB9 POST O Ij NECESSARY TO ENSURE DESIGN INTENT.
ON NEW%'.%'x12'DP fl 2•.12'LEDGER BRD. W/ IL GARAGE AND OTMER FILLED FOUNDATIONS,I&POUREp G/ONGrRETE WALL
m CONC,FOOTING, TYP, 1/2' LAG BOLTS W/20 Y5 TOP BOTTOM BARS. REST FOUNDATION ON a0 XIO STRIP PORTING.
W/WASHERS 0 12'e,e. MATCW TOP ` PROVIDE 20.D CONTINUOUS HORIZONTAL.BARS AND KEYWAY IN STRIP FOOTING.
2 ROWS STAGGERED UP OP EXI9T,WALL (DBL.j�/ LAP TOP BARB TO MAIN WALL BARS, PRO✓IDE TRANSITION REINFORCING W/uS -�
^ •NEW FND. v BARB SPACED•12.O.C.VERTICALLY. PROVIDE B )R21 ANCHOR w
m`Y BOLTS 9%'O.C.MAX.MIN 7 EMIDEDMEN7 udD"xS'.I/4 PLATE WANNER A W
EXISTINGO z GARAGE SLAB A5 till'
-- — IA5 � Z °�'-cnzIL Lu
B'TWK.4'-O' DROP TOP ,n W J
CONC,KALE oN I r—To GRADe
CON'T Is"- CONC, ———————— J � � z
B'TWK CONC. FOOTING I I 20LUnNs7T'XOI�R D STEEL
O FLOO7INGMNE OW.09 4'X'X'5A6'SQUARE STEEL TUBE Q Q a
WALL
oN EXIST. 4•TUBE.STEEL I I I FOOTINGS T02'BXE9/�44•X42'XIY SQUARE CONCRETE
YU SSUB BARSLO ALL EACW WAY.
Q ,N F
F�w w 2-mx4' PB'0R5�'xlo'.lo•(TYP.) ( I I I L Q{NE-
BAR9 PINNED 2-9/4'VIA.ANCFIOR BOLTS L O
TO EXIST. ,Li Wx" O
12'-4• 4�.II•
L
NEW CONC.
APRON
4 LJ
A .277' q
FO N4DATION PLAN
PEILD VERIFY
INDICATES NEW FOUNDATION
3ppp`gggee.tttF g �I�g
MATCH TOP OP IX19T.FIND,
g
m
W
� C \
I m
1
m
O O
< yVj
0 o v
L—_J o
DINING 0
DECK
L——J
DECK uj
d.
r BEDROOM
I I a
L---J o
n
n
----------------
�5 < a
----------------
_ 6oa�zaz19
,C�fli gW OZ�.
KITCHEN I I New o
(KlTaleN eY OTHERS) a+ewes 2gCT GR o i HuaiI = o�LL
Is � m
3Pd
' �I (VIDP.FOIRAPNE) O II CU9T BATH i O ow$oio aZo-
U ZLL'UZ U�.3wQ0
ri
I 1___ ; LIVING ROOM __ I I ' -----
IL
I
L I -- -- ,� ----_ - cn log-,
_ n LINEN _
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NEW FIRST FLOOR I-LAN WALL KEY
9'-0' I'-b' 9'-O" 2'-0' 0 EXISTING WALLS
U
WALLS TO BE REMOVED live a a1N
24'-0'S F"OPOS11,14a
PEILD VERIFY � ®WALLS
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1. ALL M EXTERIOR WALLS ALL HE 2X& m
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A CONTRACTOR SHALL VERIFY ALL WINDOW OD
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4.CONTRACTOR SHALL VERIFY ALL DIMENSIONS N Z
PRIOR TO CONSTRUCTION. CONTRACTOR t�.r
ASSUMES RESPONSIBILITY FOR ANY MISSING OR .�
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THE ATTENTION a THE DESIGNER. TO. p
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2 ND:m DM' 2 16WO OF bD NAILS•1r O.C. Y
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JOINT DESCRIPTION NUMBER OF NUMBER OF NAIL SPACING 2,
COMMON NAILS BOX NAILS
ROOF FRAMING ® TYP./GLULAM BOLTING/NAILING
J
BLOCKING TO RAFTER(TOE NAILED) 2-Sd 2-iOd EACH END MULTI I 9/4' BEAMS n
RIM BOARD TO RAFTER(END NAILED 2-16d 3-I6d EACH END 1J/ w LU
WALL FRAMING -1 lij
O z
TOP PLATES AT INTERSECTIONS(FACE NAILED) 4-Ibd 3-16d AT JOINTS Q w Q 1
STUD TO STUD(FACE NAILED) 2-16d 2-16d 24.O.C. w
HEADER TO HEADER(FACE NAILED) 16d Ibd , O.C.ALONG EDGES w
FLOOR-FRAMING
4 STRAP Lu-4 ul
JOIST TO SILL, TOP PLATE OR GIRDER(TOE NAILED) 4-Sd 4-IOd PER J018T vl -1
BLOCKING TO JOIST(TOE NAILED) 2-Sd 2-IOd EACH END �sv LSTA B EA. RAFTER Z Z �
BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 9-Ibd 4-16d EACH BLOCK 2�'
END RAFTER• 16' O.G. 0 O J W
LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-16d EACH JOIST DIST413GUIREDW14ENCOLLARTIESOF
JOIST ON LEDGER TO SEAM(TOE NAILED) 3-5d 3-IOd PER JOIST IU
YL
BAND JOIST TO JOIST(END NAILED) 3-16d 4-16d PER JOIST BAND JOIST TO SILL OR TOP PLATE(TOE NAILED) 2-16D 3-16d PER FOOT ROOF SHEATHING fif
W2.5 Y F.A. RAFTER
WOOD STRUCTURAL PANELSRIDGE BEAMRAFTERS OR TRUSSES SPACED UP TO 16'O.C. Sd 10d 6' EDGE/6'FIELDOTE'
RAFTERS OR TRUSSES SPACED OVER 16'O.C. Sd lod 4' EDGE/6'FIELDIDGE STRAPS ARE NOT TOP PLAT
GABLE ENDWALL RAKE OR RAKE TRUSS W/o GABLE OVERHANG NBd IOd 6' EDGE/6' FIELD NOMINAL INS OR 2x4 LUMBER
GABLE ENDW ARE LOCATED IN THE UPPER
OLITL ALL RAKE OR RAKE TRUSS w/STRUCTURAL E!d IOd 6' EDGE/6' FIELD THIRD OF THE ATTIC SPACE AND
GAB ATTACHED TO RAFTERS USING
GABLEE ENDWNDWALL RAKE OR RAKE TRUSS w/LOOKOUT BLOCKS Sd IOd 4• EDGE/4' FIELD S)IOd NAILS EACH END
CEILING SHEATHING
g dz
GYPSUM WALLBOARD Sd COOLERS - 7' EDGE/10' FIELD SIM SON STRONG—TIE S
WALL SHEATHING 5 SCALE,N.T.B. SIMPSON STRONG-TIE 142"5 9
WOOD STRUCTURAL PANELS
SCALES N.T.S.
STUDS SPACED UP TO 24'O.C. 6d IOd 6• EDGE/i2' FIELD
V AND 2W FIBERBOARD PANELS Sd _ pK3 31n eE � g1
V GYPSUM WALLBOARD 3d COOLERS _ S 7'' EDGE/6'FIELD g
BDGE/101 FIELD
FLOOR SHEATHING m
WOOD STRUCTURAL PANELS O Q \
1•OR LESS ad IOd 6' EDGEA* FIELD I
GREATER THAN V IOd Ibd 6' EDGE/6' FIELD
a
mE
- Ci
110 MPH WIND ZONE REQUIREMENT FOR 780 CMR 7th EDITION MA STATE BUILDING CODE N z
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