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Home My WebLink About0635 SKUNKNET ROAD - Health 635 Skiuiknet koad Centerville � _ . �' A= 169 —011,.�11 1 /// ISME- ANo. 53LO UPC 12543. smead.com • Made In USA J Commonwealth of Massachusetts � P� 'Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information Important: When filling out 1. Property Information: forms on the computer,use 635 Skunknet Road only the tab key Property Address to move your Peter& Peggy Timoney cursor-do not Owner's Name use the return key. 635 Skunknet Road Owner's Address Centerville Ma 02632 City/Town State Zip Code Date of Inspection: Date 8 Date £ 'y 2. Inspector: j -• James Holler =4 F r Name of Inspector Holler& Son Construction Co. LLC -; Company Name P.O. Box 702 1F Company Address " Marstons Mills Ma 02646' City/Town State Zip Code 508420-0280 Telephone 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: 0 Passes ❑ Conditionally Passes ❑ Fails ❑I Veeds Further Y al ation by the Local Approving Authority 3/17/08 I spe tor'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. Timoney inspection.doc•03/2006 Title 5.Official Inspection Form:Subsurface Sewage Disposal System Page 1 of 16 f t Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments ` Subsurface Sewage Disposal System Form B. Certification (cont.) " 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney " 3/10/08 Owner's Name Date of Inspection 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 failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally.sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 16 . Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form B. Certification (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 Cityrrown State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection 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 ❑ obstruction is removed ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or 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 Timoney inspection.doc•03/2006 Title 5 Official inspection Form:Subsurface Sewage Disposal System Page 3 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form X . Not for Voluntary Assessments Subsurface Sewage Disposal System Form M: B. Certification (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection C) Further Evaluation is Required by the Board of Health (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 ❑ Y P supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System- Page 4 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Not for Voluntary Assessments Subsurface Sewage Disposal System Form B. Certification (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State ZipCode Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection D)System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® 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 '/2 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: one. ❑ ® 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. Yes No El ® 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. Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 5 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form B. Certification (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection 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. Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 16 .. . _........... . . Commonwealth of Massachusetts uN, Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. Checklist 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection 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)] l Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments �M e Subsurface Sewage Disposal System Form D. System Information 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 145 GPD/2 Yr 9 ( Y 9 (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: CurrnetDate 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): Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 8 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form a Not for Voluntary Assessments Subsurface Sewage Disposal System Form �M D. System Information (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection General Information Pumping Records: Source of information: Owner Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1000 gallons How was quantity pumped determined? sight gauge Reason for pumping: floatables 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: 08/18/82, permit#82-321, Board of Health Were sewage odors detected when arriving at the site? ❑ Yes ® No Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 9 of 16 .. . ......._....._........ .... .... Commonwealth of Massachusetts Title 5 Official , Inspection Form Not for Voluntary Assessments ` Subsurface Sewage Disposal System Form D. System Information (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection Building Sewer(locate on site plan): 1.5 Depth belowgrade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: n/a feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of ❑ Yes ❑ No certificate) -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000 gallons Sludge depth: 6 inches+ Distance from top of sludge to bottom of outlet tee or baffle Winches Scum thickness 6 inches+ Distance from top of scum to top of outlet tee or baffle over by 2 inches Distance from bottom of scum to bottom of outlet tee or baffle 12 inches How were dimensions determined? sludge judge Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 10 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form D. System Information (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic pumped as part of inspection due to solids and floatables 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: f Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Inspection Form'Subsurface Sewage Disposal System Title 5 Official Ins Timoney inspection.doc•03/2006 p Page 11 of 16 Commonwealth of Massachusetts Title 5 .Official Inspection Form Not for Voluntary Assessments ^M = Subsurface Sewage Disposal System Form D. System Information (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 Cityrrown State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level.' Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert level with 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.): some minor fats carryover, Dbox brought up to within 6 inches of surface Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form D. System Information (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: one field ❑ 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.): no sign of impending failure Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 13 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments M ` Subsurface Sewage Disposal System Form D. System Information (cont.) 635 Skunknet Road, Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection 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.): Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 16 • Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form D. System Information (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 City/Town State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. i z 18 -v 3 z1 - z- 2 32.-71 2V3 3 h gr��-D Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System- Page 15 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form M D. System Information (cont.) 635 Skunknet Road Property Address Centerville Ma 02632 Cityrrown State Zip Code Peter& Peggy Timoney 3/10/08 Owner's Name Date of Inspection Site Exam: Slope Surface water Check cellar Shallow wells Estimated depth to ground water: 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: May 1982Date ❑ 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: Plan on record at Board of Health indicates 4 feet seperation to ground water. Timoney inspection.doc•03/2006 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 16 of 16 Town of Barnstable oFt�ram, . Regulatory Services BARNSrAMM Thomas F. Geiler,Director ArEo��A Public Health .Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. L L 0 CA TAON S WAGE PERMIT NO. VILLAGE ` jolt,/w�� INSTA LLER'S NAME i ADDRESS B U I L D E R OR 0 ER YA?� DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED _ ��. �2,1 F� oN-� � ��- 1 �. ,�, �� 3�� :� �, ��.�� oil • oti1 - No.��.z._. f` Fga / .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /w .... OF.... ! 'io ......................................... Appliratinn -fur Disposal 10orks Tonfi#rur#iun Pprmit Application is hereby made for a Permit to Construct (�or Repair ( ) an Individual Sewage Disposal Sysstemm at: Af � ,� !/1G1 , --.....--•--•-----------•..............L;r ..................................... oca'on•Addess �y�„ /�v or Lot o. / wz. 6� Owner 0e'_&j ddrec ..........................•-........................ ..... W Installer A dress d Type of Building Size Lot.......� .................Sq. feet Dwelling°�No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ------------------------------ -- W Design Flow........... _ ..........gallons per person per day. Total daily flow............ ......................gallon. G4 Septic Tate —Liquid ca pacity _ ��f _.. Diameter................ Depth....J4 1 q 1 1�__gallons Len h./�...�c..... Width.. Disposal —No. .................... Width---- Total Length...20..:e..-_. Total leaching area_...--_.sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area......_...........sq. ft. Z Other Distribution box ( Dosing nk ( ) Percolation Test Results Performed by._. !L �.,! J?/! .✓-•- 3._. Date__1''s __�� %: :. Test Pit No. 1...L........minutes per inch Depth of Test, it.../.'499(....... Depth to ground water...._��'a_q, ..... r34 Test Pit No. 2................minutes per inch Depth of Test Pit... t...�.... Depth to ground water......1 74:2.`..... P4 ------. - ---- ------------------- -- --- ----------------------.................................. -------------.... 0 3-. .e z is ? z�, a„ s, ° 9rq iy Description of Soil.t'i�' 9 c. .. � /1 .� / .3� �,�l ��aice...._�? �i � . . v . .mot _ / �� !'�/�.�_�A _� �1� •_a�..._..( r, .etat(�'fl�,�d�,�-`lY'fl�=!�1.�.__.G:_ . _.._.:c_k._+�:Yt.._.__�___._4F�. 17A' ..jl� . ................................... V 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 Article XI of the State Sanitary Code+-T��tl a utdersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued,by tl}/e board of health. igned � . Application Approved BY ---------------------------•------------.._....------------------ -fe -- Date Application Disapproved th following reasons:..------------------------ -----•---•--•--------••---...----------------••------------------------------•------- -------------------------------•---•-------------.....------------------------------------•---------------•----------------------------•----....-----------------------------------•-----•-------•-•-... Date PermitNo..........................................--•------------ _ Issued................................ ---•---------•-•••--. 321 ' No.r.. ------ ` , Fsa ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Od��......... OF.... Appliration -for Bilipaasal Works Tonstrurtion Pprmit Application is hereby made for a Permit to Construct (�or Repair ( ) an Individual Sewage Disposal System at: •---•-----•-- '� pp �' � ...._..- -••-•----__..................................... Loca'on Addfess or Lot -o. ....._..:: a s /s4.l�t!.-----•----------•----------------•- ......................... .fi c !4// ) 1 -�1.......... ....---- `' v+r caner.. ,`,sue.�) �f1t��d/e� ddr J�F7� psi[se%�_ __>�....._. �-•----•-••..............•-•---------...--•-------..__... .y4�K/._._+._ .._...._......--•--•-- ._... j------ ............... Installer A dress Q Type of Building Size Lot_-_._.. "4__Sq. feet Dwelling"—'"No. of Bedrooms................ :_._..___._I_:.._______.Expansion Attic`( ) Garbage Grinder ( ) aOther—Type of Building . ._- ........... No. of persons..............:............. Showers ( ) — Cafeteria ( ) w44 ....................................................... ..............•------------------------------------ Design Flow ther fixtures . it ns per person per day. Total dail flow............3.0......................gallons. W d s 0 04 Septic 1 an Liquid capacity/__gallons Length._!_'0�.4_... Width..�":r'G1 t Diameter................ Depth.... -'�. .. t Disposal T�—No_ ____________________ Width.... Total Length_-_- Total leaching area_-_.. 4 sq. ft. 3 Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..........::.-_.._sq. ft. z Other Distribution box ( td�r' Dosing tank ( ) ? Percolation Test Results Performed by... PA __. Date.. .a Test Pit No. I.._z__-___--minutes per inch Depth of Test kit Depth to ground water ----... .� 1 i=, Test Pit No. 2................nunutes per inch Depth of Test Pit.... ._.._._. Depth to ground water......./.-_ ._fit___-... 9 ------------•--------------•--- •------••-•---- ...-------_•_.... --•._._...••••----•-A-- ,-- ------ D Descri Description of SO11.�T- /_-__-�" �`0 4� -_ t'i�_ia°' a" r�► ��G 1� ,/ *'� i1 . _ _V? _. � ,✓��. P � 7" U .l0 ce'A/� Ai,,C�_. 0 ?it. .L'J-�r ��N��ij'/IfC �_.�'� p.�+f l s�J/._`.. �1__�F'✓'e W. .. , U Nature of Repairs or Alterations—Answer when applicable............................................-.................................................. -----------------•-•.._....-•--------------------•--------------------------------•--•-----------•-------------•-----------•---------•------------------------------•-........-.-__....__....--•--._.... Agreement:. The undersigned agrees to install the aforede.scribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Co — T u ersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issu t board of health. ln1ed " + -• •------ -•--------• �--��-� ,. D Application Approved,By c ..444,( -----------------•----••--•-------------------------------------- --•/ ' Date Application Disapproved r'tl f ollouting reasons:--•-------------------- ---------------- -------------------- ........................................:_.. ------------------------------•-----•--------------------------------------------._......---•-------•----•--•••-•--•-----•-----•----••-•----••••---••----•-----•-------------....•-••...•••---•••••---_. Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTtI .........................OF. � Eir .. ' ............... Tertif irate of Tontphanrp by � /[� CE -IF, ' That the Individual Sewage Disposal System constructed or Repaired ( ) s _ •.__._ .. -•-•-•--• Installer...---..._--•--•-•--•-•----------------------- ...._._.._.. at. .. .....71---_--•• �,.--� __- ,k----•.- --- - ------------•--_..._-__.-__- _------•----------------- ---••--•------------- hpsapplication for Disposal Works Construction Permit No .Z-". �Z,t_______________ __ dated._�1--'.. /-- scribed in the been installed P -iccort ance with the provisions of Article XI of The State Sanitary Co a �•� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTO Y. DATr...................................................... ��. ,.:... Inspector--------- ---- V . THE COMMONWEALTH OF MASSACHUSETTS BOAR A T A•• ................ OF ��.. t ...... .......................-. (,,`' x . ✓................. NO�__•-----��-�'- FEE is11u pa1 o trurtionprntit Permission is hereby granted - =--. . r__---• _ ......... :.............................. to Construct or P.e pair ( an :n ' dual ew D oral System f} r Street .................. as shown on the application for Disposal Works Construction Permit N 'i._",f y.r--__ Dated:.. �_ �........ .......................................... - awl-'- oard of Health DATE.................... -------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r -co 66 r 571 EX15TIN DECK A -TW24310-2 AN2BI W24310-1 _ O ( 24 X b'-b r——STING LINEN - � CEXIST I EXISTING I I O 0.0. in BATH I WALK-IN I I O CLOSET NEW BATH 6 ' EXIST. KITCHEN I ^ m I no I EXISTING ASPHALT SHINGLE EXISTING ROOFING TO Sy= �' GARAGE I" REI-IAIN ' m ZVI EX15T. BEDROOM ON EXIST- BEDROOM N I I I EXIST LIVING ROOM EXIST. MASTER ESEDROOM - _ I I I I I I I I 1 I I i UP { ` d 44i O NEW ASPHALT SHINGLE — P.T. 4 X 4 POST NEW FARMIER'S PORCH ;9 p EXROOFING STING (OVER NEW UP WITH I X FARMER'5 PORCH) TRIM, TYPICAL DS DS uP - LINE OF (2)2 X 8 � BELOW SEE SECT S'-�4° 5'-bk2° 4102" { .._ f ' f! FIRST FL002 PLAN y 0SECOND FL00�2 PLAN a SCALE, I/4" I'-0" SCALE, I/4" - y , g g a ADDITIONS AND RENOVATIONS } TO THE LAFRANCE RESIDENCE x 635 SKUNKNET ROAD - CENTERVILLE,MA L �- r' r S„ — r � I ` LEGEND D NEW'2 X 4 PARTITION-- - - ,\{/�[� (AD •f��/1' L 13'-II"j WITH Yz" G.W.B. • �J �_` + 16. VERIFY IN FIELD i EXISTING WALLS TO / REMAIN -_---I__ TW243IC TW24310 : �!; �atn NEW WINDOW - REFER TO ANDERSEN CATALOG T SCR.UNIT SIZES ti.i/L 14 Q y�L l' X 4 POST � �� Qn C. / j j Q o w � u J al UP TO RIDGE O I EXISTING DOOR rD M 0 I. - + am' i J t Ire I L_ I NEW DOOR (LEAF SIZE +J —_ - I _ LISTED) TW)4310 �� I I A SEE BUILDING' r SECTION A DOWN - 2 . \ / D HDU4 HOLD SEE DETAIL ` NEW FAM LY ROOM °X ON,THIS SHEET I Z m c --4'X-' NEW -- I 1 - ENTRYWAY IL J _ q' X 12, I LINE F FOOTINGS ,I AND A SEE BUILDING _ _— _ -_ COLUMNS BELOW 'I SECTION A UP THERM -TRU o I 36'X :n N I 4 X 4 P05T ! MOO7H STAR UP TO RIDGE I i i .� I in 1 52100 OEX15T I EXISTING I EX15T EXISTING I BATH WALK-IN I LOCATIONS OF CONC.PIERS - BATH I WALK-IN 1 CLOSET I ON SIC' -- FOOTINGS INSULATE EXIST.GARAGE WALL AND OrN CLOSET 1 - I BELOW, TYPICAL - SEE REMOVE EXIST. I I - BWLDING SECTION - PROVIDE�'TYPE X G W.B. S.G.D. AND PROVIDE CASED Q. ,OPENING EXIST KITCHEN EXIST KITCHEN ON ON EXISTING In EXISTING mGARAC o 14' X 22' o � A A O 7 14' X 22' N Z { N F , �______________-------------- _______� x N I � FXIST LIVING ROOM EXIST MA5TER EX15T MASTER BEDROOM EXIST LIVING ROOM BEDROOM r EEI UP UP w 2 > U oC u O a o EXIST FARMER'5 PORCH In a FX15T FARMER'S PORCH g ~ g N � 3 N w UP 41 up- 2 X 4 STUDS AT 16'O.C. W/R-'13 FIBERGLA55 EXSTING FIRST FLOOR PLAN PROPOSED FIRST FLOOR PLAN INSUL:BETWEEN SCALE= I/4" SCALE: 1/4" = I'-O" SIDING OVER WEATHER BARRIER OVER J'CDX PLYWOOD 5WEATHING i4 SIMPSON HDU4 HOLD DOWN, INSTALLED PER MANUFACTURER'S INSTRUCTIONS W/ 0 THREADED ROD �f 2 X FLOOR FRAMING {f AND RIM JOIST - SEE BUILDING SECTION THREADED COUPLING 2 X 6 P.T.MUD SILL °.0 ANCHOR BOLT a ON SILL SEALER ' THROUGH ;'X 3'X 3' a- ADDITIONS AND RENOVATIONS PLATE WA5HER • c B" THICK CONCRETE _ TO THE BUILDING FOUNDATION E SECTION Q LAFRANCE RESIDENCE o s� r HOLD DOWN DETAIL _ 635SKUNKNETROAD - CENTERVILLE,MA SCALE: I-I/2' I'-O" i >: ## • a 1 f ,. I 1 . i EXISTING HOUSE BEYOND + EXISTING DOUBLE HUNG WINDOWS TO BE REMOVED, AND REPLACED 4 W/AWNING WINDOWS(ENCLOSE OPENING BELOW TO MATCH EXIST) } EXIST GARAGE ® + ® ® BEYOND ASPHALT SHINGLES TO - ® 2 Aa5 MATCH EXISTING _ EXIST %3 SHADOW BOARD OVER IX b RAKE EXIST BOARD, PAINTED, 12 TYPICAL E E.P.D.M. MEMBRANE — -- ROOFING OVER ENTRYWAY DUE TO 7 i ROLL FORM ALUMINUM LOW SLOPE �xo FLOOR GUTTER AND —__ _—________—__—__ 2xo FLOOR DOWNSPOUT, TYPICAL WHITE CEDAR W2 W4401 W2401 I X 5 CORNER BOARDS SHINGLE SIDING AND WINDOW/DOOR I X 5 CORNER BOARDS WQ 1 Ir"y",p"J AT T ER THE AND WINDOW/DOOR IIII�^ I WEATHER TRIM, PAINTED, TRIM, PAINTED NEW SMOOTH STAR 521 0 X R TYPICAL Sn00TH STAR 57100 DOOR EXIST� WOOD ' AND ENTRY PORCH NEW WOOD PORCH AT - ENTRY PORCH WHITE CEDAR SHINGLE SLIDING GLASS DOOR — NE SIDING AT 5"TO THE I IsT FLOOR �- WEATHER I I Isr FLOOR —________ _ __—_____—__ EXISTING WINDOWS I I I RELOCATED FROM I I I I I NEW CONC. PIER I I FOOTINGS, TYPICAL - I I I I SECOND FLOOR SEE BUILDING SECTION CRAWL SPACE _y I I I I I r I BEDROOn FOUNDATION UNDER i t I I I l J ----------- L— 1 L_—] NEW FAMILY ROOM ——— ---------1--1--- / -------L------------------- -----� I -----------------------------------� L---------------- --------- EXISTING GARAGE NEW FAMILY ROOM Al CRAWL NEW ENTRYWAY NEW ADDITION EXISTING HOUSE BEYOND SPACE FOUNDATION BELOW ON CONC. PIERS LEFT SIDE ELEVATION REAR ELEVATION � SCALE: I/4" = I'-O" I ri II r ;f sd 44I ADDITIONS AND RENOVATIONS TO THE ;4 LAFRANCE RESIDENCE 635 SKUNKNET ROAD - CENTERMLLE,MA t ni _ f CONTINUOUS SHINGLE OVE RIDGE VENT ' LVL STRUCTURAL RIDGE - 2}:12 ROOF FRAMING TO 517E A5 DETERMINED BY OVER-FRAME ONTO 5:12 STRUCTURAL ENGINEER ROOF FRAMING AND BE FASTENED TO 2 X LEDGER i 5�,I 2 y, 60 MIL E.P.D.n. ROOF ASPHALT ROOF SHINGLES12 MEMBRANE OVER ISa � i4{ BUILDING PAPER UNDERLAYMENT (36' 21 OVER S I I ICE 6 WATER SHIELD AT EDGE) ++ � C - FULLY ADHERED OVER r COX PLYWOOD SHEATHING f SHEATHING COX PLYWOOD ( 2 X 10 RAFTERS AT I6" O.C. W/ R-30 FIBERGLASS BATT INSUL. PREFIN15HED ALUMINUM BETWEEN AND CONTINUOUS VENT -- GUTTER WITH ALUMINUM BAR BAFFLES TO MAINTAIN CLEAR I I HANGERS OVER I X 6 FASCIA PREFINISHED ALUMINUM --- __ VENT PATH BOARD, PAINTED GUTTER WITH ALUMINUM BAR ffll CONTINUOUS VENT BAFFLES TO MAINTAIN CLEAR VENT HANGERS OVER I X 8 FASCIA PATH I I BOARD, OVER }' GWB (BLUE BOARD) W/ VENEER PLASTER (SMOOTH), AT PAINTED OVER I X WOOD 16'D.C.X 1. W/ IROOF RAFTERS STRAPPING AT 16" O.C. HURRICANE TIES IN I I N ON H2.5A STALLED PER I X SOFFIT, PAINTED WITH MANUFACTURER'S INSTRUCTIONS CONTINUOUS SOFFIT VENT I X SOFFIT, PAINTED WITH CONTINUOUS SOFFIT VENT ANDERSEN SERIES 400 CLAD I I I X R FRIEZE BOARD, PAINTED I X 8 FRIEZE BOARD, PAINTED WOOD SLIDING CLASS DOOR - 2 X 6 CEILING JOISTS AT 16" OVER CONTINUOUS (2) 2 X e OVER CONTINUOUS (2) 2 X B SEE FLOOR PLAN FOR O.C. (PAD UP I" AT OUTSIDE HEADER WITH a PLYWOOD HEADER WITH 7 PLYWOOD DESIGNATIONS / UNIT 51ZES I I WALL) Al R-30 FIBERGLASS SPACER SPACER = = BATT IN5UL. BETWEEN F. - Z _ 4 X 4 POST AT EACH END OF V i �- STRUCTURAL RIDGE FROM TOP I I Z t=7 6 = OF FOUNDATION TO UNDERSIDE DOOR INSTALLED PER = W w r MANUFACTURER'S INSTRUCTIONS OF RIDGE NEW FA II Y ROOM a NEW ENTRYWAY 1 a O 'n a . Q i V TO COVER TROOP ED ARD E OF DECK OVER ING aL 1 LEDGER BOARD SEE PORCH ON OPP051TE SIDE FOR NOTES TYPICAL I5T FLOOR CONSTRUCTION 6ALV.JOIST EDG HANGERS OVER 2 X -� -- FINISH FLOORING AS SELECTED BY BACK TO BACK DOWNS 6 P.T. LEDGER, LAG BOLTED TO OWNER OVER :" T 6 G PLYWOOD I I BACK HOLD DOWNS W/ FLOOR FRAMING 5UB-FLOOR GLUED 8 NAILED OVER �' m BOLT AT 6' O.C. 2 X 10 JOISTS AT 16° O.C. Al R-30 DECKING OVER 2 X 6 P.T.JOISTS / FIBERGLASS BATT INSUL. BETWEEN I I AT I6°O.C. DECKING OVER (3)2 X 12 STRINGER, SET ON CONCRETE PAVERS • _ (2) 2 X 10 BEAM W/ }° f ° 2 X 6 P.T. MUD SILL ON SILL SEALER PLYWOOD SPACER a� 2 X 10 FLOOR JOISTS AT 16° WITH 1" ANCHOR BOLTS AT 2NSUL.BEETWETWE 4'D.C.O.C, n O.C, FIBERGLASS THROUGH;"X 3"X 3° PLATE WASHERS EN �r r r r �'�NTY r`Y r�r�� i r�i! 3'5TD.STEEL LALLY COLUMNS AT �` `` `' Y';` ```'�� `<`� ` \�� ` i• \r \r i i11 i.i rNi?� .�O- .,.r,� '� �.�F. .r,F r r� .c i iY (/ �a �� 'G��\- J v �� ^� ��j� II•a. i''Y�'�`��`�'`"``i'`` 8°THICK CONCRETE FOUNDATION W/(3) V-4'O.C., W/6'X6•X;' BASE PLATE /S✓'�% �I �` /� i rl�r7�✓r:Y�Y:�/,i .r.<✓arid`r r �h ✓��Gi✓r> r rr a4 REBAR(I EACH AT TOP, MIDDLE AND(4)Yi AA.B. TO FOOTING/SIMPSON r 3'-6° II• ,r II ` AND BOTTOM)SET ENDS IN HOLES LCC 3.5-3.5 POST CAPS i°P.T. PLYWOOD TO ':(`r �/ �� 2 X 10 P.T.BEAMS ON r��rr• 3-6 ' FILLED W/ EPDXY AT EMIT.HOUSE PROTECT INSULATION �i\`ri I r`r �i el` 'r� 5?MPSON ABU44 GALV.P05T ` ri ri e r. "� • BASE W/SIMP50N H2.5A HURRICANE TIES TO JOISTS FOUNDATION Z °\\ � Y`�r �I ``; � , II �• 8"X 16'CONCRETE FOOTING ` vy' II_ ?ter � W-4- .C, DEEP 4 RE FOOTING AT L r r`• •� �I• �\� r IL•_ rid 6'-4.O.C.W/(3)4 REBAR EACH WAY 6 MIL POLY VAPOR BARRIER W/2 X 4 `II \ •II - r` 10' OIAM.GONG.SONOTUBE P.T.BALLAST -OR- 2"CONCRETE MUD r`` l/�� .I p yr y r PIERS ON 24' BIGFOOT II' rw pr SLAB OVER POLY VAPOR BARRIER ��r��j �//• �i�/`ti ��?��'r `'ram FOOTINGS w/I a4 REBAR AT ��`r ``i``j �`` �� `rw`v r`v` r`r�/�/`r`r �r``r� r .� r\% r��\r• Ip \�`�'� r�,r'✓�� ••. Vr �\ CENTER, TYPICAL r� ri Q �,.r� ��,.!r ,...,.. �y�� ,��,,��r�r;;,.��`v '�'�,i�`✓✓r��r``rNi ram`�i yr i` `r�rr�r�i r r �i�`\:r �'�l�r��i�,rr`` r \�\. .r`i � a \a\ �`r� II y, I r T r`r•• "a `'r� 5`> ''��..r.�r�Y�;��r�iJ�rY✓S�„V`"T.Y•i.. ..�Xri r ✓ � �- ° �;F� r r ir? /u °�� .�� a .. r,�.,r v�r ,. '•�J.� .. �� r��vr�� r r `ter r %yam i`T� `r�i`r�"Y� N�`�i �,/�``'ii��r�l/\`'✓✓�i ram; ��i'�'�`i, y�irv`'r`n'�T ?��r� - �� '`�,,�� ,,''�'r.�i� ,., r ✓J �� , ��.. . :.,`,vim. �� ii�rY,v, �.v`'``r.�v` �, .n v, �i.�.rv.`.� ��:... �vv.. . i BUILDING SECTION AT NEW FAMILY ROOM / ENTRYWAY A SCALE: I/2' I'-O" ADDITIONS AND RENOVATIONS TO THE LAFRANCE RESIDENCE 635 SKUNKNET ROAD - CENTERVILLE,MA -. 1 TCST 9c,LEZeI Tt=ST fU�.0 2 �pkF* i�--ki. F-L&-V S41oxJw1 AeCTe MEawl SEA, �-AV&rk- �o�� l,AJC�.G - ' - - -'- -� BaSEv o►S 11SC.c3Q:, Gwru.-t ite.vIL _ - - - - -.,, r ti SG>PJ°�o 1 t- SU85a ( L. Sri � • • � P1K►a 1►La. 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