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HomeMy WebLinkAbout0016 CARLA ROAD - Health 16 CARLA E, HYANNIS A = P9 ro r No .__ . f. Flms......... ............._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 77aw.!V_...............OF........ ..........------ Applira#iun for i-4pusttl Works Tunstrurtiun ramit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: ........../�..0 � � .......................................... ..•------•---------LGT----------vim-- Location-Address or Lot No. ....../ 7._..l..!:S �fjCGJt —C RL�3_..,. c5/3p .............. �er "A'ddress •--•------------•--•---: ............................ 0 -.� e. 1�t'!t �s._(c� s >........................................ Installer Address U Type of Building _ Size Lot.......!_(l.l1Qo'__.Sq. feet Dwelling—No. of Bedrooms...............1.W..o.................Expansion Attic (410) Garbage Grinder W--) pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures --------------------------------- --------•..........................•----------------------------- W Design Flow................................_ ..gallons per person per day. Total daily flow............ZZQ......•............gallons. WSeptic Tank—Liquid'capacity!QaQgallons Length...S.- _`._. Width..91i'-� `. Diameter................ Depth.z=j.. "� x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No....._1........... Diameter....10......... Depth below inlet,_.; .47 .. Total leaching area. J.....sq. ft. Z Other Distribution box (n ) Dosing tank ( ) aPercolation Test Results Performed ....................................... Date... .............. Test Pit No. 1................minutes per inch Depth of Test Pit....�44....... Depth to ground 'wa� ........ (i Test Pit No. 2................minutes per inch Depth of Test Pit--- 4g........ Depth to grouno ' ra��,-- -------- a., ti a rrAs P _ ••.............................. .•--------------................................_.. • ...........•........-•-•-- �.......... .n ....... O Description of Soil---Z P 14�. . ----L'i�'_..._1-��r!2a..A4.B`. „ 1 tl�r� Cl c�1�-----•--.. ..EN.. VCcc+rs�.. ..111u�tu� 'uhc .e.. 1YZ 1.- - �?.t'...1-i�cdun..R _13..`. . ."-..1 !4.�':._ A!�Yr� ' W CLe.Y.-.... <+r..rs�..£...7? .s .ie.�rn---. tc/---------,---------------DESIGNIICTG ENGINE_Ef �165 U Nature of Repairs or Alterations—Answer when applicable...-ilLI.ATION ANl3 G I Imi ---•---•-- �FI� SYS�EJI WAS IiVST �.,�� ."T Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal e n accordance with ,T, O- _68 the provisions of LI IM 5 of the State Sanitary Cod — The undersigned further agrees not to place the system operation until a Certificate of Compliance has been i edthe oard of health. Sined--------- - -------------- ............ . . -----•---•------------------•-- Dat Application Approved BY = .�'-�. - /z ........ ate Application Disapproved for the following reasons:..............................................................•._....---._.-•-_•-------------...........--•-.._ ....................................................... --.....-----------------------......------....•-----------------------------------------•------------------------------------------•---•------- G Date i I Permit No......- •---•--.--L.---•--------------------------- Issued....... -'��. --- -- ---------------- Date' Rti1 '1 o" Q6 1 N`` Fizz.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........T2�W.A ----------------OF.........t'�goc.y-`-T?16 ,-- Appliration for Elispugaal Works Tonotrurtiun ramit Application is hereby made for a Permit to Construct ( x) or Repair ( ) an Individual Sewage Disposal Systemat:.........../ ...c am /...................................... .....•--------------G, T--•------�-- -.-.-.------------_--_-----_-------------- Location-Address or Lot No. ............ a ---- ------•-•--•---• Address•.....................•---........._...... a . �!7--•-- • /-/y.t>v.�l_ r./`�T-----------------•----•-•-•----------•--- ---------- ------•-•- •-. •- ----. Installer Address t Type of Building _ Size Lot........l(t_Q_4?4-.Sq. feet V Dwelling—No. of Bedrooms.................l.\(,i .................Expansion Attic (Na) Garbage Grinder (A/c) '4 Other—Type T e of Building No. of persons ` �_ G1 YP g -•-••---•-•---------•-••---- P ---`-•---- Showers ( ) — Cafeteria ( ) Otherfixtures ............................................................ . - x W Design Flow.....................•._......_....=--�_gallons per person per day. Total'daily-flow.............4� ..................gallons. WSeptic Tank—Liquid capacity..P=gallons Length___b-.6. . Width-__ Diameter................ Depth_ .......... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------�________-_ Diameter.....1Q./..... Depth below inlet--_ Total leaching area.. ....sq. ft. Z Other Distribution box (n) Dosing tank ( ) aPercolation Test Results Performed by.._.1'h':.fair. n/. s......................•••.•.-••..._•... Date_._.�7-1 � ___..___._... Test Pit No. 1................minutes per inch Depth of Test Pit.....�1 r1._._... Depth to ground wate al ... (il Test Pit No. 2................minutes per inch Depth of Test Pit.... ti'I`_...... Depth to ground Ix ............................................... ....................................................•------.•••............ . Description of Soil = x r?�s::se ..171scLtun1 .5urns�.a -- ----- __ I.aria.en !�4 e =4 1�1'`� r' VL'.l:.a�^� ••- v;1 . iwtrt....Su y� . ho 3C216�? C r U Nature of Repairs or Alterations—Answer when applicable.............................................................. �_- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with Y the provisions of TITLE: 5 of the State Sanitary Code . The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed b the and of health. 00— 2 �� Date Application Approved By.................. . ----. Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------•---•---•--•---•••------- ......................•-••••-••--•••.--••- •--•-••----•••-`----•-•-•--•-••-••-------•••...--••--•...-•••----••---•--••--•----•-•--••••-•-•--------•••--•---••------•-•-•......----••......•--------- Date Permit No.. .... Issued_.............3/ i............... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I _ ' ............ ` .'°y....OF........11..1i.�...J�1�S.f..��.��:..�- vEntifiratr of Toutph anrr ' THIS IS TO CERTIFY, Th�t the Individual Sewage Disposal System constructed ( .�or Repaired ( ) by -�.h. �'.. .................•-••-••--••......••... ---••----•---•.....-•-•------•-•------•...•••--•------..........--•----••-•--•---••---- /J Install -------� -----------�----------•----------------•-•----•---------------•--•------------•--------------- has been installed in accordance with the provisions of ITI,E 5 of The State Sanitary Code as de ribed in the application for Disposal Works Construction Permit No.._._...T -S._7-9'1-_1..... dated-----— ..................... THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUN CTI N SATISFACTORY. - DATE...........................J. ------------------------------------ Inspector- ---•---••------------.....-•-----•------....----•----•-•----- AC/ DESIGNING ENGINEER MUST SUPERVISE, ,O THE COMMONWEALTH OF MASSACHUSETTSTALLATION AND CERTIFY IN WRITING /// BOARD OF HEALTH E SYSTEM WAS INSTALLED IN STRICT rANCE TO P CORD C � ..........................................OF LAK .................................................................................... No.._ FEE.-- •--.S......... Disposal Works (lomitrnrtion runtit Permission is he granted........_. �' ' :..:.............. to Construct ( or Repair ) an Indivi` al ewa Disposal S stem CJ ....... .............. at No.................•• G ` - `'�• i_t/=� �C� �... ..-----•----------••----••.._..__.- Street as shown on the application for Disposal Works Constrcuction Permit No.:5 ... Dated....__y� 2:jc ................ ..........................................Board of Health --------------------------- DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Grad DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Govemor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A �r (�/� CERTIFICATIONIW aC� Property Address: 16 CARLA I&IM HYANNIS Name of Owner DAVID ALDRICH 1, c Address of Owner: n/a Date of Inspection: 10/1/99 O C T 4 1999 CO Name of Inspector:(Please Print)JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) V.XIOF WAIM HEALTH WE Company Name: n/a t) 44 Mailing Address: n/a Telephone Number: n/a Gj CERTIFICATION STATEMENT 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 inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes The inpection is based on criteria defined in Title V Conditionally Passes code 310 CMR 15.303.My findings are of how the system is Needs Further Evaluation By the Local Approving Authority performing at the time of the inspection.My inspection does _ Fails not imply any warranty or guarantee of the longgevity of the septic system and any of its components useful life. Inspector's Signature: Date:10/4/99 The System Inspector sh I submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEMS USEFULL LIFE. revised 9/2198 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:10/1/99 .INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: _ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection S. SYSTEM CONDITIONALLY PASSES: nLa 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. nLa The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. nLa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). _ broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced nLa The system required pumping more than four 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 , revised 9/2/98 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:10/1/99 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 the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 16.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. ' The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance nLa-(approximation not valid). 3) OTHER Wit • I revised 9/2/98 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) " Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:1011/99 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Na. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:1011/99 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health. X 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. X As built plans have been obtained and examined.Note if they are not available with N/A, X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non sanitary or industrial waste flow. X The site was inspected for signs of breakout, X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X Existing information,For example,Plan at B4O,H, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [1 5.302(3)(b)] X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2198 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:1011/99 FLOW CONDITIONS RESIDENTIAL: Design flow:_M g.p.d./bedroom Number of bedrooms(design): 3 Number of bedrooms(actual):I Total DESIGN flow: = Number of current residents:I Garbage grinder(yes or no):NQ Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no):JM Seasonal use(yes or no):JM Water meter readings,if available(last two year's usage(gpd): n& Sump Pump(yes or no): MQ Last date of occupancy: n& COMMERCIAL/INDUSTRIAL Type of establishment: nta Design flow: nta gpd(Based on 15.203) Basis of design flow: n& Grease trap present:(yes or no):JLQ Industrial Waste Holding Tank present:(yes or no): NQ Non-sanitary waste discharged to the Title 5 system:(yes or no):NIQ Water meter readings.if available:n& Last date of occupancy: Wa OTHER: (Describe) n& Last date of occupancy: n& GENERAL INFORMATION PUMPING RECORDS and source of information: nLa System pumped as part of inspection:(yes or no):MQ If yes,volume pumped nLa- gallons Reason for pumping: n& TYPE OF SYSTEM XSeptic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes.attach previous inspection records,if any) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other: nLa APPROXIMATE AGE of all components,date installed(if known)and source of information: 1989 PEMIT 89-90 Sewage odors detected when arriving at the site:(yes or no) NQ revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:10/1/99 BUILDING SEWER: R (Locate on site plan) Depth below grade: Z_6_ Material of construction:_ cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: TOWN Diameter: D& Comments: (condition of joints,venting,evidence of leakage,etc.) n/a SEPTIC TANK: X (locate on site plan) Depth below grade: Z' Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) n& If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): No Wa Dimensions: L 8'6"H 5'7"W 4'10" Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 3C Scum thickness:3" Distance from top of scum to top of outlet tee or baffle:l Distance from bottom of scum to bottom of outlet tee or baffle: 9" How dimensions were determined: MEASURED 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, etc.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND,RECOMMEND PUMPING SYSTEM NOW AND THEN MAINTAINED EVERY TWO YEARS GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) Ilia Dimensions: n& Scum thickness: nLa Distance from top of scum to top of outlet tee or baffle:ji& Distance from bottom of scum to bottom of outlet tee or baffle n& Date of last pumping: n& 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, etc.) nta revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:10/1199 TIGHT OR HOLDING TANK: NQ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: nta Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) n& Dimensions: nLa Capacity: nLa gallons Design flow: nLa gallons/day Alarm present: NO Alarm level:jjLa_ Alarm in working order:Yes—No—: NQ Date of previous pumping: nLa Comments: (condition of inlet tee,condition of alarm and float switches,etc.) nLa DISTRIBUTION BOX: X. (locate on site plan) Depth of liquid level above outlet invert:n& Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) n1a PUMP CHAMBER: NQ (locate on site plan) Pumps in working order:(Yes or No): NQ Alarms in working order(Yes or No): NQ Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) nLa revised 9/2/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:110/1/99 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: Wa Type: leaching pits,number: 1000 GALLON LEACH PIT leaching chambers,number: 1lLa leaching galleries,number: .ita leaching trenches,number,length: nLa leaching fields,number,dimensions: n/a overflow cesspool,number: n& Alternative system: Wa Name of Technology: 1i(a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALL SOUND AND FUNTIONING PROPERLY THE PIT HAS NOT BEEN MORE THAN 1/2 FULL PTI WAS EMPTY AT THE TIME OF CESSPOOLS: _ (locate on site plan) Number and configuration: Wa Depth-top of liquid to inlet invert: Wa Depth of solids layer: n& Depth of scum layer. n& Dimensions of cesspool: n/a Materials of construction: n& Indication of groundwater: nLa inflow(cesspool must be pumped as part of inspection)n(a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) nLa PRIVY: _ (locate on site plan) Materials of construction:n(a Dimensions:Wa Depth of solids: n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) nLa revised 9/2198 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:l0/1/99 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within I GO'(Locate where public water supply comes into house) n/a kd C. a O IJ � 30 A� �S Apt � 57 �D SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 CARLA LANE HYANNIS Owner: DAVID ALDRICH Date of Inspection:10/1199 NRCS Report name: n/a Soil Type: nLa Typical depth to groundwater: WA USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar _ Shallow wells Estimated Depth to Groundwater 12 Feet Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record _ Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps _ Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS revised 9/2/98 Page 11 of 11 /3off_ - ASSESSOR'S MAP NO. PARCEL �2 LO CAT IOk, SEWAGE IT Pi0. PILLAGE A I :NSTA L ER'sS NAME f A'DDRESS of S dos- ®' �3 S U I L D E R R OW f`R DATE PERMIT ISSUED It DATE COMPLIANCE ISSUED 4ta- i o_ 0 C tG 10 _ ( I � 4 o 0 ' SCALC . ii , I � /�i9p a A, j. + j w NOU E > I G/+RHGri� O Y Q NOTE' A ucriance s'a ,fhe O gy�t I ' 1 I t=lN.FLa a o T �33o-9 r9�acr�._ --rcSul�t�on ..Wag E�•SS,S 0 '��rgn+ckQ '-for 1 �5 lot- u✓, ! -EL 56,SoAl Jviy" ZZ 1`f87' :+a, allow' C.% k . k ��I i'-WC� �ccQroom 1'►o�iaG . � ; ' `, o ;A' w ►c \ t� TAN�1 H TH w2 +,. r \ PENCHrn1-RK -TUP _ ©F C0N-..(3NU = �L 55,34iy SIGN P097 �- �zg 4 'FA�i1IL`s'' ­ TW0 :36Urz-0001 Tcst`- b� R. Fa rlaank Da+c ; 7-/3-87 i Ir K0 �P2L3AGE :C.12{NDELt.:. ':.. o 1 k ; Ftow P— x I I o f ZZ,O. GPD. T►1 1 TH 1 53,3 JEi- IG TANK;• ZZO x Is-0% = 330 GAL. ' Horizon Vlor,zoh 11U5C IO80 GALLoN :TAkNIt p A Fr G r W/Z STONE 51. 3 2,S GFO sF I = �:45 GPD Clean ki � ' —�=I I; i e4cj 0 P.D�SF = 79 G 1�D C oz rs e C l ca n 257SF S2�►' GP-D t Coarse ;! m I;.MIN :covL-r� n _,.L... Wasti<.4 5,+onc �.� sG, S o /NV 6 /tid S/48 �LEoowiv S 73 O/ST, O,uTLET TtE I � — —•41.3 1-0' /NV /NV /6 "Do wN SQ,97 /.90X f .__ .._ __.___ _._ _.._. /.vv DESIGNING ENGINEER MUST SUPERVISE I -s/,9'$ STALLATION AND CERTIFY IN WRITING �� {' b THE SYSTEM WAS INSTALLED IN STRICT qs s o ACCORDANCE TO PLAN. a �i,• to� � SYS f MDEDSI � N 7' II HYANNIS , MASS H _ ,i1 CEt2T%FY TiYRT 7/�'� �v/L,tJ/NG SCALE e I,� ZC� 1)ATC- 7-0WIV it /V07- _ O L<Jh/U S UR 4 tl YOBS L2" I ' /yl rt Z� Al G//i!d�../'p"S' i.,_._. _._ - _ -- 1 77-111CS1f�z/7aN is ;140/C 7-.'-14= ' EJ�T/C SY57'�/Yl a/VL Y IFIVZ) /vo r A-le o r1,i,6:F,p Purr-o E S. --- . -- ... . ....... _ I I If I I II i�li i I� Dill I �• �I I I i �i.jI�III I ,I .! I t II { t z b � inn a _ , ,y t+,,: .g:G7 .. - .,r .+...:Jr v ,.,,. .,_i ' ..'P-^>+ ^r kt•• I_. �^vpw :� - - kei t - 1, i I� • _ . ___„_ - I W i I 1 - f 't. 1 - -GO IrX Co -- e TIL w}ry Oj _ MA-TLN EXISTNf �P - ' 1 p s i o / RfNs! n Is �r!�j7 1' i - AWC Guide to Wood Crmslrucllon in High Wind Areare 116 mph Wind Zone APPLICANT TO COMPLETE A SUBMIT eTSll PERMIT APPLICATION AWCGuirtarp.WpoACydtrFieRatt'le Mgir Wilid Areas:110nrph Ir dZone All GrdGaro Wood CORS'tlftedOn)k High WbrdArear:ll0 mph Wind Zone i(e )f'rinrl L'ons'raetioN%n HiKi')�"d'lrcr•`'-j10„rh 14.d z ne - Massachusetts Checklist for Compliance Rao camswl.2.LA`' Massachusetts Checklist for Compliance Rao cam zloi.inq' PVC'G.i Rnr13ag1.a3-.)' )Lad--- {fan L2(7_ "LaaalL -wnll G?Yt^etl°^ ._ / •4., Massachusetts CheektiSt for Cymp �[✓ a From TaNw 10 and 11 and lopolon o/waB aaaw BIM Bond ng Npat Retle•aee nta Pa cant Fu FFN�t. . LaUrel(n0. nap rammonarrla)._ - Bailee t) 4sff1 t•KWJ?.__...L a _ . cnmp)fum �r No w..l of du.onraa5orr __..�, b. worm s gwciAnd and vanM.WW be cing nlinh.m wdmaaa of rna+ana Da whasa o r000w.: . J SCOPE 110 mph land SeadW Wall C.""ng Gerd I-Vii.1100aning b4t deck d p nln.f _Wa.•, N H1 - L.Final law be hatalled with abwvth Sala Pa arai P dWe D a pc�.eJp Ta ......................=b HNdar$ Rah1e e)- _a_.-.d'12_.... ne All hodra+W tomb ehar omur win and W nW W m Taming. W aap•W C3-see.gust/...................'- ........._...............-.__. SN .Zar ------- Wind / On la amrY WnaHudHah Panels be mboRam .. rnbero/the dwMe . in. �.( B .bait Wa41ed plBhw and Glegory..................._._ at etude - R.bN 9L -- --._ -L m : la)tlat C � nNpa b eorlld .,Tab).H) N.�l7n MD emry wMauC6an•WPer Wnnla be P. ��upper Full 1.2 APPuc all IIY a pal which ors a in l2 fape,ahiN bn chnfldmee a s ry)1 _abides 52 atdnei I N In. ate aW m ' ....... ., Ct.:IZ12 --�yy ....__..__..._....___.__......._..._._ ;p s12' p bandMata bosom n(penel.UDPar Ala ar�mpanN.laag h�G mWemMledet Number of Stones( .....„„_(Rg 2)................ S33' _ad. - .._..__._;,__...__.__...__.._.._..Roble gL__..__.._-..___... 1p_In.S 1T �/ nd en-atmdsnant-dPI, (6 pWa at Mlrem forting. Roof Pit .:.._.. .......... ........................ <. 'LO at So ft., _ - pdabebW YeNrsl elld NBIWp and . ..........._...._............._...(Rg2)..._........ ltl ASe0" - PuIRleahtSmev lno:oratuda)__...._-..___._..__..RabN aL___._.__....._._.._:._.__......_-,-,. N v. Hortrnntal nail spacing at le band pNa,end gbda'a W Brow Moan Roof Me,gM.._....... (Fig .................................. "f-.:SaO ✓E>1WyLNea 9hpa!Inpa Radvl Upafl and HhearShlldaneeuah' eingge wan can g Buimin9 Widtn.W_- .....:................__............._..... _.: . - L:..................._.. ..............._.......:1hT93)-._....._......_......._. t.f"F3:' iMnlrnuln B41(dinp Obnendpn,W' Building Lengd+.Raae(LA^/) .__.......:....(Fl941..__._. .. .3.o`+S CB" �� �dphtof Telleal aPad^9a ....... ___._.. a . ........._. ... SB'68 otl a131ni'h 130-9/uPec' pen ngv ..............._........1(ag dl....-. ( ).-�_.._.......__.,_. ter�r W ulu Horhmlmr ror Panel Altsoten NomnalNdSMdTallesl0 ..... oa4 EdOa Nee sP.ding-_:,-._......-----.._(Yaere toot nmo/vlma)._....___'-_•y1-la II�1 !: 1.3 F.RAMINO CDNNEC710N5 aa.•,.....„„,„.(TabN 2)._._..,..:.... .................. ......._.._.......... -J- 9haY aonneWon(. _ ((�T g J G-n, compn_with training wnnecpa sled eemmon naWxT�betOl__=..._ Pee5an1 Fu114ie1gM Sitga+lnp.. :-•_ReEln i.1 7tew+9aTflN- _ lOd.1 .. Me _........ WnwlSd ailnn.[®n..mG9 _. ................ ._........:....__ Nmn6ihr,,Tjpda Titoweowntng........_.............:.... B'6•ceRrlar r.................... ...... snaew aian�� -- _(nnN 4)-:_f�_,Izaas _�,%" ................._._.._ - w anmpamagNw i _.Fla Nat BNdng.+- ..._.�._.r.•-:_(Tse WNall ].2 ' mdeoni ` .. rg,.er[.elweamf(rloJaf ee mnandn - -. _ : - -- R.ea n1 . ,M1 -- 1 nust)(rabla»)✓ 5/e' Roble 4)......._.....,.._..._..._ ..-......_.;_..... y.-- 12' Peroant FWMal ihsoMIng.: -R+N-II)------,-,__-.--' 2j ii �L � Aadtltm.l luaelydrig ror wqh Openirg e'8•(Ode n cw+pepm to.._.._....,.._-.._F1g S).�_....... ._.._.._.. L (Fld�....'...•_..•.••...•..• C' is x 1S War Cladding- 1. ..._..........•IFlg fit._..._..._.......-,....._..__._._- rm WfW 5Wed7.:.� - _._....�.�_ ' 6mt�l-i3 ...•...__. F g ....2 Yx3''xY.; _j / salad 4 ii � 'r/116w0e bd16LLMV ' v Ran1`0m-&me. ap ib---- ___.__.(fcr RaRao wa AwC-R,wn Toal:seeeeRs webcia) '+ - .3.1� � r]a0 GMR Coe 551.__.-_ ....__._. _ -z ed.__.. .. ..._.(Pa Pta•' •s1z � RDdt oxen--•. -__ -(pinata iH).._....._ -amallxafr art' �. � I� _ - �Po n�mrn�m.n�t�. i 9 6 I .. Tnsc ar Fa:- Cannecfaol Cbnadng 4Yala fain . - ygmampenTn z E?de(ar Well(Fl9 6)............. ........ II. (Fig 7).................. ..............:.. /Rsd Reple lateral (idea _ _s- pr . °rtn Laed den ...._.......Rg9)................................_........._._.........: e/ Rid 9bap Capnaerona,irmllar Dee rloruced Pnr page-21...Raba 13). __.�_....Te1L2 ge .............__......._......._......._1PU Tao CMR Chapter 55)........_:....__....._. ... =1 - .`. Gab7RRalFe thibaDker._-._.__.-.._...___..._�.=(Figure 20)..__....`_.�11-S emeiler af2'or1J2. �i) ........_........ (pm]80 CMR ChaPtar 55).... '• in: .�... FNw•Shee4erw.39;Tp°•eay..... _... .. . Fn:arSn--fR'ree �n•�i'tC --�• Pow mry�oN V•42QND _ .. ............._R We )...,._ --� 'T.. et r4a+�l nab®➢tie W� oar wN,n9 tzza,nun9.._.. .......... M• -_ r �1(ro do l6drnmmonnara)..(i" fQ _._.._:..........._.........J.JIQ.a• Bp 00 s J 4.1 WALLS Boor Shoal aq Type -..-.- CMR Chapter.6B qqf)OO 59)__...._. 5 Deng M NaH Page ti fd'' R S iP' �.n:' r_YJu..al x7/i6•WSP I Sea Well Heighe .....(FM 7e and Table 5).. .._ ZL b .: Reel Sh4sllprp TMrinpa ---:•.^.......,,.,•.�...___..�_.__..;-_.- 1,pedbeagng.wilis'....... ..........._.-..._......._. _R S20• RoaF.ShMIhag Fesaning-- •--.:.Re - g .....F1'loend Table 5): -- �2l' Nenl�tthw"m}g^'as+s...:_....._�._..........:....._..(R91,0 endTeble S)..,_...__..._.�in'S2d•.a:c _ for Panel At . ' Holes Wall Stud SPadng _....... .._.,:_....._.....- _(PigsTBW).........._.,... 1. 'THa d+edolitahae ae,-t.llaaniiew.d J.d np ore apedfi. .Pion notW m2,meomPtY,aan Uro're0olremada or Vwlicel and ' ............... .R 9'd" I Was Sterpoilt.°u• ....__....._...__._.. ----._. T80 CMR 99if121.1'RN11 1 Irtl+e uDeddml a met ro Im engolY tha fb.Ibwhq mnml.tope and ham daww aolmi " 1.2 EXTER OR VJALLS' `// recWmd par'tha WFOM 110 gWh G.1d. - Wood Stolle .. 't tl-In: 7- e. Sad allege Par.FTg$ . hl ._....._ Z B'D I. D. ZD r..ege SUeys Per Fiprea ll. walls........_._._..__..__.. R o, UppR Syepaba/Flgcae l4 . r bl 5) .._._. - qa Non1_6,dbeann9 wale......._....._............._......._...I° 11 tl. Sbspv PVF49ure1T , Gable End Wall On6ng' ......_.. a, Cgn:er$DM ibW Oowap pe Fig-fee end F191ae.see _ _....._......... �RxY✓/3 Ppa"aD 1lelgtla rupm e/L OtIaaWDemillmd eAlm S%meaae4athepereNdfuNfielG+l a+wWnp WSP Ad Flem Lm9ln(_..._.____�. R ll_,�........_ ..�nxO.9YJ _ ralpdraO mTaDlae fO -i� Gypsum Cdhng Length(tt WSP noise •( 7.l« - _:._. -_ girds atbrl end and2x4 Coalnuous Lnleml goce�$R (Fq ilh---.._...... ndrtrusa bard I. Thabematv9 PamirrveetedorwaN bullGeminhnum 2 In.romaal-lhJwac Oraaqurebaeted 92-gods. . or1 s3cawnyfurnng ctr)Ps�tG apedno m,awil2u4bleamng l�4R pad:g rn e+ld lal Double Top Plata idR r - - (Flg/3 and Tbld6)' Splice lsnglh ....._..._ ....... ._.::....... _: p olio'(no.of i6d comma'naps ICU ---•-_..._.. _ .( Spline Conn l�-I"""" � - DOUBLE TOP PLATE . I 110:MPH EXPOSURE B VAND ZONE Table 2•Gen rat Na2blg Schedule. .JOT DESCPTION Number of 'Nu W RI mber aP Nelt Soaclnu - Common-Nall$ Box Nails I - .. . - Roof Framing DOUBLE HEADER .. Bmdkinglo'Rafter(Tae-nalled) 2-8d 2-10d' each and .. _ Rtm Board be Rafter(End ratted)�� 2-10d,q Mdd �h and � � l - WaII FfDmino FULL. - Tap➢Iota.a4lnteraacBoiu(FacaaallW) 4-16d B-16d .atlana REW.UWiEM6NTE AT SACK END OF.HEADEfi 11 . 8md m"6md(Fao4'+a0ed) 2-16dt 20So 24'o.c. BSTTUD� HEADER.SPAN' •,Mi(EADgy N9 MIM OF HeadmmHeader(Frce-na8ed) 1611 l.. 1od 1Co.c alongledges :IPTJ ®Ig FSILL•Hmcwr UPLIFT LATERAL I . - OUBLE JACK STUD STUDS 'fl8•J (LBJ Pool"c eatng \Walt -- - a)rT6NO NeADFR JaIN to BW,lap Plate or Gbder(Toe-Nalied)(Flg.14) 4-Bd- 4-10d ,Perloat 2� 1-2X4 1 211132 aheolhing TOKpIpaTWp slocidnomJoat(T0e4)4w) 2.8d§r 2.10d each antl. WMDOIDSLLPLATE - 3' ,2,2X4 -1 - 416 198 BIDtlting.m.3gl or Top Pmm(•Toe•'➢11etl) 3-16d'.� '2+2X4 .. 2 584 764 .magi eMend -.,' 4.10d' .arch block : Mdw `i� eP smp mBeao or Glniwowe•rlsred) 3-fkf 4-10d aach)o111 4' heaam r;•¢, i�� joist on Leal tb48safn(Toe-Nalbp) Sad:. - 3.1ad _ par joat _ 'S!'•r - fiend Jdeim JDlel"(EAOrIBited)(FTp:14). 3.15d 4.18d par)ow _ _ _ _____ ____ ___ _ 4 3 693 330 5 :Bend Joal.m Sit orTOP Plate Rop•nellsd)(Fig•14) 2-16tl,: j"9r18tl per toot _ 6� 2-ZR6 B 831 _ 96 w - j Rda' ire/ � 3 9� -4b2 - NA)L.0PPLATIi Rafters ell upm10,Oc. .. ed.,'L 1Od Wedge/0'Iwo .. - _ ------ 2-2XI2 3 I108 B28 WR '• •TO H$ADiiw WITH. 'L tad .4•ndgd 4•fiald.. �---'--------------- -'•• d p:: Reflere DrweeePaeedover lfP o,p 8a _ _____ _ 9' 3-1k10 3 ly4'i '` ad CONHON 1w0 ROuro O.vb t (8ahie 6 all rekeDr lake huae iNo gable ovaNianB. lid. 11od Ir adHel 6'Bald •_ - . AT 3'o e )':.: N4LLd AT 3s etc1 e•edge!WWII 4 . • , • • • • 10' 3.2XI? 4 1,385 660 - . G orrnke kook hlodn+ - 4'edpd 4•ileld O•n .°d•� .°d•4 .40.4 .�d•a .°d•a dy •Gable andwall rake or relat bode wl ebuahsal Sul lookers 1W w.,. aba endwan reka' ww.wn mo as a' a, d•, tr :_.::�' pp� dna do {dn•°d•.•°n.� 4e1X10 4 1,524 126 ad' OR CeBing ShaeNtnB l a A <a• °1a%�• 1•AAaII WALL 1 /1� `I,1 O Nenad,edi GYPsumWallboard : 6dcoolera-:.. Tedgel70'pem ,` •e' �d'° q' 'IA51wr.'.g. WALL OPENINGS I- r4D R6 ad wmmorr >� ,. •: n TTP.ANCHOR DOLTS AND EI(TEHIOH _ of 3•e.c .. a� e�.° • 1,' vltw .lNallShaWIIDg' n•,°dn °de'4A, din'°po"X3"XQ/4 PdLATEdWASH6Q 4O:!�' IN LOl4 7�. •- .- - _ NabWa s u wd Paned,o.o. lad aeaaFJlz Sam 05EARING UJALLS Stdda spaced upm 24 Bd > •. a _ -3'edgNGBeld d• i,! .. a ` a,�!e _ X'end 26132'flbadneM Pmleb 8d d A,{'1) Tetl-e/.10'flsm •n•.a.d•n .46'n .°d•° .°d.•. °dro .°d•n•.° >.d•6 .� •n .4/~ .. . hemhin, - X'Gypsum Weliboard 8tl aggleB, 9 ` moat an end ' Flbor Sheathing ''' . - header WQgd Btructuial;Pgneli' 40•n_°d•A .°1n do .bdl .°0•a.°d•4 d•a .°d•d. 1-ar lase Btl _ 1 Dd fr'odge)12'item Greeterthan l' 10d 10d W adgai W fl ld Sheathing �. join)dt .. pproa. Nail achdale el)Cartoslon resistant 11 gage nails and 16 gage ample$ere permitted;ongck I�for additionalrequire menls.' mid'hei9hi 8d mmmon eI3•o.c Nall:Unless othalwlce emfed,alzae,gNen for oafs ere coinmgn Wile a#ai.Boxald Phaimetlpnalla of aquNrllaht diameter and equal ar.gre. r length to the speNBad common nala msY be aubsDluted unlesa Dthlalwlea ' : prohibited. - - - A PA _ 3rulm OWN"I t . 774Z3773 =- - _