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Home My WebLink About0060 FRANKLIN AVENUE - Health 60 Franklin Street Hyannis �- A= 292-044__ I 0 o y I 1 I , N TOWN OF BARNST Lt LOCATION � � ` a SEWAGE # VILLAGE �_ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHO NO.SEPTIC TANK CAPACITY 16ob LEACHING FACILITY: (type) (size) � P l NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished byG . o � � - a o - � o l� � r _ 7r' - � ��_ �� o s TOWN OF BARNSTABLE A Ir;N � � �1uv l.�\�v�. SEWAGE # VILLAGE C ASSESSOR'S MAP& LOT 2CA Z d INSTALLER'S NAME&PHONE NO. . . SEPTIC TANK CAPACITY \000 214,� LEACHING FACILITY: (type) P tT (size) NO.OF BEDROOMS BUILDER OR OWNER t-VP`N\ PERMffDATE: ` COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table } �.�! Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) N�A, Feet Furnished by \ U� 1 N � � � = i. � - - �, i � � � .I .,. r' � � �� ._ � � 6- , . .: -- ,. �: ,��, A 1 � _ �� _ _ ._ .i _: . _ —Tti - cc, Town ®f Barnstable Building Department Brian Florence, CB Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstablejua.us Pre-application for Business Certificate l �V Parcel 1�2N �V Date 2�6 Applicant Information Applicants Name Applicants Address 60) FkWt IL U jj CA,,V e— Email Address Telephone Number / C 6� -CD7R Listed ❑ Unlisted ❑ .Business Information New Business? ----------------------------------------• es No �Business is a registered corporation? ------------------------• Yes N . If yes Name of Corporation - Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _-_-_-__- Yes No If yes then a Home Occupation Registration is required-See Building Division Staff Name of Business 84 0-2,6 0/ Business Address II `` C Type of Busines0 yj- B Commissioner Office Use Only Conditions Building Commis o Date Clerk Office Use Only APN 292-44 14,000±SF ZON�: RB EXIST. COVERAGE = 5.47. PROPOSED PROP. COVERAGE = 7. 1 % ADDITIO 5 O /x4 U J . L1 — R L1 �l O I p — 61 ° cn Q 7 / p No. GO O — six I sTr. - WD. FR. T.O.F. = 51 5G i . / 2-3'aq- I - xxx5� d PROPOSED o T S ADDITIO O,c 5/X/ STONE PROP. DRIVE GAS �'- SERVICE so 90.00' 51 040'45"W sn G. f RAN KLi N (PUBLIC - 40' WIDE) AVENUE BENCHMARK: MAG NAIL SET ELEV. = 50.00 (ASSUMED) I HEREBY CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE, AND IN MY PROFESSIONAL OPINION, THE LOCATION OF THE PROPOSED ADDITION, AS SHOWN HEREON, CONFORMS WITH THE HORIZONTAL SETBACK REQUIREMENTS OF THE ZONING BY-LAW OF THE TOWN OF BARNSTABLE 8Z�8 91,ZZ S(N Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for.Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is Hyannis MA 02601 03/18/13 required for every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: j key to move your I cursor-do not Michael Kellett use the return Name of Inspector key. Aardvark Environmental Inspections �y Company Name PO Box 896 Company Address East Dennis MA 02641 Cityfrown State Zip Code 508-385-7608 S13742 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 ma' ance of"site.- sewage disposal systems. I am a DEP approved system inspector pursuant to S� ion 15.*of Title 5(310 CMR 15.000).The system: . 73 ® Passes ❑ Conditionally Passes ❑ Fails. I ❑ Needs Further Evaluation by the Local Approving Authority -v =o 2��C" 03/19/13 01- Inspector'srSignature 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 . j has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the _ I 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. I t5ins•11/10 Idle 5 Offcia2K:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts .. Title 5 Official Inspection Form 6, Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information isery y required for ev Hyannis MA 02601 03/18/13 page. Cttylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary:Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: I B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as.approved by the Board of Health,will pass. Check the box for"yes","no"or"not determined"(Y,N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health_ *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. } ❑ Y ❑ N ❑ ND(Explain below): t5ins•11/10 Title 5Offcial Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is Hyannis MA 02601 03/18/13 required for every y page. Cityfrown state Zip Code Date of Inspection B. Certification (cunt.) B) System Conditionally Passes(cunt): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a mannerwhich 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 t57ns•11/iQ Tide 5Official Inspection Form:Subsu�ee Saw-age Deposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well'". Method used to determine distance: **This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form_ 3. Other: D) System Failure Criteria Applicable to All Systems: E . f" You must indicate"Yes"or"No"to each of the following for all inspections: i - 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 t5ins•11/10 Tile 5 official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts lam Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is Hyannis MA 02601 03/18/13 required for every y page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped:. ❑ ® Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.) ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails.I have determined that one or more of the above failure criteria exist as describers in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either`yes"or"no"to each of the following,in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the DeparM?ent. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA' 02601 03/18/13 page. Cityfrown 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 I ❑ ® 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 sae 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)P10 CMR 15.302(5)] D. System Information Residential Flow Conditions: .Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220 t5ins•11/10 Title 5 Official Inspection Foim:Subsurface Sewage Disposal System•Page 6 of 17 . Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °f 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. Cityfrown state Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 I Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[f yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings,if available(last 2 years usage(gpd)): Detail: i Sump pump? ❑ Yes ® No Last date of occupancy: 01/13 Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) '. Basis of design flow(seats/persons/sq.ft.,etc): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings,if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. Citylrown state Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 07/01/03 per BOH 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/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): ' t51ns•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. Cityfrown state Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components,date installed (if known)and source of information: 1994 per BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: .5 Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting,evidence of leakage,etc.): Septic Tank(locate on site plan): Depth below grade: 1.4feet 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: 1,000 gal 3- Sludge depth: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 28' Scum thickness 2- 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 16n How were dimensions determined? measured Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): The tank was sound and fight with tees in place and liquid at outlet invert. 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 Wins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. City/rown State Zip Code Date of inspection D. System Information (cunt.) Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): i I Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑concrete ❑metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches,etc.): I ' *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspectlon Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert even 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.): The box was level and tight with no sign of carryover. I i Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan,excavation not required): If SAS not located,explain why: t5ins-11/10 Trite 5 Official inspection Forth:Subsurface Sewage Disposal System-Page 12 of 17 / I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. Cityfrown State Zip Code Date of Inspection D. System Information (cunt.) ' Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number,length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system I Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): This.system has a 6'x6'precast pit surrounded by two feet of stone.The pit was dry with a stain line 27"up from the bottom. Cesspools(cesspool must be pumped as part of inspection) pocate on site plan): Number and configuration Depth—top of liquid to inlet invert .Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 63/18/13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, i etc.): t51ns-11/10 Idle 5 Official Inspection Form:Suusurrace Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. City/Town state Zip Code Date of inspection D. System Information (cont.) Sketch Of Sewage Disposal System:Provide a view of the sewage disposal system,including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building.Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately rear 16 30 14 33 26 50 t5ins-11/10 Title 5 Official Inspectlon Form:Subsurface Sewage Disposal System-Page 15 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is required for every Hyannis MA 02601 03/18/13 page. City/Town state Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0 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: I ❑ Checked with local excavators,installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS maps show an elevation of over 20.0 feet Before filing this Inspection Report,please see Report Completeness Checklist on next page. t51ns-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal home Mortgage Corp Owner Owner's Name information is Hyannis MA 02601 03/18/13 required for every y page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C,D,or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i i t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Commonwealth of Massachusetts �`S Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Citylrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any Way.-Please see completeness checklist at the end of the form. Important:when A. General Information --.filling out forms I ` � on,the computer, use only the tab, , 1. Inspector: key to move your cursor-do�not� Michael Kellett use the return Name of Inspector Q key. Aa� rdvark Environmental Inspections ICI Company Name P.O. Box 896 Company Address East Dennis MA 02641 O City/town State Zip Code 508-385-7608 SI 3742 Telephone Number License Number .r B. Certification I I certify that I have personally inspected the sewage disposal system at this address and that the Q information reported below is true, accurate and complete as of the time of the inspection. The inspection u� or was performed based on my training and experience in the proper function and maintenance of on site 014 sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of ham-- 6. Title 5',(310 CMR 15.000).The system: 0'i Passes ❑ Conditionally Passes ❑ Fails Gam+ CJ U _ ❑+ Needs Further Evaluation by the Local Approving Authority � w 11/04/10 Inspector'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. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is Hyannis MA 02601 11/01/10 required for every Y page. CityrroWn State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 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. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 _ page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: i, ❑ 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA- 02601 11/01/10 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is' required for every Hyannis MA 02601 11/01/10 - page. Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is Hyannis MA 02601 11/01/10 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information Description: 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 Seasonaluse? ❑ Yes ® No I ' Water meter readings, if available (last 2 years usage(gpd)): Detail: i Sump pump? ❑ Yes ® No Last date of occupancy: 07/10 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: f Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Fonm -Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 07/01/03 per BOH Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): i i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 1994 per BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 1.4 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 4" Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. CityrTown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 29" Scum thickness 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 15" How were dimensions determined? measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was sound and tight with tees in place and liquid at outlet invert. I I 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): i Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert even 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.): The box was level and tight with no sign of carryover. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: r I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: i Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): This system has a 6'x6' precast pitsurrounded by 2' of stone. The pit was dry with a stain line two feet up from the bottom. 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i i V !i I' S i t k Commonwealth of Massachusetts @kWTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address .Federal Home loan Corporation Owner Owner's Name information is Hyannis MA 02601 11/01/10 required for every page- Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below drawing attached separately e0j_ ry !6 0�6 • � S Commonwealth of Massachusetts Rim Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0 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: USGS maps show an elevation of over 20.0 feet. Before filing this Inspection Report, please see Report Completeness Checklist on next page. Commonwealth of Massachusetts 05.UTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 60 Franklin Street Property Address Federal Home loan Corporation Owner Owner's Name information is required for every Hyannis MA 02601 11/01/10 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file COMMONWEALTH OF M SSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION r ^ � V V� TITLE, 5. OFFICIAL INSPECTION FORM-NOT OR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A ASSESSORS MAP to,, CERTIFIC TION Property Address: 60 Franklin Avenue Hyannis RECEIVE® Owner's Name: Lori Sanderson Owner's Address: 5 2004 JUL 1 Date of Inspection: 6/29/2004 TOWN OF BARNSTABLE HEALTH DEPT. Name of Inspector: (please print) Patrick T. Sullivan Company Name: Ready Rooter Mailing Address: P.O. Box 371 Sandwich, MA 02563 Telephone Number: (508)888-6055 CERTIFICATION STATEMENT { I certify that I have personally inspected the sewage disposal ystem at this address and that the information reported below is true,accurate and complete as of the time of the insp ction. 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: sses Conditionally Passes Needs Further Evaluation by the Local Authority Fails Inspector's Signature: Date: 162 The system inspector shall submit a copy of this inspection re ort to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the syst m is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall subm tthe report to the appropriate regional office of the DEP.The original should be sent to the system owner and cor ies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of in ipection 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. f Page 2 of 11 OFFICIAL INSPECTION FORM-NOT I OR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART CERTIFICATIO (continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D C. System Passes: _ZI have not found any information which indicates that a iy of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria notevaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"C nditional Pass"sect' n need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved y the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND) in the for the foII win statements. If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic t k(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank fail a is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approve by the Board of Health. *A metal septic tank will pass inspection if it is structurally so d,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 Kigh sta is water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or une en distribution box. System,will pass inspection if(with approval of Board of Health): brok s)are replaced j obstruction is removed d9tribution box is 1 veled 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,&Board of Health): broken pipe(s)are -eplaced fobstruction is remc ved ND explain: l � Page 3 of I l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSA SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by t BoaXofalth order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determine i ccordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will p tect public health,safety and the environment: —Cesspool or privy is within 50 feet of a surf e w ter Cesspool or privy is within 50 feet of a b Bering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if y)determines that the system is functioning in a manner that protects the public health,safety and a ironment: _The system has a septic tank and soil absorption s stem(SAS)and t 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 SA is within a one 1 of a public water supply. _The system has a septic tank and SAS and the SA is wit n 50 feet of a private water supply well. _The system has a septic tank and SAS and the SA i ess than 100 feet but 50 feet or more from a private water supply well". Method used to determi distance "This system passes if the well water analysis,pe o ed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the ell is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrog n is a ual to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analyst must b attached to this form. I 3. Other: t Page 4 of 11 OFFICIAL INSPECTION FORM—NO FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for II inspections: Yes No Backup of sewage into facility or system compont nt 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 o let invert due to and overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow Required pumping more than 4 times in the last yc ar NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is belo high ground water elevation. Any portion of cesspool or privy is within 100 fee of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zon 1 of a public well. ,/ Any portion of a cesspool or privy is 50 feet of a 1 rivate water supply well. Any portion of a cesspool or privy is less than 10 feet but greater than 50 feet from a private water supply well with no acceptable water quality anal sis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for c liform bacteria and volatile organic compounds indicates that the well is free from pollution fri im that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or les than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma (YesMo)The system fails. I have determined that one or more of the above 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 con ect the failure. E. Large Systems: To be considered a large system the system must serve a f cili with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the followi (The following criteria apply to large s/nsitive ddition to a criteria above) yes no _ the system is within 400 feet dr' ing w ter supply the system is within 200 feet to a surfs a drinking water supply _the system is located in a nitrive area(Int rim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supIf you have answered"yes"to any quetion E the s stem is considered a significant threat,or answered "yes"in Section D above the large s tem has failed. The owr er or operator of any large system considered a significant threat under Section E failed under Section D sf all upgrade the system in accordance with 310 CMR 15.304.The system owner shou contact the appropriate regi nal office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOI FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECIHLIST Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: I Yes No Pumping information was provided by the owner, ccupant,or Board of Health Were any of the system components pumped out ip the previous two weeks ? _ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced tot 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) PrC v;0—,5 „Z _ Was the facility or dwelling inspected for signs of 3ewage back up? _ Was the site inspected for signs of break out? _ Were all system components,excluding the SAS,1 cated 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? _\,Z_ Was the facility owner(and occupants if different 1han 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: Yes No _ Existing information. For example,a plan at the Board of Health. Determined in the field(if any of the failure criteri related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSA SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 FLOW CON ITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: Q Does residence have a garbage grinder(yes or no):rDc= Is laundry on a separate sewage system(yes or no):%)c [if yei separate inspection required] Laundry system inspected(yes or no): — Seasonal use: (yes or no):roco Water meter readings, if available(last 2 years usage(gpd)): ry yhp Sump Pump(yes or no):_A2Q Last date of occupancy: C U�"�7 COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15203): gp d Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 syste (yes or n ): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:';�e �e er _ L Was system pumped as part of the in pection(yes or no): r>✓ If yes,volume pumped: gallons--How was quantity 3umped determined? Reason for pumping: T S OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspecti)n records, if any) _Innovative/Alternative technology.Attach a copy of the c irrent 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) ind source of information: Were sewage odors detected when arriving at the site(yes or o):./JC-.-.) Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOS SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 BUILDING SEWER(locate on site plan) Depth below grade: 0 Z " Materials of construction:_cast iron�0 PVC_other explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc): SEPTIC TANK:—V<Iocate on site plan) Depth below grade: � Material of construction: 1�,Aoncrete_metal_fiberglas _polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificat of Compliance(yes or no):_(attach a copy of certifirate) Dimensions: Q, r c{. x 4! Sludge depth: —Q Distance from the top of sludge to bottom of outlet tee or ba e: 3 l 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: 1 (0 " How were dimensions determined: Tod c Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 1 GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fib glass_polyethylene_other (explain): Dimensions: ( Scum thickness: Distance from top of scum to to/ions, affle: Distance from bottom of scum tt tee or baffl Date of last pumping: I Comments(on pumping recommnd outlet to or baffle condition,structural integrity, liquid levels as related to outlet invert,evidenc.): i f I i t Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART SYSTEM INFORMATION (continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 TIGHT or HOLDING TANK: (tank must be pumped t'time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete_metal fl rglass polyethylene_other(explain): Dimensions: Capacity: gallons Design Flow: gallons/d Alarm present(yes or no): Alarm level: Alarm in worki order(yes or no): Date of last pumping: Comments(condition of alarm and oat switches,etc.): DISTRIBUTION BOX: if present must be opened)(( Cate on site plan) Depth of liquid level above outlet invert: 0 Comments(not if box is level and distribution to outlets equal any evidence of solids carryover,any evidence of leakage into or out of box,etc.): <-- "'00C PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,c dition of purips and appurtenances,etc.): Page 9 of 1 I OFFICIAL INSPECTION FORM—NO FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 SOIL ABSORPTION SYSTEM (SAS):_kz(locate on site plan,excavation not required) If SAS not located explain why: Type —zleaching pits,number: (o X 4 t--, 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, 1 vel of ponding,damp soil, condition of vegetation, etc.): C+ '� V�S.S `G�nC'a—� t l�.wv. c^�C,�4 c.t� f%•aA wrA./�V► � CESSPOOLS: (cesspool must be pumped as part o i spection)(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: 7/ Materials of construction: Indication of groundwater inflow(yes or 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 draulic failure, level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSA SYSTEM INSPECTION FORM PART C SYSTEM INFORM TION (continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 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 p iblic water supply enters the building. q 0 0 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT OR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 60 Franklin Avenue Hyannis Owner: Lori Sanderson Date of Inspection: 6/29/2004 SITE EXAM Slope Surface water Check cellar f Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: i Obtained from system design plans on record—If check d,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the local Board of Health-explain: ��„��•—t-�o� Checked with local excavators, installers-(attach documentation __.�.ZAccessed USGS database-explain: You must describe how you established the high ground wal er elevation: i ,4 AS '3-_ �S 9j r L :i (1 f � •Ye �' :� !�g i 0 co f _ CC •� hew/ '''�4 cF^�'` • � 1 TOWN OF BARNSTABLE LOCATION ® ��ti,��k, A�f SEWAGE # VILLAGE y�r,, �tid ASSESSOR'S MAP & LOT Z w INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 6-zo aid � LEACHING FACILITY:(type) PC -(AS j ( 1 (size) NO. OF BEDROOMS PRIVATE WELL OR Ai._�&UW (� BUILDER OR OWNER V J rc DATE PERMIT ISSUED: �� /,-?1s- DATE COMPLIANCE ISSUED: /3 r� VARIANCE GRANTED: Yes No � . c� - c� �� V �j � F ...�; • � ` .� �. C o S r � R � .E � ' -� a -' .; No.............. a!? ►Ep `r' Fim.. ,..�:.�C'�.... J� 1BertWMCommeiOA :� COMMONWEALTH OF MASSACHUSETTS ��teb�— OARD OF HEALTH fined *! TOWN OF BARNSTABLE Appliration for Biopwial Work,i Tontrnrtion Permit Application is hereby made for a Permit to Construct ( ) or Repair (c,4-"'an Individual Sewage Disposal System at: ......... a.-� Y � ��. ......v �---------- -------•----•-•••---• � �� V�_- or Lot No. ---------------------- Locati -t\ddress •--•-•---•-_-••----•-•---•----------•----- a `fin. . Owner ress a ......................... k.. S�-... &Z.------ •-------•: ((��_��. =�� t:�a��----...........••. Installer Ad ress d Type of Building 2 Size Lot................ q. feet ►. Dwelling— No. of Bedrooms.--3..................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ...................................................... Design Flow......... ....................gallons per person per day. Total daily flow..... ......................gallons. WSeptic Tank--�Liquid'capacitv.VV�_galIons Length.----. .... Width_�5----------- Diameter................ Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------- Diameter---.--(_0.%....... Depth below inlet...(91........... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................•••---•-•--•----•------••......-•••-•--•--••----•.. Date........................................ W ,a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water......................... f1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... R: 0 Description of Soil........................................................................................................................................................................ x U -------•-•-••-••-•--••------•-••-----------•----••-••-•---•••---•••-••------••---•-----------------------•-----------. ••--•----•-••••-•---•.....••------••••--------•----------------•••••------...••-- W UNature of Repairs or Alterations—Answerrwhen a plicable.---.' ��j .41_.(.�C�J..�..e. .. .?:< .:-ti eEiv..'...' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of been i u e board f health. ...... . .... 1377 YSigned�........ . Due Application Approved By ................. "a-- ,,�� q..:�.�..-...?Y Application Disapproved for the fo lowing � asons: ........................................................................................... / ................................................................................................................................................................................................................ ........................................ Permit No. .......C?...L.............� Issued Dare �4 �` No................-....... FIzs....3o. ........-�--" TH Ft COMMONWEALTH OF MASSACHUSETTS OF HEALTH TOWN OF BARNSTABLE Applirativit for Dhipwial Wnrkii Tomitrurtivit Verntit Application is hereby made for a Permit to Construct ( ) or Repair (c__)-an Individual Sewage Disposal System at: ....................(ol..... ......v4s'. ........... ... Locati n-Address or Lot No. Owner W -•-•--••--------------- ---'..!!�_.� ._..SZ.C�� 1� �� :�.�A_-��1Jr.. �t SS " ............��.?.�.�5 Installer Address PQ .................... .-Sq. feet U Type o Building Size Lot -•.• Dwelling—No. of Bedrooms._-_- __________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- ------------------------------------------------------------- W Design Flow.........S.s --------------------gallons per person per day. Total daily flow.....3�U-......................gallons. q gallons Length__-__E..... Width ZS....___.... Diameter................ Depth................ W Septic Tank�Li uidcapacity_�CI1_N. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.---.--- ........... Diameter------1 U_._...... Depth below inlet.__ ........... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank Percolation Test Results Performed b e............................... Date........................................ a y.. . - .a Test Pit No. 1................minutes per inch Depth of.Test Pit-----.___................Depth to ground water......................... �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.................. 1:4 --•-------------------------------------------------=-------------------•----•-•-•••--.....-•••--•--••-•----.......--••-..-•-----•----•...............•----• 0 Description of Soil-------------------------------------------------------------- U ----•-•------•-•-----•-------•--------••••••-•----•-•-----••-----•••-•••-----------------•--•-•-•-••----••----------------••-----••------•---....--------•--•------------------......--•-••-•-••-------. W x ----•----•-•-•---------------------------------------------------------------------------•------------------------....._......---•----------------------------•-•-•----•---------•-•--•-•-••••........•. V Nature of Repairs or Alterations—Answer when a plicable.-__.------ .��.C._ ------•----�n X(a..11...,.�.._a �-.�.�.._................ . •••.....--•..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Comphance_has been i �ue`by the board f health. Signed ...........: - ... ...�� .... .................... ......��.`...�. ..��..t�. Daze Application Approved B ......� 77 - PP PP Y ................ .....� �� ;........V................................................. ... ..?,...... . Application Disapproved for the following reasons: ........................................................................................................................................ ......................................................�.......................................................................................................................................................... ........................:............... Permit No. .........-,►.-v.....-........J...1_ 9 Issued Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE tLErtifirate of Campliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired Y .da. ..L.1 .t�....-C . C............................... ----In;fsller raw-�l.�.!��.......p� I �. t w . at ................................................................................. 1. �': .................................... ................ has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code as described in the application for Disposal Works Construction Permit No. .... .. ...... ..�...3... dated ............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FOCTI ON SATISFACTORY. 4�� .... ............. 6 DATE.................................................... ...............��./....................... Inspector -......... ......... ................................ ------------------ ------------------7----------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �•j TOWN OF BARNSTABLE NO.. .... 3 3 FEE.... . ....... Ropsal Vorks Tnnitrudion rrtnit Permissionis hereby granted............ ... .. - � ----•-----------------------------------------..-.-..---.------------------..-------•-------. to Construct ( ) or Repair ( �an Individual Se rage Disposal System ..........:............................................... 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AND.2813 -------------------- AND_2813 --------- ' I a I v -nWCxZ I A � I Ic°+� I 70OA � I �3 ZEN ° dsp I 01 CP M @ 2 p o 0 O I I A I n O: D r' m I I � rnx I I i nr---------------1 T—f---F,r-1 N N I I I I M 1 - I I I I I 1 x I I O I � I� 1 � 1 � to I ---� I L----- ------� NIMISX3 f121N.di—L--- J OW SS377V.OEX01r - 2' (� 99 N011735 2x8 joists 16"OG x 2 „� O 0. -- ---�S f11ECTION —_ __ v 1 1 _ 0 I I 3 0 av Q i i N � z z W I I 1 I rn I I m C` Ta o ---� — �- -- t, 0 o f i G 3 --- -� o 0 IZR O - L--- ----J 70 I---=-kf►---�nl-- -- Z---- - -->r- N rn zxe joists 16"oG I I ; - �P- I I 1 I I I I II if M 1 I a -----1 1 �__ , O 1 I ------AND 2813 -4 I O I 0 0 4'0" 41-0" O = 1 0 = -V -? n 1 I 0 r O ' 1 I D91 1 6 o: 0,-4„ T a. a. r ------"-------i r-------------- 1 1�—T-0n I l O 1 1 I I I 1 I 1 I I 1 1 1 0 I I d IF L ____________ __ J L_ __________ _ __ _J L_____ J 1J IJ tV lP IJ IJ O n ' u N 1 � O Z I D 4'-0" 4'-0" 5'-0"ADDITION EXISTING HOUSE f---------- ---------------> Your Plan Store DESIGNED FOR 60 60EXLEBDEv FRANKLIN AVENUE ALLEN B.OSGOOD HYANNIS MA NI NOTE:The purchaser of these plans is responsible for compliance with all STATE and LOCAL Builds codes and ordinances. RESIDENTIAL DESIGNER P D D D Building ns S110" APRLL 2015 Neither ALLEN B.OSGOOD or participating designers&engineers may be held responsible for changes made to,or the use of these O.PLANS-CUSTOM HOMES-ADUMONS HISTORICAL REPRODUCTIONS DRAY'UNG NP. draulings during construction. While every effort has been made in the preparation of these plans to avoid mistakes,the maker cannot GOM'WfMf c Mt9 PO BOX 10 SANDWICH,MA 02563 PH 503ab"69 A_2 guarantee against human error,therefor the purchaser is responsible to verify all elements of these plans for design,accuracy and l EMAILWuML—stm@,e .n.t reo+551011 s exalaene" sizes,wtih their builder,prior to the start of construction.NOTE PLANS ARE PROTECTED BY COPYRIGHT c 2015 ff. �d 1 D I IR 'o- I �a sz4• G I I $ 12'-2 a-r 1z-r ao ea a r v r r 1 m i A (l�C im o z I I `o A I � aexw�as ampu.,e•oc S d N I � b•r 'e i 'a, 4 — 'ZI U► aL _ r o O i I 1 3 6 j le to _ 4 I N � an4 ,rx a 9 -4 L-------- I 1 51 O I 1 O M I'll L iN11to owu�imp� `�y.4• l r.711 i i om -- -------------- ----------------- 171 x= A s of i' -- =-9J Nm -1 Z z M - ' 7C L -R G% a Z n r I � ss xOuaas I 70 D s q r I � N�. 40• 3N rn � 0 tr a,opa,e• r O Z 7-1' 4'-7 9'•11' 1,3.11• 3'5• r 244' � sr4• r F �a O 4 ® -- 70 -r -- --- -- I W, a' ---�_ --------------------i I _ I (1 W rn I =' 4. 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While every effort has been made in the preparation of these plans to avoid mistakes,the maker cannot LOrlR W c WIB PRAYUNG NP. PO WAX 7355ANDY'UCH,MA 02%3 FH 505ab4-53M ""1061^"'�'�R"F0 _3 guarantee against human error,therefor the purchaser Is responsible to verify all elements Of these plans for design,accuracy and V3E OF IRESE P1AR9 rQ1ROUT sizes,with their builder,prior to the start of construction.NOTE PLANS ARE PROTECTED SY COPYRIGHT c 2015 EMAILy�rIr011.net rem,e,51OR m ntamrteO r I rt: i i c m 28'-0" I �t 13'-11" 14'-1" —I � CONTINUOUS RIDGE VENT 2 LSTAq STRAP OVER RIDGE I RIDGE IPLATE - '3 V Ea,Prs 2 LLAR IES °O ROOF ASSEMBLY:5/8-GDX SHEATHING W/15 LB L (5)10D®EA.RAF FELT ROOFING PAPER,AND ASPHALT SHINGLES AS $ a v G• TO JST. I /PER MANF.5 IECS.=6°EDGE5/6°FIELD 0 m W s 0'-1" v 'S to b'-0" o m ,g' - g N 5S to BLK®32"OC FOR 1ST 2 61,0 I / \ S W I \ I BAYS,BOTH GABLES,TYP. I I 1 10 QQ c -y0� I� H7.9A,� I (8)1 ®EA.RAF.TO JST. R 44 ATTIC INSL. 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SOLID BRIDGING®GIRT 3/4"T&G SUB FLR.GLUE 8 NAIL I (DBL.®LOAD POINTS) - IV R.JSTS®16°O.G. 2X8 FLR.JSTS®16°04' R-25 \ LU R-25 R-25 (3)2X8 GIRT --_�_�--- f d) 3.5"DIA.STL/CONC. v __ 8 8"X48"+l-REINFORCED GONG. 0._ LALLY COLS o EE SEP.UFP DETAIL i WALL MIN.3,0001i"MIN. 12'-1° 12'-2" ALL EXST FND. $}� 16"X12"FTC."REIF. 8"XT'8"+/-REINFORCED GONG.WALL MIN.3,0001I I c n g I 6i 4• 10• r 4 4"+/-GONG.FLR.W/b MIL.FOY o a ° $eta - o W BARRIER MIN.3000# l I I I a° 4• "'. tr a NE FTG'S®VARIOUS `'' FORMED 30'X 30'X 1' LOCATIONS-SEE FND PLAN O LALLY BASES y y. no Ws T, SECTION A-N.T.S.NEW FTC.3,000# { SECTION A-N.T.S.NEW FTC.3,000# � _ � _ i Q,�—n yl❑ d GRO55 5EGTION AA - 28' GARRISON ADDITION 56ALE: 1/211 =1'-0" =A 3 0 1 5 o= SCALE i i 1 r I I �zp 00 i -nm z n I I A o, m z O I U) ;v I r N M m x � I � 7moo Nn N m I X A N ---- ---- --------- o rn O - - - N \ Z A A A C% r N .,� 1 Rt O � D 13 ZD° z cp N z ?B m ° n C r 'a o _ N ® o C 0 rn- rrrrri� IS � N A C� r � z -— VL O m zoo z d C11 -nou� nnU3io Mf�' 70 = = CNN O �� o rn � z > � Z rnz -4 ° w = = C1 W N �° � � � � � z C a � z 3 N O • ° z Z O z %" 70 rn • 4G% rcpiiACN z ,,, rnz = � 4 p rn NZQorXtp F-1 Ov GIIIIIIIIIIIII a, 03 U3dTr > A O m rn d � F U3 r az p rnC, G o x � O rnd � rn ; U3 N G% N N O N 70 N� m ' O rn rn , z � z v rn � -4 'n rn 3c n U, U3 d � 0O AC N I z rni � u o d � 7rno N U E t n � p It o '0 o rn N {tm N rn 3 N 111Lt ti N Your Plan Store OESIGNEDFOR 60FRANKUN 60 FRANKLIN AVENUE ALLEN B.05000D SCALE LATE HYANNIS MA 02601 NOTE:The purchaser of these plans is responsible for compliance udth all STATE and LOCAL Building codes and ordinances. RESIDENTIAL DE516NER ASSH" APRIL2015 Neither ALLEN B.05GOOD or rtici OCK PLANS-CUSTOM HOMES-ADDmONS pa pating designers 8 engineers may be held responsible for changes made to,or the use Of these T HISTORICAL REPRooucnoms 5 axis dra+rings during construction. While every effort has been made in the preparation of these plans to avoid mistakes,the maker cannot wma�wr c ow�ralw No- PO BOX M 5ANDMCH,MA 0250 PH SOMM-53M e � A_C, guarantee against human error,therefor the purchaser Is responsible to verify all elements of these plans for design,accuracy and EMMLwumwnswm@vctm.net rerwgsvx 6 s,rec sizes,urith their builder,prior to the start of construction.NOTE PLANS ARE PROTECTED BY COPYRIGHT c 2015 b' 24'-2 3/5" 41/2" 415/16" 32'-0 I/8" 415/16"-11'-6" N 11'-6" 1' 3'-11/2"1/2' '� 2'-111/4" 10" 10" 10" —4'-4" 2'-7" 4'-6 3/4'. 4' 22'-0 1/2" —l'-2 3/8" — xttb xavv� � 4' W A F2'--i A N Y C? A m I � z ^^Z m � A LU a J O A I W A N � G w u] w rn � N N W N� b _ b I ;_ r o fJ D �� O` I � A �= I - • A A m 0 10" D T-2 3/6"— ,I -w N a �^I x ° —�= I I rn TT J to x A O N I O O W e Q _ O y ']0 _ - �`� ]txw 'w vJ p D 4, 2,-t1 4,-T„ { 415/16" 41/2" 415/16" j G) 4-2 3/ X 10" 22'-4 1/2" 10" 24'-0 1/2" 32-2 3/4" 415/16"-11'-6" 41/2" 1V-6„ 415/16" �, 7/16„ 415/16" 2'-413/16" 3'-11/2''1011/16"3,3,8l/2" 0" 3'-3" T-61/2" z cu 11 f A r N O N 01 N N O I ,1 D N J N 4 _W g ,N 1 N _ x t ! n A O A - N W• �/ j Zxece J =z U3 _�! O N A 32'-2 3/4" D w w j 'b-1 x r 4 15/16"-11'-6" 4 1/2" 4 15/16" T-'1l/16" 4 15/16" LU } i N J 2'-413/16" 3'-1 1/2"-1011/16" ,81/2' 0" l' 3-3 3'-3 -6 1/2" Z I vboH O ' b I I xs aoH I moo A n Q'-41/2' 1'-11 15/16" � IT nI =C1 4 15/16" 4 15/16" N i5-, 4! -�%j c. K2_ I Y O N N Q. N I -40 A O� N x w _ G N f N A N I mI x z > tj I o N UI. A Ob N A Z Q We CIL 1 W 4,_6„12,-11„-4,-1„ 4 15/16" 4 1/2" 4 15/16" O ° x A f - j I N QI n 3'� c2'-4 1/ A Q N p 4 15/16" 4 15/16" m A p, N N Orn N J I11 _ -N _ ti � — I Jo X o ° I A A 4 N A x«xm, O T7 w O a 4'-b" 2'-11" 4'-1" 415/16" 11'-b" 41/2" 415/16" O 24'-2 3/8" (n } m 0 d f i I = n pD DRAWINGS PROVIDED BY: PROJECT DESCRIPTION: SHEET TITLE: NO. DESCRIPTION BY DATE m 1= rn rn DESIGNER 60 Franklin ave Hyannis MA 02601 1 r co m R15 Z 0 3/4" T&G PLYND W 0 0 Z 5/8" PT PLYWOOD 2x8 PT TOP PLATE N w 6 MILL.POLYETHYLENE FILM = w O > t0 Q N 4' MAX. BACKFILL Q BACKFILL Y ZN AIR 5PAGE 0� ~ a_ LL z z O Q Q � } G = W 0 a w 0 w MIN. 3 1/2" CONCRETE 5LAB coJ 6 MILL.POLYETHYLENE FILM ON GRAVEL BACKFILL o } MAX 3/4" GRAVEL w w tn 9 1/4" z Q 2X8 BOTTOM PLATE 0 16" 2X1O 51LL PLATE DATE: FOUNDATION AND CROSS SECTION DETAIL SCALE: 1"=1' SHEET: A-2