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Commonwealth of Massachusetts
Title 5 Offici I In a se inF p ct o Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y�. 155 Mitchells Way, Hyannis M -290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin_
Owner Owner's Name
information is required for every P.O. Box 1145, Barnstable _ MA 02630 December 13, 2011
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form. r a
Important:When filling out forms A. General Information
�" �,;
on the computer, ! -
use only the tab 1. Inspector: -
key to move your -
cursor-do not Troy Williams `
use the return key. Name of Inspector �?
Troy Williams Septic Inspections
4:11 Company Name a £ r �
19 Hummel Drive
Company Address
South Dennis MA 02660
City/Town t State Zip Code
(508) 385- 1300 S1682
Telephone Number License Number
B. Certifidation
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 performe6based 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:
y
®: Passes ❑ Conditionally,Passes ❑ Fails
} y
El
Needs Further Evaluation,by the Local Approving Authority `
'December 13, 2011
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. q
�{ v
t5ins-11110 Title 5 Official Inspection Form:Subsurface ge Disposal System-Page 1 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is required for every P.O. Box 1145, Barnstable MA 02630 December 13, 2011
page. Citylrown 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:
System meets minimum standards set by Massachusetts DEP at the time of inspection only.This
inspection is not a guarantee or warranty on the future working conditions of leaching, pipes,
components or the future structural integrity of said components and only represents conditions found
at the time of inspection only.
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 ❑ NO (Explain below):
N/A
t5ins-11/10 Title 5 Official Inspection Form:Subsurface pecU Sewage Disposal System•Page 2 of 17
f
Commonwealth of.Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for-Voluntary Assessments
i
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is
required for every P.O. Box 1145, Barnstable MA 02630 December 13, 2011.
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
I _
❑ t broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
El distribution box,is.leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
N/A ,
I
d
t
❑ 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):
N/A
j
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.
4
1.. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
1
Commonwealth of Massachusetts
lugTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is P.O. Box 1145 Barnstable MA 02630 December 13,
required for every � 2011
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 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:
N/A
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
t5ins-11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form.
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'e 155 Mitchells Way, Hyannis - M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is p O. Box 1145, Barnstable MA 02630 December 13 2011
required for every ,
page. Citylfown 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 16,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area-IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
NUM
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is required for every P.O. Box 1145, Barnstable MA 02630 December 13 2011
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 systern components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable)[310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 3 Number of bedrooms(actual):
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
lugTitle 5 Official Inspection Form
Subsurface Sewage Disposal System form-Not for Voluntary Assessments
155 Mitchelis Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is
required for every P.O. Box 1145, Barnstable MA 02630 December 13, 2011
page. Cityrrown -State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents:
0( 1 prior)
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes Z No
Laundry system inspected? ® Yes ❑ No
Seasonal use? ❑ Yes 0 No
Water meter readings, if available last 2 ears usage d 10=32,000 gals.-
g ( Y g (gP ))' 09=38,000 gals.
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: July 2011
Date
Commercial/industrial Flow Conditions:
Type of Establishment: N/A
Design flow(based on 310 CMR 15.203): N/A
Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.): N/A
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: N/A
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
155 Mitchells Way, Hyannis M -290 P-73-5
lug —
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is P.O. Box 1145 Barnstable MA 02630 December 13,
required for every � 2011
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: N/A
Date
Other(describe below):
General Information
Pumping Records:
Source of information: No pumping info was available.
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)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):
15ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official-Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin -
Owner Owner's Name
information is required for every P.O. Box 1145; Barnstable.,, MA 02630 December 13, 2011 `page. Citylrown State Zip Code Date of Inspection
D. System Information (corit.)
Approximate age of all components,date installed (if known)and source of information:
Tank, d-box and leaching were installed on 9/12/90 percompliance.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 18'
• feet
Material f a o construction: :
El cast iron ®40'PVC ❑ other,(explain):
Distance from private water-supply well or suction line: _ N/A
feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Lines were found clear at the time of inspection.
Septic Tank(locate on site plan):
Depth below grade: feet
Material of construction: F
®concrete ❑ metal ❑ fiberglass . ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confrmed•by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
6'X10.5'X6' 1500 gallon
Dimensions:
Sludge depth: 4"
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is required for every P.O. Box 1145, Barnstable MA 02630 December 13 2011
page. Cityrrown State Zip Code Date of Inspection
D. System Information (coat)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
2'8"
Scum thickness none
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
14"
How were dimensions determined? probe/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.):
Concrete inlet and outlet tees were found present and in working order. No evidence of leakage or
damage was found. Tank was not in need of pumping at this time.
Grease Trap(locate on site plan):
Depth below grade: N/A
feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
N/A
Dimensions:
N/A
Scum thickness N/A
Distance from top of scum to top of outlet tee or baffle N/A
Distance from bottom of scum to bottom of outlet tee or baffle N/A
Date of last pumping: N/A
Date
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal Sys_em-Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not,for Voluntary Assessments
yt 155 Mitchells Way, Hyannis M-290 P-73-5 r
Property Address
Estate of Dale R. Pelletier.c/o Attorney Thomas Paquin
Owner Owner'sinformation is Name
required for everyP.O.O. Box 11 45 Ba
rnstable
MA 02630 December 13, 2011
page. CitylTown 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.):
N/A
Ti .
ht rHli 0 Holding n Tank tank must be pumped at time of inspection)n s act o locate on site Ian
9 9 ( P P P ) ( P ) ,
Depth below grade: N/A
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
N/A
Dimensions:
' N/A .
Capacity: N/A
P �' gallons
`Design Flow: N/A
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.):
N/A
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
.'� 155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is P.O. Box 1145, Barnstable MA 02630 December 13,
required for every 2011
page. City/Town 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 level
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D-box was found level and in working order.
Pump Chamber(locate on site plan).-
Pumps in working order: ❑ Yes ❑ No
Alarms in workingorder: Yes No
❑ ❑
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
N/A
Soil Absorption System SAS locate on site Ian excavation not required):
P Y ( ) ( plan,
If SAS not located, explain why:
t5ins-11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System.Form-Not for Voluntary Assessments
'( 155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is required for every P.O. Box 1145, Barnstable MA 02630 December 13 2011
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number: 1 -6'X6'.pit with
2 of stone
❑ leaching chambers number:-. `
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number: _
❑ innovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leach pit was dry on inspection found with a visible stain line approx. 18" below inlet invert. No
evidence of hydraulic failure or problems in the past were found at the time of inspection.
Cesspools
p (cesspool must be_pumped as part of inspection) (locate on site plan):
Number and configuration N/A
Depth—top of liquid to inlet invert N/A
Depth of solids layer
N/A
Depth of scum layer . N/A
Dimensions of cesspool N/A
Materials of construction N/A
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal
p g System.•Page 13 of 17
v
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is P.O. Box 1145, Barnstable MA 02630 December 13, 2011
required for every
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.):
N/A
Privy(locate on site plan):
Materials of construction: N/A
Dimensions N/A
Depth of solids N/A
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
N/A
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
155'Mitchells Way, Hyannis M -290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
informrequired
is P.O. Box 1145, Barnstable MA 02630 December 13, 2011
required for every
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. 'Locate.
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
f
- 3� Vt f 13( r 5 '
y
Mfg
3 3 3wo(
3
51
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is required for every P.O. Box 1145, Barnstable MA 02630 December 13 2011
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
❑ Surface water
® Check cellar h k II r
❑ Shallow wells
Estimated depth to high ground water: 13.0'+
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. 6/5/90
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:
MIW 29 Zone C 7.9' 2.9'adjustment
You must describe how you established the high ground water elevation:
Test hole recorded on plan showed no water found at 12.0'. Hand augered 3.0' below bottom of
leaching with no water found at a depth of U.S. Groundwater adjustment at the time of inspection
was 2.9'. USGS groundwater maps showed groundwater to be approx. 17.7'. Bottom of leaching at
11.3'was found not to be located in the high groundwater elevation at the time of inspection.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•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
yy 155 Mitchells Way, Hyannis M-290 P-73-5
Property Address
Estate of Dale R. Pelletier c/o Attorney Thomas Paquin
Owner Owner's Name
information is required for every P.O. Box 1145, Barnstable MA 02630 December 13 2011
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 depthtohigh groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
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FF �fp�
Commonwealth of Massachusetts � f�Executive of Environmental Affairs
DEP
Department of .41
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Environmental Protection
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address:
Address of Owner: C� :�,r• -� �,;`:�
(if different)
Date of Inspection:
Name of Inspector: tj, ,,
Company Name, Address and Telephone number:
CERTIFICATION STATEMENT
C%?-L
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
- Passes
---- Conditionally Passes
---- Needs further evaluation by the local Approving Authority
---- Fails
Inspector ' s Signature: / �� 1 D ate: ,
The system Inspector shall submit a copy of this inspection report to the Approving
Authority 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 or the Department
of Environmental Protection.
The original should be sent to the system owner and copy sent to the buyer, if applicable
and the approving authority.
..t
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
Owners :
Date of Inspection : i A
INSPECTION SUMMARY:
Check A, B, C, or D
A) SYSTEM PASSES:
1-1 have not found any information which indicates that the system violates any of the
failure criteria as defined in 310 CM 15.303. Any failure criteria not evaluated are
indicated below
B) SYSTEM CONDITIONALLY PASSES:
---- One or more system components need to be replaced or repaired. The system, upon
completion of the replacement or repair, passes inspection.
I ndicate yes, no, or not determinate (Y,N, or N D). Describe basis of determination in all
instances. If "not determinated", explain why not.
---- The septic tank is metal, 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 conforming septic tank as approved by the Board of
Health.
---- 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
H ealth).
----- broken pipe(s) are replaced
----- obstruction is removed
---- distribution box is levelled or replaced
---- 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
1 1
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address :
Owner :
Date of Inspection : \ \
C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
---- Conditions exist which require further evaluation by the Board of Health in order to de-
termine if the system is failing to protect the public health , safety and the environ-
ment.
11 SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES 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 a surface of water
---- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small
marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER
SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC-
TIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY
AND THE ENVIRONMENT.
---- The system has a septic tank and soil absorption system and is within 100 feet to a
surface water supply or tributary to a surface water supply.
--- The system has a septic tank and soil absorption system and is within a Zoned
of a public water supply well.
---- The system has a septic tank and soil absorption system and is within 50 feet
of a private water supply well.
---- The system has a septic tank and soil absorption system and is less than 100
feet but 50 feet or more from a private water supply well, unless a well water analy-
sis 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 nctrogen is equal to or less than 5 ppm.
D)SYSTEM FAILS:
-- I have determined that the system violates one or more of the following failure criteria
as defined in 310 CM 15.303. The basis for this determination is identified below.
The Board of Health should be contacted to determine what will be necessary to cor-
rect the failure.
---- Backup of sewage into facility or system component due to an overloaded or
or clogged SAS or cesspool.
4
t i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
Owner.
Date of Inspection : \
D) SYSTEM FAILS (continued)
--- 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 over-
loaded or clogged SAS or cesspool
--- Liquid depth in cesspool is less than 6" below invert or available volume is
less than 1/2 day flow.
-- 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 Soil Absorption System, cesspool or privy is below the high
groundwater elevation.
--- Any portion of cesspool or privy is within 100 feet of a surface water supply
ortributary to a surface water supply.
---Any portion of a cesspool or privy is within a Zone I 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 ana-
lysis. If the well has been analyzed to be acceptable, attach copy of well
water analysis for coliform bacteria, volatile organic compounds, ammonia
nitrogen and nitrate nitrogen..
Y
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: SS to
Owner: 11-
Date of Inspection : ;
E) LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria above :
The design flown of system is 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 :
--- 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.
The owner or operator of any such system shall bring the system and facility into full compli-
ance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00.
Please, consult the local regional office of the Department for further information.
}
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: i S J
Owner:
Date of Inspection:
Check if the following have been done :
Pumping information was requested of the owner , occupant and Board of
H ealth.
?�- None of the system components have been pumped for at least two weeks
and the system has been receiving normal flown rates during the period. Large
volumes of water have not been introduced into the system recently or as part
of this inspection.
=� As built plans have been obtained and examined. Note if they are not available
with N/A.
- The facility or dwelling was inspected for signs of sewage back-up.
- : The system does not receive non-sanitary or industrial waste flown.
X The site was inspected for signs of breakout.
All system components, excluding the Soil Absorption System, have been
located on the site.
The septic tank manholes were uncovered, opened and the interior of the sep-
tic tank was inspected for conditions of baffles or tees, material of construc-
tion, dimensions, depth of liquid, depth of sludge, depth of scum.
. The size and location of the Soil Absorption System on the site has been deter-
mined based on existing information or approximated by non-intrusive methods
-� The facility owners and occupants if different from owner were provided with
information on the proper maintenance of Subsurface Disposal System.
I x M
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: �S%s
Owner: k=c--,�,)_t,�
Date of Inspection:
RESIDENTIAL:
Design flow : gallons
Number of bedrooms o 2
Number of current residents: C.
Garbage grinder (yes or no) : Lz_,(-.
Laundry connected to system (yes or no):
Seasonal use (yes or no) : t� o
Water meter readings, if available:
Last date of occupancy :
COMMERCIAL/INDUSTRIAL:
Type of establishment:
Design flow : gallons/day
Grease trap present: (yes or no)
Industrial waste holding tank present (yes or no) :
Non-sanitary waste discharged to the Title 5 system (yes or no) :
Water meter readings, if available
Last date of occupancy :
Other: (Describe) .................................................:..........................................................
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information :
System pumped as part of inspection (yes or no) :....!J %........
if yes, volume pomped : .................... gallons
Reasonfor pumping :............................................................................................................
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Date of inspection:
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)
-- Other (explain)...........................................................................................
APPROXIMATE AGE of all components, date installed (if known) and source of information
J,....`!.^�.� :...G�?.. ,. . ?.T.. :'.^—....�......................................
................................
Sewage odors detected when arriving at the site : (yes or no).....tu.c:r..
SEPTIC TANK : .. 4 ...
(locate on site plan)
Depth below grade: ..k:.`....
Material of construction: ..X.. concrete ......... metal ........ FR P ........ other (explain)
................................................................................................................................................
Dimensions: .�.�
Sludge depth :..:-3`.......
Distance from top of sludge to bottom of outlet tee or baffle:....... .................
Scum thickness :....t.:..............
Distance from top of scum to top of outlet tee or baffle: .......... ..................
Distance from bottom of scum to bottom of outlet tee or baffle :...!. .................
Comments :
(recommendation for pumping , condition of inlet and outlet tees or baffles, depth of liquid
level in relation to outlet invert, structural integrity, evidence of leakage, etc.)......................
ry.:. . .... ..��s%�4��c.�t;Sl...�:cx:S..�..n.��:��?.-�,�...:,:,�.:¢..,N:�.Zi��.. C1.►?���.�\�'?-�: .,,�:��ts�.�4-�- 1:��i�.,��'�4 I
4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: i'S 5 to.�-cSZ r, �►_, :-`
Owner: i-)�-- ,
D ate of inspection: \ \ w
GREASE TRAP :
(locate on site plan)
Depth below grade:
Material of construction: ........concrete.........metal........FR P........other(explain)....
.............................................................................................................................
Dimensions:...............................
Scum thickness:........................
Distance from top of scum to top of outlet tee or baffle:.......................................
Distance from bottom scum to bottom of outlet tee or baffle:...............................
Comments:
(Recommendation for pumping condition of inlet and outlet tees or baffles, depth of liquid
level in relation to outlet invert, structural integrity, evidence of leakage, etc.)........................
................................................................................................................................................
................................................................................................................................................
TIGHT OR HOLDING TANKS:.... 'C...
(locate on site plan)
Depth below grade:...............
Material of construction:........concrete........metal.........FR P..........other (explain)..........
................................................................................................................................................
D imensions:............................
Capacity:....................gallons
Design flow:...............gallons/day
Alarm level:.............................
Comments:
(condition of inlet tee, condition of alarm and float switches, etc.)
................................................................................................................................................
............................................................................................................................................
R y K
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: %S 5
Owner:
Date of inspection:
DISTRIBUTION BOX:..V,�..S
(locate on site plan)
z
Depth of liquid level above outlet invert:...
Comment:
(note if level and distribution equal eM,ence of sal' s carryover, evidence of ( akage. into
auk of box, ekc.)..�G:C� x a.... 'R�,
G �.........................................................................
PUMP CHAMBER:...t-:TC..
(locate on the site)
Pumps in working order: (yes or no)...............
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)....................
................................................................................................................................................
................................................................................................................................................
SOIL ABSORPTION SYSTEM (SAS):...UC.Z�.....
(locate on site plan, if possible, excavation not required, but may be approximated by non-
intrusive methods)
If not determined to be present, explain:
. ................................................................................................................................................
................................................................................................................................................
Type:
leaching pits, number: ...>.... ..i�:
leaching chambers, number:........
leaching galleries, number:...........
leaching trenches, number , length:.....................
leaching fields, number, dimensions:...................
overflow cesspool, number:..........
Comments:
(note condition Qf soil , signs of Odraulic failure leve of ponding, condition of vegetation,
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property address: k_ _
Owner:
Date of inspection:
CESSPOOLS:...�1 ..
(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: .....................
Indicator of ground water: ....................
inflow (cesspool must be pumped as part of inspection)
' Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.)
................................................................................................................................................
................................................................................................................................................
PRIVY : ....�?�%...
(locate on the site)
Material of construction: ...................................
Dimensions: ......................
Depth of solids: ................
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.) .
................................................................................................................................................
N y N i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address :
Owner:
Date of inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks locate at
wells within 100'.
III ��;.,,;sr•,p.
p
rim S,
� of
3 �3 3� ,
DEPTH TO GROUNDWATER:
Depth to groundwater: .!5.4.feet
Method of determination orapproximative:
Jr ,.
.......................................................................
cP ANTLANTIC ENVIRONMENTAL
P.O.BOX 2384
i MASBPEE,MA 02649
y�
G �3
�I
Attn: Commonwealth of Massachusetts Date: 02/06/96
Town of Barnstable
Board of Health
367 Main Street
Hyannis.MA 02601
From : Mr Michael DeDecko
Po Box 2384
Mashpee MA 02649
Dear Board of Health Official;
I certify that I have personnally inspected the sewage disposal system at the following
address : 155 Mitchells Way,Hyannis Ma.
The information reported is true, accurate and complete as of the time of the inspection.
I have not found any information which indicates that the system fails to adequately
protect the public health or the Environment.
If you have any questions regarding this inspection,please contact me at this number:
(508)477-14-20. Thank you.
Sincerely;
Michael DeDecko
phone 508 477-1420
TOWN OF BARNSTABLE
LGCATION it r t aI&Y SEWAGE # t7
VILLAGE gAA//V M ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. -MOB
SEPTIC TANK CAPACITY O'D c c4l't,,;6 '
LEACHING FACILITY:(type) (size) Q
NO. OF BEDROOMS PRIVATE WELL O . PUBLIC WATE
BUILDER-OR OWNER 11 tI L.L-T WILL $40A
DATE PERMIT ISSUED: i�— Ay— 9�
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No #0
M
,►
.r
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN BARNSTABI;E
.. ...................- OF..................� .., =... .......................................................
Appliration for Biiivvii al Workii Towitrurtion rumi#
Appl• o is.hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at ~
Mitehells Way
��5
Location-Address or Lot No.
......................--..............Builtw.ell...Homes................. 1Q�_1...RQute...6As.arew.ster.,-MA...... 2F-31-----
wner Address
9
Installer Address
Type of Building Size Lot-------_4._3,-_-64__..Sq. feet
V Dwelling—No. of Bedrooms............... hree-_...-_.__.._..Expansion Attic ( ) Garbage Grinder { )
Other—T e of Building ... No. of persons........................... Showers — Cafeteria
P4 Other fixtures .................
Design Flow..................... 5_.._............_.gallons per person per day. Total daily flow.................330 gallons.
WSeptic Tank—Liquid capacity---150allons Length_lo.�_6��. Width__5_'8_....-- Diameter------ Depth... '111.
x Disposal Trench—'�o..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No.........1---------- Diameter..._.__.._.•_..._. Depth below inlet.__......6.'...... Total leaching area_266.40sq. ft.
Z Other Distribution box (X ) Dosing tank ( )
`-' Percolation Test Results Performed by..........Doyle En�ineerinc� ......... Date__June...5_,1990......
a ____---minutes per inch Depth of Test Pit----- Depth to ground water -___Test Pit No. 1___.__ 2 .__.__-.
(s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O Description of Soil.......0........ 2°__-Top.&---subsoil .42"------.144't-_-M_a ulll...5.anC1------------------------•-----•----
x
w
-----------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable................................................................................................
-•---------------•---------------------•-----------------------------------------------..........-•-----•----......--------------------------------- ...................................................
Agreement:
The undersigned agrees to install the aforedescribed Indivi t 1 Sewage Disposal System in accordance with
r-i x-�
the provisions of �nT-: of the State Sanitary Cod = he u signed fur` r4agrriot to place the system in
operation until a Certificate of Compliance has been • e oar t lth.Signed•---.....•-•- -•--•-......._•••-••• .._--•••- -•----••-••• : .
ate
Application Approved By......... ------•-•------•--•--••-•-•--•--------------- ......Z.. /.5--- �rG
Date
Application Disapproved for the following reasons--------------------------------------------------------•-------------------------------•---••-•-•-••--•----••---
.........-•---••-•••---•-----•••--•---•---••-•-•••---•-----•-••---•-•-•-•-•-•--••._...-••-•----•--••.......-----•-•-•-----•--------------•---•---•-•••-••-•-----•••-•-----•-----•-••-••••----•--•---••---
�J► Date
Permit No. ! �-�--��- Date
- Issued.......................................................
La.-
THE COMMONWEALTH OF MASSACHUSETTS
:...
BOARD OF ft-1.EALTt-I �.
:
TOWN BARNSTABLE
..
:, - s-•rid.q,. _ ...__. .. .. ...................
OF........................................
I�
Applirtatiou for Uhgpvii al Workg Tuntitratrtuaat Pumit
;N Y Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: 1
Mitehells way
" Loc ion Address 'or Lot No.
Bultwell Homes . _-6A.er_ewaterlMA.._._A2fi31----
Owner Address 1
W
s ...............................................•-----------...........................••. ....__...-••---...•'•------•------•---'•..._.......-------------••-----•-
Installer Address
UType of Building Size Lot-------43t 964___;Sq.'feet
Dwelling—No. of Bedrooms______________ThY@®...............Expansion Attic ( ) Garbage Grinder; ( )
p; Other—Type of Building -........................... No. of persons.......................... Showers ( ) — Cafeteria,:.( )
' < Other fixtures
l " Design Flow__________________ 56______ allons per person er day. Total daii' `flow____...._.__.___3�0_____._ __._ lons.
1., Septic Tank—Liquid capacity---:�75.7_g'allons Length-1 6fl_ Width_5_I�„.._ Diameter.-__..""____ Depth__., 1.7M .
Disposal Trench—No_ ____________________ Width____`_._.._.__.____ Total Length...........}__ Total leaching area_____ '_: sq. ft.
z' ? Seepage Pit No,_______i---------- Diameter___._.__._s.i.__. Depth;,below inlet__._.____ _.._._. Total leaching area.296'.40 ft.
Other Distribution box Dosing tank
Percolation Test Results Performed by-__._____Doltl---- 91ne ring Date_Ilitl4 ,4 9Q
►-� 2 t
vet ;a Test Pit No. 1______ ________minutes per inch Depth of Test Pit..... _ .________ Depth to ground water_ in '...........
(� Test Pit No. 2________________minutes per inch Depth of Test Pit.................... Depth to ground water.............-----------
. ., ,
0- i` . Description of Soil----•-0__'__42" TO,p--A.-9Ltb80 1- 42"-•--`-'-.144°---MQd�.IXAt___i3�dlft9----------------------
? U ------------------------------------..................................................................
' U Nature of Repairs or Alterations—Answer when applicable-------------------------------------------------------------------------------------
- - _____________________________________________________________________________________________________________________________________________________________________ ________ 4 ^ t
4 r Agreement.
"f N The undersigned agrees to install the aforedego
1 Sewage Disposal System in accordance with +
the provisions of i T`:,s� 5 of the State Sanitary Cigned furt, r agr not to place the system in ' R
a 4f operation until a Certificate of Compliance has been` of lth.Signed_ �_ •�3 -
___________ _______ ___________________ ____._.___.. _..___._.
ate �I
Application Approved By......... �' �-----
�J� - •[r----�--Date-_- - ,.. �.
r
w Application Disapproved for the following reasons______________________________________________________............................................................
_
� 'r ---•----........Permit No.----1_- .-=•-•-. '-7 L.----._.....-•---------------- -----------------..-_..issued-----....-------------------------------•---------- '
M
Date { 4
x•
5-
t, :y
'i. THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH '
..............TOWN.....:..-......OF............BARNATABL.E................................
,.
` (11rdifirate of TaautpliFaatrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired
r by.................. 5 .....h ..
Installer
> at........... ......• F-2�• f----- -------................................ r
has been installed in accordance with the provision of i I i irk. Aof The State Sanitary Code as described in the
ei�A application for Disposal Works Construction Permit No.____,,� ____ . : ......... dated_ ..___-_-______________ ________ ________
tN ,
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
, : ..... ..--DATE......... ---•---- Ins
d....S. THE COMMONWEALTH OF MASSACHUSETTS i
BOARD OF HEALTH
z TOWN BARNSTABLE
.........OF........................'-•......_ •-•••---•.. . .._._._......_...._._............
FEE..fQ492 .......
:Yk Elias osatl Varkii TDO notr ion "Van fit ,
Permission is hereby granted.........C1tn 9tr - - ---------------------------„-_------------•-•-••--------_---,_-___-------_--•-•---
to Construct ) or Repair ( ) an Indiviidu+a'l Sewage Disposal System
atNo................... --•------• ---•- Lc � ' is*-'=-----------------------------------•----__---___-_______
Street
as shown on the application for Disposal Works Construction ermit No. 'J � ___ Dated..........................................
nn'' ...... . .4- ...................................................
DATE.................... _
�4--------------------------- Board of Health
.-=--�--7�---� --
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS -
A_42'29' CB/DH/FND
CB/DH/FND R=g46 08, S �
79 35.30„ E
10.0'� 132 14' CB/DH/FND
N
k
20.0• N
I Lot 5 setbac �'9uir men
is o.o
43,964f S.F. (.5
1.0t Ac. 3' I rn
73 �.
I �
Im
J
61.3' 12.0 36.6'
b rop Exis t. #155 U'
N or. Gar. Exis t. D wg. 0
o'
0
O prop: N
W JI
`} Deck EX%Sr. I
Deck
M I ^ 12.o' 18.o'00
m
IN 00 0 I
NI
Exis
t. I
Z I S.A.S.
I
Proposed per as—built 99'5
IAddition
108.0' I
10.o
/ fo.o'
/ CB/DH/FND
I /
5r
STREET ADDRESS: ,#155 M/TCHELL'S WAY
ASSESSORS MAP 290 PARCEL 73
CB/DH/FND OWNER: SANDRA MALLORY
DEED REF.: BK. 26064 PG. 247
TOWN OF BARNSTABLE ZONING PLAN REF.: PL. BK. 449 PG. 71 LOT 5
BY—LAW
ZONE ; RB I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL
SETBACKS : KNOWLEDGE, INFORMATION AND BELIEF THE DWELLING
FRONT = 20' SHOWN HEREON CONFORMS TO THE HORIZONTAL SETBACKS
SIDE = 10' OF THE ZONING BY—LAW FOR THE TOWN OF BARNSTABLE.
REAR = 10'
PROPERTY LINES SHOWN HEREON
WERE COMPILED FROM AVAILABLE
PLANS OF RECORD AND VERIFIED
ON THE GROUND.
PL 0 T PLAN
THE DWELLING DEPICTED ON THIS SHOWING PROPOSED ADDITION
PLAN WAS LOCATED ON THE GROUND IN
BY SURVEY ON OCT. 20, 2017 AND
EXISTS AS SHOWN AS OF THE DATE BARNSTABLE, MASS.
OF LOCATION. SCALE: 1"=40' OCT. 24, 201.7
THIS PLAN IS FOR PLOT PLAN TERRY A. WARNER, P.L.S.
PURPOSES ONLY. 22 LONG ROAD
HARW/CH, MA. 02645
(508) 432-8309
THIS PLAN /S VOID /F NOT
STAMPED AND SIGNED /N RED. 0 20 40 80
PROJECT N0. 16-142PP
6'3" 74)" 2'-9" 6'3" '
ANDERSEN NDERSEN NDERSEM1'
TW2aa6 PN2446 TW2446 TYP.ABPHAIT ROOF
SHINGLES
12
�8
TYP.PVC 1 x 6 FASCIA,FRIEZE.
A q a
" 8 SOFFIT BOARDS
3L.YPA.
NEW NEW A3 TOP OF PLATE
BEDROOM DECK -
4 ® ® ® ® ®
ANDERSEN FWG60611 U
FRE SLIDING
DOOR
SLIDING DOOR14�Q r 4Tu LL-DOWN CSTAIR A3 SUBFLOOR FIRST R
L---J �VE
B I ALL DETAILS WI OWNERS
MFR.B
`NA3 o A3 FRONT ELEVATION
4
BAT 4
12 T I
NEW NDERSEN TYP,PVC 1 z 6 RAKE BOARD
LIVING �Q TW244s I WI 1 x 3 DRIP BOARD
Exlsr. (VAULTED) Ly J 4
FORMER GARAGE TOP OF PLATE
EXIST. NEWIII Jill
MUDROOM O REIF GARAGE ; ® wz5 L1x4 TRIM
TYP.W.C.SHINGLE
KITCHEN
O flu � SIDING 5"TO
WEATHER O
R*NGE (VERIFY KITCHEN f
Q LAYOUT WI OWNER) a TYP.PVC t z6
CORNERBOARDS FIRST FLOOR
RI
2'6"x fi'6' SUBFLOOR
SINK
EXIST. 1y
CONC.
APRON �O2ERSEN NNDWE6R0 StEN ANDERSEN
6
FDEN[WZ"l AC3 RIGHT
E L E VAT I O N
ER.
OVE
p
14'4T 16'-0- 12-0'
12
44'-TY 6
FIRST FLOOR PLAN TOP DFPLATE
LEGEND: -
NOTES: ® H
O EXISTING WALLS 1.)CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS
IS
&DIMENSIONS IN THE FIELD ti 11 H=I
c 7 CONSTRUCTION TO BE REMOVED 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, g
® NEW CONSTRUCTION DETAILS,&FINISHES IN THE FIELD WITH OWNER FIRST FLOOR
.-FLOOR
O SMOKE DETECTOR
3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT O FIRST FLOOR TO BE 6-10"ABOVE SUBFLOOR
(K)CARBON MONOXIDE DETECTOR 4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS
(fD HEAT DETECTOR STATE BUILDING CODE,8TH EDITION AMENDEMENT&IRC2009
5.) 110 MPH EXPOSURE B WIND ZONE REAR ELEVATION
6.) ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY, 3
OR HORIZONTALLY W/BLOCKING AT EDGES,3"EDGE/12"FIELD NAILING v
7.) ALL LVL LUMBER/BEAMS TO BE 1.9e U360 LOAD
8.) SEE CERTIFIED PLOT PLAN DEVELOPED BY ELDREDGE SURVEYING
FOR ALL PROPOSED&EXISTING DETAILS '
9.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF f -
IECC2015 RESIDENTIAL ENERGY EFFICIENCY DETAILS ALL SIMPSON COMPONENTS
CLIMATE ZONE 5(USE EITHER PRESCRIPTIVE VALUES OR RESCHECK CALCULATION 10.)ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS ' I
TABLE 402.1.2(MINIMUM PRESCRIPTIVE INSULATION&FENESTRATION REQUIREMENTS) TO BE 3000 PSI �. K
FENESTRATION I SKYLIGHT CEILING WOOD FRAMED WALL FLOOR BASEMENT WALL BASEMENT SLAB CRAWL SPACE WALL 11.)VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE
U-FACTOR U-FACTOR R-VALUE R-VALUE R-VALUE R-VALUE R"VALUE VALUE
DURING FRAMING CONSTRUCTION
0.](1 MASS. 0.56 49 M 0113�6 30 15H9 10(4 FT.DEEP) 1W19
AMMEND. 12.)TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE -
NOTES:1.R-VALUES ARE MINIMUMS 8 U-FACTORS ARE MAXIMUMS. 13.)FOLLOW ALL REQUIREMENTS OF THE 110 MPH CHECKLIST SUPPLIED
2.15/19 MEANS R=15 CONTINUOUS INSULATED SHEATHING ON THE INTERIOR OR EXTERIOR 14.)FOLLOW ALL REQUIREMENTS OF THE IECC2015 RESIDENTIAL ENERGY
ii OF THE HOME OR R=19 INSULATION CAVITY AT THE INTERIOR OF THE BASEMENT WALL EFFICIENCY REQUIREMENTS&VERIFY ALL DETAILS WITH THE INSULATION y-
3.REFER TO IECC 2015 CHAPTER 4 FOR ALL INSULATION&ENERGY REQUIREMENTS INSTALLER/CONTRACTOR.
h 4.13+5 MEANS R5 CONTINUOUS INSULATED SHEATHING ON THE WALL EXTERIOR 15.)ALL HEADERS LESS THAN 4'0"TO BE 3-2 X 65 UNLESS OTHERWISE NOTED
&R13 CAVITY INSULATION
THE DESIGNER SHALL BE NOTIFIED IF NY
®C� NEW ADDITION REMODELING FOR• ERRORS C OMISSIONS ARE FOUND ON
R
COTUIT BAY DESIGN. LLC TH ESE DRAWINGS PRIOR TO START OF SCALE : DRAWING NO.
CONSTRUCTION.THE BUILDING CONTRACTOR
43 BREWSTER ROAD WILL BE RESPousIBLE FOR THE CONTENT
MASHPEE,MA. 02649 IN THESE DRAWINGS IF CONSTRUCTION 1/41
1
= 11-OII
MAL L O RY RESIDENCE COMMENCES W THOUT NOTIFYING THE Al
DESIGNER OF NY ERRORS OR OMISSIONS.
H OF THE OWNESE R NONGS TED ANY OTHER USE OF OLELY FOR THE E DATE :
:
FAX(50 )539-9402 TH ESE DRAWINGS REQUIRES THE WRITTEN 1O/25I2O17
155 M I TC H E LL'S WAY, HYAN N I S, MA ARCHITECTURAL
DESIGNERU PRO FICHE
ARCHITECTURAL COPYRIGHT PROTECTION
1 e'n• 1r-v' te'a' tr4r
I
P.T.2 x 10 LEDGER BOARD SCREWED TO 3K1J 2J ZJ 3K1J
SOLID BLOCKING WI(21LEDGERLOK SCRIMS NEW UM DIA.CONCRETE SONOTUBE
16'o.F'W/JOISTE HANGERS.INSTALL W/24-OIA.BIGFOOT FOOTING UNDER-
tNEWCONCRETEOR SIMPSON OTTJ Z TENSION TIES AT NEATHT04'(FBELOWGRAOE-USE _
P.T.TIMBER AREAWAY LOCATIONS FROM HOUSE TO DECK JOIS SIMPSON ASU66 POST BASE
FOR CRAWLSPACE
4 3'd ACCESS
FASTEN JOISTS TO SEA
M
n WI SIMPSON H2.5A TIES 3 A
)76
I I �
I I I 4 m 4
A I i q b
3 A3 NEW o
j CRAWLSPAC I ° 14 F
2"CO NC.SLAB WI6 M C
v POLY UNDERNEATH W A3 N
Ym -------— I
NE.PT 2.i 16-. w
WI MID-SPAN BLOCKING q
I
C 4 x 6 POST FROM RIDGE
ri \/ DOWN TO FOUND.
B B
I A3 3. A3
—— 4
o I I
A3 NSTALL 6 MIL POLY OVER A3 I
XIST.CONCRETE SLAB
x
I \\ 12 RIDGE BOARD
8 1 _ _ 4
I w
F
NEW 3-PT.2.10 GIRT_ \
(FLUSH FRAMED) I I EXISTING RIDGE
SAWCUT 3'0'OPENING
IN EXIST.FOUNDATION FOR NEW
ACCESS UNDER NEW BATHk--NEW3 11T Olk GARAGE
B KITCHEN STEEL LALLYCOLUMN O
(P CONIC.SLAB "1
NEW 30"x 30'x 17 PITCH 2'TO O.H.DOOR
4 CONCRETE FOOTING W/6 x 6 WWFEMBEDDED i EO / 3 NEW ROOF TO BE
z BUILT OVER EXIST. \
4
I ROOFSTRUCTURE
NEW P.T.2x BLOCKING
16'o.c.
EXIST. WI MID-SPAN BLOCKING DROP TOP OF WALL AT
ENTRY 8 O H.DOORS
BASEMENT I I
31<.11 3K,1J
J W EW 4 x 6 POST FROM RIDGE C
—— TO 2-1 3/4•x 11 718-LVL OR, A3
4 CONC.
APRON 14'4F 18'-0' 1Y0
NOTES
INFILL O.H.DOOR OPENING TVP.e'CONCRETE 1.)ALL ROOF RAFTERS TO BE 2 X 10's
W1 CONCRETE BLOCK,FILL C FOUNDATION WALLS ROOF FRAMING PLAN UNLESS OTHERWISE NOTED
CORES E INSTALL 15'LONG A3 WI8-z 18-CONCRETE
ANCHOR BOLTS FOOTING TO 4'D'BELOW 2.)USE LRAFTSIMPSON H2.SA HURRICANE CLIPS
GRADE W/KEY
AT ALL RAFTERS ENDS
3.)VERIFY GUTTER TYPE/LAYOUT
W/OWNERS
tr-0' NAILING SCHEDULE
110 MPH EXPOSURE B WINDZONE
FOUNDATION/FRAMING PLAN JOINT DESCRIPTION NO.OF COMMON NAILS
NO.OF BOX NAILS NAIL SPACING
ROOF FRAMING:
BLOCKING TO RAFTER(TOE NAILED) 2-8d 2-10d EACH END
RIM BOARD TO RAFTER(END NAILED) 2-16 d 3 16d EACH END
6-12'. INSTALL 5/8'ANCHOR BOLTS AT 56-a c.MAX. WALL FRAMING:
FROM END WI SIMPSON BPS 5/8-3 BEARING PLATES TOP PLATES AT INTERSECTIONS(FACE NAILED) 4-16d 5-16d AT JOINTS
OF PLATE CEBOLTSWITHINfF HINMINIMOF EACH
CORNER AND TO A6'MINIMUM DEPTH HST EADER
STUD(FER NAILED) l6d 16d 24"o.c.
HEADER TO HEADER(FACE NAILED) 16d t6d 16'o.c.ALONG EDGES '
FLOOR FRAMING:
F___ -__-_ I JOIST TO SILL,TOP PLATE OR GIRDER(TOE NAILED) 4-Btl 4-t Od PER JOIST
________
1 INSTALL FLASHING UNDER BLOCKING TO JOISTS(TOE NAILED) 2-8d 2-10d EACH END
�: HousewRAP a DECKING BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 316d 4-16d EACH BLOCK
w DECKING LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-16d EACH JOIST
E u i JOIST ON LEDGER TO BEAM(TOE NAILED) 3-ed 3-t Od PER JOIST
BAND JOIST TO JOIST(END NAILED) 316d 4-i 6d PER JOIST
'D a C BAND JOIST TO SILL OR TOP PLATE(TOE NAILEDO 2-16 d 3 16d PER FOOT
FLOOR JOISTS
P.T.2.1 Y' @ 16"o.F. —TYPICAL ASPHALT ROOF SHEATHING:
EFj ROOF SHINGLES
WOOD STRUCTURAL PANELS(PLYWOOD)
518-CDX PLYWOOD SHEATHING RAFTERS OR TRUSSES SPACED UP TO 16'o.c. Bd 10d 6'EDGE/B"FIELD
2 i 10 RAFTERS 154 FELT PAPER RAFTERS OR TRUSSES SPACED OVER 16'o.c. 8d 1 Gd 4"EDGE/4"FIELD
INSTALL PEEL a STICK I USE SIMPSON H25A HURRICANE CLIPS
RUBBER MEMBRANE GABLE END WALL RAKE OR RAKE TRUSS W/O OVERHANG Btl 10d 6"EDGEl6"FIELD
BETWEEN LEDGER S WIND WASH AT ALL RAFTERS ENDS GABLE END WALL RAKE OR RAKE TRUSS 8d 1Od 6"EDGE/6"FIELD
SHEATHING BARRIER TO'WIDE ICEAVATER SHIELD W/STRUCTURAL OUTLOOKERS
ALUMINUM DRIP EDGE GABLE END WALL RAKE OR RAKE TRUSS W/LOOKOUT BLOCKS 81 1 Od 4"EDGE/4'FIELD
w P.T.2,6 SILL WI SEALER PT.2 z 10 LEDGER BOARD SCREWED TO
I SOLID BLOCKING W/(2)LEDGERLOK SCREWS NEW PVC FASCIA,FRIEZE.a SOFFIT CEILING SHEATHING'
16'o.t,WI JOISTS HANGERS.INSTALL BOARDS TO MATCH EXISTING
DECK DETAIL SIMPSON DTTIZ TENSION TIES AT GYPSUM WALLBOARD 5d COOLERS --- 7'EDGE/10'FIELD
LOCATIONS FROM HOUSE TO DECK JOIST 1 x 3 STRAPPING WI
1l2"GYPSUM BOARD WALL SHEATHING:
TYP.214WALLS WOOD STRUCTURAL PANELS(PLYWOOD)
STUDS SPACED UP TO 24'o.c. Bd 10d 3'EDGE/12"FIELD
'y 112"825/32"FIBERBOARD PANELS 8d --- 3'EDGE/6"FIELD
12'GYPSUM WALLBOARD Ed COOLERS ---- 7"EDGE/10"FIELD
ANCHOR BOLT DETAIL DETAIL AT WALL FLOOR SHEATHING
WOOD STRUCTURAL PANELS(PLYWOOD)
SCALE:1/2"=1'-O" l'OR LESS THICKNESS 8tl 10d 6"EDGE/12"FIELD
,{ I SCALE:112"=1'-O" GREATER THAN 1"THICKNESS 1Od t6d 6'EDG E/6"FIELD
THE DESIGNER SHALL BE NOTIFIED IF ANY
ERRORS- ®C� UND ON
NEW ADDITION/REMODELING FOR: CONSTRUCTION.
CTION. HE BUILDINGS ARE CONTR
COTUIT BAY DESIGN. LLC TH ESE DRAWINGS PRIOR TO START OF SCALE : DRAWING NO.:
CONSTRRES ONSIBLEF FOR
CONTRACTOR _
43 BREWSTER ROAD WILL BE RESPONSIBLE FOR THE CONTENT
MASHPEE ,MA. 02649 IN THESE DRAWINGS IF CONSTRUCTION 1%411
MA L L O RY RESIDENCE COMMENCES WITHOUT NOTIFYING THE
DESIGNER OF ANY ERRORS OR OMI UHEJs.PH.(508)274-1166 THE SE DRAWINGS ARE SOLELY FORTHEUSE
FAX(50 )539-9402 OF THE OWNER NOTED.ANY OTHERUSEOF DATEA2
155 MITCHELL'S WAY, HYANNIS, MA COSENTOFTHED DRAWINGS EIGNER UNDERTHEHE C
ARCHTECTURALECOPYRGHT PROTECTION, 10/25/2017
r
I
TYP.ROOF CONST.
-2 x 10 ROOF RAFTERS @ lT 0.c.
-SIB"COX PLYWOOD ROOF SHEATHING
-ASPHALT ROOF SHINGLES
-1518.FELT PAPER 2 x 6's @ 16'0.c.
2x6's@16"oc. -BATT INSULATION(R49) NEW 3-13/4'x 18'LVL RIDGEBEAM
-2.12 RIDGE BOARD
-SIMPSON H 2,5A HURRICANE CLIPS
12 AT ALL RAFTER ENDS 2 x E' @ 16' c.
�e -ICEI WATER SHIELD AT BOTTOM
2
-PROP-ATE OF R VENT BETWEEN RAFTERS i
-WIND WASH BARRIERS
-ALUMINUM DRIP EDGE 12
EXIST,
TOP OF PLATE 2 x 10's @ 16'0.c. TOP OF PLATE 2 x 1,3 @ 16"a.c. TOP OF PLATE
TYP.WALL CONST. TYP.111 GYP.BOARD
ON t x 3 STRAPPING 2-1 314'x 11 1M' SIB'FIRECODE GYP.BD.
1.2 14 STUDS @ ifi'0.c. z_ @ ifi"0.c, z MULT LVL HEADER ON 1 x 3 STRAPPING @ 16'
2.tIT PLYWOOD SHEATHING 0.c.IN GARAGE
^ 3.SPRAY FOAM INSULATION(R20) - GARAGE
4.117 GYPSUM BOARD BEDROOM _ BATH LIVING -
5.W.C.SHINGLE SIDING 71
6.TYPAR EXTERIOR VAPOR BARRIER VERIFY DECKING E ~ -
3I4'T6GPLYWOOD '7 N"CONIC.SLAB
_. FIRST FLOOR SUBFLOOR-GLUED 8 NAILED FIRST FLOOR FIRST FLOOR v
PITCH 2'TO O.H.DOOR
Y W/6 x 6 W W F EMBEDDED
OPTION:2x6 WALLSWI SUBFLOOR SUBFLOOR SUBFLOOR
BATT INSULATION rPT.2.10s@I(E. NEWPT.2x10's 16'0.c.
2�P.T.2x651L1 NEW2z ttls 16'0.c.WI SEALER -P.T.2x 10 BEAM
9'BATT INSULATION(R=30)
TYP.8'CONCRETE CRAWLSPACE SPRAY FOAM INSULATION(R=30) EXISTING FOUNDATION
FOUNOATIONWALLS WALLS TO REMAIN q
W I S'z 18'CONCRETE '
FOOTING TO 4D'BELOW
GRADE W/KEY
.SLABWI6 MIL POLY U SECTION @ GARAGE
POLY UNDER 10"DIA,CONCRETE SONOTUBES
SECTION @ BEDROOM W/24'DIABIGFOOTFOOTINGS SECTION @ LIVING A3
A UNDERNEATH TO 4'(T BELOW
A3 GRADE.
6 POST BASEESON ZMAX
ARI A3
P.T.2,10 LEDGER BOARD SCREWED TO
SOLID BLOCKING W/(2)LEDGERLOK SCREWS
16'o.C.WI JOISTS HANGERS,INSTALL
SIMPSON OTT1Z TENSION TIES AT(3)
LOCATIONS FROM HOUSE TO DECK JOIST
I
INSTALL FLASHING UNDER
I HOUSEWRAPB DECKING '
I
DECKING
FLOOR JOISTS
PT.2.10's@16'o.c.
INSTALL PEEL&STICK
RUBBER MEMBRANE
BETWEEN LEDGER 8
SHEATHING
P T.2,10 LEDGER BOARD SCREWED TO
SOLID BLOCKING WI(2)LEDGERLOK SCREWS
16'0.c.W/ZMAX LU210 JOISTS HANGERS
III DTT12
TENSION TIES AT(3)LOCATIONS
FROM HOUSE TO DECK JOIST
Ill ACH END
DECK DETAIL
I
nl
®C� NEW ADDITION REMODELING FOR• THE DESIGNER SHALL
PRIOR TO
IOF -
COTUIT BAY DESIGN. LLC ERRORS OR OMISSIONS ARE FOUND ON SCALE : DRAWING NO.
THESE DRAWINGS PRIOR TO START OF
CONSTRUCTION.THE BUILDING CONTRACTOR _
43 BREWSTER ROAD
WILL BE RESPONSIBLE FOR THE CONTENT 1/4"
MASHPEE ,MA. 02649 C N DRAWINGS IF NOTIFYING
THE
M AL L O RY RESIDENCE COMMENCES WITHOUT NOTIFYING THE A
PH.(508 274-1166 DESIGNER OF ANV ERRORS OR OMISSIONS.
HE
FAX(50d)C39-(A O THERE DRAWINGS ARE SOLELY FOR THE USE J/
J J J`f L OF THE OWNER NOTED.fW V OTHER USE OF DATE
THESE DRAWINGS REOUIRES THE WRITTEN
155 M I TC H E LL'S WAY, HYAN N 1 S,--MA ARCH,ECTUR1"COPYR�EHTPROTE�TON 10/25/2017
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L STATE TITLE V FOR SURSUPFACE 0 1 S P 0 S A L OE SEWAGE . SC � ►. T. . 1,4 1
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3. 0 E S I G N FLOW .. _BEDROOMS AT 110 GALDAY PER RR . 70 GAL/ RAY Z •2
SEPTIC TANK - SItE _ ?30 u X Is 42'• GA L
{ USE /5oo GAL. W/ &17-- GARBAGE DISPOSAL ( 1
LEACHING SYSTEM : USE (/� ���/A. h G'E�F�Grr►� �Ep -CAST LEACH/uG R/T �33 x x z, , p�
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APPROVED BY oG.
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DATE :
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