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Home My WebLink About0073 DANIELE STREET - Health t 73 Daniele Street, Cotuit A= 027 - 055 -- — - r Commonwealth of Massachusetts �02�~�`� W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c�M 73 Danielle St Property Address Mike Deluga Owner Owner's Nam r information is -f required for every Cotuit Ma 02635 6/5/17 :. page. City/Town State Zip Code Date of Inspections Inspection results must be submitted on this form. Inspection forms may not be altered i any way. Please see completeness checklist at the end of the form. Important:forms A. General Information filling out forms f oZ 3S on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain Q Company Name 8 Johns path Company Address S Yarmouth MA 02664 City/Town State Zip Code 508-364-9587 S113522 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 6/5/17 •I spector'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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 /opa is Commonwealth of Massachusetts , W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G1 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 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: ® 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: System contains a 1,000 Gallon septic tank as well as a concrete distribution box and a 1,000 Gallon leach pit. System is functioning as designed. 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): Title 5 Official Ins ection Form:Subsurface Sewage Disposal System•Pa e 2 of 17 t5ins 3/13 P 9 P Y 9 Commonwealth of Massachusetts M W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is Cotuit Ma 02635 6/5/17 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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):P ❑ 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 pipes) are replaced ❑ Y ElN ❑ 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: ❑ 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts e - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 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: 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 ❑ E Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form: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 M 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 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 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 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 'I Commonwealth of Massachusetts w W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: Vacant Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ❑ No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gP ))� Detail: Vacant over two years Sump pump? ❑ Yes ® No Last date of occupancy: 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.): II� 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 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: None provided 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Original to home Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2feet 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.): System is vented at the roof line Septic Tank(locate on site plan): Depth below grade: 1.5feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1,000 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: P t5ins•3/13 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 73 Danielle St Property Address Mike Deluga Owner Owner's Name ,required for every information is Cotuit Ma 02635 6/5/17 page. City/Town 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 24" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of outlet tee or baffle Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Outlet baffle is in place 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 t5ins•3/13 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 M 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is Cotuit Ma 02635 6/5/17 required for every 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.): Outlet baffle is in place. Inlet is under deck 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 t5ins-3/13 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 M 73 Danielle St Property Address Mike Deluga Owner Owners Name information is required for every Cotuit Ma 02635 6/5/17 page. Citylrown 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 and at normal 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.): 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.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 73 Danielle St �M Property Address Mike Deluga Owner Owner's Name information is Cotuit Ma 02635 6/5/17 required for every � 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: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Clean and dry 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 page. City/Town 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.): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 page. Cityfrown 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 t5ins-3/13 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 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is required for every Cotuit Ma 02635 6/5/17 page. CityrFown 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+ 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: Home backs up to Patty's pond. Ground water level is visible Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 0/2017 Assessing As-Built Cards TOWN OF BARNSTABLE LOCATION 73 Dann;e.jLP 9Aeg± SEWAGE# _ VILLAGE AS /�SESSOR'S MAP&LOT_Z!o � Tn5pe,f,S NAME&PHONE NO.AoLJ 1 ��114, Ywe-8f'z4, SEPTIC TANK CAPACITY 7e—,.,p LEACHING FACILITY:(type) /.¢�3 f (size) /Poo NO.OF BEDROOMS 3 WAU3 BM OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 by Rear o� t-fo�,ate i i 33 Guf Mourn / 4� http://www.townofbarnstable.us/Assessing/HMdisplay.asp?mappar=027055&seq=1 1/2 Commonwealth of Massachusetts w . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 73 Danielle St Property Address Mike Deluga Owner Owner's Name information is Cotuit Ma 02635 6/5/17 required for every page. Citylrown 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 l to P" ro BORTOLOTTI CONSTRUCTION,INC. ytio� 765 WAKEBY ROAD,MARSTONS MILLS,MA 0264 508-771-9399 508428-8926 FAX: 508428-9399 � '1 C SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR- \ ' PART A �`M/y`jyl�/ I t� t CERTIFICATION y ' "c J Property Address: D et r) , v ee T (�o- F 1� 5t Date of Inspection: o? ,, Inspector's ame: Owner's Name and Address: 0 7o � CERTIFICATION STATEMENT: Ice that I have personally inspected the sewage disposal stem at this address and that the informa- tion . �Y Pe Y nspect g po system �. reported below is true,accurate and complete as of the time of inspection.The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The System: ' t/_ Passes Conditionally Passes =� Needs Further Ev tion h Local Aproving Authority Fails Inspector's Signature: Date: The.System Inspector shall sub a copy of this inspeciion report to the Approving authority within thir- ty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 go or greater,the inspector and the system owner shall submit the report to the appropriate regional sL office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: z� _ A)SYS M PASSES: y# " I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 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 comple- tion of the replacement or repair,passes inspection. Indicate yes,nor,or not determined(Y,N,OR ND).Describe basis of determination in all instances. If . "not determined",explain why not. _ The septic tank is metal,,cracked,structurally unsound,shows substantial infiltration or - r - exfiltration,:or tank failure is imminent. The-system will pass4itspection if the existing sep- tic tank is replaced with a conforming septic tank as approved by The Board of Health. F - Sewage backkup or breakout or high static water level observed in the distribution box is due x ; " to broken'or obstructed pipe(s)or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of The Board of Health): . 1 1 ,y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) w~ Broken pipe(s)replaced , Obstruction is removed r Distribution Box is levelled or replaced " <; The System required pumping more than four times a year due to broken or obstructed pipe(s). Q. The system will pass inspection if(with approval of The Board of Health): Broken pipe(s)are replaced ' Obstruction is removed C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE = �}v PUBLIC HEALTH AND 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. ` 3 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- j ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE i .ENVIRONMENT: The system has a septic tank and soil absorption system arid 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 with a Zone I 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 analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from , the facility and the presence of ammonia nitrogen and nitrate nitrogen 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 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of elluent 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 clog- ♦ ged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. .. x Required pumping more than 4 times in the last year NU due to clogged or obstructed pipe(s). Number of times pumped -2- 2 ' 5 1� f C' E. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued). : Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. j Any portion of a: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 I of a public well. p 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 t "' water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for colirorm bacteria,volatile organic .A Y? compounds,ammonia nitrogen and nitrate nitrogen. � E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a 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 s;�• ��; conditions exist: s The system is within 400 Feet of a surface drinking water supply The stem is within 200 Feet of a tributary to a surface drinking water supply system rY g PP Y '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. z, T.h6' wner'or`"operator of any such:system shall bring the system-and facility into full compliance with the , groundwater treatment program requirements of 314 CMR 5.00 and 6.00.. Pteaie consult the local y regional"offce of the Department for further;information.- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B " F : CHECKLIST ` Check if the following have been done: Z Pumping information was requested of the owner,occupant,and Board of Health. >t None of the stem components have been um for atleast two weeks and the stem has ".� system Po pumped s3' <� been receiving normal flow rates during that period. Large volumes of water have not been : introduced into the system recently or as part of this inspection. v," 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 flow. r/ The site was inspected for signs of breakout. ry. ✓ All system components,excluding the Soil Absorption System,have been located on site. aP `r. The septic tank manholes were uncovered,opened,and the interior of the septic tank was in- spected for condition of baffles or tees,material of construction;dimensions,depth of liquid, depth of sludge;depth of scum. , ✓ The size and location of the Soil Absorption Systein on the site hasbeen determined based on existing information or approximated by non-intrusive methods. dv -3- - - F x ✓ fi SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B Via; CHECKLIST(continued) ' The facility owner(and occupants, if different from owner)were provided with information on 1 the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION FLOW CONDITIONS ;.., > � ;, RESIDENTIAL* � � Design Flow: 3 Q gallons Number of Bedrooms: 3 Number of Current Residents: Garbage Grinder: NO Laundry Connected To System:_- t Seasonal Use: n Water Meter Readings,if available: ,z Last Date of Occupancy: O CC Type of Establishment: r. Design Flow: lions/day Grease Trap Present: (yes or no) z¢ Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: f„ Water Meter Readings,If Available: Last Date.of Occupancy: ; OTHER: Describe) ��x �w Last Date of Occupancy: GENERAL INFORMATION '' PUMPING RECORDS and source of information: System Pumped as part of inspection: If yes,volume pumped: gallons `a` Reason for pumping: TYPE OF SYSTEM: a t/Septic Tank/Distribution Box/Soil Absorption System t Single Cesspool • Overflow Cesspool ,? Privy =` Shared System(If yes,attach previous inspection records,if any) ti Other(explain): 6 APPRO XIMATE AGE of all components,date installed(if known)and source of information: �a. Sewage odors detected when arriving at the site: r a� 4- , F x 2�y , e - 14. f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK:- Depth below grade: /8 ' Material of Construction: ✓concrete metal FRP Other (explain) Dimisions: Sludge Depth: Scum Thickness: y`— Distance from top of sludge to bottom of outlet tee or baffle: 3 5-�� Distance from bottom of scum to bottom of outlet tee or baffle:. 6 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.) /DDD f 67 GREASE TRAP: :. Depth Below Grade: Material of Construction:_concrete_metal_FRP_Other (explain) Dimensions: Scum Thickness: Distance from top of scum to top 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,siru6iural integrity,evidence of leakage,-etc:) .. - .. � — ... .>. ....._ . ...•:.�... fir:. TIGHT OR HOLDING TANK: Depth Below Grade: Material of Construction:_concrete=metal_FRP_Other(explain) x Dimensions: Capacity: gallons Design Flow: gallons/day r Alarm Level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) _ DISTRIBUTION BOX: { Depth of liquid level above outlet invert: k/Z.k,«f Comments: (note if level and Tstribution is equal,evidence of solids {eq carryover,evidence of leakage into Y. or out of box,etc.) PUMP CHAMBER: Pump is in working order. Comments`(note'eondition,of pump chamber;condition of pumps acid appurtenances,etc.) X 45 n { SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ` SOIL ABSORPTION SYSTEM(SAS): (Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain:... k Type: A 1 Leaching pits,number:_Leaching chambers, number: Leaching galleries,number: Leaching trenches,number,length: h Leaching fields,number,dimensions: e<< Overflow cesspool,number: Comme ts: (note condition of soil, signs of hydraulic failure level of ponding,condition of vegetation, etc.) Ira �s. CESSPOOLS:17a ' 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: L-:flow(cesspool must be Vwnped as part of inspection) Comments: (note condition of soilk, signs of hydraulic failure, level.of ponding,condition of vegetation, etc.) ; �r PRIVY: n 0 ; Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) . r �r -6- y 7 5 SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. r u ' f+ 'A r C)F k DEPTH TO GROUNDWATER: ' Depth to groundwater: Z Feet �S Method of Determination or AP roxim •a on: Tiff ° -7- r �C. t i _. - t',�{N�ta�'Fd�tit� f�.- n a �� rt• as '�.,:�;^. sc`€ « k TOWN OF BARNSTABLE. L&CATION Da0 &__1le S 'NCR-1- SEWAGE # A OaL,7 ' o SS VILLAGE, U/7 ASSESSOR'S MAP & LOT � !c n j G o NAME&PHONE NO. o�c 9. &(-+ A 7ot� �9aG� SEPTIC TANK CAPACITY loco p4V_4 , Tccm LEACHING FACILITY: (type) / (size) /o�0 9a QP NO.OF-BEDROOMS &UR&ER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 by .� !�' .-.�,rs �� 0�3�, �,6� _ .._ 1 � � �� - 3j ,G ��` 4 No------ l FRz..... . THE COMMONWEALTH OF MASSACHUSETTS B®AR® F H A F� .......... ... . .......... OF...... ... ........--- Appliratinn for Dispaii al Works Toustrnrtinn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: Loca' Addre / � r-y ��y�ot No. W - Vc o � �.•./� S .................................... a Installer. �4 ddress Q rr,L Type of Building `Slze Lot.... �.J__T __..Sq. feet .a Dwelling—No. of Bedrooms---------3.............................Expansion Attic 4; ) Garbage Grinder ( ) pa,, Other—Type of Building ............................ No. of persons..................... .`�_ Showers ( ) — Cafeteria ( ) Other fixtures ............................ W Design Flow______________________ .......____gallons per person pg,z day. Total daily flow_.......�j5.O.._..................._gallons. WSeptic Tank—Liquid capacity/M.gallons Length_.....Y....-... Width.... .......... Diameter................ Depth................ x Disposal Trench—No. .................... Width_.• __........... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----------/------- Diameter......... ...... Depth below inlet---L............. Total leaching area. ....sq. ft. z Other Distribution box ( ) Dosing tank ( ) 1-4 Percolation Test Results Performed by.......................................................................... Date........................................ ,.� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ � �{ / ---- --- ----------------•------••---......................................................... Description of Soil....... .- --- ---- ------- ---------------- ----------------------------- ------------- w ------------------------------------------------------ -----------------------------------------------------------------------------------------------------------------------------.................. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------------------•----------------------------------------•--------------..........---------------------------------------------------•--------------------------------......••....---- Agreement: - The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the syste in operation it a Certificate of Compliance has been iss, ed y he rd of health. • Signed........... -- -- -•-----._....-•--•--•---- ---••------•----••------------ � �y Date / PPlication Approved By.. - �� .16 Date Application Disapproved for the following reasons:................................................................................................................ -----•-•-•..................................•------••--------...•••-------•--•--••---•--•-•-•-------•••••---------........----•------...............................•--............................... Date PermitNo.---------- � ---•------------ Issued------------------------------------------------------- Date C. _ a 7 LOCATION 73 SEWAGE PERMIT NO. VIILLAGE I N S T A LLER'S NAME A ADDRESS R U I L D E R OR OWNER -- - , �7> 2 cl. r4p �e- I DATE PERMIT ISSUED ® DATE COMPLIANCE ISSUED 1/e�/ a s �� .�- � �� 3a 6 -. G I ih No. THE COMMONWEALTH OF MASSACHUSETTS Mn; BOARD ,,OF F H A TH i . r?/.-. OF..-....i Appiiration for Bhiposal igorkii C omitrurtinu UM,it Application is hereby made for a• Permit to 'Construct ( or Repair ( ) an Individual Sewage Disposal" System at: l "; .y 1s ".h. ( /L Y / � F -,49 i f ti ! jY i .... r ... ........................... ... _- .. ....... ......... ............. Loca din Addres / - /' yp{�/ N SEt -- *; , O • . ..._ � '' ,s� ,j� 1, �dd4 s ' �f l "•x•A° '! t t...... ........... � f d............................................................fi Installer - A ress r ( f UType of Building - Size Lot____ =Sq. feet Dwelling—No. of Bedrooms......... ..:::... __._.Expansion Attic (. ) Garbage Grinder ( ) pa-, Other—Type of Building ._.:___ No. of ersons________________-------------•-•---- p ---•---•--._ Showers ( )"—,"Cafeteria ( .. 0.1 Other fixtures ......................................................:................ •- •••--•---- -----••• ••................................. Design Flow......................."_ gallons per person per day. Total daily flow........ ; ..........gallons. WSeptic Tank—Liquid capacaty :_:gallons Length ........ Width.. ......... Diameter-------- Depth Depth................ x Disposal Trench—No ______________• Width __._.__.__._ Total Length _-•-._•_ Total leaching area .: sq. ft." � Seepage Pit No--- ----- ------- Diameter__ -------------- Depth below inlet _:�v..-:--•--_._. Total leaching area.-.Z. -_--sq Z Other Distribution box ( ) Dosing tank '-' Percolation Test Results Performed by = -••••-•-•-• = Date ......... a Test Pit No. L_______________minutes per.inch Depth`of Test Pit....................... Depth to ground water - ............ 4i Test Pit No. 2................minutes per inch' Depth of Test Pit.........._........ Depth to ground water........... a .............4------- :. , ux O Description of Soil gg L - "'� 1 .� e � ,,/ r ; ....... .................................................... ______________________________ ?_..__-____._-___._.._.•____.___ _________ �.___ ..___•.._..___.E I__!!_ _______________________________________________________ ________ ..................................-__-_-_____V Nature of Repairs or Alterations—Answer when applicable................................................................. ................................ s -•--.----•-------------------•----------------------------------------------•--------:......--•---....•.-•-•---------------------------------•----------•-----------------------•._..._....-••--••-•-•-•• Agreement: The undersigned agrees to install the 'aforedescribed Individual Sewage Disposal`System in accordance with the provisions of TITiE 5 of the State Sanitary Code - Tl e undersigned further agrees not to place the system;in operatio it a Certificate of Compliance has been issued y the and of health. . A,. r rj �� ,/ -� Date / \_,)Pplica,tion Approved BY......... 3- ,", .".'e ! a`/�•? Date Application Disapproved for the following reasons:-•----=----------------------•--••-•-•--••-------- ---••---•---=-•-•-•-••--••••-•--•-•••-•-•-•-•-•-----••--•--- -----------------------------------------------------------------------------------------------............................................. ..._ Date Permit No......... `-:.:D..... `.....------ -- Issued_ ------• .'' Date _ THE COMMONWEALTH OF MASSACHUSETTS BOARDF HEAL . . ... ..:.....OF.. . .�................................................ .---- . ......... ......----. T&rrtifiratr of Toutpfiattrr, Y THIS IS TO'CERTIFY, That the Individual ewagPisposal System constructed ( or Repaired ( ) b ---•--•--......_..•--•--• e A� - , f� ' p� ! nstal� + p I f /Ce-i- at............................. 5' �•1'7 �� '�f1 - r Li ................................................. has been installed in accordance with the provisions of TIT IF 5 of The State Sanitary Cpde as described in the application for Disposal Works Construction Permit No...-_. _- r__:y_'7___ dated......._� r?_. .-.` ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F NCTION SATISFACTORY. DATE................� � �¢_.....__........... .......................... Inspector.............••--=-••. THE COMMONWEALTH OF MASSACHUSETTS BOARD - OF HEA T .....'.'.� z ... ..OF.....--=�'/. t ..........._..... -..--f................................... ;' l f 4 No......................... FEE.. J.• Btovoutt1 urku %offiar urt'01 rrutit - Permission �orRqpair ereby granted_------- -/ ✓ -•.'-.---• ----- •-••----• ------------------------------•---.............--- to Construct ( ( )-a, In ivldual F*.wage�D osal Systpm� � �f! at No....................... = ._ '' /�r' � ' f s J ( � .. 4 Street as shown on the application for Disposal.Works Construction Permit No......... :_._�t'�ated._-_t._.�.�'.:�;�� .............. DATE• •• `- Board of Health FORM 1255 A.'M. SULKIN, INC., BOST,ON - y S///GL_E F,4�y/L Y -- 3 BEo.2oarVl it/O G4�2B�1 GE G�/�C/OE.2 SEPT/C T,41VlL t7/.Sf�S,4L P/T•--USE /000 6!-f� . f ,S/OEW.4LG .4.2.�t1 � /�O 5..� �c�� /Gv • o T07T.Q,C TOTAL, l�,4/L f/�LO{�/= .330 G.•�v, S•iaus: o /� / GJ 7 OES/G�s/ �•E'.2COL�JT/apt/,2�J�.' AV ��aOf�7ol,`F�`��s�. ��L�N C�^o,•°�,a:9 / Z•U NIP, �i fv� MCHARJ `t �� —�i 0 BAXTEH Hit PJo.0 29 '33 ` ;'. Igo.24C�4£s ' .A (fly �/Oo. 3� R {.� 51• .4 a"'V S r 1 P , 3��v �Cf-1,01i S• 3/ G o/sr. l .o0o c� /,v co, /.Y✓ BoX `IM GAAL• /.w. :, �e�a sir,. ��Z y�o S.E�n•G v '' Me. G'E2T/F/EO GOT PLJJ�t/ caz�.�✓c � �'� LoG,��ay f�l�t./V .Q•EFE.��'.VC� / GE,eri�y T/�/,4T T/-/E i�;Zoso; z f/EAEa v G'OMp/- (,r//Tf/ A/t/v .e�Qv/zE�1�/NTS o� Th'� .eEG�sr�ecl,Ga�✓O.SlievEya,P� TOx�/v OF /x/�JL�/•sT4 r3LL QNI� /S NOT �{STE.2l//LLc a iyf,�r� r +,/ A-A_...= 71w 1 74'd v /.s A'0o7- .t3.4tE0 aA".4/v/ -4r7,e- Sh+'4 Ta E5-7"4/Xv LaT L/NE,S U J 191-0' 9'-9 A 2'-3" A ANDERSEN W Q TW2446 0 O O(o co �NwcIl �w(Lo F—Of O m U) EXIST. U z>a NEW HOUSE R FIRE A GARAGE NEW RA2'8 xTED D ANDERSEN DOOR ANDERSEN '6'DOORIII q Twzaas ® _ q rvvzaa6 NEW nI - nl " UNFINISHED iii o STORAGE EXIST. HOUSE o- 1 r —— `9 LINE OF WALL 12'0'X T0'O.H.DOOR BELOW CONC. ELECTRIC APRON A METER A Ll 3 6' 9-0' 3 6" 4-1- LEGEND: 191-01 20'-0• EXISTING WALLS Q C= CONSTRUCTION TO BE REMOVED SECOND FLOOR PLAN FIRST FLOOR PLAN NEW CONSTRUCTION NOTES: NAILING SCHEDULE LL 110 MPH EXPOSURE B WIND ZONE O 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS JOINT DESCRIPTION NO.OF COMMON NAILS NO.OF BOX NAILS NAIL SPACING z V &DIMENSIONS IN THE FIELD ROOF FRAMING: 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, BLOCKING TO RAFTER(TOE NAILED) 2-8d 2-10d EACH END O w RIM BOARD TO RAFTER(END NAILED) 2-16 d 3-16d EACH END DETAILS,&FINISHES IN THE FIELD WITH OWNER j WALL FRAMING: r 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT TOP PLATES AT INTERSECTIONS(FACE NAILED) 4-16d 5-16d AT JOINTS , FIRST FLOOR TO BE 7'-0"ABOVE SUBFLOOR STUD TO STUD(FACE NAILED) 2-16 d 2-16d 24"o.c. 4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS 0 Q HEADER TO HEADER(FACE NAILED) 16d 16d 16"o.c.ALONG EDGES _ STATE BUILDING CODE,9TH EDITION AMENDEMENT&IRC2015 FLOOR FRAMING:JOIST TO SILL,TOP PLATE OR GIRDER(TOE NAILED) 4-8d 4-1od PER JOIST J 5. BLOCKING TO JOISTS(TOE NAILED) 2-8d 2-1 Od EACH END J ) 110 MPH EXPOSURE B WIND ZONE BLOCKING TO SILL OR TOP PLATE(TOE NAILED) �� 3-16d 4-16d EACH BLOCK Q w 6.) ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY, LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-16d EACH JOIST ` w JOIST ON LEDGER TO BEAM(TOE NAILED) 3-8d 3-16d PER JOIST J Q Z OR HORIZONTALLY W/BLOCKING AT EDGES,3"EDGE/12"FIELD NAILING C Q BAND JOIST TO JOIST(END NAILED) 3-16d 4-16d PER JOIST J 7.) ALL LVL LUMBER/BEAMS TO BE 1.9e L/360 LOAD BAND JOIST TO SILL OR TOP PLATE(TOE NAILEDO 2-16 d 3-16d PER FOOT w Q 8.) ALL WINDOW AND DOOR HEADERS 4'0"OR LESS TO BE 3-2 x 8 W/2K,2J ROOF SHEATHING: W Y 9.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF ALL WOOD STRUCTURAL PANELS(PLYWOOD)RAFTERS RAFTERS OR TRUSSES SPACED UP TO 16"o.c. 8d tOd 6"EDGE/6"FIELD SIMPSON COMPONENTS RAFTERS OR TRUSSES SPACED OVER 16"o.c. 8d 10d 4"EDGE/4"FIELD GABLE END WALL RAKE OR RAKE TRUSS W/O OVERHANG 8d 10d 6"EDGE/6"FIELD 10.) ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS GABLE END WALL RAKE OR RAKE TRUSS 8d 10d 6"EDGE/6"FIELD - SCALE : TO BE 3000 PSI AT 28 DAYS W/STRUCTURAL OUTLOOKERS 1/4" _ V_0.. 11.)VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE GABLE END WALL RAKE OR RAKE TRUSS W/LOOKOUT BLOCKS 8d 10d 4"EDGE/4"FIELD DURING FRAMING CONSTRUCTION CEILING SHEATHING: -- 12.)TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE,900 PSI MIN. GYPSUM WALLBOARD 5d COOLERS 7"EDGE/10"FIELD DATE :WALL SHEATHING: 2/1 18/20.1 1(]7 13.)FOLLOW ALL REQUIREMENTS OF THE IECC2015 RESIDENTIAL ENERGY WOOD STRUCTURAL PANELS(PLYWOOD) EFFICIENCY REQUIREMENTS&VERIFY ALL DETAILS WITH THE INSULATION STUDS SPACED UP TO 24"o.c. 8d 10d 6"EDGE/12"FIELD INSTALLER/CONTRACTOR FOR THE STRETCH ENERGY CODE 1/2"&25132"FIBERBOARD PANELS 8d --- 3"EDGE/6"FIELD 112"GYPSUM WALLBOARD 5d COOLERS --- 7"EDGE/10"FIELD 14.)THIS STRUCTURE IS DESIGNED TO THE AF&PA WOOD FRAME CONSTRUCTION FLOOR SHEATHING: Al MANUAL FOR 110 MPH EXPOSURE"B"LOCATION PER SECTION R301.2.1.1 WOOD STRUCTURAL PANELS(PLYWOOD) 1"OR LESS THICKNESS 8d 1Od 6"EDGE/12"FIELD GREATER THAN 1"THICKNESS - 10d 16d 6"EDGE/6"FIELD a U J J - Z C� rn �0 04 oCO 12 MATCH Q w Q ' ® EXISTING mH -r-- (n LLJ CV~3:w o0 Z)wao Hm��. SECOND FLOORSUBFILOOR SECOND FLOOR " O G a _ SUBIFLOOR TOP OF PLATE TOP OF PLATE C71111 11 1111 11 H I 101 ALL EXTERIOR MATERIALS C7 r TO MATCH EXISTING w w aa00 m FIRST FLOOR 1 11 1 lill IIII 111111 11 FIRST FLOOR �E] SUBFLOOR SUBFLOOR _JL��m LEFT ELEVATION FRONT ELEVATION a TYP. ROOF CONST. -2 x 8 ROOF RAFTERS @ 16"o.c. 12 A/ -5/8"CDX PLYWOOD ROOF SHEATHING 12 -ASPHALT ROOF SHINGLES O -15LB.FELT PAPER BOTTOM OF -SPRAY FOAM INSULATION(R49) 2 x 6's @ 16"o.c. CEILING JOISTS L - -2 x 10 RIDGE BOARD U O -SIMPSON H 2.5A HURRICANE CLIPS AT ALL RAFTER ENDS r , -ICE/WATER SHIELD AT BOTTOM - Z V TO"OF ROOF _ -ALUMINUM DRIP EDGE _ SECOND FLOOR UNFINISHED O W SUBFLOOR STORAGE W�/ TOP OF PLATE - Of 3/4"T&G PLYWOOD _ SUBFLOOR-GLUED&NAILED SECOND FLOOR Q - - SUBFLOOR < ® z 2 x 12's @ 16"o.c. TOP OF PLATE /V Q W N 3-1 3/4"x 11 7/8" D w - LVL CONT.HDR. J W LLLH1 _ - 5/8"FIRECODE GYP.BD. I _ Jillv ON 1 x 3 STRAPPING @ 16" z W - AND WALLSo.c.IN GAR GE ON CEILINGS N w FIRST FLOOR TYP.WALL CONST. w Q SUBFLOOR 1. 2 x 4 OR 2 x 6 STUDS @ 16'.o.c. NEW < o I I I 2.1/2"PLYWOOD SHEATHING GARAGE 'ui Y - 3.W.C.SHINGLE SIDING Z C 4.TYPAR EXTERIOR VAPOR BARRIER 4"CONCRETE SLAB W/ FIRST FLOOR C REAR ELEVATION _—_ 6x6WWFIN THE TOP,"CLEAR SUBFLOOR —srorEraw,aRDsarc6oaR�- - SCALE - &10 MIL VAPOR RETARDER TOP OF FOUND. 1/4�� — 1. TYP.8"CONCRETE FOUNDATION P.T.2 x 6 SILL DATE : WALLS W/8"X 20"CONCRETE W/SEALER FOOTINGS TO 4'0"BELOW GRADE 2/18/2019 W/(2)#4 HORIZONTAL BARS AT - TOP OF WALL A SECTION @ GARAGE A2 20'-0" 19'-0" Z SOLID BLOCKING IN THE SOLID BLOCKING IN THE A OUTSIDE TWO CEILING JOIST A BAYS AT 48"o.c. OUTSIDE TWO RAFTER A2 '�Q FBAYS AT 48"o.c. ... , C)0 04 (o mH�� Cl)w04 H�:wcc� �wo-o Omo 2 x 12 CEILING JOISTS @ 16"o.c. - U 4 c C 0- W/TRI-SPAN BLOCKING FOR 20 PSF - UNIHABITABLE ATTIC W/LIMITED STORAGE - o - 2 x 10 RIDGE BOARD e v m _ 3-2 x8 HDR.FOR 2 x 6 WAL L OR 2-2 x 8 HDR.FOR 2 x 4 1 VALL `Q 3-1 3A.x 11 7/8"LVL HEADER FOR x 6 WALL c - 0 2-1 3/4"x 11 7/8'LVL HEADER FOR x 4 WALL '°` A - A2 FRONT WALL TO BE CONSTRUCTED PER APA PORTAL WALL DETAIL 16'-0" 4'1' 20'-0" 20'-0" A ROOF FRAMING PLAN a CEILING JOIST PLAN ___ __ NOTES: 1.) ALL ROOF RAFTERS TO BE 2 x 8's I UNLESS OTHERWISE NOTED f— I F 2.) USE SIMPSON H2.5A HURRICANE CLIPS O p INSTALL 5/8"ANCHOR BOLTS AT 24"o.c.MAX. ( I AT ALL RAFTERS ENDS W/SIMPSON BPS 518-3 BEARING PLATES 6-12' PLACE BOLTS WITHIN 6"-15"OF EACH I I 3. VERIFY GUTTER TYPE/LAYOUT CORNER AND TO A 8'MINIMUM DEPTH ) FROM END I I NEW W/OWNERS O LL OF PLATE / 1 I I GARAGE Z �J I I 4"CONCRETE SLAB W/ _ I _______El I I 6 x 6 WWF IN THE TOP I"CLEAR O L _ Lu ___ I SLOPE TOWARDS O.H.DOORS ELEVATION VIEW IFROM EXT.R�OR m°m em.amnre.r n.A nnrn.oe.r,rnal I SIDE ELEVATION &10 M IL VAPOR RETARDER ,,, iw I �a•,ro.b�e.anaro°m°o 1 `LLOJ1f EXIST. �0LL ;LLo o I HOUSE sP aum�m" a �. Q � I o I L .t r n_a II •.I. nr a rv°..aea w I TYP.8"CONCRETE FOUNDATION II a. - II aN •I•I r "ue.am � �_ ro a °c JWALLS W/8"X 20"CONCRETE FOOTINGS T04'0"BELOW GRADE .. "r e� �° •I L W/(2)#4 HORIZONTAL BARS AT ' _ TOP OF WALL rmr.w."r ti I I I 9 Pr I DROP TOP OF WALL •I•I I•I• ° ..I I,I. J ff�� i •I•I I•I• ui Irk AT ENTRY DOOR •I°I I•I• .m.prF.n m I I I I °I°I I°I• W I - J:IL_ I;I; °w""a isw om lsrnz o�°m it II - :I:I I:I: .. P.T.2 x 6 SILL W/SEALER .L J.le °LL; I I I r — — min�...n.o�r II II ••1=sa.. � � I - I:I I'I° mm°mo.a .c nin�si a II II 'I;I I'I; Z I I DROP TOP OF WALL ( r .III Lb m°m"�.e°°sa naam_eaan.m.n^ Ili SCALE : : —�AT O.H.DOOR —— I o._.m .mm mr n n.qa, °I•I ^II^ — ' n I L——— ——— —— eem,os 1/4" II' II �I II: .LI LI. ° II II .LI IJ. I ————————— I - - °I°I I'I' Fmu_c"xnw aye m i.ew,i,�i/I' I I •I•I I� -. 11 ,' DATE LAPRO, - A .e:=` h,.a.J,i` f.a': ax':=?S; : :° .11: .c.:r• M;' ` 'Y1 �i �l• '�� ! '.`� �IANCHOR BOLT DETAIL sti• x. elr:7'�s"r+'iYd._ }� . __ :::i fir. .' a 2/15/2019 SCALE: 1/2"=1t_10e, 3 3' 9'6" 3 3 16'-0. 4'-0 FOUNDATION PLAN APA APA NARROW WALL BRACING METHOD NOT TO SCALE A3 . 1 OVER CONCRETE OR MASONRY BLOCK FOUNDATION ,