Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0071 HIGH STREET - Health
71 High. Street Cotuit P f - - -- - - -- - A = 035 030 i I 4 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 71 High Street Property Address Freshette Owner Owner's Name. information is Cotuit MA -102635 June 4, 2012 required for every page. CityrTown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the I computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key, Septic Inspection Services Co. Company Name s r� 189 Cammett Road Company Address Marstons Mills MA 02648 re Cityrrown State Zip Code 508-428-1779 SI 12855, Telephone Number License Number B. Certification I certify that l 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 June 4, 2012 _ Job# 12-,84 In ector's ignature 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 *N 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•11/10 Title 5 Official In ecti Form:Subsurface Sei age Dispos Sy§t�m�a�j17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 71 High Street Property Address ` Freshette Owner Owner's Name information is required for Cotuit MA 02635 June 4, 2012 every page. City/Town State Zip Code Date of Inspection B. Certification (cont:) m° Inspection tion Summary: Check. A B C D or E al ways 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: Tanks were not in need of pumping at time of inspection, leaching pit was at 50% capacity with no signs of surcharge. 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 in tank is replaced with a complyingse tic tank as a roved by the ion if the exists tPP will pass inspect g p P , 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): r t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts" Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for.Voluntary Assessments , 01 71 High Street Property Address ' Freshette Owner Owner's Name information is required for Cotuit MA 02635 June 4,2042 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) = B) System Conditionally Passes (cont:): ❑ Observation of sewage backup or break out or high static water level,in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced' ❑ Y ❑ N C_ND (Explain below): _ ❑ obstruction is removed _ ❑ Y ❑ N ❑ ND (Explain below): ❑ . distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): r 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 ❑ YF ❑ N, ❑ ND (Explain below): ❑ obstruction is removed# •:❑ Y , ❑ ;N ❑ ND (Explain below).- C) Further Evaluation is Required by the Board of Health: } f ❑ 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 71 High Street Property Address Freshette Owner Owner's Name information is Cotuit MA 02635 June 4, 2012 required for every page. City/Town 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. ElThe.systern 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 w y water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen g 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: r" M 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 El ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ' , I El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than_day flow 15ins•11/10 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 u wM 71 High Street _ Property Address Freshette - Owner Owner's Name information is Cotuit MA 02635 June 4, 2012 required for every page. Cityrrown State`' Zip Code Date of Inspection r B. Certification (cont.) _• Yes No R ❑ ® 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. El ® Any portion of cesspool or privy is within 1.00 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. El ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a'cesspoot 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 servin 1.g 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. T' 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 i the system is located in a nitrogen sensitive area (Interim Wellhead Protection ❑ 0 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 Subsurface Sewage Disposal System Form - Not.for Voluntary Assessments w 71 High Street Property Address Freshette Owner Owner's Name d information is Cotuit MA 02635 •June 4, 2012 required for every page. Cityrrown 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 HealthF ❑ 0 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. ® El approximation 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: - 3 Number of bedrooms (design): 3 . Number of bedrooms (actual): DESIGN flow based on 310 CMR.15.203 (for example: 1.10 gpd x#of bedrooms): 330 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments M 71 High Street " Property Address a Freshette Owner Owner's Name information is required for Cotuit MA 02635 June 4, 2012 - every page. Cityrrown State Zip Code Date of Inspection D. System Information " Description: T Number of current residents: '' 2 Does residence have a garbage grinder? ❑ Yes ® .No Is laundry on a separate sewage system?(if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available.(last 2 years usage (gpd)): 6 Detail: Sump pump? M ❑ Yes ® No Currently Last date of occupancy: Occupied. Commercial/Industrial Flow Conditions: Type of Establishment: - Design flow(based on 310 CMR 15.203) ' Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): . Grease trap present? - ❑ Yes ❑ No Industrial waste holding tank present?'- ,• ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 s•ystem? ❑ Yes ❑ No Water meter readings, if available: 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 71 High Street - Property Address Freshette Owner Owner's Name information is Cotuit MA 02635 June 4, 2012 required for every page. City/Town 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: 1000 gal tank pumped 5/11 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? „ . . Reason for pumping: y 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) Fj 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.1/A system by.system operator under contract ❑ Tight tank..Attach a copy of the DEP.approval. ❑ Other(describe): t5ins-11110 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts t w Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 71 High Street Property Address Freshette Owner Owner's Name information is Cotuit MA 02635 June 4, 2012' required for every 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: 1000 gal tank and leaching pit age are unknown' 1500 gal tank and d-box were installed in 2009 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage,etc.): Septic Tank(locate on site plan): 1 Depth below grade: t feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑, Yes ❑, No 1000 gal & 1500 gal. Dimensions: 0„ Sludge depth: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments- w 71 High Street Property Address Freshette Owner Owner's Name information is Cotuit MA 02635 _' June.4, 2012 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) , . . . . Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 0" _ 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 - - Measured How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,'evidence of leakage, etc.): Tanks had liquid only, no solids Tees were intact and liquid levels were at bottom,of outlet inverts. 7 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 l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 " Commonwealth of Massachusetts : Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments ' 71 High Street Property Address - Freshette Owner Owner's Name information is Cotuit MA ' 02635 June 4, 2012 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.): 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: bate » : Comments (condition of alarm and float switches,,etc.): Attach copy of current pumping contract (required). Is copy attached? . > ,❑ Yes ❑ .No t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts , F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not,for Voluntary Assessments 71 High Street Property Address Freshette _ Owner Owner's Name information is Cotuit MA 02635 June 4, 2012 required for every page. Cityfrown State Zip Code - Date of Inspection D. System Information (cont.) s Distribution Box (if present must be opened) (locate'on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): 6 Pump Chamber(locate on site plan): Pumps in working order: ❑T-Yes ❑ ,No Alarms in working order: r ❑ Yes ❑ "No. Comments (note condition of pump chamber,..condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why:. z y t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts w F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 71 High Street Property Address Freshette Owner Owner's Name information is Cotuit MA 2 ' 02635 June 4, 2012 required for every page. City/Town 'State Zip Code Date of Inspection D. System Information (cont.) Type: 3 ® leaching pits. number: One 6x6 pit ❑ leaching chambers., number: ❑ leaching galleries number: i ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: W ❑ overflow cesspool number: , ❑ innovative/alternative system Type/name of technology: . a Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Liquid level was observed at 50% capacity with no evidence of surcharge. 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 Y Depth of scum layer . Dimensions of cesspool "f Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments � 71 High Street Property Address Freshette Owner Owner's Name information is Cotuit MA 02635 June 4, 2012 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.): 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.): 15ins•1 Ill 0 Title 5 Official Inspection Form:Subsurface Sewage Disposal System..Page 14 of 17 I Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 71 High Street Property Address -------------_----- Freshette _ Owner Owner's Name- ----- - ----- ...:.......__......._..- •• information is Cotuit MA 02635 June 4, 2012 required for _..--------.—.__---------_....-------- ----- ----- every page. CitylTown 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 e � r 86 25 47 2 / / / / r / / J r / / e • 'r r r ,•r J J 20 Y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments 4,M 71 High Street Property Address " Freshette Owner Owner's Name information is Cotuit MA' 02635 June 4, 2012 required for every page. CityrFown State Zip Code Date of Inspection D. System Information (cost.). r Site Exam: y ® Check Slope ® Surface water ® Check cellar ' I ® Shallow wells 30+ Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record Y If checked, date of design plan reviewed: r 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: Low area on opposite side of road with no surfacewater is considerably lower than SAS. f • S y i Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 f b -� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 71 High Street _ Property Address Freshette Owner Owner's Name information is Cotuit MA 02635 June 4, 2012 required for State -Zip Date of Inspection every page. City/Town 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 Y • . r S . t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Town of Barnstable Health Inspector pfc'IM roy� Regulatory Services Office Hours 8:30—9:30 p„ Thomas F.Geiler,Director 3:30—4:30 Y =AANSTABM Public Health Division 9 MASS. g' 1639. a�� Thomas McKean,Director �ArfD MA'S 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date:October 28,2011 1. General Information: Size of Property.75 acre Address: 71 High Street Cotuit,MA 02635 Map 030 Parce1035 Name: Stephen T. Frechette and Carol A Raynor Phone#: 978-790-3601 2a. How many bedrooms exist at your property now?3 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?3 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer, skip questions#4 through#9 below. 4. Location of dwelling is INSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is I INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 7. Is a disposal works construction,permit on file? YES 6r.- NO 9= 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. ? 9. Were any building permits'obtained for construction of additional bedrooms? YES or— i NO -- 10. Is there an engineered septic system plan on file at the Health Division? YES or $ NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES . or i NO S --------------------------------------------------7------------------------------------------------7--------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: p Signed. Date: //U// Q:\GMD-Housing ccessory Affordable Aputmerit Program\ADMIN\FORMS&LETTERS\Blank Forms a estyappl.DOC Town of Barnstable Geographic Information System October 20,2011 .............. ::: :::: ::: ........... :::::: + .... g.................. .... ........... .................................................................... ::::::::: :::::::::::::. :::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::: ::: ... ................... ................. ::::::::::: .,............. ........................................................................ ...... ...... ::iii:cci: :[t ciiiiiiccc>i i :i:i:ciiicicci::::: :: ':c. ................:::iiiiii ci<i' ':iic ......:::':::......:iic:iiiiciii::iiii iii ......... .........: ::::: ::: ...........:::::: .ii ':: ciii:ciiiiici:ii iiiiic:ciici ......... .. ::::::........ ....... ... ...... ............. .............. ............................ ............................... ............ ... ......................... ................. ............................. ......... ... ....,....... ................................... ............. ........... iciccciii:: ici::::::::::::::ccciiiii:'iiiiii:icii:iiiiiiiiiiiiiiicir r':ii .ii:ci:iiiii:iiiii i::::c::::iiccc::c:::: iiiiiciciii::.':::cii.ciccci. ............ :'iiiiiiiii. ic::iii:iiiiii:'iiiiiiiiii:ii:iiiiciiiiirri:ii '::i'.i::i:iiiiiiii::iii' :ci .....::.::::: ::iiic:".......:::::::iiiii::::::ccciii::::'c':cicc::::: ciiicciccii:iccc: ::........ iiiiiiii:iiiiiiccciiii[:iii: ii::::.:: ciic:icci ............................. .......................... i6 cicczi::::::::i .... ............ . . .......... ...... :: ::::::: :: :::::::: :: . ........ ... ............. �rlrrrrrrrr......:......................... DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:035 Parcel:030 Selected Parcel Owner:FRECHETTE,STEPHEN T& Total Assessed Value:$467000 boundary determination or regulatory interpretation. Enlargements beyond a scale of 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessor's tax parcels. They are not true property .Co-Owner: - Acreage:0.75 acres - Abutters boundaries and do not represent accurate relationships to physical features on the map Location:71 HIGH STREET !ff' such as building locations. Buffer �/^f Asj�uilt Page 1 of 1 TOWN OF BARNS ABLE p L J LOCATION f�,,Wi SEWAGE#VILLAGE CASSESSOR'S MAP&PARCEL 423,j—Q.3e' INSTALLER'S NAME&PHONE N0. �J/` � SEPTIC TANK CAPACITY__ d� LEACHING FACILITY:(type) (size) NO.OF BEDROOMS OWNER n / d cal/1 PERMIT DATE: Z< Z��G/? COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY � 3 r 8z � 71d�5� 70 G, ZY 7 6 i http://issgl2/intranet/propdata/ptebuilt.aspx?mappar=035030&seq=1 10/28/2011 Asl3uilt Page 1 of 1 TOWN OF BARNSTABLE - 55 l.c� 'LOCATION: � 4/ /{ SEWAGE# � 4>YriAGE .. ASSESSOR'S MAP&LO 03.0 314S-FAf l krS NAME&PHONE N 7.7 SEPTIC TANK CAPACITY 0�06) LEACHING FACILITY: (type) � (size)/ LIP NO,OFBEDROOMS 3 BUILDER OR OWNERg . ",Z f`ERMUDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by t` http://issgl2/intranet/propdata/prebuilt.aspx?mappar=035030&seq=2 10/28/2011 • \ - .ram � ���,� J�f{i � ~•� ;r fi 1 r a Y l _ � 4 a THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) z} yyv 1 t � r § ,1 TOWN OF BARNSTABLE LOCATION I 51-- 60-ale SEWAGE#. VILLAGE Co U ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) NO.OF BEDROOMS OWNER *®r PERMIT DATE: Z /Z ® COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet. Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY � _3�//� b ,, �.7- ion=d 71 V/ ` 70 G, 7 -6 TOWN OF BARNSTABLE LOCATION -7/ yh ST- E#T_,1 VILLAGE_ � �' ASSESSOR'S MAP&PARCEL fN&TA+tER'S NAME&PHONE NO. �TP'k_k_ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) Old— (size) 6AP NO.OF BEDROOMS OWNER PERMIT DATE: C DATE: i Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY • k�M 86 25 k \ Y \ ttt \ \ tt \ t \ \ 2 47 ft \ \ \ \f\ \ItJ\J\J\ \ \ \ t \ t M 117 f f\;\ f ! r f J f f f f f ! \ \ \ \ \ \ \ \ \ \ t \ \ \ t \ t \ \ ♦ \ 4 4 f f f f / ! f / / 20 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpfication for Misposaf 6pstem Construction 3perndt Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑in du 1 C p t 1 Location Address or Lot No. er's Name, ddress,and Tel.No. Assessor's Map/Parcel - Installer's Name,Address,and Tel.No. De ' er s Name ress,and Tel. Type of Building: Dwelling No.of Bedrooms 3 `%e4rLot Size. sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. "S Description of Soil Nature of Repairs or Alterations(Answer hen applicable) G Jj a . Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He ed Date T Application Approved by Date 2 A Application Disapproved by Date for the following reasons Permit No. G Date Issued 2 t =No. 1;�V V ( ` do 's �.,,.sc '., Fee THE COMMONWEALTH OF MASSA'CHIUSETTS Entered in computer: 01' a PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE"MASSACHUSETTS Yes �- ftpfication for Misposal Opstem Coni struction i9ermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Ind'vid 1 CQ p �n r Location Address or Lot No. /'7/ Owner's Name, ddre'ss,and Tel.No. Assessor's Map/Parcel -_ �/ Installer's Name,Address,and Tel.No. Designer's Name d ess,and Tel. I pe of Building:^ �ju J'1 , Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building - No.of Persons - Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank- ;, Type of S.A.S. �I i f 4 i Description of Soil Nature of Repairs or Alterations(Answer when applicable) Y.„ Date last inspected: Agreement: The undersigned agrees toensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of .r Compliance has been issued by this,Board of H'SIe tr /p •P Sd , Date Application Approved by + �4 Date a d e Application Disapproved by ,.j Date r for the following reasons Permit No. U U d 2 Date Issued .21;Lafrl sr--- --- -I--------- -- ----- --------- y � t ��, p,, THE COMMONWEALTH OF MASSACHUSETTS 1 BARNSTABLE,MASSACHUSETTS (tertificate of Compliance t J THIS IS TO CERTIFY,that the On-site Sewagee sposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by 2 h�,-, ,/ ( -,,- ;�'°i cS at �?t [- f c-L has been constructed iln�accordance _0'/ with the provisions of itle 5 and the for Disposal System Construction Permit No.P Oo �" 2 dated a 0 C► Installer Designer #bedrooms Approved de ig flow 0 /1 gpd D i The issuance of this permit s all not be oonst ed as a guarantee that, system F n�'o 'as( ,design. . ��/Date � Inspector V ��' If No. UO :L Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Oisposal Epstein (Construction permit Permission is hereby granted to Construct t�� Repair( ) Upgrade( ) Abandon( ) System located at 1/ 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction m st be completed within three years of the date of this permi, ff,, • Date -a I 0'1 Approved by VW- r Towi ®f Barnstable Regulatory Services Thomas F. Geiler, Director MAS& Publk Health Division * saxivsrns�, 1639. �Ea►�a°, Thomas McKean, Director 200 Main Street,Ilyannns,MIA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: `4 114 o Seepage Permitr# Zyo a- 4 Z Assessor's Map\Parcel 3 0 Designer: ��� �-- - In staller: �ja• �� T11 --r�*�.�' �`F, Address: Address: On L l'2 L. Oct was issued a permit to install a (date) 1 ' (installer) septic system at Cat- �T- z2+u based on a design drawn by (address) a e-( 0 �� ��- "dated (designer I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. �A�A of MqS Sd �>. DANIELA. G ` OJALA (Insta s Signature) : 't CIVIL N No,46502 folLJ —1 `���r.. (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLIE PUBLIC HEALTH DWISION. CERTIFICATE OF COMPLU NCE WILT., NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc 'V� l _C - =[77 T/5 )LO ��`�r(Juv✓� 3i� D ���fr`� � `cam Y ` it ... - .. a .. ... • V� �Y V Bk 23482 Ps 19 a9L2:1 02-26-2009 a 02 0 1 e71ss DEED RESTRICTION WHEREAS, np f' (owner's name) Of (address) MA is the owner of r P (addr ) located at -1041 i , MA (hereinafter referred to as _ �����.�� �- and b 'ng shown on a plan entitled "Subdivision of Land in n� MA, Property of et al, duly recorded in Barnstable County Registry of Deeds in Plan Book , Page Or on Land Court Plan Number WHEREAS �� .s J/Q�LA ` s the owner of said lot has (owne name) agreed with the Town of Barnstable Board of Health to a restriction as to the number.of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, deedr NOW, THEREFORE, Q es hereby place the owners name) following restriction on his above-referenced land in accordance with his Qgrea ent.with tbe.Tzwmof Ramstablewealth, whieh restrcwa:w_ . run with the land and be binding upon all•successors in title: 1• 41 may have constructed ( ress) upon the lot a house-co taining o ore than _ 3 ( ) bedrooms. nor s S rees that this shall be-permanent deed (owners narfial restriction affecting_located on MA, and . being shown on the plan recorded in Plan Book_ , Paged Or on Land Court Plan For title of see the following deed: Book_ , Page . Or Land Court Certificate of Title Number Executed as a sealed ' stru ent day of q Own9ess signature Ownei signature Owner's signature COMMONWEALTH OF MASSACHUSETTS . ss . 20 Then personally appeared the above-named known to me to be the person who executed the foregoing instrument and acknowledged the same to be free act and deed, before me, Notary Public My commission expires: (date) away COMMONWEALTH OF MASSACHUSETTS `a EXECUTIVE OFFICE OF ENVhRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION p4� 1=1V= MAR 3 1 2005 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:. �j ALA , Owner's Name:�5� Rio P. 1t• i,d,�s. n Owner's Address:- Ah PARCEV, ` v IA. ,. bc�c���xr Date of Inspection:—� f�71t�5 Name of Inspector: (please print) .c Com an .Name: P Y � Mailing Address: '-?Qct • '1 oato�� " Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 Needs Further Evaluation by the Local Approving Authority ails 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.I.f 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,ff applicable, and the approving authority. Notes and Comments _ i ****This report only describes conditions at the time of inspection ar_d 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. Title 5 Inspection Form 6/15/2000 page I . 1 r Page 2 of 1 I �. OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address; /401 a Owner: Date of Ins ction: 7 os 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 1503 or in 3.10 CMR 15.304 exist. Any failure criteria.not evaluated are indicated below.-, Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass section need to be replaced or repaired.The system,upon completion of the replacement or repair;as approved by the Board of Health, Aill.pass; Answer yes,no or not determined(Y,N ND)in the for the following statements. If"not determined'..'please explain. The septic tank ismetal.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 complyi-tag septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation.of sewage backup or break out or high static water level in the distribution box doe to broken or obstructed pipe(s)or due to a.broken, seined or uneven distribution box. System will pass inspection if(with approval of Board of Health): br4:en pipe(s)are,replaced obstruction is removed distribution boy,is leveled oryeplaced ND explain: The system required pumping mrore than'4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 1 Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION.(continued) Property Address: Owner: 6Lin Apro 1/1 Date of Inspection: C. Further Evaluation is Required by the Board.of Health: Conditions exist which require further evaluation by the Board o-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 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 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 DEEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is:free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal tc or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attad!ed to this form. 3. Other: M 3 Page 4 of 11 OFFICIAL INSPECTION FORM.:-.NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART A. CERTIFICATION(continued) Property Address: Owner: 1/, /Q "4 F-, Date of Inspection: /7 6 D. System Failure,Criteria applicable to all systems: You must indicate"yes"or"no."to eaca of the following for all inspections: Yes No . _.. . k Backup of sewage into facility.or system component.due to overloaded:or clog gged 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 �j Liquid depth in cesspool is less than.6"below invert or available volume is less than%2 day flow V 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 106 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool e.-privy is within a.Zone 1 of a.public well. Any portion.of a cesspool c.r privy is within 50 feet of d.private water supply well. Any portion of,a.cesspool er privy is less.than 100.feet but greater than;50 feet from a private water supply well with no accept-.ble water quality analysis. [This system.passes if the well water analysis, performed at a DEP certified laboratory,for coliforni bacteria.and volatile organic compounds indicates that the well is free from pollution from that facility and the:presence.of ammonia . nitrogen.and bitrate 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.] (Yes/No)The system fails. I have determined that one or more of the above failure criteria.exist as described in 310 CMR 15.303,the.refore 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• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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 nitrr+gen sensitive area(Interim Wellhead Protection Area IWPA)or a mapped Zone II of a public water sup?ly 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 contEct the appropriate regional office of the Department. Page 5 of l] OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: Date of Inspection: S W2 aS Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Pumping information v;as provided by the owner,occupant,or,Board.of Health ZWere any of the system components pumped out in the previous two weeks Z_ Has the system received normal flows in the previous two week period? _ "ZHave 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) t/ 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 in_erior 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 owne-)provided with information on the proper maintenance of subsurface sewage disposal systems The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes/no Existing information.For example, a plan.at the Board of Health. . _ .Determined in the field(if any of the failure criteria related tc Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] ' t 5 y Page.6.of 11 OFFICIALt INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION.FORM PART C SYSTEM;INFORMATION Property Address: f 41, 9- Owner:,�_, , Date of Inspection: 0 02k FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): 3 DESIGN flow based on 310.CMR 15.203 (for example: 11.0 gpd x#of bedrooms): 330 Number of current residents: Does residence have,a garbage grinder(yes or no): n Is laundry on a separate sewage system(yes or no): no f if yes separate inspection required] Laundry system inspected(yes.or no):_ Seasonal use: (yes or no): n() Water meter readings, if available(last 2 years usage(gpd)):0Xq—P e00" l00�000 ZW3 Sump pump(yes or no): Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design, flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgf€_etc.): 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/use: OTHER.(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):— If yes, volume pumped: gallons--How was quantity pumped determ_inedZ- _ Reason for pumping: TY)aE OF SYSTEM Septic tank,distribution box, soil absorption system _Single cesspool. _Overflow cesspool _Privy _Shared system(yes or no)(if yes,Ettach previous inspection records, if any) _Innovative/Alternative technology_Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank —Attach a copy of-die DEP approval Other(describe): Approximate age of all components, datz/installed(if known)and source of information: 991 l�c� Cat oA O Were sewage.odors detected when arriv_ng at the site(yes or no):J)'D 6 Page 7 of l 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM:INFORMATION(continued) Property Address: Owner: fj a �f Date of Inspection: l'2 G BUILDING SEWER.(locate on site plan) NVv Depth below grade: Materials of construction:_cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting, evidence of leakage, etc.): SEPTIC TANK:"o/ (locate on site plan) Depth below grade: Material of construction: .+/concrete_metal_fiberglass_polyethylene other(explain) If tank is metal list age: . Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) _ Dimensions: Sludge depth: `y>/ Distance from top,of sludge to bottom of outlet tee or baffle: Scum thickness: •� r! Distance from top o scum to top of outlet tee or baffle: 7— Distance from bottom of scum to botto r1i of outlet tee orbaffle: �f How were dimensions determined: Comments(on pumping recommendatio , inlet and outlet tee or baffle condition,structural integrity, liquid levels as, elated to outlet invert, evidence oA leakage,etc.): ' - Te&,vk c �&a GREASE TRAP: %(locate on site'pian) Depth below grade: 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTIiJM INFORMATION(continued) Property Address: AA �— Owner: Date of Idspec ion: p-210.S TIGHT or HOLDING TANK: rank 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: gallo-s Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and floc:switches, etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet inver:L 5j (alwl Comments(note if box is level and disc.ibution to odtlets equal,.any evidence of solids carryover, any evidence.of I akace in r C/Y� .!o or out of box,etc.): ; a PUMP CHAMBER: (locate on site.plan) Pumps in working order(yes or no): Alarms in working 6r..der(yes or'no): ` Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): R I 7 _ y Paae 9 of I I OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 2 Owner: Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): locate on site plan,excavation not required) If SAS not located explain why: Type Teaching pits,number:_ 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. : /! �! CESSPOOLS:AV (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 or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of,vegetation,etc:): PRIVY: 1)0(locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of poniing,condition of vegetation, etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY:ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM' PART C SYSTEM INFORMATION(continued) nJ Property Address: Owner: LNi-4 Date of Inspection: a,S SKETCH OF SEWAGE DISPOSAL.SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent.reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 11 I � 4c' 440 3 �, � 3 _ �� I , Page 11 of I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(cointinued) Property Address: Owner: �J eh a, / 4 Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated.depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: 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: 9 S 11 I � , . Permit-Number: Date: Completed by: 2;�-'1 HIGH GR--).UND-WATER LEVEL COMPUTATION Site Location: c C Lot No. Owner: A9 /4 dw Address. �l Contractor: Address: Notes: STEP 1 Measure depth to water tE..' le to nearest 1/10 . ............................................................................... .Date J' p5 month./day/year STEP 2 Using Water-Level Range ?one and Index Well Map locate site and determine: �---� OAppropriate index we-I.................................. �.......... Z� CWater-level range zone ...................................................... STEP 3 Using monthly report "Current Wate.r Resources Conditicns" determine current depth to �Z/off 7s5" water level for index well ........................... month,/year STEP 4 Using Table of Water-leve Adjustments Tor index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) 1 determine waterdl vel adjustment .......................................................................................... � ✓STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4; Trom measured depth to water levelat site (STEP 1) ............................................................ ................................................ Figure 11--Reproducible computation form. 15 ` i 5 COMMONWEALTH OF MASSACHUSETTS g EXECUTIVE OFFICE OF ENVIRONMENTAL S r O DEPARTMENT OF ENVIRONMENTAL P ECTi ONE WINTER STREET. BOSTON. MA 02108 617-29 -5 0 N ~ 1 V4ILLIAM F.WELD650 DY COS Governor Secretary ARGEO PAUL CELLUCCI y aVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A. CERTIFICATION 71 Hi h St o v Raleigh ut Address of Owner: Steve Property Address: � Date of Inspection: //- / I (If different) 71 High St Name of Inspector: Wm E Robinson Sr COtuit MA I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: WM E Robinson, Septic Service Mailing Address: PO Box 1089 , Cpntervi 1 1 of MA 02632 Telephone Number; 5 0 8 7 7 5—R 7 7 A CERTIFICATION STATEMENT " I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: 4W. 1/Passes n y Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails ' Inspector's Signature: L h Date: iv The System Inspector shall submit a copy of this inspection report to the Approving Authbrity within thirty (30)days of completing this a inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the.system owner and copies sent to the buyer, if applicable, and the approving authority. '_ 2 INSPECTION SUMMARY: Check A, B, C, Or D: A] SYSTEM PASSES: ` I have not found any information which indicates that the'system violates any of the failure criteria as'defined in 310 CMR 1.5.303. Any failure criteria not evaluated are indicated below. COMMENTS: � r BI SYST M CONDITIONALLY PASSES: ne or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon ompletion of the replacement or repair, as approved by the Board of Health, will pass. Indicate y s, no, or not determined (Y, N, of ND). •'Describe basis of determination in ali'instances.M If"not determined", explain,why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior,to the date of the inspection; or the septic tank, whether or not metal,-is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will,pass inspection if the existing septic tank is replaced with a conforrhi*septic tank as approved by the Board of'Health. } two y� (revise 4/25/97) Pagel of 10 DEP on the World Wide Web: http:/twww.magnet.state.ma.us/dep �J Printed on Recycled Paper r _ r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) �a Property Address: 71 High St , C o t ui t Owner: Ra.le igh Date of Inspection: B] SYSTEM CONDITIONALLY PASSES (continued) Sewage backup,or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: 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 C] FUR T ER 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. 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 water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE NVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS 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 the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) HER revised 04 25 97 Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART A CERTIFICATION (continued) Property Address: 71 High St , C o t ui t Owner: Rale ighh+ Date of Inspection: 7 D] SYSTEM FAILS: You must ' dicate ei;r,er "Yes" or "No" as to each of the following: I ave 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. - Yes No Backup of sewage into facility or system component due to an 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 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 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. 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. 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. E] LARGE SY TEM FAILS: You must in icate either "Yes" or "No" as to each of the following: T following criteria apply to large systems in addition to the criteria above: e system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to ublic health and safety and the environment because one or more of the following conditions exist: Yes N 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 owne r operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirement of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST r . Property Address: 71 High St, C O t Ui t Owner: Raleigh Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No J/ _ Pumping information was provided by the owner, occupant, or Board of Health. V _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or / as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. v _ The facility or dwelling was inspected for signs of sewage backup. _ The system does not receive non-sanitary or industrial waste flow. _ 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 septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. _ Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15:302(3)(b)] (revised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 71 High St , Cotuit Owner: Raleigh Date of Inspection: FLOW.CONDITIONS RESIDENTIAL: Design flow: 96 40 p.d./bedroom for S.A.S. Number of bedrooms:_ Number of current residents: Garbage grinder (yes or no): p Laundry connected to system (yes or no) Seasonal use (yes or no):_,dL O Water meter readings, if available (last two (2) year usage^(gpd): �997 — 31 ,0009 Sump Pump (yes or no):.!LP U 1998 A- 47 , 0009 Last date of occupancy: C MMERCIAUINDUSTRIAL: Type of establishment: Desig flow: gallons/day Gress trap present: (yes or no)_ Indust ial Waste Holding Tank present: (yes or no)_ Non-s nitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last ate of occupancy: OT ER: (Describe) Las of occupancy: GENERAL INFORMATION PUMPING RECORDS and}ource of information: ti / System pump d as part of inspection: (yes or no) If yes, volume pumped: gallons Reason for pumping: TYPk30k�YSTEM 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: .r o Sewage odors detected when arriving at the site: (yes or no) L (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 71 High S t , C of u it Owner: Rale igh Date of Inspection: BU ING SEWER: (Local on site plan) Depth low grade: Materi I of construction: _cast iron _40 PVC_other (explain) Dista ce from private water supply well or suction line Dia eter Co ments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:, (locate on site plan) 1 ' Depth below grade: Material of construction: _I/oncrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age — Is age confirmed by Certificate of Compliance —(Yes/No) c . � Dimensions: Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: t- '' Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom o outlet tee or baffle: I3 , How dimensions were determined: 0L%T— 7�, )L Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid le el in relation to outlet invert, structu al integrity evidence/of leakage, etc.) -O A4 D $P� GREA E TRAP: (locat on site plan) Depth low grade: Materi I of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimen ions: Scum t ickness: Distaric from top of scum to top of outlet tee or baffle: Distan from bottom of scum to bottom of outlet tee or baffle: Date last pumping: Co ents: (re mendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integri , evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) -Property Address: 71 High Street Cotuit k Owner: Raleigh Date of Inspection: TI T OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (local on site plan) Depth low grade: Materia of construction: _concrete_metal _Fiberglass _Polyethylene —other(explain) Dimen ions: Capac gallons Desi flow: gallons/day Ala, level: Alarm in working order_Yes; _ No Date f previous pumping: Com nts (condi 'on of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evpdence solids carryover, evidence of leakage into or out of box, etc.) PUMP HAMBER: (locate site plan) Pumps in working order: (Yes or No) Alarms in working order (Yes or No) Commen (note co ition of pump chamber, condition of pumps and appurtenances, etc.) t (revised 04/25/97) . , Page 7 of 10 y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 71 High St , C o t ui t Owner: Raleigh Date of Inspection: /`—/y—9 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: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydr c failure, level of ponding, condition of ve tion,�etcc.) )6 6 ,6/ r i C S n�- tr c CES OOLS: (local on site plan) Numbe and configuration: Depth-t of liquid to inlet invert: Depth o solids layer: Depth of scum layer: Dimensi ns of cesspool: Materials of construction: Indicatio of groundwater: inflow (cesspool must be pumped as part of inspection) Com nts: (note ondition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate o site plan) Materials of construction: Dimensions: Depth of olids- Commen s (note co dition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revixed 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 71 High St , Cotuit Owner: Raleigh Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) r Qr Jb` ) 1 � I 3 A (rovised 04/25/97) Pago 9 of 10 �� SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: . 71 High St , C o t u it t Owner: Raleigh Date of Inspection: V- Depth to Groundwater J`� Feet Please indicate all the methods used to determine High Groundwater Elevation: / Obtained from Design Plans on record f/ Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data De 'be in your own words how you establis ed the High Groundwater Elevation. (Must be completed) l o1r� Jos 1����-� 9 9 l _ r (revised 04/25/97) Page 10 of 10 .ti. ... TOWN OF BARNSTABLE a,uCATIO�' l- SEWAGE # VILLAGE ASSESOR'S MAP & LOT�� ra IN M 1 ZXS NAME&PHONE NaDlq�- SEP-nC TANK CAPACITY '= QdZaAi AkLEACHING FACILITY: (type) (size)/dam NO. OF BEDROOMS 3 `1� BUILDER OR OWNER h o MaZigA44 i'ERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adiusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i I i j ,1 TOWN OF BARNSTABLE pf LOCATION �� ���T� i SEWAGE # VILLAGE TL//T- ASSESSOR'S MAP & LOT S CJ INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY ldt!V 9 LEACHING FACILITY:(type) li dreo C4 ) NO. OF BEDROOMS PitIVA E_� zL O UBLIC WATE BUILDER OR OWNER DATE.PERMIT ISSUED: ��� DATE ,COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No I 1. 1 1 J J LOCATION"` SEWAGE PE-RMIT NO. VIL AGE INS:TA'LLER'S N-A ME . & ADDRESS x: a: t B U tLb E R //��R, OWNER M V�f1., DATE --PERMIT.' ISSUED °' =` ' ' • D-ATE COMPLIANCE ISSUED' 1 ��D, , �� ���._ ��Ly Lv ,,, --� No.......' �.. . ....... Fug �?......-.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT �...._..... .OF. ......._----------- ------- ------------------- Applirutiun -fur M,4puml Works Towi#rurtiuu Vamit Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System ..A A ,S' Location-Address or Lot No. iyr o .u------ Owne — Address w ----�- ... .. � ------ ---------------------------•--- ------------............................. ...... a .... Ins alter Address Type of Building Size Lot....------------------------Sq. feet Dwelling—No. of Bedrooms... -----------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ----------------------_---- No. of persons---------------------------. Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic "Tank—Liquid capacity------------gallons Length---------------- Width_...__.___--- Diameter---------------- Depth._...-_------ . x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area........----- ------sq. ft.. Seepage Pit No--------------------- Diameter......--.....---.... Depth below inlet--.-------.-_--- - Total leaching area...._.. ......----sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------- ------- .................................................... Date------------------------------------ Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water................._..___. (� Test Pit No. 2................minutes per inch Depth of Test Pit.............--..--. Depth to ground water------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------------- 0 Description of Soil--------------------------------------------------------------------------------------------------------------------------------------------- -------------------------- x 1"1 - ------�-.-�-,�� P� l ---- -- VNa ure of Repairs or ltera ' s—Answer wh pplicable.--s2' .... .. `—l 00 0-- J --------------- ------------------------------------------------------------- greement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article \I of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be � sued y the board o he h. Signed-•(/� % �!... ... 1l??? . Date ApplicationApproved By------- =-------------------------------....................................... ........... =:.... Date Application Disapproved for tlae following reasons:---•-----------•----------•---•-•---••••----------------------------•--.............--•---•.................... -----------•------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Date PermitNo........1r),...................................... Issued........... ............................................ Date `--------- - ------------------------------------------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT Tlit-U/y �........ - OF. .. .. .�1�-� r/J.............. .......................... Appliration -for Dhiposal Worho Tonstrurtiott Vrrmit Application is hereby'made for a Permit to Construct ( ) or Repair ( n Individual Sewage Disposal System a : " fit �c ........... G�"�j���?�° ! � .. ....... Location.Address or Lot No. VV V ....... _ ------------------- Owne Address ----•-_------ -'-- ....--- •• ............................... ..............................................................................................•... Ins alter Address UType of Building �, . Size Lot•.--_--•----______________Sq. feet �-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building --------------------------•- No. of persons..-_-_•-----________-_--__- Showers ( ) — Cafeteria ( ) d Other fixtures ---••------------------•----•-•---••----------------- W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. W Septic Tank—Liquid capacity------------gallons Length-___________-- Width_-------------- Diameter................ Depth---------------- x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter-------------------- Depth below inlet_•--_-________--__. Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY------------ ............................................................. Date------------------------------------._.. HTest Pit No. 1_-_--_______-_minutes per inch Depth of Test Pit-._________________ Depth to ground water............-..-_------- (s, Test Pit No. 2................minutes per inch Depth of Test Pit_----------------- Depth to ground water-_.-.----_-..------..... 9 --------------------------------------------------------------------------------------•---.................................................................. 0 Description of Soil-------------------------------------------=----•---------------------------------------------- --------------------_-. ---------------------------- ------------------ x ------------------------------------------------------------------------------------------------------------- . _ U Nat re of P.epairs or itera s—Answer wh plicable._. '�7 �._._j� T`� - -• -•----•-•--••-•-- ' -y-�----••-•-----------------••---------.-----.---------•--•-••-•---------------------------------- greement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the boar of hhee bh. Signed... ..' -?'?1•�'. / 1�� /--.------ �------------------------ Date ApplicationApproved By---------f�I-'-/c-------------------------------------------------------------------------- Date Application Disapproved for tlae following reasons:-------------------- -•---•-•..........------ •-••-•---------•------ ................... .---•-----•- ------------•-•-----------------------------•-----------------•-----------•-----------•------------•--••------------•--•- Date PermitNo------------=I---------•---•--------------••----------. Issued........................................................ Date w THE COMMONWEALTH OF MASSACHUSETTS l j !? . BOARD OF HEALTH ` .........O F..�? i'- '? -!.....a`....... ....................... Ir x1rdifiratr of f illImphatta > THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by......... A - e,c: " S/",-tt , • - ................T--•---•...••-•-------------------------•--•----•------•--•--•------------•--•----------•--••---•-----•......-•------••-- Installer at. I C 'i T u i y;z!/ , f 1 -f i,, f ��G - f!.✓i �f - ......................------------------••-•--............--...._......-- --•------•-•..............--------•--......•------••---•-•-•--•----..................----- has been installed in accordance with the provisions of :Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No--------;�7........................... dated..----.---:_- %.....�-_ 7............... THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIOJN SATIS ACTORY. DATE -wi -• e.' l = Inspector-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH !.. .�' :r . OF...........14, :G T/T �r c ................................. r—No..........5......... FEE U Binpoml Morkii Cnontitrurtion ramit Permission is hereby granted........:.........____.__..��____.___(_� 3._�___..��>.uj 5. . -•-..._.. ............................................................ to Construct ( ) or Repair ( �) an Individual Sewage Disposal System at No-------------'� �" -•---=-----------•' :. 't1_L T...: r f .-, - Street - as shown on the application for Disposal Works Construction Permit No------S_.._!0-_____- Dated-------- _ a`'" . - - --------------------------- ----...-•--•-----••---......................................._ _ • Board of Hea1t DATE.---•••-----/ ---.y� . i FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS WALL/DEMO LEGEND E E WALLS AND ITEMS TO c �' SE REMOVED _ cEgISTIN&A144 TO QC. _ A u ' REMAIN � N NPY1 WALLS s'n-a m DEMO NOTES o mod„ DN. MUD HALL vn. EAvnN&OASI¢D WNDOWS 4 WALLS o _� .• - To BE REMOVED AND PATC.NED AS p Q A N�OR REN.K,ED AS NOTED. I ' O bEraBLAL PLAN NOTES , r ______ ALL EJfT.WALLS TO BE 3965R16' O------ ALL PLEW NOTED OTRERWSEI t m ALL INr.WALLS TO E£7x45 a Ib' p OA.NrLE55 NOIID OMEAWISE) ' �2� r' KITCHEN - - - ' KO�—.—E%frT OPE1. 71F78-• . MMnNs:yr x ZU � _ .. _ -YULLs W TN racXEr Doors ro - - Be 7X65 MPILAU . .. F111 .. -WNDERS AND 0-SMRENCH S I Re TO TO LEVATI 'FOR KIRIE9 A�r0 o�IDIQ C FLEVAn016 FOR WNfiN PATTEfWS) tm WI-REFER 70 ELEVATIONS FOR RDOW - RA.NEIbNTS ABOVE SI,BRAOR �_/-� N .. N r I I - ..� ' i •- -FROM ENTRY DOOR 70�R°filg VALLEY _ � 294'3 a BAY - 72 - BAT --- - --- ------------- -------- r a INTO E%KT.ROOF ' rgg ��'— ---------_______ OSN7E5 OP evxED !_____yam KND01A NOTE w"VEWRA.WI�MMnrg:vy ; .. - OO LOYWWPTOBATH 3HALL - DEr.BEDROOM I A.m : . •.. REMOVE E%R)T.LYYAR . + RAILINS 4 ROOF - .. r r � r EXISTNS CvLM6 BATH IBEANO ABOVE, - LIVING I --- r _ ms$6�R �c� . MAm"WALL EXTEND ROOF INTERIOR W E<ISTM ^Y�d r Iec'� aeee - --- ----- - --- - -- ------------- --- ;-- i- ----------- ALION ----------------- ----\ $ MArcNwuL Elb f m e3e: s q 4 - ------- - w FxlsnRs .. - A Ras� a5. 3 0 POORE ir ,%BEDROOM SITTI A1F-901a m S -M Tf -3 1 DEEP SILLS FRONT WNPOVG D .—NS.DY1%IN- l4 - r�V1 OORFEA PRO.FLnON MM.7/)) - TO MATCH E%ISTNB r �• 5-0 LA I RR+MnNE.20 m I r G t N V) % L--------- -------' / '\- V) ' ICU - N v cd -- - -I --3 h �./ -0 pl rcNC ve STO WALL LOCKINb I e I G I + + g - I $� r187 euevED RooF I �. =G O ATTAYAED 0 E%IsnN6 WVl .. OV9BWHS w I % 7 � g ` L_ SIEAnIINb s EXIST.9ND i aRAQ�i9 -3 I P�`%49' - +,�{� I ..;tb a`+'4. .. - �� _ -3 �. ----- --- ------ +�-', L.L —11. @ C � _4 /IF rJ )SFaRRaoP - I -3 OVERH� 0 x ,M1 WRIDOYI AO[J�9 r $" jvk OF MASS B•d 4'-S. V-=. S'4' W-I. 6� i i O� ERIC J. G a ' job no.: ISIa I CEDER[ OLMi rn date gNooE eea2ols O STRUCTURAL y scale AS NOTEv O No. 38962 I drawn 2-4.VY .In' Y-10 1/2' ]•-N)V3• rev. F ' rev. F I RST FLOOR FLAN 51r eo. ED. s'9 - II N � 1 � SCALE. I/4• . I—O' � • � A J s S E C O N D F L O O R PLAN - 5 G A L E: 1/4' e 1•-b- ISSUED FOR CONSTRUCTION sht I of e i r SE --- - - ... ro'n cur Imo ROOF POR NIIDON nl,eJ� �y�.�I.eno-coniev wPPER � � � - KiR4�LT P/J1 RAJ'Nb OM1 - •E 'C RO HATGN E)OSi CMAL L ARLIOIEGMIAL - - M � W D M M Ossi1D I-TCN EJDST (TQ14ATCMEXWJ _ ALIM.GUTTER (11)qEJ K OMER , C - ML.90N6LE5 (TO NATGN ElOSTJ �4 GMW-mb r£D DELORATIVE to U Nb•IO:M LA6D¢S PE&Ms (4 Vl fJ�OvIdEJ vECOLl jrvE 511NW.G FLARED FAcDt AA _ LONTNAUZ FMM 918-ILt✓D i.�t aE{ m - yW V•SE FLri——-— �Y SEGOPm FiR— r F 1 _ --- ho Dora E,OSTJ _ v tB g19iB ROOR ------wr --- —-- —--- -- rtiBF _—_ — —————--—_—-- --- GF6Sr� ._ •2Ro ---- — --- LppR cc fro�%Tcm Elm) Mimi n sHiftwWLA Ems MA TJ PROPOSED RIGHT E L E V ATI ON • " - SGAL E. 1/4" a I-O' Ila PROP 0 5 E D F R O N T E L E V A T I O N SCALE, 1/4" • P-O• - - • - - - l- —� 9 A s Nei .. �• - , - , v.. ' .. --------- --- AW-4ff611RAL N 1 AS VITT sN RO HATE • .. •. a y+ W .� IMI �c (a O cf0 W — -——�� (�9'fC QERICe� �J. ERIC J. r�l-- I I M EDERHOLM c:ly BRAu�r 0 STRUCTURAL -rJ B&4&m " V NO. 38962 °' job no., mm oI � d `�'•IX VON•FAO:J5103 date B NWEDsR 2015 OF DAY W CONr.S,LL �^ ' / =ale AS s T FLOOII — DL IHI BY SFEGTEi ------ --—------ —.--_ — ------ --- ---�� — \ :(\]�?%<^;•N<!-•:J•-p NOTD -------- -- — 2AER— ---------- ORT BAG draw , SIMILAR - •uvm[+ �� rev. rev. PROP 0 5 E D LEFT ELEVATION - A-2 5GALE. 1/4• ISSUED FOR PERMIT Al 2 of 8 1 e E s M a d h N O W t N OT . W Ol M = L V ' ARCNITELMtW.ASflLY.7 .. .y -_______________________________ � 41 ' ROOP SNPffiI.GS .. w +..r fT0 MATGI EXISTUI6) ' Oe O ,)✓ W CAX PLYft= O 7XIM 0 IS,ot. p.0cF SHMAUM ASPHALT = y fro lv,TCA PASTW a M m ccTJ� w rnx PLYPOOO • ] O 7Xt05•I5.OL. m WW "RwsTl� 0 v7Ix ay eoAw :' e j ,o 0 oN 9PSrpAPPrt15 �+ AMM MMtAL ASPHALT ]XIO olD.JOISTS _ / AT.) BEDROOM 4 1 _ BE $ OR M 3 _ stee e W oY� pApR IIBISOTTMAL ASPHALT 1 A.NATI. EXI571N6) f' JR %W WX PLYM000 ] E%IST.FlO00. • 7A05.Ib•OL. T.Pi W d .4�OlElFIR.— —:— - - • ; .5EGGN0 PLR � Ll t-— ;\ ,' yI/17O• 1.IS1,Eg I 7Yb RTW00D - I'1 V 3 LIVING LIVING y O SITTING .. � • .. w ._ DUST. . / 1 , EXI57:FLooR 04 cn 5�fiDON uNB PLooe__ Mvm�/l - •\ � 41 � - SEGT.I ON A s SECTION 'la - SG AL E1-0-'a 1/4' • 1O' - ' " - - SCALE. 1/4' s 1-0----------------------------- ARCAMAIRAL ASPHALT $eu�sr'5` fro HATLSK N 24 f 0 PLTYtOODa AIM w i�15 W AW9TECTWAL ASPHALT J0,10M Y/ I+AiiPJasTSu) 4 HALO - t N 7A09 s le oIULAI _ - ♦+ Q� � 3 O U ( ��p _ U �.�yS O F�•?,� - ay O m N N um TLe etnoeoAlm i - • � .�. sTs OX=C". ----- "f----- LIVING - • ERIC J. Y PLii°P I - 444 CEDE! HOLM t -•. Q (� 0 =p ❑ U STRUCTURAL _ O " v No. {i(y,� exrsT.aoort `' 38962 r P CO job no.: &5 date . a Novv4gm 3o15 SCele AS NOTED SEGTI ON drawn: SCALE. 1/4' • I'-O' rev. _ rev. A_3 ISSUED FOR PERMIT 514 9 of a _ - EXIST.SHINGLES ARCHALT MAU LES - CM EXIST.FRAN ASPMLT SHINS < A N (D MATCH EXi5nN5) - KN'NALT SIBYaf.ES m l0 ITO MATCH EMTOW OXIO RAFTERS Ex.AWi WRIER b lb.OL. ON IX FASCIA F .0 In m N ALM DI✓8 EOOE � ++ � HIM VW SOW ALIM WRIER ON I_ • • I M OI 10 Lx FASCA I m r IXIx 90R°a VC FASCIA � EX6NG SlU0 MAIL III SOFFIT - Iran" m ' FBGb LffD taOLDlfab _ O +� Ix FmAmm)v 5 UY -W6 am MOI.DINbp IX SOFFIT m N yr cox PLYMoon - (R1E) Om'µ .o V EXI5TRL5 FOOR FRAMNS rie 10,EWJ 9 Vl i1AAT N� reolb�c`YMo�oas F rt al eXt ns Nr�Es - � 1,•f;Yd OF Il/j,+;js�� 12 ON VCN2 ED 2X BBLOMN9 ERIC J_ urCEMFeoAsm CEDERHOLM 1-4 in V eXLSnNb Frew.MALL . 0 STRUCTURAL -f 1 .0 O I/4' - _ V No. 38962 u� w C) ar l61EAo 29� a - = I Of TRIM s ODETAIL o GABLE WALL BUILD-OUT SAVE DETAIL AT LIVING (LEFT) £ SCALE,11/2•a I'-0'- SCALE.1 1/2'o r a TOM ' ho MArcH EXISnw) .. - T - w INTO ROOF FOR MINOOW f T�I ACCESS LEAD COATED COPPER bN CARVED III.3 I• PAN FL06HINs OR SIMILAR - ` - - 5//CAP IV _ _ - ADM cep MOLOMS '- 3 EWE BEYOND .. • .. Y Y S�—'�S`e5�— .E^6i EAVE DETAIL AT 51TTING $a `� =( �ygy�5. a ARCIFIZTWTAL _ _ O SCALE.I Vr-1•-0' AWHALT SNRKIB - 2a g tY'GP (IO MATGIFx6nl15) - - V4-WX FLYljV=W Ul I'<`pp �t}�i� S� m ' ALM DRIP EDGE .6 off-LIT: S a m AWHITESTIVAL _ to -• '• � - - . � � (ToMArulewsnNs) BEGIM axe TO vre' 1XI0 RAFiFRS - ' - it W •I•+ BGRF,6 •' I I I sib'OL _ • .,-. W 3 w.w.ORPWISE —————— I I II I ------- AscL oN 0-0 L U I I I i =HS FLOOR FRAxRS LUFL MP AM ¢osE ;SOFFIT E V I _ I a MEM N 0 0L 0)(Q N VWM FASCA i.. ` / Vr COX PLYWOOD txscmT I II I IXFRIlIEAPAD^ j .. cc O sGASw N atDN NOIb 0 a®MnTs Ix Sam ON P 05TO�L'STUDMALL - S T I I I I h to Le. OR snalAR I I I I S/x CAP N v III OI I I I Ieab am MOLOIM Job no.: am date a MovEmwR tots LNE OF III MALL �rao I II I p LINE OF EXIST.MALL _ scale AS NOTED BEYOND drawn: j-w O I II I S I I I EADF�wy�"s D rev. 5:4'd- I O EAVE DETAIL AT ENTRY O SAVE DETAIL AT BEDROOM 4 DORMER O EAVE DETAIL AT FRONT I' A-4 SCALE.1 V7'. -O' SCALE.1 V]'.t'-O" SCALE.11/7'v I'-O• O �� ISSUED FOR PERMIT slit 4 of a 5:CONCRETE BRICK SHALL CONFORM 10.ALL PLYWOOD SHALL BE APA SHEARWALL HOLDDOWN SCHEDULE G GENERAL 3.WALLS ACTING A5 RETAINING WALLS TO A5TM C55. + PERFORMANCE RATED PANELS CONFORMING a SHALL NOT BE BAGKFILLED WITHOUT TO THE FOLLOWING MINUMIM REQUIREMENT5: BRACING UNTIL ALL SUPPORTING SOIL b.GROUT SHALL CONFORM TO THE FOUNDATION HOLDDOWNS $ ANCHOR BOLTS: cc I.STRUCTURAL DRAWIN65 ARE $ SLABS ARE IN PLACE $ AT REQUIREMENTS OF A5TM G 146 $ A. FLOOR-STURD-i-FLOOR T$G,EXPOSURE 1, 5 TO BE USED WITH THE ENTIRE ADEQUATE STRENGTH. SHALL HAVE A COMPRESSIVE " r- y SET OF DRAWINGS. 3/4°,SPAN RATING ib . STRENGTH OF 3000 P51. ,� R 4.COMPACT ALL FILL UNDER FOOTINGS HOU5-5D525 NU 55TB24 5/5"DIAMETER ANCHOR BOLT B.WALL SHEATHING-EXPOSURE I, 1/2', 7.VERTICAL $ BOND BEAM O W/GNW 5/5"COUPLER NUT BETWEEN 55TB24 $ 5/8" Li 2.ALL SAFETY REGULATIONS $ SLABS TO THE SPECIFIED DENSITY, SPAN RATING 16". THREADED ROD INTO HOLDDOWN. POSITION 55TB24 w ARE TO BE STRICTLY FOLLOWED. $ VERIFY. REINFORCEMENT SHALL CONFORM o w c METHODS OF CONSTRUCTION $ TO THE REQUIREMENTS OF A5TM A615. G.ROOF 5HEATHING-EXP05URE t,5/8", ERECTION W/ANGHORMATE TO FORMWORK PRIOR TO CONCRETE SPAN RATING 16". POUR FOR CORRECT PLACEMENT. ." 0 as 15 THE CONTRACTOR'S RESPONSIBILITY.STRUCTURAL MATERIALS STRUCTURAL STEEL 8,MORTAR SHALL CONFORM TO THE ,� 'REQUIREMENTS OF A5TM G 270 m � I.DESIGN,FABRICATION $ ERECTION AND SHALL BE TYPE M OR S. DESIGN CRITERIA H1 CNVi-525 W/COUPLER N BE DIAMETER ANCHOR BOLT g 3.THE CONTRACTOR JS RESPONSIBLE O W/GNW 7/8'COUPLER NUT BETWEEN 55TB28 $ 7/8" � e FOR P155EMINATION OF ALL SHALL BE IN ACCORDANCE WITH THREADED ROD INTO HOLDDOWN. POSITION 55TB28 q.QUALITY ASSURANCE TESTING $ o +r REVISIONS $ REQUIREMENT5 TO THE AISG SPECIFICATION FOR INSPECTION SHALL BE PERFORMED 1.APPLICABLE BUILDING CODE W/ANGHORMATE TO FORMWORK PRIOR TO CONCRETE THE SUBCONTRACTORS. STRUCTURAL STEEL FOR BUILDINGS, IN ACCORDANCE WITH THE MA55AGHU5ETT5 8TH.EDITION POUR FOR CORRECT PLACEMENT. LATEST EDITION, RE_QUIREMENT5 OF AGI 530.1/A5CE b/88. 4.REASONABLE CARE HAS BEEN 2.DE516N WIND SPEED: 110 MPH HDU14-5052.5 W/5BIX50 1'DIAMETER ANCHOR BOLT TAKEN IN THE PREPARATION OF 2.STRUCTURAL SHAPES SHALL CONFORM EXPOSURE G,1=1.0,G= +/-0.18 14 W/GNW I' COUPLER NUT BETWEEN 5BIX30 $ I" TO THE FOLLOWING: FRAMING LUMBER $ CONNECTORS c ALL DRAWINGS AND SPEGIFIGATIONB.. O THREADED ROD INTO HOLDDOWN WITH HOLDDOWN { HOWEVER THE ENGINEER DOES NOT ATTACHED TO 6X6 POST. POSITION 5BIX30 W/ GUARANTEE AGAINST HUMAN ERROR A.WIDE FLANGE MEMBERS A5TM I.ALL FRAMING LUMBER SHALL BE STRUCTURAL DE516N CRITERIA AN(HORMATE TO FORMWORK PRIOR TO CONCRETE V y $ FOR THAT REASON IT 15 IMPERATIVE Agg2 GRADE 50. KILN DRIED Iq%MAXIMUM MOISTURE - POUR FOR CORRECT PLACEMENT. w THAT THE CONTRACTOR SHALL CHECK CONTENT. LUMBER SHALL MEET • E-1 ALL DIMENSIONS $ DETAILS $ MUST B.CHANNELS $ ANGLES A5TM A36. A5 A MINIMUM THE FOLLOWING -FIRST FLOOR 40 P5F LL _ VERIFY ALL CONDITIONS,DIMENSIONS, G. H55 ROUND $ RECTANGULAR TUBES DESIGN VALUES FOR 5PRUCE-PINE-FIR: 10 P5F DL w $ ELEVATIONS AT THE SITE.ALL - SECOND FLOOR 40 PSF LL n 015GREPANCIE-5 SHALL BE BROUGHT TO A5TM A 500,GRADE B FY=46 K51. A.2X STUDS CONSTRUCTION GRADE H TO THE ATTENTION OF THE ENGINEER FB=800,FV=65,FG=750 10 P5F DL CONNECTION TO CONCRETE FOUNDATION V +- 3.ALL GALVANIZING SHALL CONFORM -ATTIG/STO. 20 P5F LL C a� 5.THE CONTRACTOR SHALL SUBMIT TO A5TM A 125. B. 2X JOl5T5/RAFTER5 NO. I GRADE 10 P5F DL FOUNDATION SILL PLATE CONNECTION TO CONCRETE: C� FB=1I50,FV=70 - ROOF G5L 30 PSF 5L COMPLETE SHOP DRAWINGS FOR a ALL CONCRETE REINFORCING,ALL A.BOLTED CONNECTIONS SHALL BE WITH . G.POST NO.i GRADE FB=800, 10 PSF DL 5/8' DIAMETER ANCHOR BOLTS® 32"O.G.STRUCTURAL STEEL,$ BOTH HIGH STRENGTH BOLTS IN ACCORDANCE FV=65,FG=675 � � R CALCULATIONS $ SHOP DRAWING5 WITH THE SPECIFICATION FOR - EXT.WALL5/5TOR. I00 PLF DL FOR ALL MANUFAGTURERED LUMBER STRUCTURAL JOINTS U51N6 A5TM A.525 NOTE: ANCHOR BOLTS REFERENCED ABOVE TO BE 5/8"DIA. PRODUCTS $ THEIR CONNECTORS OR A 4910 BOLTS. 2.ALL FASTENING OF FRAMING, - INT.WALLS/STOR. 80 PLF OL A301 STEEL ANCHOR BOLTS W/3"X 3"X 1/4' PLATE WASHERS r 0*0 FOR REVIEW PRIOR TO FABRICATION. PLATES,SILLS,SHEATHING $ W/7"MINIMUM EMBEDMENT INTO CONCRETE. OTHER WOOD MEMBERS SHALL - DECK5/PORCHE5 40 P5F '� 5.ANCHOR BOLT5 SHALL BE A5TM A 507. IO P5F • BE IN ACCORDANCE WITH THE CONCRETE DETAILS SHOWN $ MINIMUM 6.WELD5 SHALL BE MADE BY OPERATORS - REQUIREMENTS OF THE I.ALL CONCRETE WORK AND MATERIALS CERTIFIED BY THE STANDARD MASSACHUSETTS STATE BUILDING SHALL COMPLY WITH THE SPECIFICATIONS QUALIFIGATION PROCEDURE OF THE CODE 8TH EDITION. SHEARWALL SCHEDULE FOR STRUCTURAL CONCRETE FOR BUILDINGS AMERICAN WELDING 50GIETY. (AGI 30I-Sq). 3.CONNECTORS 5HOWN ARE A5 - Z93 g 7.WELDING SHALL BE IN ACGORDANCE MANUFACTURED BY 5IMP50N WALL TYPE SCHEDULE: _ oz 2.ALL CONCRETE SHALL HAVE A 28-DAY WITH THE AW5 01.1 CODE FOR WELDING STRONG-TIE 60. INC.SUBSTITUTIONS' COMPRESSIVE STRENGTH OF 5000 P51, - IN BUILDING GON5TRUCTION MUST BE APPROVED IN WRITING 8 g WITH MAXIMUM I INCH AGGREGATE $ 6Y THE ENGINEER. INSTALLATION, 15/32" PLYWOOD-(EDGES BLOCKED) " OF ALL CONNECTORS SHALL BE • SD COMMON OR GALVANIZED BOx NAILS MAXIMUM 6%AIR ENTRAINMENT FOR 8.CONNECTIONS NOT DETAILED SHALL IN STRICT ACCORDANCE WITH THE @ 6"O.G.EDGES $ 12"O.G.FIELD. Zr 3 EXTERIOR CONCRETE EXPOSED TO BE DESIGNED FOR THE LOADS SHOWN THE MANUFACTURER'S INSTRUGT10N5' MOISTURE. ON THE DRAWINGS OR FOR LOADS $ MUST EMPLOY ALL REQUIRED 15/52 PLYWOOD-(EDGES BLOCKED) GIVEN IN THE STANDARD LOAD g ± 3.ALL REINFORCING STEEL SHALL BE FASTENERS. - 2 8D COMMON E GALVANIZED BOX NAILS TABLES OF AISG FOR THE SPAN, ®3"O.G.EDGES $ 12°O.G.FIELD. SECTION $ STRENGTH SPECIFIED. DEFORMED BARS OF NEW BILLET STEEL E o CONFORMING TO ASTM A 615 GRADE bO. 4.ALL CONNECTORS SHALL BE, �= 9.ELEVATIONS NOTED AS"TOP OF STEEL° HOT DIP GALVANIZED. 15/52"PLYWOOD-(EDGES BLOCKED) 3 8D COMMON OR GALVANIZED BOX NAILS 4.CONCRETE COVER OF REINFORCING BARS REFER TO THE TOP FLANGE OF ROLLED ® 2"O.G.EDGES $ 12"O.G.FIELD. SHALL BE AS FOLLOWS: SECTIONS. 5. INSTALL ALL CONNECTOR FASTENERS - - FRAMING AT ADJOINING PANEL EDGES BEFORE LOADING THE JOINT. SHALL BE 3" NOMINAL OR WIDER $ H OF 49,yS 0 A.3"AT CONCRETE PLACED DIRECTLY NAILS SHALL BE STAGGERER • F.� `Ss U V AGAINST EARTH. MASONRY 6. SPLIT WOOD 15 NOT ACCEPTABLE L S C 4- N co) FOR ANY CONNECTION. O ERIC J. �\ •'r N � 7 N B.2"AT ALL OTHER LOCATIONS. NOTE: FOR PLYWOOD 5HEARWALL TYPE5 I,2, $ 3 =�', N O I.MASONRY CONSTRUCTION SHALL CEDERHOLM ;nt.• 0: �L LISTED ABOVE,SD COMMON OR GALVANIZED Z CONFORM TO THE REQUIREMENTS 1.ALL EXPOSED FRAMING MEMBERS NAILS -(0.131 X 2 1/2")GUN NAILS MATCHING THE 10 STRUCTURAL {ka ++ N(1)N 5.NO HORIZONTAL CONSTRUCTION JOINTS OF SPECIFICATIONS FOR MA50NRY SHALL BE TREATED PER AWPA- NAIL DIAMETER $ LENGTH MAY BE USED AS A v No. 38S62 �`V C N ARE ALLOWED,UNLESS 5PEGIFICALLY 5TRUGTURE5(AGI 530.I/A5GE 6-88). C2/Gq GGA 025 $ MEMBERS IN SUBSTITUTE. 0 -c SHOWN ON THE DRAWINGS OR ALLOWED STRENGTH OF MASONRY F'M=1500 P51. CONTACT WITH 501L SHALL BE '� " r, .2� �� IN WRITING BY THE ENGINEER. TREATED PER AWPA C23/024 y,;, G, •� L 2.VERTICAL REINFORCING OF MASONRY GGA 0.60.JOB SITE FABRICATIONS 6. REIW awc EMEEP rrr 9TAWARD WALL5 SHALL BE AS INDICATED ON GUTS $ BORES SHALL BE TREATED IN SHEARWALL CONSTRUCTION: ' - -fir• - +' _BAR LEMTH xoac ACCORDANCE WITH AWPA 5TD.M4. I� THE DRAWINGS. ALL GORES OF '` Q MASONRY UNITS SHALL BE FILLED I.ALL 5HEARWALL5 TO HAVE DOUBLE TOP PLATES = U s 16• n• WITH GROUT. REINFORCING BAR 8.ALL MANUFACTURED LVL V400D FRAMING $ DOUBLE 2X.5TUDS AT EA(H END OF THE WALL .6 „• „• LAP5 SHALL BE 2'-6"MIN. MEMBERS SHALL RAVE THE FOLLOWING - ., 94• ,B. PHYSICAL PROPERTIES A5 A MINIMUM: 2.FACE NAIL DOUBLE TOP PLATES W/160 NAILS® 16"O.G. 3.HORIZONTAL JOINT REINFORCING 6 USE (12)- 160 NAILS AT EACH 51DE OF LAP 5PLICE5 IN TOP job no., ims FOR MA50NRY SHALL BE EQUAL E=2.0 X 10 P51.,1`5=2800,FV=240. PLATES. _SPLICE LENGTH TO BE A MINIMUM OF 4'-O"LONG. FOUNDATIONS TO DUR-O-WALL TRU55 MANUFACTURED data 9 Wver®M 2015 WITH WIRE CONFORMING TO A5TM A 82 q.ALL FLOOR J015T5 SHALL BE AS 3.NAILING FOR PERFORATED 5HEARWALLS TO BE CONTINUED scale , A9 NOTED $ COATED FOR CORROSION PROTECTION MANUFAGTURERED BY BOISE CASCADE ABOVE AND BELOW ALL OPENINGS IN SHEARWALL. I.THE ALLOWABLE PRESUMED 501L IN ACCORDANCE WITH A5TM A 155, drawn, an BEARING GAPGITY 15 3000 P5F, 8 A5 SIZED ON THE DRAWINGS. ALL WHICH 15 TO BE VERIFIED IN THE FIELD GLA55 B-2. ALL WIRE SHALL BE FASTENING,BEARING,BRACING 8 4.ATTACH DOUBLE 2X STUDS 8 BUILT-UP CORNER STUDS AT rev. , BEFORE CONSTRUCTION. LAP GAGE MINIMUM. PROVIDE MINIMUM STIFFENING SHALL BE IN STRICT ACCORDANCE 5HEARWALL EN05 W/(2) 160 NAILS a 6" O.G.FOR ATTIC/ LAP OF 6" $ USE PREFA13RIATED T'S WITH THE MANUFACTURER'S REQUIREMENTS. 5ECOND FLOOR 5HEARWALL5 AND(2) I6D NAILS® 4"O.G. fev ' OR CORNER 5ECTION5 AT ALL STAGGERED FOR FIRST FLOOR 5HEARWALLS. 2.FOOTING5 SHALL BE CARRIED WALL INTERSECTIONS. p TO LOWER ELEVATION THAN SHOWN 5.REFER TO HOLDDOWN 56HEDULE FOR TIE POW45 AT � a ON THE DRAWINGS IF REQUIRED TO 4.CONCRETE MASONRY UNIT5 SHALL SHEARWALL ENDS. S- 1 - REACH PROPER BEARING CAPGITY. CONFORM TO A5TM C q0. ISSUED FOR PERMIT snt 5 of 8 E c,i I 0 ' 6ENERAL NAILING Sc eOVILE-No MFN u JOINT OSCRIPTION LOMMON NAILS BOX IIA.IL9 NAIL SPAGN6 {2 uo O •V • - ROOF FRAMING y� O t rA . BLOLI4NG TO RAPTEA(TOE-NAILED) 2-Sp 2-IOW EACH END ua r0 RIM BOARD TO RAFTER(END-NAILED) S _ 2-IbD 9-06D EACH END • WALL FRAMING TOP RATES AT INTERSECTIONS IFAGE-NAft") 416D S•MD AT JOINTS L5TA STRAP a I6.O.G. STUD TO STUD(PAGE-NAILED) - 2- M • 44 (E'ER GSN) � IbD �-Lev 2a•ot. •, HEADER TO HEADER(FACE-NAILED) 16D 16D IB'O.G.ALONG ED6E5 m • FLOOR FRAMING • o s ROOF SHEATHING JOIST TO SILL,TOP PLATE OR 6IRDER(TOe-NAILED) q 480 41017 PER J05T BLocaNS TO J015T(TOE-NAILED) 2-00 2-IOD EACH END o -4-T (1)- IOD NAILS BLOCKING TO SILL OR TOP PLATE(TOE-WAILED) 9-I6D 4-I6D EACH MOCK e EACH END . _ - LEDGER STRIP TO SEAM OR 61RDER(FACE-NAILED) 9-16P 4-16D EACH JOIST to 0 JOIST ON LEDGER TO BEAM(TOE-NAILED) - 9-w 9-100 PER JOIST SAW JOIST TO J015T MN7-NAILED)' - -_ 8-16D 416D PER JOIST =• • - - BAND JOIST TO SILL OR TOP PLATE(TOE--NAILW) 2-161) 9-16D. PER FOOT a �1 + + { + ++++++ ROOF SHEATHING + WOOD 5TRUGTURAL FANEL5 . - -RAFTERS OR TRUSSES SPACED UP TO Ib OL. _ BD NOD 6•EDGE/6'FELD SEE ALTERNATE RAFTERS OR TENSES SPACED OVER IV OZ.. BD. _ - IOD WEDGE/4'FIELD - .. - -GAELE EHDIYALL RAKE OR RAKE TRUSS rvo GABLE OVERHANG - 8D _IOD 6'EDGE/6•R6D . -• -SAME EHIMALL RAKE OR RAKE TR 56 W/STRUCTURAL OVN.00KERS aD IOD 6'EDGE/6-HELD s V w ROOF RAFTER PER PLAN _ - - - -GAME ENvwnLL RAKE OR RAKE TRUSS w LOOKcar BLOCKS 8D IOD 4'EDGE/4•FIELD � O V ., CEILING SHEATHING ^ m F - - U .... _ GTP51W WALLBOARD .... 5D(.00lERS T EDFiE/10'FlELD '� •� ALTERNATE, ATTACH OPPOSING RAFTERS - WALL SHEATHINS _ . BELON RIDGE BEAM OR RIDGE BOARD YV . - - - 2X4 COLLAR TIE AS SHOWN.RIDGE STRAPS WOOD STRUCTURAL PANELS - - ` - NOT REQUIRED NHEN U51NG A COLLAR TIE. - - - cc -STUDS SPACED UP TO 24'O.G. - 8D 10D - 6'EDGE/Q'FIELD • • - -1/2'AND 25Y52'FIBERBOARD PANELS Do 9'EDGE/6'FIELD . - -V2'GYP5W WALLBOARD.. 50 COOLERS - T'EDGE/to,FIELD - )_J F EATH�G STRUCTURAL RIDGE BEAM • YlOOD S .. WOOD TIa1GTVRAL PANE1.9 0 ... . 6 NOT TO SCALE - I.OR LESS eD too 6•EDGE/Ir FOLD _ -GREATER THAN i' IOD {bD b'EDGE/b•FIELD zoo 0-3 Z ROOF SHEATHING EDGE NAILING - - - i 2X BLOCKING BETNEEN RAFTERS(NOTCH FORVENTILATION IF REGUIRED. - • - - (� + REFER TO ARCHITECTURAL PLANS FOR MORE INFO - _ - }. Q� (D t N�(0N o c N L to i-c3F R`�ss ° °)cu ERIC J. l � ~ (REOFER TO ARCHITECTURAL H2.5A(INSTALL PRIOR TO CEDERHOLM m cu Q PLANS FOR RAFTER DIMS. BLOCKING AND PLYWOOD - AND SAVE DETAILING) SHEATHING)ALTERNATE, H2A - - O STRUCTURAL. -4 = V 38962 0 � ` Z job no.: IBIS DOUBLE 2X TOP PLATE S/p date : 9 NDvEmem 2015 BEAM . - scale , AS NOTED (IF 5HOY'$'1 ON PLAN) " . drawn: ,yyL rev. rev. O RAFTER TO TOP PLATE 3 NOT TO SCALE S- 1 . 1 ISSUED FOR PERMIT 5nt 6 of o wvoo GaLtas-ALL FSL snawBR 7Al.NmEs g u E AT P"I"rH�R9 9%1 GAP EGGQ GLfb-.SM5 -ALL YmmON E%IEWOR POOR a •,t4u� Iq BAY TO OEM s FLGLI L4054W535 REALFRS TO BE 451 O%HS W/U? w •p ..�. BASE TO FOR.AB104 R7W000 WU55 NMW Om00Y m O !d _ A7 TRIPLE I�CER9 -ALL INTERIM malts RFAMRS TO BE -,� � •11 t:�ZXB5 W TQ•RTl'D.FOR]XO Y1All.+ w N H • - • 4M5 BASE TO -EGOq GGOa-g5P575 M25r71 ANDS W VP 919 FOR]X4/NL:+ u - BASE TO FOfI.ABMa DLLL`°S NOTED OINEFWI9B va N Co. o NJ.WOW-{YOOD JOINTS51Ui1 RAVE B V�B'Tb�719 i Wes'O o rp y METAL fOMFLTOA9 0IN 65 OTHWOES R T MSEN _ -MT59W STRAPS a ALL VALLIM TO -ALL P0515 B ENO5 OF�ATG TO BE ____________r - ' BMLP-W FOST5 AL 7PO POSTS INS O BEMI M CI IC ---------------------------------------------- EMT. W 7W+P0579 6BaE`f-+On�R/F'.E NOfF�! y ,e _1_________________— FLOOR I - - O r � -•OVERLAY FRM11N6 FOR RAPTFR • ---- _______ . • ------ ALL fRRfaF, TO BEZM RP] _______ OR WTR 0 Y O 1TPK'AL GA OD386Y w ` NORD •o O '. ••• , • - • -ML F IRDFR ALL MM AOR LL __________________________ i . OWL FLR J01515PLICAB VRD9t ALL W>Ll9 Y4Ei@/APNLAPtE • _________I - " W___________________________________________ 11ALt5 AMA 4 %0AMD4M*ff >� LIZIM + I _ i ,. i FRA LAPS L BASE9WOIB7 I AT ALL ALL ________________t______________ ____ , - •�. • 1 i - ' -WG1P POST DLFW EMST.FLOOR .- •• • I I - X-rnooFosTIP _ f ------ ------------------------------------------------ LOAD BGPoNSBrAt15 ri----- •--- ------------j --------------------- --'�_--------------------_-------------- 7---------- -------------`---- - -° ----- - - ' --- ----- ------: -------- O ... I 1 � a I t ------------------- _�I w.a..�as1s I ol- ----------T'------------------------------ - ------------------------ I --'-'--- F L'-----'----- --------• ------ ------------ ---------- --- ------ -- ---- r _ ----------"-'t EMST.FLOOR 411 ---------------- - -- ------------------ ---------'---- ___ -- ----------r'------------ --------------- - - _ fiKr3e ra 6L -__ __-___ _- - I, s _ ' .. I"I - - i"— - - - -- - --' -- -- . -----------i--------------- --------- - ---------- ---------- -----r -- ---------------I- • '\ -`--- --------- ---------- --RES_T.464 L4T5--- ------ r II 1 _____________ _____ ______I _______________________ a_ ___________ ___________ ____ •- ----- -�G'------------- ----------1------- -- ----- -- ------- -- ---- ------ --- - --- ---- - - ----------------- -------- -- ------------- ---- r ------------- ------------- --------------- r- _ -- iit--------------------------- i i ------------------- -- - --- - --------------------- --- ------------- -- - , P $ �I - - 'L� j - ' =- - --- — ------------ -------- tttk -- --------------------- o e W I �` x =i ' - - ------------------ -- ' ---------- -------------- _—EYGL FLOOR , " - -L_116.41616L. ---------- = �tfs i 1 --- - - —- - — ---------------- -----I r� ^11 ---------- _-- _---------- - -— - -------------- ------------------------- ---------------------- -------- - ----- ----- - - ---' - - - ---- ; --- - -- r r€xlsT.= - . r - --- —r -------------------------------- -- ----------------- - --------- ---- - Tr ' ------------'i - T rLL---- h II - �---�Ii-.I----r s--•I aW; � r --------- . , axe- ------ - - - C � 3O Bc�o �y 1 oZNLco:- � - NvHEAVIER ---- --- -- ----- --L - -- -- ---- ---------------- --- - - 12 - - -- -- Q= O 'JA OF �4 �•��' job no.: as 10 ERIC J. �G date B NUVEMMM pTI CEDERHOLM m 5 E C O N D FLOOR FRAM I N G PLAN C E I L I N G FRAMING P L A N STRUCTURAL Scala ,L', SCALE. Tia• . T�-o' SCALE, Tip• . I•-o a drawn• -LA No. 38962 v' NOR,EM SEG FLOOR EIRAIMS Www PLR TIWT .. - J feV. NDPER B�'7 TlPAL E1161 MMO®. l� S-2 . ISSUED FOR PERMIT Bt,t 7 of e I . FOOD CM"G-ALL F% e E STMrYLRAL NOTES, - u AT DOUBLE KIMERS via • 04 BASE GAP j �Q f5.GO34WSss AOE TO ff s Q ip. N TO FON a ARUM iLY/i7tTD B4E5 NOIED OIFffW'9`# Ta {� m O . - AT 1RIftL 1'ET9E0.5 -O 7XD q 1�Y'o FOR b7OLWl9 2 �i -O 49b GAP 6c<4d. -450S2S I pI 2ND8 Iv yr FLYFO-FOR Mo FALLS t H 94g TO E1E/W EGGO.00064SM5 MESS RO®Ormum N U) BASE TO FOR.A0J40cu ALL M TS a&M71OF DEA145 6 WN15 TO BE t J -ALL WOtOO-MOOD JDWS SKALL KAE dRREEB OREl8tl5E ltllED) FETAL cmw ORS _ -ALL RIDGES OVER 20-0 LONE ` -ALL STEEL GOLIR4Fi5EE a.59ELAR TO BE N I B/4'911 l/B'LVL L. i5d0f STRAPS I ALL vALLEY9 To - 0W LEDGER BOARD 4. d ru K_ T5W&POSTS 9OVEMAYFRAMINBFORRAFTER y 1. M MNGISLP vn m • -FROAMRMIEP NM ELT AT ALL ALL . FOST C PS I BASES AT ALL • FtlSf LAPS 1 RASES m E - ' -ALL RAFTERS TO BE 2O0 Spy.ND.7 0 ++ . OR BETTER 9 IV OQ raW.A. " V _____ O -BLOCK WVM ALL FALLS OR .O O DEL FM,OSTS WDER ALL PALLS • _ t NOW ARVGABLE . -BLOCK ALL BEARM&MAL1.9,ABOVE . - - 4-0 AT IYD-1ErW FDOD P05T DOIW n(-FOOD PDST W AM MM U r_' •� X-FOOD MST IN . LOAD BEI.PALLS --------------- I I I r I 1 ;r I I I I I I I I I rl i � I I I . I ' I _—------------ Ta I r ' - - - ------- I l I I ----------- -------- - - ------- ---- ---------- Ir I I I I . I I I I • ,� ___ _ _______- ____ _____________ _________- _ /V 8____—____ - ____ ____________ __-_____-_____________ ____________ ______ o oz i J I -----------------------------------_ __ _________-_-_ _ -___ g • a a ._ I - I ' Irl r --- ------- --------- Qq - -- - - -- +--- --- - - -- E _ z RAFiETL---•---•— --- W mm M _ - 2W RAFTERS / 7A0 WJ'TEi15 - 3 N cam., \ i m C:4.® � N cc / 0'� U i cA c� a - — — a a -- T I t L 6 r j O J��t4t Cr'figas� a S job no.: eIs f I�` ERIC J. date . B wvaH ER 20I5 CEDERHQLM rn scale As NOTED ROOF PRAMI NG P -.I -t• LAN U STRUCTURAL -� drawn: SGALE, 1/4 1-0- No. Gs jA 38962 { rev. r rev. S-3 ISSUED FOR PERMIT Bnt 6 of g Arc__,� \ '\ a E E G C> V N O - b a H HEAD 5Ja GAP W HSI- 12 . DOAXB RAKE MOLOIN6•HEAD CASING �E%IST. ON IX BLOCKING UTILITY - r4u2•ewOSIAZE1; �l ' IX5 CAS06 W 2X SILL I ) V I 70 c 12D UOAXb CaasRBOARDS s' a DORMERS y E NEW GAMBRB.ROOF 70 ALIGN Y(ITN IXSAX6 FASGA/EAVE 5INHTEEpRSECTION OF DORHIER MALL Atm Qo o BEG RETtRN IN 122 5 ICI RNOF•THIS FOINT) C 4 t •- BATH. WZVED RooF.RAKE P a°R Ix RAKE .D U 5/4 GAP FV IN001b BED LIVING/KITCHEN STUDY 4 M2 I LT ANO WA MOLDING•LX NERD CASING STANDING o_ r4 JADEOa>INSW 6 5U3 FLOOR / _� a CaPFBt IX5 JAMB CAS INS • 4o SECOND—lA '._._._._._.__ _.—.I w-3 ._._._. .�._._. I �EX15T. PA.DECORATIVE 6O1'18t ON / RE PASGA/EAVE _ M2 BRACKET . 10iCl IXb CASING O O I Q � In OOROWAR05TfM7 NC.+SHNSLE5 t� •"WIT FLOOR MALLS DN. 0 M N {{ { V . - _ I N FRONT ELEVATION •SMwm-Ip + SCALE: I/4' - 1-0' STORAGE. GARAGE STORAGE I I_________________1 — t---__--____-___ -t 1 1 I I I I i I I I I I I I I I I 1 . _ cmTaUmu��o o-m'<u� yEpp3 vtim DEEPER TRIM 6 H DOOR OPWN65 Ili i $ m �____________ _____________ Q9� 6m�V'� 9 mo EDGE OF OJHLWNS I ATTACH®TO EXIST. m x ABOVE s1EAn1ING IF ET KX S BOTTOM OF WAIJJ or`e o ao`: `mi PLAYROOM s OW 2T-4' 6'-3• � +�•-' V �+ Q F I RST FLOOR PLAN E Q) a) SCALE: 1/4' a 1-0' , m N u Y N VI o� co ••DEEPER SILL A7NWYb mo Ln co GENERAL ELEVAnON N01 O _— WALL DEMO LEGEND _______________________________ - _ _ L ROOFING: ARCHTECTILRAL ASPHALT EAVEVE,AEn� IXSAXD FASCIA(HIILT�n) POLLS AMD I135 M _ �.. ly O SWN6LE5,To MATCH DHSTING W LX SHELF W LEAD-COATED BE REMOVED - Q) C;oFPIX RASHNS' - = Q -2 SIDINS: TVIITE BAR y11NGLE5 IX Ft80REZEE ON N COVE MOLL"6 POLLS ro fT�2%B GORJI✓BIBOAR09 Nem POLLS STORAGE EAVE FB.W TER ON EXIST.IX FASOA MINWM CASING: IXS YJ EX V SOFFIT AaEAD CASING , ON X FRIEZE ONW BED MOLDING DEMO NOTES BH I 2X6 STIR Mivffil. DVKING W 2X SILL IOC IX FRIEZEII% C MG ATTAO®TO EXIST.MOLL' SHEATHING•MST.STUD EXISTING DASHED MMM R POLLS - I LOCATIONS DOOR CASING: IXS JANtF)MEAD Cl51NG STORAGE RAKEMMW 1S. F.B.wrTER ON TO Be RaP/ED AND FATCNED AS Job no.: 1515 I%FASCIA MALT•WT) NEEDED OR R@LKFD AS NOTED. W IX SHa-F W LEADTOATEZ date :.5 NOVEN9ER 2015 bAMBTJa EAV6 VVALL FASCA COPPER FLASHING; pp pp •WNS ON W26 COVE M�oFAv�ON IX ON BLOWNS/ �A xx�il xR 9 scale AS NOTED IX FRIEZE ON IX BLOMNG GOW>EN80ARD GE ERAL PLAN NOTES I $ %_ GAIN.R" IX3AX0 RAKE BOARD roRN®R SAVE r1YPJ: E%ISTN6 TO REMAIN ALL WAfARMS�®oBE n1e SE)U NCR �' drawn ON u(eRLCKtNs S rev. DORMER RAKE: IIWXB RAKE BOARD -MINDONS TO BE'ANOE>Z8P AERIES ON IX SLO A N6 � TO EEVATO NS FOR MQfTIN rev. IBaO RE FER ER TO ELEVATIONS FOR MINOC S E C O N D FLOOR P L A N RO.HEISHTS MOVE 9AIFLOOR SCALE, O/4• m 1'-0' A R •ALL EXTERIOR TRIM TO BE PVC• -ENTRY DOORS TO BE SIMPSON I O ISSUED FOR CONSTRUCTION Bnt 1 of 2 o E oEXIST,ARGHRECNRAL , EAST.ARGNT56M RAL ASPHALT%flWA ES o . N ASPHALT SHINGLES c td WL.SNIN6LE9 EXIST,FRAMNG �+ N •O _ p'./-E1wJ oN � .^ N In'COX PLYWOOD EXIST.FRAMING RAKE - ON Iz B X& - LEAp.�ggTF,p v 2X6 WALL TO EAHLO0KIN6 IXMn RAKE COPPHt SNEiP V ATTALII®i0 EXIST. ON Ix BLDCKIWS o . WALL 51E MNG(AT PJasr.snm LocAnoNs) 1"""" - wrt-L oyPEDGEPLUM.DRIP EDGEEXIST"SW WALLAND SEATNINGP.T.STUDS 1 PLYWOOD6 BOTTOM PORTION OFWALL(PROVIDE 2X6Fb.fX/nHt ONBLOLKIN6 TRAN141nON1 E%ISnNB FOUND.WALLfb.GIRTER ON ——EXIST.I%.FASLIAE%IST.I%FASCIAEXISnNG SOFPRE%ISnNG SOFFIT13 P A LIA RE4ZIn TO BE WILT OUT a In' EXSnNG MOLDING (5EE DETAIL a/A-2) In'CEMENT BOARD ON E%IST.IX FRIEZE _, _ 6 S/4'NEW BED MOLDING(TMEJLORt�OARDON I%FRIEZE ON EXIST. IX FRIEZEA3LCCKINGMC.SHINSLB V �•N-ExPJ LJ - WC.SHINGLCS - ODETAIL g GABLE WALL BUILD—OUT O EAVE/RAKE DETAIL AT DORMER O EAVE/RAKE DETAIL AT STORAGE BAY5 �I SCALE:1 In'-V-O" SCALE.1 I/2'.1'-O" 51-ALE:I V2'.V-0' I`�I L%LJM ® a) C40WERBOARIP AT TIMFOERLOK SC.RE'LTO SnJD� ` DORMER WALL lOND 016'OL.T,9 V d fd SECURE LEDGER TO SOLID • W TMIER SGRF�/G71hiE t • 0 164 OL.STA66EPW T05 P� i ROOF AT STORA6E SAYS BEYOND SEOM 2X6LEDGER t0 STUDSOF 2X6 SOFFIT J015T YV TIMEL�OK SGREAS 0 16'OL-US STANDM6 SEAM 6 METAL ROOF I%SAXB LLR'JED ONE IX3/1X6 RAKE ON 19 SLCCKING 5EGURE 2X5 RAFTER TO 2X6 SOFFIT JOIST YV S-MMBERIOK SCREWS 5 9/4• - m 54% _ m op h om .. s c WNITE CEDAR SINNGLES ON IXSAX6 FASCIA m? In'COX NALLDOSHEATNMG +m Ym3 m= OVER NS WALL STID'� �. �^3 o oP u D . aLOGKING AT 16'Of. ON MST.WALL ' u _ V2 V2' $m�3< �Yg oasm 1%LEAD-GOAT® �J. - 1X6 EWE 4 C@YTER �o E`sue COPPER SrE3.F 8:12 TYPJ eEADBOARD r�'b`.^= _ - _ y 026 LOVE MOLDING -M6 'i ALUM.DRIP FIXaE I ON I%FRIEZE s m�eeo._oY ONI%BILGICING i • � _ � I IX IEADLASMG 41n' CIO Ln FASCIA REWei _____________ ; I CL BRKd�T 4 �+ V }_ W 9 E W .note LwE MLLD1ty. s• v2 CIO m N(/') (� N OR Ix SLOM245 z-s• r•2 a'6' 6 5/a• 4• o r0 a� N C I%8 f.GRt800ARD EXIST.8 NEW DOOR HEADER • � � WWTE CWAR SHINGLES ON V2'GD%PLYWOOD SHEATHING EXIEHDW TRIM O DOOR OPENING - (� N BLOCKING AT WOO. Q RAKE / EAVE / EAVE RETURN DETAIL AT GAMBREL DETAIL AT OVERHEAD GARAGE DOOR / OVERHANG O SCALE,I In'.L-0" O• SCALE:I In'.1'-0• -lob no.; Isis date 5 NOVEMEER 2015 scale As NOTm drawn: •Illy rev. rev. 0 A 2 ISSUED FOR CONSTRUCTION snt 2 of 2 r.. Y k rr r _ N r 7-11 i C rni: € PA5`I G; Vii Y r cr '�«e. -nay 14 Ln r i S W, Ai c-* L LU f U N'F7: c� Jvc Nt R � otyNDATION PLAN —1 NOTES: 1. EXISTING 3 BEDROOM APPLICATION TO REMAIN (NO INCREASE IN FLOW) 2. DATUM: ASSUMED 3. INSTALLATION TO BE IN ACCORDANCE o a WITH TITLE 5 AND TOWN OF a BARNSTABLE REGULATIONS 4. EXISTING BARN TO BE RENOVATED (NO Q 3 CHANGE IN FOOTPRINT PROPOSED) School 5. INSTALLER SHALL ENSURE GRAVITY st CO�llll FLOW THROUGHOUT SEPTIC SYSTEM 6. PLAN ADEQUATE FOR SEPTIC WORK. DOES NOT REPRESENT A FULL Bay PERIMETER SURVEY. s o— 144.04' LOCUS MAP / LOT AREA SCALE 1"=2000'f / / 35,292E SF / / ASSESSORS MAP 35 PARCEL 30 LOCUS IS WITHIN FEMA FLOOD ZONE C Edge Lawn - — -- LOCUS IS WITHIN AP DISTRICT / / w Exist. 1000 gal. leach ZONING SUMMARY pit (retain) 6 / +48.32 �- ZONING DISTRICT: RF +48.06 D box \1___� __ MIN. LOT SIZE 43,560 SF Existing 1000 gal. MIN. LOT FRONTAGE 150 6 / i SF (retain) 0 MIN. FRONT SETBACK 30' �kk o +47.9 ''j-5 Top septic tank el _ MIN. SIDE SETBACK 15' R F_ - - - - - ---I-4 .73 45.4' MIN. REAR SETBACK 15' ej Outdoor fireploce I Deck I Cn SITE IS LOCATED WITHIN RESOURCE +47.83 I I PROTECTION OVERLAY DISTRICT .33 + 6 ( 22.3' / Exist. m +47.84 --4741 47.45 waterline / / 48.42 18" Maple OWNER OF RECORD / rWaterline Existing STEPHEN FRECHETTE AND CAROL RAYNOR +-47-&2— 47. 2 / ax / A I Dwelling 71 HIGH STREET _ — 47.86 I COTUIT I Patio ` Existing Barn I 1 I Slab E/ev. 49.4' +49. 3 I � REFERENCES +48.51 1 I -�47.77 I Benchmark.• car. patio DEED BOOK 20965 PAGE 25 Paved Drive \ at elev. 4Z6' 1500 gal. O N Septic Tank O I +�47.53 co +48.56 cn 48.73 \+48.45 \ *-472(1-_ — — /�48.23 W -(48.23 N JJ2.70' SEPTIC AS—BUILT OF 71 HIGH STREET COTUIT, MA PREPARED FOR off 508-362-4541 ya�X�"OFMyssgo CAROL RAYNOR fax 508-362-9880 �o� DANIEL y�N I downcape.com © o A. down Cope engineering, %dc. A N®�80P APRIL 14, 2009 civil engineers land surveyors suRv 1 Scale:1"= 20' 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.L.S. 08-088 YARMOUTHPORT MA 02675 0 10 20 30 40 50 FEET