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Home My WebLink About0857 MAIN STREET (COTUIT) - Health 857 MAIN STREET, COTUIT A-035.058 C� S M l I' __ .. .. O TOWN OF BARIv'STABLE L''t) ON e>S-1 M 4P\W3 S� SEWAGE # YILLAGE � �\�� ASSESSOR'S Iv1AP & LOT b INSTALLER'S NAME&PHONE NO. e ` SEPTIC TANK CAPACITY Y � �ot,,,sJ ��P�.1 LEACHING FACILITY: (type) Q(� (size) x L, NO.OF BEDROOMS � aBUILDER OR OWNER,- -.PERMIT] OMPLIANCE DATE: Separation Distance Between the: ' ,Maximum Adjusted Groundwater Table`to the Bottom of Leaching Facility s, t O Feet 2 Aa # `r Private Water Supply Well and Leaching Facility (if any wells exist - t4 z � , i t i •on site or within 200 feet of leaching facility) r 'Edge of Wetland and Leaching Facility"(If any wetlands exist f 2 q within 300 fe i of leaching facility) %xu Y '` '`Feet 'Furnished by.�"'. ' - . a 1 -A LOCATION SEWAGE PERMIT 130• 7 VILLAGE CCd,7`ulT INSTA LLER'S NAItE & ADDRESS i U-1 L D E R OR OWNER- 0 A-T E PERMIT ISSUED DAT E COMPLIANCE ISSUED e j O � 0 a V` �� s A .... Fizu THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... ... --------OF................................... .................................................. Appliration -for Uhapotial Works Towitrurtion Vrrutit Application is hereby made for a Permit to Construct or Repa' an Indi ua Sewage Disposal Svstem at: ....... . ............ ... ........ ........... .............. ..........................................................................V.................. ' ss.......... ;tw - A- d ss or Lot No. 0 dress . ................... .. ........ ........ ...... ................................ ...... ............ ...... Installer Address Type of Building Size Lot----------------------_----Sq. feet U Dwelling No. of Bedrooms--------------------------------------------Expansion Attic Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons_-_-_____---_______--___--__ Showers Cafeteria ( ) Other fixtures -------------- ---------------------------------------------------------------------------------------------------------------------------------------- Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallon.s. P4 Septic Tank—Liquid capacity------------gallons Length________________ Width.--_-..___.._._ Diameter__..._...__.-.._ Depth---------------- Disposal Trench—No. .................... Width... Total Length----___---____----- Total leaching area--------------------sq. ft. Seepage Pit No........!Z--------- Diameter.......4A__ De below 'nlet.A./_;1 Total leaching area------- ...... ---sq. It. Z Other Distribution box Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ ,4 Test Pit No. I----------------rninutesperinch Depth of Test Pit.....__.____..,__... Depth to ground water...-----_-.----_.-..._. �_q 44 Test Pit No. 2................minutes per inch Depth of Test Pit....._.__.-.__..___. Depth to ground water-_---.-- _.-_--___--. - Description of Soil ----------------------------------------------------------------------------------------------------------------------------------- 0 --- ----------- ---------------------------------------------- ................................................................................................................................ -------------- U ------------------------------------- ........ ..................................................... -----i-------- iry Naturq_of Rep rs or teratioua./L Answer when app;kablyA - --------------------- --- ------------------- ------------ . . . . ....... Agreement: 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 ben Signed-- -------- ----_------------- Date ApplicationApproved By.................................................................................................. ---------------------------------------- Date Application Disapproved for the following reasons:-------------------------------------------------------------------------------------------.................... Date -------Permit'--- ------N--- -------------------------------------I's-s u__ Date ------------------- ----------- ---- r • No.. "` Fxic.... ---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .... ... .........OF OF....--......... ............................ ....--......................--._...----- ApplirFa$iun -fur Ii,4pusal Works Tonti#rurtivaa Vrrmft Application is hereby made for a Permit to Construct ( ) or Repai ( ) an Indiu'duaVSewage Disposal System at: � /�zl�-� � ��E !�`'/G�IL"'/ 1 x.....................................Loc ._ori- s�p t /`� --------------- ------•--•--------------------------------------*.---.•--- ............ ✓✓ y,o �ddgess h� or Lot No. rJ ' Ow'er ddress Installer Address Q Type of Building Size Lot-_---_.-.-_____-_________Sq. feet Dwelling No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) PI Other fixtures -----------------------------------------•----•----------------------------------------------------------------------- ------------------------------ d 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_-__________-r----- Total leaching area--------------------sq. ft. Seepage Pit No--------- .__....._.. Diameter........ _ Depth below Total leaching area-------.----------sq. ft. z Other Distribution box ( ) Dosing tank ( ) t Percolation Test Results Performed by------ ------------------------------------------------------------------- Date--------------------------------------- a Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-----............... Depth to ground water..-.__--.__--._--_.----- 4, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...__.-.____-___.-_----- P4 /-------------------------------------------------------------------------------------•-------••-------••--------••--•-•-••-------------..----- xDescription of Soil----•iu r.rrifaa�---------------•------•---•------------------- U -----------------------------------------------------•--•--...-••---------•---•-------••--••-•-•-•---------•--•-----•--•----------------------•--•------------------------... ----•--- x ---------------------------- -------------- ............... _ _ , /f-------------- U Natur�f Reps�rs or terations Answer when app ca.bl . �?? - �__.---�_---^_��J ----- �----------------. -----< _.--------•---------•----•--•-•--•-----------------••--•----.-•----••- Agreement: 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 been issued by he board_of health? Signed. ....G f....................`l s y = r Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:----••-----------••-•--••-----•-••-•---••--•.................•---------------...-••••----......-••-------•------ ..................................•----------•------.------•-•••-------------•----•_--•--.._...------......•••••---••---•••----------•--•-------•-----------------_...-----.------••.......•-------.••--- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ...........OF....... -!. .............................................. �Zr0if ; #r of TilutpliFutrr -e X t .�_ ,MTh /I f' g Disposal System constructed ( ) or Repaired by----THIS IS O Cr�RT1�Y v t�hn Ivadual Sewage D- ---- --------�'r--------�'------•----•----------------------•-----•--•----•---------- i �. Installer a V j ,/. L at-----•--_'V il-K.GC.. ''- C tip.. •--' `'�.................!--••--c�c T� ' � '------------.._........-•---•---••---•--••----••-----•--- has been installed in accordance with the rovisions of Art'eJ �l I,�of The State Sanitary I as described in the application for Disposal Works Construction Permit No._._C '<. `.._._...._ dated................... .................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... �-1 THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTHX _ .........17,,,��n.........OF.............. �....................................................... �--- No. =-•-. •• FEE........................ R-tiutt1 U'rti .arriati Permission is hereby granted.......... bra- --.._-."-_ .._ ....w... ;l---------------------- to Constr �, ( ) ,or�R atr (' n Individual/Sewage DisBGS �Syster atNo.... ��`l .--- ------------------------ ...... Strut ` / `'�' as shown on the application for Disposal Works Construction Pelt'No%...� ted......�."__...�_�y-.._........ '. .... ..... . / Board of Health DATE. �� .... --------------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Ys No --1 Fee ------ BOARD OF HEALTH TOWN OF BARNSTABLE 0pprication for Vell Cootruct ion Permit Application is hereby made for a permi to` construct ", ter ( ), or Repair ( )an individual Well at: Loca o Address Assessors Map and Parcel Owner Address — Installer — Driller Address Type of Building Dwelling --- Other - Type of Building-=-- ------ No. of Persons----_—________—___ ---______ Type of Well—--9f Capacity - Purpose of Well- ='�`"`� Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation un ' a C. ' icat liance has been issued by the Board of Health. - a Signed - — — -- - ----� - ate Application Approved By `- - 1v- �� date Application Disapproved for the following reasons: ----- - --------- ------------------ date Permit No. — Issued - �-/-- -- - --- ..... - date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f Compliance THIS IS TO CERTIFY, That.the Individual Well Constructed, Altered ( ), or Repaired ( ) Installer has been installed in accordance with the provisions of the Town of Barnstable B' `oard of Health Private Well Protection Regulation as described in the application for Well Construction Permit No.lN�22 Dated --I �f�2 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-- Inspector------------______�^-----___-- jrk No.---------------- Fee-------------------- BOARD OF HEALTH TOWN OF BARNSTABLE application-forlVellCon5tructioupermit Application is hereby made fpr a permi tQ onstruct (.vj, 'Alter ( ), or Repair ( )an individual Well at: 0 Is Locatio Address Assessors Map and Parcel Owner Address Installer — Driller S' Address Type of Building Dwelling _-- -- -----—- Other - Type of Building--- ----- No. of Persons---------------_�_______ Type of Well �olS� �-- Capacity— Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town\of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Ce 'f e'o Co pliance has been issued by the Board of Health. y� —G 2— Signed - — _--_— — ' ate Applation Approved By L —5 — -date Application Disapproved for the following reasons: ---------- -------- _--_ date _ Permit No. -- Issued-- _ date I BOARD OF HEALTH TOWN OF BARNSTABLE C ertlf icate 0f (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed, Altered ( ), or Repaired ( ) by—_ — Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Frotection Regulation as described in the application for Well Construction Permit No. Dated 1--- 1uL2 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--__ Inspector-- -- —------ —---—-- 'BOARD OF HEALTH - TOWN OF BARNSTABLE Ivell Construct ion Permit No. Fee— Permission is hereby granted to Construct X), Alter ( ), or Repair ( ) a Individual Well at: No. `S �14C_A r i1 T O > k- -- --------------------------- Street as shown on the application for a Well Construction Permit ;v2 �2 - ( No. �� ( 2. ) U Dated r .� L( /DATE ��2 Board of Health t �.� _� f COMMONWEALTH OF I�L�SS.�,CHt;SETTS EhECL`TIVE OFFICE OF ENVIR0NMENTAL AFF�ATF :, DEPARTMENT OF ENVIRONMENTAL PROTECTI�®N B� IT ��r� 01E Rt\TER STRrET. BOSTO\ NtA 0210E (615) 292-55ou C a,. 0 P-C D1�C O�: 1p 0"40, S-c re a r. ARGEO PALL CELLUCCI DA�'ID ,mnuss._-. Gove or SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 0/ 1��TA PART A ,,11` T CERTIFICATION Property Address: i Name of Owner l.Sr�V 0 Address of Owner: �•6• t�0 X¢��I1� Date of Inspection:- C_h f�U �T(7L�� v 1 r`F Z��`° Name of Inspector:(Please rind a I f� EC I am a DEnP approved system inspector pursuant to Section 15.340 of Trde 5 (310 CMR 15.0001 Company Name: �[�es rr? Pk to r'rc— H- o264-5 Mailing Address:--jEa A 4 14-• 1=1j5 Telephone Number: 4t� S CERTIFICATION STATEMENT 1 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: _)( asses Cponditionally Passes _ Needs Furth E tion y the Local Approving Authority F "Is Inspectors Signature: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30) days of completing this inspection. If the system Is a shared system or has a design flow of 10,000 gpd or greater,the Inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to ttre system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS revised 9/2/98 pYgcIofIt _ II! 0. Pnnitd on ReaAld Paper Il SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r t PART A CERTIFICATION (continued) `roperty Address: gS 7 d t 641fj S i Jwner: Date of Iruspection: INSPECTION SUMMARY: Check A, B, C, o/ D: A. SYSTEM PASSES: k — I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure -'-" criteria not evaluated are indicated below. COMMENTS: 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. Indicate yes, no, or not determined (Y. N, or NO). Describe basis of determination in all instances. If 'not determined",explain why not. _ The septic tank is metal, unless the owner of operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tar.k was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced - _ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass Inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed revised 9/ /rev 2 9 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the stem is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH.310 R 15.303(1)(b) THAT THE SYSTEN IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SA AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt m rsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HE/st ND PUBLIC W TER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS BLIC HEAL AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil aon system SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil aon sys m and the SAS is within a Zone I of a public water supply well. _ The system has s septic tank and soil aon sy am and the SAS is within 50 feet of a.private water supply well. _ The system has a septic tank and soil aon stem and the SAS is less than 1.00 feet but 50 feet or more from a private water supply well,unless a wela lysis for coliform bacteria and volatile organic compounds indicates that th well is free from pollution from that fac he presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determince (approximation not valid). 31 OTHER f revised /9/2/98 Psge3orii SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART A CERTIFICATION (contirxwed) property Addres OwrW: Date of Inspection: D. SYSTEM FAILS: You must indicate either "Yes" or •'No" to each of the following: I have determine that one or more of the following failure conditions exist as described in Sat CMR 15.303. The basis for this d to determine what will be necessary to correct the failure determination is id ntified below. The Board of Health should be contacte Yes No _ Backup of se ge into facility or system component due to an overloaded or cogged SAS or cesspool. _ Discharge or ponds g 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 'stribution box above outlet invert due to an overloaded or clogged SAS or cesspool. _ Liquid depth in cesspool is 1 s than 6" below invert or available volume is less than 1/2 day flow. _ Required pumping more than 4 t es in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. _ Any portion of the Soil Absorption Sy tem, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is wit in 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within Zone 1 of a public well. _ Any portion of a cesspool or privy is within 50 et of a private water supply well. _ Any portion of a cesspool or'privy is less than 100 eet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has be n analyzed to be acceptable, attach copy of well water analysis for •coliform bacteria, volatile organic compounds,ammon nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must Indicate either "Yes- or "No- to each of the following: The following criteria apply to large systems in addition to the criteria ab ve: The system serves a facility with a design flow of 10.000 gpd or greater(L ge System) and the system is a significant threat to publ health and safety and the environment because one or more of the following nditions exist: Yes No _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(interim Wellhead Protection Ar -(WPA)or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30 (2). Please consult the local regiona office of the Department for further information. revised 9/2/98 pit,ge4efLt SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST property Address: Owner: Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: t Yes No Pumping information was provided by the owner, occupant, or Board of Health. 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. M�} As built plans have been obtained and examined. Note if they are not available with N;A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. 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. `r The size and location of the Soil Absorption System on the site has been determined based on: �1 Existing information. For example- 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)1 The facility owner (and occupants,if diNereru from owner) were provided with information on the proper maintenaar.4of SubSurface Disposal Systems. revised 9/2/98 Pagc5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION ,roperty Address: 0 > V �I r Owner: pate of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow:s O g.p.d.ibedroom Number of bedrooms (de:sign):_0t;? Number of bedrooms (actual): 0S Total DESIGN flow_ Number of current residents: Garbage grinder(yes or no): N - Laundry(separate system) ( es or no):fJ: If yes, separate inspection required Laundry system inspected a or no) Seasonal use (yes or no): \ Water meter readings, if available (last two year's usage (gpd): hJ Sump Pump(yes or no): Ptwc Last date of occupancy: I6A tv COMMERCIALANDUSTRIAL: Type of establishment: Design flow: qpd ( Based on 15.203) Basis of design flow Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (Yes or no)_ Water meter readings,if available: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: �` ., � /� System pumped as part of: action: (yes or n ) !�( C. If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool 'UUv[.Tiax: Casa cSv�P�� Overflow cesspool Privy Shared system(yes or no) (if yes, attach previous inspection records,if any) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other //�� APPROXIMATE AGE of all components, date installed(if known) and source of information: {-JN-tA ®1J Sewage odors detected when arriving at the site: (yes or no) revised 9/2/98 Page 6of II SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) 'rope-rty Address: Owner: Date of Inspection: BUILDING SEWER: (Locate on site plan) Depth below grade:_ Material of construction: _cast iron_40 PVC_other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK: (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 Certificate of Compliance_(Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: / Scum thickness: 1JJ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee of baffler How dimensions were determined: ;Omments: (recommendation for pumping, condition of inlet and outlet to or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) GR EASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_metal_Fi erglass _Polyethylene_other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet to or baffle: Distance from bottom of scum to bottom of utlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, eondti of Inlet and outlet tees or baffles,depth of liquid level In relation to outlet invert, structural integrity, evidence of leakage,etc.) E. revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) ,rope-ny Address: Owner: Date of Inspection: TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or 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/day Alarm present Alarm level: Alarm in working order: Yes _ No_ Date of previous pumping: Comments: (condition 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, evidence of solids carryover evidence of leakage into or out of box, etc.) PUMP CHAMBER:_ (locate on site plan) Pumps-in working order:(Yes or No) Alarms in working order(Yes or No) Comments: (note condition of pump chamber,•condition of pu s and appurtenances, etc.) revised 9/2/98 rage sor„ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) `roperty Address: Owner: Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; exca tlon not required, location may be approximated by non-intrusive methods) v If not located, explain: Type: leaching pits, number: ivll b leaching chambers, number:_ leaching galleries, number:_ leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (noxe condition of oil, signs f hydraulic failure, level of p r)ding, a p soil, conRdivioniof vegetation, etc.) I CESSPOOLS:_ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: f,f Depth of solids layer: A )epth of scum layer: ®'r Dimensions of cesspool: S IA X to Materials of construction lt �b� Indication of groundwater: N.)Q Inflow(cesspool must be pumped as part of inspection)�17 Comments: (note condition' f soil, signs of hydraulic ailure level ppnd• g, ndition of veget tion, etc.) t�� PRIVY: Y ZJ (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.) revised 9/2/98 Page 9ofIt SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART C SYSTEM INFORMATION (continued) 'roperty Address: )wnef: Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL-SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (corrtinued) ropefty Address: Owner: Date of Inspection: NRCS Report name v V - — --- Soil Type_ — - — - Typical depth to groundwater_-___ _ __- - USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope t"91) D Surface water�� • Check Cellar Shallow wells 120 ' Estimated Depth to Groundwater 17-Teet k Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records �[ Checked local excavators, installers /\ Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) revised 9/2/98 Page 11Or11 NOTES: 1 Tims 1.) The structures shown were located on the ground by FLOOD ZONE: OVERLAY DISTRICT: ,' I t `�e ! I Handy Pt Cot conventional survey methods on (or between) 18/NOV/15 &, c � � � Yn i Pt ' Zone X A: — Aquifer Protection District ng '" troopers 1r 221JUN116. Community Panel No. " ,�� "` Brach Nois r 1{✓ 2.) The property line ir.fcrmation shown hereon was compiled from �5001C0756J LO.G(1S Pt available record information. July 16, 2014 ' ' ter , ti' _ Rio �t J'' _ �� * /o 3.) This pion is not for recording and is not to be used for N/F �'t \= Pnrc V. construction layout or deed description purposes. JTD Horborview Reolty Trust i �,'� ;g1 i �'� Landing s SZ€R Y1cotuit G �— ———— -------�— CB/DH ---------- Bluff v. n = h, r gent N83'34'34„E_❑- '—❑__ I itotu3 � ,� �, ,� :Pt Tidat l 7 ase �- _�__�--------- Wide Utility — ^--` ❑ 183.56' antd Ffat 10 cl� ___— —_ n ❑ % Cyr { /.t-� �r ~a� 17._ _ ' .......... -S`ampsons._... ---- _ __ ❑ / 1 sty n n, ' i �Cg Istand Bad " ,1f Shed _❑- ❑—` �,/,�- Raised Woodstet Frd Wood / Deck Deck Ali LOCATION MAP: 6 Scale: r' = 2000'+ #857 / 2 sty w/f Dwelling �. 25-4 ASSESSORS REF.. Mlap 35, Parcel 058 I Wood Deck U 4 t / 9 w Ferro o !• s1. 00 ZONE: CID RF J B ore ,. ea (m in. 87,120 SF (,,R t cc u dihvgm,ir) i2 L cn :-- / I--------------------- PG1 Cel 4r e0 Setbacks 0, Potio s t 17,2Q8±SF : ,Font 30' Side i 5' 24.7� i Recr 1 5' I � r 1 r Crushed 54 3' t Shell Drive `--——————————————--———— —----- \ Wide Woy ---------- ------------------------------------ ------------------------ OHS. ce/DH N89'21'44"W i N/F Cotuit Library Association 0 5 10 i5 20 Jo 40 FEET Sheet �.tl Prep•ored For. e=, =ipns_ role: Plot Plan CapeSur� Peter Field See Above: y1 -20Dote: 1 f Of 857 Main Street 2 �4�esi Rd, Suite 18/OCT116 BARNSTABLE oS94 15 5 ;Ufa 02c5� (cotuit) MASS =� Id q4 ,9 4^ _30• C Q — e;.ze-3g_ ,.,Dc; �;, y� tax C202 40 1 cepesurvC�copecod.ret n rn \\ \ rn -j I z „ , • , I rn m � I rn i�( < LL - -- 0 41- z i II II I FLL-' Y rn rn -- rn \ J z L[.� :l S ''�o S. r,n�j, ;j Visit • T n Z 9 ,• _ ..__.__._..___ i i , . 1 8�:,7,n• , u; r ,raj t _--------_ �.". _�, a i•.,• '- �\ ems+—,; �,�^• T y h A GARAGE ADDITION TO THE I I i n N i.tM: T M D EL RES ADS IDENCE "Ilii�l„°�Iif'I I,nn ,,'N, 1 ^�� MAIN STREET, G - OTUIT, MA „ AIZC 7IITEC,TUf2A:[ I:�F_SIC-3N SL7L.L1TIc7NS � -' - - -- -- m.�_hl.,a_e. rnat tcl. 508-477-8930 ry •P t) N,.i IF.r.I,':I:r.:_I.:r,!emu 1'nrr. EXT. ELEVATIONS / SECTION 0.,'•.v',I IrN>I'.^a ;rvj <..rl,c.hs:,t., -;hLrt,�c�,..1_cot„ cell- 774-487-0093 m Inr,-'n,:�m.:ce.,r ra.a..r,:ry.r•tpr f f 4 Aw.;.g'R i a _ I . .. { ; r 1 ` i m I r r r r r r _ I bY.kOR 6CYT`RA'.iw:5 d?"C•G. .r 1/.". y l- AVN:IG`:A t5 Apl?63B i r y I° flF., Cfl.CFr.Apo if ldE NHAHI':)f'LApJI_ I � z z a 5- r. 1 rn z taN i I n A Y I Z'. d'-d- d'_d' Z I � I Y rn - - n ( I T C II �I o - - A n n ------------ J r - _ If Ih rt l{,a L lvujl�-e�Jlkn 2-.i It tui.�(S`�/n _ I _._I . ..I .. I_- _ Z. r I r I f I i I � yrA -...... r o rh 4 _ -—. -- - II1 . J. 4 8 GARAGE ADDITION TO THE w ','-, �.. 4Z. u. 1 l t i`Cl ly; '�k Ds FIELD RE51 DENG� T ry i f+li II F d,11)f th l<snt 0 tv MAIN STREET, GOTLIIT, MApt AKC H.ITF_'C:TUKA.L L>i✓SLC ,N SL?LUTl.L>NS --- ----------- ----— tM rV'rJr„:,not��re. - rn i._h.{_ ee- n�,a. tel-508-477 89.30 p � ii nrf na..t:„Ivanm v,na nM. he,.:l.�,;.p-essay:e,�r.•r.:.me ea.pehoL.,�e.p la n'Cftuil.com eea l- 774-487-009.3 FOUNDATION FLOOR/FR,A RW,PLAN$ f ! rs n C Zi x' G J,i r x 10 r N; r �� 1+ fJ V) I '� (3)-0JtiY WADM - zij FnTD1 SFifitT}WC TO HEADER 1R/8d \--L4GIE NW ON BACK Uit CONFAWN NA.4 1N 3' OW PRTT M AND mE OF muli7t(1YP) f ! 3'OLG N ALL T'1iiMW AS 91DIIfN- �II I .1NU41-MU.5 Y 10 r'�6 i- r_.. J S e1 t-i k �3 4�.h.J .c CT.�3 F ( F Table 2 General Nailing Schedule 7HREADm ROD Nt J (IYPMAL) Roof Framing , L Blocking to Rafter(Toe-nailed) 2-8d 2-1 Od each end f J Rim Board to Rafter(End-nailed) 2-16d 3-16d each end .," 1!i � Wall Framing Top Plates at Intersections (Face-nailed) 4-16d 5-16d at joints Stud to Stud (Face-nailed) 2-16d 2-16d 24'o.c. Q C U Header to Header(Face-nailed) 16d 16d 16"o.c.along edges ' FloorFrammg ` i ` � 4, CiARAfrE ELEVAl1ON Joist to Sill,Top Plate or Girder(Toe-nailed)(Fig.14) 4-8dJ r 4-10d per joist C/Qf 10 ttG1E) Blocking to Joist(Toe-nailed) 2-8d 2-1Od each end Blocking to Sill or Top Plate(Toe-nailed) 3-16d 4.16d each block Ledger Strip to Beam or Girder(Face-nailed) 3-16d 4-16d each joist Joist on Ledger to Beam(Toe-nailed) 3-8d 3-1Od per joist. Band Joist to Joist(End-nailed)(Fig.14) 3-16d 4-16d per joist Band Joist to Sill or Top Plate(Toe-nailed)(Fig.14) 2-16d 3.16d per foot STRUCTURAL NOTES: Roof Sheathing- Wood Structural Panels rafters or trusses spaced up to.16'o.c. 8d I od 6"edge/6"field STATE BUILDING CODE AND THE AFPA`AWC"GUIDE F = 1. ALL CONSTRUCTION SHALL CONFORM TO THE RELE VANT PROVISIONS OF THE MASS.C-;VEST'S rafters or trusses spaced over 16`o.c. 8d 10d 4"edge/4"field r-TO WOOD CONSTRUCT 11 H1G-":'.';`i,. gable endwall rake or rake truss w/o gable overhang Bd tOd 6"edge/6"field AREAS FOR ONE-AP:DTt.'O-FAM14FLY DWELLINGS,110 M?H,EXPOSURE B". g gable endwall rake or rake truss w/structural 8d 10d 6"edge/6"field Z. ALL HEAVERS NOT yHOWN SHAD CUN=ORetq TO TABLE 5502.5(1)U=THE 2005 outlookers RESIDENTIAL CODE FOR ONE-AND TL"JO-FAMILY DWELLINGS. gable endwall rake or rake truss w/lookout blocks 8d 1Od 4"edge/4"field Ceiling Sheathing ti o 3. ALL POSTS NOT SHOWN SHALL BE EQUIVALENT TO ATIM13ER 4X4 OR BETTER. - - Gypsum Wallboard 5d coolers 7 edge/10 field LU 1t�I 1 4. ALL FRAMING L UMBER SHALL BE NO.2 SPRUCE-PINE-FIR OR BETTER UNLESS NOTED I Wa11�Sheathing '•+�,' �� '� €'- `" `" "" .,t - S IU : ! -k.�,-se �rv! �, ,..::- n�'�t �" � Oil . OTHERWISE. Wood Structural Panels v i l studs spaced up to 24'o.c. 8d 10d 6"edge/12'field H Z 5. All RAFTERS SHALL BE CLIPPED TO THE EXTERIOR WALL TOP PLATE WITH SIMPSOS'H2.5 - g W � HURRICANE CLIPS OR EQUAL. 1/2'and 25/32'Fiberboard Panels Bd1 3"edge/6"field Z Q E 1/2"Gypsum Wallboard 5d coolers - 7"edge/10"field I- �I�l u kn 6. CONCRETE SHALL HAVE A MINIMUM 26 DAY COMPRESSIVE STRENGTH OF 3,OOG PSI. Floor Sheathing11 L1 Wood Structural Panels IL' Z7. O IY REINFORCING STEEL SHALL CONFORM 70 AStPV A615,GRADE 60. 1'or less 8d 10d 6`edge/12"field LU 0Y Q greater than 1" 10d 16d 6'edge/6"field LU Q Rr S. THE ALLOWABLE PRESUMED SOIL BEARING CAPACITY IS 3,000 PSF AND SHALL BE VER I.-I-D I!J 1 Corrosion resistant 11 gage roofing nails and 16 gage staples are permitted,check IBC for additional requirements. < w Z v THE FIELD PRIOR TO CONSTRUCTION. Nails.Unless otherwise stated,sizes given for nails are common wire sizes.Box and pneumatic nails of equivalent I diameter and equal or greater length to the specified common nails may be substituted unless otherwise problbllild,-,, lil 9, STRUCTURAL SHAPES SHALL CONFORP.4 TO THE FOLLWING: � M WIDEFLANUEEMBER5-ASIMA992,GRADE5U ,, I ii�i I CHANNELS AND ANGLES-ASTIVI A36 3 v' i aer_ E -ei HSS ROUND AND KEcrANfjULAR I UBES-ASTM A50U,(TRADE Y=B,F 4bKS! '�= t�` ,;�r ANCHOR BOLTS-ASTM A307 I j L++ (.'•LI-i HiC i t:. rnt Z�tr R.I i, ! i..,{{I 10.WELDING SHALL CONFORM TO AWS D1.1 CODE FOR WELDING IN BUILDING CONST?UC ' A, .{ i°„ r°�'' 11.ALL MANUFACTURED LVl W000 FRAt.71NG SHALL HAVE THE FOLLOWING PHYSICAL;OP RTIcS s- 4$gMINIMUM: c �A . E=?.O X 10`PSI fir. F;=2600 PSI = r c � Ar:{,£E'4�cG `.iPL'l+S iTr2 GAkel,CPCKfAi Ct[Y CN A-3---I --� - • - z -i j r IaLI • D ------------ --- - - ___ .__ _ -- - r ___ ...__ .__ O N _ I m � I p N At1.M2EOL*:P4'AK,:549'OL. �, r I 1 I u - l- ADH 2638 I, 1 AtTJ 263B U) _- ,. .r V O - rMJ4 5TCLL 6N.Aa'O (SCC Mrl.7%17 Q _ J i �m ° I z u { w ° r- ia s O E 1 t.+S - . THERrtATRU b-r'ar+E - O _ s ' rn 2u j 1 - d, _ w � v F z - 4-0 _. 1p'q_ r —�-- I D 'a a o Z Y m U) — �- ----- A I� �' � ° 12 rn 19 5 I _ 3'-IO' SV1' -1 r -' �. ---- Imo. ' ➢ �; j O I i I+ r o. i _ °• O Aarx�s ��___ o s v?' W — I su ° L r— _____..__ ' Cc�41 � : i I a 4- m <a l 4'-4' 4-4. �. Q .n T1F.F�n:w nq•I- t.nAed ••• g - m GARAGE ADD ITi ON TO 7i?E n FIELD izE51DNGE It ,t,i y Pt, ADS all ponsbn[y ro th t•nt - 3 11 Y n 6, 1 A m N " MAIN STREET, GOTL)IT, MA d` p ' AKC.k41•TECG-F JPAL, L�ESIC�N SUL uT1C7NS o g MII� � �t ,�to tt t r t� d 9ns� r . _-- _-- --- ----- — t m irashpee, ma' tel=_508-477-8930. o _ n 1 tru °I ve.lq,ml it me FQUNDATION FLOORTR.AKW,PLANS ayyt rt .,arn y° ordmg capelz<�use�ilans@aol_com call- 774-487-0093 4. t°tk. ChICa°I rL�py PrIt,to,Act•°r 1990. - - -