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HomeMy WebLinkAbout0244 SCHOOL STREET - Health 244 SCHOOL STREET, COTUIT o � A= 020 064 III I TOWN OF BARNSTABLE l LOcpON SEWAGE# e VILLAGE ASSES SO MAP & LOTQ. P cR 1 UAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) [ D X NO.OF BEDROOMS BUILDER R OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �' �a� ua , �, _ �, . S„ Commonwealth of Massachusetts Title 5 Officia.l Inspection. Forms- Subsurface Sewage.Disposal System Form:- Not for Voluntary Assessments 5 , 244 School.Street Property Address P Y , Ed Maddox-355 North Main Street, al W i9 n ford .CT 06492 Owner Owner's Name information is required for Cotuit MA 02635 '09/2V2007 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Ins pection,forms maypot be altered in any way. Important: A. General Information: When filling out forms on the computer,use 1. Inspector: only the tab key to move your Robert J. Bortolotti . cursor-do not Name of;Inspector " use the return key. Bortolotti Construction, Inc: �.\ Company Name ` P. 0. Box 704 45 1 ndustry road 0 620 _ o(. Company Address 3 Marstons Mills MA 02648 cR' f 17 , City/Town' State Zip Code 50&771-9399- Telephone Number License Number �. k jCI B. Certification I certify that I have personally inspected the sewage disposal system at ithisaddress 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_, 0 Fails ❑ Needs Furth aluation by the Local Approving Authority . 1 nspector'ssignature• Date ` The system inspector shall subrnit'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 DER. The original.should be sent to the system owner and copies sent to`the buyer, if applicable; and the approving'authority: This report only describes**** conditions at the,time;of inspection.and under the conditions of use at that time.This inspection does not address how the system,wil1,perform in the future under the same or different conditions of use. . 15insp•08/06 Title.5 Official Inspection Form;Subsurface Sewage Disposal System•Page.1 of 15 Commonwealth of Massachusetts ° r Title 5 Official `Inspection Form ?. Subsurface Sewage Disposal System Form Not for Voluntary Assessments 244 School Street" Property Address Ed Maddox- 355 North Main Street,Walingford, CT 06492 Owner Owner's Name information is required for COtult MA 02635 09/27/2007, every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary:Check A,B,C,D or E/always complete all of Section D A) System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: b 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. Answer yes, no or not determined-(Y, Ni ND) in the ❑°for the following statements-If"not determined,"..:please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound; exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *.A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: i ❑ Observation of sewage backup or break out or high static water level fn the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass insoectidn if(with approval of Board of Health): ❑ . broken pipe(s) are replaced obstruction is removed t5ins 08/06 P' _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 15 i Commonwealth of Massachusetts Title 5 Official lnsperct onfor:m Subsurface Sewage DisposalSystem Form-Not for Voluntary Assessments 244 School Street Property Address Ed Maddox-355.North Main Street,'Walingford,-CT 06492 Owner Owner's Name � information.is.required for Cotuit ': MA' 02635 09/27/2007 every page. Citylrown State Zip Code, Date ofinspection B. Certification(cont:) B) System Conditionally Passes(cont.),: ❑ distribution box`.is leveled or replaced ND Explain° Y . J .. . •, �. .. ' $ .. ' Ali ❑ The system required pumping more than 4•times a year due to broken,orlobstructed.pipe(s). The system:will pass inspection if.(with`approval of the Board of Health) . n. ❑: broken pipe(s) are replaced 4. f ❑ obstruction is removed ' M" ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require_further evaluation by the Board of Health in order to determine if, the system is failing to protect-pu.blic.health safety or the environment , 1, System Will, pass i nless.Bo'ard of Health;determines'in accordance.with 310 CMR UO3(1)(b),that the system is:not functioning in a manner which whi protect public health, safety and the environment: `r Cesspool or privy is„with'in 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, . safetyand environment. ❑ The system has`a septic tank and soil absorption.system (SAS)and the'SAS.iswithin . 100 feet of,a surface-water.supply or,:tributary to a surface water supply: ❑ The system has a septic tank and SAS and the SAS.is within a Zone 1 of a public water supply. ❑' The system.has a septic tank and SAS and the SAS is within 50 feet of:a private water. . supply well. N, t5insp•08/06. Title 5 Official Inspection Form:Subsurface Sewage Disposal System r,Page 3 of 151 Commonwealth of Massachusetts Title 5 Official Inspection Form r. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 244 School Street Property Address Ed Maddox-355 North Main Street,Walingford; CT 06492 Owner Owner's Name information is 'required for Cotuit MA 02635 09/27/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the-Board of Health (cont.): , ❑ The system has a septic tank and SAS and the SAS is'.less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) 'System Failure Criteria Applicable to All Systems: You must indicate"Yes"�oir"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 El due 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 ElLiquid depth in cesspool is less than,6" below invert or available volume is less El than 1/day flow. ❑ ElRequired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ❑ Any portion of the SAS, cesspool or privy 'is below high ground water elevation. ❑ ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. l5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts w x Title 5. Official Inspection Form Subsurface Sewage Disposal.System Form.=Not for Voluntary Assessments 244 School Street Property Address Ed Maddox-355 North Main Street,.Walingford, CT 06492 -.: Owner Owner's Name information is Cotuit:: MA 02635 '` 09/2Z/2007: required for - every page.a e. City/Town State. Zip Code' Date of Inspection B. Certification cont. F. D System Failure Criteria.Applicable . Y : .to All Systems (cont).� Yes No ❑.;' ❑ ,Any portion of a.cesspool or privy-is within a Zone 1 of a public well. Any portion of a cesspool or privy:is.within 50 feet of a private water supply well. EJ �T Any.portion of a cesspool or privy is-less than.1.00 feet but greater than 50 feet from a private water supply well with'no acceptable water quality analysis. [This systeni 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-servinga facility.with a design flow of 2000gpd El El . I0,000gpd. o a �.. 1.The system fails I have determined that one or,moreof the above failure criteria exist as`described;in 310 CMR'15.303, therefore the system fails. The system owner should contact the Board of Health to.determine what will be necessary to correct the failure. E) Large Systems: To be.considered a'large system the,system.must serve a facility with a design flow of.10,000 gpd to,15,000 gpd. For large systems,you must indicate either"yes"',or°no".to each of the following, in addition to the questions in Section D. -. Yes No , 0 the systemis 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 El El Area IWPA) or a mapped Zone 11 of a public water supply well If you have answered"yes"to_any question in Section the system is considere&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 ownershould.contact the appropriate " regional.office of the Department: t6insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System r Page 5 of 15 Commonwealth of Massachusetts v Title 5 Official Inspection Form co Subsurface Sewage Disposal System Form Not for Voluntary Assessments 244 School Street Property Address Ed Maddox-355 North Main Street, Walin ford; CT 06492 Owner Owner's Name information is required for Cotuit MA 02635 09/27/2007 every page. City/Town State Zip Code Date of Inspection C..Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? Have large volumes of water".been introduced to the system recently or as part of El ® this inspection? ® 0 Were as built plans of the system.obtained and examined? (If they were not available note as N/A) ® EllWas the facility or dwelling inspected for signs of sewage backup? ® ❑ 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, aplan at the Board of Health. ® ElDetermined 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)] l5insp•08106 Title 5 Official Inspection Form:,Subsurface Sewage Disposal System•P g p y age 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection .Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 244.School Street Property Address- Ed Maddox-355 North Main Street, Walingford, CT 06492".: Owner Owner's Name { " information is required for Gotuit. MA 02635: 09/27/2007 every page. City[Town. State Zip Code Date of Inspection D. System Information- Residential Flow Conditions: . r' 3 2 f s(design):f Number of bedrooms' actua Number o bedroom I 220 t DESIGN flow based on 31'0,CMR.15.203`(forexample: 11O..gpd.x'#'o(bedrooms): Number of current residents: vacant ✓ _� Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [If yes separate Inspection required] , ❑' Yes ® No x. Laundry system inspected? ❑ Yes 0 .No Seasonal use? ®- Yes fl No Water meter readings, if available (last 2 years usage (gpd)):. Sump pump? #. ❑ Yes ® No seasonal Last date of occupancy: : residence ' 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? i �❑ ,Yes ❑: No r Industrial waste holding tarik present?,,.: ❑ Yes ❑ No Non-sanitary Waste discharged to the Title 5 system?. ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use Date Other(describe): YF l5insp-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System,Page,7 of 15 ' t Commonwealth of Massachusetts W Title 5 Official , Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 244 School Street Property Address. Ed Maddox-355 North Main Street, Walin ford CT 06492 Owner Owner's Name information is required for Cotuit MA 02635 09/27/2007 every page. Cityrrown State Zip Code Date of Inspection D. System Information cont Y (cont.) General Information Pumping Records: Source of information: Pumped:7/04 provided by owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was.quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system El Single cesspool ❑ Overflow cesspool Privy ❑ Shared system (Yes or no) (if yes, attach previous ins pection 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 the DEP approval. ® Other(describe): One Cesspool (Main Tank)-and SAS (Leach Pit) Approximate age of all components, date installed (if known) and source of information: Unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insP 08/06 Title 5 Official Inspection Form.Subsurface Sewage Disposal System P g i p Sy em•Page 8 of 15 Commonwealth of Massachusetts:' u Title 5 OfficialInpection Form Subsurface.Sewage Disposal System Form -Not for'Volu`ntary Assessments, 244 School Street Property Address Ed Maddox=355 North Main Street,Walingford, CT,06492 Owner Owner's Name - information is required for Cotuit MA 02635 09/27/2007. every page. Cityrrown a State. Zip Code•, Date of Inspection. D. System Information (cont.)_' y Building Sewer(locate on site.plan) ,y 4 Depth below grade:^ ° , feet Material of construction:'n ❑,cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well.or suction Ilne feet;+; Comments (on condition of joints, venting, evidence of leakage, etc:): - Septic;Tank,(locate on site plan): Depth below grade:. . , _ reef Material of construction: •❑ concrete ❑ metal-,,,., El,fiberglass .,❑ polyethylene El.other' (explain) • _ - ..f., ,_ , ley . - If tank is metal, list age:,' '' '<• .. years ` x 3 Is age confirmed-by a Certificate.o&Compliance_?(attach a copy,of certificate) ❑ .Yes ❑ No -----'---------------- = - _ - - - - - :Dimensions:. r Sludge depth: Distance.from top ofaludge to bottom of outlet tee or.baffle 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 How were dimensions determined? l5insp•08106 Title 5 Official Inspection Form:.Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts W Title „5 Off_ icial Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 244 School Street Property Address Ed Maddox-355 North Main Street, Walin ford, CT 06492 Owner Owner's Name information is required for Cotuit MA 02635 09/27/2007 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.): 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: Dace 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 El-meta I ❑ fiberglass ❑ polyethylene ❑ other(explain): l5insp-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official .inspection. Form o Subsurface Sewage Disposal'System Form-Not for Voluntary Assessments 244 School Street Y Property Address Ed Maddox-355 North Main Street,Wolingford, CT.06492 ' Owner Owner's Name . f information is required for Cotuit MA 02635 09/27/2007: ' every page. City/Town State Zip Code Date of Inspection D. System.Information (cont .).' Tight or Holding Tank (cont.) Dimensions: ¢; , Capacity: gallons Design Flow: , gallons per day Alarm present: 0 Yes 0 .No Alarm level: Alarm in working order: 0.Yes , ;-❑ No Date of last pumping: bate Comments (condition of.aiarm and float switches, etc.): *Attach copy of current pumping contract(required) Is copy,pttached? El..Yes'. 0 No Distribution,Box(if present must be opened) (locate on site plan)-. Depth of liquid level above outlet invert A Comments (note if box is level and.distribution.to outlets equal; any evidence of solids carryover,,any evidence of leakage into or out of box, etc.): . Pump Chamber.(locate on site plan): Pumps in working.order: El Yes 0 No. Alarms in working order.' El'-Yes: 0 No t5insp-08106 ,Title 5 Official Inspection Form:Subsurface Sewage Disposal System a Paget l of 15 Commonwealth of Massachusetts v W Title 5 Official inspection Form f Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments M 244 School Street Property Address Ed Maddox-355 North Main Street, Walingford, CT 06492 Owner Owner's Name information is required for Cotuit MA 02635 09/27/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number,length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note_condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): It's a 1000 gallon precast leach pit with cover and top pit 8"to grade,'pit was dry at time of inspection with staining 18"from bottom. t5insp•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth.of Massachusetts r Title 5 `Official Inspection Form Subsurface Sewage Disposal System.Form-Not for Voluntary Assessments 244 School Street Property Address Ed Maddox 355 North Main Street, Wallingford,�CT 06492 ` Owner Owner's Name information is required for Cotuit R MA . 02635 09/27/2007, every page. City/Town State Zip_Code Date of Inspection D. System. Information (cont.) . ` t , Cesspools (cesspool,must'be pumped as part of inspection).(locate on site,plan): Number and configuration 1 1.000 gallon_ Depth-top of liquid to inlet invert ti Depth of solids layer 0. Depth of scum layer 4„ 6' x8' Dimensions of cesspool ; Materials of construction.' : block. Indication of groundwater inflow_ ❑ Yes No Comments (note_ condition`of soil, Signs of hydraulic failure; level of,ponding,condition.of vegetation, etc.): It's a 1000 gallons block-style cesspool with inlet cover 6"to grade, it has plastic inlet and out tees with 4" scum and no sludge at time of inspection. NOTE: Cesspool.was pumped immedietly following inspection. f y - 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.):., 15insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 115 Commonwealth of Massachusetts w Title Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 244 School Street Property Address Ed Maddox_355 North Main Street, Walingford CT 06492 Owner Owner's Name information is required for Cotuit MA 02635 09/27/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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. V � l5insp•08/06 Title 5 Official Inspection,Form:Subsurface Sewage Disposal System•Page 14 of 15 4 Commonwealth of Massachusetts Title 5 Official Inspection Form $� Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 244 School Street Property Address 3 Ed Maddox-355 North Main Street, Wallingford, CT 06492 Owner Owner's Name information is required for Cotuit MA' 02635. 09/27/2007 - , every page. City/Town State_ Zip Code Date of Inspection - D. System Information,(cont.) Site Exam: . , Check Slope p ❑ Surface water .P ❑ Check cellar ❑ Shallow wells <}Z Estimated depth to ground water: feet Please indicate all methods used to determinef the high ground water elevation. ❑ Obtained from system design plans on record . - If checked, date of design plan reviewed: ` -, pate ❑ 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 hoyv you established the high ground water elev tion.`.: t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 15 Permit Number:. Date: Completed by: HIGH- G RO ND-WA ER LEVEL COMPUTATION - - _ G Z - 1 e Location: Lot NO. Site ` Owner: t Address: Contractor: C�� Address: Notes: STEP 1 Measure depth to water table ./ Z to.nearest 1/10,ft.: ........:..................................:. ......:. ........ ......:,:Date Z 7 month/day/Year.. STEP 2 Using Water-Level Range Zone and Index.Well Map locate, site and determine: w ' O Appropriate;,index well O Water-le veVrange zone ............ ...... ........ ur n STEP 3 Using monthly report C re t Water Resources Conditions" determine current depth to waterlevel-for index well ......... . ' - �® month/year STEP 4. Using Table of Water-level Adjustments for index well (STEP'2A),current depth to water level.for index well (STEP 3),, and water-level.zone (STEP 2B)' determine.water-level adjustment ............................... 3; STEP 5 _ Estimate depth to High.water.``. byesubtracting the water level adjustment (STEP 4) ., from measured depth to water level at site (STEP 1) ........ ... ..... ......... ........ ........ ....... ......... Figure 13.--Reproducible computation form. 15 ' r 1 t � 3 Town of Barnstable ° �pF tHE Tpw Regulatory Services STABS Thomas F. Geiler, Director BARNMASS. 94, i639• ,0� Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the "Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. ' Commonwealth of Massachusetts Title 5_ official Inspection Form Subsurface Sewage Disposal System Form.=Not for Voluntary Assessments ; wM ,. 244 School Street Property Address Ed Maddox ' Owner Owner's Name information is required for Cotuit MA. 02635 09/27/2007 every page. City/Town State Zip Code. Date of Inspection Inspection results must be submitted on this form. Inspection forms may notL be altered in any way.Impo When filling A. General`Information When filling out forms on the. computer,use 1. Inspector: t only the tab key to move your..., Robert J. Bortolotti cursor-do not Name of Inspector . use the return key. Bortolotti Construction, Inc. Company Name P. O: Box 704-45 Industry Road Company Address Marstons Mills. MA 0264E�,; City/Town State Zip Code., 6 508-771-9399 r o Telephone Number License.Number, ur — A z B. Certification I certify that I have personally inspected the sewage disposal system at this.addr ss and 14at thP2 information reported below is true,accurate and complete as of the time of the ili pection-The inRpection was performed based on my training and experience in the.proper function and aintenance 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 El Fails ❑ ,,Needs Further Evaluation by the Local Approving Authority, • � :. ram. - - 09/29/2007 Wspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or.DEP)within 30 days of completing this,inspection. If the system is a shared system or has a design flow of 101000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner, and copies sent to the buyer, if applicable, and the approving authority. ***.*This report only describes conditions at the'time of inspection'and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use t5insp•08/O6 Title 5 Official Inspection Form:Subsurface,Sewage Disposal System•Page 1 of 15. Commonwealth of Massachusetts : »: W Title 5 Official Inspection Form I; o Subsurface Sewage Disposal System, Form Not for Voluntary Assessments 244 School Street Property Address Ed Maddox Owner Owner's Name information is Cotuit MA 02635. 00/27/2007, required for every page. Cityrrown,. _ State Zip Code Date of Inspection B. Certification(cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section.D A) System Passes: ® I have not found any information,which indicates that any,of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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... Answer yes, no or not determined,(Y, N,ND) in the ❑for the following.statements. If"not determined;" please explain. ❑ The septic tank is metal and over 20'years old*or the septic.tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.. System will pass inspection if the,existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septictank 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 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_; ❑ obstruction is removed t5lnsp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 or 1.5. i, Commonwealth of Massachusetts W Title 1.5 Official Inspection Form Subsurface Sewage Disposal System Form=Not for Voluntary Assessments 244 School Street Property Address Ed Maddox Owner Owner's Name I information is i required for COtuit . ',.. MA' 02635 09/27/2007 j every page. Cityrrown State Zip Code Date of Inspection i B. Certification (cont) B) System Conditionally Passes (cont) ❑ , distribution box is leveled or replaced i ND Explain: } ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): El broken pipe(s) are replaced j ❑ obstruction is removed i ND Explain: C) Further Evaluation is Required by the Board of Health: . y ❑ 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: A '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, i 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,ab"sorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply.' El 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. - t5insp•08106 Title.5 Official Inspection Form:Subsurface Sewage Disposal'System•Page 3 of 15 i Commonwealth of Massachusetts r Title 5 Official Inspection Form , o Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 244 School Street Property Address Ed Maddox Owner Owner's Name information is required for Cotuit MA 02635 09/27/2007 -- every,page. Cityrrown, State Zip Code Date of Inspection i i B. Certification (cont.) C) Further Evaluation is Required by the Board.of Health (cont.):, ! 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**. i Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria-indicates absent and the presence of ammonia nitrogen.and,nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form: i 3. Other: i D) ,System Failure Criteria Applicable to All Systems: You,-must indicate "Yes" or"No"to each of the following for all-inspections::, sc Yes No Backup of sewage into facility or system component due to overloaded or 0 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 '/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or 0 ❑ obstructed pipe(s)...Number of times pumped: ❑ Any portion of the SAS, Cesspool or privy is`be'low high ground water elevation. El Any portion of cesspool or.privy is with,in,100 feet of a surface water supply or El tributary to a surface water supply. t5insp•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 I Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System form-Not for Voluntary Assessments 244 School Street Property Address R µ Ed Maddox - Owner Owner's Name information is required for Cotuit - MA. 02635" 09/27/01 every page. CitylTown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes'.or."no" as to each of the following: Yes , No ®„ ❑ Pumping information was provided by.the owner, occupant,.or Board of Health ❑ . [E Were any of the system components pumped out in the previous two weeks?- ❑ 0 Has the system received normal flows in the previous two week period? ❑ . ® -Have large volumes of water been iritroduced 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`inspectedrfor signs of sewage backup? ® ❑ Was-the site inspected for signs of breakout? ® ❑ Were all system components,excluding the SAS, located on site? ® ❑ Were'the septic tank manholes uncovered,,opened,.and the interior of the tank inspected for the condition of the baffles or tees, material of construction_ , dimensions, depth of liquid, depth of sludge and depth of scum?, ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ❑ ®, Existing,information. For example, a,plan at the Board of Health. - Determined in the fieldt(if any of the failure criteria'related to Part C is at issue ® -approximation of distance is unacceptable),[310 CMR 15.302(5)] . z 44 A. l5insp•08/08 k Title 5 Official lrispection Form'Subsurface Sewage Disposal System•Page 6 of 15. • Commonwealth of Massachusetts W Title 5 Official ' Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 244 School Street Property Address Ed Maddox Owner Owner's Name information is required for Cotuit MA 02635 09/27/07 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ❑ Any portion of a cesspool or privy is within a Zone 1'of a public well. ❑ ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)'or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form r ' Subsurface Sewage Disposal System Form=Not for Voluntary Assessments M 244 School Street a Property Address Ed Maddox Owner Owner's Name + " information is required for Cotuit MA 02635 - 09/27/07 _ every page. Cityrrown s State Zip Code „Date of Inspection D. System Information (cont.)," . GeneraVinformation Pumping Records: Source of information: Pumped 7/04- provided by owner Was system pumped as part of the inspection? _ ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined?': Reason for pumping: Type of System: ❑ Septic tank, distribution box .soil absorption system ❑ Single cesspool ❑ Overflow cesspool ; ❑ Privy �. ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) EJ Tight tank. Attach a copy of the DEP approval" �. Other(describe):. One Cesspool (Main Tank)and SAS (Leach Pit) Approximate age of all components, date installed (if known)and source of information: Unknown Were sewage odors detected when arriving at the site? ❑ Yes 0 No . r ,w 6insp•08106. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 244 School Street Property Address Ed Maddox Owner Owner's Name information is required for Cotuit MA 02635 09/27/07 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms(actual): 440 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 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 Seasonaluse? ® Yes ❑ No Water meter readings, if available last 2 ears usage d 87,000/05 g ( y g (gp ))' 59,000/06 Sump pump? ❑ Yes ® No Last date of occupancy: current- seasonally used Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal Sysiern. Form -Not for Voluntary Assessments 244 School Street Property Address - Ed Maddox + Owner Owner's Name. 5' information is ` required for Cotuit MA 02635 09/27/2007 every page. City/Town State . Zip Code,- Date of Inspection x D. System Information (coat.) Building Sewer(locate:on site plan):' Depth below grade: h feet Material of construction: I ❑ cast iron ❑40 PVC El other(explain): Distance from private water supply well or suction line: feet r Comments (on condition of joints, venting, evidence of leakage;,etc.), ank(locate on site'plan): Septic�T Depth below grade: Meet 1 Material of construction: ❑ concrete ❑ metal ❑ fiberglass. ❑ polyethylene . ❑ other(explain) ` If tank is metal, list age:''' years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ `No � , - --- - - Dimensions: - Sludge depth: ` Distance from top of sludge to bottom of outlet tee or baffle . 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 How were dimensions determined? t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page of 15 Commonwealth of Massachusetts Title 5 Official lnsp ection Form , a Subsurface Sewage Disposal System Form -Not'for Voluntary Assessments .'' 244 School Street Property Address Ed Maddox Owner Owner's Name information for tion is required Cotuit . MA 02635 09/27/2007 every page. City/Town State Zip Code. Date of Inspection. i 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.): j Grease Trap(locate on site_plan): Depth below w rade p 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 um in P p 9 Date•. Comments (on pumping recommendations, inlet and'outlet.tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): i Tight or Holding Tank:(tank must be pumped at time of inspection) (locate.on:Site plan):. Depth..below grade: Material of construction: -❑ concrete ❑ metal. ❑ fiberglass ❑ polyethylene , Elother(explain): t5insp•06/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•.Page,10 of:15 Commonwealth of Massachusetts _ Title 5 Offi cial* aI Ins e ction, Form . Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 244 School Street Property Address Ed Maddox ; Owner Owner's Name information is required for Cotuit MA. 02635 09/27/2007 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cost.) Dimensions: Capacity: gallons Design Flow; gallons per day Alarm present: ❑ .Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No y Date of-last pumping. Date , Comments(condition of alarm and float switches,etc.): *Attach copy of'current pumping contract(required)As copy attached? : ❑ Yes` ❑ No - 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.): ' Pump Chamber(locate°on site plan) Pumps in working order;.: El, Yes ElNo .. Alarms in working order: ❑ Yes ❑ No t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts w Title 5 Official_ Lnspection Form Subsurface Sewage Disposal System Form -*Not for Voluntary Assessments s 244 School Street Property Address Ed Maddox Owner . Owner's Name . information is required for Cotuit. MA.. 02635 09/27/2007 every page. Cityrrown State Zip Code DaWof.Inspection i I D. System: Information (cont) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): I i I Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain'why: i Type: ® leaching pits number:. 1 ❑ leaching chambers number: ❑ leaching galleries number; ❑ leaching trenches _ number,.length; i ❑ leaching fields number.,dimensions: r overflow cesspool number. i ❑ innovative/alternative system Type/name of technology: I i I 'Comments (note condition of soil; signs of hydraulic failure; level of ponding, damp soil, condition of vegetation, etc.): It's a 1000 gallon precast leach.pit with cover and top of pit 8" to.grade, pit,was ddryat time of inspection with staining 18"from bottom. i i t5insp•06106. Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 15 Commonwealth of Massachusetts ^ . _ Title 5 Official* Inspection Form Subsurface Sewage Disposal System Form-.Not for:Voluntary Assessments . 244 School Street . Property Address Ed Maddox Owner Owner's Name information is COtUIt required for MA 02635 09/27/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (font.) Cesspools (cesspool must be pumped as part of'inspection)(locate on site plan): ' Number and configuration , 1 - 1000 gallon *, Depth—top of liquid to inlet invert Depth of solids layer '0 Depth of scum layer . _ . , > _ 4, Dimensions of cesspool 6'x 8' Materials of construction block , Indication of groundwater inflow Yes No Comments (note condition`of soil, signs of hydraulic failure, level of ponding,'condition of vegetation, etc.): ' z - 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.): r l5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form ='Not for Voluntary Assessments M 244 School Street V Property Address Ed Maddox Owner Owner's Name information is required for Cotuit MA 02635 09/27/.2007 every page. Cityfi own State Zip Code Date of Inspection D. System Information (coot:) Sketch Of Sewage Disposal System: Pro1 .vide 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 pubiic.water supply enters the building. it r 9 )DOD OD cal I o al oQ0 t5insp•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal.System Form'- Not for Voluntary Assessments' M 244 School Street Property Address Ed Maddox »" Owner Owner's Name information is required for Cotuit MA 02635 09/27/2007 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) ' Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to ground water:. 23 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from.system design plans on record If checked, date of design plan reviewed: pate ❑ 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: Approximated from U. S.,Dept. of Interior Geological survey and U.S.G.S: Groundwater Maps t5insp•08I06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15. k Commonwealth of.Massachusetts KIM Title :5 Official -Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 244 School Street Property Address _ Ed Maddox-355 North Main Street, Walingford, CT`06492` Owner Owner's Name information is Cotult required for MA 02635 09/27/2007 every page. Cityrrown State Zip Code Date of Inspection D:-System Information (cont) Site Exam: al Check Slope Surface water ❑ Check cellar Shallow wells Estimated depth to ground water: T Z 3 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system'design plans on record If checked, date of design plan reviewed: Date ❑ Observed`site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local'Board of Health-explain ❑ Checked with local excavators, installers -(attach'documentation) L� Accessed U,SGS database -explain: - You must describe h QF you established the high ground water elev tlon'. t t5insp•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 F , Permit Date: Completed by: HIIGH`G.ROUND:WATER LEVEL COMPUTATION Site Location: F Lot'No. Owner: �' Address: . Contractor Address: Address; Notes.: STEP 1 Measure:dep.th to watertable y to.nearest•1)10-ft..:.- nearest, ...........................................:.. .... .:.... Date month/day/Year STEP 2 :Using Water-Level.,Range'Zone and Index Well Map locate j site and determine: v } 0 Appropriate:indexwell.:..... ............................. �..: Water-level`range"zone ...:: ... ...... ....... .. STEP 3 Using monthly reporf",current . Water Resources Conditions", determine current depth to �;�: M. 'water-level for index.well .:....... .....:::........ - -month/Year.' -STEP 4 Using Table:of Waterdevel Adjustments.. for.:index well (STEP:2A),'current depth to water level.for index well (STEP'3), and water level zone (STEP 26) determine water=level adjustment ::...........:... 3 STEP',, 5 .. Estimate depth towhigh:water by subtracting-the water level adjgstment (-STEP 4)` from measured depth to water level at site (STEP 1) :: ..... ........ ........ ........ ......... ; 7 Figure .11--Reproducible computation form :: u' 4.. . - - w�......-.... w w . - .. - d i � d 0Co . s 00 `Ay46 BORTOLOTTI CONSTRUCTION, INC. �` ��� •765 WAKEBY ROAD, MAIISTONS MILLS, MA 02G48 . h, 508-771-9399 508-428-8926 FAX: 508-428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: Date of Inspection: Inspe or's Name: n VZqvyner's Name and Address: CERTIFICATION STATEMENT: I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true, accurate and complete as of the time of inspection. The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The System: t/ Passes Conditionally Passes Needs Further EvIftiation By the ocal Aproviug Authorily Fails Inspector's Signature: 'Date:.- The System Inspector shall submit a copy of this inspection report to the Approving authority within thir- ty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 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. INSPECTION-SUMMARY: A)SYS-yEM PASSES: y I have not found any information which tndicales that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair, passes inspection. Indicate yes, nor,or not determined(Y,N,OR ND). Describe basis of determination in all instances. If not determined",explain why not. The septic tank is metal,cracked, structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing sep- tic tank is replaced with a conforming septic tank as approved by The Board of Health. Sewage backkup 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): - 1 - 1 i S r.• ISUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PARTA CERTIFICATION (continued) Broken pipe(s)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)FURTHER EVALUATION IS REQUIRED-BY T HE-BOARD OF-HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE 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 FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 Feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. _ ..• D)SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clog- ged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped 2- c SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPFCTION FORM_ PART A CERTIFICATION (conlinued) 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_ 4 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 colifornt bacteria, volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria:►hove: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: The system is within 400 Feet of a surface drinking water supply The systern 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 Zo*ne II of if public water supply well. The owner or operator of any such system shall bring the systent and facility into full compliance with the groundwater treatment program requirements of 314 CMII 5.00 and 6.00. Please consult the local .regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART U CIIEC.KLIS'I' Check if the following have been done: 1,.,— Pumping information was requested of the owner,occupant, and Board of Health. _None of the systent components have been pumped for atleasl 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. _ The facility or dwelling was inspected for signs of sewage back-up. r -,The system does not receive non-sanitary or industrial waste now. __L,�Jhe site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on site. The septic tank manholes were uncovered,opened, and the interior of the septic tank was in- cted 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 llie site has been determined based on existing ittfortnation or approximated by non-intrusive methods. -3- r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(conlinuc(l) The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL: Design Flow: 3 3(2 gallons Number of Bedrooms: `� Ninnbcr of Current Residents: Garbage Grinder: m Laundry Connected'l'o Syste :�a Seasonal Use: ; 9�� Water Meter Readings, if ailabl.. Last Date of Occupancy. COMMERCIALANDUSTRIAL: /CSC) Type of Establishment: Design Flow: gallons/day Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings, If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: (� l/ System Pumped as part of inspection: If yes,volume pumpcd: gallofA Reason for pumping: TYPE OF SYSTEM: Septic TanVJDistribulion Box/Soil Absorption System Single Cesspool . Overflow Cesspool Privy Shared System(If yes; a tack previous inspection records if any) - __Le,fbther(explain): ' ' _Q AP ROXLVIATE A of all components, date installed(if known)and source of information: Se age odors detec ed w en arriving at the site: V -4- SUBSURFACE SEWAGE DISPOSAL SYSTEKINSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: //Ll Depth below grade: Material of Construction: concrete metal FRP Other (explain) . Dimisions: Sludge Depth: Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) GREASE TRAP:_/1 Depth Below Grade: Material of Construction: concrete metal FRP Other (explain) - - - - x Dimensions: Scum"Thickness: Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence,of leakage, etc.) TIGHT OR HOLDING TANK Depth Below Grade: Material of Construction:_concrete_metal_FRP Other(explain) : Dimensions: Capacity: gallons Design Flow: gallonstday Alarm Level: Comments: (condition of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOXY 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 Pump is in working order: Comments: (note condition of pump'chamber, condition of punips and appurtenances;etc.) i .. -5- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ., , , 1 .. SYSTEM INFORMATION (continued) SOIL ABSORPTION SYSTEM(SAS):_,:��/ (Locate on site plan, if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: Leaching pits, number: Leaching chambers, number: Leaching galleries,number: ' Leaching trenches, number, length: Leaching fields, number,dimensions: Overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure le el of ponding,condition of vegetation etc. 12X ICJ - /i �i rr CESSPOOLS: t/ Number and configuration:/l Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of Cesspool:��� Materials of construction " *_ilndication of groundwater: Inflow(cesspool must be pumped as part of inspection) Co ts: (note condition of soilk, signs of hydraulic failure, level o nding,condition of vegetation, e Q � ' (fey ij .. � _ e COP PRIVY:/ya Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil, signs of hydraulic failure, Icvel of ponding,condition of vegetation, etc.) -6 - SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM - PART C SYSTEM INFORMATION (comioued) KETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks., Locate all wells within 100 Feet. (ID r � DEPTH TO GROUNDWATER: Depth to groundwater: /6 Feet Method of Determination or A pro 'mation: ,.� ✓ 171! ----- O /'✓��'' - 7- e , l J 1 � { (P(tc4 E-d rYA O X 0.4 77 r jLto G� - - ol -� ►a e,� S p p v 14`tii 5 LaJC-l�T 1��1� g _—��W A_CaE-P—E-RM.IT—Aa_O. Q_� a D AT_E—C-O —�— ;5t . v. No.... ". F��.. ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALL8___� 7 _0,&-C4�0 F...pi -) e- Appliration -for Dbtipoiitt1 Works Tontitrurtion Vanift Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal Stem at '1 --- -- s ) l ' Q 1 o tion-Address or Lot No. --y—- ... Owner Address n er Address UType of Building Size Lot----------------------------Sq. feet �-, Dwelling—No. of Bedrooms____________________________________________Expansion Attic ( ) Garbage Grinder ( ) pa-, Other—Type of Building p ( ) ( ) ............................ No. of ersotts.________________________.__ Showers — Cafeteria Q' 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-------------------- Total leaching area--------------------sq. ft. Seepage Pit No..................... Diameter_.-_-_____-__---:__- Depth below inlet_:__-_______--_•-_ Total leaching area------------------sq. ft. Z Other.Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------- ------------------------------------------------------------_-- Date----------------------------------_-.. ,a Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water...--__-__-_---_-_..___. fZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--.------_-------__-.__. --------•---------------------------------•-•--•-------...--•-••--------------------•-----•••--•---•....................................................... 0 Description of Soil--------- -------------------------------------------------------------------------------------------------•----------------------------------------- -------- --- .. x I .. - -------- v +.. U Natur epairs lteratio�ts nswer n applicable._..._... �._ �a-�_ --------- -- -- -- -- -- -------- ---------- --- - � - ---- -- Agreement: 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 b is ued by he boar h Signe '� � ----..... .. "Date ApplicationApproved By-------------------------------------------------------------------------------------------------- --------------------------------------- Date Application Disapproved for the following reasons-------------------------- -------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------- / -------- -- - Date PermitNo.--------•------.....•-----•-••-•......•-----•---•....... Issued.- , Date FEiz. r2... ........ THE COMMONWEALTH OF MASSACHUSETTS BOA RDOOF HE�T �- �O F.. ..... . ................. Appliration -for Di-nVaiial Works Tutuitrurtivit Prrutit Application is hereby made for a Permit to Construct or R an Individual Sewage Disposal ........... . ........................................................ .......... ......................................... L ation-Address or Lot No. ............ . ................. .................................................................... ....................... Address W ' , Z... .. .................... --- --------------------------------------------------**-*-*------------------------------------------ Address Type of Building '4, Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms............................................Ex ansion Attic Garbage Grinder PL4 Other—Type of Building ---------------------------- No. 01 persons....---- .--..-------------- Showers Cafeteria PLI Other fixtures -------------------------------- ....................................11 -------------------------------- ............ Design Flow--.....---._---------------------------- ---gallons per person per day. Total daily flow....._...--,,--.---..:..-.-.--.----..........gallons. P4 Septic Tank—Liquid capacity--------------gallons Length-------- ------ Width........._._.--- Diameter----------_.--_ Depth.._-'.......... Disposal Trench—No. ................. :Width-------------------- Total Length--------------------- Total leaching area--------------------sq. f t. Seepage Pit No..................... Diameter------------_------- Depth below inlet..--..--............ Total leaching area..--__--------..sq. ft. Z Other Distribution box ( ) . Dosing�tank ( ) I I Percolation Test Results Performed b ......I.............................................................. Date----------------------------- ------ Test Pit No. I................minutes per-inch, Depth. of Test Pit.....--------....... Depth to ground water........--_-..-..--____ 0-4 .,' (14 Test Pit No. 2................minutes per ln6h.,,'Depth Test Pit..-------.._---............. Depth to ground water.......-------------.... I---1' 1­­ 1 . ..................................................................................................------- 0 Description of Soil--------_---------..........................................7.............................................................................. -------­--------........ U ------------------------------------- ...................................................................:.................................................................................................... ------------------------------ --------------------------------------------------------------------- ;05-t Nattjw_,pLJ�ep�airs pp.Xkerati s nswe applicable U rAen appl --- ----- ---- ---- ------------------------------------------------------------------------------------------------------ -U 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 Wn-*)lsued by the boa f Signe ......•... ....... -------- Date ApplicationApproved By.................................................................................................. ----------------------------------- Date Application Disapproved for ihe,.following reasons:------------_-- ..................................................._7............ ................._­_ .................................................................I........................................................................................ ........................... ................. Date Permit No. Issued.... ............. apt—'00/_ ------- - ------- Date tr THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........OF ....... . .... from fiatirr Tatiti atr f OUT IF TH 0 C hat e I di idual ewag is os System o stru e d by....... . ......... .. .... . .... . ..... ... ................... .. . .... D ............. Installer • at.-A -------------- ----------------------- --- -----------------------------r................................................................................ has b installed in accordance with the provisions of Artic� �.----=- heState Sanitary Cpdp a esc bed in the d 1 0 1 application for Disposal Works Construction Permit No.-------—---------- ­---------- - -----------�e-------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE GU N EE THAT THE SYSTEM WILL '.' FU"TlO/.iA. T. IS. ACTORY DATE lns e t ----------- THE COMMONWEALTH OF MASSACHUSETTS :BOARD 91F HEAJT . ........ .... ......OF.... ......................... N0117A�13.... FEE... Permission is hereby grante ------ .... ... ..........;;17............... ............ .. ... ...................... Ldva)i e e to Construct or Ppair/ �anAdivWv S e os.I Syst ...... ........ at No.. W, ...... .... . . . .......... ........ ----- . ..... sit as shown on the a N,p)/pl i tion f r Disposal Works Construction ---- -- - -1 ted.......................................... .. . ............................ B and of Healt DATE------. . ....... ..... ... . ..... .................................... FORM 125 HOBBS /ARREN. NC.. PUBLISHERS 0 (ADDITION) - (EXISTING) -(EXISTING) f (EXISTING( . NOTES: 1' t.) CONTRACTOR IS TO VERIFY AL1 EXISTING CONDITIONS 1'i &DIMENSIONS IN THE FIELD AS A5 2:) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, -3 DETAILS,&FINISHES IN THE FIELD WITH OWNER -4'Q Z C]� I (VERIFY°iCKING. 3.) ROUGH OPENING HEAD HEIGHT OF WNDOWS AT `y N —ING NATER-S FIRST FLOOR TO BE 6'.8"ABOVE SUBFLOOR. (/l O C) wrowNEasl NEW I I 4.).ALL CONSTRUCTION TO CONFORM TO 780CMR MASSACHUSETTS DECK STATE BUILDING CODE,SEVENTH EDITION f Q d M m .. nP n•-s ss PAD OUT EXIST-2x4 - .b m< 6.) 110 MPH EXPOSURE 8 WIND ZONE,1 Q .75 ASPECT RATIO FOR NEWADDiTION ONLY _. ) " . WALL TO WINDOW FOR Io -, } w Li AL. ENFOFNEw - 4•Xs - ' 7.) ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY N 2X 6 WAIL OUTDC aR 8.f. WITH w^ .. 0 - :'' SHow R - - - THE NAILING SCHEDULE ON SHEET AS TO BE FOLLOWED TH NO EXCEPTIONS. F"' ANOEaseN _ .Exlsr. ,-:.J ) _ _FftH OC68 R 4 DEVIATION FROM THIS SCHEDULE WILL REQUIRE ADDITIONAL METAL HOLD DOWNS&STRAPS �=L1 X ,. " ) DETAILS ON THE EXISTING PROPERTY D ENGINEERING FOR ALL U -- ---- ---- --- - -- - - ---------------- ----- -------- F 9. BY CAPE&ISLANDS E �NEER 4 1'— — — --_ -- — -- NEW BWLT�W BARSINR y"F r P CIF( NSF INSTALLATION OF ALL , 10.)FOLLOW ALL MANUFACTURER'S`S.E CATlO OR 1 ALLATIO hi'rvcaBWET r"'crli-1 - '`" SiMPSON COMPONENTS I aKVLI : - e ABOVE ". -y- „ ` - 11.)ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS - ABOVE Ht 1 U.C.REF. TO BE 3000 PSI L—UNE OF WAIL b WI 1 (VAULTED CEILING) I ABOVE -9 tt -'I- - _ 12.)VERIFY ALL PLUMBING&:ELECTRICAL DETAILS W(OWNERS ON THE SITE M L___J .DETAItS 1^ll NET I r 1 sKructir-I (sKvucxr-1 (-sKYucart-] DURING FRAMING CONSTRUCTION U m F ABOVE© 8 -I EXPANDED" TwNERs I I ABOVE I I ABOVE I I ABOVE THIS SITE IS IN THE 110 MPH WIND BORNE DEBRIS AREA,EXPOSURE"B" I &WITHIN ONE MILE FROM NANTUCKET SOUND PER SATE OF SUNROOM MASSACHUSETTS WIND SPEED MAPS L__A L__� L_._J 14.)GLAZING PROTECTION PER 780 CMR 5301.2.1.2 TO BE IMPACT GLAZING WINDOWS m ABOVE© e. I - 1 - OR PLYWOOD PANELS.VERIFY ALL WIND BORNE DEBRIS PROTECTION REQUIREMENTS 4_ - W I MST. >1:. .. - W/OWNERS PRIOR TO START OF CONSTRUCTION -_ _ ___ -- - I' I - 15.)SEAL ALL JOINTS;SEAMS,&PENETRATIONS IN THE BUILDING ENVELOPE TO - - BUII.TJN - - REDUCE AIR LEAKAGE SEE SECTION 6106.3.3 1N THE STATE BUILDING CODE • - HALF W'� - 16.)THIS ADDITION DOES NOT MEET ALL OF THE 110 MPH CHECKLIST.ACCORDINGLY,HOLDOWNS - as &STRAPS"ARE SHOWN ON THE PLAN. ac - -- --''-T-- p EXIST. EXIST. ------ ,- - -- - Q KITCHEN GARAGE r - ---- ; O ST. EXIST. EXIST. A6 LIVING HALL EXIST: O P4r - HALL C...) e-1 b.� .. R - ON. _ E1U5T. EXIST. 71 EXI "fl EXIST. .. (D: EXIST. T� BATH ' 9. <!? BEDROOM#1 © HALL EXIST. G t- - © NEw co BEDROOM'#2 C PEDESTAL .. ,. - I Q I 'SINK up LOS EXIST..' EXIST. - - - n _ .EXIST. EXIST. EXIST r . s S , �z - e e • , • , • n (EXISTING) : :.. (EXISTING) .. ' .. 7 F—i, , '. F1R�ST.F.LOOR.PLAN: � . - - .,:- � : � ;� LEGEND. �I .,: - .. �. .. .. .. �.,� ..• ... •,.'.�-:. - .'..-.-t .... . - :. >:WALL ,,,:.. ..: :..�..- - .. EXISTING,_FIRST:FLOOR.,�...,. EXISTING'WALLS. .. ,.,.0.. - E. .. . .. .. .. ":'.. .- • ...EXISTING:SECOND-FLOOR. :. 763,_ 5.. - '-: ,W.I'NDQ�V.Y.-.VC1 1:�"DV���' .. .�.- :-= GONST.RU Ti B EMOV C ON TO E R EXiST1NG:GARAGEMALC -562 S.F. - -. r - , ... - .. - ....;.:.. - .. _. .... .... . . .- _. . - ... NEWFIRST:FLOOR:'- .: .-3968.F.:._ .'.. :.. ._ ...` TYP .MANUFACTURERS.UNIT."� .', - � 'ROUGH OPENING -REMARKS���"`. _ NEW CONSTRUCTION"'..., ..:.. .. .. .. .. '. ,.. .,_.. ..,, ,. _. . . _ ... NEW SECOND FLOOR 35S:F `, :' '�-"A'".`. ��3'D�1/2"x.1•_g•... -".':`STORMWATCH AWNING�.ANDERSEN'AN 37� ':. "` a . f ,. .. ...:.. r, .:. ..- .. .. ,. -,.. .. . ., .. ..:.... - ,. . .. .. . TIN 210410'. �'. 1/4 STORMWAT.CH DOUBLEMiNG. ., _ .. a: :SMOKE DETECTOR .- .- .. :.._•; .. ., -. .CARBON MONOXIDE DETECTOR .0 ...:. .. :., .. .. ... .. ..-. ... .' ... �. _ :.9'-0"tx 5-1-'"1t4'• :�-STORMWATCH COMBO .. :.., _ . !8.-x'1'.9". -STORMWATCH`AWNING' /OHP56410/IiM2441 " ...... . � '�� -" -�'.� � � �- •-`.- '.1..CONTRRCTOR TO VERIFY ALL.WINDOWS.WITH OWNER'AND ROUGH OPENINGS . .-. . ORDERING F WIN -W . ... :. "<', WITHWINDOW.MANUFA6TURER'PRIORTOO o �o_ Dos. .. SCALE —0.' .,: .. < _ - �� �-• '.� �` � � �: .� '• � �� � -� � :"---':" _�- � - - ���:2:AND R WATCH 400 SERIES'WINDOWS WHITE EXTERIOR.WlHIGH PROFILE INTERIOR/EXTERIOR �- ' ' :, - •,..'...-... f - - ING W/TRU-SCENE SCREENS&METRO HARDWARE - ERSEN�STO M GRILLES.- - .:�. .. . .:. - � � 'DATE��.' � - � .- - - ':3::USE OFANDERSEN 400 SERIES WINDOWS�OPTIONAL WITH.PLYWOOD PANELS FOR.PROTECTION PER, :.�..` ,780CMR•5301.2.12`: � . 9/23/2008 THE DESIGNER OROWISSHALL IONSAROHFIED ON D,e'G• NO' . THESEERRO DOROM1BS NGS PRIOR TO FOUNT ON �lll 4 START OF V�/I CONSTRUCTION. RESPONSIBLE Il�l>ttJTME�CONTRACTOR fl IN THESE DRAWINGS IF CONSTRUCTION . ' DEV(SHCOMMENC ES ANY ERRORSOY NG OMIS E 1 `1Vl THESE ER OF ANY E SOLELY FOR SIONs. THEON SE ARE SOLELY OTHER USE . - - .. .. THESE E PROPERTY NOTED.ANY EWRITT N OF THESE DRAWINGS REQUIRES THE WRITTEN Al. E PRO THE DESIGNER.THESE DRAWINGS M ARE PROTECTED UNDER THE ARCHITECTURAL I COPYRIGHT PROTECTION ACT OF 1990. . CONT.RIDGE VENT - _ N C, Tn D o - - - - �p NEW ASPH T SHWAES TO MATCH EXMnNG - . NEW FASCIA 6 FRIEZE 0-00 O L. C) BOARDS TO MATCN EXIST. ~ .. TOP_OF RATE - _ .OU NEW CORNER BOARDS 0.0 i TO MATCH EMT. « - TO k,4TC. x TO MATCH FM R Tn S f FRONT ELEVATION l D l - _ .. ( ) "IExtsm,cl -- :(ExsrlNGl .. x O w, A 8 , _ I I. I - � -ROOF BELOW � .. o t7- �s EXPANDED 1: SUNROOM 7-,• BELOW (ADDITION (MSTING) (ADDITION O I I. EMST. .. EXIST.' a �. Q r, r-�� ma {IVEW ii NEW ii BKT.Dooa \/ - , .. AownoNl �CLO�Sl1 >r t' I -NEW, i' b.:' <.C 5. _ b 5 BATH : I I aB.GB MAS ER xar ii,: m' { It ry �... , ..,.. , .;,,, .. .,. -. .. i -...'. a •�.I ... „ .• ---' .REND, .. ., .,:. . .:.: .. ....,. .. _ ... �� ..: .:'MASTER _ n •.: ,.:.. .STAIR ... MOD `BEDROOM U� L , . ... .. .. . -Dar. _ � ,_ ...,.. REMODELED _ ceo s NEW 1 { I W. . ....1 ........ ..... .. .,- .:1 sKYIIGHT 1 .. -,. . ... .. .�.,, :.. .. .. ,.. ;.,.., ....� ABOVE.. ':. .. ..- .. ,. ..:.:.a.,:::�.•... .... .. .. :.... .. '. ;'.ABOVE�.,-: •. ,.�� f., I,., r k • .SCALE ' ,4 '( On X, DATE 9/23/2008 DWG.. N0: PLAN.SECOND FLOOR 1� . - . - xr . ;, . 1. s . . , z. r; . . . . , r r . . . CONT.RIDGE VEW - n7 x' - w - , ". - . I : I ; .,im :. - - -- ' . I�I.III�m- � !`Ln . QCz7N- . . . w -- . J .,, ..,, �., O AIATC ISnNG S - W O O NEW ASPHALT SHINGLE . - .. O w¢ Q r I NEW FASCIA d FRIEZE co�-x'T' . .,. - : - ,. : - J ' BOARDS TO MATCHEXIST. 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JOIST TO SILL.TOP PLATE OR GIRDER(TOE NAILED) 4-8d 4-101 PER JOIST ®ae'P.c.;ALLOW SPACE FOR AIR BLOCKING TO JOISTS(TOE NAILED) - 2-8d 2-10d EACH END FLOW ON THE UNDERMOE OF ROOF - - - - LG-' a.DO O BLOCKNG TO SILL OR TOP.PLATE(TOE NAILED) 3-16d 4-16d EACH BLOCK .SHEATHING O -LEDGER STRIP TO BEAM OR GIRDER IF NAILED) -- 3-tfitl 416tl EACH JOIST - _& 4 4 2 NEW MULTI LVL HEADER 2 X . JOIST ON LEDGER TO BEAM(TOE NAILED) 3-Bd ( 340d PER J015T BAND JOIST TO JOIST(END NAILED) 3-16d 416d PER JOl$T. - O - - - Q Ch BAND JOIST TO'SRL OR TOP PLATE(TOE NAILEDO .2-16 d' :'3-16d. 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WOOD STRUCTURAL PANELS(PLYWOOD) - b O�: I"OR LESS THICKNESS _ - 8d 10d W EDG&IT FIELD - Q' NEW MULTI LVLeENL GREATER THAN l"THICKNESS 10a lSd 6'EDGE/6'FIELD 4GN � '' !� CT - FASTEN W EXIST.WALLWSCI TO USE SIMPSON LSTA24 - NEW'ROOF c6NST. - t. _ — NEWMU LVLHEAUER _ LEDGERNTB'OARD.B SIM SON I . ER STRAPATEACHRAFTFRI 4 Q 4 2. (4. 'CONT.RI➢GEVEM�t .'RIDGE CONNEC710N- x- 2 i 10 ROOF RAFTERS@to--c - - /�A - • F. -,2'COX PLYWOOD ROOF SHEATHING. ,� 4- - .,. T,.,,. '{:: .. �-T-O - .- . ASPHALT ROOF SHINGLES -1SLB.FELT PAPER - r,' d n r - • 2x 6e�16 e.e-USE - ° HI-Ft BATTINSULATION „�, �~ - 0 :(5)1w NAILES EACH END - ®SLOPED CEILINGS(R=30) .• :S IATT WSULATION - @ FLAT C9UNGS(T=318 12 - -MULTI LVL RIDGEBFAM MATCH - -(2)SIMPSON.H 25 HURRICANE CUPS EAST, AT ALL RAFTER ENDS - -ICE!WATER SHIEWAT BOTTOM OF ROOF -PROP-A VENT BETWEEN RAFTERS - NOTE:DROP TOP OF NEW FOUNDATION - - -TO MATCH NEW SUBFLOOR W/THE - TOPOF PLATE - - (ADD IO DITI ——— - - -_ E)USTING SUBFLOOR(VERIFY IN FIELD 'NLW I-GYP:BOARD - - - _ li N} .. IF REQUIRED).. .ON,x G STRAPPING - - IV- P.T.2x III LEDGER BOARD LAG BOLTED To E.X.PANDED NEW WALL.CONST-F - SOUDBLOCKINGWI2)4E➢GERLOKSOLTS' f.2x SSTUOSQ16 P.c. : - - - I—..Wf JOISTS HA�GERSATBOTHENDS � SUNROOM 2.1?PLYWOOD SHEATHING SIIBF3WT 6 GLUEDPLYWOOD ONA)LED _ SHINGLE a E- 3.W(R 18)RATTANSULAT 4.1?GYPSUM BOARD S.W.G.SHINGLE SIDING VERIFY DECANG6RNUN0 6.TY'VEKV BARRIER I O _ MATERIALS WI OWNERS FIRST FLOOR •s„• - P.T:2 x Bs®t6 e.c. NEW 2 x 12 JOISTS®16`e.c. :T.2 x 6 SILLW SEP1ER 3-P.T.2 iOs NEW 9'BATATT. r .� N TT NEW 1 /� NEW ANCHOR BOLTS �CRAWLSPACE - .E PLAN S DETAKS FOUND.WALL NEW 2.0 SLAB e - I - I TIN iB•CONC. - ... I 1 - NEVJPT.6a6POSTSON _ _WOTNGs ROOF FRAMING \Ji - - F/—i• W . 42 OIA C SDNOTUBES - _ 'T040`BELCWIOW GRADE USE SIMPSON ABU 66 POSS BASE - s6C6POSFCAP 2X6 WALL Q )BUILDING SECTION-0 EXPANDED SUNROOM -6 DRIG.FIR PUT. . 4"'Iu SHEARWALL_PLAN A 12 �:'. � NOTES:.� _ .'as-v: � - u . .. - (EXISTWG) .. "bd . . ...- -: a .1T) ALL ROOF RAFTERS TO BE 2 x 10s - ... .. ., '�U .. - _ - �,--- *- ,:.- ., UNLESS:OTHERWISENOTED c' :HBO DOVN E V 1' m * USE 2 R PLAN' -SINIPSON:W2:5 HURRICANECLIPS �41 cOR A-vEr(Tx (),�.��. ... AT ALL RAFTERS .:'::, ,. .. .: 'SIMPSON SPH4 FRObt e..1. .,...' .m -e.. FASTEN NEW RAFTERs.To, .. .� �.- ,� '�3:VERIFY GUTTER-TYPE/1AYOUT -.:.. :::.� ,, .. .' - . �. .>. .. ..: •:.+ -ss. PLAN:VIEV .- EL{VATTON-V[EV : .: ) .. STUD TOOVER.TOVPIATE .' t' , EXIST.WALL W/6CREN/D ON. �. :?. ..:.. -:. .. �.::.. .. W]OWNERS - .. Q ., ., .. LEDGER BOARD 651MPSON. ..;: EXI'ST: : . ' ".. '. �T ) TOP PLATE E TTAOI STUOS�AT BI LTIW TCDdR.TOGETFE H . OF 16dLL162x 3.5 NAILS .2HEAOER . AT s. C FUR. 2 2NO STORY EARVALLS: ATTACH STUDS D BUILT_U P.- L :TOGETHER WITH ROI SIMPSON SPH4FR0M' JA- CK (B)ROVS, 16d CZ'x 3 5'.NAILS-_AT,9 0.C._. STAGREDD1ST'..T VALLS . STUD TO OVER HADER- :. MULn _. _ . : 'HE ARWA CH DED. .- . ,. . . .:., . . T. S . L.L.: S EDULE . EXPAN .- . : <. .. .. -z TRIPLE FULL HT.STUDS.' O .[. .. - .. SUNROOM. .. CDUFL .•:, - JACK WAL-L_TYPE H DULE a SST O . .. .. r .u.. . ..'�L IS 'n' .: ... ... ..t. � - .:.:,..A. / WINDOW SILL PLATE'.- , ANCHOR .PLYWOOD--EDGESBLOCICED .• : ..� . P . . , 0 3' AND ;...,. Sd COMMON OR GALV ANIZED BOX NAILS O.C:EDGLS ., .... , -. �: n / 12 O.C.FIELD: :,- ..:: - ,-. . OU D TIN HOLDDOW . ....a .. ,. r...,......' NEVJ2a I2 J015TS.�16 a.c. 1. .^,'. NOTE:FOR PLYWOODSHEARWALLTYPELISTEDABOVEBd ... ..,.r.:..- 7 - . . ..:.. ,. '.:;HDUB- .. '.' T"':IAMETER:ANCHOR BOLT Wl CNW - ... - 1 n {. : .. $DS2.5 WLSSTi328./.D .., •..;, . _ NEW -. r " .. COMMON OR GALVANIZED BOX NAILS- 0.131 x2.h. . GUN NAILS. -.. .....4 :. T - .- .. (,. ) :..., O. ':COUPL' ,,,. - .TA28'AND /x MATEDEDRODINTO MATCHINGUT`E,HENAfC.DIANIETER AND LENGTH MAY BE USED AS A ER NUT BETWEEN SS CRAWLSPACERIv1ATE T0: 'BorromawTE - . . .. .., . ... . '. : .; ,,. ,:.. .. ', .:.., r.:-.,... :: ..�HOLDOWN, POSITION,SSTB28 tV/ANCHO /23/2008 ' SUBSTfCUFE. FO SIMPSON CS165TRAP . 4 _ � � 'FORMWORK PRIOR:TO CONCRETE POUR R CORRECT ' - SOLE. PLATE CONNECTION. SCHEDULE;' ' PLACEMENT DWG. N0. _ CONNECTION TO FLOOR RIM BOARD.' _ R.O. DETAIL . - - WALL;TYPE SOLE PLATE CONNECTION TO RIM BOARD T - - $. BUILDING SECTION EXPANDED SUNROOM (4)-IGdCOMMON NAILS PER 1G". A sCALE:vz =�-a 2 � A5 IL -