Loading...
HomeMy WebLinkAbout0118 JOBY'S LANE - Health 1:18,,'Joby's 'Osterville P i I a I I OWN OF BARNSTABLE SEWAGE VIT:,LA- E 0�s Cry I SES'SOO MAP Sc LUG' 3INSTA1,.Liait'3 NAAIi>~�c PHC?NE NO � �SEF'I'dC TI AIgx CAPACI'CX Q ..... LIG 1P1�1C�HXTX' .(4j►pa) l a P!3(size), NO .�P'i3SDR{�t�N1S . j19YJ�1.i;1ElZ a�mR �. � �i�BFNdBT�A'X'L�: ::' ':.CClI��,YA�I+ICE 1R14'll�.,.�.�.;.:.......,�..,._.....•..._._....w. �Sepai�atic��t�E�ttGs 8stvieert trot iVl�Xlmum ijust�tt:Gkauudwtattt Table to alto HcittCoi ni?La8,hlnS F)XiliEy. .:._.:. f lea Prtyag4l�Vatr 5cly VYail"turd Lca6uuSacGty . erty+Delis exist i eitcs ae:witban 7AA feet:a�t asEuft facility) i eit �Ed�i cy$�feLland aid Leaclntn�F�cAtey.{tf,�y:weEl�nci�eRisE ivitfait�3QQ fae of leaa i44 acli ry): lac K � _ 3 � ' `f A -1 - as p--1 A - 3s� 6 .3 -3a ' / f TOWN OF BARNSTABLE `LOCATION �� � ys �Ar� SEWAGE # V i AGE C-7rerv, ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. `` SEPTIC TANK CAPACITY 07V GA 1 , LEACHING FACILITY: (type) 3 _ (size) lax 34 NO. OF BEDROOMS BUILDER OR OWNER M (�✓A�S� PERMITDATE: . COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leachi facility) l Feet Furnished by �A l_ as a9 A3- 3 S' a y TOWN OF BARNSTABLE LOCATION SEWAGE # VIIGE C4 1JI,U i ASSESSOR'S MAP & LOT JI �Z INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY q fir-1 LEACHING FACILITY: (type) 3 (size) l2 A16- NO.OF BEDROOMS-_ BUILDER OR OWNER "�-PE ITDATE: S �2ei.��0�i COMPLIANCE DATE: Separation Distance Between the: ` Maximum Adjusted Groundwater Tab( �V Feet Private Water Supply Well and Leaching Facility (If any_wells exist on site or within 200 feet of leaching facility) A' Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 fee oaf eaching facility) N Feet Furnished by �Y� ftZ-2.91 Commonwealth of Massachusetts _ ;• r.:.:.� . Title 5 Official Inspection Form'- ht Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Jobys Ln r h Property Address w. Joel Dietz " r Owner Owner's Name' information is required for every Osterville' _%` ;: MA 02655 12-12--18 page. City/Town .• State Zip Code Date of Inspection, 1AJ Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information 6141P Shawn Mcelroy Name of Inspector Upper Cape Septic Services _Company Name P.O. Box 73 Company Address E. Falmouth , WA . 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);I have personally inspected the sewage disposal system ai theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and ` the inspection was performed based on my training and experience`in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1.- ® Passes' t ;, ,2. ❑. Conditionally Passes +, 3. El ,Needs Further,Evatuation.by the Local Approving Authority ., 4. ❑ Fails -_ 12-12-18 Inspector's Signature Date The system inspector shalt 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 has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form shouldf be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority.. I Please note: 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.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts , Title 5 Official Inspection Form C�'i Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments ,�w- �" 118 Joby's Ln Y:'LP'n""Ty1 Property Address Joel Dietz Owner Owner's Name informati for every on is required Osteryille MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes:', ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: �. System is in good working order with no sign of failure. 2) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will passJnspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑N ❑ ND (Explain below): t5insp.doc-rev.V26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts • ,. , w Title 5 Official, Inspection ;Form. 1.1 Subsurface Sewage Disposal System Form_-Not for.Voluntary Assessments 118 Joby s Ln J Property Address Joel Dietz Owner Owner's Name information is Osterville -„ MA 02655 12-12-18 required for every ' page. City/Town " State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): , ❑ Pump Chamber pumps/alarms_ not operational. System will pass ywith Board of Health approval if pumps/alarms are repaired. ❑ 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 6f Health): ❑ broken pipe(s)`are replaced `❑ Y ❑N' ❑ ND (Explain below): El: obstruction is removed El ❑N' ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑Y A ❑ N ❑ *ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑Y ON ❑ ND (Explain below): ❑ obstruction is removed ❑Y ON ❑ ND (Explain below): 3) Further Evaluation is Required by the Board,'of Health: ❑ Conditions exist which require further_ evaluation by,the:Board of Health iin order to determine if tlie'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, safety and the environment: t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ill Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Joby's Ln Property Address Joel Dietz Owner Owner's Name information is required for every Osterville MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless.the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: r 4) System Failure Criteria Applicable to All Systems: . i You must indicate-"Yes"or,"No"to each of the following forall inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or El 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection,-Form' i Subsurface Sewage,Disposal System Form -Not for Voluntary Assessments , 118 Joby's Ln t Property Address Joel Dietz Owner Owner's Name information is required for every Osterville MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes . No Ei ® Static liquid level,in the distribution box above outlet invert:due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h•day flow - 1; - I- El ® Required pumping more thanA times in the last year NOTdue to clogged or obstructed pipe(s). Number of times pumped: ' ® t ,.rAny portion.of the SAS,,cesspool,or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply` ' ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well: ❑ ® ' 'Any portion of a cesspool or privy is within 50 feet of a private water supply well. El ®' Any porti6wo'f 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 2000 gpd- ` 10,000 gpd. 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.- ': - 5) 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.- i For large systems, you must indicate either"yes or:no".to each of the following, in addition to the questions in Section.C.4. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18. Commonwealth of Massachusetts - r� y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ��Sr.•�<ti,r' 118 Joby's Ln Property Address Joel Dietz Owner Owner's Name information is required for every Cisterville MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under, Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes"or"no"for each of the following for aft inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped.out in the previous two weeks? ❑ ® Has the system received normal,flows in the previous two week period? ® ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ f 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? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ 'Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official , Inspection F:oriii Mi Subsurface Sewage Disposal System Form Not for Voluntary Assessments 1:r.•,�„;, 118 Joby s Ln I Property Address Joel Dietz , Owner Owner's Name information is , required for every Cisterville MA 02655 12-12-18 , page. City/Town > State Zip Code Date of Inspection D. System Information r• 1. Residential Flow Conditions:. Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: 1 e Number of current residents: �, i ,<<• �; 0 Does residence have a garbage grinder? f A ; ; ;z ❑ Yes ® No Does residence have a water treatment unit? ,,. _ - 1 , ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: .5} Sump pump? ❑ Yes ® No Last date of occupancy: 11-2018 Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18. Commonwealth of Massachusetts 1r Title 5 Official Inspection Form f r-I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1a1 118 Joby's Ln Property Address Joel Dietz Owner Owner's Name information is Osterville MA 02655 12-12-18 required for every page. City/Town State Zip Code Date of Inspection D. System Information -(cont.) = 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges-to: Industrial waste holding tank present? El 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'below): 3. Pumping Records: Source of information: Owner--pumped spring 2018 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection F®rm A Subsurface Sewage Disposal System Form,-Not for Voluntary Assessments,; + - 118 Joby's Ln , Property Address Joel Dietz Owner Owner's Name information is required for every Osterville" - MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: , ® Septic tank, distribution box, soil absorption system, ..... , ❑ Single cesspool ❑ , . Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under.contract, ❑ Tight tank.Attach a copy of the DER approval. , ❑ Other(describe): Approximate ageof all components, date installed (if known) and source of information: 1994 Were sewage odors detected when arriving at the,site? ❑ Yes ® No 5. Building Sewer(locate on,site plan): „ 24" Depth below grade:, feet ' i ` . ` Material'of construction:' ❑ cast iron r ® 40 PVC` ❑ other('ex Olain) Distance from private water supply,welf or suction line: feet Comments (on condition of joints, venting; evidence of leakage, etc.): Good condition. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 I Commonwealth of Massachusetts r� y Title 5 Official Inspection Form 01 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r� err 118 Joby's Ln Property Address Joel Dietz Owner Owner's Name information is required for every Cisterville MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection D. System Information !(cont.) 6. Septic Tank(locate on site plan): 1811 Depth below grade: . feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: t years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 611 Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and,no sign of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 c Commonwealth of Massachusetts - �a Title 5 Official Inspection folrm N NI Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments . 118 Joby's Ln Property Address Joel Dietz >} Owner Owner's Name s information is required for every Osterville tr MA 02655 12-12-18- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) f 7. Grease Trap (locate on site plan): Depth below grade: feet ` Material of.construction: t -❑ concrete ❑ metal ❑ fiberglass ❑,polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle = Date of last pumping: ,• Date ' Comments (on pumping recommendations, inlet and outlet tee or baffle-condition, structural integrity, liquid levels as related to outlet invert,'evidence of leakage_,'etc:): 8. Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 I Commonwealth of Massachusetts Title 5 official Inspection Form %l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Joby's Ln Property Address Joel Dietz Owner Owner's Name information is Osterville MA 02655 12-12-18 required for every page. City/Town State Zip Code Date of Inspection D. System Information!(cont.) w 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 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.): Goods condition with water at working level and no sign of back-up from field. r t5insp.doc•rev.7/26/2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts 1 Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments-.". T, >' 118 Joby's Ln - Property Address Joel Dietz - Owner Owner's Name ; information is required for every Osterville ' MA 02655 12-12-18 page. City/Town', t ;' State Zip Code Date of Inspection D. System Information (cont) • r �. i 10. Pump Chamber(locate on site plan): ; M,• + : Pumps in working order` "' ` ❑ Yes ' El No* Alarms' working order} ' F t' f t f ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and,appurtenances, etc.): ' If pumps or alarms are not in working order, system is a conditional pass. .. t 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: r' R El pits'" number: ® leaching chambers number: 3-Flodiffusers ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ - leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 - i Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 4e Commonwealth of Massachusetts Title 5 Official Inspection Form ! rI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - > 118 Joby's Ln Property Address Joel Dietz Owner Owner's Name information is required y uired for ever Osterville MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection D. System Information '(cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Flodiffuser field in good working order with no sign of back-up into d-box or surrounding stone. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top,of liquid to inlet invert layer Depth of solids la ` P Y Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, . etc.): 7 . t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection :Form I,I Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 1, 118 Joby's Ln Property Address , Joel Dietz Owner Owner's Name information is a t ; required for every Osterville MA 02655 12-12-.18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) • - 13. 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.): ,1 4 • r t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 I Commonwealth of Massachusetts w Title 5 Official Inspection Form I�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Joby°s Ln Property Address Joel Dietz Owner Owner's Name information is required for every Osteryille MA 02655 12-12-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal'System: Provide a view of the sewage disposal system, including ties to'at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately ioo t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 I Commonwealth of Massachusetts r� Title 5 Official Inspection F®ran ; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _ 9 p Y rY . .. r a r1 118 Joby's Ln "4 . Property Address Joel Dietz • ,�- ' Owner Owner's Name information is required for every Osterville tJ MA 02655 12-12-18 W page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high groundwater: .- feet Please indicate all methods used to determine the high groundwater elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date '• ® • . Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form xiMi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Job 's Ln Property Address Joel Dietz Owner Owner's Name regjir atifo is Osterville MA 02655 12-12-18 req:aired for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: ` For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation'of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 t Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Sap 30 1:3 09:44p p.18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 118 Joys Ln. Property Address Leslie Shelton Owner Owner's Name information is OsterviNe MA b2655 9-23-13 required for every page. Qty/Town Slate Zip Code Date of Inspection . Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms ,"�tuuulnrNurrr on the computer, tt AOFtjq use only the tab 1. Inspector: ,�����' sqCy'- key to move your �1 I�°/ , cursor-do not James`D.Sears �f((C7✓) (J = JA M1=S :m use the return — 1= - Name of Inspector key. Ca ewideEnte rises LLC o - _ I Company Name �.T .Gr�6`r 153 Commercial St. "rn„S,r� �p0���NIN Company Address Mashpee MA 02649 cityrrown State Zip Code 508-477-8877 S1623 .. .. Telephone Number license Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails t ❑ Needs Further Evaluation by the Local Approving Authority 9-28-13 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of Inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t6hs•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 ell Sep 30 1 09:44p p.19 Commonwealth of Massachusetts Title 5 Official Inspection Form' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11B Joby's Ln_ Property Address Leslie Shelton Owner Owner's Name information is required for every Osterville MA 02655 9-23-13 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E f always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes",'no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain, t The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or.exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): Mns•3113 Title 5 Officiel Inspection Forth:Subsurfaoa Sewage Disposal System•Page 2 of 17 Sep 30 13 09:44p p.20 Commonwealth of Massachusetts- { Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 11 B Joby's Ln. Property Address Leslie Shelton Owner Owner's Name information is required for every Osterville MA 02655 9-23-13 page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system wil l pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced: ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): i C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system Is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy,is within 50 feet of a bordering vegetated wetland or a salt marsh fins-3113 - Title 5 Official Wmpection Farm:Subsurface Sewage Disposal -. g sp l--System•Pege 3 of 17 . Sep 30 13 09:45p - p.21 Commonwealth of.Massachusetts' Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments - 118 Joby's Ln- Property Address t Leslie Shelton Owner Owners Name information is required for every Osterville MA 02655 9-23-13 page. Cityfrown State Zip Code Date of Inspedion B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than .100 feet but 50 feet or more from a private water supply weir,*. Method used to determine distance: R'This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. r 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: Yes No Backup of sewage into facility or system component due to overloaded or ❑ ® clogged SAS or cesspool ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool O ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in his less than 6"below invert or available volume is less than'/z day flow .0"tWIA.,C 15ins-3l13 Title 5 Official Inspection Form:Subsw1aaa Sewage Dlsposai System•Page 4 of 17 Sep 30 13 09:46p p.22 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 118 Joby's Ln. Property Address Leslie Shelton Owner Owner's Name - reformation is required for every Osterville MA 02655 9-23-13 page. citylrown state Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOTdue to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. r ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. Q ® 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 certi1fied 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. l have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either`yes" or"no"to'each of the following, in addition to the questions in Section D. . Yes 'No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 Th3e 5 Official Unpeaion Forth:subsurface sewage Disposal system-Page 5 cd V Sep 30 13.09:46p p.23 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 118 Joby's Ln. Property Address Leslie Shelton Owner owner's Name information required for every Osterville MA 02655 9-23-13 page. Cityrrown State Zip Code Date of Inspection C. Checklist. Y. 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? El ® Have large Volumes of water been introduced to the system recently or as part of this inspection? ' ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out?- ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)) D. System-Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 M1 t5ins-3113 rife 5 OtrrJat Mpecl=Form:Subsurface Sewage Disposed System•Page 9 or 17 a ;tom- - .. Sep 30 13 09:46p p.24 a Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments f 118 Joby's Ln. Property Address Leslie Shelton Owner Owners Name information is required for every Osterville MA 02665 9-23-13 page. CitylTown State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal-tank D. Box and three flows. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes gl No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes M No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage 2011-59,000Gais 9 ( Y 9 (gPd)) 2012-74,000GaI s Detail t Sump pump? 0 Yes ® No Last date of occupancy: NA .Date CommerciaUlndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpil) Basis of design flow(seatslpersons/sq.ft, etc.): Grease trap present? ❑ Yes ❑ No . . Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title system? '' ❑ Yes ❑ No Water meter readings, if available: 15ins•3J13 - Tilb 5 Of idol Inapedlon Forh Subsurface Sewage Disposal System•Page 7 of V ' -S,ep 30 13 09:47p p.25 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 118 Joby's Ln. Property Address Leslie Shelton Owner Owner's Name inforrnrequired is Osterville MA 02655 9-23-13 required for every page. City/Town State Zip Code Date of Inspection D. System Information (oont.)' r Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: %' NA Was system,pumped as part of.the inspection? ❑ Yes ® No If yes, volume pumped: gallons 'F How was quantity pumped determined? Reason for pumping: Type of System:, ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool' P rivy ❑ Shared system,(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the t/A system by system operator-under contract t . s ❑ Tight tank.Attach a copy„of the DEP approval. Other(describe): 15ins•3/13 Tine 5 OKidel In spection Form;Suhsuiface Sewage Disposal System•Page 8 o1,7 pep 3013 09:47p p.26 Commonwealth of Massachusetts Title 5 Official Inspection Form ' -i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments h 118 Joby's Ln. Property Address Leslie Shelton Owner Owners Name information is required for every Osterville MA 02655 9-23-13 page_ CityfTown State Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components, date installed (if known)and source of information: 1992 Permit # 92 -136. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 22" Depth below grade: feet Material of construction: . ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting,evidence of leakage, etc.): Pipeing is 4" PVC SCH 40. t Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: yeas Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 1000 Gal. Precast Dimensions: Sludge depth: - 15ina:3113 TRIe 5 Of oal Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Sep 30 13°09:48p p p.27 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 118 Joby's Ln. ; Property Address - <; Leslie Shelton Owner Owner's Name ,. information is required for every Osterville MA 02655 9-23-13 page, Cityrrown State Zip Code Date of Inspection D. System Information (cont.),, - Septic Tank(cont.) r Distance from top of sludge to bottom of outlet tee or baffle 29" , Scum thickness _ 1. Distance from top of scum to top of outlet tee or baffle _ 12 Distance from bottom of scum to bottom of outlet tee or,baffle 17"- How were dimensions determined? Asbuilt-Tape Sludge Judge Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc:)_ - �.. Tank at working level. Tank and cover's at 1'below grade,in tee,outlet baffle: No sign of leakage or over loading. . Grease Trap(locate on site plan): Depth below grade: feet Material of construction:{ , ❑concrete ❑`metal , 0 fiberglass [❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Wins-3l13 ' TW16 5 Official Inspection Forth:Subswlsos Sewage Disposal System-Pegg 10 of 17 Sep 30 13 09:48p p.28 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage _Disposal posal System Form Not for Volunt ary tart'Assessments 118 Joby's Ln. Property Address Leslie Shelton Owner Owners Name Information is Osterville required for every MA 02655 9-23-13 page. Cltyfrown state Zip Code Date of Inspection D. System Information. (cont.) f 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 rank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: El concrete ❑ metal ❑fiberglass ❑polyethylene ❑other(explain): Dimensions: Capacity: A. . - gallons Design Flow: gallons per day Alarm present ❑ Yes ❑ No Alarm level: _ Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches,etc.): 'Attach copy of current pumping contract(required)_ Is copy attached? ❑ Yes• ❑ No t5ins-3M3 Title 5 Offidal Inspection Fam Subsurlace Sewage Disposal System-Page 11 of 17 $ Sap 30 13 09:48p p.29 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Joby's Ln. Property Address Leslie Shelton Owner. Owner's Name information is required For every Osterville MA 02655 9-23-13 page. CityfTown state Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site'plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 16"x16"-21"below grade. Box is clean and solid wlthree line's out. No sign of over loading or solid carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ' ❑ No* Alarms in working order. ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): .. r _ *If pumps or alarms are not in working order,system is a conditional pass. Soil Absorption System (SAS).(locate on site plan,,excavation not required): Y If SAS not located, explain why: • t t5ins•3113 Title 5 offirJel inspection Form:subsurface Sewage Disposal system•Pogo 12 of 17 r Sep 3013 09:49p p.30 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 118 Joby's Ln. Property Address Leslie Shelton Owner Owner's Name informationmeadfor is r every required Osterville MA 02655 9-23-13 page. Cityrrown State Zip Code Date of inspection D. System Information(cunt.) - i Type: ❑ leaching pits number: ® leaching chambers-' number: 3 ❑ leaching galleries number:- ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology Comments(note condition of soil, signs of hydraulic failure, level.of ponding,damp soil, condition of vegetation, etc.): Leaching is three flow's 12'x36'. Flow's are clean w T'water. No sign.of over loading or solid carry over. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer. Depth of scum layer - F Dimensions of cesspool Materials of construction = Indication of groundwater inflow ❑ Yes ❑ No t5ins r 3113 Title 5 Oftal inWedon Form:Subsurace 5"ag'a Disposed System•Page 13 of 17 Sep 30 13 09:49p p,31 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3 , 118 Joby's Ln. Property Address Leslie Shelton Owner Owner's Name information i e required for every Osterville MA 02655 9-23-13 page. Cityrrown State Zip Code Date of inspection D. System Information (cont.) Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc,): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) t (Sins•3/13 Tide 5 Official ial Inspemlgr Porn:Subsurface Sewage Disposal System•Page 14 of 17 Sep 30 13 09:49p p.32 Commonwealth of Massachusetts, Title 5 Official Inspection Form : Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Joby's Ln. Property Address Leslie Shelton Owner Owner's Name information is required for every Osterville MA 02665 9-23-13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont:) r Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separ'atel Y ¢3_ i : c2 0. n _ c2- R� 13 - a� /P EA0 1 ate a F t5ins-Y13 Title 5 official inspecwn Farts:Subsurface Sewage oispoaai System-page 15 or 17 Sep 30-13 09:49p p.33 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 118 Joby's Ln. - Property Address Leslie Shelton Owner Owner's Name i information is Osterville MA 02655 9-23-13 required for every page. CitytTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells N� ' 10, Estimated depth toFigh ground water. ° feet Please indicate all methods used to determine the high groundwater elevation: ❑ Obtained from system design plans on record If checked,date.of design plan reviewed'. Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) © Accessed USGS database-explain: You must describe how you established the high ground water elevation: Auger Hole 10' no G.W.. Bottom of flow's at 5'below grade. Bottom of flows at 5' above Auger Hole Depth. ' lip r Before filing this Inspection Report,please see Report Completeness Checklist on next page. 15ins•31113 Title 5 Ofrdal Inspection Fomx Subsiriace Sewage Disposal System Page 16 of 17 f Sep 30 13 09:50p p.34 Commonwealth of Massachusetts* Title 5 Official Inspection Form Subsurface Sewage Disposal system Form -Not for Voluntary Assessments i 18 Joby's Ln. Property Address ? - Leslie Shelton Owner Owner's Name information is reuire for every Osterville IVIA 02655' 9-23-13 page. C•itylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B; C, D,or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater, ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 „ Title 5 or8dal Inspection Fermi Suhawfeoe Sewaga Diapaaal System•Page 17 of 17 COMMONWEALTH OF MASSACHUSETTS - EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 , OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS' SUBSURFACE SEWAGE DISPOSAL SYSTEM-FORM PART A CERTIFICATION c , Property Address: 118 Joby's Lane Osterville, MA 02655 Owner's Name: Tim Walsh Owner's Address: Same VED Date of Inspection: January 28, 2002 Name of Inspector: (Please Print) James M. Ford FEB' EB "�'� 200� Company Name: James M. Ford Map: 121 Mailing Address: P.O. Box 49 Parcel 129`NN OF 13ARNSTABLE Osterville,MA 02655-0049 HEALTH DEPT. Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT } I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Condit' ally Passes Needs urther Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: January 29, 2002 The system inspector shall submi 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 of has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and'Comments ****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. A Title 5 Inspection Form 6/15/2000 page ] Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 118 Joby's Lane Osterville, MA Owner: Tim Walsh Date of Inspection: January 28, 2002 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 septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box 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 distribution box is leveled or replaced 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): broken pipe(s)are replaced obstruction is removed ND explain: 2 I Page 3 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM-INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 118 Joby's Lane' Osterville, MA Owner: Tim Walsh , Date of Inspection: January 28, 2002 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. - 1. System will pass unless Board of Health determines in.accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment:- • Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a,septic.tank and SAS and the SAS is within,a`Zone 1.of a public water supply: The system has a septic tank.and SAS and the SAS is within.50 feet of a private water supply well. The system has a septic tank and SAS and,the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance'. **This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and + the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other. x f.3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 118 Joby's Lane Osterville, AM Owner: Tim Walsh Date of Inspection: January 28, 2002 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped . ✓ Any portion of the SAS, cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or,privy is within a Zone I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal 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.] No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd- You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a 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. 4 Page 5 of 11 F� OFFICIAL INSPECTION FORM -.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART S CHECKLIST Property Address: 118 Joby's Lane Osterville, MA Owner: Tim Walsh , Date of Inspection:• January 28, 2002 Check if the following have been done: You must indicate`yes"or"no"as to each of the following:' Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received"normal flows in the previous two week period?' ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected f6i"signs of sewage back up? ✓ Was the site inspected for signs of break out?s ✓ — 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: P Y (SAS) Yes No ✓ — Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]: ,5 M1 Page 6 of 11 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 118 Joby's Lane Osterville, AM Owner: Tim Walsh Date of Inspection: January 28, 2002 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 5 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system (yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): _ No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped in 2000-per owner Was system pumped as part of the inspection (yes or no): 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components, date installed(if known)and source of information: Jul. 22, 1994-per septic plans Were sewage odors detected when arriving at the site(yes or no): No 6 f Page 7 of 11 s OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 118 Jobv's Lane Osterville, AM Owner: Tim Walsh - _ r Date of Inspection: January 28, 2002 BUILDING SEWER(locate on site plan) Depth below grade: Approx. 24" Materials of construction: _cast iron ✓ 40 PVC other(explain): Distance from private water supply well or suction line: F' Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TANK: '✓ +(locate on site plan) Depth below grade: 12" Material of construction: ✓ concrete metal _fiberglass _polyethylene . _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or. no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 1" Distance from top of scum to top of outlet tee or.baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 12 How were dimensions determined: Measuring stick f Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There were no signs ofleakake ' GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: concrete _metal _fiberglass _polyethylene _other. " (explain): — Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or,baffle; Date of last pumping. Comments(on pumping recommendations, inlet and outlet-tee or baffle condition, structural integrity, liquid levels' as related to outlet invert,evidence of leakage,etc.):' 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION'(continued) Property Address: 118 Joby's Lane Osterville, AM Owner: Tim Walsh Date of Inspection: January 28, 2002 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. There were no signs of leakage or solids. There were no signs of backup or failure in the leach field. PUMP CHAMBER: None (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 pumps and appurtenances,etc.): 8 ' • '�� Page 9 of i 1 OFFICIAL INSPECTION FORM -'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ' SYSTEM INFORMATION'(continued). Property Address: 118 Joby's Lane A ; Osterville, MA µ R r Owner: Tim Walsh Date of Inspection: January 28; 2002 SOIL ABSORPTION SYSTEM(SAS) ✓ (locate on site plan,excavation.not requited) b If SAS not located explain why: x i Type .. ` leaching pits,number: ' ✓ leaching chambers,number: 3 flow diffusors with stone(2'ongends, 4'n sides&between) 12'x 36'(per design plans) 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.): The now diffusors were located. There were no signs of failure in the D-box'F The bottom to grade.was approximately 6' CESSPOOLS:-, None (cesspool must be"pumped as,p it of inspection){locate on site plan),.' Number and configuration: {, ' Depth-top of liquid to inlet invert: Depth of solids layer: r, Depth of scum layer: {, Dimensions of cesspool: f. Materials of construction: Indication of groundwater inflow•(yes or no):" " E. Comments (note condition of soil,=signs of hydraulic failure,jevel of ponding,condition of vegetation, etc.): . PRIVY: None (locate on-site plan)- Materials of construction: .ma . . z Dimensions: r Depth of solids: - r� Comments.(note condition of soil;signs of hydraulic failure, level of ponding,conditio6eof vegetation,,etc ): a s Page 10 of 11 ' OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 118 Joby's Lane Osterville, MA Owner: Tim Walsh Date of Inspection: January 28, 2002 Map: 121 Parcel: 125 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. a9 i 3a- a 6 A3- 63' 3" a Q Ay- S3 (34 ' y 3 n y 10 Page I 1 of 11 OFFICIAL INSPECTION FORM -'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 118 Job;s Lane Osterville, MA Owner: Tim Walsh Date of Inspection: January 28, 2002 _ II SITE EXAM " Slope Surface water Check cellar Shallow wells Estimated depth to ground water 20' +/- feet Please indicate (check) all methods used to determine the high ground water elevation:, , Obtained from system design plans on record- If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: The bottom of the flow diffusors to grade was approximately 6. A perc test was done when the system was installed and no water was observed at 13'. Using the Barnstable topographic map and the Cape Cod Commission water contours map the maps were showing approximately 20'+/-to ground water at this site. j o.. r . This report has been prepared and the system inspected andpassed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 - CO\I\IONWEALTH OF NIASSACHtiSETTS EhECUTI�'E OFFICE OF E1'VIRONR4EITAI AFFAIRS DEPARTMENT OF ENvrRoNMENTAL PROTECTION ONE n%INTER STREET. BOSTON MA 02108 (611) 292.5500 TRUDY CO\7_ Secre:2n' ARGEO PALL CELLUCCI DAVID B. STP.::HS Governor Cotnmisr.�r.e r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: , (21�SO\,)yS 1_.'V Name of Owner D4U 1'j 02�V7 t5'Szc t. Address of Owner: Date of Inspection:. S\LPSkcv� / Name of Inspector:(Please Prirrt)H•C.h QA '%f�EL�CU am a DEPP approved system inspector pursuant to Section 15.1340 of True 5(310 CFlAR 15,000) Company Name: f77YC&. t"-r c k ✓A 'rr—u rL4 r..% r 4. u F Mar7rng Address: fir., r 7 -A L, H �I_12 Telephone Number: �5� _� 31 ' r CERTIFICATION STATEMENT '1 I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate r and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes _ Needs Further Evaluation By the Local'Approving Authority i aFa*s ` Inspector's Si natvr Date: 9 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 hared system o r has a design flow of 10,000 gpd or greater,the inspector and the system owner completing this inspection. If the system is a s y 9 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 F Page Iof11 4ri Printed on Recyded Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A r CERTIFICATION (continued) %ropefty Address: Jwnef: Date of Inspection: INSPECTION1 SUMMARY: Check A, B, C, or D: A.. SYSTEM PASSES: A- 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 ND). Describe basis of determination in all instances. If "not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a 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 9/2/98 Page 2of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (corrtirwed) 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 i the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE W TH 0 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND AFETY 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 sa marsh. 21 SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC W TER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEAL AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system AS) 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 absorption syste and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption syst m and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption sy em and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water anal is for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and th presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER 0 n E revised �9/V,98 Page 3of11 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) property Address: Owner: Date of Inspection: D. SYSTEM FAILS: You must indicate either "Yes" or o" to each of the following: I have determined that one r more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified b ow. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into cility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of a uent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distrib ion box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less th n 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 time in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption Syst , cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is withi 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a one I 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 10 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has b en analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammo is 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 criteri above: The system serves a facility with a design flow of 10,000 gpd or great r(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the follo ing conditions 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 upply the system is located in a nitrogen sensitive area(Interim Wellhead Protec 'on Area-IWPA) 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 CM 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address 1Vv ;dL�yt w , Owner: Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No 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. — rs- v to ' �4y-bvrlt 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. The size and location of the Soil Absorption System on the site has been determined based on: — Existing information. For example. Plan at B.O.H. x — Determined in the field (if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 115.302(3)(b)] The facility owner (and occupants,if different from-'owner) were provided with information on the properinaintanaur.8-of Subsurface Disposal Systems. T revised-.9/.2/9 8 Page S of II SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Iroperty Address: Owner: Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: g.p.d.lbedroom. Number of bedrooms (design): Number of bedrooms (actual):A3 Total DESIGN flow_ Number of current residents:Qy Garbage grinder(yes or no):_) Laundry (separate s system) or 6) ; If yes, separate inspection required Laundry system inspected �or no) Seasonal use (yes or no):4-1 Water meter readings, if available (last two year's usage (gpd): N Sump Pump(yes or no): {.i Last date of occupancy: y,3K­' COMM ERCIALfINDUSTRIAL: Type of establishment: Design flow: qpd 1 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 o inspection: (yes or no)_ If yes, volume pumped: gallons 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) IIA 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: Sewage odors detected when arriving at the site: (yes or no) revised 9/2/98 Page 6ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART SYSTEM INFORMATION (continued) 'roperty Address: 50y�S Owner: Date of Inspection: BUILDI NG 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 p an) Depth below grade: 1 " ..R '• + y ; , Material of construction: concrete_metal _Fiberglass- _Polyethylene_other explain) If tank is metal, list age_, Is age confirmed by Certificate of Compliance _(Yes/Nol , Dimensions: Sludge depth: ,&+t A Distance from top of sludge to bottom of outlet tee or baffle: 32 Scum thickness: u Distance from top of scum to top of outlet tee or baffle: Z II Distance from bottom of scum to bottom of outlet tee or baffle:_ 1k _ How dimensions were determined: 'omments: (recommendation for pumping, condition of'nlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, str slur integrity, evidence of leakage, etc.) v ` a, T- FJ GREASE TRAP: (locate on site plan) Depth below grade: ' Material of construction:_concrete-metal_Fiberglass _Polyethylene_other explain) Dimensions: r 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: y Date of last pumping: 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.) revised 9/2/98' pagc7of11 ti SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART C SYSTEM INFORMATION (coitbrwed) 'roperty 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: gallonslday 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: E ocav`(OU Comments: _ (note if level and distribution is equal, evidence of solids carryover, evid of leakage t f box, etc.) ' to or ou \5 vL\ t�1Z +ti (lA OXA2AUo-eA _._ f PUMP CHAMBER:�'c (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 pumps and appurtenances, etc.) P. C s revised 9/2/98 � of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) 4'operty Address: JOO Owner: Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible; excav tion not required, location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits, number: rs number: 3 \ZX 34� leaching chambers, . 9 leaching galleries, number:_ leaching trenches, number, length: leaching fields, number, dimensions: - overflow cesspool, number: Alternative system:' Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, da.q�p soil, ndi n of vegetation,etc. N o rL CESSPOOLS:—/b (locate on site plan) Number and configuration: - Depth-top of liquid to inlet invert: a ' r)epth of solids layer: )epth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) . t .- Comments: ' (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate on site plan) Materials of construction:. 'Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)' ey��9art► revised. 9/2/98 t 'o , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) 'roperty Address: I , Jcl\NS )wner: 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) Ct 1 � tP � 3 \ —\Ct oL s ( 3s � �3 - 32 f revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) roperty Address: ( 5U`rUys Owner: Date of Inspection: NRCS Report name Soil Type_ Typical depth to groundwater_ USGS Date website visited Y(C) ., c, . Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Sloped ! Surface water 't too r _ Check Cellar Shallow wells rV(l`fi' Estimated Depth to Groundwater''20Feet Please indicate all the methods used to determine High Groundwater Elevation:" r,• 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 s Checked local excavators. installers F Used USGS Data Describe how you established the High Groundwater Elevation. (Must be Otto, 20 Y . . revised 9/2/98 " _... Page 11or11 ASSESSORS MAP NO: PARCEL N0: c AP ................... THE COMMONWEALTH OF' MASSACHUSETTSsafn "l==I=@=== BOAR® OF HEALTH - ;7 TOWN OF BARNSTABLE OV,firation for Bisp ial Works Tomitrurtw"n Famit Application is hereby made for a Permit to Construct (V<or Repair ( ) an Individual Sewage Disposal 14g?v 1ZI G �S31>� _. tion Address or Lot No.UXN.....: .................................................... .... ......... .-------------------------------- .. Owner Address -•-----------------••--••-•-------- ----••---------.................•..... Installer Address Type of Building Size Lot.................... ...Sq. feet U Dwelling—No. of Bedrooms_J.......... .. .. ...__Expansion Attic ( ) Garbage Grinder ( ) aOther—Te yp of Building a: 1?_ J V. No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures -----------•... -•-----•------•----•--------•-------.•••-----•--•--------•••-•-•---•-•----•----------•----•--•-----••--..!.......................... w Design Flow.........&0.............................gallons per person per day. Total daily flow__��...............................gallons. WSeptic Tank—Liquid capacity.0.010._gallons Length................ Width................ Diameter__-_____--_-_- Depth................ x Disposal Trench—No..................... AAidth.................... 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..... V . C_ ._ �� ............................... Date........................................ Test Pit No. 1____�__-_-_-minutes per inch Depth of Test Pit.12.:: ........ Depth to ground water_ll.Q.Ad�K_ fr4 Test Pit No. 2................minutes per inch Depth of Test Pit...:................ Depth to ground water........................ •. ............................ ............................................................. 0 Description of Soil----L"�'-�eCtUiv1°'2-- - ---------------•--...--=................................................... -----------------------------------••---------.................................... x �., ------ w UNature of Repairs or Alterations—Answer when applicable.______...............____.....-_._______...........___....._..___._._......___.............__. ......••••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Cade—The undersigned further agrees not to place the system in operation until a Certificate of Complia e has ken issued b e board of health. Signed . ............... .. . ..... ... .-. � Application Approved By ------------------------------------------------------------------------------------------------------------------------------------------------------ -------------------- - ------------ Date Application Disapproved for the following reasons- ..........................................................------------------- -- ------------------------------------------------ --------------------------------- --- ----------------------------------------------------------- ---- --- ------------------------------------------------------------------------------- ...................................... Dace PermitNo. ------------ ----------/-/--- ----...:...._...........---.... Issued .....- -------..--- - ----.........------------------- Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I -A. m / �C(L7 DATA .............................. \ p' THE COMMONWEALTH OF MASSACHUSETTS 3 P 7r37 BOARD OF HEALTH TOWN OF BARNSTABLE 1 � , Appliratiun for Biipuua1 Works Toutitrnrtiun Prrutit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal S at: �... .................................... .................................................. ..... ............... y i Location-Address or Lot No. l! . . '.... F'r •.F Owner Address W :. [. (.. e. J/ \ ........................................ Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms____3......................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin 1P t }I 1 No. of persoin............................. Showers — Cafeteria Otherfixtures --------•------ •---------------------•----•-----•--.••-•---•----------------•-------------........................................................ W Design Flow.........1L.............................gallons per person per day. Total daily flow----_a ...............................gallons. WSeptic Tank—Liquid capacity.).L.l.-___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.---- rw `/- --=--------------•----•- --•----- Date........................................ a Test Pit No. I..... :......minutes per inch Depth of Test Pit../Z:.'`�._........ Depth to ground water.Ar - (i Test Pit No. 2........}._....minutes per inch tDepth of Test Pit.................... Depth to ground water........................ a •---•-•-•------•------------•------.-•-- D Description of Soil r' r f, t r t =[ . t ....... -- - - - - -- - - --- W V .....---•-•••--•••------•---•---•-•---------•--••-•------•-------------•-----------•-•------...-----•--•-•--•------•-------•-•-------•----------•---••---•---........................................... W UNature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia e has Peen issued by e board of health. i Signed .. --- --.��?�K2 .. 7------3/c7 Date1/.-9 ApplicationApproved By ------------------------------------------------------------------------------------------------------------------------------------------- ----------_--------------------------- Date Application Disapproved for the following reasons: .... .......................................... ............................................................................ Date, PermitNo. ' '................. Issued .... ---------------------------------------------- Date ! + i 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C9er#t£trate of Toraptianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by............................... --........P-. ^', ..--------..........------..------..--- ---------.......-----.. -----..-------........---- -- ------......----------------------. Installer - — has been installed in accordance with thy'provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ------------------------------------------------ dated ...............---...----.-..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. ...�--------`1` ..................... Inspector"'.-.... `..-.:.......------............................---- ......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �j TOWN OF BARNSTABLE FEE.../4.0......... Uiupuua1 Works TwIlmotrudion Virmit Permission is hereby granted......................................................----------••-------------•-----••--••-••--...-----•----•-•••-•............---.....----- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo............................................................................................................................................................................................... Street Q as shown on the application for Disposal Works Construction Permit No.&-- ..__ Dated.......................................... .....................................t-. -------------------------------------•-------•--------------- a ---------------•-••--------------• 3oard of Health DATE--------------------y..�� .�---- -- FORM 36508 HOBBS&WARREN,INC..PUBLISHERS r Ila Qr►yam 1 1. =t- 04T } ' �f - — I— -1 ��-.III I ';- �.� SAPS.{.,. -,1` t/-` 1_ _ ;- (X�}1 ` 4 rfH�,A1ts1VNTl� i , , -T• - , I�_ - _ _ I i. fi - - - v '- 1 Lr iL�- 1^7.. Pj�L. �:, �,, ;- MOM �- - ' j j' - F. hi RE �► Nm L I V,FE3 + r pIST /L' t� - _ - _ -- s l t1f r P -- -;-' WOOZY Ed LT 77 7 ,— (1 5 4 s� 1 �! I �_ _I ✓q-*� `� � °� � I T-•i hrw?r+ �_i �� ��� r - `� { f-} j VPyr1_]'-}V^nEf-D� r ✓i_�r[ Tj - !- ; L r ' —; t - 14 (.� I I I �-,.� J I�h1G A G•' I r f 1 I - 1-t-i {. I I I 1 r —iT I T r , '. , -c• I I '.'1 I 'I� 1— � i �I ' - - �--1-I� -f-��-�'1- --t--,-�-r--�--�—I--'--I— F- I- l t I, I� t I! : F -!A , -".} 1 -'1}�--— 1I Ii,-_; #I tI :�F S p' �tf t - tI_�_.�I•-' ` 1 L� 1" �Ti �I�t---� �I I1I `.�I-,) I I� r7t ��f4 r - }- 1 -1- �L T ' 17 77 I t I- 7"j r I ; -I i i-t I -^ '-�' I I �: I F_ ._ �, ��. _}__r (.� _I�,)� �I; �I i- I_.I _I , i� I I I ' IT 1 r a a ! i 1 �I T "j' .j L �Tl(�N� IVlta . ' r ,- r.i 7 I•- } I I �.' t�I. l' ( T r t ' i r I I I. f ..F ( , .�.-t �.. r c 1^ I � .,, F rJ I . = I r r -, r + $ � '� I! BATE- I 3�if� I�, i T-I I I F i + I i I I 1 , � , I I- _�..1 �' I� L._ L r i I-�- II JF i t .:; , f 7 zo�oSt :PLArI Y r i I- + � 1 GER rT A I-7 E -- = A. Tt�`(.- TNT G : tJ } Ir I I r - I ' . i ? I . ' } - (NEIZEDN ,coMTI-Y5 iW fit-. 1 IDEU J E� 1 I r 1- I_ I✓y^'�"r 121j ( , { �y' 7 �rTav ;.. I . , ,._ 'u12e�1 oF _'NE : A�Jbj..15 , vp PFLoGAT I: WITN�{J- A-F oDl 114711(�D.Z -� - �-i 71 (.- r , 1 { , I' -I - -,--r N -- - -I-- '-,. , A�T' 1 I _I r PI?O. �SSIONL 'LAtJDTSE Og-f r I_ j S I s S �1DT�BASEb'D�1 -; I G(v1 I- ! rl 1 pA.'J ' I A�1_ I►J u�nEN� u I �, fir -r -r ST►z evy o e�wfuc � izP_ I n A55 A�� rE_ TZV"C;-- E7S-s1aULD 'NoTt3Cru5E -I I ±_ ' ; - ;_C - r s �STA.US� -" �t I i E i }_� ' -f p r J I I , j _. I N." f�'i` U�- S ,.T._ fFPW G�rJ i' /� rSj 1 r.._^ 1 { 1�`i��5 ITiOW�r!7 , 1 I r I I OF 2 ,ASoW5 LA.Nt- ; T40MAS Pt1WEes ' 3•ZoA2 3 I g 4 ? -04 N 40 q rj m u.6� - s$ 35�• 48 - ,,34 7EAA EQSEMS4T ,j 41-� Ia2 Ft,4� � 12Len 2 1"7s a rw - _ pro dry v01 e / 1 S - ) 04 OF 1 4 4 k t PERR ------ . . .. ax;►+nrm• _ Sl1Lt.IVAtV � - f mesa Flo. 29733 . I c. `• FASTENER SCHEDULE FOR STRUCTURAL MEMBERS ITEM DESCRIPTION OF BUILDING ELEMENTS FASTENER a.A E OF SPACING OF FASTENERS ROOF 1 BLOCKING BETWEEN JOISTS OR RAFTERS TO TOP PLAT$TOE NAIL 3-81)(2-1/e X 0.113E --- _ - 2 CEILING JOISTS TO PLATE,TOE NAIL 3-61)(2-1/2"X 0.113E --- 3 CEILING JOISTS NOT ATTACHED TO PARALLEL RAFTER.LAPS OVER _ PARTITIONS,FACE MAIL 3-100 - 4 COLLAR TIE RAFTER,FACE MAIL OR 1-1/4 X 20 GAGE RIDGE STRAP 3-10D(3'X 0.128E --- --- --. -- .--.- -. 5 RAFTER TO PLATE.TOE MAIL 2-1 BD(3-1/2-X 0.135E --- -- - - - 8 ROOF RAFTERS TO RIDGE,VALLEY OR HIP RAFTERS: TOE NAIL 4-1:1)(-1/2'X 0.135 -_-_ FACE NAIL 3-16D(3-1/2"X 0.135'; -- -,- ,- ,-,-, WALL -.-.- -. -.-. - 7 BUILT-UP CORNER STUDS 10D(3'%0.128' 24'D.C. ---_ -_-.-.- - 8 BUILT-UP HEADER,TWO PIECES WITH 1/2-SPACER 16D(3-1/2-X 0.135E 16'O.C.HANG EACH SIDE -'-'-'-'-'-'-'- -'-'-'-'-'-'- - B CONTINUED HEADER.TWO PIECES 16D(3-1/2"X 0.135E 16'O.C.NAHG EACH SIDE - - -. -.-.- 10 CONTINUOUS HEADER TO STUD,TOE NAIL 4-80(2-1/2'X 0.113E --- .-,- -,- -.- -.- _ _ 11 DOUBLE STUDS,FACE NAIL 10D(3'%0.128E 24"O.C. -,- -,-,- -,-,-,- -.- - 12 DOUBLE TOP PLATES.FACE NAIL 10D(3'X 0.128E 24"O.C. -.-. -.- -.-.- .-.-...--- .-._- -. -. _- -...- .-. DOUBLE TOP PLATES. MINIMUM 48-INCH OFFSET OF END '- .. -. .- -'- -. 13 JOINTS, FACE NAIL IN LAPPED AREA a-18D(3-1/2'X O.t357 -----'- .- -. - ._._- -.- .- .-. 14 SOLE PLATE TO JOIST OR BLOCKING,FACE NAIL 160(3-1/2'X 0.135E 16"O.C. 15 SOLE PLATE TO JOIST OR BLOCKING AT BRACED WALL PANELS ... 3-181)(3-1/2-X 0.135E IV O.C. - - 16 STUD TO SOLE PLATE,TOE NAIL 3-81)( X 0.113E or --- 2-111D(3-1/(3-//2'X 0.135E -- ARCO= - 17 TOP OR SOLE PLATE TO STUD,END NAIL 2-16D(3-1/2'%0.135E --- - H, - ao ao 2-8D(2-1/2-R 0.113E 1B TOP FtATES,TAPS AT CORNERS AND INTERSECTIONS,FACE NNE, 2-10D(3"X 0.128E --- - -- 79 1'BRACE TO EACH SPUD AND PLATE,FACE N41L 2 STAPLES 1-3/4" --- 2-8D(2-1/2"X 0.113E RE 20 1"X 6" SHEATHING TO EACH BEARING,FACE NAIL 2-STAPLES 1-3/4' _ - • 21 1'X B' .SHEATHING TO EACH.BEARIN6,FACE NAIL 2-8D(2-1/2'X 0.113E3 STAPLES 1-3/4' - 2' - 22 WIDER 7FMN 1'X 8'SHEATHING TO EACH BEARING,FACE NAIL (2-1/ 0.113E L. 4 STAPLES 1-3/4%" -- FLOOR - 23 JOIST TO SILL OR GIRDER,TOE NAIL 3-80(2-1/r X 0.113E - 24 -1'X 6"SUBFIAOR OR LESS T0.EACH JOIST,FACE NAIL 2 SI (2-1/2-X 0.113' 25 2"SUBFLOOR TO JOIST OR GIRDER,SUNG AND FACE NAIL 2-16D(3-1/2-X 0.135E -�� RESIDENTIAL BUILDING 26 RIM JOIST TO TOP PLATE,TOE NAIL(ROOF APPLICATIONS ALSO) BD(2-1/2"%0.113E --- DES ON CRITERIA - - 27 2'PLANKS(PLANK AND BEAM FLOOR AND ROOF) 2-180(3-1/2"X 0.135' - .D IETZ RE S I.�.DENCE NAIL EACH LAYER AS FOLLOWS: INTERNATIONAL RESIDENTIAL CODE 2009 1.2 APPLICABILITY 4.1 WALLS - - 32'O.C.AT TOP AND BOTTOM - AND 780 CMR MASSACHUSETTS STATE Height k Area.Unritations(Toble 503 Loadbearing walls shall not exceed 28 BUILT-UP GIRDERS AN BEAMS,2-INCH LUMBER LAYERS 100(3-%0.128E AND STAGGERED.TWO NAILS AT BUILDING CODE MASSACHUSETTS _ 2009 IBC); R3 Type 5 Unprotected; -10'-0"In height. ENDS AND AT EACH SPLICE. - AMENDMENTS TO THE.INTERNATIONAL 3 Stories, Unlimited Square Feet Non-loodbearing walls shall not exceed = BUILDING CODE 2009(ONE AND.TWO Roof Pitch; 12/12 - 20'-0"in height - - - 29 LEDGER STOP SUPPORTING JOISTS OR RAPIERS - 3-18D(3-i/2"X 0.135) AT EACH JOIST OR RAFTER FAMILY DWELLINGS) Mean Roof Height; 211•-0' -Building Length x.W7dth:. . 4.2 EXTERIOR WALLS _ 118 J O BY'S .:LAN E - - NOTE: B0'-0'X Length x T IS THE INTENT TO PROVIDE A Maximum Loodbearing Stud Length Aspect Ratlo{4,/W); 1.33 FASTENER SCHEDULE.FOR STRUCTURAL MEMBERS -CONTINUED CONTINUOUS LOAD PATH,THE_ Nominal Heigh}t of Talleat Opening;. 2x4 2 at 16'O.C.;9'-9" - 7ener - s OSTERVILLE MASSACHUSETTS. INTERCONNECTION OF ALL FRAMING 2x8 2 at 16"0 C 9 9 SPACING OF FASTENERS- ELEMENTS IS CRITICAL TO A - Maximum Non-loadbearing Stud Length WIND-RESISTIVE BUILDING..A 2x4 2 at 16"0 C- 11-5" INTERMEDIATE CONTINUOUS LOAD PATH OF 1.3 FRAMING (INE�L ���°'° INTERCONNECTED FRAMING ELEMENTS General framing connections shrill be 2x8 2 at 18"O.C., 18'-5' ' ITEM DESCRIPTION OF BUILDING MATERIALS DESCRIPTION OF FASTENER b-° (INCHES) FROM FOOTINGS AND FOUNDATION In accordance with 2009 International - - WALLS TO FLOORS,WALLS,AND ROOF Residential Code Table R602.3.(1) Gable Walls WOOD STRUCTURAL PANELS, SUBFLOOR, ROOF AND INTERIOR WALL SHEATHING TO FRAMING AND, Fastener:Schedule For Structural Shall be braced,for a distance of at. PARTICLEBOARD WALL.SHEATHING TO FRAMING FRAMING SHALL BE PROVIDED. Members, unless noted. least 1/3 of the building width with - BD COMMON 2"X 0.113E NAIL(SUBFLOOR,WALL)1 1.1 SCOPE - wood structural panels or at least 90x 30 3/8'-1/2" (( g 129 Table R301.5 Minimum Uniformly of the building width with gypsum wall - - BD COMMON_(2-1/2"X 0.131E NAIL(ROOF) Table R301.2(4) Massachusetts Bask Distributed Live Loads - board. 6D COMMON((2'X 0.113E NAIL(SUBFLOOR,WALL) Wind Sppeeedo Allies without Storage; 10 paf 3i 5/18'-1/2' 6D COMMON(2-1/2"X 0.131E NAIL(ROOF)f 6 129 Town:BARNSfABIE Attics with Limited Storage; 20 pet Story to Story Uplift and Lateral Habitable Attics and with Stairs; 30 sf Connections see Detail. 32 19 32"-1- BD COMMON 2-1 2-X 0.131 6 129 Basic Wind Speed; 110 mph P / ( / Fire Escapes; and Decks; 40 paf . . ,�• +n. IOD COMMON(3-X 0.148E NAIL OR R301.2.1.4 Exposure Category Fire Escape°;40 ppaf - 4.3-EXTERIOR WALL SHEATHING '" °'•`"1v Provide 7/18'wood structural panel - 33 1-1/8"-1-1/4' SO(2-1/2"X 0.131E DEFORMED MAIL 6 - 12 1 Exposure A; City Guardrails, Handrolls;200 paf - R E S C 0 M- - _ 2 Exposure B• Urban,Surburban Guardrails In-fill components; 50 pef sheathing on all exterior walls as � �,. OTHER WALL SHEATHING h 3 Exposure C;Open Terrain Passenger vehicle garage; 50 psf detailed. Provide hold downs as �^� - W r.,zr �. - 4 Exposure D; Flat.Unobstructed Rooms other then sleeping; 40 pef data C I 1 L 1�2'SRtUC1UitAL CELLULOSIC 1/2"GAI.VANrZED ROOFING WJ4 7/16'CROWN OR 1' Sleepir Rooms; 30 pef `,p `' Architectural, Inc. FIBERBOARD SHEATHING CROWN STAPLE 16GA.1-1/4"LONG 3 8 LOGTpry;�W 6 Stairs: 40 pat 5.1 ROOF '-t. ... - Roof span shall not exceed 36'-0". i t ,. liar W'ainlrauA Road,soufn.IN 35 26132'STRUCTURAL CELLULOSIC CROWN CTPLE LSD ROOFING NM4 7/18'CROWN OR 1" 3 6 Table R301.2(5) Massachusetts Ground Table R301.7 Roof openings shall not exceed the 'r (J § �an ` ph:(0g0)76Y-B7IIl0 I :(006)750-SM Fl ERBONM SHEATHING CROWN STAPLE iBCA,1-1/2'LONG Snow Loads Rafters greater than 3/12; L/160 lesser of 12'-0" or BOX of the O ,.,+ "t,.3 1 1-1/2'GALVANIZED ROOFING NAIL.STAPLE GALVANIZED, - Town:00611AB E Interior Walls; H/180 building dimension. L/2 or W/2. ti� .y j �, 38 1/2"GYPSUM SHEATHING d 1-1/2'LONG;1-1/4-SCREWS,TYPE W OR S 7 7 - Snow Load;30 paf Floors/Ceilings L/360 Roof Slope shall not be greater than Residential BC Commercial Architecture ¢.L 1� Exterior Walls,stucco, N 360 . 12/12. a OVA J' 1-3/4"GALVANIZED ROOFING NAIL:STAPLE GALVANIZED,1-5/8- R301.2.1.2 Protection of Openings Exterior Walls,.brittle; L/240 �' a /;`' 37 1/2"GYPSUM SHEATHING d L NO;1-5/8"SCREWS.TYPE W OR S 7 7 Windows In wind Dome debris regions Exterior Walls,flexible; L/120 - 5.2 WOOD WAFTERS :.a�.a, ... shall have glazed openings protected - The clear span of ratters shall meet WOOD STRUCTURAL PANELS, COMBINATION SUBFLOOR UNDERLAYMENT TO FRAMING from wind home debris in accordance or exceed the values set forth In r ri :'• LIST OF DRAWINGS with Large Missile Test of ASTM E 2.1 FOUNDATION 2009 IRC.The maximum rafter span BD DEFORMED(Y%0.120 NAIL OR BD 1996 and of ASTM E 1588. Concrete shall'be minimum 3,000 PSI shall be limited to 3/4 of teh span 38 S/4'AND lA5 COMMON(2-1/2'X OA 31�MAIL 6 12 Exception:Wood structural panels, at 28 days, permitted for the 20psf roof live load - - BD COMMON(2-1/2-X 0.131E NAIL OR 80 7/16'x 6'-0', shall be permitted for. case, not to exceed 26'-0". - EX1 EXISTING CONDITIONS J9 7/8'-1' DEFORMED(2-1/2"X 0.120E NAIL 8 12 opening protection In one and two 2.2 NEW FOUNDATION ANCHORAGE Provide uplift connections at each story buildings In accordance with Provide 5/8"diameter x 15' long x rafter or truss. R_ A0 FOUNDATION PLAN. 1OD COMMON(3-X 0.148E MAIL OR 80 Table R301.2.1.2. 3"hook anchor bolts®41r O.C: with Provide minimum.2x6 collar/rafter ties - - 40 1-1/6 1-1/4' DEFORMED(2-1/2"X 0.120')NAG 8 12 3"x 3'x 1/8'plate washers. at 48"O.C. located In the upper thin A ca Al FIRST FLOOR PLAN WindFEM bor Definitions e pp Wind-home debris regions. Mesa within Provide one anchor troX.6°to 12' •of the attic apses and attached to 1 hurricane-prone regions located: from each end of plate and one within rafters using 5-10d nails at each end. m A` NOTE: °', � ��`aP,z 'ET A2 SECOND FLOOR PLAN,ROOF PLAN 1 ALL NAILS ARE SMOOTH-COMMON, BOX OR DEFORMED SHANKS EXCEPT WHERE OTHERWISE STATED. 1 Within 1 mile of the coastal mean 12'of.comers.. - ROOF SHEATHING - fir. 2 FOR ADDITION INFORMATION AND FOOTNOTES REFERENCE 2009 IRC TABLE R602.3(1) high water line where the basic wind - 5i3 A3 ELEVATIONS m speed 3.1 FLOORS Provide 1/2"wood structural panel to equal to or greater than 120 ph. The clear sport of Floor joist.shall sheathing an all roofs. A4 ELEVATIONS 2 In areas where the basic wind meet or-exceed the values set forth to 5.4 ROOF.BRACING ENDWALL speed is equal to or greater than 120 2009 IRC. Floor openings shall not - A5 BUILDING SECTION-A RESIDENTIAL BUILDING DESIGN CRITERIA NOTES: Blocking and connections shall be mph. exceed the lesser of 12'-0"or 50R provided at panel edges perpendicular INTERNATIONAL RESIDENTIAL CODE 2009 AND 780 CMR MASSACHUSETTS STATE BUILDING CODE MASSACHUSETTS of the building dimension. L/2 or W/2. to roof framing members in the first - A6 BUILDING SECTION-B AMENDMENTS TO THE INTERNATIONAL BUILDING CODE 2009 (ONE AND TWO FAMILY DWELLINGS) 3.2 FLOOR BRACING ' two truss or rafter spaces and shall - A7 BUILDING SECTION--C - 780 CMR Blocking and connections shall be be 48'O.C. see Brace Detail. pprovided at panel edges perpendicular - S1 FIRST,SECOND FLOOR FRAMING PLANS NOTE:. to floor framing members in the first IT IS THE INTENT'TO PROVIDE A CONTINUOUS LOAD PATH.THE INTERCONNECTION OF ALL FRAMING ELEMENTS IS CRITICAL two trues or joist spaces and shall be - SZ ROOF FRAMING PLAN TO A WIND-RESISTIVE BUILDING.A CONTINUOUS LOAD PATH OF INTERCONNECTED FRAMING ELEMENTS FROM FOOTINGS AND 48 D.C.- see Floor Bracing Detail. FOUNDATION WALLS TO FLOORS,WALLS,AND ROOF FRAMING SHALL BE PROVIDED. V EX. BEDROOM aEXISTING SECOND FLOOR PLAN EX. DECK EXISTING FRONT ELEVATION EXISTING LEFT ELEVATION . . EX. LMNG DC. BEDROOM - - - y II EX. - _ . .. •. o EX. KRCHEN UP IX. DINING O ® EXISTING FIRST FLOOR PLAN a t/a.a 1._0; P X Z a II11 ®' Iml Ell {_ A w Y5y I NO. ` �V k tP2i 1 I L ;� t Y EXISTING RIGHT ELEVATION EXISTING REAR ELEVATION ,4 F ti t tea.a t.�. t/s•=i'-o• ����e `..�:�",ida� y c REVISIONS wa r m�nm m anew 04.04-14 EXISTING FOUNDATION FLOOR PLAN EX1 T i 8x16 ALUMINUM VENT WINDOW W/ WINDOW WELL&SCREEN IN ALL \ V�y CRAWL SPACES TYP. .. CENTER BETWEEN WINDOWS ABOVE. S"CONCRETE FOUNDATION WALL on ® ►7 LL.� 24"Wx12"DP CONCRETE FOOTING T-2". 5'-0" 6'-10 - CENTER B ---I____J l_____---- --- • a - CENTER BELOW « tl WINDOWS AB VE I i___ 1 WINDOWS ABOVE m `4"CONCRETE SIAB w/Sx6 10/10 �p ,'. WWM on EMIL VAPOR BARRIER& 1 6'COMPACTED GRAVEL O O O O -- ---- --_� I .. 8"CONCRETE'FOUNDATION WALL on q I r I EAM ° 1 I _.24'Wx12bP CONCRETE FOOTING _ I ET -_J - __J CK SAWCUT EXISTING FOUNDATION WALL - I S I - LALLY COL &PROVIDE A 3/4'EXT.PLYWOOD 1 1 - Y COL - DOOR W 3"RIGID INSULATION& - io WEATN PED TYP. - , '), 1 CRAWL SPACE �' 1. - - 5'_6. 8' 8" NEW 30"X30'x15'GP t` cnanNG RASE'A,drr •. _ r--_1 - 1 I 4 CONCRETE FOOTING, (NO WORK) BEAM _ I ( - 1 - I I - POCK I I. POCK 23' SIMPSON STRONG-TIE-HDU8 HOLDOWN w/ 1 - TYPICAL ((3)5 DOWELS, DRILL - SB7 8x24 ANCHOR BOLT TYPICAL FOR(6) L'-------------------------- --- 3e RDUT SOLID TOP - - - -I_J I •1 I / MIDDLE&BOTTOM LALLY COL 1 ,., 13'- " 3'-6" 16'-10}�" - . M.O. _ M •1 L_ _ ______ ____________________________ O 1 _ _ - r—I--I 5 `. r------- ----------- -----------------� +' I _ - - BEAM - .BEAM 1 I .X . • x - POCK — --J POCK 1 STE0..COL. I I - _ LALLY COL 1 I 1 I - - - ' � - �t�Q 1 • 1 4'CONCRETE STAB w/Bx8 10/10 _ . UP I WWM on GMIL VAPOR BARRIER.& - ,j I j A 6'COMPACTED GRAVEL I �y Ii J I +(: I - 8"CONCRETE FOUNDATION.WALL on (a T' 24'Wx12'DP CONCRETE FOOTING - -. -- ---- - ----J I a (3)2x8 _. ---n— SLAB I 1 ti 6LE SIMPSON - 01 I 4"CONCRETE SLAB.w/ 66,10/10STRD - _ HDU8 HOLDOWN - r, WWM on 6MIL VAPOR BARRIER& 8' �� •' j. N. A HDue HOEDOWN - - - / �1 - /.�1 1 ° 1 COMPACTED GRAVEL SLOP TO GRAIN I - I (3)2x8 :. TYPICAL PLAN -+ - 8"0 CONCRETE PIER w/ T- -t' / I Y 1 I s^ F - - C . BIGFOOT FOOTING, MINIMUM - - °E SIMPSON - — . e r _ _ __ 48"BELOW GRADE(2). HHDU8 STRONG—TIE SIMPSON - _ STRONG—TIE - PROVIDE CONCRETE PAD I ;; I .c�e HDUB HOEDOWN - FOR STAIR I - 1 Fli01)4'/ri PTf011j' I 1: 2x FLOOR i i' i r1 Z. FRAMING - :. 7 Q STE0.COL I - ((2)2x8 P.T. I L------------------^ -----------------J ...1 O iI PLATE S87/Bx24 -SECTION 1- -- ---------------- - ---------------- ANCHOR BOLT 4'-ANCHOR BDLT &CDR BO - - FOUNDATION PLAN. —6 Z SECDOH V4:,a 1'_p° M.O. M.O. O U. HOLDOWN CONNECTION HOLDOWN CONNECTION 24'-0' DETAIL ® FLOOR DETAIL ® GARAGE FOUNDATION NOTES: 1.ALL WORK SHALL COMPLY WITH THE &REST ALL FOOTINGS ON FIRM NATURAL. INTERNATIONAL RESIDENTIAL CODE 2009 AND GRANULAR MATERIAL FREE FROM TOPSOIL. - - 61'�v i /{780 CMR STH EDITION AND ALL MUNICIPALITY *ORGANICS OR CLAY HAVING A MINIMUM SOIL ORDINANCES AND BY-LAWS. BEARINGCAPACITY OF 1 1 2 TONS PER/-SQUARE F00T.MECHAN 3"z3k1/4'PLATE 1/2'OUMETFIt■1'-3'LONG 2.CONCRETE MALL BE MINIMUM 3,500 PSI AT SUBGRADE BEFORE FORMING FOOTINGS - WASHER SEE NOTES FOR x S'HOOK ANCHOR BOLTS 28 DAYS OR AS SHOWN OTHERWISE 7. SLABS SHALL BE CONSTRUCTED WITH. 51L P.T. SILL PLATE SPACING BOLT 3.STEEL REINFORCING SHALL DE ROLLED CONTROL JOINTS HAVING A DEPTH OF AT - � e �. BILLET STEEL CONFORMING TO ASTM A615, FF q,g ' LEAST 1/4 THE SLAB THICKNESS BUT NOT Ly0- 7'MINIMUM GRADE 60. LESS SPACED �NTERVALNE S'NOT ORE THAN 30 JOINTS SHALL E 4.CONCRETE SHALL BEAR ON SUITABLE - / IMBEDDED FEET IN EACH DIRECTION AND SLABS NOT 1� �, dLra •t IN UNDISTURBED.EARTH. DO NOT PLACE RECTANGULAR IN SHAPE SHALL HAVE CONTROL FROM END CONCRETE CONCRETE IN WATER OR ON FROZEN GROUND. • a,i.. �. �• JOINTS ACROSS THE SLAB AT POINTS OF OF PLATES 5. ROUGH OPENING SIZES FOR BASEMENT OFFSET,IF OFFSET EXCEEDS TEN FEET,AND IN _ Fi ,,. �'• TS 5'`� +`' DOORS,WINDOWS&VENTS TO BE VERIFIED WITH 2O09 IRC.ED BY IMSM CONTRACTOR BEFORE POURING ANY CONCRETE, S. PROVIDE 5/8"DIA..ANCHOR BOLTS O 48" Typ' O.C. w/3'x3-x1/4'PLATE WASHER ., 1 + CONCRETE FOUNDATION` WALL&FOOTING •,t 1i..••• ANCHOR BOLT DETAIL 04-04-14 O n c E o ' '� A Y✓'. M.!�.i SF T CO k 4-• U 1�1 BATHROOM EXHAUST VENT TO EXTERIOR 4'-0" 3'2" '-2 A 4 .. . TA A H2640 t ADH 640 ic� 4.REMOVE EDRYWALL ANONSTNNEW 1./2..RYWALL 21 BATT - + 'FIREPLACE ,� BICIIHG W I.0 - - i IN 12'-0" n o . .. tO s Lh ADH2644 ADH2644 GREAT ROOM o CKET POCKET - R`x CLO T(VAULTED CEILING) - 6+6 :-z a S n a - m .. — -- -- -- — ------- I HALF '"� m BATH 4 ^ AFT �LIGN DN 3'._6" 16'-4Y m 23.-6Y. w m _ Qa ,._ _ 2-6x6-6 4' 1 t m 13'-7Y" 5'_p•_ o rn rn POCKET i m a y ADH2O40 'A♦'. 040' AOH2O46 ;,+ p - R] S' I AD 644 + O 9'-3Y4 C ' � a - - H m ._....0.w, _ s _. . r I 4< _ - VERIFY SIZE FOR.. I'-I - i 'Q - Il LAUNDRY APPLIANCES H ' I STEEL COL O /1 I q HANDRAIL KITCHEN C!!SO'� li OLD Bill-OLD I- m w F t UP O FICE ALIGN I I TEP DN - }1d ! I I O O m 3-Ox6- / 3-Ox6-8 1'I ,o 20 MIN • i, I .. STEEL BEAM ABOVE �RR1..JJJ 0 4 I (SEE FRAMING PLAN FOR SIZE) -Z "1, I TEP DNS L z .-.. N 020 MN 0 0 Fi 1 - d Y2 3 73�^ 3-7 tY1'.�i 2 CAR,GARAGE IIL 11 o o SJB"TYPE ^X'GWB'PAINTED 1 p, a. O DRYER EXHAUST VENT ALL WALLS & CEILING TO EXTERIOR .' zr - '0 LL C k 1 s C F- m CD i DO T < B a LL AB S HDI H _ ' _ ^ 3 B'LSx" a _ STEEL COL 1 t� � I ❑ ❑ 9-0x8-0 O.H. I - 9-0x8-0 O.H. FIRST FLOOR PLAN 6'-6" 1 V_O" 6'-6" GREAT ROOM-FIREPLACE D REA1 ROOM-TV WALL 1J4"=1-0" 1/4._1._D. _ - 1/8:, _ 1.'_01. 24'-0" v GENERAL REQUIREMENTS: REVISIONS 1 ALL DIMENSIONS ARE TO FACE OF STUD 5 REFER TOOTHER DRAWINGS AS PART OF O SMOKE.DETECTOR v - UNLESS INDICATED OTHERWISE, THIS SET.FOR MORE DETAILED REQUIREMENTS SO RECARDING BUILDING MATERIALS; FOUNDATIONS p HEAT DETECTOR - 2 ALL EXTERIOR WALL FRAMING SHALL BE 2x6 AND STRUCTURAL DESIGN,CRITERIA. HD CONSTRUCTION AND ALL INTERIOR WALL FRAMING Q CARBON MONOXIDE DETECTOR - - - SHALL BE 2x4 CONSTRUCTION UNLESS OTHERWISE 6. SMOKE.DETECTORS, HEAT DETECTORS I - NOTED. AND CARBON MONOXIDE DETECTORS HAVE - - BEEN SHOWN ON THE PLANS TO COMPLY - - 3 ALL WORK SHALL COMPLY WITH WITH THE REQUIREMENTS OF 780 CMR wnm INTERNATIONAL RESIDENTIAL CODE 2009 AND 780 3603.16 - FIRE PROTECTION SYSTEMS. CMR MASSACHUSETTS STATE BUILDING CODE HOWEVER THE ARCHITECT 18EARS NO MASSACHUSETTS AMENDMENTS TO THE RESPONSIBILITY FOR THE DESIGN, FINAL INTERNATIONAL BUILDING CODE 2009 (ONE AND PLACEMENT, OPERA710NOR MAINTENANCE F TWO FAMILY DWELLINGS)AND ALL LOCAL CODES, PROCEDURES OF THE HOUSEHOLD FIRE 04-04-14 REGULATIONS AND BY-LAWS. WARNING SYSTEM. 4 ALL WORKMANSHIP AND BUILDING MATERIALS 7 .ALL OPENINGS SHALL BE PROTECTED. SHALL MEET OR EXCEED RECOGNIZED INDUSTRY PROVIDE IMPACT RESISTANT WINDOWS AND - STANDARDS FOR EACH APPLICABLE TRADE. DOORS AND/OR STRUCTURAL PANELS. AS ------------------------------ t 01 s u 3 ADH2644 ADH2644 q._O.. 4._0. 1 NEW WINDOW I .. I\ III CD DAM 2•-2 SD j ON -- __-- -- -----.-1 NEW WINDOW TO MEET EGRESS REQUIREMENTS flEDROOM 1 ADH2644 ADH2644 YUM nrM t; -- -1 S I. ACCESS DOOR __ - 1 3/4'PLYWOOD DOOR W/3"RIGID I. - �Q I INSULATION&WFATHERSTRIPED TYP. I t 1 1 I 1 I < I x V rn L-------------------------------------J 1 STORAGE SPACE (LINED) o rn _y m 1 v l a E m A7 . I 5•-4YZ 12._4.. ^5 4y.. I _ - - r I Z.I ,. saaADH2644 ADH2644... J SECOND FLOOR PLAN 12-0" 12'-0" - = _ GENERAL-REQUIREMENTS: U- O 1 ALL DIMENSIONS ARE TO FACE OF STUD 5 REFER TO OTHER DRAWINGS AS PART OF Q SMOKE DETECTOR - O UNLESS INDICATED OTHERWISE. THIS SET FOR MORE DETAILED REQUIREMENTS SD - REGARDING BUILDING MATERIALS, FOUNDATIONS Q HEAT DETECTOR r --- --- -------y _ 0 2 ALL EXTERIOR WALL FRAMING SHALL BE 2z6' AND STRUCTURAL DESIGN CRITERIA. HD CONSTRUCTION AND ALL INTERIOR WALL FRAMING Q CARBON MONOXIDE DETECTOR r===== =_= I (n SHALL BE 2z4 CONSTRUCTION UNLESS OTHERWISE - 6 SMOKE DETECTORS, HEAT DETECTORS CD I I LLI NOTED. _ AND CARBON MONOXIDE DETECTORS HAVE 12t/12 BEEN SHOWN ON THE PLANS TO COMPLY - I _________ _ 3 ALL WORK SHALL COMPLY WITH WITH THE REQUIREMENTS OF 780 CMR 1 I r �f------- INTERNATIONAL RESIDENTIAL CODE 2009 AND 780 3603.16 - FIRE PROTECTION SYSTEMS. I _ )L.-J�1 CMR MASSACHUSETTS STATE BUILDING CODE HOWEVER THE ARCHITECT BEARS NO MASSACHUSETTS AMENDMENTS TO THE RESPONSIBILITY FOR THE.DESIGN, FINAL r T EXISTING INTERNATIONAL BUILDING CODE 2009 (ONE AND PLACEMENT, OPERATION OR MAINTENANCE I I f 12t/12 TWO FAMILY DWELUNGS)AND ALL LOCAL CODES, PROCEDURES OF THE HOUSEHOLD FIRE i 1723/12 I I I T of/1y I REGULATIONS AND BY-LAWS. WARNING SYSTEM. 1 4 ALL WORKMANSHIP AND BUILDING MATERIALS 7 ALL OPENINGS SHALL BE PROTECTED. 1 - ' SHALL MEET OR EXCEED RECOGNIZED INDUSTRY PROVIDE IMPACT RESISTANT WINDOWS AND ----------- 1 1 ' STANDARDS FOR EACH APPLICABLE TRADE. DOORS AND/OR STRUCTURAL PANELS. I EXISTING I 12±/12 --1-2@ tz I �,.12t/12 1 II ,,,moo L-====_ --- ---- ---------- III REVISIONS I 11 I� I dro NaCw,ai, 1112t/12 ��12 I II 11 I� II 11 I� . II II 1251 12 1. ' 0404.14 ROOF PLAN :j NOTE: SLOPE ROOF TO MATCH EXISTING. ................-.. ------------- ---- o (�a,, -------- - .-.................. qLL . ....................... ........................ ........................ - ------------------------------- ----—-—-—-—-—-—-—-—-—-—-—------------- .............................. ......------........................ ------- ............ ..... ............ ..................---............ ........................ ....................... ------------------- - ------ ............ ...................................... --------------------------------------------------------- ...................................................... ..........................................------...... ------------------------------ ----------------------------- ............I ...... ............. ................... ILLIJI =TMTrmFm1==: as oa _ oa FRONT ELEVATION ra 1/4" 1'-0 .................. ............ ............ ---------------- 22 0 a ............ No9748 Z UJ ...... ... 0 LU U- WTLTl TLHTL� . . . . . . . . . . . . . . . [Jill]III III I I I P,1141-Y-1-11-1;ITY11111 11 Y1,1Y,I I I I I I I I I I I I-T-T-fl REVISIONS I RIGHT ELEVATION 1/4' - 1--0- 04-04-14 A3 .............. ........... -— —-—-—-—-—-- O .............. ............ ------------ ------------- ............ -—-—-—-—-—-—-- -—-—-—-—-—-- ...... -—-—-—-—-—-— -—-—-—- . — —-—-—-—-—-—-- ------- - -------- ------------ ....... ...... ............ - —-—-—-—-—-—-—-—-—-—- -—-— —-—-—-—-—-—-—-—-— - -------------------- ---- ----------------- ............ ............ -—-—-—-—-—- I -—- — -—-— —-—-—-—-—-—-—-—-— - ----------------------- ............ ---------------------- ------------------ lilt -------------------------------------- ---------------------- --- ----------- --- - ------- --------- ...... ...... IIIIIIIIIIIIIIIIIIIIIII [ Itl lilt TYTIr' IIIIII I I I It It "T" till �� ao ra REAR ELEVATION 1/4" V-O' is —-—-—-—-—-—-—-—-— LL-—-—-—-—-—-—--—-—- uj 0 —-—-- - < UJ uj-—-—-—-—-—-—-- -—-—-—-—-—-—-- id A -—-—-—-—-—-—-— -—-—-—-—-—-—-- -—-—-—-—-—-—-— -—-—-—-—-—-— -—-—-—-— NbAD74E� ------------ "Y'Y'Y' 'Y'Y. .. . . . . . .. .. .. . . . . . .. . 6- MIA I IFT-F11 ti I I 1 1:1-1 EFF] I I I I I till REVISIONSop, REV LEFT ELEVATION 1/v V—O" 04-04-14 A4 STRUCTURAL DESIGN CRITERIA S THE FOLLOWING•N RI RIA: OUTLINES MINIMUM PERFORMANCE STANDARDS FOR THE PROJECT - AND THE BASIS UPON WHICH SHOP DRAWINGS(IF ANY)WILL BE REVIEWED. _ 1.1 TYPICAL ALTERNATE STANDARDS(FOR REQUIREMENTS NOT OTHERWISE INDICATED - - - 0 IN THIS SPECIFICATION OR RELATED DRAWINGS): APPLICABLE BUILDING CODE - • _ - - '� u: _ (INCLUDING INDUSTRY STANDARDS REFERENCED THERE—IN)OR PRODUCT MANUFACTURER'S RECOMMENDED STANDARD,WHICHEVER IS THE MORE STRINGENT FOR A PARTICULAR ITEM OR CONDITION. 1.2 FEMA 543 DEFINITIONS,WIND BORNE DEBRIS REGIONS WITHIN 1 MILE OF v COASTAL MEAN HIGH WATER LINE.LOCATION WITHIN 1 MILE OF COASTAL MEAN HIGH WATER LINE.PROVIDE IMPACT RESISTANT EXTERIOR WINDOWS AND DOORS. 2.n n AO I n ns. 21 STRUCTURAL SHEATHINGci77 g 21.1 FLOORS: 3/4"MIN. THICK,T&G.COX PLY. - w U 2.1.2 EXTERIOR WALLS: 1/2'MIN.EXTERIOR PLYWOOD 2.1.3 ROOFS: 5/8-MIN.EXTERIOR PLYWOOD 2.2 FINISHES: (THE FOLLOWING REPRESENTS STRUCTURAL DESIGN CRITERIA, NOT - FINISH SPECIFICATIONS) 22.1.FLOOR FINISHES AT ENTRIES,BATHROOMS AND KITCHEN AREAS: ASSUME - - RIDGE VENT TYPICAL ROOF FRAMING - THIN-SET CERAMIC TILE OVER 1/2' CEMENT FIBER BOARD UNDERLAYMENT. -2x RAFTERS 2.2.2 FLOOR FINISHES AT OTHER HABITABLE AREAS: ASSUME 3/4'HARDWOOD 2x RIDGE -ROOF SHEATHING FLOORS . . 223 WALL FINISHES: ASSUME CERAMIC 71LE WITH 1/2"CEMENT FIBER BOARD -15 LB. BUILDING FELT BACKER AT TUB AND SHOWERS, 1/2'BLUEBOARD AND PLASTER ALL OTHER - -ROOF SHINGLES, FASTENED TO MEET 11 OMPH HIGH EXISTING SHOWN BEYOND- LOCATIONS. WINDS ACCORDING TO MANUFACTURER SPECIFICATIONS - 1 224 CEILING FINISHES: ASSUME 1/2'BLUEBOARD AND PLASTER _ 22.5 ROOF FINISHES: ASSUME HEAVY DUTY,ARCHITECTURAL GRADE ASPHALT 12 D SHINGLES - MATCH EXISTING SLOPE - - 23 MAXIMUM DEAD LOAD OF 10 P.S.F. .. 3.0.(NOT USE771 4.0 All OWARL DEFECTION: - 4.1 FLOOR/CEILING ASSEMBLIES(INCLUDING SUPPORTING BEAMS)-(NOTE: - - - WINDOWS AND DOORS.-ASSUME NAIUNG TABS AT JAMBS AND HEADS, WITH °a .2x6 COLLAR - - MANUF.RECOMMENDED HEAD CLEARANCES OF APPROXIMATELY 1/2") - N O 32"O.C. 4.1.1 LIVE LOAD DEFLEC7ION: L/480 UP TO 1/2'MAX. - - 4.1.2 TOTAL LOAD DEFLECTION: L/240 UP TO 3/4'MAX. ao A�lowaelF oEF7EcnoN• 4.1 FLOOR/CEILING ASSEMBLIES(INCLUDING SUPPORTING BEAMS)—(NOTE:- - WINDOWS AND DOORS—ASSUME NAILING TABS AT JAMBS AND HEADS,WITH MANUF.RECOMMENDED HEAD CLEARANCES OF APPROXIMATELY.1/2') _ W/ER 4.1.1 LIVE LOAD DEFLECTION: ;L/480 UP TO 1/2'MAX. _ - R-36 BATT INSULATION '2x8 COLLAR TIE O EACH VENTILATION VAPOR BARRIER W/S FOR 4.1.2 TOTAL LOAD DEFLECTION: L/240 UP TO 3/4"MAX. _ - x.. "- - RAFTER - POSTNE VENTILATION - 51 FRAMING DIMENSION LUMBER - - OP OF PLATE LOAD BEARING DIMENSION LUMBER FOR JOISTS,STUDS,PLATES,RAFTERS.HEADERS, ALIGN WITH EXISTING_. - -- - ---- ---- ----------- - -- ------ BEAMS AND GIRDERS ETC.SHALL CONFORM TO 2009 IRC AND TO OTHER - APPLICABLE STANDARDS OR GRADING RULES AND SHALL BE SO IDENTIFIED BY A - WIND BLOCK GRADE MARK OR CERTIFICATE OF INSPECTION ISSUED BY AN APPROVED AGENCY. SIMPSON STRONG-TIE H2.5 - SOFFIT VENT THE GRADE MARK OR CERTIFICATE SHALL PROVIDE ADEQUATE INFORMATION TO - CONNECTOR O EACH - 3W. DETERMINE Fb, THE ALLOWABLE STRESS IN BENDING,AND E,THE MODULUS OF RAFTER/CEIUNG JOIST TYP. p ELASTICITY. - 5.1.1 ALLOWABLE JOIST SPANS: THE CLEAR SPAN OF FLOOR JOISTS SHALL NOT - EXCEED THE VALUES SET FORTH.IN TABLES 2009 IRC R50231(1)&R502.&1(2). - - - - -. - - - 00 5.1.2 ALLOWABLE SPANS: THE UNSUPPORTED SPANS FOR C©UNG JOISTS SHALL - I - TYPICAL EXTERIOR WALL ASSEMBLY NOT EXCEED THE VALUES SET FORTH IN TABLES 209 IRC R804.3.1(1),R804.3.1(2) - - - - REIG4.3.1(3),R804.3.1(4,R804.3.1(5),R804.3.1(6,R804.3.1(7), R804.3.1(8. THE •' -2x6 STUDS O 16"O.C.w/ BLACKING - - UNSUPPORTED SPANS POR RAFTERS SHALL NOT EXCEED THE VALUES SET FORTH IN - - - -1/2'ZIP.SYSTEM WALL SHEATHING TABLES 2009 IRC RSO23.1(1),R8023.1(2)R8023.1(3),R8O23.1(4).R8023.1(5), - -GREAT ROOM - -EXTERIOR SIDING OVER AIR BARRIER - - .. R8023.1(6),R8023A(7),R8023.1(8): - ,- -R=21 INSULATION &VAPOR BARRIER - 5.1.3 PLYWOOD SHEATHING AND WOOD STRUCTURAL PANELS USED FOR STRUCTURAL PURPOSES SHALL CONFORM TO 2009 IRC TABLE R60Z3(3). ALL PANELS SHALL BE IDENTIFIED BY A GRADE MARK OR CERTIFICATE OF INSPECTION ISSUED BY AN APPROVED AGENCY. - - 5.1.3o WHERE USED AS SUBFLOORING OR COMBINATION SUBFLOOR UNDERLAYMENT, 3/4'EXTERIOR'T&G LVL BFAM.(FLUSH FRAMED) - WOOD STRUCTURAL PANELS SHALL BE OF ONE OF THE GRADES SPECIFIED IN 2009 PLYWOOD GLUED&NAILED -• . IRC TABLE R503.2.1(1). WHEN SANDEDPLYWOOD IS USED AS A COMBINATION - SUBFLOOR UNDERLAYMENT,THE GRADE SHALL BE AS SPECIFIED IN 2009 IRC TABLE R503.2.1(2). - - FIRST FLOOR LINE 0 . t - .. Z 5.2 ENGINEERED WOOD ------ ---- - --- --- ALL BEAMS,HEADERS AND GIRDERS SPECIFIED ON THE PLANS AS LVL BEAMS,OR COMPOSITE(BUILT-UP)LVL BEAMS SHALL BE AS MANUFACTURED BY TRUS JOIST - U MACMILLAN bR APPROVED EQUAL ALL SPANS,LOAD CAPACITIES,BEARING - - - W CONDITIONS AND FASTENING SCHEDULES SHALL BE AS REQUIRED BY THE MANUFACTURER. 5/8'ANCHOR BOLTS m 48'O.C. \—R-21 - _ 2x8 FLOOR JOISTS O 16' . BAIT INSULATION & D.C.6.0 INSTALLATION STANDARDS RAWL SPACE VAPOR BARRIER- Z . -PROVIDE CONTINUOUS LOAD PATH BETWEEN FOOTINGS,FOUNDATION WALLS,FLOORS, STUDS AND ROOF FRAMING. 8'CONCRETE FOUNDATION WALL - 6.1 FRAMING SYSTEM: WESTERN PLATFORM w/(2)#4 BARS TOP & BOTTOM 6.2 WOOD POSTS AND JACKS SUPPORTING WOOD FRAMING - 8.2.1 WITHIN 2%4 WALL FRAMING: 4 X 4 MIN - - - ---- ---- ------------ FER TO 6.23 LLIWOOD POSTS SHALL BE AMING•CONNECTED TO THE RE FRAMING AT)TOP - 24x12 CONCRETE FOOTING W/ - - �' '�,a t' •". WITH METAL POST CAP A.C.OR A.C.E.BY SIMPSON. - 2x4 KEY - - F ' 6.3 COLUMNS(BASEMENT OR EXTERIOR LOCATIONS): 3 7/2'LALLY COLUMNS - 6.3.1 BASE PLATES: SPRINGFIELD BEARING PLATES WELDED TO COLUMN. - - S`Ja `r z 6.3.2 CAPS(CONNECTING COLUMNS TO WOOD FRAMING): SPRINGFIELD BEARING 16'-0" PLATES OR SIMPSON'CC'TYPE COLUMN CAPS 1- 6.4 ANCHORS, CONNECTORS AND HANGERS - ti 6.4.1 SIZE,CONFIGURATION.LOCATION AND QUANTITIES TO MEET WIND, EARTHQUAKE AND GRAVITY LOADS 6.4.2 JOIST HANGERS: TOP FLANGE TYPE(UNLESS NOT FEASIBLE)SHALL BE SECTION-A USED AT ALL CONNEC71ONS AS REQUIRED. HANGERS SHALL BE 18 GA. MIN.NTH ALL HOLES FILLED WITH REQUIRED FASTENERS. 1/2' 6.5 WALL FRAMING ALL EXTERIOR WALLS SHALL BE 2x4 OR 2x6(AS INDICATED ON STUD WALL - �iFy 4� REVIISIONS PLANS) - � 6.5.1 EXTERIOR WALL SHEATHING SHALL BE FASTENED WITH(SEE SCHEDULE& 2-18a PER STUD SUBFT.00R I�� - DETAILS)*INTERIOR SUPPORTS,UNLESS OTHERWISE NOTED ON PLANS(U.O.NJ STUD WALL 2-1ea O 16"O.C. ,Gus� 6.5.2 2x4 INTERIOR STUD BEARING WALLS SHALL BE 2 X 4 STUDS AT 16'O.C. - 4:'m•�*``"t, '- NTH3-16d PER JOIST - - en s= .. •�' - t �' X-B ACING(I AT MID HEIGHT FOR WADS OVER 9 FEET HIGH,AND METAL JOIST or TRUSS X-BRACING(SIMPSON STRONG TIE TYPE N'B)U.O.N. _ �--- JOIST or RnF1vt or 7RI755 - 6.6 FLOOR AND CEILING FRAMING(UNLESS NOTED OTHERWISE ON ATTACHED 4-8d PER JOIST DRAWINGS): DIMENSION LUMBER. 6.6.1 PROVIDE DOUBLE JOISTS BENEATH ALL BEARING PARTITIONS AND AT ALL 2-10d O 24'O.C. - xe e.eoc . ROUGH OPENINGS. 2-i8d PER STUD 6.6.2 PROVIDE SOLID BLOCKING BETWEEN JOISTS AT BEARING WALLS RUNNING PERPENDICULAR TO WALL AND BETWEEN JOISTS TO EITHER SIDE OF PARTITIONS STUD WALL RUNNING PARALLEL TO FRAMING. 6.6.3 PROVIDE SOLID BRIDGING AT 8 FT MAX.O.C. BLOCKING O 48'O.C. - nw 6.6.4 PLYWOOD SUBFLOOR SHALL BE GLUED AND NAILED NIIH 8D NAILS AT 10' BLOCKING O 48"O.C. 04-0414 O.C.TO INTERMEDIATE SUPPORTS AND 8D NAILS AT 6"O.C. TO PANEL EDGE STUD WALL STUD WALL SUPPORTS. 6.7 RAFTERS(UNLESS NOTED OTHERWISE ON ATTACHED DRAWINGS): DIMENSION STORY TO STORY UPLIFT & ELNpBER. FLOOR BRACE DETAIL LATERAL CONNECTIONS ROOF BRACE DETAIL A5 1•a 1'_O• 1.=1.-0. i.a 1,�. �s RIDGE VENT 2x RIDGE 1'�"1. �• m ii`. MATCH EXISTING SLOPE \ \\ 12 4 i - \ \ Q - - R-38 BA*) NSULA7K>N - 12TOP OF PLATE vyyyyyyyyyyyyy Tyv . ALIGN WITH EXISTING CEILING'1NE. - _ - - TYPICAL ROOF FRAMING 2x8 COLLAR TIE \yy__ 0 EACH RAFTER SIMRSON S'nVNG—TIE.H2.5 —2x RAFTERS CONNE¢TOR 01EACH —ROOF SHEATHING - FILING JOIST TYP. —15 LB. BUILDING FELT ' —ROOF SHINGLES. FASTENED TO MEET 11OMPH HIGH \\ \ - VANDS ACCORDING.TO MANUFACTURER SPECIFICATIONS \ \ BEDROOM \P, \ ! R-38 BAIT INSULATION . VAPOR BARRIER W/ I ( \\ VENTILATION BAFFLES FOR - - I I \ - .POSITIVE VENTILATION 4°MIN. - SIMPSON STRONG-TIE . - 3(4"EXTERIOR.T&G I HANGER _ v WIND-.BLOC _ PLYWOOD GLUED &NAILED I - SECOND FLOOR LINE - I I Lw-s 630• ' ALIGN WITH EXISTING - -—--—_-—-- - —--— O m SOFFIT \ STAGGERED BLOCKING---"' . - - - 2z12 FLOOR JOISTS ... Q - 2z12 FLOOR JOISTS - - ®18"O.C. TYPICAL EXTERIOR WALL ASSEMBLY - ' -2z8 STUDS O 18"O.C. w/BLOCKING 2z4 LOAD BEARING WALL _ - - -1/2"ZIP SYSTEM WALL SHEATHING - -EXTERIOR SIDING OVER AIR BARRIER MUDROOM CLOSET MASTER BEDROOM - -R-21 INSULATION &VAPOR BARRIER - .-Z . 3/4°EKERIOR T&G LVL BEAM (FLUSH FRAMED) ,LVL BEAM (FLUSH FRAMED) PLYWOOD GLUED& D FIRST FLOOR LINE -----_----- LU V) . - - 2x8 FLOOR JOISTS® 18" R-21 BATi INSULATION & . - 5/8°ANCHOR BOLTS-m 48'O.C. D.C. VAPOR BARRIER- CRAWL SPACE � 4k. 8"CONCRETE FOUNDATION WALL RE `'A�`ol?C� A'' w/(2)#4 BARS TOP&BOTTOM . ——————————————.————— ——————- -————————— —————————————— 2402 CONCRETE FOOTING w/ �i CY ..q its I t� 2z4 KEY f 99? 91 Y ' REVISIONS SECTION—Btid.,° m mn , ooamm r r:! tE r r. xyya4.-' *L ,sCli ra•e•me 04-04-14 Ll • A6 I - '2x RIDGE _ - _- - \ TYPICAL ROOF FRAMING \ -2x RAFTERS - - - \ \ \\\ -ROOF SHEATHING Q4 -15 LB. BUILDING FELT -ROOF SHINGLES. FASTENED TO MEET 110MPH.HIGH. (j cs \\ \\ WINDS ACCORDINGG,TO MANUFACTURER SPECIFICATIONS �+ 2 \ \ O 12 D \\ \\ o� cn om TOP Of PLATE \ \ , n \ \ E m^ U _ 2.8 COLLAR TIE®\\. \\ .w,, V B.�+ EACH RAFTER \\ \\ 'C 1~ to a \ \ STORAGE SPACE r\ \ UNHEATED \\ SIMPSON STRONG-TIE : - 3/4" EXTERIOR T&G I \\. HANGER .I \ , WIND BLOCK PLYWOOD GLUED& NAILED - I I ' ---- -- -------- SECOND FLOOR LINE AiN4. ' ALIGN W EXISTING - SIMPSON-STRONG-TIE H2.5 CONNECTOR 0,EACH (1)LAYER 5/8°TYPE"X"GWB RAFTER/CEILING JOIST TYP. on.ALL SURFACES (1 HOUR) - STEEL BEAM SOFFIT VENT - R-30'GATT INSU TION & (FLUSH FRAMED) - 2110 FLOOR JOISTS - VAPOR BARRIER - 0 16".O.C. TYPICAL EXTERIOR WALL ASSEMBLY - -2x6 STUDS®.16"O.C. w/BLOCKING Y? -1/2"ZIP SYSTEM WALL SHEATHING' W Ge7 - - -EXTERIOR SIDING OVER AIR BARRIER U -R=21 INSULATION&VAPOR BARRIER Z R7 5 i+ W S `� rn o GARAGE Pi o E- N FIRST FLOOR LINE ALIGN W EXISTING -.-_--_------ -_----- - - TOP-0F SLAB 5/8"ANCHOR BOLTS 0 48°O.C. - - 8"CONCRETE FOUNDATION WALL w/(2)#4.BARS TOP& BOTTOM. 4"CONCRETE SLAB w/6x6 10/.10 WWM on V ;_. 6 MIL POLYETHYLENE VAPOR BARRIER on 6' a a _ " ZO 1 COMPACTED GRAVEL SLOPE TO DRAIN - - 24.12 CONCRETE FOOTING w/ - - V 2.4 KEY 24.-0.. LLI U i i1 �@ SECTION-C - r'Kf� �'?1 rp�'�• '° f a ✓G ' 41 I 47,8 4 SIMPSON STRONG-TIE WBC-16GA TOP HORIZONTAL 3" O.C. STAGGERED STRAP "X" WALL.BRACING INTERIOR BOSTICH SBDR120HDG RING SHANK- TOP HORIZONTAL 3" O.C. APPLIED TO STUDS BEFORE SHEATHING 2-3/8" LONG X .120GA FULL ROUND STAGGERED COIL NAILS HEAD BMC LONG x 809OGA dRHD 2-3/8.. FIELD 6" O.C. BOSTICH 58DR 120HDG - - FIELD 6" O.C. COIL RING SHANK 2-3/8" LONG x NAILS - BMC BdRHD - c••.v- .120GA FULL ROUND HEAD 2-3/8" LONG x .090GA REVISIONS 16/32" ZIP SYSTEM WALL SHEATHING - VERTICAL EDGE 3" D.C,-BOSTICH - VERTICAL EDGE 3" O.C. BOTTOM HORIZONTAL 3" O.C. SBDR120HDG RING SHANK 2-3/8" COIL NAILS - BMC OGA STAGGERED BOSTICH SBDR1.20HOG LONG x .120GA FULL ROUND HEAD 2-.3/8" LONG x ,090GA RING SHANK 2-3/8" LONG x .120GA FULL ROUND HEAD44 BOTTOM HORIZONTAL 3" AA ' O.C. STAGGERED COIL - ANCHOR BOLTS & TIE-DOWNS - NAILS - BMC BdRHD - 2-3/8" LONG x .090GA 04-04-14 ANCHOR'BOLTS ' INTERIOR @ GARAGE DOOR SHEAR WALL DETAIL EXTERIOR WALL SHEATHING ATTACHMENT n 7 1j2" = 1'-0' AS (3) 2x6 (1. so I I Q g (3) 2x8 (3) 2x8 r- r --- ------- ---I I II I I ti II ii Ii Cl Q a If a ; 46 WO POST. I - ril 2x8 L_j m - _—II ILIDD N 2x12 J01L 11 J01 1 "0 C. gg A II � II 11 LL----- ---- I I x8 W P II (3)2x8 (3)-2z8' (3) 2x8 (3) 2x6 (3) 2x6 4 6 D P ST I STEEL COL j I 1.-3 4"x11-1 4• VL I e I I ( USH 0) 112, FL R J I O 16"O.C.' . I I � � I I I - I - - _ - - - -- _ - - - _ - -J (3) 2x8 (3) 2x6 (3)2x6 - • f 1 I I I I C 39 / A5 - • I I I I. A7 I I A7 0 -- - - - - - - - - - -J � rJ L - - B m A6 - A6 11 _ L - _[ I _ I I SECOND FLOOR FRAMING PLAN I 1 STEEL Col c L. I 1/4' 1"-0' ` I I . I EXI NG 2x8 FL R I I NOTE: I L_ _ 2x JO O 6G.C. - -' I 1.VERIFY EXISTING FLOOR JOISTS ARE 202. INTENT IS TO ALIGN FLOORS (3) 1-3/4"x11-7/6 LVL (3) 1-3/4"x11-7/6"LVL .- �.Z t 3/4 x -/4'LVL( SH ED) �- -J L =- _ - — - � -' .. � i � I I _ I 2 B 00 J01 I> 1 0 . 006 g I I f- LL x8 FLOOR J STS O 6" .C.. I F I - - I ) 1`3/Hx 7-/'LVL I - - Q n EL w i- - - - ---- - - - I II I 2 Bu JOL 1 "OC. . I 11 I I I I 4 ---_---_--------------------11 I II F I I I I I II I I II A I _ L I ) t.1fro'. Ap�.FiI 28 REVISMNS i7 L - - - - - - - - - -- - - - - L II II C II Il I' 04-04-14 I1 II , II II FIRST FLOOR FRAMING PLAN I I I I 1 1�4" a 1"-0" I L --- J I s L-=-----------ZOL-----------_-� q) A AS - - B A6 x12 Q 16.O.0 W I 1 F2x6 0 ES — — — — — -- — — — M I I I v I 202 RAFTERS• 18'O.C.W/ I I I 2x8 COLLAR TIES EACH RAFTER 1 _ 1 I I f I§fl c s I I I I I I %e2 1 c o.c w/ I — — I ? I a 2X9 RIMEM - .r . S 2x8 _ A -- ----- o A I 14 ID - .. 2x CO TIES 16' O.0 W R - I L AS .I -.. —. — — -.. — - I ---- I - w I I 1 1 I � I I � IIv . Q � LPL.. I L= w F I I I II o I LL A7 1 I I^ I I A7 0 I A6 II II F I.I I II II 11 • ROOF FRAMING PLAN 1/4A T._0- (3) 2x8• - ...�eRErD ApC 'i.. Fa 1 a SONS No IP .,�, r. Ttt�` wnaew 1s�+' �` V"t ��� ,��P��c,,,�r.'�•,�3 "rt 04-0414 1. S . Route 28 R. 21.15 a d - 9� 1 .o m 0 $ cu LOT AREA 53,2123 SF 7TL \00 G EXISTING 3 BEDROOM SYSTEM LOCUS MAP +y I I (DWELLING TO REMAIN-3 BEDROOMS) SCALE 1"=2000't I .mow 2F0 a ?per ASSESSORS MAP 121 PARCEL 125 .. ' .82 a. .. LOCUS IS WITHIN FEMA FLOOD ZONE C - .. PROP. •y'L 'ADDN. ZONING SUMMARY 5 DECK ZONING DISTRICT: RC DISTRICT V 110 88' rs7 I /28.Sa MIN. LOT SIZE 43,560 S.F. ' MIN. LOT FRONTAGE 20' "31.69 / ' MIN. LOT WIDTH 100' MIN. FRONT SETBACK 20' z� I TOP FNDN. MIN. SIDE SETBACK 10' 325' 30.67 MIN. REAR SETBACK 10' V 109 1 35 a` 81 SITE IS LOCATED WITHIN WELL PROTECTION 186 OVERLAY, RESOURCE PROTECTION OVERLAY AND ESTUARINE PROTECTION DISTRICTS /\ OWNER OF RECORD' x 30.42 . JOEL P. AND NANCY W. DIETZ V 108 1 .60' 4 / 'PROP. - �� GRAVEL ADD N - REFERENCES DRIVEWAY V 107 eOip�k / , 30.54 •30.36 l PDEEI) BOOK LAN BOOK 27942 PAGEGE 238 507 9s4 SEPTIC SYSTEM AS-BUILT CARD ON FILE AT v tos v 1o6 /.as HEALTH DEPT. —20 0 a 30.08 WETLAND FLAGGED BY VACCARO ENVIRONMENTAL CONSULTING 29.11. .. _ .. .. .. .. .. ,�,25.5 I '/ .82 .10.24.79 / / \ I / 27.97, 9.13 / \\ 40 4 5 / i SITE PLAN 25.2a OF 118 JOBY'S LANE JOBY'S LANE OSTERVILLE 25)'1/ PREPARED FOR x 25.88 - / / 11 off 508-362-4541 ea (H OF 3 fax 508-362-9880 du�1'\NOFSSgcy =y \N0f/ syc' o4�DANfELA.9cy� ��`t"a�/ JOEL & NANCY DIETZ downcape.com 0 o DANIEL DANIEL DANIEL �N // x 25.,Q A. A. ! CIVIL IVIL ;,;� / a A�OWO cape engineering,%4t, OJALA OJALA No.465oz APRIL 8, 2014 C/✓/l engineers - No. ,4 EQ A No. ...45(0ys�9 80 ' OLaH/ FN.4650E2 land surveyors mE5514e --p: 9N Ij an ,7z 939 Main Street ( Rte 6A) g SCOIB:1"=20' ` YARMOUTH,-ORT UA 02675 \DATE DANIEL A. OJALA. P.L.S. 14-030 0 10 20 30 40 50 FEET