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0207 PARKER ROAD - Health
207 Parker Road Osterville A= 250— 156 1 ,per \ COMMONWEALTH OF MASSACHUSETTS ExECUFIVE OFFICE OF BNVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION , '1 l -E H OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ; SUBSURFACE'SEWAGE DISPOSAL SYSTEM FORM PART A , CERTIFICATION Property Address: acn Pa.-fie- Owner's Name: C4A- 1ti Owner's Address- Date of Inspection: rg name of Inspector:(please,print) s Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 a � Centerville, KA 47 TelephoneNurnber: (5081 775-877`6 ) CERTIFICATION STATEMENT I ceriify 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 t�n 15340 of.Titte.5(310 CMR 15.000)- The system j Passes Conditionally Passes • ,i.. ' Needs Further Evaluation by the Local Approving Authority--•- Inspector's Signature: Date: The system inspector shill submit a copy ofthis inspection report to the Approving Authority(Board of Heattli-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 die DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Commenu ' a F•^ t 1 "*"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 to '4 4 Title 5 Inspection Form 6/15/2000 page I Page 2 of l r OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A (� CERTIFICATION(continued) Property Address- 07 T Owner. Date of inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete an orSection D A. Sys m Passes: P. t 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: /1 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'bot determined" lease explain_ F . 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 tams is replaced with a complying septic tank as approved by the Board of Health_'A meta[septic tank will pass inspection if it is structuuafly sound,not leaking and ifa 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 br_okut,settled or uneven distribution box.System will pass inspection if{wit}n., approval of Board of Health): ,q - - broken pipes)arc 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 of obstrucled p (s)-The Pass inspection if(with approval of the Board of Health): ipesystem will broken pipc(s)are replaced obstnution is s=morod ND explain: 'Page 3 bf 11 OFFICIAL INSPECTION FORM.;NOT FOR VOLUNTARY ASSESSMENTS y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM, PART A CERTIFICATION(continued) ' '.: Property Address: no? Pa 1-e'- - X�A Owner: r _ Date of Inspection: i C. Further Evaluation is Required by the Board of Health: 1 Conditions exist which require further evaluation by the Board of Hea th 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 15303(1)(b)that the . . :. .. system is not functioning in a manner which will protect public health,safetyand the environment: s " •_§ F — 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 .. ' r et . c . Z. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that(lie" a' system is functioning in a manner that protects the public health,safety and environment; F• w. t.''1 i, ,• a r , . . ;, t, .. _ 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.. tp " ? •,,- ` '_- , _ The system has a septic.tank and SAS and the SAS is within a'Zone'l of a public watei'supply.t• '}' ____ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ;,;,F r _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more front 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 coliforrn 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'' +'"`°v •= failure criteria are triggered.A copy bf the analysis must be attached to this form. L •� , ", �.. . E., l 'f•' !f/�...{ 4+. r, a ,j a' .. � t 3. Other: • s � 4,e a ,.•a'1'y. t ,. #xr'r.ls (.' t:,+•, ...( .r4r,,,'1�}'a a w x Page 4 of t 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS . SUBSURFACES EWAGE DISPOSAL SYSTEM_,INSPECTION FORM PART A CERTIFICATION(continued) Property Address: QS Owner:��t Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate')-es"or"no"to each of the following for all inspections: r. 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%day flow v�Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped . _ ! Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100.feet of a surface water supply or tributary to a surface water supply. j Any portion of a cesspool or privy is within a Zone I of a public well. Wy 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 fret from a private uaueT supply well with no acceptable water quality analysis.[This system passes if the well water analysis, performed at a DEP certified laboratory.,for conform 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-1 (YeslNo)The system fails.I have determined that one or more of.the above failure criteria exist as described in 310 CMR 15.303.therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design Dow 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 11 of a public water supply well If you have answered"yes"to any question in Section E due 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 l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTION FORM y PART B CHECKLIST Property Address:207 �tA:�' � G�i ' ' 1•r. , ti `a ;;: _ ``* Owner: (Z)Q1110CLAfa— Date of Inspection: Ok (r> n ,. Check if the following have been done-You must indicate`)res"or"no"as to each of the following: Yes .—o 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.T c s• r, i 6 Has the system received normal flows in'the previous two week period? k r 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 / •J 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 w of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum,? ,, , ,, .,P•}ry .. v i Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? F - - The size and location of the Soil Absorption System(SAS)on the site has liven determined based on: Yes no Existing information.For example,a plan at the Board of Health. _ Determined in the field(if any of the failure criteria related to Part_C is at issue approximation of distance is unacceptable)(310 CMR 15.302(3)(b)] Fr t . + i — F ' - - sty•}f 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART C SYSTEM INFORMATION f Property Address:&Q? `1 tQN' - _ Owner: r/` Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual):_ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms}�'�y �� Number of current residents: / - 1, Does residence have a garbage grinder(yes or no): GS 41 k,-4, nxo r' e- o-u +u de4►f v Is laundry on a separate sewage system(yes or no)-:; � [if yes separate inspection required) Laundry system inspected(yes or no): t%j Seasonal use:(yes or no): Water meter readings,if available(last 2 years usage(gpd)): o�C:�6 8 NOQ 000 Sump pump(yes or no): M0 pp'? J. i o0 . Last date of occupancy:'-&rr COMM ERCIAL/INDUSTRIAL Type of establishment > Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgkctc.): ' Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): - GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):� 3 If yes,-volume pumped:_)gallons—How was quantity pumped determined? Reason for pumping: TT OF SYSTEM ^ r/Septic tank,distribution box,soil absorption system Single cesspool °r Overflow cesspool —_Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the can-cat 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: Were sewage odors detected when arriving at the site(yes or no): 6 r Pag'c 7 of 11 OFFICIAL INSPECTION F0101—NOT FOR VOLUNTAItY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORA-1 PART C SYSTEM INFO RAIATION'(continued) ?^? Frf :t 1`. •f Property Addrus: 26"').1�t� .. > s Date of inspection: /cam BUILDING SEIYER(locate on site plan) Depd}below grade: .,S Materials of construction:_cast iron ✓'40 PVC Distance from private water supply well or suction lute: Comments(on condition of joints,venting,evidence of leakage,c1c.): " SEPTIC TANK: ocate on site plan) Depth below grade: Material of construction:✓ncrete_metal fiberglass J,olyethylenc t ' _001cr(explain) — If tank is metal list age:` Is age confinned-by a Certificate of Com liancc es or iro : ' { '" f• certificate) p (�' ) _(altacli a copy of Dimensions: 9M'✓ 6,i.11c^4 Sludge dcptl►: 4c, Distance from top of sludge to butiom of outict Ice or bank: �i r SCUM thickness: / • rw' ,- o + +' - Distance from top of scum to top of outlet tee or baffle. - Distance from bottom of scum to bottom of outlet tec or Wile: /i I low were dimensions determined-._ awted Co;,,,-7 �,�{ . ;tom Nt �►r�4 ty�fY • +� •' 1 : 1= Comments(on pumping reeonunendatwns,inlet and outict tee or baflle eoaditien,structu}al integri(y, liquid levels } as related to outlet invert,evidence of leakage,etc.): c.a.�+V-- i.�,,.-/ ,A, le.,.b.�`- o.-- •ra:..� .cif-"%eF�.p�,. ., j 9 ,c- .!'1 w lr.� 6�. ._.,.. . ...:, . . 4 tJ GREASE TRAP: _!�:Alicfatc on site plan) Dcpth below grade: Material of construction: concrete metal fibctglass rolycdlylcnc:°'+ oilier: (explain): Dimensions: Scum thickness: Distance froln top of stunt to lop of outlet tee or baffle: Distance from bottom of scum to bottom of oullet tee or baffle Date of last pumping: Conuncnts(on pumping rcconuucndations,Wet and outlet ice or baffle conditiu:t,structural integrity,liquid levels as related to ouilet invert,evidence of leakage;etc.): y 7 8of11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) = ,)crty Address 7 €' c r. _ r lr Ystrr'Gl SCAN e or Inspection: MT or HOLDING TANK:IVr(tank must be pumped at time of inspection)(locate on site plan) ' ith below grade: Vial of construction: concrete metal fiberglass_pulyethylene othet(explaut): rcnsions: Pacity: gallons •ign Flow: gallons/day nu present(yes or no): nn level: Alarm in working order(yes or no): .c of last pumping: mrncnts(condition of alarm and float switches.ctc.): ' STIUBUTION BOX:Z(i(P(cscnt must be o c p ncd)(locate on site plan) pth of liquid level above outlet invert: br. inmcnts(note if box is Ievcl and distribution to outlets equal•any evidence of solids carryover.any evidence of kagc in or out of box,ctc.): , — '^"•S"k rstl'�'7d s�� �..,-�S �..�C-tt �t��i S E't_i" /�'ki+� ' JAIP CHAMBER:� (locate on site plan) • imps in working order(yes or no): lams in working order(yes or no): 3nunenis(note condition of pump chamber,condition of pumps and appurtenances,etc.): ` Page 9ofI OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - } ,t PART C Y _ �" - A N y SYSTEM INFORMATION(continued) Property Address: 010� V Owner YJQ� ' r1 Date of inspection: - -- • "` ' ` t " SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,ezcavation'not required)` If SAS not located explain why: F - }" 3 }r,4s -_ . tJ ., . .. ♦ ...� .. .. t f , ..- _, ,1. Typed leaching-pits,number.0 leaching chambers,number. leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: " innovative/alternative system Type/name of technology- Comments(note condition of soil,signs of hydraulic failure,'level of ponding,damp soil,condition of vegetation,' etc.): 1 C... Sts''L.r. V� Pkr/- c-,' Pere.,,, k j fir.,1. CESSPOOLS:Aesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: ' Depth—top of liquid to-inlet-invert. Depth of solids layer.--•-- Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): cate on plan)PRIVY!V k(Po Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,'signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of I l f OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION-FORM PART C SYSTEM INFORMATION(continued) Praperty Address: Dxs ' Owner: Date of Inspection: o Vie. SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchibarks.Locate all wells within 100 feet.Locate where public water supply enters the building. t � t3 c" 0-0= 3a"6 ' A r3: 3i 3�` A, y` d � 8_ Lt- ab. .4-57 L/V 10 Page I I Of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:a07 Ke r--9CaG,d Owner. Date.of Inspection: (di/T/�3�019 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water/ feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-if checked,date of design plan reviewed- Observed site(abutting property/observation hole within ISO feet of SAS_) Checked with local Board of Health-explain: Checked with local excavators,installers-(att_ach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: F3 , 11 LOCATION SEW" E PERMIT NO. VILLAGE I KSj A LLER'S NAME & ADDRESS _,.� ; ej 1 3 _L © ` i2 BUILDER OR OWNER 1-2o7 t r DATE PERMIT ISSUED . , Zr' DATE COMPLIANCE ISSUED �, � l �3 .� !o ... � � / �'� ,�� � � _� No.._. .......... ............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® ..Qf- HEA T OF........ .. . ..- ...... - -- ----------------- �v ppliration for Disposal Works Tonstrnrtinn Pumit pp ication is hereby made for a Permit.to Co struct (401 or Repair ( ) an Individual Sewage Disposal System at- ............... - -. . ._.. .. _.. � Location- ddr s o 0 a �Kll er .9�� ........................... Installer Address �.. UType of BuildingSize Lot_____ __. .___Sq. feet Dwelling—No. of Bedrooms___-___---.............................Expansion Attic Garbage Grinder (f�Y aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------------------------------------•-••••......----------------------- �y W Design Flow............... gallons per person per day. Total daily flow___.. l�... -_ g . •--• --------g P P P Y• Y gallons. WSeptic Tank/-Liquid capacity2O!:KD..gallons Length................ Width................ Diameter..-__-_-.___.__. Depth.--__________--. x Disposal Trench—N Width...............:....Total Length.................... Total leaching area_________._ sq. ft. Seepage Pit No.___.__ _.___ Diameter_._ _ _ _ Depth belo�}' inlet.....................Total leaching area____- 2-._sq. ft. Z Other Distribution box ( ) Dosing tank ( ) <Ji®— l/_ ?�. aPercolation Test Results Performed by.^ ...................... a__ r%-_ .........I Date..-..//- -- ....... Test Pit No. 1.....0c9"__minutes per inch--- Depth of Test Pit.................... Depth to ground water____________-___- ---. rxq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ ••.a f ... ... f O Descri tion of Soil-•----=�------- -_- -,r .-- ... ............. ------ ----------- x 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is -ed by t ar lth. . �_�.u_�_� --`-------------------- --�`��'�J'- -------- Date Application APPlication Approved BY---- � - ------- --•-- -- Date Application Disapproved for the following reasons:----•--------------------------------...........................................---------- ---•-•------•_...-- ..-------- --------•-•---•- ....................................4................................................... Date PermitNo......................................................... Issued. - jl." -........... . Date .......... ...... N THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ................OF......... ........................ Application flir Disposal Works Toustrurtivit thrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at : �'I'. . : ,D, / 1;7 ----------------------- /,,, -------------------------- ---------- --- ��` Location-Address <��// o,)Lo1.No)14 )( -/�' 1A, 1�/ Owner Address.7� ................................................................................................. .................................................................................................. Installer Address M k �/ _'- '7- 1� Type of Building Size Lot..._.2....../.............Sq. feet U < Garba ge Grinder Dwelling—No. of Bedrooms-------- .............................Expansion Attic Other—'type of Buildi�ng............................... No. of persons............................ Showers Cafeteria PaOther fixtures.........................................................................................................;_7... K2-----------------------------------Design Flow..... ...............gallons per person per day. Total daily flow.........../C.-' ................gallons. P4 Septic T.ink/—Liquid capa;city&0,,0...gallons Length................ Width...._...._...__ Diameter__._.-------____ Depth----__-____-_... x Disposal Trench—No. .................... Width....._.._...__..___. Total Length................._.. Total leaching area....................sq. ft. Seepage Pit No.____. 001%....... Diameter.. inlet ............ Total leaching area.24/0.7—sq. ft. Diameter... . . ..p.. Depth Belo o in e ........ Z Other Distribution box Dosing tank ( ) .W_ //—14 Percolation Test Results Per-formed by.!n---------------------_----ai_ �41 Wt D a t e.—..&7n 5'.n 7�P-------- Test Pit No. 1....4 -__minutes per inch Depth of Test Pit-------- ----------- Depth to ground water-_----___----:::_--_-__. L%, Test Pit No. 2................minutes per inch Depth of Test Pit.______......_...... Depth to ground water..................... P4 . ................... 0 .. .... ... _Z ---;........... Description of Soil.......nt.... ....... ----------------------------k ............... 4�).... ............................ -------------..................................................................................................................................... . U .........................................................................................................................................................I------------I---------I........................ U Nature of Repairs or Alterations—Answer when applicable----------------------------------------....................................................... .............................................................................................................r----------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the.1foredescribed Individual Sewage.Disposal System in accordance with the provisions of Article X1 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the,board,of health 0 SiSi .................... ...7....................................... ................................ Dati Application Approved By--- .......... ..4441,PK.................... -7, --�4z'e4l,I Date Application Disapproved for the following reasons:................................................................................................................ ............................................................................................................................................................................... - -*-------........... - PermitNo........................................................ Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD 0 ) HEALTH 'eF ... .. . .........OF...... ........................................... (Infifiratr of Tautphattu TH�7S T T, /That the Individual Sewage Disposal System constructed or Repaired io by..... .4 . ........................e........................... 4"a=4 . ...................... ...... ------------------------------- st at---�".X_4461---- --------X ....... -------a.,_' ..................... has been installed the provisions of 411 XI of The State Sanitary Code as described in the A�f, I application for Disposal Works,.Construction Permit N .......... dated....... ------7.rq......... THE ISSUANCE OF THIS CERTIFICATE,SHAkL V!, NOT BE-�CONSTRU-9".'AS A GUARANTEE THAT THE k SYSTEM WILL F'UNCTIQN SATISFACTORY. I M I DATE---------- .......................... ........ . nspector.-A ......... ................................................... yq THE COMMONWEALTH OF MASSACHUSETTS BOARD OF,4-iEALTH ........... ........OF........... .............. 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W i ILLUSTRATION 3 I NOTE.TO BE INSTALL®DIl�LTLY 51MPSON'NDUO OR Im15 HOLD DOIVb,96f PLAN TYP. TWO STORY EXT. Cl) � Q. Qj � O SHEAR WALL 5ECTION TYPICAL FLOOR SPAN GONNECTOR INSTALLATION E7ETAILS + 5 7 xA_e yr=ry 0 L 0 Q� NN 0 - - _ job no.: ._.. date Ica . scale A0\o-0 drawn: -11_.. rev. - - rev. o S®6 o _ ISSUED FOR CONSTRUCTION I ant 15 Of 14 8 E _ � U NOTE:THIS DETAIL IS AlUO ALTERNATE TO THE Cu FLOOR SPAN rn SI - CONNECTOR"DETAIL U t SIMPSON LSU26 o L RAFTER HANGER c ` ca SHED ROOF -oms -o 2X 10/2X12 LE DGF.R m RAFTERS - - I (4)COILED STRAPS TIMBERLOK SCREWS TOP&BOT h PER CORNER e- SECURE INTO SOLID FRAMING 1 ... .I TRIPLE SPACED Q i 6'o/c s s' CORNER STUDS H F NOTE DETAIL APPLIES TO ALL 6RADE LEVEL EXT.SIEAR IULL5 I ` - • - NOTE,PETAIL APPLIES TO ALL GRADE LEVEL EXT.SFEAR YNLI.S GARAGE HOLDOWN DETAIL @ EXT. WALL 9 HOLDOWN DETAIL @ TYPICAL EXT. NALL CORNER/WALL I� COILED STRAP DETAIL II LEDGER DETAIL C `w O NOT TO SCALE O NOT TO SALE NO'TO SCALE O NOT TO SCALE ` / T = O Q H8 (2)H2.5A 1 .. .I MTS12 RAFTERS (LTS.HTS L_ _� .. SIMILAR) H10A RAFTER ` - -I ° d '� FRAME-OVER 2Y.T?,ED ER SIMPSON H3 CLIP j .I j, i HORIZONTAL 2x BLOCKING FOR 1 1 - ATTACHED WI 3-16G i0 SOLID T r I, I I I I / FR�AAtING SFLONJ I i _ C NAILING THE PLYWOOD EDGES I I - E I .i ,I II h I I J--' F: �- SHOULD BE PROVIDED WITHIN ( - LEDGER I -- II I 'I' I 4 — C 48`Of OUTSIDE CORNERS �.I - _ >IY� d I I `"` Ln • ' �- Y.=lf d II I it II-_�__ I I Cj CC) 77 R N LSTA9 I L ' L570 u 00 O PLYWOOD BLOCKING DETAIL 13 RAFTER CONNECTION DETAILS 14 FRAME-OVER LEDGER DETAIL c. NOT TO SCALE NOT TO SCALE NOT TO SCALE _ 4N FMAp N RIM JOIST s. JOIST HANGER DECK JOISTS LLIAM _ Q. �" cA � WI �� .- 7 0) , . 81S HOP u C f0 SIMPSON H1 CLIP P.T.BEAM o U En L ' (1 PER JOIST) SIMPSON BCS POST CAP - STRUCT488 L 0,� Cu V 'P On:" a�L`O e; q NO.2948 4� (Q AL- P.T.POST SIMPSON ABU POST BASE j �S a U 11in .... .. ... . .. .. ... . `: ANCHOR BOLT � o4-1 L - �U N - i- - - -- - - 10'OR 12"DIA.SONOTUBE ON _ N I 24`DIA.BIGFOOT FOOTING. Q O •, ��\ �,, O �. : j ,, ,job no ' i - data I .,.` .. -,e.: se ao5= e• • -m • - scale AS _DS. A r.N r.s a:co¢ -a. SEE AWC.ORG drawn: __ 1ALe Pea sa_ 'PRESCRIPTIVE RESDIENTIAL . rev. DECK CONSTRUCTION" 2,-0 rev. a 15 TYPICAL RIDGE STRAP DETAIL OPTIONS I6 PORCH/DECK DETAIL -7 NOT TO SCALE NOT'O SCALE O ISSUED FOR CONSTRUCTION 9ht 14 Of 14 J