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Home My WebLink About0085 SEAPUIT ROAD - Health 85 Seapuit Road _ Osterviile . F/R A = 118 119 w 1 0 y . ° a o o ° r. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Seapuit Road ' Property Address P+: Larry Gordon ='} Owner Owner's Name information is required for every Osterville Ma 02655 7-5-17 page. City/Town State Zip Code Date of Inspection sa`S 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 filling out forms A. General Information c U/�' � a�� • on the computer, use only the tab 1. Inspector: key to move your - cursor-do not Matthew Gilfoy use the return Name of Inspector key. ' B&B Excavation ran Company Name 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 - S113640 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 ❑ Needs Further Evaluation by the Local Approving Authority v 7-5-17 Y Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r ^M 85 Seapuit Road _ Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma 02655 7-5-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont. Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System was in working order at time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N,,ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name f information is required for every Osterville Ma 02655 7-5-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) r ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): t ❑ 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): . i ❑ 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 ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - M 85 Seapuit Road s Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma 02655, 7-5-17_ page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ 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., - 3. Other:. D) System Failure Criteria Applicable to All Systems: r 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 ❑ ® 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma 02655 7-5-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than`100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. . ❑ Z The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. , ti 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 11 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17. Commonwealth of Massachusetts Title 5 Official ^Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Seapuit Road- Property Address - Larry Gordon Owner Owner's Name information is Osterville Ma 02655 7-5-17 required for every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of 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 Y 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): 5 Number of bedrooms(Actual) _5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 551 gpd t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1M 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma .02655 7-5-17 page. Cityfrown State Zip Code Date of Inspection D. System Information Description: 5 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? t ❑ Yes ® No Seasonal use? y ❑ Yes ® No Water meter readings, if available last 2 ears usage d See below 9 ( Y 9 (gP )): , Detail: 2015-3,000gallons 2016-4,000gallons Sump pump? ❑ Yes ® No Last date of occupancy: 2010 Date Commercial/Industrial Flow Conditions: Type of Establishment: NA Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: — t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma 02655 7-5-17 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: DateR Other(describe below): w General Information an'o on Pumping Records: Source of information: Date of last pump unknown per realtor Was system pumped as part of the inspection? ❑ Yes E 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma 02655 7-5-17 page. City/Town State Zip Code Date of Inspection. D. System Information (cont) Approximate age of all components, date installed (if known) and source of information: 2004 Were sewage odors detected when arriving at the site? o ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2'6" feet Material of construction: ❑ cast iron ® 40 PVC . ❑ other(explain): , Distance from private water supply well or suction line. Town feet- Comments(on condition of joints;venting, evidence of leakage, etc.): Septic Tank(locate on site plan): - Depth below grade: feet Material of construction: ® concrete ❑ metal •❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑•Yes ❑ No Dimensions: 1500 gallons Sludge depth: 4 t5ins-3/13` Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 85 Seapuit Road s Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma 02655 7-5-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 32 Scum thickness 0 11 Distance from top of scum to topof outlet tee or baffle N.S Distance from bottom of scum to bottom of outlet tee or baffle NS How were dimensions determined? -, T Measured 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 was in working order at time of inspection with liquid level equal to outlet invert. Tank is not in need of pumping at this time but should be pumped every two years for maintenance. Tank also has a zabel filter that should cleaned regularly. Grease Trap (locate on site plan): NA Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 10 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is Osterville Ma 02655P 7-5-17 required for every ' page. City/Town State Zip Code Date of Inspection. D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): . Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑ concrete ❑ metal i❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: r 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - ^M 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is Osterville Ma 02655 7-5-17 required for every - page. City/Town 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 was in working order at time of inspection with no sign of past backup or 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.): NA * 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): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is required for every Osterville Ma 02655 7-5-17 page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ' ® leaching chambers number: (6) 500 gallons hi❑ 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.): Leaching was in working order at time of inspection. No high staining, damp soils or lush vegetation were present. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction h Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Sutsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is Osterville Ma 02655 7-5-17 required for every page. City/Town 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: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): l5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is Osteryille Ma 02655 7-5-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide'a view of'the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: , ® hand-sketch in the area below ❑ drawing attached separately a LEFT SIDE Al-13' BI Bl-25' A2-21 132-30'6" A3-41'6" 133-30'6" A4-40' B4-40' A5-66' t B5-48` 4 5 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is Osterville Ma 02655 7-5-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water - ❑ Check cellar ® Shallow wells Estimated depth to high ground water: No GW 120" feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 4-8-04 Date ❑ Observed site(abutting property/observation hole within 150.feet of SAS) R ❑ 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: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 'uy 85 Seapuit Road Property Address Larry Gordon Owner Owner's Name information is Osterville Ma 02655 7-5-17 required for every page. Cityrrown State ' Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems) completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file } t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IM A- , DATA TOWN OF BARNSTABLE ' CATION FIS 5��w� `�� SEWAGE # ,,�0®y"�� VILLAGE ac., — C)a�% ASSESSOR'S MAP & LOT`/8 //q'/a/ INSTALLER'S NAME&PHONE NO.� K4- SEPTIC TANK CAPACITY 15-00 G�tlr 00(zt'�%2 `T � size /1 J LEACHING FACILITY: (type) ( i ) NO.OF BEDROOMS S BUILDER OR OWNER AU-i3O G c`e o ` PERMIT DATE: 2` yr®Y COMPLIANCE DATE: Z !y Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �a- Oil �q\ a 3oTsl IWO l� r, No.C900q r FEE 1 C®MMONWE LT14 ®F MASSAC14USETTS Board of Health, 9 A Z N S'PA Z L E , MA. APPLICATION FOR DISPOSAL SYSUM CONSTRUCTION PERMIT Application for a Permit to Construct(V/Repair( ) Upgrade( ) Abandon( ) - VCmpleteSystem ❑Individual Components 16 Location t-- D O Owner's Name T r1J«t.[ Map/Parcel# A 11 1 _1 Z 1 Address C/O "1 fo Z PL.A%1,4 S-(, HAASW IC-L-10 M Lot# Telephone# -7 8 831 Installer's Name Designer's Name' Address Address 8 W TE tHAiZStjFJ-1C.LQ NA. Telephone# �+ Telephone# 1 83 4 -,8 5R I Type of Building S t N(ft L..EFA h t U a L-L rJ (, Lot Size Z 4 Bill S sq.ft. Dwelling-No.of Bedrooms .5 Garbage grinder (� Other-Type of Building No.of persons 11-') Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) �,r.� d gpd Calculated design flow -S S Design flow provided J 5 gpd Plan: Date 104 Number7 of sheets � Revision Date__ 19 1 0 4-. Title Prz000SE15 CJEwA(E DtSpostAL �La" Description of Soil(s) SEE L o fo S er1 pt_A j ' A-TT xc-t4E o0 Soil Evaluator Form No. I I Name of Soil Evaluator I�QEb,C( CNASL Date of Evaluation �d��Q.G H 2Z . 2 Dp�} DESCRIPTION OF REPAIRS OR ALTERATIONS OF fkGK4 The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with sions of d further agrees not to place a system' ration until a Certificate of Compliance has been issued by t1j, Sign Date 7—a/- O �/ C CIVIL @D®.57138 0 Inspections laTr&QUAL /GTZG�CL �.G/J,56 S� -�, ',�ts�.'i'�A'' `""y"�,9 ',z--y��y-..K!r++'v�:.-..�.,yq 7',-�h^»�. 3'v-�`'•.—�;ir�lrr .�h_••=s3a�.:.uti7tin�-.[�+.4� i`�r+'ttM+�S`"�.� • IFEE.: O XA CO f Board of Health, A S 1`\ ffES L E MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION`PERMIT J; • � �I"1� . ^ter. . Application for a Permit to Construct( RepairO Upg ade( ) A9'andonO -\Vcmplete System ❑Individual Components ok Location Owner's Name (� r g 5 S GA V 1'II O A 1� . OS'�>n Jl�«t.C {.JA �t7 �-o`��1+r.1E Map/Parcel# 1�A r j 1 a , 0_(,t L_ t 1 - 1 Z. I Address C/o -1(1 Z L.•a t r S'1' 11 A2SNFIGL.b �/ , Lot# 18 t. Telephone# -7 81) a 37 Jr \ Installer's Name �r^`�'�r Designer's Name ��CK A I OvL (nl L , Address Address 844 LJ.Las 1C-a Sit RSNFIGLD t IA Telephone# Telephone# $1 83 g _8 S 9 1 Type of Building S 1 tJ G L E. T'A s 1 I L U L- L.L 1 nl & Lot Size_!4 sq.ft. Dwelling-No.of Bedrooms, Jr Garbage grinder (i 40 Other-Type of Building No.of persons Showers( ),Cafeteria,(_) Other Fixtures Design Flow(min.required) -5-S 0 gpd Calculated design flow 5 S Design flow provided ✓�' SIr gpd *,- Plan: Date I 0 Number of sheets Revision Date 7 9 1 O Title o oS e 0 S E W A c Description of Soil(s) S F_E e 1 ,{ Soil Evaluator Form No. I I .,Name Soil'Evaluato�G42E0C1 C 4nASL Date of Evaluation r'AA_C_H 22 , 2•oo4 DESCRIPTION OF REPAIRS OR ALTERATIONS -7, The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the pr qV and further agrees not to place the system�peration until a Certificate of Compliance has been issued by the B Signed bate t—a/- Q TERENCE J. CHASE Inspections CIVIL A �OAI r� r No. ti. _�5COMMONWEAITH OF MASSAC14USETTS Board of Health, 6AA 05'TA_6L•_ MA. '. CERTIFICATE OF COMPLIANCE L� Description of Work: ❑Individual Component(s) ly'Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed Repaired ( ),Upgraded' ( ),Abandoned ( ) by: 1 at Lo'r is ( PArtcSL 115 - 113, (2,oA ) s-TG✓LVILI.t has been installed in accordance with the pro .sio "s olf 310 CMR 15.00*(Title 5) and the approved design plans/as-built plans relating to application No. Z190�'3Ns , dated /G tT Approved Design Flow (gpd) Installer Designer: STEt ssC. 1A%4. qLo✓1 INC.- Inspector: e �-'� JeA2(// . Date: /) 0 The issuance of thisypermit shall not be construed as a guarantee that the system will function as designed. No. r FEE l Gti t� COMMONWIA 114 OF MASSAC14US ETTS _- Board of Health, L7 �►J STA I�L MA. DISPOSAL SYSTEM CONSTRUCTION l�J[�� " Permission is hereby granted to; Construct( i Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at L o-r 1 0,,AC-6 LS 11 - it q 11 S- 12 I ) S ^1 9 fJ as described in the application for Disposal System Construction Permit No., dated Provided: Construction shall be completed within three years of the da oft is p Board of Health tt local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date / t' ' TOWN OF BARNSTABLE L I LOCATION I 1 - SEWAGE #.o�O®y'3 y�S P VILLAGE c ec. ^ r- �a`�% AgSESSOR'S MAP.& LOT// INSTALLER'S NAME&PHONE NO. � 4.c�1 SEPTIC TANK CAPACITY • LEACHINf FACILITY: (type- SW 641 (size) SZ NO,OF BEDROOMS S BUILDER OR OWNERQAU- rle—iocl ° PERMUDATE: y—© l COMPLIANCE DATE: •�2 (� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist Within 300 feet of leaching facility) Feet Furnished by X dS _i. hat ad 1� tea; 30�b 4 1 6 F t Town of Barnstable °FtHE T° Regulatory Services IF Thomas F. Geiler, DijetCfor BARNSTABLE, a 7 MASS. �0m Public Health Div> ,ronl 16 9. 2b rF0 Thomas McKean, Director 200 Main Street, Hyannis,VIA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 0100 Designer: I o conC Q 1 ('��,eQ Installer: P-c�ce-�_,L.Co_a s (e-r Address: �� `-i-="C'• Address: MA- C aas p — On.` 1-Lk -pry - C, o -6,Tcr was issued a permit to install a tdate) (installer) S�� Lh,(al- OJ l�R-�l(e septic system at Lo k t8 _��. llP-t`4 —�� — 0J bated on a design drawn by (address) dated �z4 -- (designer) certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. .1 certify that the septic system referenced above was installed.with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any cornpone.nt of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. . ��►OF • THENCE J. (I taAltersgnature) CML W 37136 ONA (Designer's Signature) (Affix Desigiier'stStamp Here) . PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH. DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND A.S- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THAINIK YOU. Q Flealth/Septic/Designer Certification Form No. Fee 10 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppricatiou for Migpoar *pgtem Cougtruction Permit Application for a Permit to Construct( . )Repair(i-<Upgrade( )Abandon( ) ❑Complete System D Individual Components Location Address or Lot No.8 cs E'i9 Qv-(�lF Owner's Name,Address and Tql.No. Q,�`TC^c,�t k, ��4r►�c1 12� Assessor's Map/Parcel // // Ins is Name,�1 ddress,and Tg=No. Designer's Name,Address and Tel.No. C s is-•.-.I t, `f�! 'S S�-t Type of Building: Dwelling No.of Bedrooms 2/ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Re or AVerations( Vr when appli a ) b Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue y this Bo f Health _ Signed Date J`'" '� Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued No. Fee t Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS P Yes PUBLIC HEALTH DIVISION—TOWN OF BARNSTABLE., MASSACHUSETTS r Z[pprication`for Migpoiar 6pgtem Congtruction Permit Application for a Permit to Construct( )Repair(vj'Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. S S 09?1, Owner's Name,Address and Tel.No. C)C'�--kc f'e.4j✓' Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. GS Ic (ti &(3,8 5S4r Type of Building: Dwelling No.of Bedrooms y Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i Nature of Re air or Alterations(A s%er when applicable) ZX b !� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuedyby this BorA.Of Health Signed —Date J ^C tom'G 3 Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site,_Sewage Disposal System Constructed( )Repaired (('X)Upgraded( ) Abandoned( )by I c �� t at G t 1r has been constructed in accordance with the provisions of Title 5 and thefor Disposal System Construction Permit N r -gated Installer 1� E(C,.cc-W l<<(- Designer 7 The issuance of this permit shall not be construed as a guarantee that the s tem will functionAadp- igned. Date Inspector . ———— �5f —— —————————————————————————Fee s-/_ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migogal *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair(�/)Upgrade( )Abandon( ) System located at -ScrN,2 ( P-r)(. 5�Cr i c and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constr7/t2'0 n 'ust b 7completed within three years of the date of this pet. Date:_ Approved by �� 1 TOWN OF BAMSTABLE II a�3 sa5� . � LOCATION �s ui1' 0D SEWAGE # A VILLAGE OS CVO ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK;CAPACITY LEACHING FACU-ri`Y: (type) a (size) NO.Of BEDROOMS . BUILDER,OR OWNER �h11'tGS PERN11TDATE: JUaIL , 03 COMPLIANCE DATE: Separation.Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility. Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I P q1 -1 p • • 3 a a� Cf 04A 4- 9a-g (% bid � 'T i ,33 0 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED JUN 2 6 20,03 TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 85 Sepuit Road(Pool House) ' Osterville. MA 02655 Owner's Name: James Rabb Owner's Address: 10 Possum Road Weston, MA 02493 Date of Inspection: June 11, 2003 Name of Inspector: (Please Print) James M. Ford Company Name: James M Ford Map: 118 Mailing Address: P.O. Box 49 Parcel: 119 Osterville,MA 02655-0049 Lot:2 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 Conditionally Passes Neft Further Evaluation by the Local Approving Authority Fa is Inspector's Signature: Date: June 19;2003 The system inspector shall su it a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of compl ing 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. 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.' Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM_ INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 85 Sepuit Road(Pool House) Osterville, MA Owner: James Rabb Date of Inspection: June 11, 2003 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 i 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 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 85 Seyuit Road(Pool House) Osterville, AM Owner: James Rabb Date of Inspection: June 11, 2003 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. Y)System will fail unless the Board of Health(and Public Water Supplier,if an 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 85 Sepuit Road(Pool House) Osterville, MA Owner: James Rabb Date of Inspection: June 11, 2003 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 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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 he 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 1'd• 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 I "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 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 85 Sepuit Road(Pool House) Osterville, MA Owner: James Rabb Date of Inspection: June 11, 2003 Check if the following have been done: You must indicate"yes"yor"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 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 bales 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: 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 Page 6 of 11 OFFICIAL INSPECTION FORM -NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 85 Sepuit Road(Pool House) Osterville, AM Owner: James Rabb Date of Inspection: —June 11, 2003_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): None DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Na Number of current residents: 0 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: This is a pool house system(1 toilet&sink) 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: None on file-per treatment plant 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 4 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: Apr. 3179-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road(Pool House) Osterville, AM Owner: James Rabb Date of Inspection: June 11, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 30" 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: 0" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 9" Distance from bottom of scum to bottom of outlet tee or baffle: 14" How were dimensions determined: Measuring stick 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 of leakage. A riser was installed on the outlet cover(3"below grade) 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 baffler Distance from bottom of scum to bottom,of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road(Pool House) Osterville, AM Owner: James Rabb Date of Inspection: June 11, 2003 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: allons/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 No solids were present 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.): I 8 Page 9 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road(Pool House) Osterville, AM Owner: James Rabb Date of Inspection: June 11, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 -6'x 6'(1000 gal.) 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.): The pit was dry and clean No scum line was present The bottom to grade was 86". A riser was installed on the cover(3"below grade.) CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 • Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road(Pool House) Osterville, AM Owner: James Rabb Date of Inspection: June 11, 2003 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. f Ub Ham- p� 1 B a ! 13 117 y �3 3s 10 • Page 11 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road(Pool House) Osterville, AM Owner: James Rabb Date of Inspection: June 11, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30 +1- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: ✓ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately 30'+/-to ground water at this site This report has been prepared and the system inspected and passed 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 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL'PROTECTION RECEIVED JUN 2 .6 2p03 TOWN OF BARNSTABLE TITLES HEALTH DEPT. OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 85 Sepuit Road �P I Osterville, MA 02655 �j� Owner's Name: James Rabb °ZD O Owner's Address: Date of Inspection: May 10, 2003 Name of Inspector:(Please Print) James M. Ford Company Name: James M. Ford Map: 118 Mailing Address: P.O. Box 49 Parcel. 119 Osterville,MA 02655-0049 Lot.2 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 ✓ Conditionally Passes Nlftds Further Evaluation by the Local Approving Authority ai Inspector's Signature: Date: May 12, 2003 The system inspector shall su it 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. 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. Title 5 Inspection Form 6/15/2000 page 1 • Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 85 Sepuit Road Osterville, M4 Owner: James Rabb Date of Inspection: May 10, 2003 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 CNM 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: i 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 *The garage has a bedroom and bathroom above. .The bathroom was piped to the overflow cesspool. It needs to be piped to the septic tank 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 f Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART A CERTIFICATION (continued) I Property Address: 85 Sepuit Road Osterville, MA Owner: James Rabb Date of Inspection: May 10, 2003 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 m 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 i 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 apublic 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 Gom 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: 3 • Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 85 Sepuit Road Osterville, MA Owner: James Rabb Date of Inspection: May 10, 2003 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 '/z 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 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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"nor 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 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 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 85 Sepuit Road Osterville, AM Owner: James Rabb Date of Inspection: May 10, 2003 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 ? n/a 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 .9 ✓ 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: 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 Page 6 of I 1 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 85 Sepuit Road Osterville,MA Owner: James Rabb Date of Inspection: May 10, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4. DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 Number of current residents: 0 Does residence have a garbage grinder(yes or no): n/a 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)): 2001-202,000 jzals.;2002-189,000 gals. Sump Pump(yes or no): No Last date of occupancy: Unknown CONMIERCIAL/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: Was system pumped as part of the inspection(yes or no): . No If yes,volume pumped: Qallons--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: Unknown Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road Osterville, MA Owner: James Rabb . Date of Inspection: May 10, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Approx. 30" Materials of construction: ✓ cast iron 40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ -(locate on site plan) Depth below grade: 20" 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: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 8" Distance from top of scum to top of outlet tee or baffle: -- Distance from bottom of scum to bottom of outlet tee or baffle: -- How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee,or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Baffles were present. The liquid level was even with the outlet invert. There were no signs of leakage. Recommend pumping. 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 scam to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: . Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road Osterville, MA Owner: James Rabb Date of Inspection: May 10, 2003 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: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: 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.): i 8 r Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road Osterville. MA Owner: James Rabb Date of Inspection: May 10, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: ✓ overflow cesspool,number: 2 overflows 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.): One overflow 03)was 5'W x 6'T x 9'bottom to--rade and was dry. The cover was 16"below garade The other overflow(#4) was 5'W x 5'T x 9'bottom to Qrade and was dry. There were no sign of failure The cover was to jzrade CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Seyuit Road Osterville, MA Owner: James Rabb Date of Inspection: May 10, 2003 Map: 118 Parcel: 119 SKETCH OF SEWAGE DISPOSAL SYSTEM Lot.2. 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. A t A Q a .b 30 s�d� 3 30 -fl3 1300 y 3 a /.ems. rrro,h GAr 49e. w-t 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 85 Sepuit Road Osterville, MA Owner: James Rabb Date of Inspection: May 10, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30' +/- 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 mast describe how you established the high ground water elevation: Using the Barnstable topographic map and the Came Cod Commission water contours map,the maps were shomw approximately 30'+/-to ground water at this site. This report has been prepared and the system inspected and conditionally passed 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 LOCATION S E W A G PERMIT NO. MV If Il IAGE INST LLER'S N E & ADDRESS ic B�tl,eft ` OR AN, ER DATE PER IT ISSUED DAT E COMPLIANCE ISSUED y . ? 177 ,.. ,� � _ �� t� �� i � V � 0 �� 'J � t �- y -- J No......./-—5..... THE COMMONWEALTH OF MASSACHUSETTS OAR® CIF HEALTH �....OF............ . ... . .0/. .................................................. Appliratinn -for Di,q uiitt1 Works Towitrurtion Vrrtuft Application is hereby made for a Permit to Construct (:: ) or Repair ( ) an Individual Sewage Disposal System at: .....�85---Seapuit_Road.....Osterville-----•----- ................................................................................................ Location-Address or Lot No. ....... rving--Rabb.....-------••--------------------------------------------- 85_Seapuit_-Road.----Ostervi Ro.a.d.-0s-t-e.rv.i.1.1e............... Owner Address a Alfred Fuller Cotuit_..Road. -Marstons Mills Installer Address d Type of Building Size Lot------3....acmes---Sq. feet U Dwelling 'No. of Bedrooms---------------_----------------------------Expansion A - tic ( )--------- Showers Garbage Grinder ( ) a, Other=` _Type of Building POO.1-_-HOUS2No. of persons._.___. - -- (1 ) — Cafeteria ( ) -Sink p' Other fixtures ' -_&...£lush_-_--_-__--._ _ . WDesign Flow......................� -.._...:_.. .--_ Mons per person per day. Total daily flow.............. _-.--- -.-..gallons. 0 Septic Tank Liquid capacity__ - -----gallons Length---------------- Width-.-. ---------- Diameter--.------------- Depth---------------- W Disposal Trench—No. .................... Width._.... ....---_-_.. Total Length...-.-_.-- Total leaching area.--.-.-._.-_----_---sq. ft. x d� - ...... Total leaching area --. Seepage Pit No..---.___-__�:--_-_ Diameter___ ____ ______ Depth below inlet.::.. a < �d---�.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) /r CZ p �] Percolation Test Results Performed by-----.—.._._._.....-�.... . ..:.. .. .......................... Date... .-'._d-_�"__�..n�. .. Test Pit No. 1--- _._--mutes per Inch Depth of Test it.................... Depth to ground water.--------------._..-._.. LL, Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------- p J� De th to ground water________....... __ __ 10 f. _ J� j� Description of Soil----------- `� .. ` ----- --- ----------------- UU ...................................... - - - --- -------------------------............................................................... ---------------------- 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 NI 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. i ned------- -------- - - --- .................................................. ................................ �A Date Application Approved By------ - -------------------- --------- f Date Application Disapproved for the following reasons-----------------------------------------------•-- ------------------------------..----------------------------- ---------------------------•--...---------•------------------•.....-•---------------••-•------•---------------•--•-•-----------...-•-•------------•-•-----••---------------------...............-••----- �Q Date PermitNo..................................-•-------------------- Issued-----7....`... �.(......---........---••--•-- Date a . --- No��......1 ...... Fss........ .........- THE COMMONWEALTH OF MASSACHUSETTSz. ,BOARD HEALTH G ......OF....... .... . . ................................. .................. �. Appliratiott -for Diapatittl Workii Tonstrurtion Vrrutit Application is hereby made for a Permit to Construct (9ir ) or Repair ( ) an Individual Sewage Disposal System at: ......185....Seapuit__Road,_.Osterville............ _________________ Location-Address or Lot No. ry ng-.ptQb ... 185__.aeapult...�tQac.s.... atex�ril e---------...---- Owner Address " .......................e --Fuller Cotu t ROads.... ax-qt na__N11.1a----••••••-••-••-•. Installer Address d Type of Building Size Lot_.---3._aCIg9.___S feet aDwelling "No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) a Other`-Type of Building 09.1...HOU-3e No. of persons....... (1 ) Cafeteria ( )______________ Showers — Other fixtures ,,._S nk---&---flush----------------------------------- ----------------- ___-_____---_------------------------------------ W Design Flow____________________.. ______•__-_ allons per person per day. Total daily flow____________.___ allons. //__7_ -- - •- g WSeptic Tunly-Liquid capacit /il allons Length................ Width...............: Diameter---------...-... Depth---------------. x Disposal Trench—No. ..................... Width.................... Total Length.................... Total leaching area--------•-----------sq. ft. Seepage Pit No__________ _ ______ Diameter........ Depth below i let...�* Total leachingtrea._ sc ft. z Other Distribution box ( ) Dosing tank ~" Percolation Test Results Performed by._____---.--__-.-- ,�y�___________________ Date_ ..._�__* '_�_9..- Test Pit No. 1. ..... inutes per inch Depth of Te. Pit____________________ Depth to ground water-.--_---_-.---_--.--.._. f14 Test Pit No. 2................minutes per inch Depth of Test Pit................_... Depth to ground water-_-_...______ -- --- - ----4- •-••--•---- f D Description of Soil. Y--'".-- .."- :. ,".. x W U Nature of Repairs or Alterations—Answer when applicable-------..................................... . ----------------------------------------------------- ==u_----- ----_____.___-._---------------------•-:____----- ----------------------- Agreement: , The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article YI 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. ned.... •.. ---••------• -- ------------------------------------------------- Date Application Approvd BY G!! �>ff t------= •. ,, Application Disapproved for the following reasons--------------------------- = ---••-••••--------•-•••-••---D•t----•--•-----•- ..._.._...•------------------------- ------•----------------------------...-------------:..----------------------------------------------------------._...---------------------------•----- Date PermitNo......................................................... Issued.......................=................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH . .. .........OF.... ..... � r�ifir�#r rrf• f��autpli�tnrr f' �x TH I C TI That �dividual Sewage Disposal System'constructed ('"") or Repaired ( ) b , �. y Inst e at .-•••• has been installed i` accordance with the provisions of,.A I f h tate Sanitary Code as described n the �.+L`` 7 application for Dts osal Works Construction Permit No' ' �� -__....__ dated._. _ �_._ _ --__--_. oP' THE ISSUANCE OF,THIS CERTIFICATE SHALL NOT�BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--------•-----•-----------------------------------------•-------•--------z_:..: Inspector--------------------------------------------........................................ \ THE COMMONWEALTH OF MASSACHUSETTS' BOARD F HEALTH. . / [3 _� OF a� FEE. i5i1£ r - txttrttttPrnttt Perim. Sion4.SXO eby anted------ - - ------------• ---------------- - ------------...-------------- ------ to Constr ( r R�r an Individual Sew e Disposal XSt at No."� - ------ - --V" .. - / �_ i Street n y as shown on the application for Disposal Works Construction Perm/To."' erm' o..__ DATE- ""IN � ~ �`.7� &� Board of Health __...._._.. ------ •----•- FORM 1255 HOBBS-& WARREN. INC.. PUBLISHERS THE FOLLOWING IS/ARE THEBEST - IMAGES FROM POOR QUALITY ORIGINALS) DATA ��e as i ' 7 -s�P r r - - r - e .• .. 4 "�'�•Y -k�s�, f,h.wl`[ f +� .• s 'F 4 , s a v '� 9 ''& £ W+ s i �'OI`c`scl . GGa�yy t Tt�� Y.ti ` k �: e •V C C' �4� 4d ? ,,,,``"f�- S� t C- M.R..33.. t Mkt b 7""'? .x�a `' .. wdci»+..a1'• .�.. ,"" a3•....y.r..tyu-:� •pa+s (IXT �•-�. ,�q. I Es-c.+.:1'G••4•t�`I 4�C;"+'��1�`1p�/,�•'� �..g,�ppfi`q.� +�. 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' -. � famiuy vwi Pe,klearvmd by bvJ mil.mwwmm ma ' - .w,'.gvEle➢sµbu fm avvaim,im TM bmmm of Gll ' - fmwfw NmH w wUmv. eutue'. c D:Pvm N.P'vcfemr m evnumo-lbvula • ♦ C - Toe RGwc so tbw P% umuwmas A s.As I ..._ _-_' , i - • 10lf2 �. mvdawl.v NvuWaRa N<PLmm bul.vn Glfined b. ..:i.w..... --::. •-. .. _ n I.mlmimnmelfwu,I«alsa cmaWaw JedP, f - _ . � ., ? ♦. _ rawly urv14u IJin4 mdeA'Nemu SvuAan LivinP nvs. .. ___ � • ,. xI - Ne Nbfauay4vamsbral am wdliow ampm cYMm, .. 1 .. - - --—'� - _ Gmary Vlm rams n mumnval u nmlvmaly➢ ., :. •- —__ _ _ Qua ry f ano--u6 m s uflltta Ns DETAIL P mcswr♦Ivm . SEE EYEBROW DO(3'2:d 1 IZ�. P:s w wild nvU wv v hum Ow qm(o-sn4,f.N yml Tws rlGly • _-- ��, O'!llA X 95 WD.FASCIA Y d. / AHFD� 3D ARIA8Wb�lFLARED ;p SURR{ATtD TYP. _ 1 �m l j �- #SIbI E O I X FRIEZE _ 3mE DOR'ER 9('f'EXPOSED o HIGH �� ROOF` C DETAIL B,P.12 µ .kOOF FRONT ONLY----_ CA T-9 I X b AP TAIL — . LLOOD C nR_ r---e __ 2nd FIN.CLG. .. EOARCD C—' - 1 FLA DORMER I? �D - DETAIL'A' 121, ��yy I y ROO�r'� •�. S e/ SSE D66 P1 I ._ o.._/Sd/12��-r _ � _ DE?AIL9 P_I 'lY � �® I I �®� O - 1 s yb HALP-ROUND GUTTER a (�] p __ T. - • _ —.———————27R AT .FASCIA r t �. I , -.' ._..�... FLARED BO.RB4T, 'CROWN I .. m. z L `—'A MOULD ON X V FREZE �, _ FLARED .'•"'_- 7 .e .. >• _. - FLARED llh'EX D ROOF aR'7C.F -_'tea - 4 — ❑ - — ❑ ❑ 1 5/4 X 6 — '' 2 C0193SE5 - 4 r WOOD CORNER CORE EL 4' Tilll 00�RDACH 1 em _ <'— ._ -- =•!--— _ _ __ Designed—1.,Ndy for _ I'�'SPLAYED WOOD SEE FRONT ENTRANCE BRICK PANEL SEE GARA2E ELEVATIONS i. AI—RAZE BRQC W/L2HT4.2'BED DETAIL P-II GESBED 2' P-1 FOR CatTMUATICN MOULD BELOW - WOODOPaP48LE - r'1.'EdDER TOP MOULD S/d X 12 BELT COURSE . LOUVERED SHUTTERS ALIGN W/STUDY - "} �'•n W!APPLIED l%T•VIA - EXT.WOOD S UO00 RJ'D. .. POSH PIN FLOOR SUBSILL TYR. .. 4 COURSES HIGH SHUTTER HINfiE9 MTL.FLA51{MG Ep,/'O.AIT - - .. 0\\VVII VV - - ... IR:N 34LUSTRADE ' - „ NS ` ,,,, SEE COVERED R`OD. - r ` �LA PTD.GLC89iBLALK - DETAIL P-Ys SCALE:VA'1'rl'ds° - - ... _ 6RIGK ROCK - f -- .Si1t3BILLFTY.P,o - #DIM.FROM INDICATED SUBt-1OOR-TO FIN.BOFPiT - a MASCMFr OPENNGSJ - #*DIM.FT�1-I INDICATED Svh�PLOOR TO TOP PLATE. .. St7UTTER DOG TYP• + By . I Spritzmiller&Norris Inc. Ananta,GA J p.. GENERAL NOTES _ NOTE: .. 'I.DOWNSPOUTS TO BE PANTED THE 5AME ALL REd11REh1ENTB a INFORMATION REGARDMCa COLORS A6 THE EUR�WCEB OVER LLHICH - RETAIP9NG WALL S.STEPS,DECKS,TERRACE AREAS, THEY PASS. d OR ANT OTHER RELATED LANDSCAPE FEATURES - ' 2.ALL DOJJSPOIT LOCATIONS TO 6E � � t0 ME DETER•IMED BY THE LANDSCAPE ARCHITECT. TO 01'dfr additi0nalsets OT plans COORRDiNATED BY&1ILDER. SPITZMI'.LER/NORRIS,INC.ASSUMES NO LIABILITY please ca11 1$QO.75a3122 t - S.SHUTTERS TO BE MADE TO CGMFLETELY FOR ANY etrr.ESTED LANDSCAPE FEATURES, FIT WDW.OPENINGS LLWEN IN CLOSED ALL LANDSCAPE FEATURES TO BE DETEfd•1NED PER SITE `PosmcN i! - - '". , 4.TO HAW,SHUTTERS CORRECTLY.PLACE OVER WOW.SASH N CLOSED P051TION. ALL EN'NEERINCP SPECIRCATION9. LOCATE SHUTTER HINGE AND PMTIX " ARE THE FESPONSIBILITT . ' AGANBT 5HVrTER AND SURRoI¢�67, OP THE BUILDER - ' THEN CARERILLT MARK SCP V HOLE . _ LOCATIONS.REMOVE 5HJTR"TALL - - - HARDWARE ON SHUTTER AND.TH N ON - - ' SURFOAND(HINGE PIECES ARE PANTED - i W/ITEM TO WHICH THEY ARE ATTACHED. TRANSOM WINDOW LITE WIDTH'SHALL i .. _ . ( '.' .-. • `: .. „'' .♦ '. MATCH THE DOOR OR WMDOW LUTE WIDTH BELOW. R.. ... .. • s - r .. ,. " 6.ATIICCOVENEER(IP ANY)SHALL.WAVE SMOOTH SAND FIHSH: •. - - T.Fffi P DENOTES RANDALL BROS,INC.404-OW-6606. .. . a 6,ALL METAL FLASHING TO BE MN 16 oz SHEET COPPER . S.PROVIDE COPPER FLASHING"F.—ALL HORIZONTAL - j WOOD SURFACES MEET VERTICAL SURFACES •. Centennial House . #231 page 1 r Date of issue: . 10/26/99 • 114 8 CA. WOOD.TIMM=R •: _-i ANCE SUILr•W > �', to I GA w H m 1 ESK 04ACK I ' ccoKTo l e s A �,_�• " COVE/ae a ®AR KITCHEN 1— • 3 1 — '-d 2 ' -- -- — �v . PLANT I L LEDGE ` I - B a Ib'•12•' IT-@' r at'_g' I ' -PACE /njyC,f.�i1Y Q 1 , DISCLAIMER I•@• 3•_e• /;• 011 MICRO. _ GARAGE `imve xa auas,e >aven'mamnie.p,v - �'[S' '-@• t•fl' 9'- 9'-¢' / O - Tlm Wv.'�bver�m°�uW°rcmvl°.vli.°O:ax�l vrhm�w N• A•m, 4_ S. 2_S .I 0 A°cv„�,:rec a,c.•mnm ' • .. 1 96AB 4a m T, Ae I __ _ _REP.. mo Ok.. HDR.Im ' S'-'NOR 1-Y..T: I Y_ 3m CAM eup °iussm. m im cl°nfiur'14O r+s•er. �•, .. - m Cam` ___ —___ .% —_— a-I�0 m,n; eras+ uan K C\�\ ^• BRICK /ail DEL. CAB.DOO_TV/ OVEN PAN"fRY FIG. o�im01Oa davm,o-i�1u ; ;wl,`m` j LlW TTRANS.� v{c 1' - 'N d8'MASC,MIRY ////BUILrj v r'�r•mu,�b,unla mby l°a«.I P,,,nl°w°°el�w„va... E 9'-z'HD HG'. i ♦ `FIREPLAC—__ G / INSWA AS ' mne�,�r wmr,cwe.Tm Jatm,arell�O'D. 3 m q r°Le..dww :ue e.ln.oonavc B.f T'.S' 6'-B•.. �•4' " ROW maw Or- 3.56R0leJD - I•o ID 2'-4• e'-2' .#s� _ 'Im bsm.mew�mc«vau.:v.mw q'-3' BE t1EABDa I` "iG 1 nnQ Ig I 'whme d•,igomme mml . S''e' B'-0' t.3, II' HDR MGT. aV FR37C vym..c . 9'_t• I I 1 IaDu4>.1 BFRRa�L�tE I � IM r. .k 30-6 6 4206e'SF II - WTN :. ea ._ F p_ ? - epevma.4W.wIJ vaw o-«muavw u°vq,aIo.m,ld.u.selo.°aRo-mm Wa,em,;,c n,,xWv,ie, bxLyAMILY ROOM e. mr .<.vvo-rc.v IW o Ulm MGT. - I ! I n' DR N kI . /•� • e o•�� •' w+Wu9 iWv°wmm'4cv®.im.mWa on;, IqU I I Is�c I e'•@• vow.v, .°.°.,ma,,vim,v°mmv.e ' HGT. a Dlg LLS W/D3% mul- - wm er o-v�•bm o- �' aWF°m.•mlu.a m m< D BSAFI y Q Q_NAL K!TQP1EN AN ikD HGT I BUTT-JONTEDT7 MOOD CEILING "arw ateme„o�,ao eh ,. o4%VALI '� -—————— •J1•—__-- --� - ¢] ----- ---- L IZ IQ a-x ° ' (CARPET) 9 C.O. OPEN TO a /BREAKFAST I I',f,' ®g'• I _ 6 tCAp'Ei) 1 ! 9 � FLUE PRP I 14' in ! I. AeOyE 4 10 m I-, I''G I 4`-4' 3'•2• 1 .D rl•_4. 16 X 10 .I�' 8'DARM DGE M�.� i .F.P.EElpll ;1 D WJ,C� BEDROOM NCTE:REces9, cEILCG HGr. � ® WL7_ ! a° —__ iaeLE — •P vD DROPPED c @ _p rtocR FOR FLusH ° e' F��— q BAR ----------- — 'a Ic+XatD +, pO ER'__---- 0•RECE O'D.. v •II e'-li i .., FP'-BOTT 48' 4B '_a i 5'.g• I, a'1 _ lCARPETI FILE 4CE LIVING _—n—_ m 1 e ' i IeS 4 I FI.0 ooM CI '< APo•IBr 9TrdlCT_�EN'' p MASTER < ! ib LU•�9TONE i91 X 11, AIY� 0 m BATH 2_IoeO MIRROR I-leg0 i MANTEL t 3-Iz LIMESTONE! lCARFET: o m PANELED PAN'eLED NEARThI 13 (RANDOFII l' q WALK-INUDIU.BOX cLG s \Hnu®.J PANTRY I KITCHEN O ';•!a 9 a C.O.v S''6••. fTl3C Il t ! a'-re• DRE558NG I 1 &0 G q' 4 HOR T. ' ' .% 4 Ii' b'•4' I'-9' PANELED 4 4NELm PANEL -� � •I _ __ _ __ _— VU 3U - - - - 9'-S' 4'-I@' �'-' S'.4' > MULLS 4,-4 a 1'-1' PLANT LEDGE _ 4?C WuEiN>�W C`B BUILT- .NIC1iE d o m 3L DH 2a80 - INS irvl I I DOCR �iPAINTED 108 CO. p ^ m _ ti a9 UldLlB Q BNOVGR � A I I'-b' 4 H 9':6' !' a'_g• t'.g• s _� •-@• ib I I R (P„aroOnl a°s°co. ' GALLERY(RaNDOMJ d 'd UTLIItg � o a'.ro a'-4• ¢'_ a'_4• 49'-LACE EXTENDED a• - CST' ~ ry FIREPLACE .. p m p 0 I e G:O� Y BDCD - �•� ^N ^�8'-@' g'0 t 8 C.O. l LLL,,,IIp��ppp / WD.JAM DOO Ul/a' 9 SLArE HEARTIa H V7faT. I a 9UR6GWNDRON - n .. "•_ 0 m MAIL FLUSH NEA w ___ _' a B81 ��,,,ppp V�rr,�gyyypp 9'-4y1 9'•'. ! CCM C BGG.O CFFICE ------ -- r - VIl HOliving, • x g - - STUDY m a' OPEN TO I. I 0 �.. L ZobO v � _ ® . I}— B 9 Fi1R'L I Iddx Flo r O ABOVE m OPEN r S`a B'1 ry Imam 'r S-6 FLUE RANDOM 4g¢ FOYER 'r I II¢x I14 - z 48 0 m `� Dpsg la'-I@' 5'-10'I II'-I@' lL IMESTON_ .g I0'-I@" 4 .S'•@ 9 :- I- I , DOLID 9I NDR m m I I m PLANS HDW.) RAIL DINING SERd. g I m w !' L NOTE. e 4 a cO.l I s a 5 �7 ROOM r } ALL CASED OPENMSfC.O•) 9 i% _ ___ 4.WK':ED I� 4 PEEOSS7AL D 'L�7 emPO eWj CEI 6YG !,• (BRICK) t m d 8 O.' a PANELED v I,zON$p., �� I To NAVE WOOD&IRROICJD _ __ I PORTE IUr BACK BAAb,SEE —'—` -- ----- (NICHE A ,yITRONO ____ _ ! I eLEVATIONB FOR SPECIFIC 7-�'imF N VU Z¢1mSIDEB . — — ----- --- 20g0 F�L,i90R W Y CCIC4IERE By OPENINGS. LINE OF I e 0'TRANS ARV.u e'.6' Og TO ..ALINE OF .q OAK UND'eRLA 1 o a © @ S riummer&Norris Inc. - ENTABL rURE NDR HGT. E lHDWDJ BEAM ABV F S ACE I e_I 4 8L TE I 13 X 33 :n SEE P•9 I m LAU DRY a•@' FL GARAGE 2 X 4 WbOD STUD WALL AE A Tp' i'.Ih' 4. STAIR I b i 1 ® — NDR YIGT 1 n FOR CQI PLANS A4laota,CA OPEN IL ! Q 4'-0'Im 4,. -L ¢I'1 !� I B a I I$OPE�i1NG — O° --J IW 3Y1' S '? I I CF FL'OOR PLAN � BRICK VENEER PORCH voor6 w G"v 2 X a WOOD STUD WALL e•' FOR CE+L.STUD a X a WALL) BWCK R I WOOD T d TRANS.ABV t _ ro - / UPFER C By SEE NOlF'A'2 k&U.00D 3PJD WALL', '.b '. I. �"—"'GILlN'G I BRICC TREADS y - m - _ —•,� W.RJDCW PANELED a' o o p¢ I l RISERS o� TO order additional sets of lass BEAT C'e!LWG `D. 2-2 B 1 z e UU (� - Lai "OR NG Please call 1-800-735-1122 1g�57' a�L�OY� r LAN EDGWG 3a `� _ G21LMG�� . . e0 10' 'I CEILING I I CO PORCH L9 ,3 SCALE:Va'o-rd '7. i'-8'I•-ey. e-0'' '•I '¢ T''ti, HD HGT. � —-- -- ------ D3' L u{{I� f BASEMENT 1,10' TO TOP OF.FDiR WALL - ,. ^ 'a FLOOR I I SLATr L I FL FIRST BOOR:10-d`UNp: y + _ = . a� I BRICK / i SECOND FLOOR.9'-4' .- �• > y - EDG-I ^_ _ aA ®SMOKE DETECTORS AS REQA. 'A',209 OVAL a H'.@'NDR NGT. •• •'B' im'BASE DIA.NDR FICoT.' " . . .BRICK AD / WOOD COLtB`1N'. - bd1ARF FOOTAGE. d Rio (PROVIDE 9TRUCT. - - POST M CENTER j AS REQA.FOR " BAST FLOOR,AREAL,I%I bF. _ SUPPORT) Centennial yg FIRST BOOR,3a158F. '-a a_I'i' S'.gY• 3'•SxA.' '•I'i' B'-4' e'-4 Y.e)�tQ.}IjI�Ha!10E®)Ilse 9ECONp FLOOR.IT@i 9F. 1'•S' T-3' '•II ' STUDIO ABOVE GARAGE,SIl SP; .. n _ _ �,y TOTAL,0054 9F. . #231 REFER TO ELEVATIONS FOR - t'-3" t'9• ALL LITE PATTETWS _0 A W/�'W'IN SOW DO R �—�-- '4'_B' I 13'_I• - 38 _ I page 3 LITE WIDTHS _ _ F1 6 D•@� e a ! 4 td'•a' Date of issue: 10/26/99 i mscLAlmex • .. � � , . i c_.l s.ro...onwu,,.oam vtn.p„�t�tn�.��a,rve. �au 1 T 1 . 'LMF OOR • J - - - - - - ; BELOW 1 •rr le'a�h,Puebmv JUWd ruLY JI 1 • .. - � ¢• '1 .. d aaorvv iu,he Ylm rvW a1.wW,.bd 1 *. Tr. mn +rvm.,a dwm.r wi u n - 1 ao hw by ww.:u ooauw �,a 1.<a,m,w,.,TM w m.r,u . - • .,.. - � '.i � I rw�oy,hm ea.,te Puavw fm+t�mtrvax nJ�iaula •. - ' � � - � • - . 1 a vaJY Ja aul9'wo6ala,.aycuv ` .. I I 48'-Ip• �. TMap�vG,w.1 Nam vx v,Je iu,a.eli nil. - �, W_2t1. S,_�. �]•-b. 6•_p. - b• 5•_Ip. nauau.,Pln,wbat' uav,evn,a..'6c. - 1 m m V i0 wn numn,,- uuwn rvmn.or, wru�woJmwl.lp, -LITE - `^2 -LITE 'a � c"v�Y or,a,�u m w wn:Pmmn !I4M m u,o • v '1 G9� a T'-4' CSM a l'•4' C:M. ,'-.4' c T' s,• w:nu.aucv 1. - I i•KrT. WC IC7.' H09 T HD W.T.- .. HD HGT, 1 tm w'Kh�,.6 6"'udt Jw,teW,o toad my an ---------------._.__ YwPuw fmu lay Para nodWN Pb'd•T.npa — J - 2tJD 9U IL I n.m.a u.oJyl.m ww.,«ooU'rvb r 2. TO BELM -------- COMPUTM CENTM (TILE)` BEDROOM'. BATE) tO 4-2`Vi o,•i6• �a a b'-B'NDwD aDR JGT. No.2 a I i Uv 3t}'rull.L9 fn 134.I119 I I •I :To CENTM p_p - ,..9•-I®' I'•p' 2`•B' S'-ip' i I - �� IL I . iT• FEQN j LINE OF RA19ED n o I _ !- 2ND SUB.1 CEiLiNG BELOW - i a 1 , FLOOR I ([ q i INEN d. \ EIL1tYs `' to \ \ \ 1 ]•]®� ]n� cAB.BATH r--�-_ `\\ �\ .. ut °O No.4 m. 2.2 ]ol'Ib' 793®FIXED BALCONY in - I I�C.O. �(TILE, O� ABOVE IN SABLE - ! O W/S15' S, in T_ 9'-6 q \. � 2'-©' 4'-t0' � 71 IPJ' S'-b- <'-4' 1 b-4' m m 1 .9' L_p'I L_______'________—___l' HDR MGT.• \ TrEI.1 M I i9 eeev � 2a4G57•r.ILT.6' � rWPW --------------- - \\` I DR FGr. --- — 1 n el¢oeae:m.iwel)ror oy�IrINEr i \\ �.. \\ \\\ ebia 1 's�PJJ 24�m ---- \\� Gaea ET, BELOW��r, \\`�\�_ \ _ ' _ _ 1 BEDROOM .o I 1,7tlS �1SAilatlVA9� ® \\\ \ T^ fl Pla d 1 - L— \\ \� \ \ BELU`U 61 19�`C.O. BUILT- 16F'z 14` � S'-0' e'-I t5'-2'. 3'-2' �-9' 4'-2' PLANS \ VAAULTED r BEDROOM ° CEILING r • \ Na3 ABOVE ___ _CEIL B24 CITE CE(ViER I:IINDGVI �._ �•—UND-rR GABLE 2Xy„yyy�ttt'9 TUPoQED �l.e'CLNG.I _____ O LM. ( __ _ /l —•�\ 4._4. HDR T. ABOVE 91 SEE P-5 EW,1TS,o IINEE GARAGE PLANS - IRFERWALL L.Y'uHlc-LLi oF0'1c-t WAL�p BATH `I WINDOW- L c�•FF CONTINUATION PLAA i� 6r 1 BELOW s< s Na 3 2aie — SEAT Spritzmiller&Norris Inc. (TILE) - m Atlanta.GA .SPEC.4/4 ( � 3 kND 4/4 l LITE s -p'NDR T. 1 4 _ I' FROM 2 8,1[3.IlR 1 y 3-] e,'-0 Fes. eUB.P_R 1 i! 2ND SUB FL WDR..9 I 2-2pS94 LITE 5�5ks i'-b" S T'-b' - L WGT.W/a LL9 i+ _J d' R.NGT. NDR T. W.T. ire' rR - aT" -- — __ _— DONS CA IL b VORM a TNIB 1 DO�'tER :+I LD f 'fo order additional sets of pinns BE BUILT d T E ED I please call 1-800.755-1122 . ' 0 I' b'_,•. I-I9' 4'-9 A'-9 1 ,'-6 V4' W-SV• B•-3 V4' - 1 L—_—_—______- 1 I L----_—_ ______,___________________,__J t SLCOND R®O �lAN . x ®STJOKE DETECTORS,AS REaD. .. . Centennial Hoarse #231 t page 4 o, Dote of issue: 10/26/99 BRICK r——————— GHII'OJE•r-} ------ •i. - I •✓ IN, ' I LINE OF TeeyNcm.rmb r>mn«pm:Vbfm complhia y�let FLOOR I rveevubN euiWa,mmam lswnu3yran�x Nn: - vamwWx.rwW umwmiiiw. q, - - • I 1 e.r«.,neewd..mslu m.u«d,r...:e«un . .. - .. r-m• I 1 .. �.�.m«ce„m,m.wuw.r�m w«.ro. ° - I .a-- •� 1 FLARED•: ,w .mow«rtn d�ma.m mro s ml. I $C`JTAND,G 4 x.»«un b°omr a nox md.,oi uP n.d nand'. 4 w ALv.METAL '• ••.- - usuw rvr mwarvatwa Tn N um of all < ^ I r I oulC a<mG Loluw Irotllne P M f SEAM PTD.G ROOF w .. •. ,. t-»... '1 - ' ejuul tmsacWaslnil uucwd'Wuv.Ldyv , ' -' _' I • - - vm4 nm bum q mla T'eL6 SouSw:,Llr vw ' ______ _____ FLARED 4 C � l � nd FLOOR, «nww,wa - STAND Im/i2 k9/Q O nRw>o+e+ave w nsa w ewc nob w. OR 6TANDLUG LI CR1d�R d I _' I c�u,a I+.v r«_r.ow. t z.BEAM FTD.GALY.�F I _ _LINE OF _ .- T I oasml r«vlww mob om I,o 1st FLOOR I - 4/12 FLARED - _ CHIMN_-T' .. - I I CCF'PEIB la/I2 - CRICKET _ . I OR 6TANDING : -,L - i 8'SAM PTD.GALV:ROOF .' — •• i I 6' I 9 CHvwEr CRICKET 1 - = oVERHANGom. - � cRlcxsT --------- ————————— ———— , Q FROM FACE OF 9RICK-FRAME KJ/R 1 ACCORDMGLY I _ �. #Q I I la/Ix I Ix - Daigaal a A",dy To. la/tl 1 i 6--12 G�Z 9TA,•JDING �(.}oxryc�pgy '6/Ix 8/12 Ia1 61DE OF— I - /�] ?EAM PYD.&4LV. ; ��4.'Il Ili . METAL ROOF . DIED DPRMER • I GARAGE PLANE FOR!. � .: 1+ 0,ROOF:CA4I� 1 PLANS 1. SpritzmWer&Norris Inc. • J *y CRICKET V AtIaom,GA I FLARED STANDING PWAM PE ' GALVINIZED OR COP'r ER - � ^� _-- `FGr"•al WOOD To order additional set,of plans [ - PRE-FABRICATED M-TAL - -- BALUSTRACE please colt 1-800455-1122 t BRICK NELLEL9 W/ - SGUF'F tt2 EAC/1 SIDE OF �� ! L'IOOD NEUEL W/ CAST.STONE COPMG PARAPET�— _ __ ____ — — PREFAB.METAL - - COPMC- • - WCOD EfAL 3TRADE OF"cN WOOD - . - - W/PREFAB,METAL BALUSTRADE- - CGPING . LL1DOD NELLEL W/ PREFAB.METAL .. ~ _ SCALE-:114*.?-N .. SINGLE PLT ROOF MEMBRANE ' ST6TEM f V='/FT.PITCH) . .. NOTES .. s 't REFER TO ALL ELEVATIONS FOR ALL PLATE 1 SOFFIT HEIGHTS- - • - 2.PRDYIDE RIDGE VENT&FOR METAL ROOFMG. Centennial p gggg S.BUILDER TO COORDINATE ALL COONW-OUT - Centennial House LOCATIONS. - ' PROVIDE 2 LAYERS B'BLDG PAPER - o ALL ROOF PITCHES @ 4A2. .rr 31 page 6 A Date of issue: -10/26/99 • 122/17 - a/11 _ r nISCLAIAIER tfM— Dateofissue;./4 X 6.FW,CLG`.� '^v BILL COTBE'IC�EN�UV COON'w,�a'^ SITS FULLY UNDER DORMEIR 1y SCREEN BAGX EOARV``g•OGEE ' NO KNEE WALL MAY S•VIAW90ARD GUTTERON :T [i:.LOW DOTa7'ER SUBSILL. /. ,,.,E p,rm,,SX WOOD KEY ,-A9CIA BO. :o CTTcN _ _1I'NIGH 8'W s TOP RB4T,S'GR HEADER HGT9.CF DOi+iL-re 19S'4. BOTTOMMOULD ON 1 FACE RAISED ly' FRIEZE BD. b ••1'-IP4'a 31DWGEXPOSEDOVR GARAGEsTUD10 suBEXT.M.DF.FPLCLG. <Vmn< ,<wrerwrnnsuv.TLa sm r<uOPENs'ego.F7777 9l It SUBTe•GARAGE , - - _ T ___ m,«m ce<ae.«TCP/CCNC, IX2W.LATTICE '0b®GAR DOORRECESSED'WOOD PANEL SCOI¢Ep TO RESc'-MBL4'O.C. W S_G.ARCH DIV.. UW RBI63,PANEL MOULD EAIrT JOINTEED BIDS.EACH WAY TRANSOM PANEL ABV.rYP.BRICK PIERS UAKi ELEVAT6QN ® �1E�A�E TRI o FU UCOD SI.4 Uv'5CA1F:1/4'e?•d' GARAGE DOOR DIM.FROM WBFLOOR TO FIN,SGArDRt.FROM SUBFLOOR TO TOP OF PLATEMMM OULD Ui'RAKN12 FASCIA BD.RBTO,3'BED 114MOULD CN i X a..FRIEZE ED.6EXPOSED FIN CLG. 3 ,r �. FIN.CLG.w. SEE 8M. CAST STONE DETAIL P-12 eHIPLA_ e y e? 3ION 2 COU.R9E9 - 1� Q �'�p/D—ro ('S12' Dmigocd:dwrvdT W QFp N- 2Do NNOT �iTUTEmSHINGLES RSTANDING SEAM FLARED _ __ 2 RSTUD 8UB FL. Ii_� `� 9TUCI0 SUS R.I04. TEA TYR aN OPEN �OPODBySpritzmiller&Noreic Inc. bt SUB OOR = AHanta,GA RAGE TOP/GONG.BRICK BELTRSE �� IGEAF'PL.IED 11' bHIGH BRICK PIERS WPROJ^cCTO 2'TYP. EACH UTAT BRICK ROWLOCK °PLATED 1 X W/FM8S - PrD.BLACK 1'0 order additionalsetsofplans :'//��pppp A r�^CC eUBSILL TTP. 2-COVE MOULD STUCCO �p p�''��y p r�� /+,�1p p� � -HUU-755-1122 4APYC+,A�#i �� BELOW COLOR TO MATCH ` .a ' �Y a .. 6i4C7f-YT ELWAT1QN ® CA�SCALE:V4VreWBRICK . WATERTABLE BD.COLOR .�, r .� SCN'E DIM.F5bDM SUBFLOOR TO FIN.SOFFIT • DIM.FROM SUBFLOOR TO FIN.SOFFIT¢#DIMFROMSUBFLOOR TO TOP OF PLATE DIM.FROM SUE:FLOOR TO TOP OF PLATEGENERAL NOTES 1.D0AINWI .IT9-TO BE PAINTED THE SAMECOLORS AS THE ellf•PACES OVER WHICHTHEYPASS.7.SHUTTERS TO BE MADE TO COMPLETELYFITUAW OPFNWGS WHEN W CLOSED POSITION.S.TO HANG SHUTTERS CORRECTLY,PLACEOVER WOW.SASH IN CLOSED POSITION.LOCATE SHUTTER HWGE AND PINTLAGAINST SHUTTER AND SURROUND. /^( p TT[[ggTHEN CAREFULLY MARK SCREW HOLE _ Centennial House LOCATIONS.REMOVE SHUR6Ti INSTALL HARDWARE ON SHUTTER AND rHEN CN%RROUND r111",22PIECES ARE PAINTED #231 W/ITEM TO WHICH THEY ARE ATTACHED. 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A Q • _ of wemrNU ro MluWnemtmullll eE W 8p. e 4' Uv WOOD FILLET. m a eP R02S,By'RAKE fro It,vhns b yw"riJ Cm ryN to buJJ aIY e"e 6'HALF-RND. MOULD ON 1 X B m"rnm ae u�(or mw,➢ee Pleta lnl ngv. GUTTeR ON I X 8 � FASCIA 80. - w.afyrd Pmon",m eely ree m w, _ BEE CHIMNEY FASCIA BD. CAP DETAIL 18510,S'BED P-12 R941,9'CROLL1! MOULD ON I X I0 MOULD ON I X I0 COPPER FLASH. PRIEM CIO/12 4/12 FRIEZE'BD.lit R=QUIRED. EXPOSED FIN . .CLG I. _ -- _ _ _ _ ___ _ _- __ '.M.FLASK 4 COTE _ .. . �'e I' • S/4 X 6 /4 X< _ .62 MAX PITCH ��--BCR°EN BACKINU }' 1UOOD SURROUND ® IO B g. - 'XTENDED I-� EOf:'INER + -I. V EXTENDED WOOD SILL 60AfdJ a WOOD - _ '<. i. ILL. I t _ 0 O 9y.X 9B WOOD CURVED COPPER TA _ _ - m N OCK='RdCK£!'0 PAINTED SWEET METAL x D-. E i - -9TANONG'BEAM ROOF ' 21d SUB FLOOR IrM BIIB _ ® _- . SEE P.e - r. FOR CONT. - ARAra ❑ ❑ ❑ ❑ ❑ -- _ EXPENDED SUBSIL . BEDMOW-D Imi y AL w ff 3v, I lat SJB F!OCR ":.I —— _Lbt SUB BOOR < I IfP _ ES IT.TOP1110,UA4LL Desigocd cxdurlvdy fur s FAMILY ROOft --- - - _ SIB FLOOR _ -= /• -- — ---——— - PN.CLG..' - iYW�3ai/ll 8LL - RECESSED WOOL PANEL __- W/R5160,PANEL MOULD 15FNCK TRICK BELT COLLRSE SPLAYED 2 X.W/T2B85, ® ® ® ® I--y—I T ® ® yPL9 , . RdULCC1: 4b4 HIGH 2-COVE MOULD ON I X a I py II �—ILJj - '� 8'BFdCK JACK ARCH SUBSILL FROJECTS P4-TYP. WATERTABLE BOARD W/9LAYED BRICK S C HIGH RAISED e4' IR ACALSTRAGAL- HEADER COURSE COPPER FLASH I 7 MT.WALL rh�2+.��p,4pp y9 q-r7 rip - AS REQ'D . - YYIC/'4§O LIL�TC®Y�l V \ _ .F • a --SCALE:114W.D° _ __ BBMT.TOP/SLAB •By DM FROM INDIcaTED BUDFLOOR To FIN 8GFF1T ———— SpritzmilWer&Norris Inc, Atlmlt➢GA 1 00 TO TOP OF PLATE o � ' i+l DIM.FF2'.R'1 Itm CATEp S4t>?L R A WALL GENERAL NOTES • - - I.DOURISF'OUTS TO BE PAINTED THE GAME ALL REQUIREMENTS r NATION REGARDING T.➢rder addUional sets➢f plans COLORS AS THE W4ZFACES OVER WHICH RETANING WALLS.STEPS.DECKS,TERRACE AREAS, ' ` THEY PASS. a OR ANY OTHER RELATED LANDSCAPE FEATURES .. Pkas➢call 1-800-755-1122 _ - `' ALL DOW45PCU!LOCATIONS TO BE TO BE DETERMINED BY THE LANDSCAPE ARCHITECT. _ • t COORDINATED BY.BUILDER - SPITZMILLFR 4 NORRIS,INC.ASEUME9 NO LIABILITY _ 3.SHUTTERS TO BE MADE TO COMP(:ET£LY _ FOR AN'f SUGGESTED LANDSCAPE FEATU"�cEB, - r PIT WDU OFENNY'S WHEN IN CLOSED ALL.LA 40SCAPE FEATU�9 TO BE DETERMINED PER SITE _ 4:TO HANG SHUTTER6 CORSIECTLY,PLACE NOS TEE, OAR UOW SASH IN CLOSED POSITION, ALL ENGNEERING SPECGICATIONB - - LOCATE SHUTTER HINGE AND PNTLE - ARE THE RESFONSIBILITY' - w' AGAINST SHUTTER AND SURROUND. OF THE BUILDER- THEN - CAREIVLLY MARtC SCREW HOLE . - LOCATIONS.REMOVE SRPITER INSTALL HARDWARE ON SHUTTER AND THEN ON r . SURROUND(H!NGE PIECES ARE PANTED f W/ITEM TO WHICH THEY ARE ATTACHED. I v 5.TRANSOM WINDOW LITE WIDTH SHALL - MATCH THE DOOR.OR WNDOW LITE WIDTH,BELOW. " " e.STUCCO VENEER'OF ANY)BNALL HAVE SMOOTH SAND FINISH. 1,RB"DENOTES RANDALL BROS,INC.404-092-6666 e , 7f1T S.ALL METAL PLASHING TO BE MIN. as.SHEET COPPER _ - Centennial House 9.PROVIDE COPPER PLASHING WHERE ALL HO;WONTAL - - .�SJJ,,•�U q l� WOOD SURFACES MEET VERTICAL&WAGES - #231 $Ti page 9 Date of issue: 10/26/99 • k DISCLAIMER . • .. Tm PaRM1+,n wmi,dam b wiv'+31e laa tta:tllace, ' - "' w;mm ba ewwm¢mew mtlr.ww;,m wrnmdw - - baurcWY+A:yrctlmxaomrmdaa esm.i:emNl:'vyc ' am Nx+....YmcW mwu4.M,kKN meJ:hnv w ' - - cnaiwn mY'wrmc Jra.mnima. f - - _� R , � Jwmuphty¢rmwNS A`uwla me smvao:K.al5e11 . @ own mm�:.ewm NwB�bnw. B ex wmm.,w,mamo,mo vanm.n,!,,,au.aay ou 10 ROOFING SHINGLES W/IS•6LDa PAPER . - ROOF 2'PLYwD.DECKH't a rm anw a®, u:.:tlm wA mIM1P aon m a s awn or ml wwam,'.. - . RAFTERS 2 X 4 OUTRIGGERS®EA.RAFTER .. AOJnaa NwIA e.wotl orlon fewmu Balge' 'W 6'11,RCUND GUTTER_ .....ww.nw aa:W F:m—v v kwlegmwe I x 8 L ED T 'PLATE-I x 4 Ft. _ -he voxm,n or ua o daw vmmamoa,ml a,e. aeav+uww®mlmw,sn,m muw a QNEE WALL: _ CONT.2'SCREEN SOFFIT Ir :wam bvl,eemMubo>.Jaa¢a . - + - evaN,ad]uJdep•xxka Nahn- . _ g4'S PLYWOOD M1 Swwm mr R- MIN. awl iebvm m m�m,wae;�a axboa.,<w. _ - .. ,. • - 7 X 17 .1.S'CRCUPI MOULD _ Tnl�e m,eAvb«wmwonJ m Jac - / X 10 FRIEZE SO,IVa E ARfc9 XFO . TM F laser- Im tel m m11A oJY cue t. .. . -.. ,. �ya,GYP.9D. SEE ROOF PLAN,P.16 q ammo o�a�:w.w+ema:,ovr-�tl b o FIN.CLG'J - ° \ FIN.FLOOR "T.. - S'ROUND GUTTER - 54'SHEATHING - RS 25,$!a'RAKE - - 's4'SU15FLOO7 PLYWOOD T 4�C ' X 8 FASCIA BD " ONT.2'SCREEN SOFFIT VENT - ENGINEERED WOOD J015T9 . - "I EXT.PLYWOOD SOFFIT 2-2X4 WALL PL. 1 I . FM.CLG 41.S'CROUN MOULD • ._. d- . 2 X CL J ST5 .( I 10 FRIEZE SD,Tlt'EXPOSED - . VARIES RR OUT W/IX4'S - 3l,BATT U100D SHINGLE INSUL. 51DING , _ R-14 MIN, • - . R SEE ROOF PLAN FOR DIM,Pb - . - - - FIN.FLOOR 2 X 4 SOLE PLATE-P.T. D"Ig¶ynn�M exeLni�ve Y J �73 ra,. �N�REO.O • �YiLL86a l�1�I5 llalA TYPICAL CORNICE PROFILE let 5uI3cLOOR '4' LYWOOD T 4 f�LAS • " - SCAIE:T•nr+a Y-0° _ tec F yl$H IN.FLOOR - L Y3—' ENGINEERED 1000D J0;5T9 '•: `. ."r - - 2 X S P.T. Y PATE,ANCHOR - O CONC. - SSMT.WALL I t X M WOOD WATERTABLE BD. • - - BRICK VENEER .;• ,Ww �' .. NOTE .. By, PROVIDE VAPOR . 'CARRIER+ ALL ,CONDITIONED spritzinilier& 'orris Inc. . • - - rs - _ - SPACES Atlanta,GA 4•CONC.SLAB r - 6 X 6 10/l0 W1UM. . - OR FI.BeR.CONC. PIPc FDN. . DRAIN IN VEL BED' w , to order additional sets ofI Bans CONC.FOOTING. Please call 14100-755-1122 .q. A'GRAVEL BED ON ,. COMPACTED FILL REINF AS REOb - TYPICAL WALL SECTION scue:Ve n Yv' " Centennial House. 4231 page 10 Date of issue: 10/26/99 I 514 x'FILLET CAP ON MOU 9' BED MOULD I 51,5-13CA I ' O �11 ON A BEADED .. IXS 11 .- rT, PURCHASED INC MOO DE AREA NIS=1UDES . dr ABOVE THE . _Cr MOULD(A9 BHOWS4), \ THEN THE BUILDER MUST I REM^Jve N2=4THE,.UNTILL DISCLAI ER O'LYJ J WIDE NECKING SHOWS UNDER Tarxamcw auw Emz� .' 514 X 4 TURNED THE CAPITAL.e0ME OF THIS , BOX LINED V - - 0'D!A. "'^I I W w'"t<ae3 and rormn me SIDEWAT'S NEC,aIG WILL N'?ED TO �_ b Jv Jlo xwnvnoun acL J TO RELIEVE 7-S°S•'bOOR& REMAIN TO BE N9ERTEED /-.GALVANIZED SHEET'METAL y�D, 'rs<wne��<+h v.a<maa elm.hca ) I I Igt CHOIGE� ' _ NO RB 29. BED MOULD INTO THE CAPITAL,BUT �SS-stv 9y'RAK' I iVALNUT O WOG.ANr my w WILL SHON.- 7 x IOb RAKE ON / 'p\ h EudJ rou Nm+,m ax...mn ry4 *21 STAIN IOUT.PAINT IN. - I X S RAKE 5D. ,b• a. i X 0 FASCIA awaamE and upon E my amUmx yr Ic<v..n m• BRAS$OUT. PAINT IK - ND OVERHANG o<rm wmina mo a+=.'arm<mtltuuvE I a'MUNTN BARS - \ ^ e<tlMi p'mlmv<xuw R+JYeII it I X 4 WOOD CAP 5/4 X A " U_ly,• Cm ER BD. c.urmnna as I I Srltl G:<OIES 1t- RBS5.S'COVE v - - PAINT GRADE MOILD my mv:a u.n e,H<I:,mad< II e3'THICK KEEP THIS SUBTRACTION r a e.�.m<J a+lenl sv I<onL vvas me ' I BRASS THREBFIOLD IN Ml":)WHEN SPEGIFTINIS _ _ m my ww.sEmsv.nE ti'�viao HEIGHT! 'COLUMN ,DRIP 'PA•MUNTIN BARS _ 7 x A`e v J�e� ux wi wvv,«m mvvN . . I WHEN ORDERING.' B ➢ m a axb I I I a k @ l9)S X S'e BRACKET vE LaRn�av,,amta end suu�aw� adty . � azaads nl,mw ws 'm4 �.. � mneeuvy<vdn N<;aro<,vvm 1 ,s..a Leo mfi�m ai.eu Glm mar 4 kb mm Ieb(or II +daE5q SlsFW m`mlxmc 4tlu�4n� RE142 PANEL a�v4 .1 man<a ilvn MOULD { w , r U .Pv<m m �. . ppp�q A'\NIGIn Tm Pv.loax wl Jm,.w m emw RFCEBBED I�Ol1ND C''C3_II _9,Ilc' WINDOW �C.ZX ® CC END Ia®A�LD iW h wl pucpam<a y d�a • I .PANEL SCAU 314'vR9° - SCALE:1'I!1°E'RO" SCAtE:1 T/Z"m'P4Y <men I � ENTRY DOOR D TAIL A�rL C:F GABLE a R ' ____________r____ _-__-______�. .' /'CFI ARED._f. FLARED 5TANOING SEAM COPPER OR PANTED GALV. - METAL ROOFING IV I - - _ SOFFIT OPEN Designed exclusively for , ,D T,•SX p(((ty��*p /ry��Rvryagy((r�.p44ryggg�rTTT�ppp'y��1pI - .. 3 ,- END BI D. _ 9'y' �9 s`lY thel L7lidLLi Y1 LL� lA1OER51DE OF 0X8 I I I I { :C 4'V GROOVE v WOOD RIDGE BEAM K I - EA BIDE FLARED _I `t •- FM SS-9Mj'RAKE SEAM io 9 � Tt CO- AS ( �I„ I J WOOD aSPLATED ON Df8 FASCIA BD. - I F P. H. LPLiNrW I' ILI ""VrD RSIDE _ E;L �J - - IfH SEE RALL. - - AFiC BEAM -- - BOXED IN 1 i� -•�. DEFT.,P.IS I REQ'D 'I ` h5ib IDG Uy•- 4•.. N' �.a �G WOOD TaG RECESSED CEILING B MAX 7/a J - _ Te FLR Spritzmiller&Norris Inc. - PITCH COPPER - ¢ram (fig �"9'�ppp FLASHINNG- /.COPPER I \ Ii DGE P®ST I?Fl f`itl0. AUanta,GA r / FLASH.r9Q'D. - I 1x 'D `%I <'PIN.CLG. CIE:1y?O« : 1 X e FASCIA BD. - �- 0 T 6 'RIND. I . G MATCH — ON ,®.-• - To order additional sets oY plane ' - C-`—'O! IVt'rILLET CAP ' L n L please calf 1-800-7>5-1122 DIAMETER ON RB41,B' ` _ - ` 'GROIN MOULD 9 n AIR SPACE i ON A BEADED GSN IRS 10-I s I VIE t I 1 X IO P100D W/ I . - Gl0 •d REV.O - ly,� �O Ca" I I. ll4'EXPOSED I I I--s, i I 1 CONT,PTD,GALV:MTL, CONT,CLEAT O STRUPOSTCT'L I D R I i V - R COPING FLASH. ROUND COL. SICE,UA,'vl�� I I A T'te I A TRIGAL ,� 3N' 9 P'f.WOOD 1 X 4 WD.WALL a 3 TO REC.EVE PARAPET WA n rt IG'BASE 9 CROWN MOULD I IDI V I I I y, _ 0 COPING_ Ilia. I•a• i�• I O COLUI•N5 °j UU TUSCAN -I I - BEDMOULD SH=ATHING W/ m CAP a BASE _ - .4 I I IS'SLOG. 0 PLAN SHAFT LINE CF r"`OPFTb'EXs.MDIO. PAPER .WALL a 87AIR r-CE_SED MATCH HARTMAN BANDEF'.S SPED HALL BETOidD I r PTD.GAL,.MTL 800-741-4WB I E D IL { I L >4-COVE SCUPPER 6' ! /4' I WIMH x e• PLINTH ' - I I_4 I WIDE CLEAR ... I i SLOPE. I > _ ^STD 1B FLR I X 4^"Z�.. F��REG'D. FMI - - aTE PITC11� Centennial House NOSING �4'ExPOBED 'Q¶ t, FI'.OFIL MATCH THRB}wl '-- Z.S A - ENTABLATURE WDTN ' FRONT E��^�� E�I®a1 .. BRIC!AD5 W) -.—BRICK dBUTMENT . s( — AV I NOSING PROFILE I E� PAMPET WALL SECTION page 11 5CA1E"' � ® FRONT- ENTRANCE GABLE DIM.FROM Tat SUBPLOOR TO PIK SOFFIT DIM.FROM Iet SUE3FLCOR TO TOP OF PLATE SCALE:iEP•D' FRONT ENTktAf�`CAD - AIL a - • SCALE:vrm'4r w ®xteoiissue: 10/26/99 . S D@•L FROM UIDICATED SUSKOOR TO FP!SOFFIT - - aM.FROM INDICATED BUEFLGOR TO TOP OF PLATE _ . 30.0f PROVIDE ACCESS TO WITHIN 6" OF FINAL GRADE ALL PIPING TO BE 4" DIA. SCHEDULE 40 PVC UNLESS NOTED ZONING \ O o UPPER=39.30 31.Q+ ZONE: RF- 1 •.� LOWER=31.80 14) a � �S.Of 28.Ot 25.3 � �'� MINIMUM YARD SETBACKS: ' � ti o FRONT: 30' SIDE_: 15' REAR: 1 ti o oM,`Q; C -- GRADE TO DRAIN m= __ SEAPUIT RD v ?; O r a� ;, - -- DESIGN CRITERIA - �, z --- 0----M�N � � M S=0.01 MIN n coo :i p o om 0 0 0 10' MIN. �� THE LEACHING SYSTEM SHOWN ON THIS PLAN HAS BEEN DESIGNED Q `�~� ci3 Qo X 'ro CN 11, - _ IN ACCORDANCE WITH THE MASSACHUSETTS STATE ENVIRONMENTAL -� j 10' MIN. "' INLET TEE N / � n 4' x 8 LEACHING C MBERS TCODE - 310 CMR 15.00 -- TITLE 5 AND LOCAL BOARD OF HEALTH . Rt ' ZABEL FILTER 24.68 0 o RULES AND REGULATION WITH EXCEPTIONS, IF ANY, APPROVED BY � "' ww \ ON SUPPORT 9, o THE PERMIT GRANTING AUTHORITY. tr' BOTTOM 23.50 LOCUS J / - 24.51 w of FLO V COMPUTA TIONS E...•., 'b f� �, o o START 24.46 PROVIDE 1500 GALLON SEPTIC 6" CRUSHED STONE L0 END 24.46 LOCUS MAP 1• BUILDING USE: SINGLE FAM1Ly y �y 00 �; 2. NO, Of- BEDROOMS: 5 `•Q N c TANK WITH THREE COVERS PROFILE ESHGW (NO WATER TO EL. 17.7 TP-203) 3. DESIGN NO. OF PEOPLE: 10 5 OUTLET D-BOX -� NOT To SCALE - 4. DESIGN, FLOW: 550 GPD 'O l a� v� � � � 5. TOTAL DAILY FLOW: 550 GPD REMOVE .ALL UNSUITABLE MATERIAL FROM EXISTING GRADE (EL. 6. GARBA;E GRINDER: NO 26.0) TO THE BOTTOM OF THE B HORIZON DEPTH=2.5' I II _-1 I - f=1 (=11 9" MIN SEPTIC TANK CAPACITY oo KEY PLAN =ll8=-= lr� = 0% Y VENT DETAIL AND BACKFILL WITH CLEAN GRANULAR COMPACTED FILL TO _ - I_ - II - 36"' MAX. 20 o DAL DESIGN FLOW v EL. 24.3 IN ACCORDANCE WITH 310 CMR 15.255. - NOT-TO-SCALE ...... _2.5" ? x 550 GPD = 1 100 GALLONS r BACKFILL ••••••• 6 FINE STAINLESS ••••••• _ EXCAVATION VOLUME = 130t CU. YDS. •••••�•••�•• 4" (•..r F •••••• t,._,�l" USE 150� GALLON SEPTIC TANK (TITLE 5 MINIMUM' - ti STEEL SCREEN OR CAP WITH •�•�•� r .' = f Y b - P FI VOLUME 50 CU. YDS. � � A P ERC LL 0 '�16 °'° PEASTONE � SOIL ABSORPTION S�STEM , HOLES (ADJ. FOR 159 COMPACTION) ^ �fi ty may. 4 NOTE-CONTRACTOR TO VERIFY PRIOR TO CONSTRUCTION. 314 - 1 112 •5' 4' .54 °iii 1. DESIGN PERCOLATION RATE:-2 Minlln. 67 DOUBLE ASHED STONE 2. SOIL CLASS: I 24" 3. LONG TERM ACCEPTANCE RATE (LTAR): 0. 74 GPD/SF R�� T O� 1 CROSS SECTION 4. TOTAL AREA REQUIRED - LOCAL CODE: 743 S Ft. 24 $ _ Min. Lot ! 4 NOT TO SCALE 5. TOTAL AREA REQUIRED - TITLE 5: 743 Sq.Ft. q °D 7 6. LEACHING SYSTEM USED: LEACHING CHAMBERS `� '-�q• F�• r�, 7. TOTAL LEACHING AREA PROPOSED : 745 SF c� 4" s`''• ao r �' 8. TOTAL ALLOWABLE FLOW : 551 GPD . �� 3 �32 1 t3 P v C 5. 69 A cre s / � \`) 9. WATER LEVEL: NO WATER TO EL. 17. 7 TP-203 c [-or 17 N Ab= 1 1 FT x 56 FT=616 SF m A o 874955y.Ft c� O �_ �` - As=(0.96 FT)(1 1 FT+56 FT+ 1 1 FT+56 FT)-- 129 SF w Z.00 Acrr+ At=745 �f N � .� r PONCRETE ENCHMARK-LOCATED ON TOP OF Garage e - �1�, SCHEDULE OF ELEVATIONS i G.,. 9'18" "' FOUNDATION EL=39.30 g 8 r � .r. 2 - - � , PROPOSED AS-BUILT / ' -, �y. TOP OF FOUNDATION UPPER 39.30 tUv< t>t TO BE F I L L ED TOP OF FOUNDATION LOWER 31.80 M � >�Q . . / ) _491 t0 Sq.r t. ' BASEMENT FLOOR 31.80 GARAGE FLOOR 38_.80 �� { FLOWS: INVERT AT FOUNDATION 28.00 ro x n SEPTIC TANK -- INLE7 21.80 ' EXISTING SYSTEM TO BE ABANDONED 00 I 1/ _ OUTLE F ,2 7.55 ;� c� ,_ �•• IN ACCORDANCE_ WITH 310 CMR 15,354. �� f - --- -- - C` �,�s •r-.,` _. 310 CMR 15.354 REc�UIRES � U--BOX - INLET 24.68 l I OUTLET 24.51 � co � _ All TANKS, LEACH PITS AND CESSPOOLS Z Y BE PUMPED BY A LICENSED SEPTAGE ` BE31NING OF CHAMBERS 4.46 HAULER AND EXCAVATED AND REMOVED \ �f ! FROM THE SITE OR THE BOTTOM OF THE , __- END OF CNAMBERS _ 4.4 '. % ISCL7-10 TANKS SHALL BE OPENED OR RUPI"URED '~ � � 25.2 T - AND THE TANK SHALL, BE COMPLETELY CO'b O h c / ---- r7OM O c-CHAMBERS 23.50 �. FILLED WITH CLEAN COMPACTED SAND. RESIDENCE I D EI V C � �. • ; � � WATER LL'tiEL NO WATER 70 EL. 17. : 1 . 0 /5, � /J 50!AM \ --CONSTRUCTION NOTES 1. CONSTRUCT SEWAGE SYSTEM AS DESIGNED IN ACCORDANCE \ WITH THE STATE ENVIRONMENTAL CODE - TITLE 5 AND THE r RULES AND REGULATIONS OF THE LOCAL BOARD OF HEALTH.At " z d �Q �J �= ,�'r �- 2. THE SEPTIC TANK SHALL BE PROVIDED WITH PROPER INLET AND o Z CO ((,�,, - - - L LL w ^� �o , vJ OUTLET TEES. THE INLET TEE SHALL EXTEND A MINIMUM OF 10 z z E1? H , ✓ INCHES BELOW THE OUTLET FLOW' INE. THE OUTLET TEE SHALL Lli � Q m CONSIST OF A ZABEL FILTER MODEL A 100 OR APPROVED m o o �O o 0 103 . 2 ' EQUAL. Q�J�Q 30. 0 �/ - /I J. PROPOSED GRADING SHALL NOT CREATE A. NUISANCE OR � � n 3 E 15 0 0- G�, -ti, ui Q Q o 263.32' --" �. ADDITIONAL_ FLOW ONTO THE STREET OR ABUTTING PROPERTIES. '"- v�', c�"n z `� W 34' EPTI C TANK O ' w - u INSPECTION NOTES r 2 S87' 20"E D_ BOX o 150. M Itt - lL.. L IT IS T!•'E RESPONSIBILITY OF THE INSTALLING CONTRACTOR TO � o � o o \ Q -- --" _ -- �E�ER E AREA `� W�T�A NFU S �/� � NOTIFY 1 HE LOCAL BOARD OF HEALTH AND THE DESIGN � � �° N N "' "' EA v �� ENGINEER TO CONDUCT THE FOLLOWING CONSTRUCTION ^ n � ,n ,n �` IN_. cw N, v n Q� j 1. EXCAVA 'ION AND BOTTOM OF SYSTEM PRIOR TO SYSTEM 0 50 100 200 300 400 r� O INSTALL,QTIUN'. ~----- SOIL DATA -- DETAIL OF CHAMBERS VENT / 2. 5YSILM (_UMP0NEN1S INCLUDING INVEK( ELEVATIONS PKIOH 10 SCALE. 7 _ I, NOT TO SCALE , , O � BACK FILLING SYSTEM. 1 X 5 6 FIELD WITH (� 0 3. FINAL GRADING. � TP-203 ____1 L-EACH I N C CHA1�1 BERS 3.s' L --GENERAL NOTES ---------_____. 27.5 TP-204 R&R 27.2 0,. r 26.5 4 L�L- _l 8 TYP.� Loamy Sand 67/{D�on, 26.0 3.5' , - I / - - -� (_ n�QM L- 56' IwET�,4D 1. THE LOT IS LOCATED IN FLOOD ZONE C Loamy Sandi _ 42 4 5 30" -i-24.0 1 1 'x56' LEACHING FIELD WITH -- 1�� AS SHOWN ON F.I.R.M. MAP 250001 0018 D � � � •, P.R.=-2 MIN./!N. C1 6 4'x8' LEACHING CHAMBERS i -�� L � +, 60 -23.0 , DATE,.) JULY 2, 1992 Q c-m sand �, 2 T H'-RL AHL NO SURFACE WATER SUPPLY OR GRAVEL PACKED ^ Q LOCAL CODE WAIVERS �` WELLS WITHIN 400', NO TUBULAR PUBLIC WEL_I-S WITHIN 250' c-rn Sand LOCAL 151 . O TO TITLE V �� AND N0 PRIVATE POTABLE WELLS WITHIN 150' OF THE ' R_QUIRED REQUIRED � PROPOSED SANITARY SEWAGE DISPOSAL SYSTEM. ►-a REGULATION PPOFQSED W� TLANI) - U4 LLB 124" t 7.7 NONE Bottom � 3. EXCEPT AS NOTED ON PLAN' ABUTTER SEWAGE DISPOSAL_ ' No water to 724" 120" 16.5 LOCAL UPGRADE PROVISIONS 50 ' F- � SYSTEAIS COULD NO7 BE LOCATED. Bottom '^ Na water to 120" LOCAL TITLE V -- R-O�� - VVIETLAN 44 CHANG S TO EFFLUENT FLOW, GRADING OR LANDSCAPING REGULATLQN ffQUIRC UQ IRED PRO OSED �s EITHER ON-SITE OR ADJACENT TO THE SITE OR FAILING TO SOIL OBSERVATION HOLES CLI DATE: MARCH 22, 2004 NONE �'�- PROPE?LY INSPECT OR PUMP THE SEPTIC TANK MAY EFFECT EXCAVATF_D BY: DAVID MCCALLISTER -- THE P ?OPER FUNCTIONING OF THE LEACHING SYSTEM. p EVALUATED BY: TERENCE CHASE PE,SIT,SE-STENBECK & TAYLOR, INC. -- -T �- WITNESSED BY: DAVID STANTON-DEPARTMENT OF REGULATORY SERVICES MA DFP VARIANCES 5. THE O�VNLR SHALL INSPECT AND PUMP THE SEPTIC LANK LOCAL. TITLE V SCALE 1 " = 2 0' .� �< REGULATION R n RE ---- ANNUA LY.NO. bG3O � D �-. --- --- - - -- ---- 6 THE LOCUS IS LOCATED IN A WELLHI=AD PROTf_C OON OVERLAY NONE 0 10 20 40 60 80 DISTRICT. .IUb NO. 6630 F RN 0 N8 ZONE: RF- 1 ru *_ Z C MINIMUM YARD SETBACKS: jr 2 ---7 tz- .......... ? 101\1 _&Z _, Z_ FRONT. 30' SIDE. 15' REAR: 15' LQ SEAPUIT RD 17- Ln. ot .CZ1 18 ("FNFRY4 1. NOTES �2 14R 4q-i 4 0 Sqo 0 (� ,Xn LOCUS THE LOT IS LOCATED IN FLOOD ZONE C 5. 6 9 A cres AS SHOWN ON F.I.R.M. MAP 250001 0018 D LOCUS MAP CD Existing DATED JULY 2, 1992 2 Ft House Deck 7E 0 00 Deck SCHEDULE OF ELEVATIONS PROPOSED AS-BUILT TOP GE FOUNDATIOWUPPER� 39.30o TOP OF FOUNDATION LOWER 31.80 BASEMENT FLOOR 37.80 GARAGE FLOOR 38.80 Garage FLOWS: !NVERT AT FOUNDATION 1 28.00 28. 13 SEPTIC TANK - INLET 27.80 27,69 OUTLET 27,55 27.40 BENCHMARK-LOCATED ON TOP OF 1 D-BOX - INLET 24 fig 26.54 CONCRETE FOUNDATION EL=39.30 OUTLET d".4.51 26.43 BEGINNING OF CHAMBERS 21.46 25.71 END -OF CIHAMBERS. 24,46 25.72 KEY PLAN BRLAKOUT 5,2 26.38 BOTTOM OF CHAMBERS[ 2J,50 '1 24. 76 L WATER LEVEL NC WATER TO EL. 17. 7 TP-203) P RESIDENCE Lot 17 C,.4 1 87495 Sq.H. 2.00Acrcs '""�TO PROP. L/NF- TIES TO SYSTEM D B 0'X' AC 13.0 5 .1 25. CO 88. 8 ' AD 21. 1 BF 74.2 HD 30.2 33.2 E AE 41.2 BG 59.6 AF 40.0 AG 69.5 L IN 249110 Sq.Pr. 1500 CAL SI. WITH Q 5.69 AcTes ZABEL FILTER A1800 RESERVE Q5 sus h F LWHM Ch-AdK^ VENT 1I 'x56 ' FIELD WITH 00' f WETLANOS LEACHING CHAMBERS C� a a ;� o Q 263.32' S87'34 VE THE SUBSURFACE DISPOSAL SYSTEM WAS OF INSTALLED W COMPLIANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE, THE RULES AND REGULATION50F THE BOARD OF HEALTH AND THE APPROVED PLAN. Cz SCALE 1' 100' A! 0 50 100 200 300 400 C) SCALE 1 20" Job No. 6630 Registered Professional Engineer 0 10 20 40 60 80 J o h No , 6630