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HomeMy WebLinkAbout0341 STARBOARD LANE - Health 341 STARBOARD LAN , OSTERVILLE 1 No. 0 Fee U� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -'TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliLation for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ZIndividual Components Location aAd dri or No. -3 q i c��` t�`� S Owner's Name,Address,and Tel.No. oC Assessor s Map arcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. CA A- c - Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) R& �_ • C:;o "Tic'i✓ C���trr�,r Ii Jc./J�ft�e &^.,) :f 1 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 Certificate of Compliance has been issued by this Board nMealth. Signed Date /� G Application Approved by r Date Application Disapproved by Date for the following reasons Permit No. la(6 — rl "I Date Issued1XI(VI -No. �� ' �` . „ Fee Ud THE COMMONWEALTH OF MASSACHUSETTS Entered in.computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4plitation for Disposal .6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(. ) ❑Complete System Individual Components Location Addr or Lot No. 3 `_- � Owner's Name,Address,and Tel.No. �.}�{�l��p r,� � SSG�K)C�ci� L� ssesso 's ap arcel IV1 01 S S 1 G✓1 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. V0 1M 41 ,i� Type of Building: �. ,,�� ; }# Dwelling No of Bedrooms PJ 1 Lot Size sq kft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) S Other Fixtures " a Design Flow(min.required) gpd Design flow provideds--.. gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 'r f Nature of Repairs or Alterations(Answer when applicable) (L� `,mac P }p,o ��o' �j� ego p}IC �r-�n� C 1 9 rf Date last inspected: 9 Agreement: t 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 Certificate,of� Compliance has been issued by this Board ealth. 9 j Signed Date /2 / G Application Approved by r Date Application Disapproved by Date for the following reasons , I Permit No. G f G "l �� Date Issued -------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS (ee\ce, }�P o�- T"tC. BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(` ) Upgraded( ) Abandoned( )b at } # has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �/6-'00dated bA Installer�-,,7x�G S A (�� L 4C Designer #bedrooms Approved design flow r�,�" gpd The issuance of;this permi`shall not be construed as a guarantee that the system will far J, as designed. Date Z Inspector ` 1 �C ( t --------------------------------------------------------------------------------------------------------- No. �- e �(7 `�J(��r� Fee Gam— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit f C ocx t to o� ��— Permission is hereby granted to Construct( ) Repair( L, Upgrade( ) Abandon( ) System located at ?�H 1 7k C y Nno a/ L n,4 r- (7 S k--F f U 111 e r and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. j Provided:Constructio'must be completed within three years of the date of this permit. a Date /�s Approved by 3 AsBuilt Page 1 of 1 2 TOWN OF BARNSTABLE /LOCATION J� STA °►�c I r1. SEWAGE#► VILLAGE O S rt'rvt il� ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACrrY �n5� ' LEACHING FACILITY:(type} P.�s (size)f�' Lax 40 NO.OF BEDROOMS 3 np I BUILDER OR OWNER LA AM PERMTTDATE: 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 Weiland and Leaching Facility(If any wetlands exist within 300 feet of leaching faclu Feet Furnished by SQc 7r1S01CT71i► 1 A — , a gl- y� w ANAa .sa a;,. 3S A&- 4!b . (3g- a Co a 1 1 12/14/2016 http:/hssgl2hntranet/propdata/prebullt.aspx.mappar=166 08&seq �j Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments SV.,y 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. . . : • . 02655 08/21/2014 page. Cityrown State. Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may.not.be altered in any. way. Please see completeness checklist at the end of.the form. Impg outf rms A. General Information filling out forms on the computer, 7) 3 use only the tab 1 Inspector: key to move your - cursor-do not Michael T Bisienere use the return Name of Inspector key' Cape Septic Inspections IC11 Company Name 624 Old Barnstable Road Company Address Mashpee Ma. 02649 CitylTown State . Zip Code 508-280-3356 S13938 Telephone Number. License Number B. Certification 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of 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 /2014 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 InspecrF�nrface Sewage Disposal system•Page 1 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not.for Voluntary Assessments e y 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655. . 08/21/2014 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B;C,D or E./a/ways complete all of Section Q. 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: El 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. E Y ❑ N. 0 ND (Explain below): �I II lii t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for_Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osteryille Ma. 02655 08/21/20.14 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Pump Chamber pumps/alarms not operational..System will pass.with.Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.); El 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 . . .[I Y ❑ N .❑ .ND(Explain below): ❑ The system required pumping more than-4 times a year due to broken or obstructed.pipe(s). The system will pass inspection if(with approval.of the Board,of Health): broken pipe(s) are replaced ❑ Y ❑ 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 El Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 ` Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655 08/21/2014 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 aseptic tanIk and soil absorption system (SAS)and the.SAS is within 100 feet of a surface water supply.or tributary to a surface water supply. El The system has a septic tank and SAS and the SAS is within a Zone 1 of a public.water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply I well. - ❑ The system has aseptic 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: 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. 'Elclogged 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks . Owner Owner's Name information is required for every Osterville Ma. 02655. . 08/21/2014 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'. El i ® Any portion of the SAS cesspool or privy is below high ground water elevation. El Any portion of cesspool or privy is within 100 feet of a surface water,supply or El tributary to a surface water supply... : it ❑ ® 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 watersupply well. El ® 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 DER certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than S ppm, provided that no other failure criteria are triggered.A copy of the analysis - and chain of custody must be attached to this form.] The system is:a cesspool serving a facility with a design flow of 2000gpd- ❑ ® 10,000gpd. The system fails. I have determined that one or.more of the above failure criteria exist as described.in 310 CMR 15.303, therefore the system fails. The. system owner.should contact the Board of Health.to determine.what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd.to 15,000 gpd. For large systems, you must indicate either"yes':or"no"to each of the following_, in addition to the. questions in Section D., Yes. No El the system is within 400 feet of a surface drinking water supply 0 0 the system is within 200 feet of a tributary to:a surface drinking water supply- the.system is located in a nitrogen sensitive area(Interim Wellhead Protection_ Area-IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any:large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•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 SVB,r 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville. Ma. 02655. . 08/21/2014 page. City/Town State. Zip Code Date oflnspection 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 b the owner, occu ant or Board of Health ❑ P 9 ,P Y P ❑ ® 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? ® El 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 forsigns of sewage back up? ® ❑ Was the site inspected for signs of break out? Z. ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank - inspected for the condition.of the baffles or tees,material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner(and occupants.if different from owner) provided with , : information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS).on the site has beemdetermined 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): 4 Number of bed rooms.(actual):. 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): >440 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for.Voluntary Assessments: f 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma 02655 08/21L2014 II page. Cityrrown State, Zip Code Date of Inspection D. System Information Description: 4 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® .No .Is laundry on a separate sewage systern? (Include laundry system-inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑: Yes ❑ No Seasonal use? ® Yes El. No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑. Yes: ® No . Last date of occupancy: occupied Date CommerciallIndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): canons 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: Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for.Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. .02655 08/21/2014� page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information .Pumping Records: Source of information: Was system pumped as part of the inspection? 0 Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System; Septic tank,.distribution:box, soil absorption system El Single cesspool El Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach.previous inspection records, if any). E 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 l/A system by system operator under contract F� 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 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655. . 08/21/2014 page. Cityrrown State Zip Code Date oflnspection D. System Information.(cont.) Approximate age of all components,date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes Z No Building Sewer(locate on site plan): 12,1 Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC El.other.(explain):: Distance from private water supply well or suction liner feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 6, 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 E Dimensions: - Standard 1500 gallon septic lank, lit Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspectionform Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655. . 08/21/2014 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 39' < Scum thickness : . 1 ". 8" Distance from top of scum to top of outlet tee or baffle 11„ Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Field Instruments Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I recommend the septic tank be put on a maint. plan based on the future use. li Grease Trap (locate on site plan): Depth below grade: feet Material of construction: concrete ❑ metal ❑ fiberglass .❑ polyethylene.. ❑ other(explain):. Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle ' Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655 08/21/2014 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: Material of construction: ❑ concrete ❑ metal .❑_fiberglass ❑ polyethylene :. ❑ other(explain): .: Dimensions: Capacity: gallons. Design Flow.: gallons per day Alarm present: El 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not_for.Voluntary Assessments ,.' 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. . 02655 08/21/2014 page. Cityrrown 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 p Q n/a Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any - evidence of leakage into or out of box, etc.): I Pump Chamber(locate on site plan): Pumps in working) order: . El Yes El. No* Alarms in workings order: ❑: Yes ❑ No* Comments (note condition-of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order,system is a.conditional pass.. 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: Title Official te50 ca Inspection F r Form: . Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. . . 02655. 08/21/2014 page. City/Town. State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: Two ❑ 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 second leaching pit was dry at the time of the inspection and :had one plus.foot clear of stain: lines Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth-top of liquid to inlet invert Depth of solids layer Depth of.scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655 08/21/2014 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: Dimensions Depth:of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 4 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is Osterville Ma. 02655 08/21/2014 required for every page. Cityrrown 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 g - 2 = 3a � 3 = IYO Q� 2 = 3S A C (3 I Mrs•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pape 15 of 17 i ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not.for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655. . ' 08/21/2014 page. Cityrrown State. Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high groundwater 12 plus feet .feet . Please indicate all methods.used to determine the high.ground.water elevation' . ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health =explain: ❑ Checked.with local excavators, installers-(attach documentation). ❑ Accessed USGS database-explain: You must describe how you established the high groundwater elevation: augured a five foot hole in the dry leaching. 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 341 Starboard Lane Property Address Joan Marks Owner Owner's Name information is required for every Osterville Ma. 02655 08/21/2014 page. CityrFown State Zip Code Date oflnspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked, ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed . ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on.page 15 or attached in separate file 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal:System•Page 17 of 17 2 TOWN OF BARNSTABLE LOCA;TION J� STAAPG<� SEWAGE # VILLAGE 0Srtry114- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) R-rs (size)(;I Gvx 4o NO.OF BEDROOMS 3 ! (n� BUILDER OR OWNER LA i PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facili ) Feet Furnished by - e� - y7 ' �- 3a rye•. � � _ Al- yb 33- a a 3. Ff O AT- :— NFee---------- --`----- BOARD OF HEALTH TOWN OF BARNSTABLE Zipplication,forlVell Constructionpermit Application is hereb made /yOr a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: QLocation — Address Assessors Map and Parcel - --/ -------------- —-- —--— --- ---- — — ——--- --- — Ow er Address ----SCE<���1 � '�� �/l - ---- ------------------------------------------ ------- ------ ----------- ---- ----------------- Type of Building Installer — Driller � Address p � Dwelling /l�Src, y/ -� �✓- -------- Other - Type of Building---- --------------------- No. of Persons---------------------___—__--________ Type of Well----Y---� e-_-f------------ ---- Capacity ---- --— - - ----— Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.Signed L'�f - ------------- la�-- �1 date Application Approved By — r—y- date Application Disapproved for the fol wing reasons:-------------���-///------------------------—--------_------------___________—________ ------------------------------ ----------------------------------------------------------------------------------------- ''6- A date Permit No CJ---------- - --- Issued--�1_- ---� --��- --------------- � �- ..date ----------------------------- ------ ---- - - -----_- ------------------------------------------------------------------------- - BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of Compliance THIS IS TO CERTIFY, That the Individ al Well Constructed ( K-Altered ( ), or Repaired ( ) bY-------DO---s� 1I_ 1r��o.. - Installer a t-- - -SY f� -- --- --- _Q S rrr- le f -------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection I Regulation as described in the application for Well Construction Permit No. -----------------_-------Dated---------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------- - —------------------------- - -- Inspector-------------------------------------------------------------------------- 4 d V,�`aoo 0 Fee--------------=----- - BOARD OF HEALTH TOWN OF BARNSTABLE Application ifor Well Congtructionpermit Application is hereby made r a permit to Construct ( Alter ( )t or Repair ( )an individual Well at: fx Location Address Xssessors Map and Parcel Ow er Address c -✓- ------ ---------------------------------------------- - -—- -- - - Installer — Driller Address !f Type of Dwelling Building =' ------------- r j Other - Type of Building No. of Persons-----------__________—__--______ i I `( l Type of Well— ---- - E--- f - ---— -- - Capacity------------------— - - - - - —- Purpose of Well----- --����; � =�- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. E la 3 /U Signed =L �? _�i �-----�-------------- --------date f Application Approved By: ____________ — date Application Disapproved for the foll wing reasons:------------------------------------------____________—________—_________ i i s date �{ /lv� 'r Permit Now q Q v_� --— ---------- Issued — #-9 ---Q ---------— — - — - d --------------------------- ---------------------------- ti ------------------------- -------------- v.. :BOARD OP'-HEALTH f ~ . TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the�IInJdivid al^�WellConstructed ( AAltered ( ), or Repaired by �-lq S[_��-lnzj�z ' tJ -Installer l at �L�_ Sr�f� ' f.r _�Gi=—— ------ 5_-mil//tl�p-------------------- -- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ------------------------Dated----------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL �.-- SYSTEM WILL FUNCTION SATISFACTORY. i DATE- -`-----------—-------— --------------------- — -- Inspector-------------------------------------------------------------------------- --------------------------------------------------------------------------------- --------- BOARD OF HEALTH i TOWN OF BARNSTABLE Well Congtruct ion Permit No. `—'-=- Fee- — Permission is ereby granted ---- -- ---------- - - -- -—---— -- - to Construct (�), Alter ( ), or Repair ( ) an Individual Well at: Str�-- -- ��-�---------------------------=------------------ - I` as shown on the application for a Well Construction.Permit No. --------- —- -------- - Dated-— - - ---------- -------- ---------------------- /� / � l Board of Health DATE---- ----— - y ------------ i �obS - o z� \o N. a li e I 4 l V COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617)292-5500 TRUDY CORE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 341 Starboard Lane, Osterville, MA Name of Owner: William Bright Address of Owner: Same Date of Inspection: September 18, 2000 Name of Inspector: (Please Print) James M. Ford I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: James M. Ford Mailing Address: P.O. Box 49,.Osterville, MA 02655-0049 Map: 166 Telephone Number: (508)862-9400 Parcel. 108 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 inspection.' The inspection was.performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ✓ Passes / Conditionally Passes Needs Further Evaluation a Local Approving Authority ails Inspector's Signature: Date: September 19, 2000 The System Inspector shall submit l py of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the applicable,and the approving authority. s stem owner and copies sent to the buyer,if pp g Y ceP Y NOTES AND COMMENTS ' 6�. 01- ....... revised 9/2/98 Page Iof11 Printed on Recycled Paper � y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 341 Starboard Lane, Osterville, AM Owner: William Bright Date of Inspection: September 18, 2000 INSPECTION SUMMARY: Check A, B, C, or D. A. SYSTEM PASSES: ✓ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY.PASSES: One or more system components as described in the Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank,whether or not metal, is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.' The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health.- Sewage backup or breakout or high.static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection-if(with approval of the Board of Health) broken pipe(s)are replaced _ obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 341 Starboard Lane, Osterville, MA Owner: William Bright' Date of Inspection: September 18, 2000 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 the public health,safety and 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_ THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.., f 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 AND SAFETY AND THE ENVIRONMENT: The'system has a septic'tank and soil absorption system(SAS)and the SAS,is within 100 feet to a surface water supply or ±. :_ ....— .tributary to a surface water supply. _ The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS ii less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 Page 3of11 / SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 341 Starboard Lane, OsteMlle, MA Owner: William Bright Date of Inspection: September 18, 2000 D. SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: _ I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water'supply. Any portion of a.cesspool of privy is within a Zone l.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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria, volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 The owner or operator of any such system shall upgrade the system in accordance with 310.CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 341 Starboard Lane, Osterville, MA Owner: William Bright Date of Inspection: September 18, 2000 t '}4 3 : . r"i p-� • 4 4 4 Check if the following have been done: You`must indicate'either"Yes" or"No" as to each of•the following: Yes No ✓ _ Pumping information was provided by the owner,occupant,or Board of Health. ✓ _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ✓ _ As built plans have been obtained and-examined. Note if they are not•available withV/A. F` ✓ _ The facility or dwelling was inspected for signs of sewage back-up. ✓ _ The system does not receive non-sanitary or industrial waste flow. ✓ _ The site was inspected for signs of breakout. ✓ _ All system components,excluding the Soil Absorption System,have been located on the site. ✓ _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for conditions of baft7es or tees, material of construction,-dimensions,`depth'of liquid;'depth of sludge,--depth of,scum R The size and location of the Soil Absorption System on the site has been determined based on: ✓ _ Existing information. For example,Plan at B.O.H. , ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [15.302(3)(b)l ✓ _ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. • t Al" revised 9/2/98 Page 5of11 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C `SYSTEM INFORMATION Property Address: 341 Starboard Lane, Osterville, MA Owner: William Bright Date of Inspection: September 18, 2000 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom. Number of bedrooms(design): n/a Number of bedrooms(actual): 3 Total DESIGN flow n/a Number of current residents: 2 Garbage grinder(yes or no): Yes Laundry(separate system)(yes or no):No; If yes, separate inspection required Laundry system inspected(yes or no): Yes Seasonal use(yes or no): No Water meter readings, if available(last two year's usage(gpd): 1999-201,000 Qals.;1998-172,000 Qals. Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIALANDUSTRIAL: Type of establishment: Design flow: wA(Based on 15.203) Basis of design flow Grease trap present: (yes or no) Industrial Waste Holding Tank present: (yes or no) Non-sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings, if available: Last date of occupancy: OTHER: (Describe) _ Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Pumped in May 1992 May 1996&June 1999-per owner. System pumped as part of inspection(yes or no): No If yes,volume pumped: gallons Reason for pumping: TYPE OF SYSTEM ✓ Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other "PROXIMATE AGEof all components,date_installed(if known)and source of information;. New pit added in,1988-per as built card. Sewage odors detected when arriving at the site: (yes or no) No revised 9/2/98 Page 6of11 SUBSURFACE SEWAGE,,DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATIONI (continued) Property Address: 341 Starboard Lane, Osterville, MA. oi" Owner: William Bright Date of Inspection: September 18, 2000 ' BUILDING SEWER: (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting,evidence of leakage, etc.) SEPTIC TANK: ✓ 1 (locate on site plan) Depth below grade: To grade Material of construction: ✓concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age_ Is age confirmed by Certificate of Compliance_(Yes/No) Dimensions: 1500 gal. Sludge depth: 1 Distance from top of sludge to bottom of outlet tee or baffle: 30" .,--.. Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 9" Distance from bottom of scum to bottom of outlet tee or baffle: 12" How dimensions were determined: Measuring stick Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) Both tees were present The liquid level was even with the outlet invert. Scum and sludge were minimal. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlef invert,'structural integrity, evidence of leakage,etc.) % revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 341 Starboard Lane, Osterville, MA Owner: William Bright Date of Inspection: September 18, 2000 TIGHT OR HOLDING TANK: None (Tank must be pumped prior to,or at time,of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm present: Alarm level: Alarm in working order: Yes_ No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: None (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER: 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.) revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 341 Starboard Lane, Osterville,.MA, Owner: William Bright Date of Inspection: September 18, 2000 `. v., SOIL ABSORPTION SYSTEM (SAS): ✓ (locate on site plan, if possible;excavation not required, location may be approximated by non-intrusive methods) a: E . If not located,explain: Type: leaching pits, number: 2-6'x 6' leaching chambers, number: leaching galleries, number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.) The first pit(N2)was full. The liquid level was up to the outlet pipe. The bottom to grade was approximately 7'. The second pit 03), which is an overflow from the first pit, had 3'of water on the bottom. The scum line was at the same level. There were no signs of failure. The bottom to grade was approximately 8'. CESSPOOLS: None (locate on site plan) *.V`_ ' t".+tt z {"k F Ti�i .4< 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(cesspool must be pumped as part of inspection). 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.) revised 9 2 98 Page 9 of 11 SUBSURFACE SEWAGE DISPOS AL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 341 Starboard Lane, Osterville, MA _ Owner: William Bright Date of Inspection: September 18, 2000 ,,,; ,�.�� ;.r Map. 166 Parcel. 108 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) A a 3 � ► - as y- �a, 3a rz- 3s AV �o j33- alo Tr4.baai� LgAk revised 9/2/98 Page 10of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 341 Starboard Lane, Osterville, MA t> n;,,• , r ;4, Owner: William Bright Date of Inspection: September 18, 2000 NRCS Report name Soil Type Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 55 +/- Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,,observation hole,basement sump etc.) ✓ Determined from local conditions t. t ✓ Checked with local Board of Health Checked FEMA Maps Checked pumping records Check local excavators, installers ✓ Used USGS Data i Describe how you established the High Groundwater Elevation. (Must be completed) The bottom of the pit to grade was approximately 8'. Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately SS' +/-to groundwater 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. T here have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. revised 9/2-/98 Page I of I No... :. ..... Fxs... Q.r'....... THE COMMONWEALTH OF MASSACHUSETTS �--, BOA R® F �—I EALT�IH ...... . ......... .........OF...J........--...--........-..-.....------------------------------....._...._-...----- Appliration for Dhipaii al Warkii Tons rnrtinn ratfift Application is hereby made for a Permit to Construct ( ) or Repair ('//) an Individual Sewage Disposal System at: io Address o t No. .... ........... ................................. ........................ ............. _......... _ Ow er-• �1 e"/n� d ess W - -- ................. .. - ----......._. .__........... - - -•------- -------------0-------------------- ...............--•--.a Installer Address PQ UType of Buildin Size Lot............................Sq. feet Dwelling—No. of Bedrooms................................._..........Expansion Attic ( ) Garbage Grinder ( ) Other—T e,of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures -----------------------------•-- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic.Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_____________________ Width.................... Total Length..................... Total leaching area____________________sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by................ ..............•---....................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_:_____________________. G Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---------_------------ , ------------------------------------------------------------------------------------------------•------------•--------•--------------------••--_--•-- 0 Description of Soil...... x W --•--------------------•-----------------------•----------•--------------•-•-=-=------•-------------------,---------------0-- -- UNature of Repairs or Alter ns—Answer when applicable.---- --- - -•---- = ------••• . ---- • - - •---• --------------------------------•-•.--------------------------._._._.._..-•................. Agre t The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TH'I LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance.has been issutd by the board of health. Signed --- -- •--•--• ------- ---------•---•- --� -• =•-•----- Date ApplicationApproved By............................................._....-•------•-- --- -------•------•---------- Date Application Disapproved for the following reasons:................................................................................................................ ...................••-•------------•-•--..._.._.._..----------------------•-----••------•-------._..._.....---------------------------------------------------------------------------------------------- Date Permit No-----li>-:-�—1A...---•-------------------- Issued.... Date ram^ No..- ...---•-....... THE COMMONWEALTH OF MASSACHUSETTS BOARD-"OF HEALTH ; ............................................� OF.. G�................... Appliration for DispniiFal Work.5 Tonstrnrtinn Famit 0 Application is hereby made for a Permit to Construct ( ) or Repair O an Individual Sewage Disposal System at: / LocaKwn>-Address � y•— )'` f / or.Lot No. ..............•............. . . ....................... Owners j /'/ Address r .. ...-.. , ._v Zc' a w s- ......................................11P .. .� Installer Address ................................ Type of Buildin -" Size Lot.............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g --------•-------•----------- P ( )--- Cafeteria ( ) Otherfixtures -----•------------------•-----------------------------•••--•-------••----••-•-•-----•----•-----•-•----•--.....---... ----••-•-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth--.-____-___-_-. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-___-_-______-----._- (r4 Test Pit No. 2............. minutes per inch Depth of Test Pit.................... Depth to ground water........................ _---------------------------------------•--------------.....--------.....--.'---••......_............................................................ ODescription of Soil.............. ='= '-'t.U^"--------------------------------------............................................................................................. x ..................... U Nature of Repairs or Alterations—Answer when applicable._---__-1-;__._-_�.''!.�.?�'-._!_:a___a._:'.___.���___4 4 �� / ? C� -•4r •--;Z;7- -, °f-------------- /� j r` f _ ...............____�.^'.� ____._._____._.. v.......... .._�_. _____ ._.\ ---------------------------.---------------------------------------------------------------- Agreement-: ,a The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT11 5 of the State Sanitary Code—The undersigned further agrees not to place the system in9. operation until a Certificate of Compliance has been issue Eby the board of health. �,.�` Signed....................................V C,.- •-.!�,t �, •I~..-f. ,�.ua^Y'' -- ) N ,r ................................................. •-•-••- --- •---•-•-- Date ApplicationApproved By--•••..........................................................i.._...._...........-••---•-•--- ....................................... Date , Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------•--- .........•••-••••--•-•-•--••--•-•..........•-•••••--••---••--•--•-••--•-•••-----•'•-'•-•'...-•••••••-•--'...••-•----••-•-•••`•...•..............................•--...•..............Date-------------- Permit No......4q;k.= Y 6 Issued " ---------------------•-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O_lF HEALTH � t ............O F...... ....................�-^ r ' ........................................... Trrtifirtt#r ,af f omplianrr THIS IS Tb CERTIF. That/the Individual.-6A,age Disposal System constructed ( ) or Repaired ( ) s - by :... ,. ..---•-• •-- •....._...-•-----•-•-•..................................................... ! ,t � � --.•'-Installer at-----__�-.........4/ -_f-_/=- ~,_-:- t9 S .....-" --•----- •------------- ---='..............--------------------------....--------------------------•-------•------------.......------------ has been installed in ordance with the provisions of TITLE 5 of�The State Sanitary Code as described in the application for Disposal Works Construction Permit No.........S ......... dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................ 7 lo.�. _ .......................... Inspector............................... t 0...'--•-----•-----•----•--"•--•---- THE COMMONWEALTH OF MASSACHUSETTS „�_-•• BOARD OF HEALTH-,., No.. •.. FEE....ao_.... �i��rrr��al nrk� ��an��riilan r�nti� Permission is hereby granted.. - % ' .....................? to Construct ( ) or Repair , t,,) an,;Individual Se,gage Disposal System at No :? . . x-�" . E.•= '=1 .. - .y,, ` _r '-_'-"---w"---------------"_- ':.-...^�.r'4.�5`--_-- __-_'-............................ .................. ....�--".._.---__--__ _•"- . y-•!.__............. C/ Street as shown on the application for Disposal Works Construction Permit No -->_yla_- Dated.......................................... ------•------------- . -d ..----•--•----•--•-----•..........•-•--•....-•••••......- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS TOWN QF B ARNSTABLE t r LOCA`fION a�� o��-� �9vi_� SEWAGE Q ° 7 VILLAGE cJC��L-l�/I�� ,�ASSESSOR'S MAP 6z LOT INSTALLER'S NAME &PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL OR BLIC WATER BUILDER OR OWNER f.K DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: -21/f VARIANCE GRANTED: Yes No 1� LCy T IO Q 4:� _ 5EW ,i E PERMIT MO.' ic -- III S L LE S-W& E A BUILDER ' 1.1 l� AD F- Fb - all 4 No......................... YzE d.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD Of HEA .....�_tT4------ Application is hereby made for a Permit to Construct (L-,--O*r Repair an Individual Sewage Disposal System at: ------- .. _056 ............................................... ...... ------- er dress ------------------------- Type of Building Size Lot._.2.,��.. .Sq. feet Seepage rn Nu-..�n-'«-- uiao/orr---.--- Depth belo uu -_. Tv le aching ----- area "v. ". � ��� Other D�t�but�nbox / ) Dosing tank �~�����-- 1-4 Percolation Test Results Perforoze6by.......................................................................... Date---------.---' Test Pit No l.__-_zniuotcsycrinc6 Depth of Test Pit.,--___- Depth to -round watn'-------. 1:14 Test Pit No. %----------------minntcyper inch Depth of Test Pit-------------------- Depth to ground water-------- 0 Description of Soil-------------- ------------------------------ ........................................----r--' ............. ......--....`~... ---�������----------------------------------------------------- ----- --------- � U Nature of Repairs or Alterations—Answer when applicable----------------_-.-------------- � .-_--------'-----------------'_'''-------.__-'''----'-''''_---'-'----'—� Agcrro/cot: The undersigned agrees to install the afore6escribed Individual Sewage Disposal System in accordance with the provisions of Article Il of the State Sanitary Code The undersignedfurther agrees not to place the system in operation- until - Certificate- of Compliance h_ been � --- --' 4- - ------- Da /�on�u6nu �y' '_'� '����'��^�'�� ' �^ Date Application Disapproved for the following reasons:.... _-'--_-_.---.--'--'-----_-'_-- ----'--'----''---_----_---'''-_- "=" PermitNo......................................................... Issued........................................................ � Date � ` ------------------ -----------------------------------------------'-------------------------- G 4) No.. J` �s F7��. /1�.. f THE COMMONWEALTH OF MASSACHUSETTS BOARD O H EA T Appliratinn -for 4 hapmal Works TonfUurtion Prrntit Application is hereby made for a Permit to Construct (L or Repair ( ) an Individual Sewage Disposal System at............. Location-Address or � ---- ----- A ss o` �, i Installer Address Type of Building -� Size Lot....�2 ...... ...........Sq. feet U Dwelling—No. of Bedrooms..___`: ................. .............Expansion Attic ( ) Garbage Grinder aq Other—Type of Building ---------------------------- No. of persons.--------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ...................................................... W Design Flow............... gallons per person per day. Total daily flow-------'_--__.� ?7._ ......gallons. WSeptic Tank—Liquid capacity -'_ '-gallons Len-th---------------- Width................ Diameter................ Depth-_..______------ x Disposal Trench—No- __//------------------ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.----- 1----- Diameter____________________ Depth belo inl _.__.. Total leaching area-___..._____-___sq. it. Z Other Distribution box ( ) Dosing tank ( ) O . �c'%&— ;t ^--!" 74, aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water.-_-_______--__-__-_-.-. Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water-----._..__.__--____---. W - ----------- Description of Soil-------------T: :__:.._ ----- v ---------------------------------------------------------------------%z_ .. / �-'--- -- '� 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 \I of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued e boar.•d"of-heal �I ,� �� / �gd -- ------------------------------�--------------------"--------------- ---�-- DateApplication Approved By------ - ............................ ---• �� G --7 Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- .............•-------....-----------------------...-------------------------------------------------•----••----------••-•-------•--•--••-•--------•------......•---••---..._....--••--.....---------•--. Date PermitNo......................................................... Issued........................................................ Date I - t THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH .... (.........OF............. ,ot-011.............................................. TWrtifirntr of Tnmplianrr THI S 0 G�<'T FY Tat. Indi al Sewage Disposal System constructed ( or Repaired ( ) � staller r has been installed in accordance with the provisions of a XI of The State Sanitary Code a's described in the application for Disposal Works Construction Permit No_7�__..__ `'---------------- dated_.._2__'Z_ _-'7�_.-__--_____ - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTJ�ON SATISFA TO f _ r DATE----- -- -------------------- Inspector- '!°-•-- -f ����� "a r-= ...-------------•-------•-- �e -s THE COMMONWEALTH OF MASSACHUSETTS 7� BOARD HEALTH No.-------5 FEE.../Z,........... Permission0ereby granted---- ----- K n----tt �rr;-m-----i-t-------------------------•----._.--------------- to Const or R it (/ a Individ I Sew* Disposal --- street as shown on the application for Disposal Works Constructions r it No ............ . ated___oZ___.-` '_`__: _ 0 -• - ----------_----_ Boar of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS (O(15TING) (IX15TING) oo F O ===to = m o C:3 W W O 00 NEW 0'a � 0 ENLARGED IV I ERI I I U I 3 0 O� REMODELED ~ .�. BATH #I II / I I REMODELEDI I I N Q 0 Q MASTER `° /•'� ——— II, ° I I KITCHEN I I W Y. CLO.' BEDROOM #I ( )I L _— e4. EXI5T. I I F CABINET I I A ' �! FAM I LY RM, cq urd r wi owNe I ++ Z Q N Iz-s T�EAWL. _1i ,® VI I pT. Q( f I II I " KOM'IIN MOD L- Pxlsr !' NEW EX(5T. (!� 0PDR. O ROOM A��VE�PLU5H FRAMED TSIZEDMYOTflEK5)-P - --- .REF._. _ MICO! EXIST. -------= OVEN II _ \,0 HALL �pp I i IEx1 r -- I' S I I EXI5T. EXIST-. z + I BUIILT • r 1. 6 _ w a r °�_1 i i DINING GARAGE NOSE 1 I 1 EXIST, I I rX15T.OvE m +1 LIVING B D O4R& OM D FOYER ELED� REPLACEDi N ry H ` T' © 0 = . ►� � Q W W o 12'-0'3 4,_3,± - 13'-IO't - 24_3•± O. //1 Q (EXISTING) (EXISTING) 1 (EXISTING) - cn FIRST FLOOR PLAN F I I W Vim` GENERAL NOTE5: EX15T.FIR5T FLOOR m 20G I S.F. WINDOW ✓CH ED V LE � � m EX15T,SECOND FLOOR — 389 5,F, 1.)CONTRACTOR 15 TO VERIFY EX15TING CONDITION5 AND. EXIST.GARAGE 624 S:F. TYPE MANUFACTURER'S UNIT ROUGH OPENING REMARK5 SCALE :. DIMENSIONS IN THE FIELD PRIOR TO THE START OF WORK 2.) CONTRACTOR TO REMOVE EXISTING DOOR5,WINDOWS, LEGEND A ANDER5EN TW 2646 2'-8 1/8"x 4'-8 7/8" DOUBLEHUNG WALL5,4 ROOFING A5 REQUIRED FOR NEW CONSTRUCTION, O EXISTING WALL CONSTRUCTION TO REMAIN B C 335 G'-O 3/8"x 3'-5 3/8' DOUBLEHUNG 3.) ALL NEW CONSTRUCTION TO MATCH FX15TING IN MATERIAL, C " A 2 1 2'-0 5/8"x 2'-0 5/8" AWNING DETAIL,AND FINISH. ® NEW WALL CONSTRUCTION D TW 21041 O 3'-0 1/8"x 5'-0 7/8". DOU13LEHUNG DATE C EXISTING WALL CONSTRUCTION TO BE REMOVED TW 24310 2'-6 I18"x 4'-0 7/8" DOUBLEHUNG. I I�20�20 14 4.) ALL WORK SHALL CONFORM TO THE MA55ACHU5ETT5 E STATE BUILDING CODE(LATE5T EDITION)AND ALL OTHER Q NEW 5MOKFJCAR50N MONOXIDE DETECTORS F " TW 210310 3'-0 1/81 x 4'-O 7/8" DOUBLEHUNG APPLICABLE LOCAL CODES OH NEW HEAT DETECTOR 5.)ANY DISCREPANCIES,ERRORS AND/OR OMISSIONS IN THE NOTES, NOTE#I:CONTRACTOR TO VERIFY ALL QUANTITIES AND 51ZE5 OF NEW WINDOWS WITH OWNER AND PRO. . NO. DIMENSIONS,AND/OR DRAWINGS CONTAINED ON THESE DOCUMENTS ROUGH OPENINGS WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS SHALL BE BROUGHT TO THE ATTENTION OF THE DESIGNER PRIOR TO COMMENCEMENT OF CONSTRUCTION.PROCEEDING WITH CONSTRUCTION CHECK LIST REQUIREMENTS: (I I O MPH, Exp. $) NOTE#2:CO T RACTO PER CODE. L TO PLYWOOD MARKED FOR EACH AND STOREDDINOW.INCLUDING PRE-SET 2014-G 19 CON5TITUTE5 ACCEPTANCE OF THESE DOCUMENTS AND ANY D15CREPANCIE5, ERROR5 AND/OR OMISSIONS BECOME THE RE5PON5181LITY OF THE NOTE#3:ALL WINDOWS DE5tGNATED(NEW)SHALL BE VERIFIED IN THE FIELD AFTER REMOVING TRIM. DWG. NO. : BUILDING CONTRACTOR ) "o.C.EDGE NAILING AND I Z o.c.IN PIELD NAILING CONTRACTOR TO REPLACE ALL EXISTING WINDOWS WITH LIKE NEW WINDOW5 NOTE: ALL DOORS AND WINDOW5 TO HAVE 2 KING STUDS AND I JACK STUD UNLESS NOTED BY THE OPENING BY XK,Xi _ r 1 ©COPYRIGHT 2014 ' 0 5 10 15 20 Al BY THOMA5 A. MOORE DE51GN CO. r TOP OF PLATE ZI AT NEW DORMER NEW ASPHALT me - ROOF SHINGLES NEW ASPHALT V [i] .F RDOF SHINGLE5 TYPICAL 1/2'a G'RED 107, CEDAR CLAPBOARD 5101NG W ✓ . - THE WEATHER SECOND FL AT FROOR AT FRONT ONLY 5UBF F+.i 1.1FlIf LOOR 1.l.1 00' z ❑o❑ TM IN KEW N LLLUNEW WHITE CEDAR SHINGLE \ C 1 �y 000 SHINGLE SIDING /'A ('V S�BFLOOR R 5°±TO WEA'lER .I�Lr-1j,I� 5 I.bl NO PRO NT .ELEVATION _ NOTE:CO LACE NTRACTOR TO REPAIW REP - - _ - r TRIM A9 NECC59ARY.VPRIPY V� +0� r^T.3 IN THE • - (EXISTING) - .. " (EXISTING) M (EXISTING DORMER) 1 I 3-cr .. - - (NF WDORMM - - 4'-G' 3'4' 6-1 1• I d-I' 6'-I° 3'-4' 34' 4'-e- 5'4° 314' D D E D D D J J ® § +1 5MEWC5. J m _ N 5Ho F F F+y c BTH i 1 c. JK W 13 i ___=_�-__�_== = x— — �Ne NEW rT _ MA5TER I x N BEDROOM#2 NEW L BATH r T, EXPANDED EXIST. W Q x 8'-10 He N BEDROOM Q HALL cus0ro .KNEE iv Q DN. — O NEW (c+ T KNEE WALL . -----C o ------ ( ST . CePENT; NEw N, GARAGE ATTIC +1 II 5TORAGE fp�1 SCALE.: DATE 1 I/20/2014 Qs NEW 5MOKUCAR50N MONOXIDE DETECTORS PROD. NO. 2014-G19 12'-0'± .IS'-10'± DWG. NO. ." EXISTI G) ( STING) EXIT ( (EXISTING) CHECK L15T REQUIREMENTS: (I 10 MPH, EXP. B) 5ECON D FLOOR PLAN �mE::LLoOO DWI DOWTOHAVE2FKING A2 AND I JACK STUD UNLESS NOTED BY THE OPENING O 5 15 ZO ©COPYRIGHT 2014 BY XK.w BY THOMA5 A. 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NO. MIND . 2014-619 DWG. NO. : lA31 ii � ••� it • NEW ROOF CON5T. NEW ROOF CON5T. 1 5 5 w O ROOF RAFTERS®I G'o.c. -2 x 10 ROOF RAFTERS® 16'o.c. b U j F 2 cn cn -I5P CDX PLYWOOD ROOF SHEATHING -1/2'CDX PLYWOOD ROOF SHEATHING F- 12 -ASPHALT ROOF 5H INGLE5 2 x 6 CEILING JOISTS® 16'o.c -ASPHALT ROOF SHINGLES ZZ w -15L5.FELT PAPER 12 -15LB.PELT PAPER 4 W 12 3s .B"MIN.SPRAY FOAM INSULATION -8°MIN.SPRAY FOAM INSULATION IX19T. @ ROOF RAFTERS(R-49) 0 ROOF RAFTERS(R=49) Q1 -2 x 12 RIDGE BOARD -2 x 12 RIDGE BOARD cn 2 x 8 CEIUN JOISTS16'o.c. TAT oo°w�ne�Rs 12 3x TOP OF AT DORMER O O w NEW 1/2'GYP.BO.ON IX15T. 81) EW 1/2°GYP.B0.ON L =N=s w Q uX:6 I x 3 STRAPPING® 16'ox. NEW WALL CON5T. _ � - � F I x 3 STRAPPING®I G'o.c. NEW WALL CON5T. -2x65TUDS®IG'o.c. L - -2x6STUDS® 16'ox. 4 NEW MASTER 1/2'PLYWOOD SHEATH ING NEW MASTK. 1/2'PLYWOOD SHEATHING '* cn BEDROOM :62G INSULATION(R=21) qN BATHROOM _6°LlAT�IN�IATION(R=21) TN U m" O STOR. 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