HomeMy WebLinkAbout0067 CHINE WAY - Health 67 Chine Way
Marstons Mills
---- -- — -- A= 098—070 _ -
�F
TOWN OF BARNSTABLE
LOCATION %lLh-1)bOSEWAGE #
VII.LLAG ASSESSOR'S MAP & LOT 7m
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY �Q�
LEACHING FACILITY: (type) P,7- (size) low
NO. OF BEDROOMS 3
BUILDER OR OWNER G ru/NewAl
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 leac ng facility) Feet
Furnished by Tn!FA
i
ac -
�
ce
13(o !�
30 ly `
3 1 8 ay
y193�
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
klGiVi:4`'''��tr.^i1
TITLE 5
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address:
19 FF MA-02.655----
Owner's Name: Estate otRobertL. Grunewald
Owner's Address:
Date of Inspection: May 6, 2005
Name of Inspector: (Please Print) James M. Ford
Company Name: James M. Ford
Mailing Address: P.O.Box 49
Osterville,MA 02655-0049 -*
Telephone Number: (508)862-9400 C }
CERTIFICATION STATEMENT
;.
I certify that 1 have personally inspected the sewage disposal system at this address and that the-�formationxepoded LT
below is true,accurate and complete as of the time of the inspection. The inspection was perfo d based on my�
training and experience in the proper function and maintenance of on site sewage disposal system . I am lask Ei
approved system inspector pursuant to Section 15.340 of Title 5(310 CAM 15.000). The sys em: ry V .
.. c
ry r—
✓ Passes t n
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
F it
Inspector's Signature: Date: May 9. 2005
The system inspector shaysubay�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: 67 Chine We
Osterville, MA
Owner:. . Estate ofRobert L. Grunewald
Date of Inspection: Mav 6. 2005
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR
15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass"section need to be replaced or
repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please
explain.
The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
2
f
Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 67 Chine We
Osterville, MA
Owner: Estate of Robert L. Grunewald
Date of Inspection: Me 6, 2005
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health y (and Public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well**. Method used to determine distance
**This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
3
r
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 67 Chine Way
Osterville, MA
Owner: Estate ofRobert L. Grunewald
Date of Inspection: Mav 6, 2005
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"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
Yes No
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped
Zone 11 of a public water supply well
If you have answered"yes"to any question in Section E 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
r
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 67 Chine Wav
Osterville. AM
Owner: Estate of RobertL. Grunewald
Date of Inspection: May 6, 2005
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 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:
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: 67 Chine Wav
_ Osterville. MA
Owner: Estate of Robert L. Grunewald
Date of Inspection: May 6, 2005
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Number of current residents: 1
Does residence have a garbage grinder(yes or no): Yes
Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required]
Laundry system inspected(yes or no): No
Seasonal use(yes or no): No
Water meter readings,if available(last 2 years usage(gpd)): Unavailable
Sump Pump(yes or no): No
Last date of occupancy: Currently occupied—
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sqft,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:_ Unavailable- Tank pumped after the inspection for maintenance
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped: _gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
✓ `Septic tank,distribution box,soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no) (if yes,attach previous inspection records, if any)
Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
Tight Tank Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information: 1
Date of installation 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: 67 Chine Way
Osterville. MA
Owner: Estate of RobertL. Grunewald
Date of Inspection: May 6, 2005
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: 10"
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 Qal.
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: 6"
Distance from bottom of scum to bottom of outlet tee or baffle: 10"
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 Iiauid level was even with the outlet invert There did not appear to be any signs of leakage The tank
was pumped after the inspection for maintenance
GREASE TRAP: None (locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _fiberglass _polyethylene _other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
7
Page 8 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 67 Chine Way
Osterville, MA
Owner: Estate of RobertL. Grunewald
Date of Inspection: Mav 6, 2005
TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: Even
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):
The D-box was level. 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.):
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: 67 Chine Way
Osterville. MA
Owner: Estate of RobertL. Grunewald
Date of Inspection: May 6. 2005
SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required)
If SAS not located explain why:
Type
✓ leaching pits,number: I -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 nit had 3'ofliauid on the bottom. The scum line was approximately 3 5'upfrom the bottom There did not appear to be any
signs offadure. The pit was under a 20'pine tree A video camera was used to-perform the inspection
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: 67 Chine EU
Osterville, MA
Owner: Estate ofRobert L. Grunewald
Date of Inspection: Me 6. 2005
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.
c
4.
A Q
a- 3o ly `
3 r g ay
y193�
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: 67 Chine Way
Osterville, MA
Owner: Estate of RobertL. Grunewald
Date of Inspection: May 6, 2005
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 must describe how you established the high ground water elevation:
Using Barnstable topographic and water contours maps, the maps were showing approximately 30'+1-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
LOCATION _ CO SEWAGE PERMIT NO.
VILLAGE
4
I N S T A LLER'S NAME i ADDRESS
-"<QR OWNER
DATE PERMIT ISSUED 7- � 9
DATE COMPLIANCE ISSUED
I'i r
c N ty
r
No..........9...:...., _ ( Fxs...3 .
THE COMMONWEALTH.OF MASSACHUSETTS
BOARD OF HEALTH OS ?e . v7d
.............OF...... - w r.4-l. ..........................
(' Appliratinn for 11ispnstt1 Works Tonstrnrttun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
.40. ....2_ tiS/.f.'t:�F..% LS...r � .Sl....._
..........
Location-Address or Lot No.
...-
y Owner Address r r�
W
— ........................................................ ... Ll'J- /�.�= 7 � �
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.......�� ...............................Expansion Attic ( ---�r Garbage Grinder ( &'
Other—T e of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures............................ .
w Design Flow..................6...,1.7...........gallons per person per day. Total daily flow......... .............................gallons.
WSeptic Tank_�Liquid capacity/6_01gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—: o..................... Width../... ......._.... Total Length...............r...Total leaching area----._....... _._ sq. ft.
Seepage Pit No...... .......�.. iameter......!•.�..-. Depth below inlet.........�......... Total leaching area. sq. ft.
Z Other Distribution box (e/) Dosing tank ( )
'-' Percolation Test Performed . .. ef%...-...
a Y ?t.05 Date 7�
t R d b . .
a Test Pit No. 1....2°�..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........................
a _ <�
O Description of Soil---.....---.0..`........... `. r �Z °
x '
c, ------------------------------------ ------
....---
.--------------------------------------------------------------------
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 TITL U 5 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.
SAAA .............
Application Approved By.. ------ / � � �— a j D...... .�
l`-F✓
Date
Application Disapproved for the following reasons:----•----------•-----------------•-------------...-----------------------------------------•-•-...---•------••.
--....-•----•--•----•--•-----------------------------••----•...............------•-••-•-•--••-----•------•-----••-•---------------•-•-••----•••--•-----•----•--------••-••-----•---------•---.....------
_ Date
PermitNo......................................................... Issued..... .............................................
Date
No....` .q:o........:ti. :. of FEs... Q...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................. ....................O F...........................--•--.............---•--.......-----------....._............._.
Applirattiun for Disposal Works Tonstrnrttun Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
................-___.._...................................................................... --••--------•-•••---•-••-•••.......••------•-- - - ............._...._.
Location-Address or Lot No.
......................__-__.......:............Owner
.. ........_..••---^_•---•--•----•---------- -•---....--•----------......_..._.._.........__d--d•-r^ess.......
•--_----••------•----..._..........
O , A
W
Installer Address
UType of Building Size Lot............................Sq. feet
�., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
`-4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria
QIOther fixtures ---..................................................... -----------------•--_....._._....._.. -----••---_____......
Desi n Flow.................. allons er erson er da Total daily flow...___.__________._____
g �__--••---......�-•,-,,Tg P P P Y• Y ----------
-•--gallons.
WSeptic Tank AL Liquid capacity t....gallons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—. o. .................... Width__/__. __._________ Total Length_.___.__._____. Total leaching area.____.____._j...J sq. ft.
Seepage Pit No______ _______ iameter...... ___. Depth below inlet.......... Total leaching area__2C (jF.sq. ft.
Z Other Distribution box ( ) Dosing-, t nk ( )
'~ Percolation Test Results Performed by._ A {,Xf'l!,._.-... _!__'� v�?'�-�_______________ Date.. ------------
Test Pit No.xl_._.
a +!..minutes per inch Depth of Test Pit____________________ Depth to ground water-------------------------
,.a
Test Pit No:`2.........._.....minutes per inch Depth of Test Pit..... ;............ Dept to ground water------_...__............
O Description of Soil...... l -----------•----� .._... `-Ur .. l l.�� '.
-------------------------
-----------------------------------------------------------------------------------------------------------------------
�-- r - - .
W
UNature of Repairs or.; erations—Answer when appli ble...............................................................................................
•--•---•-••---•--- l -•--- -• • -------•----••-
Agreement: 1
The undersigned; agrees to install the''.aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T I T M 5 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
Sne = -------------•--- ••---•-- ----------------
Dat
Application Approved. BY-� = ------ -------- -• �� �-=
t Date
Application Disapproved for the following;reasons:--••--•-••-...•-•••-•---••-•---•••------••-•----••••••••••---•••-•-••-•-••••--------•-•-•-•••••..............._
..........................................................................................................................................................................................................
q,y,� Date
PermitNo....................................... Issued.......................................................
Date
t
THE COMMONWEALTH OF MASSACHUSETTS
BOARD � O HEA7TP,a ..�lM..........OF........ . , . .:........ .............
"9rdifirtt e of hunt li nre
T '�l IS TO CER Y, That the Individual Sewage Disposal System constructed ( or Repaired ( )
by r _ -.
at �lY_ .C�.sf/V_�� �� fF!._ --
In + I• ••- v^--�_{-- -'�-� �._._ftS!_ Ye6i
has been installed in accordance with tle`provisions of T/� j of The State Sanitary Code asscr�b,.�jd in the
application for Disposal Works Construction`�Permit No. ____ _' �_.__________ dated-..�_-_.a. _-_ ...............
THE.ISSUANCE OF THIS�CERTIFICATE SHALL NOT BE CONST UE® A RANTEE THAT THE
SYSTEM WILL FUNCTION SIA TI�SFACTORY:'�
DATE..........? ./ -u .:.......................•---••. --_. Inspector....-• - ------• ..........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALTH/
...........OF..... `h. 1!��. ............................... �`g
No......_... r FEE.•....................
Diupuu 1 Works n#r iun leranit
Permission is hereby granted___". ...__._ .... •-_.__........... _ ._____ *........................................................
to Constr ( or Repair ( ) r ndiv r u S `ra e pf sal System �� ,/f
at No..-- -1fJ���.. .......g �� 11t_t .; -.U..t�Z7t_ 4�. .�N /mil
eet
as shown on the application for Disposal Works Construction mit Dated_._7....t._.__ed_.....__.
f. -
I
DATE........ �__�/6- �d oard of/✓/
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS "
�u4t_E F
WITS -
DA L14 tto 43 +50l.-4q5G.P.v.
SEPTt G TAUK • '330 X�.00 %= C.ls,o Li"�� ,�✓ \Q�.O d � .�'
u r,E
—7
v15 PoSAL P> T u g i= I oDv C�Ac.-�2 S�b►J� �� 0�
SIDES/{ALL. A &A a 133 Sp'
BoTTOM Atzr;A
To-rA." DESt6N '
PE>zc oLA'r to►.� P�iTt= 1 114 T I4WJ .O(Z L.EyS.
rAAAWA
r
.. •_d"'•���� �L.yk.. r -. .,.�, Try. _. _ _ _._ - - ��-O. lJ r`r/� L'.J
-19
Ile
GL:35 iVg T.G�7 7 ti.. t �i 4 OBE
¢''� wu • 3¢
S�aso�c_ "O,v� DKT cuu e.
j:
/ 'got.
33•G S�PTtG
►t,w. r Truk. i•.
1000 33 �uv. 133."(
&AL. 33 2 �.
4' LEACC"
�oT Pi T
butT41 •.
S N� 'Z
S oH&
a�
C�2 T t[=t EIS PL-oT pL A N
p2o i=l LE- l.oY,- A.rlo1-1 iI/rl\F.ST'Oi�l'rj M►c.Lfj
23 IZ' QO SCAU-- � ���= C.O t>ATR-- 7/Z-Z��
�o VA 7- g, p1201.)0 6L--
t G&c:r1F`f T"AT T"1c Fnv>`;:,/,.ioty SWowq,.J pLdt�1 2FFEst C
Gom pL-`(S WIT" T"rr- rilUF_Li o•ls--
AND Sk"T-8ACV jZSQojt f- AAr-.►T3 OF 1 WE
To%&J" of 1'!5,%2-S�e77-41 ,LS 4_ 6 Couv.-r Pt..A ,, ZSS�S
¢GZ-tsTrm czml> LAAjt> sL)evEyoer,
T41ry FL&W llp IJOT BASED OW AU htATWAAE"T OSTE:.ZVt • So AA A.
5ucvol/ 4 T"& 01=1=5r.T; -y"DULD uoT im uSej> APPL%GA±tT
To "PETF-itmo WL t.oT LIUE!*.
k `�
22 2016 06:24 Jim The Inspector Man 5085349919 page 1
man
ame Commonwealth of Massachusetts
. Title 5 Official Inspection Form
? Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 China Way
Property Address
Sean Connolly
Owner Owner's Name
information is Osteritiile 14/'ll/ Ma 02655 9-21-16
required for every page. City/Town 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.
Important:When A. General Information
filling out forms
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not James D.Sears
use the return Name of Inspector
key.
Ca ewide Enterprises, LLC
"' Company Name
153 Commrcial Street
Company Address
2� Mashpee MA 02649
CityfTcwn State Zip Code
508-477-8877 S1623
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 16.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
9- 9-21-16
nspector'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 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 nbt address how the system will perform in the future under
the same or different conditions of use.
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurlace Sewage Disposal System•Page 1 of 17
Sep 22 2016 06:24 Jim The Inspector Man 5085349919 page 2
1 Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is Osterville Ma 02655 9-21-16
required for every State ZIp Code Date of Inspection
page. City/Town
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E I 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.
F
Comments:
The system is a 1500 Gal. tank- D box & Pit.
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.
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):
l5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Sep 22 2016 06:24 Jim The Inspector Man 5085349919 page 3
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
57 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is Osterville Ma 02655 9-21-16
required for every ' State Zip Code Date of Inspection
page. Cityrrown
B. Certification (cont.)
❑ Pump Chamber pumpslalarms not operational. System will pass with Board of Health approval if
pumpslalarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
I
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ The system required pumping more than 4 times a year due to broken or'obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ElN ❑ 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.doc rev.6116 Title 5 official Inspecl.ionForm:Subsurface Sewage Disposal System•Page 3 or 17
Sep 22 2016 06:24 Jim The Inspector Man 5085349919 page 4
Commonwealth of Massachusetts
Title 5 Official Inspection Form
6 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is osterville Ma 02655 9-21-16
required for every State Zip Code Date of Inspection
page. city/Town
B. Celrtification (coot.)
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:
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
El ® 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 is less than 6" below invert or available volume is less
❑ ® than 1/z day flow �'`r
15ins.doc•rev.6116 Title S Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Sep 22 2016 0624 Jim The Inspector Man 5085349919 page 5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M� 67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is Ostervllle Ma D2655 9-21-,16
required for every
page. Cityrrown 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.
❑ ® 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 0.
Yes No
❑ ❑ the system is within 4D0 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area—IWPA) or a mapped Zone II of a public water supply well
If you have answered "yes to any question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threatwder 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.
f5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Sep 22 2016 06:24 Jim The Inspector Man 5085349919 page 6
Commonwealth of Massachusetts
Title a Official Inspection Form
s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is required for every Osterville Ma 02655 9-21-16
page. CityTTown 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 NIA)
® ❑ 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?
El ® Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information_ For example, a plan at the Board of Health.
❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
t5lns.doc ray.6)16 Title 5Official Inspeclion Form Subsurlaca Sewage Disposal System•page 6 of 17
l
Sep 22 2016 06:25 Jim The Inspector Man 5085349919 page 7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 Chine Way
Properly Address
Sean Connolly
Owner Owner's Name
information is required for every Osteryille Ma 02655 9-21-16
page. City/Town State Zip Code Date of'Inspection
D. System Information
Description:
The system is a 1500 Gal. Tank D -Box and pit.
0
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? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Gal
Water meter readings, if available last 2 ears usage d 2015-470-OOOais
g ( y g (gp ))� 2016-70,000GaIs
Detail
Sump pump? ❑ Yes ® No
Last date of occupancy: NA
Date
Commerciallindustrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd).
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 or 17
Sep 22 2016 06:25 Jim The Inspector Man 5085349919 page 8
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is required for every Osteryille Ma 02655 9-21-16
page. CitylTown State Zip Code Date of Inspection
D. System Information (coat.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: NA
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for oumping:
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 11A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins.doc•rev.6f 16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•page 8 of 17
L
Sep 22 2016 06:25 Jim The Inspector Man 5085349919 page 9
�� Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .
rt 67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is
required for every Osterville Ma 02655 9-21-16 _
page. City/Town State Zip Code Date of Inspection
D. System Information (cost.)
Approximate age of all components, date installed (if known) and source of information:
1980 Permit #80- 390.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2
feet
Material of construction:
❑ cast iron ®40 PVC ® other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Pipeing is 4" PVC SCH 40 & SCH 20.
Septic Tank (locate on site plan):
1'
Depth below grade: teat --
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 Gal. Precast H-10
Sludge depth: 2"
tSins_doc•rev.6116 Tile 5 Official Inspection Form:Subsurface.Sewage Dlsposel System•Page 9 of 17
Sep 22 2016 06:25 Jim The Inspector Man 5085349919 page 10
Commonwealth of Massachusetts
Title 5 Official Inspection Fora
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
i
w� 67 Chine Way
Property Address
Sean Connolly
Owner informatron is Owner's Name
required for every Osterville Ma 02655 9-21-16
page. cltyrrown 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 28
Scum thickness 1
Distance from top of scum to top of outlet tee or baffle 8
Distance from bottom of scum to bottom of outlet tee or baffle
17"
How were dimensions determined? Asbuilt-Tape
Sludge Judge
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank and cover's at 1'below grade. Two inlet tee's Outlet tee No sign of leak age or over loading.
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
15ins.doc•rev 6/16 Title 5 Official Inspeclion Form:Subsurface Sewage Disposal System•Page 10 of 17
E
f
Sep 22 2016 0625 Jim The Inspector Man 5085349919 page 11
Commonwealth of Massachusetts
Title 5 official Inspection Fora
a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is
required for every Osterville Ma 02655 9-21-16
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: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
e
Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
15ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
c
5ep 22 2016 06:26 Jim The Inspector Man 5085349919 page 12
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r 67 Chine Way
Property Address
Sean Connolly
Owner Owners Name
information is
required for every Osterville Ma 02655 9-21-16
page. Cltyrrown 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 16"x16"-20" below grade w/one line out Box is new 9-2016 w/cover at 8"
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.):
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:
15ins.doc•rev.6116 Title 5 official Inspection Form:Subsurface Sewage Disposal System-page 12 of 17
I
Sep 22 2016 06:26 Jim The Inspector Man 5085349919 page 13
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 Chine-Way
Property Address
Sean Connolly
Owner Owners Name
information is OSterVllle
required for every Ma 02655 9-21-16
page. Cityrrown State Zip Code Date of Inspection
D. System Information (coat.)
Type:
® leaching pits number: 1
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leaching is a 1000 Gal. Precast pit w/2' stone. Pit and cover at 22"below grade. Pit dry w/stain line
at 18". No sign of over loading or solid carry over.
a
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.doc•rev.6116 Title 5 Official Inspection Fonn:Subsurface Sewage Disposal System•Page 13 of 17
Sep 22 2016 06:26 Jim The Inspector Man 5085349919 page 14
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
67 Chine Way
Property Address
Sean Connolly
Owner Owners Name
infonmatio.n is
required for every Osterville Ma 02655 9-21-16
page. CitylTown State Zip Code Date of Inspection
D. System Information (cost.)
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.doc-rev.6/16 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
Sep 22 2016 06:26 Jim The Inspector Man 5085349919 page 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
R Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
0
J 67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is required for every Osterville Ma 02655 9-21-16
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
t5ins.doc•rev.6116 Title 5 Official Inspection Forrn:Subsurface Sewage.Disposal Systen•Page 15 of 17
Sep 22 201E 06:26 Jim The Inspector Man 5085349919 page 16
057-
8
0
!r
3 '
093
/3 :3^ ;�
/yIf
I
Sep 22 2016 06:26 Jim The Inspectcr Man 5085349919 page 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 Chine Way
Property Address
Sean Connolly
Owner Owner's Name
information is required for every Osterville Ma 02655 9-21-16
page_ Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
12'
Estimated depth to high ground water: 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: 7-22-80
Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers -(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
T.H.on design plan 7-22-80 12'no G.W.. Bottom of pit at 8' below grade. Bottom of pit at 4' above
T.H. Depth.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins.doc-rev.6116 Title 6 Official Inspecion Form:Subsurface Sewage Disposal Sysiem•Pago 16 of 17
Sep 22 2016 0626 Jim The Inspector Man 5085349919 page 18
Commonwealth of Massachusetts
v Title 5 (official Inspection Form
a) Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
s 67 Chine Way
Property Address
Sean Connolly
Owner Owner's Narne
information is Osterville Ma 02655 9-21-16
required for every
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
i
I5ins uoc•rev.6.16 Title 5 Official Inspection Form:Subsurtoce Sewage Disposal System•Page 17 of 17
No Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered m computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftphration for Disposal *pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.(off y Owner's Name,Address,and Tel.No.
M M 5qA?,! C0WiVp( 4-y
Assessor's Map/Parcel Q "] ° 33 GlN � `I(fAjC__r A
Installer's Name,Address,and Tel.No. _5Og—477_aa`7 y Designer's Name,Address,and Tel.No.
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) REP!4-- —
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 of ealth.
Srgne Date
Application Approved by oeDate
Application Disapproved by Date
for the following reasons
Permit No. Date Issued `� -�
No.` : ,., Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
0[pplication for Vgosar 6pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade(' ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. (O'1 V_jQPC y421to Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel O� o-7® M'M 3� (s M)DEX) Sr W wNCO KJ4 _-TL
Installer's Name,Address,and Tel.No. SO$—4*77—8g*7 7 Designer's/Name,Address,and Tel.No.
�536 o�G �tclf'aLF4� �-
Type of Building: f�'
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided1117 gpd �r
Plan Date Number of sheets Revision Date
6 Title
Size of Septic Tank Type of S.A.S.
Description of Soil,'
r*p$
k•
Nature of Repairs or Alterations(Answer when applicable) PtC:_Q L4• .
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 of Health.
Signe Date v^-
Application Approved by of 42 Date
Application Disapproved by Date
for the following reasons
Permit No. o Date Issued
--------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(A Upgraded( )
Abandoned( )by QAP��W 1 Z)6 4-C.9--
at &-7 0-141,yE WAY Ms M. has been constructed in accordance q
with the provisions of Title 5 and the for Disposal System Construction Permit No. �Grvo7_ " dated ( �LI
Installer ( Designer N 1,4
#bedrooms Approved design flow gpd
The issuance of this p rm' shall not be construed as a guarantee that the system will funct n f design .
Date fJ Inspector
U -
------------------/---------------------------------------------------------------------------------------------------------------------
No. �?_G 3zb
Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
30isposar 6pstem Construction Vermit
Permission is hereby granted to Construct( ) Repair(A Upgrade( ) Abandon( )
System located at_677 (2141A16 IV4Y MAA5�� g M1 L L 5
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.
Provided:Construction must be completed within three years of the date of this permit. `
Date —/ f' ` 1f2 Approved by /
o
LOCATION GE SEWA PERMIT NO.
'1- 0 `T Z C / ne- �� 3Sy
V I L L A G E
I N S T A LLER'S NAME i ADDRESS
l� (� fk 1�)
- —<4R OWN ER
DATE PERMIT ISSUED 7- � 9
DAT E COMPLIANCE ISSUED �_�6_ Se
i
C !yl
AsBuilt Page 1 of 1
TOWN OF BARNSTABLE
LOCATION ZI%I Lh-1)WSEWAGE#
VILLAGE M M ASSESSOR'S MAP&LOT 0�� 7r-
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACTTY /00V
O
LEACHING FACE MY: (type) r,I �oaC ro (size) /OW
NO.OF BEDROOMS 3
BUILDER OR OWNER
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 Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leacing facility) ] Feet
Furnished by_��uTi� F1}/G
6
Frox—i
i� •
J. 3 a
A a
1 gte 1(0
a. 30 !y
y
19 3�
http://issgl2/intranet/propdata/prebuilt.aspx?mappar=098070&seq=1 9/19/2016
21Y-6•
20'-6•
10'-3" 10'-3" A
A3 (/
A
NEW 390
PLATFORM ANDERSEN FWG120611A
FRENCHWOOD DOUBLE
SLIDING DOOR
SUNROOM ROOF BELOW
< o o e
ANDERSEN ANDERSEN
TW210410 TW210410
RE-BUILT 3'-0" 31'-0" 3'-0"
SUNROOM NEW AWNING WINDOWS
ANDERSEN ANDERSEN n VERIFY R.O.WIDTH PRIOR
TW2104107 TW21 D410 TO ORDER PLACEMENT
ANDERSON ANDERSON ANDERSON
AW251 AW251 AW251 EXIST. EXIST.
ANDERSEN ANDERSEN
TW210410 TW210410
LI OVERIFY EXISTING HDR.
SIZE.IF 2-2 x 8 OR LESS
REP x9 AC /14"W2-1 REMO
---------- BATH
�
EXIST. O EXIST.
LIVING EXIST. BEDROOM
KITCHEN
A --J REMOD. U P
L--
TWD263100N BEDROOM EXIST.
HALL
FIRST FLOOR PLAN LIN.
NOTES:
1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS EXIST. ON.
&DIMENSIONS IN THE FIELD W.I.C. F+
2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS,
DETAILS,&FINISHES IN THE FIELD WITH OWNER
3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT SECOND FLOOR PLAN
FIRST FLOOR TO BE 6'-11"ABOVE SUBFLOOR
4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS
STATE BUILDING CODE,9TH EDITION AMENDEMENT&IRC2015
5.) 110 MPH EXPOSURE B WIND ZONE
6.) ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY,
OR HORIZONTALLY W/BLOCKING AT EDGES,3"EDGE/12"FIELD NAILING
7.) ALL LVL LUMBER/BEAMS TO BE 1.9e U360 LOAD
8.) FOLLOW ALL REQUIREMENTS OF THE IECC2015 RESIDENTIAL ENERGY IECC2015 RESIDENTIAL ENERGY EFFICIENCY DETAILS
EFFICIENCY REQUIREMENTS&VERIFY ALL DETAILS WITH THE INSULATION
INSTALLER/CONTRACTOR. CLIMATE ZONE 5(USE EITHER PRESCRIPTIVE VALUES OR RESCHECK CALCULATION
9.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF TABLE 402.1.2(MINIMUM PRESCRIPTIVE INSULATION&FENESTRATION REQUIREMENTS)
FENESTRATION SKYLIGHT CEILING WOODFRAMED WALLFLOOR BASEMENT WALL BASEMENT SLAB CRAWL SPACE WALL
ALL SIMPSON COMPONENTS U-FACTOR U-FACTOR R-VALUE R-VALUE R-VALUE R-VALUE R-VA UE R-VALUE
SS.
10.)TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE o.,D ASS,MA 0.55 49 :o"r,J.S JD 5/19 0(aFT.DEEP) 1519
D.
11. VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE NOTES:
1.R-VALUES ARE MINIMUMS 8 U-FACTORS ARE MAXIMUMS.
DURING FRAMING CONSTRUCTION 2.15/19 MEANS R=15 CONTINUOUS INSULATED SHEATHING ON THE INTERIOR OR EXTERIOR
12.)THIS STRUCTURE IS DESIGNED TO THE AF&PA WOOD FRAME CONSTRUCTION OF THE HOME OR R=19 INSULATION CAVITY AT THE INTERIOR OF THE BASEMENT WALL
MANUAL FOR 110 MPH EXPOSURE"B"LOCATION PER SECTION R301.2.1.1 3.REFER TO IECC 2015 CHAPTER 4 FOR ALL INSULATION&ENERGY REQUIREMENTS
4.13+5 MEANS IRS CONTINUOUS INSULATED SHEATHING ON THE WALL EXTERIOR
&R13 CAVITY INSULATION
TMEDEDRAWINSHALLBE NOTIFIED IFANV NEW ADDITION/REMODELING FOR. SCALE : DRAWING NO.:
ERRORS OR OMISSIONS ARE FOUND ON
8Q" COTUIT BAY DESIGN, LLC THESEDRAWIN.THEIPONSOLESR TO DINGCTOF 1/4" = 1�-01,
CONSTRUCTION.THE BUILDING CONTRACTOR
43 BREWSTER ROAD IN THES DSAWINGSEF ONSTRURTH TIONNT
C THESEDRAWINGSIF CONSTRUCTION
COMMENCESWRHARE SOLELY
HE
TH EGASTI RESIDENCE DATE :
MASHPEE MA. 02649 DESIGNER OF MY ERRORS OR OMISSIONS.
THESE DRAWINGS ARE SOLELY FOR THE USE
PH. (508 274-1166 THESOF E DRAWINGWNER RED.ANVOTHERUSEOF SENT OF THE DESIGNER UNDER THE 3/1/2018
THESE DRAWINGS REQUIRES THE WRITTEN
FAX (50 ) 539-9402 ARCHHOFE990URALCOPVRIGH PROTECTION 67 CHINE WAY OSTE RV I L L E, MA
I,
® ® VERIFY ACTUAL ROOF
PITCH IN THE FIELD TO
FIT UNDER NEW S.F.
WINDOWS
NEW ASPHALT ROOF SHINGLES
TO MATCH EXISTING
NEW PVC FASCIA,FRIEZE,8
SOFFIT BOARDS TO MATCH
EXISTING
[Jill III]1 11
III
NEW PVC CORNER BOARDS
TO MATCH EXISTING
ii
NEW W.C.SHINGLE SIDING
TO MATCH EXISTING
L k
I I
REAR ELEVATION
12
12
EXIST.
EXIST.
II NEW PVC RAKE BOARDS
TO MATCH EXISTING
INN
12 u Ulm lo 12
3.5 IUILIAL LI
3.5
TOP OF PLATE TOP OF PLATE
m
FIRST FLOOR FIRST FLOOR
SUBFLOOR SUBFLOOR
LEFT ELEVATION INSIDE RIGHT ELEVATION
ERRORSIORO SHALLBAREFOIUNIFANV SCALE : DRAWING No.:
ERRORS C ION THE
ARE FOUND R NEW ADDITION/REMODELING FOR:
Ea ft COTUIT BAY DESIGN, LLC WILL BERESPONSBLEFORTHECOT 1/4" = V-0"
CONSTRUCTION,THE BUILDING CONTRACTOR
43 BREWSTER ROAD IN THESE
DRAWINGS
FONSTRU TIONNT
W THESE DRAWINGS IF CONSTRUCTION
COMM
NCES
OUT
THESE DRAWINGS
ARE SOELYI FOR HE
TH EGASTI RESIDENCE DATE : ��
MASHPEE MA. 02649 DESIGNER OF ANY ERRORS OR OMISSIONS.
OF T E DRAWINGS ARE SOLELY FOR THE USE
PH. (508 274-1166 THESE
SE DRAWINGER REQUIRESD.ANY TMERUSEOF GNER UNDER 3/THE1/2018
THESE DRAWINGS REQUIRES THE WRITTEN
FAX (50 ) 539-9402 ACONSENT RCMRECOURA COPYRIGHT PRO ECTION 67 CHINE WAY OST E RV I L L E MA
ACT OF 1SS0.
20'-6"
I
NAILING SCHEDULE
q I
A3 INSTALL FLASHING UNDER 110 MPH EXPOSURE B WIND ZONE
HOUSEWRAP&DECKING JOINT DESCRIPTION NO.OF COMMON NAILS NO.OF BOX NAILS NAIL SPACING
DECKING ROOF FRAMING:
BLOCKING TO RAFTER(TOE NAILED) 2-8d 2-10d EACH END
rj RIM BOARD TO RAFTER(END NAILED) 2-16 d 3-16d EACH END
S FLOOR JOISTS
' WALL FRAMING:
41<2J 3-1 3/4" 9 1/4"LVL HEADER q 2J 1 TOP PLATES AT INTERSECTIONS(FACE NAILED) 4-16d 5-16d AT JOINTS
P.T.2 x 6's @ 16"D.C. STUD TO STUD(FACE NAILED) 2-16 d 2-16d 24"o.c.
HEADER TO HEADER(FACE NAILED) 16d 16d 16"o.c.ALONG EDGES
2K,iJ 2K 1J INSTALL PEEL&STICK FLOOR FRAMING:
RUBBER MEMBRANE BETWEEN LEDGER 8 JOIST TO SILL,TOP PLATE OR GIRDER(TOE NAILED) 4-8d 4-1 Od PER JOIST
SHEATHING BLOCKING TO JOISTS(TOE NAILED) 2-8d 2-10d EACH END
Ir I BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 3-16d 4-16d EACH BLOCK
w w P.T.2 x 8 LEDGER BOARD SCREWED TO LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-16d EACH JOIST
w w SOLID BLOCKING W/(2)LEDGERLOK SCREWS JOIST ON LEDGER TO BEAM(TOE NAILED) 3-8d 3-1 Od PER JOIST
2.1 = = 2J 16"D.C.W/ZMAX LU210 JOISTS HANGERS BAND JOIST TO JOIST(END NAILED) 3-16d 4-16d PER JOIST
BAND JOIST TO SILL OR TOP PLATE(TOE NAILEDO 2-16 d 3-16d PER FOOT
e ROOF SHEATHING:
DECK DETAIL WOOD STRUCTURAL PANELS(PLYWOOD)
I K K RAFTERS OR TRUSSES SPACED UP TO 16"o.c. 8d 10d 6"EDGE/6"FIELD
2J c 2J RAFTERS OR TRUSSES SPACED OVER 16"o.c. 8d 10d 4"EDGE/4"FIELD
GABLE END WALL RAKE OR RAKE TRUSS W/O OVERHANG 6d 10d 6"EDGE/6"FIELD
I " GABLE END WALL RAKE OR RAKE TRUSS 8d 10d 6"EDGE/6"FIELD
W/STRUCTURAL OUTLOOKERS
GABLE END WALL RAKE OR RAKE TRUSS W/LOOKOUT BLOCKS 8d 10d 4"EDGE/4"FIELD
2K,1 J 2K,1 J
CEILING SHEATHING:
GYPSUM WALLBOARD 5d COOLERS — 7"EDGE/10"FIELD
WALt SHEATHING:
NOTES: _W000 STRUCTURAL N Ls(PLYWOOD)
1. ALL ROOF RAFTERS TO BE 2 x 10's STUDS SPACED UP TO 24"o.c. 8d 10d 3"EDGE/12"FIELD
UNLESS OTHERWISE NOTED 1/2"&25/32"FIBERBOARD PANELS 8d — 3"EDGE/6"FIELD
1/2"GYPSUM WALLBOARD 5d COOLERS — 7"EDGE/10"FIELD
2.) USE SIMPSON H2.5A HURRICANE CLIPS FLOOR SHEATHING:
AT ALL RAFTERS ENDS
F1
3.)VERIFY GUTTER TYPE/LAYOUT WOOD STRUCTURAL PANELS(PLYWOOD)
W/OWNERS 1"OR LESS THICKNESS 8d 1Od 6"EDGE/12"FIELD
GREATER THAN 1"THICKNESS 10d 16d 6"EDGE/6"FIELD
12"DIA.CONCRETE ROOF FRAMING PLAN 6-12" DRILL&EPDXY SIMPSON 5/8"TITEN HD
SONOTUBES TO 4'0" FROM END BOLTS AT 59"D.C.W/SIMPSON BPS 518-3
BELOW GRADE.USE OF PLATE BEARING PLATES.PLACE BOLTS
PSIMPSON OST BASE
WITHIN 6"-15"OF EACH CORNER 1-yp. ROOF CONST.
AND TO A 8"MINIMUM DEPTH
20'-6" -2 x 10 ROOF RAFTERS @ 16"D.C.
` ____ -5/8"COX PLYWOOD ROOF SHEATHING EXIST.HDR.
FASTEN JOISTS I -ASPHALT ROOF SHINGLES
6•_7• 6-7" TO BEAM W/ Q� -15LB.FELT PAPER �
q SIMPSON H2.5
A Z w 59 o.c. SPRAY FOAM INSULATION VERIFY ACTUAL ROOF
TIES w a @ SLOPED CEILINGS(R=49) PITCH IN THE FIELD TO
A3 ^p a 1 U SIMPSON H 2.5A HURRICANE CLIPS FIT UNDER NEW S.F. q c9
2-P.T.2 x 8's LL I o AT ALL RAFTER ENDS WINDOWS
I -ICE/WATER SHIELD AT BOTTOM
TO"OF ROOF 12
-� P.T.2 x 6's @ 16"o.c. � ALUMINUM DRIP EDGE 3.5
I
TOP OF PLATE 1/2"GYP.BOARD bob
3-1 3/4"x 9 1/4"LVL HDR. ON 1 x 3 STRAPPING
@ 16"O.C.
�/ �+ VERIFY EXISTING HDR.
1 I P.WALL CONST. SIZE.IFEW/NE BLESS
REPLACE W/NEW
w P.T.2 x 8 LEDGER BOARD SCREWED TO P.T.2 x 6 SILL W/SEALER 1.2 x 6 STUDS @ 16"o.c. 2-1 3/4"x 9 1/4"LVL
SOLID BLOCKING W/(2)LEDGERLOK SCREWS =
U 16"o.c.W/ZMAX LU210 JOISTS HANGERS 2.1/2"PLYWOOD SHEATHING _ RE-BUILT
d 3.6"(R=20)BATT.INSULATION SUNROOM
4.1/2"GYPSUM BOARD
(n ? 5.W.C.SHINGLE SIDING
J 6.TYPAR VAPOR BARRIER
4 ~ 4 FIRCT FLOOR
cn< EXIST. SUBFLOOR
wU BASEMENT P.T.2x 6's@16"D.C. EXIST.2x 10's@16"o.C.
2 x 10 FLOOR JOISTy
ANCHOR BOLT DETAIL 3-P.T.2x 8's TYP.9"BATT.
INSULATION(R=30)
@ 16"o.c. SCALE: 1/2"= 1'-O" 12"DIA.CONCRETE SONOTUBES
TO 4'0"BELOW ABU 6 POST Ag SILL
E.USE SIMPSON EXIST. W/SEALER
BASEMENT
P.T.2 x 8 LEDGER BOARD LAG BOLTED TO
EXIST. SOLID BLOCKING W/(1)LEDGERLOK BOLTS
/� 16"D.C.W/JOISTS HANGERS AT BOTH ENDS
BASEMENT A BUILDING SECTION SUNROOM
A3
THE DESIGNER
DRAWINSHALLBENOSTAR IF ANY NEW ADDITION/REMODELING FOR. SCALE : DRAWING NO.
ERRORS OR OMISSIONS ARE FOUND ON
COTUIT BAY DESIGN, LLC THESEDRAWINGSPRIO RTDF 1/411 — 1,-OII CONSTRUCTION.THE BUILDING T CONTRACTOR
43 BREWSTER ROAD IN LL BETHESE
DRAWINGS
FOR THE CONTENT
C THESE DRAWINGS IF CONSTRUCTION
COMMENCESWRMOUT NOTIFYING
ORTHE
TH EGASTI RESIDENCE DATE ��
MASHPEE MA. 02649 DES IGNER OF ANY ERRORS OR OMISSIONS.
1 THESE DRAWINGS ARE SOLELY FOR THE USE
PH. (508 274-1166 THESE
SE DRAWINGWNER REQUIRES TNERUSEOF 3/1/2018
THESE DRAWINGS REQUIRES THE WRITTEN
FAX (50 ) 539-9402 ACONSENT OF THE ACCTOFE9 oURA COPYIRGEH PRO ECTION 67 CHINE WAY OSTERVI LLE, MA
ry
a
kJt NE
Vi
J � C
CCca—Cz �� osiE f?EF
0. 0
X1
A 5
D:D
�k