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0050 FOX ISLAND ROAD - Health
'50 Fox Island'Al f - �-Marstons�-1Vhllsa�_�=� ' •" � ry A ;7 096�x �001 � i = f � Y 5 M E A D No.2-153LY UPC 12934 smead.com • Made In USA �J cp _2 � y SUSTAINABLE FORESTRY INITIATIVE Certified Fiber Sourcing www.sfiprogram.org AV 47 r�re�rti,�3w�� fl1, mv07 XU/� ,J�g i Commonwealth of Massachusetts fl f�,00/ Title 5 Official Inspection Form tr� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 50 Fox Island Drive a , Property Address h."+ i Owner The Estate of Lois Davis Owner's Name information is I/ required for every tt ry page. City/Town MA 02655 10/20/2017 ww N1QIr�1Dn S/ /y�S State Zip Code Date of Inspection C- Inspection results must be submitted on this form. Inspection forms may not be altered ered i way. Please see completeness checklist at the end of the form. n any Important:When A. General Information filling out forms i on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return key. Name of Inspector U16 Ford Septic Services, LLC Company Name P.O. Box 49 Company Address Osterville MA 02655 Citylrown State Zip Code 508-862-9400 S 12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further uation by the Local Approving Authority 10/25/2017 Inspec 's Signature Date The sy m inspect r 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. 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System--Page 1 of 17 f Commonwealth of Massachusetts u t Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name inform ahon is required for every Osterville MA 02655 10/20/2017 page. City/Town B. Certification (cont.) State Zip Code Date of In ection p Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form aX Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °�. 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. City/Town 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 (coat.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): The system required than pumping more n 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments .'" 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or.cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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 ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form a a Subsurface Sewage Disposal System Form Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 1 a e. Cit !To 0 e—o—f —e 17 p wn 9 y State Zip Code Date of Ins ection C. Checkli!st p 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: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form orm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. Cityrrown State ZipCode Date of Inspection D. System Information Description.- Number of current residents: 0 Does residence have a garbage grinder? ® Yes El No Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last date of occupancy: unknown 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•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 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. City/Town 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: pumped in 2015 Was system pumped as part of the inspection? ❑ 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 ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 8 of 17 Commonwealth of Massachusetts = Title 5 Official Inspection Form aX Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 page. City/Town 10/20/2017 State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: system installed -6/1/1987 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 30" feet Material of construction: ® concrete ❑ metal ❑ fiberglass 9 El polyethylene ® other(explain) I If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ ,No Dimensions: 2000 gal. H-20 Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. City/Town 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 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 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tees were present. The tank is in the driveway and steel covers were to grade. Grease Trap (locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El 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•3/13 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 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. Cityrrown State Zi Code P 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 9 El polyethylene El other(explain): N/a 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.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins•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 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 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 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 normal 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: l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2 - 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 pits were dry and clean. There was no sign of failure. The covers were 1' below. A camera was used to inspect. 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 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. City/Town State Zi Code P 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 la ndmarks or benchmarks. Locate all wells within where public water supply en thrn 100 feet. Locate pp y enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately (=ron 1 a �Q S 8 3 3 38 s y s GrAss l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts H Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. CitylTown State Zi Code Date of Inspection P D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20' 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: Topo and water contours map ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: - You must describe how you established the high ground water elevation: . see above 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 °,. 50 Fox Island Drive Property Address The Estate of Lois Davis Owner Owner's Name information is required for every Osterville MA 02655 10/20/2017 page. City/Town State Zi Code P Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated.depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 a Commonwealth of Massachusetts �7 � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive i-T, Property Address Lois Davis Owner Owner's Name / t" information is required for every Marstons Mills V MA 02648 10/7/2015 r page. Cityffown State Zip Code Date of Inspection 1 1.. 1.fi9 Inspection results must be submitted on this form. Inspection forms may not be altered in an'�' way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms I/6q t9C) on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return Name of Inspector key. tab Company Name P.O. Box 49 Company Address refer, Osterville MA 02655 City/Town State Zip Code 508-862-9400 S 12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails Needs Further Oalu tion by the Local Approving Authority 10/14/15 Inspector ignature Date The sy to inspect shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)wi hin 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. eysm Vs 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposalge 1 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °�.. 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A;B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 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.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachus etts u Title 5 Official Inspection Form !� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �..a 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public-health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Yz day flow 15ins-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 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 II page. City/Town State Zip Code Date of Inspection B. Certification (cost.) 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 D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply we ll 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. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts 1RMZQM Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 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 Water meter readings, if available last 2 ears usage d unknown 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: 15ins-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 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. City/Town 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: unknown Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 2000 gallons How was quantity pumped determined? Reason for pumping: maintenance 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 VA system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 r Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a,. 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: i system installed -6/1/1987 per as built Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 30" feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 2000 gal. H-20 Sludge depth: 2 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 V Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage:Disposal System Form - Not for Voluntary Assessments ,A, 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 CitylTown State Zip Code Date of Inspection page. P D. System Information (cont.) Septic Tank(co-it.) Distance from top of sludge to bottom of outlet tee or baffle 48 Scum thickness 5 Distance from tcp of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tees were present. no sign of leakage. recommend pumping every 3 years or eariler depending on the use.The tank is in the driveway and steel covers were to grade. Grease Trap (locate on site plan): Depth below grade: n/a 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 I 15ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Ins p ection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. Cltyrrown 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): N/a 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.): *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 .e 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 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 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 normal. 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: t5ins•3413 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2 - 1000gal. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system T ype/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The pits were dry and clean. There was no sign of failure. The cover was 1' below. 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 scup- layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ., 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 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 (no`e condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Dlsposal System•Page 14 of 17 , r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °�M a 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is .required for every Marstons Mills MA 02648 10/7/2015 page. City/Town • State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately Frp�T A . � Q I p a O '1 3 GrAss Art-A A Q y o s o ai si a a 9 sg 3 33 S7 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 I ' 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ..a 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is Marstons Mills MA 02648 10/7/2015 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar i ❑ Shallow wells Estimated depth to high ground water: 20'+/- i 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: Topo and water contours map ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts H Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a °• 50 Fox Island Drive Property Address Lois Davis Owner Owner's Name information is required for every Marstons Mills MA 02648 10/7/2015 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 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 -�*A_t-&OWN OF BARNSTABLE ' LOCATJ ®X S�j9Id Rd- r� n SEWAGE #�� VIL LAGE � �, 41 - -ASSESSOR'S .MAP & LOTn�7���a�� 4 INSTALLER'S NAME & PHONE NO.G19n� Z,4)!/ 0`;Zi;EPTIC TANK CAPACIT ao \ LEACHING FACILITY:(type)�--/�A _(size) �(�O� ��I � 4 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER A OG EI?S DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: 4 _ y' VARIANCE GRANTED: Yes-" No j/ �2�X�� U-I Oz V) M � . :Q�l �g r r; IF .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �OVr1/S�UWWTMAPMVP&OF ��.� ;rtr•, •P� ABU CONSERVATION ,t. of r . -t-A _. 7 r _ .............................. COMMISSION Appliratinn for Disposal Works Tonstrur#inn Prrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: cx sL� ..........................•----� ©_' �..�............----------.•....------....------------ --- Locati ss or Lot No. ••-•... ._T_u t .R.9. .. ANAJS............................ ...... ........... - ���� Ow r �%� j J/�/f� Addiess a •---.......•--•'-'... ------- ---------------------•---................----------------...... --•-.......................•�--f./'.. ' .............................................. Installer Address V?� Type of Building _ Size Lot.a.. a Dwelling—No. of Bedrooms....... .......................................Expansion Attic � Garbage Grinder (�$ aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures -----------------------••------------------•-•--------•----•-----------------•---------- ............................................................. W Design Flow.....?S..-.'t _..........gallons per person per day. Total daily flow...........15Z J�...................gallons. WSeptic Tank—Liquid capacity?.WC7Qgallons Length................ Width................ Diameter...:............ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........Z....... Diameter.....-L'7........ Depth below inlet.....(P-........... Total leaching area.6PTS....sq. ft. Z Other Distribution box Dosing tank (44t> Percolation Test Results Performed .......... Date.._. �.«�.� Test Pit No. L.L_Z......minutes per inch Depth of Test Pit...).3._......_. Depth to ground water_.�0E QUr d 44 Test Pit No. 2.L.Z......minutes per inch Depth of Test Pit....1.3.......... Depth to ground water_-_.':t...............1 � 0.i ...................................................................................................• ................... •-- O Description of Soil_.-.L.P__P- 52�4!-1- _� - -- \_3_� ?" _iC t C� t � _ L .............. U •.-•-----z .....?- 1-Q1 Pt� l?4 41L� '��= E = ��(�u`(�. 2iyl�l~_ ►ZA.�I L—iL ��' = ' j q.G.9_ ------..... !�tl�1�a7. . ----------------------------------------- --- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... •-•----••••••-•••-••---•-----••--..._..-•••-•--•--------•-••----------••--•--•-•-•......•-••--------------•••••---------•----•----•••--•--••-•.........----•-........................................ Agreement:. The undersigned agrees to install the aforedescribed Individual Sewa e Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— he un r rther agr es not to place the system in operation until a Certificate of Compliance has been u y h Signed �!t^ .................-.... Date ApplicationApproved By..................................................... . ....................... ............. Date '. Application Disapproved for the following reasons:................................................................................................................ ••-•--•-•.......•-•••-•-•----••-----••-•--•••---••••-••---.....--•••--•---•••-••-•...................•---......---------•--••----•-•---••---••---•--------•-•---•--•----.....---•-...Dau PermitNo.......................................................... Issued....................................................... Date No................-....... Fins t...-...-.......... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiou for Disposal Works Tonstrudion Fumit Application is hereby made for a Permit to Construct ( Kor Repair ( ) an Individual Sewage Disposal System at: ...lroY, 5LAt..l-V,> Cal � ��..�Cb� .....!.!�5 _.....---•--•----•-------•--•-.---•-..l .........--•--- .._.............• ----•-•------......- --•- ... ....... • .....--- Locatio s or Lot No. -- a /� / V'L L ` C_ M IS L ddress (.,r l 10Lwy /a ................ �./ ... ....._.._... Installer. Address z LA Y Type of Building ,_ l Size Lot..a: ! ______�—f et aDwelling—No. of Bedrooms........ ................................Expansion Attic (�l)) Garbage Grinder (`/4 5 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ---------.-------------------------------------------------•-----•--•--•••••--•••-------------•---•--••---------------------.....--•------........- r perso . W DSeptic Tank—Liquid capaciitty'Z allons P L ngth.. per dayWidOt 1 daily ... Diameter�Z.�.._. Depth...gallon............. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area............__._____sq. ft. Seepage Pit No.-.-_____-7 -___._... Diameter.._. AZ: ...... Depth below inlet......�2.......... Total leaching area.<.7 S_._sq. ft. Z Other Distribution box (1/05 Dosing tank (�4)j _ ` ... \ __ - a Test Pit No. 1..L.z-----minutes per inch Depth of Test Pit----1 3......_.._ Depth to ground water_44j; �-�r_c v" G14 Test Pit No. 2..G.Z_.....minutes per inch Depth of Test Pit....CI-_------- Depth to ground water._....t.....:....... I ...•.....••-••---------•................................................................................................................................... D Description of Soil....l�_ '.�_.-..1_ a-.11 L b �� a ._ ._-.l_ _'..VA C7? O_z!. _ :_ « --Sly.--1�............. ti� v , �Z�.... -- D-3.�oy�+l.�Svl.i�.. - _,_�' Swat?_ .C� F> _ _c...5, _-..� T�1 ,�_za_ts_�uZ UW -••--•-•••--yJ..........-- .....T17— .---�-�..................................................................................................................................................... Nature of Repairs or Alterations—Answer when applicable---------------------------------------........................................................ ....--------• -----••------•------••-••---•-•-•-•-------••-•-••-•••-•--•---------•-•--------••-•-•----•-•-•••-••••----••••-•---.._......•-•--•-•••----••----•----•-•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewa p Disposal Systl m in accordance with the provisions of TITIL 5 of the State Sanitary Code— e un s' Vxther agre s not to place the system in operation until a Certificate of Compliance has been i ue he o -7�23� Signed ...................... Date ApplicationApproved By......................................................-- ----------------------- ------------ ........................................ Date Application Disapproved for the following reasons:................................................................................................................ ---------------------•--------•-------•-----•--------•--••------------------•---------.......•-----....-----------•---•---•--•-.....----............................................................... Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTHl �" ...�v..........................OF......�.+�-i`.�5....)�....P."` ............................. Trrfifiratr of Tomplinna THISA�TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by-------------------------------r.Qtnc.S: :..............•-•-•-•--•-•-....--------- -------------•-------•--•--......---•---•-------................a .................... �}, � .. at �r X 5�. U t X.I t 1LJa)N4l I( r L.- .---••------•-......•• ....._ �. ............,..k....... ....._---•••---------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. `1 DATE .-J... —. . 7.. Inspector... e ................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �'- 7 27 ..h?...............OF.... No, Z�.. No......................... FEE...... `.....:-- Disposal Iforks Tonstrwtion ramit y g� Ls �_,,�:��_ Permission >s hereby anted. .--- -------------------------------•-----------------.------.......------........._...... to Construct;,,(�) or Repair ( ) an Individual Sewage Disposal System at No..._.......�i.C1lS .......r:S..L.� I`'.!�...D 1�_!J:.......... v1 ...._... ............................................................ Street as shown on the application for Disposal Works Construction Permit No..................... Dated..........:................................ •------------------------------------------- ....................................... Board of Health DATE............... f ...................... FORM 1255 HOBB & WARREN. INC.. PUBLISHERS /iT/� G�4.2GL- Gv2/NoC,2 -Fo z A/z- //oX 4 = 44o 6.Pto ICV6 440 X Zoo o =eso G.P.o. 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I MM HOWEµMy ' 5EGTI ON AAIM M OR"� Lq� $ SCALE. 1/4' • 1'-.0' 0. h _ aJ6TaE PAVES ON ON� EW STONE `,.pp.6s 34��E Qya aj;�s ZBIW2 POST BWCC S 6• vESER,E1 794 RALL ps u d r BRICK VENEER VY gg • 59' �3 B IN HEAD LASING 14 1/7Elm MK T 6 MORTAR C_— —--'7 ,R"B Y��-��� BRACKET DETAIL @ OXED-OUT WINDOW 3 BRACKETS O PPOSTNALL2ee g9a s ) B EAVE DETAIL AT MAIN MOUSE '1" FOOTMO IV W" SCALE. I IQ'.l•-o• ecALe,r 1/2••1'-0• ODETAIL AT FRONT PORCH SCAJ.E�I Ill•.I'-0' •• ALL FSRER(OR TRIM TO ERE PVC •• +'' w Eo6a Z Q) to CU 0 9/4' SOOTI(ABg /�� SHIN�µRON HEAVY COX PLT.ON NG SWWLES FLARED AT BµIFT µHt9 Q1T'1 RED CWM HEAVY SIM 12 0 �1) � 0 (n NM 7xe RAFTERS us•OZ. cur ON aaCKlxo A5 \\——— 51eNY4.®ON we•cox FLY. L -c v � cu ATTACHED TO EXIST RAFTERS �® 7x7 ELIRLSTBS ON ENSnNO RAf-lERS eftT. (u N cu 11 �7%f.RAIL W TAPERED W A 1 0 (a Q 4 i / \ \ TO r W. NSLE9 lY _ TO T`DM Y EXIST.CARVED ROOF TO BE RB40VW RTd'i I I _— ,,0( A�W`` X_N A N\I"toz \ \ W mar B I V7'FLY.ON—HALL \ AUKGlTTER }4 E- ------- — O\ IN FA5VA (2)uh•COX PLYrooD—————- I c i-- LL. U ' / n < O FLARED, � n < / 0 N (7)V4'COX PLYPWO VrN Lo o (�N 'I Aar 57 CROMI MOLDING O ON IN ANGLED FASCIA + / (AYUEOI To� W00®M0.D0i (7)7N6 BEAN a PJgG1( 0 / / ON IN FRIEZE ON IN B LCKINS lob no.: ngo � INS TRIM ON BLOCKING EAST.SEAM(A5' (♦) S U4 W IX SOFFIT date 24 AU6u5T 2010 / To REMAIN I i SCale AS NOTED SNP ON SRO'COXFLY. I I it / EgST.CAGE b15.TO ON E%ISnNO RAFTERS •Sae EED MIOlDIN6 BI• drawn: I, RE4AN�MOOIFYKUT NL.SHOYAS ON I I ORIxFRIES awl IN CIBLrxIN! BACK AS NEEDED I?COX FLYN7OD / I I rev. i SINS DORMER HALL IN WAD CAW*(4 tff 27 I O EAVE DETAIL AT DORNMR OLINE DETAIL AT FLARED OUT SHIN&LE RAKE AT DORMER ROOF EAVEDETAIL AT&ARA&E 4 FIRST FLOOR ��0 SCALE.11/2•.I'-W •• Au EXYMOR TRIM TO eE wC •• ALL P.7L7ET410R TRIM Toles PVG-0 SCALE.1142'.I'-0' •• ALL®R.TO EE PVC. •• SC..ALE�1 Ill•.I'-0' • ALL EKT.TID BE F'Vr a ISSUED FOR PERMITTING sht 6 of .9 GEAL 3. WALLS ACTING AS RETAINING WALLS 5.CONCRETE BRICK SHALL CONFORM 10.ALL PLYWOOD SHALL BE APA SHEARWALL HOLDDOWN SCHEDULE o H TO A5TM G55. PERFORMANCE RATED PANELS CONFORMING E SHALL NOT BE BACKFILLED WITHOUT I.STRUCTURAL DRAWINGS ARE BRACING UNTIL ALL SUPPORTING TO THE FOLLOWING MINUMUM REQUIREMENTS: 501E 6.GROUT SHALL CONFORM TO THE M o N 8 SLABS ARE IN PLACE 8 AT REQUIREMENTS OF A5TM C 146 8 A.FLOOR-5TURD-I-FLOOR TBG,EXPOSURE I, FOUNDATION HOLDDOWN5 4 ANCHOR BOLTS: e o R TO BE USED WITH THE ENTIRE ADEQUATE STRENGTH. O SET OF DRAWINGS. SHALL HAVE A COMPRESSIVE 3/4 SPAN RATING 16". STRENGTH OF 3000 P51. 4. COMPACT ALL FILL UNDER FOOTING5 WA LL ALL SHEATHING-EXPOSURE I, 1/2", HOU5-5052.5 W/55TB24 5/8" DIAMETER ANCHOR BOLT (A 2.ALL SAFETY REGULATION5 8 SLABS TO THE SPECIFIED DEN5ITY 1.VERTICAL $ BOND BEAM SPAN RATING 16". O W/GNW 5/8"COUPLER NUT BETWEEN 557524 8 5/5" t ARE TO BE STRICTLY FOLLOWED. 8 VERIFY. REINFORCEMENT SHALL CONFORM THREADED ROD INTO HOLDDOWN. POSITION 55T524 0 w METH005 OF CONSTRUCTION 8 TO THE REQUIREMENTS OF A5TM A615. W/ANGHORMATE TO FORMWORK PRIOR TO CONCRETE ERECTION OF STRUCTURAL MATERIALS G.ROOF SHEATHING-EXPOSURE I,5/8", d .2 r IS THE CONTRACTORS RESPONSIBILITY. STRUCTURAL STEEL 8.MORTAR SHALL CONFORM TO THE SPAN RATING 16". POUR FOR CORRECT PLACEMENT. REQUIREMENTS OF A5TM C 210 HOUS-5052.5 W/55TB28 1/8" DIAMETER ANCHOR BOLT 3. THE CONTRACTOR 15 RE5PON51BLE 1. DESIGN,FABRICATION 8 ERECTION AND SHALL BE TYPE M OR 5. DE5I6N CRITERIA O W/GNW We)"COUPLER NUT BETWEEN 55T528 8 1/8" FOR DISSEMINATION OF ALL SHALL BE IN ACCORDANCE WITH q.QUALITYASSURANCE TESTING 8 ASA THREADED ROD INTO HOLDDOWN. P051TION 55TB28 h REVISIONS 4 REQUIREMENTS TO THE A15G SPECIFICATION FOR INSPECTION SHALL BE PERFORMED I.APPLICABLE BUILDING CODE W/ANCHORMATE TO FORMWORK PRIOR TO CONCRETE S y THE SUBCONTRACTORS. LATEST STRUCTURAL STEEL FOR BUILDINGS, IN ACCORDANCE WITH THE MASSACHUSETTS 8TH EDITION POUR FOR CORRECT PLACEMENT.EDIT N REQUIREMENTS OF AGI 530.1/A5GE 6/88. g 4.REASONABLE CARE HAS BEEN 2.AFPA/AWG GUIDE TO WOOD HOU14-5052.5 W/SBIX30 I" DIAMETER ANCHOR BOLT _ TAKEN IN THE PREPARATION OF 2. STRUCTURAL SHAPES SHALL CONFORM CONSTRUCTION IN HIGH WIND AREAS 14 W/GNW I"COUPLER NUT BETWEEN 55IX30 8 1" ALL DRAWINGS AND SPECIFICATIONS. TO THE FOLLOWING: FRAMING LUMBER E CONNECTORS FOR ONE AND TWO FAMILY DWELLING5, THREADED ROD INTO HOLDDOWN WITH HOLDDOWNto jq _ HOWEVER THE ENGINEER DOES NOT 110 MPH,.EXPOSURE B ATTACHED TO bXb POST. POSITION 55IX30 W/ GUARANTEE AGAINST HUMAN ERROR A. WIDE FLANGE MEMBERS A5TM I.ALL FRAMING LUMBER SHALL BE ANGHORMATE TO FORMWORK PRIOR TO CONCRETE C� y 8 FOR THAT REA50N IT 15 IMPERATIVE A6112 GRADE 50. KILN DRIED Iq% MAXIMUM MOISTURE POUR FOR CORRECT PLACEMENT. w m THAT THE CONTRACTOR SHALL CHECK CONTENT. LUMBER SHALL MEET 1-4 a ALL DIMENSIONS 4 DETAILS 8 MUST B.CHANNELS 8 ANGLES A5TM A36. AS A MINIMUM THE FOLLOWING STRUCTURAL DE516N CRITERIA F - B ERIIFYELEVA ALL CONDIT O SITE.ALL IONS, G.H55 ROUND 8 RECTANGULAR TUBES DESIGN VALUES FOR SPRUCE-PINE-FIR: DISCREPANCIES SHALL BE BROUGHT TO A5TM A 500,GRADE B FY=46 K51. A. 2X STUDS CONSTRUCTION GRADE - FIRST FLOOR 40 P517 LL F�1 TO THE ATTENTION OF THE ENGINEER F15=800,FV=65,1`0=150 10 P5F DL V 3. ALL GALVANIZING SHALL CONFORM Q a� 5.THE CONTRACTOR SHALL SUBMIT TO A5TM A 123. B.2X JOI5T5/RAFTER5 NO. I GRADE - SECOND FLOOR 40 PSF LL COMPLETE SHOP DRAWINGS FOR FB=1150,FV=10 10 PSF DL CONNECTION TO CONCRETE FOUNDATION _ ALL CONCRETE REINFORGING,ALL 4. BOLTED CONNECTIONS SHALL BE WITH C. P05T NO. I GRADE FB=800, -ATTIC/STD. 20 P5F LL a ` STRUCTURAL STEEL, 8 BOTH HIGH STRENGTH BOLTS IN ACCORDANCE 10 P5F DL FOUNDATION SILL PLATE CONNECTION TO CONCRETE: LC CALCULATIONS 4 SHOP DRAWINGS FV=65,FG=615 -ROOF 65L 30 P5F 5L FOR ALL MANUFACTURERED LUMBER WITH THE ALJOINTS USN FOR PRODUCTS 8 THEIR CONNECTORS STRUCTURAL JOINTS USING A5TM A 325 10 P5F DL OR A 4010 BOLTS. 2.ALL FASTENING OF FRAMING, 5/8" DIAMETER ANCHOR BOLTS® 32" O.G. FOR REVIEW PRIOR TO FABRICATION. PLATES,SILLS,SHEATHING $ - EXT.WALL5/5TOR. 100 PLF DL 5.ANCHOR BOLTS SHALL BE A5TM A 301. OTHER WOOD MEMBERS SHALL NOTE: ANCHOR BOLTS REFERENCED ABOVE TO BE 5/8" VIA. BE IN ACCORDANCE WITH THE - INT.WALL5/5TOR. 80 PLF OIL A301 STEEL ANCHOR BOLTS Al 3" X 3" X 1/4" PLATE WASHERS CONCRETE DETAILS SHOWN $ MINIMUM -DEGKS/PORGHES 40 PSF Al l" MINIMUM EMBEDMENT INTO CONCRETE. 6. WELDS SHALL BE MADE BY OPERATOR5 REQUIREMENTS OF THE I.ALL CONCRETE WORK AND MATERIALS CERTIFIED BY THE STANDARD MASSACHUSETTS STATE BUILDING 10 P5F SHALL COMPLY WITH THE SPECIFICATIONS QUALIFICATION PROCEDURE OF THE CODE 8TH EDITION. FOR STRUCTURAL CONCRETE FOR BUILDING5 AMERICAN WELDING SOCIETY. Z (AGI 301-Sq). 3.GONNECTOR5 5HOWN ARE AS z� ,�A 1. WELDING SHALL BE IN ACCORDANCE MANUFACTURED BY 5IMP50N Oa a -1 2.ALL CONCRETE SHALL HAVE A 28=DAY WITH THE AW5 01.1 CODE FOR WELDING STRONG-TIE 00. INC. 5UB5TITUTION5 GENERAL NAILING SCAIEDULE-NO IN BUILDING CONSTRUCTION. MUST BE APPROVED IN WRITING JOINT DE56RIPTION ra4MON ZI "^�J NAIL SPACANB COMPRESSIVE STRENGTH OF 3000 P51, coMrON NMLs Box NAILS BY THE ENGINEER. INSTALLATION VFW 9 WITH MAXIMUM I INCH AGGREGATE 8 ROOF FRAMING W 3 MAXIMUM 6%AIR ENTRAINMENT FOR OF ALL CONNECTORS SHALL BE Z ?z 8. CONNECTIONS NOT DETAILED SHALL IN 5TRIGT ACCORDANCE WITH THE BLOC'KINSTO RAFTER(TOE-NAILED) 2-6D 2-100 EAu ED z EXTERIOR CONCRETE EXP05ED TO BE DESIGNED FOR THE LOADS SHOWN MOISTURE. ON THE DRAWINGS OR FOR LOADS THE MANUFACTURER'S INSTRUCTIONS RIM BOARD TO RAFTER faro-NAILED) 2-160 9-161, exN END GIVEN IN THE STANDARD LOAD 8 MUST EMPLOY ALL REQUIRED MALL FRAT9N6 F•'� TABLES OF AI5C FOR THE SPAN, FASTENERS. TOP PLATES AT INTE35EGTIONS(FACE-NAI�W) 4-I6D -- AT.DINTS It 3.ALL REINFORCING STEEL SHALL BE � S^ DEFORMED 5AR5 OF NEW BILLET STEEL SECTION 4 STRENGTH SPECIFIED. O STTO5TUDmACe-NAILED) 2-16D 2-1611 24.O.C. CONFORMING TO A5TM A 615 GRADE 60. 4.ALL CONNECTORS SHALL BE HEADER TO HEADER(PAGE-NAILED) 169 16D 16.0.0.ALONG EG&E5 q.ELEVATIONS NOTED AS "TOP OF STEEL" HOT DIP GALVANIZED. FLOORFRAMN& 4.CONCRETE COVER OF REINFORCING BARS REFER TO THE TOP FLANGE OF ROLLED J015T TO SILL,TOP Fore OR 61RDER(TOE-NAILED) 4-611 4-100 PER JOIST SHALL BE AS FOLLOWS: SECTIONS. 5. INSTALL ALL CONNECTOR FASTENERS BEFORE LOADING THE JOINT. B OCIC NS TO JOIST true NAIL®) 2 6D 2_100 EACH END L A.3"AT CONCRETE PLACED DIRECTLY 51.004 IN&TO SILL OR TOP PLATE CrOE-NAILED) 5-161, 4-160 EACH BLOClc AGAINST EARTH. MA50NRY 6.SPLIT WOOD 15 NOT ACCEPTABLE LEPSM STRIP TO BEAM OR&RIVE,(PACE-NAILED) 5-16D 4-160 EAGH.OIST 0 L) 0 z 0 0 FOR ANY CONNECTION. J015T ON LEDGER TO BEAM CrOE-NAIL®) 9-6D 5-100 PER JOIST B.2"AT ALL OTHER LOCATIONS. C: U c6 I. MASONRY CONSTRUCTION SHALL BAND J015T TO JOIST(END-NAILED) 5-160 4-1611 PER J015T .2-0 - to L CONFORM TO THE REQUIREMENTS 1.ALL EXPOSED FRAMING MEMBERS BAND.rnST TO SILL OR TOP PLATE(TOE-NAILm) 2-1612 5-166 . PER FOOT (6 5. NO HORIZONTAL CONSTRUCTION JOINTS OF SPECIFICATIONS FOR MASONRY SHALL BE TREATED PER AWPA ROOF SHEATHING, N ARE ALLOYED,UNLESS SPECIFICALLY STRUCTURES(AGI 530.1/A5GE(2-88). C2/Gq GGA 0.25 8 MEMBERS IN L 5HOWN ON THE DRAWIN65 OR ALLOWED STRENGTH OF MA50NRY F'M=1500 P51. CONTACT WITH SOIL SHALL BE MDODSTRLcTLRALPANELS IN WRITING BY THE ENGINEER. TREATED PER AWPA G23/C24 RAFTERS OR TRUSISM SPACED w TO 16'O.C. 6D 100 6•EDGE/6•FIELD 2.VERTICAL REINFORCING OF MA50NRY GGA 0.60.JOB SITE FABRICATIONS RAFTERS ORTrar5SE5SPACED OVER 16.OZ. 6D 100 4'EDGE/4'FIELD U) 0 Co 6. REINFORCING E1�IDEDN@lT STANDARD WALLS SHALL BE AS INDICATED ON GUTS $ BORES SHALL BE TREATED IN GABLE ENDITALL RAKE OR RAKE TRL*S WO&ABLE OVERHANG 60 100 6•EDGE/6•FIELD 0 LL BAR Lam11 MOOK THE DRAWINGS. ALL GORES OF ACCORDANCE WITH AWPA 5TD. M4. .2 -&ABLE ENDWALL RAKE OR RAKE 7RU53 W STRUOTJRAL OURDOKER9 BD IOD 6'EDGE/6'FIELD '4 12• 12• MASONRY UNITS SHALL BE FILLED _&ABLE EDMAL L RAKE OR RAKE TM55 PV LOOKOVr BLOCKS 0D 10D 4'ED&E/4•FIELD Y/" a) •5 16, 12• WITH GROUT. REINFORCING BAR 8.ALL MANUFACTURED LVL W000 FRAMING N C7 .6 W. 1. LAPS SHALL BE 2'-6" MIN. MEMBERS SHALL HAVE THE FOLLOWING CELIN6 SHEATHN6 Cu O ,T 24• 16• PHY516AL PROPERTIES AS A MINIMUM: &TPSM PIALL.eOARD sD COOLERS - T'EDGE/10•FIELD 3.HORIZONTAL JOINT REINFORCING 6 MALL__.TTaN6 job no.: m90 E=2.OXIO PSI.,FB=2800,FV=240. woOD STW date :24 Au&usr 2016 FOR MASONRY SHALL BE EQUAL /OTLRAL PANELSFOUNDATIONS TO OUR-O-WALL TRU55 MANUFAGTERED _STLV5 SPACED LF TO 24'O.C. 6D 100 6•EDGE/12'FIELD : WITH WIRE CONFORMING TO A5TM A 82 q scale AS NOTNOTED. ALL FLOOR JOISTS SHALL BE A5 v2 AND 2sa2 F BERBOARD PANELS or, 9'EDGE/b'FED 8 COATED FOR CORRO51ON PROTECTION MANUFACTURERED BY 5015E CASCADE I.THE ALLOWABLE PRESUMED SOIL IN ACCORDANCE WITH A5TM A 153, $ AS 51ZED ON THE DRAWINGS. ALL -1/2- 1M"6YP9ALLWARD sD COOL 7ERS EDGE/10'FIELD drawn: MM BEARING GAPGITY 15 3000 PSF, GLASS B-2. ALL WIRE SHALL BE FASTENING,BEARING,BRACING 8 FLOOR5HEATHIN6 rev. WHICH 15 TO BE VERIFIED IN THE FIELD q GAGE MINIMUM. PROVIDE MINIMUM 5TIFFENING SHALL BE IN 5TRIGT ACCORDANCE MOOD STRIZI AL PANELS rev. BEFORE CONSTRUCTION. LAP OF 6" & USE PREFABRIATED T'S WITH THE MANUFACTURER'S REQUIREMENTS. rORLE56 60 00 6 EDGE/@ FIELD E OR CORNER SECTIONS AT ALL WALL INTERSECTIONS. GREATER THAN r pD 160 6'EDGE/6'FIELD A m 2.FOOTINGS SHALL BE CARRIED _ I TO LOWER ELEVATION THAN SHOWN CON THE DRAWINGS IF REQUIRED TO 4. CONCRETE MA50NRY UNITS SHALL n IS REACH PROPER BEARING GAPGITY. CONFORM TO A5TM C qO. ISSUED FOR PERMITTING Ot 'f of g m o E E Vl V o W N _ G7 a i0 � L y N f0 o c ` M 0 Cu ROOF 5HEATHiN6 .-: o W LSTA STRAP® 16"O.G. E EDGE NAILIN& - (PER 65N) L tp Cl 2X BLOGKIN&BETWEEN ROOF 5HEATHIN6 RAFTERS(NOTCH FOR VENTILATION IF REQUIRED. _ REFER TO ARCHITECTURAL (1)-100 NAILS, PLANS FOR MORE INFO) ®EACH END y 07 w -p F � — +++++++ +++++++ ~ V ROOF RAFTER PER PLAN. Q (REFER TO ARCHITECTURAL H2.5A(INSTALL PRIOR TO SEE ALTERNATE / w PLANS FOR RAFTER DIM5. - BLOGKIN6 AND PLYWOOD r/ •— AND EAVE DETAILING) 5HEATHIN6)ALTERNATE: 142A ROOF RAFTER PER PLAN (n V DOUBLE 2X TOP PLATE - . ALTERNATE: ATTACH OPP051N6 RAFTERS BELOW RIDGE BEAM OR RI06E BOARD W/ 2X4 COLLAR TIE AS SHOWN.RIDGE STRAPS SEAM - NOT REQUIRED WHEN USINb A COLLAR TIE. (IF SHOWN ON PLAN) - �z 0RAFTER o TO TOP PLATE 2 STRUCTURAL RIDGE BEAM ZO R py�� NOT SCALE O NOT TO SCALE OZ 9 a c O W& �W$ ogw �Wa W z oQ 5HEARWALL SCHEDULE zt WALL TYPE SCHEDULE: 5HEARWALL CONSTRUCTION: N 15/32" PLYWOOD -(EDGES BLOCKED) I. ALL 5HEARWALL5 TO HAVE DOUBLE TOP PLATES ° rpm to ASD COMMON OR GALVANIZED BOX NAILS 8 DOUBLE 2X STUDS AT EACH END OF THE WALL. to t = b"O.G.EDGES $ 12"O.G.FIELD. N L) to 2.FACE NAIL DOUBLE TOP PLATES W/ 16D NAILS @ 16" O.G. m a) I5/32" PLYWOOD -(EDGES BLOCKED) USE(12) - I&D NAILS AT EACH SIDE OF LAP SPLICES IN TOP o'— = rn p PLATES. SPLICE LENGTH TO BE A MINIMUM OF 4'-0" LONG. to �2 SD COMMON OR GALVANIZED BOX NAILS R1 mCu 3" O.G. EDGES B 12" O.G.FIELD. 3.NAILING FOR PERFORATED 5HEARWALL5 TO BE CONTINUED N =3 I5/32" PLYWOOD (EDGES BLOCKED) ABOVE AND BELOW ALL OPENINGS IN SHEARWALL. 06 x N U &D COMMON OR GALVANIZED BOX NAILS 4. ATTACH DOUBLE 2X STUDS $ BUILT-UP CORNER STUDS AT o lL- 2" O.G.EDGES 8 12" O.G.FIELD. 5HEARNALL ENDS W/(2) 160 NAILS @ b"O.G. FOR ATTIC/ 0_r (n FRAMING AT ADJOINING PANEL EDGES SECOND FLOOR SHEARWALL5 AND(2) IbD NAILS @ 4" D.G. O a) SHALL BE 3" NOMINAL OR WIDER B STAGGERED FOR FIRST FLOOR 5HEARWALL5. a to NAILS SHALL BE STAGGERED. Cu 0 � 5.REFER TO HOLDOOWN SCHEDULE FOR TIE DOWN5 AT NOTE: FOR PLYWOOD SHEARWALL TYPE5 I,2, 8 3 SHEARWALL ENDS. L15TED ABOVE,SD job no.: ow COMMON OR GALVANIZED date :�<Auwsr,�oia NAILS-(0.131 X 2 1/2") GUN NAILS MATCHING THE NAIL DIAMETER 8 LENGTH MAY BE USED AS A SUBSTITUTE. scale As NOTW drawn:ow rev. rev. f S-2 ISSUED FOR PERMITTING sht 0 Of 0