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HomeMy WebLinkAbout0054 PRINCE AVENUE - Health 54 PRINCEW v e n.�, = ► A=,0?1 7 - O ar 5 c I I i J Commonwealth of Massachusetts . Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �� 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 — page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered ini any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information 6 1# ^� on the computer, Michael Sears use only the tab key to move your Name of Inspector cursor-do not Robert B Our Co IN_C. use the return Company Name key. 363 Whites Path � Company Address South Yarmouth Ma. 02664 City/Town State Zip Code retvra 508-477-8877 S114430 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes \`��++►utOFiuiq� 2. ❑ Conditionally Passes y MICHAEL 3. ❑ Needs Further Evaluation by the Local Approving Authority _o: SEARS * No.SI14430 4. ❑ Fails ''-.A'r'•FRT►f��. �o�� le arm nP�G��````` -- 8-17-20 Inspector's Signatur 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2016 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 c Commonwealth of Massachusetts p Title 5 Official Inspection Form +- P Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons_Mills Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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): l5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �� 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills__ Ma. 02648 8-17-20 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 cam, Commonwealth of Massachusetts +n Title 5 Official Inspection Form ti,� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Prince Ave u Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ . 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 b. 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. c. Other: 4) 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 C Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . � 54 Prince Ave Property Address Shelly & Nelson Ab_reu Owner Owner's Name information is required for every Marstons.Mills _ Ma. 02648 8-17-20 page. CityrFown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 'h 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c Commonwealth of Massachusetts Title 5 official Inspection Form �I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Prince_Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: 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? El ® 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)) t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 - -- page. City/Town State Zip Code Date of Inspection D. System Information 1. 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 Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes E. No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): 2018- 99000 gal 2019-109000gal Detail Sump pump? ❑ Yes ® No NA Last date of occupancy: Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 AN, Commonwealth of Massachusetts Title 5 Official Inspection Form iI Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 54 Prince Ave v Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 page. CitylTown _ State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. 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 pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson_Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 --------- page. CitylTown State Zip Code Date of Inspection D. System information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy i El Shared system (yes or no) (If yes, attach previous inspection records if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and n ract to be obtained from system owner and a co of latest maintenance cot ( y ) PY inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 8-19-85 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 32" 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c Commonwealth of Massachusetts �n Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson Ab_re_u Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 -----..---.--- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): 24 Depth below grade:p g feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) Both tanks1500 gal at 24" below grade If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 1500 V. 4" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 29" 24" 0 2" Scum thickness Distance from top of scum to top of outlet tee or baffle 8" 8" Distance frorr bottom of scum to bottom of outlet tee or baffle 18" 12" How were dimensions determined? Sludge gudge, tape Comments (o-i pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Both tanks have inlet and outlet tees both tanks at 2' below grade with all covers at 15" below grade t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 c Commonwealth of Massachusetts �� Title 5 Official Inspection Form �I; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson_Abr_eu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 -------- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (an pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form tiI; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) 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 9. 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 is 24"x.24" with 2 inlet pipes and 4 outlet pipes box is at 28"with cover at 17" below grade t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 I cam, Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson_A_breu Owner Owner's Name information is required for every Marstons Mills,___ Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 4 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form II; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f �� 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons Mills Ma. 02648 8-17-20 -- — page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): SAS is 4- 500 gal drywells with 2' stone wells are dry and clean with no sign of failure 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 I c Commonwealth of Massachusetts Title 5 Official Inspection Form tit Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every MarstonsMills_ Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form - _ 1- Subsurface Sewage Disposal System Form - Not for Voluntary Assessmen s 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Narne information is required for every _Marstons Mills _ _ _ Ma. 02648 8- 7-20 page. Cityrrown State Zip Code Date of Inspection D. System information (cont.) 14. 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 ry i1 At Z11 a. St I ,- .l -3 ' -34'. q S Avit i t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewag Disposal System-Page 16 of 18 T Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 54 Prince Ave Property Address Shelly & Nelson_Abreu Owner Owner's Name information is required for every Marstons_Mills Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface'water ® Check cellar ® Shallow wells Estimated depth to high ground water: 12 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 5 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: 12' no ground water per plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ............ ........ , 54 Prince Ave Property Address Shelly & Nelson Abreu Owner Owner's Name information is required for every Marstons__Mil_Is________ Ma. 02648 8-17-20 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 TOWN OF BARNSTABLE ?LOCATION ,$-5� 1Dr(/1CA- SEWAGE# ilk VILLAGE Ma,-Y&A !/►VAS ASSESSOR'S MAP&PARCEL 77/Y9. INSTALLERS NAME&PHONE NO. (_a g SEPTIC TANK CAPACITY a) /roo 14to LEACHING FACILITY:(type) S'Oa `-C. 410 (size) NO. OF BEDROOMS S OWNER PERMIT DATE: COMPLIANCE DATE: . c ,�- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility U / Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) No Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) /00 Feet FURNISHED BY (.(—C- C V �3 .o a ig9 0 �3 �O'f 6 3 33 � a5 ve cs Sa.o r No. D®o © 5 �° FEE 156 Board_of Health, Bit ten.S j­tt� le , MA. APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( Upgrade( Abandon( ) - 'Complete System ❑Individual Components Location j ��fl C2 Avv_ M M Owner's Name ex A-6 vv_c( Map/Parcel# U—7-7 04 9 Address Jr—i, ��(�°� CQ / /�M, T,3 Lot# Telephone# Installer's Name `&A- C Z (,C.C. Designer's Name e //���L �n Address �� Address l,Z (iV, C'nu SSA`2Id /01 ff0nej 4 11 Telephone# 5 e( q 1i Ll o 11 Telephone# (5-0 a 4_7-7 g 3 )`3 ®Z-&y y Type of Building /Z$ e," 1-1'1 ( W in_UX_U q 4-` �D �A Lot Size 24C k 93 sq.ft. Dwelling-No.of Bedrooms Z4EX k S I-Pn - 1 0!9Zecr1-tJ4 <h' Garbage grinder ( ) Other-Type of Building �^4M No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) S517 gpd Calculated design flow y Design flow provided -7 i 4- gpd Plan: Date 10 0 Job Number of sheets 73 Revision Date ° Title P Ot,,d nqn AC _C>Vsk l'l , ehlt CC /I/6,rP;h U Mt ' Description ofSoil(s) � 1 ��' Q — � b /� i ��3 �' "— ZOO(( SAW Soil Evaluator Form No. ire s La Name of Soil Evaluator Ao f=tt- 1![G��ippate of Evaluation �! I 1 2-00 e DESCRIPTION OF pREPAIRS ORA`LTERATIONS /D iS/ r0 OS ` b��e�->^1 .114 1 uk ev t�✓'b�pdt't S ,e The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to n plac the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date 2— 6;.7 0 /1 7 Inspections No. D007 -0- 56 156 . FEE COMMONWEALTH OF MASSAC tTst rfs V k� 10 5 )-CL� Le Boaf it ea th, MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgradex Abandon( - )dComplete System LJ Individual Components Location I'(1 c-c Av-e M Owner's Name,, Map/Parcel# 0-7-7 Address ,5-Ll we Awe , /41,M, 0?—(6, 1 Z Lot# Telephone# Installer's Name GLL Designer's Name IFAddress Aadressl Z 0, 4frCjcSTod 161, fO�ncs+ciciv, fj Tcl,p ho�u# 5 214 (4 c�-aA Telephone# (So&�47-7 -5 5 >3 0 0- )Si" sq.ft. Type of Building 11-ot 3 Dwelling-No.of Bedrooms 2 R x r S t-1.1 4- Garbage grinder( Other-Type of Building zV/A No.of persons Showers ( ),Cafeteria( Other Fixtures Design Flow (min.required) gpd Calculated design flow 575-0 Design flow provided gpd to 0 -3 1�I Plan: Date Number of sheets Revision Date Title Led o,AJ ��,Pc j ke m -1 r Mel -TP- Z -s7 q A r A Description of Soil(s) A 0 6 2 SAIVP �t 00 Soil Evaluator,Form No. &-,'f151-46Q Name of Soil Evaluator f-f---/4C-1�4 ate of Evaluation i Z e+ DESCRIPTION OF REPAIRS OR AETERATIONS 0 o, 0 S m - -r q t4 , /j A �c, 2 b-edluvl" Acio -Le ntdq";Sj1 -C-r A 1-,,VV,'0tf -lu,4-vre A 1 461fl 4 7- ao(d'l 4,fd,-0V,"5 1'elt- a -60 t C', 0 /ri W IV 67P The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to of plage the system in operation until a Certificate of Compliance has been issued by the.Board of Health. Signed Date -) /16/7 Inspections No. 'D -05 FEE COMMONWEALT14 OF MASSACHUSETTS Board of Health, B61 r1 S f I XL4. CERTIFICATE OF COMPLIANCE Description of Work: 0 Individual Component(s) $d Complete System The undersigned hereby cerfiq that the Sewage Disposal System; Constructed Repaired Upgraded Abandoned by: A k (F�x I-(-%" V--, )-e I L at 5 LA Q(-,,I C-e- 11 �04 5 o, has been installed in accordance with the 134-11tog s of 310 CMR 15.00 (Title 5) an the approved design plans/as-built plans relating to application No. D43-) 56 , dated Approved Design Flow (gpd) ' d k�� L te-� /) 0 Installer <.,Lj\ LL f Designer: e Inspector: "J Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. FEE COMMONWEALT14 OF MASSACHUSETTS Board of Health, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT r1a, Permission is hereby granted to; Construct. Repair( ) Upgrade( ) Abandon( an individual sewage disposal system at— 54 A,I* ' as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three yea'rs of the date Kf fhis perm�'. 'Moc I conditions must be met. -2 Board h Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date of Health i 8/11/2020 ShowAsbuilt(1700x2800) i TOWN OF BARNSTABLE LOCATION _f Pi nc. SEWAGE# VILLAGE' %Yla/flran N4rllf .ASSESSOR'S MAP.&PARCEL 27Zy9 INSWLERS NAME&PHONE NO.1_ .w,i, &F- yzy Ski1P SEPTIC TANK C-APACITY_Q IS-00 FHO LEACHING FACILITY:(type)S.1) sap i.[- 4 O (size) 13',1 NO.OF BEDROOMS $� OWNER PERMIT DATE: _COMPLIANCE DATE: .� Separation Distance Between the: - Maximum Adjusted'Ground-ater Table to the Bottom of Leaching Facility._,d[a 10 It Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Na Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of,leaching'facility) /d0 Feet FURNISHED BY i r � 3 RI /h.o 37- %99•a O 63 4u.I 6 3V 33.0 pS as•r e4 3s r e3 r� 4 C.'P fli.b C Sa.o i https://itsqldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=077049&sq=1 1/1 Town of Barnstable Regulatory Services Thomas F.Geller, Director NAM Public Health Division Thomas McKean, Director --- 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 2 Z2 �� Sewage Permit# 20Z�1-0 L Assessor's MaplParceD 2 7 _L 1 Designer: �►-�' _ G'1J04A_S Installer: �`� ^i°'? —S Address: L crrss�-E-1 Address: U • °�C Q S�'rr (h' c - On 2�11 " 01 �was issued a permit to install a (date) (installer) septic system at St-( d -A 1� based on a design drawn by (address) dated (designer) �-----1----� ` x I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS.or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. , !�OF4 PETER T. 'r, WENTEE taller's Si tore 1 No.35105 Nt O� Q'ISTE� 4�°✓ " (Designer's Signature) (Affix Designer's Stamp Here) PLEASE REJJJRN IQ BARNSTABLE PUBLIC HEALT'IH DIVISION, CERTIFICATE QF COMPLIANCE WILL NOT BE ISSVE+ID UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RF,CEWED BY THE§AM51ABLE EUBLIC HEAL3:H DIVISION, THA.'NK YOU. Q:Health/SepticfDesigner Certification Form 3-26-04.doc r Town of Barnstable F'(ME T�O Regulatory Services snkivsrAs Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office:.508-862-4644 Fax:..508-790-6304 October 4, 2006 Mrs Shelly Abreu 54 Prince Avenue Marstons Mills,MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located at 54 Prince Avenue,Marstons Mills, MA was last inspected June 29th, 2006 by Robert J. Bortolotti, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Liquid depth is less than 6"below invert with staining 3" above Liquid.. You have 90 days from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HE . TH DEPARTMENT Thomas A. McKean,R.S., C.H.O. Agent of the Board of Health -\ COMMONWEALTH OF MASSACHU ETTS z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS. DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE"DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: a ga'//�� //f/ ` Owner's Name: p _- Owner's Address: ;9, T a -- z Date of Inspection: t� Name of Inspecto (please Tint) s-�.y� t 1C Company Name• - E9f)'). 0 -yG Mailing Address:A06A, C51r� Telephone Number: j'R: '7'2 q :2, ' CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes eeds Further Evaluation by the Local Approving Authority yi pai s Inspector's Signature: - -®--e-- Date: 1%liflo The system inspector shall submita copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection,and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection o . / / page- Form 6 15 2000 1 Pg Page 2 of 1 I 1 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 9 � Owner:. Date of Inspection: B 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 Page 3 of l l OFFICIAL, INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION'FORM PART A CERTIFICATION(continued) Property Address: P /',1, Z , 9-6 Owner: Z ' Date of Inspection: ' 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(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 . 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 ormore 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 oraanic compounds indicates that the well is.free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL.INSPECTION FORM—.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE-DISPOSAL.SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:.: `� y4 f _ Owner �1zv v, Date of Inspectio t f1, 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 clogoed,SAS or cesspool Discharse 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, vd Liquid depth in cesspool is less.than 6"below invert r available volume ' e 'q P P o olum 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 groundwater 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 ofa.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 colifor.m 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.] � C (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described.in 310 CMR I5.303,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 You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a:surface drinking water supply the system is within 200 feet.of a tributary-to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well.- If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of an large system considered a g Y P Y g Y. significant threat under Section E or failed under Section D shall upgrade the system in accordance with 3.10 CMR 15.304.The system owner should contact the appropriate regional office of the Department. - .4 Page 5 of I 1 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 5V P, 1211"4.69'y U1;a� Owner '/A 1 v Date of Inspection: Check if the following have been done.You must indicate`yes"or"rid' as to each of the following: Yes Na Pumping.information was provided by the owner,occupant, or Board.of Health _ZWere any of the system components pumped out in the previous two weeks? i _ Has the system received normal flows in the previous two week period? / l! 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? ` 1 _ Was the site inspected for signs of breakout? Were all system components, excluding the SAS, located on site e / Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition o he 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 V Existing information.For example, a plan at the Board of Health. Determined in he 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)]. I l Page 6 of,11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART.C SYSTEM;INFORMATI ON Property Address:,6Y -Owner:" Date.,of Inspection: . - (0 _ FLOW CONDITIONS RESIDENTIAL. Number of bedrooms:(design): Number of bedrooms(actuaI).: DESIGN flow based on 310 CMR 15:203 (for example: 11.0 gpd x n.of bedrooms): Number of current residents: _ / Does residence have a garbage grinder(yes or no):/S/0 Is laundry on a separate sewage system.(yes or no):�.[if ves separate inspection required] Laundry system inspected,(�y/es or no): { (� Seasonal use: (yes or no).h/Water meter readings, if available(last 2 years usage (gpd)): Aap g9 J__ '3�0�® Sum PPumPf)'es or no):J�7 . Last date of occupancy: t el' ...a COMMERCIAL/INDUSTRIAL. /IV/() Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):— Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): i0 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). _fight tank Attach.a copy of the DEP approval =/Other(describe): �•i�'fi;.� A�p roximate age of all components, date installed(if known and source of information Were sewage odors.detected when arriving at the site(yes or no):= Page 7 of i 7 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS ` SUBSURFACE SEWAGE DISPOSAL SSYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection:. C/ BUILDING SEWER(locate on site plan)�/o. 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:,in(locate on site plan) Depth below grade: 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: Sludge depth: 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-- Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): r , GREASE TRAP: L(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 1.1 . OFFICIAL JNSPECTIO.N FORM-NOT FOR.VOL;UNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 21 Property Address:,-4sY /" A A Owner Date of Inspection: f .,/-(Z,• IV TIGHT or HOLDING TANK: A16(tank must be pumped at time of inspection)(loc.ate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_�olyetfiylene other(explain)... Dimensions: Capacity: gallons Design Flow: gallons/day Alain 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: IVO(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is Ievel and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): PUMP CHAMBER:A (Iocate 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.): g Page 9 of l 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION'(continued) Property Address: ✓ Zz✓� Owner Date of Inspection: ' %7 o(. SOIL'ABSORPTION SYSTEM (SAS): locate on site plan,excavation not required) If SAS not located explain why: Type T leaching pits,number: leaching chambers,number: Ieaching galleries, number: leaching trenches,number, len_ath: 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, a l � / sr J ail t�tx_^ i! ev CESSPOOLS: (cesspool must be pumped as part of inspect ion)(locate on site plan) Number and configuration: Depth'—top of liquid to inlet invert: Depth of solids layer: Q 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.): ov �J y 4 f y)% %.,�,( l" +.,'.1'n,�✓�:e�O�.d '�7 PRIVY::' w (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 Paae 10 of 1.1 OFFICIAL INSPECTION FORM—NOT FOR:VOLLNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: ' Y R Owner: OPT, ✓ � Date of Inspection: . 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 buildin1g. 56( C� �r ' 10 Page l I of 11 OFFIC-IAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: ✓"/�:� Q_• , Owner: Date of Inspection: cGl SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water r 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: i Checked with.local excavators,installers-(attach documentation) 11 Accessed USGS database-explain: You must describe how you established the high ground water elevation: 11 Permit Number: Date: Completed by: � HIGH GROUND-WATER LEVEL COMPUTATION. Site Location-: � - -- -' Lot No. Owner: 1 '.A/ Aka Address: Contractor: Address:— Notes.: o ' �'� STEP 1 Measure depth to water table to nearest 1/10 ft. ............. . .Date <�✓Yy�/' month/day/year STEP 2 Using Water-Level Range Zone,: and index Well Map locate site and determine (AAppropriate index we] ;� l ............... Water level range zone OB STEP 3 Using monthly report"'Current Water`:Resources Condifions determine current depth to � /� q7,5 water level for...,rndex.wel.l..,.....,.....:..,._.............. `G+' month/year STEP 4 Using Table=of-Water level Adjustments for index-Well-.(STEP. 2A),lcurrent depth to water.-le.vel:for.index-well (STEP 3), and water level zone (STEP 26) -determine water-level adjustment .......................................................................................... STEP 5 Estimate depth.to high water by subtracting the water- level adjustment (STEP 4) from measured depth-to water level at site (STEP 1) ................... Figure 13.-Reproducible.computation form. 15 /Po W�...+rmrr....-.:.y.:...�r.m:.�rn'r+.m„ _ ""��,_ _. .........• ht�r.C.,tva �i�Itlm'i+amm1�I F�(A(..�P� fr1 (y �. �� pry / ';✓l7/ ..� COV �� _ ( G ---�---- v 6�1 a ND D a I 1 oO $ry I -!P Gt Ne/son Shelley�b�eu Fluor ian 51 Ahce /-venue A44(skps glils TOWN OOF_-BARNSTABLE 07 rO.IW / ATION �J �'�"�"` SEWAG # _841,,LAGE ASSESSOR'S MAP & LOT SEPTIC TANK CAPACITY 0 LEACHING FACILITY: (type) �.� �►� (size) NO. OF BEDROOMS �� �N BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between,4 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Town of Barnstable P# of iHe roh, Department of Regulatory Services ;!A �9 BAMSTABLE• i Public Health Division Date !® 90 MASS01 . 1639• e� 200 Main Street,Hyannis MA 02601 � �PTFr)MAC s F qq: Date Scheduled Time /0 Fee Pd. lee Soil Suitability Assessment for Sewage Disp al ee_-E-e - f r q C-&n fee vlaz�� � Performed By: Witnessed By:�\��ry .._�.. ...., LOCATION & GENERAL INFORMATION Location Address Owner's Name ,n I e-i Sa vi A )J C-CLJ �r5 1 t7rS 1- \/1�15 Address S G�Q Assessor's Map/Parcel: ll'10.� 7-7 l� r L I 4 c, Engineer's Name 10, )- NEW CONSTRUCTION 'r REPAIR �C Telephone �� �� f(-7-7-53�3 Land Use l� /s f eAJJA Slopes(%) Z-t4l _ Surface Stones N/.O'' + Distances from: Open Water Body j 5 0 ft Possible Wet Area7/5Z� ft Drinking Water Well 7 13 Drainage Way ft Property Line Z-V 1-- ft Other tt SKETCH:(Street name,dimensions of lot,exact locations of test(toles&perc tests,locate wetlands in proximity to(toles) a ►-i p T� m Parent aterial(geologic) AC4 a Depth to Bedrock 7 1 Depth to Groundwater: Standing Water in Hole: f' Weeping from Pit Face N� Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: //�Q-- Depth Observed standing in obs.hole: /v v ' in. Depth to soil mottles: in• Depth to weeping from side of obs.hole: in. ' Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST Date %.j Time1G Ad Observation 2 Hole# Time att 9.. t Depth of Perc �Q � J—/ Time a r Start Pre-soak Tinte a !9� !ti 2��a - e(9" ota"aXA � C End Pre-soak Rate Min./Inch 7 r Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) X— Original: Public Health Division Observation Hole Data To Be Completed on Back----T------ ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:HEALTH/W P/PERCFORM DEEP OBSERVATION HOLE LOG Hole #_ J Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, consistency,%Gravel) d s 'A t,S 10 'I fz-4 I-z_. -- I - 3� sc ,'�1 tQ 'f 2 sf 4 LaC' s--c DEEP OBSERVATION HOLE LOG Hole# 2— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) a 13 A c-s - 1 3 4 f3 L S Lo iZ 37 a 3� C!� lcs y`Iz 1V Lk DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) A, c r L s to ' DEEP OBSERVATION HOLE LOG Hole #_ L4 _ Dept h from Soi l Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,boulders. Consistency.%Gravel) C, ► Z Flood Insurance Rate Ma Above 500 year flood boundary No_ Yes Within 500 year'boundary No `F Yes Within 100 year flood boundary No—0—e Yes C " Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? C 5- If not,what is the depth of naturally occurring pervious material? Certification �p1� I certify that on 1 I l "1� _(date)1 have passed the soil evaluator examination approved by the Department of Envirorunental Protection and that the above analysis was performed by me consistent with the required ti 'ng,expertise and experience described in 310 CMR 1.5.017. Signature Date I 1 o& Q:HEALTH/WP/PERCFORM LO- ;AT N SEWAGE PERMIT NO. V1ti . A, E 4e, g ' ai-y I NSTA LLER'S NAME & A D D R E S l BUILD R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED -y w. t{. _. � � .... _ ..< _. __ ��A� �+ ��. �... - .. � /JJ ,. l�� zo , I T j, BUCTION, INC. 45 INDUSTRY ROAD, MARSTONS MILLS, MA 02648 508-771-9399 508-428-8926 FAX: 508-428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A - CERTIFICATION Property Address:^ Date Of Inspection / Inspector's Name: klfilaOwner's Name jind Address: .� CERTIFICATION STATEMENT: I Certify that I have personally Inspected the Sewage Disposal Syste..a at this address and that i.6e informa- tion reported below is true,accurate and complete as of the time of Z,ispection. The Inspectioln was perform- ed based on my Training and Experience in the Proper Function as t Maintenance of On-Site(:.wage Dis- posal Systems.Thy system: ' ✓ Passes. Conditionally sses Needs Furrt Evalua ' n By the Local Appr� ving Auth city Failure/ Inspector's Signature D. te: TheSystem Inspector shall submit a copy of this Inspection Repo t to the Approving Authority Mth Thirty (30)Days of completing this Inspection. If the System is a Sharer 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 Rel;:.tonal Offie of the Department of Environmental Protection. The Original should be sent to the System Owner and copies sent to the Buyer,if applicable and the Approving Authority. INSPECTION SUMMARY: A) SYSTEIV�PASSES: ,/ I have not.found any Information which i ndicates that the System violates any of the fail- ure criteria as defined in 310 CMR 15.303. Any Failure Criteria not evaluated.are indi- cated below. B) SYSTEM CONDITIONALLY PASSES: One or more System Components need to be Replaced or Repaired. The.Systen,upon completion of the Replacement or Repair,Passes Inspection. Indicate yes,nor,or not determined(Y,N,OR ND). Describe bases of determination in all instances. If"not determined",explain why not. The Septic Tank is Metal,Cracked,Structurally Unsound,shows Substantial Infiltration or exfil- tration,or Tank Failure is iimminent. The System will Pass Inspection if Existing Septic Tank is Replaced with a conforming Septic Tank as.Approved by the Board Of Health. Sewage Backup or Breakout or High Static Water Level observed in the Distribution Box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven Distribution Box. The System will pass Inspection if(With Approval of the Board Of Health): -1 - a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PARS'A CERTIFICATION (continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of The Board of Health): - ...Broken pipe(s)-are replaced Obstruction is removed C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 Feet of a surface water Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh. 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH JAND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT.THE.SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE.PUBLIC.HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 Feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds-indicates that the well is free from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level'idthe distribution box,above.outlet i_nvertdue to an overloaded or clog- ged SAS or cesspool.' Liquid depth in cesspool is less than G"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped -2- SUBSURFACE SEWAGE DISPOSAL,SYSTEM,INSPECTION FORM PART A CERTIFICATION (continued) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 Feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 Feet of a private water supply well. Any portion of a cesspool or privy is less than 100 Feet but greater than 50 Feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply,to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant. threat to public health and.safety and the environment because.one or more of the following conditions exist: The system is within 400 Feet of a surface'drtnking water supply The system is within 200 Feet of a tributary to a'surface dnnkingwater supply The system is located in a nitrogen:sensitive area Interini Wellhead Protection Area QWPA)or a mapped Zone II of a public water supply well. The owner or operator of any such system shall bring the system'and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CII ECKLIST Check if the following have been done: ,Pumping information was requested of the owner,occupant,and Board of Health. J�None of the system components have been pumped for atleast two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. µ I/ As-built plans have been obtained and examined. Note if they are not available with N/A. he facility or dwelling was inspected for signs of sewage back-up. e system does not receive non-sanitary or industrial waste flow. J�/The site was inspected for signs of breakout. excluding the Soil Absorption System,have been located on site. xc rp _�/All system components,e S lThe septic`tank manhole's were uncovered;opened,and the interior of the septic tank was in- spected for condition of baffles or tees,material of construction,,dimensions,depth of liquid, epth of'sludge;'deptifof'scum. VThe size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by.non-intrusive methods., .� -3- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) 1 O , ✓ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE..DISPOSAL..SYSTEM,INSPECTION FORM PART C SYSTEM INFORMATION FLOW CONDITIONS RESID •NT AI.•_ Design Flow: all Number of Bedrooms: Nupi§cr of Current Residents X AL Garbage Grinder: laundry Connected To System:i Seasonal Use: Water Meter Readings, ' table: Last Date of Occupancy: .CO MF.R A)d ,. Type of Establishment: Design Flow:- gallons/day Grease Trap Present:.(yes or no) Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings,If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information- 9q System Pumped as part of inspection: C) If yes,'volume ume pumped: gallons Reason for pumping: TYPE OF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,atta'94 previous inspection records, if any) e6(explai ):PROXIAGE of all mponents,date installed if known)and source-of information: 17, Sewage odors detected when arriving at the site:�� -4- 0 SUBSURFACE SEWAGE DISIIOSAL SYSTEM INSPECTION FORM PART C' GENERAL INFORMATION (continued) SEPTIC TANK: /t1 C1 Depth below grade: Material of Construction: concrete metal FRP Other (explain) — Dimisions: Sludge Depth: Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: Distance from bottom of scwn to bottom of outlet tee or baffle: 1 Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) GREASE TRAP: Ah) . Depth Below Grade: Material of Constnnction: concrete_metal_FRP_Other (explain) Dimensions: -Scum Thickness: i Distance from,top of scum to,top of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet a'nd outlet,tees.or.baMes;..depih of liquid---,, level in relation to outlet invert structural irate gritY,evidence of leakage, etc.) ... _ TIGHT OR HOLDING TANK:�C� Depth Below Grade: Material of Construction:—concrete_metal FRP_Otiter(explain) Dimensions: Capacity; gallons Design Floc: gallons/day Alarm Level: Comments: (condition of inlet tee,.condition of alarm and float switches. etc.) DISTRIBUTION BOX:_A ) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of'solids carryover, evidence of leakage into or out of box,etc.) PUMP CHAMBER:L=_- Pump is in working order. Comments: (note condition of pump chamber;condition of pumps and appurtenances,etc:) -5- - i.,SrY$�.h h`"r*rp�3 ,'iPrr;:�'+t'�' - s sy':+'.' ., •";,.�. . SUBSURFACE SEWAGE DISPOSAL SYSTEM:INSPECTION FORM PART C SYSTEM INFORMATION (continued) SOIL ABSORPTION SYSTEM(SAS):, (Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: - Leaching pits,number:_Leaching chambers, number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool,number: / Comme ts: (not@ condition of soil,si ns of h7draAlic fail ur level of ponding,condition of ve etation, B. CESSPOOLS: Number and configuration: Depth-top of liquid to inlet invert::!' Depth of solids layer: Depth of scum layer: Dimensions of Cesspool: Materials of constructioQ Indication of groundwater: Inflow(cesspool must be pumped as part of inspection) Comm,Ants: (note condition of ilk,signs iydra failure, level=91 condition of)"elation, ec PRIVY:__A-D Materials of construction: -Dimensions: Depth of Solids: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.) -6- �. r,1.'.�xi7: uLTT'k^-,",,y�,, ., .,a 7: -k .A. _!, a. .5'¢.,rn �...*• �F, * R ,..,;f. ? t- t -'1g .rr'Y" +7`,�+. "p�u,. "4 4 ';,5,}r :.;:x ��y�� �" f `�•ut �! sK '� �.+,,.,, i �"�k ,�,. .r`.cC�,r}t s ' �., 'S�l ir;• 'rn r�; c .:r�' �' t., r rr-i'ti: " Sys •- =' 3�;;- ln� .r ✓1 .�...21 P 't' 4- a;.. ^4 C TL{ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include des to adeast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. i �.. 30 Q� DEPTH TO GROUNDWATER i Depth to groundwater:_ Feet Method of Determination or A•proxi don: ?(%��?j��i' u -7- > NOTES: NAILING SCHEDULE 1 I a5•6• - 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS - ',TO MPH EXPOSURE cv+flNDzor4E - &DIMENSIONS IN THE FIELD DINT-DESCR Y-rl N !'NC OF CONIM314 NAILS P40.JF BOX NAILS S NAIL SrACING a 2J CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, aAETen. G; .m a JD a ED.N Ru-E a D Eoi +s° s.+ca EnnrH w_c ' . ' DETAILS,&FINISHES IN THE FIELD WITH OWNER 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT ro PL4TES T E?J4i TbH Ace NJULEa +Ee s1m - A.oNrs SPUD TO SZJD{A -:igRPA }:t° ,♦ � FIRST FLOOR TO BE 6'-10"ABOVE SUBFLOOR - FENCER Pa HE^DE ueN:LEoi N4 Me a °.uaNCEDGEs 4.) ALL CONSTRUCTION TO CONFORM TO730CMRMASSACHUSETT$ JOISTiC:AL�TJppUTECRGRDEPTLEHNIEIA I .De +n+ PE JosT STATE BUILDING CODE:9TH EDITION AMENDEMENT&-IRC2015 BLaGKhG TC 10 QGE NA:EDj ! aei -}+a0 Era ws lED0ta 3-FIP T08E ORG RDE0.TACENA4EC; }164 6160 E4CH 10I5tR 5.) 110 MPH EXPOSURE B VIAND ZONE - JD6KiN+ETO X eEAr41.E rauum aw >ia4 cT:a Jo sr 6.).ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY. 1—�asT ro4q 'D NNtEW slel rA DNi1 ..t TOE FwT OS RiaP E KA WLE04 TfEa +Ffd PER EDO' DECK OR HORIZONTALLY W7BLOCKING AT EDGES,WEDGE/12"FIELD NAILING rwco nRucrR aAi pwe+_I rwooD 7.) ALL LVLLUMBER/BEAMS TO BE 1.9e U360 LOAD trE o � i Ea cExE,c-IErc MnERS GRTR- VE tl cECGEA'=IED ! 8.) SEE CERTIFIED PLOT PLAN DEVELOPED BY DOWN CAPE ENGINEERING cam-eicmuR..c_a?PnEE'rRu...+.oc\cRHHm to is eExE.cP�E:c - FOR ALL PROPOSED&EXISTING DETAILS r^91EwDwA,.LRUATEEo?aAEETau.H m °° e'Ex+E,e."c" r slrtu-r?., �nolceRs 9.) -FOLLOWALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF cAaJ:ENcwxi.:ReoH RARE tRuss w:ooKwrR-aws; m Yee r6xw•PIE.c ALL SIMPSON COMPONENTS - EKRJC SHE4.>HEia GPEJNYRlLWf4tp - T'ExEI+?FlELD .y - 10.).ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABS TOBE3000 PSI - rncD sraucsRu nEls,Piw000i ! ---- ' £iUJS SPA40V Ta Sa-P.a .._ e•EDGE.i.flE:D VERIFY ALL PLUMBING&ELECTRICAL DETAILS W/OWNERS ON THE SITE 'a'ams'ae'-PovAcpwvEls rE:GE6=Iq_c I - DURING FRAMING CONSTRUCTIONa'avps.u,wLLo:,;Rr. - rexE,ro•ER�Ii - KODD sraucr-au PLhIS JPIYY.WO;. - 12.)TIMBER FRAMING TOBESPRUCElPINEiFIR NO.2GRADE : ••oRLEssnacu�ss i � w sExe+.+REic 13.)FOLLOW ALL REQUIREMENTS OF THE-110 MPH CHECKLIST SUPPLIED c4+uTEa THw rnncRr+css -+ed rcDCE,r PIE.c 14.)FOLLOW ALL REQUIREMENTS OF THE-iECC2015 RESIDENTIAL ENERGY _ EBST : EFFICIENCY REQUIREMENTS&VERIFY ALL DETAILS WITH THE INSULATION _ r- _- ...__ .._. � INSTALLER/CONTRACTOR. - - CUSSES ciai�� :aim€Es. 15.)ALL HEADERS LESS THAN 4 FEET TO BE.(2)2X6's UNLESS OTHERWISE NOTED Eij - 16.)THIS STRUCTURE IS DESIGNED TO THE AF&PA WOOD FRAME CONSTRUCTION ROOF BELOW - NEW i _-_ MANUAL FOR 110 MPH EXPOSURE"B"LOCATION PER:SECTION R301:2.1.1 MUDROOM o 31 A err-c 2-a .. a A4 ibHED DYMMERi ! \— AA4 OUTl4NG f�'r���,lI�2`Ll1-B� 1.. Y'Ii r ! }_g'. Ah9E3R'-1B7EN G-E6R'4SlE tJ AtDERSE6N1 T• i. At:'DE3R-ISTANDERSE N r SIFOLD FRENCH b I YL442ANGERSEh 3 ' =14 DOOR ANDERSEN N - - w_. ---------- _J SINK : 2`z E I ANNDERSEtl N 1 1 It, RELOCATED L eta --- _ —___ S! KITCHEN 5 e£d "! - _ BEDROOM ILF T-__ --- M !L ---- -- /�, [VERIFY MTCHEN ' � r -1 KIN 3r lJt`7 1 LAYOU'W;OIMJERI 1 ♦ - I 1 ' I 1 b !I 1 i O RANGE ISLAND D 2>?LNiALL. HS53.3v 1!4' I __--- (-1 1 STEEL POST UNDER EACH ANDERSEN 1 1 I E END OF MAY - _ , J I ER A�1 1 I II -' �6 I l �e 3-13N .ti LVL er:a-' ' -�-j O ANDERSEN I I S' IWDERSEN I"i ! 1\ a JB . MAST v ..---_ ATH ............. - ---_-_ -- PI .DOOR BATH S A231 FO z NG O ON LOS.. .,;DING - t�W ------ L aNCEr.CE =� PAy4RY: \. DINING 4!' \l f oN m q -- CLOS: I-�Q zexsrr i e^. ,. ,.6•:.ea rlvzur i? _ 2C'x6'6tl µA. 31 34 .14'LVS - - AN0.'RSEN Wt W2 z 2 Ok - M2442 as •f VODx iT STEEL BEAM �1 9 5 5 _ b V � c1 ANDERSEN ' - BEDROOM ---- - J^, --- -- -- -_ �wle-- , - ANDERSEN A r- ---__ I .. 1: 2ET ,4 OOR 1 4 LIVING MASTE z< T- 9's z_1• BEDR M_ 2 ! ANDERSEN NI i I - A2S4 a. L \ BEDROOM m - : C ANDERSEN: ANDERSEN --NEYJ _--..._ _ ..NEW . I�DER58i ANDERSEN PORCH m . POROH ROOF EELO:N A _ : A4 FLOOR I IECC2015 RESIDENTIAL ENERGY EFFICIENCY DETAILS FIRST F O C/ \ PLAN/` N ....�kW.TE ZONE 5(US EITHER?RES'C4IPTNE JALUES OR RESCf ECN LAL JLATION - ��SyF+4 F`e"i4 H - --- - - J - SECOND FLOOR PLAN -" ' ' :AoLE 4D t fM h.MUM PRES..RIP IJE INSULAT ON S=ENESTRATIOtJ 4ECU'REMENTS) LEGEND: ---' - -- --- EXISTING WALLS SMOKE DETECTOR 1.R-VALUES AREtf,NuumsI&LIFA-'TORS ARENAYFAIJM .. - r__, 2.15119 MEANER 15 CON,INVOVS.IJSULATED H��4ING ON:H .NTERIOROR EXTERIOR CONSTRUCTION TO BE REMOVED OF r4E H.TM R SJ1 EOR 111Ai'all ,Ir TiHEINFRKSRUFI'HFeASFYeNiYtiAI. ® NEW CONSTRUCTION ©CARBONMONOXIDE DETECTOR - REFER TO IECG 2015 GFtAPTER4FGR ALL Ih VLAT:OtJ3_NCRGY REOI.IREMEWS 4.13-6MEAN$R50ONT'NUOUS INSULATED SHEATHING ON THE WALL EXTERIOR SRl3CAVITYINc:"7:ON - - - PIE DESIGNER SHALL SMIORTOSTARIOF NEW ADDITION/REMOD.EL1NG FOR:.:' ' - - - .. `�` E ERRORS OR OUI'SSIONSARE OlFJO CN aQ® COTUIT BAY DESIGN. LLC THEBEJRA 1hG PRIDRTDSTARTDF SCALE : DRAWING No.: CONSTRL TION THE,BUILDINCCONTRA.CTGR �+ -' 43 BREWSTER ROAD INTHES DRAVVS.BLEPONSTRUON NT ABREU RESIDENCE IN THESE DRAV,11HO IF CONSTRUCTION off R MASHPpEE,MA..102649 CDµME"JCES YNIHGUT`JOT FYINGI E PH.(5O8)274-1166 TH=SEiRZiE SOLELY EROFANtERRORSCRFORTHNS. FAX 508 539-9402 of THEA JERONOTED.AMO HER USE OFE ». u. - THESEORA INGSREQUIRESTHE WgTEN 54 PRINCE AVENUE, MARSTON MILLS, MA DATE CONS EN-CF THE DESIGNER LINDER T4E "� a su c .. Al FR,Ai TECTU.AL WL"'HI..HT PEtOTEC-IOY �• _ - - - 6/261201 9 4t,i OF Mo ,r •2 12 .2 - S TOP DF Ft ATE - ­,_TOF OF PLATE I 1: Wi F-I SEC^ND F�003 1. - R it �-TSECONDFLOO -,-OOR OF'PLATE TOP OF FLATE .. 1313 .. l r Y E 00 it E - 1 00 t m FIRST FLOOR i a FIR5i'PLOOR $JSFLCOR t: .I SVBROOR RIGHT ELEVATION FRONT ELEVATION 12 -NEW BRICK MASCNRY CIII.MNEY 70 3T ABOVE NEW RIDGE 2 —NEW ASPHALT ROOF SNWGLES 12 .. _ -.I. 1z6FPoEZEBOA NEVJ PVC 1 x 8 FASC�SCFRT &..... ... NEW R'CixSRAKE 6CAROS R �/ x'CRP BOARD TOP OF PLATE FFM 1 - •+—NE'R'PJC 1 x.6 CDRNERflCPR05 _ - NEW PNC 1 x 4'RRd ( '.L_L_L_J W 7'SILL NEVJ W C SHINGLE S DING HEATHER .I Hit 12 ID OOR EXIST. . 1 :. i .. 1 is 1. if r it m u I I FIR51 FLOOR ii i " I SU'o FLOOR LEFT ELEVATION; REAR ELEVATION cP a9 THE'DESIGNER DRA.-NGSW OR TO IF ANYNEW ADDITION/REMODELING FOR-:. - 8Q® COTUIT BAY DESIGN, LLC T�"sE °h�'T"�ToT a°�" SCALE : CONSTRUCTION THE.BUILDING CONTRACTOR DRAWING NO. 43 BREWSTER ROAD PALL BERESPON BL FOR THE COH TIT - u 1/4° 1':o11 MASHPEE,MA. 02649 NTHESEDRAY@HSIFODNSTRJCRON ABREU RESIDENCE. - PH.((5 274-1166 COMMENCES ANY ERR:JOT OR _ ) DESIGNER OF ANY ERRORS CR FOR T. U FAX 508 539-9402 OF HE AJNJER W:ED ANYEO HEAR LSE OFE xi n t 54 PRINCE AVENUE MARSTON MILLS MA = THESE]RA lTNGS RECU RE5 THE MRIT EN T T - DATE - CONSENT OF THE DESIGNER-UNDER HE - A2 ARCNITECTURJ COPYRI H1 FROTEC.I N - - - - - 6/4/2019I— _ ACT OF 1990, - - - .....__ _...._ —.-__....___.._. ... ..____ .___.. _ —�IIII� f I - INSTALL SITAnGHOR BOLTS AT 60'o c.MAX. FROM EhD� L`r SMPSCN BFS So-3 BEARltlG?COTES Y 1 3g.6' OF PLATE CORNER—OTO A&'MINIMLM DEPTH _ ........ � L-S KTiHIN 6 16`CF EACH PLACE?O " I ! : 21,-0. HO EVItAP S DECKNIL FLASHING DOER — _ --_ HST. DECKING 1 r— _.----.---_—.—_.— �0� i :LOGR JOIST S P.T.2 X 10s�i6'o. _ INSTALL PEEL&STIOK RUBBERMEMERANE 1 EETW_EN LEDGER& i � 1 EHEFTHING I I I_ F T 2x 10:EWER BOARD SCREVFD TO i �^ SOLID BLOCKING 4Y 6-OIDGERLOGSCREWS i I NSTALL S A1PSO CTTt2 h5 ON T E3 I °T'.2x6SILL WI SEALER . .. AT 14j LOCATIONS FROM HC USE TO DECK JCIST(1)EACH END - I I i DECK DETAIL 1 I i EXISTING PCRCI FRAMING TC�O GINS VERIFY RI EF HOUSE ANCHOR BOLT DETAIL 6ADJU.ST.AS NECESSAR" _ I - - i - —'-----'-------_—= � SCALE:IY2"=1'-0'. ^EXIST ROOF 70 REMA N i SISTER FRAME NEW 2X 16 JGISTe b I I EXISTING'a X6 GR 2X6 JOI3T5 (SHED DORV:ER) NEW.. SE ,x..TP x} FUTF.C,R�A9�JER FY IN MASON.RE A -i BASEMENT I A I I - ( I.. :FIELDW/D'.'&IEIRS BEAM B 1A4 1 0" A ————————— _--.---- ?KT. "sI 3W.9'4T LVL bRT I L T I r--------- ---------- Ir —� L; I o� I ooiP l I I UP BASEMENT I o PCO?ICRETE SLAB ': _m N4NCOW I IOMIL POLY UNDER +I - �. SISTER F.RA.ME NE^dd I -� FVTURE _ ( _ 2X10JOISTSTO - BATH ANDERSEI IXLSTIIY 2x 3Oft Tw244F2 I I 2i:6.lOi5T5 i i U I t — M — — b 3u I C r_ I b ._ ..— ...___............ .; aKi. a 1 314'X U T8'LVL. I —— —— —— :� 3'HIGH WA�.I_I i FOR 6:cPPEO) J _ II BASEMENT BILCO"C" r -VERIFY ALL EXISTING FRAM I NTHPFIFI AA 0L5T AS I J b b y BULKHEAD I NECESSARY zz 12 PoDGE BOARD o — +18".EXTENSION tu'M - : —i BEAM IPOS g.. +� aKr. _ at+•4•X tt-2'LVL __----- I L._36'x 3e X t2'..:. --�€ —J CONCft~iEF�nncs - m !. I SISTER FRAME NEW :. I °X 10 JOISTS TO I I EGRege 6 :. b I BASEMENT ?ka JOs&OR SOue BLOCKN wT E _ I .ours OF nx3.idsT b ' BGYS.AT:6'o.c. .. 4'CONtX2ETE SLAB'd:! - - I E 1 b 10 MIL ACLY UNDER AND DM62N b — I I I I hl L-------------------------------J I. PT.2X 10 LEDGER BOARD SCREWED TO - - - SOLIDELCCKINGWl(2}LEDGERLOKSCREWS ! i --'NEW.TO CONCRETE FOUVD.ATION 1 6•oc NCZMAY,lICtO JOISTS HANGERS : I Ni4.$L.l?3•.x 24 T`ONCRETE 11 26' - - - INSTALLSIMPSONDTTIZTENSbNTIES ! ! FOOTIYGSYb 2L'.41�Y.INSTAL:v - lSTLEC DORMER I :P.'2x85�15'o.0 Is#HORIZONTAL U? AT!e)LOCATIONS HOUSE TD DECK' __ JOIST(T I EACH END OF YL:LL DA P 8 RAT TOP �. I MIDDLE �j— 3-F.T.2.10 BEAM 3-2x IO BEP.M - . VW A J FASTEN JOISTS TO - A - SIMP3GN EPCSZ OFAS T6Z POST CA.S , I EEAMW6IMPSON TYP.WGIA:.CONCRE.ESCNOTU6ES Aq : . .. A4 H25ATIEs . .. ON 24-cox.SIGFOOT FCOTI.1-S TO 4Tl ...[ .. : BELOW GRACE LSE SIMPSOtti ABU66 t.B iO4 POSTBASEW SM: ^uTYLE ANCHOF wp[ .:_� 3t. ..._... -.. .. Ae__...._ ._ .. :._. ... BOLT' �xJP ROOF FRAMING PLAN FOUNDATION PLAN NOTES: 1 j ALL ROOF RAFTERS TO BE 2 x 1 O's : : UNLESS OTH ERWISE NOTED " 2.) USE SIWPSON.H2.5AHURRICANE CLIPS . _. ... .. AT ALL RAFTERS ENDS- - 3.)VERIFY GUTTER TYPE!LAYOUT - - I - - W/OWNERS IN E DES IUNER SHALL BE NO TIFEG IF AN _ COTUIT BAY DESIGN. LLC `THESFD�°N�PR"OTORTOf NEW.ADDITION/REMODELING FOR : CONSTRUCTIONTHEBUILDINGCONTRACTOR � 8Q® 43 BREWSTER ROAD Yf lBERESPON BLE FOR T ECONTNT a SCALE :4 DRAWING NO.: IN THESE DRAWN IGS IFOONSTRJCTICN ABREU RESIDENCE MASHPEE,MA. 02649 GOMMEYCESWIMOUTNOTFYINGTHE - M PH.(508)274-1166 DESIGNEROF ANY ERRORS OR OMISSK:NS. - THESE DRAd1h SARE SOLELY FOR THE USE FAX(508)539-9402 OFTHEOV4ERNOTED.AWO.HERLSEOF 54 PRINCE AVENUE, MARSTON MILLS, MA THESE ORA NTNG REOU[RES THE WRR'EN DATE : : T r GONSEN-OF TH_DESIGNER JNDER-HE : I a . I ARi;OF 111TURAL U^ RI;HI PROTEC"ION '.6/26/2019 IP FND PROPOSED WORK: LIFT EXISTING \ \ DWELLING, REMOVE FOUNDATION; POUR F, NEW FOUNDATION UNDER (MAINTAIN CURRENT ELEVATION, NO FILL OR 'f o �o EXPANSION PROPOSED) �5g.2 A c�Qr NATURAL AEA 71•Z e �9 ROOF DRAIN DRYWELL IP FND OUTER RIPARIAN ZONE �0 � S LAWN DECK \�� `\ /*--- - i 2 EXIST. DWELL : ' w / N o 4 TOP FNDN. EL.\23.0-0 -71 s° FIRST FL. \ per` `N, i \ 2 24.2' EXIST\DWELL. - O TOP FNQN. EL 22.7'� �` CEO FIRST FL. 2A' DECK PAVED DRIVE IN, �- `tk L TEMP \ SHED >> 0& R \ �'O LOT AREA q,Q�gi y 29,898t SF (TTL) 1,472t SF WETLAND off 508-362-4541 fax 508-362-9880 downcope.com wn cope ell ineerinB, inc. civil engineers land surveyors 939 Main free t ( R to 6A) YARMOUTHPORT MA 02675 }' EXIST, CESSPOOLS 40�^� BENCHMARK: MAGNAIL 5ET TO BE PUMPED & DANIEL P. SULLIVAN JR. r0" LOCUS',..,.. ELEV. 100.00 A55UMED DATUM) FILLED W SAND MAP 77, PARCEL 42 100.1i1 x 3 LUuU (, - - LOCUS -, N85°19'40°E V-/O/ did ua; tY'L 1 • � 99.Sg x 99,64``` 4 ° _. 100' S 9P _ s� MiT ._ cn_- . ... ........... 50' _ 111, <°� 0 r 0 4 YY , I }j � !BUILDING SETBACK LINE (TYR) \ 0 4 0 0f o }''',� Jcfi %Rao ° ~o EXIST. GAS SVC. i -_- W�-,RELOCATE AS REI'D r uj O PROP. ° --_ 1 SEPTIC ' �_ U I.. ■ 1, a 0�o G_ I� I ( TAf�-K--N0.1 `` ( I �q �1 0 O 0 ~� EXIST/SEWER . J sZ \ O z iv r.W I INV, 99.67f i s 89.91 4 8" MAPLE � I cn I ,G � � � � � alr ( � � \ �2- ,� LOCUS MAP N.T.S. Z w I p. 0 \ � f x 93,91 z ;� ��. cv �w t� �JQ �o .1 �� I f 101.47 � `', \ i LEGEND cn 3 W � "' I� .I 701.54 i 01. e 1: O ,TPr-2 % j / \ EXISTING 1p� �� c�l 99 PROPOSED CONTOUR , .: GARAGE �,• � 1,�t 9cJ PROPOSED SPOT GRADE LU 10 I T.O.S.=101.55 �,. 8,9.1�9 —� ��y� `. ; 113.2�-•-{ ' '� NO. 4� '�� .. ; .�.X.I 9 � 1� (TO� BE REMOVED) '� '! �{I, 2 \ ��d',, _._,90..._ . EXISTING CONTOUR 38.7'f a 1� / WD• h 4 4 4 o =�9� 100.36 x EXISTING SPOT GRADE w ,;'i /2 STY.' s ` N C`9 i i / .., a C) \ '� V-/04 < TEST PIT T.O F.= 102.04±/ Vs, �> 89.79 i� � � W �' �--13.2=--i ro '' / 'C ._' / -j�j� G '•�, —OHW OVERHEAD WIRES i (J w;a �A• ,� DTP`_LLJ 3 TP 4 ..... J /�,/ ti...... 5, \� t x 92 82 `• 89. 5 G`n� W EXISTING WATER SERVICE z x 101.32 - -- Q O J j ....,j CLEANOUT �� , ,O \ > s , �I Zn G EXISTING GAS SERVICE 48 N11�LE �. w 101.44.x _ ,cA » �_23 10'il.29 I �L } Al i WETLAND SYMBOL �__. _ . 10',/ ` • WETLAND FLAG iv PROP. o PROPOSED f ," / . �' ` ` V-102 TANK N0.2 GARAGE � ' n \ ',..r 91.75 \ s I ILLJ w T.O.S._ 01.5 ad ' �' o'o� • ,1 i 1,1f, l � I PRO EDGE 1.OT:2 ... /10 'x 101.24 I ��, ' xw. APN 77-49 �8v\�9 I - I _ 101 . 9 100.36 x OF RIVEWAY r -� f 26,693t5 (TO TIE LINE) QPROPOSE0 PROP.1 ' t i ADDITION DECK �.. _ J ; M° \ v 10' /r f T.O.F.=102.00 a10'x14 1 `1 x 95.1.Ow, _ S ( I ti M an C)3a 30' fW Li � 'oo ono' 94.'5 I �` 99 �� f a q�y -� -r - -` o� PETER T. Gr a � o WALK-06T 9 ` �` McENTEE S. - CIVIL wr: P •- - — _�. - _�' "� ~. V-77_,� "� No. 35109 �� v N r �. r BUILDING SETBACK LINE (TYP.) \ 0 9 E v a i rn co "� /G/STEM �'� ,% .� RET. WALL I rn I+ . � ,"� �...,... W. :. �\ -'g TOP EL.99.5 92.96 x `92.N-7x 90.31233.00 ui 7 o � ti 6f I N85 19 4d"E / LO CRETALL � —•- FE0 t iBARNSTAki`LEr LAND T •U T S I NC.MAP 77, 0ARgEL 44 TOPWETLAND DELINEATION 0-96.0 �y PROPOSED ADDITION BC SEPTIC SYSTEM VACCARO Environmental ! l s ��� o RICHARD �> 100.54 x Consulting ! , i , --" J. 54 PRINCE AVENUE, MARSTONS MILLS, MA � FLOOD PI•A`IN DESIGNATION o P.O. Box 955 HOOD Sandwich, MA 02563 y Community-Panel No. 25ooD1 oD15 c No. 35031 4 Prepared for: Nelson Abreu, 54 Prince Ave., Marstons Mills, MA 02648 (508) 888-5855 - µ � Map Revised: August 19, 1985 io '-�� Zone C J, !'EC7S1 � Engineering by: Surveying by: SCALE DRAWN JOB. NO. NOTE: ENTIRE SITE IS LOCATED WITHIN ZONING CLASSIFICATION RF J�0 EnglneednglWorks HOOD SURVEY GROUP N.T.S. P.T.M. 208-06 M FRONT YARD SETBACK: 30 FT. 12 West Crossfield Road P.O. Box 1724 THE RIVER-FRONT AREA (31 O CMR 10.58) SIDE & REAR YARD SETBACK: 15 FT. n�b6 Forestdole, MA 02644 Moshpee, MA 02649 DATE CHECKED SHEET NO. 'V (508) 477-5313 (508) 539-7799 10/9/06 P.T.M. 1 Of 3 NOTE: TO PREVENT BREAKOUT, THE PROPOSED PROVIDE RISER OVER D-BOX FINISH GRADE SHALL NOT BE < EL:97.5 TOP OF FOUNDATION " TO WITHIN 6" OF FINISH GRADE F.G. EL: 100.5 (MAX. FOR A DISTANCE OF 15' AROUND THE EL:102.04t� F.G. EL: 100.0t PERIMETER OF THE S.A.S. F.G. EL: 101.4t F.G. EL: 100.1 t (EXISTING) MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS W/COVERS OVER INLET 4-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER ONE CHAMBER W/ IN SERIES WITH 4' STONE-ALL SIDES HEAVY DUTY FRAME & COVER TO 3" OF L= 14' OUTLET TO WITHIN 6" OF FINISH GRADE FINISH GRADE (INSPECTION MANHOLE) ' L =17' C L =18'(MAX) 6•• 4' SCH 40 PVC 4" SCH 40 PVC .) gyp- -r---2" LAYER OF 1/8" TO 1/2" LAYER OF DOUBLE WASHED STONE iq ® S= 1% (MIN.) 7k-612�Z ® S= 1% (MIN.) ®aa�®ate. OR CULTEC NO. 410 FILTER FABRIC (OR APPROVED ALTERNATE) ®a®a a® 1 PROPOSED 1500 GAL. INV. ELEV.=97.35 INV. ELEV.=97.18 2' EFF. DEPTH o®®a�oo -3/4"-1 1/2" SEPTIC TANK D-BOX 4' S'2 4' DOUBLE WASHED SEWER:HOUr INV.EL:97.76 EFFECTIVE WIDTH = 13.2' STONE EXIST.INV.=9INSTALL INLET & OUTLET TEES INV. ELEV.=97.00 GAS BAFFLE TO BE INSTALLED ON OUTLET TEE AS MANUFACTURED BY TOP CONC. ELEV.=97.8 -BREAKOUT ELEV.=97.5 TUF-TITE, ZABEL, OR EQUAL SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.=97.00 GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED mer-HIMP-1001= STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). BOTTOM ELEV.=95.00 4 1 4 x 8.5' = 34.0' 4' MIN. A13OVE MAX. SEASONAL EFFECTIVE LENGTH = SEPTIC SYSTEM PROFILE NO. 1 HIGH GROUNDWATER ELEVATION a2' LEACHING SYSTEM SECTION N.T.S. NO G.W. ENCOUNTERED BOTTOM OF TP-1, EL.=89.8 ROVIDEPROPOSED T.O.F. TO WITHIN l6" OFOVER FINISH GRADE F.G. EL: 100.5 MAX. EL:102.Ot F.G. EL: 100.0t F.G. EL: 101.4t F.G. EL: 101.0t GARAGE SLAB EL.=101.5 (EXISTING) MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS W/COVERS OVER INLET 4-500 GALLON LEACHING CHAMBERS INSTALL RISER OVER ONE CHAMBER W/ L- 38' & OUTLET TO WITHIN 6" OF FINISH GRADE IN SERIES WITH 4' STONE-ALL SIDES HEAVY DUTY FRAME & COVER TO 3" OF 20' FINISH GRADE (INSPECTION MANHOLE) " 4" SCH 40 PVC - 4" pl IpE INSIDE 6» S L =41' L m18'(MAX) 4" SCH 40 PVC 4" SCH 40 PVC .i--2" LAYER OF 1/8" TO 1/2" JTINV.EL:98.01 S= 2% (MIN.) t0- B GO0 S= 1% (MIN.) s 0 S= 1% (MIN.) o�aBPi®ao DOUBLE WASHED STONE (OR APPROVED FILTER FABRIC) Svc. INV. ELEV.=97.35 INV. ELEV.=97.18 2' EFF. DEPTHia�ao�a��® �PROPOSED 1500 GAL. O 5.2 3/4"-1 1/2" SEPTIC TANK D-B.Q 4' S.2' 4' DOUBLE WASHED SEWER N0. 2 INV.EL:97.76 EFFECTIVE WIDTH = 13.2' STONE AM PROP. GARAGE INSTALL INLET & OUTLET TEES INV.=98.77 MIN. 1 INV. ELEV.=97.00 GAS BAFFLE TO BE INSTALLED ON OUTLET TEE AS MANUFACTURED BY TUF-TITE, ZABEL, OR EQUAL TOP CONC. ELEV.=97.8 -BREAKOUT ELEV.=97.5 SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.=97.00 Boo®® GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED ®a®aea®�aaaa STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). a®®aaa E3 } BOTTOM ELEV.=95.00 4 �4 x 8.5' = 34.0' .I�--•4-'-- 5' MIN. ABOVE MAX. SEASONAL L EFFECTIVE LENGTH = 42' SEPTIC SYSTEM PROFILE NO.2 HIGH GROUNDWATER ELEVATION N.T.S. NO G.W. ENCOUNTERED LEACHING SYSTEM SECTION BOTTOM OF TP-1, EL.=89.8 DESIGN CRITERIA PROPOSED ADDITION & SEPTIC SYSTEM NUMBER OF BEDROOMS: 2 BR (EXIST.) + 2 BR (ADD'L) + 1 (PROP. IN-LAW APT.) MAR STO N S MILLS J08- SOIL TEXTURAL CLASS: CLASS I USE 4-500 GALLON LEACHING CHAMBERS IN SERIES 54 PRINCE AVENUE, DESIGN PERCOLATION RATE: <5 MIN/IN DAILY FLOW = DESIGN FLOW = 550 GPD SIDEWALL AREA: 2(13.2' + 42.0') X 2 = 220.8 S.F. Prepared for: Nelson Abreu, 54 Prince Ave., Marstons Mills, M GARBAGE GRINDER: NO BOTTOM AREA: 13.2' x 42.0' = 554.4 S.F. Engineering by: Surveying by: SCALE DRAWN PROPOSED SEPTIC TANKS: 1500 GALLON CAPACITY TOTAL AREA: 775.2 S,F, Engineering Work HOOD SURVEY GROUP N.T.S. P.T.M. 12 West Crossfield Road P.O. Box 1724 LEACHING AREA REQUIRED: (550) = 743.2 S.F. DESIGN FLOW PROVIDED: 0.74(775.2) = 573.6 G.P.D. Forestdole, MA 02644 Mashpee, MA 02649 DATE CHECKED,74 (508) 477-5313 (508) 539-7799 10/9/06 P.T.M. t/ r w 10'-6" 3 - 20" Dia. Covers INVERT ®®®® ® ®®®® J C3-5" DIA. INLETS 5-5" DIA, OUTLETS E23E3®®®®0® 3® 33" // A4" GRAVITY ®®E3®®®E3E3®®® 5'-8" 1 2„ INLET(TYP.) 15 1/2' 24' ® ®®®®®®®® 0 15' 4" GRAVITY OUTLET(TYP.) 102" 8" 6" S TI — — so 1/z' FILL SIDE KNOCK-OUTS Top View Section WITH MORTAR Top View 4" KNOCKOUT ��,, �/ 20" Dla. COVER 4" Dia. Inlets 4" 4" Dia. Inlets DISTRIBUTION B O X 4" KNOCKOUT 4" KNOCKOUT 62" A 0 t N.T.S. 4" KNOCKOUT PLAN 5'-8" 4'-7' 48 Liquid Level 4'-4" GENERAL NOTES: 500 GALLON CAPACITY, H-10 LOADING 4" 3 � .�- 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL f . .. BOARD OF HEALTH AND THE DESIGN ENGINEER. CHAMBERS 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS Section OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE N.T.S. LOCAL RULES AND REGULATIONS, 1500 GALLON CAPACITY, H-10 LOADING 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE SEPTIC TANK DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING N.T.S. FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. PROVIDE SILTATION FENCE BACKING 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. DOWN GRADIENT SIDE OF HAYBALES SOIL LOG 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF DOUBLE ROW OF STAKED HAYBALES THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF DATE: SEPTEMBER 1, 2006 (P-11,405) HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 1"X1"X3' OAK BEANPOLES SOIL EVALUATOR: PETER T. MCENTEE P.E. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. (2 PER BALE) WITNESS: DONALD DESMARAIS - HEALTH AGENT 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. 9. AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A Elev. TP-- 1 Depth Elev, TP-2 Depth Elev. TP-3 Depth Elev. TP-4 Depth CONDITION ACCEPTABLE TO THE OWNER AND APPROVING AUTHORITIES, 100.3 A o" 100.3 A 0" 100.5 A 0" 100.4 A 0" 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING BINDING WIRE // / 10YR 4/2 10YR 4/2 10YR 4/2 10YR 4/2 CONSTRUCTION. OR TWINE ( f l f f f f f f f f f 99.0 B 15" 99.2 B 13"" 99.2 6 16" 99.4 B 12" LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS �RU ED 1oYR 5/s 10YR 5/6 10YR 5/8 10YR 5/B IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE 5.A.S. F f f f f f FLOW g7,3 3s" 97.5 34" 97.7 34" g7.4 3s" AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). : .,. c C 38„ c C45" 12, SUBJECT SITE DOES NOT LIE WITHIN A ZONE 2. if f f f !f f t f !�;�°`... (� U W Uj w M—C SAND 10YR 5/D 50'4 M a 57" 10YR 5/44 10YR 5/ PROPOSED ADDITION & SEPTIC SYSTEM �-C SAND M—C SAND 10YR 5/4 10YR 5/4 SEDIMENT LADEN RUNOFF 54 PRINCE AVENUE, MARSTONS MILLS, MA SILTATION FENCE SHALL BE I TRENCHED IN AND BACKFILLED I` Prepared for: Nelson Abreu, 54 Prince Ave., Marstons Mills, MA 02648 89.8 126" 89's 126" 90.0 126" 89.9 126" Engineering by: Surveying by: SCALE DRAWN JOB. NO. SILTATION BARRIER EngineeringWorkc HOOD SURVEY CROUP N.T.S. P.T.M. 208-06 NO GROUNDWATER OBSERVED — ALL TEST HOLES 12 West Crossfield Road P.O. Box 1724 PERC RATE <2 MIN/IN. ("C" HORIZON — TP 2 & 4) Forestdale, MA 02644 Mashpee, MA 02649 DATE CHECKED SHEET NO. (508) 477-5313 (508) 539-7799 10/9/06 P.T.M. 3 of 3 QQ------------- N Q L o W o in 12 V r haw 12mrorm r c REAR ELEVATION , — i ------------------------------------------� O O � � L I � w w � w � Ewa SCALE : 1/4 fl = 1'-0" DATE : LEFT SIDE ELEVATION- 12/6/2006 DRAWING NO. : PRELIMINARY DRAWING FOR DESIGN REVIEW A3 1 I I� i I \—LINE OF i EXISTING I GARAGE 20'-C, 1-0 Q N O N � � . �� co LINE OF I CLOS. 00 A-+ O EXISTING ( W x O L0 GARAGE ' �••� (�.; in BEDROOM co a o I (VAULTED CEILING) DECKOWN o I I CLOS. SCREEN DOORS ( STACK _ _ W/D }PULL-DO_WN I STAIR L __ _ J la o � X ,-a'„ _ GARAGE BATH '°v,� LIVING § A (VAULTED CEILING) ISLAND Q CLOS. 00 ••• ------------- 100 NEW ►_., HOUSE COVERED WALKWAY I REF SINK DW b 14'-0" 6 4' 14'-0" �+ FIRST FLOOR PLAN w LIVING SPACE = 640 S.F. W GARAGE = 267 S.F. LEGEND: EXISTING WALLS SCALE - CONSTRUCTION TO BE REMOVED 1/4" = 1'-0" l---J NEW CONSTRUCTION DATE : THE DESIGNER SHALL BE NOTIFIED IF ANY 12/6/2006 ERRORS OR OMISSIONS ARE FOUND ON THESE DRAWINGS PRIOR TO START OF CONSTRUCTION.THE BUILDING CONTRACTOR WILL BE RESPONSIBLE FOR THE CONTENT DRAWING NO. : IN THESE DRAWINGS IF CONSTRUCTION COMMENCES WITHOUT NOTIFYING THE DESIGNER OF ANY ERRORS OR OMISSIONS. PRELIMINARY DRAWING THESE DRAWINGS ARE SOLELY FOR THE USE ON THE PROPERTY NOTED.ANY OTHER USE OF FOR DESIGN REVIEW THESE DRAWINGS REQUIRES THE WRITTEN CONSENT OF THE DESIGNER.THESE DRAWINGS A I ARE PROTECTED UNDER THE ARCHITECTURAL COPYRIGHT PROTECTION ACT OF 1990. v 1 O N 12 �, C�IlWN00 12 � W � ►n UQ LE U� CY) ar� Nx ❑ ❑ , co n F nn I ......LJ [IUUU UHH, i i I FRONT ELEVATION I I I � I I I i I v 1 I I------ ----------------------------- *Now* i • • Z Y) O 12 12 EXIST. rOr�� O ul M�� � rr TT,,• W 12 12 EXIST. 12 F� w 1� W I......L...U co SCALE : 1/4 if = 1'-0" DATE : 12/6/2006 DRAWING NO. : RIGHT SIDE ELEVATION- PRELIMINARY DRAWING FOR DESIGN REVIEW