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HomeMy WebLinkAbout0917 SANTUIT-NEWTOWN ROAD - Health - - � I�J��S�NS �111�,5 J OErNSTABLE :CCATION SEWAGE # VILLA-E 1 (U ASSESSOR'S MAP INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i 4c N` 0 9 + COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS n DEPARTMENT OF ENVIRONMENTAL PROTECTION d t n � r , C ti ti r y r• TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A s CERTIFICATION _. Property Address: 917 NEWTOWN R D MARSTONS MILLS,MA 02648 Owner's Name: JOYCE GROEMMER Owner's Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 RECEIVE Date of Inspection: 4/6/01 APR 17 2001 Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS TOWN OF BARNSTABLE Mailing Address: P.O. BOX 2119 TEATICKET,MA.02536 HEALTH DEPT. Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system t inspector pursuant to Section 15340 of Title 5(310 CMR 15.000). The system: X Passes ° `, _ Conditionally Passes }; f _ Needs Furthe valuation by the Local Approving Authority Fails Inspector's Signature: Date: 4/6/O1 The system inspector shall submit 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 now of 10,000 gpd or greater,the x inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be r; sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. f 6 Notes and Comments THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO y PROLONG THE SYSTEM'S USEFULL LIFE. ****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. ,y T:rl� G Inc,��rtinn Pnrm (/1 5/�Mfl 'p ;= 1 � Page 2 of 11 { OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM XR PART A CERTIFICATION (continued) , Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 Inspection Summary: Check A,B C,D or E/ALWAYS complete all of Section D A. System Passes: 'r X 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: THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. 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. ; t Answer yes,no or not determined N,ND)in the for the following statements.If"not determined"please explain. s t; n/a The septic tank is metal and over 24years old*or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltratiion or tank failure is imminent. System will pass inspection if the existing tank is replaced r' 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: n/a n/a 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:n/a n/a 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 t ND explain: n/a .l ti '3 7 Page 3 of 11 .,5 { OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ; CERTIFICATION(continued) Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 _ r - Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 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 q�0feet of a surface water _ Cesspool or privy is within S6 feet of a bordering vegetated wetland or a salt marsh y.,t Eyre 4 � c w,� 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. 1 _ 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 n/a ; 1e "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds micates 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 1 of the analysis must be attached to this form. 3. Other: i n/a { Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER ; ,` , -._ R Date of Inspection: 4/6/01 jt D. System Failure Criteria applicable to all systems: '$ You must indicate"yes"or"no"to`each of the following for all-inspections: Yes No - X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool - X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged ` € SAS or cesspool - X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool - X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow ; X Required pumping more than 4 times in the last year NOT due to clogged or obstructed i e s .Number of times a, - q P P g Y gg P P ( ) . pumped 2000 BY ARCO. - X Any portion of the SAS,cesspool or privy is below high ground water elevation. - X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. g r - X Any portion of a cesspool or privy is within a Zone I of a public well. - X Any portion of a cesspool or privy is within 50 feet of a private water supply well. f - X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with r no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from tliai 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.] (Yes/No)The system fails. 1.have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails'.i The system owner should contact the Board of Health to determine what will be r$k ' 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) S E yes no - X the system is within 400 feet of a surface drinking water supply ti - X the system is within 200 feet of a tributary to a surface drinking water supply ; - X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped r.. 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 'ri` "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat , .. under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. qi a d Page 5 of 11 it OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? _ X Have large volumes of water been introduced to the system recently or as part of this inspection? _ X Were as built plans of the system obtained and examined?(If they were not available note as N/A) , X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site? X _ 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? X _ 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 X Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is t unacceptable)[310 CMR 15.302(3)(b)] t T 1 " Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 FLOW CONDITIONS RESIDENTIAL '1 FS Number of bedrooms(design):3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents:3 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] d Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgtt,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a # ',,GENERAL INFORMATION Pumping Records 3; Source of information: 2000 BY ABCO Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1971 Were sewage odors detected when arriving at the site(yes or no): NO r F 'i F • Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � 6 PART C 3, SYSTEM INFORMATION(continued) !' 4' Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 BUILDING SEWER(locate on site plan) Depth below grade:30" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): THERE IS TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade:24 Material of construction: Xconcrete,:°metal fiberglass_polyethylene other(explain)n/a q s If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6" H 5' 7" Wi 4' 10"" Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle:32" Scum thickness: 1" t Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related } to outlet invert,evidence of leakage,etc.): THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS. GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to too of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a ;. Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage;:et� n/a ' . d 11-. s 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 TIGHT or HOLDING TANK: "(tank must be pumped at time of inspection)(locate on site plan) Ti Depth below grade: n/a Material of construction:_concrete_metal_fiberglass polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO ' Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:_(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n/a Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): n/a PUMP CHAMBER:_(locate on site plan) } Pumps in working order(yes or no)`11�0 Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): � { Fh � �c •1 �.N t F A ,. R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS • .b, t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 917 NEWTOWN RzD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) x ,r If SAS not located explain why: ` n/a Type 1000 GAL 6'X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a I;:r. innovative/alternative system Type/name of technology: nla Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT 2 HAD Y OF WATER IN IT AT THE TIME OF THE INSPECTION. `CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a ; Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a a, , , 3 age i a Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 4 5ck slab Q 5 � 3s`b o � PA 3-7 gc 62 E f in Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 917 NEWTOWN RD MARSTONS MILLS,MA 02648 Owner: JOYCE GROEMMER Date of Inspection: 4/6/01 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators,installers-(attach documentation) YES Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS- 12+FEET I;4 II ill � r ,1fzo 30. 8 16 9 w 0 36 w 0 rn LOT 11 #g1 cr cA i P . ,SEED LOT 10 w LOT 9 m i i 4.69 LOT 13 0�16 35 S LOT 14 RES. ZONE.- J'RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE- "C" TOWN: _ 5 'Q11jS SILLS___---- REGISTRY OWNER: P 'TER b &Bank Use Only JOYCEK GRO DEED REF: _ CTF�113006__—___BUYER: STUARR'D_Bc�ONNZF'P--H-ELF-- _________ DATE: _06,�Q1 M1_, __—______ PLAN REF: _LC — 6 B __SCALE:1 — 30---FT. I HEREBY CERTIFY TO AN_Coo��_cG YANKEE SURVEY ___--THAT THE BUILDING SHO WN ON THIS PLAN IS LOCATED ON THE GROUND AS PAUt CONSULTANTS SHOD AND THAT ITS POSITION DOES _—__ CONFORM A 40B (SUITE l) TO TH"E ZONING LAW SETBACK REQUIREMENTS OF THE �^ TOWN ;OF bARNSZA&E _ ___AND THAT �° � INDUSTRY ROAD IT DOES_tVOT'_ LIE ::WITHIN THE SPECIAL FLOOD HAZARD G>'�rc ��' MARSTONS MILLS, MA. 02648 `.... AREA SHOWN ON 'THE H.U.D. MAP DATED TEL 428—0055 it - anel 50001 0015 C FAX 420-5553 �n __ THIS PLAN NOT MADE FROM AN INSTRUMENT SURVEY 6 Y TTT R - V. PTc -- ATnT -Tfl IM TreL'n VAD VVIxT111.10 TTTTTTI T/r TT1TrrTn r.,m., .�n.9R1 .�F' TOWN OF BARNSTABLE E �'• 5 .. 1 'LOCATION � �� NCw w V--� SEWAGE # 3 1 VILLAGE �, a me ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. r�� �rE.a.1�r�Ck 77:mr � SEPTIC TANK CAPACITY I o ®-D S rz� 1`bv%j S LEACHING FACILITY:(type) Pi '� (size) 1 00c . NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER G,<— C�P_ n-N DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No (� - r ATO qc oq No...� .-..�-. 'Y 1 �) ® 3r, FI±:s..3.0.......... 9r THE COMMONWEALTH OFVASSACHUSETTS gPPRM I) BOARD OF HEALTH oorCa TOWN OF BARNSTABLE . pphration for Diripmial Mi ork,i Tomitrnrtion rrmif Application is hereby made for Permit to Construct ( ) or Repair ().,-<an Individual Sewage Disposal System at• tt p ................. -------.--- ---------------•-•-------- ---------------------- ------•----------------•-------------------P=..!---� ...... Lnriti -� lr or Lot Np er ldress ..... ----- Installer Address Type of Building Size Lot............................Sq. feet U U Dwelling—No. of Bedrooms__________________---------------------------Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building ---------------------_-___- No. of persons.---_-----.__-..-----_-._... Showers ( ) — Cafeteria ( ) a' Other fixtures _________________________________ _ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. GG Septic Tank—Liquid capacity............gallons Length________________ Width................ Diameter---------------- Depth................ Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per Inch Depth of Test Pit.................... Depth to ground water........................ GZq Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................ x ...........................••. ....................................................................................................................... 0 Description of Soil...................... %..........40 -,,.,.�_:_ U •-••-----•-••-•-•-•-------------------•--•------•---••---------......-----•-------•-------•----------------------•----------------------•-••.......-----•----•-•---....-•-.............----------....--- 6. W ..................................................................................................... •-----------------........-----------•----•••---••------`•-----••--------•--•-••--•...•-----... U Nature of Repairs or Alter tions—Ans ver when applicable_._.._.& .... _iS'3'i�"'_._... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environ mental Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp a haXz bn issued by the board of health. Signed . ........ '►y am ............... t.....-.1. ..—?..3 ----'—... . ...... ....... Dare _Q Application Approved By ............(J' V... c r J : . Date Application Disapproved for the following reasons: .......................................... ........................... ............................................... . .........----..........................—..._--------------............................--.......---..........-----.....................---------...- �- rDace�.. .9.. Permit No. ....... .... ......... .... . . .................. Issued ......... ^......�Dace�........................................ d No... _ _-..�_. �//; t © 3y/"• Fas...... .......... THE COMMONWEALTH OFVASSACHUSETTS .� BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diaipwial Works Tatuitrnrtion rrrmit Application is hereby made for a Permit to Construct ( ) or Repair (�n Individual Sewage Disposal Sy ` , .........................F=_as ...... stem at �w��� - . Location-Address ' p•Q —7 or Lot N, .......... ...............C..—.b...... -V e"`!-----------•-•--•-••-- 1 / wCki L O c cr A dress Installer Address Q Type of Building Size Lot................ q. feet �-t Dwelling—No. of Bedrooms...................................... Expansion Attic ( ) Garbage Grinder ( ) p`�.I Other—Type of Building --------------_------------ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures ............................... . . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width-----.---------. Diameter................ Depth................ x Disposal Trench—No. .................... Width---------...._.-.-_ T ottl Length.----............--. Total leaching area....................sq. ft. Seepage Pit No.---..-- _--_---_ Diameter.---.--..-_-.----. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ! 0.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit------_----_---._ Depth to ground water.......---.............. 93 Test Pit No. 2................minutes per inch Depth of Test Pit--...--............. Depth to ground water..--.................... 1:4 -----------------------------------•----------------------••---.....------------•---..........-.............---.................---............--••----_...-- DDescription of Soil_----------------�,r7N•�X. ............ ----------------------------------••-----•---------------•-•----••---•------_------ W UNature of Repairs or Alter tions—Answer when applicable.-.--....- s ..... .....�.�.....a�-'.....�.. l C �. ........... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp 7arL/ehas been issued by the board of health. t Signed .... t. ``E� .. ........................... ....t............................. Date Application Approved By ................. .- ... .. .. ... .........-.-.-.......-...........�_ Date Application Disapproved for the following reasons: ..................................... . . . ............. ............--...../ —n.7....... ......................................................................................................................................•...------..------...........................--.........---............... -------- .. . Date ./... !Permit No. ......... Issued --------- ......................................................... .......�.,.. # � . Dare THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE Clertiftctt#P of Clompliance THIS IS TO CERTIFY, That the In ividual Sewwa—ge Disposal System constructed ( ) or Repaired ��w .�., c_1�--� by ..................... U. ......\. ..v.......... _..... - - ................... M1 at ............ . .................... .............. -e. - .w``---------- --------------------..... .. . ............... . ............. has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......�.-3...-----.�._. �-..... dated ..-........................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. -...-DATE................................ '_.... .....�...--..- Inspector ......... ....._ � -.-... .._..- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ? TOWN OF BARNSTABLE Dioponl Vorkii Tomitrudion famit Permission is hereby granted------- ................ -` t '-LS.--•--••-------•......--•................ to Construct ( ) or Repair ( Z) n Individual Sewage�D sp System at No.----......�..1� � e �ww _ -- .................................-................................................ Street as shown on the application for Disposal Works Construction Permit No.73_4o--. Dated.....j-7.11 .7_3...•-• .......................... -- DATE...... I --- --.... ..............•........... Board of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS OUTLINE SPECIFICATIONS SCHULMAN ADDITION IV. MASONRY DRA\^IING KEY 9w oantroa A. GENERAL ® NEW CONSTRUCTION Newtown road --- MaU 02 Mills, 1. QUALITT CONTROL - GOMPLT WITH BRICK EXISTING CONSTRUCTION MA 02648 �^ INSTITUTE of AMERICAN (BIA) AND NATIONAL XITl XIT' O TO REMAIN 027/039 CONCREJ\ --- RECOMMENDATIONS MASONRY A AaaoclATIOM RDb (NCMA) BED RM BED RM C___ EXISTING CONSTRUCTION a.co„Mn„DArlona AND arANDAaoa. PaoDucre TO BE DEMOLISHED NOTES: 4.B. .•—ro . 9 , GRAD. ww— NRr MASO UNITS (CMU) - ASTM C O GRADE N-1. ��- w a N��_ •�_ 2. MASONRY MORTAR - ASTM G 270, TYPE S F eNuaR�N.cv..c.. p ...,...,• O OR B' AND 12' WALLS, TYPE N FOR OTHER MASONRY WA-3. TM raw a w.ewR ww wow 3. HORIZONTAL REINFORCING - TIE... Tip., 9 GA. Twp wMwR Ad M r.anNw a.r WIR.e, GALVANIZED, WIDTH AS APPROPRIATE FOR ��D 4 "-'""'• WALL THICKNESS. INSTALL EACH COURSE BELOW GRAD. AND 24' ON CENTER ABOVE GRAD., (OR A. ti OT M.RWIa. NOTED IN CONTRACT DRAWINGS). 4. REINFORCING BARS - ASTM A 615, GRAD. GrIG k R.L. 60, DEFORMED A.S. I �} C. E1lHCVTION XIT' tevbb- ( 1. INSTALL WITH RUNNING SOED AND CONCAVE TOOLED JOINT. SECURELY GROUT ALL REINFORCING IT.Ma AN BATH I 1MEBRT ITEMS. REMOVE EXCELS MORTAR AS WORK l5 pROGREeaEB. O Y 2. PROVIDE CONTROL JOINTS AT 4 MAXIMUM OF 25 XII FEET (OR AS OTHERWISE NOTED IN CONTRACT Docu...To) BED RM B. ANCHORING 5/5' X 16' ANCHOR BOLTS SPACED - 4'0' O/C 42' FROM CORNNERS (TYP.) ATTACH NEW FOUNDATION TO OLD W/ 24' LONG its DOWELS DRILLED AND EPDXYED ® 16' O.G. VERTICALLY EMBED WMIN TO EXISTING (TYP. AT ALL NEW END WALL CONNECTIONS) XIT' ° KITCHEN GNG DESIGN Inc. ' 247 ONSET AVENUE,ONSET VBIAGE P.O.BOX1200 A-3 ONSET MA 02532 ATTACH NEW FOUNDATION TO OLD TEL.508-295-2952 W/ 24' LONG #5 DOWELS DRILLED FAX 508-743-0903 AND EPDXYED ® 16' O.C. VERTICALLY EMBED WMIN TO EXISTING info@gng-design.c°m (TYP.AT ALL NEW END WALL CONNECTIONS) TycY m XIY LIVING RNA ZD PROVIDE 51W X 16' XIT' I I ANCHOR BOLTS SPACED I I DINING If 4'0' O/C 12'FROM I I b CORNNERS REMOVE EXIST'G I I 1 0 WND AND WALL I i SAW CUT NEW OPEN'G INTO FOUNDATION I I REPLACE W/ C/O—� R.O.3O5124'PROVIDE P.T.W.FRAME AND I I BIRTCH PLYWD PANEL W/RIGID INSUL I I NEW j EXPDXY TO BACK FPIISH WD.TRIM AS'REOD FAMILY �p OR PROVE v1 NEW FCUNDATM I ( ROOM G m I I .F. � v j op r "d Q NEW GARAGE WALLS 2 1 N TO RECEIVE (1) LAYER 5/8' sneelmb. N I TYPE 'X' GWB CONTINUOUS N XIT' .=1N �B.•.• 0 I GARAGE DN N 20-MINUTE STEEL O I I DOOR W/ APPLIED NEW 'GAP' SLAB TO I I NEW -1 FORM 4- MINIMUM CURB RAISED WD. PANELING I I BATH LL �' I ® GARAGE AT TOP OF STAIRS N 5/8'. 9' THREADED ROD, I i ROOM v;a X I SET INTO EXISTING I I w �, ^OfBCK SLAB 3' (NOT THRU) I I i� ID Dla.e by, AND SET IN EPDXY 3�• 31{I 31' S'- 1' 31• 32 EF 2 4'-O' 2 3 0' 2 2 2 2'�' 2 cnBCKaa by, GG Scale: — — — — L 12'-0' 8' CONCRETE FOUNDATION WALL(3'-10' DW.: March 22,2006 POUR), ON 42'X20' CONT. GONG. FOOTING (48'MIN BELOW GRADE) DOWEL NEW A d d 1 t 1 on --� sneef Mumeer. 12'-0' FOUNDATION WALL INTO EXISTING. ' r POUR A 3' DUSTGAP SLAB IN THE CRAWL SPACE. A-3 /AL 11 11 Partial Foundation Plan Scale: ></4��= I�-ot� 1 First Floor Plan Scale: l/4�t=��-o�� 2 1 SCHULMAN ADDITION 917 santuit- Newtown road Marstons Mills, MA 02648 027/039 NOTES: Tr.. r.rw oesrrl�i-- _ _h TOP OF WALL E01-1— OO.00r ® =oesir�t.ir•..e'v�. ReNfbm AjJN FIRST SUBFLOOR — ELEV.= 00.00 �- -- Addition - -� GNG DESIGN Inc. 247 ONSET AVENUE,ONSET VB.LAGE P.O.BOX1200 ONSET MA 02532 TEL.508-295-2952 FAX 508-743-0903 info@gng-design.com SIDE ELEVATION SCALE: 114• _ T-O' TOP OF WALL ELEV.= 00.00 — i \. ® ILI] ® Sheet Tft: FIRST SUBFLOOR — ELEV.= 00.00 RojeM. Drown er Addition EF eheckoe ky: GG Scab: Dote: March 22,2006 Sheet Number: mml lip REAR ELEVATION SCALE: 1/4° L SCHULMAN ADDITION 917 santuit- Newtown road Marstons Mills, MA 02648 027/039 NOTES: w.e�.a.. e.. un6 oesKd+.r�i� JJAW 10 90T _ '00.00 =.V3J3 ___ � •• ieewlom 1 �1 _ ROOJ'18U2 T2AFi — �-- Addition - -� GNG DESIGN Inc. 247 ONSET AVENUE,ONSET VBIAGE P.O.BOX 1200 ONSET MA 02532 TEL. 508-295-2952 FAX 508-743-0903 info@gng-design.com SIDE ELEVATION SCALE: 1/4' = l'-O' I RIDGE VENT ASHALT ROOF SHINGLES MATCH EXISTING OVER 30x FELT OVER 1/2 CDX OVER 2X10 RAFTERS ® 16. O.C. W/ R-30 HIGH-DENSITY KRAFT-FACED INSULATION AND VENT BAFFLES 12 PROVIDE 36, ICE AND WATER SHEILD AT 5 ROOF EDGE CONT. �`b pG• ,FAO 1 2X8®16'O.G. TOP OF WALL _ 00.00 CONT. EVE VENT Sheaf Me: TYPICAL EXTERIOR WALL: I WHITE CEADAR SIDING AND T EXPOSURE, 15u BUILDERS FELT, 1/2, CDX PLYWD. SHEATHING. 2X4 ® 16, O.G., W/ R13 BATT INSUL. BLUEBOARD, AND VENEER PLASTER _ IK FIRST SUBFLOOR ELEV= 00.00 2X10®16'O.C. no)ect. °`°""'By. EF v Checked°r. GG TOP OF SLAB score: ELEV.= 00.00 Vale: March 22,2006 Sheet Namb-.. IL mm SECTION SCALE: 1V4' _ -O' 2 1