HomeMy WebLinkAbout2745 MAIN ST./RTE 6A(BARN.) - Health 2745 IvIAR4 ST. (BARNSTABLE)
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Page 10 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
Owner.�f-(CLVAc
Date of Inspection: — L^
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.
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r COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL'PROTECTION ,elf
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TITLE S - - - --
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OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: ,,;L-7 5 0' ' S_>`Fs {
Owners Name: c 1 w1 Cz�
Owner's Address: "3C-; L�°, l411 sF f A 5
Date of Inspection: C, '
Name of Inspector:(please print) W i 1 l i am E_ -Rob?nson Sr.
Company Name: William E. Robinson Septic Service , + a I
Mailing Address: P O Box 1089
Centerville, MA
Telephone Number: tsogi 775-8776' �.
CERTIFICATION STATEMENT €
t certify that 1 have personalty inspected the sewage disposal system at this address and that the infom ation-re ja led
below is true,accurate and complete as of the time of the inspection.The inspection was performed f ed on myb L'
training and experience in the proper function and maintenance of on site sewage disposal systems.T m a DEP_ L^
approved system inspector pursuant to Section 15340 of Title 5(310 CbtR 15.000).'The system: t. c.:�' -��
" - - .. CV,__
r' ,t , L7`F .ri Un ,r-
t Passes
Conditionally Passes , g, . -4, t '
p Needs Further Evaluation by the Local Approving Authority::• t
Fails
Ins ector s Si a , i
P gn tur . D ute: f
The system inspector shall submit a copy of this inspection report to the Approving/AuthoeF(Board of Health vt,;, ,
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design Clow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the aopropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approxing
authority.
Notes and Comments d �-
"-1'
"This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address how the system will perform in the future.under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Page 2oflt '
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFAC
E SEWAGE DISPOSAL SYSTEM INSPECTION FO
RM
PART A
CERTIFICATION(continued)
Property Address:
Owner:
Date of Iospection:
Inspection Summary Check A,'DAD or E/ALWAYS complete all of Section D
A. System Passes: `
✓ 1 have not found any information which indicates that any of the failure criteria described in 310 CM11
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 ,
repa' ed.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Ans er yes,no or not determined(Y,N,ND)in the' for the following statements.If"not determined';pkase
explain.
The septic tank is metal and over 20 years old"or the septic tank(whether metal or not)is structurally
un und,exhibits substantial infiltration or exfiltration or tank failure is imminent.Systcrn will pass inspection if the
cx,ing 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:
�bObservation of sewage backup or break out or high static water level in the distribution box'� p () x due to-broken or
ct
ob ed p r e s or due to a broken,settled or uneven distribution box.System will pass inspection if(with
app Val of Board of Health): x
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND expi ain:
Ilse sstem J y required pumping more than 4 times a year due to broken or obstructcd pipe(s).The system will
pass inspection if(with approval of the Board of Health):
broken pipes)are replaced
obstruction is removed i
ND explain:
•Page 3ofli
OFFICIAL INSPECTION FORM-`NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM w '
PART A
CERTIFICATION(continued)
Property Address: Q7 95
dl`'j�uk . .
Owner,
Date of Inspection: ')('- �'`YK
G Further Evaluation is Required by the Board or Health:
Conditions-exist which require further evaluation by the Board of Health in order to determine if the'system
is fail' g to protect public health,safety or the environment.
1. S�stem will pass unless Board of Heatth determines in accordance with 310 C.UR 15.303(I)(b)ttiat the _
s}stem is not functioning in a manner which will protect public health,safety and the environment:
Cesspool or privy is within A feet of a'surface water
M Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
1 Ma
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
s stem is.functioning Ina manner that protects the public health,safety and envirenment: "
_ The system has'a septic tank and soil absorption sysiem(SAS)and the'SA3 is within 100 feet of a'
surface water supply or tributary to a surface water supply.
( — The system has a septic stank and SAS and the SAS is within a Zone 1'of a public water supply.• t a.
— 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 l00 feet but 50 feet or'more Goifi a' ' z
private water supply'wcll" Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is Gee from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than S ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form:
Other:
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?,' a .� .t.y. a.. .fir•, �� . y`, s.. •q -
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Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:
Owner:
`��
Date of Inspection:
rk
D. System Failure Criteria applicable to all systems:
You must indicate'). res"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
i Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded.or
clogged SAS or cesspool
Static liquid level in the distribution box above.outlet invert due to an overloaded or clogged SAS or
cesspool
Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
of times pumped
I Any portion of the SAS,cesspool or privy is below high ground water elevation.
_ Any portion of cesspool or privy is within i00.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.(This system passes if the well water analysis,
performed at a DEP certified laboratory,for conform 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.]
(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system faits.The system owner should contact the Board of
;! Health to determine what will be necessary to correct the failure.
E. arge Systems:
To b 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:
(17te llowing 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
fd} Zone 11 of a public water supply well
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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 mmer or operator of any large system considered a
significant threat under Section E or failed tinder Section D shall upgrade the system in accordance with 310 CMR
15.304.The system outer should contact the appropriate regional office of the Department.
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Page of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B ,.
CHECKLIST
Property Address: ���l -y
Owner:
Date of Inspection:
Check if the following have been done.You must indicate !ks"or"no"as to each of the'following:
Yes No
}' •_ f P _
=r _ Pumping information was provided by the owner,occupant,or Board of Health..,
Were any of the system components pumped out in'the previous two weeks?
_ Has the system received normal flows in the previous two week period?
Have large volumes of water been introduced to the system recently or as part of this inspection,?
Were as built plans of the system obtained and examined?(if they were not available note as N/A).
Was the facility or dwelling inspected for signs of sewage back up?
Was the site inspected for signs of break out? - - -
Were all system components,excluding the SAS,located.on site
i
_ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition .. £.
of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum'?
Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems
The size and location of the Soil Absorption System(SAS)on the site has been determined based on
Yes no
Existing information.For example,a plan at the Board of Health. ,
Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance. .k;.
is unacceptable)[310 C1vIR 15.302(3)(b)]
.. �. fy '' `i, xt ,,eF+ '� t C'. ..�
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Page 6 of I I
OFFICIAL INSPECTION FORM—NOT FOR-VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 7�5
Owner• a� '1 r✓c-Y t
Date of Inspection: `7-1 C-C a',
FLOW CONDITIONS ,
RESIDENTIAL
Number of bedrooms(design): Number of bedrooms(actual): .
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x Hof bedrooms): �=('c?
Number of current residents: tv
Does residence have a garbage grinder(yes or no): ijc
Is laundry on a separate sewage system(yes or no):_;I-v[if yes separate inspection required]
Laundry system inspected(yes or no):AQ
Seasonal use:(yes or no):
Water meter readings,if available(last 2 years usage(gpd)):
Sump pump(yes or no): �.
Last date of occupancy:. ik
COMAI ERCIALIIKD USTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): Qvd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no):
Non- anitary waste discharged to the Title 5 system(yes or no):_
W,ate'r 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): /VC,,
If yes,volume pumped:_galloris—How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
Septic tank,distribution box,soil absorption system
_Single cesspool
Overflow cesspool
Privy
Shared system(yes or no)(if yes,attach previous inspection records,if any)
�_Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no): t✓C>.
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Pagc 7 of I!
OFFICIAL INSPECI•ION FOI01—NOT FOR VOLUN-rARV ASSESSNIM'S
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSUCTION{Ii-0101; j •, Y. , ,, f
IARTCr . • ,
SYS M INFORMATION(coritinucd)
Properly Address: vi 5 t h S
-
Qwncr: ►J�t(.t \ dui i Ei Y i ,+,,
Date of Inspccilon: 'Z—ID
BUILDING SEWER(lucatc on site plan)
DqU►below giadc: 10
hlalctials of conswctioti: —cast iron -40 PVC_vUtcr(explain),J
Distance from private ss'ater supple well or suction line:
Conunertts(on condition of juilsts,ver►ting,evidence of I"I'abe,etc.):
SEPTIC TANK;-(lucatc on site plan) � � _ _ '� •'' ? ti
Depth below grade: C
Material of eonslrugion: r cuncrctc natal fiberglass IrolycUrylcne
_utltcr(cxplain)
1f tarn:is metal list age:— Is age cunfrrrned-by a Certificate of Compliance(yes or nu):_(altacir a cup).of -
ccrlifrcatc)
Dinscnsions:
Sludge depUl ?
Distance from top of sludge Iu bullum of uullcl Ice or bafllc: ,
y.rr t
Sewn thickness: '�(�•' ... •• '• --
Uistancc from top u(sewn to top of outlet lee or bafllc: y& .a '! ''
Distance Gorn bottom of scum to bottom of uutict I e or bajlle�:
I low Were dimensions delcrtnincd:
Comments(un pumping rc'cummcnJatiuns,inlet and outlet lee or bafllc conditiwr, struclural intcbri►y,Iiyuid Icvcls
as related tv outict urvert,cvidcttcc of leakage•etc.): t
GRE-�SETRAP._(locate on site plan)
Dc lU►Geluw grade:_ .� y ,; ' .;.{ ,� .. �_ '
Matcria of eonsUuction:_cuncrctc t-Inctal_'fibei(lass jolycili)-knc _otltcr _
Dimalsions: -r• - - '
Scum tltick less:
Distance(r, n1 lop of scum to top of outict Ice or bafllc:
Distance tom boltont of scum to bollunl of outlet tcc or bank:
Dalc of ash pumping:
Cunu eels(on pumping rccunuucndalions,inlet and uutict(cc or bafllc cunditir•:t;sltucluial in1cbt1ty, liquid Imb
as[ tcd lu oullct invert,ct'idcltcc of Icaka fc,cic.):
,
)'age 8 of I I
OFFICIAL,INSPECTION R)KAI—NOT FOR VOLUNTARY ASSL:SSIIIEN"I-S
SUUSUIVACE SL NN'AGI; DISPOSAL SYSTER11NSPECTI0N FOI(NI
PAI(T C
SYSTE11l INFORMATION(conlinucd)
rroperty Address• _�-IH 5 n%c.: ,
Owner: DP I Ctv� ; t
Dale of Inspection:
T1GIlT or IfOLUING TANK;_(tatth t„ust be pumped at wile of inspection)(lucate on site plan)
Dcpllt below grade;
hlatttial of construction: __concrete______r,tctal_fiberglass�tolydhylene othcr(explain):
Uintcnsions:
Capacity: paIluns
Ucsign flow. gallunsiday
Alarm present(yes ur no):
Alarm level: Alann in svorkin utdcr
Date of last pumputg: 6 �'cs or nu):
Cununcnts(condition of alarm and float switcbcs,cit.):
DISTRIBUTION f10X:—`/(if present must be opcncd)(locale on site plan)
Depth of liquid level above quilt,invert: G
Comments(note if box is level and distributiun to outlets equal,an}•evidence of sulids carr)-over,any evidence of
leakage into or out of box,ctc.):
C'
PUMP CRA111BLIk;_(locale on site plan)
rumps in working order(yes or nu):
Alarms in ss•orking order(Yes or no):_
Comments(tote condition of pump chautbcr,cuuditign u(pu,aps and apputttnanccs,etc.):
Page 9of11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTIONFORM
{ , PART
SYSTEM INFORMATION(continued)
Property Address: `)
Owner:
Date of Inspection: '
SOIL-ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not-required)'
If SAS not located explain why:
Type
r leaching pits,number: 3
leaching chambers,number:
leaching galleries,number: ,
leaching trenches,number,length:
leaching fields,number,dimensions:._
overflow cesspool,number: ' +
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):
V
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan)
Numgr and configuration:
Depth'.—top of liquid to inlet invert: -'
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool: .� +
Mate als of construction: t
Indic tton of groundwater inflow(yes or no): - 4
Co J ents(note condition of soil,signs of hydraulic failure,*level of ponding,condition of vegetation,etc.):
PR4VY: (locate on site plan) '
Milterials of construction:
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
. t
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Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION-FORM
PART C
SYSTEM INFORMATION(continued)
f
Prop"Address:
Owner:
Date of Inspection: 7 —t V-•G�y_
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.•
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'age,11,of I l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: :- ��
Owner-. �Y1C1 —C� t`,li
Date of Inspection: `7 f Fes)-C-Q;.
SITE EXAM
Slope
Surface water ,
Check cellar ;
Shallow wells
Estimated depth to ground water ! 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 hote 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:
- lI
Town of Barnstable
Regulatory Services
BMINSMBLE. : Thomas F. Geiler,Director
9$ 639• `0�
p f 639. a Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
REGARDING SEPTIC INSPECTIONS BY PRIVATE CONTRACTORS
DISCLAIMER
This septic system inspection report was completed by a private inspector who is certified by
the State of Massachusetts, Department of Environmental Protection.
Although the Town of Barnstable Health Division received the original or copy of the report;
this Division does not warranty the functionality of the septic system in the future nor does
this Division agree with any technical observations and interpretations contained within this
report.
In addition, by receiving this report the Town of Barnstable Health Division does not
automatically approve the number of bedrooms listed within this report. The actual number
of bedrooms approved at a particular property would be listed on the "Disposal Works
Construction Permit".
If you should have any questions regarding this report, please contact the certified Septic
System Inspector who conducted the inspection.
QASFPTIMisclaimer Private Septic Inspections.DOC p
AsBuilt Page 1 of 1
TOWN OF BARNSTABLE
LOCATION , `;' .S .i' ^, j "� SEWAGE # ? 5 C
VILLAGE ASSESSOR'S MAP & LOT P,4e, 634
INSTALLER'S NAME St PHONE NO. % , a '.S- 0 % L
SEPTIC TANK CAPACITY /f4) C
LEACHING FACILITY:(type) / 6 v S (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER_
BUILDER OR OWNER
DATE PERMIT ISSUED:
1
DATE COMPLIANCE ISSUED: I i s /
VARIANCE GRANTED: Yes No ,V
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http://issgl2/intranet/propdata/prebuilt.aspx?mappar=258030&seq=1 7/7/2015-
TOWN OF BARNSTABLE O
LOCATION SEWAGE #
VILLAGE JJ ASSESSOR'S MAP 6i LOTV-�'Xr' 9:534)
INSTALLER'S NAME & PHONE NO. ; -JS 7S %7
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) "1 6 6 6 � � (size)
NO. OF BEDROOMS �� PRIVATE WELL OR PUBLIC WATER_
BUILDER OR OWNER v a DATE PERMIT PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No 1/%
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ASSESSORS MAP NO.
PARCEL NO: 0 3 D
No........=�.. .. Fss3.Q....O.Q.............
10 THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
1'
Apphratiou for Bi_nVv!3a1 Wor1w Tomitrurtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal
System at:
2745 Main St Barnstable
•--•••........................•-•-•••................---••--•-------....-------•------------...... ----•--••-•-•-------------•-••------------•---.....------------•-•-•----.......•-•---.....--•--••.
Robert Davis Location-Address 55 Cresent Bener lfbndale NJ
......................-.......................................................................... •---••---------•-•--------------------•----------•-•-----------••-----•-....................---•--
Owner Address
.A1...E .1:Wbinson...Septic.-Serui.c.e................ P...0...__1 Qx---1.0.8.9.._ceatasville..U'bb..---••.......---
Installer Address
d Type of Building Size Lot----------------------_---Sq. feet
Dwelling—No. of Bedrooms--------------4
----------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures ----------------------- ------- - -
W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons.
04 W Septic Tank—Liquid capacity__-.-_--_-gallons Length---------------- Width---------------- Diameter---------------- Depth................
x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No------------- ------ Diameter-------------....... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed bY--------- ----------------- ----------------------••------•--------------- Date......................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..--_.----.---_------_-.
G Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 ----------------------------------------------------------------------------------------------------.........................................................
ODescription of Soil..................zand..........................................................................................................................................
x
w
x --------•--•--- ------------------------------------ -------------------------------------------------------••-------------------.....-------•--------------•---------------------•----•--------....--
U N t re of Re it or AI ions—Answer when �a,b le..-install a 1 , 500 gal tank,
c-'fox a�i'd � 1 , ��� gal sonepac)aC�'� leachpit�
---••---•-----•------------------••----••--••------...--•--...-------------•--••---------•---•-.....---------•------------- ----------.....-----....-•---•------------------------------........-----•--
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—T e undersigned further agrees not to place the
system in operation until a Certificate of Compliance has be is ed by theAboaof health.• �� �
Application Approved B /1 s/ � /..�.��....
Dace
Application Disapproved for the following reasons- ----------------------------------------------------------------------------------------------------------------------- --------
------------------------------------------------------------------------------------------------- - ------.-........------.....
o, Q Dace
Permit No. / �. g-------- -------------------------- Issued ---............ ---`lr l'
Da
03D
No......t.. _.... J FEBM.:..O.A............
C) • THE COMMONWEALTH OF MASSACHUSETTS
r\ J BOARD OF HEALTH
TOWN OF BARNSTABLE
Appltratiott for Di-tipoial Workii Towitrnrtton jJrrtnit
Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal
System at:
2745 Main St Barnstable
•---•---------------------•--••-----•--•----•---•-•--------•-------------•-----.............-••--- --•---•-------•-----:...---------•------.....--------•---.....--•--------------................•-
Robert Davis L...t'o»-Address 55 Cresent BendTrklkbndale NJ
......................-.......................................................................... •-----•--•------•-------•-----•--••---•.....--•--•------•••...----.....----•-•-•••-......•----•---
Owner Address
a M. FA...Fmb.i.ns n-_-5e t_ic--SPr i.cne.-----•-------- �' p= B�� 1.0�9 !Centerville.-MA
Installer Address
d Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.__--__---__4----------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther-Type of Building ____________________________ No. of persons-------------------_-------- Showers ( ) — Cafeteria ( )
p' Other fixtures _______________________________ _ _
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity------------gallons Length---------------- Width---------------- Diameter_-..--_-.----_ Depth----------------
x Disposal Trench—No. .................... Width---------_.......... Total Length.................... Total leaching area_____._.._......__.sq. ft.
Seepage Pit No.___---_-_--.------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......----.......... .................................................... Date.......................................
aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Li, Test Pit No. 2................minutes per inch Depth of Test Pit--..------________-- Depth to ground water........................
R+ •-------------•-------------------------------••-----------•------------------------•----•----•-•.........Z:................................................
DDescription of Soil----------------- gamd...........................................................................................................................................
x
W
x atur of Re air or A ions-A Answer when a 'ca le---install a 1 '500 g3.1 tank,
U ,-pax aria 1 , �i gal stonepack d �'ea vits--
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—Tie undersigned further agrees not to place the
system in operation until a Certificate of Compliance has be is ed by the boa d of health.
Signed - �y/�U. �--------------
S_
ce i
r - _
Application Approved By -------------------- -------
....... ... ...... -------------------- ,.. ..-------1'1.
Dace
Application Disapproved for the following reasons- ------------ ----------------------------------------------------------------------------------------------......................
...... ......................................... . ...... .
Date
Permit No. � � �....................................... Issued .... ... -�r---------------- ---
Dae
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Qlerttfiutt#e of C�nmpliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x )
by ...W.sE' Robinson....Septic Service ------------------------------------------------------------------------------------------------
Installer
at 274 5 .Main St Barnstable -------------------------------------------------------------------------
....................._----------------..-----
has been installed in accordance with the provisions of TITLE 55 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. �--------- ----------- dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.......,1 ''`- .... f f _ Inspector.--_ - ... - ���
!/
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE 30 0'0
No......................... FEE.......................
11isplasal Works Toni3trurtion "omit
W E Robinson Se tic Service
Permissionis hereby granted..... . --- ------•-- -------------•----- ------•-----•--•--•••-•----•.....---------••••----------•--••--.............
to Constru t ( ) or2epair ( x) an Individual Sewage Disposal System
`L745 Main St Barnstable
atNo......... ---- --- ---- - - --------------------------------------------------------------------------------------------•---........e.................
Street q
as shown on the application for Disposal Works Construction Permit No)!5____�_-._ ated_-____-- �--�
---
4t yia
Board of Health
DATE-- ••-----------------------•---•---------�,�-"-�---•---
FORM 36508 HOBBS✓!WARREN.INC..PUBLISHERS
-\ COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
RECEIVED
JUN 13 2001
TITLE 5 _
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY � ABIE
SUBSURFACE SEWAGE DISPOSAL SYSTE
PART A
CERTIFICATION
Property Address: 2 7 4 5 Main St.
Barnstable
Owner's Name: Robert Davis
Owner's Address:
Date of Inspection:
Name of Inspector:(please print) Wi 11 i am E_ • Robinson Sr.
Company Name: William E. Robinson Septic Service
Mailing Address: P O Box 1089
Centerville, MA
Telephone Number: (5 0 8) 7 7 5—8 7 7 6
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 inspector pursuant to Sec 'on 15.340 of Title 5(310 CMR 15.000} The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
Fails
Inspector's Signature: _ j: 1� - Date: Z'—1—0 /
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
\j
Page 2 of 1 l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 2745 Main St.
Rn
rnctab1P
Owner: � - - --
Date of Inspection:
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System/Passes:
ZI 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
repa ed.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Ans er yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please
expl in.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally
uns und,exhibits substantial infiltration or exfiltration or tank failure is imminent System will pass inspection if the
exi ling tank is replaced with a complying septic tank as approved by the Board of Health.
• metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
in icating that the tank is less than 20 years old is available.
N explain:
Observation of sewage backup or break out or high static water level in the distribution box due to-broken or
ob cted 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 xplain:
The system required pumping more than 4 tines a year due to broken or obstructed pipe(s).The system will
pas pection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
A
r Page 3 of l l
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 2745 Main St..
Barnstable
Owner: Davis
Date of Inspection:
C. Further Evaluation is Required by the Board of Health:
4Conditions exist which require further evaluation by the Board of Health in order to determine if the system
fai—�hg P 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 aseptic tank and soil absorption system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3 Other.
3
Page 4 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address- 2745 Main St.
Barnstable
Owner:
Date of Inspection: —
D�System Failure Criteria applicable to all systems:.
Yod must indicate"yes"or"no"to each of the following for all inspections:
Yes No
Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
Tcesspool
_ Liquid depth in cesspool is less s than 6"below invert or available volume is less than''/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
! Any portion of the SAS,cesspool or privy is below high ground water elevation.
Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
Any portion of a cesspool or privy is within a Zone 1 of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.]
(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. L rge Systems:
To be onsidered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
g Y Y h' g
gPd-
You myst indicate either"yes"or"no"to each of the following:
(The f.Ilowing criteria apply to large systems in addition to the criteria above)
yes o
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary,to a sm1ace drutldng 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 . 4
If you ha a answered"yes"to any question in Scctinn E the system is considered a significant threat,or answered
"yes"in ection D above the large system has failed.The owner or operator of any large system considered a
significa t threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304. he system owner should contact the appropriate regional office of the Department.
4
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 2745 Main St.
barnsdtable
Owner: Davis
Date of Inspection:
Check if the following have been done You must indicate"yes"or"no"as to each of the following:
Yes/No
Pumping information was provided by the owner,occupant,or Board of Health
Were any of the system components pumped out in the previous two weeks?.
(/ Has the system received normal flows in the previous two week period?
_ Have large volumes of water been introduced to the system recently or as part of this inspection?
_ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
c/ Was the facility or dwelling inspected for signs of sewage back up?
Ll 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 b_affles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
e� 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:
Ygs, no
Existing information.For example,a plan at the Board of Health.
Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b)]
5
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
PropertyAddress2745 Main St-
Barnstable
Owner: Davis
Date of Inspection: t- 9 'G
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): t Number of bedrooms(actual): Z/
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):'::� C, Ci
Number of current residents:-tAl .
Does residence have a garbage grinder(yes or no):i o
Is laundry on a separate sewage system(yes or no): .6cl [if yes separate inspection required]
Laundry system inspected(yes or no)/L dd
Seasonal use:(yes or no):
Water meter readings,if avdilable(last 2 years usage(gpd)): -2 n n 2001 99,000 gal.
Sump pump(yes or no): R—b 1999 - 2000 88, 000 gal.
Last date of occupancy: A
CO MERCIAL/INDUSTRIAL
Type f establishment:
Desi flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sqft,etc.):
Gre a trap present(yes or no):
Ind ktrial waste holding tank present(yes or no):
Noy}-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings,if available:
L t date of occupancy/use:
O HER(describe):
GENERAL INFORMATION
Pumping Records /l
Source of information:
Was system pumped as part of the inspection(yes or no): /vd
If yes,volume pumped:_gallons--How was quantity pumped determined?
Reason for pumping:
TYF!JZ OF SYSTEM
`Septic tank,distribution box,soil absorption system
_Single cesspool
_Overflow cesspool
—ivy
_Shared system(yes or no)(if yes,attach previous inspection records, if any)
_Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
_Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of in ormation:
Were sewage odors detected when arriving at the site(yes or no):�tJ
6
Page 7 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 2745 Main St.
Barnstable
Owner- Davis
Date of Inspection:
BUILDING SEWER(locate on site plan)
Depth below grade: ► i -
Materials of construction:_cast iron _40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK:_(locate on site plan)
Depth below grade: 1
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: L -le G 1
Sludge depth: ir e `7
Distance from top of ludpe�to bottom of outlet tee or baffler
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 bafflq: Z °
How were dimensions determined: 0 e%=t- 7�0'0"/
Comments(on pumping recommendations,inlet and outlet tee or baffle.condition,structural integrity,liquid levels
as related to outlet invert,evidence of.leakage,etc.):
GRISE TRAP: locate on site plan)
—( P )
Depth below grade:_
Mater,al of construction:_concrete_metal_fiberglass_polyethylene_other
(explain):
Dimensions:
Scum Thickness:
Dista4e from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date last pumping:
Co ents(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as rel ted to outlet invert,evidence of leakage,etc.):
7
Page 8 of l l
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 2745 Main St.
arns a e
Owner: Davis
Date of Inspection: l
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/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: B
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.):
4
PUMP CHAMBER: (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
i
8
Page 9 of 1 l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 2745 Main St.
Barnstable
Owner: Davis
Date of Inspection:
SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Ty
P
r _�-
leaching pits,number:
leaching chambers,number:
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions:
overflow cesspool,number:
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):
.0 4- L. Y�
SSPOOLS: (cesspool must be pumped as part of inspection)(locate on site'plan)
Num er and configuration:
Depth top of liquid to inlet invert:
Depth f solids layer:
Depth scum layer:
Dimens ons of cesspool:
Material of construction:
Indicatio of groundwater inflow(yes or no):
Comm
s(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
PRIVY: (locate on site plan)
Materials of construction:
Dimensi ns:
Depth of solids:
Comme is(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
9
Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 2745 Main St.
P
Barnstable
Owner: Davis
Date of Inspection: 7
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.
! f.vas
10
Page 11 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 2745 Main St-
Barnstable
Owner: Davis
Date of Inspection: — —U
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water 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)
hecked with local Board of Health-explain:
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how yo established the high ground water elevation:
0
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NO. REVISION DATE
NEW BROOM `Y
LUUKPLAim CLOSET
O PROVIDE PRICING OPTION FOR OWNER ON INTERIOR WALL FINISH: O r, OWNER IS TO PROVIDE ALL PAINTING EXTERIOR AND INTERIOR AND ALL
OPTION#1:B1.2 GYPSUM BLUE BOARD w/y"SKIM COAT OF KEENE'S OTHER PREPERATION AS NECESSARY FOR PAINTING. CLIENT:
RIZZOLIRESIDENCE
CEMENT VENEER PLASTER SMOOTH FINISH. 2745 Main Street
OPTION#2: NANTUCKET BEADBOARD INTERIOR MDF Y"x 4'x 12". O OWNER IS TO PROVIDE CERAMIC TILE FLOOR AS WELL AS THE INSTALLATION. Bamstatge MA 02630
O INTERIOR TRIM: 2"x 2"SCOTIA MOULDING @ CEILINGS PERIMETER; 0 " EXTERIOR STEPS TO BE AZEK DECKING FOR STEPS AND AZEK PORCH FOR E SCALE: 1/8"=V-0"
DOOR AND WINDOW CASING 1"x 4"FLAT STOCK TRIM;AND BASE ENTRY PORCH. FRAMING TO BE P.T.RISERS AND SURROUNDS FABRICATED TITLE: ADDITION FLOOR PLAN
BOARD MOULDING 1"x 6"FLAT STOCK INSTALLED AFTER OWNER j FROM 1"BORAL'TRUEXTERIOR'TRIM BOARDS.
INSTALLS CERAMIC TILE FLOORING. O EXTERIOR STEPS TO BE AZEK DECKING FOR STEPS AND AZEK PORCH FOR E DATE:MAY 15,2015
ENTRY PORCH. FRAMING TO BE P.T.RISERS AND SURROUNDS FABRICATED
FROM 1"BORAL'TRUEXTERIOR'TRIM BOARDS. MICHAELA.JIMERSON A.LA.
ARCMTECTURE&E4MRIORS
193 Horseshoe Lane
Centerville,MA.02632
508 775-4264
majarch@com"^stxwt
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