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HomeMy WebLinkAbout0036 KAY AVENUE - Health 36 KAY AVE Centerville A= 248 -043 No. u Fee U(J THE COMMONWEALTH OF MASSACHUSETTS Entered incom uter: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippliCatlon for Disposal *pBtem ConstCUCtlon Permit Application for a Permit to Construct( ) Repair N-� Upgrade( ) Abandon( ) Eat/omplete System ❑Individual Components Location Address or Lot No. K4Y A&t^Ot Si Owner's Name,Address,and Teljo. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Yc Type of Building: Dwelling No.of Bedrooms Lf Lot Size sq.ft. Garbage Grinder(JV0 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) L4 0 gpd Design flow provided tic� gpd Plan Date a. Number of sheets Revision Date Title Size of Septic Tank O (T GL \A ao Q�Type of S.A.S. L Z( (o C�.e,�b�t5 i.9 S�v n-t— Description of Soil 6 � � "' pj co w b-c c5(:vim Nature of Repairs or Alterations(Answer when applicable)_ _mac�. _ e X C nG, C-e6 9igoo L S kp\" 1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. f , Si a Date Application Approved by 1/1/t Date Application Disapproved by Date for the following reasons Permit No. d 0 -7 Date Issued 4 ( No. /`'O IO O � Fee 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in co4uter: Z, PUBLIC HEALTH DIVISION - TbWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Disposal Opstem Construction J)Prmit Application for a Permit to �Construct( ) Repair(4 Upgrade( ) Abandon( ) ©Complete System El Individual Components Location Address or Lot No. K4Y A44.^ C G• `k Owner's Name,Address,and Tel.IZ1o. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. SCo T k1-5 b\v yG('•i•�w��(• $}C.�G NCg3 �'.O OkV0f ST F* d 54 004 C1 :M2 561.3 Type of Building: v Dwelling No.of Bedrooms Lot Size lak sq.ft. Garbage Grinder( bf U Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures J i - . Design Flow(min.required) ��r� gpd Design flow provided U C gpd Plan Date (a 3 Number of sheets Revision Date Title Size of Septic Tank 0 (s o— \A R6 d ftt Type of S.A.S. L ( C L C V LAw66-V3 W / SAn^t_ Description of Soil k I M P r I CGWs-e SC.J.d Nature of Repairs or Alterations(Answer when applicable) 3--n \ C-e S Synci L 1?�1C C�at C Gnu (� yX r j C ti, c.,,. r�r L.) S ftey_ Date last inspected- ` Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in y accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. t , Signeq Date `-�/� f �{ Application Approved by 1i1ri l� ,� Date A y Application Disapproved by Date for the following reasons Permit No. tr 0 % Date Issued l✓�� 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(11< Upgraded( ) Abandoned( )by -?cc,A F ct..J V- -at-3 Y� A yl#,UC.. 1\`LP -has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. G �'Of7dated L//) Installer G 6 �r c-t anll�_ Designer #bedrooms l( Approved design flow _ �� gpd The issuance of this permitshall not be construed as a guarantee that the syste will fun n as ,es ed. Date tU J, I Inspectors No._ Do t�-O 0 7 Fee UG THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction permit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at Z !!4,F y c � (� • V c and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with .Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date I / J/j 1117 Approved by Mildred McDonald 36 Kay Ave Centerville, MA 02632 February 9, 2018 To Whom It May Concern: The property at 36 Kay Ave, Centerville MA, Lot 248/042/-Use code 1010, was built in 1963 as a (4) four bedroom home. It still remains a (4) bedroom home. Sincerely, Mildred McDonald r - Town of Barnstable Regulatory Services Richard V. Scali,Interim Director 1e,¢ Public Health Division +" Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 y Installer& Designer Certification Form n Date: �L A/ u Sewage Permit# QC)f Assessor's Map\Parcel Designer: STF4P IkE1J X. 4AA . C Installer: eG,�"PC" iA- Address: 16 Address: l l3 O W YAP.. OOT 14 I tAk g ekoQ i S . y4 A. c2_6o o Zt�o 0n.L1(dt I! fir' k• FLAP K was issued a permit to install a (date) (installer) septic system at Co K4y AVDU G V� UZ— based on a design drawn by (address) <"T6=t,E-�63,3 A,- . Sedated �^�� -7 l! -7 (designer) _ZI 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. Strip out (if required) was inspected and the soils were found satisfactory. � above was installed with major changes i.e.I certify that the septic system referenced b S ' the SAS or an vertical relocation of an component greater than 10 lateral relocation of Y p g Y of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed c Hance with the terms of the IW approval letters (if applicable) (Installer's Signature) Rl. (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE B_AR_N_STABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:1SepticlDesigner Certification Form Rev 8-14-13.doc F TOWN OF BARNSTABLE . i LOCATION �C� /�l SEWAGE# Zo Zn VILLAGE �'J�� !1 ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 7S CO &" \L It I'M r-0—ct H d® 6 SEPTIC TANK CAPACITY tS� kA C�3 goic LEACHING FACILITY:(type)( L C el �,ti(rc BS (size) 16 X$S-o k / NO.OF BEDROOMS �' S^t,u^t co-vj�t � OWNERS ��'1 1�3 d��•`—� 'PERMIT DATE: W /;2 l( COMPLIANCE DATE: Separation Distance Between the: 3 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 can a . f 3 .. r _ ee all t~5400vt Ate • S Xi'J'�v�v sl-s �'Gv�*s c�-S r��i,!e T S—D — 5—ag 1cJ1� p Town of Barnstable Pit 4. i b Departitnent of Regulatory Services s' "MIMANiA F Public Health Division Date MA&t j, ie3tt• 200 Main Street,Hyannis MA 02601 7�rfr►� � / V Date Scheduled 3 b Time I l .�AllFee Pd._ / Soil Suitability Assessment for Sew ge I ispo all Performed-By: S��hf �� //+A./FS P.�. Witnessed By: r v,- ,! LOCATION&.GENERAL INFORMATION Location Address � Y i4 IlE Owner's Nama /Vn'/p//1 erl ML Dovlf4 11 GrirJi`�/rd+%/e ysy/ Address 36, )el4 i4 v.c Assessor's Map/Parcel: ` 2 elel©t/ Engineer's Name s�P✓ah.e�G�.¢�s NEW CONST1tUCIYON REPAIR Tela hone# Land Use• A-_r_ Slopes(96)_ S Surface Stones VV Distaneca ftm: Open Water Body — ft I'oss(ble Wot Area ft Drinking Water Well ft Dmlhaga Way i ft Property Line w = ft Other f1 SKETCHt(Street name,dimensions of lot,exact locations of test holes&pora tests,locate wetlands-in proximity, to holes) V, ei '�V Parent material(geologic) T �-1 Depth to tied►-Oak Z ► I r I Depth to Groundwater. Standing Water In Hole: N Weeping(rain Pit Faca N A, f Estimated Seasonal High Groundwater It A DETERMINATION FOR SEASONAL•HIGH'WATER TABLE � Method Used: _ A>Z,* Do th Observed standing in obs.hole: In. Depth to soil mottiast la.' Dzth to weeping from side of obs.hole: In, Oroundwater Adjustment I tt. tndox Wally Reading bAtoa Index Wall level�_,_ w„ Adj4actor, , Adj.Grpun'dwatar•Le al,,_, PERCOLATION TEST Hato 3 3o I 'xvnu I-!� Observation Hole# Timn at 9" u d � Depth of Pero '• l b Time at 6" I Start Pro-soak Time @ D' Time(9,141) End Pro-soak Rate Min./Inoh Site Suitability Assessment: Site Passed Sitp Failed: Additional Testing Noodad(Y/N) I Original: Public Health Division Observation Hole Data To Be Completed on Back-- *** s If percolation test Is to be conducted within 100 of wetland,you must first notify the s Barnstable Conseirvation Division at least one(i)week prior to beginning. Q:ISBPTI0PHRCFORM.DOC i 10 � vS DEEP•OBSERVATION HOLE LOG Hole# 1 Depth from Sell Horizon Soil Texture Shcl Color Sall• Other Surface(in.) (USDA) (Mansell) Mottling (Stnucture,Stones;Boulders. Consistency.,%'arival) to A z f c s 16,eti `�/1. f DEEP OESERVATION HOLE'LOG Hole#. L. Depth from Soil Horizon Sall Texture Soil Color Soil Other Surface(In.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. s 8 A. (bYA- ;3 ZZ b Ls A. 41� z� c -eS 1DYti DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders.. DEEP OBSERVATION HOLE LOG Hole# Depth fiom Sot(Horizon Soil Texture Sall Color Sall Other Surface(in.) (U$DA) (Mansell) Mottling (Structure,Stones;Boulders, Consistency. 0MV111 Flood Insurance Rate Man: Above 500 year Mood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No. Yes Dan th of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the area proposed for the soil absorptibn system? If not,what is the depth of naturally occurring pervious material?,._..._..�. . Certification I certify that on �� !y 4 (date)I have passed the soil evaluator examination.approved by the Department of Environglental Protection and that the above analysis was performed by me consistent with the required tralni ertise and experience described in 10 CMR 15.017. Signature Datis Q;ISEPTICkPSACPORM.DOC ACCESS COVERS MUST BE WITHIN 9" MINIMUM. 'INVERT ELEVATIONS : DES l GN CR l TER l A : GENERAL NO TES : 6" OF FINISH GRADE 104.69 FIRST 2' TO 3' MAXIMUM COVER 'INVERT AT BUILDING: 102.0 DESIGN FLOW: ro3.0 BE LEVEL MIN 2" OF PEASTONE INVERT IN SEPTIC TANK: /0/•0 4 BEDROOMS AT 1/0 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION 103.6 MAX OR F/L TER FABRIC INVERT OUT SEPTIC TANK: 100.75 BEDROOM EQUALS 440 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONL Y. l0/.4 MIN /3• 38. r00.6 3' 3/4" - ! l/2" CIA. INVERT IN DIST. BOX: 100.0 �4' LDIAAMPIPEfl G NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS Tj� ,0 100.75 99.83 12- DOUBLE WASHED STONEINVERT OUT 0/ST. BOX: 99.83 Q v GAS 100.0 � � 99.8 °�°� 98 8 INVERT IN LEACH CHAMBER: 9g•8 S€T, S€€ SIT€ PLAN. BAFFLE SEPTIC TANK REQUIRED: 3 OUTLET 6 LC-6 LEACHING CHAMBERS BOTTOM OF LEACH CHAMBER: 96.8 440 G.P.D. X 200% - 880 GAL. J. ALL CONSTRUCTION METHODS AND MATERIALS AND amifww- � D-BOX W/3.5' STONE AROUND. 10'w x 50'1 x 12"d ADJUSTED GROUND WATER: N/A SEPTIC TANK PROVIDED: 1500 GAL. MIN. MAINTENANCE OF THE SEPTIC SYSTEM SHALL 1500 GAL H-20 OBSERVED GROUND WATER: N/A CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL SEPTIC TANK 6* CRUSHED STONE OR BOTTOM OF TEST HOLE #l: 92. 1 SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS. COMPACTED BASE DESIGN PERC RATE C 5 M I N/INCH N PROF l L E : NOT TO SCALE SOIL TEXTURAL CLASS - 1 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER 330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH- STANDING H-20 WHEEL LOADS. PROVIDED: 6 LC-6 LEACHING CHAMBERS W/3.5' STONE AROUND. A-620 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR 620 S.F. x 0.74 - 458 G.P.D. APPROVED EQUAL. 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED SOIL TES T P l T DA TA & PRECAST CONCRETE OR APPROVED POL YETHYL ENE. 104.0 BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER INDICATES INDICATES BRB FND �� +105.3 PERCOLATION OBSERVED TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE + E 107.E TEST - GROUNDWATER OUTLET. 49 00» �\ �\ �\ e 6 LC-6 PRECA�r CHAMBERS- /05 �g� �� `� ��� TP #/ P#153/0 TP #2 W/3.5�*STONE AROUND _ 7. BEFORE CONSTRUCTION CALL "DIG-SAFE". \\ ' �• 1-888-DIG-5AFE AND THE LOCAL WATER DEPT. 9�.6 ---_�so 0» HOR!ZON TEXTURE COLOR 102 / 0» HORIZON TEXTURE COL OR /02. I FOR LOCATION OF UNDERGROUND UTILITIES. :: : .... . ..::. g X.:...... 4- Q LOAMY IOYR .Q LOAMY IOYR o SAND 3/3 SAND 3/3 8 .... ....i., '� 6 25' ��00.9- ""TP !..' . ::•� "' SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE o � LOAMY IOYR LOAMY IOYR DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION cEssPoei�104.2 ___ B OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE SAND 4/6 SAND 4/6 / - -_ 24' - - - - - - - - - - - - - - - - - - - - IDD. I 22" - - - - - - - - - - - - - - - - - - - - CONSTRUCTION INSPECTIONS. l00.3 MED-COARSE IOYR C/ MED-COARSE IOYR /E"1 o3R44,/e r 0z,6 i 102 4- SAND 6/6 SAND 6/6 9. EXISTING CESSPOOLS TO BE PUMPED DRY AND 3/,- / �� +1cLz.s ---- BACKFILLED. `[ 101.5 ACES_POOL ' W + CESSPOOL b � 1500 GALLON cl 40" -SEPTIC TANK ' / EXISTING o DWELL IN 103,4 G - 10s. m I II ��/// NO WA TER NO WATER I`f H°c c r 12O" 92. 1 120" 92. 1 L 0 T PORCH I 110. 188± S.F. DATE: MARCH 30, 2017 I I w TEST BY: STEPHEN HAAS I W_ /\e�/ WITNESSED BY: DAVID STANTON l SHED '\� i M 1 / PERC RATE: C 2 MIN/INCH 0\0 � I PAVED DR►VEWAY I \\ I I / 00.00' p-50.21 _W � 0 UP 687-21 1 a� G fl SEP T / C SYSTEM DES / ON 36 KAY AVENUE . MAP 24B PARCEL 43 �Fsr BARNS TASL E ( CEN TER V 1 LLE ) MA sr�F�r PREPARE70 FOR PI E Sr EET �o LECEi M / L DREG Mc DONAL D L OCUS CB CONCRETE BOUND -W WATER LINE SCALE / 20 ' MAY 23 , 2017 o O HYDRANT cc G GAS LINE STEPHEN A . HAAS OHW- OVER HEAD WIRES 4F LIGHT POST _ ENGINEERING , INC w --E- UNDERGROUND ELECTRIC LINE r �� R . O . B o x 16 a -T- UNDERGROUND TELEPHONE LINE ��j� ��� I �� S o u t h Die n n i s , MA 02660 h,'� �� S h � -CTV- UNDERGROUND CABLEV/SJON LINE � O 8 I\ � 3 6 2-8 '1 3 2 p -1-40.4 SPOT ELEVATION / / � A •--•40------- EXISTING CONTOUR L.L 0 CV S MAP 0 /0 20 40 Q( 1- PROPOSED CONTOUR JOB NO: 17-016