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HomeMy WebLinkAbout0436 NYE ROAD - Health 436 NYE ROAD CENTERVILLE A = 148 - 091 No / & Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitation for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair( )r Upgrade,( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. )4,36 N ve P Owner's Name,Address,and Tel.No. C C Assessor's Map/Parcel g �N m &®�l'� 6 0X c'7 7v _ 927 6 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 509 .477-&6 -�� Cn y r1 q --gqq - 11&, Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building t�6 tjl� o No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required gpd Design flow provided a3 D gpd Plan Date 1 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) x0 DA 3 d nil (2) N.2b,S bb QQJ/ k, Ghamb 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 a It Signe Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. �l B Date Issued 4 / No, � '' (!/ Fee Q C/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppiication for Misposal 6pstem Construction permit Application for a Permit to Construct( ) Repair( )t;:UjjgCdAe,( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3�j N y� " "' Owner's Name,Address,and Tel.No. r �1 Assessor's Map/Parcel yg "", 1 l 61DDC(e 6 d9t 775 ` 929 L Installer's Name,Address,and Tel.No. Designer's Name,Addres and Tel.No. 13 t,-G 4 xv v - 5og -q77-a �c� s hw troy 7 ri� -qqq - I1 Type of Building: Dwelling No.of Bedrooms Q( Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 1JP43 [.� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)++ gpd Design flow provided `3l) gpd Plan Date 19 1 t`7 Number of sheets Revision Date Title x Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) H Zd as,3 d Ddy (2) J z!� ,3bQ Q0_1I00 A GhQtuber S 1 I 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 e t Signed Date Application Approved by Date Application Disapproved by Date for the following reasons - Permit No. ( ��G Date Issued --------------------------------=---------------------------------- ---------------------------------=-------- I--------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,tha the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgrade( ) Abandoned( )by ,vcd ( (> at " '-{ ('p y-e- P_�x� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.--' -96,6 dated Installer Pobfyi --i i IirQ Designer Q f' � n / #bedrooms Approved design flow —J gpd The issuance of this permits all not be )onstrued as a guarantee that the system will function designed. Date J, �� Inspector - L-�-------.-.-- ------_--------------------------------------------------------------= - , :_ ----------.--- No. /Q'io Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction i3ermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at 4314 3 1 W ye 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. y Date �_�J` Approved by �`l Town of Barnstable .°�t"E7D .� Regulatory Services Richard V. Scali,Interim Director r &UMSTABM r ' Public Health Division ; Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 11-Z I-i 9 Sewage Permit# 20 t r1 - 4 oG Assessor's Map\Parcel 144 g- q 1 Designer: Dau e nal%e r.A L Installer: B +d IA EX ac,QaA 10 p Address: -P p gnx H I Address: 19 -rr_Q.Sc.rru i,&) Ynrr+no.Al. Foresicto_ic- On 11- Iy -1'1 .(3#r Q Excc yo A i o r\ was issued a permit to install a (date) (installer) septic system at 431, N UE R,L based on a design drawn by (address) _0M%JG F'1o.1.er�c I dated (designer) _X I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. r•a, I certify that the system referenced above was conscted co phhe.terms of the IAA approval letters (if applicable) JR TY, JR. N to ler's Si a CT 1211 aISTEF / gip. �qNl TAR►P . Desig er's Signature) (Affix Designer's Stamp"Hare)" v b 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 BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc TOWN OF BARNSTABLE LOCATION 431, tjYc 1QJ SEWAGE# 201-1 - y ol. VILLAGE ecnict'vi 1l c- ASSESSOR'S MAP&PARCEL ly$ -R i INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1000 4a�) LEACHING FACILITY:(type) (size) 13 x 25 it?- NO.OF BEDROOMS Z OWNER PERMIT DATE: t l- l 4 - 1`l COMPLIANCE DATE: Separation Distance Between the: 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 Al - 39'6 A2- 331g.. $2- A3. 23'4 63. 39 A Aq- z� r, B ey 3 Town of Barnstable P l S ,�;Os ' Departinent of Regulatory Services i l„t„a,.AkA a Public Health Division Date 10 r 1 D F+ MASS. 200 Main Street,Hyannis MA 02601 { lED►AXt C; Date Scheduled_ L � 'I Time Fee Pd.— d DO Soil Suitability As eUment for Sewage Disposal o Q / �/2S Performed•By: Witnessed By:- LOCATION&.GENERAL INFORMATIO Location AddressY9 Q„� Owner's Name Iq 4— Address Assessor's Map/Parcel: 'l r Engineer's Name � � q-4"'T 7 NEW CONSTRUCTION / REPAIR Telephone# � ' � Lnnd Usa• � Slopes(96)� /_ Surface Stones /�✓ Distances from: Open Water Bod �(0 1rv,.�1 ft Possible Wet•Aren !(2V ft Drinking Water Well >/5vft Dral'nage Way ft Property Line ? ! —oft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands-in proximity to holes) v Parent material(geologic)�G � !/ Depth to Bedrock Depth to Groundwater. Standing Water in Hole:�/ Weeping from Pit Pnee Estimated Seasonal High Groundwater DETERMINATION FOR SEASONALMIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In. Depth to soil mottles; In,' Depth to weeping from side of obs.hole: In, Groundwater Adjustment ft. Index Well-# Readingbato: Index Well level_ Adj,fketor— Adj,ClroundwaterLeval PERCOLATION TEST Duty 0 a 0-0 Observation Hole# Time at 4" Depth of Pere .7 Time at 6" A Start Pro-soak Time® ff'U Time(9"4") End Pre-soak //:?o Rate MihAnch . !i Site Suitability Assessment: Site Passed Slto Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:ISEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Shcl Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stoneif;Boulders. • , o lsistency.96'aravetl 0 - /0 3 k C LOG Hole� DEEP OBSERVATION HOLE L' # Depth from Soil Horizon Soil Texture Soil Color Soil Other ' Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. 6 � .- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders._ Consistency, ]DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon oSoil Texture Soli Color- Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, 0 Flood Insurance Rate Map: Above 500 year flood boundary No--K- Yes Within 500 year boundary No= Yes 4— Within 100 year flood boundary No,-)L Yes Depth of Naturally Occurring Pervious Material ,. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorptibn system? If not,what is the depth of naturally occurring pe ous material?,._.._. � Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Envi nm tal krotection and that the above analysis was performed by me consistent with . the required traini expertise and experience described in�10 CMR 15.017. Signature 7X 7 >� Date Q;ISLPT1CkPE1RCPORM.DOC LOCATION y3ly SEWoC�E PERMIT UO. VILLAGE nfe 1(-If — — — — IPlST LLER ,111 N E: 6 ADDRESS BUILDER 5 Q` E ADDRESS DATE PERMIT ISSUED ?,6 DATE COMPLI &1,4cE ISSUED; a ��, 3. �L3� 5 CJ C. COVERS TO BE WATERTIGHT AND SEPTIC SYSTEM PROFILE Flaherty Environmental Services TOP OF FOUNDATION BROUGHT TO WITHIN 6" OF FINAL GRADE (not to scale) EL. 60.0' EL. 58.0 INSP. PORT W I 3 OF GRADE CLEAN SAND P.0. BOX 81 2" of k to 4" DOUBLE WASHED Yarmouth Port, MA 02675 r PEASTONOR GEOTEXTILE EL. sB.of 4" CAST IRON or EQUIVALENT FILTER FABRIC ~ 774.994. 166 MIN. PITCH 1/4" PER FOOT 4"SCHEDULE 40 PVC PIPE 4" SCHEDULE 40 PVC PIPE VENT "..; NT IF REQUIRED FLOW LINE (first 2'to be/eyeQ 5' 3.2% 5' 1% ° EL.54.7't L.EXISTING 14" 0 0 0 0 0 0 0 0°0°0°o°c —�► 0 0 �'O�C� O O D O o 0 0 0 EL. EXIST. —�- 0000000000 ° 0 00000°00o0ooc 4EL. 54.5'i4EL• 53.53' °0°0° 0 00000000 �0 aQD� °0°o°0°oc 0 000000 0000c2.0' 0 0 0 0 0 0 0 o 0 0 EL.53.7' o 0 0 0 0 0 0 0 0•o o C�jq�' 0 0 0 0 o cGAS BAFFLE EL. 53.5' o 0 0 0 0 0 0 o O® �� �' O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o e �-- °0°0°0°0° 0°0°0° .. a °0°0°o°oc EL,51.5' „ :: , • 0.5'CRUSHED STONE OR(H-20DBOX) SOIL ABSORPTION SYSTEM ' MECHANICAL COMPACTION (2) 500 GALLON H-20 CHAMBERS 4� 1000 GALLON SEPTIC TANK WITH 4'STONE AROUND IN A (DATUM: ASSUMED) (EXISTING) " to A" DOUBLE WASHED S ONE 12.83'W X 25.01 X 2'D CONFIGURATION ELL. 47.5' BOTTOM OF TEST HOLE EL. 47.5' LOCATIONMAP ,27, CEDRIC ROAD USGS ADJUSTMENT: N/A 9 56 v n' .00 (;46 46' GROUNDWATER ELEV: N/A N TH. Qqk street LOT 11 010af Road 15,224 SF± MAP 148 LOT 91 3' PINE i a O I; �_ LOCUS mF O ENCLOSED PORCH o O (SONO TUBES) _ Nye Road EXISTING / NTS i 2 BR DWELLING BENCHMARK: TOP OF FNDNZN flF}�yyS EXISTING / EL. 60.0' ' '�� DAVI D (\ 1000 GST ON D. FLt 'J 11 ` (SLAB) 20, 10.5' G/STEM q� SgNIT R) DRIVEWAY �S 0 DATE.'111912017 REVISED: 0 J �"• TH-, SHED SITE AND SEWAGE PLAN 56 1 O FOR 4 58 ,45, 58 B & B EXCAVATION, INC./ { WILLIAM L. GODFREY 436 NYE ROAD y SCALE : 1 = 3 O' CENTERVILLE, MA REF.PS 281 PG 72 PAGE 1 OF2 ¢ �T ....... ... ....... . ... ..... ............ ....... ............. ...................... ...... .... ............................. ..... ....... ................. .............. .... .. ............ ...... ..... ........ ...... .... . ................ ........ .. ........ ... . ............... ...... .... ... ................ GENERAL NOTES DESIGN CAL CULA TIONS S YS TEM DETAIL Flaherty Environmental Services P. 0. Box 81 1. ALL PRECAST COMPONENTS TO BE H-1 0 Yarmouth Port, MA 02675 RATED. ALL COMPONENTS WITH ANY NUMBER OFACTUAL BEDROOMS 2 (DESIGN FOR� 774.994.1166 ANTICIPATED VEHICULAR TRAFFIC TO BE H-20 RATED. GARBAGE DISPOSAL UNIT NO 2. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF GARBAGE TOTAL ESTIMATED FLOW GRINDER. (110 GALIBRIDA YX 3 BR) 330 GALADAY 3. MUNICIPAL WATER IS AVAILABLE. REQUIRED SEPTIC TANK CAPACITY 660 GAL. 4. ALL CONSTRUCTION TO CONFORM WITH 310 CMR 15.000 AND ALL OTHER SIZE OF SEPTIC TANK 1000 GAL. (EXISTING) APPLICABLE LOCAL, STATE AND FEDERAL CODES AND REGULATIONS. SOIL CLASSIFICATION 5, INSTALLERICONTRACTOR TO REVIEW& VERIFY ALL ELEVATIONS AND DETAILS DESIGN PERCOLATION RATE <2 MIN./INCH AND REPORT ANY DISCREPANCIES TO 12,83' DESIGNER PRIOR TO CONSTRUCTION OR EFFLUENT LOADINGRATE 0.74 GAL./DAY/FTC ASSUME ALL RESPONSIBILITY, LE40HINGARE4 6. INSTALLER/CONTRACTOR IS (2)x(25'+ 12.83)(2) = 151SF RESPONSIBLE FOR MAINTAINING SAFE 25'x 12.83' =321 SF WORK AREA, VERIFYING ALL UTILITIES 472 SF x 0.74 =349 GPD 25' AND NOTIFYING "DIG SAFE" (1-888-344-7233) 72 HOURS PRIOR TO USE(2)500 GALLON H-20 CHAMBERS WITH 4'STONE CONSTRUCTION. AS DIAGR4MMED INA 12.83'X25.0'X 2'CONFIGURATION 7, ANY CHANGES TO OR DEVIATIONS FROM THIS PLAN MUST BE APPROVED IN RESERVE LEACHING CAPACITY NIA WRITING BY FLAHERTY ENVIRONMENTAL SERVICES AND LOCAL BOARD OF HEA L TH. 8. FINISH COVER OVER COMPONENTS IS NOT TO EXCEED XPER 310 CMR 15.000 (NTS) UNLESS SHOWN PER PLAN. 9. ALL ABANDONED SEPTIC SYSTEM COMPONENTS TO BE PUMPED DRY AND FILLED WITH CLEAN SAND OR REMOVED SOIL EVAL UA TION AND REPLACED WITH CLEAN SAND. TEST HOLE#1 F#15505 TEST HOLE#2 P#15505 VkOFRqS. 10.ALL COMPONENTS TO BE PROVIDED Evaluator., David D.Flaherty Jr.,RS,REHS Evaluator David D.Flaherty Jr.,RS,REHS yam WITH WA TER TIGHT ACCESS PORTS SE#2755 SE#2755 WITHIN 6"OF FINISH GRADE. BOH Witness: Don Desmarais,RS BOH Witness. Don Desmarais,RS Date: October 24,2017 Date: October 24,2017 F HE 11.ALL SEPTIC TANKS, DISTRIBUTION BOXES AND PIPING TO BE INSTALLED TH-I ELEV.58.0' TH-I ELEV.58.0' No 1 WATERTIGHT. STS " 01-10, A LS IOYR412 0"-10 A LS IOYR312 12.NO KNOWN WETLANDS OR WELLS ITA % WITHIN 100 FEET OF PROPOSED LEACHING. to"-28" B LS 10YR 516 10"-28" B LS I0YR516 13,THIS IS NOT CERTIFIED PLOT PLAN 28"-64" C1 LMS 2.5Y616 AND UNDER NO CIRCUMSTANCES IS THIS 28"-64" C1 LMS 2.5Y616 PLAN TO BE USED FOR ZONING OR BUILDING PURPOSES. 7 certify that on November 12,2002,I have passed SITE AND SEWAGE PLAN 14.LOT IS SHO WN AS ASSESSOR'S 64%126" C2 MS 2.5Y614 F77.PFRQ the examination approved by the Department of Protection and that the above analysis FOR 64%120" C2 MS 2.5Y614 Environmental PROPERTY MAP 148 PARCEL 91. has 15-LOCUS PROPERTY IS LOCATED WITHIN been performed by me consistent with the B & 8 EXCAVATION, INC. required training,expertise,and experience described 15.018(2). WILLIAM L. GODFREY In 310 CMR AN AQUIFER PROTEC77ON DISTRICT (ZONE II). G.W.ELEV.NIA G.W.EL EV.N/A 436 NYE ROAD BOTTOM TH-I ELEV. 47.5' BOTTOM TH-2 ELEV. 48.0 CENTERVILLE, MA' PAGE 20F2 ........................................... .......... .......... ............. ............................................... ................................................................................... ...........- ..................... .......... ................ ......................... ................................................................. ................................................... .............................. ............................................................... ................