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HomeMy WebLinkAbout0092 KELLEY ROAD - Health 92:KELLEY ROAD ". HYANNIS' a 0 Town of Barnstable �F1ME T�� Regulatory Services Richard V. Scali, Interim Director BARNSTABLE. MASS. a;q. Public .Health Division yqj ►6 `0m Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-630 t Installer & Designer Certification Form Date: CC . Z3 l �•'Sewagc Permit# Assessor's IN1apTarcel z -C)E-To Designer: [�t�, ,ne��;n Wor�(s l�� • Installer: (all- AVM` S --�Address: lZ LQ, Cass+-n ,e w Rc1 Address: �a 5 T-.-e s V-atc.1e MA 0 ZG 414 pn �� n�,} Cl�a�� o�-•-was issued a permit to install a (date) (installer) septic system at 1 Z (ep_�Ve y based on a design drawn by (address) ��.t•e� %, 1M c.E.�+�e •fit✓ . , Gplo «tom r1 eic; clkll-tau I4 c , dated to 1 (designer) r 1 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 chaii'm 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 Wcrc found satisfactory. I certify that the system referenced above was COnStRIC qnce with the terms of the lA approval letters (if applicable) MOF PETER T � LICENTEE CIVIL (Installer's Signature) NO.35109 (Designer's Signature) (Affix Designer tamp 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 BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\.Scpti6Dcsicncr Certification Fonn Rev 5-14-13.doe TOWN OF BARNSTABLE LOCATION k pli't��� SEWAGE# c�0/9 3 i,'VILLAGE ASSESSOR'S MAP&PARCEL-2g2 " OS INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY. . �O �1 LEACHING FACILITY.(type) i (size) 121 X 21 NO.OF BEDROOMS OWNER A PERMIT DATE: COMPLIANCE DATE: Z42� � 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 Kn 4- W r ' �^ •mot No.�s� r Fee V`� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for ]Disposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(v"Abandon( ) [Complete System ❑Individual Components Location Address or Lot No. 2 �(�{ /,U u q hM Owner's Name,Address,and Tel.No. Assessor's Map/Pazcel 2q ps l 1 U!• •t4W+k Installer's Name,Address,and Tel.No. ' `� ����Q8 Designer's Name,Address,and Tel.No. QIAMAS5'XcuV -01- rzK ^.C,&''I MfK,S 569)q 1-1-9313 Type of Building: 2 Dwelling No.of Bedrooms J Lot Size I Q U 00 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures p Design Flow(min.required) 3n gpd Design flow provided 8 • gpd Plan Date I b i I 118 Number of sheets 2 Revision Date Title (l�lt � .S�Gh/1 6�bQ✓A 2 . Size of Septic Tank Type of S.A.S. ' Description of Soil rA,�' • SQ �L1 M rh �a{`d Nature of Repairs or Alterations(Answer when applicable) CI Is h,ce 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 Boar o ealth. Signed 03 Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. of Date Issued — 1 I • 1 No. Fee. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS YeS Zippfication for bisposai 6pstem Construction Permit Application for a Permit to Construct( ) Repair( �) lUpgrade Abandon Complete System ❑Individual Components Location Address or Lot No. C r(11 C F� �� �.��j Ct N!t a_ Owner's Name,Address,and Tel.No. ��, !'��s,� �'�•-�� Assessor's Map/Parcel 2,2-u 1 l�� �h ICc���� tr f tv• l+j��Ih4,1 Installer's Name,Address,and Tel.No. j t ' •{,C;t� Designer's Name,Address,and Tel.No. d (�tC.�ljf11< �crr<,b�tt�- i ��}e1I ,rIA � s� S Type of Building: Y si Dwelling No.of Bedrooms Lot Size 11 L4 bO sq.ft. Garbage Grinder( ) ! Other Type of Building 0� 1111 No.of Persons Showers( ) Cafeteria( ) Other Fixtures -� Design Flow(min.required) 2 91') gpd Design flow provided u �4' 1 gpd Plan Date I0 j 1 hi yy,, Number of sheets % Revision Date Title 12i'nl��l'e/f �t l/t f( ','Q > r hit i I IA"l lb "i h Size of Septic Tank Type of S.A.S. 1 Description of Soil rill . �'+ (A 1 b a�+ ��11 . r`,1 j,4 . Nature of Repairs or Alterations(Answer when applicable) 11f, 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. Signed • �._ ' '".. _ Date (v " Application Approved by Date k' x Application Disapproved by Date for the following reasons Permit No. 01 D 3 k` Date Issued '� I _ . _-.: - -. - . -•—____ - -------------- -- ---------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance , THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired,(��T?�n$Upgrdded bL. Abandoned( )by at AL K f !?L{ - lr t (14 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.; 7 dated Installer ,r11,110 1�_VA Va Designer 1-. hA t Yj a".Cj 1 ) 4 �n)t,j #bedrooms Approved design flow ` 3j { gpd The issuance of this permit shall not be construed as a guarantee that the system will function as des'gned. Date ��� �� Inspector --------------------- ---------------------------------------------------------------------------------------------------l--------------- No. a 2 y Fee Ll THE COMMONWEALTH OF MASSACHUSETTS 1 PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS 30isposal Opstem Construction Permit Permission is hereby granted to Construct( ) �jRepair( ) Upgrade( ) Abandon( ) System located at a and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with l�Title 5 and the following local provisions or special conditions. ., / 1 Provided:Con/str�uction must be completed within three years of the date of this permit. / ` { �_�fl� �. Date Approved by Cf I `J�/ Town of Barnstable P# _ Department of Regulatory Services Public Realih Division Date 9 IZ :'l1 �A 1639- `0� 20Q Main.Street,Hyannis MA 02601 ys Date Scheduled Tune r Fee i �U e U� [%5 Pd. -o Soil Suitability Assessment for Ste e Disposal Performed'BY: Be `C Gn_ 1-" S(,`—/Sy Z. Witnessed By. LOCATION& GENERAL INl�+ORMATION Location Address Q-z lie 11�y {7_t Owner's Name lT l`t(Al V1(5. 1 Address 1 Z SJ`�f�t'Ct S T�i i Cl Assessor's Map/Parcel: MA, Z� 29Z_ —GSA Engineer's Name C ��y�n�trin5 WV, CONSTRUCTION REPAM _J Telephone# .SC)F—.9-77 S'3 13 Land'Use t Slopes(40) Surface Stones `� t Distances from: Open Water Body ft Possible Wet Area'y// 4- ft Drinking Water Well f s Drainage Way ;\3�A' ft Property Line tom?" `7 ( ft Other ft SKETCH:(Street-name,dimensions of jot,exact locations of test holes&pere tests,locate wetlands in proximity-to holes) T(' �Z xzu _.... ._. _.- _ .. = L r ty Parent material(geologic) O 4+y4C`Jti r/'� Depth to Bedrock "��'/" Depth to Groundwater: Standing Water in Hole: A;A Weeping from pit Pace / v Estimated Seasonal High Groundwater 7 1 3 E�. t DETERMINATION FOR SEASONAL HIGH WATER TA13LE Method Used: . Depth Observed standing in obs.hole: _—__ „_In. Depth to soil mottles: Depth to weeping from side of obs:hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Wellievel �r Aql.factor,,.,,,,@.,_ Adj.ClroundwaterLevel PERCOLATION TEST Date Time Observation Hole# lime at V, Depth of Pen; � � _ / ( Time at8" Start Pre-soak Time© ` Time(0"•6") End ft-soak •.n �hc Rate Min./Inch Site Suitability Assessment: Site'Passed y Site Failed: Additional Testing Needed(Y/N) 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 fir'st'notify the; Barnstable Conservation Division at least one(1)week prior to beginning. Q:\.5EPTIC\PERCFO.R.M..DOC. DEEP.OBSERVATION HOLE LO.G Hole# 1 b Depth from Soil Horiion Soil Texture .Soil Color' Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure;Stones;Boulders. n i tcncy.%Gravel) A DEEP'OBSERVATION HOLE LOG - Hole# - Depth from Soil Horizon Soil Texture ,Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,.Boulders. Consistency.% Gravel)—" DEEP OPSERVATIONIi.OLE-LOG Hole# Depth from Soil.Horizon Soil Texture Soil Color , Soil Other Surface(iu.) (USDA) (Munsell) y Mottling (Structure,Stones,.Boulders. Consistency,%Gravel) t , DEEP OBSERVATION HOLE LOG 1 Hole# Depth from Soil Horizon 1 Soil Texture l Soil Color Soil Other Surface(in.) I (USDA) + (Munsell) Mottling (Structure,Stones,Boulders, h onsi ten t- • 1<lood Insurance,Rate Map: Above 500 year flood boundary No— Yes ` Within 500 year boundary .No T Yes t Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv`q�u�sjmaterial exist in all areas observed throughout the area proposed for the soil absorption system?. If not,what is the depth of naturally occurring pervious material? Certification �g • I Certify that on � � (date)I have passed 'the soil evaluator zarrtinationjapproved by the Department ofE,nvirontnental Protection and that the above analysis'was performed by me consistent with . the required tra• ,. xpertise,and experience described in 10 CMR 15.017.. l Date 2 f I Signature i J 5 QA.S,E PT I CAPE R C FO R M.D O C R. :f LEGEND 600^ N —— 98 —— EXISTING CONTOUR ses x 100.98 EXISTING SPOT GRADE ivy e.H.� OVERHEAD WIRES ROUTE 28 PL W EXISTING WATER SERVICE TEST PIT BENCHMARK 153-P�. 3�. m ie •- ° a b �0 °° m cm a � Eldridge Patton Ave. LOCUS LOCUS MAP NOT TO SCALE N. 15'40'45" E stockade fence i x 96.51 90.00' i V 97.64x \�� 97.18 LOT 73A 25' -� 14,400fS.F. 34' PROPOSED SEPTIC TANK J + 9 .62 9-8 x 98.32 r � � •�- 98.58 BENCHMARK 20 0 - - � - -- - ORANGE DOT/DECK F0077NG O EL.=100.11 0 0 C 9 EXISTING CESSPOOLS -�.:'a--- (approximate)----r-•--�: _ TO BE PUMPED, FILLED WITH SAND & ABANDONED x 98.94 X-19 10g� DECK x 1 o 2 Z A MET c bh 100E 99 J i EX. SEWER 0 1 INV.=99 1 Z /EXISTING HOUSE(192) x 101.1� --j T.O.F.=102.24t O1 9.96 x 101.39 o 101.00 o Cn 101.20 10117 x �. 101.59 WALK too, ; 'DRIVEWAY:° 10 03 x:101,2 + 101.45 � � � •101.16.� •� - :- . / 10 .95 90.00' T-A — ` — S 15'40'45" W/ LAMP Q a-9-t- 100.F31 edge 100.91 of 100.54 povement 100.42 100.16 s ��G KELLEY ROAD MPER T. cENTEE N ; PARCEL ID: 292-056 CIVIL NO.35109 0 PROPOSED SEPTIC SYSTEM UPGRADE, PLAN T 92 KELLEY ROAD, HYANNIS, MA N Prepared for: Kristen M. Halliday, 125 Capes Trail, W. Barnstable, MA 02668 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. HALLIDAY, KRISTEN M Engineering Works, Inc. 1"=20' P.T.M. 244-18 125 CAPES TRAIL 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. W. BARNSTABLE, MA 02668 (508) 477-5313 10/1/18 P.T.M. 1 Of 2 le 7 r NOTE: TO PREVENT BREAKOUT, FINAL GRADE SHALL NOT BE AT, OR BELOW, EL.=95.0 SEPTIC TANK PROPOSED D-BOX FOR A DISTANCE OF 15' FROM THE EDGE INSTALL RISERS & COVERS OVER INLET & OF THE PROPOSED S.A.S. OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT PROPOSED S.A.S. COVER SET TO 6" OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND T.O.F.=102.24t SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT F.G. EL.=99.9t F.G. EL.=99.Ot F.G. EL.=98.1 t F.G. EL.=98.0t MAINTAIN 2% SLOPE OVER S.A.S. .� Torvzm ... L = 34' , ® S=1% (MIN.) L = 23' L = 13' 4"SCH40 PVC @ S=1% (MIN.) S=1% (MIN.) 2" LAYER OF 1/8' TO 1/2"4"SCH40 PVC "SCH40 PVC 6" DOUBLE WASHED STONE to'I . a8aSaaa OR APPROVED FILTER FABRIC) 14" aaaaaa9 INV.= aBaBaaa --3/4- TO 1-1/2" DOUBLE LL-i 97.00 �� LIQUID WASHED STONE LEVEL GAS�BAFFLE 14' 4.8' 4' INV.=95.67V.=95.00 INV.=96.75 D-BOX EFFECTIVE WIDTH = 12.8, ARM Am! A30m1&7 INV.=94.50 ` PROPOSED SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN _ ICONNECT TO SUITABLE 4" SEWER AT HOUSE, INV.=99.9t H-10 RATED TOP CONC. ELEV.=95.3t NOTES: BREAKOUT ELEV.=95.00 INV. ELEV.=94.50 ease 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE aaaaaaaaaaa INVERTS, PRIOR TO INSTALLATION. aaaaaaaaaaa BOTTOM ELEV.=92.50 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 4' 2 x 8.5' = 17.0' 4' TRUE TO GRADE ON A MECHANICALLY COMPACTED 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN PERVIOUS MATERIAL 310 CMR 15.221(2). 5' (MIN.) ABOVE G.W. 1EACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO G.W., EL=86.4 - 4) GAS BAFFLE TO BE.INSTALLED ON OUTLET TEE _ AS MANUFACTURED BY.TUF-TITE, ZABEL OR EQUAL. SEPTIC SYSTEM PROFILE N.T.S. GENERAL NOTES: BAClC� 1. ALL CHANGES TO THIS PLAN MUST BE ,APPROVED BY THE LOCAL I.Lh] y' BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DECK OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN rn ENGINEER BEFORE CONSTRUCTION CONTINUES. LA to T 5. ALL ELEVATION S__BASED_ON AN ASSUMED DATUM. _ _ _ _ _ _� S - 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF O 6'. ^� _ ^d THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY.THE APPROVING AUTHORITIES. - T 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY QO THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING PROP. S.A.S. CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS -____ IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND ---25' -I REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE SEPTIC LAYOUT INSPECTED BY DESIGN ENGINEER PRIOR, TO BACKFILL. 13. .THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. SOIL LOG 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC SYSTEM COMPONENTS NOT SHOWN ON THE PLAN GATE: SEPTEMBER 28, 2017 (REF#15,783) SOIL EVALUATOR: PETER McENTEE PE(SE#1542) WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT ELEv. TP-1 DEPTH ELEV. TP-2 DEPTH 98.3 0" 97.9 A 0" DESIGN CRITERIA 973 A FILL 12 S RY4/2M 97.4 10Yg" SANDY LOAM B NUMBER OF BEDROOMS: 3 BEDROOMS 10YR 4/2 SANDY LOAM SOIL TEXTURAL CLASS: CLASS I 97.0 B 16" 10YR 5/6 SANDY LOAM 94.9 36" DESIGN PERCOLATION RATE: <2 MiN/IN IOYR 5/6 c PERC DAILY FLOW: 330 G.P:D. 94.6 44" 36"/54" . c DESIGN FLOW: 330 G.P.D. MED. SAND GARBAGE GRINDER: NO-not allowed with design MED. SAND 2.5Y 6/4 2.5Y 6/4 5% COBBLESL LEACHING AREA REQUIRED: (330) = 445.9 S.F. 5% COBBLESL .74 86.8 138" 86.4 138" PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY PERC RATE <2 MIN/IN. "C" HORIZON PROPOSED D-BOX: 1 INLET, 3 OUTLETS, H-10 RATED NO GROUNDWATER ENCOUNTERED USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 92 KELLEY ROAD, HYANNIS, MA SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: Kristen M. Halliday, 125 Capes Trail, W. Barnstable, MA 02668 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: SCALE DRAWN JOB. NO. TOTAL AREA:.............................................................. 471.2 S.F. Engineering Works, Inc. N.T.S. P.T.M. 244-18 DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 10/1/18 P.T.M. 2 Of 2