HomeMy WebLinkAbout0105 KELLEY ROAD - Health ✓ 105 Kelly Road
_ Hyannis
A = 292 061
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No. (% � . . FEE
COMMONWEALTH OF MASSACN,,US[jTS
Boat d of Health, t K SDI ` �' MA.
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair(L-Y'ol-Jpgrade( ) Abandon( ) - 21.Gomplete System ❑Individual Components
Location /Q S k-e—1 4 i N Owner's Name _-TOA AJIU& E 4 TOE
Map/Parcel# a O f Address �Q S /!Ce// R ai9
Lot# Telephone# 77S'— 6A%k
Installer's Name -5 kip M w Cv i-4-4rt-✓�. Designer's Name i�►"Ce G, V1.4 R
Address Address. 7 7 tqp— km-S /h Ik MM
Telephone# '77S"` Telephone# ly-Ab
Type of Building Lot Size sq.ft.
Dwelling-No.of Bedrooms Garbage grinder V40
Other-Type of Building No.of persons Showers ( ),Cafeteria (
Other Fixtures
Design Flow (min. required) 3 gpd Calculated design flow 3 Q Design flow provided �18 gpd
Plan: Date NON AC Number of sheets Revision Date
Title ('''UDOS'-C Septic
z
Description of Soil(s) Sre C"�►N
Soil Evaluator Form No. /� 09 3 Name of Soil EvahiatoZraGP�%M� ate of Evaluation 0Cr I�, ;�eo f
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further afire,gs to not c e syste m eration until a Certificate of omp�v�as been issued by the Board of Health.
Signed Date
o
�o�
No. ��( � CJ / t 1 �`` FEE ;
t Bott�d of Health,
APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair(L-�<pgrade( ) Abandon( - QICMomplete System ❑Individual Components
Location` 4 Q S Ke R O A 1 N N l Owner's Name /V/V C C/q 7Oti
Map/Parcel# p I Address /Q S Ke// a&4l> 4
Lot# // Telephone# 7-7S^- $d
r j Installer's Name 5 M lq C 0 wt lq,t f Designer's Name 3
Address Address 7 7 s v l k M 4
Telephone# -775— $ Telephone# p
Type of Building t Lot Size !(5 3 G sq.ft.
Dwelling-No.of Bedrooms '' Garbage grinder (A40 -
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fi tures Design Flot (min.required) 3 3 gpd 'Calculated design flow.3 3 Design flow provided Mod
gpd
Plan: Date'1 / VI ��� a� f _�Nu bn�er of sheets Revision Date
Title (�'-epos'C� $e0±1.c- -0YS 1 yN
Description of Soil(s) See Lb N
Soil Evaluator Form No. PA" �� O q 3 Name of Soil Evaluato1ZA 1C'e&,M U fO y ate of Evaluation OCR �O
DESCRIPTION OF REPAIRS OR ALTERATIONS X
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further algregs to not e syste yin o,eration until a Certificate of Compliance has been issued by the Board of Health.
Signed / Date
o p r
No. FEE !`/U
COlam®NWIF-AL114 OF MASSAC14USETTS
Board of Health; t Ja/'V+I-u��� IWA.
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) i`GI-e"omplete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired (y;Upgraded (.).,Abandoned( )
by: M AC-o k-% 6 A n I
at IO S
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and t e approved design plans/As-built plans relating to
application No. dated -�Approved Design Flow. (gpd)
Installer /t'1�C0'^^ f� ?,V .2;i Fj
• _
Designer: j3YtKelT Mui0 y 01• Inspector: ''^ Date: I lin I
r t ;_The.issuance of tlus'permit�shall not.be construed as a guarantee that the system willfunction as,designed. t
No. 400 FEE
COMM ONW-EALTH Of MASSAC14USETTS
Board of Health, fe ' MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct( ) Repair( Upgrade( ) Abandon( an individual sewage disposal system
at /o S K=l/ Ro,9 l/ G �^.N 1 j ' F as described in the application for
Disposal System Construction Permit No. , dated
Provided: Construction shall be completed with'i t ee years of the date of Wi"erpllt. 1local conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health
l t
TOWN OF BARNSTABLE
LOCATION SEWAGE # A u')/— 7-?,)
vELLAGE &Q/A AIA✓15 ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. _� /4 A C O Al ge,P_ t SON
SEPTIC TANK CAPACITY _A f O 6
LEACHING FACILITY: (type) 9 y w e Z C S (size) 13 X
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: 11 )t b l COMPLIANCE DATE: -Rfku
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
ro Or
6 f
6
I '
� A
Tf
wIN-
FssA....-.Po........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
...................T own.............OF.........Barnstable
.... . ................................................................
ApplirFa#ion for Disposal i0orks T. nstrnr#inn rrmi#
Application is hereby made for a Permit to Construct ( ) or Repair (.x) an Individual Sewage Disposal
System at:
sx..M......02601--•••........ .................................................................................................
Location-Address or Lot No.
Joanne Eaton..............................................................
10 Ke11y Rd:+ H3`annis,...MA.....02601........ ....
.......•-••-...-- e._.........
Owner Address
.........................esspool__Seryice ___________________ 128,Bishops_Terrace, Hyannis,_MA 02601
p� Address
Installer
UType of Building Size Lot.... ......... .........Sq. feet
Dwelling—No. of Bedrooms...........3..............................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................'No. of persons.......................... Showers ( ) — Cafeteria ( )
Otherfixtures ------------------------------------------------------------------
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.........................................
W
,.� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
--•----••-------------------------•---.....-----.......--------•--.......------•---••-•-••-•................................................................
O Description of Soil...............Sand
.................................................................................................................................................
U .--•----------------••••-----••--------••••••-----•----•----------------------•----•••----•-•--••--••.....•--•-------------------.....-•-•-•-••---------•----•------------------...............----••-•--
W
UNature of Repairs or Alterations—Answer when applicableinstal1atiori__of_a__1,_000...gallon__j) cast_,.
stone__packed__leach it _(oyerflr) .......-----•--------------------------•---------------------------------------------------.....--•--•---•.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee 'issued by the board of l . 1 h
Signed---- -�'�. �-A-- ---.._... �................ j 81 4/81 .
to
Application APPr v�d By.............. ... . ----•--------------•---------••-----• ...................�.. 4181----=
Date
Application Disapproved for the following reasons------------------------------•------•-----------------....------------------------------------------.........._
...............=.........................................................................................................................................................................................
Date
Permit No.Ai...............................................- Issued..§ V81.----•••-
Date
i Fps. ....5:.00........._
THE COMMONWEALTH OF MASSACHUSETTS
r BOARD OF HEALTH
.................... own.............O F..........Barnstable
....... ........•------..--....----...•••••--............_.
Appliration for Dhipooal Works Touotratrtton Trutt#
Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal
System at:
••••10,E Kelp.r�.d.:•�--•l yanni sa 14A - 02601 '
................................... .....••-••-•--•--•-••-•-••••......._._............--••---•••--••••-----.-..........•............._
Location-Address or Lot No.
Joanne Eaton-----•...........................................••-........... 10� Kelly Rd.:.._HyanniS'.1A---_•02be1
......................__.... ....................
Owne Address
a A L.B.Cesspool Service 128 Bishops Terrace,...H-yannis;.••1JA....02601
Installer Address
Type of Building I Size Lot____ _________ _________Sq. feet
.-� Dwelling ' No. of Bedrooms...........3..............................Expansion Attic ( ) Garbage Grinder ( )
Other—T e
a Other—Type of Buildin g -•-----••------------------- No. of persons........ '.................. Showers ( ) Cafeteria ( )
d 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 ( )
aPercolation Test Results Performed by........................................................................:. Date..: ........
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground
x water___.__..._____._._I.____-
Descriptionof Soil........................................................................................................................................................................
U -••-•-•-----•-._...•-------•-------•-••------•-•.._..---•---•-•--•-•--••••-•------•-•----•--------•------••••--•--••-•-•••••---•------••-•--••••--••-------••....................•-.....•---•-••-••_•••-
W .
U Nature of Repairs or Alterations—Answer when applicablainstal lation alf a 1,000 gallon pre-cast,
--stone ,packed leach pit raverflcr�r ,
.......... ---------------------------------------------------••--•--•----._.........--_.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE_ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee '*issueq by the board of It
Signed-•_• =
------••••............................. 8/ 131/1. `.�f''� -- --4
E��t4/81
Application Approved By_.:::; /p .......................... -••-•-••••--••-•-, -•--
- Date
Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------
............................................••--•-----• ............................ .........--
__ _ ate
Permit No._81-....................................................... Issued..8/ 4/81
Date
THE COMMONWEALTH OF MASSACHUSETTSI
..BOARD OF HEALTH
............`...Town..............OF.............Baznstable.............................................
T.Wrtif irtttr of TontpltFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System construct ( ) or R ed
. by A & B Cesspool Service, 12d Bisho-os Terrace, Iiyannis, MA 02601 - 775-�L�1
...............: ---------------......------•--•--...__._.......--•-----._._.......-------........--•-......•••••••-•-•--
105 Kell Rd., H anni - In "9 '
at-------•---••-•••_•----y-•----•--•'-••--y---_----s-=--MA----�2Ea®1-----------.�oanne Eaton
has been installed in accordance with the provisions of, TLE , 5 of The State Sanitary Co s A scribed in the
application for Disposal Works Construction Permit INb----_.-----V2.,,?.................... dated--------__......................................
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
8/ /81 •-••---••-•-- Inspector----------
DATE........... . ......... x `�
THE COMMONWEALTH OF-MASSACHUSETTS :
BOARD OFF HEALTH
..............Town.-......oF...--Barnstable
...................................................... $ 5•.00
No....1::..yZ..3. FEE............:...........
Utopos al Works Tono#ra ion rrntit
Permission is hereby granted...........A__& B Cesspool Service
---------------------------•-----------------------.....---._................._._._
to Construct ( ) or Repair ( x) an Individual Sewage Dis oral System
at No.....105 Kelp Rd.4...Iiyanni s,• P% 02601 3oanne Eaton
-----------------------------•------------------------------------------------...•-••••_•_....
Street Q R
as shown onrthe application for Disposal Works Construction it No.81-__________._ Datid_.__:_____-...v�__V81
___4_
8/y/8l
B f Health
DATE ... ------•--------
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
z
_-k
-OCA- GE-4
5P5
VItLA' GE ASSESSOR'S MAP OT_Z2j_
INSTALLER'S NAME&PHONE NO. )1.1 ' A
SEPTIC TANK.CAPACITY 6"6
LEACHING FACILrrY:-,.(typ0,1;2— A k. Z4 S .,(size) 113
-NO.mOFBEDROOMS
BUILDER OR OWNER
PERMITDA
i
4 Z)
qQmp
Separation.Distancd Between the:
und Facility Maximum Adiusted Groundwater Table to the Bottom of Leaching Pk elirt
P rivate Water Supply Well and Leaching Facility
(If any wells exist
on:sjte.or within lbbmfeet of leaching,facility)
Edge'of Wet
land.ind�Leaching.Facijiry.(U.-any.-wetlands.exist.
'within 300 feet of leiching facility)
Furnished
p�is-ed by
z `A)
IN,
BENCHMARK
TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR SOIL TEST
'ELEV. (0 0 10 FT. MINIMUM
10 FT. MiNWUW FROM SLAB OR CRAWL SPACE PATE of Soa. TEST u GT' t 2 Oa I
(ASSUMED) CLEAN SAND SOIL TEST DONE Y uG�., 'fT� A
CCOONNCRRSETE 1MTNESSED I o A►
LOAM AND SEED
4' SCHEDULE 40 pVC PIPE OBSERVATION HOLE 1 ELEv= OBSERVATION HOLE 2 ELEV.-
MIN. PITCH 1/8` PER FT. 2 17`8
2 LAYER OF PERCOLATION RATE . „_. MIN.jWCH AT INCHES PERCOLATION RATE MIN./INCH AT INCHES
1/8- TO 1/2" DEPTH HORIZ TEXTURE . COLOR MOTT. OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER
30
4` CAST IRON PIPE � WASHED,STONE
�$. O i/
(OR EQUAL MINIMUM NOTTREQUIRED O—b A S 10193-3
PITCH I/4 PER FT. oil LOAM
1 CU. FT. OF •�
Flow LINE NC .: . S LOAMY 101R16
92.5 ICOD
ELEV. • 97-'50 10' SuMo
TIN. 9 3.2 5 .0. . o n n n ro n o n o ,
v m LiVEI n n n ' n o o n 2 o U ziz- c- N EZIUM 10I R7-b ICE tlK
ELEV �,�.� GAS 6' SUMP ELEV. _ ° . ELEV. m t
BAFFLE EL EV. a 2•
DISTRIBUTION ELEV.
OUTLET (TO BE PLACED ON FIRM BASE) BOX �
TO BE WATER TESTED U ID
1 500 GALLON IF MORE THAN ONE OUTLET I TRENCH FORMATION 3 t
14 INCHES WELL "WATER ENCOUNTERED AT _ _ ELEV. i _ WATER ENCOUNTERED AT ELEV.
6 �4 INCHES SEPTIC TANK (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION ' ZONE
7 INCHES 3/4' TO 1 1/2' CI EAN SYSTEM (SAS) INDEX
8 INCHES DOUBLE WASHED STONE ADJUST
FREE OF FINES is SILT
LEGEND. DESIGN CALCULATIONS
USGS PROBABLE WATER TABLE ELEV. a I C � O )
SEWAGE DISPOSAL `SYSTEM PROFILE a � ExlsnNc SPOT ELEVATION ooXo NUMBER of BEDROOMS �
NOT TO SCALE N OBSERVED WATER TABLE (1 D/ 1 A/01) ELEV. �1�. EXISTING CONTOUR ----00---- GARBAGE DISPOSAL UNIT NO
BOTTOM OF TEST HOLE ELEV. �`'I _ FINAL'SPOT ELEVATION - TOTAL ESTIMATED FLOW
FINAL CONTOUR (110 GAL/BR/DAY X ( 10 BR.) : 330 CAL/DAY
SOIL TEST LOCATION I,, REQUIRED SEPTIC TANK CAPACITY 00 GAL
UTILITY POLE -O- ACTUAL SIZE OF SEPTIC TANK _.1 . GAL
TOWN WATER �W, V f SOIL CLASSIFICATION
CATCH BASIN '` (�j DESIGN PERCOLATION RATE MIN./IN.
S N S TA L L 2-- 500 GALLON L 1 GAS LINE G\'� LEACHING LOADING RATE .. 7 SQA. /I AY/S.F.
(25tZs•I-a-8 4%a.,B XAREA �.�•'�°I)42� 5X12,8Y.7�t)
5 TON L `.� '4 t'` 4E :�'S LEACHING CAPACITY (AREA X RATE) _ GAL/DAY
Z x, RESERVE LEACHING CAPACITY IY8 GAL/DAY
�< k9g15
NOTES:
1. ALL WORKMANSHIP AND MA I SH FORM TO D.E.P.
q�, CAN
TITLE 5 AND THE TOWN OF A I�fSTflSL RULES AND
SHED 96.76 REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE.
2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO -
WITHIN 6' OF FINISHED GRADE
5,91 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
D WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN
Cp' 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS.
4. ANY MASONARY BE MORTARED NUNITS USED TO BRING COVERS TO GRADE SHALL
E.
5. NO DETERMINATION HA,S BEEN MADE AS TO COMPLIANCE WITH
DEEDED
OR SUCH DING REGULATIONS. OWNER / APPLICANT IS TO
NATION FROM APPROPRIATE AUTHORITY.
OF 6. UTILITIES SHOWN ARE APPROXIMATE ONLY. EXCAVATION CONTRACTOR
IS TO CALL 'DIG-SAFE' AT 1-888-344-7233 AT LEAST 72 HOURS
`• PRIOR TO COMMENCING WORK ON SITE.
1�'
#� epUGE �'. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS
c.
O' c T: .�
S� .� 95 4 �,y �„ SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION
Q) V MURPNY
No.749 IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER
SHED / IMMEDIATELY. .... .
X 101 3p F�`rr iEa�� 8. PARCEL IS IN FLOOD ZONE C
2 -28 r��-=--%'P 8. LOT IS SHOWN ON ASSESSORS MAP-� _ AS PARCEL 01;
16, 8J8 S.F `
LOT 87 p Ia P e
DECK `
00
5.34 I GEC
i. a�fin, •"'fwE'
APPROVED: BOARD OF HEALTH
ou
98-30 PAv�'4 'V
DATE AGENT
/ 70s�8 , � PROPOSED SEPTIC DESIGN
e4l- 6 FOR
PROJECT LOCATION
to 5 KE L4L Y ROAD
X l pp 28
HYANNI`� MA_
BRUCE G. _ MURPHY R.S.
LANE
fll-��t� S REGISTERED 7 R SANITARIAN
MARSTONS MILLS, MASS.
426--3358 02648
DATE NDV 12.. �,t�Qt` = 2 L7
FEET
FEET
100,00
�2- REVISED JOB NO.
LOCATION MAP REVISED -1
- - SHEET OF