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HomeMy WebLinkAbout0027 KALWEIT DRIVE - Health 27 Kalweit Lane, West Barnstable. A= 111-010 c f i n k No. 4210 1/3 BLU psn � � ESSELTE 10% w o N . Fee THE COMMONWEAL H OF MASSACHUSETTS Entered incom uteri Yes 41 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4plication for Misposaf *pstrm Construction Permit Application for a Permit to Construct( ) Repair(VY11`iJpgrade( ) Abandon( ) ❑Complete System 9'nI dividual Components Location Address or Lot No.D7" ��`�' Owner's Name,)Vd ss,and Tel.No. Jc:�' Assessor's Map/Parcel \` oa C�y� Installer's Name,Address,and Tel.No.5 $a 3 Designer's ame,Address,and Tel.No. `� '3CO r Q aS .2 8 'C. S.e VV\,A 0 6-3 7 Type of Building: `r Dwelling No.of Bedrooms 1� Lot Size Y(�;k�__f� sq.ft. Garbage Grinder( ) Other Type of Building SL,= No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �{(o gpd Design flow provided 4 gpd Plan Date � _ Number of sheets ICDI Revision Date Title Size of Septic Tank tc e)3 ype of S.A.S.Q=4<*eff I C ��!!.,n- cam Description of Soil , Nature of Repairs or Alterations(Answer when applicable) 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 issue -s Board of e , i Date 7111/0, Application Approved by Date Application Disapproved by ff Date for the following reasons Permit No. '9 Date Issued fi'"'sr• "^' —.i...Z - -+.. ."'' - +�'j .....- r r; -t`i.. ,� jr�j frp, No. �\ ''� / % Fee 'uter: THE COMMONWEALTH OF MASSACHUSETTS Entered in com P Yes PUBLIC HEALTH DIVISION - TOWN 0FBARNSTABLE, MASSACHUSETTS lflYUatlon for -Misposal 6psteni Construction Permit Application for a Permit to Construct( ) Repair(VV pgr'de( )n Abandon( ) ❑Complete System Individual Components Location Address or Lot No.D 1 �,�,`� � Owner's Name,Address,and Tel.No. .5v Assessor's Map/Parcel �` O'A R�N Installer's Name,Address,and Tel.'No. � � Designer's Dame,Address,and Tel.No. S6 Z- GC3-33 if G -0 Q 6ey+ c3o r 3? Type of Building: a Dwelling No.of Bedrooms 1, Lot Size 'e��,c , sq.ft. Garbage Grinder( ) } Other Type of Building - No.of Persons Showers( ) Cafeteria( ) Other Fixtures P Design Flow(min.required) gpd Design flow provided 4( gpd Plan Date� Q Number of sheets. ID, Revision Date Title Size of Septic Tank �Yve of S.A.S.<Zx=„ s'r- G,,i Description of Soil 2��.v , 4 Nature of Repairs or Alterations(Answer when applicable)ytv *- j Date last inspected: "Agreement: ' r n 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 ealth. ..� Date / C` Application Approved by Date • Application Disapproved by Date for the following reasons a _ Permit No. A 10/ "' Date Issued _ E - - v -THE COMMONWEALTH OF MASSACHUSETTS F!' BARNSTABLE,MASSACHUSETTS (Certificate of Compliance x THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by _ . at has been con u a r acc7daa /elm with the provisions of Title 5 and the for Disposal System Construction Permit No. .� �atea' Installer y��C-_Q&I�y�,� .S" �.�iG � Designer '� � �' `r S<Z- #bedrooms Approved design flow /a gpd The issuance of this perm/it shall jot be cons Date trued as a guarantee that the systemm7ill fu�etion ign d. � �/ / f/ Inspector --- ---- -------------.------- - --- ----------------------•-•-- ------------ ----------------"---------------------- No. ! // j Fee - -- THE COMMONWEALTH OF MASSACHUSETTS -� PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(6J Upgrade( ) Abandon ) r System located at r 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 b/ecoc p to w' three years of the date of this permit. J Date / Approved by Town of Barnstable Regulatory Services . Richard V. Scali,Interim Director • anitxsrnsi.E. Public Health Division A'Fo 3 ° Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form cry,I )Date: 1 � l� Sewage Permit#�(`�-��� Assessor's Map\Parcel I Designer: N�Installer: V,_ , -Q,, . ,v„ Address: Z se "( Address: %Qn,,X � E 7W 0 Z> On 1K ,� --� , �,\, was issued a permit to install a '(date) (mstaller) septic system at Xw�r v based on a design drawn by (address) G -e„/" dated 7 ct O (desi er) Jz 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. I certify that the system referenced above was construct a with the terms of the RA approval letters(if applicable) RA E (In ller's Si ature) esigner's Signature) (Affix Designer amp He PLEASE RETURN TO B ST LE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NW 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 oQ_J ��`� �S , SEWAGE# D(2)� 0- olOc tVILLAGEG.0, 1�sdN�J*(&eASSESSOR'S MAP&PARCEL M t 6 INSTALLER'S NAME&PHONE NO��,%,-„� ,Q SEPTIC TANK CAPACITY `QQQ) . LEACHING FACILITY:(type) csj[ _sjt3"*_0 , (size) NO.OF BEDROOMS OWNER 0-ca(,..& e_ PERMIT DATE:?Ck� � ! COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 8 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�Z-AC;gs vv 1 Ol yIN X01411e-1'41ay TOWN OF BARNSTABLE 40CATION SEWAGE # 'TILLAGE �� �lj'/`/15 �' ASSESSOR'S MAP & LOT /l/"10/0 INSTALLER'S NAME&PHONE NO. AO/�A'el,0 % CG��S); 77l'�✓��� SEPTIC TANK CAPACITY /,0,0,9 &A L LEACHING FACILITY: (type) Sb0 G.rL 4,%e4 /ima be4 0) (size) /J '2�t 3S NO.OF BEDROOMS y BUILDER OR _/ Vie/f PERMTTDATE: /�°" 7� :�Fb COMPLIANCE DATE: AE'' Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Facility an wells exist Private Water Supply Well and Leaching ty (If y on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of hing facili ) Feet Furnished by a7 g ea.- 3� O 31, Town of Barnstable �P Department of Regulatory Services F Public Heal ' 'th Division I Date )0r\6 �1 i �, surly. 200 Main Stroat,Hyannis MA 02601 � / _ �" Data Scheduled Ti'ma_ � Fee P�'._ 11 Suitabil'ty Assessment for S ge fJzsposal Performed By: �P✓� I Witnessed By: I LOCATION&.GENERAL INFORMATION Location Address ed �,C` r waer's Name Ue � ` v 1� CA-', JAddross �� '� c�-• Assessor's Map/Parcel: • ` ( \ r® ( Engineer's Name zt �N 'SetC NEW CONSTRUcmoN 1.}RREP�AIIIR Tele hone# 5'Og Land Uso vo 1 1 J 1 Li Slopes 96 — A p ( ) 3urfeco Stone Distances from: Open Water Body $ Possible Wet,Area�ft Drltddng VYater Well ft Dtalhago Way t ft Property Une ft Other A SIKE•TCHt(Street name,dimensions of lot,exact locations of test holes&Para testa,local*wetlands•I'n'proximity to holes) • J .T 716tI� Parent material a a� —"� I `"� 5� r tl (geologic) ` l Depth to Bedrock Depth to Oroundwatcr. Standing Water in Hole: h Weeping 1Yom Pit Face Estimated Seasonal High Groundwater j D RMINATION FOR SE AS ONAL'ffiGH'( ATT�xt TALC Method Used: Do th Observed standing In obs.hole: In, Depth to moll mottles: ln.' Do th to weeping from aide of obs,hole: - —in,in, Groundwater Adjumtmont �ft. IndexWoll-1 ReadingDato: Indexwell1mvel .,..,, Adrthetor, .Adj.0rriutidwaten•Legml,,,_ PERCOLATION TRST Dais Time Time__.__ Observation e -43 Hole# Tinto at 9" t, Depth of Pero Time at 6" �� I ' O Start Pro-soak Time 0 Timo(91141) End Pro-soak � > Rate MIn.Raoh , ' Silo Suitability Asscssment: Sitd Passed Situ Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Holo Data To Be Comploted on pack ' ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Consell.•vation Division at least one(1)week prior to beginning. Q:ISBPTIMHRCFORM.DOC • I• I DEEP.OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Sail Texture Shcl Cal or Sall. ther Surface On.) (USDA) (Munsell) Mottling (Stnucture,Stonef;Boulders. p.� Isis oncy.%llravell on l.0144 d DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soi l 11 Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. © ; r, •S 7 DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Soil Texture Sall Color Soil 'Other Surface(in.) (USDA) (Muusell) Mottling (Structure,Stones,Boulders.. DEEP OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Solt Texture Soil Color Hall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Slopes;Boulders, CM191jingy. gravel) Blood Insurance Rate Map:, r Above 500 year f load boundary No Yes-Z. Wlthln 500 year boundary No Yes Within 100 year flood boundary No.,� Yee,,�..... pel)th of Natoraliv ecurring Pervious Material Does at least four feet of naturally occurring pervious mtiterial exist in all areas observed thrpughout the area proposed for the soil absorption system? If not,what Is the depth of haturally occurring perlhous mator al? !Qedifleation I certify that on (date)I have passed the soil javaluatorexamination approved by the Department of Bn mnmental Protection and that the above 6alysis was performed by me consistent with . the required tra n wardscand xperience described In 410 CMR 15.017. /Signature � Dath • Q-. 8PM0PERCPORM.DOC a a V ,�pprr7�i 9�n fl CIT 4 '3 ilk �s0 SF W£ 1 � 6/21/2018 Assessing As-Built Cards K/j- 4/tvic 7 IUWN ur ISAKN31"Lt: 'LOCATION � 7 SEWAGE a VILLAGE Gt/f �ll/r5 o'G�' ASSESSOR'S MAP&LOT ///—®/C> INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY man Gu LEACHING FACILCI'y:(type) �poIrwt Grcr< [l aw M 6 (size) /2 'Y_3, 6,p � NO.OF BEDROOMS BUILDER OR W 7' PERMITDATE: ! COMPLIANCE DATE. l� Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility f Feet Private Water Supply WeU and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) n Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of thing facili ) Feet Furnished by a? 1z--4 v��7 g ea., ;tq Sb fo O 31 t f http://www.townofbarnstable.us/Assessing/HMdisplay.asp?mappar=111010&seq=1 1/2 CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL 1VORKS CONSTRUCTION PE1011T (NVITHQU•I' DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated `/�� ��� , concerning the property located at �eyb1l AfWs1?l��� meets all of the ' J following criteria: ' �✓ i iicre arc no wctlnnds,vithin Jon rect of the proposed semic system Xcre arc no P rivntc wcils within !°0 'ie-v f'he proposed septic system .ic n cr�cd rennanater'^bie a i s rcc• ^r ?renter eio1v the i dtorrt of the ienchintt raciliiv bs e �;ure is no increase in flow .1nd/nr e7nnv! :n !jse nr000sed nc._are no•;anancrs mq ueste^or SIGNED : _ DATE: L!CENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER iAllich a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan. this plan should be submitted]. 13 � � d-7 � d GJ �v Q S it �7 G W�'i D L -14 c. Le S n l� I No. 9 4-3(l Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01p plication for Migaal *pgtem Construction Permit Application is hereby made for a Pe t o Construct )or Repair an On-site Sewage Disposal System at: Location Address or Lot No. n s Name,Address and Tel.No. Assessor's Map/Parcel ( �� 'ea� �� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder Other Type of Building &� e_eLl No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of)Repairs or�Iterati ns(Answer when applicable) 'Te-5kll e,A,Y an 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 Certifi- cate of Compliance has been issued d o ea Signed Date Application Approved by Date �— Application Disapproved for the following reasons Permit NO. 3 Date Issued —A57 _ m� � � _ _..,,...,� No. Al 6-3 3 0 ^.'"".r ,.tom- Fee J` 1A THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Mi0po0al *pgtem Conotruct on Permit Application is hereby made for a Pe t o Construct )or Repair(✓)an On-site Sewage Disposal System at: t Location Address or Lot No. Zi -Qwne 's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms �' Garbage Grinder(� Other Type of Building �W 5 W-,; fCP No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //d gallons per day. Calculated daily flow gallons. Plan Date Number of sheets X Revision Date. .e Title Description of Soil -7 ,/ 1/ Nature of !pairs or teratifrns(Answer when applicable) .Ze5A,71 4 e AUX anW 3 BOG 'I Date last inspected: Agreement: s 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 Certifi- cate of Compliance has been issued this oard of eal l lg Signed Date Application Approved by Date -2 7— Application Disapproved for the following reasons Permit No. 6-3 0 'Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance / THISiel 9 CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(V)on by el.�Al Installer at 22 li/, le e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.?Co 3 O dated //—e2 7—�?'� Date •� /` Inspectorf"' Z2 r THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. � --------------------! ald No. /6 3O S Fee U . i l THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Miopool *p.tem Conotruction Permit I Permission is hereby granted to to construct( )repair( L�`aan.On-site Sewage System located at No.# Z7 110W1 -40e' A, II g47 eve!7 Sveet 4` G 3 6 //-d - Y and as described in the above Application for Disposal System Construction Permit. 1r No. Date The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within three years of the date below. t Date: �- /�G .�. Approved by / '" -t/Ail Board of Health / + r �. NO-7.1&I ........ Fnic...2................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALT 111 .010 .; .. . ...._... . ... ............... ..... Application -for Uiiipviiat Worko Cnomitrixrtilan Vrrmi# Application is hereb d for Per it to Construct ( ) or Repair ( �n Indivi al Sewage Disposal System - -� ---- - -------------------- ----- ------ ----- .. - -� 'J G�� a A dress or Lot No. Onstaller --•--•---•-------------------•Address ------------ =----- --••-•---- ......--- ----- ... --- Address Q Type of Build Size Lot............................Sq. feet v Dwelling No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building .________________•_---.._-- No. of persons.-._____--________--..--_- Showers ( ) — Cafeteria ( ) a Other 'fixtures --------- -------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons, 9 Septic Tank—Liquid capacity-_-__-___-_gallons Length---------------- Width................ Diameter__-..__....-___- Depth.__.--_-_.-- -- xDisposal 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---------------------------------------. Test Pit No. I...:............minutes per inch Depth of Test Pit.................... Depth to ground water---------.-------....... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_.__.-____._--_----_- -•----------------------------•-•-••------------------------ 0 Description of Soil---------------------------------------------- ----------------- --- - --- - - =- x --- - -- - G"1 --------------------------------------------------------------------------------------------------------------------------------------- - VNature of Repairs or Alterations—Answer when applicabl _ :.--.��.... .. . . ... .. ... , ------------------------------------------------------------------------- ................ = / --- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage D osal System in accordance with the provisions of Article XI of the State Sanitary C de— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en 's ued by e rd of heath. ned_ ••. . .... . ..---•.. ............./.' t s, Application Approved.BY _. 7)&/ 7 Application Disapproved for the following reasons-------------------------------------------------- _- ------------------------------------- .......... ----------------------------------------------------------------------------------------------------•--------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date ru.i.__- - - --- - ----..�.�...�.�...��.�..�--._------- -------------- 71---------- FEE... .................. ? THE COMMONWEALTH OF MASSACHUSETTS }1. - �l BOARD F HE LT -... OF. _ 1 Appliratiun -fur Digpniittl Vorko Cnl twlrurtion Vrrntit 4. Application is hereby made for Per it to Constr ct ( /) or epair ( an Indivi al Sewa�-e Disposal system. --- A dress or Lot No. W Address ----- --------------- - -------- -----•-- .......... -•-----• ...... nstaller Address d Type.of Buildip Size Lot----------------------------Sq. feet U Dwelling No. of 'Bedrooms._.-- _________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons.--------------------------- Showers ( ) — Cafeteria ( ) P4 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........................ - --.. aTest Pit No. 1----------------minutes per inch Depth of Test Pit___________..___--_ Depth to ground water-----------------....... rs, .,Test,Pit. No. 2................minutes per inch Depth of Test Pit______--_______-__-_ Depth to ground water-.._-.---__.-_-_--j__-- _______________________________ _ ___________________________________ DDescript on of Soil----- ----- •. ...................................................... ---- ,.- ----- -------------- -------- x = �W_ s U Nature of Repairs or Alterations—Answer when a plicabl ____.�,,,_ -_-.-.-- -. ,! Agreement: The undersigned agrees to install the aforedescribed h3vidual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary e—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en ed by rd of hh. ned- /Date Application Approved BY---- --- ----- - - ----- --- -•-- _ ---- _ _ Application Disapproved for the following reasons:................................................... ......... ................................................ .......... ......•----------------------- Date PermitNo......................................................... Issued:........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH .ti.•.� OF....... ......................... THI TO TIF at the In du 1 Sewa r/. isposal System constructed ( N or Repaired"C -4, t n taller . ytit "^ - , at. �` --' 7 - -- --- -- -- .............. •--- �:W14 ---iv !_______________ has been installe in accordance with.the provisions of Article XI T /State Sanitary Cod des abed in the application for Disposal,Works Consi;�_uction Permit No...... f.___.._._. dated_-.►!-_��__, __ ,THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUE© AS A GUARA -TEE THAT TIME SYSTEM WILL FUNCTION SATISFACTORY. DATE r•--- ------------------......................................... Inspector.,..,------------.-----------------------------------•-------•----------_•----------- THE.COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTIJ f ......��..........OF... . ................. No......1.-�t:..... FEE.41 - _ :BOVogal r ii n iitr on rr it Permissibh,,reb rante ___ _:_-__ _to Constructr Repair' an hd' idua ewage Rasp Sa System/ d„ ,�at No. �*� Street as shown on the application for Disposal Works Construction Per o________ ................... -•-- • ---• -• ----- .. ..... ........... oard of Healf v .DATE-'----- .< - -------------------- -----=..... , FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS— No...... THE COMMONWEALTH OF MASSACHUSETTS j BOARD OF HEALTH //rf Ill /w o ....... i� �,OF...........�. .. .. -. - ....... . .. Appliration -for Bispaaoal Workii Tutuitrurti Vrrmft � Application is eby—made f r a Permit to.Construct or epair ( an Individual Sewage Disposal -- -••--- -- -- ---- - --------- � . - ddress -G. _ or 410�; ^a W w Address aer ........................•-•---•----•--- 4' Insta r Address Q Type"of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms............................................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. WSeptic Tank—Liquid capacitv.-.........gallons Length................ Width................ Diameter---------------- De, t1i___ ,, ^ x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area_ 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 "Pest Pit-------------------- Depth to ground water...--.__-_-----_.--._. �14 Test Pit No. 2....._----------minutes per inch Dept o Fest Pit-------------------- Depth to ground water---------------------- ---- ------------------ ---------------------------------------------------------- Description of Soil ------------ --------- ----------------------------------- x W -------------------- -------------- ---•--------•-------•---••--•----••-•------------•--------•--•------•-•----- ---•---- U Nature.of e or Alters — nswer hen applicable._:_--__:_ ---------= (1 ..-... !%� �,- —+ -.-- - ---------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed ---- --------- Dat Application Approved By. ..... _. /1 .� -. ....-•- ---- ••- -- -- ---` .. .l--r--• . ate--- Application Disapproved for the following reasons-......................................... ........................................... --------------- ......-•--•-----•--•-•---•-•---•-•-•-------•-----------------••--•......-----------•--•-•---•--•-----........-••------------------•---•------•--••....---•----------------......-----•-----_'..----•--•-- Date PermitNo......................................................... Issued........................................................ Date No.- 7_ J........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OE HEALTH *07 �o�.OF_..........Appliration.-for Uhipoii t Works Towitrurtl Vrrmft Application is hereby m de f r a Pe mit 10 Construct � or epair ( an Individual Sewage Disposal sy �. dress 4 r Lot No Own Address W .............. .--••- 4 Instal er Address Q Type of Buildi Size Lot----------------------------Sq. feet U Dwelling o. of Bedrooms.--------------------------------------------Expansion Attic.( ) Garbage Grinder ( ) P-4 Other—Type of Building _________ _________________ No. of persons------------------------------- Showers ( ) — Cafeteria ( ) 4 Other fixtures -----------------------•---•----••------------------•----------•-•-•---•--------------------------------•----------------------•-•---•--------------- W Design Flow_______________;______________.._.__..______gallons per person per day. Total daily flow----------------------------------------.---gallons. P4 Septic Tankl—Liquid capacity------------gallons Length---------------- Width................ Diameter---------- 11 T Disposal Trench—No--•------------------ Width-------------------- Total Length.................... Total leaching ar ! ----sq. ft. x Seepage Pit No_____________________tDiameter---------------------- Depth below inlet.................... Total'leaching area------------------sq. It. z Other Distribution box O Dosing tank (' ) ~' Percolation Test Results . Performed b ________________________________________________________ Date------------------------.______-__.-.... Test Pit No. 1---------------minutes per inch Depth of Test Pit.................... Depth to ground water-..______-_.____-__._._- G� Test Pit No. 2________________minutes per inch Dept of est Pit.................... Depth to ground water__---:_:___._:______.___ a •----••--• ----------------------••......... I- ---------- -- -----................................................................................ D Description of Soil-------------------------- •--•- x W UNature of Repairs or Alterations—Answer when applicable._____________________________________________________________________________________________ ------------------------------------------------------------------------ ----------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.---„:. . -- ---•--- ---------------•----------- Dat. Application Approved BY /, "---` ate Application Disapproved for:the following reasons______________________________.: ••---•---------------------------------------------------------------=------------------•--------------------------------------------------------------------------------------------------------------- Date PermitNo..............................=''-=--------------------• Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH z:::...(✓Z .`..: .OF.......:.......... j, ' rrtifirO#r Of Tompiiaurr, THIS I 0 ER' Y, T at e In u 1 Sew e Disposal System constructed ( ) or Repaired b % -,�at M. __ _ e has been installeAn accordance with the provisions'of Article XI of T e State Sanitary Coc des I -d the application for.Disposal Works Construction Permit No............... ... ____ dated._-___f __. ------ .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE.THAT TIME SYSTEM WILL FUNCTION SATI5;FACTORY. DATE................................................................................----- Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEAD 00 f .......... :.......O F..... Cr + !.1. r- G No: FEE ----•_•..... Or CITO rOr iO$t err � 4 Q� n!Perma ion is hereby granted/:_ to Cons ct _ ) Repair ( jIZni dual Sew ispos yste at No. -•--•• - '' ......�a Street as shown on the application for Disposal Works Construction Per ' " ted__l . ... . ............ - ---- - -- - ----- / ` B d of Health DATE------------ ----`--- .....-- ' FORM 1255 HoeB & WARREN. INC.. PUBLISHERS rr. - LEGEND WEST BARNSTABLE PROPOSED CONTOUR �oG� ® PROPOSED SPOT GRADE sq EXISTING CONTOUR o + 96.52 EXISTING SPOT GRADE36, / W— EXISTING WATER SERVICE O � 24/ 40 54 ( TEST PIT ,� ST 26 28 24'' Oye ¢�/ ,1 30 32 �� yP�Q���.tQ LOCUS / 1F4 q �� i COVH�Y /0P 27 KALWEIT DR. 26-' 0 / Hl GH sr LOCUS MAP 28 ; - LOCUS INFORMATION oy j APF4,ROX. WELL PLAN REF: 203/133 TITLE LOCATION (per owner)1 PARCEL REF: ID: MAP 91117PAR. 010 i II 30� FLOOD ZONE: PROPERTY NOT IN FLOOD ZONE SEPTIC SYSTEM REPAIR PLAN LOCATED AT: r 32 27 KALWEIT DRIVE � � � �\ WEST BARNSTABLE, MA N PREPARED FOR 34 oy 1 \ J 36 , ' ' , �-_____36 DOUGLAS KALWEIT PARCEL 10 DULY 9, 2018 C�EL AREA = 46000 sf+— ` �oP ol� 60-v o ft J\ PLAN Boor: 203 PAGE 133 OF k4s E� ASSR MAP 111 PCL 1 O \\ 8 DARRE y E ' \ No. EXIST. 1,000G �a 1 SEPTIC TANK TP-2 22a6�' MEYER & SONS, INC. PLAN P.O. BOX 981 'TP_, 38 EXIST. LEACHING SCALE: 1 in = 30 ft EAST SANDWICH, . MA. 02537 BENCH MARK � 0 30 60 PH: (508)360-3311 TOP OF FOUNDATION 0 10 20 30 60 FAX: (774)413-9468 39.60 ' meyerandsonstitle5(g�gma.il...com BARNSTABLE GIS DATUM SHEET 1 OF 2 J 1894 NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GENERAL NOTES: TOF SEPTIC TANK GRADE SHALL NOT BE < EL:36.0 FOR A DISTANCE INSTALL RISERS & COVERS OVER INLET & PROPOSED D-BOX 15' AROUND THE PERIMETER OF,THE S.A.S. EL.=39.60t OUTLET AND SET TO 6" OF FINISH GRADE P PROPOSED S.A.S. 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL INSTALL RISER & COVER BOARD OF HEALTH AND THE DESIGN ENGINEER. INSTALL LOCKING COVERS IF AT FINISH GRADE SET TO 6" OF GRADE INSTALL A RISER OVER ONE CHAMBER (MIIN) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS F.G. EL=38.Ot AND SET TO 3 OF F.G. OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE F.G. EL.=42.80t F.G. EL: 42.90t LOCAL RULES AND REGULATIONS, EXCEPT AS LISTED BELOW: AIM F.G. EL- 38.80(MAX.) - BARNSTABLE BOARD OF HEALTH REGULATIONS: 1) ALLOW PROPOSED LEACH TO BE 126 Fr. FROM ON SITE PRIVATE WELL VS. 9" MIN COVER/ - REDUIRED iS0 FT. 36" MAX COVER L 1 2( L 25'(MAX) 3. THE SEWAGE DISPOSAL. SYSTEM SWILL NOT BE BACKFILLED PRIOR O S=1R (MIN.) EL ®37.59 O S=1R (MM.) O S�1R (MIN.) 3 4" - 1-1 2" DESIGN AND D APPROVAL BY THE BOARD OF HEALTH AND THE 4"SCH40 PVC 4"SCH40 PVC 4'SCH40 PVC 2" OF 3/8" DOUjFABR ED STONE OR FILTE / / 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 10" DOUBLE WASHED STONE FROM THOSE SHOWN HEREON SHALT. BE REPORTED TO THE DESIGN INV.=36.50 14 ENGINEER BEFORE CONSTRUCTION CONTINUES. 48'UW/D INV.=36.25 aaa• Q ®aa® 5. ALL ELEYATK>riS BASED ON ASSUMED DATUM. �� PROPOSED aaa6aaaaaa 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF GAS BAFFLE Ta a a a a a a a a a THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF �0INV.=35.80 aaaaaaa®aa HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. INV.=36.0 DB-57. DWEWNG IS SERVICED BY PRIVATE WELL EXISTING 1.000 GALLON SEPTIC TANK 3.23 X 8.5' 3.25' 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. EXIST. SEWER OUTLET EFFECTIVE LENGTH = 32.0' 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES. PRIOR TO STARTING WORK. INV. ELEV.= 35.0 10. EXISTING LEACHING TO BE PUMPED. CRUSHED AND REMOVED PER TITLE 5. NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING BREAKOUT 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION PIPE INVERTS PRIOR TO CONSTRUCTION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 2) D-BOX SHALL BE SET LEVEL AND TRUE TO TOP CONC. ELEV.= 36.0 EL. 36.0 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO KNOWN ABUTTING PRIVATE WENS WITHIN 150 FT. OF PROPOSED LEACHING GRADE ON A MECHANICALLY COMPACTED SIX INV. ELEV.= 35.0 ae 14. ALL PIPING TO BE 4" SCH 40 O 1/8-/FT (UNLESS SPEC. )INCH CRUSHED STONE BASE, AS SPECIFIED IN ®®a 310 CMR 15.221(2) a�aaaaa 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK BOTTOM EL.= 33.0 to as®® FOR THE USE OF A GARBAGE GRINDER. WITH 1500 GALLON SEPTIC TANK IF FAILED, 4' 5 FT. 4' 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING DAMAGED, NOT H2O LOADING, OR UNDERSIZED. SEPARATION 8.05 FT. EFFECTIVE WIDTH = 13' 4) INSTALL INLET & OUTLET TEES W/ GAS BAFFLE AS REQUIRED SOIL ABSORPTION SYSTEM (SECTION) SEPTIC SYSTEM PROFILE BOTTOM OF TESTHOLE EL: 24.95 (500 GALLON H-20 LEACH CHAMBER) N.T.S. DESIGN CRITERIA SOIL LOGS P#: 15715 NUMBER OF BEDROOMS: 4 BEDROOM DESIGN SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) DATE: JUNE 26, 2018 DESIGN PERCOLATION RATE: <2 MIN/IN WOIILE VALUATOR: DARREN MEYER, CSE 1614 Of DONALD DESMARAIS, BARNS. HEALTH �� Aq DAILY FLOW: 110 G.P.D. X 4 BR DESIGN FLOW: 440 G.P.D. GARBAGE GRINDER: NO (not designed for garbage grinder) Elev. TP-1 Depth Eger. TP-2 Depth AR 95 SEPTIC TANK: 440 gpd x 20090 = 880 gpd RE-USE EXIST. 1,000G SEPTIC TANK 37. 0" 38.95 A 0" M1140 LEACHING AREA REQUIRED: (440)/0.74 = 594.59 S.F. L1o� 3/2SAN � 3/'o 37.12 10" 38.03 11" USE THREE (3) 500 GALLON H-20 PRECAST LEACH CHAMBERS B B �LOAMY SAND LOAMY SAND NITAVW0 l W/ 3.25 STONE ON ENDS AND 4 ON SIDES: 32 L x 13 W x 2 D BOTTOM AREA: 32 x 13 = 416 SF 34.53 C 41" 35.62 C 40" SIDE AREA: (32 + 13) X 2 X 2 = 180 SF LOAMY PERc TEsr LOAMY SAND OR. 33.62 SAND TOTAL SQUARE FEET PROVIDED = 596 vs. 594.59 REQ'D 2.SY 7/4 2.5Y 7/3 PROPOSED SEPTIC SYSTEM UPGRADE PLAN DESIGN FLOW PROVIDED: 0.74(596 S.F.) = 441 G.P.D. vs. 440 G.P.D. req'd 24.95 156" 25.95 156" I 27 KALWEIT DRIVE, WEST BARNSTABLE, MA PERC RATE <5 MIN/IN. (*Cl' HORIZON) NO GROUNDWATER OBSERVED Prepared for: Kalweit System Design and Topography Plan by: SCALE DRAWN DATE " 1. Darren M. I MEYER&SONS,INC. N.T.S. DMM Meyer. R.S.,.CSE, hereby certify that-1 am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX 1981 . . . 07/09/18 to conduct Roil evaluations and that the above analysis hm been performed by me consistent with the EAST SANDWICH,MA 02537 REV DATE CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that 11 have passed the Soil Eval. Exam in October, 1999. 508-W-2922 DMM 2 Of 2