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Home My WebLink About0516 SOUTH MAIN STREET - Health (2) ao�- oar - 00.3 xo 3 l3 � (]3U C/F 0 t7 'Gib i 60 ` c® T No....l. ..' .y..�71 JFas..0 /: .)...... ••G THE COMMONVVEALTH•OF /SSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE/ Appliration for Di ipati al Work,i Tan rurftnn Permit Application is hereby made for a Permit to Construct ( ) or -epair ( ) an Individual Sewage Disposal System at:. 2,o Q Lotation-Address or Lot No. ( ._44 _ � ...................................•...._._•.._ _... .....................•.----..............:............. owner / A •ress �%40............................................. ----.��t_ ✓"_l/��1 e �... ................................ 1iistaller Address d Type of Building Size Lot............................S q. feet U` Dwelling Ito. of Bedrooms--- ..............................L�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 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........................................ aTest Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water...._._.----I............ f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ ....,................................................................................................................----•-•---............_...----......._.. 0 Description of Soil........................................................................................................................................................................ W ...•------------------------------------•......-••-----------...............-----.......--------•-•---•-------•--T-------- U Nature of Repairs or Alterations—Answer when applicable......... -5..... P✓`....P_---- ............................................ ....•--•-•----•--------------------••---•--•-------•----•--•------------•--.....__...--••----•-----------------------------------------------------•--------------•-------------••••---•-----•-------•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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 .. .... . .. w......,P-:---------- ................. ......... ......:- ...D...................... ace Application Approved By ...........� `1-�.. ...... ........ ........ --.. ......... ........................ ... �` Application Disapproved for the following reasons: ..................................... .. .. ................ ... - .- ...... .......------.................... ... ............... ....... ....... ........................ ... . . ........................... ............................... .................. ............. CC�� .........Dace PermitNo. .......... ...3-------Y---? 7.................. Issued ......................................................... Dace raw, —7 No... Fimx......... )........ THE COMMONWIEALT.H, OF MIASSACHUSETTS BOARD OF HEALTH oTOWN OF BARNSTABLE Allpfirationfor Diripwial Workii Towitriartion 1hrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: .................. ....... ........................ ............................................................. L t' -Address Lot No. At(I C 41-,49 . VL ",`f,:" 3..7.4 ................................ ------------------------------------------- ......................................................... o r --------------------------------------------- .... f........./ Zle... ---------------------------------------- Installer Address U Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms-----------,?...............__-____--_.___Expansion Attic .( Garbage,Grinder Other—Type of Building ---------------------------- No. of persons__-.________-__-____--_-.___ Showers Cafeteria Otherfixtures --_-------------------- ........................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic,Tank--Liquid capacity------------gallons Length________________ Width_____.___-_____. Diameter__-_.___.___.__ Depth....._..._...... Disposal Trench—No. .................... Width.._...___...._._____ Total Length_.__.....___........ Total leaching area....................sq. f t. 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..__.................... GPI Test Pit No. 2................minutes per inch Depth of Test Pit-_- ................ Depth to ground water..__................_... .............................................................................................................................................................. 0 Description of Soil.....................................I...................................................................................................... ........................ U ............................................................................................................................................... ................... ....... W _� 1 , 7----------------------............................................................................r................................................7A--------------4....................................................... Z U Nature of Repairs or Alterations' Answer when applicable.__-___ .................................. ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed�lndividtfa;ll,Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Eivironmental"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. Signe&.. .. .... .....——------- ..........................------ Dare ApplicationApproved By ---------- ... ...... ........................................................................ ......?I i Application Disapproved forth,follow" \inJ, g reasons: ...................................................................................................................................... ............................................................................................................................................................................................................... ------------I........................... Dare PermitNo. ...........�3n ----------------- Issued ........................D.am...................................... ——————————————————————————————————————————---——— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE TWrtifirate of Q-Tilomplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by .....................0...C-4, iat.......... ............................................................................................................................................................. Insm icr at ...........t.. 7......... __ M... p. ....................5._//........ ------- Vaxl�..................................... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No- -------------------------------- ............ dated ....... .............................._----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............t6' 4 ..... .... .. X ............ ...... ........... Inspector —————---------———————————————————— ——————————---——————- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... ..... V 7 FEE... 11isposal Vorkii Permission is hereby granted...........j65�on'r............ '7,C---——------------------------------------------------------- to Construct or Repair an Individual Sewage DisposM System atNo....... ...... ...... ............. Street as shown on the application for Disposal Works Construction Permit No--------- Dated_-_____-` 7- 91-1 ................................. ................................................. DATE.......... Board of Health -----------w....... ..........7------ FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS A ENVIROTECH I.AB®RAT®RIES Mass. Cert.#:MA063 _-- 449 Route 130 Sandwich,MA 02563 • (508) 888-6460 U� CLIENT: Michael White LOCATION: Lot 516 ADDRESS: 11 Bay Road South Main St. W. Yarmouth, MA Centerville, MA COLLECTED BY: client SAMPLE DATE: 9-6-93 TIME: 2:OOPM DATE RECEIVED.9-6-93 SAMPLE ID:'294 JOB#: Existing well WELL DEPTH: 21 RESULTS OF ANALYSIS: Parameter Units Recommended limit Result Coliform bacteria/100 ml (MF Method) 0 0 pH pH units 6.0-8.5 5.64 Conductance umhos/cm 500 219 Sodium mg/L 28.0 23.1 Nitrate-N mg/L 10.0 4.86 Iron mg/L 0.3 0.22 Manganese mg/L 0.05 Hardness mg/L as CaCO3 500 Sulfate mg/L 250 Potassium mg/L 20.0 Alkalinity mg/L 200 Chloride mg/L 250 Turbidity NTU 5.0 Color APC units 15.0 Background bacteria/100 ml (MF method) 200 VOC 601 602 ; ug/L N.D. COMMENT: Low pH indicates high corrosive characteristics. I * N.D. = None Detected - see attached report. YES NO 0 WATER IS SUITABLE FOR DRINKING PURPRSRIP. ERS TESTED. _ DATE /Slq s ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: 294 Lab ID: 5914-01 Project: Batch ID: VG2-0221-W Client: Envirotech Sampled: 09-06-93 Cont/Prsv: 40mL VOA Vial/NaHSO4 Cool Received: 09-07-93 Matrix: Aqueous Analyzed: 09-10-93 PARAMETER CONCENTRATION REPORTING .LIMIT (u9/L) (u5/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL 1 Vinyl lcride BRL ? Bromome-L,—a BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chlorde BRL 1 trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethane BRL cis-1,2-Dichloroethene * BRL 1 Chloroform BRL I 1,1,1-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL 1 I 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichioropropane BRL 1 Bromodichloromethane BRL 1 2-Chloroethylvinyl Ether BRL b I trans-1,3-Dichloropropene BRL 1 Toluene BRL 1 cis-1,3-Dichloropropene BRL i 1,1,2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethyibenzene BRL_ 1 m+E-Xylene _* BRL 1 o-Aylene * BRL 1 Bromoform BRL 1 1,1,2,2-Tetrachloroethane BRL I 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 32 108 % 87 - 113 % 1 ,2-Dichloroethane-d4 30 26 85 % 83 - 117 % No-_1C , _ _. . Fee' - `�ARb OF HEALTH TOWN OF BARNSTABLE - � 1 2ppritation or Vern Con5truction pff uit Application is hereb made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: -----------------------------------------------------------___ Location 7 -ddress Assessors Map and Parcel __---------------- ------------------------------ ----------------------------------------- -------------- Own e Address Ll Installer — Driller Address Type of Building p Dwelling------ - - Other - Type of Building---------------------------------- No. of Persons - -- - -------- Type of Well---------------------------------- -----, Capacity----------- Purpose of Well--:�r✓�Cr!�C_ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificates of Compliance has been issued by the Board of Health. Signed— -It ----- - --- --- - aR 0C— _ date Application Approved By---' c= -�-' �_ � •__S� date Application Disapproved for the.following reasons: ----------------- -- ----- --—- -- -- - - --- - - -- — - - - -------------------------—----- — date Permit Nov ~ e/ - - - - -— - - -- - -- ------- Issued —_— date BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate ®f Comphaute THIS IS TO CERTIFY, That the Individual Well Constructed ( tered ( ), or Yevaired 19 40-- Installer at_ b T l6 -,SO o f �? ! ---- �-�-�' ---------- -------------�- -----has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit N '� Dated-- �l--=-- ��-` �" THE ISSUANCE OF.THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE -- ____--- - ------------------ Inspector--------------------------------------- --- — -- -— r No.-G/f'--- :- `� ` ! _ ( Fee=-----==----=-—= BOARD OF HEALTH TOWN OF BARNSTABLE Application for Vell Con5truct ion Permit Application is herebV made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: ---------------------------------------------------------------------- Locat'on — Address Assessors Map and Parcel /1 l� l C�IGP� (�/I ' -e - - ------------ Owner L v, AddLI 3 �LJ--y t Y -------- --- ---------------------------------------------- ---------------------------- ---------------------------------------------------------------------------------------------------- Installer — Driller Address Type of Building Dwelling 96 Other - Type of Building-------------=---------------------- No. of Persons -- -------------------------------------- Type of Well--- ��- --GC/�EGC- - - — Capacity------� Purpose of Well-'�o�I%�IrL Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed------_______----------�i------------------------------------------------- ----------------------------- date Application Approved By---r -=— — v- - - �� —-- ---- date I Application Disapproved for the following reasons:------------------------------------------------------------------------------ ---- ------- - ---------------—- - - -- - ---_—--- -------------------—- - ------- —- - ---- date ` — — Permit No. ---- -�-------^---------------------- Issued--- -----—---------- `- ----- - � �--- date BOARD OF HEALTH TOWN OF BARNSTABLE j Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( Altered ( ), pr Rppaired ( ) ✓ LIC 3 by---- -Installerat ----�---------------------�-- G0 r 15-1,6 .SO IAIf%----------6�-_---, vr�/�-------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit N.1 ' __Dated- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------------------------------------------------------------- Inspector----------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Veer Con5truct ion Permit W No. —-------------------- Fee------------------- Permission is hereby granted- -- - - - --to Construct ( ), Alter ( ), or Repair ( ) an Individual Well at: No. --`a-/ -- - — Q^- —E�r ------ ------------------------------------- Street as shown on the application for a Well Construction Permit J 1/U --- - --- - / ?f�3 --- ------------------ No.----------------------- - -- ------------ Dated----------------- -------- r------------------ �� Board of Health DATE-------- - - -------------------------------------------- 0 gyp�!j �jY CLIA pap ? z3 3 W �" L,"• {��a1,c�y�.w !'�• q Irv.�� .. ��1�. f�', �' -r '�;I ,+,,...�vn..�+•.,, .. dw COC .,t,�'slot iM. .w.,• 1+""'......,.' ..w .. taa ! : T~ Im .? y ( �MS*' i'S �y. * r. r._: a+'°+ +. s�. ..,y :r.�,p S ;�./�� ^...`' ~•. ...y .., . . _. '. (..' 'S`4`y*a- `�ca Vf�d""' � `e R % v.z� � 1 .✓•" � l{...- (�•:� � �'Q, S ., r u �?7 �^N .'..i' i `J ' ._ter•' �� (}'V' �',-��'h't RgL3 �� r'k ++ \ h�a i�Vxr '. �� _..i"' � ./^,^. 1•-. S.,r` 'h?M„,',�:I r, /' WWW ,r,•� tt• r .�k �' ��•„ 3' .+✓ ,y�, � ray i ;�,� �' 'O Po �-�.G'� vY ;fi• Sf t ' ' Ae(�� . �.ii f `y� �k i f, I 1 el 114,, -I In * .+'�+- •�' "+r))``k i #l,3,. hit�,", � i x � t � .•vt:. �"r•' 1 _ ��+�fi"!t'Yt } " � ;,1i}'i• x' wltY '1� t r (j � 1 ' �y#'. �Yic• i�i., '��t�5ry j+. .fl s � s�, a ,r,.. a 'i;. .:ed �;✓ ,t. a .k� � •! �_f .( � ice•� '+ - �' "✓V5k' t'� �g 1 � �k'"°�, � s urn` .,s: �':r xr^�•c ar , ,y�'r- 'try' '� �t� \/j�/ s , '� 4 R.f` 9t� � ' �� fir+ l .. •� ��y � is� z .' � ti i �''•�• { ..�� i ,.; .� 3. .� U UTUT`( POLE —O— 10 FT. OF DRIVES OR PARKING AREAS. H-2 TOWN WATER —W WI USED UNDER OR WITHIN 10-FT_. OF DRIVES CATCH BASIN `®j 5. ANY MASONARY UNITS USED. TO BRING,NCO EDC—C 0Er(.4lJ P F�,�G BE ,MORTARED f IN PLACE. ','�t.d • ' ' 6. NO .DETERMINATION HAS BEEN MADE AS TO DEEDED OR ZONING. REGULATIONS. OWNER / OBTAIN SUCH DETERMINATION FROM APPROP .7. Pl; 7v2RirD '' �t� 4.• APPROVED: BOARDIST DATE PROPOSED ,= l PROJECT LOCATION .. k ROBIN t X PROFESSION V,LAN 20 S CKKET`. 3 F ?° SOUTH'DEN IS.- 385--6478 L!!ALE DAK REVISED RM LOCATION.,- MAP. JOB No. ..p 77Y-UU 7,7 Est Ta ± r a 9 3 ray rt#, L & s Af 20 FT. MINIMUM _ SOIL TEST Fr 'o, OF FOUNDATION 10 FT. MINIMUM DATE OF SOIL TEST LEV _ _ CLEAN SAND WITNESSED BY 1- !21 -,)- ,? ILL CONCRETE PERCOLATION RATE MIN./INCH. COVERS 4" SCHEDULE 40 PVC PIPE I MIN. PITCH 1/8" PER FT. 2" LAYER OF A�,,`"� OBSERVATION HgLE 1 OBSERVATION HOLE 2 CONCRETE 1/8" TO 1/2" r �f. ELEV.= I U/ ELEV.— WASHED STONE 0" COVERS 12" MAX. �I z`" TOP AND 7 - 4" CAST IRON PIPE rC�-- ? ��gfodd. ! Y SUBSOIL (OR EQUAL) MINIMUM Z -3r PITCH 1/4" PER FT. FLOW LINE s,��,� y, ..;� ,�a�•Ms " ELEV. _ �� 10" ,�,r_ � ,)q j -TMIN. 19" ELEV. s gypp• J�D o ° ELEV. _ LVEL 00 — 's' ELEV. ELEV. = T w O o° 110 Wa s-cv 3>t S a 40 _ o 0 0 7�r WATER AT EL.— 7 WATER AT f y ` EL= DISTRIBUTION ENV. - — °oBOX ASHED STONE;" o ° ° r - NUMBER D E EDROOMSSIGN ALCULATIONS 1 00 GALLON TO BE WATER TESTED W ° ° ELEV. = s` GARBAGE DISPOSAL UNITIF MORE THAN ONE OUTLET r ° TOTAL ESTIMATED FLOW SEPTIC TANK ( `0 GAL/BR./DAY X BR.) <J GAL/DAY ` PRECAST LE CHIJu "' 6' DIA. �/ �f REQUIRED SEPTIC TANK CAPACITY 6 6 0 GAL BASIN OR EQUIP WELL WELL ACTUAL SIZE OF SEPTIC TANK /5-,90 GAL ZONE LEACHING AREA REQUIRENTS INDEX SEWAGE DISPOSAL SYSTEM PROFILE � � ADJUST BOTTOM AREA !� GAL/S.F' ,` ACHING CAPACITY BOTTOM + SIDEWA GAL/DAY NOT TO SCALE O BOTTOM OF ?EST F OLE OR USGS PROBABLE WATER TABLE ELEV. = -77 -Z' RESERVE LEACHING CAPACITY GAL/DAY ' r - OEISERVED WATER TABLE ( / / ) ELEV. = NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. LEGEND: TITL.E 5 AND THE TOWN OF RULES AND EXISTING SPOT ELEVATION OOxO REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO 4. EXISTING CONTOUR ----00---- WITHIN 12" OF FlNISHED GRADE. FINAL SPOT ELEVATION 6 r,i 3. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME:.FINAL CONTOUR A. AL �'O►A��R1E?�"�c 0; ? 4F �ANlTA9Y c"'3TFkj %HA! I ac �4 c��Pi c � �r ' rat` � WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN _% �✓ *",, 17": ': r6 UTILITY POLE —o--TOWN WATER W—m—W 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE 1 .. = '- CATCH BASIN to) USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. \_ 5. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL 0 BE MORTARED IN PLACE.. , 6. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH -- DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 7. 1 t / et 41) M PPR A OVED: BOARD OF HEALTH L -; �q DATE AGENT 3 �` PROPOSED PLOT PLAN FOR , v� V t 40 PR CT LOCATION o T l —17950 v Z 4 /�" T o �� `d ' WTI �j llFF j o v7 ''� ,' ,_l !'" ^J7reu0cLc , 17 Der RUr+ v PROFESSIONAL LAND SURVEYOR 203 SETUCKET ROAD SOUTH DENNIS, MASS. 385-6478 02660 SCALE DATE,.r 2 n ,ram rJT'r U 1 y _ /0T 9 rr2 ra — 4 ' REVISED -,Zz 3� REVISED �7 R cTv>ac. 1 U 26AKo�f v✓� `� NL LOCATION MAP '10B N0• 7 �� UU SHEET / OF /�