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HomeMy WebLinkAbout0072 COTUIT COVE ROAD - Health 72 COTUIT COVE -ROAD, COTUIT _� Va- . 'o"'�►.o �iicadon Number..................................... . . 00 - 3� ......other Fee.................... Pc�t Fee....... ..................... .... MABEL TotalFee Paid....................... ..... ................................... I =ait .W..............On..........t.. ....... . TOWN OF BARNSTABLE P �� �-" BUILDING PERMIT MV ..po ........................ arxL..... s..._........................ APPLICATION Section I — Owner's Information and Project Location Project Address Cc j �o�� V01age e—o i v i Owners Name Owners Legal Address /��i C State /,,-1 zip Owners Cell# c� , g"- }�_�• E-mail PG6 247'r-u 7 Section 2—Use of Structure Use Grroup ❑ Commercial Structure over 35,000 cubic feet ❑] CoCommercial Structure under 35,000 cubic feet R Single/Two Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ .Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Al m Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Ad 'lion ❑ Retaining Wall ❑ Solar Renovation ❑ Pool ❑ Insulation Other—Specify Section 4-Work Description T ACt undated:219t201 8 TOWN OF BARNSTABLE LOCATION C®�-v�k CWC- 0,� SEWAGE# YVILLAGE ASSESSOR'S MAP&PARCEL 605'��(2 INSTALLER'S NAME&PHONE NO. Sc,C�'A �-L,� K70�k d ci q 0 ID (, q SEPTIC TANK CAPACITY Ob 0 LEACHING FACILITY: (type) \ S _' (size) 4)C4* +aA L NO.OF BEDROOMS OWNER \c r PERMIT DATE: 72 COMPLIANCE DATE: Ir 7 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 F7 "A ev, 5 A 0 aI = S� No. � 30, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓� Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppfieatiou for ]Disposal *pstem Construction permit Application for a Permit to Construct( ) Repair(Vrupgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. Cwt N Owner's Name,Address,and Tel.No. Assessor's Map/Parcel C) Q �(>3 C�' '` Installer's tLame,Address,and Tel.No. Designer's Name,Address,and Tel.No. Scow ctv_V 2 Type of uilding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) `A V f365G 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 C► �l�Il� Application Approved by ._. Date Application Disapproved by Date for the following reasons Permit No. 201 " 311 Date Issued r lq' i No. 4 t Fee ,c THE COMMONWEALTH'OF MASSACHUSETTS Entered in computer. ��'PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppliLation for Disposal Opstem Construction 3offmit Application for a Permit to Construct( ) Repair(1<Upgrade( ) Abandon( ) ❑Complete System ®Individual Components Location Address or.Lot No. C04G Ck Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Q d ld � Cove i Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. er b vc r �v R d Mill ,1_^1 Cl Type of Building: Dwelling No.of Bedrooms Lot Size. sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers Cafeteria YP g ( ) ( ) Other Fixtures ))// Design Flow(min.required) gpd Design flow provided A J p� gpd . r Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Q.X p�s tx_ o a-o5 x �c. �D ncl tip:1 v 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 noty Place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date f Application Approved by t Date f Application Disapproved by Date for the following reasons Permit No. 2 Q T �/ Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS W Certifilrate of (Compriante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(L✓}f� Upgraded( ) Abandoned( )by Se-e�_ u► j�/`� �c-trv-� at :2 ♦*'c'sgg y)k-k r- ng e Rd 60 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 90(7 !I dated -/-" Installer ``a�b .t{"E . Designer _ #bedrooms �. g/ Approved design^floo��A/4- -gpd The issuance of this�yermit(shall not be construed as a guarantee that the system w' jlfunct'/b`n as designed. t� s Date - < F! Inspector v vp -- " - - -- _ -- --- ----------------------- - - - - - -- ------- -- No. r� G I — 311 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction j3ermit Permission is hereby granted to Construct( ) Repair(t-4 Upgrade( ) Abandon( ) System located at "7 C ON cAk it OJ e rk C r_o A %J 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. --r '":XjIow � '1 JDate L{ — A PP Y roved b � �� r � , f 8 ^ l® Thomas&Betts('corporation 452 John Dietsch Blvd. P.O. Box 2510 ��166'�L1Ip�[ Attleboro Falls, MA 02763 (508) 699-9800 S E P 4 1998 4 Facsimile(508) 695-8111 J LiFI -WE � s ti� Thomas° efts August 10, 1998 Mrs. R.A. Martin c/o Mrs. Melinda Gildea P.O. Box 2026 Cotuit, Massachusetts 02635 Dear Mrs. Martin: Attached please find the laboratory results of the analysis of your well water, which we recently sampled at your property located at 72 Cotuit Cove Road in Cotuit, Massachusetts. The water sample, designated as RW-19, was collected by GZA GeoEnvironmental, Inc. and analyzed by the Mitkem Corporation laboratory. No Volatile Organic Compounds (VOCs) were detected in your well water. The Department of Environmental Protection has been provided a copy of these results. As you may,recall, the contaminants of concern at the 106 Falmouth Road Site were industrial solvents and cleaners potentially related to historic operations at that facility. To test for such materials, the laboratory analyzes for the range of VOCs specified by the EPA's testing method. That is why the Laboratory Analysis Report covers such a long list of organic compounds. Beside the list of compounds are two columns of data. The first column shows the concentration of the compound in parts per billion (ppb) found in the water sample. The letters "ND" mean the compound was not detected. The second column shows the lowest level at which the laboratory could accurately quantify the compound. We appreciate your allowing us to come in and test your water. If you have any,questions, please do not hesitate to call Mike Powers at GZA (401-421-4140, ext. 3404)., Sincere , William O. Frigon Attachment: Laboratory Analysis Report cc: Town of Barnstable Board of Health Mark Wood, DEP Robert Martin A o 1L=Q7Lnn JUL 0 June 29, 1998 GZA GeoEnvironmental, Inc. 140 Broadway Providence, RI 02903 '"'""""--------�""""_.. Attn: Ms. Hilary Fortune RE: Client Project#: 31751.13, Residential Well Sampling Lab Project#: E0993 Dear Ms. Fortune: Enclosed please find the data report of the required analyses for the samples associated with the above referenced project. If you have any questions regarding this report, please call me. We appreciate your business. Since , Edward A. Lawler Laboratory Operations Manager s 175 Metro Center Boulevard • Warwick, Rhode Island 02886-1755 • (401) 732-3400 • Fax (401) 732-3499 email: mitkem@worldnet.att.net Client: GZA GeoEnvironmental, Inc. Client Project: 31751.13, Residential Well Sampling Lab Project: E0993 Date samples received: 6/24/98 Project Narrative This data report includes the analysis results for two (2) aqueous samples that were received from GZA GeoEnvironmental, Inc. on June 24, 1998. Analyses were performed per Y p specification in the Chain of Custody form. For reference, a copy of the Mitkem Sample Log- In form is included for cross-referencing the client sample ID and laboratory sample ID. All of the analyses were performed according to method specifications. No unusual occurrences were noted during sample analysis. This data report has been reviewed and is authorized for release as evidenced by the signature below. Edward A. Lawler Laboratory Operations Manager 001 AUG 05 CORPORATION Analysis Report: Purgeable Volatile Organics Client: GZA GeoEnviron mental, Inc. Analysis Date: 6/25/98 Client ID: RW-19 Concentration in: ug/L Lab ID: E0993-01 Dilution: 1 Analysis: Method 524.2 Reporting Analyte Results, Limit Dichlorodifluoromethane ND 0.5 Chloromethane ND 0.5 Vinyl chloride ND 0.5 Bromomethane ND 0.5 Chloroethane ND 0.5 Trichlorofluoromethane ND 0.5 1,1-Dichloroethene ND 0.5 Methylene chloride ND 0.5 trans-1,2-Dichloroethene ND 0.5 1,1-Dichloroethane ND 0.5 2,2-Dichloropropane ND 0.5 cis-1,2-Dichloroethene ND 0.5 Bromochloromethane ND 0.5 Chloroform ND - 0.5 1,1 1 1-Trich loroethane ND 0.5 Carbon tetrachloride ND 0.5 1,1-Dichloropropene ND 0.5 Benzene ND 0.5 1,2-Dichloroethane ND 0.5 Trichloroethene ND 0.5 1,2-Dichloropropane ND 0.5 Dibromomethane ND 0.5 Bromodichloromethane ND 0.5 cis-1,3-Dichloropropene ND ` 0.5 Toluene ND 0.5 trans-1,3-Dichloropropene ND 0.5 1,1,2-Trichloroethane ND 0.5 Tetrachloroethene ND' 0.5 1,3-Dichloropropane ND 0.5 Dibromochloromethane ND 0.5 1,2-Dibromoethane ND 0.5 Chlorobenzene ND 0.5 1,1,1,2-Tetrachloroethane ND 0.5 Revised 8/4/91002. Pagel of 2 E0993-01 MITKEM CORPORATION Client ID: RW-19 Lab ID: E0993-01 Reporting Analyte Result Limit Ethylbenzene ND 0.5 Xylenes (total) ND 0.5 Styrene ND 0.5 Bromoform ND 0.5 Isopropylbenzene ND t 0.5 Bromobenzene ND 0.5 1,1,2,2-Tetrachloroethane , ND 0.5 1,2,3-Trichloropropane ND 0.5 n-Propylbenzene ND 0.5 2-Chlorotoluene ND 0.5 4-Chlorotoluene ND 0.5 1,3,5-Trimethylbenzene ND 0.5 tert-Butylbenzene ND 0.5 1,2,4-Trimethylbenzene ND 0.5 sec-Butyl benzene ND 0.5 1,3-Dichlorobenzene ND 0.5 4-Isopropyltoluene ND 0.5 1,4-Dichlorobenzene ND 0.5 1,2-Dichlorobenzene ND 0.5 n-Butylbenzene ND 0.5 1,2-Dibromo-3-chloropropane ND 0.5 1,2,4-Trichlorobenzene ND 0.5 Hexachlorobutadiene ND 0.5 1,2,3-Trichlorobenzene - ' ND 0.5 Naphthalene ND 0.5 QC'Batch: V1 B0625A Surrogate Recovery: Bromofluorobenzene 114% 1,2-Dichlorobenzene-d4 102% ND= Not Detected" Revised 8/4/98 n Page 2 of 2 E0993-01 A�� CORPORATION Analysis Report: Purgeable Volatile Organics Client: GZA GeoEnvironmental, Inc. Analysis Date: 6/25/98 Client ID: Trip Blank Y Concentration in: ug/L Lab ID: E0993-02 Dilution: 1 Analysis: Method 524.2 Reporting Analyte Results Limit Dichlorodifluoromethane ND 0.5 , Chloromethane ND 0.5 Vinyl chloride ND 0.5 Bromomethane ND 0.5 Chloroethane ND 0.57 Trichlorofluoromethane ND 0.5 1,1-Dichloroethene ND 0.5 Methylene chloride ND 0.5 trans-1,2-Dichloroethene ND 0.5 1,1-Dichloroethane ND 0.5 2,2-Dichloropropane ND 0.5 cis-1,2-Dichloroethene ND 0.5 Bromochloromethane ND 0.5 Chloroform ND 0.5 1,1,1-Trichloroethane ND 0.5 Carbon tetrachloride ND 0.5 1,1-Dichloropropene ND -0.5 Benzene ND 0.5 1,2-Dichloroethane ND 0.5 Trichloroethene - ND 0.5 1,2-Dichloropropane ND 0.5 Dibromomethane ND 0.5 Bromodichloromethane ND -0.5 cis-1,3-Dichloropropene ND 0.5 Toluene ND 0.5 trans-1,3-Dichloropropene ND 0.5 1,1,2-Trichloroethane ND 0.5. Tetrachloroethene ND 0.5 1,3-Dichloropropane ND _0.5 Dibromochloromethane ND 0.5 1,2-Dibromoethane ND 0.5 Chlorobenzene ND 0.5 1,1,1,2-Tetrachloroethane ND 0.5 004 Pagel of 2 E0993-02 i f MITKEINI CORPORATION Client ID: Trip Blank Lab ID: E0993-02 Reporting Ana yte Result Limit; Ethylbenzene ND 0.5 Xylenes (total) ND 0.5 Styrene ND 0.5 Bromoform ND 0.5 Isopropylbenzene ND ' 0.5 Bromobenzene ND 0.5 1,1,2,2-Tetrachloroethane ND 0.5 1,2,3-Trichloropropane ND 0.5 n-Propylbenzene ND 0.5 2-Chlorotoluene ND 0.5 4-Chlorotoluene ND '0.5 1,3,5-Trimethylbenzene ND 0.5 to rt-Buty(benzene ND 0.5 1,2,4-Trimethylbenzene . ND 0.5 sec-Butylbenzene ND 0.5 1,3-Dichlorobenzene ND 0.5 4-Isopropyltoluene ND 0.5 1,4-Dichlorobenzene ND 0.5 1,2-Dichlorobenzene ND 0.5 n-Butylbenzene ND 0.5 1,2-Dibromo-3-chloropropane ND 0.5 1,2,4-Trichlorobenzene ND .0.5 Hexachlorobutadiene ND 0.5 1,2,3-Trichlorobenzene ND 0.5 Naphthalene ND 0.5 QC Batch: V1 B0625A Surrogate Recovery: Bromofluorobenzene 116% 1,2-Dichlorobenzene-d4 102% ND= Not Detected 005 Page 2 of 2 E0993-02 MIT KEW CORPORATION Analysis Report: Purgeable Volatile Organics Client: GZA GeoEnvironmental, Inc. Analysis Date: 6/25/98 Client ID: Concentration in: ug/L Lab ID: Method Blank, V1 B0625A Dilution: 1. Analysis: Method 524.2 Reporting Analyte Results Limit Dichlorodifluoromethane ND 0.5 Chloromethane ND 0.5 Vinyl chloride ND 0.5 Bromomethane ND 0.5 Chloroethane ND 0.5 Trichlorofluoromethane ND 0.5 1,1-Dichloroethene ND 0.5 Methylene chloride ND 0.5 trans-1,2-Dichloroethene ND 0.5 1,1-Dichloroethane ND 0.5 2,2-Dichloropropane ND 0.5 cis-1,2-Dichloroethene ND 0.5 Bromochloromethane ND 0.5 Chloroform ND 0.5 1,1,1-Trichloroethane. ND 0.5 Carbon tetrachloride ND 0.5 1,1-Dichloropropene ND 0.5 Benzene ND 0.5 1,2-Dichloroethane ND 0.5 Trichloroethene ND 0.5 1,2-Dichloropropane ND 0.5 Dibromomethane ND 0:5 Bromodichloromethane ND 0.5 cis-1,3-Dichloropropene ND 0.5 Toluene ND 0.5 trans-1;3-Dichloropropene ND 0.5 1,12-Trichooroethane ND 0.5 Tetrachloroethene ND 0.5 1,3-Dichloropropane ND 0.5 Dibromochloromethane - ND 0.5 1,2-Dibromoethane ND 0.5 Chlorobenzene ND 0.5 1,1,1,2-Tetrachloroethane N D 0.5 006 Page 1 of 2 E0993-MB COIZPORATION Client ID: Lab ID: Method Blank, V1 B0625A Reporting P 9 Analyte Result bimit Ethylbenzene ND 0.5 Xylenes(total) ND 0.5 Styrene ND 0.5 Bromoform ND 0.5 I sopropy I benzene ND 0.5 Bromobenzene ND 0.5 1,1,2,2-Tetrachloroethane ND 0.5 1,2,3-Trichloropropane ND 0.5 n-Propylbenzene ND 0.5 2-Chlorotoluene ND 0.5 4-Chlorotoluene ND 0.5 1,3,5-Trimethylbenzene ND 0.5 tert-Butylbenzene ND 0.5 1,2,4-Trimethylbenzene ND 0.5- sec-Butylbenzene ND 0.5 1,3-Dichlorobenzene ND ' 0.5 4-Isopropyltoluene ND 0.5 1,4-Dichlorobenzene ND 0.5 1,2-Dichlorobenzene - ND 0.5 n-Butylbenzene ND 0.5 1,2-Dibromo-3-chloropropane ND 0.5 1,2,4-Trichlorobenzene ND 0.5 Hexachlorobutadiene ND 0.5 1,2,3-Trichlorobenzene ND 0.5 Naphthalene ND 0.5 QC Batch: V1 B0625A Surrogate Recovery: Bromofluorobenzene 108% 1,2-Dichlorobenzene-d4 ' 102% ND= Not Detected 007 Page 2 of 2 E0993-MB MITKEM CORPORATION Lab Project#: E0993 Client Name: GZA GeoEnvironmental,Inc. Client Proj#: 31751.13 Logged In By: ,� Client PO#: 3-02043 Project Name: Residential Well Sampling Reviewed By: Date Due: 9 _..` Total Price: $ - Date: 6.-2Z-sS Time: Project Mgr: PAS Salesman: PAS Del Req'd: Std. & Raw Data Completed?: YES Lab ID Client ID Matrix Analysis REige Sampled Received TPH IR BNA Her P/P Wet Met V-GC V-MS Sub -01 RW-22 AQ 524.2 6/24/98 6/24/98 1 -02 Trip Blank AQ. 524.2 6/24/98 6/24/98 1 TPH I_R BNA Herb P/P Wet Met V-GC V-MS Sub Please run and report with E0963 0 0 0 0 0 0 0 0 2 0 0XIMI -MINER y ORIGINAL REPORT GOES TO: INVOICE GOES TO: ADDITIONAL REPORT GOES TO: GZA GeoEnvironmental,Inc Attn: Hilary Fortune Same None 140 Broadway Phone: 401 421-4140 Providence,RI02903 Fax: 401 751-8613 O O 00 6/26/98 1:54 PM Page 1 of 1 Lab Project#: E0993 t` WHITE COPY-Original ` � YELLOW COPY-Lab Files PINK COPY.Project Manager W.O. # -i �CHAIWOF-CUSTODY RECORD (for lab use only) ANALYSES RE UIRED Sample �� Date/Time Matrix N m s bn; y I.D.+ t A A=Art S=Soil r t * (Very Important) GW=GroundW. O 7 m g = d , a Total I sw=suZ.w. o ; a g #of Note WW=w.ete W. DW=Drinking W. n m m m Cont. # -41 Other(sDecdy) 2 tVA _.'7 7 m 7 a n E i f 3 - PRESERVATIVE.(Cl-HCI N-HNO;,S-H,SO.,Na-NaOH,O-Other)* F. CONTAINER TYPE-(P-Plastic,,G-Glass,V-Vial,T-Teflon,O-Other)` RELLIINNQ ISHE :(Affiliation) f ,DATEMME RECEIVED Y:(Affiliation) NOTES:Preservatives,special reporting limits,known contamination,etc.: (Unless otherwise noted,all VOA vials have been preserved w/1:1 HCL.) RELINQUIS D BY:(Affiliation) DATE/TIME RECEIVED BY:(Affiliation) I `a RELINQUISHED BY:(Affiliation) DATE/TIME RECEIVED BY:(Affiliation) f e,, q PROJECT,MANAGER: EXT: � ti TURNAROUND TIME:❑Standard ❑ Rush Days,Approved by: r'EA t GZA FILE NO. 3/7V I—I3 P.O. N.O. GZA GEOENVIRONMENTAL INC. 4PROJECT ,1� r� ? G�C7 / . ��i9M ENGINEERS AND SCIENTISTS -' 140 Broadway /� 3 1��/Iw� PROVIDENCE,RI 02903 LOCATION C) (401)421-4140 FAX(401)751-8613 COLLECTOR(S) y ����✓�� SHEET OF_�_ r MITKEM CORPORATION Sample Condition Form Page_of_ Received By: Reviewed By: Date: IMITIKEM Project: Z ay�� Client Project: Client: Sample ID Preservation (pH) Comments/Remarks/ Condition: Lab Client HNO3 H2SO4 Hci NaOH Corrective Action* a( 1)Custody Seal(s) Present/ se .6Z 7�(j Cooler / ottl s Intact/Broken 2)Custody Seal Number(s) IV 3)Chain-of-Custody ®reseAbsent 4)Cooler Temperature Coolant Condition 5)Airbill(s) Presentot . Airbill Number(s) 6)Sample Bottles Intac Broken Leaking 7) Date Received 8)Time Received 9)Project Due Date Oin * See Sample Condition Notification/Corrective Action Form yes/ f a Last Page of Data Report Oil *CA T ION SEWAGE PERMIT NO. Vi ! LAGE =A I N S T A LLER'S NAME S ADDRESS d UILDER�^ OR WNER n 1 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED A1o2-427 L y T~ �--•� No._.. ... Fss 1. THE COMMONWEALTH OF MASSACHusETTS BOARD OF cHEALTH p®5 0,3 5 !..0 Y_\..._......OF....... . ................................... Appliratiaan for Bispnsttl Marks Tonstrurtiun Orrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal -System at: D :s� .!_a.:►� .-••.... n as �.X.LI........................ . �1.. or Lot,�Tq.Q ACC - --- . t Owner �r�s� ---- ..................... - Installer Address Type of Building Size. Lot. ._2 ....Sq. feet Dwelling.—No. of Bedrooms.........c ..............................Expansion Attic ( ) Garbage Grinder. ( ) p, Other—,Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( , ) Other fixtures -•................................••--------.•--- WW Design Flow..-:......: ... ................gallons per person per day. Total daily flow............. WSeptic Tank—Liquid capacity............gallons Length.•...:.......... Width................ Diameter................ Depth................. Disposal Trench—No.................... Width.................... Total Length................... Total leaching area.............._....sq. ft. 3 Seepage Pit No...___.._.L..._._.:. Diameter........: .... Depth below inlet......:....... Total leaching area.syI.. sq-ft. � Z Other Distribution box ( )' Dosing tank ( ) 1-+ o e Date_._...'l7-�1----•--•••----•. Percolation Test Results Performed by..... .................. -.._........_......_....:..... �. 1.4 0-j Test, Pit No. 1..�..2 ..minutes per inch Depth of Test Pit......I`�.`�.._.. Depth to ground water.................... 44 Test Pit No. 2...4:2....minutes per inch Depth of Test Pit......1.`E`t�..: Depth to ground water.....77.7 - a ---------- ......Poll . 0 Description of.Soil.:...................... ----------••-••.................. ---...............•--•-•••--•............._.....••............ ........ V = -••-•-..... -- ---------•----•----•--------------- ... U Nature 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 7PU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli e n d by board of health. Sign ;. ID J Application Approved By_..� �-� - - �''_....'...!.. Date Application Disapproved for the following reasons:................:.............................................................................................._.. •.......... Per No ........ -= ......... Issued_.V C1__...d .,,1_ Date a I l _e ................ e__.—✓•v`:Wwt1'..r..,�,. �....•a�w-.._,rt^�+•.%.—.....,k,... .. .:4'w.w'•s,..-.....�iw...�V•'*..�.d'er""`y;-�*,�^"..d.'- V THE COMMONWEALTH OF MASSACHUSETTS x• r,... BOARD OF HEALTH ..C..W1n..........OF....... ....... -_ Applirtttinn for Disposal Works Tonstm inn Vamit Application is hereby made for a Permit to Construct ( �) or Repair ( ) an Individual Sewage Disposal �15C Syshm at: , •Address.................................... .!. �p.�)....4................ or Lot•No•--..... ..................»..»»._.. Owner .... ate+ ..l 7 .. dd'reSs.....' �.. y = -=-C-- ..! ...................•---- ..:....... - -- - ... ..... . ...... � Lie s. 1. 2 ...... i.� Installer Address Type of Building Size Lot. ;e..c�'M....Sq. feet U Dwelling—No. of Bedrooms.........t.:........ ........Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............`.............. No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .............•• •--•.._...............---....... --' WW Design Flow...........e2s_ ...S'S................gallons per person per day. Total daily flow............. ...............gallons. OG Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ `* Disposal Trench—No..................... Width.................... Total Length....................Total leaching area................... ft. 3 Seepage Pit No................... Diameter.........!_... Depth below inlet......-: ......... Total leaching Z Other Distribution box ( ) , Dosing tank ( ) Percolation Test Results Performed by._._.t_ ? -F•`:J.ec..I.-----......................... Date...:3:.t...-. _. .................. Test Pit No. I......:Z ..minutes per inch" Depth of Test Pit......!':.:(..... Depth to ground water..._.'`..... .... Test Pit No. 2.._G _..._minutes per inch Depth of Test Pit....... Depth to ground water..... --......... a ---------------------------------------------------------------------------------...............-•••---... ...--------------•---------...... ..---------------- 0 Description of Soil..................cP e...... ^ ........................-----------•------...............-----•-----•-•------ •--••---.........••. ---------•-----•----••••----•-•............_.....----....---......_......••-----•-----•-... U Nature 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 TITM' 5 of the State Sanitary Code—The undersigned further agrees not to place the system in p e of Compliance (issued by th2e board of health.operation until a Certificate Signed."'!nce-has-been ..' ^. ...�. =_................................ -- /�Y!-•a'�,•;"--=1---7- Application Approved By...---.-` --------------- > er - _ ............................... Date Application Disapproved for the following reasons:............................................................................................................--- ..----•.......................•--------------..............--•------•----------------------•------...........--•--------•------.....---......:.....--•----------=-------..........•-•--.._...._....._... Dq_ 1 _� , PermitNo..................................�........--...._.... Issued_. -- -. Date ----------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS .� �--- BOARD OF HEALTH ( � w ev �=SP F""T-Pra ..........................................OF..................................................................................... Trrtifirttte ,af Toutplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b ..�..... .>.`......o, ,, _1 ................••---------"•---------------•------•-------------•--...------............•............--------......»-----.... Y-•.................. CA_ � Installer has been installed in accordance with the provisions of TITLE , The State Sanitary Code as described in the application for Disposal Works Construction Permit No...............��53?'zs. dated...��-t _ _ .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. A, DATE..............................................1 r ��� Inspector---•- � )1 1 � Br'1 71 i� THE COMMONWEALTH OF MASSACHUSETTS ---- BOARD OF HEALTH j� `7€y (�`7v�,`►........OF._ � ............................•............. \�7 �z2_._- Fzz 13iupuuttl Works Tunutrnrtinn Prrmit Permission is hereby granted..••--=�� .......Q ---....---1-,_'.Is.v�'O!�--------------------•-•-----.......-"-•---•---••--••-•--..__.... to Construct ( )or Repair ( ) an Individual Sewage Disposal Sy&m at No.:.... '��.......,` 7.4?.......t.... ?�.:f C" 'a�`'- -�� .r:' .....................•---•-•-••--•---•-----.............. Strcet as shown on the application for Disposal Works Construction Permit ! .... Board of Health DATE.......................... -----�------....-•-------•---- L .C:4A aT 10 N S E W A G E PERMIT Y.-J L AGE Go}U•`t I N S T A LLER'S NAME i A.DDRESS .. R_ U I L D E R OR OWNER O Lo ,4,1. gee, DATE PERMIT ISSUED DAT E COMPII-ANCE ISSUED �,/ �j . ���� d ,� { �,o�,�� } ^In-° ., j - � tf + i f' � II l �,�4 '�q 6 , i e . ��ry��� vas� _` h X� M. Le t.. .. (Q� �• � w. e. � -. ..•-�� �' , l i �`_ u � _ .� _.� 0C)Nd.......l. -'........... THE COMMONWEALTH.OF MASSACHUSETTS BOAR® OF HEALTH Al OF ��TH L C"' Application for Hippos al Morkii Tonsirurtion Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ........... ...---- •-•-••..... ------•• --.........--- pp ocation-Address or Lot No. ..... ... _ ... 11. �. 3....--••.................................•. .....................--•---•------------....... ........•----------- ...................... Owner Address a 'Lr .t-A) -�NcA....................... �.Hq�.Q.11?.s:THl.�1.eA �t�H1�'A.ee7"....:... ` Installer Address 1i a , Type o ui11ding Size Lot_zr_� �...Sq. feet U Dwelling—No. of Bedrooms................d........................Expansion Attic ( ) Garbage Grinder (X) `4 Other—Type of Building No. of persons................ 1�, YP g p Showers ( ) — Cafeteria ( ) Otherfixtures .......................•.........................................................................................................0.................... WDesign Flow..............��5.......................gallons.per person per day. Total daily flow.__.......3.3_®__._................ lons. 4 Septic Tank—Liquid capacityl�94..gallons Length.-M." .. Width Diameter................ Depth 5 -�.y. x Disposal Trench—No..................... Width.............._._... Total Length.....................Total leaching area....... ._.._._._____sq. ft. Seepage Pit No........J._-------- Diameter....t®.`........ Depth below inlet......iLl....... Total leaching area..?�.Z....sq. ft. Z Other Distribution box (>() Dosing tank ( ) aPercolation Test Results Performed by...40�'.__�... E.4: _.....l..N_ .a--- Date -/7..-.19�..___..... Test Pit No. 1. .....minutes per inch Depth of Test Pit..... 44`.... Depth to ground waterAM 7 4rV:- 44 Test Pit No. 2.!<.�_...minutes per inch Depth of Test Pit--- Depth to ground waterdd !�ED a ...---••--•----•--•------••.......-•••-•--•---..............-.......................................-••---•----•.......•-••••••-----•...........-••-••-••-•-- O Description of Soil L_..� 4?Y._s (1 t3 ®!Lt. �:- `�.1�'I E2� ..,6A,S4 ...•............. U — Z rD -• w --- .C [.._ �7� ...f�� I'1®�T�.Sc'.--F- - - �' �T'F1 ..� - •------------------T W Al iZ"8'r��tJlj��f1t355' '('.�P�"NjEO� C(dTti-.��e.SfDl�s�ll��---r�--Q�-•':.L_lf.� �_f' �Jl-E_v/r1rU1�� U Nature of Repairs or Alterations—Answer when applicable................................................................................................ �. , . ------ -- Agreement., � �ual The undersi ed a rees to i sta11 the aforedescri ed Individewa e Dis osal S stem in accordance with gg P Y the provisions of TITLE 5 of the State Sanitary Code— The undersigr further agrees not to place the system in operation until a Certificate of Compliance has issued by the b d f h lth Si a : . ......... ..... • .... _.. �j Date Application Approved By..... 101 ��'!� Date Application Disapproved for the following reasons:-----•------------------------------•-------•-•-----•---------•---------.....•••......---.. - •---•--..._._ ----------------- ..................•......-----••--•-•--•--------•••--•--•-----•••...------•...•••------•-----••-•------•-----•--------•------•------•---•--•-•-•-..................... Date PermitNo........................................................ Issued........-.............................................. Date Zin No --------------..-----— FEB..........................._ THE COMMONWEALTH OF MASSACHUSETTS : BOARD OF HEALTH `» w.N... OF...,..45,f-3./ N-5 i 13 L - Applirtttion fear Mipasttl parks Tonotrnrtiun ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal _..,-System at: Cary/ T COOC R0, c0 iv/ T �o7" 3b ......... ....................•-•.........---......••-•............................ --•--•-----------................................................................................ Lo Address ..-or Lot No. .... .A ��,�.�-�.,1�... .•-•--_•-• -•---.....-••-_.... ................................................ Owner Address W ✓. o �.....�tit c�._._..._... .... !-�A�2 oLl� 'S�, (� !✓�c� nU2 i _A�4 ----•--- --------------•----... .... Installer,. Address d Type of Building Size Lot.!81..R-SO....Sq. feet - Dwelling—No. -of Bedrooms..............: .........................Expansion Attic ( ) Garbage Grinder (K) YIN Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfi to es •••••••••••••-•••---•-••--•-•--•-••................ ••-- .....---•---•--••......•- -Dex- sign Flow.................................____.__.gallons per person per day. Total daily flow.........J3_0.....................gallons. f� '"Septic Tank—Liquid capacity?�s..O._gallons `Length.A�'.�."�. Width Diameter................ Depth6._:.¢_.... x Dtsposal Tr{ench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit -.-_-_--., Diameter....... .._....s............. Depth below inlet...........•......_. Total leaching area......•..._ q. ft. ' Z Other Distribution box (x '�� /�osing tank ( ) G • Z6 7 '-' Percolation Test Results Performed by._LU-w...�---- _L«= ......._�Nc.•.... Date.3--.�.7 - g/ • ........•......_..... aTest Pit No. 1. .......minutes per inch Depth of Test Pit....�!J�....._. Depth to ground water!UG 7_.6A-) Test Pit No. 2...Z.=..minutes per inch Depth of Test Pit... . .�.__. Depth to ground wate�'ouw?�,q E O IYi .. w. $O 17_" S,gA)0$1 -a dSV1L /Z''-�`�"/i1cp, 06, Description of Soil#�... _......................................................... 13.E',Sf1N1� .. -••....... .. ...�. . .. ......•,L-.--------------•-----------•-•--------------- ''McD.CI�r w�Fi,v6 �1; �2 ''-/ f"Mvs Gi!•F%AtE t-T, s J J V �......i�...... . ..........•ii_-• ---•----- - --�•--- -� •----- ----------- t — W , -...........................................I Y,SudSoiL /Z----.GO...MEo, COT_ Be, .SH.0D� 60 ...._/Zfg" 1116O_ •i=i�VE St9.uTj, x V Nature of Repairs or Alterations=Answer when applicable............................................................................................... .......... ......... .................................. ......................................................................... ... Agreement: The undersigned agrees to ' stall the aforedescrlbed Indivi ual Sewage Disposal System in accordance with the provisions of TIT!L- 5 of the State Sanitary Code—The undersig e further agrees not to place the system in operation until a Certificate of Compliance hab issue by th d of alt . '. S ne �` _. ... ------. . Date 1 Application Approved By....- �. t---------------------- - ---�r/f �r Date Application Disapproved for the following'reasons---------------••------•---------------------•----------•----.....-----------•.................................. --•-•-•--••••••--•.............•-•--.........._.....••-•----•--•----•---------- ------•••••-•••.......--•••----••-••..........••-•-•-•••--------••.............................•....................... ° Date Permit No.............. -----..... Issued.. ----------------- ^= Date 'k J THE COMMONWEALTH OF MASS'ACHUSETTS . BOARD F HE _ d2'I � .............0 a �rrt�f rtt�e of f�u�n�li��tre T Irs'j 17, CEERYIF hat the Ind v> ual,._Sewage l isp, sal System constructed (�or Repaired ( ) { ff++ �......41_ l...l.. l i by---- - ............ . . ... # .. --•------------•------•--•---••-•-- at .;€-_ = -------------- --------•-•------.---._.....-----.-•_..--r-r-------------------- has been installed in accordance with the provisions of �o�T)3e State Sanitarykje jy �r�ed in the application for Disposal Works Construction Permit No........................................ dated__...-__ ._:____......_......_................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. '`_ DATE... ...........`.... Inspector ---•-•----------- --------------- •--------------- THE COMMONWEALTH OF MASSACHUSETTS 0 BOARD OF HEAL :1... ... �r........O F.......... '�'G"�j.......:. `.:... ... No......................... FEE........................ Mop 1 nr j nnstr wait Wrmit P ermission h u Seto Const ((C r R at No v s / reet ° 3•' .2 7 i" le;k as shown on the application for Disposal Works Construction oit N o.._._ __ Dated.._ .. .............................. - ......................... .--- Board of Health DATE ........................I....... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ' � * k • . • - EX/sT. Vt w ECG ' zl2 I. 4 s k-,` /9oP/�D x. f �.1i „ i F: . , LoC0. . (� ,e 4 " ` t P ; r ', i. ♦ 4/.4 . �,,. 41, d Q N ` i //Z \ S u8 301E SO . , , Y Y FF K �oT' 90. 4 /z" 40. p s �t , Co 7 11 v S, - _ . ,t - caT. ScA� ND• w -' /( \ 1. SAND S {rt.ti`StkcW «. •.4Zt /. ` �• • ��.• �- -O U y Y . Z .P n , 11 ,,{.t t _ _ _ - - If 28/8so ,, %t, t \�, it i� is r,�,} Gd tr 1 t;4.J> S r.,e',A .3.• (� '. I 1',> �.,\; r rf} f`. t' i � rI t'{i } k' 3e 'Mi:ro•d�.S..iZs.e,{?'4..`� .st ,{. .. l .� :�Jr � ''� �� ; ..+- A t+ •�� - n'A j .,�•t IA L r••q�r7.• �\- _ �.as/ ... # /Ooa6; * ., �,f I. G.P• ,�/�iE �u6ty /S u�Z., 4rM O1. 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