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HomeMy WebLinkAbout0595 OLD POST ROAD (CT & MM) - Health (2) _ 595 Old Post Road _ Cotuit A= 054-016 fi (�JZflt.�� ot( No.----------------- Fee-, BOARD OF HEALTH JOWIN OF BARNSTABLE Application-*rlVell Conoructi®n-Vernut Application is! V),hereby made for a permit to Construct ( Alter ( ), or Repair ( )an individual Well at:Po _a_Cof-u r i—— Location — Address — —` — ors Map and Parcel --LO Mrs n�c Pa!�_ �; L�; — j —Owner--T-- —_._.._—�—_.----_-- Address .----- Installer — ller Address Type of Building Dwelling Other - Type of Building—=—__—__—______ No. of Persons--------------------- - Type of Well W SCA.'k fNC_--- Ca acit Purpose of We11.— 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 --- -------__— -_ U!_112tfl date Application Approved date Application Disapproved for the following reasons: ------------------------_______.____ _—__.—____ � � � 1 date Permit No. -- Issued— ---i% -----'----------------- date BOARD OF HEALTH TOWN OF BARNSTABLE (certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (J ), Altered ( ), or Repaired ( ) by-- ©e sN,nG-n& V� Si���._ __--- installer 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 No.W zo 1 0('(Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE --_— -- Inspector------_-- -------------- No.------------------- Fee-------7-----:------ BOARD OF HEALTH -� TOWN OF BARNSTABLE 0[pplicat ion-for Well Cootruct ion Permit Application is hereby made for a permit to Construct (�/), Alter ( ), or Repair ( )an individual Well at: Location — Address ,-- — Assessors Map and Parcel — -- M of 4h� x 595 O►� PaS� 1 Co+U Owner Address 83 --------= -,— -- - --------Olnsal 053 Installer — Dtiller Address Type of Building Dwelling-- ------_—_—_ Other - Type of Building-=--_-__-________ No. of Persons----------.----------_ Type of Well y��SC y0 Nc- — Purpose of Well —_— 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 SignedJ��` ---- b / date Application Approved By ___—_________ 6{ z 1) /Z • date Application Disapproved for the following reasons: date - Permit No. Issued---- ------ --------------------___-- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (✓ ), Altered ( ), or Repaired ( ) Installer at—_ 5'15 O�A PUS k 1,Coi-,ji ----- ---_— - ------- -------- -- --- ---- - 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 No.W Z•0 -�(�Dated—�°-r� -z° t 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 Ivetf Cootruct ion Permit No. ------ Fee- ---------- Permission is hereby granted YYIb �"`1 !lr�, �- to Construct ( ✓), Alter ( ), or Repair ( ) an Individual Well at: No. -._ --- -- -'--- --_-_- - - Street ------- t as shown on the application for a Well Construction Permit ot , No.- _- ------ Dated-- Z%-�Z.o�--�---------------------- --= - --------- j -_� - --- --- ' -------- .. . �_- DATE Z� �'�1�_ oard of Health -ti From: "Brunelle, Eugene(DEP)"<eugene.brunelle@state.ma.us> Subject: Barnstable-595 Old Post Road,Cotuit Date: June 16,2011 3:27:11 PM EDT To: "michelle@desmondwelldrilling.com"<michelle@desmondwelldrilling.com> Cc: "Cerutti,Joseph(DEP)"<joseph.cerutti@state.ma.us>,"Rao, Purnachander(DEP)"<pu rnachander.rao @state.ma.us>, health @town.barnstable.ma.us"'<health@town.barnstable.ma.us> Dear Donald and Sarah Law, I'm writing to provide you with MassDEP Underground Injection Control (UIC) registration number MAS41A020219- 5C2 for the installation of one open-loop ground source heat pump (GSHP) return well at the private residence located at 595 Old Post Road, Cotuit. The ground-loop portion of the GSHP system will consist of one dedicated supply well and two dedicated return wells. The well driller for this project will be Thomas Desmond Reg#299, Desmond Well Drilling, PO Box 2783, 5 Rayber Road, Orleans, MA 02653. I The GSHP system designer for this project will be Sun Engineering, 491 Maple Street#209, Danvers MA 01923- 4025. The GSHP system installer for this,project will be Dan's Service, 26 Elm Street, Somerville MA 02143-2229 This approval is only for the installation of the GSHP return well and is not an approval for system start-up. The -:installation of the supply well does not require MassDEP approval. Prior to receiving system start-up approval MassDEP requires that groundwater laboratory analyses be completed and submitted to MassDEP on a raw water sample collected from the supply well and a post heat pump sample analyzed for coliform bacteria. See the Guidelines for Ground Source Heat Pump Wells for a list of the required laboratory analytical work at the following web site http://%vw-v.niass.gov/dep/water/drinking/uic.htm (3rd item on the main column). You may submit the laboratory results in stages. For instance, you may wish to submit the raw water analytical results prior to the installation of the heat pump equipment to make certain that the well water is approvable as a groundwater discharge. If the raw water results are acceptable you could then install the equipment and collect the post heat pump water sample for bacteria analysis. The following analyses are not required on Cape Cod: gross alpha and radon. Perchlorate analysis is no longer required statewide for new residential geothermal installations. The ground source heat pump system shall be installed with an automatic system shut-off device in the event of significant pressure loss in the refrigerant system. The heat pump discharge to the well shall not contain any chemical additives(i.e. water softening chemicals or corrosion inhibitors). The GSHP system shall also be installed with automatic shut off controls in the event that the return well is at risk of overflowing or pressurizing (as the potential result of long term build up of blockage of the well screen). Once the installation is complete, the system designer shall complete one of the following: * If the system was installed as designed,the system designer shall send a letter to MassDEP UIC Program, I Winter Street, 5th F1., Boston, MA 02108 indicating that the system was installed as designed and shall submit a copy of the well completion report that was sent to the MassDEP Well Driller Certification Program and local Board of Health (including latitude and longitude of the well location). * If the system was not installed as designed,the system designer shall submit a BRP WS06e modification registration form with the above referenced UIC registration number, completing only those parts of the form that were changed, including any revisions to attachments such as design plans or specifications. A copy of the well completion report that was sent to the MassDEP Well Driller Certification Program and local Board of Health (including latitude and longitude of the well location) shall also be:submitted., Please be aware that the issuance of the above UIC registration number only indicates that MassDEP's UIC Program has received the information that we have requested. If you haven't already done so, you shall submit a copy of the application package submitted for this UIC registration to the local board of health. There may be other local permits, ordinances, or regulations that apply, including but not limited to board of health permits for well installations and Building Department regulations regarding trenching work. MassDEP understands that the well will not be used as a source of drinking water. Please be aware that if the well is to be used as a source of drinking water in the future it would require an approval from the local board of health. The issuance of a UIC registration number by MassDEP does not supersede the requirements of any other state or local regulatory entity. This email has been copied to the Barnstable Board of health. Thanks, Eugene Brunelle Environmental Engineer' MassDEP 627 Main Street Worcester MA 01608 Office 508-767-2710 Fax 508-792-7621 Sullivan Engineering Inc. 7 Parker Road,P.O. Bog 659 Osterville,MA 02655 phone 508-428-3344 fax 508-428-9617 peternsullivanen ig n.com July 05, 2011 Thomas McKean, Director Health Division Town of Barnstable 200 Main Street Hyannis MA 02601 RE: Don Law&Sara Molyneaux_ 595 Old Post Road Cotuit,.Map 054 Parcel.016� Phoenix Composting Toilets Dear Tom, As per your recommendation this letter is to document the proposed use of composting toilets at 595 Old Post Road and how that use complies with all the requirements of the State Environmental Code, Title 5. As an overview this property is developed with a 5 bedroom single family home and detached garage circa 1930. The home is presently in the process of extensive remodeling. The property has the benefit of a Disposal System Construction Permit No.2010-445, designed for 5 bedrooms without variance to Title 5. The septic system will be upgraded as part of the present remodeling. The owners wish to go above and beyond what is required and therefore propose to install 3 composting toilets to supplement the upgraded/new septic system. All of the composting toilets will be installed on the first floor. The composting toilets are the Phoenix Model R-200 as manufactured by Advanced Composting Systems of Whitefish, Montana. In accordance with Title 5, composting toilets are approved for General Use subject to the following conditions: • The system is capable of storing solids up to two years and the residual will be removed by a licensed septic hauler. (310 CMR 15.289 (1) (C)). The Phoenix has more than two year storage and the residual will be removed by a licensed septic hauler at the time of pumping the septic tank. See the attached literature page 2/4 item 7. • The site has a valid permit to upgrade the existing septic system in full compliance to Title 5. (310 CMR 15.289 (2)). A copy of the septic permit is attached and the system will be installed shortly. The composting toilets will supplement the upgraded system. Given that the above conditions are met and documented then there is no further action required by the homeowner. I trust that this meets your present needs and thank you for your help with this matter. eloo?ry,truly yours, LO �erulhvan PE Sullivan Engineering, Inc. cc: David Stanton, Health Division (via e-mail) D. Law&S. Molyneaux(via e-mail) Members of American Society of Civil Engineers and Boston Society of Civil Engineers Section Phoenix Composting Toilets Performance Criteria .6 E /� f In summary, the composting toilet design,must include the following features for effec- tive operation: .1. Maintain compost pile temperature 2. Maintain compost pile moisture 3. Provide aerobic conditions 4. Separate leachate from compost 5.Maximize effective compost volume 6. Promote plug flow(maximize minimum retention time) How does the Phoenix'satisfy thes e criteria. 1. The Phoenix chamber,wall is insulated with foamed polyethylene to reduce heat loss and the ventila- tion rate can be adjusted to reduce cooling from evaporation and cold air introduction. 2. The ratio of the surface.area of the compost pile within the Phoenix composting chamber to the toilet chute area is 16,much lower than other designs so the compost pile within the Phoenix is'naturally. uniformlymoist. T y more he Phoenix also includes a manual or automatic spray system to help maintain uni- form moisture throughout the composting mass: .3.Air is drawn into the Phoenix composting chamber through an air inlet(and ..the toilet if the seat is open) circulates under the porous floor and travels up both sides of the chamber behind baffles allow- .ing frequent contact with the compost mass.Air can also be in' through the tine shafts. iected mto the center of the compost pile 4.An elevated porous floor separates leachate from compost in the bottom of the chamber so leachate is not in contact with compost.Air blowing over the leachate under the floor provides aerobic conditions to both the leachate and bottom of the compost pile. S. The Phoenix compost chamber is the size and shape to allow compost pile maintenance and removal through top and bottom access doors with a conventional shovel or rake.There is essentially no material which remains in the chamber forever. 6. Rotating tine shafts control vertical downward movement to promote plug floe-. The bottom tine shaft keeps the compost pile from collapsing allowing the entire volume of compost beneath the shaft to be removed. This maximizes the minimum retention time. 7 Retention time for waste within the Phoenix depends upon the number of persons using the toilet. The model 200 Phoenix has a suggested capacity of 4 persons. This amount of use will produce about 200-300 liters of finished compost'year.About 350 liters of material is removed during annual mainte- nance from the area beneath the bottom tine shaft. This is about 1/3 of the total mass volume so a reten- t ion time of 3.years is predicted..Measurements over a 3 year period using an array of different colored marbles applied over the top of the compost pile every 6 months confirmed a minimum retention time of 3 years fora four person family using a Phoenix model.200 system. M Zf f i Toilet , Spray System Controlle to Maintain pile Ventilation Moisture - k 4 i ZZ Frequent Air ' Contact from Y E Side Baffles r r ITT Additional Aeration E` Insulated through Perforated Tine-Shafts t Chamber Wall ' a Bottom of Compost Pile Aerated through Porous : `; ;- T Porous Floor Floor. \Separates Leachate Phoenix._ Insulated Chamber Wail, Aeration, Leachate Separation and Mo isture Control- 31A Access Door for Convenient Access :y;; %j to the Top of the Compost Pile Rotatable Tine Shafts _ t — Control Downward Compost Movement �. 4 A Conventional Length Rake Reaches to the Back of the Chamber Access Door Allows Removal of all of Compost beneath the. 1 Bottom Tine Shaft Phoenix Design High Effective Volume and Plug Flow 4 A i Fee THE I'r,OM ONWEALTH OF MASSACHUSETTS Entered in computer: .r\Y PUBLIC.HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes \ \ application for ssp`� gat I*pgtem Construction Vermit Application for a Permit to Construct I ) Repa Upgrade(-�-Abandon( ) Complete System(]Individual Components Location Address or Lot No.S1S `0 d��O�- Owner's Name,Address,and Tel.No. _ 0.\A4,F ,3�} Spry 1NOIy rlegv� Assessor's Map/Parcel Os Li 7 O O D Installer's Name,Address,and Tel.No. - Designer's Name,Address and Tel.No. �ntAr1 Tif- Type of Building: . Dwelling No.of Bedrooms Lot Size I(XQC sq.ft. Garbage Grinder OW Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) C>T(5 gpd Design flow provided (p(] Plan Date even Z.rJl6 BPd 1l Number of sheets ` Revision Date1 Title 5 k -V(4n Proao5erl� trOkr Size of septic Tank ASO 0 Type of S.A.S.�-500 \ (1nr �-je.t In w(c4'x, t fiEt-f') Description of Soil 90Z. Q_Z.tt 0 QrNeK 2-1 l LU R for 4 Z- & r c 11 ZS" ►3 LME k 191tY fC_t�.�iY SRrJ Z -flLt LfAvrQ Nature of Repairs or Alterations(Answer when applicable) - Date last mspected. 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. Sig*by: !J� Date Application Approved by Dace Application Disapproved Date for the Coiluwing reasons —__ Permit-—— — Date Issued —— —————=— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,ti;::;;4::;);t-sile Sew;ige Disposal System Constructed Abandoned( ) ( ) Repaired( ) Upgraded(�j by at .L-_—JZA '�,,,� [„��1 has been constructed i �ecordance with the provisions oaf,iittlle-_9 Aatnddttrh`e for Disposal System Construction Permit No. Installer D dated esigner N bedrooms - Approved design flow gpd The issuance of this permit shall not be construed a v guarantee that the system will function as designed. Dale Inspector --- — I — — No. —THE COMMOIN M VALTH OF MASSACHUSETTS Fee PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS �isposaC�pstlem (Construction joermit Permission is hereby granted to Construct.( Repair ( ) U System located at rjy S OLD Upgrade (Abandon ( ) and as described in the abpve Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local pro visions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Dale Approved by V I Z Stanton, David From: McKean, Thomas on behalf of Health Sent: Friday, June 17, 2011 3:51 PM To: Stanton, David; Desmarais, Donald; McKenzie, Marybeth; Miorandi, Donna; O'Connell, Timothy; Parziale, Jim Subject: FW: UIC NUMBER/595 Old Post Road, Cotuit -----Original Message----- From: Brunelle, Eugene (DEP) [mailto:eugene.brunelle@state.ma.us] Sent: Thursday, June 16, 2011 3:27 PM To: michelle@desmondwelldrilling.com Cc: Cerutti, Joseph (DEP); Rao, Purnachander (DEP); Health Subject: Barnstable - 595 Old Post Road, Cotuit Dear Donald and Sarah Law, I'm writing to provide you with MassDEP Underground Injection Control (UIC) registration number MAS41A020219-5C2 for the installation of one open-loop ground source heat pump (GSHP) return well at the private residence located at 595 Old Post Road, Cotuit.. The ground- loop portion of the GSHP system will consist of one dedicated supply well and two dedicated return wells. The well driller for this project will be Thomas Desmond Reg#299, Desmond Well Drilling, PO Box 2783, 5 Rayber Road, Orleans, MA 02653. The GSHP system designer for this project will be Sun Engineering, 491 Maple Street#209, Danvers MA 01923-4025. The GSHP system installer for this project will be Dan's Service, 26 Elm Street, Somerville MA 02143-2229 This approval is only for the installation of the GSHP return well and is not an approval for system start-up. The installation of the supply well does not require MassDEP approval Prior to receiving system start-up approval MassDEP requires that groundwater laboratory analyses be completed and submitted to MassDEP on a raw water sample collected from the supply well and a post heat pump sample analyzed for coliform bacteria. See.the Guidelines for Ground Source Heat Pump Wells for a list of the required laboratory analytical work at the following web site http://www.mass.2ov/dep/water/drinkin2/uic.htm (3rd item on the main column). You may submit the laboratory results in stages. For instance, you may wish to submit the raw water analytical results prior to the installation of the heat pump equipment to make certain that the well water is approvable as a groundwater discharge. If the raw water results are acceptable you could then install the equipment and collect the post heat pump water sample for bacteria analysis. The following analyses are not required on Cape Cod: gross alpha and radon. Perchlorate analysis is no longer required statewide for new residential geothermal installations. The ground source heat pump system shall be installed with an automatic system shut-off device in the event of significant pressure loss in the refrigerant system. The heat pump discharge to the well shall not contain any chemical additives (i.e. water softening chemicals or corrosion inhibitors). The GSHP system shall also be installed with automatic shut off controls in the event that the return well is at risk of overflowing or pressurizing (as the potential result of long term build up of blockage of the well screen). 6/20/2011 ri �X Once the installation is complete, the system designer shall complete one of the following: * If the system was installed as designed, the system designer shall send a letter to MassDEP UIC Program, 1 Winter Street, 5th Fl., Boston, MA 02108 indicating that the system was installed as designed and shall submit a copy of the well completion report that was sent to the MassDEP Well Driller Certification Program and local Board of Health (including latitude and longitude of the well location). * If the system was not installed as designed, the system designer shall submit a BRP WS06e modification registration form with the above referenced UIC registration number, completing only those parts of the form that were changed, including any revisions to attachments such as design plans or specifications. A copy of the well completion report that was sent to the MassDEP Well Driller Certification Program and local Board of Health (including latitude and longitude of the well location) shall also be submitted. c ' Please be aware that the issuance of the above UIC registration number only indicates that MassDEP's UIC Program has received the information that we have requested. If you haven't already done so, you shall submit a copy of the application package submitted for this UIC registration to the local board of health. There may be other local permits, ordinances, or regulations that apply, including but not limited to board of health permits for well installations and Building Department regulations regarding trenching work. MassDEP understands that the well will not be used as a source of drinking water. Please be aware that if the well is to be used as a source of drinking water in the future it would require an approval from the local board of health. The issuance of a UIC registration number by MassDEP does not supersede the requirements of any other state or local regulatory entity. This email has been copied to the Barnstable Board of health. Thanks, Eugene Brunelle Environmental Engineer MassDEP 627 Main Street Worcester MA 01608 Office 508-767-2710 Fax 508-792-7621 6/20/2011 Town of Barnstable P# �°z ' Department of Regulatory Services z , , F Public Health Division Date 200 Main Street,Hyannis MA 02601 NIKt Date Scheduled ZJ Time Fee Pd. ®d D t3 Soil Suitability Assessment for Sewage isposal Performed By: .��It�a RY 2S Witnessed By: LOCATION&GENERAL INFORMATION Location Address �j`�{S QI��eS�r' � c� Owner's Name -a-5 ,M-1yrlert Cety Address 30 \�Srn�oZyo Assessor's Map/Parcel: QS 9 a 1 Engineer's Name 5,3%\.Jtv\L' ��aQStYvJ NEW CONSTRUCTION Telephone l C9' /0 urn d tut6LN d� Land Use kes\ Slopes(0/04Tu 30%o SeawvA.ck!tkce Stones r t r F Distances from: Open Water Body Z�.S ft Possible Wet Area Z IS- ft Drinking lWater Well 560 ft Drainage Way Q,. 8 ,Property Line ���` ft Other !V tl ft SKETCH:(Street time,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) FRn xrN F Y F { Parent material(geologic) Depth to Bedrock 06 Depth to Groundwater: Standing Water in Hole: /J 0J\9- Weeping from Pit Face I�1Ur�Fo u � � Estimated seasonal High Groundwater 'I RMINATION FOR SEASONAL HIGH wATER,TABLE` Method Used: Depth Observed standing in obs.hole: ' in. Depth to soil mottles: in. Depth to weeping from side,of obs.hole: in. Groundwater Adjustment Index Well# - Reading Date` Index Well'level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST . lmte Y O, ,lime ttL Observation Z Hole# Time at 9" Depth of Pere Time at 6" Start Pre-soak Time® 1�o n Time(9"-V) •tti End Pre-soak Rate Min./Inch Site Suitability Assessment Site Passed.' Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division,, Observation Hole Data To Be Completed on Back----------- ***If percolation test is twbe conducted within 100'of wetland,you must first notify the Barnstable.Conservation Division at least one(1)week prior to beginning. Q:\SEFnC\PERCFORM.DOC i DEEP OBSERVATION HOLE LOU- ' Hole# Depth from Soil Horizon Soil'Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. i Consistency_%Gravel) e SA�o7 "o DEEP OBSERV E ATION HOLE LOG Hole# Z- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulders. Consistency_%Gravel) :DEEP OBSERVATION HOLE LOG . Hole* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) f t I f r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,"Boulders. Consistency.%Gravel) i 1 ' Flood(Insurance Rate Mai): Above 500 year flood boundary =No Yes 1 ��� {�(yw� Ctao�, PoI Tty� y 1 Oc PQa Pe��/ 15_Utt"lN LAS'�7 {, Within 500 year boundary No Yes Within 100 year flood boundary No / Yes Depth of Naturally Occurrie '`Petvlons Material Does at least four feet of naturally occurring pe ious material exist in all areas observed throughout the area proposed for the soil absorption system? t If not,'what is the depth of naturally occurring p�rvious material? . r .o . Certification I certify that on ! (date):I have p6sed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience dscribed in 310 CMR 15.017. Signature r Date 5hilo _ Q:\SEPTIC\PERCFORM.DOC f f _ r ENVIROTECII LABORATORIES,INC. M4 CERT. NO.:M-MA 063 8 Jan Sebastian Drive Unit 12 Sandwich,MA 02563 . (508)888-6460 1-800-339-6460 FAX(508)888-6446 Client Name Desmond Well Drilling Location Law,595 Old Post Rd. Address PO Box 2783 Cotuit,MA Orleans MA 02653 Sample Date 08/24/11 Collected By Desmond wells Sample Time 15:00 Sample Type New WeIU Geothermal Date Received 08/25/11 Lab Order Number DW-112512 Well Specs 6"SCH40 PVC/657 42' Location Source Date'.Collected Time Collected Comments , 8124M1 Analysis Requested Units Recommended Limits Analysis Result Method Date Analyzed Analyzed By Total Coliform /100ml 0 2 BG>200 SM9222B 8/25/2011 RS pH pH units 6.5-8.5 6.22 SM4500-H-B 8/25/2011 LL Specific Conductancen umhos/cm 500 151 EPA 120.1 8/25/2011 LL Nitrite-N mg/L 1.00 __ <0.004 EPA 300.0 8/25/2011 LL Nitrate-N — — mg/L 10.0 ` 0.47 EPA 300.0 8/25/2011 LL -- - — ---_ _— --------- - - -— --- - -.....------------------- Sodium mg/L 20.0 13.1 EPA 200.7 8/29/2011 MC Total Irons----— mg/L---- 0.3 -- 1.40 —EPA 200.7 8/29/2011 -- _--MC - — Manganesen mg/L 0.05 0.45 EPA 200.7 8/29/2011 MC Comments: Coliform exceeds maximum contaminant level. BG=Background Bacteria.Should not exceed 200. Suggest retest. pH is below recommended limit and may have corrosive characteristics. Iron and manganese are not a health hazard,but can cause taste,staining and odor problems. Water is not Suitable for ddnkm' urposes for parameters tested. ---- — ---- --.Date --- Ronal Saar Laboratory D re for BRL=Below Reportable Limits 'See Attached Page 1 of 1 QCertifrcation is not available for this analyte for non potable water samples.. CERTIFICATE OF ANALYSIS Page: 1 L Barnstable County Health Laboratory (M-MA009) RepOrt Prepared For: Report Dated:8/9/2011 Sally Desmond Desmond Well Drilling Order No.: G1164267 P O Box 2783 Orleans, MA 02653 Laboratory ID#: 1164267-01 Description: Water-Drinking Water Sample#: Sample Location: 595 Old Post Rd,Cotuit, MA Collected 8/4/2011 Collected by: Customer Received 8/4/2011 Test Parameters ITEM -RESULT UNITS RL MCL METHOD# TESTED Chlorides 30 mg/L 1.0 _ EPA 300.0 8/4/2011 Nitrate as Nitrogen 0.81 mg/L 0.10 .10 EPA 300.0 8/4/2011 Nitrate plus Nitrite as N 0.81 mg/L 0.10 10 EPA 300.0 8/4/2011 Nitrite as Nitrogen ND mg/L 0.050 1.0 EPA 300.0 8/5/2011 Arsenic ND mg/L 0.0030 0.010 EPA 200.8 8/5/2011 Iron 0.34 mg/L 0.075 20 EPA 200.8 8/5/2011 Manganese 0.21 mg/L 0.003 SM 3111B 8/5/2011 Sodium 18 mg/L 0.075 20 EPA 200.8 8/5/2011 Total Coliform Present /100mL 0 0 SM9223 8/4/2011 pH 6.6 PH AT 25C 6.5-8.5 SM 4500-H-B 8/4/2011 The recommended maximum contamination level for drinking water exceeded due to Coliform Bacteria. Tested negative for E.coli.Retesting is recommended.May present aesthetic problems(taste, odor,staining)due to Iron. Attached please find the laboratory certified parameter list. Approved _ (L' Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 /�.pFNAlZtf CERTIFICATE OF. ANALYSIS �O�C �ro Barnstable County Health Laboratory (M-MA009) Recipient: Sally Desmond Matrix: Water-Drinking Water Desmond Well Drilling Sampled: 08/04/2011 13:00 P 0 Box 2783 Received: 08/04/2011 16:00 Orleans, MA 02653 Collection Address: 595 Old Post Rd,Cotuit, MA Order#: G1164267 Sample Location: Description: Geotherm Lab ID: 1164267-01 Date Analyzed: 8/5/2011 @ 15:34 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: The recommended maximum contamination level for drinking water exceeded due to Coliform Bacteria.Tested negative for E.coli. Retesting is recommended. May present aesthetic problems(taste,odor,staining)due to Iron. EPA 524.2- Volatile Organics by GC/MS. Result MCL MDL Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Chloromethane ND 0.50 cis-1,3-Dichloropropene ND 0.50 Vinyl chloride ND 2.0 0.50 Dibromochloromethane ND 0.50 Bromomethane ND 0.50 Dibromomethane NO I 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Ethlbenzene ND 700 0.50 1,1,1-Trchloroethane ND 200 0.50 Hexachlorobutadiene ND 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Isopropylbenzene ND o.50 1,1,2-Trichloroethane ND 5.0 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethane ND 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloroethene ND 7.0 0.50 Naphthalene ND 0.50 1,1-Dichloropropene ND 0.50 n-Butylbenzene ND - 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Propylbenzene ND 0.50 1,2,3-Trichloropropane ND 0.50 p-Isopropyltoluene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 sec-Butylbenzene ND 0.50 1,2,4-Trimethylbenzene ND 0.50 Styrene ND 100 0.50 1,2-Dibromo-3-chloropropane ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dibromoethane(EDB) ND 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichlorobenzene ND 600 0.50 Toluene ND 1000 0.50 1,2-Dichloroethane ND 5.0 0.50 Total xylenes ND 10000 0.50 1,2-Dichloropropane ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3,5-Trimethylbenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichlorobenzene ND 0.56 Trichloroethene ND 5.0 0.50 1,3-Dichloropropane ND 0.50 ITrichlorofluoromethane ND 0.50 1,4-Dichlorobenzene ND 5.0 0.50 2,2-Dichloropropane ND 0.50 2-Chlorotoluene ND 0.50 4-Chlorotoluene ND 0.50 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Chloroform 0.55 80 0.50 Attached please find the laboratory certified parameter list. Approved B (Lab Director) NO=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 r ENVIROTECHLABORATORIES,INC. MA CERT. NO.:M-MA 063 8 Jan Sebastian Drive Unit 12 Sandwich,MA 02563 (508)888-6460 1-800-339-6460 FAX(508)888-6446 Client Name Desmond Well Drilling Location Law,595 Old Post Rd Address PO Box 2783 COW,Ma Orleans MA 02653 Sample Date 11/01/11 Collected By Client Sample Time 14:30 Sample Type well Date Received 11/02/11 Lab Order Number ow-113166 Well Specs 6"x 65'/42' Location Source Date Collected Time Collected7. Cointnents A 11/01/11 14:30. _ Analysis Requested Units Recommended Limits Analysis Result Method Date Analyzed Analyzed By Total Coliform /100m1 0 0 SM9222B 1 1/11201 1 RS Comments: ------__._.-------- --_----- ---- ----- ---------- Date RonaldlDi Labora I BRL=Below Reportable Limits 'See Attached Page 1 of 1 aCertication is not available for this analyte for non potable water samples.. rl Massachusetts Department of Environmental Protection Bureau of Resource Protection WELL DRILLER Please specify work performed: Address at well location: New Well Street Number: Street Name: (264 PARKER ROAD Please specify well type: Building Lot#: Assessor's Map#: Domestic 176 ---- Assessor's Lot#: ZIP Code: Number Of Wells: 1014 02668 City/Town: Well Location BARNSTABLE In public right-of-way: GPS North: West: 41.69632 170.36394 Subdivision/Property/Description: Mailing Address: r click here if same as well location address Property Owner: Street Number: Street Name: CAMERON 264 PARKER ROAD City/Town: State: Engineering Firm: IBARNSTABLE MASSACNUSETTS ZIP Code: 02668 Board of health permit obtained: Cl)Yes Cj Not Required Permit Number: Date Issued: 2011 016 9/6/2011 I i Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) i Well Driller - ;General Well''Form DRILLING METHOD Overburden Bedrock Auger —Choose Bedrock-- I WELL LOG OVERBURDEN LITHOLOGY From -To(ft) Code Color Comment Drop in Extra fast or slow Loss or addition of . - (ft) drill stem drill rate fluid F 20 Silty S ( Ye and Brown J . GI Fast GO Slow Loss 7co.— F20Addition --.--34 Fine To Coarse Sand Brown Yes r Fast r Slow Loss r Addition I WELL LOG BEDROCK LITHOLOGY — Visible Extra From Drop in Extra fast or slow Loss or addition of To(ft) Code Comment Rust Large (ft) drill stem drill rate fluid Staining Chips i - Choose Code 17 r Fast r Slow; r Loss Addition r Yes Ye ---- ADDITIONAL WELL INFORMATION Developed Yes C',No Disinfected t Yes r No! Total Well Depth 34 Depth to Bedrock I Fracture Surface Seal Type None ! Enhancement C Yes F No? CASING Fj Is Casing above ground? From: �— To: tV From To Type Thickness Diameter Driveshoe 0 30 (Polyvinyl Chloride (Schedule 40 (4� Yes t ---. I-..- r _ .. SCREEN ❑No Screen From To Type Slot Size Diameter 30 34 I Stainless Steel Well Point 0.012 WATER-BEARING ZONES I r DRY WELL From To + Yield (gpm) 3 PT7734 15 PERMANENT PUMP i(IF AVAILABLE) 2 Wire Constant Speed Pump Description Horsepower ff Submersible 1/2 I Pump Intake Depth(ft) 130 1 Nominal Pump Capacity(gpm) 110 i ANNULAR SEAL I FILTER PACK i l — Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program :..v Well Completion Reports(General) Water From To Material 1 Weight Material 2 Weight(gal) Batches Method Of Placement Choose Material Choose Material Choose One-- C -__ C C C u [ ----- ------ WELL TEST DATA Time Pumping Time To Date Method Yield (gpm) Pumped Level (ft Recover Recovery{ft (HH:MM) BGS) (HH:MM) BGS) 19/20/201.1 Constant Rate Pump 1�^ 1:00 23 0:01 .20 �_._ WATER LEVEL_ s Date Measured Static Depth BGS (ft) Flowing Rate (gpm) 9120/2011 20 I 15 COMMENTS S WELL DRILLERS STATEMENT This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report is complete a knowledge. Driller THOMASEDESMONDIII, Registration# Monitoring[M] Supervising Drill Firm I DESMOND WELL DRIW Rig Permit# 023 r Date Job Compl NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory (M-MA009) Report Prepared For: Report Dated:9/16/2011 P Sally Desmond Desmond Well Drilling Order NO.: G1165112 P O Box 2783 Orleans, MA 02653 Laboratory ID#: 1165112-01 Description: water-Dn4QglPater—. ��, . Sample#: Sample Location: 264 Parker Rd,West Ba erl Collected 9/14/2011 Collected by: Customer Received 9/14/2011 Routine ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen -0:14 `-mg/L 0A0 10 EPA 300.0 LAP 9/14/2011 Copper 0.018 mg/L 0.0030 1.3 EPA 200.7 LAP 9/16/2011 Iron 0.57 mg/L 0.010 0.3 EPA 200.7 •LAP 9/16/2011 pH 6.3 PH AT 25C NA 6.5-8.5 SM 4500-H-B LAP 9/14/2011 Sodium 25 mg/L 1.0 20 EPA 200.7 LAP 9/16/2011 Total Coliform Absent PIA 0 0 SM9223 AF 9/14/2011 Conductance 160 umohs/cm 2.0 EPA 120.1 DCB 9/14/2011 Sodium level is above the maximum contaminant level. Those on a low sodium diet may wish to consult a Physician. The water may present aesthetic problems(taste, odor,staining)due to Iron. Attached please find the laboratory certified parameter list. Approved B ( Manager) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 k Fk CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009 Recipient: Sally Desmond Matrix: Water-Drinking Water Desmond Well Drilling Sampled: 09/14/2011 12:00 P 0 Box 2783 Received: 09/14/2011 Orleans, MA 02653 Collection Address: 264 Parker Rd,West Barnstable Order#: G1165112 Sample Location: Description: R E Kit Lab ID: 1165112-01 Sample#: Date Analyzed: 9/14/2011 @ 9:23 Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Sodium level is above the maximum contaminant level. Those on a low sodium diet may wish to consult a Physician. The water may present aesthetic problems(taste,odor,staining)due to Iron. EPA 524.2- Volatile Organics by GC/MS Result MCL MDL Result MCL MDR Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 c7is-1,2-Dichloroethene ND 70 0.50 Chloromethane ND 0.50 ds-1,3-Dichloropropene ND 0.50 Vinyl chloride ND 2.0 0.50 Dibromochloromethane ND 0.50 Bromomethane ND 0.50 Dibromomethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Ethlbenzene ND 700 0.50 1,1,1-Trichloroethane ND 200 0.50 Hexachlorobutadiene ND 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Isopropylbenzene ND 0.50 1,1,2-Trichloroethane ND 5.0 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethane ND 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloroethene _ ND 7.0 0.50 Naphthalene ND 0.50 1,1-Dichloropropene ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Propylbenzene ND 0.50 1,2,3-Trichloropropane ND 0.50 p-Isopropyltoluene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 sec-Butylbenzene ND 0.50 1,2,4-Trimethylbenzene ND 0.50 Styrene ND 100 0.50 1,2-Dibromo-3-chloropropane ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dibromoethane(EDB) ND 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichlorobenzene ND 600 0.50 Toluene ND 1000 0.50 1,2-Dichloroethane ND 5.0 0.50 Total xylenes ND 10000 0.50 1,2-Dichloropropane ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 _.__-.1,3,5_Tnmethylbenzene. __._- ND-- 0.50 trans-1,3-Dichloropropene NU 0.50 1,3-Dichlorobenzene ND 0.50 Trichloroethene ND 5.0 0.50 1,3-Dichloropropane ND 0.50 Trichlorofluoromethane ND o'50 1,4-Dichlorobenzene ND 5.0 0.50 2,2-Dichloropropane ND 0.50 2-Chlorotoluene ND 0.50 4-Chlorotoluene ND 0.50 Benzene ND 5.0 0.50 Bromobenzene ND 0.50Rnv Bromochloromethane ND 0.50 ®� Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Chloroform 4.0 80 0.50 Attached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 i TOWN /OF BARNSTABLE LOCATION SSIS Q/p��CtS%.'�d SEWAGE#1O/O— YycS VILLAGE Co/;; ASSESSOR'S MAP&PARCEL QT` —0/6p INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /5-00 G&(- r � LEACHING FACILITY: (type) 600r0rrl.QAAmLeX4( (size) (3 Y,'U n -ao NO.OF BEDROOMS S_ OWNER O+C.- Gt41-IcT2. 514 / 1CA(X PERMIT DATE:J !a t S'a0(( COMPLIANCE DATE: 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 i O r �7 ve~t. Lf ado 16 6 _ai k7 .r r °+ No. Fee THE COMMONWEALTH OF MASSACHU ;:`' Entered in computer. PUBLIC HEALTH-DIVISION - TOWN OF BARNSTAo6L SACHUSETTS Yes Yication for iq og�� � � aY *pgtetn Congtructton Permit Application for a Permit to Construct( ) Repair( ) Upgrade(,�"Abandon O Complete System ❑Individual Components Location Address or Lot No.595 0%-k 96* Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Osy O� '7 Vwls +fie tQ 0 o b Installer's Na e,Addrq s-,and Tel.N(j.-, 50&0 y� De si ner's Name,Address and Tel.No. r.. c 1�C.ecZl l:s 541pv1 ��ii�.�o�(.rr OS(en.t,(T 't�•a•�°x 4 � _ Z �� V`� Type of Building: Dwelling No.of Bedrooms 'S Lot Size kQE sq. ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) G56 gpd Design flow provided 566 AA gpd Plan Date oVCMVAC *5 Z01& Number of sheets p , Revision Date Title Size of Septic Tank 1S-0 0 Type of S.A.S. 9-5100 (tw`. � Description o�Soil e� al02.. (3—Zt p Lpiy0!�n, Z4 At ��y��, ion 4�Z SAAu� Lght, n—Z.V' t3 LMEYE , jQj jk tgl►eny SAOC) 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 CoA pd not to place the system in operation until a Certificate of Compliance has been issued by this BoarqK Heal / o20I/ Sign Date Application Approved by , Date Application Disapproved by: Date for the following reasons Permit No. "` Date Issued -- —————— A No. 1 ' ,s� Fee f J THE COMMONVIIEALTH,Or- ASSACHU: Entered in computer PUBLIC HEALTAW)VISION - TOWN OF BARNSTABI SACHUSETTS Yes \ Zipprtcalt'ion for Migpool *p�tem C,on5.truction Permit Application for a Permit to Construct( ) Repair( ) Upgrade Abandon /p pg ( ( ) �Complete.System El Individual Components Location Address or Lot No:tJ S 0 �o�� Ivlllk Owner's Name,Address,and Tel.No. • n ��1�:�" ` t.?an�da t`,t.gv.Sr + .�,rr\ Y�'1��y V1��+"� Assessor's Map/Parcel r 4 W i1 °^"'(`E,e R�} Installer's Name,Addre s,and Tel.NQ._ G�u y�� Designer's Name,Address and Tel.No. I�C�C y0 IpF _ uclt .i teSS �Vu-�IZ`�`3-3y� Type of Building: Dwelling No.of Bedrooms �j Lot Size I k(Z� sq.ft. Garbage Grinder (/(lo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures r! Design Flow(min.required) r5 V gpd Design flow provided G gpd t Plan` Date Nov e rv\1?y '5, Z U I Number of sheets f Revision Date U 1 (l t* Title -Size of Septic Tank �'>o 0 Type of S.A.S. LI_QUO (r Description of Soil �P CC (z 9 o L 0—Z 0 L A%.,-I _.. 1 u'i c `t 11_ -5A/j;a)t (UAM 11- E � C J k. !s, l u-► 'I 717-is Z 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 Co•e d not to place the system in operation until a Certificate of Compliance has been issued by this Boar of Health? J ` a p// Sign /rA, �' Date v J Application Approved byCW/1,,7r _ /�', , �� Date Application Disapproved by: r Date for the following reasons Permit No. —' Date Issued \ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded (�} Abandoned( ')by ST10 fC�k, ,�A �� 4 at S q�- O�A. pa.-A uat has been constructed u a_ccordance a //�,j with they-rqvisions of Title 5 and the for Disposal System Construction Permit No. dated j Installer. '0f-U(C (6 I(,CG c� g `� if 1 f� � Designer_ � r�a� ��r7!li7C r #bedrooms Approved design flow gpd The issuance of this permit shhall not be c/onstrued as a guarantee that the system I1 cti a de igned. Date `-1�-9 Inspector �L�---^` t (--.. ——— -----j+;fY —.—t .r-��a��: rr---'— ' No../ ltJ ! / Fee t THE COMMONWEALTH OF MASSACHUSETTS '„4 PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS igpoml *pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( Abandon ,( ) System located at j �_ OLD �o5-' k Pr and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special condiLon Provided: Construction must be complete' within three years of the date s pa'L Date 51 Approved by Fawn of.Barnstable .. ' Regulatory Services . ices . g rY (Yl o &, t 61 c4p . . C. T�omas F. Geiier,Director a s.a. f:. � Public Health Division Ea Wit` Thomas McKean,Director 200 Main Street,Hyannis,INIA 02.601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification.Form Date: Designer: Sygw&ft (Qgb W%Sgr Installer: D m Address: Address: Vn or- l� 1 d was issued a permit to install.a (date) (installer} septic system at S-4 o Id VW7 based on-a desip.draw'n by (address) J A WC!C, w��ru z1 n.A dated ( l Z4 i l - (designer) 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: 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: �tv , Ply IZy�� r . o���F• 0� q s . s JOHN C 9�y o OCEA . N CIV rn (Installers Signature) Na 48168 90� AFC/ST E R0 ass/ANAL EN����� (De 'gner's Signature) , . (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTA.BLE PUBLIC HEALTH DIV_ISION. CERTIFICATE OF COINITLLANCE NVML NOT BE ISSUED UNTIL BOTH THIS FOIC AND AS- BUILT CARD ARE RECEIYED BY THE B_ARNST_4BLE PUBLIC HEALTH DIVISION. THANK YOU. ` Q:Health/Septic/Desigaer Cerdff a icn Form hi' f n » CStO /,� •, tt o WOY)Ro publi W 1� rb `� T,rna '}n �varlable N80.59'24"E 27 U JHand �!Ptr < Cove r. S� 14.63r 1 Y~}S Y 0 / / r r Pt _ VH oilers Beach r �. .6tu �f0 O 1 Of. Jz / N93p00 1 jc\ r Location Map 1 � —_2,000 f'. , I Assessors Ref.: I " Map 054, Parcel. 016 V. Lo ' Overlay District: . I AP — Aquifer Protection .District ;o 0 Flood Zone: Zones C & V11(EI9) 37.70 ° Community Panel No. —_- #250001 0018 D N '4 July 2, 1992 30.41 — 16.56•.- r I W - one. LO RF-1 z I Area (min.) 87;1.20 SF (RPOD) ...... i c Frontage (min) 150' � Width (min) no o Setbacks: Fron t 30' ' i Side 15 -- ILL- F�roposed Garage f.............. See Variance # 2010-0 1 (DB 246211125) z , .015 I a, a \\ Propose_ — d- v ` yo ``, N\ N it- Septic System .Proposed a �a. r\� (Approved) d rid �.�► �. Addition N ' N 8 RIHE�RE .oa Ux Co N e �a Nil. 343 18.6 �zss .r #595 4h'OIgS�P$J� 2sty W o p� Dwelling µ N 8" K Note: Fnd 1.) The structures shown were located on the . �'."•... _ ground by conventional survey i ethods .6n. (or between) 14/DEC/10 & 13/JAN/11. J Top Of Bonk As Located By Sullivan Engineering Inc. 2.) The property line information shown hereon was • � - -- (see BCC DA-10002) MA/ compiled from available . record information. —VII(EL9) 3.) The topographic information shown is from a plan prepared by Field Resources Inc. dated April / FEMA•Zone Line 16, 2010. i (as per.FIRM) 4.) The- datum used is assumed. Prepared For: / J Cotuit Bay Donald F. Law, Jr. & Sara Molyneaux sheet # Title: Plan Showing Proposed Dwg # CapeSury C,343-2q 1 Addition and Garage 1 Scale nn 7 Parker Rood UV of / osterville MA 02655 At 595 Old Post Road 1"=40' Date (508)420-399c pe08)42@Ocopecod.net BARNSTABLE (cotuit) MASS. 181JAN/11 Pub'C OCUs� fi� 3 public W 6 IW�dth Ro OL ableI �VOrj N80 59 2 63 1 z � Handy rF't,y 14. R 3 16 —Be.^EN 015Y ¢3z„ Q 3 000. PI II Put(ja X. zz Location Map , I Assessors Ref. : j h Map 054, Parcel 016 10 • � I 2 Overlay District: I AP — Aquifer Protection District 3 p �o Flood Zone: Zones C & V11(E19) 37.70• Community Panel No. #250001 0018 D N _ _ 751 July 2, 1992 4 ' I Z. 30.41 �p • � VVV I Zone. I � RF-1 z j Area (min.) 87:120 SF (RPOD) o z I Frontage (min) 150 a I Width (min) no Setbacks: I � Front 30' 5, a .,.,<..,.._.. � Rear 11 5 Proposed _o �k Ir- r Sep Vurinnce ,� 201 G—O i 1 /D8 24621 j 125` Garageco o r'01, 15 �� — t Proposed—— U �0 2\ 'N Septic System Proposed �° k° \�� (Approved) Addition s• RICHARD R• /� 6.00 UHEUREUX / NO. 34312 0 a \ a #595 � o�J Q18TE,a�O 1s.s' z6s 2 sty w/f a ..Dwelling N 4 a•'w 30,41'— .b `t _ j•j Y^ C6AH ti f Fnd1.) The structures shown were located on the ground by conventional survey methods on (or between) 14/DEC/10 & 13/JAN/11. Top Of Bank w� As Located By 2.) The property line information. shown 'hereon was Sullivan Engineering Inc. (see BCC DA-10002) ,�MA� compiled from available record information. --V-11 3.) The topographic information shown is from a / plan prepared by Field Resources Inc. dated April FEMA Zone Line 16, 2010. L 1,^� (as per FIRM) l 1 '�'`� �-- 4.) The datum used is assumed. Prepare or: Cotuit Say Donald F. Law, Jr. & Sara Molyneaux Sheet # Title: Plan Showing Proposed D c3#43_2 1 CapeSury.: R, Addition and Garage scope— ,, 7 Parker Road 1 -40 1 of 1 osterville MA 02655 At 595 Old Post Road Date (508)420-3994 pesurv@copec 5 fax BARNSTABLE (cotuit) MASS. copesurvC�copecod.net 18/JAN/1 9 !';I.I I ! 1 ii I `1i111:l•lil 'I ! !I I;l ii `I,�III' 'r!!II,'�• ,!1 I•i,,il!!t" i �I - I I'I I . III I I (1 !! II, Il! � I!' � � � � i :I j� IIi I I III:• i'''I'IiIII !''lll;,'� ( Ilil i i ill, l I�i I hi.l�,l lid II ' .II I 'll !jl� , II'I� 'll' lili li�!II :III !I � ►� r�l. � , - _ ,!.I i III. I ; ; II !.II � !�� I�, I ;I �` I'_ ------ i i --_ � ;III �, li�il� I�I�'i►�� I I�' ! � • jl ,I!i � II I 1 _ - =�. x - '�' •i IIII iI�I�IIIII !� i rs6,,OOH — - .7" - T I- '�;, 11 Till I I• — --_ � =�.—..--:- I 'i, I�� -=— --,;��' !I hI - II; - �'�' ' ;ill i I,;I II i,i II; l - � ill il.!II I f li; I i�li;1 ►' Pi34 0 1� s�caN0 1=!_oaf ' p� N = sc �M� 4f3, if • :Ilii; I 'I � ' I !I ii , 1 I,, illl,l I`I; ".I lil I it :! ,'• • illl i; I I 'jl�;l I' ' it �,;.i ,iI' - ;; ! .III I + IIlil I ill'I;iI;il, llllll .Ues/I C�/oa `a!"- zoosl-; !)l !: it I � Ill! I I !i I(• l l' I II; f I I ( ! I I I li III SEP02M _aw.ResWeja -_. _-525 n1c�PcictPcia Road _cSzluit,j ksachuseff 0 -635 �f..J��tree_t-- p fT �_QQ6�,,,. k......-JJiuicdllgip-.SkettonSmith-Ine-AichitwAs- .�stnn,_....M$ssachusett'r. TAephne• 17-� v a r • . �nos o.9� r ——— 7 x — I I --1 - _S17T I NCT mool.:j_ - - -• < IcJt. A'`I C „ r -" . --------I L-------J L------ --.._ ---- 1 r— --1 r-- — gw- -- --I L. J L--'. a } — �-- L ------J .L--_I--- I L----_�J I NP •.�YruiRc .' ' - i ( -----1.1`'�--�--1 r----- �� Jr:�•AIIE N4L-L- � �,, �+:riJi d' 7. T I ————— I r' ac I ( I �_Y —NCH&N ell PiTRY Mm I ' �. topoS.1=D ... �Irz5? �1-ootz P�.oN — .6u�� le. hQ o SEP 022009 Tl'�g�Skelt�►n Smith-- i.,r Arc���r�tc. -- __.- ... ... _ _. - _ _ : T • cea�1incetic 026�5 � .cl e;.fd 2-221_2Q62.... W '� "� . . . . . ZONE: RF d DESIGN DATA SEPTIC NOTES Area (min.) 87,120 SF (RPOD) �x Single Family 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours Frontage (min) 150' . . . . . . -5 Bedroom 110 GPD Width (min) -- •a fit ' @ Prior to Any Excavation For This Project the Contractor Shall Make No Garbage Grinder the Required Notification to Dig Safe(1-888-344-7233). Setbacks: Total Daily Flow=550 GPD 2.The Contractor is Required to Secure Appropriate Permits From Town Fron t 30' �' & Use a 1500 Gal Septic Tank Side 15' ep� Agencies For Construction Defined by This Plan. 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall Rear 15' OLEACHING AREA Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to i p�sa, 550 GPD/0.74(LTAR)=743 SF Required Assure Watertightness. In General,Water Lines Shall be Constructed inCoordination With rd With 248 CMR OU o 0&it a310 CM and R 15.00.be Accordance " Sidewall=2(12'-lU"+42')2'=219sF OVERLAY DISTRICT. :�� Bottom Area=(12'-10"x 42)=539 SFa € f 4.A Minimum of 9"of cover is Required for All Components. AP - Aquifer Protection District Xg 758 SF Total Provided 5.All Structures Buried Three Feet or More or Subject RPOD - Resource Protection Overlay District war h } LEACHING CHA�/IBER DESIGN to Vehicular Traffic to be H-20 Loading.It is the Engineer's Estuarine Watershed O Recommendation that H-20 Always be Used All Pipes to be Schedule 40. Use 6.Install Watertight Risers and Covers to Within 6"of Finished Grade 4-500 Gal.Leaching Chambers in a Over Septic Tank Inlet and Outlet,D-Box,and One Leaching Chamber. FLOOD ZONE. IT-10"x 42'Washed Stone Field as Shown. 7.Septic System to be Installed in Accordance With 310 CMR 15.00& LOCATION MAP N 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable Zone V 11 (El. 9) & C N 00 Board of Health Regulations. Community Panel No. 1"=2,000f' 00 cc 8.All Piping to be Sch.40 PVC. #250001 0018 D 1 O , 00 9.D-Box Shall Have a Minimum Inside Dimension of 12",and a Minimum July 2, 1992 ASSESSORS REF: II 00 A S-B 10.The Separation UILT TIES sump6". Map 054, Parcel 016 � J arration Distance Between the Septic Tank Inlet and 4 A B Outlet Shall be No Less than the Liquid Depth.An Inlet Tes Shall Extend 1 18'-0" 41'-0" a Minimum of 10"Below the Flow Line.An Outlet Tee Shall Extend 14" 2 15'-6" 47'-0" Below the Flow Line,and Shall be Equiped With a Gas Baffle. 3 26'-6" 57'-6" N PERC TEST: 12,902 4 31'-6" 38'-0" Q3s + 5 38'-6" 62'-6" 4 9 QQ,+ PERFORMED BY:JOHN O DEA,PE- SULLIVAN ENGINEERING S6 s8+ F SOIL EVALUATOR NO.2911 WITNESSED BY:DAVID STANTON,R.S.-TOWN OF BARNSTABLE APRIL 23,2010 F • � c r/Sf/�9 TEST HOLE- I TEST HOLE-2 oge AROp ;; EL.104.0 EL.104.0 SO S 9 F S O �,... 103.8 :•::•::;>:•:;>";:; i:;tk 3 tk :lfil'R?l%2`t ::::•'.•:i:`.:`. ;a::':: ......i :: R: 7 t'. ::: :•'.•...... ,.,,.., ;: s;:•;:•:;;:;•.:.;:.;:•.:::.::.:::.:::.:•:::::::::.::::•:;:•::•. .;;•::::::::.: :•:•::••::::...;;..._..;.......;.....;............. p F1i ::•::::•::•::•::•:•:iIAR3S•t3RAYISM•BR(kWN:•:::...........: :> t...............? 0 G•�"at i # A : .. . ... . ...•:.........:...:.:.:.:. 11" •:::•::•:;•a•>:•::•;:<;•::•::•:;•: Sr4 •1,tit?t16I::;::•:::•::•::•:::•::•::•::•::•103.1 I1" ......................s : :: :'.: : : `.....!!�•s......•::•::•.........::•:::•103.1 q �e0 FO F RF O�i�e 9 • • > O ....;:>: : s r f�L E.... . .. ; : ............................................ ?' :.::: :A ........................................................ t . Q �jg, PR A 25 .......................... }tlk�'f�2li;.`i:::; f 101.9 26 .... 101.8 ........ . 3S + OPOSEO qS ti ROA C LAYER 2.SY 6/4 2.5Y 0/4 91 ORf S / ^ 5 �+ �q OSF LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN Q F q S TR 132" MED.SAND 193.0 MED.SAND -Finish Grade ^' s , NO GROUNDWATER ENCOUNTERED 43" PERC TEST 100.4 25 GALLONS IN 6 MIN.30 SEC. 3' Max. "Fz '' I I :a ?w I I �'\ ,�Cb Q s O. U/� •. . ® �\� 120" PERC RATE<2 MINAN(LTAR=0.74) 94.0 9" Min Compacted Fill Filter [� J J2, e°.� 2 NO GROUNDWATER ENCOUNTERED Fabric .� F And/Or 2„ 118„ - 112" cbh SITE PASSED s a Pea Stone \ M SFp0o H-20 3/4" - 1 112" G T9N41) LEACHING Double Washed TqN� - 100 CHAMBER. Stone 4' - 10'�i �; �`�� V' o��o`' 50' ( 12'-10" A CO3�� O lO ✓T gRop° oR�,M CROSS SECTION OF CHAMBER OO/�SFO OHO cA =O o 0 Cn I NOT TO SCALE }�'-`1y o I I _ Q I I � (SEE NOTE 3) See Note 6 (typ.) F r rr o: a Ir I F.G. EL. 104.00 I I G. EL. 103. I I I I POSED rl I I rl Flow Equilizers EL.RD102.75 f As Required �,.. ._,.OPOSEp Installer To TonAny Work firm EL. 1 1. 1500-201on EL. 101.50 EL. H-20 L. 101.00 WPROR1vE o��0� A ' I Septic Tank D-Box EL. 100.18 p �oe0� ( 1 r EL. 100.00 �, H-20 Leaching I I To Be Installed On r Chamber (n m~ ✓ \ 1CV Ufa a ompac a ase 0 - I ► I Beddin Ts, 1 1 I m g•" " .\ I Inspection Port 1f: rieeiuiattl?h�p�rfdt :iPe?;f2 '`'lac ;: P .... .. .... .. .... p.......... �n r & Baffels4(:?:iristartalsi .`Sol,1s: itfi{i: .•: a: :;i: as Per Title 5 i1a Outer P �nrsker of ti'e :S sts?: 1 i I l .t Et. 93.0 - TH-1 DEVELOPED PROFILE F EL. 62 v 8 -cb I OO O S Estimated High Groundwater Per T.O.B. Groundwater Maps h NOT TO SCALE �P� gOti F `� N JO C. o3s9' As Built Septic DATE 07128111 LD o• 68Cn 00''F Ir 11 1 / Add Additions & °� cISTE�``� ``Q Associated Property Line Adjustments DATE: 01124111 °FF sloaaL��'��� Eliminate Additions & ; l REVISION: Associated Property Line Adjustments DATE: 11104110 I f 1 TITLE: Site Plan PREPARED BY. PREPARED FOR: NOTES Donald F. Law Jr. 1.) The intent of this plan is for the permitting Proposed Septic Upgrade Sullivan Engineering, Inc. of a septic upgrade only. _ w PO Box 659 & Sara Mol neaux r t Osterville, MA 02655 'y 2.) For property line, topographic, and property y G G p (508)428-3344 (50A)40265 7 fax 7 Wilsondale Street line relocation information see plans by J9�J Old Post Road Field Resources Inc. Land Surveyors Dover, MA 020.30 Auburn & Needham, MA. �..�. Barnstable (Cotuit) , Mass. 3.) The datum used is assumed. INSTALLER MUST � Draft: SOD 20 0 10 20 40 80 CONTACT ENGINEER PRIOR TO INSTALLATION DATE: SCALE: Review: PS TO VERIFY BENCH MARK & ELEVATIONS. November 3, 2010 1" = 20' Project: 98148