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LOCATION SEWD,C�E PERMIT O.
VILLAGE- - — — — - - - - � >e
IWSTNLLER�S 1 &L AE.. ADDRESS
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BUILDER 5 Q &MF- �- ADDRESS
--DATE--PERMIT -15SUED
- -D AT-E COMPLIAMCE_ -ISSUED : - -
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LOCATION SEW&,C E PERMIT UO,
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DATE-P-ER"17 1.55UED_-
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No: .......... Fa$..' .....................
THE COMMONWEALTH OF MASSACHUSETTS
B®AR.D. HEALTH
..... - --- --.OF........ .......................
h Appliration -for Uttipwial Works Tomitrurtion Vamit
Application is hereby made for a Permit to Construct (4 ) or Repair ( ) an Individual Sewage Disposal
System at:
Loc tion- ddress or Lot No.
eT,f�.. 11 '!9c� a / : 5...........................
Owner Addre
,1
Installer Address
Type of Building Size Lot----------------------------Sq. feet
^ Dwelling�FVO. of Bedrooms._.--_--_. -EY Expansion Attic � Garbage Grinder
P ( Q1 g ( )
a, Other—Type of Building ............................ No. of persons-------5.._-____----___- Showers (f ) — Cafeteria ( )
a' Other fixtures _..X v$S -- f 111 .rL l('_------3--T L�__X-----------------------_
W Design Flow.._...._...i ._�?........................gallons per person per day. Total daily flow_--_-__-_____ _� gallons.
USeptic Tank—Liquid capacity-%DOO-gallons Length................ Width_... ---------- Diameter__.___...__._-._ Depth_.-_.___.-._.
Disposal Trench—No. .J40.0....__. Width-------------------- Total Length-------------------- Total-leaching area..-.-_.---_-.__-----sq. ft.
Seepage Pit No--------------------- Diameter-------------------- Depth below ' let of eachin tre:....................sq. ft.
tit ...
Z Other Distribution box ( ) Dosing tank ( ) �p YG •- a _J �
Percolation Test Results Performed by._44-_"._Jav___ ___________________________________
Test Pit No. 1.....2r------minutes per inch Depth of Test Pit....e_.�-_!21_j. Depth to ground water_A.20AJ.�......
f1 Test Pit No. 2................tninutes per inch Depth of Test Pit.................... Depth to ground water--..-._-_-_--_-----_....
P4 -------------------------------�--------- -•....__...._--------------..........------------•-----..........................................................
0 Description of Soil----TLZ.tO_-�d!_1.......6_.. -.._...r/.&.4...
M�Q/G! Q------.-.
V ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
W ----------------------- ----=------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------
UNature of Repairs or Alterations—Answer when applicable-------------------------------------------------------------------------------------------
---------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not-*4o place the system in
operation until a Certificate of Compliance has been issued b the
,.board of health.
Sign
Date
Application Approved By.. -- --- ----------
Date
Application Disapproved for the following reasons:.... ......•-•---------------••----••------------------....------------_---
.............••------•----------•--......-•--•----------------••-............... .._..-----••---_.-:z.---••--------•--•----•--•---•---•---------_---•-•----•-------------------------------•-------
nate
PermitNo......................................................... Issued-------?,:It. ---- ...................
Date
r
No -••2`...-G----
THE COMMONWEALTH OF MASSACHUSETTS
BOARDHEALTH
�z
Appliratiun -for Biipufittl Works C omitrurtion Prruift
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at:
......'..............,..}............. ..--....T_........... .r'�' .�.._ '}
Q%� ��rC U l� ocatici � c�ss s f�N/1/ C(�/v� ` forot No.
----•-----------------------•------...... ------------------------------------------
W � ti.ti g I�"I /pl c y �. c� l=A.Wa,;?r7-777^r—------------------------------
--•---------------------------••-------••-------------•--- --....... ................ ---- • -------•---•-•--•------------------
CAInsta er /C'f'`i/ 0 S AP r'V K�' /�/�Ci i�A d es .
Type of Bulldingj Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms......... ................................Expansion Attic 40 ) Garbage Grinder ( )
aOther—` rype of Building __.---__._-.---______________ No. of persons..---,--------------------- Showers Cafeteria ( )
d Ott-ier fixtures _.. -------------- -------- -- -
d a / )/✓/ /i FS' / / _r/y-:h-------- ---�t-- ----_f�---------------------------
W Design Flow_____________ ___________________________gallons peKperson per day. dtal daily {iow .......__._..__(/...................gallons.
WSeptic Tank—Liquid capacity_-j-000-gallons Length................ Width.........------- Diameter................ Depth_----___.-._.
x Disposal Trench—No. ____ oclo__._-- Width___________________ Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No--------------------- Diameter____________________ Depth belo� ile C, .:G a9hinVrjtva---._..__---____-sq. fI.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by, {_��/f�.__ .,���---•---------------------------•___----- D &e,L __�....6_7 ........
Test -____-__-minutes per in h Depth of "Pest Pit,K_ _� ._'_._.. Depth to ground wateX.C).,'J_P_-----
._._Pit No. 1--,.
fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-•._---._--_--_--___.._.
a ----------------------------••-----------------------------------••-•------•----•-----••._.......----.....................................................
xDescription of Soil =1 u �=u i L------ `' Ft✓ t ear G l E j�'� !1�' Stl/Q-------------
V ------------------------------------------------------------------•--------------------------------------------------------------------------------------------
W
VNature of Repairs or Alterations—Answer when applicable..----------------------------------------------------------------------------------------------
---------------------------------------------- -----•------------•------••----------•-•----------------------------------------------------------•--------------------------------------------•--------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Sign ---- --- ------• ..........................................
W _C/ L-Dat� J
Application Approved By--------•-//•- 2 f-
•.---------• ��� � /7
Date
Application Disapproved for 11he following reasons------------------•----•----------------•-------•-------------------••- •-----••-•-•-•-------•--•------•-•----•--
-•................•-------•-•--•---------------------------------------•---•--------------------•--------..------------........------------.•---------._....._....---------------..........--------------
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF`/ HEALTH
IVETrrtifirate of (.11lampliatta
THIS IS TO�ERTIFY, That Pie Individual Sewage Disposal System constructed (,<or Repaired ( )
by.............................. .. = ' "—------- .... _-..............=............................................................................
Installer // }Q
at......... � '� ------... �j = f l/_tom ......................................-/ 7
has been installed in accordance with the provisions of Ar I �T)i�State Sanitary Co jc e -jes�e7�in the
application for Disposal Works Construction Permit No------------------..........:...................... dated-.......... ..______.._....__..._..........._....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............................................................................... Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OFF HEALTH lei
s
2 ` ..........
No......................... FEE........................
Binvofia larks QIonVrurtion Prrmit
Permission is hereby granted------------
!tom I- _ =`�=`�,�._..��p• =`_' 't-
to Construct (✓) or Repair ( an Individ 1 Sewage Dii,osal System
A. Ore, ------------------------------------------------
treet
as shown on the application for Disposal Works Construction e it p^; -------- Dated--------------------------------------•-•-
--•---------------- L----- •--------------------------...-
� th
DATE------. .._l.l��-5----,-------------------• Board of
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINALS)
I M ^C&L
DATA
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No.—-- -- -= ------ Fee---- ---------
BOARD OF HEALTH
TOWN OF BARNSTABLE
0[ppYicatioujorlVerr Cootructioupertuit
e. c_ - D Q_
Application is hereby made for a permit to Cons uct ( ), Alter ( ), or gepair (vTan individual Well at:
Lo ion — Address �°®�(,L Assessors Map and Parcel
----------- --------------------------------------------------------------------------- ----
- ------------
O//wner / Address
Installer — Driller Address
Type of Building
Dwelling---------------------------------------------------------=---
Other - Type of Building ---------- No. of Persons-------'-----------------------------------
Typeof Well----?--" ------.------------------------- Capacity-------------------------------------------------———-----
Purpose of Well---W0.d-e-Y'L N- -----
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 ComnJiance has been issued by the Board of Health.
At
a sa ___2 -i�/�-9------
Signed��?ti?��'-----------------------------------------
r
date
Application Approved B
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 X/), Altered ( ), or Repaired ( )
bY------ r ----------------------------------------------- _-- -----------------------------------------------------
Installer
�j - --------- — -- ---- -----
at--_-l/—.rj-----�-��r��'&si�__ -�1'--�—'�-�-----�17�G/f�(_�_------------------------ ----
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. Dated---1/ {Q{ g---
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----—--------------------- ------------------------------ Inspector----------------------------------------- --— --- -
`>N `-'' ------ Fee— 2 _—-
BOARD OF HEALTH
TOWN OF BARNSTABLE
Zippritation—*rVell eouotruttioriPermit
{
Application hereby made for a permit to Construct ( ), Alter ( ), or Repair�(selan individual Well at:
--- -- - - -
1Loc�tion — AAddress �(,{,j " n� Assessors Map and Parcel
f ♦ _Ce+•1 • 1 (-f _�, ` , .aa .1:p. �.e>..H �4... ..:Yk ,... ____y —_—_ —_--__•_••___•_•___—___—___---------
_— ______----------
Owner Address
Installer — Driller Address
Type of Building
Dwelling-------- ----- --- - *
Other - Type of Building-----______________—__________ No. of Persons-------
T e of Well -------------------- Capacity
Purpose of Well--- aAlr"1- -----� )L4L"_-V1
� Y
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 Compl'ance has been issued by the Board of Health.
Si ned'/).Fir"- �G��,v.r�
date
Application Approved By----- ------------- ------ ------ --
date
Application Disapproved for the following reasons:---- -- ------ -- -------
------------- ----------------------------------------------— — date
Permit No. L«v— Issued-__ - --- —----—---- --__— -_—
date ,
6 �
* BOARD OF HEALTH
TOWN , OF BARNSTABLE
Certificate Of Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed()(1, Altered ( ), or Repaired ( )
Installer
at—--2 z -0k r - — D ------------------------------------------------- ------- -----—
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. -- IA2E l__Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUEDAS-A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----------------------------------------------------------- -- - Inspector--------- --- -- --— - - --
BOARD OF HEALTH
y., TOWN OF BARNSTABLE
Melt Coustruct ion permit
No.lj)X y=- ------ Fee - ---
}}�� ✓� Y�r . /ems) �e �<'! �'
Permission is hereby granted=!J �^ ���� P �� -- 2l �---�- —� ---
to Construct (,�6, Alter ( ), or Repair ( ) an Individual Well at:
No. Q k(�e_s ti�i 4), u``' --------------------------------------------------
r✓ Street
as shown on the application for a Well Construction Permit
No.---------------- ----=_-------------------- Dated----
Board of Health
DATE —�Y � - --------------------------------
LOT 25
S 64'21 '25"E i/ \
0 26 r ,�
40
G9.+
I
3
i� LOT 26
h 48, 700 S.F. se�►_ m p o
I W O �p ' rJ L,
I 81 PROPOSED 1$ (4 Q
GARAGE . I$ 60 t y k
is.00
28{ PROPOSED
MELL
3,9 7'-''
64'21 '25'W
_ ':LOT 26
(VACANT).
\ O DENOTES LEACHING FACILITY
\ PLOT PLAN OF LAND
'TO THE BEST OF MY KNOWLEDGE, THE BUILDING LOCA TED IN
SHOWN ON THIS PLAN IS AS IT ACTUALLY EXISTS .=1t1 BARNS TABL E-CO TUI T-MA SS.
ON THE GROUND.
r D�vIU PREPARED .FOR
OA TE.• JUN
t v'
• E 7, 1989
CHA -. KE VIN MA L L O Y
SANICRI CKI NI
28085
r>�`� f�c -�,:. s� -c. l _ R.L..S. pf C� DATE.'✓UNE 7, 1989 SCALE.' 1'�50 FT.
Sl.E��p
FLOOD ZONE C (NON—HAZARD) ��t—It LAND'— . CAPE 6 ISLANDS SURVEYING
r D-30w FALMOUTH — MASS.
i•
��1)it(itit�ilt(iii"tt"atin!��tlilittitititi;iiittittt8ttitiititittttli�tittttifiitttittiititititititttttltttttiilitiitiiiiittit►ititiitiiitittiititiitititittitiititittittttittttittiittilt((ttiltitiittliiittitittitlilfittit?itttttttiTit/ir, ,
Y`
ENVIROTECH LABORATORIES
449 Route 130 Sandwich, MA 02563 • (508) 888-6460 --�.
;
CLIENT: Ken Malby LOCATION: 225 Oxford Dr.
ADDRESS: P.O. Box 1014 Cotuit, MA
Cotuit. MA 02635
COLLECTED BY: D.A. Scannell SAMPLE DATE: 11/9/89 TIME: 12:00 _
DATE RECEIVED: 11 10 89 SAMPLE ID: BC 271 Al
JOB #: WELL DEPTH: 5$' —
RESULTS OF ANALYSIS: `
Parameter Units ' Recommended limit Result
Coliform.bacteria/100 ml (MF Method) 0 0
pH pH units 6.0-8.5 —
6.00 —
Conductance umhos/cm 500 91
Hi
Sodium mg/L 20.0
9.2
Nitrate-N mg/L 10.0
0.38 _
Iron mg/L. 0.3
0.60
Manganese mg/L 0.05
Hardness mg/L as CaCO 3 500
Sulfate
mg/L 250
Potassium mg/L 20.0
Alkalinity mg/L 200
Chloride mg/L 25
Turbidity NTU 5.0
Color APC units 15.0
Background bacteria
z COMMENT: Iron level is not a health hazard. '
E. YES NO WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS ESTED.
X)a ❑
DATE —
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