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Home My WebLink About0435 POPONESSETT ROAD - Health 435 Poponessett Road _ Cotut M A = 019 .003 I! —,J ill i a, I. j - ----- No. --------- � Fee--------- ----- BOARD OF HEALTH #�,b TOWN OF BARNSTABLE rication rVell Construction A3rrmtt 00 P OD--3 Application is hereby made fgr a permit to Construct ( ), Alter ( ), or Repair (14an individual Well at: ,93S �1w Location — Address _ Assessors Malf and Parcel ^� =`rs C / u hd / —.L S--00 i`r SS e b/i,I I --- Owner Address Installer — Driller Address Type of Building Dwelling Other - Type of Building—= ------ No. of Persons------------_.----______ Type of Well Y __ Capacity----------------------- Purpose of Well--20n6es tk_—_-- 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 Certifica e o Compliance has been issued by the Board of Health. / c '� 3l u L Signe �----- — — --------- date Application Approved By ------- ----- date Application Disapproved for the following reasons: ----_--_-- --------- ----- date Permit No. __ Issued----------------------------- ----------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certifitate ®f (Compliance THIS IS TO CERTIFY, at the Individual Well Constructed ( ), Altered ( ), or Repaired (✓j ,/0' ---- - /- -- v��C�wfnt 4- Installer ___----------------------------- ------------ ----- Installer Y3S. PoPP --vSs C 7{ I?j . ( LAX 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---- ------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-- __ Inspector----------------.—__----_—_______-- ---- } rMJ1,`///1/ � _ V /��1(\/� Gv _ �r sue- No. Fee_ _______ ` l i BOARD OF HEALTH 'TOWN OF BARNSTABLE Applicat forVell Con5truction ermit 00 r 00-3 Application is hereby made f r a permit to Construct ( ), Alter ( ), or Repair (t-jan individual Well at: /3S Fo M^ Location — Address Assessors a�cel --- jA IS C �.� �� - -- Yam'S Po0'/'o �S Owner / Address — �A SCE • c%c _'dig``—/ Z�-_ eox �6G /u&S emu' Nta aJ C"'q Installer — Driller —�— Address Type of Building Dwelling Other - Type of Building---- -------- No. of Persons-----------------------____ Type of Well ---- Ca acit Purpose of Well o'Ars be Q. 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 o�, Compliance has been issued by the Board of Health. uU�ZJ l�l U Signe _— __— _7 ,_ —_--- --____-- date Application Approved By ------ -- ---- 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, at the Individual Well Constructed ( ), Altered ( ), or Repaired (t-j by--- ---- --------- -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. -----------Dated-------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- ------- -- -- Inspector-------_-______- -- --------___-- BOARD OF HEALTH TOWN OF BARNSTABLE AVerf Congtruct ion Permit No. ---- ---- Fee---r-- _ Permission is hereby granted A SCG dIJAJC to Construct ( ), Alter ( ), or Repair ( � an Individual Well at: No. ��S. !�'y✓C vvs S'. ✓1tJ• --------------------------------- Street as sho o t e ap li tion f r r Construction Permit No.- Da —ted - -- - - ------------------- -�— -= ---------------------- Board of/f-lealth DATE — £ 77 74 LOC&TI SEWar-4E PERMIT MO. Y35- i Q - - - - - VILLAGE — — — — — IW5T&LL R.5 MWE ADDRESS BUIL.DP-0 5 W l MF- ADDRESS DQTE PERMIT 155UED -'1/_"'1 D ATE COMPLI &MCE ISSUED ., — _ �d w�� G 6 i�d �� z �- �� s �� 4 r- 7 7 Z/ .,. r THE C''OMMONWEALTH OF MASSACHUSETTS (� �Q BOARD OF HEALTH ...........................t Appliration -for 43iiposttl Works Tonstrurtiou PPrutitZDisposal Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewb System at: a.... V.I.".................. .............. ......................................... Location.Address or Lot No. .AM �� Owner Address L--------------------------------------------•---------- --.............................................................................................. Installer Address Type of Building/ Size Lot_._Z®.�. . .-Sq. feet V Dwelling No. of Bedrooms----->___...____(_ 91/ �.......Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity_t56tVallons Length................ Width................ Diameter_............... Depth---------------- x Disposal Trench—No- ____________________ Width..._ i.......-..---_-_ Total Length........_........... Total leaching area....................sq. ft. Seepage Pit No..... _________ Diameter.... ------------ Depth below jj'nlet.. ...__. Total leaching area-__--_-.-.-__--sq. ft. Z Other Distribution box ( Dosing tank ( ) ®JCL- �G �.1 •: Percolation Test Results Performed by--------- ---------------------------------------------------------------- Date-..-----------------------------------.. w Test Pit No. 1________________minutes per inch Depth of Test Pit-------------------- Depth to ground water..-.-.-------.-.--.----- f14 ,Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--.--.--.__-.--..---.._. 9 ----------------------------•-••---------•--•-------------•-•-•-•--.-....-..-...--•-•-•------.-.---....------•--------•-------------------------•-----..---- O Description of Soil----&I.L40C --- � �'i�� /� -------- ----------------Y. W p x �b " 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the health. S. ► �� J� ----- •--•----•-----••---••-•-----••----------•------• ----------------•---------..-.-- •' Application Approved By------- .��`'------ ---- --------•----��-------- .......................... 7�. ----- 7 Date Application Disapproved for the following reasons---------------------- Date PermitNo......................................................... Issued........................................................ Date T7= 5 7 N -••----•,-- Fas......,� ................. THE C6MMONWEALTH OF MASSACHUSETTS BOARD OF HEALtH" , _ YQw.N---OF...... :�4tZ.y.r,.T...,.L..i .L. Appliratiuu -fur Bi.ipuiittl Vorks (�utt�#rurttutt rr tit Application is hereb made for a Permit tConstru or Re'air an Individual Sewage Disposal PP y x O P (' ) a P System at .......................... ............................................................. -----------------------••--••--••-••. •••••-•••---•••---•-•-•-•----------------------.._--- Location.Address or Lot No. �. • Gil v tvi L I..1 I e-"Aa t—= �I.De-.-• . 1*,1 r;_..._...: =........................'-•--•--•---•---------.......-...----•-----••_.-.•-...................... ------............- ...._.._ Owner 3 Address ----------------------------------- Installer Address Type of Building Size Lot..7__�_7.�._Z-..Sq. feet 4 g— ..................................Expansion Attic ( ) Garbage Grinder ( �` Dwellin No. of Bedrooms..___ ...._.., _. Other—Type of Building ....................`.... No. of persons............................ Showers ( ) — Cafeteria ( ) A' Other fixtures W Design Flow.............................................gallons per --_,on per day. Total daily flow............................................gallons. Septic Tank—Liquid capacitv_A_$n�gallons Lena .'�............... Width..__.......---- Diameter----------- .... Depth...------_------ xDisposal Trench—, No. .................... Width____.-..._.__--.___ Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No-___--Z-___---`--�-- Diameter__-_l'?_-_____._-- Depth below inlet____________________ Total leaching area--.-.-__-.-.-.--_sq. ft. Z Other Distribution box ( V1 Dosing tank �� Fr aPercolation Test Results Performed by......................................................................... Date..........................--------.----. Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-------------------- Depth to ground water._.._-_---.---.-__-.__.. (� Test Pit,..Nw o. 2----------------minutes per inch Depth of Test Pit.-.-__-__-__ --•__- Depth to ground water------------------------ k� .„ --------------------------------------------------------------------------------------------------------•--------------------------------------------------- O Description of Soil'_''-- �'•4_-c,t�'... '`" 1di 2-i(._r..�':_..C:r^T t i I ' 5 n f4 Ta. (xj l -------`--1/ 's.-- . -----••-•--- -••-----•--- •-•---------------" -- ./ --------------- ---------------'--=r`---------r' ._ M -------------------------------------.......-------------------------------•_------------•---------------------------------•--•-------------------------------------------------------------_----_----- WU 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed..!....:.....` -.1 _ Application Approved B -' ' / /��..//� i r.�i _ ,Date-------------- PP PP Y ---- te Application Disapproved for the following,reasons:...._111............./--.........................................................-----na......---------- ...................................•------•--•-----------•--.......-------------•------.........----------------••----------------------------........-••--•----•--------•--•----------------------•--•- Date PermitNo........................................---••---•••-•-•- '. Issued........................................................ Date r THE COMMONWEALTH.-OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF........ ......... .....r..........:............................................... Qrrtifira#r of feumplitturr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (L)or Repaired ( ) by........�-/�. =---------•---------------- ..................................................... ------•-•••-•---•--•••----•-••-------•--•-•--••--•---------•••... ---•-- ----- r f' er _ Install I n w at --••------------------------••-- --•--------- -------------------------- has been installed in accordance with the provisionst.of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit'No__________________ _____11-___-____-_-__ dated.............'............ .................... l THE ISSUANCE OF THIS (CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL //FUNCTION SATISFACTORY. �DATE ? I - � . •-� nsPector- - THE l� COMMONWEALTH OF MASSACHUSETTS BOARD� �O F HEALTH ,r 7 �f; . ............. .. D✓ .�........................................................ 1 J OF �� No...----•- --• FEE..../_ .......... Di�-pu,i'Ftl r Nor 5 Qlawitrurtiuu Vrrmi# Permission is.hereby granted L ................................................ to Construc or Re)air an IndiytzJ a S e Dtsp Ll System >� g y at No �. � r , �ct Wit. _ Street' t as shown on the application for Disposal Works Construction Pelt t No ,- . Dated.................................... .. ,11 ". -'` Board of Health DATE �_.!. ......... - FORM ,.1:255 HOBBS & WARREN. INC.: PUBLISHERS r ' O''N WATER ANALYSIS Lab Xert . No . F-5847 Customer Mary L. Crumlin. Lot _123B, Cotuit Sample Number 3767 Received From W. Dermon Date Received 1 5/77 Analyzed By Jim Date Drawn 6/l11/17 Source Well Date Run 6/1 /7 7 All readings in ppm unless otherwise noted pH (pH units) 6 . 9 B-Alkalinityto pH8 as CaCO3 0 Chloride as Cl 12 . A-Alkalinity (Total) as CaCO3 8 Nitrate as NO3 Hydroxide Alkalinity (213-A) as CaC0 Camphor Test (Oil) Sulfite Excess as Na2SO ouri es as Iron as Fe . 0 0711 Cadmium as Cd Orthophosphate as PO Silver as Ag Total Phosphate as PO _ Lead as Pb Polyphosphate as PO * ul ate as SO4 Hardness as CaCO38 onductivity ( Umho) 74 Calcium as CaCO3 onductivity after Neutralization (Umho) Magnesium as CaCO3* 0 or A. Units) 2 EDTA - Free as Na2112 EDTA rbidity (A.P.H.A. Units) 1 EDTA - Total as NaZH2 EDTA uminum as Al NTA - Free as Na NTA anganese as Mn 000 Silica as S10 _ opper as Cu 0. 0 Dissolved Oxygen ml 02 per liter ickel as Ni Suspended Solids filterable 5 . 0 in as Sn Settleable Solids Imhof ml liter 0. 2 inc as Zn Total Solids 5 . 0 yanide as CN Total Organics hromium as Cr Chemical Oxygen Demand hromate as Cr04 Chlorine free as C12 Ammonia s N 0. 0 Chlorine (OTA) as C12 Coliform Count per 100 ml ne g. *BY DIFFERENCE REMARKS: The analysis indicates the water to be of good potable quality_ and meets Public Health Standards. Tim Hennigan, P. E. o Tim r.j 1':7. 2'2v..3 -,'I: o� GIS7E ONAL J r7rri+ "'p/ewv ..,L1*" r'°°I.d4 A&A-ansr ,l,.t�ta►w9..olsyi1 i4y do 4a OM st NV94 rw" vy 4,4 Sol . �. .. 40 000", .•» is -041 100, fp '/ ./� far •�' � � ,✓ .�" o A Mad 40 AL 0000, too s 1 t ®Q Ole loop, ., 000, •� �o !y' 4 i v z .00 bit 'v -9 m i - air _Zt4 s � r 179 o Z i v e