HomeMy WebLinkAbout0304 PUTNAM AVENUE - Health 304, 304 PUTNAM AVE.ft"Lf'''-
A= t? p C7
N CERTIFICATE OF ANALYSIS Page:
Barnstable County Health Laboratory
Report Dated: 01/18/2000
Report Prepared For:
Order Number: G0004782
Roger Monteiro
304 Putnam Avenue
Cotuit, MA 02635
Laboratory ID#: 0004/SZ-01 Description: Water-Drirdung Water
Sample#: 04782 Sampling Location: 304 Putnam Ave.,Cotuit Collected: 01/12/2000
Collected by: Roger Montei Received: 01/12/2000
Test Parameters
ITEM RESULT UNITS MCL Method# Tested
LAB: Microbiology
Total Coliform Present CFU/100ml, 0 MF 01/12/2000
Note:' Exceeds the recommended maximum contamination levellor drinking water due to the presence of Coliform Bacteria
Approved By:
(Lab Director) t
ell
a
t
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605
M :} Page:
CERTIFICATE OF' ANALYSIS
Barnstable County Health Laboratory
Report Prepared For: Report Dated: 01/19/2000
Order Number: G0004725
Roger Monteiro
304 Putnam Avenue
Cotuit, MA_ 02635
Laboratory II)#: 0004725-01 Description: Water-Drhddng Water
Sample#: 04725 Sampline Location: 304 Putnam Avenue,Cotuit Collected: 01/07/2000
Collected by: Roger Montei Received: 01/07/2000
Koudize
ITEM RESULT UNITS MCL Method# Tested
LAB:7C Lab
Nitrates <0.1 mg/L 10 EPA 300.0 01/07/2000
LAB:Metals
Copper 0.6 mg/L 1.3 SM 3111B 01/07/2000.
Iron <0.1 mg/L 0.3 sM3111B 0.1/07/2000
Sodium 6 mg/L 20 SM 3111B 01/07/2000
LAB:Microbiology
Total Coliform Present P/A Absent: P/A 01/07/2000
LAB:Physical Chemistry
Conductance 60 umohs/cm EPA 120.1 01/07/2000
pH 5,5 pH-units EPA 150.1 01/07/2000
Note: Exceeds the recommended maximum contamination level for drinking water due to the presence of Coliform Bacteria
Approved By:
(Lab Director)
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605,
No.- ------------ Fee----- -
BOARD OF HEALTH
TOWN OF BARNSTABLE
01pprication,forlVell Begtruction i9ermit
Application is hereby made for a permit to destruct an Individual Well at:
Location — Address —�_--Assessors Map and Parcel �—
w er Address.
Insta er — Driller Address
Type of Building
Dwelling �-------—----------
Other - Type of Building--- ------ No. of Persons--
Type of Well—------ --s,:. iLl _ - --------------- Capacity
Agreement:
The undersigned agrees to destruct the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health PrIyate Well Protection Regulation.
Signed
i date
Application Approved By
date
Application Disapproved for the following reasons: ------- ----------h----___--�__ _
date -
Permit No. Issued--- _
date
BOARD OF HEALTH
. TOWN OF BARNSTABLE
'h
Certificate Of Compliance
THIS IS T GAS O CERTIFY, That the Individual Well destructed by--.--
at . . . . �.:4 . . � .I� r K.t,M�. . . . .�� . . . . . . . . . . . . . . . . . . . . . . . . Installer. . . . . . . . . . . . . . . .
�t A
has been destructed in accordance with the provisions of the Town of Barnstable Board of Health as described in
the application for Well Destruction Permit No.. ... .�tV.�.1? ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at. . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . : . . . . . . . . .. . . . . . . . . . . . ... . . . . .. . . . . . . . . . . . . . . . . .. .. . .. . . . .. . .
. . . .
has been destructed in accordance with the the provisions of the Town of Barnstable Board of Health as described in the application
for Well Destruction Permit No. . . . . Q:_t'r`�. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . .. . .... .. .. . . .
DATE— �d___ —�__�—_— __ Inspector— _
No.-IAL L Q 6------15 Fee.r.y�
BOARD OF.HEALTH
TOWN OF BARNSTABLE
ApplicationArWer[ Zegtruction Permit
Application is hereby made for a permit to destruct an Individual Well at:
Location — Address Assessors Map and Parcel
O er Address
Installer — Driller Address
Type of Building 1
Dwelling- -
Other - Type of Building— _ No. of Persons---
Type —
of Well Capacity—
Agreement: —
The undersigned agrees to destruct the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation.
Signed ��D.
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, That the Individual Well destructed by
Q - —T -- I Installer
at . . . . . .� .L� . . .Y . ...�. C.."'. . . . . .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
has been destructed in accordance with the provisions of the Town of Barnstable Board of Health as described in
the application for Well Destruction Permit No.. . . .V\,I. .? !. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at. . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. .. .. . . .. . .. ..
has been destructed in accordance with the the rovisions of the Town of Barnstable Board of Health as described in the application
for Well Destruction Permit No. . . . . . C)— r--'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .. . . . .. . .
DATE - Inspector---'
nspector--- -_���--------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Well Destruction Permit
No. t� 0 1 Fee s
Permission is hereby granted--------------�-:.-----;---- ---___---------- ____-----------------
to destruct an Individual Well at No. n -----P124 t 1�,—__ _�'l____—_______--
Street
as shown on the application for a Well Destruction Permit
9U
No.------------------------------------------------------ Dated-------��-���-17------------____----------
Board of Health
DATE------- -- - . -
No. Fee— ------- --
BOARD OF HEALTH
TOWN OF BARNSTABLE
2(pplitation-*rIftl Congtructionvermit
Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair (-fan individual Well at:
----—---------------------—--------------- -------_--- — -- —
Location — Address Assessors Map and Parcel -�
e--------------- — -
Owner Address
ns Call er — Driller _ Address
Type of Building
Dwelling --
Other -,Type of Building ----- No. of Persons----------------------------------------
l� '
Type of Well- -__,�t'�. ;---- --- ----- - Capacity------— --------------------------=-------
Purpose of Well--Qtz�?s 7;� ---=-- -— - ---
Agreement: p
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.
rf" c �
`S�3 0 �4 `
Signed ------
dateApplication A B
PP Approved Y=—= - --- � 2 ----- date —=
Application Disapproved for the following reasons:----—---_----------_______
date
Permit No. Issued'------- �-- � ---—--
date
BOARD OF HEALTH'
TOWN "OF BARNSTABLE
Certificate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed P�',, Altered ( ), or Repaired ( )
by '' _?L!L;_v_i /gyp jy.l2 _ _s %' '_-— --—Y -— — — Installer — — —
at - i --� ` r 1- zG _ __�,�p�t.�� -- --------------------------------
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. -�-_-=_!V1 Z96rDated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE -- - -- -- —--------— - - - --------------------- Inspector—----------------------------------------------------------------------
No.�?"-- -----= Fee--------------------
BOARD OF HEALTH
TOXIN OF BARNSTABLE .
Application•for Vell Con.5truct ion Permit
Application is.hereby made for a permit to Construct (, ), Alter ( ), or Repair ( "Ian individual Well at:
c� Co7-ui IkAC
—L--- — -- ——— -- — — — —-- —-----— -------- — ---- --— — --'--—
Location — Address Assessors/M�C7aP and Parcel
------------------------------------------------------------ A.t-u----------
Owner Address
------------
Installer — Driller } Address
Type of Building
Dwelling -------------------- - ' -
Other - Type of Building ---------- No. of Persons---------------_---------------------------------- #;'
YP g-- - -- -
` Type of Well =----------- -------------- Capacity--------------------------- I
Purpose of Well-ALP t!aLt________----__ -- -
Agreement:
The undersigne, agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable oard of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in op ration until a Certificate of Compliance has been issued by the Board of Health.
Signed- '-_r�t �u..� %- -� S 3 0 / --------
- - - - -- --
�i date I
Application A roved B t''
PP PP Y- = = - date
Application Disapp oved for the following rea ons ✓ - -------------------
r
date
---- -----------------
Permit No.-_ �'- °�- ------------ - -- Issued-------- - - -- -- ----------------
a date
t �
-J
BOARD OF HEALTH
TOWN F BARNSTABLE
Certifirate ®f Compliance
THIS IS TO CERTIFY, That the Individual We11 Constructed (✓), Altered ( ), or Repaired ( )
r — .3� --T/�/'l�v_ L�----4-V A� ----°�'-�---------"=a `�'r� ' ��----------------------
Installer
---------- , ----------------------------------------------
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection 4a
I - }
Regulation as described in the apLp'lication for Well Construction Permit No. - '—��j= Dated-- `--��`" �
THE ISSUANCE�OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL JUNCTION SATISFACTORY. -~--"_-`---
o 1, --�
DATE---------- l!------------------ --------------------- Inspector---------------------------------------------------------------------------------
f
G _
BOARD OF'HEALTH
TOWN PF BARNSTABLE � �-
Verr1 Con5tructionVermiC a
No. -"'---- ---- - ��= b Fee
Permission is hereby granted
to Construct (t-f) Alter ( ), or Repair ( i) an Individual Well at:
No. �_�p_ �---`----'-- - - � ��[_t���' �=- �'�`r'�'U t`�- - - - i- - ''- ------------
( Street 1 y
as shown on the application for a Well Construction Permit '
No.- ,� `�` "�" L� - Dated -���`' ---�------- ----------
Board of Health
DATE ---I�-�� -' -^-'--- , j-- I - ----
I
�cl(
-� yt
Sc
i
NBI�dr
w �
D o co o
4
No.--------�r-------1� Fee-----------
BOARD OF HEALTH
TOWN OF BARNSTABLE
ZippYicatiou1orVell Congtructioni3ermit
Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at:
------- ------------------------------- ------------------
,{ yLocation — Address Assessors Map and Parcel
ek2i------------------------------------ —---------------------------------- ----------------------------------------- ------------------
Owner Address
1 , ' e�111 G -f------------------- -----------------------------------—----------------------
-----------
---------------------
Installer — Driller Address
4
Type of Building y /Dwelling-------------- ----- )
Ell rr !l
------------------- �-(e-------------------
Other - Type of Building -------- No. of Persons---�--------—----------------------------
/ ---------------------------------------------------
Type of Well-------��-f r-------------------------------------------------- Capacity-------�--�
Purposeof 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 Certific f Com liance has been issued by the Board of Health.
Signed ---�- ------------ —---------------
date---------------
Application Approved By-- - ate
Application Disapproved for the following reasons:---------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------- ------- ----------------------------------
date
Il , r
Permit No. �11_ --0 -11�e-------------------- Issued----------- - -- ____------------
------ -
date
BOARD OF HEALTH
TOWN . OF BARNSTABLE
Certificate ®f Compliance
THIS IS TO CERTIFY, That the IndividuAl Well Constructed , Altered ( ), or Repaired ( )
bY----f-4-j Q ----�1_ �� __�--- _ -----------------------------------------
at-- -- -�_v�ntaller /=" L-r— -----------
—------
—-------------_----------------------------
has been installed in accordance with the provisions of the Town of Barnstable Board of Heal Private Wel�C7
ction
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-----------------------------------------------------------------------
td 9e /4 ��S. o
- ----------- Fee--------------------
BOARD OF HEALTH "
TOWN OF BARNSTABLE
Applicat ion-for Vell Construction'Perron
Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at:
-3oe--/ ,;�'- ----------------------------------- - - -
�Location — Address Assessors Map and Parcel
---r" -----—--------- ----------------------------------------------------------------------------------------------
Owner Address
IGTS
--------------------------------------------- ----------------------------------------------------------------------------------------------
Installer — Driller Address
Type of Building A A
Dwellingle6fl DC'!V I �
-- ------------------------------
Other - Type of Building -- No. of Persons-- ---- ------ --
��- � ------------------------------------------
Type of Well------- --------•--- �------------------------------------------ Capacity---------- ------
Purposeof 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-if Compliance has been issued by the Board of Health.
Signed �!�- ------- - —----------- ---------------------------------
C O date
Application Approved By-, r-- E �
date
Application Disapproved for the following reasons:----------------------------------------------------------------------------------------------------------
-
---------------------------------------------
-------------------- -------- ------------------------—---------------
date
LV V -- Issued- 5 -�_
Permit No.-- -- ---
• rdate�
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of COMPhance -
THIS IS TO CERTIFY,;That the Individual Well Constructed ), Altered ( ), or Repaired ( )
Et1lAl2��' -
�{ Installer- - -- t.
A)rAlfi —Or ! r_�
- - - - -
at— - 116 ----
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. -9�� -Dated�_% -t>/-7
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
Yell Con5tructionVermit
No.j/-------. 1(/ f_ Q Fee---"-"------------
Permission is hereby granted---!=!-i_- A) Ref f l ve -----------------------------------------
to Construct (�), Alter.r ( jqr,Rep�a)ir` (yj)_ranf I�(n�dip"dual W 11/ /a� �0_
--------------3—0 a�_F✓ /__/_V__s Y l_f_---reetA V la— —C 0- ) ------------------------------------
as shown on the ap lication fora ell Construction Permit �� Q
No. ------------------- Dated
tom - � i-� l -
-- ------------------
Board of Health
DATE----`- - 7--`1 i - ------------------------------------------------- C/