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HomeMy WebLinkAbout0116 TIMBER LANE - Health 116 TIMBER LANE, MARSTON MILLS A _ 1c'� - deb - -- _-- - I r j r No. _ Fee—------1_JJ—, BOARD OF HEALTH TOWN OF BARNSTABLE ZIppYicat ion for Veri Constructionpermit Application-is hereby made for a permit to Construct ( ), Alter ( ), or Repair (vfan individual Well at: !�L— J�. brr L &Uss7oaY 1llr _ 149 1 ( --- /�� / Location — Address Assessors Map and Parcel Owner Address - S ca•.'e..�-- ------�-- P�= �o)c y'G G ,t,,vJ G _v�uS-_ oa G Y-r - - Installer — Driller Address Type of Building Dwelling --- -- - ------ Other - Type of Building— - —_—_-__ No. of Persons------------------- --------- Type of Well y Capacity Purpose of Well-40D"OS tic- wG 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 Ce 'ficcaatte of Compliance has been issued by the Board of Health. Signed S 8 v.) ---- date Application Approved By �` GL. — _. ate Application Disapproved for the following reasons: - ------ date _ ----- -------- Permit No. �----- -- Issued _--_______ date BOARD OF HEALTH TOWN OF BARNSTABLE (C ertif irate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired (Lj DASt.-k,, 4/ / Installer at 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. K'eD O Dated--�d-�%-'6-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE Inspector--- ----- ----- t f � f No.�4 � =�`j Fee------ -- - BOARD OF HEALTH TOWN OF BARNSTABLE t J ZIpplicat ion for Well Con5tructionPerMit ' Application.is hereby made for a permit to Construct ( ), Alter ( ), or Repair 1-1`an individual Well at: Location — Address Assessors Map and Farcel 1 Owner Address ��/� o, FGa A.;4�d4�n� w�� o�G Y . Installer — Driller Address Type of Building f Dwelling ----------- Other - Type of Building--- --_____ No. of Persons-----_____—__---__ Type of Well y -- Capacity -------------- 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 Ce ificate Hof Compliance has been issued by the Board of Health. D� � � CJ Signed �� date Application Approved By C���`-� �� L� Mate' Application Disapproved for the following reasons: --- - — — ----1- _� date _ Permit No. A:�`a� _ Issued '--"- � — date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired DA Scu w^_, // by--- — ------- ------------------------------- Installer �/� T� �n� LN • 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 NoA --��—'_'N(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 Well Congtruct ion Permit No. � `) Fee---- Permission is hereby grantedto Construct ( ), Alter ( ), or Re pai/r (v) aiIndividual Well at: No. r�M l7r. ti Street as shown on the application for a Well Construction Permit No._ -- <;- I /u— Dated —-- --- - C DATE k �� Board of Health �­ . � .- , . - , 4 � .. .,w .,��'-. ::��:i.,.`�:...­.�,.-.:".._., `_ "i i I �'. ,.. �., ,� . I - 11 i , ".".: ..., ,-! i,z�:��i _. �,. ,,. ;_�� 11 �_11'." - ,--1 , 11111111 11�..........�,. - _ . I. .�,l-��... �, �,�...:, ��,�. -* ,-,:.-��-.. -- ;. .:,:�, ,��, .I * - - �w�` ,:�i�-�. ..,�"�,v 11 � - , . �- 4A. _'ff ,, - .'_ .. .;�� , .�,' I : 11 �,,�, - ,t,; , ,�1.:,.,.L-'.�,%_;i -..'. .. . , . 1 �. .� . - . - . - --,. t�, ,i � --��i,�.� ,T. -,.� ,��.. - � ... r- . - -�-, 1�. _:.�, ...,., �-..��I z: ".'.� �; , :- _.�. ...- ".��.�,� _At� ,; . .. ,,,; 1,- ,::" "". _ .. . , . '__� � . 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WELL LOCATION GPS (OPTIONAL) LATITUDE, w ffi LONGITUDE - Address at Well Location: /,�� T ^t L Property Owner: e- IJ wF r Subdivision Name: Mailing Address:Al-4 7 r ty fio $ �li S �ttr 1 e,_1 7-04 1.&1-1 tCity/Town:.'''�&L L.—c City/Town/Town: M�`� M Assessors Map Assessors Lot#: NOTE: Assessors Map and Lot# mandatory if nostreetUad'dress available Board of Health permit obtained: Yes 0 Not Required ❑ Permit Number Date,lssued 2.WORK PERFORMED 3. PROPOSE© USE" 4. DRILLING' HOD Y ❑ New Well ❑ Abandon C Domestic 0 Irrigation ❑ Cable `Auger ❑ Deepen ❑ Recondition ❑ Monitoring ❑ Municipal ❑ Air Hammer'";Q Direct Push EY'Re lace ❑ Other ❑ Industrial ❑ Other ❑ Muclijlo'tarV010 Other 5 WELL LOG aC Unconsolidated Consolidated 6 SITE SKETCH (use permanent iandnarks with distances) W Permeability Q j From (ft) To (ft) High Low U .C7 c, m Other Rock Type 7 ,.7.WELL CONSTRUCTION 8. CASING Total Depth Drilled y61 From (ft) To (ft) Casing Typewand Material Size O.D. (in) Well Seal Type tDate Drilling Complete 9."SCREEN m x ep From (ft) To (ft) Slot Size Screen_Type and Material Screen Diameter sc v i 10:.FILTER PACK/GROUT/ABANDONMENT MATERIAL, 4 a 11. ADDITIONAL WELL INFORMATION `. Developed? ❑ Yes ❑ No From.,(ft) To (ft) Material Description` Purpose Fracture ` Enhancement? ❑ Yes ❑ No Method Disinfected? CP'Yes ❑ No 12=WELL TEST IDMA(PRODUCTION WELLS) 13. STATIC`WATER LEVEL(ALL.WELLS)' -i Yield�`,Time.Pumped Drawdown to. Time Recovery to Depth Below Date Method (GPM)�;`I(hrs&min) (Ft. BGS) (hrs & min) (Ft. BGS) Date Measured Ground Surface (FT) Jgla I 14:r PERMANENT PUMP (IF AVAILABLE) 15.NAMEIADDRESS OF PUMP INSTALL4110N COMPANY Pump Description Horsepower Pump Intake Depth .`Y..� a . (ft) Nominal Pump Capacity (gpm) 1 `.COMMENTS 17.WELL DRILLER'S STATEMENT This well was drilled and/or abandoned under my supervision, according to applicable rules . and regulations, and this report is co ple and correct to the best of my knowledge. Driller: dew � '�° Supervising Driller Si nature: �� Registration #:I I D I Q I P 9 9 9 Firm: . A Date: — Rig Permit#: I NOTE. Well`Completion Reports must be filed by the registered well driller,within 30 days;of well completion. BOARD OF HEALTH COPY v : Lnl" -37 i W�— c�—00,� 3''j /®5',? V" LO CA TjQ SEWAGE PERMIT NO. PILL GE NA INSTALLER'SE A ADDRESSM JOHN A. AALTO .BACKHOE SERVICE Walnut ree West Barnstable, Mass. 02668 8 U I L D E R OR OWNER 71 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED I� r �. �4 �; � . � 3 �Eft'(Z »�' � � ��)� ' r No....11.... F>cs. �.....— THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .........................................OF......................................---------------------..........._..........--------- Appliratiun for Uiipugal Works Tonotrnrtiun ramit Application is hereby made for t to nstrucct or Repair ( ) an Individual Sewage Disposal System at: ................__......_...................................... .-/ --•...--• --• ...32.-•-----•-•--•------- •--•------.....--•---._..........._---•-• . otlss77/,r�4F,� G ...---•-- ... No. . ..-----••-------------•---------................................. ,[-------•1----•--- -•--•--�----•---- W -jQ4N Owner f1� S VI"'J !� Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................Expansion Attic ( ) Garbage Grinder ( '_l Other—Type of Building No. of persons........./---------------- Showers — Cafeteria QOther fixtures ......................... --•-------------------------.-------------------------------------------------------------------------------••-•......------ W Design Flow...3o............................gallons per person per day. Total daily flow............................................gallons. WSeptic 'Tank—Liquid capacity./99 611ons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area...................sq.-ft: Z Other Distribution box ( ) Dosing tank 1­4 Percolation Test Results Performed by---------------------------------------------------------•-----•--•--..... ate Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fTq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ------------------------------------ -....................... -------------------- •-----•----•------------------------ ------------- ---------------------------- 0 Description of Soil........................................................................................................................................................................ x U ---------•-----------------------------------------------------•.............................••---------•••-------------•--•----------------------------.....---.....----................--------------- x ................................... 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 iITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the s tem in operation until a Certificate of Kpl' nc een ' ed by the bo heal .ft . ..•..... ate Application Approved By-------- ...... .......................................' -•----------� �6 Date Application Disapproved for the following reasons-------------------------------------------------------•-----------------------------------.....---------......_ .......-•--•-•--......-•--------------------•--------------•-•--••----------......--•--•---........----------------------------------------------------------------------------------------••---•--- Date Permit No. ..��.-'.lOS9................... Issued_ Date No..t"..1��.ic..� r I - / ) - FE ... ............. THE COMMONWEALTH OF MASSACHUSETTS 'r BOARD OF HEALTH ............. ..........................OF...............I.............. ..... Appliratiun for Disposal Works Tonstrnr#tun rimmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 2 J ................_..........----...... •------•-...............-•-........... .........- •-�•------•-•------•------- ------------............-----.......--•-- / V bot No. r . �.. .................................. 4 •Tl " --��, .- .................................................. Owner 1 Ais -�' -----------------------•--------------------..... 1� .5 +ul._.......1. ........................................... Installer Address Type of Building, Size Lot............................Sq. feet Dwelling—No. of Bedrooms__. .............................Expansion Attic ( ) Garbage Grinder Other—T e of Building No. of persons /----------------- ShowersCafeteria ( ) a YP g ............................ P (----)-- --------- Q Other fixtures ......................................••--------•----...-•------------------------------------------------•-•- WDesign Flow.,,33.0.............................gallons per person per day. Total daily flow..........................................._gallons. WSeptic Tank—Liquid capacity/.��gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total.leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet-................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 1-4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth�t'�-.g�,round water........................ fs, Test Pit No. 2.............:..minutes per inch Depth of Test Pit----=ti............ Depth to ground,water._____..............___. ..........................-.................................................................................................................... 0 Description of Soil...................................................................................-----------------------•------------•------------ -----•------- ---------- x 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 TITL1 5 of the State Sanitary Code— The undersigned further agrees not to place the s stem in operation until a Certificate of9p..' be ed by the bo f hea . .�=4 ......... �: : ate APPlication Approved By----•-. - •--G'�. � �c?k� .---•--•..........•------- -------•-•1; .fit �f------- Dat6 Application Disapproved for the following reasons:-------••------•.................•-------•--•---------------••------------------•-----------------••-.._........ ....................•----.............•....--------------------..............-----------•---------........_......--------•-----------------------.....---------------------------------••-------.....-••- Date PermitNo..... 5��..............--.... Issued............................................t.......... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.........................................q........................................... Tntifiratr of Tomplianrr TH S IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.... -- /�...�'� -----....---•--•......... ................................••-----•------.... ...............-f----../.-}--�---'-----•--------------- !!l 1Gow Installer --------—� ""a ..... _--•-----•-- s -•----- --- + v ^77—,a; tid has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described 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 UN TION SATISFACTORY. (j Inspector. DATE.... ...�� bar...._... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH yr ...........................................OF'..................................................................................... Disposal Iforks Tonstrurtion prrmit Permissionis hereby granted....r��-1-�-•-•-=...................................-............................................................................... to Constr )�—or--�e•pair ( ) an Individual Sewage Disposal System at No...... ._...._I.(.;,I.''r �.,c. �!.!:.^._.. �- ---•------------•---•-----------••---•---------------------------•....... Street as shown on the application for Disposal Works Construction Permit No��:.4__... 05".Dated.../_.�..l(0��"............. ... , ............................................. Board of Health DATE.._ 1�. .�-� _:..._._ FORM 1255 A. M. SULKIN, INC., BOSTON Log Number: �4272 Bottle # RR24 s . . Dat?: 11/15/84 04 SqR� BARNSTABLE COUNTY HEALTH DEPARTMENT �SUPERIOR_COURT',HOUSE V ' BARNSTABLE, MASSACHUSETTS 02630 o • Ash DRINKING WATER LABORATORY ANALYSIS PHONE:,362-2311 ." .. �EXT. 331 Client: ' °3F Bruce. E.::Gardner ,,, _;; •:Colle:ctor:: ,r fa 3: Paul. Jenkins Mai l i ng'=Address. •� •: , - ocust Jen i ns ; We, .1 , U,ri I 11 ng Date of 4 Co;l;lect�on 11%.4/814, 10:301 a.m. Telephone: - := �� ;Type:�of Supgly.; t _,<� 1. :,we wa er ,. Sample Location: Lot 31 Timberlane Well Depth: Mars tons Mills Date of Analysis: 11/ 14/84 PARAMETER SAMPLE RESULT RECOMMENDED LIMITS S 1F'..f�_� ,t Total Col i form Bacteria/100 '1 r '"`'y 0 =y0 H 5.1 Conductivity (micromhos/cm) 76. 500.-0` ' Iron m 0.07,,.... �,.... , 0` 3 Nitrate-Nitrogen ( m) 1 .25 10.0 Sodium m) -- 20.0 1 ... z, '+ ��;.. � ,4 ,. Yr. ... `3 n :f2"J 3 7' ;,Rr ., .. '?i„ld. �`, ! .>�iY1 .,...i •, -. ., �i 1 „5.4. t. .... '., :a I, xx Water sample meets the recommended limits for drinking of 'a'l l above''tested 'p'arameters II . Based only on results of the parameters tested .for this sample, the water is suitable for drinking but may present the problems checked below: A. 6dater sample iias h'iglier than average hevels``df Nitrate: ''Future monitoring is � „recommendq, .(2 3q,tir es�pfer�.yea )E_lto e tabl ish Any upward ,trends.fj .. B. The low pH of the water may shorten the useful life of the house's plumbing. C. Water may present aesthetic problems (taste, odor, staining) due to D. ;..Water sample has high levels'-'bf sodium: Persons on, low sodium diets should consult' their 'do ctor. III. Due to one or more of the reasons checked below, this water sample is unfit for human consumption: A. High Bacteria B. High Nitrates REMARKS: CC: Barnstable Board of Health CC: Jenkins Well Drilling LaboratoV Director 7/17/84 CAPE & ISLANDS SURVEYING CO., INC. ENGINEERING DIVISION P.O. BOX 334 TEATICKET, MASSACHUSETTS 02536 617-548-5486 July 8, 1985 Barnstable Board of Health Main Street Hyannis, MA 02601 RE: Lot #37, Timber Lane, Marstons Mills, MA I certify that the distance between the well and the leaching pit at the above referenced lot is 117 feet. Sincerely yours, ?John P. Slavinsky JPS/mm ENVIROTECHLABORATORIES,INC. MA CERT.NO.:M-MA 063 449 Me.130 Sandwich, MA 02963 508(888-6460) 1-800-339-6460 FAX(508)888-6446 CLIENT. Bruce Gardner LOCATION: 116 Timber Lane ADDRESS: 116 Timber Lane Marstons Mills, MA 02648 Marstons Mills, MA 02648 COLLECTED BY: DA Scannell SAMPLE DATE. 1/29/2002 SAMPLE TIME: 2:00 WATER SAMPLE TYPE. New Well/Repair DATE RECEIVED: 1/29/2002 LAB I.D. #: 0201370 WELL SPECS.: 48' RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria 1100ml 0 0 9222 B 1/29/2002 pH pH units 6.5-8.5 6.81 4500 H+ 1/29/2002 Conductance umhos/cm 500 665 120.1 1/29/2002 Nitrate-N mg/L 10.0 1.85 300.0 1/29/2002 Nitrite-N mg/L 1,00 < 0..004 300.0 1/29/2002 Sodium mg/L V8.0 —141-i 200.7 1/30/2002 Iron mg/L 0.3 < 0.1 200.7 1/30/2002 Manganese mg/L 0.05 0.051 200.7 1/30/2002 COMMENTS: Sodium indicates possible-salt-water intrusion-orroad salt ru` o Manganese anes`e is not a health hazard. F itering system should-be-considered. <=less than Date >=greater than RAnald J. Sa ri TNTC=too numerous to count Laborato irector aPUL i s i 2¢ 0 f J j z ' Ile _ I` 4 '+gkAt�Y �1t<: dd.a? "'aa.I. ��n ''P�a, °!r.4 r'Y;� F ,¢a Rot�F 3•�i�tl �r V�`� ;1� {-0La !. �!t vllrS .Xy° :^�: s�: t��l nl.•'..,,�.i e,o-. r,;r, „n i.: �i.,+C,,..!ro,•.' 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' •. 6 n. � ;,, �'' "4 K .'i ? q�t t .f. �•+.�, + / •t �r1' i�' r �is f y 9r f x*. rw f A �" k r t r r "r K # .r �`.fi:Y A ' r. .`` �3 f 4.r a • •„ r ^^ rc� 't y �r?.^A, r' r {, ra � ,,'.r- ,- +•,"' �,'«` 1 � k ° .. 4 t Mr, Bruce L Gardner 9 •* e a r ' . ,r '16 Lust Road a`i ?1• •'F�'Q .4 r •u `vj'<r 'T t,ran -. �Y «rJ .r...r..: J �t,51,a rt 'r kk r•�,rr ,•••. -.' %�4...• .wt v, 1 R �r _ � ., $ �qy + ,� 4 4�'•a 1•$^ -z+r� a '� r x� ,.r � .i `'`Orleans, Ma:-- 2653 T A. Y r q ,te j_ M1r ,;'. r•_` t .,• L'F:!T r sy, �' k +r d�$" .: I ` • r" f �''. Y¢ � , � Y �Aear-Mr. Gardner:; d :mow "'r. -dvi .i•` t ,�:�cw r.* 4 `z:..A'i 3r r r y Fw• r? 'x j s r, ; �,! r v ..in ,si' _- '`+r -r� ,+r ; t V� t•y, t` f %u �' ,x .'r �5A '+k rr• a /R '' .�"' r'r�' r �.Er"�k+y Vti: r a V dt i... ,+.E',. �, s t; r ua .:♦ - >•ar .'wiq L d J ? r. k ,w .you ute granted $'`conditional' variance to ingtal'1 -septic. leactifng"xpit;1'17 ,,yam •T feet .f rom a ;proposed`we l l""`in `T"iim,of the re ixired 150 r q feet,r,$t l,ot 37, Timber�`•r,� Lane,;M&rstons T1i'l ls;'srraith, tha f.oirlowtig conctivns ; � ° ?� ,s" 45 ;` S 4 t q`?' r '` ; r ,�.� wr~ '1 r t• r r „(1) ; Properly,prepareda engiiaeerlrig 'plans -for your" on�i'te ;sewage di'aposal` system'sttigt`ti�ie' ubmi°ttedand ap to.:.fial approvals.provedr pfiior T` `• �� ' 't - w .ram P" rs.� '`'"� �•,.,7 rt. ..'� +y.V� `; � �,,., 4 r;P ;'f.1.•r�#�'t•.ri r r• "�" ,�"t.- •'a} - r ' r e sF` �, , 41 °,•.;J' 2) ,,Building permits iaiIY not :be%'apprpved by'r'the` Board-of ,Iie t f 'al h on indi ` r r > Y . .,,vidtial lots until the w 'I`1 is :iaralied:°and cert3ieationsubiriitteci° .t V, ;•as to the bacteriological. and mineral ,content: of ehe water by 'a-State , t roved, ; � rf_ .. i .t <App V Lborapo�Y, The.,.water.must, meet all of the.T,standardsw estab dished by .the Safe�DAnk"ing,Act' of '1974. r # 1. �.r , e t{... ,.•#. ,_"a t y .ti .'"F t a' a -r ! . y ,h,''.? . r4 }r= Y';, �' t.„•r, i redfgn { resan;(3) ,Th ' ginee' muste t ,on' '.superrvi e the' con-, f truct`i©n�O 'thei S a 1C '8" S eID,c1 Y(� 'tnt38C eerti:f A1$ t r P.. 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Y tb a .- '.Vr � r',,n T 1 DR.➢T Y a'i�a r `, 3A'' ti, _•ti �('�. �� � � � �' =r '. t s K r pk, t r% r r��f )..� }M �a �''bt�H r .;,s �5�I r��.r h � T^' �° .�(C,KS � � Va*f,� "�..b •'r t�' �. ' ' T.� r1+ •'.y Si t-r J4 K a r �n a', � a y # .�' r, S tr ' A�•. � �,�, '7. • BOARD�.Of, HEALTH 'jjlt r� yt ';+. ' f• �'t •4.cr'1: i ,i i, 4 vt 4 x sr.^.'.P<;t'f,.i'- fr ,j}� 'a' t rr ram: • ,:,TQWN.OF"'.BARN AB.LB r � ""'r Y•" C N. 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'}`s � '#t k i y #� bi i �g.;�x,,�,tJa�' vr, P� . t •� _ x , .• $ r Y r r' +veti•J ' ,�. �" r,# s p+1: ��.��'` x tt���rx. •tti n k ic. � a ., w^�{,' ,r r � �� �'��yp`t yb'�a�`i; Fw{.� f` ,.� j J �. y. „ 't. e w ; < +^ t� E 3 +, a ,i ,l,.-..:i j' 1 •`�ri ±' . rr r J,S'!*ry If�'f#* f ,4�#ark• t,.•ria ?: t, r �+,',i k rC r t Jt 'r x - r �°,��' k':v} •' '£, P'4'r t*rY'°',#4. Ys.'_,,,t. .• '} ,r+lSrr �G' trf. s t ,�ta4".":. .,)a;.Y,�Kgw�Sofa` I�y,� f'� ;"Ya'" ,1,a. .d.. '��,. _A. r#,' s�.: .� t'#t~ , . ,r j •+' rvr`,¢` w^ .. . a t �r :�"+ �1.... r �,� < � .`4i ,# 'A ! y. t `4 �� •,r. ' , .F,` t a� Y a�, y,ir'.s t rV•'t `t'y`b rr.it �p;Z f ocrra 4 r �' w r'! * " Z1 n",'ta,,,•', '° 4R, •r. 4P.# + G k"a a:t p�.�`tri}t,y.7. R ,� r `�' ,'� M Y* '+ 3:•L µ' -/ .� F •'$ #a ? `. GLy . '~ec l ,r"'. r'*t•'St ,y`iri �" t .ar 4.v, f�'ar .''J;w-. ' e • i r. .:1 �' ��„ j _ :'"r a „a, N.,t •� IV , � � � b. #� R,+r�����•� r ?.cs+ 6 w• �.�4.�A�� f+' it •T`: r '� {a+; � �J'�� �r..z rr ,`y S ,�,•I, �k."., 'f'� _, .• �<'# '� >.,, i.♦ .,! f g-'?�- _ a �� is. 'y .r:',-. 'a". J '',Y yK�� , Tov"N 6F 3.4R!NSTABLE , \ 1A OFFICE OF xnLzsT� BOARD OF HEALTH C 46L ,1 E i63Q• ���� a67 MAIN STREET y l `HYANNIS, MASS. 02601 VARIANCE REQUEST FORM . All variance requests must\be submitte;d, five (S) days prior to the scheduled Board of Health meeting. PDQ /• � - � NAME OF APPLICANT wit(f TELEPHONE NO.`;Z p6 `� ADDRESS OF APPLICANT NAME OF OWNER OF PROPERTY ' LOCATION OF REQUEST�_6>-�' 32 VARIANCE FROM REGULATION (List regulation) a- VARIANCE REQUESTED (Specific reques��A1((/A�� l�x�l '� ��'.�pe�� �sS , 1li9iJ � •i REASON FOR VARIANCE (May attach letter if more space needed0e)>4 /96a� /,te �C 5' rC� Q�iL'2 4u PLANS - Two copies of plan must be submitted clearly outlining variance requested. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPPROVAIt (' i • i i i Robert L. Childs, Chairman Ann Jane Eshbaugh H. F. Inge, M. D. 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I I,,1.,E:-"\1IIII IE lI'I--II y.I I�vI1I�,I I'1I J .x.. x. ..Y ,-.Y .. r, y4. -VP .a. E.. f _ : , , .4'•''' �.,, ,c 7 ,, , , .:, _., . ._,__ r ,; l ,, >;,, _. .. rc -rr' x. r. .Rh. .. ... , S_. -.. _ k.. ., _.. r. s ..,,.. .. ,. s. .. .,.. v..,::+- ,.. .. .._- ar .- __. :...- , t`.._ 'E,^'Ps.. xn._,..a.+ :..' _., + ...-T� ,_,,.. ,.. .,. ,?.. ,. v .. „Y € Y. a ,b... w. ...:. ... .. :.., t. ..».. T;'.. c;, _ <.. {- 2 ... ... e. w--. :. � .».. .,... ..E...- v. al....•. ,r.`!4.. :. I a._ _.. .,.�vq `�'' ,." , .:':' k :.:t .._ ..,.-. , .. ... ,.� ). , ,. , ... d_ s 1 r u....,n. . , I YST PRD . L , ., v ... f , : % - S EM . . _ :: T T SCALE NO O , . -• F A/` OP D FINISH _GRADE OVER II RAGE . FINISH G 7! {a P - _ - .:-. : R L N SH: GRADE OVE -`r •o.., _,. FI I DIS T T. ;BOX <`7 C? D FINISH GRADE OVER K, .,,•a..o SEPTIC ;TAN, l� _ LEACHING PIT "- , a•. . . , A••'d : . ., . - o.,o VARIES •,o ' .14 " o. ..0.: - „ �, ,o. o .. :. a.:. .o — o. o..a: g .,b_..o: ,o• .p, e..a.. V. q, . a 4: 3 OF 1/8 1/2 12 - 0 , e . "..' a's. .0..•.6.:.b._.:d:..0..-•ell.`O.•.i4l.o:�.::1:1 1 . 0:,0.0.0.0 ,•:, PRECAST CONC. OR • .oQ '• a': o. WA SHED "PEAS TONE •o BRICK 6 MORTAR 0.0.: 0. p OUTLET, PIPE LEVEL 42 0: ,.. . TO 12" BELOW GRADE F f ` 2 FT. MIN: Q d.• e. b ::,. .... y0•, .D:o. c cb ,eo.. , .,'. •o • O a_ 0 A• d A P /� p ..., Q. C. I. DA PVC EES & . �,. a•a, . I - 0, t.e.: o ;•.a. n. a : a� q O,O' d p�:­d-. Q., •,Q, Q•o .•,n a D. ,a . c . .6 - :D o_ 4, ; , r .Q •;10. ..• esMT. FLR. a GALLON —D DIS TRISUTIGN . BOX :.. 0 0. a p EL `6��z a . R p• :Q: I - b. INSTALL QN :LEVEL BASE ;. �+ 4 ' n. p :. „ PRECAST CONCf�ETE' �4 To 1 zs2 PRECAST D o WASHED :o`:'o a:.na:.:o:r Ai :a :•,9. -,'•a•,d..•.c 0 l0 REINFORCED CPUSHED .0 CONCRETE I 8 _ a: .NONE I , . O•,_ 6.� q;d ,..,._ .�Y.1�.. p.a_O, A O,_, b O •4, . .:.. , . O, p, 4t a� li I . lJ::d'.o. d'Q:Q4o:.Cr.Or 2p.Q .O. +P::-:a-,O:b.55. :9::4:'[t•:O.,R., o + : . � I H- I ' RE,INF. � SEP TIC TANK 4= 40 ,, //''�� a.:© a. .... �'.o `'o I - L07, , 5 INSTALL ON; LEVEL BASE NOTE:` EXCA VA TE TO ELEV. 57 � t7R : �' o .a.o a. �• 'o d Q :a -, _ �},i4• p a O #6 4:d: C>. ', 6'a r s .. L Oi✓ER TO AEMO VE ALL IMPERVIOUS .,.> C MA TERIAL BENEATH THE L EA CHI'1VG AREA ,- {�" 3'- �" ° ; z MI f- , i �: is h . 11 . REPL ACE EXCA VA TED MA TERIA L MI TH 6 -C,. .' . {t F ;;;' , , , -= : :, _ CLEAN, CLAY FREE• SAND Jam ,E N n : � _, / 2 . 6 EFFECTIVE DIAMETER . t, C" I - ,, 1 . . F ;t d zip h e; , t _ , _ _.�.... # . 1 / •` �, 4 ; fy, . .7... ,. _ a ' GE1/ERAL NOTES LEAG'HING P'I T a, b „ ., , 14 . .,., a _-'S, .._. . ..µ.r INSTALL Ol4 LEVEL BASE r-. ,,_,. , 1* a ; t r,.., W R A ED ON c„�1�!, � i : _ �, -- :�,<�r�.,, ?. ALL ELEVATIONS SHO N A E B S � � ( ,. I . e'..i•.x ... a,, A PIPES: IN THE SYSTEM MUST BE,CAST IRON .X, b -� , .. ,. ,< 2 LL „ � V,/ , : _f Y .,,. OR SCHEDULE 4J_, C. .a6•n.. - '. t V T N _ PI T , ..- ,. ,H . T T F ED k •, ,, ,, ,__ . 3.- THE BOARD-OF HEAL T MUS BE NO_I .I ,,,,. .: .,.. . , .;: ,•, �, :. WHEN ONSTRUC T.ION IS COMPL ETE PRIOR i.; :. , ,,; ,C ;f., ,�, ::, /PERCOL A TION RA TE.' f , -, . T BA CKFIL L ING �, t ,. 17 ' ,a9 y: . . ., , , , a .• . b . -, e� '. ,2 MIN./IN. GES I rH S PL AN MUST:BE`APPROVED } ti� � 4. _ ANY CHAN N I ;. X.,, 1 r_,, .4- t wf4z 3 - WITNESSED BY: ": K �-I BY THE BOARD OF HEAL TH AND CAPE 6 ISLANDS s • ,,, SURVEYING CO: ,' 1'NC.„x d-- a, .<,,. `,�. . 14 � !_ � - . r•,• ., _. v r ,. " 3 ;,,. N -- 5.' MA rERIALS AND INSTALLATION SHALL BE .I 1DQ0 GALLON +A; .. , �- 3 A BRD. OF .HEALTH B - SIN DA TA , a T rA _ DE G PRECAST'CONCRETE _._ °, =f.f � COMPLIANCE WI TH rHE ST E SANI RY C) ., ,rt , k � . , ., �, F L& � SEPTIC TANK P }-� DA TE. QG _ �� _' 7 ;` CODE. - TITLE V - AND t OCAL APPLIL'ABLE t 1_. N , _ of . k RULES AND REGULA TTONS ii~ NUMBER (. F BEDP�C7MS Il II 11 II 1 , ; ; ! ,y . ' ,,: 5. NORTH ARROW IS FROM RECORD PLANS ANDL. . ?G. _11 x *a .. d T.,x. ; � _ GARBAGE DIS C7SAL l :" 4, I S NOT TO BE eJSED FOR SOLAR PURPDSES . r _ �. , _ 4 q I , , -,_;i, . . ".. Y FLOW __ GPD v , . 7, FL OOD HAZARD ZONE (_ G?A IL O_, v, "I _ �- , ,; r°X ! B. WA TER SUPPL Y. �.. k l.G � EP TI C TANK REO L?. GA L S .# , , E t?V_ • ,. : ,:, I Vim/l../�•� 7�7 _ f , F 5,�,"D �. SEP TIC TANK PPO VIDED GAL :, Aa fi , ti -. LE ACHING PEOUIPED ? GPD fi _ ; j a t ,_ , , — - ,, , 1- 4 [I,.r ��II 1B.I�I 1I,�[II1.�I'�1 II • " () ' <" _ ' .., �r,; AREA S. F. ,. >� ,l SIDEWALL -_( ,,i :� M < • f, , :. _ 5'i S. F. X Z G S. F. _ 2 GPD. f +�� frt I 3- t. f �` -►' BOTTOM AREA S. F.15 f f � ;, 1, �.� #?„� S.F. X r ,O C/S. F. Z GPD • _, LEGEND . _ - r r _ 5 5, G'PD y ! f .,,; LEACHING PROVIDED , ,Lr , - t -� :xJ 1. -_•_TM `.-._ r- �. ,,�• - PROPOSED EL EVA TION ` 7 't1r ' ? f , , ... x yff , , EXISTING CONTOUR 7:C� �. , 1 —7D i W _ . , tt e� `. t rt I :A i'"a,11 it'^ r^q , P",*4 -h Ip7 t E � „ �'"' yn r`�.°� '/ f... r. n "'.:" s : .. ui..�.T.',4 Y Fi 1,,.4.,�.+t 1 "+t /.. . 5 +i ... j r.J t './ ! t� kY f t. Q 1 : ,.. OBSERVATION PIT ,, : , �, T .�..., xr, '"r - , • T : VARIA E R U �7.: � INIM M DIS ANCE, NO E >r,,L Q DISTAIBCJTIOIU BOX r,,', 1-_.', m PREL"AST CONCl4E'TE *,,: ,_ . ,e. A � _, ; 71_ � POSED SEA'A GE DISPOSAL SYSTEM WELL TO LEA RING>; ';4L,. 7`Y FT. : °*, PRO LEACHING PI7f r . „' 4' . O LEACHING PIT r � ,K '4 �', �,4 �� '4 PREPARED FOR ,, , , ;¢ � . `_(3 0 o SEPTIC TANK ,, ' ' � ,,' BRUCE E. GARONEA' k' // x a ai l' /� ,xs �-� f EP`t RESERVE PIT AREA - . , � _ aerf �R LOT 37 TII+9BER LANE a _. y= -' t I 0 , ., . .; �� ARNSTABLE MASS. Y; F 1,,T,s �. t r_. ;, fi 3 t PIPE. 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