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HomeMy WebLinkAbout0770 WAKEBY ROAD - Health 770 WAKEBY R .-v,\, A ���, — 0-0--�'mcrrs/oons 1'n LA-5 J 1 I 4 III �_ -1 �'. TOWN OIL BAR NSTABLE LOCATION 7`1&0 L4 a-7--W _SEWAGE # � -- VILLAGEfYJ ?��C InA ASSESSOR'S MAP & LOTOi.1�C�S � INSTALLER'S NAME & PHONE NO.;I SEPTIC TANK CAPACITY -�� LEACHING FACILITY:(type) I (size) NO. OF BEDROOMS PRIVAT WELL OR PUBLIC WATER BUILDER OR OWNER -�� DATE PERMIT ISSUED: - DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No/ � � 4 i ' .�a __ r �^ l�� f �® �� �� � . 4 No. V Ll--0-3�5— Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2pp icatiou jor 3961 Con!5tructton Permit Application is hereby made for a permit to Construct( ), Alter( ), or Repair(&�" an individual well at: Location-Address Assessors Map and Parcel M/. 7 20 (-,)A/ff3V AJ Own r Address DA S'ceA IvC l/ /off oeg,orr /tJ /u&S tP« Altq a,)G Yf Installer-Driller Address Type of Building Dwelling ti o t.A S { Other-Type of Building No. of Persons Type of Well q " P U C Capacity Purpose of Well Q a aticS T"c waL t r' A eement: The undersigned agrees to install the afore described 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 Certifi�pAte o Co liance has been issued by the Board of Health. / Signed 4 Date (� Application Approved 1) h �/) j 1 Date Application Disapproved for the following reasons: Date Permit No. c / Issued U I Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired(�j by J) ASCGN10e// Installer at 7 7a wa ►AP/S I /� /140 has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Prot M n Regulation as described in the application for Well Construction Permit Noj, i J14 --0-3 S Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. W r 0/Ll--G 3 6— Fee Y L5 BOARD OF HEALTH TOWN OF BARNSTABLE 2pplicatiou jfor Vern Cougtructiou. Perron Application is hereby made for a permit to Construct( ), Alter( ), or Repair(4- an individual well at: Location'-Address Assessors Map and Parcel Owner Address Installer-Driller Address Type of Building Dwelling v e Other-Type of Building No. of Persons Type of Well �j c. C Capacity Purpose of Well 0 s%i r- T Agreement: The undersigned agrees to install the afore described 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 Co pliance has been issued by the Board of Health. Signed �)'J��.�/(% Date Application Approved rB ! gl ILl Date Application Disapproved for the following reasons: Date 3 3 5 Permit No. w � Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed( ), Altered( ), or Repaired(� by -)m e// Installer at D L �G �f� 1/ I\�� ✓1ii✓� v r, M i /� /1/4 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 Nov- )C/Lr —G-3 S Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Yell c�ongtructiou permit 5 No. -�� �'v /� ` G � Fee Permission is hereby granted to Installer to Construct( ), Alter( ), or Repair(✓j an individual well at: No. Aj )L/" ,S%, w S /"l, l�r �✓j rt Street as shown on the application for a Well Construction Permit No. L�D)/`—— 0,.3,5 ated �� ) Date 11 1 I 1 Approved By —� Map ¢, 6i�o0 3 Cg3 Rfc� :�� 1999 BORTOLOTTI CONSTRUCTION, C. TOWN OFSMNswu 45 INDUSTRY ROAD, MARSTONS MILLS, MA 02 �1D 508-771-9399, 508-428-8926 FAX: 508-428-9399 r 6� r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ra CERTIFICATION Property Address: Date Of Inspection 8" l0 spector's Name: II�er's� Name and Address:& iA C'�-x_ o S9 , CERTIFICATION STATEMENT: I Certify that I haxe,personally Inspected the Sewage Disposal System at this,address,and that the informa- tion reported below is true,accurate and complete as of the time of Inspection. The Inspectioin was perform- ed based on my Training and Experience in the Proper Function and Maintenance of On-Site Sewage Dis- posal Systems.T • ,system:. � e Passes Conditionally Passes Needs Furt valu n By the Local Approving Authority Failur Inspector,'s.Signature Date: �9 TheSystem Inli-Ispector sh1.all submit-a copy of this Inspection Report to the Approving Authority with Thirty (30)Days of completing this Inspection. If the System is a Shared System or has a Design Flow of 10,000 gpd or greater,_the Inspector,and the System Owner shall submit the Report to the appropriate Regional Offie of the Department of Environmental Protection. The Original should be sent.to the System Owner and copies sent to the,Buyer,if applicable and the Approving Authority. INSPECTION SUMMARY! A) SYSTE !PASSES: I have not found any Information which i ndicates that the System violates any of the fail- ure criteria as defined in 310 CMR 15.303. Any Failure Criteria not evaluated are indi- cated below.,•, > , B) SYSTEM CONDITIONALLY PASSES: One or more System Components need to be Replaced or Repaired.'TheSystem,upon completion of the Replacement or Repair,Passes Inspection.- Indicate yes;nor,orv'notdetermined(Y,N,OR ND). Describe bases of determination in all instances. If"not determined",explain why not. 0, , The Septic•Tank is Metal,Cracked,Structurally Unsound,shows Substantial Infiltration or exfil- tration,or Tank Failure is iimminent. The System will Pass Inspection if Existing Septic Tank ' -Is Replaced with a'conforming Septic Tank as Approved by the Board'Of Health. Sewage Backup.or Breakout or High Static Water Level observed in the Distribution Box is due to -broken or obstructed pipe(s)or due to a broken,settled or uneven Distribution Box. The System will pass Inspection if(With Approval of the Board Of Health): h . . T'"tix SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) . t. - Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of The Board of Health): Broken pipe(s)are replaced Obstruction is removed C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. , 1),SYSTEM WILL:PA_ SS UNLESS BOARD OF HEALTH DETERMINES THAT THE '3YSTEM;IS' NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE ` PUBLIC.HEALTH AND SAFETY AND.,THE ENVIRONMENT: Cesspool or privy is within 50 Feet of a surface water Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh. 2)SYSTEM WELL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM1S FUNCTION- ING IN A MANNER THAT PROTECT.THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100.Feet-to a surface water supply or tributary to a surface water supply. The system has' a septic tank and soil absorption system and is with a Zone I of a public 'water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supplywell. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile orgaiuc compounds indicates that the well is free from pollution from' the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less i. than 5 ppm• `D)SYSTEM FAQ.S: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health a should.be:contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or.ponding of efluent to the surface of the ground or surface waters due to an r. overloaded or clogged SAS or cesspool. , F;Static liquid,level.in the distribution box above outlet invert due to an overloaded or clog- _ ,� +Liquid>depth in cesspooCis less than G",below invert or available volume is less than 1/2 t'•.:ii . . . p t q ; :day,flow�«� • I_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped -2- is SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 Feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 Feet of a private water supply well. Any portion of a cesspool or privy is less than 100 Feet but greater than 50 Feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. Q LARGE SYSTEM FAIIS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: The system is within 400 Feet of a surface drinking water supply The system is within 200 Feet of a tributary to a surface drinking water supply The system is located in a nitrogen sensitive area Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program"•requirements of 314 CMR 5.00 and 6.00. Please consult thelocal ' regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST . Checkif the following have been done: Pumping information was requested of the owner,occupant,and Board of Health. None of the system components have been pumped for atleast two weeks and the system has .been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As-built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _7yhe site was inspected for signs of breakout. All,syslem'components,excluding the Soil Absorption System,have been located on site. ✓The'septic tank manholes were uncovered,opened,and the interior of the'septic W*was'in foi condition of baffles or tees, material of constiucdon,�dimensions;depth of liquid; depth of sludge,depth of scum. ' , , The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. -3- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) ✓The facility.owner.(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM'INSPECTION.FORM.". PART C SYSTEM INFORMATION FLOW CONDITIONS RF.SiDF.NT Ai:_ Design Flow: Ions Number of Bedrooms:_ Nun r of Current Residents: Garbage Grinder: 1V0 Laundry Connected To System:CAa Seasonal Use: Water•*ter Readings..if ailable• LAW pate .ate of;Occupancy: — .. COMMF.RCIAL/iND ST iAi •. �.. P> Type of Establishment: Design Flow,' Eallons/day Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: -,,Non,-Sanitary Waste Discharged To The Title V System: WaterMeter Readings,If Available: Last Date of Occupancy: OTHER Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: �e�,c�> p L a System Pumped as part of inspection: �(j If yes,volume pumped; ,', —gallons Reason for pumping TYP F,SYSTEM:,, Septic Tank/Distribution Box/Soil Absorption System Single Cesspool ,Overflow Cesspool Privy Shared System(If yes,attach previous inspection records, if any) Other(explain): 4-,' PROXIMATE AGE of all components, PA in called(if known)and source of.-.information &- ge odors detected when arriving at the site: e� 9---- -4- SUBSURFACE SEWAGE BISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: f Depth below grade: Material of Constriction: cncrete metal FRP—Other o Dimisions: Sludge Depth: 7i Scum Thi�kness: J �/ Distance from top of sludge to bottom of outlet tee or baffle: D Distance from bottom of'scum to bottom of outlet tee or baffle: Z Comments:(recommendation for pumping,condition of inlet and outlet tees or,b es,de th of liquid level in relation outlet invert,structural integrity evidence of leakage,etc.) ' A/ exl - GREASE-TRAP: /lit) Depth Below Grade: Material of Constriction: concrete metal FRP Other (explain) — — — Dimensions: Scum Thickness:'.. Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid., level in.relation to outlet invert,`structural integrity,evidence of leakage, etc.) r' TIGHT OR HOLDING TANK:AM Depth Below Grade: Material of Constrtction:_concrete_metal=FRP_Other(explain) Dimensions: Capacity: gallons Design Floc: gallons/day Alarm Level: Comments: (condition of inlet tee...condition of alarm and float switches, etc.) DISTRIBUTION BOX: t� Depth of liquid level above outlet invert: /,l �a�cf Comments: (note if 1 el aqd distfibution is equal,evid solids carryover, evidencq of leakage into 0 out of box,etc.) all oe PUMP CHAMBER: __Pump is in working order: Comments: (note condition of pump chamber,condition of pumps and appurtenances, etc.).. -5- i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SOIIL ABSORPTION SYSTEM(SAS): (Locate on site plan,if possible;excavation not required,but may be approximated b non-intrusive pp y on intrusive methods) If not determined to be present,explain: Type f Leaching pits,nwnber zLeLeaching chambers, number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool,number: ` Co nts:(note condition ofsoil,signs of by raulic fa' re lev I of nding,conditio f vegetation, etc. / i CESSPOOLS:0, , , Number andt configuration: Depth-top of liquid to inlet invert; Depth of solids layer: Depth of scum layer: Dimensions of Cesspool: __Materials of construction: Indication of groundwater: Wow(cesspool must be pumped as part of inspection) Comments: (note condition of soilk,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) 3f PRIVY:-A2f) Materials of construction: Dimensions: Depth of Solids: Comments:(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) 6- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. I i 01 �v n DEPTH TO.GROUNDWATER: Depth to groundwater: 3 Feet A Metligg of. ti4n or Appro 'ma ' n: /l7✓1'/%1 �� �i ia'1' d urr� cps ,5, -7- B 113 ber: X15 Date: 11/19/93 M 0 � BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT + SUPERIOR COURT HOUSE V �7 BARNSTABLE, MASSACHUSETTS 02630 q.S tJ PHONE: 362-2511 LAB 337 Client: 5-D -Collector: EDWARD MEEHAN Mailing 5 MECHANICS COURT Affiliation: WELL DRILLER Address: BOSTON -MA 02113 Type of Supply: Private Well Telephone: 428-0084 Well Depth: 63 FT Sample Location: 770 WAKEBY ROAD Date of Collection: 11/17/93 Town: MARSTONS MILLS Date of Analysis: 11/18/93 ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- PARAMETER SAMPLE RESULT RECOMMENDED LIMITS ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Total Coliform Bacteria/100mL 0 0 pH Conductivity (micromhos/cm) 500 Iron (ppm) 0 . 3 Nitrate-Nitrogen (ppm) 10 .0 Sodium (ppm) 20 .0 Copper (ppm) 1 .3 ------------------=------------------------------------------------------------ ------------------------------------------------------------------------------- BASED ON THE ANALYSES PERFORMED, THE FOLLOWING ADVISORIES ARE GIVEN: * Water sample meets the recommended limits for drinking water . of all above tested parameters. Remarks : THIS SAMPLE IS A RETEST. Thomas F. Bourne, Laboratory Director a BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT LABORATORY REPORT VOLATILE ORGANIC CHEMICAL ANALYTICAL RESULTS Client: 5 D CONSTRUCTION INC . Collection Date: 11/15/93 Mailing Address: 5 MECHANICS CT. Date of Analysi.s :11/15/93 BOSTON MA 02113 Type of Supply: WELL Well Depth (FT) : 63 Telephone: Sample Location:770 WAKEBY ROAD LAT. (DDMMSS) : Not Given BARNSTABLE LONG. (DDMMSS) : Not Given Collector: C STIEFEL Map/Parcel: Affiliation: BCHD Analytical Method: 502 . 1=1 , 502 . 2=2 , 503 .1=3 , 504=4 , 524 .1=5 , 524 . 2=6 , 502. 1/503=7 Contaminants Anal . Result MCL Detection Detected Meth. ug/1 ug/l Limits (ug/1) --------------------------------------------------------------------- Chloroform 2 8 . 1 0 . 5 Only those compounds listed above were detected. Attached is a list of compounds for which this sample was analyzed. NOTE: Contaminant levels equal to or exceeding the Detection Limits are reported. MCL means Maximum Contaminant Level for EPA-regulated compounds. (ug/1 = micrograms per liter = Parts Per Billion) The Environmental Protection Agency has set Maximum Contaminant Levels (MCL) for the following compounds . This sample compares as follows : COMPOUND MCL (in PPB) Benzene 5.0 * level not exceeded * Carbon Tetrachloride 5 .0 * level not exceeded * 1 , 2-Dichloroethane 5. 0 * level not exceeded * 1 , 1-Dichloroethene 7 . 0 * level not exceeded * 1 , 4-Dichlorobenzene 75 * level not exceeded * 1 , 1 , 1-Trichloroethane 200 * level not exceeded * Trichloroethene 5.0 * level not exceeded * Vinyl Chloride 2 . 0 * level not exceeded * Comments or additional compounds found: + T omas F. Bourne, Laboratory Director i F$s.......0............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OOFs A HEALTH INV13. .......... ................OF............ ..!.S ................... ........ Apptiration for Biopooal 10orlun Tonotrudion Vrrntit Application is hereby made for a Permit to Construct l ) or Repair ( ) an Individual Sewage Disposal System at: ............... _... .. ...........-+... .._........... .......................L... ... ...... .... ......................................._.... Locati - ddres� p i, � � or Lo-No. ........ !. �.... :ill ?! .., .. ...rj.............�T.-.A.. .JC.�..q!d�1 G{ a;/l?lL` .......0 er GY. ... Installer ......................................... .......... 01....�................ ......Addresi..... 9:.:::Sq. . ............. a; Type of Building ,� 1 feet � A Dwelling—No. of Bedrooms............................................Expansion Attic ( Garbage Grinder ( o A7, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a" Other fixtures ........................ ......................... Design Flow.................... ... gallons per person per,daay. Total dail�y��w.................� .. ..........ggons. Septic Tank—Liquid capacit .1 ......gallons Length.....1.:...:.... Width... .... Diameter......... 1 .. Depth....'. ..... i Disposal Trench No. A Width. ... Total Length........... Total leaching a ea....................s ft. �tJ " Seepage Pit No..................... Diameter...... .` .... Depth below inlet.....4 .... Total leaching area....' �>.sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed b J �.��� -Z y..............: .......................... �. ... . ... . ....... Date....................... Test Pit No. 1........ :....minutes per inch Depth of Test Pit....��.......... D ppth to ground ound water..- i t Test Pit No. 2......=......minutes per inch Depth of Test Pit.......1.V....... Depth to round water.(.............R' i..................... ...... ... C Description of Soil... :q .. .:a ........................................................( 9�e ^ ............... ............. ...:....................:.:........ . ....... ...rr ,.. ............... ................... Q.`... .. !J 11Yh► St�a��O. .............................................................•........................................... ....-.......................... 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be ssued by he rd of health. Signed...................... ................................................... ...... ...Gr'••=•• _.... Application Approved By.........( .. ..... ................................... Dare AApplication Di Date PP Disapproved for the following reasons: .........................................c9......................... .. ................................... ...••---.:...................................................................................... te Perm; No.......L-.a.....� . rr�.8..................... Issued........................................... ....... ___y - Date p Do •boa No....41.4;Ls r F$s............._............... THE COMMONWEALTH OF MASSACHUSETTS P ©� BOARD O��F�� �� H�� EALTH ...... . ?A.?................OF............!_...."....! S ................... Appliratiun fur Disposal Murks Tuntrixrtiun ramit Application is her made for a Permit to Construct l ) or Repair ( ) an Individual Sewage Disposal System at: ................»»»..»»..�2 : .. .. ....:. .._........... ......................1-...... ... ...................._......»...._.... ._ . c Loeati ddresa .......... ..........p... .... go LoF No. t I` ?'2us� � o1J A 0? tie. ............................�............. ................................................. ..............: ...................................'....... ............ Y_ Installer Addrea� a Type of Building Size Lot..... .:......Sq. feat Dwelling—No, of Bedrooms............................................Expansion Attic ( Garbage Grinder ( c is Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) '+ Other fixtures Design Flow......................:r r .�.. gallons per person per day. .To...........� fl?.....................-��'j O......... one, g Total dail fl w.................... a. Septic Tank—Liquid'capacit . allons Length....A21�'Width...�-�?. Diameter....!?.��.. Depth..... - � T Disposal Trench—No. .......'....P..... Width ....... Total Length....... Total leaching See a e Pit No.......1............. �-p`` t c ing a ea ... sq, ft. iameter......la -4? Total leaching area...,.......�-�...sq, ft. Seepage .... .... Depth below inlet.... .... � 2, Other Distribution box ( ) Dosing tank1() . Percolation Test Results Performed by........,.J: ?� -!? :.. 441 ....... Date �13.. ...... ... Test Pit No. I..;.............minutes per inch Depth,of-_.Vest Pit....kZ ........ D th to ground water. .:..... P gCo o Test Pit No. 2................minutes per inch Depth of Test Pit.......1�:1....... Depth to ground water. ................:��'�-�� 1. Description of oil...�.Qt...... .�a......lOmn lie?.e;nti;..!'.*..'. .....SQe-&0 h,. .......... ...................... .7R.......... ........... :�......lz:.........!...:1%XJ 1........ m.....4r.�...`P................................................................................................................ 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha7bD issued by bo of health. 'Signed ..G � -.. .... .. ...... Application Approved By........... ;;+;;;;�-,,. Date Application Disapproved for the following reasons:.................................................................................:: .•.. ..... .....:......»..» ........................................................................................................................................ , gg _ �� � Date PermitNo........./... ........................................ Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tn ilir& of font Ii�tn� THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( �Ifor Repaired ( ) by.............../..........¢¢............ .�. rr .... .. .. ............. -- at.............4,r. (......�,.........'.kll:t. '-....................... .:.. ....`......................................................................................... ...... has been installed in accordance with the rovisions of TITLE g5pf The,t Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON 1J� A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTQ DATE.............. .. .................7 ..1/�,-:1 as ...... ......................................... pector.. e THE COMMONWEALTH OF MASSACHUSE; rs BOARD OF HEALTH No.......� .:.. -� .......... , ..........OF............. .................................... FEZ,....................... �io�,a�tt1 Marko �unotr�ttiun ��rutit . i Permission is hereby granted............................................................. .......... to at Nonstruc...(... .1-4 pair!. O..an i��i ual ew age�Dispo�al System ........................................ .... fsv�$ !rl stye .. as shown on the application for isposal Works Construction Per DATE......................�. ., �.,. ...................Board of ?ieaith .............................. FORM 1255 A. M. SULKIN, INC., BOSTON c �'(T-3 3 No.M- -- ---------- Fee--- -- ------------ BOARD OF HEALTH TOWN OF BARNSTABLE ZippricationArVell Con0rurtionpermit Application is hereby made for a pe it t onstruct ); Alter ( ) r Repair ( )an individual Well at: - - -------------------------------------------- Location — Address Assessors Map and Parcel --5--sue--- n-- - --- -------------------------------------- --- -- -- -------- Owner Address - - °`'`�` -- - --- ---- - -- -- ------- ---------- - Installer — Driller Address Type of Building Dwelling— -- ---_----------------- Other - Type of Building ------ No. of Persons-----_________________________ _____--___-_-- Type of Well-- -e -Q` L— - 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 Certificate of Compliance has been issued by the Board of Health. - - - -- -------- � - ��- Signed-- - - ---- �-- G ate Application Approved By-- - date Application Disapproved for the following reas s:---------------------------------------------------------------------------------------------------------------- ------------------ - ------ ------ ------------------------___---�---- ___- -------------------------- date Permit No.--- --- -- -- --- Issued------- - ------ — -- -- date BOARD OF HEALTH TOWN[ OF BARN[STABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( Altered ( ), or Repaired ( ) --------------------------------------------------------------- ----------------------------------- r Installer at— —- _—_ --- - ---- —— _-- — --- ---- ----—------- ----- --has been installed in accordance with the provisions of the Town of Barnstable Board of Healt ivate Well Protection Regulation as described in the application for Well Construction Permit No. - --3- - ated--------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------------------------------------------------------------- Inspector-------------------------------------------------------------------------- l�1 i No.-----------3 5--------- Fee' BOARD OF HEALTH TOWN OF BARNSTABLE Application-*r Veil Con!6truct ion Permit Application is hereby made for a permit to Construct ), Alter ( ) or Repair ( )an individual Well at: C� l 1�)C��v�n. a (.s�C -i)l 11,E CL.1__.------ ------- ------- Location — Address Assessors Map and Parcel -------�� -- e1�,_� --'�—---------------- ---—---------------------------—-----—---—------------------------------------------ Owner Address Installer — Driller Address Type of Building Dwelling-..... — �=--- ----------------- Other - Type of Building ---------- No. of Persons--------------------------------------------__— Type of Well—— \\— �c.C _� P Q �i-- 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 Certificate of Compliance has been issued by the Board of Health. Signed- _ ____��L' / � .---- ----------- -— -\\ I I �C 3 ate Application Approved B r /�t - f'ihf - � �� j date , Application Disapproved for the following reasons:----------------- --------------—— b' r / date Permit No._tJf y -` --- ---- ------------------------ Issued----------------?C_ �', / date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ,/Altered ( ), or Repaired ( ) —--------------------------------------------------------------------- -- - --- -------------—------------------------------------------------------ —- Installer o 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. /J��3ZJ ated--------------- 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 . Melt Con5truct ion Permit f . No.% Y`-- --- Fee-- Permission is hereby granted-------- % !!----------------------- - to Construct ( Y), Alter ( ), or Repair ( ) an Individual Well at: 4 �� r f C,- v v . 7 \ I — ��"—C': / Street / as shown on the,application for a Well Construction Permit �� )� --------------------- Dated--- No. � .� �- ---- --- ------- 1 r Board of'Health- DATE 38 — LOT 1 LOT 3 40 41 N 4,e LOT 2 i IRS SEPTIC . 43 — 43,692 S.F. LOCATION PROPOSED o0 44 — 6116189 4.5 46 4#1 RESER VE R31 &A �A�jN.oF , REA, LOT 3 Uf 44 &A Uf sgcy �� JOHN eyGCAU t / D / D LEY PAU LAN ERS-CAU. X c.> CIVIL BOX m NERITHEW o. 32098 elclsT • / x / oj� s��NAL LAN�SJ �aVA E `—SEP TA EXISTING POSSIBLE ENCROACHMENT SHED PROJECT LOCA TION 770. WAKEBY-ROAD 5 HARSTONS Afff--J:- S 0 APPLICANT MARCARET FITMEBON 428-0084 well YANAEE SURVEY CONSULTANT'S proposed UNIT 5, 40B INDUSTRY ROAD .well \ BOX 265 s n P. 0. fnd MARSTONS MILLS AM 02648 TEL 428—0055, FAX 420-5553 � �\�� p���h' `c� \ GRAPHIC SCALE 0 0 0 60 ISCALE I" DATE.• 1114193 - - REV REV- IN FEET 1 inch = 30 M JJOB NO.: 50379 SHEET 1 OF ,? = co - 5 J: 10' 49-5-± ------- 7 12" 5 PROPOSEDMN 49. 7 7 7 4' SCHEDULE 4.0 P.V C DIST PRECAST 7-17-1-7-7 Box z LEACHING CAST IRON Sz=0. 03 OR IN pjTCH 1/8 PER FT 4 LE 40 D=10- Of - Ui SCHEDULE OR SCH 0 p. V C. PIPE FLOW LINE D =O. 03 2' oc 10 19 0( 2v 1--l/ _w 3'�4 S 0.02 INVERT VEL 0. - S�ED S7VJVE D==53. 0, S 0 4p tz j c INVERT 46-21 iNVER C-A - i EL. 145.80 Tt .. ol4752EL. 0 41.5- - I ERT INVER EL. - 0 EL.EL. ArV 1� EL.z=_A6. 46 EL. 97 LEACH PIT PFF 3' 1250----GALLONS i2 r 6 SEPTIC TANK SGS PROBABLE WATER TABLE EL== 37.5 OF U ppOFILE EST HOLE OR BOTTOM OF T SYSTEM SEWAGE DISPOSAL NOT TO SCALE SOIL LOG ALL ELEVATIONS ARE ASSUMED P A U& MEN T-Hj V W WITNESSED BY: CA ULE Y J. LANDER J. DUNNING PERCOLATION RATE 2 - MIX/ INCH voTE5 SYSTEM.TEAf B-27-93 DATE DATA.- A SEWERAGE DISPOSAL DATE 'L DESIG TjoN OF N IS FOR CONSTRUCTION FAIR 5, BARN. REG. DEEDS LE 1 TEST HOLE 2 1. THIS PLAN BOOK LCC37518A ,Tic SYSTEM TEST HO EL,== 50o 0 THRDE 2. PLAN REFERENCE OF SET 5 3' FOR INSTALLATION/ R ING PURPOSES EL, == 49.5 50.0 NUMBER OF BEDROOMS 3. THIS PLAN I-' BE USED FOR SURVEYING OR ZONING NONE ------- D NOT TO CONFORM To D.E.P. WOOD LOAM AN fA TERIALS SHALL C REGULATIONS TIONS 49. WOOD LOA-"I s ADS IL 0 GARBAGE DISPOSAL THREE ---� GPD ) A NSTABLE RULES AND SEAL --- 47 4. ALL WORKMANSHIP ANljqV OF BAR. 3' AL ESTIMATED FLOW D TH OF SEwAGE. TITLE 5 AN E TO P NITHIN 46.5 3L--- TOT FOR THE SUBSURFACE DISPOSAL BROUGHT UGHT TO y x 3 -- BR-) 5. ALL Co VER To SANITARY UNITS SHALL BE _Ljg__GAL-1BR-1DA -- THE 1250 12. OF FINISHED GRADE SHALL REMAIN ESSENTIALLY SEPTIC TANK CAPACITY -—- -- TING AND FINAL GRADES IL CONSySTEMOURS- MED. SAND REQUIREMENTS- 6. EMS No TED B Y FIN., SHALL BE CAPABLE MED. SAND 150*25==375gpdSAME, UNLESS LEACHING AREA REQUIR3— ,NE,TS OF THESANITARY UNLESS THEY ARE 7 ALL COMPI r-lo LOADING DING �EA 159- GALIS-F OF WiTHST,4NDIArG I DRIVES OR PARKING AREAS. H-20 LOA 38. 0 SIDEWALL Afi GALISIF 113*1- Oz= 113gpd WITHIN lo' OF DRIVES OR PARA7NG- lo' OF DI 1; 12' BOTTOM AREA & SjDENALL)_j&LGAL 0 R WITHIN UNDER OR USED SHALL 3 7.51 1 SHALL BE U VERS To GRADE UNCTER�ED LEACHING CAPACITY (BOTTOM UNLESS NOTED. BRING CO 1vo wA TER ENCO ANY MASONRY UNITS USED TO WITH -Aaa- -- GAL 8. To COMPLIANCE RESERVE' BE MORTARED IN PLACE BEEN MADE AS E LEACHING CAPACITY ,)�ERIAITL�ICANT IS TO � 379 9. Aro DETERMINATION HAS IONSA UTI-10RITY r? ZONING REGULATIONS. JOB NUMBER___- • DET DEEDED 0) ERMINATION FROM APPROPRIATEN OF ALL OBTAIN SUCH SHA LL VERIFY THE LOCATIO EXCAvATOR\CONTRACTO' TO ANY EXCA VA TION 10. THE N N DERGRO U D L�TLjTIES PRIOR - LOT 1 39 � LOT 3 " — — 40 Imo t.0 41 — 00 — 42 - _ LOT 2 SEPTIC — — 43 - - 43,692S.F. LOCATION _ PROPOSED 0 _ 'a 6116189 0 _ 44 — / 45 i r 46 47 ` \ I RESERVE Ara ���� of ���� AREA, , V,,of 414 �' ti (� g LOT 3 s,� ��,- z o LAN DER JONN Gcn PAUL y� S-CAULEY A. C-3 CIVIL T. BOX / �O o MER 7HEvv DIS N No.35101 CIO _ 0 -o No. 32098 GISTER� / /SEPTI ��NAL LANas TANK/ G POSSIBLE ENCROACHMENT 1e)titi sow, SHED __��. �, PROJECT LOCATION 1 0 51 7 WAKEBY ROAD �o \ , '� ¢`95p ¢ MARSTONS MILLS .01 ' 15 ti O APPLICANT MARGARET FITMEBON 428—0084 well o \ ,� o PT Y"7= SURVEY CONSULTANTS n \ proposed o� \ o Q UNIT 5, 40B INDUSTRY ROAD s o \ �� P. 0. BOX 265 . fnd MARSTONS MILLS, MA. 02648 f TEL. 428-0055, FAX 420-5553 f GRAPHIC SCALE , SCALE 1 = 30 DATE. 11/4/93 30 0 15 30 60 120 REV REV.- IN FEET ) i 1 inch = 30 ft. JOB NO.. 503,79 SHEET 1 OF 2 EL. =_5_0.5 PROPOSED TOP OF FOUNDATION 20' MIN. 10' min CONCRETE COVERS � 2"LA YER OF 49.5 PROPOSED 1/8"-1/2"49.5�- CONCRETE COVERS WAS ED STONE 4" CAST IRON 2.5f / / / / , / � . / / i / / � OR SCHEDULE 40 4" SCHEDULE 40 P. V.C. P. V.C. PIPE 12» MIN. PITCH 1/8 PER FT. 8 X M N. INVE7z RT D=53. 0, S=0. 02 1 FLOW LINE D=10. O,S=0. 03 PRECAST 10" 4 7.52 MIN 19" D=8, S=O 03 LEACHING EL.---- --- C OR INVERT46.21 2' f q p EQUIVALENT INVERT EL. I a EL.= 46. 46 0.LEVEL pc INVER INVERT INVER ° 4' � ° 314" TO 1-112" - ��� __GALLONS - 45.80 WASHED STONE SEPTIC TANK EL.= 45. 97 EL. EL.= 45.50 0° o1 ---- ° w 0- EL. LEACH PIT I - 3' r- B" 3' PROFILE OF 12'DIAM.-- � SEWAGE DISPOSAL SYSTEM NOT TO SCALE BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE EL= 37.5- ALL ELEVATIONS ARE ASSUMED SOIL LOG WITNESSED BY- PAUl, MERITHEW J. LANDERS-CA ULEY GENERAL NOTES J. DUNNING PERCOLATION RATE- 2 MIN./ INCH 1. THIS PLAN IS FOR CONSTRUCTION OF A SEWERAGE DISPOSAL SYSTEM. 2. PLAN REFERENCE BOOK LCC37518A LOT 105, BARN. REG. DEEDS. DATE 08-27-93 DATE 08-27-93 3. THIS PLAN IS FOR INSTALLATION/ REPAIR OF SEPTIC SYSTEM TEST HOLE I TEST HOLE 2 AND NOT TO BE USED FOR SURVEYING OR ZONING PURPOSES EL= 49.5 EL = 50. 0 DESIGN DA TA.' 4. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO DEP. TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 49 WOOD LOAM SWOOD LO" NUMBER OF BEDROOMS THREE 5. ALL COVER TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN , sdo suet. AND NONE 12" OF FINISHED GRADE. 46.5 3 3' 47. 0 GARBAGE DISPOSAL 6. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME, UNLESS NOTED BY FINAL CONTOURS. TOTAL ESTIMATED FLOW THREE GPD 7. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE ( 11_0_-GAL/BR./DAY x 3 __ BR.) OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER - OR WITHIN 10' OF DRIVES OR PARKING AREAS. H-20 LOADING MED. SAND MED. SAND SEPTIC TANK CAPACITY _ - 1250 SHALL BE USED UNDER OR WITHIN 10' OF DRIVES OR PARKING. UNLESS NOTED. LEACHING AREA REQUIREMENTS 8. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL 37.5 12' 12' 38. 0 BE MORTARED IN PLACE SIDEWALL AREA 150- GAL/S.F. 1 2.50 5=375gpd 9. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH NO WATER ENCOUNTERED BOTTOM AREA �3_ GAL./S/F 113*1. 0= 1139pd DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO LEACHING CAPACITY (BOTTOM & SIDEWALL) 488 GAL OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. _--- 10. THE EXCA VA TOR�CONTRACTOR SHALL VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES PRIOR TO ANY EXCAVATION. RESERVE LEACHING CAPACITY 488 - GAL. 50�79 R � 4 ,z .:�.�x�,W-� _...y��,- ;�. :;.. :-:.�� :��_ r,��,�,A,p, _:,:a:,n a.-::x:s .._:,,•;;=4 �.:.., ....�,a.��:�,�.:��,�.--�,,s �-.�w�,.:�, ,,,�xa:,� ,�-._ - ,.�-, �--����,. ,..,.......