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HomeMy WebLinkAbout0100 ALDER BROOK LANE - Health 00 ALDERBROOK , ' ,W. BARNSTABLE A = 1' - o\o o a I a o TOWN OF BARNSTABLE LOCATION 1 4'-0 A kD FI� SEWAGE # VILLAGE i2l;1P/L- ASSESSOR'S MAP & LOT /3 ' ®/® I yT P£ S D�ERR'S NAME&PHONE NO. SEPTIC TANK CAPACITY 11L;i�£ C //.0A, LEACHING FACILITY: (type) (size) N,b.OF BEDROOMS BUILDER OR OWNER ,v S £c lzm— ,/ PERMITDATE: C1��9E DATE: ,3"'� 3�- 1 r Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by pl, 1 s TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE_!ft Pb %4 A ASSESSOR'S MAP & LOT/ 31 c 010 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY. Lw J� LEACHING FACILITY:(type) P 1 T (size) too 0 NO. OF BEDROOMS PRIVATE CELL' R PUBLIC WATER BUILDER OR OWNER , 6 WPO vs-) rt DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r e4 06/ �Q � I U No.--------- �----- Fee--------------------- i BOARD OF HEALTH �I TOWN OF BARNSTABLE Application-*rVell Cootructionpermit AppliCafion i er by�de for a per ), A it to Construct ( � lter ( ), or Repair ( )an individual Well at: l-U- - Location — Address Assessors Map and Parcel ner Address Installer — Driller Address Type of Building_ —---------------------------- Other - Type of Building---------------------------- No. of Perso//ns------------------------ Type of Well---- `�`�-- - ------- 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 Hea Private Well ro c ' n Regulation - The undersigned further agrees not to place the well in operation unt' a e if' t .o has been issued by the Board of Health. Signed — - -- --------------- - —�-0 y date Application Approved By a-- -- -------------____-- _-?--/ - D 5 ------------- date Application Disapproved fo the following reasons:-------------------------------------------------------------_____—___—__________ ----------------- ----- --- ---------------- ---------------------------------- ---------------------------- date Permit No. __ ZO Oj� -tL- ------------------ Issued---- --- / - - - — -------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO C�TIFY, T t dnngji.,vidual'We Constructed (� Altered ( ), or Repaired ( ) by-------------�--L—� _ / L_v��t --_I------------------------------------------------------------------------------------------- Installer at------/10 - ---— - — _ —--------------------------------------------------------------------------------------- --- 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------------------------------------------------------------------------ r ' i W Zo o 5- G 2 Fee--- BOA.RD OF HEALTH TOWN OFBARNSTABLE x. y.. Zipp[ication-*rVell Con0ructionPermit r Appl' ation is- er by made fora permit to Construct ( Alter ( ), or Repair ( )an individual Well at: ------------------------------------------- Location — AddreA Assessors Ma and Parcel rs-------------- ____ --- -s_ .- P---------------------------------- 0/41mer Address --- ---4�./_0------mod ? �----- - ----- Installer — Driller Address Type of Building Dwelling -------------------------- ! Other - Type,of Building --------- No. of Persons------------------------------_________ { Type of Well-----� `S`�-- ---------------- Capacit I Purpose of Well-------- D . � Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The i Town of Barnstable Board of Health Private Well Pro/ec 'on Regulation - The undersigned further agrees not to place the well in operation until �er ifi a .of o ,P 'a /has been issued by the Board of Health. Signed _--- - - ------------------------ / oY --------------------- ' date Application Approved By— -- ---- ---- --- --- -— 7 ' - D ------------ ------------ date I ----------------------------------------------------4--- 1 Application Disapproved for he following reasons:------------ -----------—-- ------------- - ----------------------------------------------------------------------------- date --------- Permit No. _-W- O 5 U Z _ -- - Issued--- -- ? - / - ----------------- -------------------------------- date --- i II BOARD OF HEALTH TOWN OF BARNSTABLE ws Certificate Of Compliance THIS IS TO CERTIFY Th t,t a In i al Wel Constructed (� Altered ( ), or Repaired ( ) bY- -- �=/ ------------------------------ ------------------ - --- ---- ---- -- ----------------------------------- Installer �y', 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. --------------------------Dated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. iDATE-------------------—------—--------------------------- - -- Inspector-------------------------------------------------------------------------- ------------------------------------- ------------------------------------------------------------b'--.� BOARD OF HEALTH TOWN OF BARNSTABLE Velf Con5truct ion Permit o �- No. w-2'--U- U 21 /' Fee------�------- z� , .� Permission is hereby granted— ------- --------------------------------------------------------------------------------- 'I to Construct ( Alter ( ), or pair ( ) an Individual Well at: �1� _ �� No. - — --— 4—_-- - - --- - - - -- street as shown on the application for a Well Construction Permit No. ------------- Dated--- L-------�t-- -------------- Z-7 -- --- ---------------------- DATE 0 0 .. - - / Board of Health ----�-_-�--- —2 � —_— // r 1 19 V<) COMMONWEALTH OF MASSACHUSETTS Z f EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION 61 2— /1 c,�qM s�av 1� G.�. 350 MAIN STREET. MAP 3 2 & WEST YARMOUTH,MA PARCEL ® `_ �� 508-775-2800 i 7 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A ry CERTIFICATION Map 132 Par 010 3>- Property Address: 100 Alder Brook Road `D West Barnstable,MA. 02668 _ Owner's Name: Tony Glydon tV Owner's Address: 100 Alder Brook Road O West Barnstable,MA. 02668 cn Date of Inspection Name of Inspector:(please print) James D.Sears r � � m Company Name: A&B Canco Mailing Address: 350 Main Street West Yarmouth,MA 02673 Telephone Number: 508-775-2800 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: The system inspector shall suPmitopy of this inspection report to the Approving Authority(Board of Health or DEP)within 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 office of the DEP. The original should be sent to the system owner and copies sent tot he buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: N/A One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined" please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 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 ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 C. Further Evaluation is Required by the Board of Health:N/A Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety,or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health 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 salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 3 r P 4 f Page o I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 D. System Failure Criteria applicable to all systems: N/A You must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ./ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ./ Liquid depth in leaching is less than 6"below invert or available volume is less than'/2 day flow �— Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ./ Any portion of the SAS,cesspool or privy is below high ground water elevation N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone 1 of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A 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. (This system passes if the well water analysis performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No 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. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system is failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Form 6/15/2000 4 I Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 Check if the following have been done. You must indicate"yes"or"no"as to each of the following Yes No Pumping information was provided by the owner,occupant,or Board of Health Were any of the syste_n components pumped out in the previous two weeks? ./ Has the system received normal flows in the previous two week period? ./ Have large volumes of water been introduced to the system recently or as part of this inspection? ./ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ./ Was the facility or dwelling inspected for signs of sewage back up? ./ Was the site inspected for signs of break out? Were all system components,excluding the SAS,located on site? ./ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum 4 Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yes No Existing information. For example,a plan at the Board of Health. ./ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 1`.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 FLOW CONDITIONS RESIDENTIAL Number of Bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms: 440 Number of current residents: 2 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): YES Seasonal use(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): WELL WATER Sump pump(yes or no) NO Last date of occupancy: PRESENT COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: 2002 Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ./ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 1999—PERMIT#99-391 Were sewage odors detected when arriving at the site(yes or no): NO Title 5 Inspection Form 6/15/2000 6 f OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 BUILDING SEWER(locate on site plan): ./ Depth below grade: 14" Materials of construction: Cast iron ,/ 40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): Depth below grade: 14" Material of construction: ,/ concrete metal fiberglass polyethylene other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 GALLON PRE CAST Sludge depth: 2" Distance from top of sludge to the bottom of outlet tee or baffle: 28" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 16" How were dimensions determined: AS BUILT AND TAPE Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): MAIN TANK AT WORKING LEVEL,INLET TEE OUTLET TEE,TANK AND COVERS 14"BELOW GRADE. NO SIGN OF LEAKAGE OR OVER LOADING. GREASE TRAP(located on site plan) N/A Depth below grade: Material of construction: concrete metal fiberglass polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(]ocate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no) Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: 4 (if present must be opened)(locate on site plan) ) Depth of liquid level above outlet invert: 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.,): D BOX NOTED ON PLAN. PUMP CHAMBER: ./ (locate on site plan) Pumps in working order(yes or no): Yes Alarms in working order(yes or no): Yes Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): PUMP CHAMBER—1000 GALLON PRE CAST WITH COVERS 14"BELOW GRADE CHAMBER CLEAN. ONE PUMP WORKING,ALARM WORKING. Title 5 Inspection Form 6/15/2000 8 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 100 Alder Brook Road West Barnstable,MA. 02668 Owner: Tony Glydon Date of Inspection: March 23,2004 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: 4 leaching galleries,number leaching trenches,number,length leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) LEACHING IS FOUR CULTAC RECHARGER 34'X13'X2' TEST HOLE AT LEACHING NO SIGN OF OVER LOADING. CESSPOOLS: N/A (cesspool must be pumped as part of inspection)(locate on site plan) Number and 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 inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.): PRIVY: N/A (locate on site plan) Materials of Construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Title 5 Inspection Form 6/15/2000 9 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least t,bo permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I T:': Inspection Form 6/1 5/?000 10 r PagL 1 I of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: i SITE EXAM Slone Surface water Check cellar Shallow wells Estimated depth to groundwater feet Please indicate(check)all methods used to detennine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observation site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: 4 Tit.e 5 inspection Form 6/15/2000 l l t Massachusetts Department of Environmental Protection �i Bureau of Resource Protection i+ Well Driller Please specify work performed: Address at well location: New Well Street Number: Street Name: 100 ALDERBROOKLANE Please specify well type: Building Lot#: Assessor's Map#: Irrigation I 132 Assessor's Lot#: ZIP Code: Number Of Wells: 110 102668 1 1 City/rown: Well Location V v , BARNSTABLE In public right-of-way: V" GPS North: West: 41.77127 170.38670 1 Subdivision/Property/Description: Mailing Address: b click here if same as well location addres Property Owner: Street Number: Street Name: FRANEY 1100 JALDERBROOKLANE City/Town: State: Engineering Firm: 1BARNSTABLE MASSACHUSETTS ZIP Code: 02668 Board of health permit obtained: a O ji Yes Not Required Permit Number: Date Issued: ? 013 007 5/8/2013 ^' N CD 0 Massachusetts Department of Environmental Protection i Bureau of Resource Protection—Well Driller Program ' t Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock Auger � �-Choose Bedrock— WELL LOG OVERBURDEN LITHOLOGY From Drop in Extra fast or slow Loss or addition of To(ft) Code Color Comment (ft) drill stem drill rate fluid P-057 IFine To Coarse Sand jBrown c Ye r ji Fast rjq Slow �Loss )Addition 20 40 Fine To Coarse Sand ( Brownn��� E.Ye sju Fast Tji Slow m Loss rjq Addition 40 60 �Sil Sand Brown TRACE CLAY l ry �� Ye rJt,Fast rj.r SlowLoss eja Addition 60 70 Sil Sand Brown TRACE CLAY —� � Ye ajn Fast ,jt Slow rj,Loss ,joy Addition 70 75 Medium Sand Brown —_ Ye rju Fast rja Slow ,jT Loss Ij,Addition 75 90 Clay ^�� Light Gray71 Ye ija Fast rj:r Slow ,ja Loss ,j Addition 90 110 Fine To Coarse Sand Brown Ye jA Fast rj,Slow rjn Loss ,jr Addition 110 112 Fine To Coarse Sand Brown ; Ye TjoT Fast Tj,Slow ,je�Loss pjT Addition .WELL LOG BEDROCK LITHOLOGY Visible Extra From Drop In Extra fast or slow Loss or addition of To(ft) Code Comment Rust Large c M (ft) drill stem drill rate fluid a. Staining Chips Choose Code [—� Ye rjT Fast ,jA Slow rja.Loss TJA Addition Ye Ye ADDITIONAL WELL INFORMATION __ F Developed x>j�Yes s j,No Disinfected T#�Yes T,No Total Well Depth 1112 Depth to Bedrock Fracture Surface Seal Type iNone Enhancement rj;Yes CASING I b Is Casing above ground. From: I' ®� To: 10 From To Type Thickness Diameter Drlveshoe 0� 92 Polyvinyl Chloride Schedule 40 0 Ye SCREEN c: No Scree From To Type Slot Size Diameter 92 112 Stainless Steel Well Point 0.012 WATER-BEARING ZONES C DRY WEL From To Yield(gpm) Massachusetts Department of Environmental Protection I Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) L� 112 115 PERMANENT PUMP(IF AVAILABLE) --Choose Pump --Choose Horsepower-- Pump Description Horsepower Description--- _ Pump Intake Depth(ft) Pump Capacity(gpm) ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material Weight Water Batches Method Of Placement (gal) Choose Material Choose Material Choose One--� WELL TEST DATA Time Pumping Time To Recovery (ft Date Method Yield (gpm) Pumped Level (ft Recover BGS) (HH:MM) BGS) (HH:MM) 8/29/2013 Constant Rate Pump 15 1:30 0:01 C� WATER LEVEL Date Measured Static Depth BGS (ft) Flowing Rate (gpm) F812912-01-3 17 15 COMMENTS WELL DRILLERS STATEMENT This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report is complete a knowledge. Driller THOMAS E DESM )ND III Registration# 7764 Monitoring[M] Supervising Drill Firm IDESMONDWELLDRI Rig Permit# 1023 Date Job Compl NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. Page: 1 of 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) Ysi;��at�tst^! Report Prepared For: Report Dated: 8/30/2013 Sally Desmond Desmond Well Drilling Order No.: G1376882 P O Box 2783 Orleans, MA 02653 i Laboratory ID#: 1376882-01 Description: Water-Drinking Water Sample#: Sample Location: 100 Alderbrook Lane W. Barnstable, MA Collected: 08/29/2013 Collected by: Customer Received: 08/29/2013 Routine_M ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen ND mg/L 0.10 10 EPA300.0 LAP 8/29/2013 Iron 2,1 mg/L 0.10 0.3 SM 3111E LAP 8/30/2013 i Manganese 0.40 mg/L 0.10 SM 3111 B LAP 8/30/2013 pH 7.0 PH AT 25C NA 6.5-8.5 SM 4500-H-8 DCB 8/29/2013 Sodium 12 mg/L 2.5 20 SM 3111E LAP 8/30/2013 1 i Total Coliform Absent P/A 0 0 SM9223 RG 8/29/2013 Conductance 150 umohs/cm 2.0 EPA 120.1 DCB 812g/2013 Based on the results of the parameters tested, the water is suitable for drinking, but may present aesthetic problems (taste, odor, staining)due to Iron. Attached please find the laboratory certified parameter list. Approved By: —kill- '► l (Lab Manager) ' ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 No. CJ 2�-O/ 3 '._00'7 Fee y5 BOARD OF HEALTH TOWN OF BARNSTABLE 2pplicatiou _for lVell Cougtrurttou permit Application is hereby (made for a permit to Construct a), Alter( ), or Repair( ) an individual well at: loo p►�c fib`(�t7�/. L�aV�� '�Q�, )lY uod to Location-Address T Assessors M1ap,hand Parcel i Po (�- Vim,"W )Oo L" T Own Address Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well Hoy So&q(l PIC Capacity Purpose of Well (C-\,g 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 Compliance has been issued by the Board of Health. Signed J 6, 13 D to Application Approved ���!' J Date Application Disapproved for the following reasons: Date Permit No. A) L 3 �� Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of Comphauce THIS IS TO CERTIFY,that the individual well Constructed(J), Altered( ), or Repaired( ) by heLYinm Ak NiWf\-% (yy nn ` Installer at ) Dd I, 6fOo has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private W ll Protection Regulation as described in the application for Well Construction Permit No.V)6MV3^ Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. Q a-G/ 3 �'c>� ) Fee BOARD OF HEALTH k TOWN OF BARNSTABLE 01ppYf cation _for Vern Con.5truction Permit Application is hereby made for a permit to Construct Alter( ), or Repair( an individual well at: Location-Address Assessors Map and Parcel OwneFj Address OLt form N-hA nz(,,53 Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons ° Type of Well H„a sxup eqc- Capacity Purpose of Well fTM 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 Compliance has been issued by the Board of Health. Signed b „� 5 6 13 Date Application Approved y 510 -7 Date Application Disapproved for the following reasons: Date Permit No. G 1 3 00 Issued �j J °V Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY, that the individual well Constructed(J), Altered( ), or Repaired( ) byP,c .� Installer at 1 Od A 1C�,r b tk- (,,, ;W . �. 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.NU c C 3-©C 7 Dated 51�-J1 3 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 Con!5truction Permit j No. Fee Permission is hereby granted to ( �—I;IG� Installer to Construct(/), Alter( ), or Repair( an individual well at: No. T A�ao c�ncwl- �,. VV � cL-aUL Street JJ as shown on the application for a Well Construction Permit No. W 2�-D ► -3 i U o�) Dated j)? /1 3 Date �j/ �� 3 Approved M • 15.8 \ /_ 16.3 16.4 417.2 n n `jQs CRANBERRY BOG47 18.1 114----WATER EL. 12,3 : RCE A[ (4/27/99 odd y KA L/ L' ..-417.3 22.9 LEA + SO COVER IS' : 25.2 . 17.0 - 17.1 � �17.7 Qr` . 3.9 4 16 17.074 i 1� �183 i 28 2 .1 � 7 O �,8.2 WELL f32.19 ' 32 9.1 / �3.2 >r/ 210 K 18.3 34.8 . 37.4 / 6. C, 231 �36 4 ` 2 .2 i 22 4.3 ;:...� K ;.. 22.5 25.7 :•:: ::• \G o O • 5.5••• `���\v .O tad. :i•• •'G�� M 38.2 2 37.1 39.1 • 24.5 6.1 \ 7g), 0.0 1 CS / . 39.5 • 25.3 1"PINE • 27.3 �2x626.0 26.3 0.0 •140.5 .9 / !Gj 4 2 7 121' RNE D. -27.9 26.6 29 40.6\ 3 .2 x 0.0 4X1/ 41.0 30.5 3,0 21 - --' // / drill h 4 I&�. *40.7 `\6 41.6 fn d. Y 32 /�-� / 40. 18" PINE 39.2 3 ' 40. 41.2,. 34.5 �6_7 40.9`. • 37 2 '� 41.0 BENCH MARK--TOP W00© S1 • 38.2 SET FLUSH , ,40;00 ASSI.GNE[ O 40.4 J.! 4 �- x 39.7 drill hole TOWN CONSERVATION fn d. LAND a THIS PLAN `IS A VALID COPY 0 AN ORIGINAL REU STAMP AND` 4jN OFMAS �1N OF4f4 RONALD 9° o RO Lp ACATION, N JA JA-UMBER d CA I ;LECTRIC WIRES (IF SHOWN.) O CAD I C o PROPOSED ELEVATIONS (Y MARKS POINT) s��''/STEP � S� NTOUR` �N�TAP�P �osu :ONTOUR "� 1 1 ��I �C4 TII ITICc fir c•i.....,..� TOWN OF BARNSTAKE IOLJA) e09Y LOCATION'AV A 06-'L.;�-X,r; L dAll SEWAGE # VILLAGE i,�� % 4fgfL�7Sf"p 6i� _ ASSESSOR'S MAP & LOT 13 Z -010 INSTALLER'S NAME&PHONE NO. AiR C00-;C-0 SEPTIC TANK CAPACITY n- tt(/A;� !,aT C41. LEACHING FACILITY: (type) ( ti�,�Cyl�r�� '"�r' (size) " - NO. OF BEDROOMS 3c- BUILDER OR OWNER_ Lv/gd1�.� PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply.Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet. Furnished by 42-q, TOWN OF BARNSTA.BLE a`''A) e°�y LOCATION100 111 Oe-It PY- 4- L42 4Mr- SEWAGE # VILLAGE 06,57' 24aA S&6I,e_ ASSESSOR'S MAP & LOT 13 Z —010 INSTALLER'S NAME&PHONE NO.A iR 003CL "7"7'J7�-Z 8-M SEPTIC TANK CAPACITY Atff"/;4 99 le' (54/ "P /aim 6­41- PC . LEACHING FACILITY: (type) 6)( Cv�ic n dAr?er (size) A 13>X 4 ,;NO. OF BEDROOMS 33t% . BUILDER OR OWNER ��11tJ PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 4 III 2� s • �� Q.: Ci O G ti � Er �a e ��^ P i tea,. ^--��• �, f'�.i<- ,..a /�� . . t No. ✓3 Fee 150 s/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for Xoioaal *Paem Construction Permit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. ql&r ad IAf, Owner's Name,Address and Tel. o. w• GC rAJ. tK�-f-wLts. &fly&aY1 Assessor's Map/Parcel ( /O Installer's Name,AddresAa&e.CA CO Designer's Name,Address and Tel.No. 350 Main Street 04ce I(✓C E" W. Yarmouth, MA 02673 7 7 S- T7 o a Type of Building: Dwelling No.of Bedrooms_� Lot Size sq. ft. Garbage Grinder( ) Other Type of Building fiC S„ No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ���y gallons per day. Calculated daily flow LI 3 gallons. Plan Date M 4 y /d /g 9 q Number of sheets a Revision Date IUTA Title Size of Septic Tank Ejc Ss A Q io ore Type of S.A.S. Pe r A Description of Soil pG f/:'ln A) Nature of Repairs or Alterations(Answer when applicable) _/e-r P�� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of It Signed Date Application Approved by — —Date '� y Application Disapproved for the following reasons I Permit No. Date Issued` j7 Ito Fee J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN"OF BARNSTABLE, MASSACHUSETTS 2pprication for �Bigooal *p6tem Construction Permit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /o U /-?Idler/>!v o A). Owner's Name,Address and Tel.,No. W i2i c r Aj. —Assessor's Map/Parcel d• Installer's Name,Address, d TeI�v ^� Designer's Name,Address nd Tel.No. (�e�i D�At�C(3 1 I" C'ACe i I(AC v► 350 Main Street 'W.Yarmouth. MA 026 7,z 77 Type of Building: Dwelling No.of Bedrooms<r f q' -4 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building re S . No.of Persons Showers( ) Cafeteria( ) ti .. ,,Other Fixtures Design Flow /_/yd gallons per day. Calculated daily flow 46 3 gallons. Plan Date N1+4 y /V /5 9 9 Number of sheets d Revision Date ;UTA Title S t r S e rJA Size of Septic Tank �'��a frn /�/o d Type of S.A.S. P r/?�04�✓ Description of Soil Pe r /D l lq Nature of Repairs or Alterations(Answer when applicable) Pe r /W iL) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has'been issued by this Board of FeNlt . Signed v Date d Application Approved by K Date "Zl�-• Application Disapproved for the following reasons Permit No., Date Issued Z CTHE COMMONWEALTH OF MASSACHUSETTS �%("A, Ifl��> BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the/On-site Sewage Disposal System Constructed( )Repaired (✓Upgraded( ) Abandoned( )by A)1 C c, at /UU A I .e r 13!0.0(,- . Zx( / It s been constructed in acco ace r with the provisions of Title 5 and the for Disposal System Construction Permit No. 3' r/ dated Installer Designer l The issuance of this peg t ued as a guarantee that the sy dtlincf as signs �C Date Inspector ' r No. �( `'.J — -------------=---Fee, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1wi,5poar *p.5tem Con.5truction Permit -Permission is hereby granted to Cons�t( ) epair( `✓` f�Up rad ( )Abandon System located at �� ��(.f [.c and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constr 1 ttio must b ogmpleted within three years of the date of thi p it. Date: � / --Approved PP Y � 1 LOCATION : /b® 5EWa6-4E PERMIT UO. IWSTALLER�5 U&tAF- ADDRESS L 0 _JIZLL C: 0 J=l-de +, , RcOK Lim — 5UILDER 5- Q &DIME ADDRESS L f./4Qhr Si hr�Z� DATE PERMIT _15S-UED D ATE - COM-PLI ht-10E _— �B �� :� �] 4� i �7 �� W / � () /f�1 ,b � E � T3 �- �, No....JYrf........ /10-----�------ THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH . .... :.............OF..........0.. . ... ..... ........ Appliration -fur 43 uuttl Works Towitrurttuu Vrrnift Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst at Lee 'o Address or Lot No: Ominer Address nstaller Address Type of Buildin Size Lot..�[u7. ..............Sq. feet Dwelling—No. of Bedrooms�g'_ *oD .....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building4e No. f persons.......Z--------------- Showers ( J ) — Cafeteria ( ) dOther fixtures --•--- � ------------------------------------------------- ----------------------------------------------- Design Flow--_-_-____ ......................... er person per day. Total daily flow__________-_`rt_4--0......................gallons. WSeptic Tank 4-Liquid capacity�AvD_gallons Length................ Width................ Diameter---------------- Depth---------------- x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below[[inlet_____._______._.__.. Tot 1 leaf]litt ----------sq. ft. z Other Distribution box ( ) Dosing tank ( • ) -D,O" d)- _ �-(> ' ~' Percolation Test Results Performed by----------------------------------------------------------- __-- Date-----------------------------/-_--..... aTest Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water--.-�_---.---------- G=, Test Pit No. 2-----_----------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ f� --•----------- .... - O Description of SoiL..................................... Z 2. x U .....---•-----------------------••--------------------...---•-••--••-•-••----•--•••----•--------•--•--•-------•------•--•--••-------•------------------------------------------------------------ -- W 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 Article YI 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 oard of health. Signed -tYC [ ----------------------- p/ Date Application Approved By---- ----- fib_. ---•----------- �`1 -` Date Application Disapproved for the following reasons--------------- ........... ---------•-------------------...-•--•-------•-•-------•---•-•-•----------- ----------------- ------------------------------------------••--•-------------,------------•-=�-•-----��------- ------------------------�---------------------...----------------- i' Date Permit No.------•--••...................... •---•C_,! Issued ---� 7 ----------...... '�— Date THE COMMONWEALTH OF MASSACHUSETTS BOARD 9f HEALTH _. f-1-!M. ............OF.......... Application -fur Uiopoiial Vorks Ton,itrurtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System.at: ........4 ---6A------(-;Z..... -A,47. s �. Loca ion Address or Lot No. cat Owner Address W --�RMh -•----..:I: ................... ..........•--------••-- staller Address UType of Buildin Size Lot...&I&L..:'........Sq. feet aDwelling—No. of Bedrooms... __I.._.__ :_..........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _ ..__-".*No. of persons........ .:.............. Showers ( /) — Cafeteria ( ) Other fixtures .... �//, tf. ..t�tr€ -..................... W Design Flow____.......�4�.........................gallons per person per day. Total daily flow....._.....2�-v-____--_____-----..._.gallons. WSeptic Tank-! Liquid capacity-l<?i-_0._gallons Length................ Width_.............. Diameter-----.__........ Depth.-..--_--__----- x Disposal Trench—No..................... Width-------------------- Total Length.................... Total leaching area-------.------------sq. ft. Seepage Pit No..................... Diameter-------------------- Depth below inlet ........... Tot leaching area------............sq. ft. z Other Distribution box ( ) Dosing tank ( ) - d - �C - X 4G, �`r aPercolation Test Results Performed by--------------------------------......................................... Date---------------------•••-----/---.... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water...._7-------------- f14 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water--.-..--_-_--__-___-.... 04 ----------------------------- � . . O Description of Soil-------------` `��2P_ x W VNature of Repairs or Alterations—Answer when applicable.............----------------------------------------------------------------------------------. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ) Signed---- - ( --- -- -....... &(,v------------------------- ............ - / Date Application Approved By--- r /�. ------------------ Date Application Disapproved for the following reasons:.............................. ------------------------------------- a.t.e.............. -- ------------------------•--------•-•---••---•-••.-•-- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD CIF HEALTIJ OF.........�.;. .......... ... ..... ...... ................ C.rrtifiratr of 10,omplittnrr T S IS TO CERT That the Individual Sewage Disposal System constructed (� Repaired ( ) bye.... - ........................................ ......-- ..... In tiller at 4"/ has been installed in acco df tnce with the provisions of Art' e I of The State Sanitary Code as described in the ._ .� application for Disposal Works Construction Permit No . �,�..... _ _ ........... dated.... --/---3 1 ,- --------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE y� �'z Inspector--.../) CW -------------------- THE COMMONWEALTH OF MASSACHUSETTS 7S BOARD OF �. 4 ...........O F........... . No.... C� •• ,l FEE.'. LIT 44v urktrnrtiorrmit Permission is ereby granted........ _..._ .... ��_.. ---- - -----------•----------------------- to Constr t ( r R pa' ( ) an �Itid 1 Sewag spos Systeat No.'.. .li f5 ---- �j !�% .... /6' ice+ �� Street � as shown on the application for Disposal Works Construction P m' No.- _____--_------- •ted-----�.�_ .. �_ J-......... DATE......................................... =----------------------------------- o rd o Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 7 .7 v ZZ 6 7 q v� f �U S/L L fLE✓.,_ _ Ff�T 4E30✓� �O.dD L OCA T/ON• ��, �U~, ir, E PLA/V T AIZ-. 4eY CE 'T/FY TNA T THE EXIST- �'' R°ti i-,. /N6 FOUNDAT/ON LOCAT/pe% /5 Q?ZZ6 ! .45 SHOMV AND_ _-"_COA/f'ORi�J 4 iAt T>4 v>� ! TA14 Su/LD/niG SE7-4�3r4CZ,869UiPZM6V71 OF TfI4- TOwVN Of _e� ,6 Wes'�LF}� I 44 r Y14oc4, Ccs. r�- ------ No.---'=-"-q� 3q Fee-�� BOARD OF HEALTH TOWN OF BARNSTABLE ZIppYicationArVerr Congtructionpermit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair (k1an individual Well at: { Location — Address Assessors Map and Parcel V-- (- —---— ------------- - --------------------------------------- Owner Address CCC ----------------------------------------------- d _Ud, -----`--- ---- � �- - - ---------------------------- Installer — Driller Address Type of Building ,/ Dwelling— --A!¢�S 2----------------------------------- Other - Type of Building No. of Persons-------X--_----------__________—________________ Capacity Type of Well---1------------------------------------- ----------------------- ------------------------------------------- — 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. L Slgned — - - --- ---— ---- <S)-- �� date ti — Application Approved By --------------------- --//-/ D date Application Disapproved for the following reasons:--------_____________________—_-------------------_------ ---------—— - —-- ---- ------- ___------ date Permit No. W- � - — ----- ---—-- — Issued- - =-f ---- — date ^'t BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (V(, Altered ( ), or Repaired ( ) __---------------------------------- ------------------------------------------------------------ Installer u 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.0I f'2- ---DatedTHE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT/THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE -- --—- - —---___ _--—--- — Inspector r No.--Wqo-✓ Fee A_`�_------ { B-ARD OF HEALTH �t TOWN OF ARNSTABLE App lit ation AhrU)eYI evn5truction Permit d Application is hereby made for a permit to Construct ( ), Alter ), or Repair:-,(i- an individual Well at: Location — Address Assessois Map and Parcel ------ —/00--0-1- C/QO / /- 'V C,,}�/�c,!.� � �, P Owner Address 5'6e &J�/1�tn'—/�'(u '° _�� . Installer — Driller Address Type of Building Dwelling —f-�a�t S ---- ---------------�__------------------- Other - Type of Buildin" -------__—__—____\Noof Persons----y=-- ---- ---- Type of Well- ap Purpose of Well --_--_--- -------- —- - `C gG/ \ Agreement: \\ The undersigned agrees to install the aforedescribed individual well in accordance with the ptovisions offThe 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 �—____---�----------- --------- ' date Application Approved B �t""� — _ —__ PP PP Y------ --L j --- - -- - - - - - — �' date r Application Disapproved for the following reasons: --- ----- - -- date Permit No. f �__ � --- - -- - -- Issued _ date. 1 . BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (4/), Altered ( ), or Repaired ( ) mil' wa.�/E'll_ l Installer P - - - -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- � �4 - 1 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. . DATE-----------—------------------------------------------------------------------ Inspector-- -- -- - - -- _--_--_ --I------------- - ' BOARD OF HEALTH" TOWN OF BARNSTABL/E Vern Con5truct ion Permit v No. fa -' ---<--�:-;-----�r-- r' Fee- .� --------------------------------- Permission is hereby granted---------------------- ----------------------------------------- = —---r- -—------—— -- to Construct (� Alter ( ), or Repair ( )� Individual Well at: G Street as shown on the application for a Well Construction Permit GG� �ilJO �� —---- / ------ ---- Dated �Y/'I�/__=��7-----No.- -- - ---- - -r DATE-__:-�--.---��-,/ �ll------------/---------------------------------------- Board of �'ealth �\ . � � � � � n . �� �p � �J ., Q o � �, �� �� o° �� �` �O . � .�i i LTH THEBOARDAOF FHEALTH TS /4) gab bI o�,� �s,r ......... . ... --.. Appliration -for Uiipoiittl 10orkii Tonotrnrtion Vrrniit Applicatior_ is hereby made for a Permit to Construct (/K) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. ( Owner Address a ......--•---... ---••-G , / ----------------- -------------••....--------•-..._...... ........---••--•------------------....-•--- Installer Address Q Type of Building Size Lot--------------------------_Sq. feet U Dwelling—No. of Bedrooms--._-.V-__ _______________ _ -Expansion Attic ( ) Garbage Grinder ( ) a —Type g p Showers ( ) — Cafeteria ( ) Other—T e of Building ____________________________ No. of ersolis.________.•--•-.--.--..._-•- a' Other fixtures --------------- ------------- - Q -- ----------------------------------------- W Design Flow.... �.�f______________________ gallons per person per day. Total daily flow._..._... 9 U gallons. WSeptic Tank—Liquid capacity_�X�Vgallons Length................ Width................ Diameter---------------- Depth---_-----...-.- x Disposal Trench J� No......I............. Width.................... Total Length...................: Total leaching area---_--_-----_-_-_sq. ft. Seepage Pit No.__._. —--------- Diameter.----__--___-__---- Depth below inlet-------------------- Total leaching area------------------sq. ft. Z Other Distribut:on box 0(1 ) Dosing tank ( ) Percolation Test Results Performed by-------- ----------•-...._.._..._............-------------------••-----... Date--------------------------------------- a Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water..-.__-..-_--.-.--.----- fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water--.------------..----... 9 ----------------------- -•-•-------------•--••-••-•---••---••--•••-••--•--------•-----•---••••-•-••---------•-••••-•••--•......_............----------•----- O Description of Soil-------------------- ........ 77M, y�.._....S.aIL-----p: a�7CL U ---------------------------------------- - � -----------------------------------•-•••••-•••••---•---•---•............•--•--••-•-- ----------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repa-rs or Alterations—Answer when applicable...----------___---------------------------------------------------------___--.---.-------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions o Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued Xoard of h t �, 2 7_73 Signed - l -- •----------- Date Application Ap-3roved By..... -- Da ��.� . te Application Disapproved for e f ollowing r v sons:---------•----------------------•------------------------•-•----•-•-•---•----•--------------•-•----------------- •.....................................•----•••.........----------------...--•-•-••••••-------...•-------_.. Date PermitNo......................................................... Issued........................................................ Date No..... :.. �`...... F:nc.......... ..... ...`..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �l�t��.._..._.. --- .OF........t Appliratiun -fur Uiipniittl Worho C owitrurtiou Prrmit Application is hereby made for a Permit to Construct (,A) or Repair ( ) an Individual Sewage Disposal System at: / 4 C% •--•--------------------------••---•---------------------•----------------------------------...... ---•-----------•-•-----•----••-----•---•---•-----------•----•-•--------•---••--------•-----•-•--. Location.Address or Lot No. .... . . .. .......r�l6r t✓ ---•------------------------------------------................................................. Owner Address Installer Address d Type of Building Size Lot----------------------------Sq. feet U Dwellin No. of Bedrooms.-.-.--- .-.-.Expansion Attic Garbage Grinder Other Type of Building ............................ No. of persons----_-_---.----_-.--------. Showers ( ) — Cafeteria ( ) A'' Other fixtures ------------------------------- -- W Design Flow..........>_ %----- ---------�...._ ..gallons per person per day. Total daily flow........... .�`1.�.._._-.-..-----..-_-.-gallons. 9 Septic Tank--Liquid capacity..'^ �gailons Length................ Width................ Diameter---------------- Depth--------------- xDisposal Trench—No. .................... Width-------------------- Total Length-.-..--.-.-_------ Total leaching area......-------.------sq. ft. r t 01 =Y Seepage Pit No.:.... ---_--.-_- Diameter-------------------- Depth below inlet-------------------- Total leaching area------------.-----Sq. it. Z Other Distribution box (,,(,) Dosing tank ( ) Percolation -Test Results Performed by-------------------------------------------------------------------------- Date--------------------------------------- ,� Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water.--_----__-_._----- f� Test Pi- No. 2----------------minutes per inch Depth of Test Pit................---. Depth to ground water......-..-.......--.---- P4 ------------------------------------------•-----•-•-------•----••-••-------------...--•----•-•-•---•......................................................... 0 Description of Soil--------------------------------------------------------------- = - " ------------------------------------------------------- �i 'k r✓' fl=G '` �iraPt<,'G�. G L — U -------•-------------—--•---------------------------- (/ ----•-......----••. W •-----••--------------- --------------------------------------•---•-...--•-•---••--•--------•--•-•------•-•-----------------•--------.-.....---•--------•--------------------------------------------- V 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 brthe board of healtlt.,s' r rs• 0 .. Signed..... - C. ..', �....:_;b� ------ ---------------------- Date Application Approved B �r2✓-€'. PP PP y----------- ------- - ---------------------------------------------------- -- --...---------- z ` Date Application Disapproved for the following rea/sons:........................••------------------------------•-----------------..................................... .......................---------------------------------------------------------------------------------------------------------•-----•-------------------....-----------------------•------•-------- Date Perrr:,it No......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS f .� BOARD OF HEALTH 0 f5r# 'r - r r tdi Lt.. OF...... � '�.!!�<`r ! . c Y �j Carr#if irate of Tumphaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( } or Repaired ( ) Installer at......... .................J' -r--------- 1� . +r fi~a r -------•- ----• has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------!.-?ti':.--____.............. dated.--------:-.._1 f.'..):- ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............----------------------------------------------------------------- Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ---------------------------------------- No.---- =------'—••••---• FEE........................ . %spotial Norkii Tlomitrurtion rrrmit Permission :s hereby granted---------- �� // -- ---- ---- ----- - to Construct ( ?') or Repair ( ) an Individual Sewage Disposal System at No..------ --/J- t" = t' ��r% it, r fi''/>f e- ----------....................................................... --------------------------------------------------------------------------------- Street t l 7 as shown on the application for Disposal Works Construction Permit No------------------------ Dated........................ :....... -------------------------------------------------------------------------•--•-•-----•--••-••---........_ Board of Health DATE.................------------------------------......-------------------------• ` FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ' u cT . 362-2626 , { Land Developmew CG Enjginecrin{ a ' { 89 `lilloty Street ` Yarrnouthport , Pala; Sept m 5, 19?3 , a Board of health Townof �urnstab1e � nyann_Ls, Ii:assachusetts Re e Percolation Test for '4ilfred Taylor off �lderbroolt .' Lane , dcst Barnstable , Masse Gentlemen. #: i Please be advised that on September:5th I recorded the enclosed TestHole Log arid- a per `olation rate = 1 inch per minute a•t a depth of 30 inches. TPie ( r � f area tested is on a sand and gravel knoll'', 'Just-- east of f a j}z acre cranberry Log, -the top elevation of Which � s , Gar approximately 20 feet above the bog el.evationA Thy `r 3 q . material can be cis -erved in an open fit and, should: Prove excellent for the ins tallation of a- s'b-surfaoo k r - sewage disposal system. �1so enclosed is a sketch plan indicating n the approximate test dole location. T_f I can`:�b o.f any further assis ence9 please contact meo Yours truly, �' f Yf Aj r r�� led l�'o Te.ylo�."� 'Q � f Enclosures t 7 ,s � �µ t 2 - y Ni v F FS y422 k. 4" ft - y . INN gr f�.' 1 a a Si9y 1 'a ...t0s ' '�4 11�'r► CJ {xd :�k yrt .tid ,xiy t t,t" ,� Rat., At rit 4 ^4. .•e ;{•� Or i • ss iyr,Yt 'a s ' .+i4i"S _. 4•" ......>+«••—.o• t-�! {� F. _ -K°YP•J. f D A a8y- ,r"{,R: � i sm-T v. •$ f `",' 211 -.� +'t 1. '/. �b' - dr4d yam• t � S ft s �� �-N�'�� �6 tN-a�. egi; 4'' + 4r,. 7 - � - i„"•A+. { '� q�� �r+�z*x Ki _.}�% � +c i i I 7��' g ' Y •a' •a",o'. ......,,w�l�(f ,.Y� - /Y� ®�y°'�y. tm>qx.' ,� .,�'y",,,�.� t«ia w. t .: $ #4• a 3•r• L n i i J�� .!•' 'T �,S-.� (siv-.D '1 ,Mk" 1 d f ...� } tM1Y; S I"Y 4 i �•i� 4 "`�,t J� � •4't J i � _ •. __ .. �r' � -fi�i r �s � � �rr� r���.ta ,R 4��-A`4 1 ��°`ktszWrr.r f .t�''����� rt „y'` •.,a 4a ..,x f ,6r ,fr t t,.s { Gr Y��. •. + 3: "' ,'x - g. x '� S d YJ-7 x„� Y1 a .r,� Tit 'W� i" �• �` - A V�f at �r C_ M1 s9s y :.E i . 'Es �,� •4' i r ,"^. t•z. s•� y w� fad � *�f,; M!{sty r c. - .. � � -+ '1 e .k�r �a.'�,.i,v�i�. � r�t y..ro � Lro k�'.N3 �+, �k'9�•�L�' ;P'S + �°fi <j }b t y': 7 -� t "i 1 f�✓' `�q `, Axtf.;'etr€k� c� - FlAR.M ST���.(�) 4ry1�'�. t � �^*. ?'. 1 Q..o G G.��� _ 'r �.s� t�:.- ''�Y�s , k T C�,,' �r � �N.'.� rM�fAt '��„e��,• ` jk44}{ r. 1 N•. .. f'�' � < �dtit �k'� +a�1 ;•F2i.�s k7! �p•„vy' - � ... _ ,+ .' '� li it '> }� �.� I �� r �; �eftt�4m x'I��,w,�{ F, t We. �': �'.�`"'4�'� r ,. .mob.,..._...._-...,,•..,....._...o.a.,M...w N:-n.....,w.., ..�. «. .. .. .: - ""�"r anew iy�.,�y,;-,Yr a. -��,,� r 'Fas„#^�Y✓- Y� yY'y�4 ^$' {e 't. a, ri 'i�'"�.' 4'``>'s f;,r-•'"m?a*J -3"- l�'r xd� . s,.. ' �� r R s Y,x s$� "`�,'�"�ki'y�,,'S`r wV�� i' '��'' ♦�£.� n`� 'rr"s y'�`�y� •�:'-R �,,a r ft�r � .�'y '' � .w a __v 1 �`�' 4;+'f.•��' 3 "yr'fir 3"' r � •�^ �'Y y" eF' w� - r 1 /f f I I IS /i ZSY,�; J I S I 3 � /.1'/ }t /i3x✓J Y' I Kam' is Y�Y r' t. i lI ..���.�C�.v�r�,"�7�1.. G.��:-'V.}�]r`):�S fiQ � `�"�'j" .r} r 1•' }` § � M Y zv'kWa- Yw rr +ter ��r_'4 K2, ss. `4 }C q r ro t'4 s,sr>H;,t ?� �' u� R.��^Y S� � -+ Ya.�'+� �.ggaM I✓�F Y t� '`��+ r•�,m��"i 4 ��'- 7'�"�A �' �'+�''ar. �'` �at 8'u' e t 9 '�"`M '.,,7*C_, �{:�s :L��e-w� � ,d��r'`u ' �ti:• N 4t;: �+''r`}'.h�`3G 1'e^�°L+`j�'ty*;3`er• '�,t�.as'x y.S pY�,r'eF#Rt��"��4 Department of Health,Safety,and Environmental Services Public Health Division Date 367 //Main Street,Hyannis MA 02601 ^ D /v. r67q ate Scheduled / rEDMRt� l Time� Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: LOCATION & GENERAL INFORMATION Location Address 16O �I lCjPr Owner's Name J U M �r)711 0A� 4; 2 M 6(2-6 Vi-111 6LY DC)rj 6� Die# Address 100 140,i, 51r0"k L IIQ6 Assessor's Map/Parcel: 1 7ja/I o Engineer's Name 1?,4AM 1G, `"W/14 U NEW CONSTRUCTION REPAIR Telephone# 775--/Z Ino Land Use tNl,oJ Slopes(%) Q TO 33 w Surface Stones Distances from: O en Water Bod N / p y R Possible Wel Area ( (5 R Drinking Water Well Z 00 R 1 � Drainage Way JB0_R Property Line 1 0 r R Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) J J =7_011 _0 to ' e I got 1�41 i26't Zoo ^tip P/�YGe�C /C) J44 r. Q TH i =40,71 2�3N o Rgf��,�D � o. z✓, r Parent material(geologic) (46g aO 114a Upa_/_/ Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Z c l `7" Weeping from Pit Face A0 6&-E2 ve-o /IV �o6 , Estimated Seasonal High Groundwater Zj� �pW�J DETE NATION FOR SEASONAL.HIGT 'WATE>Et TABLE Method Used: 41Z�(q q — E L r Depth Observed standing in o .hole: �' in. Depth to soil mottles: Al in. Depth to weeping from side of obs.hole: in. Groundwater Adiustment A. R. Index Well*# _ ._, Reading Date:_ Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Da e 3 tt' gTim¢ 4.. ` Observation Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ & r7 Time(9"-6") End Pre-soak ' Lq yrp/EF; Rate Min./Inch L2 y Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) /V Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant 1 DEEP.OBSERVATION HOLE LOG Hole # depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell Mottlin g (Structure,Stones,Boulderes. 0 0 -zZ '' /� / P,- . SAP low �oyr� 3lZ CVO 2,7 it 42 lO Y r 516 ADO 62" C/ / or /or�i� .1 2, 4/4 /JO C 2 Pr Meji 21 6 ¢ /1 A�) t DEEP OUSERVATI0. HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % I DEEP OBSERVATION HOLE LO;G Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USD A)( ) Munsell ( ) Mottling (Structure,Stones,BouFderes. Cons i stency..° a DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % Flood Insurance Rate Man; Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? - Y5,; If not,what is the depth of naturally occurring pervious material? Certification ''11 I certify that on / 0 • 93 (date)1 have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required tr 'ning,expertise and experience described in 310 CMR 15.017. Signature �✓t,� �� Date r A'LDtr7, 13 A oo 1<.. L A Ale. . Q� W S rh L Le 1--,Ar0 v TA2 2�t � t21�2i� � S 's v 2- 7 / 73 � oRit l� LI'A 1yGe I s� UP- D //2- 5- 7Y r -;,`' •_ J `�'D O a CL LA s N \ �16.47.2 4 / 7.9 CRANBERRY BOG 47 ; 18.�1% :REDUCE , , WATER EL. 2..3 � zy / ' �� LY. -OVEF \ (4/27/99) �e\a� a T3 i 1 22.1/' O�x . 2 SO (�OVE 2 0�. / / ���!/ 25.2 \\ Q 17.1 � �1 7 QC` 8 3.s 17.0 3 \ - 16 17.0 7.4 18.3 ll \ I O 2 .1 2 ` � 17`7 . 18.2 Al C U, F3 2.19 3 2 WELL 9.1 / 190/. / +: 21 0 \ / �3.2 I 34.8 18.3 / • 20.9 t /�37.4 x i' / 6.it1 � 31 \ 2 .2 22 4.3 Q O� :::r.. x 25.7 22.5 38.2 23.2 �\ \ FoJ\ �eG�\ ��` 2 32. cl, 24.5 .: - - - 25.3 .3� \ 26. Q, c, r 0 _ 27.3 \ `26-16.0 12, 4( 29 p, 27.9 26.6 12"* y \Q .2 J / dr 40. 18 PINE dA. 32 / � 39..2 .�pi. 0 �/ � 40. 41.2 3 34.5 " 16.7 n(1 �a " 40.9 40,5VV \+ / 37 2 41.0 BENCH MARK---TO 38 2 SET FLUSH = 40.0 f 40.4 4 ��- • 39.7 drill hole TOWN OONSERVATIf fnd. LAND • o THIS PLAN ' IS A VALIIC AN ORIGINAL REd' STA �'(H OF titAs ' � S GENQ � RONALD �o JA TH 1 TEST HOLE LOCATION, NUMBER - o CADI.. C --0E OVERHEAD ELECTRIC WIRES (IF SHOWN.) F `� Y 9.5 w 11.0 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) a s N,TAR� 9 \P �6-� EXISTING CONTOUR 3 5- ® �. [ I L� g--- PROPOSED i CONTOUR �. -OL}-- OVERHEAD UTILITIES (IF SHOWN) CD ®® TREE (IF SHOWN, .NOT ALL SHOWN) -� Os EXISTING SEPTIC COVER �. ` . x - FENCE (IF SHOWN, NOT ALL SHOWN) ® ~ HEALTH AGENT APf NOTESLJ Rte 0 1. LOCUS IS A.M. 132, PARCEL 10. S� o .6' rn 2. ELEVATIONS SHOWN ARE ASSIGNED. �° 9 6 3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED JULY 2, 1992. Q'o' ° 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) Pa 0 5. WELL WATER IS USED. WELLS WITHIN 180' OF PROPOSED LEACHING ARE SHOWN. cw 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14". ' t5.8 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW el a6 3 D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET., ° 9. DEPTH OF COMPONENTS NOT TO EX-CEED 3', OR VENTING MUST BE PROVIDED. NOT TO 16.4 BUILD UP COVERS TO WITHIN 1 ''OF GRADE. MORTOR CHIMNEYS IN PLACE. SCALE ONE COVER OF TANK TO BE WITHIN 6" OF GRADE. LOCA11ON AP 4 10. .STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEASTONE ON TOP. 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, 17.2 � 9 CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. CRANBERRY BOG 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING TEST HQLE 1 IS TO BE CLEAN GRANDULAR SAND MEETING SPECIFICATIONS OF 310CMR 15.255(3). \ 4.78.1 18. � 13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN \ REDUCE GRADE SLIGHT- LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. DEPTH (inches) EUEV.,(feet) 1 - WATER EL. 2.3 d ����F LY OVER LEACH AREA, 14, ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. p 40.7 (4/27/99) �e�\° �I �' Q¢X.� 1 g 2� SO COVER IS: 3 MAX. TEST HOLE DATE: March 11, 1999 A layer 10yr 3/2 sandy loam �� 25 2 B.M.-TOP REAR CENTER SEPTIC PERFORMED BY: 'Ron Cadillac, Soil Evaluator 22" i e 0 �� TANK(not cover)=25.10 ASSIGNED WITNESSED BY: Donna Miorandi, IRS e6 . 17.1 ,rt�7 QP /, s. 3.9 PERC RATE: <2'-00"/inclh (C layer) B to d 1 yr /8 1�o _, i 3 y SOIL SURVEY(1993): Carver coarse sand y 4_ 6 . 17.0 a '� 1a.3 ` 2g y GEOLOGIC MAP(1986): Cape Cod Bay Lake deposits 42 37.2. j G� 2 �,.� C1 layer 2.5y 6/4 \ _--17 7 O 2 .1 27.05 Invert 23.68t Invert 23.27 62iO loamy sand N E �+ 6 7 18.2 F32.19 32 Exist. Top Found. 62" 35.5 Existing Invert 37.24 4 RECHARGER 330 S C2 layer 2.5y 6/4 WELL 19 o y --- -" Proposed medium sand 0 37.2 \ 3.2 I 34.8 �--�x 36.2 1 18.3 ,r Existing Prop. Pump TOP PEA STONE n 20.9 x 37.4 \ 6 '' ;µ 1000 Gal, Chamber 3 , 37 9 (See float detail) 144 no water 128.7 231 - - - -� 2 6:::: C>� J " Invert 23.5 Sanitary 24" ::.. .... n 2 �� .� Proposed Tee 4 6'2�`, 2 .2 i 22 22.5 4.3 \ ��O j 1P 25.7 ' Bottom 19.02 34J ` \ �� 38.2 ____ Invert 37.41 Invert 36.70 NX .,,; 5� (� tea. Gam\ x 2 3 .s Proposed Proposed I S 0 Bottom 23.2 5 5 �\ o� e Use 6" Stone under P Proposed j p 39.1 I 8, I I 78' I_2-12. I 22.4' J B O t pC7' m x 24.5 /9,, DESIGN DATA '. 0.,0 1 1� 14" PINE . 25.3 // �V / 40 ,x.- 39.9 Water in Bog {4/27/99)=12.3 26.3 O' / a0.o BEDROOMS: 4 27.3 - LEACH,-_AREA 26.11 2 .9/ �F 140 PINE GARBAGE GRINDER: No 2 4°.6 USE 4- CULTEC RECHARGER 330 S � 29 REQUIRED CAPACITY: 44,0 GPD` o. 27.9 I WITH 4' OF STONE ALL AROUND 26.6 / �O EXISTING SEPTIC TANK: 1000 GAL. FOR A 34'-2" LONG BY 12'-4" 41.c BOTTOM LEACHING AREA: 421.3 SF 28 `'`' 2 0.0 4/1� WIDE BY 2 DEEP LEACH AREA. i drill, h41�_6 [(34.17' X 12.33')] ` 30.5 "-�- 2 '� iJ 41.6 SIDE LEACHING AREA: 186 SF 3°0 C, 407 fnd. ALARM & PUMP NOTES 40. 18" PINE [2(12.33'+ 34.17 )' X 2' DEEP)] x -- 32 . 39.2 P� DESIGN CAPACITY: 449 GPD 1. ALARM TO BE WIRED BY ELECTRICIAN ON /� t x 41� ; [(421.3 SF- + 186 SF) 'X .74 GPD/SF] SEPARATE CIRCIUT FROM PUMP. ��i 40. 2. ELECTRICAL WORK TO BE INSPECTED BY 3 a4.5 36.7 } rL �a� 40.9 PUMP CHAMBER STORAGE CAPACITY: 453 GAL. WIRING INSPECTOR. ` 40 �' �� DOSES PER ,DAY: >4 3. ALARM 7O BE LOCATED IN HOUSE. 2 �'�� 41.0 BENCH MARK---TOP WOOD STAKE rr 4. PUMP TO BE CAPABLE OF PASSING / lx SET FLUSH _ 40.00 ASSIGNED y� 38.2 4a4 FLOAT DETAIL 1-1/4" SOLIDS AND INSTALLED IN STRICT CONFORMANCE WITH MANUFACTURER'S 4 --'^- H-14 1000 GAL. PUMP CHAMBER SPECIFICATIONS. 0XIN, x 39.7 WATER TIGHT DRILL 3/8" WEEP/VENT HOLE 5. USE MEYER WHR5, 1/2 HP PUMP, OR EQUAL, CAPABLE OF PUMPING 38 GPM TO HJN CONSERVATION ® 20.4 FEET TOTAL DYNAMIC HEAD. drill hole 2" C10e fnd. LAND ALARM 2�" CHECK VALVE ON 25" OFF 20" SITE PLAN • FOR THIS PLAN " IS A VALID COPY ONLY IF IT BEARS j�� Q� MEREDITH AN ORIGINAL RECi' STAMP AND SIGNATURE. JON ANTHOI VY VC. M ,. G�YQON S 0-RO 1As9 100 ALDER BROOK LANE, WEST BARNSTABLE, MA OF s� �RO s�ti RONALD o JA �1L �: JAI o G MAY 1O, 1999 SCALE: 1 =�O TH 1 TEST HOLE LOCATION, NUMBER o CADi C ----OE OVERHEAD ELECTRIC WIRES (IF SHOWN) ��/SIT S EP`° x 9..5 x 11.0 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) s"/VtTAP\P� rP �asu EXISTING CONTOUR I /�/� RONAL;D J. CADILLAC., PAS, RS PROPOSED 'CONTOUR 8 PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN -OU OVERHEAD UTILITIES (IF SHOWN) " r 258 TREE (IF SHOWN, .NOT ALL SHOWN) M BOXA ® . . EXISTING SEPTIC COVER . ,' WEST 2673 . . . . YA O H, x -- FENCE (IF SHOWN, NOT ALL SHOWN) (508) 775-9700 HEALTH AGENT APPROVAL DATE PAGE I OF 2 C 1999 BY R.J. CADILLAC I o�- FORMERLY FRISHMAN 9- , 6p. O� R� N/F A.M. 132 PARCEL 10 MULLIN CRANBERRY BOG 60e - - I - x N F ` TOWN CONSERVATION Atl . LAND \ a A SITE PLAN FOR r . z JON ANTHONY & MEREDITH M . GLYDON t — 100 ALDER BROOK LANE, WEST BARNSTABLE, MA MAY 10, 1999 SCALE: 1 "=60' RONALD J. CADILLAC, PLS, RS . , . . PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN �D P.O. Box 258 WEST YARM OU TH,, MA 02673 j (508) 775--9700 PAGE 2 OF 2 i/ _ II