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HomeMy WebLinkAbout0205 CARLSON LANE - Health 205 CARLSON LANE 113-058 West Barnstable 4 0 r ,or,3 TOWN OF BARNS TABLE ®P LOCATION C?06 d/R&56A0 e-A . (�-a r SEWAGE # q 3- VILLAGE ASSESSOR'S MAP & LOT/5:6--70-r4? INSTALLER'S NAME & PHONE NO.M- Cr . M'-D'J7-ye6 SEPTIC TANK CAPACITY /f100 646 LEACHING FACILITY:(type) ( �119 L L B Y15 (size)/OX /8 x 3,2� NO. OF. BEDROOMS 3 PRIVATE WELL OR PUBLIC WATERW64-L BUILDER OR OWNER tV19 L-ra Z- C7, M/q/-IO,J6y� O(,e "C p DATE PERMIT ISSUED: 12- 1 - 93 DATE COMPLIANCE ISSUED: .3 - 2,3 - 9 4- VARIANCE GRANTED: Yes No GAP_ � v v �j V� A , / / , 13 No...f-C -.12.�? Fws......�D ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uinpmml lVnrk.6 Tomitrnrtiun 11amit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ............................. Loc lion-Add...s or Lot No. O vncr Address Installer Address Type of Building 3 Size Lot---43... �...Sq. feet t-. Dwelling— No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons-_----.-_.-__-___--_-_----. Showers ( ) — Cafeteria ( ) p' Other fixtures ---------------------------------- W Design Flow...............T,5----------------------gallons per person per day. Total da�ilY flow.......... . .?...................gallons. WSeptic Tank—Liquid capacity/Md.gallons Length----_r Width._...s7___ Diameter................ Depth... ....... x Disposal Trench—No- -------------------- Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No.--- Diameter-----/Q....... Depth below inlet.....I----------- Total leaching areal .5744}. G P P Z Other Distribution box (X) Dosing tank ( ) '~ Percolation Test Results Performed by....,0_Q.V ----- ............................ Date...._ ..'__.�.'. _�......._.. Test Pit No. I_4__ —....minutes per inch Depth of Test Pit---!Z®•_-`__- Depth to ground water..?vo% Gz Test Pit No. 2.5..Z...minutes per inch Depth of Test Pit._,11.1------- Depth to groung_water004_W.__7ZX:&?> a •-•........................•---•-----------------------------------••---•----------•----------------........................................................ 0 Description of Soil---------------: ' --•----- L' ..-•-------------------------------------------------------------•------------------------------•------------•--- x w M. ---••------------------------------------••••...................--•-•--•••••• -----------•••--••-•-----•-------•--•--------••-----•-•••----------••-------•--------•••--------•---------------------•-• 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' ed by th board of health. ti. �, �� � ------------- ------------------- ----1 .:- 9...-�.. ... Signed .............................................. Date ApplicationApproved By .............. - ------------------------------......---------------------------- Date Application Disapproved for the ollowing reasonf: --------------------------------------------------------------------------------------------------------------------------------- -- ..............._.............................. . .. . .. . ..._............. .. .........................................................-- ---------------------------------------- Da" Permit No. ...... .... .... ...... q f ��� - Issued - - - -- ............................................ Date _ . . , 13 No. -.L2��� Fss.......�.:�- - ........ -t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ,\ Appliration for Divi-Vu!ittl Modw Tunutrnrt"inn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at ................................•--.....•-•- Loc lion-Address or Lot No. ......................}L ---=�'•---�fi_ff vtV ` ---...--•---------------- f .X.._._ = �f1 t�u,Jl�1�.....---GZ_SC3.. Owner Address .+ a --M, �° /N!• .��te. �'�----------------------• ....................................... 5�av �l�c�eT �z� �5 Installer Address Type of Building Size Lot__.�_..._._...._...`.......Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------- _-------------------------_---_------------------------ ............................................................... Design Flow..............�l_-_-_---_-___-_____--gallons per person per day. Total dail flow..........5.._�?_?..._..._.........__gallons. W 1:4 x3 Septic Tank—Liquid ca acrty/ �_4. allons _ Len th__._�` __._._. Width------ .. Diameter................ Depth'..._.__......Poral Trench . 1� Total Length Total leaching area q Seepage Pit No... Diameter 1P...,.... Depth belowilet----A........._Total leaachingarea.75r. sq_fx.6 r'v Z Other Distribution box (X) Dosing tank ( ) '~ Percolation Test Results Performed by.._P_<?.y1-_.....9�!:2G.......................---------- Date---:4."__.-.'_.g.7__.___.... ,aa Test Pit No. 1.C__z....minutes per inch Depth of Test Pit---�Z .... Depth to ground water_.qof__.6 !— (i Test Pit No. 2_ ._7....minutes per inch Depth of Test Pit._J ..4....... Depth to ground water °!��AZ:Z?5K7 O- Description of Soil--------------5tG_.....-- �LZq u.....--------------------•------- V .....••---•----•--••-----••••••••-•---•----••••--•--•--•-•----•---•-•-•----•-•••---•--•-•-•---•-----•----•--•--•-•••-----•-•----------••••-------•--------•------•--•----•-•--•- 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 TITLE 5 of the State Environmental 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 ✓ Dare Application Approved By .:.....- � .. �`�`�`` ............._. J Dare Application Disapproved for the following reasons: ------...._--------- --------------_..._-----------...i.------------------------------------------------------------------------ ........... .............. ._................ . ---...... . ........................................................ ---------------r-------------------------------- ........................................ Dare PermitNo. -----7.3--------- ------ - Issued ........................D-------------------------- -------....... are THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Gertifirate of (11,IIznylianre THIS IS TO CERTIFY, constructed the Individual Sewage Disposal System c .nstructed ( �,r ) or Repaired ( ) by..............py1............ �- Ins rall - __....... - - - - cr at ------- ...�--�---------.. "' - -----------------------------------------------------------.------------------------------ has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _..q3-�-_-__C�6�. -...._ - dated .-.....__....__..._...._._......_._.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ..... = �� � ------- - ------- Inspect r f'y ._..���! �.. /� ��1 --------------------- DATETHE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..�� TOWN OF BARNSTABLE FEE �'_ Dinpnuttl Workii Tnnutrudinn rrniit Permission is hereby granted------ ---- ,l--,-------- ... ---•----------•--•••-----•••••---•-•-••........................ to Construct ( ') or Repair ( ) an Individual Sew age Disposal Syem ...v--•-•--'_.._. ro vj ............ ........................................................... Street a as shown on the application for Disposal Works Construction Permit —I6\6_ter_ Dated........................................... e� --------------------------------- Board of Health DATE----••------ ..�-•----1-,-��- FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS L — — — = Departmeni of Environmental Management/Division of Water Resources WATER WELL COMPLETION REPORT WELL LOCATION Address Al 4"h r City/Town (1, Z 5 � r � y f`/ ef) G.S.Quadrangle Map ,tC/ %� Grid Location Owne,b WZE1C Z1 ,04,1/mix Address WELL USE USE CONSOLIDATED Domestic[] Public ❑ Industrial ❑ Type of Water-bearing Other Water-bearing Zones Method Drilledt�" �� f) From �'� V14 t 2) From To Date Drilled 3) From To 4) From To CASING Depth to Bedrock Length/Vb Diameter f/Type C. UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land sur ace Sand: fine❑ medium❑ coarse❑ Date measuredA& Gravel: fine❑ medium❑ coarseQf Screen: r�GRAVEL PACK WELL S lot 0 length F frorte-�to/-5�& Yes ❑ No Q Split Screen (or 2nd screen) WATER Q�U,A6TY TESTS MALE slot length from to Chemical 2 Biological;z] Depth To Bedrock.;i a, PUMP TEST j Drawdown feet after pumping dayshours at �GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To Cb rz fj�r � .,,� DRILLER t e. Firmdr1.4 Vt—7!/A�t � Addresy�'tIr, tf y y !1 ` Registraron Noi. R X { Operator's ignature ease print irm y ., .. _ BOARD OF_ HEALTH__.QPY ssA►-lo-as-sonot No.-------------------- Fee--------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Application-forlVell CootructionVfrmit Applicati n i hereby made for permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: ems- - � --- - ------ art ' ----------------------------------------------------------------------- Location Address Assessors Map and Parcel Owner Address -_ - -- ----------------------------------------------------------------------------------- Installer — Drily 0© A0 K d e ` `Q Address Type of Building Dwelling �v o� �� ------------------------------ 1---- -- o "Ll C Other - Type of Building---------------------------------- No. of Persons-------------------------------------------------- �t V-�' ----- Ca acit -------------------------------------------- TYPe of Well-- ------ - -- -- - - - - P Y- - - Purpose of Well — }'—ems -- ------- 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 unti Certificate of Compliance%h s been issued by the Board of Health. Si ne --------------------------------- ate Application Approved By---- - - - = r-� �---------- -------- _ '�d "`�� date Application Disapproved for the following reasons:------------------------------------------------------------------------------------------=--------- ------------------ do Issued date Permit No. -�G s� ? ------------ Issued -- � -�� - ---------------- date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f Compliance THIS rp TO C RTIFY, That the Individu 1 Well Constructed (Altered ( ), or Repaired ( ) r by -�-- -- --�=�`�---��✓ - -----------------------------=-------- p n Installer C -- — -- —-- at -� edce ------------ has been installed in accwith the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit : "-,F—s?4,/__Dated- N -- - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------------------------------------- Inspector--------------------------------------------------------------------------- cif � � �� , C901 No.-------------------- Fee-"�`- --------------- BOARD OF HEALTH TOWN OF BARNSTABLE ZIpplicat ion for VrIl Conotruction3perinit Applicati n -hereby made for permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: _2 - --?-- � --S <Q �1t ------------------------------------------------------------------- Location /Address Assessors Map and Parcel ------------- Installer — Driller f/'(j ro L / Address Type of Building s o�v M r4 cj Dwelling----------------------------- - 1 - J c I''$ Other - Type of Building --------------- v` No. of Persons----------------------------------------- Type of Well- ------ ,Capacity -------------------------------------------------------- � Purpose of Well---------- � ,-i(.vl. ' - --------- Agreement: The undersigned agrees to iftkall 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 unti Certificate of Compliance�h s been issued by the Board of Health. - -I. Signe --- „r -----— -- - - -----------—- -- --- date Application Approved By-- ��--- Y date Application Disapproved for the following reasons: --=-`'------------------------------------------------------`------------------------- --- - -- ----------------------------------------------------------------------- -- - -- .'' date Permit No. -1 �'-- ," `--- ----------------- Issued--------------��'-��-_ `= -i� - date BOARD OF HEALTH TOWN, OF BARNSTABLE Certificate Of Compliance THIS IS TO C RTIFY, That the Individual Well Constructed (L�, Altered ( ), or Repaired ( ) y byc - i - ` vrt-- — --''------------- --- - -f InstallerJ�-------------------------------------------------------- at_10— -��� �T! ` - -------- --------g l' a> -------- ` �,�=---- ------------ has been installed in..accordance with the provisions-of the Town of'Barnstable Board of Health P,rivate.Well Protection Regulation as-described in the application for Well Construction Permit _,?:"�/Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. ; t , DATE------------------------------------------------------------------------- Inspector- ------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Velr Con5tructionvermit No. ------- -----------�! Fee------------------- t— - --` =-------------------------------------------------------—------ Permission is ereby granted/epair --�� -Y--to Construct \ ), Alter ( ), or ( ) an Individual Well at,1"6'f No. - - -- ----- - - - ---- ---- -----------------------------------�-e- -- _- - --- Street as shown on the application for a Well Construction Permit No.--1 - =' - , --- Dated------ -` — — -- --- ----------------------- ------ -- - �. �------------------------- Board of Health DATE----- �� ENWROTECH LABORATORIES Mass.Cert.#:MA063 449 Route 130 Sandwich,MA 02563 • (508) 888-6460 CLIENT: Walter Mahoney. LOCATION: Lot 3 High Street ADDRESS W. Barnstable, MA COLLECTED BY: L. Wile SAMPLE DATE:11-27-93 TIME: DATE RECEIVED: 11-27-93 SAMPLE ID: Z159 JOB#: New well WELLDEPTH: 140' 4"PVC 103' Static Water Level RESULTS OF ANALYSIS: 20 G.P.M. Parameter Units Recommended limit Result Coliform bacteria/100 ml (MF Method) 0 0 pH pH units 6.0-8.5 6.53 Conductance umhos/cm 500 101 Sodium mg/L 28.0 10.3 Nitrate-N mg/L 10.0 0.48 Iron mg/L 0.3 0.08 Manganese mg/L 0.05 0.01 Hardness mg/L as CaCO3 500 16.2 Sulfate mg/L 250 0.37 Potassium mg/L 20.0 2.6 Alkalinity mg/L 200 22 Chloride mg/L 250 21.3 Turbidity NTU 5.0 2.4 Color APC units 15.0 <1.0 Background bacteria/100 ml (MF method) 200 EPA524 * ug/L N.D. COMMENT: See Report attached. YES NO XU ❑ WATER IS SUITABLE FOR DRINKING PURPOS OR P ERS TESTED. 1 �l/ DATE ( 7 3 i LAIPUCK LABORATORIES, INC. 50 Hunt Street CHEMICAL ANALYSIS Watertown,MA 02172 BACTERIOLOGY (617) 923-0300 WATER ANALYSIS REPORT FOOD ANALYSIS SPECIFICATION TESTING LAB. NO. 42555 Client I.D. Maloney (Hight Street) Volatile Organic - EPA Method #524 in ppb (ug/L) RESULT MCL DETECTION LIMIT Benzene LT 5 . 0 0 . 5 Bromobenzene LT 2 . 0 0 . 5 Bromochloromethane LT 2 . 0 0 . 5 Bromodichloromethane LT 100 . 0 0 . 5 Bromoform LT 2 . 0 0 . 5 Bromomethane LT 2 . 0 0 . 5 n-Butyl Benzene LT 2 . 0 0 . 5 Sec-Butyl Benzene LT 2 . 0 0 . 5 Tert-Butyl Benzene LT 2 . 0 0. 5 Carbon Tetrachloride LT 5 . 0 0. 5 Chlorobenzene LT 2 . 0 0 . 5 Chloroethane LT 2 . 0 0 . 5 Chloroform 10 2 . 0 0. 5 Chloromethane LT 2 .0 0 . 5 2-Chlorotoluene LT 2 . 0 0 . 5 4-Chlorotoluene LT 2 .0 0 . 5 Dibromomethane LT 2 . 0 0. 5 1 , 2-Dichlorobenzene LT 2 . 0 0 . 5 1 , 3-Dichlorobenzene LT 2 . 0 0 . 5 1 ,4-Dichlorobenzene LT 75 .0 0 . 5 Ortho-Chlorotoluene LT 2 . 0 0 . 5 Dibromochloromethane LT 2 . 0 0 . 5 1 , 2 Dibromoethane (EDB) LT 0 . 10 0 . 5 Dichlorodifluoromethane LT 2 .0 0 . 5 1 , 1 Dichloroethane LT 2 . 0 0. 5 1 , 2 Dichloroethane (EDC) LT 5 . 0 0 . 5 1 , 1 Dichloroethylene LT 7 . 0 0. 5 Cis 1 , 2 Dichloroethylene LT 2 . 0 0. 5 Trans 1 , 2 Dichloroethylene LT 2 . 0 0. 5 1 , 2 Dichloropropane LT 2 . 0 0 . 5 1 , 3 Dichloropropene LT 2 . 0 0 . 5 2 , 2'-Dichloropropane LT 2 . 0 0 . 5 1 , 1-Dichloropropene LT 2 . 0 0 . 5 cis-1 , 3-Dichloropropene LT 2 . 0 0. 5 trans-1 , 3-Dichloropropene LT 2 .0 0 . 5 I Consulting& Testing Services for over 20 Years... This report is rendered upon the condition that it is not be be reproduced wholly or in part for advertising or other purposes over our signature or in connection with our name without special permission in writing.Total liability is limited to the invoiced amount.The results listed refer only to tested samples and/or applicable parameters. LAIPUCK LABORATORIES, INC. 50 Hunt Street CHEMICAL ANALYSIS Watertown,MA 02172 BACTERIOLOGY (617)923-0300 WATER ANALYSIS FOOD ANALYSIS SPECIFICATION TESTING LAB. NO. 42555-Maloney (Hight Street) - 2 - Volatile Organic - EPA Method #524 RESULT MCL DETECTION LIMIT Ethylbenzene LT 2 . 0 0 . 5 Hexachlorobutadiene LT 2 . 0 0 . 5 Isopropylbanzene LT 2 . 0 0 . 5 p-Isopropyltoluene LT 2 . 0 0 . 5 Methylene Chloride LT 2 . 0 0 . 5 n Propylbenzene LT 2 .0 0. 5 Styrene LT 2 . 0 0 . 5 1 , 1 , 1 , 2-tetrachloroethane LT 2 . 0 0 . 5 1 , 1 , 2 , 2-tetrachloroethane LT 2 . 0 0 . 5 Tetrachloroethene LT 2 . 0 0 . 5 Toluene LT 2 . 0 0 . 5 1 , 2 , 3-Trichlorobenzene LT 2 .0 0. 5 1 , 2 ,4 Trichlorobenzene LT 2 . 0 0. 5 1 , 1 , 1 Trichloroethane LT 2 . 0 0. 5 1 , 1 , 2 Trichloroethane LT 2 . 0 0 . 5 Trichlorotrifluorethane LT 2 . 0 0 . 5 Trichlorofluoromethane LT 2 . 0 0 . 5 Trichloroethene LT 5 . 0 0 . 5 1 , 2 , 3-Trichloropropane LT 2 . 0 0 . 5 1 , 2 , 3 Trimethylbenzene LT 2 . 0 0 . 5 1 , 2 , 4-Trimethylbenzene LT 2 . 0 0 . 5 1 , 3 , 5-Trimethylbenzene LT 2 . 0 0. 5 Vinyl Chloride LT 2 . 0 0. 5 Total Xylene LT 2 . 0 0 . 5 d8 Recoveries of Internal Standards % Fluorobenzene 105 P-Bromofluorobenzene 103 1 , 2-Dichlorobenzene-d4 107 LT = Less Than Detection Limit Analysis Date - December 01 , 1993 D.E.P. MA -061 Consulting & Testing Services for over 20 Years... This report is rendered upon the condition that it is not be be reproduced wholly or in part for advertising or other purposes over our signature or in connection with our name without special permission in writing.Total liability is limited to the invoiced amount.The results listed refer only to tested samples and/or applicable parameters. C Lc::5T Z� j oo - ,f //I i ice•" r w `` � �+ / / ole IL loo 7 � 9 /�i � / �,�:;� 1 �i -� � f � � / '�+� +�E¢c �q'•�'c : L 2 M+.J'I.J s6l, lot, S A4 War co *�k X" ' 11� � Y / rt . _ __,,.f ,,,:..,..•_,...__,____- e�. /' q4.� _.. �._c-, -�I�, _._ lam-" IF 3' _ ice_ , LOB"' 4 � 1� 11rx1T eP P LEI Et�pC-3 Aso ( vIS�,pso�C �R 1 i <�►l`( F1 A► A: LE L4 �t� Al-IZ1Xr0r z' IAYE2 O 12A1 ALJ_Ap t�r�E., i- .4 0Lr- 3/4"- I'/ " b�l�ShiF V =o1Ji� c�u. V i~_2�'�"v �- � — (��C•�I,.�Cy, top o� �ctl lv aw L piPIF-To Kra ��`` r \ c 4 "zl`I Z3 ►� °> 1-���11-� S � Y�E 1 =� P�l� N�A �. 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