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HomeMy WebLinkAbout0816 CEDAR STREET - Health LOT 3 CEDAR ST., W. BARNSTABLE A=088-004.00A �� wR 0 I U �ii L-5T762 C�pc6 L3/GL TOWN OF BARNSTABLE LOCATION P 7 Cyr 7 SEWAGE # t✓to/ _� VILLAGE L-U/�i�� �� �ASSESSyORR'S MAP & LO��y INSTALLER'S NAME&PHONE NO. �i.��/ SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size)Zfd4T/ NO.OF BEDROOMS BUILDER OR OWNER `A CJ PERMIT,DATE: COMPLIANCE DATE: D Separation Distance Between the: 1 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Z/ 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 R-3&�,Oavi4s PAW—or-- , r I P 06 Pceo 00q No.ZmJ; ,7 d Fee j THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:;,.,b Yes UBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ,�000 2pplication for Migogar 6potem Conelructiou Permit Application for a Permit to Construct pair( )Upgrade( )Abandon(?<) ❑Complete System ❑Individual Components Location Address or Lot No. C� �-� Owner's Name,Address and Tel.No. Assessor's Map/Parcel e33 O Installer's Name,Address,and Tel.No. / Designer's Name,Address and Tel.No. At 0// Type of Building: Dwelling No.of Bedrooms Lot Size Zsq.ft. Garbage Grinder( ) Other Type of Building o. of Persons Showers(3) Cafeteria( ) Other Fixtures ,,ii Design Flow q T 0 gallons per day. Calculated daily flow allons. Plan Date Number of sheets f Revision Date S'��'®0 Title S Size of Septic Tank Type of S.A.S. _ Description of Soil /Z /Z Ld, -itf / 2. — / Z j Nature of Repairs or Alterations(Answer when applicable) ®� VISE j3S_gjrk G ENGIN ` Wp�ITING —. IN Date last inspected: INSTALLATION ANLJ�N�. p 1M STRIC -THE. SYSTEM WAS Agreement: ACCORDANCE To PL• 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 qf the Environmental Cpoe and not to place the s stem in operation until a Certifi- cate of Compliance has been issu oard of alth. Signed Date Application Approved by Date FA& Application Disapproved for the following reasons Permit No. ZM Date Issued Z6 _� t / r Fee THE COMMONWEALTH OF MASSACHUSETTS _Entered in computer: Yes Q�Q PUBLIC HEALTH DIVISION -TOWN.OF BARNSTABLES MASSACHUSETTS ZippYication for Migpoml bp5tem 'Conotructton Verrn t 4 44 Application for a Permit to Co struct )Repair( )Upgrade( )Abandon ) ❑Complete System ❑Individual Components � :. ,Location Address or Lot No. L64f e A-f ,tom `r, Owner's Name,Address d Tel-.No. &Db `i VA- Assessor's Map/Parcel '3,F Installer's Name,Address,and Tel.No.., ✓ Designer's Name,Address and Tel.No. s5ur'�uc� s1. ,tom), )a) Type of Building: Dwelling No.of Bedrooms 3 Lot Size 2�2"sq.ft. Garbage Grinder( ) Other Type of Building 001P EE'' 1o.of Persons ' 1 Showers(3 ) Cafeteria( ) Other Fixtures ( 1 'J Design Flow t! gallons pei day.1,Calculated daily flow � C� allons. Plan Date V Numbers of sheets f Revision Date Title L? Size of Septic Tank �d yp r t T e of S.A.S. Description of Soil l Z 17� �a S b Nature of Repairs or Alterations(Answer when.applicable) # f v 1 Y ' 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 $the Environ ental •de and not to place the s'stem in operation until a Certifi- cafe of Compliance has been issued!y 4 oard o `ealffi:'` i Signed Date // L Application ApprIr oved by Date Application Disapproved for the following reasons m— ,r 7 Date Issued Z 6 Permit No. ` THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CER ,,t}atlthe On-site l age ispo o..System Constructed((. Repaired( )Upgraded( ) Abando-teal( )by �[ n �/ at a 6 CL.:k f A-V h J ww has been constructe in acc rdance with the provisions of Title 5 and the for Disposal System Construction Permit No.16 �S 7� dated ' Installer r Designer nt_ 00 f(S The issance of petmthall �t a strued as a guarantee that th s I st will functio as d ed. MW { Date Inspector /�/l� /t Y vI r i�,� ------------ No -------------Fee .�G THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 0igpo0a1 * stem Construction 3permtt Permission t hereby gjan�to3 onst> � Re Upgr�de{ bP A V H_1� 4 6 System located at 1 ) � � 6J 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:Construction must be c'o4leted-within three years of the date of this p Date: Approved by i No:- —' �o qy Fee� --------- BOARD OF HEALTH t= TOWN OF BARNSTABLE Zlpp[icat ion,forWell Congtruct ion Permit Application:''s`hereby made for a permit to gConstruct ( ✓f Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel __ -� _ lira � �� �� v% Gfl• �. caner Address Installer — Driller — — — Address Type of Building Dwelling-- ----- - - - ----- Other Type of Building-- ---- -------_ No. of Persons---_------.._---- --.-.-. Type of Well..-� � _ ��C Capacity_ � Purpose of Well — — Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until ertificate.of Cprppliance has been issued by the Board of Health. Sig - -- -/�- - _— daatettee Application Approved By - --------- — b date date Application Disapproved for the following reasons: ------------------- ---.--- --- r�o L1 l ` date Permit No. — — -- Issued---— 1�= �-�1a '-- ------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS I TO CERTIFY, That th Individual ell Constructe ✓f, Altered ( ), or Repaired ( ) by— -- _as� f --- -- `=�- - - -- - ------- ----__---- nsta er 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— ------------ _ —___--___--- _ l 1 IN s � y Fee-4 BOARD OF HEALTH TOWN OF BARNSTABLE ZDpIicat ion-for Vell Cootruction.Permit Application is hereby made for a permit to Construct ( Alter ( ), or Repair`( )an individual Well at: Location — Address Assessors 1Gtap and Parcel p 11 fOwner Address ._�/ll�t�i�irc�__ G✓0�/��2,��c'��r. �__ c �D �dX ���_� ► ORC��i/►�S ----- \Installer — Driller Address Type of Building Dwelling Other - Type of Building-=-------------------- No. of Persons-------------------------------- Type of Well— — /ALE r� �CCapa city 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. Sig —--- - -- - — /� daie Application Approved date Application Disapproved for the following reasons:— — --- -- - ---- - —-—------------—------ --- - ---_-- ------- date Permit No. W a�o 61 0 Ll L4 -- Issued ---------- date BOARD OF HEALTH s`t TOWN OF BARNSTABLE Certificate ®f Compliance r s THIS IS TO CERTIFY, That th Individual Well Constructed Altered ( ), or Repaired ( ) s ,- by— nstaller 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. k, DATE—______— _____-- ---- Inspector------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Very Con5tructionpermit No. �° —0 La Y / Fee- =-----__ Permission is hereby ranted ��"�r-� n �-� 2l.GC _- _ _� --_----------- -- g r to Construct ( v� lter ( ), or R pair ( ) an Individual Well-at:A O- No. - �� _ � __� ��22+�% �% �--- ---- - -— -- ------------------ f ---�� Street as shown on the application for a Well Construction Permit - No.-- - ---- ----- Date --- --- --�oiHe'a�lth --------- - Board DATE EIVTjMROTECH LARORATORIES. 1NC MA CERT NO.:M-MA 063 8 Jan Sebastian Drive Unit 12 Sandwich.MA 02S63 (S08)888-6460 1-800-339-6460 F.4X(S08)888-6446 Client Name Desmond Well Drilling Location Stuart,816 Cedar Street _ Address PO Box 2783 W Barnstable, MA Orleans MA 02653 Sample Date 1 o/26/o6 Collected By Desmond wells Sample Time 2:00 Sample Type New Well Date Deceived 10/27/06 Lab Order Number DW-2oo6-4749 Yell Specs 1461100' -- ocutrantrce ate Galled ?'ime Gotleetect . Go»rmen-S _.... Analysis Reqnested Units Recommended Limits 1.4nalysis Resnh I Method DateAnalyze t nal}zed Bp Total Coliform /100ml 0 0 9222 B 10/27/2006 RS pH pH units 6.5-8.5 6.57 4500-H-B 10/27/2006 LL Specific Conductance umhos/cm 500 149 120.1 10/27/2006 LL Nitrite-N mg/L 1.00 <0.004 300.0 1012712006 LL Nitrate-N mg/L 10.0 0.17 300.0 10/27/2006 LL Sodium mg/L 20.0 20.3 200.7 10/30/2006 MC Total Iran mg/L 0.3 <0.1 200.7 10/30/2006 MC Manganese mg1L 0.05 <0.008 200.7 1013012006 MC Comments: Sodium level is not a health hazard. Water meets EPA standards and is suitable for drinking for parameters tested. Date 6(3 ll lJ on J. Saar' Laboratory D ector BRL=BelowReportableLimits Page 1 of.1 {See Attached ` Massachusetts Department-of Conservation and Recreation Office of Water Resources 14 8 4 0 n TYPE OR PRINT ONLY Well Completion Report 1.WELL LOCATION GpP`S (Required) North ( 2- :. c1 C3 West -1 O L t ) a Address.at Well Location: Gf C Property Owner/Client: Cb h cz, Subdivision Name: Mailing Address: City/Town: ','A -� c�khS..Li,� City/Town: Assessors Map Assessors Lot#: NOTE:Assessors Map and Lot# mandatory if nosfreetaadd ss available 04 Board of Health permit obtained: Yes LSD Not Required ElPermit Number NNZ - 413ate.Issued /O/2q! 06 2.WORK PERFORMED 3. WELL TYPE- 4. DRILLING:METHOD'-` 6.CASING =. Overburden Bedrock • • From(ft) To(ft) e`ti47 Thickness- Diameter ❑ ❑. ❑� t ❑ ❑ FT I: ❑. ❑ '�i �° yt . ®ate 5� �� �;�, 5.WELL LOG ! OVERBURDEN Extra �C1❑Q Water Loss or Drop in LITHOLOGY Bearing Addition Drill Fast or + `❑❑❑ From (ft). To (ft) Code Color Comment Zone of Fluid Stem D Slow Rate 7. SCREEN e ZU ( � Y / Y / s1i " / S From(ft)"`To (ftj�a�' Type Slot Size Diameter -I�l P� 0❑® o t 2 it EME] -G5 -fib Cl~ 13�' _ Y / kb Y !"U) F /Awl 8.ANNULARSEALIFIL'fER PACKZABANDONMENT M'fL. 80 - 100 C.I it - . Y / Q)l Y F /, ' From-(ft) To (ft) Material Description Purpose -)do -1z-0 rc,sl (ZA Y / Y / & �. /'s� ❑ ❑❑ ❑❑ t(70 -ms FGS 13 _ !� Y / Y / t'S� ❑❑ ❑❑_ _ _ kY / N Y / NrF / ❑❑_ ❑❑ Y. /.N Y / N DF�/ S El El El El WELL LOG = BEDROCK Extra: r. g SITE:SKETCH Fast er.. Water Drop in Extra :Visible• Loss or #of LITHOLOGY Bearing Drill Large Slow /Rust- Addition Fractures From (ft) To (ft) Code Comment Zone Stem- Chips,poll Rate Staining of Fluid per foot Y / N Y`i�RF?/ S YLNY / N Y / N. Y4/'Fhf F / S Y ! N Y / N Y, / N Y"/­N F / S Y / N Y / N -,YI/"N,Y / N F / S Y / N Y / N Y NF { SY / NY / N ` 'ter, Y % NY / N F / S Y / N Y / N Y�1NY / N F / S Y / N Y / N Y / NY / N F / S Y / N Y /.N R. �9'❑G Y / NY / N F / S Y / N YlN A►4*, Y / N Y / N F / S Y / N Y / N 10. WELL TEST DATA(ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) 11. STATIC WATER LEVEL,(ALL-WELLS) Yield Time Pumped Pumping Level Time to Recover Recovery Depth Below Date Method (GPM) (h'rs`&'min)' (Ft..BGS) (hrs& min) (Ft.BGS) Date Measured. Ground Surface (ft) .12. PERMANENT PUMP(IF AVAILABLE)_ 13.ADDITIONAL WELL INFORMATION � v Pump Description �`® ® ® Horsepower -4 C3 Developed;/ N. Fracture Enhancement Y AN; Pump Intake Depth = 446 (ft) Nominal Pump Capacity 10 (gpm) Disinfected(D N.. Surface Seal Type ❑ L�l 14. COMMENTS `` Total WellDepth.—I 95 Depth to Bedrock 15. WELL DRILLER'S STATEMENT This well was drilled, altered,and/or abandoned under my supervision,according to applicable rules and regulations, and this reI46rt is complete and correct to the best of my knowledge- . Drille Supervising Driller Signature: r� � �! -t� Registration#:1 1 (,141 Firm: tir`t i 1�1t1q,�Ala Date Complete: 1)- r7-/3 Rig Permit#: ( ) Zf 1 ) NOTE. Well Completion Reports must be filed by the registered well driller within 30 days of well.eompledon. BOARD OF HEALTH COPY r . • w .. Well Completion Report Codes Section 2 Section 3 Section 4 Work Well Drilling Work Performed Type Method Performed Code Well Type Code Drilling Method Code Decommission DC Cathodic'Protection CTPR Air Hammer AH Deepen DP Domestic DMST Air Rotary AR Hydrofracture HF Geoconstruction GCON Auger AG New Well NW Geothermal Closed Loop GTCL Cable Tool CT Repair RP Geothermal Open Loop GTOL Casing Advancement CA Replacement RE Industrial INDS Core CR Injection INJC Direct Push DP Irrigation IRRG Drive and Wash DW Monitoring MONT Dug DG , Public Water.Supply PBWS Mud Rotary MR Recovery RCVR Reverse Rotary RR Test Wells TSTW Sonic SN Section 5 ` Section 6 Overburden ` Casing Lithology Overburden Overburden Overburden `. Bedrock Type Thickness Name (OB)Code Color Color Code. Bedrock Name (BR Code) Casing Type Code Thickness (NO CODE) Artificial Fill AF Black BL Amphibolite r a AM Certa-Lok CTL' Schedule 5 � `.. Boulders B Bluish Gray BG Basalt BS Fiberglass FBG Schedule 10 Clay CL Brown BR Conglomerate/Breccia CG/BR Galvanized Pipe GLP Schedule 40 " Coarse Sand CS Dark Gray DG Diorite DI HDPE HDP Schedule 80 f Cobbles C Greenish Gray GG Gabbro GBH; NSF Coated Steel NCS Schedule 160, w Fine Sand FS Light Gray LG Gneiss GN PVC PVC SDR 13.5 , Fine to Coarse Sand FCS Reddish Brown RB Granite GR Stainless Steel SST SDR 17 € Gravel G Yellowish Brown YB Limestone LS Steel STL SDR 21 Medium Sand MS Marble MA SDR 26 Organics, 0 Quartzite QZ SDR 32.5 Sand&Gravel SG Rhyolite RH - SDR 40 Silt SI Sandstone SS 17# Silty Clay SICL Schist SC 19# Silty Sand SIS Shale SH Silty Sand&Gravel SISG .. Slate/Phyllite SL/PH Till T Pegmatite PM Section 7 Section 8 Section 10 J Annular Seal/Filter Screen Annular.Seal/Filter Pack/Abandonment Purpose Method, Screen Type Code PacklAbandonment Material Code Purpose Code - Method Code Carbon Steel ' CST Bentonite Chips/Pellets BC Fill FL Air Blow with Drill Stem AB Continuous Wire PVC CWP Bentonite Grout BG Filter. FT Air Lift AL Galvanized Wire Wrapped 'GWW, Cement/Bentonite Grout CB Seal AS Bailing BL Perforated Pipe PFP Concrete CT Constant Rate Pump CR Pre-pack PVC PPP Sand SO Variable Rate Pump VR Pre-pack Stainless PPS Native Material -NM Slug SG Slotted PVC SLP Stainless Steel Vee Wire SSV Stainless Steel Well Point SSP Section 12 Section 13 Pump t Description Well Seal Pump Description Code Horsepower Surface Seal Type Type Code 2 Wire Constant Speed Submersible 2WSS 1/2 20 Cement CM 3 Wire Constant Speed Submersible 3WSS 3/4 25 -Cement/Bentonite CB Constant Speed Submersible Turbine CSST' 1 . 30 Concrete CT Variable Speed Submersible Turbine VSST 1 1/2 40 None NO Jet JET 2 50 Line Shaft Turbine LST- - 3 60 Centrifical CENT 5 75 7-1/2 100 y _ 1. 15 ;25 , - 56' 200. TOWN OF BARNSTABLE LOCATION SEWAGE # " 00 7F : VILLAGE_ ASSESSOR'S MAP & L0� INSTALLER'S NAME&PHONE NO. i��/ SEPTIC TANK CAPACITY LEACHING FACILITY: (type) C;1i 2L J, (size) NO. OF BEDROOMS BUILDER OR OWNER .,r l PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility L� Feet Private Water Supply Welland Leaching Facility (If any wells exist on site or within 200 feet of leaching facility)' 4� Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Feet Furnished by n� 1, 2 - r�,6341 � i TOWN OF BARNSTABLE LOCATION L'�7 .-F � � . <� SEWAGE # VILLAGE ��� �5� � ASSESSOR'S MAP & L INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) NO.OF BEDROOMS BUILDER OR OWNER . PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 2� 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 ±. l MY11 UI ifal•IISt11bIC I'1! r �Z2 / 1�__ Dc )artnicl 3 ,_ I it of Ilcallh,Safely, and Gnvironntcnlal Serrvices lilt � Division E lirilt �� I� 3 /•� 367 Mnilr Street,I lynnn!s non 02601 I uxnrr-rAmz i A m 1639 I ! o � Dale Scheduled T Z420 1 i Time hce 1'd. Soil Suitability) Assessment f0l ,Ste' ge vIS'jJ rS'( I'crfnnd BY:- �1� S5�, \VihlcsScd Uy: ) I ? J ,. M,00 "10 &Local!on Address! Owner's N�k -e ame Address Z Assessor's Map/1'nrccl: 1?n illecr's Nno NEW CONS'fkllCfIOPJ V 11G1'AIR telephone Il F � ) Land Ilse �S, �h/ 1\7 Q� Slopes(:o) 3 % Surface Stones Distances Itoul: Opco Water Body ')V, II Possible\VcI ArcnR/• I `' to O R Drinking 1Vnlcr 1\cl(``' ft Drainnge Way y Il I'ropaly I.inc C ) O II Olhcr Il i I SICI�'I'CI I: (Slice(name,dimensions 01,101,exact localions Ill lest holes teC perc tests,locale wcllmlds in proximity lu hoics) i i I I fl ® o ! � J 1 � 1 4 ' I t ill )il'. hnre�d olnicli+l(gcolugic) Dcplh to I)cdrock j I i iDeplh to Groundwmcr. Standing Water ill Ilulc: Weeping limn I'll face ,. � I t _- iGstinm(cd Sensorial I ligh Uroundwnlct t DETERMINATION FOIZ SL•A.SONAL 111GII V A I'1�RMAIILI� .. ;... - it lJscd: . = t � ''• :. _ ._-.._ ._ _ _. f t ' i)epth ,Observed Sinnding In obs,hole: in. Depll,r to sail mollies: 3 I Depih t,o weeping from side of ohs.hole: In. Gnnmdwnlcr Adjustment II• l+ Index Well/! _ ' IlrntllnR Dale: _ _ Index Weil level Adl.factorOrowidwnicr Level I + � I'rIZCt)1.;A't'IflN '['LS`f' >:li�iie` � ,i�Irlre !� Obscrvnlion � j lute!1 I I 'time at 9" 1 Depth of I'crc; S a'/ Time al G" l Slnrl Pre-souk•fink n / 1 1 it n I brie(9"-G") C, ) J I ! ap ) 4) End l'rc-soak ' Ratc Min./Inch •r Site Suitability Asscssmad: Site Passed Site 1'nilcd: Addi(ipnnl'I•estiug Ncedcd(1'M) Original: I'uhlie Ilca'Itll Division Observn(foil I tole Dnln ToBe Completed on Ilack j Copy: Appilcnnt ! j � 1 k. 1)G�I?,I' U13S[�1tVa�'('1<OlV 1 OLL:LUG. i 11ole If I I� Ucplh lineni '` E Suil Ilorizon Soil I'cslurc Sull Color soil (')Ihcr jI .Scilacc(in.) (USDA � 't ) (h,lunscll) hlollliog (Shnclmc,Slimes,Ilnuldcres. S 9ll513JS11GY i�QS11t1v�t) M sn, n ---- ---- --- - - - -' 2.5 y 6 2 s,J 1 --......_.. -- -- - ----- --------- ----= — ------- - ;� - I DEEP OBSERVATION MAJ11 JIM, Ilulc,# 2 I)clNh linen i Soil Ilorizun soil l•cshoe Soil Color Soil OIlrcr Surince(in.) P (USDA) (hbnrscll) ; I hlolllbrg (Shuelurc,Slimes,Ilnuldcres. Cual,ttusx—s AilIlLl) Ij (� f LOAM y SN.I-O 1 oy ( , i j i 1)I,EP 01181PA07ATION 11OLIP, LO(, IWe 11 i UcpIll Iionl Soil Ilorltnn Soil'Icslurc Soil Color Soil Ulhcr Surl':rcc(in.) (IISI)A) (hlunscll) hinllling (Slnrclorc,Sloncs,Ilnoldcres. --- I - i i ? F l I I ll1l,LI). OMERVATION IIOIJIJ LOG UcplhOonr ISoil Ilorizon Soil'I'exhoc soil Color Soil Odrer S�rrlirce(in.j (IISUA) (hlnnscll) Mollling (Shuclloc,Slimes,Ilnuldcres. '� � -- - S.Sl115i51SJ14Y.1��11ilYSl)r - i 1 F. '1 I I�I_ntuulur�iu r�13 il11n1>. ,. . . it ., Above 500 yc:lr llond boundary No _ Yes Wilirin 50U year bounrl:ny No Yes Wilhin 100,yenr'lloodboundnry Nil Yes r I ' D.901I L—OfNLIlILL. 11 Oc liaing_ 'e 'v'(L 11�1�rilil I)ocs at least limn-•feel of naturally occurring perviou�n)alcrial exist in all are;)s observed 1111oughont 111e 41 �alca p)oposcd I'M the soil absorption syslem? E-s I f rlol, what is the(leplll of maturnlly occurring pcl violls motel ial'? --- -Qi Wf sm.1Lm f I certify that on ��b ((talc) I have passed the soil evaloaloi,examinalioli approval by the Department of Gnvironn)ental I'rolection and I11n1 Ilse nbove analysis was perfornle(l by nle consistent will) !i the required (Ir in exper(ise I.pd`cx Cl`'i n scribe(I in 710 CM It I5:017. Sigonlurc__....._... --�� I);11c7 'S ------ �yl TOWN OF BARNSTABLE - LOCATION ' SEWAGE # VILLAGE_ _ASSESSOR'S MAP & LO�` INSTALLER'S NAME &PHONE NO. SEPTIC TANK CAPACITY— LEACHING FACILITY: (type) �O >1� NO. OF BEDROOMS f BUILDER OR OWNER , t. PERMIT DATE: . COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Y Facilit Feet Private Wa ter Supply W pp y 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) ai Feet Furnished by I _ S IF-or d-Re_ w of "•fllrll. .' �- - y f w bat, k r=. 14 , J1 w aj M s � • x k - w 'drys. .s Ar , _ 'J m cell SCR-4 053 `g � � ..# � �^_� .� - y r . •� xi.. . .�� -.�: ���, �: .. A William McMahon 4 _ PROJECT MANAGER UTILITJ�Y CON;�S�T�T�� - Tel: 568-432-0530 Fax:508-432-4385 E-mail:wbmcmahon@robertbour.com Web:robertbour.com 24 Great Western Road, P.O. Box 1539, Harwich, MA 02645 , , Fee-------- BOARD OF HEALTH TOWN OF BARNSTABLE 2pplicationArVell Con0ructionpermit Application is hereby,made for a permit to Construct Alter ( ) or Repair ( )an individual Well at: - d , _C`_ dr.� -- Location — Address Assessors Map and Parcel Owner n Address —-------------------- --------—------------- --------- ------------------------4 --------- Installer — Driller Address Type of Building ��`�� Dwelling —- o�---------------------------------- Other - Type of Building------------------------------ No. of Persons--------------------______—__—_—______ Type of Well AA 11196` - ---- Capacity------------ --——--- ---- Purpose of Well-------------- Agree m- ent: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. Signed — ` - — -- e Application Approved By _! _'______— 7 -r ir" date Application Disapproved for the following reasons:-----------------------------.-.--------.-------_—____—_ ------------- - - ------ --------------------------------- ------date----- Permit No. ---- Issued----- -— - --- ---- ---------- date BOARD OF HEALTH TOWN OF BARNSTABLE (tertif sate ®f (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (/), Altered by---- ---- Installer 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------------------.-- —__ —___ i Gild 34. . - -. ------ `5`�"----- No. Fee BOARD OF HEALTH TOWN OF ,.BARNSTABLE " - lication-*rIV01 Congtrurtion ermit.. Application is hereby made for a permit to`Construct Alter ( ) or Repair ( )an individual Well at:. 1 'Location !Address. Assessors Ma and'Paccel w— `S'7lir�.r�� fOwner Address ------- --------- Installer — Driller Address. TYPe of Building Dwelling - —- --- -------- ------------ Other - Type. of Building---- ------ ----------- '' No. of Persons---- ------ ------ - ------ Type of Well— ---- ---------- --- Capacit 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. is Signed f dale Application Approved By date: Application Disapproved for the.following reasons: =— -----=—=--- -- -- ---- _____ — ---------- --— —— ----date------ V;j {: Permit No. —___ _ '—Issued, date ��9w!^>Ifif6li\L!L�tfi.Rili��i!5G�iArliliFit�fi4S'SiMobv.li!ifi�idi�7ll�►wil��aA`rRifGtiTiRGTi9696w�Rtl1L8SRi�i'id9fNNS8lisBiTYfi6iR8TfK9i0gfia69i9Gfiap.GVilieilie.p4yhV?.B.RSfsSe-=r-- BOARD OF�'HEALTH TOWN OF BARNSTABLE C ertif irate of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (/), Altered ( ), or Repaired'( ) , by---- Installer --- at= -_ — has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application,for Well Construction Permit No. ---------------Dated --- ------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A.GUARANTEE THAT THE WELL SYSTEM WILL.FUNCTION SATISFACTORY. DATE =--- __ `: Inspector-- - - ------- --_ .a`_- '•d!IitbliB.a!&1iF3bl.ili9!i0i�i4GDwhiliTGBidli4GW GDGCiRi4i4i4i@G4iGYGTi4i4i960ipiPi'INBGT TSIi 069iti9iT06i4Gli.TiPaTiTGOiOigbYi5le�iTwii434i�i'!'+i'+i!i�4�soi4i4i9i1iOGl8.olilGli eili!♦ ! BOARD OF HEALTH TOWN OF ' BARNSTABLE r lVell ctCon5truct ion 3permit No. — Fee Permission is hereby granted.— to Construct V), Alter. ( ),,or 'Repair ( ) an Individual Wep at No. 04 - } street as shown on the application f r a Well-Construction Permit No.- _ — Dated ------- --------------------- -- Board ofalth - DATE— • ' A aA CERTIFICATE OF ANALYSIS Page: Barnstable County Health Laboratory Report Prepared For: Report Dated: 08/04/2000 Center Place Order Number: G0007085 Jeffrey Sollows 1550 Falmouth Road#15 Centerville, MA 02632 Laboratory ED#: 0007085-01 Description: ,�tt10 {ater-Drinking Water Sample#: 07085 Sampling Location!' 3 Cedar Street West B rnstable MA Collected: 08/02/2000 ollected by: C Stiefel F7 .� Received: 08/02/2000 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB: IC Lab Nitrates <0.1 mg/L 0.1 10 EPA 300.0 08/04/2000 LAB: Metals Copper 0.1 mg/L 0.1 1.3 SM 3111B 08/03/2000 Iron 0.01 mg/L 0.1 0.3 SM 3111B 08/03/2000 Sodium 52 mg/L 1.0 20 SM 3111B 08/03/2000 LAB: Microbiology Total Coliform Absent P/A 0 Absent P/A 08/02/2000 LAB: Physical Chemistry Conductance 342 umohs/cm 1 EPA 120.1 08/03/2000 pH 6.6 pH-units 0 EPA 150.1 08/03/2000 Note: The water has high levels of,sodium;persons on a low sodium diet should consult their doctor. Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 r . E • a.ai Page: 2 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Dated: 08/04/2000 Report Prepared For: Center Place Order Number: G0007085 Jeffrey Sollows 1550 Falmouth Road#15 Centerville, MA 02632 Laboratory ID#: 0007085-02 Description: Water-Drinking Water Sample#: B642 643 Sampling Location: 3 Cedar Street West Barnstable MA Collected: 08/02/2000 ollected by: C Stiefel Received: 08/02/2000 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS MDL MCL Method# Tested LAB: GUMS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 08/02/2000 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 08/02/2000 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 08/02/2000 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 08/02/2000 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 08/02/2000 1,1-Dichloroethene BRL ug/L 0.5 7.0 EPA 524.2 08/02/2000 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 08/02/2000 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 08/02/2000 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 08/02/2000' 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 1,2-Dibromo-3-chloropropan BRL ug/L 0.5 EPA 524.2 08/02/2000 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 08/02/2000 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 08/02/2000 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 08/02/2000 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/02/2000 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/02/2000 1,4-Dichlorobenzene ' BRL ug/L 0.5 5.0 EPA 524.2 08/02/2000 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 08/02/2000 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 08/02/2000 4-Chlorotoluene BRL ug/L 0.5 EPA 524.2 08/02/2000 Superior Court House, PO.Bog 427, Barnstable, MA 02630 Ph: 508-375-6605 • Page: 3 CERTIFICATE OF ANALYSIS 9 Barnstable County Health Laboratory \•Fsq�H�3r.. Report Prepared For: Report Dated: 08/04/2000 Center Place Order Number: G0007085 Jeffrey Sollows. 1550 Falmouth Road#15 Centerville, MA 02632 Laboratory ID#: 0007085-02 Description: Water-Drinking Water Sample#: B642 643 Sampling Location: 3 Cedar Street West Barnstable MA Collected: 08/02/2000 ollected by: C Stiefel Received: 08/02/2000 Benzene BILL ug/L 0.5 5.0 EPA 524.2 08/02/2000 Bromobenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 Bromochloromethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Bromodichloromethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Bromoform BRL ug/L 0.5 EPA 524.2 08/02/2000 Bromomethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 08/02/2000 Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 08/02/2000 Chloroethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Chloroform 2.5 ug/L 0.5 EPA 524.2 08/02/2000 Chloromethane BRL ug/L 0.5 EPA 524.2 08/02/2000 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 08/02/2000 cis4,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 08/02/2000 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Dibromomethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 08/02/2000 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 09/02/2000 Isopropylbenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 Methyl-tert-butyl ether BRL ug/L 2.0 EPA 524.2 08/02/2000 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 08/02/2000 n-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 Naphthalene BRL ug/L 0.5 EPA 524.2 08/02/2000 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 08/02/2000 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 Styrene BRL ug/L 0.5 100 EPA 524.2 08/02/2000 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 f 4,a CERTIFICATE OF ANALYSIS Page: 4 Acmes�` Barnstable County Health Laboratory Report Prepared For: Report Dated: 08/04/2000 Center Place Order Number: G0007085 Jeffrey Sollows 1550 Falmouth Road#15 Centerville, MA 02632 Laboratory ID#: 0007085-02 Description: Water-Drinking Water Sample#: B642 643 Sampling Location: 3 Cedar Street West Barnstable MA Collected: 08/02/2000 ollected by: C Stiefel Received: 08/02/2000 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 08/02/2000 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 08/02/2000 Toluene BRL ug/L 0.5 200 EPA 524.2 08/02/2000 Total xylenes BRL ug/L 0.5 10000 EPA 524.2 08/02/2000 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 08/02/2000 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 08/02/2000 Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 08/02/2000 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 08/02/2000 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 08/02/2000 Note: Approved By: - (Lab Director) Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 -0. 7--6- -0, 2wleµ M.71;7.7/71 BATH BATH ROBBIE'S BEDROOM 00 O l a - � 1io]i 0. �� � II� 0, os U HED STSAG E UNFINISHED RINGS E STORAGE vd, MASTER BEDROOM ASH' 8 f E)R to GARAGE 2.1 V) 3 6,-6, 3'-3* SECTION THROUGH GARAGE < @ < 81 SECOND FLOOR PLAN < yl nmaa as 2.11'Z-X E-Q - ---------------------------- --------- ---------------------------- -------------------------- - ATTIC ---------------------------------------------- - ------------------------ ------------- 12 FULL ,A-S jm-26u-fA�m— ? D�� BEDROOM #2 BEDROOM # GARAGE FWDAECTIONS o.R "-x ii IL VIN DINING --- raw Wr ------------------------ ------ --- - ---------- ------------------------ ----------- - ----------- - --- ---- -------- ------------------- ------------ ----------- uo o - --- ------------- ------------------------- FULL ------------------------------ - BASEMEN FOUNDATION PLAN L-j SECTION THROUGH KITCHEN/LOFT A2 (D MDDM mn,rou mu,vo —_ wmacxw m wm,./owd / I'¢ 12 IZ 10 J. LEFT SIDE ELEVATION [30 I.,.sm 0 LR.9 T.ELEVATIQN V REAR 0, u DINING GARAGE HALL =AE PLANSIELEW a*-" -2, T-6' LIVING ROOM DEW V-6, • W-6- Al RIGHT SIDE LL��7ATION FIRST FLOOR PLAN �I1 1gT Ft_ooeZ ( ` s E L. 133.0 ? fl w" - EL 13Z•0 f T 5 I _ _.: . t �' >UG G'2_ E>_ T t_ x s } y5_ F 1 ^ z 6 SLOPE ELV_ )2�b � E ACCES, w/>>v 6 0l GR. t'N. 3 MAx cove _ ! I i { 2 LEV El_ 1 O'rF ST I ,, C C S i� 1,500 G14A TOR,LE110 MIN I «40 1 27.E P. 0. Ccw1r_ 61Mw,j ?AT 04. ) g58A�F�z e . ,r csc a Se <39 1257 A }25.0 �o� EL-1z3.0 .a � __ _:� �,� ST t k 1 e ---- oa - 3P ",d} a Daugit --6'cpo5kirp SroNE DR Cot PACTE '� W ASt�D STwAV } zo'ml')4. r LOG U 5 Dc?rA oI~ l.,gv,p-'`F � 5 _�N1N I OMEN INL-Er Et I)E?rl� - l o ( c1-I�0 f3 L- Loy✓ duZt�T�EE �4 �L ► ��.o N CTES: 1. 015P0�5AL �,5TE- ra as C8I'V5TRUCTED ire STRI C? ACCORDANCE 01 CONII` I. OF Iv)AK ENV1R N. -OD 0 C E TITLE .� . 2 _ SURVCY DATA IN �3fl12NSTAI3LE MA Fc�? FF\09 L'E �F DISP OSAL SXSTE V\ } , N1,�RT1NO a-,i A,T_ 5, EAsrsANnWIC-H DA- Eb 7- H -I1 S9. .` CNO'r To SCAU-) 3. ST?1P OUT,IMPE IMPERIOUS ;\/��?'E Z3Al- ;4F-�v J 1.O istF(�Rt (3J�CK F)LL wi nA CLEfW MEE) SANS_ ASSI=SSatZ'SMA? 88 PC '-3 _ �Cs1V1N6 "RC ,' 5. BENCH M �R1� I C� C..$. 1-Z�tJ 1 R I �i 1�T .0 r�)J�3Z r LCir E LV. 13 E. , 3 USE 3 b 8 X Z F C. CoxJC_ LEI�CI-1 . C lAMREKS wi--A -V -QF /4 ,o !` Ile WASH © STONE w,'r Z or r��ASTO�JC 7. PVT•'T='s A�� 3AS �3AT-FLEE ,N SEPTI Q. TAN TITLE �_ i6 ; ,i tV_�3),0 i 1 a ) 3 ' ' '4'Q � 3.M. E � f f7S 5 12a 36122 124 I'26 130 U __ ------------- --/ 4 9 . 09 ! I L DT 3 Iy��•' i t i 7 C�'2 6Z l 36 _ _. I 8 a f.r o c - ; ,z4- ►zz f HEATH P',(3 T RpPR�Vh,L DJ\TC L cn 1 - TE 5- (�: f Pc a C.I t�1 J 0� - E r\ 1STH I 1 z 5♦0 _ xRr — — t2� .0 1 L o RM �w� EARL ; --- 1ANTERY, JR. ti J 1pNo.A�75p l .— [.o'�rn Y 'S p•�th r fiFs -r�. �� S 1 T P �°P\ E� S Dcs1Gry _ �� I . I r? I I -y-..;'>rRC♦Tf S� 1 l i1. I I ' 'F .f o <, 2 M,N.�r►J. .�I,'�YG�_ rAMtIsY hWELIIyG W/4 f3CDRt' C 't� 0 - G ARIc G1� D 1 S►P O S fit SYSTEM DESI N G D!A I LN F L D W 1 I a Y . 4 =`t40 G.P,fJ,` _ ��» SEPTI C TA�`IY, CVaL. REQ' D� ja�� AL� 1-aR /\A ,t 'M. ROBERT' S, STUART Z+/t a CG.P.D: x ..6 - �,S 0 6AL 5. tst OSSUl Y 2 6 3 K hl 1)TI N G 1-1 W D LEGEND k eo 15 �0 GAL, IZMV. 0 K, I 1 CEN-T f . . : � _ EP,VlLLE MA 02� _ �- c 1 �CI�CIl1I-AG J\ �u U SE 3 S'X5'xZ" P_ C_ CQNC_ L_ C_ + -- ' STONE LOT 3 C.E DAR S T. L-1`� E TIVE DEPTH = 2.0 - �x►snN� cocvToJP� ASSESSORS I�IAPEgP�_�+-3 \VEST BARNSTAal-E MA -EC6i+2(7 x Q.-74 133 PRw c",/py , 13x3Z* D.7A 308 •�,r i ADVANCED T-CM SOLO7 YO S Ff1PM �DNL J15_v Noll 140 12_ 1 — �20 �_ 1 O -7 0 1-1,L CJ��RCI I V = '�'►-�} 1 GALS. T-� 5T�D: s�J1)oo C0NSVLT ENG'R. E .Si%/YD MA _ T3j7L'X1�o���� Dl�,TE� 5127I OO Dw G.� 527001 I