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HomeMy WebLinkAbout0260 CHURCH STREET - Health 260,,CHURCH STREET .. _West Ba"mstable A = 153 007 F=` r r= J /lI SMEA61 No.53LNt UPC 13193 . gmeadjwm • Made In USA MW c�rune�so�u+o 1 WWWARWOMMOM i .i Ik ' ` '_ d S To 'v :ripr f Lo 0j) a g TT Stop,le 1 V zi 14 ID t i too No. V��" p l Fee BOARD OF HEALTH TOWN OF BARNSTABLE 01ppYicatiou -for Yell Cou5tructiou Vermcit Application is hereby made for a permit to Construct( ), Alter( ), or Repair( ) an individual well at: 4��A6 ah(Lrch 5+, 63 66--� Location- dress Assessors Map and Parcel c miy-cam. \m Owner Address � oiVy,V\e.� I N k C 3Yew�ev � W-f Q Installer Driller Address Type of Building Dwelling "'Z Other-Type of Building No. of Persons Type of Well A-{'' PVL �gJ iy , Q, Capacity Purpose of Well 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 Prot io gulation-The undersigned further agrees not to place the well in operation until a Certificate of Co 1'an a as a ssue y the Board of Health. Signed bate Application Approved By 7 je1) Date Application Disapproved for the following reasons: /J Date Permit No. t Issued 7 Date --------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of ion' auce THIS IS TO CERTIFY,that the individual well Constructed , Altered( ), or Repaired( ) by �� � ��r�� \,N � 0 \� Installer at ��\ nl� C. >�' \ts., "(:�> has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well P ote io Regulation as described in the application for Well Construction Permit No.\^bD01(p ' 01') Dated 7/Z,/i THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector :�N 5 No. V-,1�l� 1 � 0 17 Fee BOARD OF HEALTH TOWN OF BARNSTABLE zfpprication jFor Ivell con6truction permit Application is hereby made for a permit to Construct( ), Alter( ), or Repair( ) an individual well at: Location-Address_ Assessors Map and Parcel D r 1 Owner Address -t CL—r%Y\C�-an 1 a�� C'cLae w��� .�• t3�� 1Z� �3vew��e_y �� �7I Installe Driller Address Type of Building / Dwelling Other-Type of Building No. of Persons Type of Well " PvL Capacity Purpose of Well POA-aLw , 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 Protectio egulation-The undersigned further agrees not to place the well in operation until a Certificate of Co/'a ce as be ssued•by the Board of Health. Signed Dat Application Approved By )0I Date Application Disapproved for the following reasons: Date Permit No. Issued � Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of EOM Lance THIS IS TO CERTIFY,that the individual well Constructed Altered( ), or Repaired( by --R C� Q \� Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well rote ti n Regulation as described in the application for Well Construction Permit No.1r.7�G/lc 'a 7 Dated - ���� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL i SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector 1 BOARD OF HEALTH TOWN OF BARNSTABLE Vern Construction Permit No.� � IP ' 7 Fee 7 Permission is hereby granted to C. c �/�J/ Q-\\Installer I; to Construct Alter( ), or Repair( an individual well at: I' No. a C.Vw V-6 S,�- Street • /G / as shown on the application for a Well Construction Permit No. Wl G I Dated ?( o Date O /�Y Approved B PP Y I� i 1 Page: 1 of 1 CERTIFICATE OF ANALYSIS ° $ �M,, • Barnstable County Health Laboratory (M-MA009) sr�cHu Report Prepared For: Report Dated: 4/28/2015 Keith W. Bradley Broadmeadow Realty Order No.: G1586287 P O Box 203 W Chatham, MA 02669 Laboratory ID#: 1586287-01 Description: Water-Drinking Water Sample#: Sample Location: 260 Church St.W. Barnstable, MA Collected: 04/21/2015 Collected by: Customer Received: 04/21/2015 Routine ITEM RESULT UNITS RL MCL METHOD# TESTED' Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 4/21/2015 Copper 0.33 mg/L 0.10 1.3 SM 3111 B 4/24/2015 Iron 1.4 mg/L 0.10 0.3 SM 3 i 11 B 4/24/2015 pH 6.4 PH AT 25C NA 6.5-8.5 SM.4500-H-B 4/21/2015 Sodium 12 mg/L 2.5 20 SM 3111B 4/24/2015 Total Coliform Absent P/A 0 0 SM 9223 4/21/2015 Conductance 150 umohs/cm 2.0 EPA 120.1 4/21/2015 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: (Lab Director) _1 ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) Recipient: Keith W. Bradley Matrix: Water-Drinking Water Broadmeadow Realty Sampled: 04/21/2015 8:45 P 0 Box 203 Received: 04/21/2015 9:10 Collection Address: 260 Church St.W. Barnstable,MA W.Chatham, MA 02669 Sample Location: Order#: G1586287 Description: rkt Lab ID: 1586287-01 Date Analyzed: 4/21/2015 @ 10:13 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: 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. EPA 524.2 - Volatile Organics by GC/MS Result MCL MDL Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0:50 1,1,1-Tdchloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachlbroethane ND 0.50 Hexachlorobutadiene ND 0.50 1,1,2-Trichloroethane ND 5.0 0.50 Isopropyl benzene ND 0.50 1,1-Dichloroethane _ ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Tdchlorobenzene ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Trichloropropane ND 0.50 n-Propylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND 0.50 D.50 sec-Bu Ibenzene ND 0.50 1,2,4-Trimethylbenzene ND ty 1,2-Dibrcmo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibrcmoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 �1,2-Dichloroethane ND 5.0 0.50 Toluene ND loon 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Tri methyl benzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlomfluoromethane ND 0.50 2,2-Dichloropropane ND 0.50 Surrogates %Recovered QC Limits(%) 2-Chloroboluene ND 0.50 p-Bromofluorobenzene 93% 70 130 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 102% 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND. 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Approved B Attached please find the laboratory certified parameter list. (Lab Director) /M� 2�ND=None Detected RL = Reporting Limit MCL=Maxiinonta inant Lev Superior Court House, P0. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 r .�,.� ,�5• s h .. CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory Report Dated: 4/29/2005 Report Prepared For: Mike Pickering Order No.: G0529833 P&R Plumbing and Heating P 0 Box 103 W Barnstable, MA 02668 Laboratory ID#: 0529833-01 Description: Water-Driuldng Water Sample#: 29833 Sampling Location: 260 Church St.West.Banistable;MA Collected: 4/21/2005 Collected by: M.Pickering Received: 4/21/2005 Routine +Ammonia ITEivi RESULT UNITS RL MCL Method# Tested LAB: IC Lab Ammonia BRL mg/L 0.10 EPA 350.3 4/21/2005 LAB: Inorganics Nitrate as Nitrogen 1.4 mg/L 0.10 10 EPA 300.0 4/21/2005 LAB: Metals Copper BRL mg/L 0.10 1.3 SM 3111E 4/26/2005 Iron BRL mg/L 0.10 0.3 SM 3111E 4/26/2005 ' `Sodium 15 mg/L 1.0 20 SM3111B 4/26/2005 LAB: Microbiology Total Coliform Absent P/A 0 Absent 309 . 4/21/2005 LAB: Physical Chemistry Conductance 150 umohs/cm 1.0 EPA 120.1 4/21/2005 pH 6.4 pH-units 0 EPA 150.1 4/21/2005 EPA 524.2 - Volatile u Organics b GUMS � ITEM ' RESULT UNITS RL MCL Method# Tested LAB: GUMS 1,,141,2-Tetrachloroethane BRL ug/L 0.5 EPA524.2 4/22/2005 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA524.2 4/22/2005 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA524.2 4/22/2005 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA524.2 4/22/2005 1,1-Dichloroethane BRL ug/L o.s EPA524.2 4/22/2005 IJ-Dichloroethene BRL ug/L 0.5 7.0 EPA524.2 4/22/2005, 1 RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE OF ANALYSISPage: 2 Barnstable County Health Laboratory Report Dated: 4/29/2005 Report Prepared For: Mike Pickering Order No.: G0529833 P.&R Plumbing and Heating P0 Box 103 W Barnstable, MA 02668 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 4/22/2005 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 4/22/2005 1,2,4-Trikhlorobenzene BRL ug/L 0.5 70 EPA 524.2 4/22/2005 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 1,2-Dibromo-3-chloropropan BRL ug/L 0.5 EPA 524.2 4/22/2005 1,2-Dibromoethane (EDB) BRL ug/L 0.5 EPA 524.2 4/22/2005 112-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 4/22/2005 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 4/22/2005 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 4/22/2005 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 4/22/2005 1,4-Dichlorobenzene BRL ug/L 0.5 5.0 EPA 524.2 4/22/2005 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 4/22/2005 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 4/22/2005 4-Chlorotoluene BRL ug/L 0.5 EPA 524.2 4/22/2005 Benzene BRL ug/L 0.5 5.0 EPA 524.2 4/22/2005 Bromobenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 Bromochloromethane BRL ug/L 0.5 EPA 524.2 4/22/2005 Bromodlchloromethan-e BRL ug/L 0.5 EPA 524.2 4/22/2005 Bromoform BRL ug/L 0.5 EPA 524.2 4/22/2005 Bromomethane BRL ug/L 0.5 EPA 524.2 4/22/2005 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 4/22/2005 Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 4/22/2005 Chloroethane BRL ug/L 0.5 EPA 524.2 4/22/2005 Chloroform BRL ug/L 0.5 EPA 524.2 4/22/2005 Chloromethane BRL ug/L 0.5 EPA 524.2 4/22/2005 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 4/22/2005 RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 sF, r ''`q'�; CERTIFICATE OF ANALYSIS Page: 3 . . 4 Barnstable County Health Laboratory Report Dated: 4/29/2005 Report Prepared For: Mike Pickering Order No.: G0529833 P&R Plumbing and Heating P O Box 103 W Barnstable, MA 02668 cis-1.,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 4/22/2005 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 4/22/2005 Dibromomethane BRL ug/L 0.5 EPA 524.2 4/22/2005 Dichlorodifluoromethane BRL ug/L 0.5 EPA524.2 4/22/2005 Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 " 4/22/2005 Hexa.chlorobutadiene BRL ug/L 0.5 EPA 524.2 4/22/2005 Is op ropyl benzene BRL ug/L 0.5 EPA 524.2 4/22/2005 Methyl-tert-butyl ether BRL ug/L 0.5 EPA 524.2 4/22/2005 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 4/22/2005 n-Butylbenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 Naphthalene BRL ug/L 0.5 EPA 524.2 4/22/2005 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 4/22/2005 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 Styrene BRL ug/L 0.5 100 EPA 524.2 4/22/2005 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 4/22/2005 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 4/22/2005 Toluene BRL ug/L 0.5 1000 EPA 524.2 4/22/2005 Total xylenes BRL ug/L 0.5 10000 EPA 524.2 4/22/2005 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 4/22/2005 trans-.1,3-Dichloropro pep e BRL ug/L 0.5 EPA 524.2 4/22/2005 Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 4/22/2005 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 4/22/2005 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 4/22/2005 Water sample meets the recommended limits for drinking water for all above tested parameters. Approved By: (L#Director) RL = Reporling Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 AsBuilt Page 1 of 2 TOWN OF BARNSTABLE LOCATION 1.�gQ t{ (Y'h q SEWAGE# VILLAGE Ll,Dar()5:k3'h)Z ASSESSOR'S MAP&LOT l S�3-b,1 INSTALLER'S NAME&PHONE NO—T,Pd aco(j g-r- SEPTIC TANK CAPACITY f C= LEACHING FACILITY: (type)3 R 4W 6aeYa C (size) NO.OF BEDROOMS A B:tDATE: OR OWNERP 2 7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 l http://issgl2/intranet/propdata/prebuilt.aspx?mappar=153007&seq=1 10/18/2017 TOWN OF BARNSTABLE LOCATION 1I®® Gh0rr-- SEWAGE # VII.I,AGE Ll+(3Q C )jr- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.ff,Pi aro(ahGC'" SEPTIC TANK CAPACITY 10= noI Jc3a) LEACHING FACILITY: (type) 3 R 4P 6exca et' (size) 3� ° NO.OF BEDROOMS BUILDER OR OWNER 25 q PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 i a f� r �� i ,,� y� �' 9 � � 30 �"� � A 03 ` � I ® •� V No. l / / 50.00 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Mgogal *pgtem Conotruction Permit Application for a Permit to Construct( )RepaiKU)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 260 Church Street Owner's Name,Address and Tel.No. West Barnstable,Mass. 02668 Samuels Assessor'sMap/Parcel 260 Church Street West Barnstable,Mass. Installer's Name,Address,and Tel.No. — — Designer's Name,Address and Tel.No. 508-775-3338 J.P.Macomber & Son Inc. J.p.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass. 02632 TI pe of Building: Dwelling XMNo.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building RES No.of Persons 2 Showers( ) Cafeteria( ) Other Fixtures Design Flow 33n gallons per day. Calculated daily flow . 3x110 gallons. Plan Date 8/4&7 Number of sheets Revision Date Title Size of Septic Tank Existing 1000 Type of S.A.S. Description of Soil C�aY 31 t,n cl Pan sand Nature of Repairs or Alterations(Answer when applicable) +: Omitting existing leach field. Installing 3-330 rechargers jDacked in 31 of 12ll stone. 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 issu by this oAHlth. 8/5/97 Signed Ae ` Date Application Approved by _ Date Application Disapproved for the following reasons Permit No. / Date Issued 7 No. lri / Fee � jam $ 50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS F application for Miopool *potem Construction Permit Application for a Permit to Construct( )Repai (W)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 260 Charch MeeOwner's e,Address and Tel.No. West Barnstable,Mass. 02668 j Samue s Assessor'sMap/Parcel 1 260 Church Street West BARnstable,Mass. Installer's Name,Addressindd del.Ng — 3'�� Designer's Name,Address and Tel.No. - j 38 J.P.Macomber ��I lnc. J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 `` Box 66 Centerville,Mass. 02632 Type of Building:yy�� Dwelling l)PNr o.of Bedrooms 1 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 1 No.of Person Showers( ) Cafeteria( ) Other Fixtures Design Flow g p y y 3X110 g 330 gallons per day. Calculated daily flow allons. Plan Date 8/4/97 Number of sheets Revision Date Title Size of Septic Tank Existing Type of S.A.S. r � Description of Soil Clay 3' to clean ;sand Nature of Repairs or Alterations(Answer when"applicable) Omitting existing leach field. Installing 3-330 rechargers packed in 31 of lilt stone. 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 th1;�lth. nmentalZCddand not to place the system in operation until a Certifi- "'` cate of Compliance has been issu d by this 8/5/97 Signed Date Application Approved by ' Date 7, Application Disapproved for the following reasons Permit No.- Date Issued _ ---------------------------------------- 4"A THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CEWIIFY, th t the pn-site Sewage Disposal System Constructed( ) Repaired(�Upgraded( ) Abaa!joaec� ) y J. .Macom er & Son Inc. at UrC treeL W esL BomstMe,Mtiss. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N dated '`, Y7 Installer J.P.Macomber & Son Inc. Designer J.P.Macomber & Son (Dnc. The issuance of this permit shall not be constru d as a guarantee that the systemwill fugstion as designed. Date 1Z - � - rj� Inspector — /� �- $ 50.00 No. � / ���------------------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS lwiopool *p5tem Conotruction Permit Permission is hereby granted to Construct( )Repair�X )Upgrade( )Abandon( ) System located at 260 Church Street West Barnstable 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 mpleted within three years of the date ofVternnit. Date: 45 Approved CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPL.- WORKS CONSTRUCTION PL ItN,l l'l' (1V1'1'fl0U'1' DESIGNED PLANS) 1, Joseph P. Macomber Jr,- - c crtily th:1t tile application for disposal works construction permit signed by 111E �: lCd _ 8/5/97__ , concerning the property located at 260 Church Street West Barnstahl P meets all of the following criteria: • There are no wetlands within 300 fcct of the proposed septic system • There are no private Nvells within 150 feet of the proposed septic system • The observed groundwater t:jblc ii t Itet or greater below the bottom of the lcachinb facility There is no increase in flow and/or cllanbc in u'sc proposed '�`'" _^•_--�-�.~___-- _--_ • There are no variances requested or nccdcd. 01 SIGNED DATE: 8/5/97 LICE SEPTIC SYSTE,NI !NSTALLER IN THE TO%YN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed s�stun. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. a r TOWN OF BARNSTABLE LOCATION SEWAGE # VII LADE .1,DQ faj,ilghl-- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. Pi SEPTIC TANK CAPACITY no I om LEACHING FACILITY: (type) r" (size) 3S h ciae_C-� NO:OF BEDR OOMS DR S � BMDER OR OWNER q PERMUDATE: �,� — cf 7 COMPLIANCE DATE: 5� Lam'/ 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 Ftirttished by J ' 9� , .b LO CAT IO SEWAGE PERMIT NO. r U o 5 � �o VILLAGE w= l INSTA LLER'S NAME i ADDRESS - BUILDER OR OWNER IL6� 80ak C D ATE PERMIT ISSUED 13 - 7 DATE COMPLIANCE ISSUED IL l I A 1 0 S To Al e S F,-,k Olt l ¢_ 79- 63 No. ...._r_ .. Fx$.... 5^ THE COMMONWEALTH OF MASSACHUSETTS BOA RD O HEALTH P,�RCE�. 007 ............ ...D ..........oF....... .. ...� �� ._,........... LOB' " Appliratiun for DtipusFal Works Cfunwtrur#tun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at:2 6b �'' _._tjtP.......... ..0../ �+Ldocation-/Address --•. g) - tl or.Lot No. ..........��..!.�.!4�'{........s>�.!! U..'4j.�..L...................................... ....••--•--------••-•------.--•-----•-• ---------_---. --------------- Owner Address . -...- IU Piz!!IRN A�.gAe-•---•..... aflustc�Y....... ..............................................- Installer Address d Type of Building Size Lot.... ,1 ��..:...Sq. feet Dwelling—No. of Bedrooms............................_._....-__......Expansion Attic ( ) Garbage Grinder (i-o Other—T e of Building No. of persons............................ Showers — Cafeteria aOther fixtures -_------------_-----.............................................. W Design Flow................ ,5 ....._____.gallons per person per day. Total daily flow............ -.a_.__...........gallons. <x Septic Tank/--Li uld capacit ._ _::gallons Length....•........... Width................ Diameter................ Depth............... Disposal Trench�No..................... Width.. �..... Total Length.......S:C7..... Total leaching area ._ _:.:.sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) // --. Percolation Test Results Performed by......................................................................•--- Date------------�ali�/Z 2 aTest Pit No. 1._. ....�.._:.minutes per inch Depth`of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2................minutes per•inch Depth of Test Pit.................... Depth to ground water........................ ....-------•-----T• -------------------------------- O Description of Soil.............. •.. .... ...�4---•--- . - -•--••-=----fir -'-- ---r'--'�- - -. - x ------------------•---------..........-.........-•-- W ----....---•----------•--•---------•--------•---------•--•-•-•......••------•---•----------•---•-----------•--•---------•-------•---------------•--------•-•------•-....--.............................. UNature 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 TL 11,LE 5 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. Sined .......................•-•---•-•-••-•••......-----....._•-•---=•--- = Date Application Approved By....4 �� --•-----s---------------•- 0 �'-7 ........ - � :Date Application Disapproved for the-following reasons----------------------------•-----------•--------------..........------------------------------•------•-••---•- ..--....---•-•-----.....••-•-------------•--•---=---•-----------•----•-•....---------------------••-•-•••-----•-------••---•---•---------------------------••-----•-••-----••------•----------......... Date Permit.No.......................................................... Issued-....................................................... Date No............. - .......... THE COMMONWEALTH OF MASSACHUSETTS . BOARD O HEALTF .:-- h. r � - Appliration for i� o �a1� uxk Cron ra #tunJIrrutit Application is hereby ma&.for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...........cwgmJie.....1�.f..l .. ..d.M.:JLh il:SiLL ............. ....T.. ..... .. ........................... Location-Address •• or Lot No. ..................•................--- ...................................... ........----•-........--------•-•---•-----.... ----.............................................. Owner Address .------ -•----•......................................•-----•-•---••------••-•----------------•--•-••-•---- Installer Address Type of ding DwellinNo. of Bedrooms_______________ — Size Lot___.1��'� �E'_.�___.Sq. feet g— .............................Expansion Attic (. ) Garbage Grinder (, g a'4 Other—T e of Building No. of persons .................. .. Showers YP g ---------------------------- P -- - (_.__) .— Cafeteria - -- -fixtures ------------------------------------------------------.--..........----•----•---•--••-•---••--•-----•---•••-•- W Design Flow.__ they k7s gallons per person per day.'Total daily flow........... _P.. ...........gallons. W Se o gallons Length................ Width................ Diameter................ Depth................ Disposal Tanksal Trench iq capacit No � Width.2) .;4..... Total Length.......lt� ..... Total leaching area.._, 0 d_-`-...sq. ft. Seepage Pit No-_----------------- Diameter.................... Depth below inlet........... ...... Total leaching area..................sq. ft. Z Other Distribution box( ,•): Dosing tank ( ) Percolation Test Results Performed by.................................................. ............ Date...... ................................ ,.-a Test Pit No. 1... ... .....minutes per inch Depth of-Test Pit........... ...... Depth to ground water -:�__...._........._. " I., (s, - Test Pit No. 2.__...._........minutes per inch Depth of Test Pit.................... Depth to ground water_ ................. ... --- _ O ' Description of Soil------- C3 " � d ` ' 1� ag W --.- ------------------------------------------------- ----•------------------ ------•------------------- -••--•-•---•---------•-------•••-•-••-•••--••-•-••------•--•--•----•-----y----.....••--......-••-•,-•---••••-••-•-------------•-•-------•--••••--•---------•....•-•-...•••-•-..w...---•----•••---•------- 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 TT i'M 5 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. t Sined / .--.--,----.-----------------------•--------•--.---------------•--------- � . Application Approved By.. � Date ------------------ -- � • Date Application Disapproved.f or the following reasons:.................. .......................••............----••......-----------------------. •..........._ .................................................................!:•-•-•--.........__._.........-•---......-••----••--••---•---------•••-•---•-•----------•-•••--•-••-••----•---......................... I Date PermitNo.........................................-•......_...... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF'JiEALTH li :..:....OF................ .... ..'n,........................................ f9rdifiratr of Toutph aurr f T IfS/ TO CERTIF , That t e, ndividual Sewage Disposal System constructed ( or Repaired ( ) by------W;0 . .- s.............................. r ............... Installer +.. has been installe- in accordance with the provisions of T 5 f The State Sanitary Cpde as describedm the t Jr— application fox Disposal Works Construction Permit No. _ _�d.�..._..6 dated__.r_d.................... ��'� ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEMOW"'ILL FUNCTION"SATISI;ACTORY.' DATE..........................................................I.................... 'Inspector-----•-•----••-•----•................•-•:-----•---="=-. THE COMMONWEALTH OF MASSACHUSETTS ;� BOARD OF HEALTH `< P�� ............Q :..OF..... ...... ...�•�1 ................................... k... lN .. ....: ft FEE.... ....' Disposal r�5 (1on95, io rrmit Permission i reby granted.'•."' �l` `mil.- ,A . . . ------ ------------------------------------------ ----------- `r:`t... to Constr• t (": or Rep'aPr an Jo9dividual Sewage is SysteT at No... G .. `'" .. 0. Street n as shown on the application for Disposal,,N,�Torks Construction 'Perpy No__ ,.. Board of Health DATE............... -------------------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS "' . i 1 I tr��c-,►J �a"�"A I Z 1x��, t '41Jt 5G LU r� Y�N V�,v ;r 1 ' f � I �, A ' t 1 1�r4 tN 1 56Y TARS' � 'tit,►� �,�� � � AVU C c1 f r i, lU }�i11 o; �... .' A�.CXa 1L UP ,r- cr N `7 G Pox le hl1} f Lf .r '. Lo(-ATIOf-J e i Gov Ci1= 7"Ar Tl- -' t1U�'� ClWIrL� 5ucyw►.1 Pt.U,�1 R�F'�=tZEi.IGE -IEQEo►rt GwVli'L�(S W JTN TWG Si DE U"& _ Atv�, SET13hCK Vr--QUirZtNAcNrS Gi= TNT 'jC W►J G� 1�C1'.�l..��..��Tc�C.��� '�✓` A•M V L:.'ti.. pATc j } ,, t3 A.XTE�Z T�415 Qt_Aw is uSTErzv�LLC v ArCA5S. tlUr BE USCQ i"u GTE 2Mi�iC Lv'T Ll►.t(=5 #F71ANO 501/NDARY PER / / h s �� DE7FRA/7NAMV, OF C APPLICAMITY OA OS-028, l Fop j Q fc��c `�Rogo �U LOCU APR/L 4 FO05 // h�f/ �Q r es„T R�"Sr 10 p / J USGS — SANDWICH QUAD f40 \ 2000 0 1000 2000 4000 1' - 2000 FEET / f / COHOLAN, RYAN D & KATIE J 260 CHURCH STREET WEST BARNSTABLE, MA. 02668 :'t /r MAP/BLOCK/LOT: 153/007 00 N / PROPERTY ADDRESS: 260 CHURCH V) f STREET 42 DEED BOOK: 28881 PAGE 117 PLAN BOOK: 588 PAGE 47 r / \ PLAN DATE: JANUARY 8, 2004 / / / Existing Shed I I A pox. /oc0t/on FLOOD ZONE X SEE FEMA FLOOD PP INSURANCE RATE MAP NUMBER / 25001CO553J, EFFECTIVE DATE JULY 16, 2014 6\10' 3 ZONING DISTRICT: R-F AQUIFER PROTECTION DISTRICT °' _M MIN. LOT AREA: 87,120 SF N•-60.4 Exis/Ing K'e// / 4X30/ ill MIN. LOT FRONTAGE: 150 FT. / 00-W — r / — /BARN j cN MIN. FRONT YARD: 30 FT, J 11.00 O \ ` C 40 ) f / p� N MIN. SIDE/REAR YARD: 15 FT. V) MAX. BUILDING HEIGHT: 30 FT. TOPOGRAPHIC CONTOURS PRODUCED FROM Screen PrOP ` \ DATA PROVIDED ONLINE BY NOAA Porch . --- 44'1 \ https://coast.n000.gov/dotaviewer/ — \ l� Existin Portion r' —\ \ 2011 data l 9 House huddin oy LOCOtiOn remove ;d " \ 44 \ 43.S- _ PROPOSED — \ ` ADDITION ,\A OF \ — DB— 1 Z'2 DAVID b S C.T u. r SAS ` THUUM. 'y \ O \ N O r `\ \ \ N / 1 cA 04 42 En l 1 ` 1) \ I 9OZ J � .i�l n l l 42 NN H TO CB DH C i / S 71'15'07" E CBD CB-DH \ 71'17'17 � 163.07' * FND S \ _ n 64.55 _48 V �,. SHED AND DRIVE LOCATION DIGITIZED FROM., TOWN OF — 46 STREET 5o BARNSTABLE GIS AND MASSGIS ORTHO PHOTOS _� •� ��`/ � ����� 2013/2014 40 0 20 40 80 160 EXISTING SEPTIC LOCATION NO SEPTIC AS-BUILT ( IN FEET ) CARD ON FILE WITH THE 1 inch = 40 ft. TOWN OF BARNSTABLE 160908 - WORKING PLAN SITE PLAN DRAFTER: SET REVISIONS: 260 CHURCH STREET CHKD BY: DA��//YI�� D C. THULIN, PE, PLS DESIGN: DCT 211 MILL ROAD p SANDWICH, MASSACHUSETTS SCALE AS NOTED EAST SANDWICH, MASSACHUSETTS 02537 RYAN D & KATIE J COHOLAN SEPT. 18, 2017 260 CHURCH ST., W. BARNSTABLE, MA. 02668 WP01—SHEET2 (c�08) 888-2345 FAX (508) 888-7259 From The Workshopps� of COUNTRY CARPENTERS, INC. ; CONFIRM LOCAL REQUlREMENSS <'+r m t�.1.A FI I). , WINO LOAD —'— MPH M ` , ROOF LOAD #PSF HEIGHT RESTRICTIONS FEET _ --- V ,}S'<r` �G e•+ V � ��'�� �-i_,T tie;= „�I — i 1 ), __L^.. . P 13NN�NG & I � --f-d i PRELIMINARY PLAN CUSIOMrR: !CATALOG PAGE: 06 SIZE: 24'x24' ` ROOF PITCH: 10/12_.� r. ' FOUNUATIGN TTPE: '—OW N-E— OWNER ❑ BLOCK 40 POURED WALL ❑ PIERS CLTE(Jui rk;TK,E_ ROOF SHINGLES: BY OWNER rlcc(�UtTC►ViiCp vanlEn a„w.rrwt.E.ucti7 IHAt I1u: f�AJ+" arKe r,+r+OK�, L'i�{:4v AWI DPAWIgCS Ue GGUNrrrr rwrWfNtER, ❑ METAL ❑ ASPHALT $1 WOOD wcamila"Ico NUr to w tr!4r.o Ire Am Kltl:ON3 011il:N F1wr 111E pi;40v za t,ItOW?1r��1R MD THAT SUCH tA7CLMtF%T AR�f SID{NG: _ ® SHIPLAP D B & B THESEPOOCUTAEArTS ARE NOT T LAWS BE COF r VA OR Q Enrrtls�o MD REMARKS: ANY V10LAi1ON OF THIS CGPMGHT WkL BE PROSECUTED TO THE FULL, EXTENT OF THE LAW. THIS PLAN 15 UMITE:D TO 1HE CGNSTRUCIION OF THE ONE BUILDING FOR OTHER INFORMATION SEE PURCHASE FROM COUNTRY CARPENTERS INCORPORATEO. AGREEMENT & SPECiFICATION SHEET / / f �f2r11AN0 BOLNDARY PER � / � �_ /� 0 DEIFRM/NW70V OF APPL/CAB/L/TY DA 05-02B, J �O f f� �"�o LOCUS APR/L B, 2065 // 0 j �- crc Q / a / kv USGS - SANDWICH QUAD j 40 2000 0 1000 2000 4000 Cly' 1' . 2000 FEET (� ��, --� COHOLAN, RYAN D & KATIE J �(y 260 CHURCH STREET WEST BARNSTABLE, MA. 02668 MAP/BLOCK/LOT: 153/007 zo / 04 PROPERTY ADDRESS: 260 CHURCH N f STREET 42 \ DEED BOOK: 28881 PAGE 117 PLAN BOOK: 588 PAGE 47 ( � / \ PLAN DATE: JANUARY 8, 2004 / r Exlsfing Shed I FLOOD ZONE X SEE FEMA FLOOD -56 / r �� A,00rox. /ocofion ` INSURANCE RATE MAP NUMBER l / 25001C0553J, EFFECTIVE DATE JULY 16. 2014 16,0' ZONING DISTRICT: R-F AQUIFER PROTECTION DISTRICT 'S�, — / °i ►'� MIN. LOT AREA: 87,120 SF N'60.4 �00- W Exishrig lYe// \ / 4 O/ L MIN. LOT FRONTAGE: 150 FT. � — / in aN MIN. FRONT YARD: 30 FT. / ! 11.00 l 40 ) 16.01 o N MIN. SIDE/REAR YARD: 15 FT. L - tk J �/ N MAX. BUILDING HEIGHT: 30 FT. -_ 4i -•--�--� --..,..� ,. A ,..�:� � _.. �- � � _ -TOPOGRAPHIC CONTOURS PR D rED FROM Scree9"'Pro... n � p•�' DATA PROVIDED ONLINE BY-`NOAA - - I Porch oe _ 44'f \ https://coost.n000.gov/datoviewer/ - Exisfinq House -11 inS•°n or` \ \ 2011 data --� to:be 1V\ �44 \ \ Eoc_olion removed. \ \ 43.3�' PROPOSED DDITION '(N OF r \ ST SAS ` DA VI �0 9 \ THULIN \ \\ O N O�y Ln \ 04 00 N / CID 42 42 tktk •I DH C N9 // S 71'15 07 E CB- TO CB D CB_DH S.\ FND ^64.55 48 \/ — J SHED AND DRIVE LOCATION �, _ ✓ _ 46 DIGITIZED FROM TOWN OF H STREET BARNSTABLE GIS AND C .7 MASSGIS ORTHO PHOTOS 2013/2014 40 0 20 40 .80 160 EXISTING SEPTIC LOCATION FROM SEPTIC AS-BUILT ( IN FEET ) CARD ON FILE WITH THE 1 inch = 40 ft. TOWN OF BARNSTABLE 160908 - WORKING PLAN SITE PLAN DRAFTER: SET REVISIONS: 260 CHURCH STREET CHKD BY: DMAD C.'-' THULIN, PE, PLS I DESIGN: DCT O SANDWICH, MASSACHUSETTS SCALE AS NOTED 211 MILL ROAD C) RYAN D & KATIE J COHOLAN EAST SANDWICH, MASSACHUSETTS 02537 260 CHURCH ST., W. 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