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HomeMy WebLinkAbout0324 CHURCH STREET - Health 324 Church,Street f W.Barnstable A = 153 009002 i .L +/ Massachusetts Department of Environmental Protection Bureau of Resource Protection # Well Completion Reports 41, Well Driller Please specify work performed: Address at well location: e New Well Street Number: Street Name: e, 324 CHURCH STREET t-Ah Please specify well type: Building Lot#: Assessor's Map Domestic 153 009 � Assessor's Lot#: ZIP Code: Number Of Wells: 002 02668 ` City/Town: Well Location }, BARNSTABLE In public right-of-way: GPS r Yes r No North: West: 41.69570 70.37203 Subdivision/Property/Description: Mailing Address: .!click here if same as well location addres Property Owner: Street Number: Street Name: DAVE CAPPELLO 324 CHURCH STREET City/Town: State: Engineering Firm: BARNSTABLE MASSACHUSETTS ZIP Code: 02668 Board of health permit obtained: Yes C)Not Required Permit Number: Date Issued: W2014 037 11/26/2014 l l NEW Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Driller Program ` Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock Auger ( I--Choose Bedrock WELL LOG OVERBURDEN LITHOLOGY From 'Drop in drill Extra fast or slow Loss or addition of To(ft) Code Color Comment (ft) stem , drill rate fluid' 0 20 ISilty Sand jBrown (4 YES 0 NO r Fast r Slow 0 Loss r Addition 20 36 Medium Sand � Brown G YES (j NO 00 Fast r Slow � C) Loss CJ Addltl0n WELL LOG BEDROCK LITHOLOGY Visible „Extra From Drop in drill Extra fast or slow 'Loss or addition of To(ft) Code Comment "Rust ;Large (ft) stem drill rate fluid _ ,Staining '!Chips Choose Code r YES r NO r Fast 0 Slow r Loss r Addition rJ YeFPJYe ADDITIONAL WELL INFORMATION • • Yes r No Disinfected Q Yes r No Developed rr Total Well Depth 36 Depth to Bedrock Fracture Surface Seal Type INone Enhancement CASING F Is Casing above ground. From: 1 To: 0 From To Type Thickness Diameter Driveshoe 0 33 Polyvinyl Chloride 11 Schedule 40 4 �J Ye SCREEN ❑No Scree - ` From To Type Slot Size Diameter 33 36 Stainless Steel Well Point 0.010 4 WATER-BEARING ZONES r DRY WEL From To Yield(gpm) 10 36 15 PERMANENT PUMP(IF AVAILABLE) 2 Wire Constant Speed Pump Description Submersible Horsepower 3/ Pump Intake Depth(ft) 32 Nominal Pump Capacity(gpm) 10 ANNULAR SEAL/FILTER PACK ;.� Massachusetts Department of Environmental Protection LAureau of Resource Protection—Well Driller Program Well Completion Reports(General) From To Material 1 Weight Material 2 Weight Water Batches Method Of Placement (gal) Choose Material Choose Material --Choose One—� WELL TEST DATA Time Pumping Time To Date Method Yield(gpm) Pumped Level (ft Recover Recovery (ft BGS) (HH:MM) BGS) (HH:MM) 12/1/-0-1 Constant Rate Pump 15 1:30 24 0:01 10 WATER LEVEL Date Measured Static Depth BGS (ft) Flowing Rate(gpm) F'2/-1/2o—l4-1 10 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 and accurate to the best of my knowledge. PATRICK Supervising Driller DESMON Driller DESMOND Registration# 877 Monitoring[M] 9 Signature PATRICK, DESMOND WELL Firm DRILLING INC. Rig Permit# 024 Date Job Complete 12/2/2014 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. °F nqa � CERTIFICATE OF ANALYSIS page: 1 of 1 Barnstable County Health Laboratory (M-MA009) `y sar}��tisw^ Report Prepared For: Report Dated: 12/4/2014 Sally Desmond Desmond Well Drilling Order No,: G1484717 P O Box 2783 Orleans, MA 02653 Laboratory ID#: 1484717-01 Description: Water-Drinking Water Sample#: Sample Location: 324 Church St.W.Bamstable,MA Collected: 12/01/2014 Collected by: Customer Received: 12/02/2014 I ITEM RESULT UNITS RL MCL METHOD# TESTED Nitrate as Nitrogen 7,7 mg/L 0.10 10 EPA 300.0 12/2/2014 Iron ND mg/L 0.10 0.3 EPA 200.8 12/4/2014 Manganese 0.025 mg/L 0.0030 0.050 EPA 200.8 12/4/2014 pH 5.8 PH AT 25C NA &5-8.5 SM 4500-H-B 12/2/2014 Sodium 40 mg/L 0.10 20 EPA 200.8 12/4/2014 Total Coliform Absent P/A 0 0 SM 9223 12/2/2014 Conductance 300 umohs/cm 2.0 SM 2510E 12/2/2014 ! Sodium level is above the maxium contaminant level. Those on a low sodium diet may wish to consult a physician. Attached please find the laboratory certified parameter list. Approved By: ` f (Lab Directo ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 M; CERTIFICATE OF ANALYSIS ,.......... Barnstable County Health Laboratory (M-MA009) Recipient: Sally Desmond Matrix: Water-Drinking Water Desmond Well Drilling Sampled: 12/01/2014 14:30 P 0 Box 2783 Received: 12/02/2014 9:15 Orleans, MA 02653 Collection Address: 324 Church St.W.Barnstable,MA Order#: G1484717 Sample Location: Lab ID: 1484717-01 Description: 2day-324 Church St Date Analyzed: 12/2/2014 @ 14:39 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Sodium level Is above the maxium contaminant level.Those on a low sodium diet may wish to consult a physician. _...... EPA 524.2- Volatile Organics by GC/MS l..._._.__ Result MCL Mil Re-suit MCL KU Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluommethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichioroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochlorometihane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dlbromomethane ND 0.50 1,1,1-Trichloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachloroethane ND f 0.50 Hexachlorobutadlene _ ND 0.50 1,1,2-Tdchloroethane _ ND 5.0 0.50 Isopropyibenzene ND 0.50 1,1-Dichloroethane ND o.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-DicNoropropene 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 1,2,4-Trimethylbenze_ne ND 0.50 sec-Butylbenzene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 _...-- ............._.. ................. -- - - ............ 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichiorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 -._..... - -._.._..._.............. ------------ 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Trimethyibenzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichiorobenzene 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 Trichlorofluoromethane ND 0.50 2 2-Dichloro ro ane ND---., - 050 p.._.P...._. . Surrogates %Recovered QC Limits(%) 2-Chlorotoluene ND •_- - 0.50-Chlorotoluene ND 0.50 p-Bromofluorobenzene 99% 70 130 1,2-Dichlorobenzene-d4 106% 70 1 130 Benzene ND 5.0 0.50 - Bromobenzene ND 0.50 Bromorhloromethane 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 Attached please fled the laboratory certified parameter fist. Approved (Lab Director) ND=None Detected RL = Reporting Limit MCL=ia)drmum Contaminant Levef�l Superior Court House, Po. Box 427, Barnstable, MA 02630 Ph: 608-376-6605 Page 1 of 1 I TOWN OF BARNSTABLE LOCATION , 14 C k0r _k t I SEWAGE # X003 7 VILLAGE Wei Qt"MTd L—� f AU ASSESSOR'S MAP & LOT IS-3-004 �2 INSTALLER'S NAME&PHONE NO. 1 orit kcru' ep y f;oz a6.z--=C SEPTIC TANK CAPACnT l GtOD o a i Cb a'l0�x xb size fl i o y 1 yb V N0, LEACHING FACII.ITY: (type) �� � (size) � NO.OF BEDROOMS 3 BUILDER OR OWNER VI D C& PPELL.0 PERMIT DATE: 7 A-I 0 3 COMPLIANCE DATE: 13110 3 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 ���� -; �- ._ �'�) -�-- -- ' 1��. �____._ �� �� � ■ "�„! �., . �r it TOWN OF BARNSTABLE LOCATION Ckur _ tl SEWAGE # VILLAGE 9C � --NIA ,/ASSESSOR'S MAP& LOTlE3'®fJ1—ODZ INSTALLER'S NAME_&PHONE NO. T PK Ks-nKr z -'razG?— � SEPTIC TANK CAPACITY LEACHING FACILITY: (type) X26 r .(size) #A 001 yb Y4l�� NO.OF BEDROOMS 3 Bu .DER OR OWNER DW L PERMUDATE: /0 COMPLIANCE DATE: �� 6 1 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.,M�etlands exist within 300 feet of leaching facility) ' Feet iFurnished by I j i i s �I CAC.K J, Flo. Fee J 6•Oo THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,� MASSACHUSETTS- ric�tion for �i� oaf apaem Cow6truction,Permit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot S o. f Owner's Name,Address and Tel.No. f � 3 - vu -orb a s o2GSg 3� •�2 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. - -T>m Kanvt-e a y Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder( ) Other Type of Building No.of Persons Showers(.?-) Cafeteria( ) Other Fixtures Design Flow 3 gallons per day. Calculated daily flow yDQ gallons. Plan Date $ 7 2/./S2 Number of sheets ! Revision Date Title Description of Soil C-LAQU& 184C Sdrtn� Nature of Repairs or Alterations(Answer when applicable)_IL AC. V�r'�. t ti5TtQ1 Nceu Date last inspected: i 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 iss thi of ealti Sign - ate .2 D Application Approved by Application Disapproved for the following yeas Permit No. — Date Issued VA W 3 No. Fee 3-0_00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS.- 01pprication for-Mig;pool *p2;tem ctCon2;trucicon,Permit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot TO, Owner's Name,Address and Tel.No. y c�+vrc (Javi4j GO.PPea;•�•,D 3.zq GkuriGk Sl, 3- 00 -00� ft D?l.Sff Asr •Fs'2 installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 77> m Keznvt-e-�Y ,Sam 3G2-3c�o�'• Type of I'iuilding: Dwelling No.of Bedrooms 3 Garbage Grinder( ) Other Type of Building No.of Persons Showers(.X4 Cafeteria( ) Other Fixtures Design Flow 3 gallons per day. Calculated daily flow $/00 gallons. Plan Date 1/24/912 Number of sheets Revision Date " Title \\ Description of Soil C,L4 A tn,.ca 54A"t Nature of Repairs.or Alterations(Answer when applicable) TL^L R le sett1c A rCQ-_ r�3� Nttu 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 iss. th' . of ealtk Signed. Da Application Approved by Application Disapproved for the AgAing rea ons r Permit No. —2b. Date`Issued o ..� ..�.r.���.���an�a�+-a-...lr w•—J.®�J�!���►T.��1.—���A T TS.TT����������.. .���'S �1�-—. � .. � . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Certificate of Comp ia= THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( ')on. b for as 57" q . _ D S A , tias been construcVan a cordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 4'02 337 dated Use of this system is condi Toned c a compliance.with the provisions set forth below: .._ . . . .�— �..._., � —�....,—_..._—.�....._..—_.—,_--._.....--_...y—_,—fie No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Abpgtem Cougtructiou Permit. Permission is hereby granted to to construct( )repairl(.A/S an On-site Sewage System located it 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. All Go:istruction mus be comlAeted within two years of the date below. Date: Approved by 4dw 6-hilralo Sir a ..: . �G''J All Poo �I p r YYI Of . . r, i. Aft., . c r ' No. 0 — V 37 Fee l BOARD OF HEALTH TOWN OF BARNSTABLE 01ppricatiou jor Yell Cougtructtou permit Application is hereby made for a permit to Construct(f, Alter( ), or Repair( ) an individual well at: \531 Omloc)-L Location-Address Assessors Nbp and Parcel �4� Ca o ne\\a 2�1 CJhu 1�cA�.S- , {�(t 1 .c., l�,i�l� oz(�� OOwe,{rneer Address `\f r Installer-Driller Address Type of Building / Dwelling +� Other-Type of Building No. 11 of Persons Type of Well� I�SNC O �JG Capacity 1 �� 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 Protection Regulation-The undersigned further agrees not to place the well in operation until a Cert' cate of Compliance has been issued by the Board of Health. Signed ZSliq Date Application Approved By Date Application Disapproved for the following reasons: , .. \\ Date w Permit No. 'FON— o 3-7 Issued Da e -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of QCompliauce THIS IS TO CERTIFY,that the individual well Constructed(Altered( ), or Repaired( ) by�126ZU� �,� !I (�I LLJA�Qo Installer at 3a d C-4U" 'ST lt�7i7Z./V9 ycz 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 SATISFACTORILY. Date Inspector r: No. Fee 7 r BOARD OF HEALTH TOWN OF BARNSTABLE 01ppYicatton _for Yell Congtructton Permit Application is hereby made for a permit to Construct(�), Alter( ), or Repair( ) an individual well at: Location-Address Assessors Nlap and Parcel Ca0M��0 32�-i ���'�` 1 �lV ��a�11cT �R,�1 ()7 -f Owner Address �QSYV O"N\\ 0(.\\\ Installer-Driller J Address Type of Building / Dwelling V Other-Type of(B'uilding No. of Persons ,Type of Well"I SCN`l r) 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 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 1 f 2S 1' Date Application Approved By Date Application Disapproved for the following reasons: Date Permit No. ��`�` 3 Issued s Date i i BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(,,I/, Altered( ), or Repaired( 1J ) by ��J 1439I:c l�12 ►t L//V�C, r Installer at 3a C (_�U�t i 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 SATISFACTORILY. Date Inspector ti BOARD OF HEALTH TOWN OF BARNSTABLE Very Con.5tructton Permit _ r,l o No. ._ U 3 Fee y Permission is hereby granted to � O�� (NU.(_ 1 LUrU Installer to Construct Alter( ), or Repair( ) an individual well at: No. .'3�q /-flit LC..H i S�' (-.7 ���rJ S-rA L L. Street as shown on the application for a Well Construction Permit No. �� 03 Dated /f/?4 Lza)t(-t Date L?,O) Approved By 7x`.i AN 1 '13 P,45V vTq.R,� .Sctl.�+ i -F L t M LT. f r� zat 3 i 1 f r . 19 tj 1 .4 --Q IS TANCE AS CERTIFIED -t;I HE CERTIFY THAT-THE BUILDING � SITE PLAN SHOWN OS PLAN IS LOCATED ON THE t z GROUND HEREON &THAT IT LOCUS: CONFORM TO'FEif,ZO AWSOF THETOWN OF WHEN CONSTRUCTED. DATE l 4 REF: do- o _cape f4 f/Weef/ft a PREPARED i CIVIL ENGINEERS -- 3— ci-cit L !� C T IOM S E '+� A G E PERMIT NO. VILLAGE I N S T A LLE,R'S MADE a A000EaSS �? 1 IUILDER OR OWNER 4 a DATE PERMIT ISSUED f 67 IX DAT E C0M ►LIAMCE ISSUED � fXz/ L i r, `i a �� -e'Ali . 796 3"Z z/ L9 ATI,ON J jt SENACI PERMIT NO. VIIIACE INS ALER'S !J IRE & ADDREt ? � qj, o U I LID E R OR OWNER DATA . PERMIT ISSN E D � `' �:. C1 DATE COMPLIANCE ISSUE D, f P D IAo .� 1 ,No.41:vS_.::.4� ,7 FEB.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH LU (� .. ..................OF.. CZ. -f-`.A. ... Appilratinn for Bispaa al Worko Tnnstrnr#inn ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at%.��� ��.- •�:.._... p k .................. ... n-A or Lot No. -"----------------•---------- -•--.......v 2Ckt...........��t_:1`..................................................... w,.a wner 'i ( ` Address Kee. _....•................ - -- ................................................... -----�--n----a---s---s----------------•- - nstaller Address ^, UType of Building Size Lot_! �o,5-v_��___._..Sq. feet �..� Dwelling—No. of Bedrooms..............3.........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------•-----•---•---•-----••---------•-•••-------••--••--•--••-•---------•--•......-.......---•-------_.... W Design Flow.......... ............................gallons per person per day. Total daily flow-------------------- 0__•____.____.gallons. WSeptic Tank—Liquid capacity_�.'�?©_gallons Length.___-_(c_._... Width.____��_______. Diameter________________ Depth_...___.... x Disposal Trench—No.-___-j_........... Width...4�+v........ Total Length__..P_-__•--_ Total leaching area_4a�.....sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) j Percolation Test Results Performed by.'R�_ _1_� .!�'__-•_.___ ____..______ Date____�� ` -1-$__________..•_____.. Test Pit No. 1....... _.__.minutes per inch Depth of Test Pit___ ...... Depth to ground water:._$.............. (i, Test Pit No. 2........2__minutes per inch Depth of Test Pit___- 2........ Depth to ground water-..._�2� a O Description of Soil - l�Jtvrw 1�.D..........Vatl-�P_-�......_ C. `L.......a-v-E. `441.i _ 1� W VNature of Repairs or Alterat-0 s Answ w applicable_______ ____ _ _________4Disp1'Syst,,em -------&_ ----------- ----------------------------------- ! ' ----- Agreement: The undersigned agrees to install the of edescribed Individual Sewag in accordance with the provisions of TITL 5 of the State Sanitary Code— The undersigned further agrees t to place he system i operation until a Certificate of Compliance has,bee issued by th boa d of health. 1 Dat Application Approved By-•.----- --•--•. �----------------•--------------..-..-•----•---•---........ -.�lr �2� ----...----- ate Application Disapproved r e following reasons----------------•----------------------------------------------------------------------------------------••-_.... .....................••----_.._..-••---•--•-•-•--•--•-•••----.....--••--••-••••-----•-.......---•...---•--•--_-..•---•-•------•--•--•••---•-•-----..................................................... Date PermitNo......................................................... Issued....................................................... Date .............-...... Fss............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .w.-N ...OF... �5� �1-C •�L.............................. Appliratiou for Disposal Works Towitratrtiou Famit Application is hereby made for a Permit to Construct ()4) or Repair ( ) an Individual Sewage Disposal System at: ...... __..__.... -.... .................................................. ....�"r•---.3......................................... •-----••--•-•--•---•----•--•---• Location-Address or Lot No. ......................-.......................................................................... -•........•••---••-•--•-•------••-•-•-•---...........•----•--••---•----•------•-----...........•-- Owner Address ' Z 5 ............U)� ........................ •---••--•--•------•--__ .I�../..`..1...�.....•-----------•--- Installer Address Z dType of Building Size Lot__-r�_��5_0_�......Sq. feet U Dwelling—No. of Bedrooms_______________3____________.._..........Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria 0.1 Other fixtures --------------------------------------- - W Design Flow.......... S............................gallons per person per day. Total daily flow.............._..___33!2.............gallons. Septic Tank—Liquid capacity_ .! __gallons Length..__. _..... Width....-}�....... Diameter................ Depth...... Disposal Trench—No.......I............ Width... :-�........ Total Length.._, •U_._..._. Total leaching area.42Q 2.....sq. ft. Seepage Pit No-_------------------ Diameter.................... Depth below inlet..................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) rr Z Percolation Test Results Performed by..�...:_ 1 _�.�.<<:............................�._. Date.... ..k�` %-). ............. rl as Test Pit No. 1....... ..._.minutes per inch Depth of Test Pit... �i______ Depth to ground water...Iq�.-�--i---------- (i, Test Pit No. 2._______-�-__minutes per inch Depth of Test Pit-__A-i . Depth to ground water-__:`a�___.._.___. � --•---•-------------------------------• --------------•-• -•-- -------------••-•------................................................... O Description of Soil...........-- �A� C...--- . ----- 2N x ----- x �` •. U Nature of Repairs or Altera Ans er n a flea le_:_._.._ x _ _ ----------------................................. •-- .......... ......-- --•.... ----•-••-•-••--.......-••--•---•••......•••-•---•••---••••• .............................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sys in accordance wi, i the provisions of TITj 1Z 5 of the State Sanitary Code— The undersigned further agrees.no , 1 e operation until a Certific ateCorn nce h is bin is iy th boar of h h. ytt a j� I � , p ,i� D -�APPlication Approved •-•----•-•--•••--•-••.........•-•-----•-•-••---......-•---•-._......._••••. ••--•-�--�......---•-----•-- Date Application Disapproveowing reasons:.......................................................... . .. '� ...................................... .......................................--................................................................................................................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR OF .......... ..t:.......................OF............. .... ........................................................ (Irrtifiratr of Tomplivatrr THIS IS TO CER Y That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) .....L ---------------- Insta--er---------•-------•------___•_______________________________•-----•-•--•--------•--------------- at ..-•'___________________Installer ------•----•--....-•------•--•-----------•-•--•-------••- has been installed in accordance with the provisions of LEG -qf The State Sanitr3'_'_�c e described in the IE application for Disposal Works Construction Permit No......................................... da ed.--.._z_--.: ._.._ _:..._.,___.___.____._. THE ISS AN E OF THIS CERTIFICATE SHALL NOT BE CONST AS A GBJARANTEE THAT THE SYSTEIyI VII L NCTION SATISFACTORY. DATE, ...� 1--------------------•-•---__-_________--•------•---____-. Inspector. ..... _....... __...... ...... THE COMMONWEALTH OF MASSACHUSETTS BO F S No......................... FEE........................ Disposal Works 0onstrurtiou 'permit Permis i• 1s hereb d... ............. -•---•••--••-•-•••••.................................••• ••--••-•....._.......__•----- yg ; to Con t"r ) R pair"(� ) Indivld ewage D>sposal System at ...........................................................-•--••••................ Street /a /j� rz.-, as shown on the application for Disposal Works Construction Permit No..................... Dated.._..._`_�__`_'__.__.._.__._..__..._...._._.... ------- ---•---------------------------•-------._......_....---...---- Board of Health DATE................. / FORM 1?55 A.M. SULKIN, INC., BOSTON • rlii. � 362-4541 926 main street yarmouth mass. 02675 down cope engineering civil engineers& land surveyors structural design James H.Bowman P.E.,R.L.S. Arne H.Ojala P.E.,R.L.S. land court « John W.Jalicki surveys site planning sewage system February 3, 1983 designs inspections Town of Barnstable Board of Health Town Hall permits Hyannis, MA 02601 Gentlemen: SUBJECT: CAPPELLO - LOT 3, CHURCH STREET, WEST BARNSTABLE, MA This is to certify that the sewage system at Lot 3, Church Street, has been installed .-at the elevation shown on the approved plans. The elevation at the bottom of the leaching field is 35.4 -feet, which is 7.4 feet above the observed ground water elevation. Sincerely, Arne H 1 N94o L.S. OJALA AHO/mkh .CIVIL '. No. 30792 r cc: D. Cappello A�o,�sFG/STE�`����,�``�„a f SIONAL E t r � .} SEWA. s } RCH vn.tsv�tgt;`5 '.sotI -SEPTIC TANK — ,V,BO'X _' - LE ;__.,_—___...._._.__ 3 £x�avati Ec:�t �'•{. T if..'.. k�1U� .4,Ly uv SU;7 .' .-�. WAT 'itit,,,, ...a..OF 1ia TO?,s.. C-: f t I,- t.�+A. 1 lU L O'er A ... .:.._. _.. !` "1 W SHED STONE t uJ:a� �-i G,ssty f./:rta l'.er•5,�. �sa:a_.h.?,}1.. .._.-__...._.___. � �J�� A41 , 1��F I T hzo „ I- OUT .IN- OUT-, ._ --'-�-'I 1 3- �•', '� j ,./ . ._ .. f r =AN �j i ... LEI rANk TOWN OF �LEV. f-LE F'LEV 37 �.Zv _ �av: ELEV. ELEV. i a. . 3i 4•i 4.e93�.► OF Xa - 1112" WASHEDsST.QNE n wJ R"7A,�LE L V d i �. n. 6p "M WITNESS - — ! J'�8EDROOM HOUSE [DESIGN t ,,l Lp ELE•J 7 . DISPOSER DISPOSER { �►.;� .. .� i �' PERCRATTY '. .,__ MIN/IN. it t C' FLOW U RATE' '�_!-C,(GALWDAY y •�_ t - — I w :� _._...,,.. ».�•�-.. :Q. •h a,..: .:ry "�- ,-,�^ � SEPTIC TANK '•��"3 C.: {i.5)= . >�" --+ 7' �lss,aGy` 4= I. I ] w �``" lei A REO'D SEPTIC TANK SIZE -- --------- J - - LEACH FACILITY _ �m . ° . .._ ,.- .�c..l SIDE WA'tL. GfD v r 4ts t..cGr? G/D.HOTT TOTAL ..�.. .I. �_• .��.. ;G„;a. _-i7-. .c- '�... .,{p 6 �:�;� ��1 _ fir. "► !+}f` �^a --!_EAGHIiVG. t L 'A.Tfi ES.raCOUPf7ERFt) _.. _ - -- __ --- — I ' = tLINLES1, OTHERWISE NO EI,�r f I W°'(•Sk�S!_r -__TjAKEN F ROM__. GTUP�i�RANG�E.FVIA3' a PAL'WATEF'•.....__9................; r_._.- ..*iVAiL,ABLE SsF "�. s L.=1 ' .G7 +'�fi:.8•i: :i.",PER FOOT I 4V LOADING FOP AL1,..PP.F-rAST 11NJT�. AAShiO- TANCE AS CERTIFIED —_.0._... ._._ [ R*ou,Nb Cow,AR OVI-R ALL SEWAGE F<AC1laT1ES: tly f T, Aid NE }?. ?S.SHA'-.., ERE �elr.1:lt WATER TIGHt .Q-5 4r 1S`rw, -•GtPC i5 � t— ':'°ON DF"A;; 510 BE ACCCIRnANCE WITH COMM.OF MASS CT� CIViiL � I HER BY CERTIFY THAT.THE BUILDING j --�--- SITE , PLAN se S� No. 30792 SHOWN ON% HIS PLAN IS LOCATED ON THE I` �, ;T ^� .. ���5 y4�}•� �j j r 1.04)€. TITLE 5 r LOCUS:---:..------- - �` GROUND A HEREON &THAT IT --'- d A17NLi ' CONFORM TO�I`bdE ZO WS OF THE ��i ( �� �,. (yilit4 EG. NGINEE - — a a e R WHEN CONSTRUCTED. DATE { "`-- REF: I •t. 19. iZ ?. . 3D6 !..ttaa. ow'a Cifpe. �►rll/40.efift PREPARED — • .,"��D'��,--'yam. •• �U��� E�°,�.--- � if CIVIL ENGINEERS LANDSURVEYORS REG. LAN 0SURVEYOR j ' ^ MCI n OI'1 A'F MF AI TN zcJ 5 � ,_•- r 1, I a ' SECT -.SEWAGE `,.-- .•. I .—SEPTIC TANK _ f.0„BOX - LEACH. k --V-;, -v ON 4u .. y^ sir. �1i,glC. {WbtY,l. kE3v i[7V ,nlaY u',., utTf ? MATt; t+'a 3 " ' " �$:��. ra'tr,;a44ai'rA+t+Y�:�.- <:�F=" ;e✓ �"e" /mw'E'�,J 2 OF r`s TO !,a c=r`,-r•,W 4-4..�•t 1pi L.p' :�..-..s H ED STONE 7 c� Iry =*TA;K T-. 4 — �IN OUT a I t �4 ✓ 3�.`t.t� CLEV. E1.EV 'a Le i' a £ r 1 \ !%- tA A I. t Ill a WASHED?$TQNE \� "t p�csia a it LOG, VQ TEST HOLE 'EST F1y ''. �.idl., 'rya d'.: P.x t•;• _ 'r.__.. �` _ `` `'�:ti... .�.' Y -- ' . i f T�. T o '� z wITNE EDROOM HOUSE }} t { NO !f DISPOSER DISPOSER ! l� { it�C" \ l} PERC RA?ft _ _MIN/IN. FLOW RATE '3`�4�:(Gat..:/p'Av SEPTIC TANK i'T') r n t { 1..I REO'D.SEPTIC TANK SIZE ''_ ' j` LEACH FACILITY �• I SIDE WALL _ G/D. cia'.•-� :� i BTC41 G/D + f it Ftis c :y c id .+ raca _ TOT A.L . ..2 r _'.._....� -1,_. _✓ •.'rat. .. 4 '-----LEACHING — ... : � Lc Z rc 2 > 'F l> t'T ,v W -._ __..... _.... - - -- -- ... =...-.. R'�c3COUNTERE't) _- -._�- `' �J.11 ;. MOTES: tUNLESS OTHERWISE NUTE0,, ,.:..�f tl.q.,e..t•,a.. F.. }'.�,Sx.=.,!a.e;."SG..w.+4 i , i� t.t 1. E)saFUt4 fPPI�,Lt_.TAKEN F Rs�M.....-•-----_ ;.._ {iIUAL7RANt;I£MAP . _ d.Ao404ICtPAL WATE1=__-. 8cr nS G�7-___ AVAiLA5LE 0 Q4 ts`� ~ ^1 ". �! _ .C�Ty rj �xR _.._. .. l - Ic P..•7»?f�"£.pe` CP•i,. �a"PEF2 FOOT # Q.QESt� L.9Ai.}tNG r OR AL.i..PRE CAST UNITS: AASHo -- --__._—_--•- as TA E E 1 5.f*kSt. 9 0I.)t40 COVI'R DV,F R ALL SEWAG£FACILITIES:]11 rT• � � I.i —� S NC AS C RTIFIED � � ��`�=��- L_.C', _. t"}�;t" APN 1 }j S.PI E -,i'4. tS.SF{A BE wA a}:9f WATER TIGHT ,u'9E '4P` A6•r't•h -rk'?G_ � OJALA c AA'' i c rr� 'tons Ut-,.4, S 10 B£ ACCORDANCE WITH COMM.Of'MASS. `�} Q CiiV�L 1 HER BY CERTIFY THAT THE BUILDING ��TG �AI� 9yd4�rF cjmv. +--p4�O AaTs+t. a rsz.)E. TITLE 5 �4 ` too. 9?9Z SHOWN ON' HIS PLAN IS LOCATED ON THE - _ �i 'c.rG -_ i LOCUS: :.`"'....'q" 1-�r 1 s qqq AR a t>�. ' GROUND A HEREON'&THAT IT-_ ----- II y CONFORM TO`FtIE.ZO AWS OF THE TOWN OF NGINE.ER WHEN CONSTRUCTED. DATE . - r tt Ls:.:S$8R£G. 1 c I �..p REF II �•.�� `f,� jy;Fi�� }� r'L �/ cape efi illeer ng � PREPARED CIVIL ENGINEERS - — _..._ - t' LAND'SURVEYORS ---- -- ------ SECTION - SEWAGE — SEPTIC TANK — — "D" BOX — -- LEACH TOP OF FON - 4',• O 1-r>r.'rM1A� .QAi`r :1 I...{SLJ I-T'A-��.F- VtA`T-G•�'.,r'a,,,, .+ t-1 M 1T FY.,x'y f* 1aI''tF ►►.G c�C- 1t� y. x.al+zS VS1 N r VISTj. �%S'L (3 v rc�,,,,1~t"7l.AC. .• '\WASHE D ST ONE W 1"1`1-•1 Gt_G/+.1J GtiF,.. .5.�.. .a>1.�Y7.-�..__.._._-.__� �'•--__. -- •-- �. .• r r'. (�-ZU - -! 1.•i T, IN OUT- IN- OUT C7 Old ' 3g_It7 TANK 3.7-S ` ria.b(�t ` �� 1 _. r 1 ELEV. ELEV. ELEV �• i C - t ELEV ELLV.E�CCJ1�lA�� S LIE V. 5►.heA ►z.L,. + �7'.43 r( ,/1 f "t- _ 'mot c»• � o'___`"' �31.L1 +03�.1- �.:. OF ?r4"- 1V7" ( � WASHED STONE TEST HOLE LOG ( r TEST BY' -�' �.�.:A TEST DATE _ - WITNESS —BEDROOM HOUSE DESIGN - T.H. a 1 3-t,�,. T.H. � 2 _, ELEV. C>c'T� ELEV. 777 NO - Z I DISPOSER I DISPOSER ty PERC RATE MIN/IN. FLOW RATE �3rC>(GAL./DAY ) w� t•y -- SEPTIC TANK ' fl (i.C,)= i uAY LAB REO'D SEPTIC TANK SIZE LEACH FACILITY `)Z 3Z .1 WALL _ - - _ - — _SIDE G/D BOTTOM i k. 0 �(c� �; p f t TOTAL - q�� `= 1 a,_'�• II - It 1 G..v' _...}}}._ .� --_ "L`�.c•� t L,''' . ...,,...,....,_, .� 2_-1,lc ( f <�fir.,r �n , ,� USE. t � � _LEACHING �,��'-� ' ' J -WATER ENCOUNTERED l;i S Y I NOTES: (UNLESS OTHERWISE NOTED) I t}..1P.t.lr.sty E �✓f>n.Gal.nitC..1-d ^' _.._._:_...-_71__QUAORANGLE- MAP 1. DATUM (MSL)+TAKEN FROM .... _ ) 2.MUNICIPAL WATER-,,,,,_1 __..__ ._.._AVAIL"ABLE 3. PIPE PITCH: 44"PER FOOT 4.DESIGN LOADING FOR ALL PRE-CAST UNITS: AASNO 44 "�` c, I`-"�-- ')I' t• .7.'- / J. 5. MIN. GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. ARNE h, C�ISTANCE AS CERTIFIED G. PIPE JOINTS SHALL BE MADE WATER TIGHT v3E A As-rI•M -P%Pt OJraLA• 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. ' STATE ENVIRONMENTAL CODE TITLE 5 �H fl!< Mq CIVIL j - I HERLIS RTIFY THAT THE BUILDING SITE PLAN {cy ` No, 3J72 SHOWN ONELAN IS LOCATED ON THE LOCUS CST �$ ARNr ck GROUND A1N HEREON & THAT IT ...__ _ H. - 11T . (' _Et„ CONFORM TO`F+dE ZOh771VfTF3Y._1�WS_ O THE r k� `�7 1 t �Z-.C�Ia� i O ALA- �•• - - --- ---- -- __ `` - - �4$REG. $ ENGINEER W ENCCONSTRUCTED. DATE --_.___�____ _ �� __� f 'ft`7 I ti.�I REF L.c_ t A+.t rL�' ?,C, -- ���f$Tf: cO.t�Q R`CV��,i FJ d0WJ? Cif e en ifteerin PREPARED FOR .• �I lr� "� � �L C7_-__. U, t, CIVIL ENGINEERS LAND SURVEYORS (EXISTING)------------- BOARD OF HEALTH REG. LAND SURVE SCALE YOR ,•^ -� CONTOURS J 1 "• '7�� O�Zfo��,� (PROPOSED)-0-^0-0-0- APPROVED -----DATE— -- _- MA r Yarmouth& Orleans,MA 1 DAA ATE LIB