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HomeMy WebLinkAbout0047 COVENTRY LANE - Health 47 COVENTRY LN, W. BARNSTABLE y A= 110 -004. 00/+ y i 1 g No. 4214 1/3 BLU Ps Im d mQ 0� ESSELTE 10% 0 o u v ggg 4Q2,4 Of for,fiv AI ZIA BATH- Add Dormer fiEDROOM z:x��= _ - ' -' BEDROOM o UDY zr r' o -z ®2 C r, OPEN BELOW 9�4 012019 LL 1` 2nd Floor x 1/8 in=1 ft to Existing DECK P _ ---� -- -- ----� A f E ]� Z 3 LAUNDRY BATH I m Jl I I I I DINING KITCHEN (:,BATH "I UNFIN15HED BASEMENT I I Q I I No Changes vARAGE21 r---------i I > m I I I:I ' I BEDROOM I' LIVING - DATE: I II Cl ————— ——_—— J 3/28/2019 1 St Floor Not to sale Foundation 1/8 in=1 ft 1/8 in=1 ft Existing SHEET: Existing Remodel Entry/ Covered Porch 110/04 Parcel Py—i CS _ goo -- - _ --- 0 Exterior Elevation Front > 1/8 in=1 ft 'L -_= Existing ' �z _ter �W Exterior Elevation Right 0110 1/8in=1ft m Q Existing N t � � 3 N p O t N Z 3 'Dmin Q Exterior Elevation Left 1/8in=1ft 2 Existing N i N � > E o � �Y ... ... .. ... DATE: ' " 3/28/2019 �� SCALE: Exterior Elevation Back -< «- -:- on SHEET: 1/8 in=1 ft Map&Parcel Existing 110/04 P4_Z z0 ' r———————————_———————————---- -.r--{-- A,npnn roa amrglea Q 5 I. ioe a a.�er-ran Bonner roof tn•cvx aneeminq 1 EVE I i ..___—__ ._ -_-.- .__ _ ].6 wlbr ties 16 C A..,...:.a.x�,.n..�.,A:::..«. .}� ...� ..®.:: - t f .3 w6 Raflers.l6• C`/C R36 sprmJ roams inti ,=' 1 I �I la3 sbnpgng 3 T I X 4 3 I°�. I_vl_ ln'ansam board o 1' 11 X 1'-8" rnm I $� - 11 I NW15 E I tl 9 M9e.rohrs. �6 I 91,,1'.IIIIOI 3 s b singb sfwe knee we I etc.rcmnln °p✓�'o I 4 2 a b double by plate I I 3absWds/16•o.c. ,�. 1176 X,hentirg ®d� Typarbaibirg paper 52 I o I li' • .1 t�,I 1------- slid bl kl 5TUDY PZ�, dm Ebn 2.10 f tb 34' n 21r-4"X1T-0"---- _ ' "y:..cent.flasn beam remab.cono-acbao wnnrm ambmlbj .. Cross Section 2 n 1/4 in= 1 ft oxn'�9OC ' Steere Working Plan � n°r InbeCCd doc: � - I 2nd Floor Dormer m _— o f 1/4 in=1 ft Steere Working Plan �i _ _ i kn Q kn o L� 43 �ofl o o - --------------------s—���ov�s� ]n 10 ridge S hip, � cn O 3.6r . m N ,n-cvx anon^ �a a„rer Front Entry A,pnn¢snbgba 1/4in=1ft Steere Working Plan I . Gomposk<wlumn .. m Neu masamy step - 3/28/2019 to"pier xt ap°n 3a•aprend r°°tlrg-ab•be gredn SCALE: Cross Section 5 1/4 in=1 ft sMEET: Map&Parcel Steere Working Plan P 3 110/04 4- i W_ f -- - - m. m. Qm .. — ,m. iw .. . �* —d:. k. 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III �B :u■: .; ,v, IUI III r.B. _ _ er ❑ o#■ ■ �. 1 II •..,....e..e..m..,a........a...........:.:.vB::•a;,o......... .......d.. .... ....m...,.w . L ap ■ III illl III. °eee e`e IE_ �a....._...... �II I„�,I_.....a. rM. ::I' 'eee' �. ■■r i, I�in�i �� IIIIIIII ., I.C.f. Cf:IE 1 P III} a�. tr : r� � a _® - __ram—■ ... m... TOWN OF BARNSTABLE LOCATION !���>°a > /h SEWAGE.# 4149 f VILLAGE �J��'�Sp�1PJ J ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �`®W �����o�✓` (size) NO.OF BEDROOMS q BUILDER OR OWNER ge�� Xed PERMITDATE: 7"57—?5" 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 3�i A 9 s 41 Al - a3 33 35 •� ti ASSESSORS MAP NO° Na. ° �` PARCELNO• �/ FEs...... 8............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE pphrathan for Bi-aip Sal Works C outitrur#ion rumit Applica 'o is hereby made for a Permit to Construct ( ) or Repair ( ' ) an Individual Sewage Disposal System at. _ Lo-tion-Address .._=1.1.1.[vS���43.1.��y��--•� - -- ��✓ -----•----•----- -•----•-- ��- --�--��._F�.lc�.?.Lam:�:_��-^�� �q g' Cvn�er( j�11 t Address W Installer Address Type of Building Size Lot.3►t .........Sq. feet t—t Dwelling— No. of Bedrooms------4--------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther-1 Type of Building ____________________________ No. of persons___-•---.-_•_-------_____-__ Showers ( ) — Cafeteria ( ) Otherfixtures --------------•-•-------------••---•--------------------•--.----------------------•--- ..._...----......- W Design Flow...............1 1_Q.....___......__..__gallons per person p r day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity-1 vgallons Length_!�_'__z-_____ width_,_�:__�! Diameter................ Depth_ P..?;E=F x Disposal Trench—No. _. ^?.! _.... Width.: 'Z-�_.._._._.. Total Length---s �______ Total leaching area..J`���7I Dsq. ft. Seepage Pit No_____________________ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed ......................... Date....3- 4.'53......__.. a Test Pit No. I....0 __minutes per inch Depth of Test Pit------1.�v/1--- Depth to ground water.../N_v_^� ._. fit Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ aDescriptionai . ��------------------------------................................................................ •--'i--------------•-------•-•--•------••--•.._....... O of Soil-Q` `T�.� .. 1( ..... y UW --------------- ------ ------------------------------•-•-•-------------------------------------••----_-----------------------•------•---------------•-- -- Nature of Repairs or�Alterations—Answer when appli abl ._.._ �,�?_____Z____�A?,e 5..4..!"�..................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environment I Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance as en iss the board of health. Signed --------- ... �....- ------------------ Application Approved By ............ '2: - .5'---------. ......... `�.... e ` Application Disapproved for the following reasons: -------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------- -------- Permit No. .......s.�/ L� ................. Issuedr` l - . ` Dare V No.l(�'^h' " �' FEs......' .............. -`•- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applutttioit for Diopoottl Workii Tottotrortion,.ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Systm at: 7 L r � CU\1Et�T 1= 'Z-: l�at.\� -� f_� �n I.��.--1!.\ iVlf1 IIO , � ......................... Locttou i\ddress r Lot No 0 �--•�-Cfl .?EQ:;............... '- ............ . c _.•t�`'� .1c.... --- Owner 6 4 Address 7 Installer Address UType of Building Size Lot.. ...,....• ---------Sq. feet Dwelling—No. of Bedrooms.___-_4________________________________Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtures . W Design Flow----------------U_Q._._..........._.._gallons per person per day. Total da�ly flow............q4o....................gallons. WSeptic Tank—Liquid'capacity.] ?gallons Length_` ,,&—__-_ Width__9.__/-L __ Diameter_------------- Depth.-q!__-ia,= x Disposal Trench—No. ....... Width__�7_..`...._...... Total Length.--� ....... Total leaching area...5©61q/D_sq. ft. Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by ......................... Date----- `_!_i.:.S -.......... Test Pit No. I----4-.---__-minutes per`inch' Depth of Test Pit-----1-�-�-C)'/... Depth to ground water.._l��.�?.!�.�._.. fro Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P4 •--•• -•--•----------------•------••---••••-••--•••..........-•-•-••------•------ ....-•-----•••-•........-•--•--•--•----•-•-•-•-•••--............---...... D Description of SoiLfi-' fi -------- U -�►lc•. � 2`! L<�_f-t'..5.(�`f`�..... V ..�._ .� .. C LE ba.! �._..C'�F�? -S F1&th)..-•------------------------•----- -....._......----------------...........---------•--------------•---- W U Nature of Repairs or,Alterations-Answer wfien applicable._.__Q 1_-...Z.____1.�G1__77liSd'S................... Agreement: _- The-undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en/Z5i_1 b" the board of health. ------------------------- Signed Application Approved B - �:"-''l Y� ........................................................ `` ------ - Application Disapproved for the following reasons- --------------------------------------- ----------------------------------------------- --------------!----------------------------------------------------------------------------------------.......---------------------..-.--------------. ------ -------*.. ------- ' ,/ 4/� �-- /� Dare ... Permit No. -...- ...... Issued ........... Dare THE COMMONWEALTH OF MASSACHUSETTS i 1 BOARD OF HEALTH `� TOWN OF BARNSTABLE x1ertifirat>e of Q-111omplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ') by' ------------------------------------------%�--G-/,�__-------- .:'. c_,_c,.� 1s .'2v. '�c--r�J-.----------------------- -- Installer at --------------------------------- . 7 ....- .. . . Cj.-j_6�. _...._i�E:------- /- ^�"r` 3. Z±VS - has been installed in accordance with the provisions of TITL 5 of he State Environmental Code as described in the application for Disposal Works Construction Permit No. E t > ...... L'-�( ........ dated - .-.e"�"�,,�'! THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.- DATE----f L/ ----- ------------------------ Insp-c.to .Zoe-ti,y / -------------- --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.. TOWN OF BARNSTABLE FEE .. 0 ...... ........ ..... Mopmat Worhp Tomitrurtiort "awit --> ..� �. Permission is hereby granted........................... -------------- --�J.S_!..� ►G.+~7tirJ to Construct ( ) or Repair an Individual Sewage Disposal System at No. .r_.... ' ' � �` •--W=•• LC............ Streeter �as shown on the application for Disposal Works Construction Per' ito ' i'ai Dated.._ _.__.? __...__ 5-- _ Board of Health DATE--;- -----• -- •.•................... --------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS 4,6j��p o. TOWN OF BARNSTABLE � LOCATION co y4 4r, , SEWAGE VILLAGE ASSESSOR'S MAP & LOT ...,_ INSTALLER'S NAME & PHONE NO. c✓��1� �' i�l� SEPTIC TANK CAPACITY yyu LEACHING FACILITY:(type) ,I u.5se w (size) L40 NO. OF BEDROOMS �i PRIV TE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: � 'FARIANCE GRANTED: Yes No v b ' ALK Ll !t` 1f 1 S No...9 5 u. $.........jo a.... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Apphratiun for Diripinial Works Tontitrurtiinn Famit Applicat i'i heret�y made for a Pernlu't to C'onstnict ( ) or Repair ( ) an Individual Sewage Disposal System at: cff v Location-Addres' or Lot ND Installer Address /. d Type of Building 2 Size Lot...... I--•--Sq. feet J ; � Dwelling—No. of Bedrooms-----...................................___E.xpa`4t, on Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons.;......_..._............... Showers ( ) — Cafeteria ( ) a' Other fixtures ...................................................... w Design Flow.......... .... ........ .....gallons per person I per da� Total daily flow........... t3..D......................gallons. R: Septic Tank—Liquid capacity-__QSaD.gallons i engtllo-_./k...._.. W"idth-�_1—... Diameter....:........... Depth�._.e1 Disposal Trench—No. l�_N E........ Width..7-------.-_... Total Length--- Jf Total leaching area3' _<27 2sgrftt Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `"' Percolation Test Resu)ts Performed by Ali Ill!1 C. 1 fi�_..._.P:�,.......... Date...3_.............. ............ `a Test Pit No. 1--- ?-_.___minutes per inch Depth of Test Pit---156:......... Depth to ground water...6.10 . ..... Gz, Test Pit No. 2............'..minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------•--•-------- .......................................................................................................................................... 0 Description of Soil&—_�,". .. � ............ '.._. -.. ! -------•----------------------------------------------------•--------..................-----.......-•---- w UNature of Repairs or Alterations—Answer when applicable........................_. ..................................................................... ......-•••---•---------•---•-•-•••••••-•---•----•-••--•----•-----------•------•-----••-•-----•----------••-•---------------------------------------•-----------------------------------•---•--......•••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage D' a s m in accordance the provisions of TITLE 5 of the Stake EnvironmeRtal Code—The undersi ned fu e��J of t pla t e p system in operation until a Certificate of Coal ante ee cig�sue d by the board h 6 Sightd ...... .. O y r�.. 6..� '.•FS - ce Application Approved B PP PP Y Application Disapproved for the following re „ nS: .................................................................................................. . .............................. . ................... . . . . . ................................-- ................................ . ...................................--- ............ ............ --------------------- Date_.�F..:. s S.� r Permit No. .......p .. .........._:...! ..... Issued ........................................................ ...... Dare 'S . 9y- �No....: �.. = ss...._..../n f-...... • r THE COMMONWEALTH OF MASSACHUSETTS c6a 1 g BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uiiipoittl Wi ork,i Tonotrnstion ramit Application hereb made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: '7 / Fa RA I •i 3C,vF►.•. i L._.,►�-rs� �s�F_��,ti�.� -���' ��L� -SSA-�2�� y (( Location-Address- r { 11f1V ..._. lJ( i '�)• f��1_ _ ! f �l Lot N.� �J h_ � ..:Rt s.._.... .......................... •••••-•-•• - O�+n A " ............... W ---- ..................�k _M� l-�•- �- �1c t,��, -�t.��.y��cZ �__`._`���_����....NA Installer Address I Q Type of Building Size Lot.____�l_;_0�__._Sq. feet Dwelling—No. of Bed rooms______________________________________ Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------------- ------------------------------------ ---------•---•-••-•-••-•----•-.-••••--••-•------.....----•-•- W Design Flow.............C6.............................gallons per person per day. Total daily flow....._.�30._..____.___.___._.___gallons. , 9 Septic Tank—Liquid capacity 1 X?(.gallons Lengthoo_fh �___.____ Width. _,/i...... Diameter................ Depth�_`k'Jr_ .. Disposal Trench—No. h-N d___.____ Width__!..._______._ Total Length-_�a�_._______ Total leaching area.3(e_.5;i!'2..sq--Ftt Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed .-_-___P. :......... Date_. ��_'_!! ............ ,.a Test Pit No. I...(.?-......minutes per inch Depth of Test Pit...!.r .' --___ Depth to ground water...) +J_6 ..... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0+ •--__-- ----•-•••--•--------------- --•------------------•---..._._.._._..._..._--•-----_--.--... ....... ......... ......... _---------- O Description of Soil f? ''^ ^ �Q t ��1�--! .'' -•------ a'�11 1E " 'Cr r--_ t^�_ �... tJ� U ( .. .. !Sn"___C _,Fa?t.N.. . 1_j E_.. - + ` ?-------------•--------------•---------._..._•__-•----•-•--------•---...----..........._________.......... U ... -� - W U Nature of Repairs or Alterations—Answer when applicable..._............................................................................................ .....-••-•-----•...-••-••-••............•••-••--••-•-•-••-•-•-•--•-•••--••••--••-••.....-••-•-••-•- Agreement: The undersigned afire, to install the aforedescribed Individual Sewage Dip l s m in accordance w o Pk the provisions of TITLE 5 of the State Environmental Code—The undersi ned f� erl ee Riot t place t e 6cy fp�t� system in operation until,a Certificate of Compliance has beewissued by the board f he 1 .� r , Signed, �.L.±''.. 1 ........ .. ... . .;:; .. Irt j•.......... ............................. _ 4 -.1 Ct.. ....:..... y �r Application Approved B ' PP PP y ----------- A.......... Application Disapproved for the following reasons: .................................................................................................................................. ...................................... ......................... . ..... . ..:......------------------------------------------- ... .............. ..... ------ Permit No. - .7 .-.....{ _... .. ..........:. Issued ------- ........................................................................................ i Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (f ertifi at.e of C amplianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed O or Repaired ( ) ' by ..............+ - -- --- �. � ........_ ? ?,r "�"� G--`holy at .........L...,J.....�.........t"_¢.t: -���K ........ '. . 4o.,4Q•!.......................................... �.- �- --..--,y.. .--....._ a a.. has been installed in accordance withltI provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....._................................._._.. dated ___---.......................... .._........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. / .r--'-a ....... Inspector......�5°` .<�►-�°7, ( f _. —........------------------------ DATE l / THE COMMONWEALTH OF MASSACHUSETTS any BOARD OF HEALTH jQ - p TOWN OF'BARNSTABLE No...(.. .'.. - ..�j f�'�q>;L 'L �-' FEE.... !:�s'1....... �i no�tl ork ` unotrurtion runt _ y _ Permission is hereby granted_..___.__... —x r---- ..... .--------------------- ------I e ------•_.. a'r • - _ -to Construct . or Repair`( )?an Individual Sewage Disposal System at No. 4� - ------••--.� ------ --- ................................................. ............................ old /? l' '�, '*'`,_ " _ t,�` .* Street GG ' as shown on the application for,Disposal �l'orls Consfruction.;Permit No.?�` � Dated_____.._ - t. 4 1-1 r� i +' Bof oardcalth " r N DATE ` � � "& ` ._..__ t' f � Ft� FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS �' t( ENVIROTE H LABO RATORIES,ORATORIES, INC. MA Cert. No.: M-MA 063 449 Rte. 130 . Sandwich, MA 02563 (508)888-6460 • 1-800-339-6460 FAX(508)888-6446 CLIENT: Reef Realty LOCATION_ : Lot 3 ADDRESS: School St. Coventry Lane West Dennis, Ma 02670 West Barnstable, MA SAMPLE DATE: 7-20-94 COLLECTED BY: Fred. Clifford DATE RECEIVED: 7-20-94 TIME: 11:OOAM SAMPLE I.D. : 3C JOB TYPE: New Well WELL DEPTH: 70' RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100m1 (MF Method) 0 0 pH pH units 6.0-8.5 6.45 Conductance umhos/cm 500 95 Sodium mg/L 28.0 8.00 Nitrate-N mg/L 10.0 0.32 Iron mg/L 0.3 LT 0.05 Volatile Organics EPA 601/602* ug/L N.D. COMMENT: * See report attached. Yes No WATER IS SUITABLE FOR DRINKING URPOSES OR PARAMETERS TESTED. XXX Date orleld J. aari Laborator Director IT = Less Than GROUNDWATER ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: 3C Lab ID: 8254-01 Project: Reef Realty/Lot 3 Coventry Lane Batch ID: VG2-0422-W Client: Envirotech Sampled: 07-20-94 Cont/Prsv: 40mL VOA Vial/NaHSO4 Cool Received: 07-20-94 Matrix: Aqueous Analyzed: 07-21-94 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) (ug/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BRL 5 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL 1 trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethane BRL 1 cis-1,2-Dichloroethene * BRL 1 Chloroform BRL 1 1,1,1-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene. BRL 1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichloropropene BRL 1 Bromodichloromethane BRL 1 2-Chloroethyl Vinyl Ether BRL 5 cis-1,3-Dichloropropene BRL 1 Toluene BRL 1 trans-1,3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethylbenzene BRL 1 meta-and Para-Xylene * BRL I ortho-Xylene * BRL 1 Bromoform BRL 1 1, 1,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1 1,2-Dichloroberzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 29 96 % 87 - 1-13 % . 1,2-Dichloroethane-d4 30 33 112 % 83 - 117 % BRL = Below Reporting Limit. * Non-target compound. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986) . No.WAY-::3- -y Fee---'- --- ------- BOARD OF HEALTH TOWN OF BARNSTABLE ZIpplicat ion i orlVell Con!9truct ion Permit A pli ation is hereby m e for g ^permit to Construct Alter ( ), or Repair ( )an individual Well at: _ Locat10 Address A sors Map and Parcel —Owner Address Installer — Driller Address Type of Building ! � Dwelling — — ------------------------------ Other - Type of Building---------------------------------- No. of Persons------------------------------ Type of Well--- C� - - - Capacity---------,-7- -- 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 u a rt' is to p ' ce has been issued by the Board of Health. Signed ------ - ------------------------------- ---- ---- ate. — ----- Application Approved By J �L�s = V -----_---- date Application Disapproved for the following reasons:-- ------------------------------------------------_—__—__—_____—_ ---------------------------------- -------- ------ ------------—---------—--------------------------- 1 date Permit No. --Y�'1-Lf=—� Issued---------------------------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by-----------02, ----UL&QL--------------------------------------------------------- --------------------------------------------------- (' ,,� Installer at at------ �'- -Z—� =�='=`--- — f---All `'------------------------------------------------- -- ---- -- has been installed in accordance with the visions of the Town of Barnstable Board of Health Private Well Protection .Regulation as described in the application for Well Construction Permit No. ---1- '- ----Dated---------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------——--- —-- ------ Inspector--------------------------------------— - - ----------- ti- � .��,'� .,�s ..R,, -, -,,... ,. _'4_,--`' 's� r�`. -.1--�i-� �i,�v""'wrs �.. � v ..yv� r�.�. +,4.�...�w�. r �.,�. ... � ,. •I --� Fee--------------------- BOARD OF HEALTH J TOWN OF BARNSTABLE Application-ftlVell CongtructionPermit Application is hereby. m4de for a permit to Construct ), Alter ( ), or Repair ( )an individual Well at: t _ Locatio Address Assessors Map and Parcel ----- ------ wner Address WA Installer — Driller Address Type of Building Dwelling - - - - - Other - Type of Building----=-----=------------------- No. of Persons---------------------- Type of Well- Capacity Purpose of Well-_ �1--�'��-� - - - — 4 _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 u r a C rti 'cate p ' �►ce has been issued by the Board of Health. Signed ------ - ------------------------------ � ` - ----- ----ate _ ---- Application.Approved By-- ----------- date Application Disapproved for the following reasons:------------------------------------________—_—______ —__—______—_ date i Permit No. --W( `!= ---- —------ Issued--- -- -- = - -- - - — --- date BOARD OF HEALTH TOWN OF BARNSTABLE �f Certifitate VIDf Compliance THIS IS TO CERTIFY, That the Individual.Well Constructed ( ), Altered ( ), or Repaired ( ) bY----------- - - ------ --------------- - --------- ------ - ------------- - - --- --- 1 Installer at ------------------- -------- ----------------- ---------------------------------- has been installed in accordance with the- visions 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--------------------------------------—--- ------------ BOARD OF HEALTH ,. TOWN OF BARNSTABLE lVell ton0ructionPermit f No.- = -i' Fee-- Permission is hereby granted-- to Construct (%�, , Alter ( ), or Repair ( ) an Individual Well at: Y J street t, as shown on the application for a Well Construction Permit No. - - --- --=-- ------- -- —__ -- Dated---- -� -- -------------------- -- - ------------ - --- - oard of Health DATE---- -= -= — _- f R r rr ; o I l i 55 5 2 r, 1! � >✓ 50 S MA a CAL..- 41 N tr TEST yot r P vots � t �. u v . T a ` P;E,. A55 M 0 FtZ�r�t c4 AV rrNc�n � C�P_.Q.:EhtT ZOhlttlLs � � ,�Q ANC-riNEEtZ FtOM 5 r{�£t.t..,el.i, `I. YEt?t1Gs�l_ bAtVM _ Q Oy►,in�tr� 5 T ESS .1CtZ r FOIL-VIN& eT AC-K5 Z. Mt�Ntc (PrIL W�4TEtZ I Na /�YAILAf3t� . � 5 B � ,. hri / 3-11-93 - 4 C- TO BE USED c,y F;�p� 5. �� �• l a , ,� b.a.TE 3. s C',r-►EDut� 4o PVC- Q I pE sr CS' loe1 2; PE2L. PATS • M►:+/I�t TH LO V aH JT sEPTIc. SY 5T -M �tp �ora� G -- 4. 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