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HomeMy WebLinkAbout1684 MAIN ST./RTE 6A(W.BARN.) - Health 1684 MAIN STREET West Barnstable A = 197 - 032 7 / t� No. Li Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2pplication jfor Yell Con5truction Permit Application is hereby made for a permit to Construct(4, Alter( ), or Repair( an individual well at: Ro"-3tv—(-0A I N�kc l (�`1 C132 Location-Address Assessors Map and Parcel Owner Address 2283 , 6-mh3 1 A GZC53 Installer-Driller Address Type of Building / Dwelling o/ Other-Type of Building No. of Persons Type of Well Ll" S(A41) 1p j(— Capacity 10 f 9 pYr Purpose of Well ?Ol w" 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 Certifi ate of Compliance has been issued by the Board of Health. Signed 1 Aate Application Approved By '� `� , ✓ Date Application Disapproved for the following reasons: A Date Permit No. ` / Issued / Date — ------------------------------------------ BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS I`SSTTO,�CERTIFY,that the individual well Constructed W), Altered( ), or Repaired( ) by l �1 Q -'•T�r j 1�\n Installer at UIA has been installed in accordance with the provisions of the Town of Barnstabl, �a d h 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 No, �/V / � Fee BOARD OF HEALTH TOWN OF BARNSTABLE Tfpplicatiou if or Yell Conotruction Permit Application is hereby made for a permit to Construct(1), Alter( ), or Repair( ) an individual well at: Location-Address Aslessors Map and Parcel .rr .. Owner t tr Address (lm6rc�1 �(,1�1'na ,j'\e C1.1�ic��. �1(t 3 .nCUt\V-\3 (SZCS Installer-Driller ' Address Type of Building Dwelling Other-Type-of Building No. of Persons Type of Well y'l-S cAt4 r) Capacity {5 p\v- Purpose of Well ?0-a-UL 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. f r Signed ^ ate / Application Approved By k,/L�r e V ry Date/ / Application Disapproved for the following reasons: Date Permit No. �1 Issued / 1 - r Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of (Compliance THIS IS TTO CERTIFY,that the individual well Constructed(f), Altered( ), or Repaired( ) by 1,= C1.ncv\A ��4 l 1rT'k'sn �)ac - / 1 Installer at has been installed i'n accordance'witA the provisions of'the�Town of Barnstable Boa ealth-Private Well Protection Regulation asp described in the application for Well Construction Permit No. b >� l �� ;Dated VP � v THE'ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector noes--- ---------------- ------- ----------------------------------- --- BOARD OF HEALTH TOWN OF BARNSTABLE Derr Con�truction hermit No. �)Z/W,7v F Fee v w , Permission is hereby granted to I� )00 el-A k 11 hr,�o l►l l— Installer j n to // Construct(v), Alter( ), or Repair( an individual well at: No. OtAAr__ (,A Street as shown on the applic ion for a Well Construction Permit NO. /� Dated / Date �/ Approved By p�� J&5 B n --- .�To NCJ�38o`tt's .NOTE ; Stone .Mkd. All unsuitable material rrH11 fnd . • . do be remove Tpi I.. :.ir d I replace , ?U.03 3v7. .with; clean 1-6x4 I 100 f ( ) rr, :. :I :_: . fill". N Exp: z��► . 1:6�. > .YID ' . .Fit 3 , Sto> e stone PLAN SCALE 3 - r 1 - 40 t .3.a�- - }" �'� =490 g.p Date 6/12/85 A -=-- - 3 - �l.'� it STK D=B N N \ z.A DB ��. co ; W rn Z PROFILE 4o.7 t ._. L^ 1500 v No SCALE srK i 5 T 3g7 12 I EXisting hse ;o.z td 3 BaR ro : _ $ }. I �00 xistin I g G' S.T.. . Well I �, 41,7 Lot iarea . _.._._._._ I lc� 30*0_*S � 4 3J.G C.B. B. 40.0 ` Existing fnd. Lot 1 I ' • Lot 4 All . C'4Lpe .Engine�ring o. LA. 49 Ha 'bor Road SKETCH :PLAN OF LAND IN (.WEST') SARNSTABLE,MA. � Hyanra�s , -Ma. 02601 FOR : WALTER V." Nd.RTHCROSS Being a ;lot as described in 'Deed Bk.2795 Pg. 100, and reco'ed in B :r stable Reistry.l _. Elevations shown are on assumed datum: Route 6A ari:a-ble ,width Date Agent; . Barnstable Board' of Health �eSign flow . . - $. 330 GPD .S :Q.:.. G ST bist-. Box �, -6 XV pit W/31 storie Tgst pit data . � 263. S.F'. Made 9/13/85 ' 490 G.P.D. Wit . T. McKean Water. encountered Pere.rate 3 min.per 11t :Top 243 :Top zs.4 Fine Fine , . sand :sand JJILLIMA v. FARDIE 9 Nu. 3395�4 .� ...__.-.. .90FFG I S.T.. u FsS10NkL�� i ►�.3 7.c. ivhQ'i 2 �q T P' 4v A re I % Massachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports •,r M Well Driller Please specify work performed: Address at well location: l> `New Well 1 Street Number: Street Name: rf 1684 ROUTE 6A X. Please specify well type: Building Lot#: Assessor's Map#: 110 Domestic T T 197 ;3 Assessor's Lot#: ZIP Code: E Number Of Wells: 32 02668 City/rown: Well Location BARNSTABLE In public right-of-way: GPS f�Yes r No North: West: 41.69801 70.35201 Subdivision/Property/Description: Mailing Address: click here if same as well location addres Property Owner: Street Number: Street Name: VAN NORTHCROSS 1684 ROUTE 6A City/town: State: Engineering Firm: BARNSTABLE MASSACHUSETTS ZIP Code: 02668 Board of health permit obtained: C•Yes r.Not Required Permit Number: Date Issued: W2018 002 01/2 2018�- VS �V� 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 uger Choose Bedrock- WELL LOG OVERBURDEN LITHOLOGY From(ft) To(ft) Code Color Comment Drop in drill Extra fast or slow Loss or addition stem drill rate of fluid 0 20 Fine To Coarse S l: Brown f'Fast('Slow YES NO � Loss Addition ( SOME SILT f" (" f" f" 20 40 Medium Sand i : Brown i - #�`Fast r Slow YES NO ��� Loss Addition .__...._ [SOME SILT r r =Lo.. Addto. Medium Sand Brown _-____—._..._......_...... _.......... ..._ TRACE C,TRACE �' f` f f 50 70 1 [Medium Sand ^ Brown �" SILT Fast(7 Slow ........._ L —...-- YES NO Loss Addition ----.._.._____._......_._................._..... ._....__.................__..-__....___...._....____.. 70 80 (Fine Coa B . 1E N'. To rse S rown °Fat(� r YES NO �...� __s Slow_____............_.�__....................... Loss Addition WELL LOG BEDROCK LITHOLOGY Drop in Extra fast or Loss or Visible Rust Extra From(ft) To(ftr Code Comment addition of Large drill stem slow drill rate fluid Staining Chips P Choose 1r11 LL.—.sr �Yesl r Yes Addition ----- -- -- ADDITIONAL WELL INFORMATION Developed (-7 Yes f`No Disinfected C.Yes t No Total Well Depth 80 Depth to Bedrock f:No Surface Seal Type None racture Enhancement t Yes CASING pI Is Casing above ground?� From: 1 To: 0 From To Type Thickness Diameter Driveshoe 76_ Polyvinyl Chloride ?? Schedule 40 4 1Yes SCREEN i No Screen From To Type Slot Size Diameter 76 BO Stainless Steel Well Point WATER-BEARING ZONES ; DRY WELL __...._....._.__�__.w From To Yield(gpm) PERMANENT PUMP(IF AVAILABLE) Massachusetts Department of Environmental Protection .: Bureau of Resource Protection—Well Driller Program Well Completion Reports(General) 3 Wire Variable Speed Pump Description Horsepower Submersible 1! Pump Intake Depth(ft) 74 Nominal Pump Capacity(gpm) 10 ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material 2 Weight Water Batches Method Of (gal) (count) Placement ____._---__---- Choose Material - Choose Material + —Choose One— WELL TEST DATA Time Pumped Pumping Level(ft Time To Recover Recovery(ft Date Method Yield(gpm) (HH:MM) BGS) (HH:MM) BGS) 1/26/2018 Constant Rate Pump ji 15 1:30 16 0:01 11 ! WATER LEVEL ! ,Date Static Depth BGS(ft) Flowing Rate(gpm) Measured 1/26/2018 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. DESMOND THOMAS E Monitoring[M] Supervising Driller III, DrillerDESMOND III Registration# 764 Signature THOMAS,E DESMOND WELL Date Job Complete 2/1/2016 Firm DRILLING INC. Rig Permit# 023 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. CERTIFICATE OF ANALYSIS , � ? Barnstable County Health Laboratory (M-MA009) Recipient: Sally Desmond order No.:. G18104.637 Desmond Well Drilling Report Dated:. 01130/2018. - P O Box 2783 Submitter we11 Driller Orleans, MA 0255.3 Description: 2 DAY RUSH- 1684 Rte.6A -- Laboratory IN: 18104637-01 Matrix. Water-Drinking Water Sample#: Sampled: 01126/20118 13:00 By: DWD Collection Address: 1684 Rte 6A W.Barnstable Received:: 01/26/2018 15:11 By: PalmerP L Sample Location: Turn Around: 48.Hr. Rush I 1 Routine_M j :ITEM RESULT UNITS 'RL MCL. METHOD# ANALYST TESTED TIME Nitrate as Nitrogen 1;.8 - mg/L 6..10 10 _ EPA 300.0 LAP 01/23/2018 14:57 Iron 0,26 mg/L 0,10 .0.3 SM 3111B LAP 01/30/2018 14:55 Manganese ND mg/L 0.02.5 0.050 SM3111B LAP 01/30/2018 14:56 pH 6.6 PH AT 25C NA. 6.5-8.5 SM 4500-H-B DCB 01126/2018 15:39 Sodium 15:. mg/L 2,5 20 SM 3111E LAP 01/30/2018 14:56 Total COliform p 1100ML 0 0 SM 922213 RG 01/26/2018 14A5 I Conductance 170 umohs/cm. .2.0.' SM 2510B DCB 01/26/2018 15:39 Water sample meets the recommended limits for drinking weter oPall the above.tested parameters: Attached please rind the laboratory certified parameter list Approved By: (Lab Director)' ND=None Detected RL = Reporting Limit MCL Maximum Contaminant.Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Pager 1 of 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) Recipient: Sally Desmond Order No,:: G18104637 Desmond Weil Drilling Report Dated. 01/30/2018 P 0 Box 270 Submitte.r: Well Driller Orleans; MA. 02553 Description: 2.DAY RUSH-1684 fate. 6A ----_._ .._................._ ..... w. _ _:_. _ __._... ,.:__-- La orat ID#: 18104637-01 Matrix: Water-Drinking Water Sample#: Sampled: 01/26/2018 13:00 . By: DWD Collection.Addr; 1684 Rte 6A,W: Barnstable Received: 01/26/2018 15:11 By: PalmerP Sample Location:, `Turn Around: 48 He Rush Analyst: yn Methods EPA 524.2 Dilutioni.'.1 Date Analyzed: 01/26/2018 @ 11*144 EPA 524.2-- Volatile Organics by GC/MS Result MCL . MQL , Result MCL JMDIL Parameter ug/L ug/L. ug/L. Para.meter ug/L ug/L :ug/L Dichlorodifluoromethane ND 0.:50. Chloroethane NO. 0:50 Chloromethane ND .0.50 Chloroform 1.6' 80 0.50 Vinyl chloride, ND 2.o 0.50 cls4,2-D.ichloroethene ND 70 0.50 Bromomethane. NO, 0.50 cis 1,3-Dichloropropene NO 0.50 1,1,1,2-Tetrachloroethane NO 0.50 Dibromochloromethane NO 0.50 1,1,1-Trichloroethane NO 200 0.5.0 Dibromomethane NO 0 5.0 1,1,2,2-Tetrachloroethane NO D150 Ethylbenzene NO 700 0,50 1,1,27Trichloroethane NO 5.0 0.50 Hexachlorobutadiene ND 0:50 1,1-Dichloroethane NO 0:5.0 Isopropyl benzene NO 0.50 1,1-Dchlproethene ' NO 7;0 0.50 Methylene,chloride NO 5.0 0.50. 11-Dichloropropene ND 0,50 Methyl-tent-butyl ether NO 0.50 1,2,3-Trichiorobenzene NO 0.50 Naphthalene NO 0.50 1,2,3-Tiichloropropane NO 0.50 n-Butylbenzene ND 0.50 1,2,4-Trichlorobenzene ND: '70: 0.50 n-Propylbenze, ne ND 0,50 1,2,4-Trimethylbenzene ND 0.5.0 p-Isopropyitoluene ND 0.50 . 1,2-Dibromo<3-chloropropane: ND 0.50 sec-Butylbenzene ND 0.50 1,2-Dibromoethane(EDB) NO 0.50 Styrene NO. 100 0.50 1,2-Dichlorobenzene NO 600 0:5.0. tert-Butylbenzene ND o;5o 1,2-Dichloroethane ND .5:0 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloropropane ND 0.5.0 Toluene ND 1000 0.50. 1,-0-Trimethylbenzene NO. 0.50 Total xylenes NO 10000 0.50 1,3-Dichlorobenzehe ND o 50 trans-1,2-Dichloroethene' NO 100 0150 1,3-Dichloropropane NO . 0.50 trans-1,3-Dichloropropene NO 0.50 1,4-Dichlorobenzene ND ..5:0 015.0 Trichloroethene ND 5.0 0.50 2,2-Dichloropropane ND 0.50 Trichlorofluoromethane ND 0.50 2-Chlorotoluene ND 0.50 Compound %Recovered QC Limits(%) 4-Chlorotoluene NO o:50 1 2 Dichlorobenzene-d4 110% 70 130 Benzene.. ND 5.0 0.50 -. -._- - .................. p!3romofluorobenzene 89% 70 M Bromobenzene ND 0;50 Bromochloromethane NO 0.50 Bromodichloromethane . NO 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chiorobenzene NO 100 0.50 . ...._�1......r% ....,. ..._.._ Attached piease.firid..fhe laboratory certified.parameter list. Approved 8(Lab. Director) NO --None.Detected RL = Reporting limit' MCL= Maximum Contaminant Leiie,� 3195 Main Street,, PO. Box 427f Barnstable, MA 0.2630 _Ph:508-3.75-6605 Page 1 of 1 CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory (M-MA009) Report Prepared For: Report Dated: 08/13/2015 Van Northcross Van Northcross Order No.: G1589292 u== PO Box 865 �Wo W. Barnstable, MA 02668 ;«a Laboratory ID#: 1589292-01 Description: Water-Drinking Water Sample#: Sample Location: 1684 Main St.,W.Barnstable Collected: 08/06/2015 Collected by: Customer Received: 08/06/2015 0 Routine ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 LAP 08/06/2015 Copper 0.043 mg/L 0.0030 1.3 EPA 200.8 KK 08/13/2015 Iron 0.10 mg/L 0.10 0.3 EPA 200.8 KK 08/13/2015 pH 6.9 PH AT 25C NA 6.5-8.5 SM 4500-1-1-13 DCB 08/06/2615 Sodium 1.2 mg/L 0.10 20 EPA 200.8 KK 08/13/2015 Total Coliform Absent P/A 0 0 SM 9223 RG 08/06/2015 Conductance 480 umohs/cm 2.0 EPA 120.1 DCB 08/06/2015 Water sample meets the recommended limits for drinking water of all the above tested parameters. Attached please find the laboratory certified parameter list. Approved By: (Lab Manager) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 AsBuilt Page 1 of 1 LOCATIO SEWAGE PERMIT NO. 7 VILLAGE I N S T A LLER'S NAME R ADDRESS Y C. r - $UILDER OR OWNER Y ^A71 /t4rAe-rdSS DATE PERMIT ISSUED 0/ -� DATE COMPLIANCE ISSUED t iy Q 't http://issgl2/intranet/propiata/prebuilt.aspx?mappar=197032&seq=1 1/19/2018 10 CAT ION a SEWAGE PERMIT NO. VALAGE 45b INSTA LLER'S NAME & ADDRESS BUILDER,/ OR OWNER Ila �rrOrTM c rd sz DATE PERMIT ISSUED J V ✓ DAT E COMPLIANCE ISSUED 10-- 1 ,5 :� - C ` � ., .,. �.a ___ _ �'� �� a R �� � n� i� c �" 3 �J No`.�. —.�...�� Fxs....�.�..�............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............... .........................O F...................1......................... ...... Appliration for Disposal Works Tonstrudion Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �S ................1 ...._ .._...o _.... .. .....1 .�� QN ..... ------.............-----.......................................................... _- Loe ti Address or Lot No. 04ne.r Address ( a . ...O 4::,......... � Installer Address UType of Building _ Size Lot............................Sq. feet �-, - Dwelling—No. of Bedrooms...... ..................................Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No. of ersons............................ Showers Other—Type g ---------------------------- P ( )--- Cafeteria ( ) Otherfixtures .............................................................f-----•--••---•-••-•••---------•---•---•••---........-- ----•----- W Design Flow....................... ..............gallons per person per day. Total daily flow-------3-_ .........................gallons. WSeptic Tank—Liquid capacity/ a©..gallons Length ' Diameter----------.-- - Depth.g..'-g"-. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..........1.......... Diameter.......a__..._..... Depth below inlet......._.......... Total leaching area..Z.A?t�...sq. ft. Z Other Distribution box ( /) Dosing tank ( ) Percolation Test Results Performed by........ d-L...��► 1�...t=['!(t/!!r=.l=!"� Date �cz'./. :. .............. Test Pit No. 1..... .......minutes per inch Depth of Test Pit..... ........ Depth to ground water-------I'd ............ Test Pit No. 2--------3--_-_minutes per inch Depth of Test Pit... --- Depth to ground water.....60 52...._... R+' .................................... .................................................................................................. 0 Description of Soil--J...... ' ?`j r� ............i»!r� Sr7 %,� H ,. c.� --------------• -•-- -------- . ------------------------------. ---------------------------------------------•----------------------------------•---.-----------..:-------------------------------•-• ...........................................-.................... VNature of Repairs or Alterations—Answer when applicable.................................:.............................................................. -•• ------------•---------------------- ----•-------•------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL I'i LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b d by boar 31t Signed ..... -- .......-----•. ----- z / Date ApplicationApproved By..... =-----•-----------------------•-----.......-•-•_••....._.......----- .....•�-•�91, —----------------- Date Application Disapproved for the following reasons-------------------------------------•-------------..._..------------------•-----------------......•----- ............................•----...--------•---•-••-----------•----.....----------------------..........._..........._......-•--••-•----------------------------------------••••--..................... Date PermitNo......................................................... Issued--•------......-------•--------•---- --- - - -- --- ------- --- - ----- - - ----� ram' AFS THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... .. .........................OF....................................... Appliration for Disposal Works Tonstrurtion Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual'Sewage Disposal -System at: ................_........_...................................................................... --••--•----•-•--•--•----•---------------•---•-L N ........................................... Location-Address or o .............................................. . ............•--------......... --------------- -•-----.-.-------------..-•-•-------•----------------..-----------•-----•----•------_......---•--. Owner Address W Installer Address UType of Building Size Lot...................:........Sq. feet ' Dwelling—No. of Bedrooms.._...3...................................Expansion Attic ( ) Garbage Grinder ( ') Other—Type of Building No. of persons............................ Showers a yP g ---------------------------- P ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------•-----.••-••-••-•-•-•••---••••-••-•--------........--••••-------••---.............-•-•---------------- W Design Flow.....................:`? ...............gallons per person per day. Total daily flow.......3_':Sa..........................gallons. W Septic Tank—Liquid capacityl_->'�-•��_..gallons Length_ =_ _'.._ Width. S.`_. Diameter__- -..... Depth0..*" "-_.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------- ---------- Diameter..... ........... Depth below inlet....4-_'........... Total leaching area.Z.4-3....sq. ft. Z Other Distribution box (ti%) Dosing tank ( ) aPercolation Test Results Performed by...... .�.: ___G t`._.+=! _!�!t=.'-!!�� Date.�.---s 3-:-� .............. a Test Pit No. I.....3.......minutes per inch Depth of Test Pit.....Z!?.i..._... Depth to ground water...... ........... rX4 Test Pit No. 2_.._..'3......minutes per inch Depth of Test Pit--,/t -�..•. Depth to ground water-----L ��'...___. .................................... -;----•----........-----.....--------....-•--------------••.......................................................... Description of Soil-.••---Z-,--_Tv ..................�---------!..!!= A_N r7-•---------•---••------••--------------------...----------...----------- �� ........� ......-•••••.....U .................................-sue-----•`_------ ------•------------•--`-••--•-- ---------•----------•-••----•------•--•---------------••---------•----••-----• 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 TITL- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has sued by e boarder f I It Signed I...............•- ••....... Date Application Approved By-• = '-_... _•-. ---- �f 19 `s' ............ Date Application Disapproved for the following reasons------------------------•----•-•--•------------------------------------------•-------------......•-•--.....------ ----------•-------------------------------•-•---•--•----------•----------------......----......-----------•----------•----------....-----•••••-•-•------•••••••••-•-•-••-•-•-••-•••-••-••-----....._.._. Date Permit No. _.._. Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (Intifiratr of Tuntplianrr THIS,IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by...............'•---•----•--•-----------•--•---•--•...............................•-•----------•----------...------•---••---•----------.................-�---................--•---•----•--- iInstaller at........ 69-S...... :. ........... ..P ..................................................... has been installed in accordance with the provisions of TITI of The Ste Sanitary Codes d scribed in the application for Disposal Works Construction Permit No.......... _.: __._____ dated........ ................... THE ISSUANCE OF ;THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEMk-, /ILL FUNCTION SATISFACTORY. i DATE...................1(,.'.�r�.-:. ................................ Inspector............... ---•--------- ---------------•--•---------------- THE COMMONWEALTH OF MASSACHUSETTS ,. i ' -� OARD OF HEALTH " . ..................................... ..:O F..............._..................................................................... �D No FEE..,__:............... Disposal Works Tnnstrurtion ramit Permission is hereby granted..;...........IV 1ql lLl C.-........ ............ to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo........619..`�........! .._ ---....\� &fE;......................................................................................................... Street as shown on the application for Disposal Works Construction Permit Dated-_- '�_!_�.���....:......... Board of Health DATE...............ho.......... .....?- ................................ FORM 1255 'A. M. SULKIN, INC., BOSTON To r� nl C 1 G1 F l.Qa 2-'S NO E+ i .B: fn Stone : Akd: -All unsuitable material 1.1R1 f rid. . . to -be remove _ - -�0:?f�o_�n pit +. .. ,-.P;� and replace 26C's Sat- : with clean 100�/0 ( _ - 1 � 5�� fill: N , ,� Exp., W/3., 3 Stone _ PLAN SCALE stone - f 40 _ f Date 6/12/85 A =-=- 3 .4 DB Sao `40.7 M 2 PROFILE t_._.... ,� .. 15.00 -No SCALE . GST II .Li_: 3� 7 iz Existing..hse 30,2 m ' tO 3 :B4R o xistin " G.S.T.` Well 41.7 Lot -'area � - 39,6004*5: _..._ . f C-.B. B.40.10 14.0 ExistIng :fnd. Lot 1 I Lot A11 :G4pe :Engineering _ '� 49. Ra�bor _Road SKETCH PLAN OF LAND IN (WEST) BARNSTABLE,MA. �' Hyannis , -Ma. 02601 • FOR: WALTER �IflRTHCROSS Being a ,lot as described in 'Deed Bki.279 K PF, 100, -a,nd reco ed in Ha:rnstab1e :R-egistry:� , Elevations shown are on assumed datum: i a Route 6k'Var kble `width Date Agent; Barnstable Board' of Health i t Design, flow .. -fit 330: GPD . ._ .. . ------ 5 sT Dist Box 61x4' Pit W/3f stone Test gait data r 263:: S.F Made 6/13/85 490 G.P;.D, Wit. T. McKean ' _-Wat.er. encountered. _ Perc.rate 3 'min.ner 1" i Top �4.3 `Top i Fine - ,Fine. sand tsand IU_iAM z: H. FARDIF P NIs o. 4j5�4 TP' t- w a reFt. fPz�.� i1wt+P 2 w�1e:...�Gf, csaL Phi t ~ ------ Fee-- ---------- BOARD OF HEALTH TOWN OF BARNSTABLE Zpnlicat ion ArMelt Con0ruct ion Permit Application is hereby made for a permit to Construct (+(Alter ( ) or air ( )an individual Well at: 1684 Rte. 6A W.Barn stab le --- - - ----------------------------- Location — Address Assessors Map and Parcel W. VanNorthcross Same ------------------------------------------------------------------- ---------------------------------------------------------------------------------- Owner Address Meehan Well_Drillings__Inc_._____________________ P.O. Box_ 800_,__ Forestdale_P___MA______02644 Installer — Driller Address Type of Building Residential Dwelling----------------------------------------------------------------- Other - Type of Building-------------------------------- No. of Persons----------__-------------_--------- Water - Drinking Capacity Type of Well--------------------------------------- -------------------------------------------------------------- ------------ Purpose of Well------------------------- ---------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until•aa Certificate of Compliance has been issued by the Board of Health. Signed—C- _�_ -b' i ---------- -A.uc__-__25 date ID Q - ----- - ---------- -2 O -e q Application Approved By-_________ ! ----- ---- - - --------- date Application Disapproved for the following reasons:-------------------------------------------------_____---------------------------------__ -------------------------------------------------------------------------------- ------------ date Permit No. Issued - '' L - --- --- -- ---- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (Altered ( ), or Repairedptl_ ( ) -1 %F -�-� -- — ------------------------------------------------------------------ bY-----�'��7'_AfA--�ellC---- �P Installer ' at--------1 U-�1' -R'i<- --------- -4 - --------------------------- 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. C__t V q= Z----Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-- - ---- --- -- - -- - -- - -- Inspector------------------------------------------------------------ --_— r No.-f�-t.�_ __ _-- Fee--a - ------- BOARD OF HEALTH TOWN OF BARNSTABLE 21ppricationfforlVe­11 Con!gtructionpermit Application is hereby made for a permit to Construct (vj, Alter ( )� or Repair ( )an individual Well at: t 1684 Rte. 6A,W.B.& n,s tabje - --- r I �?'—L-------------------------------------------------- Location- Address Assessors Map and Parcel ia, VanKorthcross Same --------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- Owner Address Meehan Well Drilling, Inc. P.O. Box 800, Forestdale, 14A 02644 nstaller - Driller Address Type of Building, Residential Dwelling Other - Type of Building------------------------------------ No. of Persons--------------------------------------------------------- Water - Drinking - -------- Capacity Type of Well-------------- ------- - - - - ----------------------------------------------------------------------- Purposeof Well------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed c c� — .1 ��V� --- u — S_=1989 -- ----------------------------- date Application Approved B / �_�_- �G��� �=,,1""'.' - ------------------ date Application Disapproved for the following reasons:----------------------------------------------------------------------------------------------------- -------------------------------------------------- ---------------------------------------------------- �/ date Permit No. !� _t��Z —-- - ---- - Issued------'y -'- -- - --------------------------- date BOARD OF' HEALTH - TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (Altered ( ), or RepairedZby-------- ( ) LUG /- D,;_lj%et ' - 11 Installer --------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. 60— =�-Z--Dated i 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 - r Yell Con5truct ion Permit No. l/v =_�L_. Fee---� -- Permissionis hereby granted- - --- --- ---------------------------------------------------------------------------------------------------- to Construct ( ( ), or Repair ( ) an Individual Well at: No. -74-f1 q--��:t- � ------------------------------------------------------------------------------------------------- a Street as shown on the application for a Well Construction Permit , No._�1)��--- ---------------------------------------------------------- Dated---- - f ----------------- Board of Health DATE------------------------------------------------------------------------------------ 13 PLOT PLAN I FOR LOT a , Ladtcate location of garage or accessory building Additions with dashed lines Sewerage disposal (cesspool) ® j Well ® I (Lot....................ft- rear) I I f Abuttoc's y AbI rt 's 4UL Zme 5 C 1 Lot Rear Yard Lot # .................ft. I this is a ;jif this is a u , ccaner ornex lot write to w , 'MC in Dame of aame of other met. Sideyard HOUSE Sideyard ' Iorher t. ft* ft. tIa a o I ' Set Back .. ...............h. I 1 I i i I ! 40` - - (Lot.....................ft. frontage) \ / (Name of street) / ( lniormat,on Mark North Point it 1 _ ENVIROTECH LABORATORIES 449 Route 130 Sandwich, MA 02563 • (508) 888-6460 CLIENT: W. VanNorthcross LOCATION: Same ADDRESS: 1684 Rte 6A W. Barnstable, MA 02668 COLLECTED BY: Meehan SAMPLE DATE: 8/24/89 TIME: 2:30 PM -_ DATE RECEIVED: 8/25/89 SAMPLE ID: ET 502 JOB #: New Well WELL DEPTH: 20 ft RESULTS OF ANALYSIS: Parameter Units Recommended limit Result — Coliform bacteria/100 ml (MF Method) 0 0 BE —_ p1-1 pH units 6.0-8.5 6.83 BE Conductance umhos/cm 500 317 Sodium mg/L 20.0 18.8 Nitrate-N mg/L 10.0 .06 Iron mg/L 0.3 — .06 _ = Manganese mg/L 0.05 _ Hardness mg/L as CaCO 3 500 _ Sulfate mg/L 250 Potassium mg/L 20.0 Alkalinity mg/L 200 Chloride mg/L 250 Turbidity NTU 5.0 Color APC units 15.0 BE EE Background bacteria COMMENT: c YES No WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. xxxx 0 — � DATE �! ;iuiiiiiil►iilitiii; ;; ;; tiUtiiiuiliuu ;;; ,; ;; 1liUUlUuIUtlWli;iitiuuiiiiiullUUWilIiW��