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0020 MCCORMICK DRIVE - Health
20 MCCORMICK DRIVE W. BARNSTABLE A=153-012.002 i t p 4 i I J ' t No. 4210 1/3 BLU ESSELTE 10% a 0 0 TOWN OF BARNSTABLE � LOCATION aO IBC Cdsr yv,�l�'_I� 1)fL SEWAGE VILLAGE Uk; ASSESSOR'S MAP & LOT IS 'a(2-�� INSTALLER'S NAME & PHONE NO. C:rQ �'7�6 SEPTIC TANK CAPACITY 1,5 N GAL LEACHING FACILITY:(type) 3��`�60,C 0, w�► -r (size) j3 X 3d6,2V NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER?riv#fQ'— BUILDER OR OWNER �(� t TAM I C'b o a - DATE PERMIT ISSUED: y3/ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No / �1 j1 jj (y t �ik No. "" Fee �00 ' THE COMMONWEALTH OF MASSACHUSETTS L'ntered in computer: Yes � PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for Diopoar *pgtem Construction Vertu Application for a Permit to Con ruct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. C a Owner's Name,Address ,�andd} i CoTe�.No.ofo �> Assessor's Map/Parcel ® �' " " " " " '" " o" s 00.a- Installer's Name,Address,and Tel.No. , Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 issueed�by t is Board of He h. j Signed 1AAA 0 Date Application Approved by Date Application Disapproved for the following reasons 6L Permit No. Date Issued L� No. _ -, �:_ r Fee Sao yr ,+ THE COMMONWEALTH OF MASSACHUSETTS _" � erect in computer: Yes F, PUBLIC HEALTH DIVISION -,TOWN OF BARNSTABLES MASSACHUSETTS { 2pprication for Mi5po5a[ *pgtem Congtruction Permit Application for a Permit to Con tract( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Y Location Address or.Lot No. Owner's Name,Address andTel.No. JJ� C 0 O G.I✓ 1 COV U ��' Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 1 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil F � s n 1 1 Nature of Repairs or Alterations(Answer when applicable) l i `✓ 3 v Date last inspected: Agreement: The undersigned agrees to ensure•the•construction and maintenance of the afore described on-site sewage disposal system it accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- catq pf Compliance has been issued by this Board of { Signed ZflA A 6 Date / 7 d 1 Application Approved by w W.� Date Application Disapproved for the following reasons y - i Permit No. Date Issued �I THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( Repaired ( ) Upgraded.( ) Abandoned( )by i at ` has ben constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No 6Ydated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date © . - -7 Inspector r ,,,,, _y- -— —— —————————————————— —————————Fee _ r THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migogaf pgtem Construction permit Permission is hereby granted to Construct( )Repair( Upgr de( Ab don( System located at 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. 4, } Provided: Construction must be completed within three years of the date of this permit. Date: - ? Approved by � TOWN OF-BARNSTABLE LOCATION MC Q,-yv�0,C h DO, SEWAGE # �Ll VILLAGE_ ASSESSOR'S MAP & LOT 15 INSTALLER'S NAME PHONE NO. Lr L` 132.�7Da SEPTIC TANK CAPACITY I�5 ICJ Cjq� LEACHING FACILITY:(type) 3�S 6o�C _f (size) /3 X 40 ,7� NO: OF BEDROOMS y PRIVATE WELL OR PUBLIC WATER?r;✓ef � BUILDER OR OWNER Eo t TF}f1'1 , Cb - IZ DATE PERMIT ISSUED: / 7 DATE COMPLIANCE ISSUED: I Id VARIANCE GRANTED: Yes No . .. ICI f • 1 00 .LP , Z.L. . _ V �}• � � � �. ��`� = Q ��'d. LL HE'S .... -" ... . ; . t- -=- --� Fee-1 ------------._...- BOARD OF HEALTH TOWN OF BARNSTABLE Appiicat ion for Vell CootrurtionPermit ,,,Application is hereby ade for a permit to Construct ( <Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Ma and Parcel Owner�(( Address -- - ------ -- ---------------- ------------------------------------------------------------------------------ ----------------- Installer — Driller Address Type of Building Dwelling---------------------------------------------------------------- Other - Type of Building--------------------------------- No. of Persons--------------------------------------------------- Type of Well- --- - -- - _ , -¢GPvL Capacity-—/O- >� /f- W1641 61h7,0r 4,16Z . Purpose of Well____-2_ ,'n&E5 77C:- -- - -------------- ?011L� 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 Certificate .of Compliance has been issued by the Board of Health. Signed - --- --------------------------------------- - ,-- date Application Approved By- ---- -- -- --- - -— ---- -- - date Application Disapproved for the following reasons:-----—------------------------------------------------------------------------------------------- ---------------------------------------- - --------------------------------------------------------------- date PermitNo. --- - - ——---------------- Issued---- -- - - -- - - ----------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE C ertif irate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by------------ - '' -------------------------------------------------------------------------------------------- - - - - -------------------- Installer at- ---� -�-- ---- - -- - 1��------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. _ ____Dated------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------- — - --- -- Inspector-------------------------------------------------------------- if `No. -=- - t' Fee-1- ----- ---._...- ., , BOARD OF HEALTH ;sTOWN OF BARNSTABLE 0[pplicat ion-*r V ell Construct ion permit L , Application is hereby . ade for a permit to Construct ( ✓), Alter ( ), or Repair ( )an individual`Well at: --f - }'1'I C'oR.m+ e/ D 2• •g f' 1.53 - Location — Address Assessors Map and Parcel AO 16— ----------------------------------------- -- -------------------- Owner•' Address S Ix.Urt� �F'LL �� ------------------------------------------------------------------- - - ----------- Installer — Driller _ Address Type of Building Dwelling------------------------------------------------------------------ Other - Type of Building ------------------- No. of Persons----------------------------------- —------ ------ YP g------------ ,. Type-of Well Capacity-— - - -— --- Purpose of Well- O/77tC577C ------ 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 Certific�.offCompliance has been issued by the Board of Health. Signed - — -- -----------------------— - -1�- 4�U - date Application Approved By --- - --—-- —-- -— --- - -- date Application Disapproved for the following reasons:------------—---------------------------------------------------------------- -----------— --=----— ------------------------------------------------------------------------------------------ date � x -Permit No. --: ��-----= - ..�„ ;- - - - -; R date, i • _..-,..._...,....,...,.....�...:..,�..........:.....,..�......,.:..�......�..r...«...�...,.... ..,.. „ram BOARD OF HEALTH TOWN, OF BARNSTABLE , C-ertif irate Of Compliance ' THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ),-or Repaired ---------------- Installer IP— at— -- 'd— -- '' *"1+ !'-e.� ---- -- ----------------------------------------------------------------------------- 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. r��-' ----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 Veil Con5tructionAermit ILL!-_-Q Fee---- -- Permission is hereby granted----�--- ------------------------------------------------------------------------------------ to Construct�6, Alter ( ), or Repair ( w)�an Indiivindual Well at: /- j� No. ------� - ---A*- —+ 5,, "�'" — - ------- L-` ------------------------------------------------------------------------- Street as shown on the application for a Well Construction Permit No. - �-�'�- ---- --- -- - Dated-------¢--®---------------- - G - ------------------------------------- ------------------ r----------------------------------------- Board of Health DATE-----—-------- -- — - Department of Environmental Management/Division of Water Resources .. r µ WELL COMPLETION REPORT WELL LOCATION GEOGRAPHIC DESCRIPTION Address I� ����-° -� N S E W of _ Ireetl (circle) City/Town '�'r�nnT<7 J G Well owner Q /2E (road) Address >00 '60Y v N S E W of (nil.in tenths! (circle) Board of Health permit obtained: yes 0 no ❑ fi'tersecr. w/ (road) WELL USE WELL DATA fDomestic [2 Public❑ .Industrial ❑ Total well depth /Pd ft. Monitoring❑ Other Depth to bedrock ft. Water-bearing rock/unconsolidated material: Method drilled ¢�� mug/✓ Date drilled �/' / H-/`6 Description CASING Water-bearing zones: p yoU� 1) From To Type 2) FromTo Length—fZ-_ft. Dia(.I:D.) _in. 3) From To Length into bedrock ft. Gravel pack well: dia. Protective well seal: Screen: dia. Ir / Grout Uther Slot �length from�l�to c ) STATIC WATER LEVEL(all wells) Static water level below land surface ft. Date Z/'i5/ 6 WELL TEST(productionwells) f Drawdown ��It. after pumping fir. �'—' min.at CPO gpltt f How measured ArL,` 71M4iecover `( a�t�l' fir min. �/ y LOG of FORMATIONS COMMENTS e p Materiels From To - - - i 6 5 % S .e- Driller f7tpit { Firm �E S/no�it %4/E (1ti4 P 0 bib'/ Address G tE5 City/Town /•PLANS /f7 4 GLG`5 Su eniisin Driller Reg.# y P 9 Si nature o to ervlsln re lstered well driller Flaw Print firmly BOARD OF HEALTH COPY �...a .. �...,.G. ... �K _ f ENVIROTECH LABORATORII,S, INC. MA Cott. No.. M-MA 063 449 Ric. 130 • Sandwi0,MA 02563 (508)888-6460 . 1-800-339-6460 FAX(508)888-6446 CLIENT: Tanny Coture LOCATION: 19 McCormick Dr. ADDRESS: PO Box 2 Map 153/Pcl 1.2-2 W. Barnstable MA 02668 W. Barnstable MA SAMPLE DATE: 11-14-96 COLLECTED BY: Desmond Well DATE RECEIVED: 11--14-96 TDIE: 1.0.:30 LAB I.D. #: E11206 JOB `I'Y r: New Well SAMPLE T.D. #: E11206 WELL SPECS. : N/A RESULIS OF ANALYSIS: Parameters Units Recomended Limit Result Coliform bacteria/100m7. (MP Method) 0 0 PH pH units 6.0-8.5 5.94 Conductance umhos/csn 500 677 Sodium mg/L 28.0 82.5 Nitrate-N/Nitrite-N mg/L 10.0 0.36 Iron mg/L 0.3 0.10 Manganese mg/L 0.05 0.079 Volatile Organic Compounds See Attached Report EPA Method 524.2 Cl.oroform ug/L 100.0 2.9 Tetrachlo.roet.hene ug/L 5.0 2.3 Toluene ug/L 11000 2.0 Trichloroethene ug/L 5.0 0.9 Total Xylene ug/L 10,000 1.7 COt PJTS: Low PH indicates high corrosive characteristics. Sodium level is not a health hazard, but it on a low sodium diet, consult physician before drinking. Sodium level indicates probable road salt run off. Manganese is not a health hazard. YES TATER IS SUITABLE FOR DRINKItO PURPOSES FOR. PARAMETERS TESTED. .Xxx DATE IoZ on d J. Sa i . Laboratory D rector i LAPUCK LABORATORIES,INC, f NV1RONMI,'NTALTESTING WAST11 WA'11IR JASCHARGI; .50 li„nl siccet 'TI STiN(.; Wmevlow,n, MA 02172 FOOD ANALYSIS (617)923-Q300 (III MICALANA1 Y41S V/i X ((!17)9)1-0101 I�Olt1IN51C:"1'1?,S'I'1NG REPORT` LA1:3 NO, 56S23 December 5, 1990. Mr RC,n Saari ENVIROTECH LABORATORIES, UNC. SampleReoeived: 11/18/96 449 Route 130 Client I.D.: Coi►(tire Sandwich, MA 02563 Seniple 1.1).: 19 Mc:Conlied Test R.esulta: Yuhstllc Organics-PPu(uglL) T..�..,.......,.,...�- Method 0524.2 l3cu cu ND 1,2-Dichloropropa w NJ) 13x ot.ttobct►rralo NT) 1,3•Diol►loropropaue N1) I;,aotll�clalcttY►l,lothlul3 NJ) 2;2•l)ioltlorop,rpnne ND firomoclicl,tc►rllz,��thtano Ni) 1,1-Diohloropmpene ND 13romc►fi►,,,, NO C'is-1.3-Dioh)oropropcao NU liroanonlothane NJ) 'Trans-1,3•Diohlotopropeuo NL1 N-13➢tty113o„zcno ND l lIkylboweue ND "W-Butyl 130=110 NU ND To1•t-13u1y)f3euae,aa ND ND ('abou Teltaohlorido ND P-lsoptopyl(ol,luuJ NJ) ('11101obow,eue ND Methyl Chloride NJ) C:l+lnt cx�t.l►atic NT]") Naphthalene ND {'hlorol'rn,tl 2,9 N-Propylbewene N1) (hiort;litotha,r= ND Stytetto Nl) .'.-Chlorotolueilo ND 1,1,1,2''1'etrAchfJroetl►ai,i: Nl) 4-(,')+lotc�lc.luu+ao ND 1,1,2.2-Telrnoldoroolhenc NJ) 1,2.1)ibrc>rltu•3-Cl,iorop,npBnc ND Tel rnoliloroetheno 213 1 f)ibrtatatf�rl�cAladto NJ) 1'oluouo 2.0 1,2�1)iolalorobeures►o NI) 1;2,3-'1'ricl►lrn'nbot17c11e ND 1,3-17iol,lorot:et�zene Nil) 1,2,4•'1'rio111c►rnhon�Auo ND 1.4.1)iullloroba,.tze„e N]:? 1,1,1.7,iol,lorin thsrto ND Dibiotuool1l01.011 Qihaw 1,1,2-TrichloruAft,ae Nf) 1,2.DiBm,noethano (14)11) NJ) Triohlorofluoromethme N1) Diehlorodiilitoromothano N1) Triohloroethc,ie 0.9 1,1-Dichloroothow NJ) 1,2,3-` riohloroprophu,; Nt) 1,2-IA,ohloroelllatte 0111)C) N1) 1,2,4-TrituatLylboutene N1) 1,1-Diahloroethelene ND 1,3,5-Triluethylbenwao NI) C'.is-1,2-Uiohloroethyluuo N1) Vinyl Chloride NI) T?'h�-i.2•faio+l� „s➢t�vt tt� �j S�3n�ylea 1,?��. ND. Not 1)utu 1od Analysis Laic: I I/'U00 hUhlxl Dotwtion 1,inl.it cz 0,5 tgVI, Iteroya.iaa o 1.2;Diohlorobom-no-d4 - 1 UU PAIromotluorobemne 110 7�'St1329 �011,Vu �T/��y (� fin� Services ..,.,^mes Fot►tenivostt,Lab Manager for over 30 t I;r, R'jndl i.1{u14'rrti gpin (l,p l•undl,tutl ih Al it is❑M to Ir iPlnudnl'.'+t�tdroN;tsl'ie r0rl rof Rdwillshp.Or 01110f 1Ritjiwstk(n•M uuf 6t(:nMQrc•.of i6 CUflliiclnw wilit Mir 11;r1lIC\vllhktll sl>cClnt rKa•+lllssil, in Wlif Ul(,.'thUll hnl'.�i111y IR;tJplltl;�t Jo Ihf irlt•U lrt•¢11HUUI11,'➢tta tc�ou�t•ett;tt rr?i't unl�lu 1rtilGtf n9Rtpjpn nh6(Gr el"q,11raA1r IlilriUh.(!; : i - - . R , - T _ T1 n TEST SOLE LOG T. I'ERC RATS: a n kt.)11,3 T lie A= It cl -ric, iz r; cy IL o� o - • W ^J . rll -DESIGN DATA � Iv �+ DAILY FLOW: {4-j 13DIIMS. x 110 GPD GPD ��• SEPTFC TANK: -GPD z 200% —�— USE: 18cx=> GALLON PRECAST SEP-]-FC TANK LEACHING FACH T IV.- , USE _ � •s'�alE.RE.3�..st6��x.lr o ,�' CAPACITY. .�« 2' SIDEWALL: gccx-.'Zx.7T 'fOTA CT) cl y Iti t m 1. m.L fli?F.TO BTi VP DbL SCH 46 PVC. -- i 2. PIPF 1-0 BE.LAII:LEWEL FOR 2'OUT OF AIS'I'RIBUTION � BOX. 3. pAi S£ALL.:YI`T.IC'.�Bi,E AfANHOLE COVERS TO WITHIN 6"OF FIMSH GRADE. 4. SEPTIC SYSiE 'f IS NOT DESIGNED FOR THE USE OF A + 2"LAYER OF 319"PEASTONE OVER I'AI0,tGI DISLOSAL, !± Cl SFFTIC TANK AND DI.STRIBITFION BOX TO BE INS7AI,L1 U 314" 1 lf2"5d`+'aSIIED STONE ALL ' ! ON A 61'LAYER OF STONE. AROUND I 7 m TOP OF FOUND. - '- 41, SEPTICSYSTEN1 PROFILE �� �� � ''`1`TA ems. y • ffi GENERAL NOTES- { 4 SITE ..+ SEWAGE PLAN 1. CONTRACTOR T0BERESPGXSIIILERORTIIELOCATION ©� OF ALL UTILITIES.AWN%AND UNDERGROUND.PRIOR " ,��'� To ANN'EXCAVATION OR CONSTRUMON-VAr� ��`I, �cj c. ""' I `" „ ` 2. Sh'PI iC.SYS IEi�.1 To BE INSTALLED IN COMPLIANCE WITH 3IACA41t 35.D0:'TiTL��'. [11 {' PREPkRED O 3. TIIIS PI-AN IS NOT TO BE L'SISD FOR PROYEPTY LINE { f DETFnN.ff-NA,TION. 'r T! !P i E FDf�TE: . Z3,R'llt•. SCALE: I (� SwAKAN cn CN IA y p • _ .o/i G.,^T -CIL irk WELLER & ASSOCLALTES o2 i75 714 MAIN ST. ---P.O.-BOX 119 YARNIOUTIIPORT,3MA TEL (508)362-9131 � • ! j APPROVED BY: �' t J Nk 54- 1 \ �S�3 r TEST HOLE LOG DATE: Cel= 1?1 199(I TEST BY: WELLER&ASSOCIATES WITNESS: r-.OA' q PERC RATE: 3 rbO Ito 4. ( O„ • 44 4a Sh►J►7i O� $" A. s.c.. " IoYEG G/& r: FED �¢• f�L. 247 ClA' 31.o v DESIGN DATA DAILY FLOW: +BDRMS.x 110 GPD—440 GPD SEPTIC TANK:44o GPD x 200%=9!eC> + r 49 USE: Ir GALLON PRECAST SEPTIC TANK LEACHING FACILITY: �3 USE:C3)5'x 8 x z' fi ov4Al azS 4-4'E CAPACITY: . SIDEWALL:'9o.x'ZX:7¢= I .Z-"- BOTTOM: ►5vc 3ZJf,•74- z 'S°�•$ TOTAL: 4i>c> ..., vk�;.'.,r:s. • s�3,��its f!^r.';v'mA� NOTES: .. 1. ALL PIPE TO BE 4"DIA.SCH 40 PVC. 2. PIPE TO BE LAID LEVEL FOR 2'OUT OF DISTRIBUTION BOX. 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN 6"OF FINISH GRADE. 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL. 2"LAYER OF 3/8"PEASTONE OVER 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED 3/4"-1 1/2"WASHED STONE ALL ON A 6"LAYER OF STONE. AROUND TOP OF FOUND. 42 @ GEL. ,�"•�ja \ / 10" 14" r 8A L. e �2,cc� 41, OL, 4G.oo 41.Z3 4 I.00 41 ,4-o KEr10 4►y� lrl�/pas "-A SEPTIC SYSTEM PROFILE 5 S � UiE , � SITE SEWAGE PLAN GENERAL NOTES 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION FOR OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR 1q G���,,./� y TO ANY EXCAVATION OR CONSTRUCTION. 1 {IF S.- `^�' rr�IS-5 ✓'�- 1 Z•Z , 1' 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH 310 CMR 15.00:TITLE V. PREPARED FOR 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE i/ 7AH I co > � DETERMINATION. DATE: Z31 Iq j L SCALE: OF M 4. v 7 ��` q �t� O� DANIEI E. CyG BRAMAN N • p CIVIL V No.32686C ~ ti 'Po, GIST SO WELLER & ASSOCIATES 714 MAIN ST. P.O. BOX 119 YARMOUTHPORT,MA. 02675 TEL: (508) 362-8131 APPROVED BY: CL I � ED �r U' •� yz -it i-- - - Z5 f=i l — , --'.. t r - ` 54- �. rL LO i r 6 7 —171 (` d LI t m 4,5 -Floe U _ 0 " n cri t .. Ii t