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HomeMy WebLinkAbout0388 PLUM STREET - Health 388 Plum Street West Barnstable A= 196-018 l 1 I{f I _ it No. 4210 1/3 BLU w 10% U Fee ()Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS es ftPlication for Misposaf *pstrm Construction permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) XCompleteSystern ❑Individual Components Location Address or Lot No. J)LUAK $T w, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 19(p CA32�19 c.,l,u4 5-- to es-r BAWS TAV Installer's Name,Address,and Tel.No. OV.-tf 77"8 9-7-7 Designer's Name,Address,and Tel.No. 56$-d-73---037-7 C AP&c AbC_ E+VT L15ES L — :Tc CAC-WC GaWU& zWC. r Sr M 85' eraN_ HWY W,,"REHAAA Type of Building: Dwelling No.of Bedrooms Lot Size aZ�, 9 7�- sq.ft. Garbage Grinder( ) Other Type of Building EZr-:S t i)6�JT/A-U No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 a gpd Design flow provided 3 3-3,r7 gpd Plan Date 16-oL5-(c. Number of sheets Revision Date Title 329, PL6m S T' wsaT- Size of Septic Tank i ,00 o Type of S.A.S.�� LC-6 6(-(oMAe)S (sLj/S-Tr;bAJ� Description of Soil (.qAm-( 5e tJD (P .2q" — FIaX SA-AD 52 o" JIE=Z �C ll� Nature of Repairs or Alterations(Answer when applicable) USrr EX(ST-t lU6C jic2l)o Cr�&) 5 PT IC-190K, 7 N E J V -13 O)C. (P LCAZ9 i JG- f,L-Ea¢ W i T 44- D or, A-N c'�o i GAT 0 xp (_SAS 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 Certificate of Compliance has been issued by this Boar of Healt . Si ned Date T® Application Approved by A Date /0- Application Disapproved by Date for the following reasons Permit No. l c' Date Issued No. U ( 1 ,+, Fee /06 THE COMMONWEALTH�OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RppliLatlon for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) XcompleteSystern ❑Individual Components Location Address or Lot No. 3$8 (PL,UM 5T W.1 Owner's Name,Address and Tel.No. CA- 46�R PG kUR3A Assessor's Map/Parcel 1 9(p 8 1 3$8 p c A, t ST t-i F---5T $yV.-OS TAB- _ Installer's Name,Address,and Tel.No. 502-477 897-7 Designer's Name,Address,and Tel.No. 508-da3--63-77 CAP&LADC 6;o1sW4j5&3 C.�.� ZC C-i,<-rAl a)0A- s zAX I� 153 <- Sr MAEbWE& I asS4 <-kA JQ HWY W,"tS-N4M Type of Building: E Dwelling No.of Bedrooms 3 Lot Size A 119 9 7 — sq.ft. Garbage Grinder( ) Other Type of Building Rom$( 1) (/(-- No.of Persons Showers( ) Cafeteria( ) Other Fixtures I Design Flow(min.required) 3 3 U gpd Design flow provided 3 33,rJ gpd Plan Date Number of sheets Revision Date Title 2 g PLLOA 5 T wear 5-rA-3 Z: Size of Septic Tank / GOO Type of S.A.S. 5 Lc 6 C(4*W `k5 (st1 STpA)C Description of Soil LoAm,.4 SAeJA (2 •2q t( F(OG 50E4L-0 @ G0" /$tFz=_ P4.d ti/ 1i�.,•} cif Nature of Repairs or Alterations(Answer when/ap licable) USE t X(ST(x�& /,0OO C-X4U_ J SERric, U� .1.b ( LC Co C G4C9(064 CC44uMGQ5; w I t W- J 4 F&V I' Or /���-'("� 0 Y J 51 0 Ar N �� 5 Ebb O 1C1 L as 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 Certificate of Compliance has been issued by this BoarlI of Heal Si ed 1 Date �0 1�- ' Application Approved by --y` Date /0- ) 7 -/ Application Disapproved by Date for the following reasons Permit No. s l L Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X) Upgraded( ) Abandoned( )by CA PE w f n€ at 3 2�g P4,um\ Sr (A)e ► has been constructed in/accordance . with the provisions of Title 5.and the for Disposal System Construction Permit No. 6 -1/d-' dated y Installer (!AA_C rJ[1)C �iC-�7 LAG[ s �-� Designer _ ZTC #bedrooms 3 Approved design flow 3 j 0 gpd /I O The issuance of this permit shall not be con r e a antee that the s stem wi /nctiln desi d. p / g y dp' ig4`3 Date ( Inspector d" �/ f /j�: ( Ci :'�c� -------------------=--------- No. �J l L/v Fee PO s THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction permit Permission is hereby granted to Construct( ) Repair(/%10 Upgrade( ) Abandon( ) System located at 388 pL(V/K 577- 6Z5-t- ( 6Tr AA)S McG— and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. ' P Provided: onstrt{ction mu be completed within three years of the date of this permit i Date ' Approved by/, V 10/29/2014 06:22 5082730367 #3429 P. 001/001 Town of Barnstable Regulatory Services Thomas F.Geiler,Director 4 g Public Health Division NAM t659. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Date: ID Zq'/Y Sewage Permit# oZ614-410`l Assessor's Map/Parcel 96 8 Installer &Designer Certification Form Designer: _SC. Installer: Cdeewido- �r�Ferpr�szS Address: Lti5 y CrcwMerr% �`5\"wT— Address: 1 j 3 C-O mMe.r c-Col Sirec l E0 % w6rF_\no n t4A 01539 MasMQee. G'i SoS-273'•0377 On I -a"1 r I 14 CQpcwtdIL E-149' rises was issued a permit to install a (date) (installer) septic system at Ms Plum Sk-r eelt based on a design drawn by (address) 1 C Engtnee►tang , T.nc_ dated 6"25~ / Y _ (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required) ected and the soils were found satisfactory. .MOF C/ CJOHN�L HURCHILL (I t ler's Si re) IVIL 4180 esigner s Signature (Affix De gn Here) P ASE RETURN TO ARNSTABL r L C HEA DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED OML 13UH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HPAI.'I"1EI DIVISION. THANK YOU. q:\otriceforvns\dtsigntreeniricationform.doc Town of Barnstable Department of Regulatory Services Mtn LK . Public Health Division Date �A tdgy 200 Main Street,Hy nis MA 02601 f Date Scheduled— (/ -'! Ttme Fee I'd. _9�2_ Soil Suitability Assessment for Se e Di4olt-m Performed By: g;�I ey 4, 6Z.6`o, C-T 1 I CS f5, Witnessed By: LOCAT ION&GENERAL INFORMATION Location Address WEST" Owner's Name 6ATHOW KURRA "�F g D LV T 0 &05TA ter Address 322 a t,(+rr t 57"_ V J�3 , Assessor's Map/Parcel 4't�'�d t' p Engineer's Name (!4RF_(,L jt_06 Gu ULC NEW CONSTRUCTION REPAIR Telephbne# 60 D-4`7-7 �R 19-71 �G 5`�►ee'i�� Land Use S�nhle �CL-i l7 div41t-rl� Slopes(96) 2- y Surface Stones 5U S-273-4 3 77 Distances from: Open Water Body- -- ft Possible Wet Area ft Drinking Water Well 12 7 t ft Fo 1 e GuS t red Drainage Way ft Property Line i0 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands{n proximity to holes) Ste- CD_ z N. Parent material(geologic) OUt4u(45vrt Depth to Bedrock� y 132t� b ram. Depth to Groundwater. Standing Water in Hole: '- Weepingft'otn Pit Fpcc 1 it Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: alceck Obse;-uUaktuv% Depth Observed standing in obs.hole: In, Depth to soil mottles: In. Depth to weeping from side of obs.hole: 13.2 in, Groundwater Adjustment Index Well# Reading Date: Index Well levoi Adj,#'actor, - Ado,Groundwater Level, e PERCOLATION TEST Date �017-/Ynme it r," Observation Hole# Tinto at 911 Depth ofPerc 30a Time at6" 6 yew _ Start Pre-soak Time @ Time(9"-G") -2 wi"n5 -� End Pre-soak Rate Min./Inch { 2 - Site Suitability Assessment: Site Passed Y 1s Site Failed: - Additional Testing Needed(YM) A,v Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conseirvation Division at least one(1)week prior to beginning. Q:ISEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Sail Horizon Soil Texture Sdil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Stnucture,Stones;Boulders. onsistency,%"Gravel) o .. ZY A L S 1v`�r 312. 2y .r� g LS iv�f5/i, 60 - JS.2 G I=S 2:5Y6/y t 16$" -- 7 5Yr 5/6 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. onsisten %Gravel) DEEP OBSERVATION BOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency, Gravel) VEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders, Consistency, Flood Insurance Rate Mau: Above 500 year flood boundary No— Yes .✓_ Within 500 year boundary No V Yes Within 100 year flood boundary No..✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not,what is the depth of naturally occurring pervious material? Certification I certify that on 7 U.3 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise n/d.e peperiie�nce described in 10 CMR 15.017. Signature D at 6--�--�� • Q:1S.EPTICVERCPORM.DOC TOWN OF BARNSTABLE LOCATION 3 aW14 laME&-r SEWAGE# AO !4- 017 VILLAGE WGST li oA105 _ ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PRONE NO. ( WeUJM6 CNTM-Vises . 5705f —?8-11 SEPTIC TANK CAPACITY 00® GA-(,L0tJS LEACHING FACILITY:(type)(5) LV- G L6A.VA1►,C, CA° (size) NO.OF BEDROOMS 3 OWNER CokTRVU 0E KJtZ� PERMIT DATE: l©-a., -aoI 4 COMPLIANCE DATE: 1® -,-19 - -10 Separation Distance Between the: MCVT7u►lGc 108'r Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility C 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) NIA Feet FURNISHED BY CAOEuxbE /JSeS 'a (v P3M B- 3 = .t o(o l A - 3 : 3 q 1 Town of Barnstable �FTHE tp Barnstable o Regulatory Services Thomas F. Geiler, Director ;mericaCii * B^ MAM i Public Health Division Ar 1639. A Thomas McKean, Director 2007 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 22, 2013 Ms. Catherine Marie Kurra 388 Plum Street West Barnstable, MA 02668 Dear Ms. Kurra: It has come to the attention of the Town of Barnstable Health Department that there may be a possible groundwater contamination in your area. At this time we request access to your house for the purposes of collecting a water sample from your private well for testing. The testing of your private water well would be without cost to you. I would like to do these tests as soon as possible. Please contact me at this office or my work cell phone (listed below) to arrange a convenient time for me to collect this sample. Thank you for your timely attention to this request. Sinc y, s Donna Z. Miorandi, S. Health Inspector Town of Barnstable Office: 508-862-4644 or 508-862-4639 (Direct Line) Work cell: 508-294-1394 BARNSTABLE COUNTY DEPARTMENT OF HEALTH&ENVIRONMENT Of B q WATER QUALITY LABORATORY , �� sT BARNSTABLE SUPERIOR COURTHOUSE v3195 MAIN STREET/P.O.Box 427•lBARNSTABLE,MA 02630 PHONE: 508-375-6605 4 FAX: 508-362-7103 9SSgCHUg�S� BOTTLE IDENTIFI e on ION NUMBER DRINKING WATER ANALYSIS (PLEASE FOLLOW ALL INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING THIS FORM) REPORT GOES TO: ���CK//YL /)!/`J�C/� �I�1_1/ SAMPLING DATE: AAw'j�h�Q �O11 TIMNE: !1 @ ,1. lf�p M COMPANY NAME: SAMPLE,COLLECTED BY: 1 J17A/AJ / ,e�11 l�I/�It-by. DS J MAILING ADDRESS: ' SAMPLE LOCATION: eum O W 6s-f zet 0 G t eet J PHONE#�:`�D n � U c FAX: MAP&PARCEL# Mff_ — E-MAIL: TOWN WATER WELL WATER WELL DEPTH FINANCIALLY RESPONSIBLE PARTY: CONTACT NUMBER: BILLING ADDRESS: IF REQUIRED BY MA DEP,PLEASE PROVIDE THE FOLLOWING INFORMATION: PWS ID: PWS NAME: DEP LOCATION(LOC)ID# DEP LOCATION NAME: PWS CLASS: COM NTNC TNC SAMPLE ACEDIFIED:YES ti SAMPLE INFORMATION: (1)(M)ULTIPLE (S)INGLE (2)(R)AW (F)INISHED (3)ROUTINE SAMPLE(RS) SPECIAL SAMPLE(SS) (4)'RESAMPLED;YES NO CUSTODY TRAN FER DATE TIME Relinquished By: 3 z Received By: , -2� L&/.,0 COMMENT: ANALYSIS REQUESTED: —Lab Use Only— CHECK ANALYTE PRESERVATION „RESULT UNIT ANALYSIS ENTERED BY REVIEWED DATE &DATE BY&DATE Copper mg/L Iron ��' No mg/L Sodium mg/L ., Conductance umols/cm. Nitrate HNO3 No mg/L; PH Total Coliform THIO:Yes No VOC(524.2) HCl:Yes No ug/L Ammonia H2SO4:Yes—No— mg/L Other COMMENT: BARNSTABLE COUNTY DEPARTMENT OF HEALTH & ENVIRONMENT BARNSTABLE SUPERIOR COURTHOUSE OF BA/j�s V 3195 MAIN STREET/P.O.BOX 427 BARNSTABLE,MASSACHUSETTS 02630 sACH`15��q' PHONE: 508-375-6605 •FAX: 508-362-7103 SAMPLING INSTRUCTIONS FOR PRIVATE WELLS 1. Obtain the sampling bottle(s) from the County Lab or Town Health Department. A 100 mL sterile bottle is for bacteria analysis. If water is chlorinated or smells strong chlorine, a 100 mL sterile bottle with preservative of sodium thiosulfate must be used. 2. It is recommended to use a straight faucet preferably NOT swing-type. 3. Turn on the cold water and let it run for five(5)minutes. 4. Fill the bacteria bottle to well above the 100 mL line. This is critical to ensure that there is enough water to perform the test. Do not place the cap on any surfaces or allow anything(i.. e. faucet,hands, etc.)to touch the inside of the bottle. a. When filling the larger of the two bottles, do not fill the bottle to the very top. Be careful not to touch the inside of the bottle or cap with the faucet,your hands,or anything else. b. Sample must be kept cold after drawing the water. 5. Fill out the reverse side of this form and the labels on all bottles. The laboratory requires accurate and complete information. The lab is not held responsible for damages resulting from lack of or incorrect information given,including phones#'s. Please check off all tests being requested. 6. The charge for a routine well analysis (coliform bacteria,pH,conductivity,iron, nitrate,sodium, and copper) is $30.00. Checks should be made out to Barnstable County.Exact change is required if paying in cash. Additional tests require additional fees. Consult the lab for more information. 7. Samples are accepted Monday—Thursday from 8:00 AM to 4:00 PM. They must be delivered to the lab within 6 hours of collection or 24 hours if refrigerated. NOTES: • Samples for bacteria are not accepted on Friday. •Whirlpool,hot tub and pool samples are accepted ONLY Monday and Tuesday. 8. Completion of tests and results takes 10 business days. Results will be sent in the mail. 9. Special requests, such as results in less than 10 business days, are available for an additional charge. Contact the laboratory for pricing. NOTICE: WATER FROM THE SAME SOURCE CAN PRODUCE CONTRARY RESULTS IF TESTED AT DIFFERENT TIMES AND/OR DIFFERENT LOCATIONS. THE COUNTY OF BARNSTABLE SHALL NOT BE LIABLE FOR DAMAGES RESULTING FROM THE RELIANCE ON RESULTS OF WATER TESTS INACCURATELY PERFORMED. PLEASE COMPLETE REVERSE SIDE OF FORM S9Y. CERTIFICATE OF ANALYSIS M, Barnstable County Health Laboratory (M-MA009) Recipient:• Donna Miorandi Matrix: Water-Drinking Water West Barnstable Petroleum Study. Sampled: 03/26/2013 9:53 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 38B Plum Street,West Barnstable Order#: G1372876 Sample Location: 196-018 Description: voc Lab ID: 1372876-03 Date Analyzed: 3/26/2013 @ 10:28 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Catherine Marie Kurra,388 Plum St EPA 524,2 - Volatile Organics by GC/MS Result MCL MDL Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 lChloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND o.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachioroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Trichloroethane ` ND 200 0.50 Ethylbenzene ND Too 0.50 1,1,2,2-Tetrachioroethane ND 0.50 Hexachlorobutadiene ND 0.50 1,1,2 Trichloroethane ND 5.0 0.50 Isopropyl benzene ND o.so 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dlchloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Butylbenzene ND 0.50 1,2,3 Trichloropropane ND 0.50 n-Propylbenzene !ND o.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene 0.50 1,2,4-Trimethylbenzene ND 0.50 sec-Butylbenzene 0.5a1,2-Dlbromo-3-chloropropane ND 0.50 Styrene Lo0 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 050 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 Trimethylbenzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 1 Trichloroethene ND 5.0 11.50 1,4-Dichlorobenzene ND 5.0 0.5o richlorofluoromethane ND 0.50 2,2-Dlchloropropane ND 0.50 Surrogates % Recovered QC Limits(%) 2-Chlorotoluene ND 0.50 p-Bromofluorobenzene 100010 70 1.30 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 1010/0 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 050 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0ao Chloroethane ND 0.50 Attached please find the laboratory certified parameter list. Approved By:,(Lab Director) 3 2 ND=None Detected RL.= Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 3 of 5 FINE Town of Barnstable, Barnstable o Regulatory Services rbillsawly ' Thomas F. Geiler, Director �ed� + BMMSTA MAMBLE, : Public Health Division Q � D D- 9� se39. ArE1 3:s Thomas McKean, Director 2007 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 22, 2013 Ms. Catherine Marie Kurra 388 Plum Street West Barnstable, MA 02668 Dear Ms. Kurra: It has come to the attention of the Town of Barnstable Health Department that there may be a possible groundwater contamination in your area. At this time we request access to your house for the purposes of collecting a water sample from your private well for testing. The testing of your private water well would be without cost to you. I would like to do these tests as soon as possible. Please contact me at this office or my work cell phone (listed below) to arrange a convenient time for me to collect this sample. Thank you for your timely attention to this request. Sincerely, Donna Z. Miorandi, R.S. Health Inspector Town of Barnstable Office: 508-862-4644 or 508-862-4639 (Direct Line) Work cell: 508-294-1394 r •pF HA..' . CERTIFICATE OF ANALYSIS 4 M' Barnstable County Health Laboratory (M-MA009) '_aCHL'S- Recipient: Donna Miorandi Matrix: Water-Drinking Water^ West Barnstable Petroleum Study Sampled: 03/26/2013 9:53 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 388 Plum Street,West Barnstable Order#: G1372876 Sample Location: 196-018 Description: voc Lab ID: 1372876-03 Date Analyzed: 3/26/2013 @ 10:28 Sample#: Analyst: y yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Catherine Marie Kurra,388 Plum St EPA 524,2- Volatile Organics by GCIMS Result MCL MDL Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cls-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Trichloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Hexachlorobutadiene ND 0.50 5.0. 0.50 0.50 11 2-Trichloroethane ND Isopropyl(benzene ND P PY 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene 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-Trimethylbenzene 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-Butyl benzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Trimethylbenzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichlorobenzene I 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-Dichloropropane ND 0.50 Surrogates %Recovered °g QC Limits(/o) 2-Chlorotoluene ND 0.50 4-Chlorotoluene ND 0 40 p-Bromofluorobenzene 100% 70 130 1,2-Dichlorobenzene-d4 101% 1 70 1 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 1 0.50 Attached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Le Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: SOW75-6605 Page 3 of 5 I Health Master Detail Page'l of 1 �,�`'� s`i � - � �„•. �, i m ftdm ' � `€�. ter" Logged In As: TOWN\miorandd Health Master Detail Monday, March 18 2013 Application Center Parcel Lookup Selection Items Parcel Septic Perc Well Fuel Tank Parcel: 196-018 Location: 388 PLUM STREET, WEST BARNSTABLE Owner: KURRA, CATHERINE MARIE i Business name: Business phone:�- jRental property: G Deed restricted: ❑ Number of bedrooms Contaminant released: (- Fuel storage tank permit: r i Save Parcel Changes' IReturnyto Lookup .1 Parcel Info Parcel ID: 196-018 Developer lot: Location:388 PLUM STREET Primary frontage: 140 Secondary road: Secondary frontage: village:WEST BARNSTABLE Fire district:W BARNSTABLE Town sewer exists at this address: No Road Index: 1284 Interactive map Town zone of contribution:AP (Aquifer Protection Overlay District) State zone of contribution:OUT Owner Info Owner: KURRA, CATHERINE MARIE Co-Owner: Streets:388 PLUM ST Street2: City:WEST BARNSTABLE State:MA zip: 02668 Country: Deed date:8/5/1999 Deed reference: 12458/064 Land Info Acres: 0.51 Use: Single Fam MDL-01 zoning:RF Neighborhood: 0108 Topography:Level Road:Paved Utilities:Septic,Well Location: Construction Info Building No ear 3uil Gross Area Living Area Bedrooms Bathrooms 1 1900 1796 1170 3 Bedroom 1 Full Buildings value:$98,800.00 Extra features: $6,300.00 Land value: $205,100.00 � l http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=196018 3/18/2013 T.O.F. EL.= 47.8'± FINISH GRADE OVER D-BOX= 44.3'+ FINISH GRADE OVER CHAMBERS= 44,2' - 44.8' 0 3J4"TO 1-1/2"DOUBLE WASHED GENERAL NOTES PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2/° MIN. OVER SYSTEM STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET 8 RISER TO WITHIN 6"OF FINISHED GRADE 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS FINISH GRADE OUTLET TO WITHIN 6"OF F.G. 0 2"OF 1/8"TO 1/2"DOUBLE WASHED METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL , F.G. OVER TANK EL. = 44.6'+ 5"DIA. OUTLET(S) MIN SLOPE 1 /° BOX TO F.G. (SEE NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES. STONE OR GEOTEXTILE FILTER FABRIC 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE I PLACE RISERS ON ALL DESIGN ENGINEER. TOP OF SAS= 42.43' PROPOSED 4" 9"MIN. " CHAMBERS WITH " --EXISTING 4" " 9 MIN. 3. 4 SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEINER WIPE ft.- SCH.40 PVC 36 MAX. 41.60' 36"MAX. BREAKOUT EL= 42.10' INLET PIPES TO 6"OF SYSTEM UNLESS OTHERWISE NOTED. ___�_L_._��-�i?��" " " � SEWER PIPE _ , � FINISHED GRADE 16 3 3 DROP MAX 3 9 L 14 .+ 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN � 2"DROP MIN MIN.sLOPE01% PROVIDE WATERTIGHT o ELEVATION =42.10' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A s "PVC IN �-JOINTS(TYP.) o40 MIL �" 14" *�2 e'1 SEPTIC TANK 4"PVC OUT TO 0 Q O 0 0 0 o° O 0 o THE LINER S NOT LESS THAN THE BREAKOUT ELEVATION. ET FROM S.A.S.AND THE TOP OF CONTRACTOR TO PROVIDE O LEACHING FACILITY o0 0 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SPECIFIED DROP BETWEEN " oo 0 0 INLET AND OUTLET CONTRACTOR " CONTRACTOR SHALL OUTLET TEE 42•00� MIN. 6 41 .H3' oo ° 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48 VERIFY CONDITION OF 1 0 0 0 0 00 'o o0 I CDo 00 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE o° o o oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM 1S EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY oo °° _ o CD NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 5 1.6 6 0'(TYP) I 1 5' AND DESIGN ENGINEER. OUTLET DISTRIBUTION BOX 41.0 3.0' 4.0 8. ELEVATIONS BASED ON APPROXIMATE MEAN SEA LEVEL DATUM. BENCHMARK ELEVATION OF TO BE INSTALLED ON A LEVEL STABLE 33.0' (NP') 45.00'ESTABLISHED ON CORNER OF A CONCRETE PROPERTY BOUND AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 40.60, GROUND WATER ELEV.= 35.50' 11.0' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1,000 GALLON CONCRETE SEPTIC TANK 5 - LC-6 CHAMBERS 5'MIN. CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES SEPTIC TANK PROFILEDISTRIBUTION �+ CROSS SECTION VIEW TYPICAL CHAMBER PROFILE /� TO THE DESIGN ENGINEER. *CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR D I STR I B D T I O N BOX DETAIL CHAMBER DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT. TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS'TO OBTAIN SUCH DETERMINATION FROM B/DH-3 - -_ " .p~• � ! APPROPRIATE AUTHORITY. .. _ . PERC NO. 14520 INSPECTOR: Donna Z.)Niorandi, RS 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS ' - LOCATED UNDER PAVEMENT, '! DRIVES OR TRAVELED WAYS IN WHICH CASE EVALUATOR: Bradley B6rtolo, EIT, CSE THEY SHALL WITHSTAND H-20 LOADING. ( -4 k - �, C.S.E.APPROVAL DATE: July 2003 4 . October 17,2014 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT DUST AND FINES. DATE: O O + ° o 14. WHERE REQUIRED CONTRACTOR SHALL REMOVE ALL LOAM AND UNSUITABLE MATERIAL L p O O .. CB/DH-2 � µ ;.; _ , TEST PIT#: 1 IN AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF LEACHING FACILITY. REPLACE ALL 2) ELEV TOP= 44.50' UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,FINES OR OTHER - CB/DH-1 UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). (3 ' +c! ELEV WATER= 35.50' �p �;; *yN►�; t 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN �' PERC RATE_ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. DEPTH OF PERC 30 8 16. PROPOSED PROJECT IS LOCATED WITHIN: TEXTURAL CLASS: 1 s � M ASSESSOR'S MAP 196 PARCEL 18 2 LOCUS C6 IRA, OWNER OF RECORD: CATHERINE MARIE KURRA m 4 50 SWING-TIES SCALE: 1"=20' ��� _ : � � ' w4+ 0" 4 ADDRESS: 388 PLUM STREET l DESCRIPTION CB/DH-1 CB/DH-2 CBJDH-3 A Loamy Sand W. BARNSTABLE, MA 02668 24" 10Yr 3/2 42.50' > CORNER OF STONE(1) 55.9' 32.5' 14.5' x FEMA FLOOD ZONE X( 500 yr.) 30" 42.00' COMMUNITY PANEL# 25001CO553J 2/ \ CORNER OF STONE(2) 54.7 30.2 25.5 A y \ Pere 48" t``, 40. 17. DEED REFER ENCE: BOOK 12485, PAGE 64 / MAP 196 CORNER OF STONE(3) 21.7' 63.2' 42.0 t 50' �� Loamy Sand PARCEL 18 � MAP 196 � �, �.�a ��; ,_ B 18. PLAN REFERENCE: P.B.453, PG.94 Q 21,997 S.F.t 00 CORNER OF STONE(4) 24.6' 64.3' 36.4' 10Yr5/6 � PARCEL 17 � <-- � � ~-� �s�Q .. ? ' � , �� 60" 39.50' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. p tv p WELL 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY i rpi -FORS I YST 4/ o (ABANDONED),. _ _ ; EPT C_5_ EM UPGRADE JC ENGINEERING WILL NOT ASSUME ANY LIABILITY Q FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. - / / r C Fine Sand k. a 2.5Y 6/4 K BUSH # 21. A 4"PERFORATED SCH,40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A �9 ,,, TREELINE � S),SS ®�'' _ DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A ` Buses 7j� 7�, o cL „ Mottling @ 108" REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. WELL ���, 96• F f TO BE 1,000 GALLON SEPTIC TANK 108 7.5Yr 516 - 35.50' 22 THE FOLLOWING LOCAL VARIANCE IS REQUESTED FROM THE TOWN OF BARNSTABLE'S U.P. w -o�� 1 TO fE UTILIZED IN THIS DESIGN LOCUS PLAN CHAPTER397: WELLS REGULATIONS; SECTION 397-2: o�H, l % H,w ' "_ (I.) A 38.V VARIANCE(150.0'- 111.9')FOR THE SETBACK FROM THE PROPOSED LEACHING r_ �6 6'\� PROPOSED DISTRIBUTION BOX SCALE: 1 =1000 132" Weeping @ 132" - 33.50' SYTEM TO THE EXISTING WELL LOCATED AT 388 PLUM STREET(MAP 196, PARCEL 18). #388 DECK / �.p�� / No Standing Water Observed EXISTING OHO �/ / (2)-18"CHERRY 91, 3-BEDROOM �_ G 46 DESIGN DATA TEST PIT DATA LEGEND j O / DWELLING ( ) 1� 9 /��' \ 4 PERC NO. Q TOF=47.8'+ ao"OAK /� BUSF��) / .� ` , 5� 14520 '`� - \ / / � � � � \ 46 INSPECTOR:. Donna Z.Miorandi, IRS `EL113 / \ c,? TP 1 ` PROPOSED INSPECTION PORT EVALUATOR: Bradley Bertolo, , NUMBER OF BEDROOMS (DESIGN) 3 EIT CSE 50x0' EXISTING SPOT GRADE 196 RA p / a ` 44x5' DESIGN FLOW 110 GAUDAYBEDROOM J? ,� PARCEL I U� ____/ / / "<oC TP 2� S C.S.E.APPROVAL DATE: July 2003 _ _ _ m� / / / 44x5 Sjo TOTAL DESIGN FLOW 330 GAUDAY - 50 - EXISTING CONTOUR Benchmark ( Sr 3 Ski , DATE: October 17, 2014 Q / 99 F DESIGN FLOW x 200 % = 660 GAUDAY 50 PROPOSED CONTOUR Cnr. Concr. Bnd. 7� TEST PIT#: < 2 Elev. =45.00' p O O USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= r` 44.50' 50 PROPOSED SPOT GRADE /T qA 1 A rox. M.S.L. ; O O .. 150, ELEV WATER= 35.50' A44P /9 `O/ PERC RATE O/H/W EXISTING OVERHEAD UTILITIES / y, cF�\ Ln GRAVEL DRIVE /, / �, do , IS\ DEPTH OF PERC= TEST PIT LOCATION •• ` / 1 so"MAPLE �{ INSTALL 5 - LC-6 CHAMBERS i �. TEXTURAL CLASS: 1 ~SHRUBS �S8 46 '��\ Doti h SIDEWALL CAPACITY Q EXISTING 1,000 GALLON SEPTIC TANK --� EXISTING \ m , GARAGE \ / I se. r (LENGTH + WIDTH) (2 SIDES) (1 HIGH) (0.74 GPD/S.F.)) = GALIDAY ' L (33.0'+ 11.0')(2) ( V) (0.74 GPD/S.F.) = 65.1 GAUDAY 0" 44.50' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE WEL 1 '� PROPOSED 5-LC-6 BOTTOM CAPACITY A Loamy Sand a PROPOSED DISTRIBUTION BOX LEACHING CHAMBERS 10Yr3/2 (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY __-AB WITH AGGREGATE 24" 42.50' PROPOSED 500 GALLON LEACHING CHAMBER �8�� a w o� ho• -�'� i � (33.0'x 11.0') (0.74 GPD/S.F.) = 268.E GAUDAY a� Loamy Sand TOTALS: 10Yr 5/6 B MAP 196 5 REV. DATE BY APP'D. DESCRIPTION MAP 196 \! TOTAL NUMBER OF CHAMBERS 90 : EXISTING LEACHING PIT TO BE PARCEL 24 60" 39.50' PARCEL 19 �, �O PUMPED, FILLED WITH CLEAN (V/ACANT-NO WELL) TOTAL LEACHING AREA 451.0 SQ.FT. m PROPOSED SEPTIC SYSTEM UPGRADE �ry4' titi COARSE SAND &ABANDONED TOTAL LEACHING CAPACITY 333.7 GAL./DAY PREPARED FOR: c Fine Sand CAPEWIDE ENTERPRISES f 2.5Y 614 LOCATED AT MAP 196 NOTES: 108" Mottling @ 108" - 35.50' PARCEL 15 388 PLUM STREET 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH SEPTIC W. BARNSTABLE, MA 02668 SYSTEM COMPONENT. 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE PROPOSED 132" Weeping @ 132" - 33.50' SCALE: 1 INCH = 20 FT. DATE: OCTOBER 25,2014 LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. 0 10 20 4o ao FEET No Standing Water Observed H of Mass REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH o J� N L. N� PREPARED BY: TEST PIT DATA. RESERVED FOR BOARD OF HEALTH USE cr►u c IL TEST JC ENGINEERING, INC. IL 3.) ENTIRE PROPERTY IS LOCATED OUTSIDE THE LIMITS OF THE GROUNDWATER AND p N 807 2854 CRANBERRY HIGHWAY WELLHEAD PROTECTION OVERLAY DISTRICTS AND LIMITS OF THE ESTUARINE WATERSHEDS. Nr EAST WAREHAM, MA 02538 4.) CONTRACTOR TO BACKFILL SYSTEM SO AS TO AVOID STORMWATER RUNOFF PONDING SITE PLAN - y � / g� ` 508.273.0377 OVER THE FOOTPRINT OF THE LEACHING SYSTEM. SCALE: 1"=20' Drawn By: BSM Designed By:MCP Checked By:JLC JOB No.2898 i