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HomeMy WebLinkAbout0124 POINT HILL ROAD - Health 124 Point Hill Road West Barilstable A= 136 -- 042 � Ro�l— No. Fee Od THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplication for Misposal *pstem Construction permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System individual Components Location Address or Lot No.p �n� M/N Owner's Name,Address,and Tel.No. Assessor's Map/Parcel/� Dai/a w �U 'ts�/;�, Installer's Name,Address,and Tel.No.J2,9- esigner's Name,Address,and Tel.No;foS-�1(o;?- OffVI 1/s.i.+-ac%c5fr /�° ,J`awr) /i»e_ri ,�nc 934�"nSY- s / o� 8 ti S' Type of Building: Dwelling No.of Bedrooms Lot Size 35 AC^Q sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) J 3® gpd Design flow provided gpd Plan Date Awta 9 3, go--1 Number of sheets 1 Revision Date Title iw ��N, A 1.1t1 �t��hk 04 Rc,• Gt� nba� A4I} Size of Septic Tank�(/ l`��� Type of S.A.S 11a0,1,.,4W -10 ZX 9 d`YW Description of Soil ABT� _�o Nature of Repairs or Alterations(Answer�when applicable) ®?� �' , l _�eoQ, C�li/t/![rrr�i/4W SLI k , i17 a `L x ; ,911.kI e �i&� aan/9t'2G/ /'o pt Date last inspected: Agreement: The undersigned agrees to ensure the construction and main ance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environment and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by �^ Date 7 "�g 2r Application Disapproved by Date for the following reasons Permit No. C �' Date Issued e5 -,X- 2- r � No. Fee, : THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ..,: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Mispo8al 6pettin Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ,V Individual Components Location Address or Lot No./,,7 Owner's Name,Address,and Tel.No. y rs1 z� 1�%//�' say . Assessor's Ma /Parcel Tle<A do, Installer's Name,Address,and Tel.No.,$;>6- Designer's Name,Address,and Tel.No.foS-�p- O,$V/ (prfvlct` �rr�5 -rvctt�»,`�»c y5i..�r/cc�f r� /'t'� 1�cvr7 G' nyi.�cer?i�,?�c g3yla<'.�Sf ✓1'12/'�at!zr»� f't7�%/5 1� Da't+.w' r/1�f 4/(Al�ar�.+r _ , #` rVa�. �a:l��S" Type of Building:,; Dwelling No.of Bedrooms -3 Lot Size :75 a06 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Q gpd -esign flow provided 33— d r gp Plan Date a3, a0�u Number of sheet i Revision Date r C, Title �1 4n, 5 tom.•N , A 1 P-Ll t l,; ,1 Wet t.j• nnrt41 M i4 Size'of Septic Tank /�ittn4 ac>Q Type of S.A.S,?11*10 PCJ !?o x yF3a,�/,��k3 Description of Soil V 0 Nature of Repairs or Alterations(Answer when/applicable)'/�4". /�w x 9. '_ Date Iast 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 EnvironmentahCodZd not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by -%L- ------P Date Application Disapproved by : / Date for the following reasons Permit No. t 9l °� Date Issued THE COMMONWEALTH OF MASSACHUSETTS F BARNSTABLE,MASSACHUSETTS f Certificate of Compliance ��// THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(' ) Repaired(11 ) Upgraded( ) Abandoned )by ar 4 a/�>///,! i t`Y'u!.T•�ri'YJ . L at A?5/ 4i//41 /./1 1�rn�S�a �i/� has been constructed,in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.a 031 1 ,�d`ated 5- Installer ,g�'�1 �a{ f�SnS�rr g � ,b Z� It Me r i L,rat Designer _ .2 ,and s n #bedrooms .3 Approved design flo[v� J,��� gpd The issuance of this perm shall shall not be construed as a guarantee that the system willcf�on as designed. 2?- Z• Date �� � � Inspector /n['j/ �,J �5 .. - ----- --- -- ---- ---- ( - ----- -°- -I-- ---- ---- -- - -- -- ------ - __ --- -.,. -°-- -- - ---- ----- -- - a No. 012 + 1 /. -Fe - -� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair,(/).. Upgrade( ) Abandon System located at /dy f 111;0/ ,�$, •__ r t 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. j Provided:Construction must be completed within three years of the date of this permit. Date l Approved by ��// JUL-01-2021 02:59 From: To:15087906304 Page:1/1 A 1 Town of Barnstable t ° Inspectional Services Public Health Division I MMsr�u I i MAM Thomas McKean,Director �O14. o ° 200 Main Street,Hyannis,'KA 02601 Office: 508-862.4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Sewage Permit# Z1091 .14� Assessor's Map\Parcci 3 42— Designer: E-n . Installer: 6 lane- Address: 9M Puyk QA Address: cur mo 4�_�?�Iv75ftm61, 106, 'MA On •��S'a LAU"la.U. was issued a permit to install a (date) (installer) septic system at 1240 i I I gd, w, BQV ( based on a design drawn by (address) ress) PE dated 04-23-2021 . (designe I certify that the septic system referenced above was•installed substantially according to the design, which'I ay Include'minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (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. Strip out(if required)was inspected and the soils were found satisfactory. I certify t syste referenced above was constructed in fiance with the to rms of th approval ers(if applicable) ia�F L�," DANIELA. �� OJALA ti CIVIL H (Installer's Signature) , No.46602 /DNAL E�G� -Designer's Signature) Affix Designer's Stamp Here PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FO AND AS- BUILT CA ARE CEIVED BY THE BAUSTABLE PUBLIC HEALTH DIVISION. THANK YOU. \1l9aWepls\HEALTh\$EWER cennealSEPTICOosigncr Cenl0cation Form Rev&14-13.DOC TOWN OF BARNSTABLE LOCATION f— � _�-I LL Zf\ SEWAGE#� �Q�11.- 1�/ VILLAGE t�.�3 �I.�,',47f A�ESSOR'S MAP&PARCEL t��•Qe�_9_.., INSTALLER'S NAME&PHONE NO. C. �- 'SO `"f"'(I • �3�6j SEPTIC TANK CAPACITY izXiZ;ol LEACHING FACILITY:(type) ��*2etl to i.� (size) _56�x Of_-4-f' NO.OF BEDROOMS �-•5 00 4.,kl— OWNER � 1 PERMIT DATE: COMPLIANCE DATE: a Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -1-46.457 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) I Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _ M Feet FURNISHED BY t2aHZ o I cam,f cz IG � 3 3 � S�- `� S�f 576" r A t CERTIFICATE OF ANALYSIS Page: I � MI Barnstable County Walth Laboratory \ss �Hycv Report Prepared For: Report Dated: 8/20/2009 Sally Desmond Desmond Well Drilling " Order No.: G0954210 P O Box 2783 Orleans, MA 02653 Laboratory ID#: 0954210-01 Description: Water-Drinking Water j Sample#: Sampling Location 124 Point Hill Rd.West Barnstable,MA Collected: 8/18/2009 i Collected by: Customer Received: 8/18/2009 j i Routine i ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 8/18/2009 Copper ND Nn m.aL 0.10 1.3 SM 311113 S/20/2009 Iron 1.8 mg/L 0.10 0.3 SM 31 l 1 B 8/20/2009 i Sodium 9.7 mg/L 1.0 20 SM 311113 8/20/2009 Total Coliform Present P/A 0 0 SM9223 8/18/2009 Conductance 120 umohs/cm 2.0 EPA 120.1 8/18/2009 p14 7.5 pH-units 0 SM 4500 H-B 8/18/2009 I Recommended maximum contamination level exceeded due to Coliform Bacteria. Retesting is recommended May present i aesthetic problems(taste,odor,staining)due to Iron. iLf \ I Attached please find the laboratory certified parameter list. Approved By: 7 __ (Lab ]rector) l ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 ---------------- D Fee-- --- -- --------- BOARD OF HEALTH TOWN OF BARNSTABLE N' Application-*rlDpll Com5tructionj3prmit Application is hereby made for a permit to Construct (41�,-�Alter or Repair ( )an individual Well at: Location - Address Assessors Map and Parcel Owner Address Installer Driller Address Type of Buil well -----—-----——---------------------------------------------- Other - Type of Building------------—---------------- No. of Persons--—--------------------- Type of Well Capacity--Z�± ------------------------------- Purpose of Well Agreement: The undersigned agrees to install the aforidescribed individual well in accordance with the provisions of The Town of Barnstable Board of H Ith Private Well Protection Regulation — The undersigned further agrees not to place the well in operation un I Certificate . Compliance has been issued by the Board of Health. Signed date Application Approved By date Application Disapproved for the following reasons: ------------- Issued ------------- —---------- Permit No. 7 --14;---------------------date - - --- --------- ------- -- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS-J,S TO CERTIFY, That the Individual Well Constructed (c,<'Altered or Repaired by-- <v -----------------------------—----------------- Installer 0 L-j z5g-1— —----------------------- t at------------- H-2�------—---------------------------Rw has been installed in accordance with the provisions of the Town of Barnstable Boardipf alth pri ate Well Protection Regulation as described in the application for Well Construction Permit NoWk$��-/-- ated---------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------- —---------—------------ Inspector—--------------------------------------------—---------------—--------- --------- - FeeNo.A -- BOARD OF HEALTH TO N OF BARNSTABLE 0[pplicat pArVrlk'CongtructionPermit . Application is hereby made,for a permit to Construct(4_ Alter ( ), or Repair ( )an individual Well at: N Location — Address Assessors Mapand Parcel Owner ' Address --- - ---------------- - '� Installer — Driller Address Type of Buil " '�. v Other - Type of Building No. of Persons------------------- S j Capacity- U ----Type of Well- - --- �`-- - ---- --- 1 t= Purpose of Well 1411u6-w #/T G y {mi 1, -R r A/r(C,:_-:> i ,tA Agreement: + The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of alth Private Well Protection Regulation - The undersigned further agrees not to place the well in operatio*ed cate . Compliance has been issued by the Board of Health. S f Sign dateApplication Approved By date Application Disapproved-for the following reasons:-- .,. -- ---------------------------------- ' � date . DD / ------ Issued -- �_ Permit No. - ---------- ' � �r7 � ate ` s------------------------------------------------------------------------------- ---------------------- iw BOARD OF HEALTH T6WN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (Altered ( a), or Repaired'( ) by_ � ' d ------� aXd-/LW/-<�D --------------------------------`------------------------------------------ Installer at- -1 --(--�OIQI / L_ Old -- � ��-------------------------- has been installed in accordance with the provisions of the Town of Barnstable Boar of Health Er vate Well Protection Regulation as described in the application for Well Construction Permit Now ---V-/---,/D'ated------------------------ 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 Cootruct ion Permit No.w --. - --- 7C Fee------1---------- Permission is hereby granted tw L.t '�'�I L _2(1.u----- ---------------------------------- - to Construct ter ( ), or Repair ( ) an Individual Well at: Street as shown oln�he p• i lion E a W 1 Construction Permit I /� � I - ------------------------- No. - 1 , ��./ ', - - — j---- --------- - Dated - A r ------ ----------- i �. i ------------ ------ -—� N ----------------------------_----- Sk f Y- Bo�d of Health DA 1T E r ,(/ LLL -- -- — -- i LA Fv ------------ r pL • i / r z E ,y Y , \ t 4 . i it . � 1. 1 f do r Massachusetts Department of Conservation and Recreation Massachusetts Office of Water Resources Well Completion Report 02-SEP-09 10:15:55 WELL LOCATION 263910 GPS North: 410 43.847' GPS West: -700 23.329' Address: 124, Point Hill Road Property Owner/Client: Jeanne Edwards Subdivision Name: Mailing Address: 124 Point Hill Rd City/Town: Barnstable City/Town, State:W Barnstable MA Assessors Map: Assessors Lot #: Permit Number:W2009-017 Board of Health permit obtained: Y Date Issued: 08/12/2009 Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Domestic Auger CASING From (ft) To (ft) Type Thickness Diameter 1.00 -76.00 PVC Schedule 40 4.00 SCREEN From (ft) To (ft) Type Slot Size Diameter -76.00 -80.00 Stainless Steel Well .012 4.00 Point WELL SEAL / FILTER PACK / ABANDONMENT MATERIAL From (ft) To (ft) Material Description Purpose WELL TEST DATA (ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) Date Method Yield Time Pumped Pumping Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) 08/19/2009 Constant Rate Pump 15.0000 1:30 22.0000 0:01 15 STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAILABLE) Date Depth Below Ground p,tr:r Description:Goulds 10GS10,122 Measured Surface (ft) Type: 2 Wire Constant Speed Submersible Intake Depth: 76.0000 08/19/2009 15 Nominal Pump Capacity: 10.0000 Horsepower: 1.0000 WELL DRILLER'S STATEMENT ADDITIONAL WELL INFORMATION Driller: Thomas E Desmond III Developed: Yes Fracture Enhancement:No Supervisor: Thomas Desmond III Rig #: 100 Disinfected: Yes Well Seal. Type:None Firm: Desmond Well Drilling Inc. Total Well Depth: 80.000 Depth to Bedrock: Registration #: 764 Date Complete:08/19/2009 Comments: OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 60.00 Fine to Coarse Sand Brown Yes N/A 60.00 70.00 Cobbles Light Gray Yes N/A 70.00 80.00 Fine to Coarse Sand Brown Yes N/A BEDROCK From To Code Comment Water Drill Extra Drill Rust Loss/ # of (ft) (ft) Zone Stem Large Rate Stain Add of Frac Drop per ft 1/1 i . '.: 5'' - "stet_„,- f ✓ ',m j l'z'. 2 F yfL'. engineering inc. civil engineers & land surveyors December 22 , 1986 Watt Brothers Construction P.O. Box 130 Forestdale, Ma. 02563 Re: Lot 27 Point Hill Road Barnstable, Ma. Dear Mr. Watt : On September 3 , 1986 , we made an on site inspection of Lot 27 Point Hill Road in Barnstable, Massachusetts . At that time we witnessed an additional test hole at the location of the proposed leaching pit . While the location of the pit was per design plan, the soils encoutered at the plan elevations were not as suitable as found during the original percolation tests. Having found clean, medium sand at 16 ' to 25 ' we amended the elevation of the pit to be in the sand strata. We later verified the elevations of the pit and found them to be per the amended elevations . If you have any questions for need further information, please contact our office. Very truly yours , ARROW ENGINEERING INC. o ert E. aymon �/esident 10 cape drive, suite B, mashpee, ma 02649 (617) 540-0354 • (617) 477-2120 l tIDr / TOWN OF BARNSTABLE LOCATION La""T - 6y�ribl (C� . SEWAGE # VILLAGE t�j �_ ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. (SEPTIC TANK CAPACITY tJ LEACHING FACILITY:(type) (size) c, 1`NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER 10BUILDER OR OWNER DATE PERMIT ISSUED: DATE . COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No Sewer Permit No. Vame Location Installer's Name and Address F�f42 r Builder's Name and Address Date Permit Issued: Date Compliance Issued: V J 91 n S' J 1 i f 0 1. fit/-Zap r p,Wl(,JC lLJ cA ............THE COMMONWEALTH OF MASSACHUSETTS �--� BOAR® F HEALTH .. .�y1...............OF......... :> ............... App irFation for DiipnsFai Works TnnWnrtion Prrafit Application is hereby made for a�Permit to Construct ( or Repair ( ) an Individual Sewage Disposal ....................... .........�- --_-----•--------......•--...........----- 1 - on-Address or Lot No. ---------------------•---- 0 p�60)&Gr 1 yet) !Owner Address rC1(M v 1 6/ " ......�I,J A W.`_S...E xC AMIA.T.! �!?� 14 S_�#_A E.................... Installer Address d Type of Building Size Lot___35 nQA3,. feet U Dwelling-No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtu d r s .._..._.. W Design Flow.....___.___�. gallons per person per day. Total daily, flow...........3.36_..................gallons. WSeptic Tank—Liquid capacityIS'40_gallons Length__LO�_ �5__.`�__ Width._ ___. Diameter________________ Depth__S-�.-7 x Disposal Trench—No..................... Width........7._.1_____ Total Length..__.__t___. area............................. Diameter........ Total leaching area7-��4 Z Other Distribution box � Dosing tank ) '-' Percolation Test Results Performed Date._:3 .`,2/��_. a Test Pit No. 1... �____minutes per inch Depth of Test Pit..... ... ____ Depth to ground water__ .___a..... Test Pit No: 2...____ minutes per inch Depth of Test Pit.....,13........ Depth to ground water_._1V.V4?-____ O - --- --------•------- ---•----y _.....____�___--•_• -•----•-•-- x Description of So -9- . f ...----,�..�.. .. � ___BUST.SUP 1 --- � ----- A--------------------------------- J-- ---------T - W --------------------------------------- IN TAhhATI_CN•AND CERTIFI( �tFfi �'r W U Nature of Repairs or Alterations—Answer when applicable -Hp__RY�iTEM.WAS INSTALLS �'.'" ----.......-.......................................... TO-PLAN. Agreement: ` The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with t` the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in _ c•\, P Signed..__.__ _ he boa oth operation until C �i}cate of Compliance has been issued by the � ,��f heal -•--•-._..-•-----.....__ ���_1.�.Cf....._..._ A lication Approved B .,.___.....`�...... . Application Disapproved for the following reasons_.............................:.............................................._.................................... _ ----------------------------••---•----•--.---.--......------•------------------------...-----------------•--•-•----•-•----------•---•--•••-•--•------•-•••••-••-----------------•---••--••--•---•••-_--- Date Permit No.__7 ...__...���? �-� __..__. Issued...........................•---•----._..._.......__._... Date Fim..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARDIL ...- F HEALTH .. - W. . ..... ". ..57 5 ............... Appliration for Bispoiittl Workii Tomitrnr#inn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at* .............. _ ' _► :.... olu ......�Zo.......... � ...........................................................'on-Address or Lot N A.t,1Z j...............•-•-•--••-- �a3 �l� � 5...���..`.51.�., _ �� ........ -_ ----- ••- ....... O _ - -- Owner Address 7 5 e ��^'�' W Installer Address .,. UType of Building Size Lot..... _.2.-9---_-_--.--'9q. feet Dwelling—No. of Bedrooms.............. .........................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type T e of Building No. of persons............................ Showers � YP g -•-------------------------- P ( ) •— Cafeteria ( ) < Other fixtu�„gs .............................................................. •--•••-••--•---•---•-•-------------------•-- wDesign Flow...............,j ............... gallons per person per day. Total daily flow............ _._.___..._....__glons. WSeptic Tank—Liquid capacity./__._.0 gallons Length...!(.__... Width....._.:a_... Diameter................ Depth-_3_-.'. x Disposal Trench—No_____________________ Width..-_._-_____�._._ Total Length......... Total leaching area............ ft. Seepage Pit No........ .......... Diameter__..._..�. _� Depth below inlet_..::........... Total leaching area_ _ l.__..s z Other Distribution box Dosing tank ) a Percolation Test Results Performed by-_ ... __. /!!�_� ______..._ _ Date..._ Test Pit No. I...A._._....minutes per inch Depth of Test Pit------ Z......... Depth to ground water.....t _. 44 Test Pit No. 2....!�:"iinutes per inch Depth of Test Pit......1.3....... Depth to ground water.... ------Ui. --- ............................ .......••---•.•••-- O P ' �..._ 9... x Desj rlption of�SoI - .. + - y.- � --- -: ..._�'�rt1 Sit.�.!? sa'...� Q _n...../9.... � ............. .. . ----- - .., �.... 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ti i, J Signed...................................................................................... ............-.-.--.............. Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................-.................................................................................................................................................. .....- te Permit No.......r.= ..*........���C':?--.�"'�---•`-1..... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS ,C,_--------sue'" BOARD OF HEALTH .......... ..OF.......... ........................................................................ %rrfifirttt of ToutpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) .......................................... ... ........................................................ Installer -------� -- i !^!r -N 1 L =2!Q------------W_...Iv-A F•N S7 A 3 ----------------•. has been installed in accordance with the provisions of TITLE- 5 of The State Sanitary as gcred in the application for Disposal Works Construction Permit No... __. _. dated_ ..ib................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION ATISFACTORY. t �_ DATE--••-•••..........j2�z3 f ................................ Inspector..••.�1......---------.......------------............-------------•-••---......--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . JN.............0F............. ............... No. FEE . .... Disposal Workii Tannitrndion rrntit Permission is hereby granted. �?.� .. - N�^.•l"- ) ............... ..... to Construct ( "�_or Repair ( ) an Individual Sewage Disposal System k Y at No.-- .9= 2.....'=G•I/uT ...tr-��..C.-..!?') w r= A )e o S 7 f43l. I •-• .....-•-- •.................. /......-•--------•--•---------•--- ...... Street -(� � —7 as shown on the application for Disposal Works Construction Permit;,No:-_----•______________.Dated....._..... ___.... ..................... C - Z -----•------------------•--.--•-.:- ..--. --..� Board of Health DATE -------••-••--••-•-•---•........._ FORM 1255 HO'BB a WARREN. INC.,. PUBLISHERS Department of Environmental Management/Divisidn of Water Resources WATER WELL COMPLETION REPORT ,.,��r�� WELL LOCATION. /V Addre."Ai/'� ��� �4�l Ctrs //y / City/Town U6. at 1400,,,Z 1'�Cl+'W I—lflal_z, G.S.Quadrangle Map Grid Location,A Owner Luelp- " 1(i�C�fj Address nAn S�7 fl,/UVELL USE CONSOLIDATED WELL Domestic Q Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zonei' Method Drilled�lt/ `" 1) From ��� To 2) From To Date Drilled �• 3) From Tc r — 4) From To CASING ! " Depth to Bedrock Length Diameter ` Type vv L UNCONSOLIDATED WELL STATIC WATER LEVE�rL-,�' Water-bearing'Materials Feet below land surface i /r"" Sand: fine❑ medium❑ coarse❑ Date measured ��-� � VIA Gravel: fine❑ medium❑ ❑ coarse � GRAVEL PACK WELL Screen:` 4� / Slot#f4 length / fromle tobVd Yes El No Q �/ Split Screen (or 2nd screen) from to# length WATER QUALITY TESTS MADE Slot ,tj Chemical ❑ Biological 0 Depth To Bedrock 7y/�J art ,, PUMP TEST �p / Drawdown th%#-%feet after,pumping days 7 hours at ! 4 GPM. How measured ���yIA Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 PO o Cb m DRILLER /� y F i rm]t Wa-..jp �` 'YJ7i. *✓r//Jiiv 'to u Address /JV4,5,,mva 77 V1 \ cityk#y-W;E17'fVe_' _ IWA Registration No. 47f r24 t'J k� / �!i'lv \/ Operator's Signature Please print firmly BOARD OF HEALTH COPY 15M.2 84-175471 J ICI �i I ALL SYSTEM COMPONENTS SHALL BE VEPNT W/ CHARCOAL FILTER NOTE) LEGEND SYSTEM PROFILE MARKED WITH MAGNETIC TAPE OR 99_ SYSTEM. DESIGN: COMPARABLE MEANS FOR FUTURE LOCATION. (NOT TO SCALE). 1. DATUM IS .NAND 88 Cape C v d EXISTING CONTOUR ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE X ss.� TOP FOUND. EL. a1s5 2. MUNICIPAL WATER IS EXISTING B R y EXIST. SPOT ELEV. \ GARBAGE DISPOSER IS NOT ALLOWED 27.0' 3. MINIMUM PIPE PITCH To BE 1 " MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 25.0-28.0 /8 PER FOOT. -[99]- PROPOSED CONTOUR DESIGN FLOW: 3 BEDROOMS @ 110 GPD = 330 GPD `. PRECAST H-10 WATERTEST D'BOX FOR LEVELNESS BLOCKS OR MIN. 2" WALL THICKNESS 4: DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS RISERS (TYP.) PRECAST RISERS TO BE AASHO H-2Q (LEACHING) [98.41 PROPOSED SPOT EL. 4"0SCH40 PVC MORTAR ALL ) USE A 330 GPD DESIGN FLOW 2 .78 _n PIPES LEVEL 1ST 2' COMPONENTS H-10 TH1 TEST HOLE _ EXISTING 1000 GAL �ENDS (T'P.) 7' HS116 5. PIPE JOINTS TO BE MADE WATERTIGHT.ES 23.0 SEPTIC TANK: 330 GPD (2) 660 10" SEPTIC TANK** 14" '° °$`° 0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH >� a ° ° ° ° ., TEE TEE ,* :. ° ° ° ° ®®®® ®®®® oo°oforMPE71 ® -®m®® O c \ 2% SLOPE OF GROUND **RE-USE EXISTING 1000 GAL. SEPTIC TANK y° \24.4,5± ° o 0 0 0 0 6" MIN. SUMP ° ° ° ° ° ®®®® ° ° ° 310 CMR 15.000 (TITLE 5.) o �o 000000,00000 ° ° ° ° ®®®®®®®®®®® °° ° ° ®®®® ° ° °1_o 0 0 0 0_ 12' MIPi. INT. DIM. o 0 0 0 0 0 0 O O O O O ° ° ° ° °° ° ° °°°°°°°°° ���0®®®�®®® oo°g°o ®®®® °o°o° OT TOGAS BAFFLE N ,o °o°o° ®®®®®®®®®®® °°o°o° ®®®®®®®® ,°o 7."THIS PLAN IS FOR PROPOSED WORK ONLY AND N UTILITY POLE ' 22.54' 22.37' ' ° ° ° ° 0 LEACHING: ° ° ° ° °O ° ° ° 20 17' BE .USED FOR LOT LINE STAKING OR ANY OTHER �.. °°°°°°°° oo°°°° °°°°°°°° PURPOSE. FIRE HYDRANT SIDES: 2 (30 + 9.83) 2 (.74) = 118 GPD •-- R :* OSE. o d � NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 8. PIPE FOR SEPTIC SYSTEM To SCH. 40-4" PVC. µ BOTTOM 30 x 9.83 (.74) = 218 GPD z 6" CRUSHED STONE OR MECHANICAL 3/4"-1-1/2" DOUBLE WASHED STONE (2) UNITS REQUIRED oGfP of o HoYwoy TOTAL: 454 S.F. 336 GPD COMPACTION. (15.221 [21) 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED t III OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30' X 9.83' WITHOUT INSPECTION BY BOARD OF HEALTH AND °o ( % SLOPE) ( 2 % SLOPE) tIR o PERMISSION OBTAINED FROM BOARD OF HEALTH. Locus 5 THE INSTALLER SHALL VERIFY THE USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) LOCATIONS OF ALL UTILITIES AND ALL WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5' FOUNDATION- EXIST. SEPTIC TANK 38' D' BOX 12' LEACHING DI CONTRACTOR SHALL 3 RESPONSIBLE FOR CALLING FACILITY DIGSAFE (1-888-344-7233) AND VERIFYING THE BUILDING SEWER OUTLETS AND BETWEEN UNITS LOCATION OF;ALL UNDERGROUND & OVERHEAD UTILITIES LOCUS MAP ELEVATIONS PRIOR TO INSTALLING ANY 13.5' BOTTOM TH-2 PRIOR TO COMMENCEMENT OF WORK. PORTION OF SEPTIC SYSTEM No GROUNDWATER FOUIND SCALE 1"=2000't � **INSTALLER -SHALL CONFIRM MINIMUM 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE *THE INSTALLER SHALL VERIFY THE SEPTIC TANK `SIZE AT 1000 GALLONS REMOVED BENEATH AND 5' AROUND THE PROPOSED � LOCATIONS OF ALL UTILITIES AND ALLRE-USE. LEACHING FACILITY. ASSESSORS MAP 136 PARCEL 042 __. _ BUILDING SEWER OUTLETS AND REPLACE WITH 81500 GALLON SEPTIC-; 12. EXISTING 'LEACHING FACILITY SHALL BE PUMPED AND LOCUS IS WITHIN FEMA FLOOD ZONE X ELEVATIONS PRIOR TO INSTALLING ANY TANK APPROPRIATE TO SITE REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. (AREA OF MINIMAL FLOOD HAZARD) AS PORTION OF SEPTIC SYSTEM CONDITIONS IF NOT SUITABLE SHOWN ON COMMUNITY PANEL #25001 CO532J f DATED 7/16/2014 TEST HOLE LOGS � VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY CRAIG J. FERRARI SE 13871 O ° BE IMMEDIATELY GIRANTED BY THE BOARD OF ENGINEER. # HEALTH AGENT OR BY HEALTH INSPECTOR PAPERWORK AND HEARING REDUCTION PROPOSALS WITNESS: DON DESMARAIS L O 0��wE<< - _ _ _ _ _ - _ APPROVED BY THE BOARD OF HEALTH REVISED 4 20 21 DURING A PUBLIC HEARING HELD ON DEC. 10, 2013 DATE: / / 87'36 "E 2) SYSTEM COMPONENT INSTALLATIONS PROPOSED PERC. RATE _ < 2 MIN/INCH MORE THAN THREE: FEET BELOW GRADE WITH I 21 -98 PROPER VENTING (;PIPED TO ATMOSPHERE) AND CLASS SOILS P# 3 WITH H-20 LOADING, BUT IN NO CASE SHALL ° 9 THE SAS BE LOCA'TED MORE THAN SIX FEET 1 ELEV. 2 ELEV. BELOW GRADE.O Q» 4 25.0 Q„ � 24.5 o o • �` 3) FAILED SYSTEMS ONLY, SAS TO PRIVATE I WELL SEPARATION DISTANCE VARIANCES, IF LOCATED IN THE S>AME GENERAL LOCATION AS FILL FILL PROP. NT WITH HARC / THE OLD SAS AND MORE THAN 100 FEET FIL ER A D » BUGSCR FINAL LACE NT B' 'CO TRA TOR SEPARATION IS PROPOSED BOTH FROM ON-SITE 18 12 o WELL AND ANY ANID .ALL WELLS ON ADJACENT a WITH, 0 ER C NSUI] A N) A A AND NEIGHBORING PARCELS. o BLS / /LS „ 1OYR 3/1 / ,10YR 3 1 24 23.0' 18" 23.0 6 _ 0 SA EE UNSUITABLEB SOIL ' \ A „ 1 OYR 6/2 1!OYR 6/2 , " (J,r' 30 22.5 24 22.5 m / �� C, G 0 28 .E \ P w 1O.YR 5/3 /3 0 60 20.0' 66" 10.YR 5 19.0 o rn \ o i( N CV C2 C2 NT PERC ° \ MS MS `o ��F<< \ 2.5Y 7/4 2.5Y 7/4 N / \ ENC ARK r COR ST STEP 9. 132" 14.0 132" 13.5' DECK T NO GROUNDWATER ENCOUNTERED f h a WELL � \�PATIQ cry 5' Q 0 A INS TA TER IL I * LEA ACILI D SUI BIL I EXIS�fI\NG DWELLING / \ Zti pLS 1L LA C AN M TOF =\29.0' SA T MEET DE C ATi 0 10 \ / � Q C 1 55 TITLE 20- 2� � I 0 F c` �o �\ \ STONE RPTAINING I LOT 27 2 WALL 124 POINT HILLROO. 35,200f S.F. LL 24 \ a i9� 21 WEST BARNSTABLE MA 23 9 \ I , PREPARED FOR 22 2 i 19 3 \ o BORTOLOT I CONSTRUCTION -z20 + , D 19 \ c: NOFM,4SS�y1 \ "\� �a DANIEL. �s DATE. APRIL. 23, 2021 9 7.5 ®ANIELfa 538. R_gO T36' 0"W o �� CCIVI\. ��1 o ALA 0 - >aF Scale: 1"= 20' No.40980 L7 Q o Sr ��qj .. D 11jT o tv s�11� D O �'� D,�ikIT�L��rr� ",g��� A � �s�� 0 10 20 30 40 50 FEETJJo pro C�JAL An Evil- n 0 J I A " A Y `�� NO 46502 i � `" off 508-362-4541 o i`J <I: �cs© T G srER'� °FEss fax 508-362-9880 � vA..�ONAL E, /fDg V�. downca e.com WELL uR_.� ( P d0W4 cope engineering, inc. • ° a � � _ `,� Z� _�-- _.� � '---. ers land surcivil veyors / y 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 DICE #2 >-096 21-096 BORTOLOTTI-BURGOYNE.DWG f --- I I , �, . .I. :_vl��, I , -.1", .' I �� I � I i . ". � � � ,.� � ,- ".-I '. ,- . I . . I , -. . I� - I I ,� . - _____7 � -- '..�'��­ 1 -7� -------- I-. -�---f=-----T-----,---------------------,,.,,,,, :� I " , .1, , , �.' , - , . � 1. 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