HomeMy WebLinkAbout1135 SERVICE ROAD - Health Y
1135 Service Road, W. Barnstable_
A=152, 33
rW6Fs STABLE IOOR7
Se 97 PY 6/
LCCATION SEWAGE #
e
r �
VIUAGE ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY t 1 e d 2
LEACHING FACILITY: (type) �/� 5�� (size) /BX y6
NO.OF BEDROOMS
BUILDER OR OWNER /C a� ;"u � - rc ,
PERMTTDATE: COMPLIANCE DATE: Q Zd
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility)
" " Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) d Feet
Furnished by N�G- '3 Z4 -�
r
y ,
�v
No.
Fee
_
�Af 9-7'2`-f THE COMMONWEALTH OF MASSACHUSETTS. Entered in computer:
Yes
c� t� PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zipplication for ;Diooal *patent Cow5tructivn Permit
Application for a Permit to Construct)()Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Add of Lot No. ,f ��,3C �� -owner's
Name, dress pRd Tel.NNoo� , /
sivVirt G�f;/�• /�,�, �. /FT I v ?�
Assessor's Map/Parcel /,� G�Lce 3 3
Installer's Name,Address,and Tel.No. / `� Designer's Name,Address and Tel.No. �-aJ
I /:;� r L4:,
-Cj Zr
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 `} yS gallons per day. Calculated daily flow gallons.
Plan Date / e' 1_4 Number of sheets Revision Date
Title
Size of Septic Tank 0Z O U n Type of S.A.S. Co/a-
Pol
i
Description of Soil
oe�5;!Z'I
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 issued by this Board of lth.
Signed Date 7X/"
Application Approved by Date P 7
Application Disapproved for the llowing reasons
Permit No. 3 Date Issued — —�
.... .-,r w:_ 'T•---•.._ r r,• .v � ,� .r"r ' . J v 6 .+�}.t !� it
Fee No:
.. #` � ` � �+ '• I �
�(iJ 97 �—`q = THE COMMONWEALTH OF MASSACHUSETTS,
Enteredin computer:
,t Yes
g PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MAS�SACHUSETTS
ZIpprication for �Oigonl *p.5tem Con$trUCtiot ,vermit•
Application for a Permit to,Construct e Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Addres or'Lot No. LOT s/•f' <<,k ��/,? Owner's Name,AA dress�'d Tel.N`o.
Assessor's Map/Parcel c/f -j
Installer's Name,Address,/and Tel.No. / [[�, , Designer's Name,Address and Tel.No.
/,Lr Z r / c
Type of Building: `
Dwelling . No.of Bedrooms Lot Sizesq.ft. Garbage Grinder( )
Other Type of Building s rr No. of Persons .5!!!� Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons perday. Calculated daily flow gallons.
Plan Date gg�44 cat ej fj, : Number of sheets Z Revision Date
Title i' r+
Size of Septic Tank / 57—G �c�� Type of S.A.S. _ c� f
Description of Soil
i 7 !-�
Nature of Repairs or Alterations(Answer when applicable)
E
Date last inspected:
dI �'
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 issued by this Board of Atli
Signed Date
Application Approved by § Date
Application Disapproved for the lowing easons
- - - _
Permit No. Date Date Issued 7 — e9-- / 7.
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that t e On-site Sewage is sal System Constructed( )Repaired ( )Upgraded ( )
Abandoned( )by �--:-
at , 4j46has been constructed in accordance
with the provisions of Title 5 and the fob Dispo} 1 Sys Construction Permit No. dated
Installer�ri i l t/� (' fC Designer —��
The issuance o his permit shall not be construed as a guarantee that the system�will functtbn as designed.
Date /Inspector *
-------------------------------- -
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
DiooaY $tens Congtruction 3permit
Permission is hereby granted to Construct(n Repair( )Upgrade( )Abandon
System located at t1cs
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.
Provided:Construction must be completed within three years of the date of this permit.
Date: �U Approved by
No.--°"-------------- Fee--------------
�. . BOARD OF HEALTH-'
TOWN OF BARNSTABLE
Zpplication-*rVell CongtrurtionPermit
Application is hereby made for a permit t on truct ( Alter ( ), or Repair ( )a individ 1 Well at:
Location — Address Assessors Map and Parcel
Owner Addres
- ------- f -z-�l-r�cr / ------------ _-
----- _
---------------------
Installer Driller Address
Type of Building
Dwelling------—---------------------------------------------------
Other - Type of Building---l�------------------------- No. of Persons-------------------------------------------------
Type of Well- ---- -- - ----------------- Capacity -------------— ----
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 P otection Regulation - The undersigned further agrees not to
place the well in operation until a Certificate .o om ce h been issued by the Board of Health.
Signed - - - — - - ---------------
.� � 6--.i-t?_ F-7
Application Approved B,y- - -- -- - --- -
�� date
Application Disapproved for the following reasons:------—----------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------
date
Permit No. - 27-- 02�— — ------ Issued ---- --- ` 9 7 --..............
-------------------------------------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
C ertif irate (Of Compliance
THIS IS TO CE , That the Indiv' 1 Well Construct d�( � ), Altered ( ), or Repaired ( )
bY--------- � --- ---------------------------------------------------
----
---------------
7 Insta at --------------- r_------
"--
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.01'W_012y-Dated---h- g-2
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-------- _—_---—-- ---- -- Inspector-------------------------------------------—- - --- -
� �, d f v , ..' � 'nt.--a .., r „y, •;�"'"�"°4'f""`'i, '4,".-^^� ��•a.r-+�1'+!+t-+••-,r►'tr�%"f+'il'�a'
Fee-----------------------
BOARD;OK HEALFr�
r `N
TOWN. OF `sBi 'NSTABLE
4 } F f¢
u ��� � �ppluation �or�eCr, �ot��tru�tion�ernit
Ap ica 'on is hereby made for a permit t�.`on truct ( Alter ( ), or Repair ( )a individ 1 Well at:`
Location — Address Assessors Map and Parcel
Addre
Installer — Driller Address
Type of Building '
a.
Dwelling----------------------------------------------- '
Other !, Type of Building ------ No. of Persons---------------------------------------------------
Type of Well--------------------° - ---------------- N,. Ca-p' aci - - - - - - - -----
Purposeof Well--------------------; =----------------------------------------- t
ti
Agreement:
The undersigned agree to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Boardlof HealePrivateotection Regulation - The undersigned further agrees not to
place the well in operation until a '. ce h been issued by the Board of Health%"Slgne -- ------------------------ , -----------
i
Application Approved By —` `-- - — ____-- _
date --_._.._-----
Application Disapproved for, the following reasons:----------- - ---- -==-
-- —-- -------- -------------
----------------
------
----
------------------------
-- - - - -----------------------
Permit No. ---- r,E -----
1 date
- --------------------------- Issued---------------------------------------------------------------------
date
serer asrrs+esss gW=any4rcmePCZ=___—t.NUMIGN c +aersir+
1
BOARD OF HEALTH
TOWN OF BARNSTABLE
' Certificate Of Compliance.
1 ,
r
THIS IS TO CE , That the Indiyklgl Well Construct d'(r) AItered ( ), or Repaired ( )
bY-------- -- - - w--_-'- ------ - ---------------------------------- - ------- --
` Installer
__--------------------K-_7-----------
r
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.L4/-9Z_�Z (Dated__h Z2__-2�
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
F Vell Congtruct ion Permit
7-
No. �,,,,,.,_.,
--�-------- Fee-------
Permissio is reby granted--- -------- �T-------- ----------
------------------------------
to Construct Alter an), or Repair ( ) div'dual Well at:
No. - - - - /'v_r- ' -- =- ---------- ---------------
Street
as shown on the application for a Well Construction Permit
No• ---------------- - — - Dated -— - -
---------------— -
i ------- //¢^
Board of Health
DATE j
f
h
TOWN OF BARNSTABLE
� �1 � P 1 �
LOCATION 4� �'�, � .�- SEWAGE #
VILLAGE /_ f-c- S.� �Ct /'Y� ASSESSOR'S MAP & LOT Z f <
INSTALLER'S NAME&PHONE NO. -
SEPTIC TANK CAPACITY w y 0
LEACHING FACILITY: (type) ������C �) (size)
NO.OF BEDROOMS
BUILDER OR OWNE C d ,
PERMTTDATE: _COMPLIANCE DATE: Ed
Separation Distance Between the: /V,,
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of le hing facility)� / Feet
Furnished by / r t-�•3 72 d, �w
_
Al
-
i
f
TOWN OF BARNSTABLE
- `. � � f
9 �.�,., f SEWAGE #
VILLAGE /_ f-� S.� C J''r�
fi,LOCATION
ASSESSOR'S MAP & LOT �
j�INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY Ira,o
LEACHING FACILITY: (type) ��Ijr l � �/ (size) /Q X'16
NO.OF BEDROOMS
BUILDER OR OWNE C ,
PERMTTDATE: COMPLIANCE DATE d
.3z
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of le hing facility)� Feet
Furnished by /_,-
s�
i I ,Bh
r -
r +16a ,
ENVIROTECH LABORATORIES, INC.
MA Cert. No.: M-MA 063
449 Rte.130
Sandwich, MA 02563
(508) 888-6460 1800-339-6460
FAX(508) 888-6446
CLIENT: Nickulas Building Co. LOCATION: Lot 5, Service Rd.
ADDRESS: PO Box 507 W. Barnstable, MA 02668
W. Barnstable, MA 02668 0
COLLECTED BY: L. Wile/Desmond SAMPLE DATE: 7-2-97
SAMPLE TIME: 9:00
WATER SAMPLE TYPE: New Well DATE RECEIVED: 7-2-97
LAB I.D.#: 977-038
WELL SPECS.: 4"/907 30'
RESULTS OF ANALYSIS:
Parameters Units Recommended Results Method
Limits
Coliform bacteria /100ml 0 0 9222 B
pH pH units 6.5-8.5 6.99 4500 H+
Conductance umhos/cm 500 152 120.1
Sodium mg/L 28.0 13.5 200.7
Nitrate-N/Nitrite-N mg/L 10.0 1.86 4500-NO3 E
Iron mg/L 0.3 < 0.02 200.7
Manganese mg/L 0.05 0.007 200.7
Volatile Organics ug/L See attached report. EPA 524.2
Chloroform ug/L 100 0.8
Total Xylene ug/L 10, 000 2.9
YES WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED.
"I
� Date ll- '
Ro Id J. S5ctor
Laboratory
<=less than
>=greater than
TNTC=too numerous to count
I - l
FROM LAPUCK LABORATORIES PHONE NO. 617 923 0301 Jul. 17 1997 09:040M P2
LAPUCK
LABORATORIES,INC.
1 NVIRONMEW AL TrS'1`IN(3
50 Hunt street WAST13 WATLIt 1)ISC}lA1tGIs
Watertown, MA 02172 `1'ES'1.1NG
(6)7)923-0300 NOOK)ANAI Y,S1S
FAX (617)923-0301 011,MICA1,ANALYSIS
REPORT FORT N,SIC 11 S'I'IN0
LAB NO, 58490
Mr. Ron Saari
ENVIROT11,0 i LABORATORIES, INC. Satuple Received: 7n/97
449 Route 130 Client 13). :Nickulns
Sandwich, MA 02563
'Felit Rexults:
Volatile Organics-ppb(uglL) — -
Mel.hod#524.2
I3cnzortc ND 1,2-Dichloropropat►o ND
I3rontolicrtrunc NJ) 0-DiolAmpropane ND
I3romochhiromothano ND 2,2-Diohloropropane NJ)
13rontodiehloromedkime NC) 1,1-llichlornproperte Nl.)
Brontoforul NI) 0,Q4,3-Dieliloropropenc N1)
13ronmmci.ltrine NJ) Trnits-1,3-Dichloiopropcne m')
N-Butyl licivene ND 1 tliylbenzene ND
Sec-1311tyl13cimum, ND IImoolilor•obutadicue N1)
Teri-13tuyl 11mimtc ND 1sopropylbeu7eue NI)
Carbon`i'otrachl<iride ND 11-IROJImpyttolueue NI)
Cltlorobciurenc ND Methyl f3doride NI)
Chloroethano ND Naplithalcnc NI)
Chloroform O'S N-Yropylhclizeue NJ)
Chloron►otlulnc NI) Stymile N1)
2-Cl►lor'otolucito NI) 1,1,1,2-Tetrachloruothanc ND
4-Cblorotoluene ND 1,1,2,2=I'elrnclrloroctl►auc N1)
I,2-I)ibromo-:3-C'hlorol)r•opu»o ND Tell'aeltlot C1110[te NI)
Dibromometltanc NI) Toluene NI)
1,2-1)icl►lorobcuzeue ND 1,2,3-Trichlorobeu7,cr►c NJ)
I,3-Dichlor•obcnzcnc NI) 1,2,4-Trichlorobon�.one NJ)
,4-DiAlor•obonrcne N1) 1,1,I-1'richloroethanc NJ)
Dibrrnuoclrinromt3thnne N1) 1,1,2-1'rlchloroet1 ime NJ)
1,2-Dibromocthnne (1?))T3) ND Triohloroflooromethanc NJ)
1)it ltlorodilluororncthanc ND 1'riol►Ioroethcne NI)
l,l-I)ich.icimethane ND I,2,3-'I'riohloropropaue ND
1,2-Dich1r»•octhanc(EDC) NI) 1,2,4=1'rimetltylherl7cue NI)
I,1-1)iclilorriethclerte NI) 1,3,5-'1'rimcl.hvlbenzeue NI)
Cis-1,2.Dichlorocthyleue NI) Vinyl Chloride N1)
�1� 1,2=L)ickalorocthylcnc 'I'otnl X]eue 2.9
N.I). =Not Delooted Analvsis Date:7/11/97
Method I)etoction Limit =0.5 ugA,
11myerieg of Surroule-0K
1,2-Dich1orobenrono-d4 110
Y-13rO11iOlIUc>rY)11t321iGytc 110
1.).R.l'. -MA ofi 1 _
Testing t& Consulting Services awes Fonlc H sa,Lab Manager
for over 30 Yearn . . .
'I fill;rupurl k rcackred upon the conditimt that it is trot to lu reprotlucod wholly or in put for sdvcrtldng nr whnr purposes over our
sirpnlum.or in eonamtion with our uamc without spc¢iel pefolisskm in writing.Total 11ab11gy is litnited to the invoiccd emounl.'fhc
SD/LS 7�T T-
7 F�GVNGA97oi✓ E>L.. B9.S �W.q��' s YsT�'.�-� PROF/LG�
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TOTAL E '.yriVG f�rP_'41�/SrGu�' = 4J LOCJ = ;C' NO t��9�t 1+. 11/.S�U.9G . t y v ^�
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srs/. �fYc ScH. 4o f'►� soh/ Pik — 316" MAX „
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