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HomeMy WebLinkAbout0041 WAYSIDE LANE - Health 41 Wayside Lane IN I LW. Barnstable A = 110 01 f. i I Adi WOO TOWN OF BARNSTABLE LOCATION 1-/4 ti 5-1-4 Z o SEWAGE # o?aQ 3 37Y VILLAGE Aar uT Az�le ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I Q�d GN G LEACHING FACILITY: (type) 3-12 e`! Gkwl ✓ i�)) (size) %J �X 3XJ' X2- NO.OF BEDROOMS BUILDER O WNER Aweed- PERMITDATE: `5'/3't0J COMPLIANCE DATE: q 1 03 Separation Distance Between the: _ Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility y 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) r— Feet Furnished by C"e, C-l44w",� #q1 a _F •i ,�V- Y3' a1• 6g � � � t i F r i�o, � Fee OV6eCOWMIZ.� SO �' Sul 2S2'U1T'5TS13t THE COMMONW ALTH F Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for �Digpogar *pgtem Cottgtruction Permit Application for a Permit to Construct( . )Repair(9/)Upgrade( )Abandon( ) 0 Complete System EIndividual Components Location Address or Lot No. � �ay,�r1 )�, Owner's Name,Address and Tel.No. Ass e is Map/Pazc /./ fa�1#5� L `e f/L� /L (O Installer's Name,Ad Tess,and Tel.No. Designer's Name,Address and Tel.No. 7 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 7 ` 0 gallons. Plan Date 9l Number of sheets Revision Date Title S )lf W4 % e Size of Septic Tank /©f.��'�� Type of S.A.S. '�Sa4 G Q•iy e S Description of Soil 33, 5X 13 2- ' 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' sued b this Bo d Signed I A. Date Application Approved by Date rjv Application Disapproved for the following reaso Permit No. Date Issued 91 —I u �Fe Va - u�i rc) v tv ssr� 13� Entered in computer: y THE COMMONWEALTH OF MASSACHUS TTS Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS application for Mizpogat *pgtem Congtruction Permit/ Application for a Permit to Construct( )Repair(�/)Upgrade( )Abandon( ) El Complete System WrIndividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Asse sor's ', arce Installer's Name,Ad ess,and Tel.No. Designer's Name,Address and Tel.No. 7 7i� 36 ysy/ Type of Building: Dwelling No.of Bedrooms Lot Size yy�9 sq.ft. Garbage Grinder(/ Q Other Type of Building. tfCEp No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow / gallons per day. Calculated daily flow ZI`�� gallons. Plan Date qd k 14 Number of sheets Revision Date Title S 52h- ���h ('� N/ �qs il� Av , �At Size of Septic Tank y01W�V/ ' Type of S.A.S. Description of Soil 33, SX 13 2— 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 • su ed b this Bo d ol< ealth. � � Signed Date Application Approved by Date -_ Application Disapproved for the following reaso Permit No. — ��K 6 Date Issued ——————————————————————————— ——————————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CER IFY, that the On- ite Se a e Disposal System Constructed( )Repaired( !/)Upgraded( ) Abandoned( )by 4/ O f G `l.S at Lfl V ® _5 has bcep constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No gated Installer Designer The issuanc f t ' permit shall not be construed as a guarantee that the system wi ed. Date Inspector tw/o. --- ----------------------`.�— ✓_ No. �' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Of 6pogal *pgtem (Congtructfon Permit Permission is hereby granted to Construct( ) epair( v Upgrade( )Abandon( ) System located at gy �L' �' V ,5, ie l�l, ,�•1�� ,�/"�/it'S 'tf���' i 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:C04tructioo /must be completed within three years of the date of i pe it. Date:_ I l Approved by 01 (lllt V TOWN OF BARNSTABLE L SEWAGE# ,?era 3. 37T LOCATION IVAe i ,�/e C�ASSESSOR'S MAP &LOT �-0 - VILLAGE �' dar s INSTALLER'S NAME&PHONE NO. 41V SEPTIC TANK CAPACITY Ord �" L LEACHING FACILITY: (type) (size) /,I NO.OF BEDROOMS t BUILDER O EWNEiR i PERMIT DATE: COMPLIANCE ISATE: Separation Distance Between the: y Feet Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells ezisf ?S f• Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) j Furnished by d '� Caf'� C�c•ksN.ry� l i I I 6 1 Y3 r V6 i r ENVIROTECHLABORATORIES,INC. MA CERT.NO.:M-MA 063 449 Rte.130 Sandwich, MA 02563 508(888-6460) 1-800-339-6460 t: - FAX(908)888-6446 d'CLIENT: Gayle Feeley- U•.:c; ,,; OCAT/ON:_., ,,,,.,41,Wayside Ln_ ADDRESS-,,, ,..:_� ..._ • _ _ 41 Wayside Ln � W`Barnstable 'MA-02668 �,. W'13amstable MA=02668 COLLECTED BY: Meehan Wells , SAMPLE DATE: 12=30-99 SAMPLE TIME: N/A WATER SAMPLE TYPE: Replacement DATE RECEIVED:12-30-99 LAB I.D. #: 9912551 WELL SPECS.: 140' RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria /100ml 0 0 9222 B 12/30/1999 pH pH units 6.5-8.5 6.38 4500 H+ 12/30/1999 Conductance umhos/cm 500 88 120.1 12/30/1999 Nitrate-N mg/L 10.0 0.19 300.0 12/30/1999 Sodium mg/L 28.0 8.0 200.7 12/30/1999 Iron mg/L 0.3 < 0.05 '200.7- 12/30/1999 Manganese �mg/L = '. :0.05,.;;;., ; < 0.003 200.7 12/30/1999 J COMMENTS: pH is below recommended limit and•mayshave corrosive characteristics: WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. Date 3XTU Rdoald J. aaft Laborato ctor <=less than >=greater than TNTC--too numerous to count ' LOCATION SEWAGE PERMIT NO. o,r vi Sys � VILLAGE _ l�J i�Y S�► '0� Ov'�ve. 95' 11) INSTALLER'S --N;-A�ME i ADDRESS � � CMG e •- �= ��y��`� � U I L D E R OR .OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED leap(,Pi- �� O emu. �._ 25 tJ 3' 3q RAT SIPS b ivF,- !y/�•Cj5 .J lac./<s u �� !M •u1/LLB 3 7 3 W /3<rtKJr�rbGc . a _ L OGL,c � JA yS r/G 7 =r Fes$ - ® _ •....................... r '- -_............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH a � IS Applira#ion for DhipasallMorks Tnamtrur#inn. ramit Application is hereby made for a Permit to Construct (✓�_Or Repair ( ) an Individual Sewage Disposal System at __...... .....................................................-- ••-•••..........................................:.._..._............... ._... ..__............. Loca' dress oA No �.-- J • <Ti�cGcs� 2 00a _Ta N Own r ddress Installer 'Address `� �/ , Dwelling—No. of Bedrooms............................................Ex Expansion Attic Garbage Sq: feet U T e of Building Size Lot..__..---1-.__ �-, g p ( ) ge Grinder (" ) a`4 Other—Type of.Building _.__._._0...•...__ yp g •._.__..._. No. of persons......... ....:......... Showers ( ) — Cafeteria A4Other fix s .----------•----•-•--------------•-•-----------------••------•---•----------------------..__....- %--= ---- W Design Flow______________________Ib-5-__._.____ allons per person per day. Total daily flow...._...-...� _............_...._....gallons. 04 Septic Tank—Liquid capacitylaa allons . Length_.__ ...:�.. Width-. ........ Diameter________________ Depth....,_:>....... Disposal Trench—No........o............ Width .--............. Total Length__._.._._...____..._ Total leaching area....._....___.__.__sq. ft. Seepage Pit No.......I............ Diameter.................... Depth below inlet_._,j............ Total leaching area..,:�.J- O..W=t.aptz_ z Other Distribution box ( ) Dosing to ( ) / `-' Percolation Test Results Permed by......��r(_.-..- 'r. ................ Date..... . Test Pit No. 14!M��7 �inu�es per inch Depth of Test Pit.....1--�------ be to ground water._AIYOte��N (i, Test Pit No. 2 Ni>�iutR'per inch Depth of Test Pit---- ..�..._... Depth to ground water....................•.... ' .. O Description of Soil t'Q. ''. Gr1 ®f =� 7 / .................................................. 4Al D.. x ------------- 1�.......C�-'-�'A�4......----`/......` `------------------....------------..... VNature of Repairs or Alterations—Answer when applicable__________________________________________________________:........._........................... "Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in oper Cert' ca lia cc has ben ' sued by the d f hea / t ned-- ----- .......: ........ -_----. // Date Application Approved By.............. .-•------------------------------- --'_lam, ---------------------•--•----------•-- Date Application Disapproved for the following reasons------------------•---------•-•--•--•--------•---•-----------------------------------------------•---------_...._ .....................................................................................................................................................------•-----••----------------------•----......:_.. Date PermitNo................-...............................0........ Issued........................................................ Date -------- - ----------, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . /.N...........OF........ / h/u.�.�',; r°% .............. Appliration for Disposal Works Tonstrnrtion Prrmit Application is hereby. made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: / x�- ..--••-...--•-•-...................................................................%.. ----•--•••-...-----•--.----- ----------••......•-•-------•.......-•-•- Location-Address or Lot No. ......................--............................................................................ ................................................................................................. �R Owner �- Address W �. Installer ' Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a4 Other—T e of Building ...... No. of persons............................ Showers YP g ---------------------- P ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------•---------.------•-•••••-••-••-----••-•-•----•-•••••••---------...----•...--•••-••--......-•••------•----- W Design Flow.................C,,,S._:'_...........gallons per person per day. Total daily flow...... ....................gallons. 04 Septic Tank—Liquid capacity../agaallons Length.__, _.J0 Width..;'___..... Diameter---------------- Depth.....Z------- W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.__..____.---------sq. ft. x 3 Seepage Pit No.......I........... Diameter----TO-------- Depth below inlet...6............ Total leaching area..62� s*cd2.0Pt4.. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by...... '/ _}' ..j,./d1111'x' Y` _______________ Date..... __..-�.......-f ,tea Test Pit No. LL es per inch Depth of Test Pit. 11,��_ Depth to ground water-. _ .....RMr�f"f f? Test Pit No.45. 0.2A�liini6sper inch Depth of Test Pit�_•�....._.__.. Depth to ground watefa........ ! f7` ; 0 Description of Soil_ 4e4---------- ----------------------------------------------------------------- ....................................................--•••-•--••••--•••-•••---------•••----••--•-••----•---••----------------•------•••--•-••--•--••-•---•--•-•---•-•-----------•--••-•-•.....-•-•---•-- U Nature 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 uun�til`aC�ertificat ompha ce has b 'ssued by the bo f heal {... -fined--- 1.�... -- --- --•---•------------- f ..� ........ --- ate �plica.tion Approve By......................................-=••---r=;f ....................... ......................................... Date Application Disapproved for the following reasons:.............................................................................................................. ................................................................................................................................................................................._..................... .. r' Date PermitNo........................................................ Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF EALTH ............ .........OF................ ........................... (Irrtif irate of Toutplianre THIS IS TO CERTIFY, That e Individuual SeW!5r Disposystem-eonstructed ( ) or Repaired ( ) -by---•--•------ ........._. . - .. - --•----•----•--------------- has been installed in 7oraance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........fit:-..���___.____ dated__..__....._.�`�.��r_���............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................................o•- A= ................................. Inspector............ .......................................... THE COMMONWEALTH OF MASSACHUSETTS / BOARD HEALTH ........................................OF FEE..�,f Disposal Works forks ion trrtiort rrmit Permission is hereby granted C '"� ---W_,_' ` '.`L.......................................................' to Constru t ( ) or Repair,( ) an Individual 5ejwage ispos em atNo.... � J i ,,..c - /r. . --- ._.... ............................................................ Street ¢,/ as shown on the appli7ain for Disposal Works Construction Permit NO._ _r acted,............. -�a�_1(-,t'-•...... �1 rd of Health DATE..................... Z..l.... --..... FORM 1255 A. M. SULKIN, INC., BOSTON r 1P, AC K co-�J . AAA LOT �� g /o EA U o.26575 O k \ \-� FSSlONAl�N6 �R T E A-A-V 1 /\/or v,-- V DA T-,4 141VD o r / S7-,i K 4-v 2>V C)Ty-= 6, Ar I 9 / J R e,serve n -a �- t I � I �>^s G NEB y ; LANT)�R ssc)c, 71; 3)8 4 .D w G �3 I r G c) W, eo Ave or 6 Lt C7, ram? coo,_ e RECEIVED OKH HIST. DIST. BARNSTABLE JUL 2 4 1984 A OF 04. HARRY vo-tar $�No. 5 T N FL CD 0 1 FSS� At L L. C, ------ F_\A T lill G G P- 7,5- F--b� Pvc IN'V 4,6 0 -i o < x DO'SA i- c w H E D z o'C" 00 c) Ar AJ / ? 4 37 ,41 V_N A Ira- IN INA CEPiTIFJE / . PLOT FOR yy . w i SCA1 E OATE ,0 : Z 1 C-ERTIFY ' THAT WHAT I S-H0W'N ON THIS PLAN r IS AS I EXISTS ON' THE GROUND AND CONFORMS., TO THE TOWN. REGULATIONS BOYLE ASSOCIATES A LM0UTHc:--,,tfA. 4 . � �No. -1 �s.....1�.. ......_......,.... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH sy y t, Appliration for Disposal Work,5 Tomitrnr#iun Frrafit : x .Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individu2 Sewage 'Disposal system al.: r� ' --. • ---.. ..._ �u Loc on•Add ss or Lot NO. 2 ..L.-- !7 tGC /e t/ .S' �Ct' sI .�� d/a¢ple_/.a!Q�..............................•• .... '-----------------------•---•.---•- -----... .............. ..._............._ �Own Ad ress a ---••------•--------------- - ------- ---------------------------------- -•••--•••--..................*........ alter Address UType of Building - Size Lot_:1 _ff�7_8-...Sq. feet ., Dwelling—No. of Bedrooms........................................Expansion Attic ( ) Garbage Grinder (µ o) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ....................... . . W Design Flow........................ ll..........;:gallons per person per day. Total daily flow.............. 3 ...................gallons. W Septic Tank—Liquid capacity.l .gallons Length................ Width................ Diameter---------------- Depth................ OG ` x Disposal Trench—No.-•----------------e2-- Widt .................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.........0�....... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--___-____--_---..:.._.. Test Pit No. 2................minutes per -inch De f Test Pi ._--- ----------- Depth to ground water........................ O Description of Soil,. __ __Ct.°�..._. . _ ___._ f V --------------------------- ....... ---------------------------------------------------------- •-------------------------------•-------------------------------------------•------•------------ 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 boarq of health. igne "............... - <, ,/ a Application Approved B . .- ..... --••-•••-•--••-••----••---••---•--•-••.......................•--------- -..- .. ------•---------- PP PP Y--- •-- -- ---- Date Application Disapprove {or e f ollowing reasons: .-•••-•-•...-••--------•--•••-•.....----•••------------•--••----••-•---•-----•..............•••••......---•-•---•-•----•------•---------•-••--•-•••----------••-----------------..__...----.........-- Date PermitNo........=---•-•-•-------------------------------•---•--• Issued-....................................................... Date t a N0. !' .n ............ ^� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ° ............ .... ... ...................OF.........................................------------------...............---------------- Appliratiou for DiipnaFal Works Tomitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ ....................................................---------------------------------------------- Location.Address or Lot No. ......................—.......................................................................... ..........--...................................................................................... Owner Address w 14 Installer Address Pq Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (nb) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) alOther fixtures -------------------------------•........................................................ Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width.......----.---. Diameter...-..--.------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.............--..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1-4 Percolation Test Results Performed by...............................................................-.......... Date......................................... aTest Pit No. 1................minutes per inch Depth of Test Pit................---. Depth to ground water..--........---......--.. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-.------------.--.--.-. ------------------------------------ --........ ---------------------- -----..... ---... -------- •----- •--------•----•------•--------------------------- .......... 0 Description of Soil........................................................................................................................................................................ x w U Nature 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 T IT LE 5 of the State Slanitary 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. igne --•------- ••------••---• •. --- ............ ApplicationApproved By... -•---- . ------------------------------------••------------------------------_. ....r ..- �'-----•------ Date Application Disapprove . or a following reasons:..............................................................................- ,t.............................. .........--•--•-•----•----••-----•-•--•------------•---------------•------•------•---•-•-------------•--•.....------------------------•••---••--- ..................................................... Date PermitNo........................................................ Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trtifiratr of (Tum li nrr THIS IS TO CERTIFY, That the Individual Sewage Dis ystem constructed ( ) or Repaired ( ) b ........... ..�.W /.V ................................................................. at......................................� :_G lI. r-----`-•---------Installer has been installed in accor an ' with the provisions of TIDE 5 o he State Sanitary Co e /� cribed in the application for Disposal A s Construction Permit No.--�?J...- i..- .............. da.ted,� - .....---................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL-FUNCTION SATISFACTORY. DATE................................................... .�.i t: -------- Inspector.......................... r�- THE COMMONWEALTH OF MASSACHUSETTS 1-, h BOARD OF HEALTH- `' No.--.�'.---•---------- --- ��ti �: FEE-• ----............ nrk� �nn�� #uan rrmi� Permission is hereby granted- =-.................-..... ....................... - - - ...................................................... � to Construct or Repair ��iv'.'ual .�r�g�'�-�''osal S tem................. -•---- ------- ------------ -- -- - at No........... O P ( P street y ..................... as shown on the ap ication f r Disposal Works Constructio Permit No... ...... Dated.�✓.............................. ... PHOBSS � �/ Board of Health DATE_ -- . . �.::........................FORM 1Z & WARREN, INC., PUBLISHERS ASSESSORS MAP NO* l No. Y/_":-?Pr-- Fee4 1 BOARD OF HEALTH TOWN OF BARNSTABLE Zipplicat ion-*r Well Congtruct ion Permit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Ma.P and Parcel Owner a Address ------------------ 63 wow _ ------------------------------------------------------------- Installer Driller Address Type of Bui - - C� wellin ---[-Y-c�✓-14�-��-/-'--���`-'"�----���'��.�� ®Qi� LLi� Other - Type of Building ------ No. of Persons--------------------_—_----_____ Type of Well Capacity YP - ----— -- - Y--- - - — — ----- --— Purpose of Well---------__ — - --- — ----- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Wtificate of Compliance has been issued by the Board of Health. QQ Signed date Application Approved By date Application Disapproved for the following reasons: ------ --------- -------- __—_ --- - -- — — ---------------------— - —— -- __---__ date Permit No. --- --=� Issued--` -1 date d --- BOARD OF HEALTH TOWN OF BARNSTABLE C ertif icate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (./J, Altered ( ), or Repaired ( } by--- Installerat has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protections Regulation as described in the application for Well Construction Permit Nk/L `�9�Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCCTION SATISFACTORY. DATE /6 -f f Inspector---- ----� NO.A--- ------. Fee-- BOARD OF HEALTH _ N, TOWN OF BARNSTABLE Application Ar V ell Congtruct ion Permit Application is hereby ma a for a permit to Construct ( lter ( ), or Repa ( )an individual Well at: Location Address Assessors Map and Parcel Owner r ! Address — — r Installer — Driller / Address Type of Bui i wellin - -- - --- ---------------- Other - Type of Building-------------=----------------- Nc'loe Persons----------------------------_____ Type of Well---- - ----- - Capacity-------------------- -- — - - ---- 5 Purpose of Well--- - mx, ---- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned.further agrees not to place the well in operation until a C tificate .of Compliance has been issued by the Board of Health. Signed date Application Approved By - - 1.4 date Application Disapproved for the following reasons:=---------- --------------=---------------_-__—___ ---------- — - date Permit No. 'Issued e , date r!r!itG9io'.�r'hifli!i'�i!AR01G4 !G?i4iTPK4pRblN�6ARG'RdOilMlSikTi4bTite.et�4i!bSGT►emi8e«BieleiliN!i!w!6Rd7a'�ievea9ifi1G06aa?tb8f5'►bv�:#!Fila!Si'iYIZ.>ueis.:Z led4Geawdo6sieiP_i!iealLes!�4 BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TOrCE)ITIFY, That the Individual.Well Constructed (/j, Altered ( ); or Repaired ( p by— Installer — at- -1"/ �- /n/� /Y• ,I= .f�i-J/C----— 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 -�'�''�' -��7 „ THE ISSUANCE OF THIS CERTIFICATE SI4ALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. , /ate � ��t f `i' DATE--_ �- - - Inspector---==----- -- —- — rt . '«eaiei+!J�!i1«KTi!i►..�iei!69.leiK?i!a.►at•MiVwlawi JalB:Y{.1r1!!6!Naomi+liE+iS4iviRsKlYIiK'1i�rswd'c�r�iiMTGOieGSGKeiVaei�iTM_e!¢'!i ate.e:PiSiti'!�L4TiTi?a96eb.liiNreG!«Te!i!e!FTG?w!Gr BOARD OF HEALTH TOWN OF- BARNSTABLE Well Con5tructionPermit 6 o. - ' N / Fee d Permission is hereby granted to Construct ( ), Alter ( ), or Repair ( ) an Individual Well at: Street as shown on th ap lica ' n for Well Construction Permit r No. - r --_ Dated-�' -� �!_T/_ ---------------------- Board of Health DATE _ I PROVIDE IF SYSTEM PROFILE TEST HOLE LOGS TOP FNDN. = 60.1 ' NECESSARY ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) . ACCESS COVER (WATERTIGHT) TO ' PROP INSPECTION PORT,WITHIN 6" OF FIN. GRADE ENGINEER: LANTERY ASSOC. MINIMUM .75' OF COVER OVER PRECAST /` WITHIN 6" of FIN. GRADE WITNESS: BARNSTABLE BOARD OF HEALTH- LOCUS�2% SLOPE REQUIRED OVER SYSTEM , 55.3 / / RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE DATE: 3 30 83 FOR FIRST 2' CROCKER RO. 4'E XISTING 1000 / 3' MAX. PERC. RATE = < 2 MiN/INCH GALLON SEPTIC * / 66.0' CLASS I SOILS P# TANK (H- 10 ) �--� (RE-USE) AS BAFFLE Co 1 .4' W AA Siff 51 .57 DOI� CI O C� C� C� CI 51 .3 C] I I� 0 C=l ® 0 4' AROUND �6" CRUSHED STONE OR MECHANICAL 171 1:1 0 0 171 0 0 1 0 W COMPACTION. (15.221 [21) SLOPE) 0 8 2' Q Q 0 0 Q 0 Q 49.3 DEPTH OF FLOW 4' o ELEV. ( % SLOPE) ( 1 7. " 57.0' 0" _ 61 .5' TEE SIZES: 3/4" TO 1 1/2" DOUBLE WASHED STONE INLET DEPTH = 10 OUTLET DEPTH = 14" TOP AND TOP AND SUBSOIL SUBSOIL LOCATION MAP NO SCALE FOUNDATION-- EXIST. SEPTIC TANK 38' D' BOX 12' LEACHING FACILITY 48" 53.0 48" 57.5' ASSESSORS MAP 110 PARCEL 18 *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL UTILITIES AND ALL g� LOCAL VARIANCE REQUESTED: NEW SAS TO BE 131' TO BUILDING SEWER OUTLETS AND ELEVATIONS 6.3 EXISTING (LOCUS) WELL (19' VARIANCE REQUESTED). PRIOR TO INSTALLING ANY PORTION OF ® NOTE: EXIST. LEACH PIT IS 125' TO WELL SEPTIC SYSTEM (UNABLE TO FIND/OBTAIN SEPTIC TANK PROBABLE 5' REMOVAL OF \ \ MED-COARSE MED-COARSE INVERT. PROVIDE GRAVITY FLOW TO NEW UNSUITABLE SOIL REQUIRED oo SAND AND SAND AND SYSTEM FROM EXISTING SEPTIC TANK) AROUND PORTION OF PERIMETER 6� e�ti GRAVEL OF LEACHING FACILITY, DOWN TO GRAVEL SUITABLE SOIL LAYER. REPLACE edge 43.0' l WITH CLEAN MED. SAND. .� +�3 \ e,0 t• "-5 6y/ 55.65 C. BASIN + .60 + 7 F 57.65 EXIST. ST �/ (RE-USE) y. 58--3 BENCHMARK: USE TOP �s LP +58.5 2�S' FOUNDATION THIS AREA AT +5 ' �� TH1 ss.9s �, TO Iy�CC 168" 43.0' 16$ 47.5' NOTES: EL. 60.1 ` 56.01 4`ox 58 8.25 `rs9 42 ` NO WATER ENCOUNTERED -» 5 58.47 60 . SEPTIC DESIGN: (GARBAGE DISPOSER Is .____NOT ALLOWED ____ APPROXIMATE NGVD I -) 1. DATUM IS w - _ _ - _ - - r_ _ .53 ''. r 4 ii DESIGN L. �. : ' �acn-. ten.., 1+:n 4 59.20 "' _ � (-.• :. �E'�) en .;. Z MUNIi.;�1-'f;L r�TEK IS li'9 USE A 440 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 5,10 EXIST. ` i \ 1.49 61.14 �L_ SEPTIC TANK: 440 GPD (_2_) = 88Q GALLONS 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AA = 10 s HO H 5 o DWELL. 8V 40 s1.1 6ti \ USE A 1_000_ GALLON SEPTIC TANK (RE-USE EXISTING) 60.V 5• PIPE JOINTS TO BE MADE WATERTIGHT. C T / 6199 �` LEACHING: _ 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. 1 0.72 1.99 < -r ENVIRONMENTAL CODE TITLE V. LOT B i 26.02 SIDES: ) (• ) = 137�$ � '9 � 2(33.5 + 12.83 2 74 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE ��- 44094fSF9 85 o.1s - 1.z5 2.09 3� \ BOTTOM: 33.5 x 12.83 (.74) = 31$ USED FOR LOT LINE STAKING. s� 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. N60.79 GRAVEL �.81 \�q ,'� , TOTAL: _fz1� S.F. 455_ GPD / ��\ e 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT \ USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED TH2 /61.3 \ \ FROM BOARD OF HEALTH. � F66.69 EQUAL) WITH 4 STONE ALL AROUND \61.59 / \ 10. LEACH PIT TO BE PUMPED AND REMOVED. +63.26 LEGEND .80 62.50- .0 100.0 PROPOSED SPOT ELEVATION 62.53 TITLE 5 SITE PLAN SHED EXIST. WELLS 100x0 EXISTING SPOT ELEVATION 100 PROPOSED CONTOUR OF 41 WAYSIDE LANE -•6�19 100 EXISTING CONTOUR IN THE TOWN OF: (WEST) BARNSTABLE ��� ryyery PREPARED FOR: BORTOLOTTI CONSTRUCTION/FULLER BOARD OF HEALTH 30 0 30 60 90 MA i APPROVED DATE SCALE: 1" = 30' DATE: AUGUST 11 , 2003 off 508-362-4541 fox 508 362-98M I down cape engineering, inc. L;H of Mqs of M CIVIL ENGINEERS ��P AH E yJ; ' e`� ARNEH.4q��� LAND SURVEYORS U GJAIfi " OCIAIL 0 No.2 48 om o 792 N s 939 vain st. yarmouth, rya 02675 -�Q 0 03-- 198 _ AR ' OJA .L.S. DATE - •'.a-..w.w4+++-•Wl+a.+Y- ...ase.,r-.q.«+r..a.Y:y..;...1...: ✓w.. .._-._ .. --.__ .-.- -__� s-..-.__--_.._ ___.____........._-"___-._-_—.........- ..__._"__-_-_-----...._...-.._ ___...-.__..._._-__.._.._..-_.._._-_..__...re-_._.__.__ ._«._.___ ._.-.._..____.. -._-._.-_-...-.-"_-_-_.._-_-. ._...-_ ----.. -_._._._.... --.___..- _._-.-_.. -._.w_..... . -.r.s...._.__-_...a_.. -..,__._ .._. wY.. -•JL�.b fV G i _ .�-� L0. 2 r4W iL..LCU- P IsT 6 -!� NQAT 0/V T ?90 SLOPE OVER LEACHiNG AP _.A 6 :a -- . 6 �? c. 0;, .: - T-- - / ?a' D!A CONCPL=T F COVE ? c 4Z -` - i8 Dl NCRE X t?lN� A C O � f--- �i r tt 4 rE� � _ 2 COVET? -.3 '8 ES �' LIQUID E` y D B W41 �6``SWP 314 r, / m +' WASHY 5 TO1%,E.) I r EL13Z,S a o o !� EFF DEPlN4J � 1J / o � / / B p D v9 � a�� k' PER►C RATE t a 9 o f : ,, , ,� oo r''o o°o /�/ WflI TNESSED BY 100o G, ,� •Y� ,v PRECAST t ^ r ` a 0 o e z ' •;�� 'l°y iE�.. 32 �;?�J -� ARQ 0E HEAD _lr --_- SEPT(C , ANK W,,W (_AS ; lJ � P ; ,� � INLET AND OUTL E r T S PER TITLE �- f f o _ 15, ,�-- D/A. ALL APOUND , a SIZE If,17 i I PRECAST LFr,CHI/ ,G PtT sue!. —_ f ;;YS E iW DES/G����'a V1�I�I O F L z N s �", �. t_ R E G U L A 1 i 0 NS 0 � SEWAGE ND STA, E T�; i g ^R CUBS t1R�AC E DfSPOSAL 1 J NOTES : I-AL PIP"S `�riA- � BE SCHEDULE 40 ,�;;:C. SFW ER PIPS '� _ -- 4 `, '-ALL PIPES SHALL BE SLOPED 4 " PEP FOOT MIN. EXCEPT F �!'!� ' � - FOr+ 7rtE lRST FEE , OUT OJ THE GyB WHICH SHALL PE LEVEL r r ' Oil 3 BEDROOMS AT ll0 GALDAY PERBR GALIDAY 3-DESIGN r � F � �, � .,.. .S E P T iC TA NK .3IZF- : X 4-` -GAL • USE W� -�- GARBAGE G R !i'%E R _ ?� - ----- - " L E A.C H i NG SYSTEM : US E 1 v' ! t� x F C'� It'E AREA SIDE � , 7'x10 � � X L B D) TOM_ . ,, TOTAL _FT 0W: - s5 ---- - — - _ 4z,s 7s A TOTAL REQD FLOW ?- �7a>o ---_ - W; yGARBAGE GRINDER RESERVE FLOW ,54� - �3v 2 SAT DAY x r _: _ _ <- — --— - _ I i 1 PPOPOSL_l HOUSE & SC''A�;C7� - S!,A L _ APPROVED BY *' _ - B O D ri t o y - -- , • BEDROOM S INGL FA� LYJ1r'►�LL1PiG WILLIAM ' IEBEPMA,N ~-_RPE `