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HomeMy WebLinkAbout0042 BURNING TREE LANE - Health rlfBURNING TREE LANIVBARNSTABLE A=136.026 - ( ' eotLj u 0 Department of Environmental Management/Division of Water Resou c s t WELL COMPLETION REPORT ' WELL LOCATION GEOGRAPHIC DESCRIPTION Address c?& dakAlIA/9 X/i) N S E W of g (feet) (circle) City/Town VY ••g-�.��J�i�NS���13L C Well owner �)�4t67EI',(914 C. YO B` (road) Address ! G7X �46 N S E W of (mi.intenths) (circle) Board of Health permit obtained: 'yes Elk no ❑ intersect. w/ (road) WELL USE WELL DATA Domestic❑'Public❑ Industrial ❑ Total well depth I ft. Monitoring❑ Other Depth to bedrock: ft. -Water-bearing rock/unconsolidated material: Method drilled Description o7 Date drilled 9 Water-bearing zones: CASING GG� �f� v� 1) From S To Type 7 2) From To Length 7�ft. Dla(I.D.) in. 3) From To Length into bedrock ft. Gravel pack well: dia. Protective well seal: dia. Screen: �//�� i ,�J/� Grout E] Other Slot#�length from 1d to_ STATIC WATER LEVEL (all wells) Static water level below land surface ft. Date, / �1 WELL TEST(production wells) Drawdown— 1--,? ft. after pumping 3�hr. "' min. at `r gpm r. How measured � .m� �'{ eovery 7" 'ft. fter-" Kr —min. LOG of FORMATIONS COMMENTS 0 Materials Froml To Cb Driller Firm J � Address city/ Town Supervising Driller Reg.# EA Ao-m oat Signature of supervising^Pegistered we .driller Please print firmly r BOARD OF HEALTH COPY t Department of•.Environmental ManagemenUDivision o41 f Water Resou c "s f WELL COMPLETION REPORT `/ i} WELL LO H ) GEO,'GR7 C-DESCRIPTION Addres �o/ G4e/t//it/L /�EC� �tJ l _ N S . E ) of 1 r~ _-• - (leer) �(circle) • City/Tawri 1/y oad�fl 'iV5'7 ©CC-^ o: ) 1Nell.owner. r Address N S- E' W of 1 (mi.in;[enths) (circle) - / Intersect w/t - Board of Health permit obtained; yes L no,0. - 1. (road) K.- WELL USE WELL DATA Domestic E9 Public❑ Industrial.❑; Total well.depth L4Y Monitoring❑ .Other Depth•to bedrock; -Water bearing roek/unconsolidated material: k Method drilled S' Description,o-AN It Date drilled a 9 Water bearing zones: ' F ,• CASING x 1) From-`• To 4 t Type 3 T� P(/� '. 2):From ' :To . i r 3 From ,To Length _L__ - Dia(I D),_ in• ) l Length into bedrock ft. Gravel pack'well dia f ' Protective well seal i dia t i Screen r f •• i Grout,❑ th ., Other Slot .len k g .from�to STATIC WATER LEVEL (all wells) Static.water level below land surface ft Datej' "�` 9t I. WELL TEST-(production wells) ti 1 Drawdown_ ,ft. after pumping h. - }min at_1,5 gpm How measured: I� 4eovery fter"'�"fir-in. �'. -LOG of FORMATIONS COMMENTS ; Materials From ' To s`•. _ Driller Firm. f Address . L`` C1y o'bGL: 1 �.City/Town ' 4-t'g•;t /�1 Driller Supervising Reg# 6 Signature ofsupervis�n gistered we*dhlle, Please prinCRrmly. BOARD OF'HEALTH.COPY No.--------- -?------- Fee �5------ -- - - BOARD OF HEALTH / 3 z-- TOWN OF BARNSTABLE G Applicat ion-*r' Well Com9truction-Vermit f Application is hereby made for a permit to Construct (.,I, Alter ( ), or Repair ( )an individual Well at: --- �`�ci / �ia.v_� --- — /a5 s ni �- 13�v -—-/'7'// -- ------------ Lo6tion — Address Assessors Map and Parcel �TQF CJiGC� ct�lo /PNiN /aEEE /N O ner Address -- - -- - --- -- --- ----------------------------------------------------- Installer — Driller Address Type of Building Dwelling------------------------------------------------------------------ Other - Type of Building ------------------- No. of Persons------------------------------------------------------ Type of Well--- ��°� y� �C" -- - - - - ------ - - -- - Capacity-- - - - Purpose of We11-----------9Ed TC- U�-�o------ 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 Certificcaatee . Compliance has been issued by the Board of Health. / Signed v' - D------------ ------�� AL— date O date Application Approved By- ----- ----- - - --- ----- -------- date---—---------- Application Disapproved for the following reason .----------------------------------------------------------------------------------------------------- ------------------------'------ ---- --- ------------------------------------------------------------'' ---- -----------------date---------------- Permit No. -- - —- Issued— ! C-- - - ------------------------- --- --- date BOARD OF HEALTH TOWN OF BARNSTABLE Certif sate ®f ComFe ce '�! ,�' THIS IS TO CERTIFY, That the Individual Well Constructed ( ), ), or Repaired ( ) - X bY-------------------------------------------------------------------------------- -------------------------------------------------------------------------------------- Installer at-------------—— ------- ---- ------------------------------------------------------------------------------------------------------ has been installed in accordance with the provisions of the Town of Barnstable Boar teal Private Well Protection Regulation as described in the application for Well Construction Permit No -- - '-i -Dated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- ---- --- ---- — ---- - -- Inspector------------------------------------------------------------------------- .I'a•, '..e - .y'J♦. .. ..._../'T- �+.� � � o r �+ ;' r. vs. �r:�'4. «,.�^ ....4{ li .•^, fi'.. 4i No,--------- ---------- Fee BOARD OF HEALTH V 2 TOWN ` OF ,BARNSTABLE Applicat ion ffor Vell Congtrurt ion Permit 'Application is hereby made for a permit to Construct (./S Alter ( ), or;Repair ( )an individual Well at: /9 6 s M 4"V �3(o o�b. 4,7- Location- Address Assessors Ma "d Parcel ----------------------------------------- ----------------------- ------------ ------------- -------------------------------- ---------- --------------------------------------------- Owner Address ,op. Installer — Driller Address _...» .._ Type of Building «, Dwelling Other - Type of Building--------------------------------- No. of Persons-------------------------------- Type of Well VC yp - - -— - Capacity-— - - - - - — ----- Purpose of Well----q rrr r�C_____ fi�d`��-0----- -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 Certificcat/e of Compliance has been issued by the Board of Health. l� f Signed f3 -- -- i. date Application Approved By s ------ ----- - - ------- ----- date k Application Disapproved for the following reason .-----------------------------—------------------------------=--------------------------------_----- S a date i .+/ / T -- Issued——/ -date Permit No. --- - ---- -- - -__—__---- -- ---------------—----------------------- .�f!rrerm�r.`h!C'e+'.Lwa,r:. •. :..; •..fl�'M .:n«�w.,.N.�wra..W4��:w>�i?'.5:✓+i.iwigr :it�Alp. .. ..... .. 1 BOARD OF HEALTH TOWN OF BARNSTABLE Certiftrate f ComFterelfi cc THIS IS TO CERTIFY, That.the Individual Well Constructed (X), ), or Repaired ( ) by-------------------------------------------------------------- Installer at- - —-- ---=--- --= =—-- ------------------------------------------------------------------------------------------------ has been installed in accordance with the provisions of the Town of Barnstable Boar�� f HealthPrivate Well Protection , Regulation as described in the application for Well Construction Permit NoW-/?'-= 3-Dated------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- ---- -- -- Inspector--------------------- '-—------------------------- a0-.0w:«w..noRt. BOARD OF HEALTH TOWN OF BARNSTABLE lVell Con$tructionPermit No. -------T— _--___03 Fee----- ------------ Permission is he b ted-- — ®--=-:� to.Construct ( At,i �Ike air ( ")' an Ind' 'dual Well a : /� �. ��� ` �� `r-' " ` - --------------------------------- NO. Street as shown on th application for ll Construction Permit No. - - -�• � - - Dated-- �'"� -------I--------------- - -- - - t lr �. i Board of H .a DATE---------+--_ -� ��- -�-�-------- ,. 1 TOWN OF BARNSTABLE LOCATION A,,,- � /-4/„_ SEa►AG15 #_ �d' " /•�,� VILLAGE �• /✓fni�r� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.Atype) G,Wu" (Size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER I DATE PERMIT ISSUED.- DATE :COMPLIANCE ISSUED: 1 i VARIANCE GRANTED: Yes No ku r 31 �+ Ito 37, No. ' CJ7' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS y :application for Digpool *pgtem Congtruction j3ermit Application for a Permit to Con cat )Repair( )Upgrade( )Abandon( ) El Complete System Individual Components 0Z,1 U_/n Location Address or Lot No. �/j,P�Vjag(o `J"2E� owner's Name,Address and Tel.No. Lt? Gib• �,32 N sTA413 ,6 �-JOI Assessor's Map/Parcel r /- D Installe 's Nay,Address,and T No. Designer's Name,Address and Tel.No. ��NV '(2tc Ze Inc S4 0< BrVC_c G, MurPhy 42B -pOSS 21 a- d 3 'YANK N E S U E Type of Building: Dwelling No.of Bedrooms Lot Size Z� sq.ft. Garbage Grinder(IJ(9 Other Type of Building 140V 5 E No.of Persons Showers( ) Cafeteria( ) Other Fixtures /J Design Flow 5-50 7 �� gallons per day. Calculated daily flow gallons. Plan Date A r�D d 9. CIA Number of sheets Z- Revision Date NOV, 10, 99 Title S'iTE PLA —OF L.AWf) AT 26 BLANINb TRC-e LANs Size of Septic Tank 1.5 O c) Type of S.A.S. C l►'1 6 E A S Description of Soil rJ E E P L A IV Nature of Repairs or Alterations(Answer when applicable) ' / 071-1 Date last inspected: f C/odr10 V v 0 s Agreement: T-1 7—C F S-2 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 issgo by this Board of Heart Signed Date l l P Application Approved by 2!�- Date 9� / Application Disapproved for the following reasons Permit No. 7 J Z_ Date Issued �• -{- � �j., ,'.. .. ,.-,''l• ..,�.�'i•-. �..}. :.,+ .� �f.; ''Vr.v,> ' .per...:.. , f.,�r-._._. r ,�. p' \ Fee ACVNo. - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 7 f Yes PUBLIC HEALTH DIVISION.-TOWN OF BARNSTABLE., MASSACHUSETTS Application for 3Di-qpoiar *p! tem Congtru'ction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 24 $o,wj� J6 T'zeFs -,Owner's Name,Address and Tel.�No. _ LV• 8i42N ST1�8GE i ' r -:. b t t�'ILC� G�o '6U,W//JK l✓L£� ZAI Assessor's Map/Parcel13` .Z ` Installe's N e,Address,and Tel No. Designer's Name,Address and Tel.No. .czwc IMthti��1ne� S; ��C� ' 2�. 42 8 -Doss grULe G• M Ur Phy 1AN F-E SVRVE Type of Building: Dwelling No.of Bedrooms Lot Size 6 Z 9/g sq..ft, Garbage Grinder'( r Other Type of Building N ou 5 e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow J ��/O gallons. Plan Date A D rd 9, 98 Number of sheets 2- Revision Date N()V, 10, 98 Title 511C PLAN of L.ANO AT • 26 6'U'ANIN6 TRG--E LAIbE Size of Septic Tank 15 0 0 Type of S.A.S. I C A A rR 6 E 9,5 Description of Soil 5 E L P L. A N Nature of Repairs'o_rAlterations(Answer when applicable) n r �S' C Z��� Date last inspected: (Z 6 S�t C 7,rQ V v /V �'Q 3 , 1 Agreement: , '" ?r 7 -/7-14 �--e The undersigned agrees,to ensure the construction and maintenance of the afore described on-site sewage disposal system to 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 is' by tV card ofU��— I q+ Signed .� Application Approved by Date �f �� ✓ '' Application Disapproved for the following reasons f .- Permit No. Z- Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ''�"t Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( v ) Abandoned )by at G am' on ns 7 S .4t has been constructe in a corrddance with the provisions of Title 5 and the for Disposal System Construction Permit No. P'7 1 2- t dated ' Installer Designer 136ULE G. mvi�P\H l 1 'iANu[-E VRVey The issuance of this permit shall not.be construed as a guarantee that the system--will lffunction as designed. Date 0 "q Inspector \ `� _ ___ No.��� � -------------------------- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,, MASSACHUSETTS Mi.5pooaf *potem ConeUpction Permit Permission is hereby granted to Construct( )Repair( O�Upgrade( ✓)Abandon System located at 26 Q U R N I N C, T R C F_ L..A N e 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: il� 1 ,�+ Approved by 6\01 1 R -a„ 06110 d d ".�"✓�/'lam . ��l�Lt�t{G.0 �'<.C. �G2crlre,� -XJCu�zc�� A4,c cz iJC3Lt/UC-c-�-tr*-� � G� •�'G�J!'Cz-L� /�L' /l/1'L�%E�sL.L�,L1 f-LJ /J'.,-�,f-f--,.Ki�' .�C�C ,,�,e ,�LL,�G.2.f�i � �'-''2�=�t�L�. � (��`tJ ,�G�ra7L� �-K-c�� x-�LC.• _�-C�=-d ,.�Gli�-/L.i%fi2J C-LGYL�+�I•L .�<1.Z.{�Ci�iJ r S"' 7 � � / . •-�C.>> �J �:c�.y�.� .iLL-tL f�P�C,�Q 9LIC.• ./'n l��Q1 G L--c"-Zf/ .:-liG�-yLa?fib ..��Z.t"-� _-�•�-`�, L7� O-2Ls ,�ALxo c"yL,�-72a7��1� .,'/�C��.Lr-.,2�,�� ,/�-�.s:t_,� �Q-G�2G� .��2��jQ�'7'(�.Z(��:✓ •-�-�J C� �1�,��'c�c•YC,�2� _�_-17�(-ii.c-�t.-e>z::.� ��t�e(•'� �Ky ,, ' tLJ l ��� :�CJC/ .�t,t.LrC,•�Zj L�LG� �2�'-C� .?20 /�-' �_t�1�`�dtLtr/ � `—GL-`7Lc�-� TT ,, .. �..�c�--•ram. i ,�L7,Lcec..-��u.��� °� /�,,x, CJ,yv�t�.,1�,,y� _r'Q,G�7,�� !�i � • ,� ✓ •� Le�cL,E� �'?�G'�J G�72� .��'L�c.�cvye.¢. �.�a ,•����i�/r.C/-�fL�' �- ./�L.{�� ..�C�C.�.t?� G��. �u7� � �.��' �.��L�iryLi L��j� ���.i: `_ t' J� zo ../J�..t'�L�•.+1id_�� �,�,.: ( 1�_, /J� „/�y /L.F.✓�.C.��-zJi�, "�� - .i� GLLL�i �_-C/ �—e�s�ri /hZzl..LitJ .-G!J t-c•� x-4� � _ L �.QU t'aSci� NN Ki ._.. ------ � S � c.NI ? ( IN FEET ) G1 '11) 71. inch = 20 ft. Ir N A- - KVIST X - k- n� ` TO h7l' Q) ; ' n -� G�11;':ICI' (ON57. , �_ \ �J t �r c�� h�.'f J �� �-�• '� 'J/LOCH TION \\ . K A f,K :>� >`\ r7i; H1.' Ir'L.tlnll./>) y / PROP `.� .SAPTIC O \1/� ,�� ,,/L;.l'LST�:1 G .o. 44. 6 TANK 48,1 i; AZTOWN OF BARNSTABLEj LOCATIONc t ,g e- 06 SEWAIGN # VILLAGE ' �+ �� ASSESSOR'S MAP LOT 136 .2 INSTALLER'S NAME & PHONE NO.17ctf/jep A Acwz SEPTIC TANK CAPACITYOr LEACHING FACILITY:(type) lpj 'iCc�c (she) C�D NO. OF BEDROOMS VA Vi1ELL OR PUBLIC WATERS BUILDER OR OWNER DATE PERMIT ISSUED.- u -roc lk ✓Lr w.v , DATE :COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No iu tom! (off 0 f TOWN OF BARNSTABLE .WCATION, C�X ,_SEWACE # VILLAGE 2 . i ASSESSOR'S MAP & LOTJ V_lk_ INSTALLER'S NAME & PHONE NO. 451 ROUTE GA P. O. BOX 438 SEPTIC TANK CAPACITY EAST SANDWICH, MA 02537 LEACHING FACILITY:(type)_ (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: �,S / /4 I p� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No / / — � _. h ��, �� id � �� x � G� F v�� 5.,y �c�( � � n �� �� No.......... ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR F• HEALTH ..................OF. -S./ ��......................... Appliration for Bigpufittl Workg Tonfitrur#iun Prruti# Application is hereby made for a Permit to Construct ( ) or Repair (YQ'an Individual Sewage Disposal System at, _ ................ - e .�----- tea ... ........�ic� 'f ......... ........................ a' Address or Lot No. ..........•• ._.. -........ ........................ ............................................... ner ? A �es�s) W . °"i. ....J-----•---------------•--- a ........................•. Installer Address 14 Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ---------- ........................................... W 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 ( ) ~'' Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ t� Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water-_-__-_-___-_-_-----___- -------••--------------------------------•-----------------•------------._._................................................................................. 0 Description of Soil........................................................................................................................................................................ W U -------------------------- •-------------------------------------- ------------------------------------- •--------- •---------- •------------------------------------------- .._..---------------------------- ---------------------•---------------------•----•-----------------------------------------------------------. -------------------- --••• ......... ---- -------- U Natu pf epairs or Alterations—Answer when applicable.__ _... 8 __ _ -- ------_-. � t::�.---------------------------- --------------- Agreement: The undersigned agrees to install the aforedescr ed Individual Sewage Disposal System in accordance with the provisions of iI'= 5 of the State Sanitary C e .The undersigned further agrees not to place the system in operation until a Certificate of Compliance has n . sued by th bard of h alth. Signed --------• -- • ------ -- �f•... .iCS._____.•- Date Application Approved By........... - ^^ .._... .. .....-----•-•------.... ..-..L_�_--. ....... Date Application Disapproved for the following reasons--------------------------•-•--------•---------------•------------------------------------------------•......•... --------------------------------------------•---•-•--------------•-------•-----------------•-•----------.--•---•---•---•._....._...._..---------••------•---•--------•------•••-•----------•--•••-•-•--- Date PermitNo........... b`�.�l---------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD ,,;PF HEALTH Application is hereby made for a Permit to Construct or Repair (_'�k an Individual Sewage Disposal System at* /-- ---------VZ----------------- ....... ... ......... ...... a� ddress or Lot No. er Ins Address Septic Tank--Liquid Leooth'_-'_'_- Diameter................ Disposal Trench--No. .................... Total .................... Total leaching area...................sq. ft. Seepage Pit l4o.-------- Dianoeter------.--- Depth b�m. �Jet_--------' Totu �uc6' urea-----'--'�g. f t. �q Other Z6o�ixz�oobox ( ) Dosing tank ( ) '- Percolation Test Results Performed by.------------------.---'------------' Date........................................ Test Pb No. l................minutes per inch Depth of Test Pit.................... Depth u, ground water-_'--'_'_ Test Pit No. per inch Depth of Tex Depth to ground water........................ '-__----------__-'-_-_----------'_-----_'_-_'-'_-_-'_--'-_--'-----'-__-_-.. 0 Description cf Soil......................................................................................................................................................................... __________________________________________________________________________________________________ The undersigned agrees to install the aforedesco�ed Individual Sewage Disposal Systernin accordance with the provisions of TITIE 5 of the State Sanitary Code -.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has V�Xsued by th bard of health � ^, Date Application Approved By--' ___�,_�.���_�.����___ _ Date Application Disapproved for the following reasons:.......................................................................................................... ----------------'------------------'---'-------------'--'--'--'---'-------------'---------'----'------ Date PcnmitNo. ..................................................... � Date � THE COMMONWEALTH or MAssAceossrrs /;a BOARD HEALTH -- ..L...........OF...... ...................... THIS IS RTIFY hat the dividual age Disposal System constructed or Repaired f�-4 ----------------------- ........."...... nst has been installf!d in accordan ith the p visions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated.............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION ������������ � -�-_� � DATE THE ooMMomvvsAcr* or MusSAo*ussTTS ' BOARDZPF HEALTH ....................O Constructionto C6nstr1kCt or Repair an IndividyA Sewage i sal ystem as shown on the application f r isposal Works - Permit - P s No. .............._.. Fix.. . ......... THE COMMONWEALTH OFUMASSACH-�U•SETTS . . ..... BOARDX Ov�p O F-. Appliration for l iivaoal Iforkii Tumotrurtion Vamit Application is hereby made for a Permit to Construct ( or Repair ( ) -an Individual Sewage Disposal Syster at Location-Address L.Lo No FEE .... 56 ............................................... •• ..........•... -• ..................... .... O net •Add ss nstaller Address U Type of Buildipor Size Lot............................Sq. feet Dwelling No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ______________________ ___ •---•----•--•----------•---•--------•-------- •- W Design Flow.............................�d _._ gallons per person per day. Total daily flow________ --________...............gallons. WSeptic Tank—Liquid capacity/___ allons Length................ Width................ Diameter................ Depth-____________--. xDisposal Trench—,No. .................... Width........ . __. Total Length............ Total leaching area....................sq. ft. Seepage Pit No._(--------------- Diameter _______ Depth below inlet:................. Total leaching ar a fi�. z Other Distribution box ( ) Dosing tank ( ) Lvl0"4 aPercolation Test Result PZformed�y-__-- � L-. :_ -- Date 1� ` ' Test Pit No. 1_ _ i�inu es per incll� Depth�of Test Pit_-_e•_______________ Depth to ground water........................ (� Test Pit No. 2 riper i h Depth of Test Pit.. Depth to ground water Description of Soil...... �, --------• --- - - ••. -- `.--E ale•. �G� -- - - x &_--�,.�-.----- - --- ----- ------- 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 Article YI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b &issuebye board of lth. Si ed--•-- _.lam --- .. _._ _✓ ..............Application Approved By """ Application Disapproved for the following reasons__...........................................................................-................................... _ _________________________________________________________________________________________.___..__._._________.__..____-_____._____________________.___________.__._.________________...._ :wE,uiiw,(•� Date x„Y@. PfsrmitNo........................................................ Issued........................................................ s'. Date A. y No........------------- Fn�.. ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF. '�'`� ----------------------- .NvOiration for i-qvasaf 19orkis Towitrurtion Punfit Application is hereby made for a Permit to Construct ( 2ir Repair ( ) an Individual Sewage Disposal System at: r ,,55 > .,,-•. y�'g .^,,, �` , fr !`A l ax '"` T....... 7E,. A o¢ tiob4�&less f ✓ LF g z , r of Lot No td f w °haw' Owner........ ......... ................ . v�tw{, u ..... ,.... .... ° Kd { �.p.,,% ._... ,+ dress �_.,,v✓ .._ r .�J .. .......................... r,^ rL r & .... �✓ ,: - � . � mst�lde Address ' Q Type of Build Size Lot............................Sq. feet Dwelling Zlo. of Bedrooms...............'S.,.........................Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons............................ Showers ( : ) = Cafeteria ( ) Q' Other fixtures -------_............................................................................................. Q Design Flow...........................4,;/,:��-J)._grailons per person per day. Total daily flow........ gallons. USeptic Tank—Liquid capaci Zallons Length................ Width•_...:..____-___ Diameter................ Depth..---___•-_____. xDisposal Trench—No .................... Width :.. Total Length-------------- Total leaching area___._ ..sq. ft. Seepage Pit No..../______________ Diameter. —/-r -------- Depth below inlet_°_"...... ..... Total leaching area.;,?,. `=:sq. fL. Z Other Distribution box ( ) Dosing tank ( ) y1 Percolation Test Result Performed ell � '�.- �✓_. , ° ,��` r - Date Test Pit No. 1: - ` ._"_r nnutes per I epthp of Test Pit...,_______________ Depth to ground water ..--.______..__-._-_. f=, Test Pit No. 2.......... .minutes.,per tr, h Depth of Test Pit_ ............. Depth to ground water........................ ' Description of Soil Q me � _ t r (> ! = 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 visions-of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been tssued by the board of health. ff Dot Application Approved ,t .. d ace Application Disapproved for the following reasons:------------- :....• = __..._. ......;. Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD-OF,--HEALTH ... .... -vo—..................OF ,!'c� a -� � ...'•`".......,e ......... At rrfifarate of To pffiturr, TLIS IS 0 CTIFY fiT 't e' Indiv dual Sew e Disposalsteiil constructed or Repaired4 if by. ( ) J. , y a at.... .................. --------------------- has been installed in accordance w:iWDie provisions of Article XI of The,State Sanitary Code as (escribod in the .application for Disposal Works Construction Permit No.......................... ____A` _. dated_ -_____-t _ ..J`. ' . !`6'°_-___. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � t DATE a = ........................................... Inspector----- ... Pam. ,THE .COMMONWEALTH OF MASSACHUSETTS BOARD OF j HEAL V .R ...O F.- 9 ..:.....: ...... ... No...........i.......... . FEE r.. ...: ...:..... Permission:j,2�� hereby gran�ed.-: _ ----- ----• ... ••-•--�"° . .... ............... to Constr t :J. Repai ( ) an Indi ual Se ,-e Disp dal Systat l Street F as shown on the application fra,Disposal Works Construction Pernut .' !�_-........ Dated=_ l�' ��". �. '".:........ 1 Bo.,rd of x¢aIti ' DATE. � ... .---•---- ....................... FORM 1255 HOBBS -& WARREN INC.. PUBLISHERS . L t ALAN W. JONES & ASSOCIATES ' CONSULTING ENGINEERS BOSTON EAST SANDWICH 229 BERKELEY STREET CARLETON DRIVE BOSTON. MASS. 02116 EAST SANDWICH, MASS. 02537 (617) 267-8136 (617) 888-31.94 Lot #13, Bunning Tree Lane., West Barnstable October 3, 1972 Page 2 of 2 pages' 0100. Ground .surface 9`& T6Rsoil -& ve etation Average Percolation Rates 1" drop in la seen d.s 4•o" Dense, 'brown clay;,; trace grey clay and very fire,_-sand Filrm.L. very fine,. grey sand,, some brawn clay 2 *00 Vater, Level 2 -''C�" Firm,. fine to medium, grey sand _.0von Firm,- medium,, grey sand 35 a" Test log determined by drilling a 6" diameter well casing to a depth of 5;.. Percolation ;date approximated by extrapolating data obtained by filling test hale with water to elevation .4*Oft and tiring a 5*0" fall as 2 minutes. Water levels indicated, if any., are those observed when test hole was drilled and do not necessarily rrepresent,permanent ground water levels. 1 ALAN W. JONES & ASSOCIATES CONSULTING ENGINEERS BOSTON EAST SANDWICH 229 BERKELEY STREET CARLETON DRIVE BOSTON. MASS. 02116 EAST SANDWICH, MASS. 02537 (617) 267-15136 (617) 888-3154 October 4:, 1972 TBST HOLE AND PERCOLATION TEST t Fage i of 2 pages Y Tos Mr. Robert Bridges Rowe 6A Bast Sandwich'.. Mass: Res Lot #11, Burning Tree Lane Point Hill, West Barnstable., lass: Bate of Testy. 3 October 1972 time of Tests 8r10 Al Location of Tests 10 ' into lot from Burning Tree Lane layout Personnel presents Robert Bridges Alan W. Jones N OF Mq�qti N .P E o. 25 0 0 G/ST Fss/ONAL 6 R. A. Bousfield Backhoe Service Sandwich, Massachusetts Dear Customer: Your newly installed septic system has been expertly installed by our qualified workers. Your local Board of Health has set the capacity of the system, inspected the installation of the septic system, seen that all local and state laws are strictly enforced, and ensures that proper drainage requirements are met. If properly maintained, your septic system will give you many years of trouble free service. Cooking grease, coffee grounds, and table scraps clog pipes and interfere with proper functioning of your septic system. It is important that these substances are not dumped down the drain. Your new septic tank system is the most common type of'sewage treatment. The system is econ- omical and adaptable for homes and commercial type installations where ready access to sewers is not available and other types of sewage treatment are impossible or to expensive. Function of Septic Tank Systems Three functions occur within a septic tank to condition the sewage for final disposal by percolation (drainage) into the sub-soil of the ground: 1. Solids that would clog the sub-soil are removed by settling of the heavier solids to the bottom of the tank, forming a sludge blanket. Then the lighter solids rise to the surface of the liquid and form a scum layer. 2. Solids and liquids within the tank are decomposed by bacterial and natural process under anaerobic (absence of oxygen) conditions. This process is termed "septic" from which the septic tank obtained its name. 3. Sludge and scum are stored within the tank where digestion will reduce the volume. However, no matter how efficient the process is, some material will remain that must be removed mechanically, once a year, before it is scoured into the disposal pool and cause clogging. Two functions occur within a leaching pool to complete the final disposal of the septic tank effluent (liquid sewerage) : 1. The effluent is disposed by percolation through the soil. 2. Purification of the effluent is affected by filtering through the soil. It is here that the disease- producing bacteria are removed, since they die due to exposure to an unfavorable environment. • , We have sketched a rough diagram of the location of your sewerage system on the back for your convenience. Sincerely, '6 }rt Q � f � '� r 9 � " � - �;< k � , '`,. ���, �� �ti `� .�yi �i �,. ..�,,. ~��``�. f .,: �`Y-�...iA .`_ �,' '` ��� .,� �,� � °�,i s+�''k y ��''.Y �'.. 32 57 TOP OF SILL 20 MIN. 10 MIN. CONCRETE COVERS 4" SCHEDULE' 40 P. VC. MIN. PITCH 118 PER FT. VENT 2 LA YER OF EL = 31. 0 „ CONCRETE COVER 118H-112 / � � � � � WASHED STONE 6 MAX � � / � EL =33 12" MAX ✓ i i i i—i / / i ,/ i ✓ i , 4" CAST-IRON PIPE (OR EQUAL) MINIMUM PITCH 114 PER FT. 45 CLEAN SAND FLOW LINE 44, MIN. INVERT 1 10" ,� E'L=27.25' MIN. 14 ° zo o °° o 0 0 0 0 CAS INVERT LEVEL ° BAFFLE 16- SUMP ° o ® o c o r� a ° ° INVERT INVERT ° ° ° ° ° ° -24, 75 INVERT EL._ .28— , , EL. — 28.25 EL 27.25'----- EL. 7_�_ IN 4 4 - ' VERT : (TO BE PLACED ON FIRM BASE) „ , _ "DE 9 DISTRIBUTION EL.=_26. 7_ MECHANICALLY COMPACTED OR 6 OF STONE 1500 BOX - 00 --GALLONS TO BE WATER TESTED SEPTIC TANK IF MORE THAN ONE OUTLET t - - 45 X 12.5 TRENCH FORMATION - PLACE ON 6".'STONE 3 4„ TO 1-112„ SOIL ABSORPTION WASHED STONE PROFILE OF SYSTEM (SAS) - SEWAGE DISPOSAL SYSTEM BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELE V. = 185 NOT TO SCALE NO OBSERVED WATER TABLE (3119198) ELEV. =- 18. _ OBSERVATION HOLE' ELE'V. =333.0 = 33. 0 �T J, OBSERVATION HOLE ,�2 ELEV. ---- _ �. PERCOLATION RATE <5 HINI INCH A T INCHE'S, DEPTH HORIZ TEXTURE COLOR MO TT. OTHER ; DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 0-12" A SANDY LOAM IOYR3-1 D 12 _ A SANDY LOAM IOYR3 1 2"-114 B CLAY 2. 5Y6-3 2"-120 ' B CLAY ,2. 5Y6-3 114„--162„ Cl MEDIUM SAND IOYR6-6 PERK 120 -174 Cl MEDIUM SAND IOYR6-6 62„-168' C2 CLAY 2. 5Y6-3 NO WATER NO WATER r GENERAL NOTES SOIL TEST 1 ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D. E' P. ` � TEST 3119198 SOIL— TEST DONE BY BRUCE G. MURPHY , R.S. �, ; DATE OF_ SOIL TITLE 5 AND THE TO WN OF _BARNSTABLE' --- RULES ` AND ,�� to, DISPOSAL OF SEWAGE. WITNESSED BY: JERRY DUNNING � "" ;rj REGULATIONS FOR THE SUBSURFACEq� ► � , 2 ONE CO VE'R ON SEPTIC TANK SHALL BE BRO UGHT TO Q, WITHIN 6 OF FINISHED GRADE OTHERS WITHIN 12 �77 U v S 3 ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF E UNDER OR WITHIN WITHSTANDING H-10 LOADING UNLESS THEY ARE DE,SIG.�V CALC�JLA TIO�T,�S.' - G 10 FT. OF DRIVES OR PARKING AREAS. H 20 LOADING SHALL BE � 4 0 FT. OF DRIVES OR PARKING AREAS: INSTALL FOUR O ACME USED — UNDER OR WITHIN 1 NUMBER OF .BEDROOMS . . . . . . . . 4) ANY M4 SONARY UNITS USED TO BRING COVERS TO GRADE SHALL 500 GALLON LEACHING GARBAGE DISPOSAL NO CHAMBERS WITH FO UR FEET 'BE MORTERED IN PLACE' TOTAL ESTIMATED FLOW ' . -5 STONE SIDES AND FOUR FEET ENDS N0 DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH I10 GAL. BR. DA Y x 5 BR 550 GAL/DA Y SPACED ONE FOOT APART. ( ----- / � ,—_—_ ) DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO 45� ,X 1� 5' REQUIRED SEPTIC TANK CAPACITY 1500 GAL OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. , MAKE 5 0 VERDIG TO APPROX 6 UTILITIES SHO WN ARE APPROXIMA TE ONL Y, EXCA VA TION CONTRA CTOR SOIL CLASSIFICA TION 1 IS TO . CALL "DIG-- SAFE" A T "1-800-322-4844 A T LEAST 72 HOURS DEPTH OF 10 TO MEDIUM ,SAND LAYER. DESIGN PERCOLATION RATE <5 MIN./IN. TO BE INSPECTED BY HEALTH INSPECTOR 74_ PRIOR TO COMMENCING WORK ON SITE. EFFLU�'NT LOADING RATE . GAL/DAY/S.F. REPLACE WITH MEDIUM SAND 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS AND THEN CRACKING CAPACITY (AREA X RATE) 586 GAL DA Y 0 `COMMENCING WORK ON SITE. RESERVE LEACHING CAPACITY . 586 / . .SITE CONDITIONS PRIOR T GAL/DA Y C y 8 PARCEL IS IN FLOOD ZONE----` _ (45 X 12. 5 X . 74)f(45f 45f12.5f12 5 X . 74 X 2 ) 26 � 9) LOT IS SHOWN ON ASSESSORS MAP -136 AS PARCEL ----- # 51481 JOB SHEET 2 OF 2 G� lid I i