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HomeMy WebLinkAbout0065 NORTH WINDS LANE - Health 65 North- Winds Lane, W. Barnstable ►. A= 109-013-004 Lot 24 i r T 'I No. 4210 1/3 BLU ESSELT 1 0°I° o a � t�'• '/ ��TOWN OFBARN TAB E LOCATION T" A9U A4&? i� 111,,E <, L.� - SEWAGE # IVULAGE U)- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ��g9 f e044—,r,JA SEPTIC TANK CAPACITY /.So 0 LEACHING FACILrTY: (type) to (size) NO.OF BEDROOMS BUILDER OR OWNER ��t >►'l�L CfI�R PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 5 /� Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) N Feet . Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) )f9 Feet Furnished by SP 3r, �^ '�" `.1 .+"1..•"_ _ 3�" ` _ 77 _...�m 4 3 ten: -------------- JS ^Y �t iY'4 oYa e-l,'Vol r'r•,'�, ♦. '.,+ u' Fah -t� .,:. ✓x �R ,� 11107�This paw —R x ram.,•^' :.'. AN' ... s iX"�^fit. ✓�t" �e,>.:;rM:" ..� sWJ OF BARNSTABLE 'LOCATION A"f✓aJz5V'4i"f-SEWAGE # .1eJ,, VILLAGE G✓ S T,-,--r Sod//e ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. FQ, 7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) 4 1 ! (ter NO.OF BEDROOMS /�� � �^ � BUILDER OR OWNER-I y j' `1/i c -<-- PERMITDATE: �9 ' COMPLIANCE DATE: " Y � + Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feei. Private Wate 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 achin facility) Feet Furnished by - -r rw a - ,' 'ice THE COMMONWEALTH OF MASSACHUSETTS 17 / BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiolt for Diripoml Work,i Towitrurt"ton Permit Application Is, re made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: t1'v Location-Address ...•..• ••••. or Lot No. ».............�.__--------acr-----•----••---•--------------•----•-•--- -•---••------------------------------•-•---Address -•----••---__________••••_--------------•- ..--••-....----.-•.•....................•-- Installer Address Type of Building Size Lot.:......................:...Sq. feet ,., Dwelling—No, of Bedrooms________________•_-___--•_.._-_-___-_---_...Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------ d ......-_-•--• W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width-.____._-_-__.- Diameter_------------- Depth................ 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........................................ a ,.� Test Pit No. I................minutes per Inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ R: ................. ----------------------------------------------------- .------- ..._... --------------- -... _--------------- _____---------- -•- O Description of Soil••-•---•-••--•---•.._...•-•---------•...............••-_--...�w U ------------------ ••-•••...............•----•----•-•------•---------•----------••••-•....... ----------------------------•------------------------------------ ......--------•---- 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 Environmental Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance as b ued by the board of health. Signed . . .. .. .. ... ........................................................ Date Application Approved By ............. . ..... .. �a �"'� --------.......................----...----.....�.........---- Dare.. Application Disapproved for the following reasons: ..................:..................................................................................................................... ... . ................................ ...... ..... .............................. ............................................ ........................................ Dace Permit No. TLY.- ---�... .. ............ Issued ........................... Dare c lV ���� � �t�w.... � `""'�'�r..v'"' tire...`Jl.✓•�^� �..++r-� ���--- �� �-'�,,,..i� �.�.,,,ti..� v. `-"a�.r rod,..��.�-a����.� ..' v.r�j+r`�-r�:.,,,,v„-'��n� rNo...?V Fic • THE COMMONWEALTH OF MASSACHUSETTS � 7 BOARD OF HEALTH TOWN OF BARNSTABLE XpVtirativit for Diripini al Works Tomitrnrtiun Ilprmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: vwx-.� Location-Address 51 or Lot No. ,t j........».............u......................................0................... ------------------------------------........----------•-.....-----................................ � ner Address -------------- ------------------------ -------------------- --------- � Installer Address Type of Building Size Lot............................Sq. feet U Ii a Dwelling— No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons...............0............ Showers ( ) — Cafeteria ( ) d Other fixtures . - --------------------------------- ••----------------•--- W Design Flow............................................gallons per person per day. Total daily flow........-.-.-.-..-_---o...................gallons. WSeptic Tank—Liquid capacity------------gallons Length.--_-------_-- Width................ Diameter..--....... Depth..... x Disposal Trench--No ................ Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..---..---_-------- Diameter......----_------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) j Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................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........................ R+ ---------------------------------------------------------------------------------- ..... -.. ----------------------- Description of Soil ( . U -------------- -------------------------------------- ---------------------- -................ VW ..............f------------------------...................---------------------....------------------..........--------...-----....-----------..............-...............--------.......-•----...... 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 Environmental Cod The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been Issued by the board of health. Signed ... -.:-. .. ;J .. ... ----------.'-------------------------- Date Application Approved By ............. .... .. _..._ ... 7 / ^Dace �..........� Application Disapproved for the following reasons: .. ... .................. . ....................... .......... ........................................ E ; ......................... ......._.................................................... .. .. .. ............. .. .. . ...................................................... ........................ .............. Date Permit No. ............TL/.. .......�...q.. Issued f. ............ . . .......... { Dare a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I TOWN OF BARNSTABLE 0-lertifirate of �Lomplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ,?�) or Repaired ( ) I --------- -------------- .............. -............................................... .................... fat .. 0.......... r -- ..... 1tt .......... ........i 1. �' .................... has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code as described in the application for Disposal Works Construction Permit No. _.......................... .. dated ........... ...... .........-........... . y ....... _ _ _- 1 � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � _ /............................ Inspect r ..�°1DATE . ...._ ... . - �f ------------- ------------.------___--___—_.___ _--____----- —_—. THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEALTH TOWN OF BARNSTABLE No... ......� FEE.--I ......... Rojtanal Iforkii Taanitrurtiaan "aermit Permissionis hereby granted............ t?j'--------------------------- ------•---•-------.... ------------------------------------------- ( to Construct ( or Repair ( ) an Individual Sewage Disposal System f .---------- at No. 92�+.� ......l/.tt�... ���F •�i�� _,,�.. rV �`................ Street as shown on the application for Disposal Works Construction Permit No... )L,Dated..... ..�2.�...j.L1............ I - - /z (---Board of Health DATE2 , $ ---•---------- ------------ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS Fee. BOARD OF HEALTH TOWN OF BARNSTABLE ZIppYitatfon-*rVell Con6tructionPermit A plication is hereby made fora ermit to nstruct ( ), Alter ( ), or Repair ( A individual Well at: Location — Address Assessors Map an4 Parcel A~------------------------- ------- Owner Addres ------------------------------------------ Installer — Driller Address Type of Building Dwelling------------------------------------------------------------- Other - Type of Building ------------- No. of Persons----------------__________ ir ' Type of Well—, Capacity 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 Certificate of Compliance has been issued by the Board of Health. Signe -- date — _-- Application Approved B ----_261-k-- 5_` date Application Disapproved for the following reasons:-------.--------- ------------------------------------ date Permit No.- � '-_� '-`.�' — -— - Issued---------- - ---date-- . BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS I TO�CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by- — = `------------ --------------------------------- Installer j . 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. lGy� ated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------ ------- - - Inspector------------------------------------_— No. ----- 45 T__ - lJ D. Fee--------------------- - BOARD OF HEALTH a -~TOWN OF BARNSTABLE 0(pplication-*rIftl Con0ructfouPermit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )a.� individual Well at: - y -/l/o -f -` / ----1---tea-- P - - --- Location — Address Assessors Ma and Parcel w Owner Address - ----------------------------------------- Installer — Driller Address Type of Building Dwelling---------------------------------------------------------------- Other - Type of Building - No. of Persons--------------------------—_______—_------------ Type of Well—--------------9-------Pi/C.V------------------- ---------- Capacity -- -- - - Purpose of Well-7,-') ---------------------------------------- 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 Certificate of Compliance has been issued by the Board of Health. ,! Signed- /� '! ��-----------' -`��' - -- --- -- y _��1_--------- date Application Approved By ^----� „ - date Application Disapproved for the following reasons:--------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------- date Permit No.- -----—---------- ,Issued -- - - - ------------------ � date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO�CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by � ---------------- - ---------------------- Installer 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. � �Y/ Dated---11Z 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 Yell Con5truct ion Permit �- No. Fee- Permission is hereby granted - -- V,-- - \ -------------------------------------------------------------------- to Construct Alter ( ), or Repair ( ) an Individual Well at: No. ----------------------------------------------- Street rW 11 CL/Jra/GlX!` f� S e, as shown on the application for a Well Construction Permit f No.-------- "— --�''�"'"_ ------------------------------- Dated nn Board of Health !!,, DATE----3 /?_7_ ----------------------------------------- e f ENVIROTECH LABORATORIES, INC. 449 Rte. 130 • Sandwich,MA 02563 (508)888-6460 • 1-800-339-6460 ,�( r FAX(508)888-8457 CLIENT: David Marshall LOCATION: Lot 24 ADDRESS: c/o L. Wile & Son North Winds Lane P.O. Box 236 W. Barnstable, MA .`Plympton, MA SAMPLE DATE: 3-25-94 COLLECTED BY: L. Wile DATE RECEIVED: 3-25-94 TIME: SAMPLE ID: Z196 JOB #: New well WELL DEPTH: 200' 4" PVC 132' Static water lev Flow: 7 G.P.M. RESULTS OF ANALYSIS: Parameters Units Recommended Result Limit Coliform bacteria/100ml (MF Method) 0 0 pH pH units 6.0-8.5 5.97 Conductance umhos/cm 500 90 Sodium mg/L 28.0 8.23 Nitrate-N mg/L 10.0 0.07 Iron mg/L 0.3 0.06 Manganese mg/L 0.05 0.012 Hardness mg/L as CaCO3 500 . 15.1 Sulfate mg/L 250 LT 0.1 Potassium mg/L 20.0 2.22 Alkalinity mg/L 200 12.8 Chloride mg/L 250 16.8 Turbidity NTU 5.0 1.23 Color APC units 15.0 LT 1.0 Volatile Organics EPA 601/602 * ug/L N.D. COMMENTS * See report attached. Yes No WATER IS SUITABLE FOR DRINKING PURPOSES F PARAMETERS TESTED. XX Date ' - Rona d J. Sa ri IT = Less Than Laboratory irector �ri vir:u i-k_r. GRouN ATER ANALYTICALEPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) F Lab ID: 7267-01 Field ID: Z196 Batch ID: VG2-0349-W Project: Marshall/Lot 24 Sampled: 03-25-94 . Client: Enviro-Tech Received: 03-25-94 Cont/Prsv: 40mL VOA Vial/NaHSO4 Cool Analyzed: 03-29-94 Matrix: Aqueous PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) BRL 5 Dichlorodifluoromethane BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL I trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethene 1 cis-1,2-Dichloroethene * BRLBRL 1 Chloroform BRL I 1,1,1-Trichloraethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL 1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichloropropane BRL 1 Bromodichloromethane BRL 5 2-Chloroethyl Vinyl Ether 1 cis-1,3-Dichloropropene BRL 1 Toluene BRL 1 trans-1,3-Dichloropropene 1 11 11 2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethylbenzene I meta-and Para-Xylene * BRL 1 ortho-Xylene * BRL 1 Bromoform BRL 1 1,1,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1,2-Dichlorobenzene QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifluorotoluene 30 30 100 % 87 - 113 % 1,2-Dichloroethene-d4 30 27 89 % 83 - 117 BRL - Below Reporting Limit. * Non-target compound. Method References: Method 601 - Purgeabie Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986). a'" Department of Environmental Managernent/Division of Water Resources �;, WELL COMPLETION REPORT., WELL L CATION GEOGRAPHIC DESCRIPTION Address '"'"` t� cal R th r S: j9, N S E NW of (leerl (circle) City/Town {lR�,� / t?/ j� �ill7� 40— Well owne[ �— "'"��$rf (road) Address Q 0 S E W. of . (mi.in tenths! (circle) Board of Health permit obtained: yes no ❑ u'tersecr. w/ q2 WELL USE WELL DATA Domestic Public❑ Industrial ❑ Total well depth 0 ft. Monitoring❑ Other Depth to bedrock .ft. �� 7 Water-bearing rock/unconsViidaled material: Method drilled 9(7/ Description- Date drilled Water-bearing zones: ©� CASING,r(_ �t 1) From To Type 4` m Length-20 ft. Dia(.I.D.) in. 2) From To �1,� 3) From To Length into bedrock : 1 ft. ��� Gravel pack well: dia. Protective well seal: Screen: dia. Grout-0 Other Slot'',length from _ to B STATIC WATER LEVEL(all wells) _ 1 Static water level below land surface�� �' ft. Date �'`077 WELL TEST(production wells) Drawdown ft. aftor pumping—t—hr. min,at gpin How measured'_`6`4- Recovery it. aIted—hr. " min. o LOG.of FORMATIONS COMMENTS Ma terials ''From To . 0 "90 - ( V 't1G> Drille rr- ! Ill `. Q Q Firm Address' r►" V P/D?` �?y' . ' J City/Town 9 r Jdn�Yo 1 90 Supervising Driller Reg.# if ffl, Signature of supervisin re istered well driller - °'°°'°p" firmly BOARD OF HEALTH COPY v l , TO W-F, v w. , v i -�-- , / s /f ►,'! , ! �, r�ru ' NG.vp r4KE► J Peck P p '� ? ' "L� ��w! 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