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HomeMy WebLinkAbout0070 NORTH WINDS LANE - Health «� . •74O North Winds,Lane A=.108—002—008 M'"` 'W.`Barnstable - - •--, -. ._ � _ n � w _ _ � . 0l TO NEE BARNSTABLE LOCATION Or Gt, l�` C SEWAGE #' .: VILLAGE ASSESSOP.'S MAP & LOTI INSTALLER'S NAME & PIiONE NO. SEPTIC TANK CAPACITY l LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �Au f)1 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: I K VARIANCE GRANTED: Yes 140 "�1 .�-�,--" .� G . . .� :.� . � 3 S r �.� ��' `�� 5 ��� ,� �l� � �'� . "N�. 4 D� THE COMMONWEALTH OF MASSACHUSETTS to O�� BOARD OF HEALTH 1° Appliration for Dispas al Works Tonfitrnrtiun rrani# Application is hereby made for a Permit to Construct ( ) or Repair A(r' ) an Individual Sewage Disposal System at .• Location-Address/ 3, or Lot No. �.- .... Ow er a - Address ... ...1 ::-�X------------ --------••--..---------....-----......- ._......--•---...........----.•......------ Installer Address Type of Building Size Lo ....;1.� ----__Sq. feet Dwelling—No. of Bedrooms............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building No. of persons............................ Showers a YP g ---------------------------- P ( ) — Cafeteria ( ) Q' Other fixtures -------------•-••-•-•••---•••••• ..... W Design Flow........... , _..................gallons per person per ay. Total daily flow.........- __�......q............gallons. WSeptic Tank—Liquid capacity�!'CS:*allons Length..... . Width....t�._....._ Diameter................ Depth-- ��.__ x Disposal Trench—No.1.................. 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..... ..........4-©. ................... Dat ___ __r _d- __.._.______.. Test Pit No. minutes per inch Depth of Test Pit.................... Depth to roun water_.___ .•_.-_ ___._.. - P P P g � 44 Test Pit No. 2.ec-.-...minutes per inch Depth of Test Pit.................... Depth to ground water- -•.-_ l___�'...._ tx -•------------------------------•-------•--------------•----•.......-----...........------ = O Description of Soil--------------•-- :.... -•---- -------/.-------- �J x / - ...._ ----------------------- UW -----------------------------------•---------------------------------------------------•-------------------------------------------------------------•-------------------------------------------.------ 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 JITHE 5 of the State Sanitary Code— The ndersigned further a ees of to place the system in operation until a Certificate of Compliance has been is b the b rd of h Signed------.... ----- - - - ......... ate Application Approved By ------------------------- --------------------- � _;,ale ate --- Application Disapproved for the following reasons-............................------..........................................................------....... ------- ......................................................................................................................................................................................................... Date Permit No....... ... _... ...... Issued..--- •-�- �- Date THE COMMONWEALTH OF MASSACHUSETTS -- BOARD OF HEALTH L.................0 F................ , ppliration for Uttipmal Workii Tunotrurtion runfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at, / ........ -----•--•- f/D/"e `/!lJ�vtt ..._..� ,6�✓v / Location Address or Lot ao. ±..I._■-`P.... \r-- --=�.r� �C--1 f X' .. ..................t"r= l..S C1,��!?'?i'7t,(. O er Address C R f Installer Address A QType of Building Size Lot... � ^ �Sq. feet Dwelling—No. of Bedrooms............... ------------ -----Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................... WDesign Flow........... f_ gallons per person per y. Total daily flow............................................g-a WSeptic Tank—Liquid capacity./Q�Jallons Length....... ..... Width-----_/.... Diameter................ Depth... 1�_.___... 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&ta (Percolation Test Results Performed by._._.. .......'............ •---•------------- Date. _.__., _..!x'/............ Test Pit No. 1 .:.",_..minutes per inch Depth of Test Pit.....:.............. Depth to ground water.-}___ _. (z, Test Pit No. 2_�i'_ ._nunutes per inch Depth of Test Prt____________________ Depth to ground water._____________--_-_- a' --•---•---------•-•-•-------- .... ..... .... ----------------------•------------•----- O Description of Soil - • - ...- ------------- W ---..••.--------••---••---•-• ---.-••---•-•-•-•--. . -----------------------------------------------------------------------------------------------m............................................................................ ..................... V Nature of Repairs or Alterations—Answer when applicable--------------------------------------------------------------- --------•-- ----------------------••---•-------....------------------------------.......---------------------•------------------------------------------------------••...._..-------------------...--•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with T r'1:--• the provisions of .T s:iE- 5 of the State Sanitary Code— The un ersigned further agre no to place the system in operation until a Certificate of Compliance has been issued�l'��t oarrl•-of healt1117 /(f C /�/ / Signed.................. '--_ j.._...--------- ,. ... �----------- -•-- �--..... -•---..... Date Application Approved By___.___ �?r�� . - - ate Application Disapproved for the following reasons_...................... ________________ ___ _ ___________________________________________________•------•-----•----........_..._ ------•••-•---_--•--•-----....•-••-•--•-•---•-•-•---•-•--•••--•-•-•-•-•-•------•.............•-•---....._-•---------•----•---•--•-------•-••--------•-••----------•----•-••-----------•-•--•---••--••--- Date Permit No.__4;99.11 .................... Issued_.... "�`. �_ ''. .-------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _..114.41ZAV...............0F......�. .+ �'�1,r�. ........I...................... Trrtifiratr of ToutpliFanrr THIS IS T CERTIFY, hat tf e Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.......--•--------. <. -''...... . .- .----•-----------••---._...-•-------......-------•-••----...-•---...............-------------•-•-•-------•-----•------------- � a . Iinstal at ... ', ....�,P - / � _.. e ..� - • -- •---- -------------------------- has been installed in accordance with the provisions of TIT-LE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No '..'�__.� ..... dated-----4<":":�.l' _%; ..... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH aa // ..............OF.....+��.L 1/Jt�g .............................. NoZe....... '� FEE! ` DisposFal��� o�,.r-�kn �o union motif Permission is hereby granted.......... L .�...- ::=---•-----....------------.........-----...........••...._•-•_.. to Construet or Repair,g( ) an Individual Se ge Disposal Syst ----- at No..A., . -.----{ 4 r .f�•- 11. -�---y ... Street j as shown on the application for Disposal Works Construction Permit 4 _''_ Dated.... •-----•---------••--•---••---•---••---------------------•------------------•------•- ................... Board of Health DATE.....................................................................••-•••---- FORM 12554 HOBBS & WARREN. INC., PUBLISHERS .�11i?iiiti't?t?i?t??iiTitt??i?i?rTnrii+rtttrfrtttn?itt.....Ttmfr.... .. ..... nmrfrnnrrtrnmfrtatmttmttrfrtfrtf�nnrtmrnnfrtfrrnnnstrrttrrnrrstr nftrn x frujrrrrrrf nrtnnxTfm nnnnn a ttnnnrnu::::: . :::::::.....:t::::::::::::::::::::::: ::....:.:::.::..:...:.::.....................................::t::.,...T......... .....i........... ENVIROTECH LABORATORIES Mass. Cert.4:MA063 �- 449 Route 130 Sandwich;MA 025Lte, 0 CLIENT: Larry Nickulos LOCATIkshire TrailsADDRESS: ane, W. Barnstable MA COLLECTED BY: L+ Wile Well Drilling SAMPLE DATE: 5-6-91 TIME: - DATE RECEIVED: 5-6-91 SAMPLE ID: Z250 JOB #: New Well _ WELL DEPTH: _ 150 _= RESULTS OF ANALYSIS: c Parameter Units Recommended limit Result - - Coliform bacteria/100 mi (MF Method) 0 - 0 - pH pH units --- -- 6.0-8 .5 6.83 Conductance umhos cm '00 81 Sodium mg/L 20.0 97 Nitrate-N mg/L 10.0 0.07 _ iron - mg/L ----- 0.3 -- - 0.12 - ` Manganese mg/L 0.05 - 0.03 Hardness;~ mg/L as CaCO 500 3 12.0 >=. Sulfate mg/L 250 -x _ 19,.6 Potassium mg/L 20.0 0.8 - Alkalinity mg/L 200 = _ _ 8.0 E: Chloride mg/L 250 9.1 - Turbidity_ NTU 5.0 6.4 Color APC units 15.0 ! 10.0 Background bacteria COMMENT: _ All Parameters EPA Diethod 601/602 ug/L Below Reporting Limit (see attached. report) '= YES NO WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. _ ;^= ax � DATE - �t(ill;;!llt;litllilUlllilitlli11U14!!!Wiii,,,Uttali„1 sit,lllil,11;1,11,,,11,t;,1„,ud„11u1;11;iu;1i;l;lii;;;i1;;11;1ai;;;;;;;;;i;;;;;;;;;;;;li;u;;;ti;l;;1i;;;;i;;i;;;l;ii;;;l;;;;it;i;ii i;lii iliiitiiiiiiiiliilliitiiilisiiiiil�'� GROUNDWATER ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: Z-250 Lab ID: 1283-01 Project: Nickulas Lot 42 QC Batch: VGA-765 Client: Envirotech Sampled: 05-04-91 Cont/Prsv: 40ml VOA Vial/Cool Received: 05-06-91 Matrix: Aqueous Analyzed: 05-08-91 PARAMETER CONCENTRATION REPORTING LIMIT (ug/L) (ug/L) Dichlorodifluoromethane BRL 5 Chloromethane BRL 1 Vinyl Chloride BRL 1 Bromomethane BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL 1 trans-1,2-Dichloroethene BRL l 1,1-Dichloroethane BRL 1 cis-1,2-Dichloroethene * BRL 1 Chloroform BRL 1 1,1, 1-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL 1 1,2-Dichloroethane BRL 1 Trichloroethene BRL 1 1,2-Dichloropropene BRL 1 Bromodichloromethane BRL 1 2-Chloroethylvinyl Ether BRL 1 trans-1,3-Dichloropropene BRL 1 Toluene BRL 1 cis-1,3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethylbenzene BRL 1 m+P-Xylene * BRL 1 o-Xylene * BRL 1 Bromoform BRL 1 1,1,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL 1 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS Bromochloromethane 30 31 103 % 83 - 117 % Fluorobenzene 30 30 100 % 87 - 113 % BRL = Below Reporting Limit. Non-target compound. "Trace" indicates probable presence below listed Reporting Limit. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986). No. --7f-=-- Fee----- = BOARD OF HEALTH TOWN OF BARNSTABLE Application i orMelt Congtructioupertnit Applicat' n is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: — _- —_ —� %o- T �v-►2=1 -� -1--��-J- ----- -------- ------- --------- P - Location — Address Assessors Ma and Parcel .--S f c -l <</a• ------------ --------------------------------------------------------------------------------- ----- Owner — -- — _Address Installer - Driller r Address Type of Building ,( DwellingC//z -1= ----- ---- Other - Type of Building ------- No. of Persons------------------------------------------------------ Puosf of Well _:1!` 1 -.pia- ---- --- Capacity---------------------------------------------------------------------------------- Type of Well-- - -- - - - -------- --- rp `' - `.� u �-c 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 Certifi to of Comphance s been issued by the Board of Health. Signed--- - ---------- ---�---- �- ------ ----------------------- �N--�- -------��-- date Application Approved By-----� --------- date Application Disapproved for the following reasons:—______—---_----- -----------_____---___—__ __ ___ ----------_---__ -------------------------- ------- - �} date PermitNo.- -f�—_ '7--------------—---------------------- Issued------------------------------- ----------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) bY----------I---t------W Je---------- -- -- ------ -—------------------------r-------------� --------('- -4 - -- -- -Inst __ ------------—-------------P-4-1------------------------—----------- has been installed in accordance with Oe provisions of the Town of Barnstable Board '' of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. —N/71--17--Dated--------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------------------------------------------------------------- Inspector--------------------------------------------------------------------------------- NO.IkAI--�/f=-- 6=� Fee----- �T Y BOARD OF HEALTH TOWN OF BARNSTABLE Application- orVell C on5truct ion Permit Application is hereby made for a permit to Construct ( ), Alter (. ), or Repair ( )an individual Well at: ---------- — ------------- _mac - Location — Address Assessors Map and Parcel G L✓!GX-1------e v— - - -- —�'_�-------------- --------—---------—---—-------—------------—------------- ..L —-- _ Owner Address - - ---------------- ------- Installer — Driller i Address Type of Building Dwelling---------'-- - ------ Other - Type of Building -- -- No. of Persons-------------------------------------------------------- Typeof Well---------------- --�—------------------------------- Capacity----------------------------------------------------------------------------- Purpose of Well,f 4 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 Certif' Lte/ofCopliance s be , issued by the Board of Health. Signed- -- --- ;c ----------------- Adte t t/ �r� a e --------------------------- — — r— Application Approved By------- -----a 'date Application Disapproved for the following reasons:-------------------------------------------------------------------------A-- ---------_______,_________ ----------------------------------------—--------------------------------------------—--------------------------------------—----—---------------—----—--- y _— _ date ,Vt Permit No.Jj_t---��-�--_--1-7--------------------------------------- Issued---------------------------------�-- -- — te --- -- ---------------------------- 1 . � da (I V )� _ f + � ' BOARD OF HEALTH ,Ir TOWN OF BARNSTABLE r � Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) 11,� --- Install !� 1i -----------—---------- — — — - at--------------------------------------------------------------- - —v 'c�F has been Nnstalled in accordance with tl e provisions of the Town of Barnstable Board ff of Health Private Well Protection ,Regulation as described in the application for Well Construction Permit No. J 3= 2-Dated-------------------+-------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM-WILL FUNCTION SATISFACTORY. DATE----------------------------------------------------------------------------------------- Inspector------------------------------------------------------------------------------------ a BOARD OF HEALTH TOWN "OF BARNSTABLE Yell Con5tructionpermit NJ\ IL --g"-7-- Fee--- Permission is hereby granted------�'-----V-- - ?:-? �_�^""� -- -to Construct ), Alter ( ), or Repair ( ) an Individual Well at: Street as shown on the application for a Well Construction Permit No.--------------------------------------------------------------------------------------- Dated-------------------------------------------------------------------------------------- -------------------------- —=s----------------------------------------------- Board of Health DATE------------------------------------------------------------------------------------ Department of Environmental Management/Division of Water Resources a WATER WELL COMPLETION REPORT�� 9�•• .7 WELL LjJCAT101� / EOGRAPHIC DESCRIPTION Addres �TDOEFS F1 N S E W of All (reed (circle) lCity/Townik.jaut— f �Rk Shfi1/� 11�►/I Well own. el rr u Q (road) Address d ' 0 S E W of AnA, :; (mi.(n tenths) (circle)/^� Board of Health permit: yes no ❑ intersect. w ZQ. (road) WELL USE WELL DATA Domestic Public❑ Industrial ❑ Total well depth ft. Monitoring❑ Other Depth to bedrock ft. ©T10 Water-bearing rock/uncons idated material: Method drilled Description «/�� f� Date drilled A Water-bearing zones: CASIN Type �� 11 From 6 To 2) From To Length- ft. Dia(.I.D.) In• 3) From To Length into bedrock ft. - Gravel pack well: 4 die. Protective well seal: �r M � Screen: �t +�',di�a. Grout_❑ Other f- Slot01.-- lengthaw from_bto PUMP TEST _ Static water level below land surface ft. Date Drawdown F ft., after pumping hr. —min.at gpm How measured Recoveiy _ft. after—hr. min. 0 LOG of FORMATIONS COMMENTS Materiels From To Driller Mass. Registrar 6'4c'A 5r B Q .Firm r lw f~► .. � 8K0. Addres 1 City/Town 9 « ' 8V i nature,of supervising registered well.driller - Please print firmly - BOARD.OF HEALTH COPY n i " v i r r iT►JE�� ri. I 2- AL , :o+tom V C 'TUO L�ISL1�rrVC T4KEt.f FQONi -� -- ---- 2, 3, Pi Pr- P,fi� r -t"u►J►.�ss at�!Eszw N�rEv 4. 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