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0227 PINE STREET - Health
227 Pine Street L.MBarnstable015 p , TOWN OF BARNSTABLE LOCATION Ja �t ti ri S . SEWAGE# VILLAGE (,t,9 � jfikXTtJU F ASSESSOR'S M 1AR&PARCEL / INSTALLER'S NAME&PHONE NO. e'-e-CA l"S R,- LuL8'S S39 SEPTIC TANK CAPACITY 1 LEACHING FACILITY:(type)SZO Gil-6A (size) 33 S X t ol. 3 NO.OF BEDROOMS �{ r OWNER J 0 Nt 1iS PERMIT DATE: ���., 3, ©f SS COMPLIANCE DATE: �. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �Ai.y r �, HousR i 35 G2�S�nil� � A IW• I,�Mn I - q _ No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYicatiou for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade Y) Abandon( ) Complete System ❑Individual Components Location Address or Lot No.�Z /�fAM 7- Q J�O�cne �Nar e Addr�sg/arlc� .No.�08 Z(o' j�2�C Assessor's Map/Parcel A/EX2. �, 0f.�� V b`' Z 2. �3 �,C- SiC77�1/ow'✓����� �� Installer's Name,Address,and T 1.No. B-Yoh$ Des', ner's Name,Address,and Tel.No.s0 8 T�rvee Maca-l�:sTe� 4Tssooe. FZ f'b no( ST• me� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures //ll Design Flow(min.required) �7"� gpd Design flow provided gpd gpd Plan Date Number of sheets Revis* n Date Title ff _M- IN Size of Septic Tank �dj®� "' "41 Type of S.A.S. /e S" Description of Soil 0— 3 41 1_i 111 Nature of Repairs or Alterations(Answer when applicable) J Q,A 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 Certificate of Compliance has been issued is Board Health. ig Q Date Tv 020[b Application Approved by WIN Date Application Disapproved l: Date for the following reasons Permit No. "� Date Issued ; t ;AI0. �. Fee r: • THE COMMONWEALTH OF MASSACHUSETTS Entered in computet PUBLIC"HEALTH DIVISION — TOWN OF BARNSTABLE, MASSACHUSETTS Yes Rpplication for Disposal 6pstrm Construction 3pettriit y" J Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) Complete System ❑Individual Components Location Address or Lot No.ZZ 7 /���{/ S?: w O}ICne Name, � �ess,�nd 1.No.S"o8-.3 Z L ,J`- Z. Assessor's Map/Parcel �,`f�,2, P, Q/„� l !' 2.7—�� \CC/ S, 77 W d A0A15� .8L Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No..Sp 8 ..13��99 r10. �Ck�. S�<.� JUG �l �i .T_40Y4e gss;oC , lie- Typeof Building: Dwelling No.of Bedrooms. Lot Size p fi sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ��✓�� gpd Design flow provided gpd Plan Date 7- Z;� j� n Number of sheets f2 Revisrn Date Title .51JJW ) Size of Septic Tank f15QLI) 4V1,1.DNJ Type of S.A.S. �/) �,f�L, C.46"dj a ��... " °i ... il Description of Soil — 3 O ,_r4 Ad 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 Certificate of Compliance has been issued is Board of Health. w i d d Date 3-J.� f,,)G/S Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliatirr THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(kl') Upgraded( ) Abandoned( )by at 711 r•�t ST (,y f �10." Ta��r has been const cTdin ac conc with the provisions of Title 5 and the for Disposal System Construction Permit No. da3d Installer ry,C e r1 C,c_Cl-1 S 71 Designer #bedrooms y __ Approved design flow gpd The issuance of this pe . it shall not be construed as a guarantee that the system will function s desi ed. r)t Date Inspector ! ------------R---------- ----------------------------------------------------------------------------------------- =-----------==-- /J No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposat 6pstem (Construction jiffmit Permission is hereby granted to Construct( ) Repair(� Upgrade( ) Abandon( ) System located at a 711 (il.�. 3Gr�ns l abl+' - i - r and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:C ns ction mint be completed within three years of the date of this permit. Date Approved by A TIBBETTS ENGINEERING CORP. EUEUVRE W VML 11N9u O4V&JL E 3090 Amsbnet Avenue 716 County Street DATE 1Vew a-dford,Ma 02745 Taunton,Ma 02790 04/29/2015 (508)998-3700 (508)822-6934 JOB NO. cwbite@tibbettsengineering.com Inst. 15-3464 www.tibbettsengineering.com ATTENTION John Doyle i TO John Doyle RE; 170 Cloverfield Way 227 Pine Street Barnstable,MA Falmouth,MA 02536 WE ARE SENDING YOU ® Attached ❑Under separate cover via the following item: ❑ Shop Drawings ❑ Prints ❑ Plans Samples Specifications ❑ Copy of Letter ❑ Change order ® REPORT COPIES DATE NO. DESCRIPTION 1 Title V Grainsize Analysis Test Report No.GS5117A THESE ARE TRANSMITTED as checked below. ❑ For approval ❑Approved as submitted ❑ Resubmit copies for approval ® For your use ❑Approved as noted ❑ Submit copies for distribution ® As requested ❑Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US TYPE OF DELIVERY: ❑ UPS ❑ FEDERAL EXPRESS �] CERTIFIED MAIL ❑ PRIORITY MAIL ❑ EXPRESS MAIL ® FIRST CLASS MAIL ❑ HAND CARRIED PICKED UP BY CLIENT REMARKS: COPY TO: SIGNED: Philip J.Medeiros If enclosed are not as noted,kindly notify us at once. F .'= _ tibtrtts rngires ing corp. CONSULTING ENGINEERS 716 CountyStree%TaumtonMA 02780 Tel.(3(8)822-6934 Fax.(309)880.7811 Client: John Doyle Job No. Inst.15-3464 170 Cloverfield Way Date: 4/29/2015 Falmouth,MA 02536 Report No GS5117A Project: 227 Pine Street,Bamstable,MA Combined Hydrometer and Sieve Analysis Report ASTM D-422 Dry Sieve Analysis Hydrometer Analysis of the Portion of the Total Sample Passing the#10 Sieve Sieve % Pass. Size MM Sieve Size MM % Pass 3.01' 100.0 76.100 No. 10 2.00000 100.00 1.0" 100.0 25.400 No. 18 1.00000 84.84 112" 99.1 12.700 No. 35 0.50000 62.22 3/81' 98.0 9.510 No. 60 0.25000 37.58 No.4 94.5 4.760 No. 140 0.10500 17.28 No. 10 86.9 2.000 No. 270 0.05300 15.10 0.05012 14.80 0.03556 12.80. 0.02924 10.80 0.02082 8.80 0.01475 7.80 0.01044 6.80 0.00743 4.80 0.00529 2.80 0.00374 2.80 0.00265 1.80 0.00137 1.80 Percent of Total Sample For Triangle Classification Retained on the No. 10 Sieve Based on Material passing the No. 10 Sieve Retained (2mm) = 13.1 % Sand 84.9 %Silt 13.3 % Clay 1.8 Remarks: Philip J. Medeiros Technician Christopher M. White S.E.,P.E. Laboratory Director t^ INK i&YrY"i�'.1�9iiCf tibbetts engheew iN core. Graph of Grain Size Analysis Using ASTM D-422 P1, w4..ft"Kw CONSULTING ENGINEERS nee�ae.n'r.mm�mnmeo Ta.(��.erxr-.(�aaami John Doyle Job No. Inst.15-3464 Date: 429/2015 -�e Material Passing#10 Sieve -+-Report No. GS5117A —o-Gravel Portion Curve 100 #270 #140 #60 #35 #18 #10 #4 3/8"1/2" 10, 3 0" 100 90 90 80 80 t 70 70 L ,of M m 60 60 50 50 ii iL 40 40 m a a 30 30 20 20 10 10 0 0 0.001 0.010 0.100 1.000 10.000 100.000 Grain Size in Millimeters 09/04/2015 04:22PM 17744139468 MEYER AND SONS PAGE 01101 Town of Barnstable Repbtory Service RloheW V.Sm14 ivwxim Director Prrltk Heaft DlvWou Thomas Mclean,Dire 200 Ma&Sorest,Hysnm%MA QW1 WSW 5094WA644 Fax: 508-790-ON 14Nler 8c oaff Cerm"tion i+'ornu ■ 1 � m Date: swap renwt# As or's MspIP 0�.,5� oedgner Address: !?-V G' Addrm: 07 g Nl Jr, On septic system at V27 based on a design&awn by (mess) Assoc/ d mod 7-2-If certif r 9W the sepbio sy$tenn referenced above was installed sub*n6wy to the design,which may iwhmk minor appmed cbanps such as lateral relocation distribution box anftr sapac tmk 94 out Cif required)was ffiVemd and the tolls were found satisfactory. I certify that the septic system referenced above was hstalled with ma' quangos 0-e- gneater dUm 10'1 1 roloc"on of the SAS or any vertical rel ion 01 Way component of the soptic system)but In accordance with State dt LOW Regulations. Plan rievlsion or eertilled wbuilt by designer to follow- Strip out(if requite was inspected and the sails were found satisfactory. I certify that the sum refer above was construct with the terms of the AA approval ktm(ifagplicable) ll� M. er s lgnatanc) MEYER NO; 1140 (Affl p ee+c PLEASE RETURN TO BARNSTAVU ZLALW BEA I TO UPAISION. MCA OF NO'r' MI T Cfi%f II.E P IC>EIE �!YOD. Qiseptiawequ�aerCWHIaW=Foam R4v&14-13-dw ZO 3JVd moms Sdfl EE88LLb90S 90�Z� 5i0Zlti015H Town of Barnstable c* Regulatory Services ����frywpbaw � Richard V.Scab,Interim Director Public Health Division Thomas McKean,Director Tom' 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 8-/,�'�-� Sewage Permit#201.3'-2 2 3 . Assessor's Map\Parcel Designer: <T1�oYG E AsSOC/�9� .5` Installer: JRVC 6 111AC41-Lis-1-254-f Address: /7P CLO✓,iE'GA5Z-,0 !fi41 Address: 87 100A& ST On 7/2 -/j ,MICA 1D 4CA,ZG1sTE1z-- was issued a permit to install a (date) (installer) septic system at 227 ST, .,Aff2ysT.¢BGc based on a design drawn by (address) J1)oyGC ,�s'SocsyT�� dated 7'2-Zola (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the AA approval letters(if applicable) yaL v Y r71� :YOtiN (Installer's Signature) t P. ;? oo•rLF,tit y►f No.33385 �fr t`V (Designer ignature) (Affix ere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:15eptieWesigner Certification Form Rev 8-14-13.doc Sty lrewlr" C �1�9iG JP°L3ZI/� Vcrizon, n t ToWn,.of AgM.ka.ble ->P#_1 5 � Departmdnt of Regulatory Services Public Health Division Hate ;;senrterears 200 Main Street,Hyannis MAF02601 Date Scheduled UI l ( � Time _ Fe e N. too r / Soil Suitability Assessment for Sew e Disposal Performed By: \/���� �r� � Witnessed By: v c J;L LOCATION& GENERAL INFORMATION.: Luca[;on Address Owner's Name ��/l/JE Address Assessor's Map/Parcel: � /""''/S-Z Engineer's Name 1 NEW CONSTRUCTION REPAIR - Tele hone ' P :JrD 8'S. J .' Land Use /� Slopes(%)-� Surface Stones -! Distances from: Open Water Body, 2 eW ft Possible Wet Area 20. ft Drinking Water Weli/-J 0 ft Drainage Way a� ft. Property Line _/�- ft. Other ft SKETCH:(Street name dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ET 30 . P�R�� rs . 3/s ti �s '� ,fix • Parent in (geologic) S�/l�� g Depth to Bedrock Depth to Groundwater. Standing Water in Hole: < 7B we, from Plt Face Estimated Seasonal High Oroundwater�L 6 14 3Z t 4 f /W/Il 1"21 Q �V1 lsrA -V r. S/,�i+/�/A//c ZS3 G✓G� / i4 lA/G S;�c�P cap co14141 ss1`aA) DETERNIINATION FORSEASONAL HIGH WATER TABLE ; Method Used: Depth Observed standing in obs.hole: In, Depth to soli mottles: Jn, Depth to weeping from side of obs.hole: In. Orbundwater Ad,�ustt lent C[. Index Well# Reading Dater index Well levol� AdJ,faetor„�_. A41 (Groundwater Level .,-Time:_. Observation A�'�- Hole# 5� /G l 11�C`6� b S-Val GHQ R.Ii✓5r 2.c- _ Time at 9 Depth of Perc h/U4�-ySl S FAD/M , Time at 9 Start Pre-soak Time @ me(9"=6") End Pre-soak Rate Min./Inch / Site Suitability Assessment: Site Passed . V Site Palled:. Addition5l Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back--------. ***If. percolation test is to be conducted within 100' of wetland,you must first notify the• 0 Barnstable Conservation Division at least one(1) week prior to beginning. , Q:ISEPTICIPERCFORM.DOC L ' DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture_ Soil Color Soil Other Surface(in.) (USDA) (Munseli) Mottling (Structure,Stones,,Boulders. onsistency.%t3ravel/00 3 0" s4 �, mkn. sAno(. 7 Sy2 srt, r-Gp,91n . /yle s z _ g 7UEF.P OBSERVATION HOLE T.,O Bole# 7�-3 . bepth'from Soil Horizon Stlil Texture Soil Color Soil Other Surface(in.) (USDA) (Munseli) "Mottling (Structure,Stones,Boulders. Consistency.% CoAhl r. C /n 6h, s//W o s%C,. T-Wee o DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munseli)- Mottling (Structure,Stones,Boulders. Con t to c (DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stot►es',Boulders. Consistency. Flood)(insurance Rate Map: Above 500 year flood boundary .No— Yes Within 500 year boundary No_j� Yes ' Within 100 year flood boundary No. V Yes _ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �S If not,what is the depth of naturally occurring pervious material`? Certification I certify that on jy (date)I.have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise)and experience described in 310 CMR 15.017. Signature �"' Date Q:ISEPTICVERCPORM.DOC TIBBETTS ENGINEERING CORP. dCir4L ` COG 4 �l� t]�44L°Qd 3090 Apnhnet Avenue 716 County Street DATE New tdford,Ma 02745 Taunton,Ma 02780 04/29/2015 (508)998-3700 (508)822-6934 JOB NO. ewhite@tibbensengineering.com Inst. 15-3464 www.tibbettmgineering.com ATTENTION John Doyle TO John Doyle RE: 170 Cloverfield Way 227 Pine Street Barnstable,MA Falmouth,MA 02536 WE ARE SENDING YOU ® Attached ❑Under separate cover via the following item: ❑ Shop Drawings ❑ Prints ❑ Plans Samples ❑ Specifications ❑ Copy of Letter ❑ Change order ® REPORT COPIES DATE NO. DESCRIPTION 1 Title V Grainsize Analysis Test Report No.GS5117A THESE ARE TRANSMITTED as checked below: ❑ For approval ❑Approved as submitted ❑ Resubmit copies for approval ® For your use ❑Approved as noted ❑ Submit copies for distribution ® As requested ❑Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US TYPE OF DELIVERY: ❑ UPS 11 FEDERAL EXPRESS E] CERTIFIED MAIL ❑ PRIORITY MAIL ❑ EXPRESS MAIL ® FIRST CLASS MAIL ❑ HAND CARRIED PICKED UP BY CLIENT REMARKS: COPY TO: SIGNED: Philip J.Medeiros If enclosed are not as noted,kindly notify us at once. ZE:c i bbetts r=nginEaring core_ CONSULTING ENGINEERS 716 CountyStree%TaintonMA 02790 Tel.(508)822-6934 Fax.(508)990.7911 Client: John Doyle Job No. Inst.15-3464 170 Cloverfield Way Date: 4/29/2015 Falmouth,MA 02536 Report No GS5117A Project: 227 Pine Street,Bamstable,MA Combined Hydrometer and Sieve Analysis Report ASTM D-422 Dry Sieve Analysis Hydrometer Analysis of the Portion of the Total Sample Passing the#10 Sieve Sieve % Pass. Size MM Sieve Size MM % Pass 3.0" 100.0 76.100 No. 10 2.00000 100.00 1.0" 100.0 25.400 No. 18 1.00000 84.84 1/2" 99.1 12.700 No. 35 0.50000 62.22 3/8" 98.0 9.510 No. 60 0.25000 37.58 No.4 94.5 4.760 No. 140 0.10500 17.28 No. 10 86.9 2.000 No.270 0.05300 15.10 0.05012 14.80 0.03556 12.80 0.02924 10.80 0.02082 8.80 0.01475 7.80 0.01044 6.80 0.00743 4.80 0.00529 2.80 0.00374 2.80 0.00265 1.80 0.00137 1.80 Percent of Total Samole For Triangle Classification Retained on the No. 10 Sieve Based on Material passing the No. 10 Sieve % Retained (2mm) = 13.1 % Sand 84.9 % Silt 13.3 % Clay 1.8 Remarks: Philip J. Medeiros Technician Christopher M. White S.E.,P.E. Laboratory Director i l r t(ECtit) bettsenOinETING E Corp. Graph of Grain Size Analysis Using ASTM D-422 CONSULTING ENGINEERS 116C—Wft-TmM1® .180 Td,QMM]MFm(601n88 M1 John Doyle Job No. Inst.15-3464 Date: 4/29/2015 Material Passing #10 Sieve Report No. GS5117A —&—Gravel Portion Curve 100 #270 #140 #60 #35 #18 #10 #4 3/8"1/2" 1 0" 3,010 100 00, 90 90 80 80 = 70 70 t 4 60 60 50 50 iL U. 40 40 a� a 30 30 a 20 20 10 10 0 0 0.001 0.010 0.100 1.000 10.000 100.000 Grain Size in Millimeters Massachusetts Department of Environmental Management Office of Water Resources 134136 TYPE OR PRINT ONLY _ Well Completion Report 1.WELL LOCATION GPS (OPTIONAL) LATITUDE LONGITUDE Address at Well.Location: Property Owner: o'm-eS �2t�kt rS Subdivision Name Mailing Address: 11 � • nn City/Town: y W,. .�joci�S} j,Q-- Cit frown: Assessors Map Assessors Lot#: NOTE: Assessors Map and Lot#mandatory if no street a d ss available Board of Health permit obtained: Yes ❑ Not Required ❑ Permit Number Date.Issued,. 2.WORK PERFORMED 3. PROPOSED USE 4. DRILLING METHOD - ❑ New Well ❑ Abandon X Domestic ❑ Irrigation ❑ Cable Auger El Deepen ❑ Recondition El Monitoring ❑ Municipal El Air Hammer e❑" Direct Push 54 Replace ❑ Other ❑ Industrial ❑.Other ❑ Mud',_Rota ❑ Other 5.WELL LOG Q Unconsolidated Consolidated 6.SITE SKETCH (use permanent landmarks with distances) W Permeability v > CD From (ft) To (ft) High Low rn rn C7 m Other Rock Type - 5 Tr.�m C. w:J s+ 7.WELL CONSTRUCTION", 8!CASING - From-(ft)" To (ft) - Casing Type and Material Size O.D. (in) Well Seal:Type Total Depth Drilled Date Drilling Complete 4-$l — (o( S C.�K A 4 P v C y+ ?(TLE SS AApTr__ t 9. SCREEN - _ From (ft) To (ft) Slot Size Screen_Type and Material Screen Diameter w 765 .OIZ L4 10. FILTER PACK!GROUT[ABANDONMENT MATERIAL 11. ADDITIONAL WELL.INFORMATION - , Developed? Yes ❑ No From (ft) To (ft) Material Description`o� Purpose Fracture Enhancement? ❑ Yes No Method Disinfected? Yes ❑ No ;'12.WELL-TEST DATA(PRODUCTION°WELLS) ` 11 STATIC"'WATER LEVEL(AILLVELLS) YieldRTime Pumped Drawdown to Time Recovery to Depth Below Date Method (GPM) (hrs&min) (Ft. BGS) (hrs & min) (Ft. BGS) Date Measured Ground Surface (FT) 3ajvy PUMPTAPp- 2.14P.5 1 -5 I/Va o -27 14. PERMANENT-,PUMP(IF:AVAILABLE) t ,,;}ea V 15.NAMEIADDRgSS OF PUMP kNSTAI.UITf%COMPAfVY Pump Description - Horsepower Pump Intake Depth - '`�` (ft) Nominal Pump Capacity (gpm) 16. COMMENTS 17.WELLDRILLER'S STATEMENT This well was drilled and/or abandbned under my supervision, according to applicable rules r' and regulations, and this rep is complete/and corre t to the best of my knowledge. Driller�`1 Dw L laC �� Supervising Driller Signatur «4744 CXMLRegistration #: Firm: Q•,� 11 h� Date: �` ' ^ 6`1 RigPermit#: NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY EATT7ROTECHI.ABORATORIES,INC. AIA CERT JNTO.:J1T AL4 063 8 m.crebastimi Dfi e-Unit#12 Sandi ich A-L4 02563 508(888-6460) 1-800-.339-64fr0 FAY(508)888-6446 CLIENT: Desmond Well Drilling LOCATION: 227 Pine St ADDRESS: (Jim Jenkins) W Barnstable MA COLLECTED BY. Desmond Well Drilling SAMPLE DATE: 7/30/2004/8/4/04* SAMPLE TIME. 2:00 WATER SAMPLE TYPE: New Well MATE RECEIVED: 7/30/2004/8/4/04* LAB I.D. #: 0407827/0408090* WELL SPECS,: 4" SCH 40 PVC 65'/28' RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Colitorm bacteria 1100ml 0 0* 9222 B 8/4/2004 pH pH units 6.5-8.5 6.29 4500 H+ 7/30/2004 Conductance umhos/cm 500 408 120.1 7/30/2004 Nitrate-N mg/L 10.0 0.07 300.0 7/30/2004 Nitrite_N mg/L 1.00 < 0.004 300.0 7/30/2004 Sodium mg/L 20.0 62.0 200.7 7/30/2004 Iron mg/L 0.3 < 0.1 200.7 7/30/2004 Manganese mg/L 0.05 0.043 200.7 7/30/2004 COMMENTS: pH is below recommended limit and may have corrosive characteristics. Retest Sodium level is not a health hazard, but if on a low sodium diet, consult a physician before drinking. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. <=less than >=greater than TNTC=too numerous to count lA, Dat ley p J. Sa V�r� -Laborat€�ry Dct®r i Fee— - ------------- ---- ------------ �D BOARD OF HEALTH TOWN OF BARNSTABLE Application for Veil Construction Permit Application is hereby made for a permit to Construct Alter ( ), or Repair ( )ani ividual Well at: ys�— Location Address Assessors Map and Parcel 7 k5i,.5,q A, ., it.Cy/?.'"e-4 i7eLk, e Address 'Vell 01ale-(-t �q 2 7 IT, e_'09�V5 j7f A Installer - Driller Address Type of Building Dwelling Other - Type of Building No. of Type of Well 15c-04 4'/0 O'OVC Capacity---------- e,� Purpose of Well--- Agreement: V The undersigned agrees to install the aforidescribed 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 rtificate of Co ce has been issued by the Board of Health. Signed 1.2 2-41 ate date Application Approved By — — , - ---- Application Disapproved for the following rea s: ---—--- date Permit No. —— -------- Issued U date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of COMPhan[P THIS JSJO CERTIFY, That the Individual Well Constructed (Altered or Repaired In has been installed in accordance with the provisions of the Town of Barnstable Board of Health i itc Well Protection ' — Regulation as described in the application for Well Construction Permit No. led -------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- Inspector——------—---------------------- _ No.-- ----------- Fee��------------- BOARD'OF HEALTH TOWN OF BARNSTABLE Zipplicat ion-for lVel[ Congtruct ion Permit Application is hereby made for a permit to Construct (✓r Alter- ), or epair)an in ividual"Well at: d� / fit/ - Location''.- Address Assessors Map and Parcel p Gr S 17 A., V. !Y"q'/77 av_-���It�/—�—�---- —�—`�7 - �-/N P �-�1�_—� ��cCC%2 jYliS)`-C4� _ Owner f� Address Q l F'/f 6'P r G c r ti. Oq 4! ca?7 r 3 ----------- - --- -- ----- -------- -- - ---- - -- - ------ - - Installer - Driller Address Type of Building Dwelling ---------- Other - Type of Building— ---------- - No. of Persons----_—_________—__—_—_____ Type of Well— O 'z;'VC - ='� Capacity---- — ,' �--- Purpose of Well-----��'—�77�,��d r-�- w 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 Certificate .of Compliance has been issued by the Board of Health. .2 2-0 Signed - - -- l" --- -= ate -� Application Approved By 'date— Application Disapproved for the following rea s:— __-____----______—_____________ - date Permit No. v - Issued--------- ------ - ---- date BOARD OF HEALTH t TOWN OF BARNSTABLE (Certificate Of ICompriante THIS IS TO CERTIFY, That the Individual Well Constructed (,�!Altered ( ), or Repaired ( ) ---------------------- - ----------- Ins /�r, `, ---- at- - -� -- --------- - -- - ----- -- ---has been installed in accordance with the provisions of the Town of Barnstable Board of Health vate Well Protection Regulation as described in the application for Well Construction Permit No. ,! %� Dateedd---------------- 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 W It Con$truct ion permit No. _ �o Fee -�----�-- Permission is hereby granted��� ---- --- -- -- s-�--------------- to Construct ( ,4!Alter ( ), or Re air ( ) an/Individ�u(al Well at: No. - -7 i/t/�T. _ "e.�v-s . /.3 ��`_-------------------- Street as shown On the appli ation for Well Construction Permit -71 a/,?.ti/----------------------------- No.-���.. --- Dated-- I -- — — ---------------------- -------- Boaid of-F'ealth DATE ;LOCATION { SEWAGE PERMIT NO. VILLAGE ga -5 ) A - 4 5 2 015 INSTA LLER'S NAME i ADDRESS n UILD ,R OR OWNER a DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ,� . a � +�- � � .. ,s t �� o + _/�— �_ �.. � :� �� �� �� 3: Ile N0.22 .._2.* Fxs.... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.........8/ ................................. 15z_0f Appliration for Btipoial Works Tomitratr 'oat rantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sys at: l.E------...,,SZ tCe ............... ......•-----------•---•.....................•....--------------•------• Location-Address or Lot No. a�4_!!2.f1=S.........-T V/5<l N s--------------•--•-- ...........................................•...................................................... Owner Address Oar- .............................................................................................••. Installer Address PQ Type of Building Size Lot__�....._.._.A ..s�-�i€et V Dwelling—No. of Bedrooms........... .Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria P-4 Other fixtures -------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow----........................................gallons. W Septic 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit....--.............. Depth to ground water.....................--. GT4 Test Pit No. 2................minutes per inch Depth of Test Pit.-.---.--.___--_.--- Depth to ground water................... ----- a -••••--•---•--------...••••••••-••--••-••-•--•------••--•----•-••-•----• ....................... -•.......-••---••...........----------------------------- 0 Description of Soil........................................................................................................................................................................ x U ---•--•••-•-•--•-------•-•--•--•••--•--......---•-•••-------•------•-••---•--•-----------•-•-•••-•--•-•-...-----•-------••-••-•••---••--••-•----•----.................................................. U Nature of Repairs or Alterations—Answer when applicable.....- .............. &.e5�!yT.- na - do ' ........... ,� y----------------------------•-----------------------.....---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iT: " y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lice the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...............................r..................................................... -••------•---•-------•-•-----•-- / ate Application Approved BY•••-••. 4—--•--•----- Date Application Disapproved for the following reasons:................................................................................................................ ---•-•----------•-------•.....•••---•------•----••-•-----------•--•-------•---••..............•------------•...•-------•--•-...-•-•-----•••••--••-•---...------••-•------------•-----••......•......--- Date PermitNo.......................................................... Issued_....................................................... r Date ' THE COMMONWEALTH OF MASSACHUSETTS o' BOARD OF HEALTH ©!�.N...............oF.........F1.. J&,.Q.-S.TA...T&.e............................ C-Errtifsrair of Toutlrltiaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by........116N.1t.7--......... /a+M.l?- ----------------------------• ------------------------------------------------------------------------------....----...------------. Installer has been installed in accordance with the provisions of T : ` of The State Sanitary Code as described in the ._ . -...application for Disposal Works Construction Permit N _ -- _-- �.__.--..---- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL. OT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUN(;.... SATISFACTORY. DATE.......ll �. 7�.. Inspector........ -•••....._-•.............•. No.22 ....25? FizE... .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....' .............OF.......... e!QfLay. .r�9 y Appliratinn for Biopoaial Workii Tnntrnr inn rantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System=at Location-Address or Lot No. ........--•-••--•-•.........................•-----••-•----.....................-----•-•......... Owner Address ;..4Kt!IL-7.........4-4-m-'P l.--_--... Installer Address UType of Building Size Lot.. ..........---------._"feet Dwelling—No. of Bedrooms......... .............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ <s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---•-------------------------••--••--•••----•••--••--------•---.....--•-------.............-•-------........................._..------..................---- 0 Description of Soil............................:........................................................................................................................................... x U .-----------------•-•-----•--•---••••-••-------•-----•-------••-----•----------•---.......••••--•------•-..._..•••-•--------•-----•••----•-•-••----------••••----•-•--••.........---••----.............. w U Nature of Repairs or Alterations—Answer when applicable.__--- ! �-� ne9t -------------OR- !_____ `�1¢ ..........P.ea-........g-a.... �-•-.�Y4e ......... ............ / , 'y'------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of lT`:L p 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 board of health. Signed................................. -•----------------------•--------------------••----- •--•--------------.--.---------- ate Application Approved By... �gr� ". ------------------------- Date Application Disapproved for the following reasons----------------•---------------------------------.....---------------...--------•----------••---•--------••---•- --...••••---•••--•••---••••------•--•--•----•-•--------•-•-•••--•-•-•--•-----------•-•----------•--••••--•--------------------•------...----••-----•----------•-••••-•---••-........................... Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................I.......OF......... ......................... C�rdifiratr of f omplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by.........f"°�...e`N --------.4.- !. p.l..................................... Installer at =�--�-------------- -w ir.......�elA-..4�7.----------- L r.-..r' -TA^1 z - Zre/V&,,IDS has been installed in accordance with the provisions of T T ry of The State Sanitary Code as described in the �T __application for Disposal Works Construction Permit _ _________________ dated....------...................................... THE ISSUANCE OF THIS CERTIFICATE SHALL' OT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........11./Z 0 I-------------------•------••----•---•-•--...... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH * '} :......�� �^✓. ............OF......... f r'? " ..tr .......................... .!.. , FEE.. ................. % asal Workii Twnnitriuriiott rrnti# Permission is hereby granted.... .rr.AX.X-•......... ,, ---------------•---•-----=---------........-----_---............. ------- to Construct ( l�or Repair ( ) an Individual Se,%L e Disposal System F at No..... A.M-d'll..----- ''t!,K.! j-------------�.......-- ... �!e'�e...S.''.. ?`!�+.".�,!$k.N... Street as shown on the application for Disposal Works Constructs a-- mit No..................... D gyred........................................... Boar Health DATE- .�, ,� , `. ------ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS No.. - •-•- -- ................. THE COMMONWEALTH OF MASSACHUSETTS ���'� BOARDIf -iEALTt-S �./... .. .... .....OF.......... .G..','I� ......................................................... 4 y ppliratiou for Bispoattl Vorkti Tonstru rtion ramit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal Sys .� .� ---- --�......--•-•-•••--- -- .... ---•------------------------ ----- •----- ocation 4ress or Lot No. •... --� ................................ ........................................... ........................................... ner Address Insta lep, Address d Type of Buildi g Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' 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_.._..p .......... Total Length....._.__.__.rr Total leaching area....................sq. ft. Seepage Pit No..... ............. Diameter..__.__.._ . .. Depth below inlet........lam....... Total leaching area.- ;C�. .A...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) � Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit--------_........... Depth to ground water....................... G4 Test Pit No. 2................minutes per inch Depth of .Test Pit..............._.... Depth to ground water........................ R'+ ...........•................................................................................................................................................ O Description of Soil...........7.------t-•------------------------------•--............_.....------------------------. .. ----•- U Nature of Repairs or Alterations—Answer when applicable...'-_ ____� ._. __._5 ..... ....... ./........_...__........ -••------------------------------••••-•-••-•--•-•--•-----•-•------••----------------...........---••---••----------•------•-----•••-•••-•-- ............................................................ 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 bee issued by the b arealth. Sig Date Application Approved-BY 1�'� Date Application Disapproved for the following reasons-----------=---------------------•-•---------------------------•-------------................................... .........................••••----------•--•-•------•-•••-•--•-----------..............--•----•----.........•---••--•--••--•--••••-•--•--•----•---•--•----••-•-•-------•••-------•-----••-••-•••••--•-•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... . f'L !..........OF............ 1 ............................... Trrtif irabr of Toutpliatta TH IS TO ERT That the Individual Sewage Disposal System constructed ( ) or Repaired by...... .. • -- ...... ._... .................. •;nsta.... ..... lle has bee installed in ac rdance with the provisions of TIT 5 of The tate Sanitary Code as escribed in the application for Disposal Works Construction Permit No.- �..___.� .�_..... dated-... .................... 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 71 y ..........OF... F HEAL H ........................ 1� No......................... FEE.............................. �i��u 1 urk� �u #rnnr�i�rn rrnti� Permission is hereby gr ted........ --•--• -- -•. . ...... c.._.. to Construc ( ) or Rep ( � Indivi al Sewag isposal" Sy _ � I . Street as shown on the application for Disposal Works Construction Per o.___. _ ._ .. .__- ed........L/ .............. ......... L. GLI. ----••-._--• - Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS -aj I W - No.-- •--.._....._..... F1m$ ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH ..........OF.......... .................................... -for Uisps al Works Tnnitrnrtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair (A an Individual Sewage Disposal,: System at: ....__...... .. ...... .:G........................ ...._._......... ................... ocation 7A 4ress or Lot No. r,r • a. .•••......•---• -•---•. ..........----------•------•-••-•-•-....... ..••---•----•----- ................ ner a Address W t a ---- --------- •-••-• ............ ----------------------- --•_. ....••-•...........-•-•---------•---•-•.........-•--_.._. Installe Address dType of Buildi g Size Lot............................Sq. feet U Dwelling No. of. Bedrooms_________________ ________._______.__._Expansion Attic,,`( ) Garbage Grinder ( ) Other—Type-of Building :___-__ .__ __ No. of persons_____________ ....... Showers ( ) — Cafeteria ( ) P4Other fixtures --------------------•------•--..-------------------•------.------------------------•--•-------•---....--------------•---------. W Design Flow...................... AA�..__ _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.� Apsq. ft. Z Other,Distribution box ( ." ) Dosing tank ( ) ~' Percolation,Test Results Performed by.........__.............................................................. Date........................................ Test P:t,,No. 1________________minutes per inch Depth of Test Pit........_........... Depth to ground water........................ ti Test Pit-No. 2.........______minutes per inch Depth of Test Pit.................... Depth to ground water........................ ............................................. ................................................................................_............................. D Description of Soil...........`40. ------------ ---- - ----- .._..._..--••------------ .._. .............. r y w ---- ---------- - ,?*� : ' U Nature of Repairs or Alterations—Answer when applicable.__"~�"..j..._AXI `,r ____. __ _._�F►.... `____________________ -------------------------•---------------------.............................................................. ..................................................................................... 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 bTeg,issued by the and ealth. l t Sig : ........................... ............... Date Application Approved BY----- -f = •• ........ .............................. ............-71 Date Application Disapproved for the.following reasons_.................._....................................................................................__.......... -••------------------------------•--•---....-•---..._...------------------...---•----------•-•-•--..._..----•-•-------------=-------=---------------=-_-----------------------------------------....... Date PermitNo......................................................... Issued•....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH !?G!! 1..........OF............ ......... . .. ......................... f�er#ifirtt#e n�4.'f�nnt�� �anrr TH IS T0. ERT , That tht#' Individual Sewage"Disposal System constructed ( ) or Repaired (10<,.----•-_ ----..._•••----•---_---- •------••---------••--•-by I�staller "'--- has bee IS in ac rdance with the provisions of TIT of The State Sanitary Code as dcy ribed in the application for Disposal Works Construction Permit No... __. .. _d�__�. ..... dated_.-.1/t/'" ....... ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEA+I=1dlIILL FUNCTION SATISFACTORY. , DATE................................................................................ Inspector..................................................................• ............ ti THE COMMONWEALTH OF MASSACHUSETTS 7.- BOARD HEAL .H N ....... FEE..,... •- �i� n� �rk� �.� #rnr�uan �•erntt� �...,, Permission is hereby gr ted k ............. ` to Construct ( ) or Rep ; ( IndividufaI Sewripsosv� pp����� �. wiz 2 a Street as shown on the application for Disposal Works Construction Per o. "'d �� -- Board of Health DATE--- - c b FORM 1255 .:HOBBS & WARREN, INC.. PUBLISHERS a f x tw 3' Vv�_. ! 4 - s A rat ... _ x - M .• r',�a'V .. 1. - �` 'x , ., to June T 1975 Ar Mr. William J. ,Cl nghan Pine. Street West FBarnsabl'e, Dear mr . ` Clinghan s`' You -are. granted a 'variance �to replace and �upgrade.i your existing + -sewage `system with'-'a 1500 gal l6n septic tank" and a leachin y pit 65y•feet from,a.,pond 'ins lieu. of the required 100., £eet and` , 126 ,f et from' an'°exis i well in liexi, 6f the' rpquired 150 feet. .. g A.1l other, provisions contained` .n a;the Town.:,of .Barnst 3,e 'Health , Y�♦ v Regulations `arid Title. 5, cif!• the Stake Enviroiaental Code:, 'must be 'complied with. ` � , A 't • r r .yV .. .q � e+ `"' +• - t :fir* . .This is considered`an .emergency repair. Th�,s yy es Jul. ,l r'� variance •e ic , M r �+ .���0�- a wk tr „Fr Very* truly you'r$, Ann.J a baug Chairman ; L Robe L. Chi .ds -a.•' ' s r' c: a t a I�rg /F,r�Or YupYiA•ri # i ,{ ".f . � t A ,W. mandelstam'�= .M. D, TMty rro s •♦ `!' � � �m ,v. r x +s. �ta v' ^ BOARD OP,IMn `BARNS41 TADLI: 1 xr MM cc.. Conserva Lori` Commissican • f lM r Y'�, t 4�Yk ...c�.. ? r - ♦ ,.f, aF. .a .. .. ,�km `.. '. .. s{,y .' 'i '.i a '.r .r p r: * ;r• .i.,• r ^. a, I fL ° O TABL 1639 r MV k- TOWN OFFICES 397 MAIN STREET (617) 775-1120 EX. 128-129 HYANNIS, MASS. 02601 TOWN OF BARNSTABLE - EMERGENCY ORDER FOR WORK UNDER MASS. G. L. Ch. 131 Sec. 40 AND TOWN OF BARNSTABLE BY-LAW ARTICLE XXVIII To: William J. Clinghan File # Pine Street West Barnstable, Mass. 02668 Project Location: Pine Street, West Barnstable Date: June 7, 1979 Pursuant to the authority of.G. L. Ch. l31 sec. 40 and Article 28 of the Town of Barnstable By-Laws, emergency work necessitated by failure of the existing septic system is allowed. CONDITIONS: 1) Septic system .is to be located as per "Sketch Plan" dated May 21, 1979 and received by the Barnstable Conservation Commission May 21, 1979 2) Subject to approval by, and variance from the Barnstable Board of Health. - 3) This permit applies only to work on the septic system. 4) The Conservation Commission shall be supplied with a copy of the Board of Health permit for the septic system. Arlene M. Wilson, Chairman - r 04- � � e q ` '{g 1f i a .. P y+' + rr. �. i s a• t a y. ' •r°9'y•,. 07 "Sept'ember 6, "44 r a .. x ':'"°1 ,a _r,k- '� «,,,J r qit p 'x, 8 r*}r Y' .� i•x; ... ,.!' ° r+ d, �RN.. . - •,a §;4 t , b" ,..r � ..''.t a...,r yxv a - ',., ., .. •. g .Mr• i3nd Mrs., SameS Jenkins` ,;r t J,R ¢ "' , 4 22? `Pixie':,Street° f West 8arri it le „MAC `�ear`�Mr*:•z�id.:iii ,ir Jenkins« •° ,*3 All, t S'. ,,Thank you•for apt eariug at-our, meting on September,5, -1970 " i` +. X -. > 4 J -'W Y � ..•r 4 NK�F � ..J*.a• .f.: s r. You are granted,�a .variant to_winsta�.l�a ;�®ptic: tank' and . 'leaching .pit 104 ,feet fra i your well' l: ,Aieu of the: required ; 1�©.£eet�. and to' inst lY' a leachi:hq,'pit„60`.feet rfrom-,the wi pondhi$:'. 11 upgrade ryour �pr`went; inadequate system .--You. must` 'reoeive japprovaj-�of ;the "Canservat on ComYn3,�sian prior to any. construct ' s A1 .t lather provisions'contained in 'Title , State 'Env .rosmental 0. D. . . . Code, and the Totan of°;;H ►srnstable° HealtYa' regulations must °be strictly 'i dhered)-tq, ' islvarance, expires.+dctober`'2M 1.98©. ; 1y yours h> a Ro rt L , Childs- ` airman ; r A* #tl,' Mande 6tr'�iCt M; D. _ n Jane, s Baugh.' a .. BOARD,,OF.HEALTH"" r TOWN OF BARNStl �B E � .!, Y •ts .j )all�' f ..ynM p • • s F , cc: Cornseryatio' n-Commisssio,n. ' 4 ..t 4 .lak _s r ,' . + t•r e` .. a .-l. .! * 4,•K • x:Y k n a M1^> N a} ! `Y, .. - yr e: - X'$3."'" r ". �. _,- ,Z OD '. II G ,i I CI �I I I I� G � i� .� �� I ,� ,_ �{ i ,� i j II _..-_��i I -- - ---- - - ---.,c- - I i - -^- •--- ---- i- i ,, �I { i I i tf j 0 r r � � t �e 41 4 Old . f J F F *941 6 f t f T/ 4:5 AXC-7 7_11VC- ��/_ S o iP f1,C SE,o G�ACh�/r�tr Jr/ FG16 P�oPos�d 7f� �DGUS _--y .IMP 17 r SEPTIC 7 /A- \ � N OF JOHN t Gs .BAT,IV .� .1 T iV� COk'•c/E.�' �f Q , C �© P DOYLE,111 a No.33589 SEvv�G SysTEj� L/PFl2lJh /��f�jU CIST /jsS,ESS"sDIC'S r�AP /.,5'Z �.4.C�CEG D/✓' OF, A107t 6?15 /S N47" LOC,4TE� 11V X STATE Zo// 7I 1-Y; G'f1�4>✓ T A .13.9R�c%s"Ti48/E 1-/i91��' ,Pi�07ECT/D�/ L�/STEP/CT, ate.. DA EN _ u SE WA 6 E SXS76M PROF/[.E /A/sTi1LL. 4 AA5fr� An/v- �L OOR E'G • g PYC /NSPE C T/oN POR Ts Td Co✓ER To W/T//inl 6" ►wtTN/N 3" OF F/N- GRAOE . OF FiN/sH GAAGE •e f/N/S h/ BRA 1�E MIN. _I-z_ 217, COVER WITH/M G' F/IV GR. RISER A,VA CO V,6R TO 36"Mi4X W/TN/N G" OF F/n/. G4ADe. �L . C3.8.6 RISER wiITE�Tl6NT. CoVER -2 MAX• ANa AV C/2IV T pNE SCIV, 't0 f'YC ISER /N V. 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