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HomeMy WebLinkAbout0305 PINE STREET - Health 305 Pine-Street'. West Barnstable A= 175 — 034 TO ARNSTABLE LOCATION SEWAGE # � VILLAGE W A aZ�y ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 1 i�-00 4,1 J I-44 S -- LEACHING FACILITY:(type) 11 1Lt (Size) NO. OF BEDROOMS L PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER V5 \/f-lg CO, DATE PERMIT ISSUED: Z C3_ __ DATE COMPLIANCE ISSUED 7 � VARIANCE GRANTED: Yes No �/� it i fl a No... Fps..... `-?...:..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............ 7�.�.� ........OF.......... liraa#'aaaa fear s usat Works Tomitrartinaa rnmit Applica on is hereby made for a Permit to Construct ()<) or Repair ( ) an Individual Sewage Disposal System at• b 17 ................ -.............- ....._........ to . ................................................. Lo ation-Address or t o. ---• ..�Y. _.�.t < ��t'...... 0.C..--•-... ...... .0x.......51g.......�v..:. ----- ----...----•- Owner Address --..... Installer Address Type of Building Size Lot..__A/.7��-----Sq. feet Dwelling—No. of Bedrooms___..._:_._..___________________________Expansion Attic ( ) Garbage Grinder (R/� cua�v rRhru� Other—Type of Building ...___._....'______________ No. of persons..........rz?............... Showers (,,A) — Cafeteria ( ) a' Other fixtures ................................. . W Design Flow................ ............................ ;R �Y.. --, .� R; Septic Tank—Liquid*capacity..._...___gallons �Length....ZV_..___ Width..,1..�_.._.. Diameter________________ Depth__,`z_.._._._.. Disposal Trench--No. ____-•_---.-.._--- Width....-Fr•-.......... Total Length..._ Y...... Total leaching area.... ------sq. ft. " f Seepage Pit No-------/------------ Diameter____________________ Depth below inlet.._ _�.._..__ Total leaching area._ Q"5.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by.......................................................................... Date....................................... ,aa Test Pit No. 1......�.?`minutes per inch Depth of Test Pit----- 4!`+�.`�._ Depth to ground water----- ©_-_�%' TEA f3, Test Pit No. 2.... .-'-..minutes per inch Depth of Test Pit----- fc►.`!.. Depth to ground water----!vq..4'470' � Pa' -----•- -----•-- ..................................................................................................................... 0 Description of Soil-0)_.®.��_.��' `....LOB/.. 151949 - -50" -7�"--,4OU- ................ ST ezg --'�-�------.Q- G-..[Qf� v..... G U W Z`l-- l- .._ OU .. "1 � .................... 0:--...f1-e.!......... x V 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 ii:'s� p 5 of the State Sanitary Code— he un - igned furthera es not to place the system in operation until a Certificate of Compliance h een issue b the rd of heal Signe -- --------------•• � Date Application Approved By............ ... .................................... ..... ........ Date Application Disapproved for the following reasons:................................................................................................................ --------------------------------------------------•-----------------------•-•-----------.......-----------•••••----•-•-----------------------•----•--•--------•------•----------•----------•------------ Date PermitNo........ .........................- Issued....................................................... Date No... :..f�. .� t `_ Flcs _..� ......"- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ---:--- �.-Gd .-..--.OF....... . S�r�»' e� } d -------------------------------- Alip iration for DhipasFal Works Tonstrnrtion rranit Application is hereby made for a Permit to Construct ( I) or Repair ( ) an Individual Sewage Disposal System at: �. ::.............. P/ ...... 1:.�� ................................. .....ev.......1317 AI:�. ......................................... �? location-Address or Lot No. g�y p ` _._...,,....`�......__ :. �%'�- !I«"--p 'Af iid.t (:Q,,......._...___ 1_, k Owner Address ►W.a '+• _-' '� 1 •---------------------•----•-•-•--•------------ •--• ; ........ ............................... Installer Address < Type of Building Size Lot.... 7 ;4:�-----Sq. feet U' Dwelling—No. of Bedrooms ___ _____________________Expansion Attic ( ) .''Garbage Grinder W, P4 Other—T e of Building No. of persons_._.._.._ Showers — Cafeteria Otherfixtures --------------••••••-••---•••• ---------•••••---••••••--•-••--•-- ------- ......................................... W Design Flow................J ....................gallons per person per day. Total daily flow.........'V!� ..........................gallons. 1:4_ Septic Tank—Liquid capacity,t L(}__gallons Length.....pa'_ _____ Width__�'LIJ*' _ Diameter_______________ Depth...r- °l: Disposal Trench—No_ ____________________ Width____FI.......... Total Length Total leaching area____ ---------sq. ft. 3 Seepage Pit No........t----------- Diameter.................... Depth below inlet...... _3z...... Total leaching area_yN ----sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by Date ----------------- Test Pit No. 1______OC_;�.;minutes per inch Depth of Test Pit......l tq.4�2�__ Depth to ground water_____ _p___-V-OF- 'z-W. fsl Test Pit No. 2____ ,-_ ._minutes per inch Depth of Test Pit......f '6_tt__ Depth to ground water----- __ -,n_ a ••-----•--••-------------••••--•-••••--••••••-•--••••-----•--...--••••------•--•----...------..........._..-----••------------.._.._--••--------•---_--•-- O Description of So>l ,cc _ p 1 yy . ) { x {cf ¢ &4! t �`et a �i� a' ; °" - .�� C. "f €"�,e�' ,w .-- f ✓il ra i ve _ V Nature of epairs or AlteratiAs—Answer when applicable_____________________ _____________________ _________ _____________________ __________ •---------------------------•--------------------•-----------------•----------------._..............-•••.._...••••••••--•••-••••-•--•••••-••--•-••••••--••••--------------------------------------••••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T=p or the State Sanitary Code— ' e and igned furtl.er a es not to place the system in operation until a Certificate of Compliance h een issue b the rd of heal Signe �✓v Date Application Approved By............. . . ........................................... -c -- �,--------- �K Application Disapproved for the following reasons________________________________________________________________________________________________________________ ----------•----------------------•-------------------------._....-------------------.......__•- Date Permit No....... S.;7............................ = --._._.... Issued_-------_--- ;--n�c.. -------...--------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... .....OF....... ' �` ._......_.. Qurrfifiratr of TampliFana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( } by-----¢ ........ ------------------------------------------------------------------------------------------------------------------------------------------•---•- Installer at__._ ''� ` ........... --•----------------------------------------------------------------------- has been installed in accordance with the provisions of TITIE 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 CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................................................................•--------.... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L.D.a).a .........OF.........., h A(,W..� .d�'Z t-�........................... Bigpotiatl Works TAanstrnrtion ami Permission is hereby granted....... . to Construct O or Repair ( } an Individual Sewage Disposal System at No-._,�-�-�..... .......... -If1'-- • ,I-__-___ 4-4).. �,4—` aAv- �? _t ..__... Street as shown on the application for Disposal Works Construction - _ Dated.......................................... DATE----------/ �l� ---------•----•.._...--- Board of Health - •• -=•-••-•........................ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS Department of gnvironmentalManagement/Division of Water Resources WATER WELL COMPLETION REPORT WELL LOCATION Address IA7- /G A ir,e E T (_j e_ f City/Town(=? G.S.Quadrangle Map Grid Location d /!'r Owner gA1/ w, rliw Address/ti 5- a r-V fi/v �Ouorc Ce�.t�/ui�lr WELL USE CONSOLIDATED WELL Domestic Qi Public ❑ Industrial ❑ Type.of Water-bearing Rock Other L Water-bearing Zones Method Drilled f 1) From To 2) From To Date Drilled 3) From To 4) From To CASING Depth to Bedrock Length/ (�_Diameter _ Type pyc UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface Sand: fige❑ medium❑/poarse❑ Date measured ��!/ , (/ Gravel: fine❑ medium�' coarse❑ • Screen: GRAVEL PACK WELL.,/ IFPJ Slot# =length from to/M— Yes ❑ No Split Screen (or 2nd screen) WATER QUALITY TESTS MA Slot# lenqth f om to Chemical d Biological Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at GPM. How measured. Recovery feet after / hours. 1 LOG of FORMATIONS COMMENTS: (OWwell'or water"1 �K Materials From To V k 0 m �0 DRILLER y • Fir c A r r { �Qb Address �i •S .A \ City Registration No............ �( perators ignature ease print firmly 25M-10-95.807101 l BOARD OF HEALTH COPY �tiiiiifiiffiititiiitiiiiitiiiiifi(„ i;iiifil„ Mitt`iiitiiin(iiiiitiiiiiiiiiiiiiii;tiiiiiiiiiiiiiiii"iiiiiifififififififi;"iitifit"fit';tiiiiiififii"fifiiiiiiiti6;liiiiitiifitfi'titi#i)iiifi�iiii"itiiitiitiiiiitiiiiitiiiiii iiiiiiiiiiiiiitiiiijfi� ENVIROTECH LABORATORIES 449 Route 130 Sandwich, MA 02563 • (508) 888-6460 c ; CLIENT: Bayside Building LOCATION: Lot 16/2 Pine St. "- ADDRESS: 1645- Rte 28 Bayberry Square W. Barnstable, MA Centerville, MA 02632 j COLLECTED BY: D.A. Scannell SAMPLE DATE: 11/12/88 TIME: 8 AM DATE RECEIVED:11 12 88 SAMPLE ID: ET 432 JOB #: New Well WELL DEPTH: 104 f t RESULTS OF ANALYSIS: B Parameter Units Recommended limit Result � I Coliform bacteria/100 ml (MF Method) 0 0 PH pH units 6.0-8.5 5.92 Conductance umhos/cm 500 736 Sodium mg/L 20.0 108 Nitrate-N mg/L 10.0 <.03 Iron mg/L 0.3 .16. Manganese mg/L 0.05 Hardness mg/L as CaCO 3 500 Sulfate mg/L 250 _ Potassium mg/L 20.0 Alkalinity mg/L 200 ;~ Chloride mg/L 250 Turbidity NTU 5.0 ;~ y Color APC units 15.0 EE Background bacteria COMMENT:Sodium indicates possible.salt water intrusion or road salt run off. if on low sodium diet consult physician before drinking. Consult local Board of Health regulations concerning sodium level. ; „—_ YES No WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETER ESTED. 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