HomeMy WebLinkAbout0035 PLUM STREET - Health 35 PLUM STREET
WEST BARNSTABLE
A = 195 - 011
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VILLACEQf( v) _ ASSESSOR'S MAP & LOT -
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INSTALLER'S NAME & PHONE ta01���(� 6-R
37
SEPTIC TANK CAPACITY,S OQ
LEACHING FACILITY:(type) a _.�1 '
Dp0 (stt 1.
NO. OF BEDROOMS Vk PRIVATE WELL OR PUBLIC WATER
BUILDEi� OR O� WN_ ERA
DATE PERMIT ISSUE.D:____b
DATE . COMPLIANCE ISSUED:.
VARIANCE GRANTED: Yes ___ —No � _
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No..... .......... k. FEB.......... ......._
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN BARPdSTABLE
O F...................
......................................................................
ApplirFatiun for Disposal Works Cfuntrurtiun Prranit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
system at:
Plum Street Parcel "A"
.....----................................................................................. ......-------•---•----•--- -•••-•-•••--.........•------•••---•••-•-----------._.....-----
Location Address or Lot ;�o.
_Thomas Mortland 56 Ft Hil ,Hingham,MA____.02043_„______-
..... --- .............................................. ............................
Address
Installer Address 2. 7 A e r e s
Type of Building Four Size Lot.-_._t.•___________________#4F�=
U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( )
`04 4 Other—T e of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures ............................ .
W Design Flow..................... .........._........._._gallons per person per day. Total daily flow_.__._._.....__..440_,__•_............gallons.
WSeptic Tank—Liquid capacity.1500gallons Length__10'6'_ Width---5_'8��_ Diameter.......--_.. Depth...5J.'.4.'.'...
x Disposal Trench—No. .................... Width............._...... Total Length............. Total leaching area....... gg_....sq. ft.
Seepage Pit No.___......1---____-- Diameter.__...._.6......... Depth below inlet........ Total leaching area..................sq. ft.
Z Other Distribution box (;; ) Dosing tank (
Percolation Test Results Performed by.......Wm. L 12 b e r ma n_,P_..3 5 01___.______ Date...J u 1,y_6_,_19 8 4_--."
a
Test Pit No. 1............minutes per inch Depth of Test Pit -_____- ...... Depth to ground water _ __ ----.
(s, Test Pit No. 2.......:�.6._minutes per inch Depth of Test Pit......... Depth to ground water.....-.-______________
Ri - -------- ----------------------------••:•-----•-•-............ ------•----•----------•-----------------------•---------------•--
O Descrip ion of Soil...........1).__0 - 12" Sand. topsoi1, 12" - ':.,1.0_ 8" Consolidated_ medium
x sand some small stones, - 156" Medium sand
U •-----------------•--------- ----- -----------•----------------....................................................................................................................................
x 2) 0 - 12" Sandy_ top & subsoil, 12" - 108" Consolidated medium sand_____
U Nature of Repairs or Alterations—Answer when applicable__..some s m a 11t o n e s,10 8" - 14 4" Medium
5
-----------------------------------------------------------•------------------------................----•--------------------------- sand
Agreement: .
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
TTt1s-.�
the provisions of ': LE 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.
Sign d.-••----------7�Fo;��
Application Approved By = . ...... ..•-- • ------••---. ......./4
to
Application Disapproved for the following reasons----------------•-----------•---------------------------•------------------------...--••-•---•--•-----........._
....................•-------••----•----.......--•-••-----------•-----•-•--•----------........------....---------•---••--•-----•------•••----•------•-----•------•......................................
Date
Permit No..... o-..�... --------------------------- Issued-......�/ ............... -----------------
No......j9.J. ..... Fj.....;_�.........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH -
TOWN BARNSTABLE
OF.............
Appliration for UWp aiittl Works Tonstrnrtiun f lumit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
Plum Street
•----•• ..... . .................. ......................................... .........................Pal1.Q.0,1 " .....----------....----•-----•-•-••---•----••-'
Location-dress r Lot 'No.
Thomas. Mort and 56 Fort-•8fk1.,ftH3�n nam_(,M�------Q2Q!��_.------
a
Owner Address
Installer Address
p:
Type of Building Size Lot_1 7..ACL
Dwelling—No. of Bedrooms.........Four Expansion Attic ( ) Garbage Grinder. ( )
Other—Type T e of Building ............... No. of ersons.....__._..... ... Showers — ;
P� YP g ------------- P -------- ( ) Cafeteria,' ( )
`.
Other fixtures
------------------------------•--------------------------------------
%'. Design Flow......................�.......... ._...___gallons per person per da . Total daily flow............._.•.44.0..................gallons.
Septic Tank—Liquid eapacity.1500gallons Length.. :�_BWidth___ 8"._ Diameter___.___""... De th_._ :!4"_.
T
ai
x Disposal Trench—'_\o. .................... Width.................... Total Length.................... Total leaching area............9....sq. ft.
Seepage Pit No
---------- Diameter......... ...... Depth below inlet.,--- .,...... Total leaching area..................sq. ft.
' z Other Distribution box (X) Dosing tank ( )
e4 '-' Percolation Test Results Performed by..............................................abQ n.an,18-35Q1......_.. Date...JM1y__6•,.1964:--..
r
1 r Test Pit No. 1.......�_.'6'.niinutes
_minutes per inch Depth of Test Pit_._. __.. r Depth to ground'water "•
L?. Test Pit No. 2_______ per inch Depth of Test Pit.........1 t_.. Depth to ground water----- _...............
r: : : ": ------------*..--•-------•.....................................................-•-•-------.------
O Descrl 'on of Soil.._..._._1 . 0 12"...sandy tOpg0 1i1x" ^- 109"---Conaolidated medium
x saiTS some smai 1 stoi-es,108' - PO A*9'--um, sand-- ----
t� a
Sandy top & .eubeoi1,12' - 10e" Con+soldated--me �m.._ d.----
w --------------------------- ---'-
°' U mm
Nature of Repairs or Alterations—Answer when applicable.___.ome 9laalI tones fAPA0, 1446 ,MQd3Llm 88n4
------------------------------------------------------------------------------------------------------------ ------- -• --------------... ...--•-• ---•--•-----•---•.... ..------.. sand
Agreement:
"! The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
t}. theme fovisions of T= 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 --- . _..._ -----------------------•----•----- ................................
Date
----
Approved BY l` ,
`t Application --.
Date,
_-, Application Disapproved for the following reasons--------------------------------•-•-••-•--------"......-------•---------.....................................
Date
-
F,3 ------------- ---------- ---------.---- ---- -----
(� "
Permit No.------. !U.._(... ....................... Issued-.....II ` � ------..... --_
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THE COMMONWEALTH OF•MASSACHUSETTS
' BOARD OF HEALTH
...................TOWN..........OF.................BARNSTABLE ..
f•x
�nnt�rltttn�e
k THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (, or Repaired ( }
T ....................................................... r
/---------------------------Installer
has been installed in accordance with the provisions of iIT 5pf State Sanitary Code as described in the
application for Disposal Works Construction Permit No.... "........ . ........... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION. SATISFACTORY.
// 55 p p.�............. Ins ector.._ _ .
' DATE._...-•--- !�.:Ct .-Q-.Sl. - P /P.!!`.�l... .. •... .ti....
r 4s _�...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN BARNSTABLE
....................OF............. .................._.._..
No.....................:.. FEE....... ,
�i���a�tt1 nrk� C�nn��riinn �ernti�
Permission is reby granted------.... .•..-- f =
.. to Construct ( or Repot, ) an Inf�;vi�duual ewage Disposal System
-----------------------
Street as shown on the application for Disposal Works Construction Permit No..6.f _• �`-
.... Dated...)1.//._ �: L .
---------------------- U� ------- ------- _
� Board of Health
DATL�---".........------------- -----------------
........ .......
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
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ENVIROTECH LABORATORIES
449 Route 130 Sandwich, MA 02563 • (508) 888-6460
CLIENT: Tom Morton LOCATION: Lot A Plum St
ADDRESS: 56
Fort Ell Rd Barnstable,MA _
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ingham,MA _
COLLECTED BY: Louis Kapolis SAMPLE DATE: 11/17/88 TiME: 12:30 PM
DATE RECEIVED:11/17/88 SAMPLE ID: Et81A
;
JOB #: New Well WELL DEPTH: 106 ft
.= RESULTS OF ANALYSIS:
Parameter Units Recommended limit Result
Coliform bacteria/100 ml (MF Method) 0 0
pH pH units 6.0-8.5, 6.33
Conductance umhos/cm 500 217
Sodium mg/L 20.0 28.5 M
Nitrate-N mg/L 10.0 23 _
Iron mg/L 0.3 .13
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
Color APC units 15.0
Background bacteria
COMMENT: Sodium level is not a health hazard.
YES NO WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS YES/ ED.Xf DATE
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is = Department of Environmental Management/Division of Water Resources
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i WATER WELL COMPLETION REPORT
' WELL LOCATION
Address J,0 .0 //--J ej/'1"1' U/
City/Town /,05, Al J��/1/_' To
4
G.S.Quadrangle Map
Grid Location
Owner /O /a a 1/! -1 i+- 13
Address Af 7— /,1i
WELL USE CONSOLIDATED WELL
Domestic Public ❑ Industrial ❑
� Type of Water-bearing Rock
Other
Water-bearing Zones
1) From To
Method Drilled USG�. ,r
2) From To!
Date Drilled 3) From / To
.4) From To
CASING Depth to Bedrock
Length Ln4 r Diameter
Type UNCONSOLIDATED WELL
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STATIC WATER LEVEL Water-bearing'Materials
Feet below land surface 4!it r Sand: fine❑ mediumj0 coarse,
Date measured //�' Gravel: fine❑ medium❑ coarse
Screen:
GRAVEL PACK WELL
Slot#WFJ � length 4 ' from /d!/'to ,/04
Yes ❑ No ❑
Split Screen (or 2nd screen)
WATER QUALITY TESTS MADE S.lot4t- length from to
Chemical ❑ Biological ❑ Depth To Bedrock
PUMP TEST ,
Drawdown i'Z feet after pumping days / hours at /4 GPM.
How measured -!4 Recovery feet after hours.
LOG of FORMATIONS COMMENTS: (On well or water) .
Materials From Toa o
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DRILLERCb
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FirmSfli�
Alddress.//4.+?�,0 .,.
City A"
Registration No.
4
/r":. �' / /� p6rator s
Sign-ure
ease print firmly BOARD OF HEALTH COPY- 25M 10-85--807101
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