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Home My WebLink About0293 CARRIAGE LANE - Health CARIAGE 2, 3 1 D LANE h,� 457-14, • p� • • i 31 ii r 1 1 U J No. W'�o Fee BOARD OF HEALTH TOWN OF BARNSTABLE ZIppYication jFor Yell Construction J)ermit Application is hereby made for a permit to Construct(V�, Alter( ), or Repair( ) an individual well at: 2�3 c-OK c i 2 . L, 1-9 04v)S�J VL 2(-A-1 I o-31 Location Uddress Assessors Map and Parcel (xvr\-bvr 2Q3 (�Acc�� din crlS�abl�.,�l11aZ63� Owner'j Address " ji�Nl(A�h� �.0`Bo�. 2`1$3, (��'V.arS O L03 Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well W,1Sy® Q� Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described 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 Certi a of Compliance has been issued by the Board of Health. Signed A3 1 t o / D Application Approved By 317��` 1 7 Date Application Disapproved for the following reasons: 1 / Date Permit No. V� 17 —'� Issued 3 Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed V), Altered( ), or Repaired( ) by �yy�ar� l ' Installer at 2p\r3 C-ac chas 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.ln`�80 I,?^0)d Dated . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector No. o 17_ Id Fee R BOARD OF HEALTH TOWN OF BARNSTABLE 0(pplicatiou _for Yell Con0tructton Permit Application is hereby made for a permit to Construct( Alter( ), or Repair O an individual well at: 0-0, , tom-, 2n'i >v Location�-Xddress Assessors Map and Parcel kkA dZ�3o Owner 0 Address 2-�03 , C�r�rS UL�53 Installer-Driller Address Type of Building Dwelling Other-Type o\f�Building `/ No. of Persons Type of Well 1ST d�� V L Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described 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 Certi ca e of Co liance has been issued by the Board of Health. l Signed a� �.� - 1 I Date Application Approved By Date Application Disapproved for the following reasons: 1 _ f/ Date Permit No. �/'`1' 3)-o 7 ' 0 Issued Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIIS�IISS TO CERTIFY,that the individual lwell C1onstructedl ), Altered( ), or Repaired( ) by VY�an\ Installer at C. Lr 61> has been installed in accordance4ith the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No.t.-00 I--?—o)d Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH - TOWN - OF BARNSTABLE Vell Congtructton permit No. �Jc U> 7--a>v Fee Permission is hereby granted toS f Installer to Construct(�i, Alter( ), or Repair( an individual well at: No. Z��3 Ca C C:c'q"- , -'R 0-(-N� b��_ l� Street as shown on the application for a Well Construction Permit No.� 7 �� Dated 3/dam 7 Date �� Approved By 'y 1 !► r Legend i r t no IN Ilk t Ar: s Parcels i .- �• Town Boundary a 297032 Railroad Tracks -_. �Buildings Painted Lines Parking Lots 0 Paved ,1 L l Unpaved Driveways. p 4 C Paved • {:i Unpaved Roads Bridges: �. Paved Roads a� C3 Unpaved Roads Streams '297037 Marsh Water Bodies a ... - 797051 s #20 `: �-- • 297031 ..: -- - #293 S✓L�2 t GP77 NCP 297030 x ° .:d .: • #'312 297049 297030 #193 313 o e ammre�a Map printed on: 3/15/2017 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent. 367 Main Street,Hyannis,MA o26oi 0 42 83 an on-the-ground survey.It may be generalized,may not accurate relationships.to physical objects on the map 508-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: i inch= 42 feet cartographic errors or omissions. gis@town.barnstable.ma.us a-v.� d�. 1 1- U J/ • • �!'y Z°1Zi B�IRNSY�iBL� TOWN ofilmoomw Loatloe = �A RI�xRC E. _O R, !i•...rPandt No - l7 Yfnse C��4RyErTRt3� InstA§ff,sN*w&Address RRIM ,OR b ARS d Sby_S 313 Hamm AO, bE VA/:X,,<, f aUkr or Owner R 2 L C-rA RD2 -Nte Ptmft tined Date Cowpfbaee bmW C Page: 1 of 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) Report Prepared For: Report Dated: 4/26/2017 Sally Desmond Desmond Well Drilling Order No.: G1799106 P O Box 2783 Orleans, MA 02663 ---....................:........._._..-_......................_..............................._..._...............................................-..._.._.._.... i Laboratory ID#: 1799106-01 Description: Water-Irrigation Wire-1-1- Sample#: Sample Location: 293 Carriage Lane,Barnstable,MA Collected: 04/24/2017 { Collected by: DWD tr Received: 04/24/2017 j Routine M ITEM RESULT UNITS Rl MCL METHOD# ANALYST TESTED NOTE ' Nitrate as Nitrogen 3.5 mg/L 0.10 10 EPA 300.0 LAP 4/25/2017 Iron ND mg/L 0.15 0.30 EPA 200.8 LAP 4/26/2017 j Manganese ND mg/L 0,025 0.050 EPA 200.8 LAP 4/26/2017 pH 6.2 PH AT 25C NA 6.5-8.5 SM 4500-H-B DCB 4/24/2017 Sodium 13 mglL 2.5 20. EPA 200.8 LAP 4/26/2017 Total Coliform Absent P/A 0 0 SM 9223 RG 4/24/2017 Conductance 120 umohs/cm 2.0 SM 2510E DCB 4/24/2017 i Water sample meets the recommended limits for drinking water of all the above tested parameters.Note:irrigation 100%72 l ! l Attached please find the laboratory certifled parameter list, Approved By: (Lab Director) I 7 • I a ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6606.. i Massachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports Well Driller Please specify work performed: Address at well location: New Well Street Number: Street Name: 293 CARRIAGE LANE Please specify well type: Building Lot#: Assessor's Map#: a Irrigation Assessor's Lot#: ZIP Code: Number Of Wells: 02630 City/Town: Well Location BARNSTABLE In public right-of-way:. GPS C'•Yes f"No North: West: 41.68871 70.2.9665 Subdivision/Property/Description: Mailing Address: W click here if same as well location address Property Owner: Street Number:--Street Name: PAM DUNMEYER 293 CARRIAGE LANE City/Town: State: Engineering Firm: BARNSTABLE MASSACHUSETTS ZIP Code: 02630 Board of health permit obtained: l+Yes r Not Required Permit Number: Date Issued: W2017 010 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Well Driller Program € � Well Completion Reports(General) Well Driller - General Well Form DRILLING METHOD Overburden Bedrock uger Choose Bedrock- WELL LOG OVERBURDEN LITHOLOGY From(ft) TOM Code Color Comment Drop in drill Extra fast or slow Loss or addition stem drill rate of fluid Brown J 2 20 Fine To Coarse S!:� YES NO �� Loss Addition 20 40 Fine To Coarse S Brown i+ f Fast f".Slow YES NO =L.s,. Addit,.n f l (_...:......._.... n r� ;NO [Loss f- 40 60 Fine To Coarse S I .� Brown t'"'°Fast�Slow YES Addition 60 80 (Fine To Coarse S, (Brown�� 1 t-.Fast f'Slow ._.._. 1........_._......_......... a LL__ YES 'NO Loss Addition ------------__-- _---._-_..-_..� PT---------- [YES C r C BO 100 Fine To Coarse S Brown ��Fast t Slow �� —� NO -� __ Loss Addition WELL LOG BEDROCK LITHOLOGY Drop in Extra fast or Loss or Visible Rust Extra From(ft) To(ft) Code Comment addition of Large drill stem slow drill rate fluid Staining Chips p Choose Code �" r r Yes YeFr s YES NO Fast Slow Loss Addition ADDITIONAL WELL INFORMATION Developed (F Yes r No Disinfected r-Yes Ir No Total Well Depth 100 Depth to Bedrock Surface Seal TYPe (.'—' _ Yes o No�fracture Enhancement .. _ CASING r Is Casing above ground? __. .._ _.... ..._....___._.._._._. �`v _...._..._.._---- _-------- From To Type (T`hiic'knne�s�s'"' Diameter .. , Driveshoe 0 6 Povyinyl Chloride Schedule 40 e __.... LI.- Yes -_—__-_— __----------__.._..---- _ _......................_...... ----__��_ SCREEN E No Screen From To Type Slot Size Diameter 96 100 Stainless Ste.:[ Point m 0.012 ............... ____._.. _._..._.�__�_�._ _._.__ _.....---..-- __.__....__....._.__.......__-__....__.........__.. WATER43EAMNG ZONES r DRY WELL From To Yield(gpm) 72- 100 10 -- PERMANENT PUMP(IF AVAILABLE) , v Massachusetts Department of Environmental Protection Bureau of Resource Protection Well Driller Program p Well Completion Reports(General) t Wire Constant Speed Pump Description Horsepower Submersible 1� Pump Intake Depth(ft) 94 Nominal Pump Capacity(gpm) 20 ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material 2 Weight Water Batches Method Of (gal) (count) Placement -- ( -' -- -- -—— - — - - ----------------------------------- �— L Choose Material �� Choose Material WELL TEST DATA Date Method Yield m Time Pumped Pumping Level(ft Time To Recover Recovery(ft (gpm) HH:MM BGS) (HH:MM BGS 04/24/2017 Constant Rate Pump ,+� 10 1:30 73 O:Ot, 72 ............_._.._._._....__..........._..................._....._....... WATER LEVEL Date Static Depth BGS(ft) Flowing Rate(gpm) Measured 04/24/2017 ri2 1 10 COMMENTS WELL DRILLERS STATEMENT This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report is complete and accurate to the best of my knowledge. DESMOND THOMAS Monitoring[M] Supervising Driller III Driller Signature THOMAS,III Registration# 764 THOMAS,E i DESMOND WELL Firm DRILLING INC. Rig Permit# 023 Date Job Complete 65/26/2617 NOTE:Well Completion Reports must tie filed by the registered well driller within 30 days of well completion. 9 3- 33 ! No...............3--.... FE$....�, a. ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........TW,ho......... ...OF....... �ues�f� GG Appliratiura for DdupugFal Works C9ua strurtiurt Prrutit Application is hereby made for a Permit to Construct (L j or Repair ( ) an Individual Sewage Disposal System at: e4-vz- ��97Zacs'Ti9L3G •>-i.n -----------------•--•---••--•----•- ----- J�i�L�l Location-Address •-------------.....------...----------------------------------------------------------- or... G Lot No WOwner � Address -••..................................... ... 'sc�as �C�✓.,viS . -----.----•---------------- 1q Installer ............................. U Type of Building Address Size Lot.. Sq. feet Dwelling—No. of Bedrooms........... ...........•-. ""_______________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _________________•_-.._---- No. of persons............ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow.............. gallons per person per day. Total daily flow..._.......:t7 4?_•____ Septic Tank—Li uid ca acit .�' �__ gallons. W q P Y -- gallons Length.��G.'�---. VVidth.�''�••---- Diameter---------------- Depth.s='4'.- x Disposal Trench—No. .................... Width.................... Total Length..........._...._- Total leaching area....................sq. ft. Seepage Pit No......./......__.:._ Diameter.....`o.'........ Depth below inlet...... Z Other Distribution box Dosing tank '_ ...... Total leaching area...Z6- .....sq. ft. ( ) ( ) aPercolation Test Results Performed by-sti_-.._%?�4t S, y ................................ Date....--�Z VP�............. Test Pit No. 1 .._ ..._._minutes per inch Depth of Test Pit_.____ Depth to ground water........................ f� Test Pit No. 2.L:- --_._minutes per inch Depth of Test Pit.__.___ '.:_. Depth to ground water.......-............ . x " �. ••-•sc)i 4 ... `2 , - y . ..................................- ------------•-- -------.---------- •--- •--•---------••--------- .............. ------•- Description of Soil •-P ......--•3 - SSA------•--•.....--•-------- U ...............................................................•--•--......•---••-•--•-....•-••--•--•-•--•-•---••••-----••---•-•••---••••-----••--••--•-••-----•---......••. W ------------•••--•--•---•---•----•--•- U 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 Sanitary Code—The undersigned further agrees not to place the system in ration un ' a Ce tificate of Compliance has been issued by the board of health. Si ne r. Pc ....---•--......--•-------- /l �� - Application Approved B Date Y _ _ � - t �..... ----------- DaTe Application Disapproved for the following reasons: ----•------•-----•--•----•-----------------------•---------------•--•--•--•----•••----•-----•---••-- -------••-•-•--•--••••........•--•----•••••-------•-••-••----•-•----•-•-.......--•----------•••---........•-•-----•-----•••----•--------•-••------••----- u Permit No Date .................................... >, Issued............. ....................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T, .• ... •... (9rdifiratr of Tuui-plitturr THIS IS TO CERT..WY, That the Individual Sewage Disposal System constructed (--' or Repaired ( ) by........................:..-. ...............-•--•------... ....---- •-••-•----------••--•------•--••-•-•---•-------...............................-----.....-- stal ler at.. x'` -� ` ,. ,r �-f-------------• ) ...--------------------•---•------.......------------.......-----•----.. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in;the application for Disposal Works Construction Permit , THE ISSU NC OF THIS CERTIFICATE SHALL NOT BE CONSTRU AS A GUARANTEE THAT THE SYSTEM V9lI F NCTION SATISFACTORY. DATE.... /�. .................... Inspector-------- --------.-------------------.-.--•----.--•-........-----•--•---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH J ......OF................................---..........---..-_.-............--................ 'el FEE........................ "iupmal Workg (gonlitnutio t ramit Permission is hereby granted ( " ...--•......................................................................•--....... to Construct (vff or a air ( an Intlividual *varage D' osal System at No...- �� u c '............. Street ----•-----------------------------------------...........----------------------- Street as shown on the application for Disposal Works Construction —P-eermit No--------------------- Dated.......................;........._........ C1� and of ealth DATE----------------- -= --------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS G, t---z --Xy7 031 62 q,33 Q�RN5T�4BL� TOWN of Loation " Gs�RR L4G-� O R. ScwxW Permit No,L,1=1Oa Village Installer's Name A Address R R-TN u R SEARS So Vv S 313 Hogu rm 80 , m Builder or Owner RZCC.ZA Rba :'ate Permit Issued y•1-9o'L-Hite Comosace Iawed �' �_ t + _ A�LK � � e � b ,�-c� �3` t3--c- L�3� No..� `.9.....`� `� ^ ®� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Barn APPROVED stable Conservation Department TOWN OF BARNSTABLE Arltrtt$iuit furiripul Work Tugt $r r$t rruti Date Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ................0.3..................... .A ^.. ------- --•-•---••- ----- �,-_�_ ..................... n Lo on- wT. s or Lot No. t+�N 1. . i..0 - ........................................ Own Address Installer Address PQ UU 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 ...................................................... W Design Flow............................................gallons per person per day. Total daily flow-----------------...........................gall ons. 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water.................. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --•-•-•-••---------------------------•-------•--••-•--......-••-•-•-•-•...••••-••----------.....--------------------•-----•-•-•---•-----......----------..... ODescription of Soil........................................................................................................................................................................ x x --------------------------•-•-•-----------------•--------------------•-----•-•---.....--------------------•------------- ---- - -••-----•----. ..... U Nature of Repairs or Alterations—Answer when applicable_-.- 1 tJ j Pt�.A..�°L° _._. ___._'v U2� r�?'�._.i.-"�........._.. :_.l�'3e!U- kwt................................. Agreement. The undersigned agrees to install the aforedescribed Ih 'vidual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environ I C d The undersigned further a r es not to place the system in operation until a Certificate of Complian e h s e is d by the Doarf healSigned -----------—- ---- -.. ..: ...1."' ....� ....... 1 ..:...... Application Approved B .144 ...C� .........Z..... - , .... :..C� Application Disapproved for the following reasons: ...................... ..................... ..........................................................ate.................. ...............................................(�..r..................................................................................................................................................... ........................................ Permit No. ..........�......... Issued .......... ....... .....: Dare i"�.i�i.:rir-+•r,:r7�4..:•�.»rU..=a3^-...i:,.'.r•.� . _ • .��. � �4 w_ , y,�, ,`;��,a.-..-.,.,,;.,,,.+t.S._1,�1✓^�1•�;»,-"�:..,A�.°dw»r•Y,4i:,.tyr•;,r,7�t,�"'�l+,+. ...�.......••c.1:r•aa..-.�-.:'-.1..n�d+r-rt:..«--.skw.+...r^.:.._s±a�.....�,.�•w � o3 --.. Fps................:.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ,/Appliratinn for Di ipotial Wurkii C ontitrnrtinu rrmif Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ................a9__�......C. �_s__�. ---...&-td ............ .s�-3 --. �,__iJ ....�t ..................... .. Loc-tion-Ad ress � or Lot No. N'F 1,_ctntr.........t<;c c_s.g!r ----------------- -------------------------- .._._..-•-----...--------._.....-•----••- O cnc Address a We -t--•-•-•-•---------••••-•-••• ------------------------------------------ ------------------------------------------- Installer Address UType of Building a Size Lot............................Sq. feet . t Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) al 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 ( ) 0.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit_______.____________ Depth to ground water........................ Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... P4 ...--•-----------•----•--•-•----•--••----•----•--•-•--•••---•-•--••-••••••••••-•-••-••----••--_...--......................................... ----------__ 0 Description of Soil............................................................................................-----------_..----------••-•----•-------•--------•-•-•----•..._....__-----• W U ---------------•--------...------._._.....-----•-------------------•---•----------...----....---------•----------...-----------------------•----•---................................................... •---••------------------------------------------------------------------------------------------------------------------------------•••---- UNature of Repairs or Alterations—Answer when applicable_..__.kL .S?-P1.�_9_ �wa._ � __..(�!�e�. 1.��!�L._ ............. .......................... ................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environme al Code The undersigned further a gees not to place the system in operation until a Certificate of Compliance h s e 1 is u d by the boar of healt . Signed ................ ..... ... ........_....-. -1-V-'. ....... .. .. .. . ........ ` --�� ).....�.. . ------ Application Approved B<.......... . ........................ .. ..../..........? ........ ..`,3�" --- le Ih Application Disapproved for the following yearont: ............................ 3 ... ................................................................ ................ . ................... . . .. ............................�... ........................................ Permit No. .,c�t7' � ......... Issued ..... .��... "..... ...�. ---....-................. Dare --------------------.-.--.-.- ---.--,-- _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T��rTT (( OWN OF BARNSTABLE LLPrtifirate of V Dittpltanve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ... .. ...........pror+"Qk ............... ........ ..... ..... .._.... .. . ............. ....................................... at ............' J........ 3 (a. - -- -—-t.. ............ ._.......... ...... .... ... .. ............. ................. . .......... -- has been installed in accordance with tpie provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _ ..'' .... ..._.dated ... ..._�`y.-� �,�r� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR EA AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �� DATE.....................V_.. ....1..._' . �._. .... __......... Inspector .................... ��.. .- ....... . .. ........... ---------------------------------------------- ----------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c� TOWN OF BARNSTABLE _..:?...-. FEE............... Ilispnsttl I rlks Tnnotrudion rautit Permission is hereby granted---_------------- ---�TS-��-1�.....1�_.----CIJ--`-D/ _-(J-V&{-1"-,"................................................... to Construct ( ) or Repair (Gan Individual Sewage Disposal System atNo.•-••••---•••-•••-•••---•••�.1-�3....... _:_...-----••------------- .-----------...---•--.._..------------------------..--------------------.._._......... V street -:,7 as shown on the application for Disposal Works Construction Permit .....� Dated______ Board of Health V DATE.--------"1-=-----� ----�'----•=-�------------------------•-•---- FORM 36508 HOBBS Q WARREN,INC.,PUBLISHERS L ® CA.TI®N � 3 3 ` y SEWAGE PERMIT NO. VILLA G E' ASSESSORS MAP N0:_ - PARCEL NO: 031 r INSTA LLER'S NAME i ADDRESS B U I L D E R OR OWNER DATE PERMIT ISSUED �- DATE COMPLIANCE ISSUED ' _ f �'-'�T � �.. ,. . •T'� r. . ��/ w P � �� s�� ' y � - ,� ,,I No.--- 3• �� Fimic .. ._.............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ------..TwN.............OF....... 1�/ESTG :.......-_.........._......-_. Appliration for DiopoiFal Work,5 Tonotrnrtion Frrutit Application is hereby made for a Permit to Construct (L�-j or Repair ( ) an individual Sewage Disposal System at: Location-Address or Lot No. --------- Bs n!.:5�_ G4',....�1fJ �__ _____ �� ______________ ___ .... Owner Address Installer Address Type of Building Size Lot_- Z`�' ....Sq. feet Dwelling—No. of Bedrooms........... .............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of ersons____________________________ Showers a YP g -----•-------•-•--------••-- P ( )--- Cafeteria ( ) a4Other fixtures ----------------•--------------------------•----•------••••-•-•-•••••••--•••••-••••-•-------•-••-.._...••----•_•--• ...__•--•- W Design Flow...............` .......................gallons per person per day. Total daily flow...........-3-�d-_____ ........gallons. WSeptic Tank—Liquid*capacity-Z�o._gallons Length._ K..___ Width_:!`X".... Diameter________________ Depth_s'8_"_-_ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------/------___::. Diameter.__._e.......... Depth below inlet...... ".......... Total leaching area...z6_7.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.s ' .____ 4z___'e S______________________ Date.... ............. 14 Test Pit No. 1:IL_A_.____minutes per inch Depth of Test Pit...... Depth to ground water________________________ 44 Test Pit No. 2_G_�A_____minutes per inch Depth of Test Pit........ Depth to ground water......_'".............. R+' •-••••••--••-----•--------•-••••-•••-•••--••••-•-•••-••...----•....:........•-----------•-------._........--•.....-••--•--•---•.........--••-.....----•------ O Description of Soil...... - 3L" 7O 'SO'e- 0 4 " . .... ... . `=`'-`,&. s x W U 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 TH TTl 5 of the State Sanitary Code—The undersigned further agrees not to place the system in � ration un ' a Ce tificate of Compliance has been issued by the board of health. Slgne - ----•••--•-•••---•-••---••-• ................................ Date Application pproved By......... r__ . . -U•P ............ Application Disapproved for the following reasons:------•------------------------------------------------•------------------•------------------•••--•.....__...._ . --••-••••--••---••••........-••••-••••-••.....--••-••••••---•--•--•••••--••--•--•••---•---...••--•-•-•--•••-•---••--._......-••--••-••--•-••••-••-•-------•••--•••--•---•••---••-••--•--•-••••---....... Date PermitNo......................................................... IssuecL--•------....:.------------=-••-•-•-•--•-----...__-•--- - Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i. +�/..............OF....... ,/G?/�/5? ,l;G.G.^-----------...................._ Appliratinn for Disposal Works Tnnstrurtion thrmit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: C'�?Krc/�1GC L �> B<rrrz•usT:ar�G c T ' 5 3 ..... _..__. ........................................................••-•-•--•-- -••--••-••--...............-•-----••--•--•---. .......................................... Location-Address or Lot No. V, ✓ / , L.A. We e c// b � A4.1 1 :, ...................... _ ............... n ...... •--...._.....7 • r Owner 7� Address W /1.. r/.�..... �..NS .'.....j Installer Address 3_57 Z q Type of Building Size Lot.............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria QI Other fixtures ................................. •-•----••---- WDesign Flow............. '__......................_gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.'sn!:�...gallons Length.A.' .:..... Width.`-''........... Diameter................ Depth.A_:�-'...._. x Disposal Trench—No...................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No______ ___________ Diameter.-_--!n ........ Depth below inlet.....G............ Total leaching area...I....... ......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '— Percolation Test Results Performed by-.:7-=o,�'..__....f'►�......t .. ��._5 : Date....`/Z.��?�' a Test Pit No. I .._3.......minutes per inch Depth`of Test Pit --__�4 ._._. Depth to ground water........................ ------. % fT Test Pit No. 2.4:._:'_.....minutes per inch Depft of Test Pit........ __.. Depth to ground wat P4 ....................•---..............................................................................M_--:....................--........................... O - Description of Soil•-- �-= ` ' '=so.c 34.. -/�I ,, >_.e ovz S/j-x= - ------------------ ---- U ---------------------------•------------------------•-•----------------------------------•--••------------•----••--•-----•-•------------•...-•-- W U 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'TTLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in o eration u a Ctiiicate of Compliance has been issued by the board of health. 9 Signed .. ........ ...............•--........... -•------------------............ k /tA;y7r v Date Application Approved By------= ...................................... Application Disapproved for the following reason.•---•-----------------------------------------•--...--•--------------------- -----------a....------•---- .....................................•-•--•--•-----------------..............••-------.......•---------•--------•••-•-----••.--•-------•---•-----------------------------------------------•---•---•--- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T.�....... OF........ ................•-----..................................... .................. Trrtifirate of (9nnt#1tFtnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) by----------------- ---......------------ -----...------------------------.....__........_....------...--------------------------------...----•-•----------------- staller at.............. `.s-7.--- •----.�'.....-------•��. _..--------------------------•------•--------•-----------------------......---•------------------- has been installed in accordance with the provisions of TIT r,", 5 of The State Sanitary Code as described in1 the application for Disposal Works Construction Permit ............... dated----------------------------------------- .... THE ISSU NC OF THIS CERTIFICATE SHALL NOT BE CONSTRU AS A GUARANTEE THAT THE SYSTEM Wl F NCTION SATISFACTORY. DATE.... � -------------•--•---•-------------•------•----•---.---- Inspector.•.- - ........---.....----------•----•----....---------------------•---•----. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH • ( J N�.�: . FEE........................ kl` Disposal Works Tnnsirnrtinn anti# Permission is hereby granted-•-........4.. ----- -----------------------------------------------.............................................. to Construct ( or a air ( an Individual wage D' osal System ---------------- -----------------............----- .............•---------------............... L. Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................'.................. qof �aith--------------••-•-- DATE. ...... and a Sa FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r q �� dv' 3� Pi r r�0 ,SE7Lvie� P � r o D�sr �Qtij _ 8 U Aeop j.D D 2 w r 6 • q0 IeZ-65V ,UP or (`, �izg-ram of Z--X1 TiNa N &AZ V �� M�,v. Eiasr-rie�r zc'w/DF i CERTIFIED PLOT. FLAN Mo..7Z�- G2L-/,9T/vtis /-�ssu.ye-n �.4ruM. LDCATION r_ SCALE . . -. . . . . DATE MM Y.iG i9B3 s PLAN REFEREJVCE .l3��.�c T . . . . . file �� I CERTIFY THAT THE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED. D � u. DATE V/I//A PETITIONER: ''TE�f'e&�/ WELcN REGISTERED LAND SURVEY, .Ss/&LwT Z. 0"C� Z 3rb em-rS TOP OF FOUNDATION c CONCRETE COVER CONCRETE COVERS e; 4' CAST IRON 12"MAX. ` I "MAX. PIPE IP(OR MIN. 4"ORANGEBURG(OR EQUIV.) PITCH 1/4 PER. PIPE- MIN. LEACH „o PITCH 1/4"PER.FT. PITr/4 T NVEERT aG EL.8.?r7�.. INVERT INVER o • SEPTIC TANK 3 DIST. 6 • W .EL.Ax•A 7 .. EL..1e. .. ' ; >_INVERT BOX 0: GAL. INVERTINVERT �'�.va 0` I/2' EL. B , �.. W W o= De1 /z o• • • . /O' DIA. PROFILE OF GROUND WATER. TABLE SEWAGE DISPOSAL SYSTEM NO SCALE P-/7,93 SOI L LOG WITNESSED BY DATE . ��?��8 TIME A .3e,P.y N C/!�{- ??a 5; BOARD OF HEALTH TEST HOLE I TEST HOLE 2ENGINEER ELEV. .B¢•7v . . ELEV. .04-.8� c Ar-, 7Dp3o, DESIGN( DATA : 3G„ NUMBER OF BEDROOMS TOTAL ESTIMATED FLOW -33v GALLONS/DAY F.vt 78 S" Sq,✓p SfiwD BOTTOM LEACHING AREA . . • SO.FT. LPIT• . SIDE LEACHING AREA SQ.FT./ PIT GARBAGE. DISPOSAL . .NQ. . .(50% AREA INCREASE) TOTAL LEACHING 'AREA_ :44 7"C0:. SO.FT PERCOLATION RATE 49MS: A'!-r 3 MIN./INCH /44 4z,7Z.76 LEACHING AREA PER PERCOLATION RATE .,'�.r.'Y SQ.FT: No WATER ENCOUNTERED , NUMBER OF LEACHING PITS .Yl R"r !N!y71 7wo APPROVED . . . . . . . . . . . . . BOARD'OF HEALTH aF Srpw any . si� 3 DATE . . . . . . . .. . . AGENT OR INSPECTOR OF EDWARD c� E. x0'OF 527 PETITIONER T��Fsi /�J. Wc�ZC�/ $' I/iu/gw t/, INbZQN �rt+��♦