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HomeMy WebLinkAbout0154 KEVENEY LANE - Health Fy 154 Keveney Lane Barnstable, MA A = 351 - 022 O a a O No. ------------------ Fee- -------------- BOARD OF HEALTH TOWN OF BARNSTABLE 0ppCicat ion-for Well Con0ruct ion Permit Application.is.hereby made for a permit to Construct (�), Alter ( ), or Repair ( )an individual Well at: mtLi —_Location — Address �sors Map and Parcel caner Address Installer ri ler — -- Address Type of Building Dwelling Other - Type of Building-=--_i_,—__—_______ No. of Persons----.-I _- Type of Well �'�r�- °� l_�1ri� q SCMd_p V(. Capacity-- — Purpose of 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 Certific a.of Compliance has been issued by the Board of Health. date/ Application Approved ____—_ __--_— 6 . date Application Disapproved for the following reasons: -- _— __----__--_------------------ date ►-�, / l Permit No.��-___�'�-�� �� ___-_- Issued---_� 11�___—___------------------ date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed Altered ( ), or Repaired ( ) by %46:5MoIVA installer Ev .ic- II, has been installed in accordance with the provisions of the To Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -----------_Dated—_------------- 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 F Applirat ion iforWell Congtrurt ion Permit 4 Application is hereby made for a permit to Construct Alter ( ), or Repair ( )an individual Well at: Location — Addr ess ress I Assessors Map and Parcel � c0L144,a� YY19 75 Owner— Address oZ 3 -------- ----------------------- s ----- Installer — ruler Address Type of Building Dwelling i( Other - Type of Building-=---__—_______ No. of Persons--- ____.--____ Type of Well ''�t qo - S�_ NL �y�. Capacity-- Purpose �_� —____.____ — of Well------N-��L �7_�?� --- Agreement: The undersigned agrees yto 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 untiI'a Certlfica.a.of Compliance has been Issued by the Board of Health. Si ne 4 - ----_----- (6 Z b°►_ date --- Application Approved — —__—____—___— 6/ �q_________ date Application Disapproved for the following reasons: date Permit No. Issued----�� date BOARD OF HEALTH TOWN OF BARNSTABLE C ertif irate ®f Compliariie _ THIS IS TO CERTIFY, That the Individual Well Constructed ( vr, Altered ( ), or Repaired ( ) by .T 6 5-0DNLi 40EGL Z_ (vC _Gam___.-____--------------------------------------------------- " Installer at-;/_�� E(✓�ti_� /y2 Ca�i�1.e-4"ut -------- has 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. --_—__________Dated—----- ------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE---------- _-- _ Inspector-----------------------________—__________--_ r.r. BOARD OF HEALTH TOWN OF BARNSTABLE Well con!9trurtionPermit No. Fee Permission is hereby granted J h L � to Construct ( �, Alter ( ), or Repair ( ) an Individual Well at: , No. _ -- —E/f/E ZZ.9�C- ,�`_ J �u 4y,'m a -- — - ---------------- ------ ---------------------- Street — as shown on the application for a Well Construction Permit No.- ---_-- (7ate - --- --------------------------------- - — —--- -------------------- --. DAT E . Board of Health --- __ do r Massachusetts Department of Conservation and Recreation Massncbusesss Office of Water Resources - Well Completion Report 21-OCT-09 11:16:00 WELL LOCATION 265609 GPS North: 410 42.325' GPS West: -700 15.869' Address: 154, Keveney Lane Property Owner/Client: Bob Kittredge Subdivision Name:Cummaquid Mailing Address: 154 Keveney Lane City/Town: Barnstable City/Town, State:Yarmouthport MA Assessors Map: Assessors Lot #: Permit Number:W2009-023 Board of Health permit obtained: Y Date Issued: 10/08/2009 Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Irrigation Auger CASING From (ft) To (ft) Type Thickness Diameter .00 -66.00 PVC Schedule 40 4.00 SCREEN From (ft) To (ft) Type Slot Size Diameter -66.00 -70.00 Stainless Steel Vee Wire .012 4.00 WELL SEAL / FILTER PACK / ABANDONMENT MATERIAL From (ft) -.To (ft),. Material Description Purpose r: WELL TEST DATA (ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) Date Method Yield Time Pumped Pumping, Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) 10/14/2009 Constant Rate Pump 15-0000 1:30 33.0000 0:01 30 STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAILABLE) Date Depth Below Ground Pump Description:Goulds 18GS10422 Measured Surface (ft) Type: 2 Wire Constant Speed Submersible Intake Depth: 65.0000 10/14/2009 30 Nominal Pump Capacity: 18.0000 Horsepower: 1.0000 WELL DRILLER'S STATEMENT ADDITIONAL WELL INFORMATION Driller: Thomas E Desmond III Developed: Yes Fracture Enhancement:No Supervisor: Thomas Desmond III Rig. #: 100 Disinfected: Yes Well Seal Type:None Firm: Desmond Well Drilling Inc. Total Well Depth: 70.000 Depth to Bedrock: Registration #: 764 Date Complete:10/14/2009 Comments: OVERBURDEN . From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 15.001 Silty Sand & Gravel ,,Brown' No 15.00 70.00 Fine to Coarse Sand Brown Yes N/A BEDROCK From To Code Comment Water Drill Extra Drill Rust Loss/ # of (ft) (ft) Zone Stem Large Rate Stain Add of Frac Droo per ft 1/1 '~° aARys�. CERTIFICATE OF ANALYSIS Page: 1 ,q M Barnstable County Health Laboratory yssnc�ct}s `j Report Prepared For: Report Dated: 3/25/2008 Suzanne Kittredge Order No.: G0845497 154 Keveney Lane Yannouthport, MA 02675 Laboratory ID#: 0845497-01 Description: Water�Drinking Water Sample#: Sampling Location 154 Keveney Ln.Cummaquid,MA Collected: 3/23/2008 Collected by: S.Kittredge Received: 3/24/2008 Routine ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen 0.58 mg/L 0.10 10 EPA 300.0 3/24/2008 Copper 0.10 mg/L 0.10 1.3 SM 3111B 3/25/2008 Iron ND mg/L 0.10 03 SM 3111 B 3/25/2008 Sodium 20 mg/L 1.0 20 SM 3111 B 3/25/2008 Total Coliform Absent P/A 0. 0 SM9223 3/24/2008 Conductance 250 umohS/cm 2.0 EPA 120.1 3/24/2008 pH 7.6 pH-units 0 SM 4500 H-B 3/24/2008 Sodium Level is-al the maximum contamina 2t leveL'''Tl:ose on a low sodium diet may wis/t 10 consult a"physi'ciari.- Approved By: — ab Direc r) i ; } '1. co =0.-w L it :Y ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 LO ON !''~�{ SEWAGE PERMIT A - C5 C VILLAGE II I N S T A LLER-S YAME b ADDRESS e LDE § OR OWNER DATE PE MIT ISSUED DATE COMPLIANCE ISSUED �sjO �BS ., '� 4 js _ v_ � tip^. n J ! l ' ` .� '� No.... ...............� Fxs......�.�.� LTH OF THE BOARDAOFHEALTH S 1 d�3..----...� . ....................OF......--ram -.... 35 Applirtttion for Disposal Works ( onstrurtivit Prrmit � f Application is hereby made for a Permit tog Construct ( ) or Repair (k;j an Individual Sewage Disposal System at: } -------------- ------------------------------------------------------------•--------......._...------•----------- :Ion,-Address 0 � or t N . �- .......... �3.3 = ... _ - �nx►.t�-------------- Owner Y ddress i ab= ----.9:)b ....... ceifl........f-sP.ee..__-.....(VA-v Installer Address d Type of Building Size Lot..._........................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building _______________ No. of ersons_._____.__.__________._._._. Showers — Cafeteria a YP g --------•---- P ( ) ( ) 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. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2..._............minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----•------------------------------------------------------••----•-------------------------------••-------•- ...-----•....- --------- -......... . 0 Description of Soil........................................................................................................................................................................ x U -------------------•-•-••------•••••-••------•------•--------••------- ----------•--._........-•••------------------•---.....--•------------------------••----•-•--•.._......----•--------......_..--•- w x *� q-------------------- ----- -----_____--- U Nature of Re air or Iterations—Answer when appli able._.__..?���l f___f _ _ _. ____________________ = � "f•6�_�.__91'1_a2!�Iti�!` a 's5 �3L=--------------------------------------------------------•---...--------- Agreemen The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI - 5 of the State Sanita —The un igned further agrees not to place the system in operation until a Certificate of Compliance ha en issue th boar health. --- ......•------•-- - •-- - ......... --------•--• .......................... .. D Application Approved By............ ••••. �. ate Application Disapproved for the following reasons:--............................................................................................................ ..........................•-•-----•---------•-•-------•--._.......-••---•----------...•-•---------.....----------------•------•••--------•----------•-•---•--------------•••--•----•--------•----------- Date PermitNo......................................................... Issued_........................................................ Date No... .......� Fims 1• ...........•.•.•.. c. «y*THE COMMONE LTH .OF lkSSACHUSEi-' I/V tBOARD .,OF THEA ; i Ap' ira ilan for Diipn� Works Tumitrurtiun ramit Y" Application is hereby made for a Permit to Construct `( .3) or Repair (44' an Individual ;Sewage Disposal' Systein at: ...I�1 v.....?ra 4�(�xtc..' 71 f,}trl o S.Sa l... f4i QCi[t l - ............... `..............................n - - f ' 7 .......... .._... v ... =-- ............... .... �Location-Address o Lot ryo Owner ddress w .• � - _ -x� ..fib er�ncX+ _3 �Q._ r n;s r Je A _. -!�1 t.Inst�ller Address :.._.. UType of Building Size Lot........ ..................Sq. feet Dwelling—No. of Bedrooms.....:......................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building r .a. yp g ____________________________ 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 7. Disposal.Trench—No_ ____________________ Width..............._.... Total Length.................... Total,leaching area................_:_ Sq. ft. Seepage Pit No--------------------- Diameter.................... Depth,below inlet.................... Total leaching area____ %(ql, tt. 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....................... r (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth,to ground water.........._........ ::. O Description of Soil.................... = s .. ------ ---- ------------- --------------•-- r { 7­.7 U Nature of Re air or Iterations Answ when applicable...- SCR ...t�' _ ? ..:;. .............. f p ins a s l •:i_> __�9 5 1�►_9__-45V_4'A'K.............................. x Agreemen i The undersigned`,agrees`tt :install the aforedescribed Individual Sewage Disposal Syst� m m.acc' dance with ` the provisions of TITIE 5 of the. Sthte''-Sanitary__Code— The undersigned further agrees not to place the system in' l operation until a Certificate-of Compliance h 1,been issued by the board of health p' . - •. Da .w. k� l n - -. Application Approved By:.... 6: - . -. � ;................................ - -- -. . Application D> approved f or,tthe following reasons:........................... _-________-_._. kr •. - - _ ........................................ __ ____________ _ _ __- _ . Date Permit No = n ................. Issued................................ Date i- d ��. _P�+►1�7 WERE s •. :; _ r� r•.' -ra ,.-\: tq R$Gorlrh�'D� THE COMMONWEALTH'OF MASSACHUSETTS;. N M sTL o: coy+/ - BOARD OF., HEALTH . - ._ .! a�•./GalNa � OF. ....... ....... ;� i .. f�r # ftrtte n " �ntr�inrr THIS IS CERTIFY, That the Ind vidual Sewage Disposal System constructed ( )-or.-Repaired ' w ` by---r-----...--•---.... 3y�!C�QS�-_--•- ..:.-•• •-••• -----------••--•-••-----•• 1 - ---- ........... at. t ,- C_:. cZ �Styvi M v „- •••• 1, has.been installed in accordance wit i'the provisions of TITLE] j of The State Sanitary Code'as described in the ap�pliVon for Disposal Works Construction'Pe,rmit Na__�a?%'.��o'7_____________ _ dated__.____�th_fZ5,,5'____________._____. • VTHE ISSUANCE OF THIS CERTIFICATE,SHALT. NOT BE CO STRUED A GUARANTEE THAT THE SYSTEM WILL UNCTION SATISFACTORY. ` Inspector .. DATE............... .. . 4. A THE,.COMMONWEALTH"OF MASSACHUSETTS ,f • - f BOARD OF HEALTH OF - •� ....................... FEE.... No._ ...... l ............ LL . Permission is hereby granted.............. C 10.. saw: to Construct ( ) or�Repair ( an Individual Sewage Disposal System " at No.------..1_ :{_l2. 7 � n-Q Lam- �`u.r ass^-u�. ------------------- -------•- ---•• -•--•..__.._... �3' \ street as shown on the application for Disposal Works Construction Permit No - �''_ Dated..... 11.454 ................ .....................I---- //^(� �/J/�(�{� dFr ---.____--=-•--•-- Health S i 41.0�$�... F ` Board of DATE--------�- -� - ' FORM 1255 A. M. 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