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Home My WebLink About3420 MAIN ST./RTE 6A(BARN.) - Health 3420 Main Street Barnstable e 00A No.------�a_ Fee---- -- ------- BOARD OF HEALTH TOWN OF BARNSTAB LE Zipp[icationforlVell ConQructionAermit Application is hereb made fo a e i to wit ct (✓), Alter ( ), or Repair ( )an individual Well at: Location - Address _—~— Assessors Map and Parcel _Uo,c.i9v��c�rrn -- -------------- --- 3-`�-2t�__�ou�e_(oA _`�a�r,s-�able_L(YI�►- O263c�_ Owner Address 02�53 Installer - Drilldr Address Type of Building / Dwelling Other - Type of Building-------------------- No. of Type of Well T'SC\A40.JIC Purpose of Well 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 Comp fiance has been issued by the Board of Health. Signe - -- --- Application Approved By — ' ;4�109_ date Application Disapproved for the following reasons; - - o. -------------- ---- - -- ---------------------------_date - -Permit N __----- _-__-_-- Issued date ----------------- --- --- -- BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by---- --------- ---- ______ —_-- ---- - - -- - ------- ---- - - Installer at____ _— ----__ _ _----- --- -- --- - ---_-- --- ---- __ 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 CA E SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE — - — Inspector-- - -------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Pit CongtruttionPrrmit Permission is hereby granted--�--� _.d--�-----v �-;-------.----vL;�---/J to Construct ( �, Alter ( ), or Re air ( ) n Individual Well - — / street„ as shown ionJ the application fora Well�Construction Permit r� NO.- 1i/ )�wly069 0 v -- ---- Dated--- -/ -- --^ - - - - -- _ _ _ -- Board f Health DATE 00h -No. � Fee --�-------- BOARD OF HEALTH TOWN OF BARNSTABLE , Aoptication,pfl err Con0ructioni9ermit Application is hereby made for a permit to Constr_ct (J)} Alter ( ), or Repair ( )an individual Well at: Locatio — Address'V� Assessors Map and Parcel - ba�arFa��, �_z__o got�e.�A `aa�rS�able.,lYlA o2630 --------------------------------------------- Owner O t—-- — _. Address _De5_vnga Wo_\\V')L \ ng `nc, �,o- ( ��21 3 Or�2Qti�s 0265 Installer — Dril � -Address -- — - - 1 Type of Building / tDwelling -- -- ------------------------------- Other - Type of Building---________-__________ No. of Persons------------------------__—____—____. ,Type of Well -- - ---------_ 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 Certificate .of Compliance has been issued by the Board of Health. � `"^`•,�..• Signed — - zj- ! d - - da — Application Approved By 4 +�*`• =' � date Application Disapproved for the following reasons: date �_ I Permit No. - Issued T date __.._ --_--- _—__ __ ______ _____________..__. ---__—_—_—_.._.._________._—___.'.________________-- I BOARD OF HEALTH �, - `- TOWN OF 4BAIRNSTABLE Certificate.. f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) bY—- ------- - --------— -- Installer — --at -- 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 CONSTRUEDAS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- — - —-- Inspector-------------------------- --------—--------- s s FORM30 &W Ho88s&WARRENrn THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /�,2 t� S"t ra�t►�, CITY/TOWN W )A AI_ T H a DEPARTMENT Oo MAC u SZ Z �wtAit AA iS ti ADORES G^M SBy`0� `l J TELEPHONE Address 3y20 MP1IIA sT. V,.,%'( AZ-Occupant Q—A N L C �"� �1,.L S — Floor Apartment No. No. of Occupants No.of Habitable Rooms Q No.Sleeping Rooms No. dwelling or rooming units No.Stories_ i�/�Name and address of owner �►% N L. M V— � w N }Ads tjlL ('20V✓yam( L-'d0 o$1 or- CA •61y G2 Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑A Doors,Windows: 1/ Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT / Gen.Sanitation: Dampness: Stairs: IF Lighting: STRUCTURE INT. Hall,Stairway: NJ / Obst'n.: I (� Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Su I Line: El MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICW Panels, Meters,Cir.: ❑ 110 Y220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom(1). p Bedroom 2 / Bedroom 3 PG Bedroom 4 Hot Water Facil. Sup. Oil, Elect.: s, ues, ts, afeties: Kitchen Facilities Sink /(3 Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted GS't r,p Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES F PERJURY." INSPECTOR TITLE DATE �^ �v� G TIME •• /S P.M. n A.M. THE NEXT SCHEDULED REINSPECTION N /�` P.M. .e 410.750: Conditions Deemed to Endanger or Impair•Health or Safety The following conditions; when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific.situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in noway be construed'as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 44'0.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of%Water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR,410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. '• (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do'not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. is Qd os.oc FJ/C 'Re o Mcv\ "S+ fa �n r)0S ENVIROTECI-I LABORATORIES, INC. AM CERT. NO.:M MA 063. 1 8 Jan Sebastian.Drive Unit 12 �� ® Sand►vick,AM 02563 , (508)888-6460 1-800-339-6460 FAX(508)888-6446 Client Name Desmond Well Drilling Location Qw—�-Farm--#3420=Route.6A Address PO Box 2783 Brra6le x1U1i4 Orleans MA 02653 Sample Date o4m o/08 Collected By Desmond Well Drilling Sample Time 11:3o Sample Type New Irrigation Well. Date Deceived o4/10/08 Lab Order Number DW-M17 Well Specs 4"Well 40'PVC 161,W .Location Source Date Collected Time Collected z -Comments.f. Analysis Requested Units Recommended Limits Analysis Result Method Date Analyze Analyzed By Total Coliform /100ml 0 0 9222 B 4/10/2008 MC pH pH units 6.5-8.5 5.70 4500-H-B 4/10/2008 LL Specific Conductance umhos/cm 500 255 120.1 4/10/2008 LL Nitrite-N mg/L 1.00 <0.004 300.0 4/10/2008 LL Nitrate-N mg/L 10.0 4.41 300.0 4/10/2008 LL Sodium mg/L 20.0 32.9 200.7 4/11/2008 MC Total Iron mg/L 0.3 <0.01 200.7 4111/2008 MC Manganese mg/L 0.05 <0.008 200.7 4/11/2008 MC Comments: Low pH indicates high corrosive characteristics. Sodium level is not a health hazard. TN#e mr ets EPA-standards:and-is suitable-for drin`king,for parameters tested: • Date S�U 4Rona . Saari- Laboratory Director Tap W Y .. ••�� r W M - BRL=BelowReportableLimits Page 1 of 1 ;See Attached C l l• Massachusetts Department of Conservation and Recreation nr�:ssa�tiusens Office of Water Resources Well Completion Report 24-APR-08 13:08:46 WELL LOCATION 251479 GPS North: 410 42.0521 GPS West: 700 17.7651 Property Owner/Client: Bacon"Farm,a Address: 3420, Route 6A P Y Subdivision Name: Mailing Address: 3f 20'Route"6A City/Town: Barnstable City/Town, State:Barnstable MA Assessors Map: Assessors Lot #: Permit Number:Wi2008'r006� Board of Health permit obtained: Y Date Issued: 04/02/2008 Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Irrigation Auger CASING From (ft) To (ft) Type Thickness Diameter .00 -71.00 PVC Schedule 40 4.00 SCREEN From (ft) To (ft) Type Slot Size Diameter -71.00 -75.00 Stainless Steel Well .015 4.00 Point WELL SEAL / FILTER PACK / ABANDONMENT MATERIAL From (ft) To (ft) Material Description Purpose 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) 04/10/2008 Constant Rate Pump 15.0000 1:00 48.5000 0:01 48 STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAILABLE) cz C, ( C7 Date Depth Below Ground eec_ n r E Pump, _pti,.r. Measured Surface (ft) Type: intake Depth j 04/10/2008 48 Nominal Pump Capacity: Hor-sepower:r�i r WELL DRILLER-'1S STATEMENT ADDITIONAL WELL INFORMATION VII _ Driller: Thomas E Desmond III=' n Developed: Yes Fracture Enhancement:No Supervisor: Thomas Desmond III Rig`#: 36 Disinfected:Yes Well Seal Type:None Firm: Desmond Well Drilling Inc. CD Total Well Depth: 75.000 Depth to Bedrock: Registration #: 764 Data Comp1kete.-04_/10 Comments: OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 75.00 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 Drov per ft 1/1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH mom :-..........OF........ ..... - ``:.._... Appliratiott -for 43iiipaaiitt1 Worko C onotrurtintt Vatuit ... Application is hereby made for a Permit to Construct (1<0-r Repair ( ) an Individual Sewage., Disposal System _ -s 7 d oca n. Lot No. o Owner Address a ............. ------ ............................................................ Installer Address d Type of Building . Size Lot----------------------------Sq. feet U DwellingNo. of Bedrooms__________ ___---------------------------- Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building -----------------_--_-___- No. of;persons.-.._____--___---_.-------_- Showers ( ) — Cafeteria ( ) a' Other fixtures -------------••---llloris per person d --•------------ -------------------- --- -------------- --------------------- W Design Flow ........' --------- P P Per day. Total daily flow................ ..........................gallons. WSeptic Tank Liquid capacity/ZS_1allons Length................ Width................ Diameter._.---..-._-_--- Depth-.-.------.-.._ x Disposal Trench--No- _________________ Width--------- __ tal th- _-_-_ _-____-_ Total leaching area.--.---_-_._--_---sq. ft. Kj Seepage Pit No.... �_____ Di eter U.�...:_._ Opt ow m e�................ Tota leacl iu area---_.---_.---_-_sq.�, X$ Z OthetDistribtition box (/ Dosing tank ( ) � •d.(/ ,V '717173-�C � Percolation Test Results Performed by.......................................................................... Date---------------------------------------- aa Test Pit No. 1................minutes per inch Depth of "Pest Pit-.----_-____---.-_-_ Depth to ground water...---___---.--.__.--._. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ --------- --- - --------- - O Description of Soil------------_-- = _- -- ------ l x U -------------------------------- .................................................................................................................................................................... - ------------------------------------------------------- VNature 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 Article NI of the State Sanitary Code— he unde ned further a rees not to place the system in operation until a Certificate of Compliance has been i s ed th oard o ealth. ned--•--- - 1----- --- ................................ ate Application Approved By--- .....-- L � - -------- Application Disapproved for the following reasons_____________________________________ _ -•----......-•-•.....................Date-----------•-- --------------------------------------------------------------------------•----------......--••-•----•-----------•------••-----•----....--•-----•--------------------------------...........------------ Date PermitNo.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /17 Apphration fur Uhip ial Works Towitrurtion Vamit 61-11, Application is hereby o made for a Permit to Construct ( r Repair ( ) an Individual Sewage Disposal System at ,------i A /�^( Locaytion rt�_ld s °r Lot No. _! i-�( ..!,+(..rau ......... ...... ... ✓ �'L•---•°S f - Owner r Address - Installer Address Q Type of Building, Size Lot----------------------------Sq. feet Dwelling LNo. of Bedrooms--------- .............................Expansion Attic ( ) Garbage Grinder ( ) a, Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures _________________________________ _ Q '---------------------- W Design Flow.......................��C. ........gallons per person per day. Total daily flow............................................gallons. WSeptic Tankl Liquid capacity/Z_---kallons Length................ Width_.............. Diameter----------.----- Depth....._-__.----- x Disposal Trench Vo_ ____________________ Width-___-__----_ _ Total Le�l %_-- __ Total leaching area--__.__._-__.._-__-sq. ft. Seepage Pit No.___L_-_____-Dieter__4!1 De th _ . Total leachingarea-_..___-_---____-sq. ft, --- --- P e ow inlet_.---•-•---•-----=' Other Distribution box , Dosing tank a Percolation Test Results Performed bY--------- ----------------------------------------------------- Date...................................... .. a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water.._.._-..___-._----____. f14 Test Pit No. 2................minutes per inch Depth of Test Pit---------.---------- Depth to ground water--._-.-------__-.___-._. � ---------------••-f•----•-•--•.......................... O � --------- --- ---- a Description of Soil ! :,d`" "�,=f - - �-��' -----"- ---- �� i---`�;_------ x �d ------------------------------------- - -------------------------=--------------------------------------------------------------------------------------------- ................ ..................... 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 Article XI 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. r, Signed------- � N,• (--------------------------- ------------ ------ -------------------------------- !( Date Application Approved BY---V ------•.i `. ; `6-=� -� Date Application Disapproved for the following reasons:...................................:._-•________-______--__-_-•--_---___-f____________ --•--- -----•---------------------------------------------------------------------------------------------------------------------------------------------------------- ------------ --•-----•-- ------------ �� _�te PermitNo......................................................... Issu .••......... D e THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Qrrtifiratr of Tomphaurr THIS IS TO CERTIFY, Th the dividual Sewage;Di§posaL System constructed ( or Repaired ( ) by =�; p :-R ?c � rr1....................r....--•-----•--•--- a - Y LL A ,fi r Al at...jP:T.g. _."._ __..:'"t_ ':' ..7�' 'n��fi �_. e`�"_o_�_._ ,- "'___.__.__ � :.•(�J r�`_.w' .�...�.'S/ �' _' ._?-"_t^'-'Z':___�. has been installed in accordance with the provisions of Article Xiof The State Sanitary Code as described in the application for Disposal Works Construction Permit No._____-_ _Z__----.------------ dated---7�a_ f_._l... ........... THE ISSUAN E OF THIS OERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL N TI S 1 C O DATE------D•-----••• --------- •--- ---------- ----•••• •-•-•---•-•-••-- Inspector... ------------------------------------•---- THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH, G-r ......../ ....�} f a.T,t..v........OF ' 'Z�:SL<-....:. . - ....._.... `✓"rJ No.. ..........`.-..... I FEE ==-------•-••-•'-'. �i Vniial: ork.i Cnonfitrurtivit "Prmit Permission is hereby granted_....�._ �-f rr �-------- -t8_��J c:..._._.. to Construct ) or Repair (.�) an Individual Sewage Disposal System .� at No. ./�-�'-�%'-. t----- ref,-f= r L...—... r�-(!Iri..r'/ :: a�-�r... =---------------------- ------------------------------- v - Street as shown on the a lication for Disposal Works Construction Per it No.-___;_ _'`,,:_��X Dit�ed__71.. _.-/ .--�_........ PP P ------------ -- fiBoard of Health DATE......................................................................••---•..•. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS f' 5W8,41- 22 W- } - • ,. z /I�O�P:• �rh/YO�'f�icUC'ST f 6, CO1I i—,�j '71-7 ip deli/ 7Z.1.711s Sre. 0 o� /28.007 p�. UN,E�F-G/STE�2Epy' �U A/6� �oUTj� lo.Q '+ A • STEM*,*:-'..., ,