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HomeMy WebLinkAbout0021 RACHEL CARSON LANE - Health 21 Rachel Carson Lane Centerville A = 190— 203 S M F.A D No.2-153LOR UPC 12M aaMd.mn • Mob In USA .AMM N. ��j Affidavit of Walter J. Varney STATE OF MASSACHUSETTS COUNTY OF BARNSTABLE The undersigned,Walter J.Varney,being duly sworn,hereby deposes and says: 1. 1 am over the age of 18 and am a resident of the State of Massachusetts. I have personal knowledge of the facts herein,and,if called as a witness,could testify completely thereto. 2. 1 suffer no legal disabilities and have personal knowledge of the facts set forth below. 3. 1 purchased a four bedroom home at 21 Rachel Carson Lane Centerville,MA on June 6, 1979 and have lived in the house since then. I declare that,to the best of my knowledgeand belief,the information herein is true,correct,and complete. Executed this� �Wday of 2016 ag Walter J.Varney NOTARY ACKNOWLEDGEMENT STATE OF MASSACHUSETTS,COUNTY OF BARNSTABLE,ss On this ZL day of J uy� 2014 ,before me personally appeared Walter J Varney,to me known to be the person described in and who executed the foregoing Affidavit,and,being duly sworn on oath according to law, deposes and says that he has read the foregoing Affidavit subscribed by him,and that the matters stated herein are true to the best of his information,knowledge,an elief. Notary Public Title(and Rank) kale•;� * U: My commission expir&,- ' ••' •�.a, a ���IN/INIIINNIIN` TOWN OF BARNSTABLE LOCATION 5 SEWAGE # VILLAGE ASSESSOR'S MAP LOT \�-�;f� •Q ok�A INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY \ 0 O 0 CD u LEACHING FACILITY:(type) Q \N--5 (size) 00PSA NO. OF BEDROOMS ` D PRIVATE WELL OR �BLICWATE BUILDER O OWN DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: - 1 VARIANCE GRANTED: Yes No �/' 3 •J i� q i.# E A 2 (,P _ V FiE:x ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEA1L-"' . I-------OF....................... Appfiration -for Uiiipviiat Workii Towitrurtion Vrruiit IApplication is hereby made for a Permit to Construct (-<or Repair an Individual Sewage Disposal System at: ............... ------- ------------- ................ .................................................... L cation-Address or Lot No. .. 0/. 7-/ .........YV...0 ................. ...... .. ............. ... ........ ..... .<....................... Owner Address ........... ........... ................ ...................... .................... /......................................................... Installer Address Type of Building Size Lot------ea_!2_d_0-------Sq. feet Dwelling—No. of Bedrooms--------------3--------------------------Expansion Attic (/Q? Garbage Grinder ((a/c)) a4 Other—Type of Building ............. No. of persons------------S~--------- Showers-- Cafeteria 44 Other fixtures ----- ----------------------------------------------------------------------------- < ---------------------------------------------------------------- W Design Flow...Y.0.?1A gallons per person per day. Total daily flow____a ----------------------------_gallons. P4 Septic Tank—Liquid capacity-If--- --gallons Length________________ Width_.____.-....._-- Diameter___-.---.._____ Deptli_ ------- Disposal Trench—No. ...-*............... Width.---_____-____-----. Total Length_--_______-_______-- Total leaching area-------------- -----sq. f t. Seepage Pit No..................... Diameter-----_______________ Depth below inlet-------- Total leaching area----------------sq. ft. Other Distribution box Dosing tank d,6. C4'ft _ S1,;X,01-7,91- Percolation Test Results Performed by---------- ........................................... ................... Date----------_-------------------------- Test Pit No. I_--------------minutes per inch Depth of Test Pit_._________--__--_ Depth to ground water------------------------ f4 Test Pit No. 2------------_minutes per inch Depth of Test Pit_._.__._.........._. Depth to ground water_..____________.__._-.-. 9 -------- -------------------------------r-------------------------V--7----------------------------------------------------------------------- 0 Description of Soil.-C-7/_'_ /- ;. ........:9.,74.., �4 a--1,4,/ &&�- - ------------------ ------------------ -------P�� -- U ------- ---------------------------------- �--"-�_ _.-f,_,.,�_A-* .... -2..�i--------------/11----------------------------------- ------------------------- ---------------------------------------:�;------------------------------------------------------------------- ------------------------------------------------------------------ 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 issu d by the board of health. Signed. ............. ---------------------------------------------- --------------------------- Date Application Approved By------- ..... --- Date Application Disapproved for the following reasons:----------- 6 . --_---------- ------------------------------- ----------------------------------------------------- ------------------------------------------------------ ------------------------------------- Date PermitNo......................................................... Issued--------------------- .................................. Date ----------- --------------------------- 4 o No:---.,ram/---!-•. FI&$........ Q........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _.. OF. ......................... ...................... Alipliraatirrn"for Di_qvuiiFal Works Tna'itrurtinn Vrrm t Application is hereby made for a' Permit to Construct'( W-11or Repair ( ) an Individual- Sewage Disposal '~ System at 9�G R Sam A14C- - 0. cation Address or Lot No ................/t Er ------�-- i --?-------------- - -----i'� �z_ _1 _ U_ '--: .rvT e!� 1 �! ---•--------..__...---- Owner Address p Installer Address Type of Building Size Lot......C'.o.__.1?.......Sq. feet U Dwelling—No. of Bedrooms............. ..........................Expansion Attic ( L/t Garbage Grinder ( ) per, Other—Type of Building __ w _+______________ No. of persons-________-__—......... Showers ( ) — Cafeteria ( ) Q' Other Ktures --------------------------------------------------- Des gri: Flow_. __.__:_-_ gallons per person.per day. Total daily flow___.. 5V_________________________ _____gallons. WSeptic Tank—Liquld cahaclty.j _-__gallons Length ______________ Width_-------- ...._.- Diameter._____--__-____ Depth-________-_---- x Disposal Trench—'No. ....:............. Width.............`------ Total Length.................... Total leaching area......-------- ------sq. ft. Seepage Pit No_____________________ Diameter__ _'-______________ Depth below inlett__________ _ Total leaching area_____:.___-_____sq. ft. z Other Distribution box ( ) Dosing tank ( ) ®/v, c� . -ila d l-7 Percolation Test Results Performed bY--•---- -•-------------•------•--••-----•----•--•-------••--••-••--•----• Date--------------------------------------- Test Pit No. l—'............minutes per inch Depth of Test Pit____________________ Depth to ground water........................ �14 Test Pit No. 2...._-----------minutes per inch Depth of Test Pit________________.___ Depth to ground water__-..._____-________---- a ----------------------------- �; x Description f Soil + 0� !.t�r�c. -" +a----fit------ w -----�-- !�''------�-------------- ------ '-a�, .�y �° .. U Nature of Repairs or Alterations—Answer when applicable.___________________________________________________________________________________________ ------=-------------------------------------------------------------------------------------------------------------------------------------- ------- -------------------------------------------- Agreement: Th.M1 e,•*undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issuej by the board of health. Signed --- .--•• 4AItA6►sue'-_--------_--------------------------- ................................. Date Application Approved BY ---------- --•--- %�_ Da e Application Disapproved for the following reasons_______________"�':. -------------------------------_............................................................................._.................._........................................................................ Date ....... ---........ Issued.._. . ....a -7 �/ 4 Permit No. .....:.._ Date THE COMMONWEALTH OF MASSACHUSETTS i BOARD O F a EA LTH { ..............A ............OF....................................... - .--...._.......--...--......... TrrtifirFatr of 1091,11mplittnre .+. THIS IS T CERTIF�, T}at'the IndioIidual Sewage Disposal System constructed (�or Repaired ( ) zl Installer has been installed in accordance w-ith,the provisions of Article XI of The State Sanitary Cede as described in the .� u application for Disposal Works Construction Permit No----------- .�._ ............... dated --___:_.__.___..._........._____.___._.._._.... TAIL ISSUANCE OF THIS,,CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA NTEE THAT THE SYSTEM ILL .FUNCT N SATISSFACTORY. DATE. - ........... ` 'z ¢................................. ---------------•--. ---: Inspector----- ,1 r.. 7�7 THE COMMONWEALTH OF MASSACHUSETTS I t_ . BOARD:;OF HEALTH ..: .............•- . FEE. tt �x" un�tr�trttnEt �rr�ttt . Permission hereby granted-------- ---•-----•----------------------------•-----•-•--------•-•---•••-..•--_--.... to at Con uc vr»Re ( , an In 'vidual SewageDisposal S Street as shown on the' pplication for Disposal Works Construction P it No_____ ____________ ate :.__ /"� r___.__ `•t yq, ....... ar of ealth DATE--- ..__.._.. - FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS + E e 5(- t. . y _- _� ���� C) . 1 1_ E pp O N U = Mc� U C coc00 N � Fire Damaged Area J No XcL ca m IS � c CD 0 ---- IT q �-- U °O --- N qIT c6 t O N P Ln mDID -0 t? a BATH 67 s x s•-z• s]s0 KITCH /BREAKFAST I e a ® ¢ 55 SO FT I 2]SO" LIVING J a° F s 161 SO 1C]so" I --------- i re 1— HALL I I GARAGE y - Y'-t0,Y,6 ,•. ry1'-n'XT3' I I o' 1F-3•X22'-6' I. 65 SO FT ,I/ 365 SO FT ]8 U3 SO SO FT I I FT Cased Opening 2 9.25"LVL Header _ Cased Opening 2 9.25"L Header I PORCH 35 FT b N OFFICE HALL FAMILY 15'3•X 12'S' S-e•X 12'E' 12'.2'x 12'-6• 20 SO FT 67 SO FT 165 SO 190t5TFT - 595O FT 15250 FT 1 y � 117 i--I Proposed Layout LIVING AREA 1945 SO FT P � O- N L6 N _ rd C~/] ! CD ti 0 N c U CCO0O U = ca cO o a) J N LO C- C) X M m fa d-) O - M � N _CC J e ena vie oo a., a) ____ __ ----a —_ —__ e-- LO LO y s BATH e•-1•xer BEDROOM 2 62 so BEDROOM 3 I 1SJ•X12•B• R 1—X 12'-8• A . 187 SO Ff _ 157 SO Ff s Z I HALL I m usxe•-2• A 40 SO FT I I b MASTER BDRM m'l BEDROOM 4, e 19'3•X 12'-6 12'-2•X 12•-8' 240 SO Ff yp 182 SO n --------------------------------------- Existing Second Floor Plan O ! N N CENTERVILLE LOCUS �/ = MBERT VIE 2� N �� RD < RC 04 LL- LL ao LOCUS MAP cV LOT 45. N PLAN REF: 272/58 F2 / AREA=15,026f S.F. p LOT 44 TITLE REF: 2934/115 / PARCEL ID: MAP 190 LOT 203 ZONING: "RC" SETBACKS: 20'F-10'S-10'R jv�I M ((R. WIND ZONE EXPOSURE: "B" O PROPOSED BUILDING LOT COVERAGE: 13% �t FLOOD ZONE: "X" COMMUNITY PANEL: 25001CO561J DATED:07/16/14. ryo / DRIVEWAY \ 17.5' LOT 46 CERTIFIED PLOT PLAN 22.7' I 24.3 ' (FOR REBUILD) N #21 ,yap LOCATED AT: C� 21 RACHEL CARSON LANE PROPOSED CENTERVILLE, MA. ADDITION %%�� %%%% DECK PREPARED FOR FIRE DAMAGE LoJ WALTER J. & KAREN M . 47.4' SEPTIC VAR N EY PER TIE CARD/ \ SCALE: 1"=20' (^Y LOT 42 AUGUST 26, 2016 PARCEL ID: 190/157 S75e OF wA MacDougall Surveying 0526 �.P�` Ssgc EDWARD 8c Associates y� GRAPHIC SCALE STONE P. O. Box 2428 20 0 10 20 40 80 'ss.oo �o o.28 M a s h p e e, Ma. 02649 PH. PARCEL ID: fax �508�419-1086 508419-1087 ( IN FEET ) 190/160 _ email: i inch = 20 ft. macdougalIsurvey©com cost.net SHEET 1 OF 1 J 1861