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HomeMy WebLinkAbout0054 SHIRLEY POINT ROAD - Health (2) 54 Shirley Point Circle - -- Centerville A=213-010 S M E A D No.2-153LOR UPC 12534 emead.com • Made in USA J4�-Q�b,k � y FM USED W YM PMW UNE SFI � '� G RiiFlEO SOURGNGSFIMGRW L I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form .Not for Voluntary Assessments Sq s ,r,le P,h lied Property Address ON ner Cw ner's Name _/. /� information is �:�7Ti✓l/Y / A14 f. 16 �T 11� / /required for every �c� ! �, l/a` Jc� / page. Ci Nown State Zip Code Date of Inspe Ion Inspection results must be submitted on this form. Inspection forms may not be altered In any way. Please see completeness checklist at the end of the form. tmnt:for When fillingng out u out A. General Information ms on the computer, use only the tab 1. Inspector: key to move your xcursor-do not o 05b(J use the return key. Name Inspector Company Name C� / �a CompanyA X 01 Address a vtl 11V / V o- b Y p� City/Town State Zip Code Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system Inspector pursuant to Section 16.340 of Title�6 (3�10 CM 16.000). The system: U.d Passes ❑ Conditionally Passes ❑ Fails D Needs Further Evaluation by the Local Approving Authority Inspector Signature Date The s tem inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection, If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5 ns-3113 Tioe 5VIFSbsuYSe / o�ys tem Page 10117 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments l e Plh 7 Property Address CahoUV Oro ner ON ner's Name / information is e vs 4r y 6/ IPA required for every � � � /'�"� oaG3 page. City[Tow n State Zip Code Date of I specC n B. Certification (cont.) Inspection Summary: Check A,B,C,D or E / always complete all of Section D A) Syste Passes: I have not found any information which indicates that any of the failure cntena described in 310 CMR 15.303 or in 310 CMR 15.304 exist, Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced aced o r repaired.red. Th p p e system, upon completion of the replacement or repair, pp as approved by the Board of Health, will pass, p Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Healt h. *A metal septic tank will pass Inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): Mrs-W3 Tito50fficial InspeceonForm Subsurface Sewageolsposai system-Page 20r17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal Sy/stem Form - Not for Voluntary Assessments S'/ .stilr lQ / ��h Property Address Ca �ov�r ON ner ON ner's Name l information 6e N �c✓(�/ .� 1'1'�e required for every � ._ page. (Ayfrown State Zip Code Date of Inspec4on B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational, System will pass with Board of Health approval if pumps/alarms are repaired, B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipes) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ NO (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ NO(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ NO(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ NO (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a mannerwhich will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh tNns.3113 Title 50fficial Ins pactlon F orm:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form - Not for Voluntary Assessments `f VI w/e N T / o, n Property Address a �00 in r Cw ner Cw ner's Name information Is C // //7 Qa L 3 / / required for every L'�^ ✓y� � page. Cityfrown State Zip Code Date of Ins action B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, If any) determines that the system is functioning Ina manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well", Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for Ift inspections: Yes No ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ �/ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume Is less than '/z day flow t51ns•3113 Title$Official Ins pec don Form Sub rfineS"aDisposalSystem•Pape4oft7 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1� i k,l e /oi h Property Address ON ner Cw ner's Name information is Cep►�7L dvv! /l �� f� O )6 M �/� l required for every ` o page. City/Town State Zip Code Date of inspettion B. Certification (cont.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ U� Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ E--- Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ IJ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 6 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- / 10,000gpd. ❑ The system Wj1 . I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D, Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ Cl the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. thins 3113 Title501ficlel InspectonForm Subsuiace S"eDlspossi System-Pape 5of17 Commonwealth of Massachusetts Title 5 Official Inspection Form L Subsurface Sewage Disposal System Form -Not for Voluntary Assessments prr Property Address le, dolti 6 io rmation is ner Cw ner's Name info required forevery Ce �yl l�� / /T Op1(, page. Cityfrown State Zip Code Date'ofinspeclion C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes �❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ LJ Were any of the system components pumped out in the previous two weeks? ❑ I�! Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) �❑ Was the facility or dwelling inspected for signs of sewage back up? �❑ Was the site inspected for signs of break out? u ❑ Were all system components, excluding the SAS, located on site? �❑ Were the septic tank manholes uncovered, opened, and the interior f o the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Existing information, For example, a plan at the Board of Health. ❑ Determined in the field (if any of the failure criteria related to Part C Is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 for example: 110 gpd x #of bedrooms): 92.2 Val AV) 6�0Pd II 00 l5ino t3 GJroV14 d �f le — tlfo TiUe50fAciatInspeotlm Form Subsurfaoe Sewage DlsposalSysleffl-pagaeOW Commonwealth of Massachusetts - Title 5 Official Inspection Form a Subsurface Sewage (Disposal System Form -Not for VoluntaryAssessments Property Address 6oc4r Cw ner Owner's Name information is c(?V4KI/114X/�requlredforevery page. Chy/Town State Zip Code Date of nape tbn D. System Information ' Description: j/ _ /00'0 rc� Number of current residents: Does residence have a garbage grinder? O Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection information in this report,) ❑ Yes 2---No Laundry system inspected? ❑ Ye 2 No Seasonal use? LEI Yes ❑ No Water meter readings, if available (last 2 years usage(gpd)): Detail: Sump pump? ❑ Ye No Last date of occupancy: ✓` Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq,ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Ons-3/13 Title 5 01Acid Ins pec ton Form Subsurface Sewage Dlapceel System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r Property Address Ow ner Owner's Name information is required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes a- No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of stem: Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy Cl Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (descd be): Mns•3/13 Title 6 Of fidal Ire pec don F orm Subsurface Sewage Disposal System•Page$of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal�System Form - Not for Voluntary Assessments Property Address Xe tj /4'0",-1 7L /�I'J ON ner Owner's Name information Is `/ G /l required for every C em ✓ /7 oC page. Cityrrown State Zip Code Date of Inspe tion D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes 5 No Building Sewer(locate on site plan): /0) Depth below grade: feet Material of constructi;�4�OPVC : ❑ cast iron ❑ other(explain): Distance from private water supply well or suction line: /O feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: feet Materi of construction: concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: y Sludge depth: Mrs•Y13 Ne5Official InspeciicnForm SubsLrf ace Sewage Disposal System Pegs 90W Commonwealth of Massachusetts Title 5 Official Inspection Form 6 Subsurface Sewage Disposal System Form -Not four Voluntary Assessments a- % '5 f/k^le Property Address /� 1..- Ow ner OH ner's Name inforfrmtion is required for every 2 TG✓l��`/e / '// pC�j �pC page. 5 7—row n State Zip Code Date of'Inspection D. System Information (cont.) Septic Tank(cont.) 3 �� Distance from top of sludge to bottom of outlet tee or baffle Scum thickness ' " 0'�C Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, e\idence of leakage, etc.): Co" df7�ioh A/0 Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t9ns Y13 T105018clalIre pectlon Fam Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments S�1►'"�2 O l n T �� Property Address Ckv ner �G J 0 l� ✓ Ow nor's Name �'141 information is /hrequired for every �wt page. City/Town State Zip Code Date o sped' n D. System Information (cons) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of Inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Di i mansions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc,): "Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t51ns•3113 TIUe50lflclal UrepecUmForm Subeurfece Sewegeolsposel System-Page 11 d 17 i i Commonwealth of Massachusetts Title 5 Official Inspection Form 5 Subsurface Sewage SY Disposal System Form -Not for Voluntary Assessments S�lr Ile Property Address Cw ner Cw ner's Name 1 n Information Is Cep, �v6/ � OP-`3,�- required for every page. Cityrrown State Zip Code Date of In pectlo D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): -'-/D/� Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage Into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Mns.3113 Title 5Official Inspection Form Subsurface Sewage Disposal System•Pegg 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments d. T l✓'�C /�0/ �c� Property Address Owner oN ner's Name i%14 oa 6 3� i� Information is (_ �N ✓(/( / 7/y required for every -^--~— page. Cityfrown State Zip Code Date Of)Aspectiifi D. System Information (cont.) �/ V 1)4 Type: 6� ' ( ��f "le-- leaching pits a number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): // �"'�N ,� / " � ��/✓] L/!/ram . Hsi -- /0-C t Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Mns 3113 Title5Official Inspection F orm Subsurface Sewage Disposal System Page 13of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form per. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address LA Ow ner ON ner's Name Information is �� required for every 0 � l 4 0.) page. CityfTown State Zip Code Datd o Inspectlon D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 TiOe50f6clallnspectlanForm SubsLrface Sewage Disposal System Page 14of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form V Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3� .5�/rle 7 1- {t'� Property Address ON nor Ow ner's Name Information Is n required for every Cat^ VV��'�- � 0�6JU page. Gtyrrown State Zip Code Date df Inspectlon D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate 7�h2n,l_ekatt,.h blic water supply enters the building. Check one of the boxes below: in the nroa holnw ❑ drawing attached separately B C ao /0 '7% C, ' •� (ore✓ Q.7-')7 �/ P t5lne•3'13 TItie5Dlflcial Ins pectionForm Subsurface Sewsp Disposal System-Page 15d 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address C 4�i 6 0 k Ow ner Owner's Name information Is required for every C' VI/l/ Qo� 6✓7pZ �� page. 5F—TOW n State Zip Code Date of Inspectibn D. System Information (cons) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: feet � Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑,/ Observed site(abutting prop ertylobservation hole within 150 feet of SAS) 1!� Checked with cal Board of Health-explain: ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database-explain: You must describe w you esta lisheld the high ground water elevation: /'O �Lv -1/- or fS �O f u�t o �G � S 2�tl (51 � t �m�� J10 i, Before tiling this Inspection Report, please see Report Completeness Checklist on next page. t61ns•3!13 `/I_ Me50fBcial lnsp%UonForm Subsurface Se l T wage DlsposA Syslem•Pape 18 d 17 � Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System //Form -Not for Voluntary Assessments `P ,5 SDI l r 4 Property Address Cw ner ON ner's Name / information is �QN yV, A Dot. jp_ required for®very 777���rrr��� page. City/Town State Zip Code Date of Irfspecti6n E. Report Completeness Checklist Inspection Summary; A, B, C, D, or E checked ,M'IInspection Summary D(System Failure Criteria Applicable to All Systems)completed 1 R SS stem Information—Estimated depth to high groundwater L� Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 9 p Y Pg P e Ons•3113 Tito 5 official lnspecfionForm Subsurface Sewage Disposal System•Pape 17of 17 Loop Up Print Page 1 of 3 GBH . Owner Information -Map/Block/Lot: 213/0.10/-Use Code: 1010 Owner Map/Block/Lot GIS MA A! 213 /010/ CABOUR,HELENE Property Address Owner Name as of 201 BROOKSBY VILLAGE DR 1/1/12 #231 54 SHIRLEY POINT ROAD PEABODY, MA. 01960 Co-Owner Name Village: Centerville Town Sewer At Address: No GIS Zoning Value: RD-1 . Assessed Values 2013-Map/Block/Lot: 213/010/-Use Code: 1010 2013 Appraised Value 2013 Assessed Value Past Comparisons Building $ 414,000 $414,000 Year Total Assessed Value: Value Extra $ 31,100 $ 31,100 2012 - $ 1,273,600 Features: 2011 - $ 1,228,700 Outbuildings: $ 23,100 $ 23,100 2010 - $ 1,226,200 Land Value: $ 682,500 $ 682,500 2009 - $ 1,375,100. 2008 - $ 1,493,600 2013 Totals $ 1,150,700 $ 1,150,700 2007 - $ 1,493,600 . Tax Information 2013- Map/Block/Lot: 213 /010/-Use Code: 1010 Taxes C.O.M.M. FD Tax $ 1,703.04 (Residential) Community Preservation Act $ 302.40 Tax Town Tax(Residential) $10,080.13 Fiscal Year 2013 TAX RATES HERE 12,085.57 . Sales History- Map/Block/Lot: 213/010/-Use Code: 1010 History: ' Owner: Sale Date Book/Page: Sale Price: CABOUR, HELENE 4/15/1994 9142/179 $650000 BAIER, MARTHA L 7/15/1992 8115/274 $1 BAIER, MARTHA L, EXECUTOR 7/15/1991 P0694-El $1 BAIER, CLARENCE W JR 2/15/1984 4025/314 $75000 BALER, CLARENCE W JR 6/15/1983 3774/244 $0 http://town.bamstable.ma.us/Assessing/printl 3.asp?ap=0&searchparcel=2l 3010 6/30/2013 Loop Up Print Page 2 of 3 BAIER, CLARENCE W M-792 8115/276 $1 . Photos 213/010/-Use Code: 1010 • Sketches-Map/Block/Lot: 213/010/-Use Code: 1010 a �j�rr�hii?rrr, 4 N Sri re Sh p 4° rk Y z l IMP AsBuilt Card N/A • Constructions - - o s Details Map/Block/Lot: 213/O10/ Use Coder 1010 Building Details Land Building value $ 414,000 Bedrooms 3 Bedrooms USE CODE 101( Replacement Cost $440,434 Bathrooms 2 Full + 1 H Lot Size(Acres) 1.9 Model Residential Total Rooms 6 Rooms Appraised Value $ 682 Style Modern/Contemp Heat Fuel Oil Assessed Value $ 68'. Grade Luxury Minus Heat Type Hot Water Year Built 1985 AC Type Central Effective depreciation 6 Interior Floors CarpetHardwood Stories 2 Stories Interior Walls Plastered Living Area sq/ft 3,088 Exterior Walls Wood on Sheath Gross Area sq/ft 5,244 Roof Structure Gable/Hip Roof Cover Asph/F Gls/Cmp . Outbuildings & Extra Features-Map/Block/Lot: 213/010/-Use Code: 1010 http://town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=213010 6/30/2013 Loop Up Print Page 3 of 3 r r Code Description Units/SQ ft Appraised Value Assessed Value PAT1 Patio-Average 1556 $ 12,400 $ 12,400 FGR2 Garage-Avg-Wd 357 $ 10,700 $ 10,700 Shingle FPL2 Fireplace 1.5 stories 2 $ 8,600 $ 8,600 GAR Attached Garage 600 $ 22,500 $22,500 . Sketch Legend Property Sketch Legend 132N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area(Finished) SOL •Solarium BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished) TQS Three Quarters Story(Finish( BRN Barn GAR Garage UAT Attic Area(Unfinished) CAN Canopy GAZ Gazebo UHS Half Story(Unfinished) CLP Loading Platform GRN Greenhouse UST Utility Area(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UTQ Three Quarters Story(Unfinis FCP Carport KEN Kennel UUA Unfinished Utility Attic FEP Enclosed Porch MZ1 Mezzanine, Unfinished UUS Full Upper 2nd Story(Unfinisl FHS Half Story(Finished) PRG Pergola WDK Wood Deck FOP Open or Screened in Porch PTO Patio http://town.bamstable.ma.us/Assessing/print l 3.asp?ap=0&searchparcel=213010 6/30/2013 t. i�8m-mR���r—•.3�„.u:�.l r�'�.i� ��w.+---�"i3,�1`.+..e�.r.=s�'as."a:",>?:4.iw-,s S�F'S �: �1 c ra` MY IF -- NUN I - momOR — :(� RP'R IS an 8<15 i I i I� Towh of Barnstable Geographic Information System 233008� March 25,2016 r #6 j 233070 ( #30 r i 4 d S 2333009 #'4a 4!al 233007 2336104' a 233066 " #100 $ 213011 233011 - �� #74 233006 #35 213010 #54 233004 , #14 wC 233003 233005 #141 #34 0 68 Feet r. ; Ry M l� DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:213 Parcel:010 bounds determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel.. boundary Owner:MENDU CAPITAL LLC Total Assessed Value:$1139900 _ 4 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:1.90 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:54 SHIRLEY POINT ROAD such as building locations. Buffer APR 26'S AM $�i'� h'•D I ,; .r/� — � ' `F t'•.O_,,1.1P.f�oF Ftio••I 1 ..__ — � , I I N' R:.g :5� r F 2d;�y. Z • , _ y _ ;.' ulnl it�I Gti r 5>�1.— V Pjy,ti C3SK3:. O3x3. P�yxl �isl 65� l� Isv LI rN'i,u_. /1(0 ill ,C TV I�.1 /Q0E MIT I Y I INGLLS r/Pb I 9 3�O LRX7 I F � n. ixa NANI'll.._— b 2 _ Z l ' ! W t k I ';%•.� J m• �' - m � � � �� � I sun nNi_r_vrn 1 r., IF. 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Pkone f617/719.9450 •Ir�°w lh< h uv,,, .na.ee nu:rnl«....ewntl SD/ o,.�, Smfv; Rr cM� Pr Ul °/r' . •• « ...,. .• ,�..w L�Ii VE!� �PNLL 1`�^ '/�' I'•0 /V PJF mYYrldhthl awn APR 26'i6 An 6=15 I J —jo [,5 N®...�... ` Fmc....... .�... THE COMMONWEALTH OF MASSACHUSETTS �- BOAR® OF HEALTH 4 ..........................................O F........................................ .�..Vp iration for Dispaii al Work, Cfonitrnr#ion ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at• ` . . .. �.� 1 41f_..C,t V.11.�k. -- i .............................. ocation-Address t ..or-Lot No. .x a. .------...n— .�� .: --------------•-------------------.._....._._.... ®tl7 k� _ ± �^ Owner Address _ -.................................................... ��. �� ...................................................... Installer Address U Type of Building Size Lot.. 3�.. ?_f,?_...Sq. feet Dwelling—No. of Bedrooms...........�............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other xtures ..............• •-----•-----------•---•------•-•--•-......-•------•-••---•--•---•-•--••-•---•----•---•---------•----------- W Design Flow... ..G.!M.............gallons per person per day. Total daily flow--_.'� .b..........._.........._....gallons. WSeptic Tank—Liquid capacityl.5Q_{J.gallons Leng h................ Width.........._..... Diameter................ Depth................ x Disposal Trench—No. .................... Width..�r�d.�o4� Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......a.......... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................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 ..........-.................................................................................................................................................. Descriptionof Soil................................................................................................................... ..................................................... -------------------------------•----------••---•----•--------------.---------------•-----------------•----•-----•--------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------•-------------------------------------------••------... ------------------------- •----------- Nature of Repairs or Alterations—Answer when applicable...................................................•............__.______..._..._.____.._..___. 1 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI:- 5 of the State,Sanitary Code— The undersigned further agrees not to place the system in operation until a Certifi- to 1' nce has been issued by the board of heal Si ned._....._ --•--•-••_..g ry D e Application Approved BY - _ = ...-------•--...----- i Date -------- Application Disapproved for the following reasons_..............__________________________ _ -----------------•---•----••---•--.....-----•-----•------------•-•----------••-----.............-----•-------•-......------------••---•--•-••---•-••••••-------•--•-••--------••-••----•••••---••------- Date PermitNo......................................................... Issued....................................................... Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA No Ii'ES THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................... ....................OF....................:..................---------------------------..............._..._.... Appliration for BhiposFal Works Tonarurtinn rranit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. ._._.. .... x................. ............................ _: ............................................ r Location-Address or Lot No. .::•= -•--•-- .... .....................•---•---------------•---•----.......-•-•--• .....................t ----.. .....r Owner Address t ................................................................................ .......................... ' .......•....................... Installer Address Type of Building Size Lot... . :' ,_..Sq. feet aDwelling—No. of Bedrooms...........:.:::............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -----------------------------------------------•-•---....------------------------------------------------•-••------------...........---..........._.. Design Flow...:__.......................................gallons per person per day. Total daily flow ..:_:, ' ..............................gallons. W. s> 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........................ " (N Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--------_............... a' ............. ------------------- ----•-•..... •.... ---------------------------------------------------- ----------------------- -••-------------------------- •--•- ODescription of Soil...................................•-•-•-•--••---•--...............-------------------------------------------------•----------------------------------.._...---------•- x W x ••--••----------------------------------••---------------------------•---....__...-------•--•-••--•--------------•--•-------------------------••--•----•----•-•--•-•--•--•--•-•-•---•••-•--••--•--•----- 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 operation until a Certificate of Compliance has been issued by the board of health. Signed --------=- .. ......•.. ........................ Date Application Approved BY ....: ------•- --------- ----•-. .••--•---•----•---........-_--......_ ............ ........... 'Date Application Disapproved for•the..following reasons-----------------------------------------------------------------------------------------------------------•... ---•--•-•-----------------------------•--------------------•---------------------•---------•-----•----------•-•--••---•----•----•-•--•----••-•••--•------.............................................. Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Cfuntif irate of Tuniph anrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( )`yor.Repaired ( ) by Installer �. 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 No---------°__-___,__:.................... dated............... __ ..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS UE® AS A GUAR TEE THAT THE SYSTEM WI-7LL FUN TION SATISFACTORY. DATE........... .. ...]� � Inspector............. �.. / �'t...... ......... THE COMMONWEALTH OF MAS�-ACH ETTS BOARD OF HEALTH No FEE.== .... �i��r�r�tt1 nrk� C�nn�trnrtuan rrutit . Permissionis hereby granted.....................:.. . ':.. :...._--•-----------------•-••-•----•----••---•-•-•.....--•-•••..:::...•-••-........................ to Construct ( ) or�Repair ( ) an Individual' Sewage Disposal System at No -.,,,!. . . --•-•......--- Street as shown on the application for Disposal Works Construction Permit No,.................... Dated_,.:!..'..,................................. Board of Health DATE -- ':. �� .................... FORM 1255 A. M. SULKIN, I C., BO TON L O C T ION � 1� _ rSEW " E PERMIT NO. VILLAGE I N S T A LLER'S , NAME i ADDRESS IUILDERr OR OWNER _ DATE PERMIT ISSUED g c � DATE COMPLIANCE ISSUED '� 3 ® 71 pe> M I l � MAP W�"t"�t �rf�;�8 l�v2 t►J'�3�L. A�� f Df S t�lA v t 7` t 2- o L � I'1D it wj -SVT 7rrAA At,2 GA 5 F- ! a A '��� >u`Z' 1'L G Cam►"i N��-''��7 �t + � �`4�t� `7 t n(�t'.-!� 'L' �5��'�;.- � \`�� �� 1 \%{� � � T©U-)Q -F?,A rz kYiTA'r6L.j5 A tJ r.) is f k)7' ( oc A-Tie te Tw t j 0 � �. ^orb\ �'`+� � j � i �,�o ` ••:.k Al A.�j) Z d oil I ; AA y �--- r 11 \L Of rtjc� '. 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