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HomeMy WebLinkAbout0685 STRAWBERRY HILL ROAD - Health 685 STRAWBERRY HILL RD., CENTERV. A= a9 D(0o k UPC 534 2 • . -1531L R I i M ,ir Goa 28745 P s 266 •011371 03-18-20 1 S a 12 2 20P t 2'5 7. h K _T - Sri f ' t - - DEED REST1:qCT1ON -- WHEREAS, O I Z ALGA-ry ..D S s P NToJ of r (owners,name) (address) is the owner of (ji'M ZU _yMI& AP looted (address) at 6' S" 52,A L&J -67 AR,: /fIGL F O ` Cen�ecv�ti\e MA (hereinafter,referred to as and being shown-on a plan entitled "Subdivlsi n of Landin 'fit ns;�blt MA, Property of _ v,2 At m,kid DOSS ANT4s , et al, - duly recorded in Barnstable County Registry ; Of - Deeds in _. Book 02'3 a q C •_ _ Page Oron Land Court Plan Number ,;y---- 1iVHEREAS, L iZ A466M ®¢ as the owner of said lot has (ow ne1's name) [1°x 3 �'r d 'N sja° agreed with the Town of Barnstable Board of Health to a restriction as tote number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 OMR 1 5.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage.; WHEREAS, the Town of Barnstable Board df.Heatth, as a pre-condition to granting a disposal works construction permit for a septic system In compliance with 310 CMR'16.200, State Environmental Code, Title V, minimum Requirements for the Subsurface'Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, dw& €4 NOW, THEREFORE, 101 ALke�_.��fs�.��_::" tloes hereby place the (owners name) following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 5rkA0 p,(-_R f4 4,Q._ may have constructed (address) u on the lot a house containing'no more than -b U (�) bedrooms. Lvrz .AC. .q auto "; agrees that this shall be permanent deed (owner•®name) ��S"S��.tl���NII,Z• F� MA, and restriction affecting _located on being shown on..the plan recorded in l.. Book�319 Q , Paged _...Or on Land Court Plan 6 For title of ' �" - - , -see the following deed:. BookaC Page Or g !� .TOr Land,Court Certificate of Title Number Executed as a sealed instrument day of �, ^ '�• Owner's signature: - . . _ Owner's signature _ Owner's signature COMmoNWEALTH OF MASS.ACHUSETTS y 20_ Then personally appeared the above-named known to me to be the person who executed the foregoing instrument and acknowledged the same to be free aceand deed, before me, - Notary Public < „ My commission express a (date) BARNSTABLE REGISTRY OF DEEDS ; a__,_ Jahn 9: Meade. Register Q' M QL m �o 0 o z o o- o W Yv S s 9r 1r►o J � � y��od f i ATII- i Af ITN;FNrt 376 Sa F7 Hazaydous Materials Inventory Sheet Checklist lQ ZDate Physical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts -( ie. gas being used to fuel machines,thinner to clean brushes all count as hazardous materials-no blanks) Storage Information -location of storage, how long is storage for? If none, note that. jam-- Disposal Information -where and who? If none, note that. _Applicant Signature -understand what is listed and noted Staff Initial -any questions, know who'to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it . Attach the Business Certificate with your sign off and comments "The inventoryform.should explain what the business:consists of and:the procedures they are doing.: Notes need to be left to explain what you discussed with them. ` YOU WISH TO OPEN A BUSINESS? For Your.Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, I st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Fill in please: APPLICANT'S YOUR NAME/S: L S i BUSINESS YOUR HOME ADDRESS: rn�C�l 5 C P(�Qf�I 1\ R��. PY1� P(V qS (o4 O 2 ' TELEPHONE # Home Telephone Number '�>O NAME OF CORPORATION. NAME OF NEW BUSINESS n TYPE OF.BUSINESS 1 {i IS THIS A HOME OCCUPATION? '"YES NO r ADDRESS OF BUSINESS ' ur fief 41I Ie AP PARCEL NUMBER /�''!. / � [ ssessin 3�Z When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: I � 2. BOARD OF'HEALTH This individual h e n info d f hG� J i ements that pertain to this type of business. Authorized*nature*** MUST 41MPLY WITH ALL COMMENTS: 4 EGULATIONIS 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of-the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: r- rY Date: ljl �l /'�, TOWN OF �ARNSTA�LE EzQ* �� TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS: BUSINESS LOCATION: 1,P4VENTORY MAILING ADDRESS: (p�'S L' Ca,,\Nbfy V 'N,`1l Dd . ,oenY P(0Il' M Y�-, 1j)�7 TOTAL AMOUNT: TELEPHONE NUMBER:I-5Q -�j�_ ''%GLA CONTACT PERSON: L 1-7,- �Ol�Y1US EMERGENCY CONTACT TELEPHONE NUMBER: f��j -��� - C030CI MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIO S: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) 0 C) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): © (', Metal polishes Laundry soil &stain removers Q C) (including bleach) Spot removers &cleaning fluids (dry cleaners) C) O Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS licant's Signature Staff's Initials COM-MOY"EALTH OF MASSACHL;SETTS ExFCI;TIVE OFFICE OF E.NVIRONMENTAL AFF.AIP.c, F DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREE:'. BOSTON ALA 0210t; r61,1 292.550t, TRL DY COL Secre:a-.v ARGEO PALL CELLUCCI DAVID B STP. .'H5 Governor Corrunissione- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 685 Strawberry Hill Rd. Name of owner Car61ine Ewing Centerville Address of Owner: Date of Inspection: Name of Inspector:(Please Print)Wm. E . Robinson Sr. I am a DEP approved systert'inspector rsuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: Wm. E . Robinsoneptic Service Mailing Address: PO Box 1089, Centerville , MA Telephone Number: CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: t asses Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: `b IL - Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty (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 Department of Environmental Protection. The original should be sent to tfre system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS 1 200 i revised 9/2/95 Page IofII ati i• -?ed on Rea•cird Panc, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(confiinued) iop"Address: 585 Strawberry Hill -Rd.. , Centerville Jwner: Caroline Ewing Date of Inspection: (rti 1 INSPECTION SUMMARY: Check 6)B, C, or D: A. 71 EM PASSES: �//I have not found any information which indicates that'any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. YSTEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon ompletion of the replacement or repair, as approved by the Board of Health, will pass. Indicate y s, no, or not determined (Y. N, or NO). Describe basis of determination in all instances. If "not determined', explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached)indicating that the tank was installed within twenty (20) years prior to the date of the inspection: or the septic tank, whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 obstruction is removed revised 9/2/98 Page 2 of I I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Icorronued) Property Address: 685 Strawberry_ Hill -'-�d- , Centerville Owner: Caroline Ewing Date of Inspection: C. RTHER 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 the ublic health, safety and the environment. 1) YSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES W ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH IAND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revise 9�2�9$ Page 3of11 . f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 685 Strawberry Hill Rd. , Centerville Owner: Caroline Ewing Date of Inspection:')- D. SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will bi necessary to correct the failure. Yes No Backup of sewage into facility.or system component due to an 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 1 f2 day flow. _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. RGE SYSTEM FAILS: You m t indicate either "Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public ealth and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply 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) The ow er or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office o the Department for further information. revised 9/2/98 Pakc4orn SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART B CHECKLIST Prop"Address:685 Strawberry Hill Rd,. r Centerville Owner: Caroline Ewing Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No JI/ _ Pumping information was provided by the owner,occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: Existing information. For example, Plan at B.O.H. y _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) 11.5.302(3)(b)) _ The facility owner (and occupants,if different from owner) were provided with information on the propermaintenaar."f SubSurface Disposal Systems. I revised 9/2/96 Page 5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION 'rop"Address: 685 Strawberry Hill Zd- , Centerville Owner: Caroline Ewing Date of Inspection: J -6-6 FLOW CONDITIONS RESIDENTIAL: Design flow:�� Sb g.p.d./bedroom. Number of bedrooms(designl:-17 Number of bedrooms (actual): Total DESIGN flow 41_< Number of current residents: Garbage grinder lyes or no):_,&rj Laundry(separate system) (yes or no):,,d&; If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use lyes or no):A,D Water meter readings,if available (last two year's usage lgpd): 1 1-�2 , 000 gal, Sump Pump (yes or no):A�V 1998 102, 000 gal. Last date of occupancy: L>—/2- G-z) COMMERCIAL/INDUSTRIAL: Type o stablishment: Design fl w: qpd ( Based on 15.203) Basis of esign flow Grease tr p present: (yes or no)_ Industrial aste Holding Tank present: (yes or no)_ Non-sanit ry waste discharged to the Title 5 system: (yes or no)_ Water m ter readings, if available: Last dat of occupancy: OTHE (Describe) Last d of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)pi If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes, attach previous inspection records;if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed(if known) and source of information: b • ,f� -3 Sewage odors detected when arriving at the site: (yes or no)"A D revised 9/2/9�'- Page 6(if 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'ropertyAddress: CH 'Jtrawberry Hill Rd- , Centerville Owner: Caroline Ewing Date of Inspection: t/—/2—o—u BUIL NG SEWER: (Local on site plan) Depth Blow grade:_ Materi I of construction:_east iron_40 PVC_other(explain) Distan a from private water supply well or suction line Diame er Com ents: (condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK:_ (locate on site plan) 1 Depth below grade: Material of construction: ✓concrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age_ Wage confirmed by Certificate of Compliance_ (Yes/N0 Dimensions: x 4 1(Ca Sludge depth:'! Distance from top of sludge to bottom of outlet tee or baffle: I/ Scum thickness: /—3 J' i. t Distance from top of scum to top of outlet tee or baffle: a Distance from bottom of scum to bottom 91 outlet tee or baffle: I3, How dimensions were determined: 'omments: (recommendation for pumping, condition of inlet and ou!1!qtees or baffles, depth of liquid level in vela i n to outlet invert, structural integrity, evidence of leakage. etc.) _fSb-Q C /o / / w ), S�.f /�- C GREAS TRAP: floc o site plan) Depth belo grade:_ Material of onstruction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dimensions: Scum thick ess: Distance fr m top of scum to top of outlet tee or baffle: Distance tr m bottom of scum to bottom of outlet tee or baffle: Date of las pumping: Commen (recom ndation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural,integrity, evidenc of leakage, etc.) revised P2ge7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM , PART C SYSTEM INFORMATION(continued) bropertyAddress: 685 Strawberry Hill P.d . , Centerville Owner: Caroline Ewing Date of Inspection: /oL-c>---V TIGHT HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection) (locate o site plan) Depth)bebe[ w grade:_ Mater construction:_concrete metal Fiberglass_Polyethylene_other(explain) Dimes: Capac gallons Desigw: gallons/day l Al., present Alarm evel: Alarm in working order: Yes_ No_ Date o previous pumping: Comm nts: (condi on of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:v (locate on site plan) Depth of liquid level above outlet invert:` Comments: (note if level and distribution is equal, of solids carryover, evidence of leakage into or out of box, etc.) - K Y PUMP AMBER:_ (locate n site plan) Pumps i working order: (Yes or No) Alarms i working order (Yes or No) Comore ts: (note c ndition of pump chamber, condition of pumps and appurtenances,etc.) revises 9/2/98 Page 8ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) topertyAddress: 685 Strawberry Hill Rd.. , Centerville Owner: Caroline Ewing Date of Inspection: L/—/, —6- 0 y SOIL ABSORPTION SYSTEM(SAS):_ (locate on site plan, if possible;excavation not required,location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits', number:_ leaching chambers, number:_ leaching galleries• number:_ leaching trenches, number, length:_L 6 leaching fields, number, dimensions: overflow cesspool, number:_ Altemative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic ailure, level of ponding, damp soil, condition of vegetation, etc.) CESSPO _ (locate on sit plan) Number and co figuration: Depth-top of liqu d to inlet invert: Depth of solids la er: )epth of scum lay r: Dimensions of ces pool: Materials of constr ction: Indication of groun water: inflow (ce spool must be pumped as part of inspection) Comments: (note condition)0 . oil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:_ (locate on site pl n) Materials of cons ruction: Dimensions: Depth of solids: Comments: (note condition f soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) rev see 5/2/7C PaFc9ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Nop"Address: 685 Strawberry Hill -d.. , Centerville 'Wnw: Caroline Ewing Date of Inspection: i/1.7^6—G SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks.or benchmarks locate all wells within 100' (Locate where public water supply comes into house) �4 f pC 3 G � f t G o Jk revised 9/2/98 Page 10of11 ~ SUBSURFACE SEWAGE DISPOSAL SYSTEM PART C INSPECTION FORM SYSTEM INFORMATION(continued) top"Address: 685 Strawberry Hill Rd.. , Centerville Owner: Caroline Ewing Date of Ins pection: y/-i��C , NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater-Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site (Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) d� J b-6 1,,�17,6 '7 97 y A revises 9/2/96 Page 11 of 11 AsBuilt Page 1 of 1 . r TOWN OF I3ARNSTABLE LOCATION � ;� �1�ic�,►ary%� �� [� SEWAGE # -* ZW1~ VILLAGE ��y ��, .•: ASSESSOR'S MAP & LOT e' INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(tgpe) (size) '50 y,1• NO. OF BEDROOMS PRIVATE WELL OR �IC WATEIR� BUILDER OR OWNERr DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED:1,�'` VARIANCE GRANTED: Yes No 6 I SCE S�-frf c http://issgl2/intranet/propdata/prebuilt.aspx?mappar=249060&seq=1 3/17/2015 Health Master Detail Page 1 of 1 !`�/1 a. �.. � v �" �He � �,,,, Logged In As: TOWN\health Health Master Detail Tuesday, March 17 2015 Application Center Parcel Lookup Selection Items Parcel Septic Perc Well Fuel Tank Parcel: 249-060 Location: 685 STRAWBERRY HILL ROAD, CENTERVILLE Owner: SANTOS, LUIZ& MARCIA TRS Business name: Business phone: Rental property: r Deed restricted: r Number of bedrooms : Oj Contaminant released: r Fuel storage tank permit: r .tea -g Save Parcel Changes Return to Lookup Parcel Info Parcel ID: 249-060 Developer lot: Location:685 STRAWBERRY HILL ROAD Primary frontage:200 Secondary road: Secondary frontage: Village:CENTERVILLE Fire district:C-O-MM Town sewer exists at this address:No Road index: 1546 Asbuilt Septic Scan: 249060_1 Interactive map Town zone of contribution:WP (Wellhead Protection Overlay State zone of contribution:IN District) Owner Info Owner: SANTOS, LUIZ & MARCIA TRS, Co-Owner:TAMADULU REALTY TRUST Streetl:685 STRAWBERRY HILL ROAD Street2: City:CENTERVILLE State:MA Zip: 02632 Country: Deed date: 12/1/2008 Deed reference:23290/74 Land Info Acres: 0.48 use: Single Fam MDL-01 Zoning:RD-1 Neighborhood: .0105 Topography:Level Road:Paved Utilities:Public Water,Gas,Septic Location: Construction Info Building No ear Buil Gross Area Living Area Bedrooms Bathrooms 1 1964 3024 1668 3 Bedrooms2 Full-0 Half Buildings value:$114,900.00 Extra features: $29,800.00 Land value: $109,600.00 http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=249060 3/17/2015 Map Page 1 of 1 Town of Barnstable Geographic Information System New Search Home I Help Parcel Viewer IF Custom Map Abutters Map size ® Zoom Out �In JPG Turn map layers on/off by >,R selecting check boxes below r [, Town Boundaries it c rl Road Names F Voter Precincts } 13 r, Multiple Address House Numbers r, Map&Parcel Numbers n F7, Parcels c 1 4 "y/ ) �/ r ' qr?.�.-` ✓ { r F-i FEMA Flood Zones Effective July 16,20144 7 , M VE-Velocity Zonet' \ x AE-100 year flood4 100 year flood 0.2%A nnual Chance Flood .\•.:t•>:� x\: \ 1 7.r i r\„/`•: ? `Open Water Neighboring Towns .v "h ti' f ♦ 1 J r o i ... ,✓.`.'`�.. ...�i....,.. ... r'".. ... ... " 1-1 Water Streams Ili Set Scale 1" = 86 I Aerlal Photos I MAP DISCLAIMER Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v1.2.5494[Production] I http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=249060 3/17/2015 Map Page I of I Town of Barnstable Geographic Information System New Search Home I Help Parcel Viewer Custom Map Abutters Map Size ® Zoom OutfifilfilIII®In (a s r ar r7 Q .lp El & 7PG Map: 249 Parcel: 060 Full Property ry 210112 Location: 685 STRAWBERRY HILL ROAD Info 249053001 A713 249050 a0 240065 x26 Owner: SANTOS,LUIZ&MARCIA TRS 240061� p708 0 703 t �Y. location Information ' Map&Parcel 249060 Location 685 STRAWBERRY HILL ROAD y- 249054CNO Acreage 0.48 acres Pr N042 a. '249084 9682 Current Owner 'z Mailing Address SANTOS,LUIZ&MARCIA TRS o, TAMADULU REALTY TRUST 240060 685 STRAWBERRY HILL ROAD �a a085 CENTERVILLE,MA 02632 -. 240085 �Appralsed Value(FY 2015) i Extra Features $29,800 �l 249055 C In NO Out Buildings $53,000 a A40 �j Land $109,600 ^k4 fit Buildings $114,900 �. rf Total Appraised $307,300 k' 2I8B78 * 24084e Assessed Value(FY 2015) 4 249056 Extra Features $29,600 0032 24A087 0654 Out Buildings $53,0005 j Land $109,600 ' Buildings $114,900 Set Scale 1" = 86 _ ..� .Aerial Photos 1 I MAP DISCLAIMER Total Assessed t307.300 J Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v1.2.5494[Production) http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=249060 3/17/2015 6 C, TOWN OF BARN/STABLE / LOCATION J���kl t%✓Y l�/Y (/ SEWAGE #7.9f f�- (� VILLAGE ay-ASSESSOR'S MAP 6& LOTg INSTALLER'S NAME & PHONE NO. r ! SEPTIC TANK CAPACITY i LEACHING FACILITY:(type)-:7:;U 4�:aG:TrrTe2S (size) ',z�O)e,7 NO. OF BEDROOMS 4 PRIVATE WELL OR _ LIC WATER BUILDER OR OWNER 95-7✓ryi -e— <� w F , �, DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r , 9 �r D---6,0 1 Ficz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Application is hereby made for a Permit to Const-,uct or Repair ( V<an Individual Sewage Disposal System at: Location-Address or Lot No. Owner Installer Address Other fix Z Other Distribution box ( ) Dosing tank ( ) 0.4 U Nature of Repairs or Alterations—Answer when -------io N The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system n operation until a Certificate of Compliance Issu IT 7--,7 V Date ------------- — ------'— ----- ---------- '----- ---'------ c� Issued -------------------------------------------------------- | ��������� � _ r No.._.... ._._ 'a.`b.`7 Fss..... �......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE App iratiou for Bi-nVnottl Works Tomitrurtinit ramit Application is hereby made for a Permit to Construct ( ) or Repair ( V) an Individual Sewage Disposal j System at: --••--- Location-address 11 or Lot No. saw-:_.. --•----.__-- -:. . _ .................................................... Owner —J Ad ress I w . E/) ..' (. t,4c.� !v Installer Address UType of Building Size Lot............................Sq. feet ►.� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons------------------------- Showers ( ) — Cafeteria ( ) Otherfixtuzes -------------------------------------------------------•...--------------•......------. ---.....•--•-•------•----------•-•---•--•-----•-•--•-..-•-•-• w Design Flow..__.._.. ..............................gallons per person per day. Total daily flow---__-�A&2.........................gallons. R: Septic Tank-L Liquid capacity-/_gallons Length ......... Width---//J...... Diameter---------------- Depth................ Disposal Trench—No.�,�.rh!t�±.L.... Width......'f._......... Total Length...3n.'...... 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........................................ ,.a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 .---•-•--•................................•-------•------•-•-•-•----•-••••................................................................ .-•••----•--------. 0 Description of Soil--------•--------------•-----------------------------------......-•------------------------------•--------------------------------...------------------•-------•-.••--- x U -•-...--•------------------••------•----------••-•--•----•--•--•-------•-------------••-•----------•-•---•-----------•-•-•-•----•-•-----•--•------------•-----••................---•---•-•-•-------•---- w Z. •-•-•-•-------- ---------- --------------------------------------------------------- ------------------------------------------------ ------------------------------------------ ------------ U Nature of Repairs or Alterations—Answer when applicable.---Ty_u-ST'!_� --.. -`j C ,Tt_--.-- ...................) l — �- e a. ............. ?..._.T vrl t_�.T t� .:i/ ------.'`'').3....5 G r Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h-as-been/issued.b.y the_board-of health. Signed ------------- ------- Date Application Approved By ................. 4- .........................:....... ............................ .1/..--.1_7...-..T..C✓..... Date Application Disapproved for the following reasons: .................................. ......................... ................. .................. Permit No. Tt-.t--- Date ............. ....................... Issued Date ----------------------- -------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ClEr#ifi ate of C�tompliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by --------------------------------------------------- (� �r In}rtller at ....._........ ....... 1.�: Gv�JYvr` r �� ------------------ ... . 1. .. has been installed in accordance with the provisions of TITLE 5.0,f The State Environmental Code as described in the application for Disposal Works Construction Permit No. _.�.''(.." ..c6_.'.57---- dated _....._..__............................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........ /`` 1 ;� 'fir'.------------- ---- Inspector-..... e4��i .. %��.I ?1. : ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c�y _��i TOWN OF BARNSTABLE No. J FEE.......1............. UwVa al Works Tnnntrurtion ramIt Permission is hereby granted ..._T-f- . to Construct ( ) or Repair (A-)an Individual Sewage Disposal System atNo......................................... --•- -... ------ Stet / C as shown on the application for Disposal Works Construction Permit No� 'tPg _._ Dated......�_(_.'..�.�.'..�..��........ I 9 -- Board of Health -Y--------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS