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THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplitation for Disposal *pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon(k ❑Complete System ❑Individual Components
Location Address or Lot No. SU La¢ (fV(EQ LA C Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel as;g �� �1yd1Nr.11s ��L��rC� vL,(�f Ot-(442aoPLou A
Installer's Name,Address,an�Tel.No. 5 OS-q 77_22 I Designer's/Name,Address,and Tel.No.
c
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health. [�
Signe Date i�—/7 —d-(9 1-7
Application Approved by Date ()--( 7— =7 a/Y
Application Disapproved by Date
for the following reasons
Permit No. V o Date Issued 1 Z.— i 7
j� a
/10
No. Antered in computer:
THE COMMONWEALTH OF MASSACHUSETTS
Yes
PUBLIC HEALTH DIVISION-- TOWN OF BARNSTABLE, MASSACHUSETTS
01ppl cation for Disposal �&pstrm Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade.( ) Abandon(X ❑Complete System ❑Individual Components
Location Address or Lot No. 50 c, 4-TTjA f&-Q LA�J 0 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel p� 5g4 My �(S Cz0�C.,"-� A44"os w d
Installer's Name,Address,and Tel.No. 50?-q,7 7 -21 y Designer's Name,Address,and Tel.No.
Cgpsw 1�s P�l4sZ (,LC-
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
3
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
_ Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
>tl'� J�� C�CI_S7�tiEc St�3�✓7�G SKIS G)"
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
--= accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signe Date
Application Approved by Date —/ 7- -2 G/
Application Disapproved by Date
for the following reasons
\Permit No. o�C I Y` ! 1 o Date Issued 12 - ZIP l7
---------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
—,'FWS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) /Upgraded( )
Aband nod(k)by �c� Pt�Wl �JJ�
at SO (A—rT 61W has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. l
Q(%- `�q'dated 2 - i ? -
Installer RO( e� axrgQC I-LC Designer J�
#bedrooms u Approved design flo�w1 /i1.J/ gpd
The issuance of this permit shall not be construed as a guarantee that the systemr\ ,
cfioi�asdesigned.
Date I/ Inspector /
\.
No. �I ' L/ l q U Fee 12
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Bisposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon(y)
System located at 50 4—,+TT(14c 0Z L-AA)t—: H t/i4 XJXJ/S
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
` ✓lv� �f
Date 1 1 ! 7 /( Approved by
Town of Barnstable Barnstable
.�. Regulatory Services Department AlAmedcaCHV
RARNSTPAHM I
0� ,� Public Health Division
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7012-1010-0000-2848 -0585
March 28, 2013
DOROTHY CROCKER, TR.
DOROTHY CROCKER TRUST
PO BOX 214 IMPORTANT NOTICE
HYANNIS PORT, MA 02647 Map & Parcel: 288- 156
The Department of Public Works informed us that public sewer lines are now
available in your neighborhood. According to our records, your property has a septic
system. This letter directs you to connect your dwelling, at 50 Lattimer Lane, Hyannis,
MA, to public sewer on or before 3/30/2015.
The old septic system must be either removed or filled in due to future safety
concerns. This may be done by the same contractor who connects you to the sewer.
Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main
Street, Hyannis.
Failure to comply with this Board of Health Order may result in a complaint
against you, in a court of law.
For additional information pertaining to the sewer connection, please see the
reverse side of this page.
PER ORDER OF THE OARD OF HEALTH
Thomas A. McKean, R.S., C.H.O.
Agent of the Board of Health
Cc: Barbara Childs, WPC/Roger Parsons, Town Engineering, DPW
Enc.
QASEWER connect\Letters Stewart Creek Sewer Connects\MAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc
Public Health Division March 28, 2013
ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS:
SAVINGS AVAILABLE/GRINDER PUMP:
A reminder to those of you who need a grinder pump for your connection:
Department of Public Works (DPW) sent you a letter in December 2012 stating the town,
for a limited time of two years, only from the receipt of the DPW letter, would provide
you with the pump at no charge. (This can save you thousands of dollars.) Please note:
You must pay the installation cost through your own contractor. Please make your
contractor aware of this, if interested. Also be aware: this is a shorter deadline than
the Public Health Division's deadline on the reverse side of this page.
SAVINGS AVAILABLE/PERMIT FEE:
The Town offers a waiver of the residential sewer connection fee of $420.00 for those
properties that connect within two years of the receipt of the DPW December 2012 letter.
LOANS:
For loan(s) available, please see the enclosed brochure, or see the town website:
http://www.town.barnstable.uia.us/cdb�,, (under the "CDBG Programs", see "Sewer
Connection Loan Program). For loan specific questions, you may contact Kathleen
Girouard, Growth Management, at 508-862-4702.
CONTRACTORS:
Information on Licensed Sewer Installers is available on our web site at
www.town.barnstable.ma.us/PubilcWorksTech/sewerinstallers. Contractors, approved to
perform sewer connection work in the Town of Barnstable must obtain and file a Sewer
Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way,
Hyannis—contractors, please call Dave Anderson at (508) 790-6244.
FOR ANY QUESTIONS /ASSISTANCE:
Len Gobeil at the Town Manager's Office is available to provide you with direction you
may need in reference to the Stewart Creek Sewer Connections. You may contact him at
508-862-4701.
QASEWER connectTetters Stewart Creek Sewer Connects\ TAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc
7
SELLER'S NOTICE OF DEADLINE FOR CONNECTION TO MUNICIPAL SEWER
BUYERS: George W. Jensen and Donna M. Jensen
SELLERS: J. David Crawford, Co-Trustee,
Linda J. Genest, Co-Trustee, and
Donald D. Crocker, Co-Trustee,
The Dorothy Crocker Trust, u/d/t January 21, 1986
PROPERTY: 50 Lattimer Lane, Hyannisport, MA
LENDER: None
CLOSING DATE: June 14, 2013
I, J. David Crawford,OTrustee of The Dorothy Crocker Trust, u/d/t dated January 21,
1986, the Seller of the property located at 50 Lattimer Lane, Hyannisport, MA, hereby
inform-the Buyers, George W. Jensen andDonna M. Jensen, that pursuant to the Town
of Barnstable Board of Health Policy: Deadlines for Connections to Public Sewer
Stewart's Creek Area Project, the on-site septic system does not have to be inspected
for compliance with the requirements of the Title V of the State Environmental Code (310
CMR 15.301 et seq.) in connection with the transfer of title to this property on June 14,
2013. Further, pursuant to said Board of Health Policy, the owner of said property is
required to connect the property to the public sewer system on or before March 30,
2015.
jr. G %✓�sf @o'er � d D G/a e/,tb 4Y6+n,
Sellers:
The Dorothy Crocker Trust
y: J. David Cr wford, Co-Tr stee By: Li a J. Genest, Co-Trustfae
By: Donald D. Crocker, Co-Trustee
Dated: June .� T , 2013
1
ACKNOWLEDGMENT
We, George W. Jensen and Donna M. Jensen, Buyers, hereby acknowledge that the
Seller has informed us of the requirements of the Town of Barnstable Board of Health
Policy: Deadlines for Connections to Public Sewer Stewart's Creek Area Project and the
deadline to connect the property located at 50 Lattimer Lane, Hyannisport, MA, to the
public sewer system is on or before March 30, 2015. We hereby agree to comply with
the requirement to connect said property to the public sewer system on or before said
date.
Further, we understand that if the system is in hydraulic failure (i.e. overflowing onto the
ground, or wastewater backing up into the home), we will be required to connect the
property to the public sewer system within sixty (60) days of the hydraulic failure,, .
I 1JOP�
eo ge en n, B6yer Donna M. Jens , Buyer
Dated: June 14, 2013 Dated: June 14, 2013
A copy of this Notice as been filed with the Town of Barnstable Health Division.
-- Dated:
Thomas Mckean, C.H.O.
Director of Public Health
Town of Barnstable Health Division
2
i
POWER OF ATTORNEY
Delegation of Authority
Massachusetts, Individually
I, J. David Crawford of Centerville, M ss y and as Co-Trustee of
The Dorothy Crocker Trust Agreement dated January 21, 1986, do hereby delegate
authority to and appoint Mary M. Gaffney, Esquire of Mashpee, Barnstable County,
Massachusetts, my attorney in fact, and grant her the authority to negotiate, execute,
acknowledge and deliver any and all documents necessary to complete the sale of
properties held in the Trust's name, known as and located at 50 Lattimer Lane,
Hyannisport, Barnstable County, Massachusetts to George W. Jensen and Donna M.
Jensen, husband and wife, both of 101 Littlefield Lane, Marlborough, Massachusetts
01752, as tenants by the entirety, for consideration of One Hundred Ninety-Five
Thousand and 001100 ($195,000.00).
I further authorize Mary M. Gaffney, Esquire to make payment of and satisfy all
mortgages, taxes, assessments and other encumbrances that may be a lien or charge on
the above-described properties.
Mary M. Gaffney, Esquire has authority to receive payment of the purchase money of
any and all real property sold, and of any and all notes or other evidences of indebtedness
received in payment.
This Power of Attorney shall expire at the end of the day on September 30, 2013.
Prepared by the Law office of Patricia J Mello,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
IN WITNESS WHEREOF I have hereunto set my hand and seal this day of
,046 2013.
1
J. Davig Crawford, Co-Trust e
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss.
On this day of 2013, before met°the'undersigned notary public,
personally appeared J. David Crawford, as Trustee as aforesaid, proved to me through
satisfactory evidence of identification, which was personal knowledge of identity or
to be the person whose name is signed on the preceding or
attached document, and who swore or affirmed to me that the contents of the document
are truthful and accurate to the best of his knowledge and belief and that he executed said
document voluntarily.
Virginia A.Scott
Notary Public
(U
Commonweekli®t Massachusetts
My Commissin E*rn Aug.22,2014
Prepared by the Law office of Patricia J Mello,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
POA
1 .
POWER OF ATTORNEY
Delegation of Authority
I, Linda J. Genest, of Mashpee, Massachusetts, Individually and as Co-Trustee of The
Dorothy Crocker Trust Agreement dated January 21, 1986, do hereby delegate authority
to and appoint Mary M. Gaffiiey, Esquire of Mashpee, Barnstable County,
Massachusetts, my attorney in fact, and grant her the authority to negotiate, execute,
acknowledge and deliver any and all documents necessary to complete the sale of
properties held in the Trust's name, known as and located at 50 Lattimer Lane,
Hyannisport, Barnstable County, Massachusetts to. George W. Jensen and Donna M.
Jensen, husband and wife, both of 101 Littlefield Lane, Marlborough, Massachusetts
01752, as tenants by the entirety, for consideration of One Hundred Ninety-Five
Thousand and 00/100 ($195,000.00).
I further authorize Mary M. Gaffiiey, Esquire to make payment of and satisfy all
mortgages, taxes, assessments and other encumbrances that may be a lien or charge on
the above-described properties.
Mary M. Gaffney, Esquire has authority to receive payment of the purchase money of
any and all real property sold, and of any and all notes or other evidences of indebtedness
received in payment.
This Power of Attorney shall expire at the end of the day on September 30, 2013.
Prepared by the Law office of Patricia J Mello,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
IN WITNESS WHEREOF I have hereunto set my hand and seal this day of
2013.
Linda J. Genest, Co-Trustee
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss.
r rr'-3"1
On this l ! day of 013, before me, the undersigned notary public,
personally appeared Lintrd J. Genest, as.Trustee as a resaid, proved to me through
satisfactory evidence of identification, which was _ ersonal knowledge of identity or
to be the person whose name is signed on the preceding or
attached document, and who swore or affirmed to me that the contents of the document
are truthful and accurate to the best of her knowledge and belief and that she executed
said document voluntarily.
WV
JENNIFER S.BARTH
d �
Notary Public
y�
a' Massachusetts
Commission Expires Mar 10,2017
Prepared by the Law office of Patricia J Mello,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
POA
POWER OF ATTORNEY
Delegation of Authority
1, Donald D. Crocker of Hyannis, Massachusetts, Individually and as Co-Trustee of The
Dorothy Crocker Trust Agreement dated January 21, 1986, do hereby delegate authority
to and appoint Mary M. Gaffney, Esquire of Mashpee, Barnstable County,
Massachusetts, my attorney in fact, and grant her the authority to negotiate, execute,
acknowledge and deliver any and all documents necessary to complete the sale of
properties held in the Trust's name, known as and located at 50 Lattimer Lane,
Hyannisport, Barnstable County, Massachusetts to George W. Jensen and Donna M.
Jensen, husband and wife, both of 101 Littlefield Lane, Marlborough, Massachusetts
01752, as tenants by the entirety, for consideration of One Hundred Ninety-Five
Thousand and 00/100 ($195,000.00). =�
I further authorize Mary M. Gaffney, Esquire to make payment of and satisfy all
mortgages, taxes, assessments and other encumbrances that may be a lien or charge on
the above-described properties.
Mary M. Gaffney, Esquire has authority to receive payment of the purchase money of
any and all real property sold, and of any and all notes or other evidences of indebtedness
received in payment.
This Power of Attorney shall expire at the end of the day on September 30, 2013.
Prepared by the Law office of Patricia J Mello,P.C.
766 Falmouth Road,MashFee,MA 02649
508-477-0267
IN WITNESS WHEREOF I have hereunto set my hand and seal this L day of
�013.
Don er, Co-Trustee
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss.
On this day of 314-o—,' 2013, before me, the undersigned notary public,
personally appeared Donald D. Crocker, as Trustee as aforesaid, proved to me through
satisfactory ,evidence of identification, which was _ personal knowledge of identity or
—brl VW A(,5,2 , to be the person whose name is signed on the preceding or
attached document, and who swore or armed to me that the contents of the document
are truthful and accurate to the best of his knowledge and belief and that he executed said
document voluntarily.
1
JENNIFER T. BOUTHILLIER
NOTARY PUBLIC
Commonwealth of Massachusetts
My Commission Expires
March 14, 2019
Prepared by the Law office of Patricia J Mello,P.C.
766 Falmouth Road,Mashpee,MA 02649
508-477-0267
POA