Loading...
HomeMy WebLinkAbout0124 NOBADEER ROAD - Health 124 Nobadeer Road Hvanrris a ei ac bm W� d W � 0 N ® � Q W N IN n C N Q tA V Yt v C Vici — a z W O t. o �r IL w ac @ d W W J - ® Q ry v� 0 C N h ` TOWN OF BARNSTABLE --ATION `� o d��Q SEWAGE # T'AGE I I te SSESSOR'S MAP & LOT a S l o?3 &PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size).. _ NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r � �� � � > > o , —� �� � � � `- � � `� . . BARNSTABLE LAND- COURT REGISTRY DEED RESTRICTION WHEREAS, Jose R. Miranda and Junia C. Miranda, of 124 Nobadeer Rd, Centerville, MA, is the owner of 124 Nobadeer Rd, located at Centerville, MA (hereinafter referred -to as HOUSE and being shown on.a plan entitled Subdivision of Land in Centerville, MA, Property of Jose. R. Miranda and Junia C. Miranda, et al, duly recorded in d Barnstable County Registry of Deeds on Land Court Plan Number 40592-C. ' s WHEREAS, Jose R. .miranda and Junia-C. Miranda as the owner of said lot has agreed'.• with the Town of Barnstable Board of Health to a restriction as to the number of Vj 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 CMR 15.000, ,r ,State Environmental,Code; Title V,'Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; , WHEREAS, the Town of Barnstable Board Of Health, as a pre-condition to granting a _ disposal works construction permit for aj septic'system in compliance with 3-10 CMR 15.200 State Environmental T'�i Code, Title V, Minimum Requirements for the Subsurface . of Disposal on f bed Sanitary the number oao thorizing the issuance of a building permit for the bedrooms in anv house constructed on de lot be put`on record with the Barnstable County.Registry of Deeds.by recording this document. NOW, THEREFORE, Jose R. Miranda tiarid Junia C.. Miranda does hereby place the 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: ' r 1. 124 Nobadeer Rd, Centerville, MA ,may have constructed upon the lot a house r. containing no more than THREE Y(3) bedrooms. Jose R. Miranda and Junia C. � Miranda, agrees "t hat this shall be permanent deed re striction affecting house located on 124 Nobadeer Rd, Centerville, MA, 'and being shown on the plan recorded on Land Court Plan 40592-C. For Land.Court Certificate of Title Number 211289: Q Executed realed ' ument 23 day of september, 2020. V JOSE R. MI . AN JU CIA C. RANDA 6 vaD'0 LIN6YISTIC COMMUNICRTION SEPYICPb,LLC _ . Eliminating language barriers. Commonwealth of Massachusetts County of Barnstable' On this 23rd day of September, 2020, before.me, the undersigned notary public, personally L appeared JOSE ROBERTO MIRANDA & JUNIA S: MIRANDA . proved to me through. satisfactory evidence of identification, which were MA DL S71670161 — EXP.: 10/02/2020 & S60410160 — Exp.: 11/02/2021, respectively to be-the persons who signed the preceding or attached document in my presence, and who swore-or affirmed to me that the contents of the, , document are truthful-and accurate to the best of their knowledge and belief Hyannis, September 23, 2020 - 'X 4� g ; CLAUDIA MARIA SILVA KENNEDY Notary Public COMMONWEALTH OF MASSACHUSETTS My Commission Expires on ; March 27,2028 Address:724 Main Street Unit J—Hyannis,MA 02601 Fax(774)552-2602* www.lingLiistiecommiinication.com 4 • _ _ COMMONWEALTH OF . 1VIASSACHUSETTS -7� EXEC UTIVE OFFICE OF ENVIRONMENTAL,AFFAIRS • DSPARTMNT OF ZIFVMONIMNTAL PROTECTION( OFFICIAL INSPE TITLE 5 CTION FORM RY SUBSURFACE SEWAGE DISPOSAL SY 1EM FORM PART A M CERTMCAITON Property Address: / � zlob Owner's Name: ,,, Od b 3 -- � .s Owner's Address: ,2 O Date of Ind: d Sd- Name of Inspector:( p ) g�mpany Nam, , N �/p, Mailing Address: Ile T, a a dephone Number: CERTMCATION STATEMENT I certify that I bave personalty inspecW the below is une,amurate sewage cOsposal system at this ' the training and m o�omplete as of the time of the inspection.The ink� based�� approved l ivacoion and roe ofon site sewage disposal Wstems.I am a Dim r L�15-M of Title S(310 CMR 11MM). Tic s9stm Passes Needs Fbrther Evahmdon by the Local AXroving Au&ody F . Inspector's Signature: Date: s �''�'eW shau cops►of this Eli within 30 Haft or gpdDE or S t day spa:tar d n a shared system or has aaddea:(gn�ilow 000 DEP.The original should be sent to the system owner and owner SJUM submit the to the appropriate regiionel a I approving ce of the copies seat to the toyer,if appiic�b and the �eC0 t'"vVIeode, o"f Notes and Chnmems Re wr o ve •••`T report 0*describes conditions at the time of t�nh inspection does not address bow the system rm in the der the conditions of use at that conditions of ose. fatme under the same or different t Pale 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOL `. SUBSURFACE SEWAGE DISPOSAL SYSTEM Il�PE�O FORM TS PART A N FORM CERTIFI ATION(contimr4 PmPerty Adder k0 0, V% Y ACV owner.Owne �' •4 ©a �� Date of IndbWxdon • may'S Check A^C,D or E/AL AV A. —�—_j complete all of Section D i y —_ I have not farad any ikon hi 15.303 or in 310 CI�IIt 15.304 w �� that�of the failure ageria m° �y farlure critaia not evaluated are below.bel in 310 CIbIIt Comte a S Conditonafly paama:sYstem - lePaindThe sy �as d is the" pW Completion of the replacement or rejxdr, °� sation need to be replaced or as appi,oved by the Board of Health,will pass. Answer yam,no or not detamiaed(Y,N")in the_for follow'ng momenta If"not 'use The septic tank is BMW and its dal m 20 3'aars old*or the septic tank(wl etbgr meW or no)is d°�g tank is replaced with a won or tank h&ft i8 immbw L em will y 'A l mpdC tank willpam SePfiC tank as approved by the Board of Heahh, On if the Wkating that the task is less than 20 yam old isis*WtUM4 act leaking and'if a Cadfi of CMPUa= ND wiplam; obstructed o fs to a of break out or high static ]m approval of Board of Health).�' ,wed or uneven won boar. S will ,the ftulution box�w or s)am replaced obstructicil is moved man box is leveled or n0wed ND explain; requiredPwVM9 MINO than 4 times a Pam inspection if(with appea►aj of the Board of Health). Year dne to b '*=or auoted PPe(s) system will 3 _ bwken pipes)are replaced . obstruction is t+emaved NDwqLjjL- Page 3 of 11 OFFICIAL INSPECTIO N FORM-NOT FOR VOLUNTARY SUBSURFACE SEWAGE DLSPOSAL SYSTEM ASSESSMENTS IATSPECT'I ASS SS FORM f PART A CER77F7CATION(continued) ty Addr+eas; Owner: q, �. oa C3� Date of boa: C Further Zvahutioa is Required by the Board of Heft: /y is failia8 to Protect public he qm or� Hoard a�f Heaifh is older to d system 1• System will pass nnleas Board of Health determ1nesin system 10 not lhnctioning�a manner w aCOo��with 310 t�13�303(1 hich will rot�ect Kb)that the P pubde health,satNy and the fit: — Casp001 or prn►y is within 30 fat of a Mace water — CeSSP0o1 or Prh7 is within S0 fiaet of a bordering vet wetland or a salt marsh Z. System wM fail unless to Board o<He21%(and ftb&water Su system is In a manner flan protects the public health,safes an �r�t the mrface water 7be System has a Septic tank and (SAS)and the SAS is �9 or tributary to a surface water� within 100 feet era -- T system has a septic tank and SAS and the SAS is within a Zone 1 of a public weer The system has a septic tank and SAS and the SAS is within 50 feet of a private wer MV*Wa 7U system has a SePtic tank and SAS P*We =PDIY vmU**.Method used to d miaeS is less than 100 fat but SO ��� �ormore from a *ems Passes if the vvQ WSW pemrmed at a the Pcesenoe of ammonia - m tit the well is fft�Pollutim �i f Dorm Bihar alter;$are triggered.A copy of the mts0�g equal to or less than 3 ppm,Pw'ided Am �� analysis must be attached to this fmm. 3. Other. 4 Pape 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CF.RTMCATION(contimr0 Property Address; at Date of D. er: You m nh F � a pHuble to all systems; �indicate ea"`� ar"no to each of the following for&i:uspftfio= Yes IVoOf/ p �. - �WWponI i fbaw or due to overloaded or cl � SAS or eesspow to woe of the ge+amd ce to as OwWded or' _._. S toc hgmd level m the&90budon box above outlet invert due col to an ovmerloadod or 08�SAS or -- — depth m Coaspool is less than 6"below invert or avaiw*-- > pumped PLW teas than 4 times in d ogged or �fls Number �/A3ppogjon of cempool or" CURMol or Pm'Y n below high Sound water elevatiam• PAY within 100 f+oet of a surface water supply or tn`,�vater supply. btttary to a stnfaoe -- _ of a cesspool or is P of a cesspool or p y is within fm of a jvM well. Any Pordou of a cesspool per,is less thorn 100 iieet but water Y well. mPPiY well with no aooeptable water 8 than SO ihst from a private water Performed at a DZP Certitled lahoratory ��ww Pm ell if ffie wallet anat3'ads, indkates that the well is free fi+om p tr+aya that! mid v�olaflle oink Compounds �M and nitrate is equal to or leas than S Pp provided�no otte ammonia r faftre are tift ered.A Copy of the&nab*mart be attached to this form.) criteria / �(YMWO)The system fgb described in 310 CMR 15.303,&areficme the sy fails.The the above failure criteria exist as Health to determine what will be necessary to qhe g °wn"old contga ft l3 d of & Luse Spftft To be considered a huv sydem the stem si' mast serve a facility with a Bow of 10,000 gpd to 15,W You must indicate either' or`W to each of the following mowing cditda apply to large sYscems in addition to the C itaa above) Yes no — the is within 4W fat of a surface chinlang wars sup* system>8 within 200 fat ofaftftft9 to a Sm*ce Making water supply a Pica aen stye area(Interim{Wellhead Arotection Area_IWPA Y )or a mapped If you have "Yes'to my question in I `des"to Sear D above the large system has failed Section nie E the 09M is co a s'��lvV or S� under Section E orfailed.under S�aD� tht �!' Wstem considered system owner should Contact the�mgianal ppa of the wish 310..C� 1'a�e S of 11 OFFICIAL INSPECTION FORM—•NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHEMIST PnWrly Addr+e 0 r/C n j e� ®a 6 3� Owner: �r . Date of h �$ Check if the following have been done.You mast ' �cate ear Or"no"as to each of the follo ' :Yes information was pmowidod by the Owner,mupwit at Board of Health We any of the system c oniponerts prmped out is the previous two weeks — Has received noel sows in the pnrvians two week pen .od laW vreoues of xvater been i8trodumd to the system none*or as Part of this kVma. 1 Were as built plans of the system.obtained and mod?(ifs,wac not riailabie none as N/A) as the facility or dwelling for sigps of bade up Was the sit-inspected for signs of bmak out Were all system conPonents,elod°din8 the SA4'locmd on site of the Of�,n6VM'd opened,and the i of the tank far tha con"an of of dodo and depth of scam ( OCCUPRO if di&am from gamer)p vvided with on the pry The sae and location of the Soff Absorption System(S&R)02 the site has been determined based an: Yes no M boa.For exam*,a pin at the Board' of Health, Ddennincd �) m tale field(3 any of the faihme criteria related to Fart C is at issue approximation of 310 2( )(b)l , distame t Page 6 of l l OFFICIAL INSPECTION FORM-NOT FOR YOLUNTARy . ASS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECI'IOIY FORM I� PART C /! SYSTEM PO O3tMATION Propert;A7d 7 0 Ja► y� Owner:Date ofipectlora; RESIDENTIA3, w COx�I'i'�ort8 of- (�: 3 x of (actualr DFSIGbT Bow based.oa 310 C&IR-15,203(ice ; 110 apd x d of bedrom m). Numbeiefcanwti WFgs. Does residence have a garbage grinder(yes or no): Pf Is ladry no o�n a separate sewage system(yam or no)42[if Yet separate in Lmndry system nrspocxed(yes or no):�D !Seasonal use:(yes or no): W IL(D meter ¢avertable(last 2 years nags(ice); Sump Pump(yes or no): /1-0 last date of occ pansy: COMMEHCf LTOUSTRIAL Type of establishment: Design flow(based on 310 CZbIIt 15.203): gpd Basis of design now(se"tersons/sgkeetc.). Indnsorial� waste holding tank p (yes or no): Nw4nkay waste disc)mrlpd to the Tme S system(yes orwater : Last date of `¢avertable. no) ° '/u: OTHER(deambe): ftping R wx* GENERAL EMRMATION Source of info �`'' V" e Cl Was system pumped as pat of the If yes,volume pumped: (Yes or no):� Reason far —How was gnaobty p d SYSTEM — Uk distr&Wou bob soil*sorpaw*sue Sinee Cesspod Privy —Shared eum(To of no)Ci'3'eB,attach paWm h=NalKWAftcrnative tech maoa At�ch a copy in the� ►if any) obtained from system owner) and maintenam contract(to be Migbi taste —Attach a copy of the DEP approval Other(describe): ApProsdmate age of all ooUVonenK daft mstalted(If k wn) sooroe of i ow /92?3 duo Were sewage odors detected when=vmg at the site(yes or no): -O f Pap yofll OFFICIAL INSPECTION FORM NOT FOR.VOLUNTARY ASSESS SUBSURFACE SEWAGE DISPOSAL SYSTEM IN ITS . SPECTI0�1T FORM PART.0 SYSTEM Pff oRMA-MN(coamm04 Property Adder 9, Owner: [ '�. C��G 732— Date of BUILDING Sl%r=toe. Dcptb br1ow grade: Materials of Distaaaoe from pa"m wan BUPA,cast�or hw Comments(cm roman of' of lvajago,.); SEPTIC TANK'—( ate.on plaaa) Depth below Material of mnamcum If tank is metal list age:_ hap ooffirmed ate) bg'a a ofCcmapl;aoa(yes or no):_(attach a copy of X *to baft=Ofoutlettee•arbaffie: Distance from,ballom of of antlet toe.ar batBe: an How were dimeosiami bottom toe ar _� / e Comments deter�no� ° e asZw ( 8 inlet card outlet tee or baffie to mvm%evidence of leakw d � 4 strucftW integrity;.hqwd levels e. . GREASE TRAP;L1G( te on site Material of wm&ocd; ( )• _concrete metal_fibergiw--Plethylene_othw Scam : aa Distoe from top of sarma to tqp of outlet tee or baffle: Distance fmm bottmn of scam to bottom of outlet toe or bat' , Date of last P=%* as related to Conwacm(onamut* ink cad outlet,tee as ballet . ��etc.): levels Page 8 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMEM SUBSURFACE SEWAGE-DEPOSAL SYSTEM INSPECTION FORM PART C SYSTEM/ INFORMATION(confinu4 Pro"Addr+esc �� J�►�Q2I� J 6e,^-�� Date of Inspection: TIGHT or HOLDING TANK;/ V (tank mug be pumped at time of kgmdcn)Oocde on site plan) Depth below grade: Material of conslructim concrete metal asi ethylew aaIIo>!s Design Flow: __~day Alarm present(yea or no): Alarm Date of Alarm m working order(yes or no). Comments(condition of alarm and. Ion switches,etc.): DISTRIBUTION BOM (ifpcsent must be'apenco(locate on site plan) Depth of hgmd kvd above outlet invert: �A©/_/0 G Comments(note if boaae is kvd and dsW&Wm to outlets eq*aW evidence of solids carryover,any evidence of leaks into of I= P W CHA11IBEg; on site " per) Pine in vorldn8 order(yes or no): Alarms in woddM order(yes or no): Commew(note conmout ofpump pwpB chamber,oondmoaa of and appnrtenaoces,etc.): Pale 9 of 11 . OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMM SUBSURFACE SEWAGE-DISPOSAL SYSTEM RMEMON.FORM SYSTEM � . /off Y Owwr. Al ©� Dale of L SOII,ABSOBt'tlQ1i 3YS'��L($A,4j: . ( as s9 08p,mcava*m Aw.r If SAS nat bcateie,111 a►* eaS� kacwmg mro*: ovelf bw cessfol oember steer Type,, m 0 j I g - ��H CESMOOM lG =a be pumpw as p®rt of bV=i=Xbcft am she plan) Numberaa@cow. � , DgXhofma"bjw m , I"= Dimas ofcea Maw afoot mcafton of gmmdmw io&W( a ar j ConimftE &Iiaa ofse�sigaa oihjodraoiic 1ece1 afpooe>ee�o aim�,� PR1YY: *aftamsibepi Dimco*m Depth of aoii& commem(notsc tioe(fsea SM kvd 4)fpwdiq&cmaim of vepbdm eft). • Pa—loaf I I OFFICIAL INSPECTION FORAM-NOT FOR VOLUNTARY ASSESSMUM SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORAM PART C SYSTEM ROORMATION O timi4 e w tt,-'- Oo Owner. Date of SKETCH Of SEWAGE DISF(K"SYSTEM Provide a sketch of the wasp disposal system incl�g ties tO at least two pmummeot refetenoe laandmaft or beochma kL Lacate all wells within loo feet.Locate when pubfic water sq*enters the der LG �✓ . F 1�3. 5.5 Dr 63 - a � � Pa®e 11 of I1 OFFICIAL INSPECTION FORAM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(cosmva4 �A Owner: � 3 Dare of hopectionr sm EXAM su awl Chuck cellar_ shallow wells Estimated depth to s+wmd water*.runt 1 e✓' Q Please indicate(check)all mdW&used to detemdue the inghSmand�devation: Obtained ham system desip pia ova record-if checker date of dedp plan reviewed site(abutting pWmty/aboewatkm hok wftfiip 150 fiaet SA$) with local Board of Hm h in; G ,�2:92:Zitl1 Accessed local (attach docome�ation) YOU mast pfte how y ��the hi wad devax • O 70 � f 0. 000 �� j OQoc� r