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0085 OLD YARMOUTH ROAD - Health
t5r). Old. Yormouth 12d 344-051 Hyannis �I01 i r r Date: ? /z, / 1.3 TOWN OF BARNSTABLE s ,o TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: reeee l 4-4.'s 'ne-e G.)I VI- BUSINESS LOCATION: VA VillIS INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: SOS - 771 - 11 21 11 I a ( (ows CONTACT PERSON: I{0— EMERGENCY CONTACT J�LEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 946 eI ;>i5 o s,0 AVo -X- INFORMATION / RECOMME DA (O S: Fire District: 1 o e&o cs 19 4 V4�.r 5Wt Ir' Ova.��f� e,,�. +-r h rl 15 1 1M455 11>C r 3) I t,GCp re-Eoroes arL ©b 4-4, w M S DS s kit g �c.JC t2ee.o o n s,+-e. Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: o,/ f`pe bvcri,!jjj /�Uafcrs) 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) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes lot- ot— Laundry soil &stain removers (including bleach) s,xey� l I 00 - s5 R- �f Spot removers&cleaning fluids (dry cleaners) �iSGUSSe��f 7 !r(gdv(_�!e G � Other cleaning solvents L Bug and tar removers 1✓� �YtTo� lt��l 6eAldK.. Q boon.�✓� Windshield wash Q�sv eh�fo��C�,�iD��O�ct'���'Gf?✓ueK�S ��. WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: Business Name: /"_/,A,6-)A �S /�EJ'�L 1f ECYC4-1A)6 Business Location: �S ©LLA �flDu �o� yysa Mailing Address: A5 v9 Telephone Number: f'7 7/-//2- Contact Person: %11yo 77-f/ 1q-7*-'k&79A Emergency Contact Telephone Number: Type of Business: HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts,gallons, Shed,retail store, drums,tank,etc... cabinet,closet,etc rl�� �/ 4.)nri,AL9-s 7Da c- /R.Oaq 6A_t_%o4_) S/r,5Z V,nr C. /AJ S -aZ66t �' � e0kV7#-i L9Z -IDOL- Boa 1t15_Cau-4-,v00 _ �z o a4cc s�ZV1 NUC _;,i A�iKAIfBL,—s `" i ABeo aL-cA--)LfS TOOL- RoU'-1 . lAI EVgti Q u per'' $h_6?W/4t/G /Al sPi �n d,SG �tI c�ea;,�,,��-►25 7-6oL 0yoom Aos La-LAN e2US UArLT !j t.JELV i U G /,J C) 53—G�ue� f�'�ycuNy - 1 - t, Misc. Combustibles Misc. Corrosives Misc.Reactive Misc.Toxics Inventory Total Amount: Hazardous Materials License Posted?Yes No Contingency Plan Posted? Yes No Fire District: IIW.+t/!/,S Fire Extinguisher Service Date: / Metal Covered Rag Bin: Yes NoOAbsorbent Material Available? es No Type of Absorbent: Speedy Dry Pads Pigs Other: / i/abrn>72, MSDS on site? Yes a Hard Copy Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: A/O itI UABf! Type(s) of hazardous waste product(s): WA-src 0/4- Date of last hazardous waste shipment,type of waste and quantity: &d s�iPk T k VW5 51rr -IV DA rE, Hazardous Waste Transporter(s): Designated Hazardous Waste Facility: Hazardous Waste Storage Area Description: /4�72"- d A'� 1-6C,*� o/J J&&o,hg�U 04-UET 0/U Uu64Z-lr TNL WA-91-L- Ole- Is hazardous waste storage area labeled: Yes o Are tanks/drums/containers labeled with the words "Hazardous Waste",the a of waste and the associated hazard (i.e. ignitable,corrosive,reactive or toxic) Yes If hazardous waste is stored out of doors is it covered from the elements? Yes N ,t1 A- Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floor? es No - 2 - I FLOOR DRAINS (Chapter 381) Town Sewer Account Number: & A- Indoor floor drains: es No If yes,circle one,does it discharge to a: holding tank dry well on site septic. Outdoor surface drains. es No If yes,circle one,does it discharge to a: holding tank dry well on site septic. FUEL AND CHEMICAL STORAGE TANKS (Chapter 326) Underground Storage Tank(s) on site? Yes (9 Age: Is removal required? Yes No If yes,when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on site? Yes To If yes,is it protected from the elements? Yes No If yes,how? Is it on a foundation larger in size than the tank? Yes No COMMENTS/RECOMMENDATIONS/CORRECTIVE ACTIONS • A A42A e, 4M WA57r ibe-,d-n F>cA 77e0l N gedo rSSujM ey Z nr 91--E7JV-1" tAe&-XSTA-L PX07ru1"f 15 fEaW19Cb 7V 6C 66MI-01eD ks yo ls- G eX ERA-m W 3 rr-a1L oN 517E. /k 4-7EM'L 2±ft 4 PA-7'A 5HET "S(DNS h3) A F RF WlkM 77) i3E Qad SIZE J-'VX- Wak CHP"vEr3 9140r Ta- K)UeU/. te%'i'ff 2aDee9 s 77&v "Atl Or w®KKIAJ(, 724 arVaf 6AZ gai-tom L-I-C&Ws E is moT &Ex Date:,:ZltopayoAj Public Health Inspector: Facility Representative: - 3 - TOWN OF BARNSTABLE LOCATION �� � ^�: � � SEWAGE # VILLAGE ' UJ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. r SEPTIC TANK CAPACITY Cr.•X LEACHING FACILITY: (type) (size) �X� NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 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 _JL ct Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: rel(e,:,6ci5 BUSINESS LOCATION: 9,5- Old INVENTORY MAILING ADDRESS: 85 O(d TOTAL AMOUNT: TELEPHONE NUMBER: .56- 9- , 4u i'c Zvi CONTACT PERSON: ,fjm FerYc:�0.- EMERGENCY CONTACT TELEPHONE NUMBER:(-771- FSy 166E MSDS ON SITE? TYPE OF BUSINESS: Qi5oa5y4l 112e�„�,�:•n� INFORMATION/RECOMMENDATIONS: 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 IUSED line or coolant systems) Miscellaneous Corrosive ❑ NEW Cesspool cleaners 7 Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils / Pesticides ❑ NEW Ly'l1SED (insecticides, herbicides, rodenticides) (UG 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 ther chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ N W ❑ US Any other products with "poison" labels (including chloroform, formaldehyde, Paint& arnish remo ers, deglossers hydrochloric acid, other acids) Miscellan us. Fla mables Other products not listed which you feel Floor&furnl re rippers may be toxic or hazardous (please list): Metal polishes Laundry soil sta removers (including bl ach) Spot remo ers &cleani fluids (dry clea rs) Other cl aning solvents Bug an tar removers Windsh'eld wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applican g-nature Staff's Initials 1 TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: e_ac_� c�5 c BUSINESS LOCATION: ' Ofc) INVENTORY MAILING ADDRESS: 65 TOTAL AMOUNT: TELEPHONE NUMBER: lrs.s CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: 7-71 FF y-1666 MSDS ON SITE? TYPE OF BUSINESS: 0i 5na 5r-7l 117eGMc INFORMATION/RECOMMENDATIONS: 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 Zus- El) line or coolant systems) Miscellaneous Corrosive ❑ NEW Cesspool cleaners � GPI Automatic transmission fluid Disinfectants cGnl Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW Ca'GSED (insecticides, herbicides, rodenticides) � Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) 'I{ 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 t Rustproofers / Miscellaneous Combustible Car wash detergents Leather dyes .-Car-waxes and polishes Fertilizers Asphalt& roofing tar r PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer:thinners (including carbon tetrachloride) ❑ NW ❑ US 6, Any other products with "poison" labels (including chloroform, formaldehyde, Paint& arnish removers, deglossers hydrochloric acid, other acids) ' Miscellan us. Fla mables Other products not listed which you feel Floor&furni re rippers may be toxicor hazardous (pleA8 list): \ Metal polishes kit Laundry soil sta removers (including bl ach) Spot remo ers &cleani fluids °f (dry clea rs) Other cl/aning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applican $'gnature Staff's Initials yp � d` q, Date: f"3.t ':.. .t°.......... TOWN OF BARNSTABLE ❑ New Application LICENSE APPLICATION ®Renewal ► AM 200 Main Street ❑ Transfer i639. Hyannis,MA 02601 Fp ` (508)862-4674 ❑ Other —� NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE PREMISES 4 Name of a licant/corporation: ? `t i- Home phone M PP r ,r , i' Business hon #: ...::..":............!........................................... Address ofapplicant/corporation:.....:..........-�........._�:�r:_3.. , " .... ..............._.�_.... t::�:.......__c�.....................-............_........................_...... us ess p e 'x .� . , ..................................... Li.s. -�. !-,' ....._ .. ............._......._......_............... D/BIA _............_ Business phone#: ................<.=...._............._................... ... r . �; `l i #4s^✓".tr.,.'�..'�..............'+�.<•�.....................................................� .^C::.._...�.f�_S_.�.................................................._......_............._........................................................................................................................................ Business location. Business mailing address: ` '� ._ `—'`.. ......`' . € >�,p ` ..`....t 11.E .... .... `.. ......... ................ .................................................................................................................................. ........ Local business address: _.............. ............._......._..............................................................................................................................................................._........................................................................................_............................................._..._....................................................._........_....... . Localmailing address: .......................... . ..............................................................................................................................................................................................................................................................................................................::.. o g LICENSE TYPE: "�,,���,�.y .......t�:"...��.�.:......:.e;...c�....................................................................................... Annual �y° Seasonal ................ .. .. HOURS OF OPERATION: ........._`.3 '�%�?.........................................._............ FID#: i ................................................................................. Name of manager: " �t._c, entail: ............_4._S.. ............_...._..-_. .......... .............................__...._......._......................................................................._........................................................ Localmailing address: ... p..................... ....................................................................................................................................................... Managers permanent mailing address: ....._ _ ..:j n.:._f':......._�� -._ :........................................................................ ................................................................................................................................................................................................................. ...... Manager's home phone#: 7 ..... r.`:+....:_t.._._ ._ ....... Business phone#: ............................................................................. f Nameof propertyowner: .. ... . .._........ ..........: "..................._.._............................_'................__..................... ..................................... _.._.._................................_................._.._..._......................................._............................................. ................. r.............................. _ ASSESSOR'S MAP/PARCEL#: MAP.................................................... PARCEL .............:............ .............. ....� List any flammable substance or hazardous waste used in business (specify): Applicants must ONLY contact the Building\ Commissioner' s office, (508) 862- 4038, the Board of Health office, (508) 862-4644, and the appropriate Fire District office to schedule inspections IF YOU ARE NOT OPEN OFFICE BUSINESS HOURS (8 :30 - 4:30 daily) . Signature of applicant _•,..->� ; c. ^w ._ rw .................................................................... I............................................................................ ......... ......................................................................... For Town use only REAL ESTATE TAXES PAID IN FULL C t ,[ PAYMENT AGREEMENT IN EFFECT ON IS THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES ❑ NO ❑ INSPECTORS APPROVAL Capacity set by Building Division......................:............................_........................._....._.............__.. Building/Zoning...............................................................................................I.................... Date ... ......................................................... Board of Health. ...................................................................................................... Date ................................._........................................... .. FireDistrict Date...................I............. ........_Comments:.......................................................................................................................................................................... White-Licensing Authority Gold-Building Commissioner Pink-Fire Department Canary-Health Division Number Fee 1079 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Ferreira Is 85 OLD YARMOUTH, Hyannis,MA 02601 Is Hereby Granted a�License FOR: STORING OR HANDLING 111'GALLONS OR MORE OF HAZARDOUS MATERIALS. ------- ------- ---- - -------- ------- -------- ----- ------------ ------ ------ -- ---- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2012 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,'CHAIRMAN - PAUL J.CANNIFF,D.M.D. 12/29/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health J c Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: Business Name: Business Location: Mailing Address: Telephone Number: Contact Person: Emergency Contact Telephone Number: Type of Business: HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts, gallons, Shed,retail store, drums,tank,etc... cabinet,closet,e c 1 5 _ / VIP,/ �la I WD VUV�� 1 ti 3 Misc. Combustibles Misc. Corrosives Misc.Reactive Misc.Toxics Inventory Total Amount: Hazardous Materials License Posted?Yes No Contingency Plan Posted? Yes No Fire District: Fire Extinguisher Service Date: Metal Covered Rag Bin: Yes No Absorbent"Material Available? Yes o Type of Absorbent: Speedy Dry Pads .Pigs.Other: MSDS on site? Yes No Hard Copy Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: Type(s) of hazardous waste product(s): Date of last hazardous waste shipment,type of waste and quantity: Hazardous Waste Transporter(s): Designated Hazardous,Waste Facility: Hazardous Waste Storage Area Description Is hazardous waste storage area labeled: Yes No Are tanks/drums/containers labeled with the words "Hazardous Waste",the type of waste and the associated hazard (i.e. ignitable,corrosive,reactive or toxic) Yes No If hazardous waste is stored out of doors is it covered from the elements? Yes No Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floor? Yes No = FLOOR DRAINS (Chapter 3 81) Town Sewer Account Number: Indoor floor drains: Yes No' If yes,circle one,does it discharge to a: holding tank dry well on site se c. /�-) l Outdoor surface drains: Yes No If yes,circle one,does it discharge to a: holding tank dry well on site septic. FUEL AND CHEMICAL STORAGE TANKS (Chapter 326) Underground Storage Tank(s) on site? Yes oNo Age: Is removal required? Yes No If yes,when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on site? Yes No If yes,is it protected from the elements? Yes No If yes,howl Is it on a foundation larger in size than the tank? Yes No COlOMIENTS/REC0MMENDATIONS/CORRECTIVE ACTIONS - f - Date: Public Health Inspector: Facility Representative: - 3 - Number Fee 1079- THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This.is to Certify that Ferreira's 85 OLD-YARMOUTH, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2011 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 12/29/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable �FTHE Tp Regulatory Services O Thomas F. Geiler,Director * BARNSTABLE. g Public Health Division °rFo 39. Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Wayne Miller,M.D. . Fax: 508-790-6304 Paul J.Canniff,D.M.D. Junichi Sawayanagi NOTICE TO ALL BUSINESS OPERATORS WITH HAZARDOUS MATERIALS IN BARNSTABLE The Town of Barnstable Town Council adopted, Chapter 108: Hazardous Materials, a requirement for each business operator to obtain an annual permit and to remit a fee of$100.00 if one-hundred and eleven (111) gallons or more of hazardous materials are stored, transported, utilized, and/or disposed of at a particular site. STEPS 1 — 2 - 3: 1. Please complete the attached application form 2. Include a copy of your contingency plan (to handle hazardous waste spills, etc.) 3. Submit the fee of$100.00 payable to the: Town of Barnstable. MAIL all of the above to this office on or before June 30, 2011. A late charge of$10.00 will be assessed if payment is not received by July 8, 2011. Please feel free to view the above Code, Chapter 108: Hazardous Materials on the Town Website, www.town.barnstable.ma.us , which is located under the E-Code section if you°should have any questions,or concerns. Q:\Hazmat\Haz Mat Permit Letter.DOC Town of Barnstable Regulatory Services ti Thomas F. Geiler,Director BARN ,STABLE ` Public Health Division 9� 1639. `fig ArED Nw� Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 I ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS ,f FULL NAME OF APPLICANT d e ' NAME OF ESTABLISHMENT f✓/e)-,4 S ADDRESS OF ESTABLISHMENT AY (,'�� �y�rrr► d TELEPHONE NUMBER (50a-) -77/`//,;2-9 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT �;,�,�, .�e cam:c� C�c ,�elt ir,.c� .f jag. ,af%Z S Q\ TREASURER CLERK e SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS i�Q �y �ceit �,,1, HOME TELEPHONE# Haz.doc/wp/q MAIL-IN REQUESTS Please mail the completed application form to the address below. In addition, please include the required fee amount. Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. For further assistance on any item above, call (508) 862-4644 YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 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.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall). ?n �1 � DATE: KI xs°� t g '� ��� Fill in please: wr tF � m Mraffl APPLICANT'S YOUR NAME: BUSINESS YOUR HOME ADDRESS: 8U cal�ecL CZo�� TELEPHONE # Home Telephone Number: qci 1 :... Y .r.... .. .:........g .._...r_....... . 1'... .: rrt. h. .b rLd�.n .rrd u� . o. , 1 r ADC�RESS OF_. US N:ESS �. ,. 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 o.f 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' FFIC a�be '-,This individual hormed ny permit requirements that pertain to this type of business. oriz d Signature** COMMENTS: 2. BOARD R OF HEALTH , This individual h s een i formed of Jhq per it requirements that pertain to this type of business. - Authorize Signature COMMENTS: ' " MUST COMPLY WITH ALL KqWDOLIS MATERIALS TON 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been.informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: z YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 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.) Business Certificates are available at the Town Clerk's Office, 1" FL.(367 Nlain Street, Hyannis, MA 02601 (Town Hall) r rIuzvz uil DATE: 1 ' DQ Fill in please: ' ` rx APPLICANT'S YOUR NAME S: BUSINESS YOUR HOME ADDRESS: Ce 1 R:i ` ✓�.hi V ,£;;� � r TELEPHONE # Home Telephone Number 27Li NAME OF CORPORATION: it NAME:OF NEW BUSINESS TYPE OF BUSINESS L IS THIS A HOME OCCUPATIONS YES NO t/ ADDRESS OF BUSINESS : a; MAP/PARCEL NUMBERy aS�. [assessing).` 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 CO ISSI NER'S OFFICE This individu I A e n inir o an �.per it require ents that pertain to this type of business. Aut orized Sat ` COMMENTS: rY�f rt �1 .. 6(�!� Zu ItcZ) � v --) S' > 2. .BOARD OF HEALTH This individual ha b n info of permit r wrements that pertain to this type of business: Authorized ignature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS; No L COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION F A O,M SJe 1 TITLE 5 cP r OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A 3 i� CERTIFICATION MAP 1" Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 05 PARCEL ; 0 CS Owner's Name: LOU D'ARPINO LOT Owner's Address: 123 GURNET RD.DUXBERRY MA. 02332 Date of Inspection: 12/15/03 Name of Inspector: (please print) JOHN GRACI,INC. Company Name: SEPTIC INSPECTIONS Mailing Address: P.O. BOX 2119 TEATICKET,MA. 02536 Telephone Number: 508-564-6813 FAX 508-564-7270 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 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 15.340 of Title 5(310 CMR 15.000). The system: X Passes _ Conditionally P es _ Needs Further luation by the Local Approving Authority Fails Inspector's Signature: Date: 12/15/03 The system inspector shall submit a co of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall sL bmit 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. Notes and Comments SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****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. Title S IncnPctinn Fnrm F/i S/mm 1 Page 2 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU WARPINO Date of Inspection: 12/15/03 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. n/a 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 Health. *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. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)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 _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a 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 _obstruction is removed ND explain: n/a r Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 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 functioningin a manner which will protect public p p 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 2. System will fail unless the Board of Health(and Public Water Supplier, if any)determines that the system is functioning in a 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 n/a "This system passes if the well water analysis, performed at a DEP certified laboratory, 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU WARPINO Date of Inspection: 12/15/03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for alLinspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped NOT IN THE.LAST YEAR. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _ X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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 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, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] NO (Yes/No)The system fails. 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 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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. 4 Page 5 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period `? X Have large volumes of water been introduced to the system recently or as part of this inspection? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site '? X _ Were the septic tank manholes uncovered,opened,and the interior of 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? X _ 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: Yes no X Existing information.For example, a plan at the Board of Health. X _ 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(3)(b)] S Page 6 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): n/a DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 0 Number of current residents: n/a Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO _ Water meter readings, if available(last 2 years usage(gpd)):gtw Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: COMMERCIAL OFFICE-2000 SQ. FEET Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: NOT IN THE LAST YEAR. Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM _Septic tank,distribution box, soil absorption system X Single cesspool X Overflow cesspool _Privy _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) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed (if known)and source of information: OVER 25 YEARS PER OWNER Were sewage odors detected when arriving at the site(yes or no): NO A Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 BUILDING SEWER(locate on site plan) Depth below grade: 16" Materials of construction:_cast iron =40 PVC Xother(explain): ORANGEBURG Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: (locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: n/a Sludge depth: n/a Distance from top of sludge to bottom of outlet tee or baffle: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): n/a GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): n/a 7 Page 8of11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: _(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n/a 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.): NONE PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU WARPINO Date of Inspection: 12/15/03 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type n/a leaching pits, number: n/a n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a 6' X 6' BLOCK overflow cesspool, number: n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation,etc.): THE OVERFLOW AND ALL COMPONENTS ARE STRUCTURALLY SOUND.PIT HAD 1' OF LEACHING LEFT AT THE TIME OF THE INSPECTION AND SHOWED NO SIGNS OF FAILURE AT THE TIME OF INSPECTION. BOTTOM IS AT 8' CESSPOOLS: X(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: I Depth—top of liquid to inlet invert: 2" Depth of solids layer:3" Depth of scum layer: 4" Dimensions of cesspool: 6' X 6"' Materials of construction: BLOCK Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): MAIN CESSPOOL AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. COVER IS TO GRADE PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a n Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 1 34 r in Page 1 j pf l l , OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 SITE EXAM _Slope _Surface water _Check cellar _Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record - If checked, date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- 12+FEET 11 , . ' Bk 25949 P:9323 -16F65398 12-23-2011 & 11255a MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date; 12-23-2011 a 11 ea 1:5Ta65396 Ct1T: 578 Feel $1,368.00 Cans $400r000.00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 12-23-2011 a 11:55am Ctlay.' 578 Doc#: 65398 Return to: Fee: $1,080.00 Cons: $40MOO.O0 TUFANKJIAN,MCDONALD, WELCH&SACCHITELLA,PA 207 FRONT STREET SCITUATE,MA 02116 QUITCLAIM DEED n Highlight Properties, Inc., a duly organized and validly existing Massachusetts corporation with its usual place of business at 123 Gurnet Road,Duxbury, Plymouth County, MA, for consideration paid and in full consideration of FOUR HUNDRED THOUSAND 00/100 DOLLARS ($400,000.00)grants to Timothy J. Ferreira of 85 Old Yarmouth Road, Hyannis, --� Barnstable County,Massachusetts, individually with QUITCLAIM COVENANTS: The land in Hyannis, Barnstable County,Massachusetts,together with the buildings situated thereon, bounded and described as follows: NORTHEASTERLY by land now or formerly of Frederick L.Jones et ux as shown on plan hereinafter mentioned, One Hundred Sixteen and 32/100 (116.32)feet; SOUTHEASTERLY by land now or formerly of James F. Kenney, as shown on said plan,Two Hundred Eighty-Six and 98/100 (286.98) feet; SOUTHWESTERLY by land now or formerly of Elizabeth Cobb,as shown on said plan, One Hundred One and 84/100(101.84)feet; O WESTERLY by Old Yarmouth Road, as shown on said plan,by two lines measuring One Hundred fourteen and 37/100(114.37) feet; and NORTHWESTERLY by said Old Yarmouth Road, as shown on said plan,by three lines measuring One Hundred Sixty-Eight and 00/100(168.00) feet. The above;-described premises are shown as Lots 4, 5, 6 and 7 on plan of land entitled "Subdivision of Land in Hyannis-Barnstable,Mass.,property of Henry L. Murphy&Margaret- E. Byrne, Julia G. Powers,Trustees, Scale: 1"—40',August 27, 1957, Ed Kellogg—Civil Engineer," which plan is duly recorded in the Barnstable County Registry of Deeds in Plan Book 137, Page 55. This deed is subject to and with the benefit of any and all other rights,restrictions and easements of record, if any there be, insofar as now in force and applicable. Bk 25949 Pg 324 #65398 Being the same premises conveyed to Highlight Properties,Inc. by deed dated October 11, 1995, and recorded with the Barnstable County Registry of Deeds in Book 9922, Page 195. This conveyance is not part of a transaction in which there is a sale, lease, exchange,or other transfer of all or substantially all of the property or assets of Highlight Properties, Inc. Property Address: 85 Old Yarmouth Road, Hyannis, MA 02601 Witness my hand and seal this a 1 day of December,2011. HIGHLIGHT PROPERTIES, INC., A Massachusetts Corporation y: Kimb y D. Smith, President&Treasurer COMMONWEALTH OF MASSACHUSETTS Plymouth, SS December&j,2011 On this mil=day of December, 2011,before me, the undersigned notary public, personally appeared Kimberly D. Smith, President and Treasurer of Highlight Properties, Inc., a Massachusetts Corporation, proved to me through satisfactory evidence of identification, which was _ ;ru's C ,tio2.. to be the person(s)whose name is/are signed on the preceding or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose. DANA C. MYERS Notary Publi : ana . Myers Notary Publtc My Commiss xpires: May 24,2013 COMMONWEALTH OF MASSACHUSETTS My Commission Expires May 24, 2013 --------------- BARNSTABLE REGISTRY OF DEEDS i Bk 25949 P .325 b:�399 1`�--1 23-2011 MORTGAGE THIS MORTGAGE is made this 21t day of between the Mortgagor,Timothy J. Ferreira(herein"Borrower"), and the Mortgagee;Highlight Properties, Inc., a corporation organized and existing under the laws of the Commonwealth of Massachusetts,whose address is 123 Gurnet Road, Duxbury, MA(herein"Lender"). WHEREAS, Borrower is indebted to Lender in the principal sum of Two Hundred Eighty Three Thousand Eight Hundred Sixty Six and 02/100 Dollars ($283,866.02), which indebtedness is evidenced by Borrower's note of even date (herein"Note"),providing for monthly installments of principal and interest,with the balance of the indebtedness, if not sooner paid, due and payable ten (10)years from the date of the Note(the last five years being an extension of the original Note,all at the lender's option). WHEREAS, Borrower is indebted to Lender in the additional principal sum of Thirty Five Thousand Eight Hundred Sixty Five and 051100 Dollars($35,865.05),which indebtedness is evidenced by Borrower's note of even date(herein"45 Day Note"),providing for the payment of principal and interest, with the balance of the indebtedness, if not sooner paid, due and payable within forty-five (45)days from the date of the 45 Day Note. TO SECURE to LENDER(a)the repayment of the indebtedness evidenced by the Note and 45 Day Note,with interest thereon,the payment of all other sums,with interest thereon, advanced in accordance herewith to protect the security of this Mortgage, and the performance of the covenants and agreements of Borrower herein contained,and(b)the repayment of any future advances,with interest thereon,made to Borrower by Lender pursuant to paragraph 22 hereof (herein"Future Advances"),Borrower does hereby mortgage,grant and convey to Lender, with power of sale,the following described property located in the County of Barnstable, ; Commonwealth of Massachusetts: The land,together with the buildings situated thereon,bounded and described as follows: NORTHEASTERLY by land now or formerly of Frederick L. Jones et ux as shown on plan hereinafter mentioned,One Hundred Sixteen and 32/100 (116.32) feet; SOUTHEASTERLY by land now or formerly of James F. Kenney,as shown on said plan,Two Hundred Eighty-Six and 98/100(286.98) feet; SOUTHWESTERLY by land now or formerly of Elizabeth Cobb,as shown on said plan, One Hundred One and 84/100(101.84)feet; WESTERLY by Old Yarmouth Road, as shown.on said plan,by two lines measuring One Hundred Fourteen and 37/100 (114.37) feet; and NORTHWESTERLY by said Old Yarmouth Road,as shown on said plan,by three lines measuring One Hundred Sixty-Eight and 00/100 (168.00) feet. Tutankiian,McDonald&Welch 207 Front Street �1-�' Scituate,MA 02066 Bk 25949 Pg 326 #65399 The above-described premises are shown as Lots 4, 5,6 and 7 on plan of land entitled "Subdivision of Land in Hyannis-Barnstable,Mass.,property of Henry L. Murphy &Margaret E. Byrne, Julia G. Powers,Trustees, Scale: I"—40',August 27, 1957, Ed Kellogg—Civil Engineer,"which plan is duly recorded in the Barnstable County Registry of Deeds in Plan Book 137,Page 55. r Being the same premises conveyed to Highlight Properties, Inc. by deed of SKW Real Estate Limited Partnership dated October 11, 1995, and recorded with the Barnstable County Registry of Deeds in Book 9922,Page 195. which has the address of 85 Old Yarmouth Road,Hyannis (Barnstable),Massachusetts(herein "Property Address"); TOGETHER with all the improvements now or hereafter erected on the property,and all easements,rights,appurtenances,rents,royalties,mineral,oil and gas rights and profits,water, water rights,and water stock, and all-fixtures now or hereafter attached to the property,all of which, including replacements and additions thereto, shall be deemed to be and remain a part of the property covered by this Mortgage; and all of the foregoing,together with said property(or the leasehold estate if this Mortgage is on a leasehold)are herein referred to as the"Property". Borrower covenants that Borrower is lawfully seised of the estate hereby conveyed and has the right to mortgage, grant and convey the Property;that the Property is unencumbered, and that Borrower will warrant and defend generally the title to the Property against all claims and demands, subject to any declarations,easements or restrictions listed in a schedule of exceptions to coverage in any title insurance policy insuring Lender's interest in the Property. UNIFORM COVENANTS. Borrower and Lender covenant.and agree as follows: 1. Payment of Principal and Interest. Borrower shall promptly pay when due the principal of and interest on the indebtedness evidenced by the Note and 45 Day Note,prepayment and late charges as provided in the Note and 45 Day Note,and the principal of and interest on any Future Advances secured by this Mortgage. 2. Funds for Taxes and Insurance. Subject to applicable law or to a written waiver by Lender, Borrower shall pay to Lender on the day monthly installments of principal and interest are payable under the Note, until the Note is paid in full,a sum(herein"Funds")equal to one- twelfth of the yearly taxes and assessments which may attain priority over this Mortgage,and ground rents on the Property,if any,plus one-twelfth of yearly premium installments for hazard insurance,plus one-twelfth of yearly premium installments for mortgage insurance,if any,all as reasonably estimated initially and from time to time by Lender on the basis of assessments and bills and reasonable estimates thereof. The Funds shall be held in an institution the deposits or accounts of which are insured or guaranteed by a Federal or state agency (including Lender if Lender is such an institution). Lender shall apply the Funds to pay said taxes, assessments, insurance premiums and ground Bk 25949 Pg 327 #65399 rents. Lender may not charge for so holding and applying the Funds,analyzing said account, or verifying and compiling said assessments and bills, unless Lender pays Borrower interest on the. Funds and applicable law permits Lender to make such a charge. Borrower and Lender may agree in writing at the time of the execution of this Mortgage that interest on the Funds shall be paid to Borrower, and unless such agreement is made or applicable law requires such interest to be paid, Lender shall not be required to pay Borrower any interest or earnings on the Funds. Lender shall give to Borrower, without charge, an annual accounting of the Funds showing credits and debits to the Funds and the purpose for which each debit to the Funds was made. The Funds are pledged as additional security for the sums secured by this Mortgage. If the amount of the Funds held by Lender,together with the future monthly installments of Funds payable prior to the due dates of taxes, assessments, insurance premiums and ground rents, shall exceed the amount required to pay said taxes,assessments, insurance premiums and ground rents as they fall due, such excess shall be, at Borrower's option,either promptly repaid to Borrower or credited to Borrower on monthly installments of Funds. If the amount of the Funds held by Lender shall not be sufficient to pay taxes, assessments, insurance premiums and ground rents as they fall due, Borrowers shall pay to Lender any amount necessary to make up the deficiency within 30 days from the date notice is mailed by Lender to Borrower requesting payment thereof. Upon payment in full of all sums secured by this Mortgage, Lender shall promptly refund to Borrower any Funds held by Lender. If under paragraph 19 hereof the Property is sold or the Property is otherwise acquired by Lender, Lender shall apply,no later than immediately prior to the sale of the Property or its acquisition by Lender,any Funds held by Lender at the time of application as a credit against the sums secured by this Mortgage. 3. Application of Payments. Unless applicable law provides otherwise,all payments received by Lender under the Note and paragraphs 1 and 2 hereof shall be applied by Lender firsf in payment of amounts payable to Lender by Borrower under paragraph 2 hereof,then to interest payable on the Note,then to the principal of the Note,and then to interest and principal on any. Future Advances. 4. Charges; Liens. Borrower shall pay all taxes,assessments and other charges,fines and impositions attributable to the Property which may attain a priority over this Mortgage, and leasehold payments or ground rents,if any, in the manner provided under paragraph 2 hereof or, if not paid in such manner,by Borrower making payment,when due, directly to the payee thereof. Borrower shall promptly furnish to Lender all notices of amounts due under this paragraph,and in the event Borrower shall make payment directly, Borrower shall promptly furnish to Lender receipts evidencing such payments. Borrower shall promptly discharge any lien which has priority over this Mortgage;provided,that Borrower shall not be required to discharge any such lien so long as Borrower shall agree in writing to the payment of the obligation secured by such lien in a manner acceptable to Lender, or shall in good faith contest such lien by,or defend enforcement of such lien in, legal proceedings which operate to prevent the enforcement of the lien or forfeiture of the Property or any part thereof. Bk 25949 Pg 328 #65399 5. Hazard Insurance. Borrower shall keep the improvements now existing or hereafter erected y on the Property insured against loss b fire, hazards included within the term"extended coverage", and such other hazards as Lender may require and in such amounts and for such periods as Lender may require; provided,that Lender shall not require that the amount of such coverage exceed that amount of coverage required to pay the sums secured by this Mortgage. The insurance carrier providing the insurance shall be chosen by Borrower subject to approval by Lender;provided,that such approval shall not be unreasonably withheld. All premiums on insurance policies shall be paid in the manner provided under paragraph 2 hereof or,if not paid in such manner,by Borrower making payment,when due, directly to the insurance carrier. All insurance policies and renewals thereof shall be in form acceptable to Lender and shall include a standard mortgage clause in favor of and in form acceptable to Lender. Lender shall have the right to hold the policies and renewals thereof, and Borrower shall promptly furnish . Lender all renewal notices and all receipts of paid premiums. In the event of loss, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing,insurance proceeds shall be applied to restoration or repair of the Property damaged,provided such restoration or repair is economically feasible and the security of this Mortgage is not thereby impaired. If such restoration or repair is .not economically feasible or if the security of this Mortgage would be impaired,the insurance proceeds shall be applied to the sums secured,by this Mortgage,with the excess, if any,paid to Borrower. If the Property is abandoned by Borrower,or if Borrower fails to respond to Lender within 30 days from the date notice is mailed by Lender to Borrower that the insurance carrier offers to settle a claim for insurance benefits, Lender is authorized to collect and apply the insurance proceeds at Lender's option either to restoration or repair of the Property or to the sums secured by this Mortgage. Unless Lender and Borrower otherwise agree in writing, any such application of proceeds to principal shall not extend or postpone the due date of the monthly installments referred to in paragraphs I and 2 hereof or change the amount of such installments. If under paragraph 19 hereof the Property is acquired by Lender,all right,title and interest of Borrower in and to any insurance policies and in and to the proceeds thereof resulting from damage to the Property prior to the sale or acquisition shall pass to Lender to the extent of the sums secured by this Mortgage immediately prior to such sale or acquisition. 6. Preservation and Maintenance of Property; Leaseholds; Condominiums; Planned Unit Developments. Borrower shall keep the Property in good repair and shall not commit waste or permit impairment or deterioration of the Property and shall comply with the provisions of any lease if this Mortgage is on a leasehold. If this Mortgage is on a unit in a condominium or a planned unit development,Borrower shall perform all of Borrower's obligations under the declaration or covenants creating or governing the condominium or planned unit development, the by-laws and regulations of the condominium or planned unit development,and.constituent n, documents. If a condominium or planned unit development rider is executed by Borrower and recorded together with this Mortgage,the covenants and agreements of such rider shall be Bk 25949 Pg 329 #65399 incorporated into and shall amend and supplement the covenants and agreements of this Mortgage as if the rider were a part hereof. 7. Protection of Lender's Security. If Borrower fails to perform the covenants and agreements contained in this Mortgage,or if any action or proceeding is commenced which materially affects Lender's interest in the Property, including,but not limited,eminent domain, insolvency, code enforcement, or arrangements or proceedings involving a bankrupt or decedent, then Lender at Lender's option,upon notice to Borrower,may make such appearances,disburse such sums and take such action as is necessary to protect Lender's interest,including,but not limited to, disbursement of reasonable attorney's fees and entry upon the Property to make - repairs. If Lender required mortgage insurance as a condition of making the loan secured by this Mortgage, Borrower shall pay the premiums required to maintain such insurance in effect until such time as the requirement for such insurance terminates in accordance with Borrower's and Lender's written agreement or applicable law. Borrower shall pay the amount of all mortgage insurance premiums in the manner provided under paragraph 2 thereof. Any amounts disbursed by Lender pursuant to this paragraph 7,with interest thereon, shall become additional indebtedness of Borrower secured by this Mortgage. Unless Borrower and Lender agree to other terms of payment, such amounts shall be payable upon notice from Lender to Borrower requesting payment thereof,and shall bear interest from the date of disbursement at the rate payable from time to time on outstanding principal under the Note and/or 45 Day Note unless payment of interest at such rate would be contrary to applicable law, in which event such amounts shall bear interest at the highest rate permissible under applicable law. Nothing contained in this paragraph 7 shall require,Lender to incur any expense or take any action hereunder. 8. Inspection. Lender may make or cause to be made reasonable entries upon and inspections of the Property,provided.that Lender shall give Borrower notice prior to any such inspection specifying reasonable cause therefor related to Lender's interest in the Property. 9. Condemnation. The proceeds of any award or`claim for damages,direct or consequential, in connection with any condemnation or other taking of the Property, or part thereof,or for conveyance in lieu of condemnation, are hereby assigned and shall be paid to Lender. In the event of a total taking of the Property,the proceeds shall be applied to the sums secured by this Mortgage, with the excess, if any,paid to the Borrower. In the event of a partial taking of the Property,unless Borrower and Lender otherwise agree in writing,there shall be applied to the sums secured by this Mortgage such proportion of the proceeds as is equal to that proportion which the amount of the sums secured by this Mortgage immediately prior to the date of taking bears to the fair market value of the Property immediately prior to the date of taking, with the balance of the proceeds paid to Borrower. If the Property is abandoned,by Borrower,or if,after notice by Lender to Borrower that the + condemnor offers to make an award or settle a claim for damages, Borrower fails to respond to Lender within 30 days after the date such notice is mailed. Lender is authorized to collect and CIO Bk 25949 Pg 330 #65399 apply the proceeds,at Lender's option,either to restoration or repair of the Property or to the sums secured by this Mortgage. Unless Lender and Borrower otherwise agree in writing, any such application of proceeds to postpone principal shall not extenost or d one the due date of the monthly installments referred to in paragraphs 1 and 2 hereof or change the amount of such installment. 14. Borrower Not Released. Extension of the time for payment or modification of amortization of the sums secured by this Mortgage granted by Lender to any successor in interest of Borrower shall not operate to release,in any manner,the liability of the original Borrower and Borrower's successors in interest. Lender shall not be required to commence proceedings - against such successor or refuse to extend time for payment or otherwise modify amortization of the sums secured by this Mortgage by reason of any demand made by the original Borrower and Borrower's successors in interest. _ 11. Forbearance by Lender Not a Waiver. Any forbearance by Lender in exercising any right or remedy hereunder, or otherwise afforded by applicable law, shall not be a waiver of or preclude the exercise of any such right or remedy. The procurement of insurance or the payment of taxes or other liens or charges by Lender shall not be a waiver of Lender's right to accelerate the maturity of the indebtedness secured by this Mortgage. 12. Remedies Cumulative. All remedies provided in this Mortgage are distinct and cumulative to any other right or remedy under.this Mortgage or afforded by law or equity,and may be exercised concurrently,independently or successively. 13. Successors and As Bound; Joint and Several Liability; Captions. The covenants and agreements herein contained shall bind,and the rights hereunder shall inure to,the respective successors and assigns of Lender and Borrower,subject to the provisions of paragraph 18 hereof. All covenants and agreements of Borrower shall be joint and several. The captions and headings of the paragraphs of this Mortgage are for convenience only and are not to be used to interpret or define the provisions hereof. , 14. Notice. Except for any notice required under applicable law to be given in another manner, (a)any notice to Borrower provided for in this Mortgage shall be given by mailing such notice by certified mail addressed to Borrower at the Property Address or at such other address as Borrower may designate by notice to Lender as provided herein, and(b) any notice to Lender shall be given by certified mail,return receipt requested,to Lender's address stated herein or to such other address as Lender may designate by notice to Borrower as provided herein. Any notice provided for in this Mortgage shall be deemed to have been given to Borrower or Lender when given in the manner designated herein. 15. Uniform Mortgage; Governing Law; Severability. This form of mortgage combines uniform covenants for national use and non-uniform covenants with limited variations by jurisdiction to constitute a uniform security instrument covering real property. This Mortgage shall be governed by law of the jurisdiction in which Property is located. In the event that any provision or clause of this Mortgage or the Note or the 45 Day Note conflicts with applicable f Bk 25949 Pg 331 #65399 law, such conflict shall not affect other provisions of this Mortgage or the Note which can be given effect without the conflicting provision, and to this end the provisions of the Mortgage and the Note are declared to be severable. 16. Borrower's Copy. Borrower shall be furnished a conformed copy of the Note,of the 45 Day Note and of this Mortgage at the time of execution or after recordation hereof. 17. Life Insurance. Until the principal and interest have been fully paid under the terms of the Note, the 45 Day Note and this Mortgage,Borrower shall pay for and maintain a life insurance policy from a recognized and reputable insurance company naming Borrower as the insured and Lender as the owner and beneficiary of said policy. The amount of the life insurance policy shall be in an amount at least equal to the total amount of principal and interest owed to Lender under this Mortgage. Written proof of coverage shall be provided to Lender within 30 days of the closing. In the event of Borrower's death, any insurance proceeds paid to Lender that exceeds the amount of principal and interest remaining due to Lender shall be reimbursed to Borrower's estate. Failure to comply with the terms of this paragraph 17 shall constitute as a default under this Mortgage. 18. Transfer of the Property; Assumption. If all or any part of the Property or an interest therein is sold or transferred by Borrower without Lender's prior written consent, excluding(a) the creation of a lien or encumbrance subordinate to this Mortgage, (b)the creation of a purchase money security interest for household appliances,(c)a transfer by devise, descent or by operation of law upon the death of a joint tenant or(d)the grant of any leasehold interest of three years or less not containing an option to purchase, Lender may, at Lender's option,declare all the sums secured by this Mortgage to be immediately due and payable. Lender shall have waived such option to accelerate if,prior to the sale or transfer, Lender and the person to whom the Property is to be sold or transferred reach agreement in writing that the credit of such person is satisfactory to Lender and that the interest payable on the sums secured by this Mortgage shall be at such rate as Lender shall request. If Lender.has waived the option to accelerate provided in this paragraph 18, and if Borrower's successor in interest has executed a written assumption agreement accepted in writing by Lender,Lender shall release Borrower from all obligations under this Mortgage,the Note and the 45 Day Note. If Lender exercises such option to accelerate,Lender shall mail Borrower notice of acceleration in accordance with paragraph 14 hereof. Such notice shall provide a period of not less than 30 days from the date the notice is mailed within which Borrower may pay the sums declared due. If Borrower fails to pay such sums prior to the expiration of such period,Lender may,without further notice or demand on Borrower, invoke any remedies permitted by paragraph 19 hereof. NON-UNIFORM COVENANTS. Borrower and Lender further covenant and agree as follows: 19. Acceleration; Remedies. Except as provided in paragraph 18 hereof,upon Borrower's beach of any covenant or agreement of Borrower in this Mortgage,including the covenants to pay when due any sums secured by this Mortgage,lender prior to acceleration shall mail notice to Borrower as provided in paragraph 14 hereof specifying: (1)the breach; (2)the action required to cure such breach; (3) a date, not less than 30 days from the date the Bk 25949 Pg 332 #65399 notices mailed to Borrower,by which such breach must be cured; and(4) that failure to cure such breach on or before the date specified in the notice may result in acceleration of the sums secured by this Mortgage and sale of the Property. The notice shall further inform Borrower of the right to reinstate after acceleration and the right to bring a court action to assert the non-existence of a default or any other defense of Borrower to acceleration and sale. If the breach is not cured on or before the date specified in the notice, Lender at Lender's option may declare all of the sums secured by this Mortgage to be immediately due and payable without further demand and Lender may invoke the STATUTORY POWER OF SALE and any other remedies permitted by applicable law. Lender shall be entitled to collect all reasonable costs and expenses incurred in pursuing the remedies provided in this paragraph 19,including,but not limited to, reasonable attorney's fees. If Lender invokes the STATUTORY POWER OF SALE,Lender shall mail a copy of a notice of sale to Borrower,and to any other person required by applicable law,in the manner provided by applicable law. Lender shall publish the notice of sale and the. Property shall be sold in the manner prescribed by applicable law. Lender or-Lender's designee may purchase the Property at any sale. The proceeds of the sale shall be applied in the following order: (a)to all reasonable costs and expenses of the sale,including reasonable attorney's fees and costs of title evidence; (b)to all sums secured by this Mortgage; and(c) the excess,if any,to the person or persons legally entitled thereto. 20. Borrower's Right to Reinstate. Notwithstanding Lender's acceleration of the sums. secured by this Mortgage,Borrower shall have the right to have any proceedings begun by Lender to enforce this Mortgage discontinued at any time prior to the earlier to occur of(i)the fifth day before sale of the Property pursuant to the power of sale contained in this Mortgage or (ii)entry of a judgment enforcing this Mortgage if. (a)Borrower pays Lender all sums which would be then due under this Mortgage,the Note and notes securing Future Advances, if any, had no acceleration occurred; (b)Borrower cures all breaches of any other.covenants or agreements of Borrower contained in this Mortgage; (c) Borrower pays all reasonable expenses incurred by Lender in enforcing the covenants and agreements of Borrower contained in this Mortgage and in enforcing Lender's remedies as provided in paragraph 19 thereof, including,but not limited to,reasonable attorney's fees; and(d) Borrower takes such action as Lender may. reasonably require to assure that the lien of this Mortgage, Lender's interest in the Property and Borrower's obligation to pay the sums secured by this Mortgage shall continue unimpaired. Upon such payment and cure by Borrower,this Mortgage and the obligations secured hereby shall remain in full force and effect as if no acceleration had occurred. 21. Assignment of Rents; Lender in Possession. As additional security hereunder,Borrower hereby assigns to Lender the rents of the Property,provided the Borrower shall, prior to acceleration under paragraph 19 hereof or abandonment of the Property,have the right to collect and retain such rents as they become due and payable. Upon acceleration under paragraph 19 hereof or abandonment of the Property, Lender shall be. entitled to enter upon,take possession of and manage the Property and to collect the rents of the Property including those past due. All rents collected by Lender shall be applied first to payment Bk 25949 Pg 333 #65399 of the costs of management of the Property and collection of rents, including,but not limited to, reasonable attorney's fees,and then to the sums secured by this Mortgage. Lender shall be liable to account only for those rents actually received. 22. Future Advances. For the purposes per mitted by applicable law and upon request of Borrower, Lender,at Lender's option prior to release of this Mortgage, may make Future Advances to Borrower. Such Future Advances,with interest thereon, shall be secured by this Mortgage when evidenced by promissory notes stating that said notes are secured hereby. At no time shall the principal amount of the indebtedness secured by this Mortgage,not including sums advanced in accordance herewith to protect the security of this Mortgage, exceed the original amount of the Note plus US $ d, o 0 23. Release. Upon payment of all sums secured by this Mortgage,Lender shall discharge this Mortgage without cost to Borrower. Borrower shall pay all costs of recordation,if any. IN WITNESS WHEREOF,Borrower has executed this Mortgage under seal. Timotlfy J. Ferreira- (Borrower) COMMONWEALTH OF MASSACHUSETTS Plymouth, SS 1 �-v� ,/ �1 ,201-1 On this G-1-- day of DW4k� , .2011 before me, the undersigned Notary Public,personally appeared Timothy J. Ferreira,personally known to me and whose identity was proved to me through satisfactory evidence of a Massachusetts Driver's License to be the person whose name is signed on the within document,whose swore and affirmed to me that he signed the document voluntarily for its stated purpose. DANA C. MYERS �? NotorY Public cOMMONWEALTH OF MAMCHUSEM My Commission Expires Notary Publ• Da C.Myers May sa, zo►s My Commission Expires: May 24,2013 BARNSTABLE REGISTRY OF DEEDS R•-:r P 131- .666 220 � I i j ®��s 37 Pammy's Path, N. Easton, MA 02356 i a •A 0 �z Mr. Thomas A M s cKean t Health Department 367 Main Street Hyannis, MA 02601 RETURN RECEIPT EQE E . . . .. .: I'll fill llFfY{11411.11[ 'lJ-11IIIIA13i 'P1YYi13i;. 113E1 a r )lanufactureriui triquor of Food Service Products Since 1955. S i C { �S q.. W r ® 66r 3 r. ccri^cnweatth of Massachusetts Exe--utive Office of Environmental Affairs Department of Environmental Protection -� Willem F.Weld Trudy Coze ran« .., Argeo Paul Calluee) David 8.Struhs tZ Gommar G rnmea,onee SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION f ��� Address of Owner. Property Address: 'U C'L-l� Yio�inG';15�i f��, ►J�J\S (If different) Date of Inspection rr�/9/9i;, 1ait0 Name of Inspector. R.c" _r1l-M--'SYUSK1 6')W(-Yl MA OZ4C9 Company Name.Address and Telephone Number, Art-9).tv c b£j14iJ &4 111 Li1'� Rb x !J� CERTIFICATION STATE.titE.ti� I certify that I have personally=spee-ed the sewage dispo°al system at this address and that the inforaraa-eparee 7eiaw is t e,er��te and complete as of the time of is soeean. Z"ae inspection was per.'ormed based on my mining and erpenea:s the;raper mainre..==of on•aite sewage dsooaai sostems. The system: Passes _ Condirarally Passes _ Needs r'urt er 7raluation By the Local Approving Authority _ Fast' / Lupector,s Signature Date: 6-"'T-37¢b '/(( The System Inspector shall sabre a eogy of this iaspec-do repPort to the Approving Authority within thirty(301 days ms:?let g t'ns inspection, If the system is scared system gr , or has a design Slow of 10,000 gpd or eater,the inspector and•t'a spstc owner snail subrzit the report to the appropriate regional=T-ce of the Department of Eavironmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving wrthof'. INSPECTION SUMMARY: Check A.B,C,or D: A] SYSTEM PASSES: L/ I have not found any,inforrsation which indicates that the system violates any of the failure ctera as dec.ad in 310 C`'IS 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The syste=upon completion of the repiaaaent or repair,passes Indicate pet,no,or hat determined(Y,N,or ND). Desciee basis of determination in all ia� If"not detersi-.ea',esplain way not) The septic tank is metaL tacked.strncu mny unsound,.shows substantial infiltration or ezr-1traron,or tank failure s imminent. The system wi l pass inspection if the ezistixsg seotic'aak is replaced with a Snaior septic tank as apgrwed by the Board of Health. (revised 11/03/95) 1 One WlnterStreet •' .Boston,Massachusetts 02108 a FAX(617)558.1049 a Telephone(617)292•d500 4M•Peened an Reeyded P7Pa � . r r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Gil, y��,4 K,), fl '0,0).),j Owner- Date of Inspection: Bl SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or hi3a static water level observed in the distribution box is due to broken or obstruct-ed pipets) or due to a broke sest.ea or uneven distribution box. The system will pass insPe"On if(with approval of the Baud n. of Health): _ broken pipets)are replaced _ _ o'ostruc—tioa is removed dist-3ution box is levelled or replaced _ The system required pumping more than four times a year due to broken or obstructed pix%s,. T':a system will;.ass iaspeetioa if(with approval of the Board of Health): broken pipe(s)are replaced a'ostr c:�on is removed CZ FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: _ Conditions edit which reanixe f zrther evaivatioa by the Board of Health in order to determine if the syssm is fait:-$to protect the public hovel 1. safety and the eavironmeat. 1) SYSTEM WILL PAS PROTECTTEE OPUBI IC HE.�,I.TS AND SAFETY AND THE �*10��FUNCTIONING IN A MANNER WHICH Cesspool or privy is within 50 feet of a surfce water wetland a salt marsh. Cal or privy is within 50 feet of a bordering vegetated SUppLML IF APPROPRIATE) :) SYSTEM WILL FALL UNLESS THE BO FFUUNCTIONIN IN OF HEALTH A MANNER THAT ND PUBLIC OTECT THE PUBLIC HEALTH AND DETERMUfES THAT THE SYSTEM IS SAFETY AND THE E.`iVIRONMENT' The system has a septic tank and sou absorption system and is within 100 feet to a surace water supply or tributary to a surface water supply. water supply well. The system has a septic tank and sort absorption system and is within a Zone I of a public The sysum has a septic tank and sea absorption system and is within 50 fees of a private what supply wee The system,bin h a septic tank and soil absorption system and isless than 100 feet but 50 feet or more$om a Pia water for eoliform bacteria and volatge organic compoands indicates that the well is free suppiyr"I unless a well wear analysis for nitrate sic ogees is,mil to or leas than 5 ppm. f=polluzioa from that facslisy and the Presence of ammonia nitrogen 3) OTHER S � (revised 11/03/95) 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION.(continued). Property Address: I� Otte 7p>�l�o�SY4 � >�►�.uu Owner. hlf4kLlCtNk r�oP4►�'T�i� , >>�. Date of Inspection: DI SYSTEM FAILS: I have deer_:ned that the ahem violates one or more of the following failure criteria as de:iaed i 1.10 CIC 15.303. The basis for this deter...isation is idend ed below. The Board of health should be contacted to determine wrest-E be necessary to corzec:the failure. daczuo of xwa^e to faclty or system component due to an overloaded or clogged SAS or=spool Disccarge or pond!:;of ei2uent to the surace of the ground or mrace waters due to an cverissced or clogged SAS or OrJfDOOL Static lieuid level in the distribution b=above outlet invert due to an overloaded or elcgz, d,S�15 or cesspool - _ Liquid death_.cesspool is less than E below invert or avaBable volume is less than L2 dap paw• Required gut::;:g more than 4 times in the last year NOT due to clogged or obstr:cad;ipetsi. Number of t:a pumped Any portion of_.e Soil Absorption Syste=cesspool or privy is below the high groundwater elevation. Aay portion of a cesspool or privy is within 100 feet of a surface water supply or tr.:uary:o a atxau 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 prraw water supply well with no aeteptable water quality analysis. If the well has been analyzed to be acceptable,at:ac c rp7 of veil water analysis for conform baear;,volatile organic compounds.ammonia nitrogen and nitrate nitrogen. M LARGE SYSTEM FAILS: The following citera apply to large systems in addition to the miteria above: The system serves a&cMty with a design flow of 10,000 gpd or greater(Large System)and the system is a signiiieaat threat to public health and safety and the environment because one or more of the following conditions cd= the system is within 400 feet of a surface drinking water supply the system is wit'sin 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim WeIDsaad Protection Area(M-43 or a mapped Zone II of a public water sttpp17 well) The owner or operator of any suL system shall bring the system and facility into Ail compllaaee with the pcu=dwater treacment program requi:amente of 314 CUR 5.00 and 6.00. Please consult the local regional ot3kce of the Department for�.ss.—.her farmatioa.. Crevised 11103195) 3 SUBSURFACE SEWAGE DISPOSAL SYSTF-A INSPECTION FORM PART B CHECKLIST pYopertyAddrees ps OLD S/!'I1Zh1(�1�1 I�U.,_��%11�J.�ls . Owner. �i r,kLl f 7'�PM1,5, Y.. Date of Inspection: Cheek if the foilowing:.ave been done: l�p�giag_sor...ation wns requested of the owner,occupant.and Boar_of Health. _Acne of the system components have been pumped for at least two -.eeits and the system has been recsiving normal IIow rates du._=;that period. Larp volumes of water have not been introduced into the system recentiy or as part of this inspection. 11)1 As built picas bave been obtained and examined. Note if they are not avaiable with NIA. fa�or dweiliom;was inspected for signs of sewage back-up. y2'!� ,The system does s*;eceive non-sanitary or industrial waste flow ✓The site was inspected for signs of breakout. '/All system competent:,excluding the Soil Absorption System.have been located on the sita- r N.a•.The sapde tank manholes were uncovered.opened.and the interior of the septic tank was is spee-ed for condition of bal" or teen,materai of const:ttc-ion.dimensions,depth of liquid.depth of sludge,depth of scum. A),A.The size and location of the Soil Absorption System on the site has been determined based on cdscg information or appraz: azed by non=mtrusiva methods. facaity owner(and oetripants,if different from owner)were provided with infor=ation on the proper maintenance of Sub. Suriace Disposal System. (revised 11/03/95) ; SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PropertyAddresx ya9x:,0 Owner. l�t�flzfkH �F'��?143� 1.1JG. Date of Inspection: FLAW CONDITIONS RESIDENTIAL• Design flow�a]Ioaa Number of bedrooms: Number of c=.-ens residents— Garbage gr...der(yes or no)•_ - Laundry maaevad ra system(yes or moi•_ Seasonal use(yes or so)•_ Water meter eadi:7, if available: Last data of aecspa=-r. - C O MM ERCLAL/INDUSTRIAL• Type of esrablisbmeat ICJ/)?`c N)v5i/hl`�TR1tiU77g� Design floor. rn D plonsiday Grease trap prose=(yes or ao)IJ 0 Industrial Warta Holding Tanis present:(yes or no)_ Nan-aanitaty vast&disc-%=- d to the Title 5 apstam:(yes or bo)_YL$ Water meter readings,1f available A,'-G-W il4 "" 2£G�3J a- 1 l Jii 17 � Go•. Cif, u�G�i 04,- wIrms' w)ls (w;.i, 4"'cM r/31 S -6 ;oZI f26= TNrs is Q7-PRiOy)M4TTl J -5Z, 4n:lynx Last date of otrsPaney: Lu)° fkFl OT1[Elk(Deyc3e) Iris data of oocnpaacy: �J•R GENERAL INFORMATION PUMPING RECORDS and source of information: , AIG��f�JK 1'0 System Iu=Ped as part of inspe=cu:(yes or as—MC If yes,vob=e pumped: gallons ` Rsasca for psbnping: TYPE OF SYSTEM Septic tank(distrludon bomised absorption system sko cesspool Overilow eeas000l P:iv9 Sbared system(yes or no) (if yes,attach previous inspection records.if any) Other(explain) APPROXIMATE AGE of all ff components,data instaIIed(if kwwn ee)and saur of iatcrsation: S/J7sii hs 3��LD�a1� �Jt �/fn S J ASSf!;j= c I/MLU 1-"O, Sewage odors detected when arriving at the sita:(yes or no)�4 (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYS MM INFORMATION (oontinued) Property Addres= g� 0'_1) `/"►rCvl'� Owner. i�14k tl,Nt PstJ�.�?)45�1ac, Date of Inspection: SEPTIC TANK: NONri f(rS} ce=r,CldQ� (1=te on site piaa) Y Depth beio.v ae A4-G P OthetteZDiam) �rlG� _ Material of eonst:s:e•.,on:_eaacete_mewl F3. Dimanaans: Dat M e foA x 6•-) P Sludge depth: ' Dist•..,,y from top of siudge to bottom of outlet tee or War. S•7S Scam this' me k°'n Distance from top of ar:m to top of outlet tee e baffle:N�_ Dismnu from boaam of scsm to bottom of outlet tee or batIle:—� Comments (recommendaz:aa for pumping.eondit:oa of iaiee and outlet tees r bashes,depth ai�.iav:d level is;eiatioa ra Outlet invert,st'ue:ural iatQ3�7, y�ws 1'.+ l e f BPS evidence of leakage, etc.) ►`e c a So PS o 1 a�Ns C C l R Ti 11!1 C c01^ rC+N r to re GREASE TR U- l OQ4 , (locate on site plan) ' Depth belQ-ri p—ochcr(ezpIaial Material of ooaszra =n.—eon�eCe_metal— Dimenxia= Seam thie3mesc Distance Prom top of scum to top of outlet toe or batIle�-- Distanee from bottom of term to bottom of antlet tee or baffle: Commsatx of • level is re)atfott to antler invert.sctte_arsl mcag 7' �n for Pumping.condition of inlet and outlet tees or bashes,depth evideum of]ea)sage.eta) 6 (revised 11103195) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address �7 �7Lt) %rtr�h,d(IT1i jZJ), Vs/17N15 l Owner. Date of Inspection: TIGHT OR HOLDING TANK:N'�`t, (10=4 on site plan) Depth below grade: Material of mnstr=mn:_eoacete_metal_F:ZP LLotheriespl"nl Dimaasions: Capacity: eallbas Design ilpw aailonsiday Mart level- Comments:_. (condition of inlet tee.eondhioa of alarm and float switches.e=) DISTRIBUTION Box.—tAol - (locate an site plan) Depth of liquid level above ousiet invert: , Comments~ (note if level and distribution is equal, evidence of solids Carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER: N).,J P- (locate on site plan) Ptmspe in working ordsr:(yes or no) Comments: (note condition,of pump chamber,condition of pumps and appurtananees.ere.) (revised 11/03/95) , SUBSURFACE SEWAGE DISPOSAL SYSTEt INSPECTION FOR.Nt SYSTEM INFORMATION (continued) Address ��� t-�rarr�r4r1�' �xt��.i21�4,S�.1NL. Date of Inspection: v��y be 89)>4 KY , tr*AOw C.eSs pool 17 SOIL ABSORPTION SYSTEM(SAS) O prosunated by non'n'-salve methods) - (locate on sire plan.if possible:--vatioa not required. If not determined to be present.eI Type. leaching pin number_ 1(`;1i"gellerim number. .t1:11a ttenchm aumber.length learning Saida,number,dimensions. averiZoa•eesapooL aumber.� of vegetation ete.l Comments:(note condition of soil.lit as of hydraulic failure.level of pondiag, condition cESSPOOLS: (locate on site plan) Namber and eoaSgarsCion: 5 p r f S Depth-mP of li4nid to ialet�avert sS3 U j�j,�/ L Depth of solids Depth of seam layer. D>J� c ¢� 6'0 x 6.7' CM-. 1& DimebsiansafgesspooL l 6'af x G 7 nc bR►c�C Awe coauk4r4 Materials of consauo:ian= B►t r� Nam„ty, Inman N a �. of insoec•:on, G�55�OdL I;,-)- t5 Gam, t4 t y �nY inflao►(cesspool must be pumped as pet �TW G Ra+Ub V x�'s M11 4 LZ r i 6,ro�i k4b �M HE /R r G455 �• of ulie fame.level of pow Co dition of boa,eta) Comments(note aoad+aon of sort.sigsss hydza � P L Nam/✓`q - r At-L r-` 1!*i MPPtiOfZ DAiLV Fww is 53 Gn21a� dVA%ZRTtz p1�>* /A1 PRrvy: . (locate as site plan) Dimeasions:�--- Matmials of omm ntetiom Depth of solids: poI condition of vegetation.ate.) Comments(=w condition of sorb signs of hydraulic l°vs3 ai 8 (revised 11/03/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ym2y OUS'K Owner. Date of Inspection: SK=H OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks U uJ£�t5 r ,�b W IT N rJ f ao Iorate all wells within 100' j�U11�(N4 (,,,ppafNG DG�� • h y"Pf PL ��t„a�a �i�u1�5 ShNitxny � vhv-.r Gt5SR991�� � _ _ 33' Gk7,, S-Stcl,� -41 6,;r game" ctsSvaaL a O zs' agicK �_ 1 IL �C _ / - �2 Aim Ga•at¢cTL — —ALTO "o wArc� /� 3..75 I �Je 6.y' (ov` '� 19 -22 waluZ a-LSLT 3'Fk ' Gw Tb6t �� P Gw T+9Lq- � DEPTH TO GROUNDWATER Depth to gioundwater. t a-�Ia feet method of determination or app:oumation ��+'i S�Ua►4 S A zh v24 d�T ir ,y�2► (revised 11/03/95) 9 44 V, Al _2 JOHN A. VARPINO PRESIDENT LOUIS H. VARPINO F O VICE PRESIDENT/TREASURER El R. MASEFIELD VI PRESIDENT PURCHASING January 12, 1993 BAN 5 �� �i 1993 Mr. Thomas A. McKean `F'_ 4* Health Department ` 367 Main Street Hyannis, MA 02601 RE: Old Yarmouth Road, Hyannis, MA 02601 Dear Mr. McKean: As per our y hoon . conversation of Friday, January 8, 1993, I am writing this ter :_.in regards to the above captioned property as I did previously on August 13,. 1992. I am writing to confirm that from 1980 until the time that it - ceased operations at this property, South Shore Packing, Inc. processed fresh fish as well as fresh meats at this property. It is my understanding that, as a result of the prior use, the Board of Health will allow future use of this property (by a purchaser or lessee) as a fish processing facility without the requirement of any further approval or permit from the Board of Health. I hope that this letter will satisfy the Board. This problem t is causing me severe hardship. I have already lost two potential buyers for this property and now I have a possible tenant that I don't want to lose. Please let me hear from you as soon as possible. Thank you agajf<_'_ for your cooperation in this matter. Very .truly yours, /cv- Louis- H. D.'Arpino, Treasurer South Shore. Packing, Inc(- ". LHD:seed Manufacturer/Distributor of Food Service Products Since 1955. IV- JOHN A. D'ARPINO PRESIDENT LOUIS H. D'ARPINO Ft DX5 ESIDENT/TREASURER R. MASEFIELD / ESIDENT PURCHASING January 12, 1993 tn�Mr. Thomas A. McKeanHealth Department 367 Main Street i Hyannis, MA 02601 RE: Old Yarmouth Road, Hyannis, MA 02601 Dear Mr. McKean: As per our(— ur phoon . conversation of Friday, January 8, 1993, I am ' writing this-letter :.in regards to the above captioned property as I did previously on August 13, 1992. I am writing to confirm that from 1980 until the time that it ceased operations at this property, South Shore Packing, Inc. processed fresh fish as well as fresh meats at this property. It is my understanding that, as a result of the prior use, the Board of Health will allow future use of this property (by a purchaser or lessee) as a fish processing facility without the requirement of any further approval or permit from the Board of Health. I hope that this letter will satisfy the Board. This problem is causing me severe hardship. I have already lost two potential buyers for this property and now I have a possible tenant that I don't want to lose. Please let me hear from you as soon as possible. Thank you agaxh_ for your cooperation in this matter. Very truly yours, Louis H. DIArpino, Treasurer South Shore Packing, Inc( . LHD:seed Manufacturer/Distributor of Food Service Products Since 1955. 'T.'t' JOHN A. VARPINO PRESIDENT LOUIS H. VARPINO VICE PRESIDENT/TREASURER ERRY R. MASEFIELD yl PRESIDENT PURCHASING �vEO January 12, 1993 JAIL 1993 Mr. Thomas A. McKean " ; r: Health Department 367 Main Street Hyannis, MA 02601 RE: Old Yarmouth Road, Hyannis, MA 02601 Dear Mr. McKean: As per our phoon : conversation of Friday, January 8, 1993, I am writing this-letter ..in regards to the above captioned property as I did previously on August 13, 1992. I am writing to confirm that from 1980 until the time that it ceased operations at this property, South Shore Packing, Inc. processed fresh fish as well as fresh meats at this property. It is my understanding that, as a result of the prior use, the Board of Health will allow future use of this property (by a purchaser or lessee) as a fish processing facility without the requirement of any further approval or permit from the Board of Health. I hope that this letter will satisfy the Board. This problem is causing me severe hardship. I have already lost two potential buyers for this property and now I have a possible tenant that I don't want to lose. Please let me hear from you as soon as possible. Thank you agaifi: for your cooperation in this matter. Very truly yours, Louis H. D'Arpino, Treasurer South Shore Packing, Inc(. . LHD:seed Manufacturer/Distributor of Food Service Products Since 1955. i a t ., x�� �� �„„ � '� .,"&.'�.a ✓•.� d�,u � �. t'J .. � S?5'a ,. hr� +'��• fiL s ; L�'h�i7� m�s::,���i'�v}�"1�'7y�a � � � .a�� '-• �, � � c. � ��u'��,'��r �'• '. � ���� n ..�i � � �, ems.+,� JOHN A. D'ARPINO PRESIDENT LOUIS H. D'ARPINO VICE PRESIDENTITREASURER ERRY R. MASEFIELD YI PRESIDENT PURCHASING January 12, 1993 BAN tn� 5 1993 Mr. Thomas A. McKean Health Department 367 Main Street .Hyannis, MA 02601 RE: Old Yarmouth Road, Hyannis, MA 02601 Dear Mr. McKean: As per o _phoon conversation of Friday, January 8, 1993, I am writing this-letter ..in regards to the above captioned property as I did previously on August 13, 1992. I am writing to confirm that from 1980 until the time that it ceased operations at this property, South Shore Packing, Inc. processed fresh fish as well as fresh meats at this property. It is my understanding that, as a result of the prior use, the Board of Health will allow future use of this property (by a purchaser or lessee) as a fish processing facility without the requirement of any further approval or permit from the Board of Health. I hope that this letter will satisfy the Board. This problem is causing me severe hardship. I have already lost two potential buyers for this property and now I have a possible tenant that I don't want to lose. Please let me hear from you as soon as possible. Thank you agaifi: for your cooperation in this matter. Very truly yours, Louis H. D'Arpino, Treasurer South Shore Packing, Inc,. . LHD:seed Manufacturer/Distributor of Food Service Products Since 1955. I .ssessor's map and lot number ... ...... ^J J THE ....................... / t".• A%j. ' Yf t f wS.4 �Q f Sewage Pdrinit number .........................:....i. i �. INS14ALLED IN co" "- House number . 0«6.... ...... ..............Li Ett;VIr'�C91tla�.EENTAL ','1 �,,�Oe3Y. 0 ;R TOWN 'OF BARNSTABLE BUILDING INSPECTOR C'v APPLICATION-FOR PERMIT TO .. Aao...... ..4. :...........M .............. Ci......y....... M.O..eQ( 12 TYPE OF CONSTRUCTION .....-S.... N............ ........................................... .................. ....................l. ...�..................19.�� — TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: --ff nn Location .........................Q�4K....y4,dC!`4Utr �!1...... c ..,......... .Y AIJ,Y.................................................................... � 'Proposed Use ...........Qs.4........................ .................................................... ............................................................. Zoning District ........Fire District / 4lU��-� Name of Owner ..... .......@.9.ce......if.0 c-ki&. ....Address .................................................................................... Name of Builder .... .. ..$6_1..............................Address ..? ...N4eS.E . ,l N .t ........6.t.......��.4&44rs...... l Nameof Architect ..................................................................Address .................................................................................... Number- of Rooms ..........Gk<...............................................Foundation ................ 4s.K!i.r�...........................:................... Exterior ......... .;�.....$........................................:.......Roofing .......................lt.!54.`.4.f�................................................. FloorsSG.rr!l..e ......................................................Interior .................................................................................... Heating .......... �r.L.............................................................Plumbing ................Vv.0...... . .................................... Fireplace ...........AD................................................................Approximate. Cost ......... ��...�........................ Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area ........ b..... ................ . 00 Diagram of Lot and Building with Dimensions Fee 3v SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... .,� ........ .......................... Construction Supervisor's License C� - fo.3 10 f COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION Y TITLE S OFFICIAL INSPECTION FORM—NOTYOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP � PARCEL Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 - Owner's-Name: LOU D'ARPINO LOT _ Owner's Address: 123 GURNET RD. DUXBERRY MA.02332 _ �s IDate of Inspection: 12/15/03 Name of Inspector: (please print) JOHN GRACI,INC. Company Name: SEPTIC INSPECTIONS Mailing Address: P.O. BOX 2119 TEATICKET, MA. 02536 , Telephone Number: 508-564-6813 FAX 508-564-7270 , 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 the inspection. The inspection was perfonned 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 15.340 of Title 5(310 CMR 15.000). The system: l X Passes _ Conditionally P es _ Needs Further �hluation by the Local Approving Authority Fails ! Inspectors Signature: � � Date: 12/15/03 The system inspector shall submit a co6k of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall simit 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. Notes and Comments f SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. **"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. .. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 Inspection.Summary: Check A;B,C,D or E/ALWAYS complete all of Section D A. System Passes: X"I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2` SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE.. B. System Conditionally Passes: One or more system.comp orients as described in the"Conditional Pass"section need to be replaced or repaired. The system, i upon completion of the replacement or repair, as approved by the Board of Health, will pass. . • R s ` Answer yes, no or not determined (Y,N,ND) m the for the following statements. If"not determined"please explain. n/a-,.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 Health. *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., . ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed• pipe(s)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 obstr`dction is removed —,distribution box is leveled'or replaced- ND explain: n/a n/a,The.system required pumping more than 4 timers 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 ND explain: n/a . sip Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOIE PART A CERTIFICATION(continued) Property Address: 85 OLD YARMOUTH RD HY.ANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 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(i)(b)that the system is ; not functioning in a manner which will protect public health,safety and the environment: i i _ 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 I i I 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a 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 n/a **This system passes if the well water analysis, performed at a DEP certified laboratory, 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form: I 3. Other:• n/a Page 4 of.1 I OFFICIAL. INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAIN A CERTIFICATION(cohtinued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 D. System Failure Criteria applicable to all systems: You mast indicate"yes"or"no"to each of the following for alLinspections: Yes No , X Backup of sewage into facility or system component due to overloaded or.clogged SAS or cesspool _ X Discharge or ponding of effluent to the surface"of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ X Liquid depth in cesspool is less than 6"below invert or available volume is less than"/2 day flow _ X Required pumping more than 4 times in the last year NOT due to clogged or obstructedpipe(s).Number of times pumped N01 IN THE LAST YF,AR.. _ X Any portion of the SAS, cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _ X Any portion of a cesspool,or privy is within 50 feet of a private water supply well. X 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 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, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.]' - NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15303,therefore the system fails.The system owner should contact the Board of Health to detennin'e 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 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) I yes no X the system is within 400 feet of a surface drinking water supply _ X the system is within 200 feet of a tributary to a surface drinking water supply _ X 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 a "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. Page 5 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR 1 PART B CHECKLIST Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No X _ Pumping information w8 provided by the owner, occupant, or Board of Health X Were any of the system components pumped out in the previous two weeks X _ Has the system received normal flows in the previous two week period X Have large volumes of water been introduced to the system recently or as part of this inspection ? _ X Were as built plans of the system obtained and examined? (If they were not available note as N/A) X.. _ Was the facility or dwelling inspected for signs of sewage back up X Was the site inspected for signs of break out X _ Were all system components, excluding the SAS, located on site X _ Were the septic tank manholes uncovered, opened, and the interior of 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 ? j X _ Was the facility owner(and occupants if different from m 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: Yes. no _ X Existing information.For example, a plan at the Board of Health. X Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)`[310 CMR 15302(3)(b)] f I I I Page 6ofjI OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): n/a DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 0 Number`of current residents: n/a, Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system (yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings if available -last 2 years usage( d `� '��:C)o C' F'kCf1 Sump Pump(yes or no): NO 10 Last dateof occupancy: n/a 1 — L COMMERCIAL/INDUSTRIAL Type of establishment: COMMERCIAL OFFICE-2000 SQ. FEET Design-flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a ' Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no):SNO Non-sanitary waste discharged to the Title 5 system(yes or no):NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: NOT IN THE LAST YEAR. Was system pumped as part of the inspection (yes or no): NO f If yes, volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a - TYPE OF SYSTEM Septic tank, distribution box, soil absorption system I X Single cesspool X Overflow cesspool _Privy I -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) _Tight tank Attach a copy of the DEP approval Other(describe): n/a fI Approximate age of all components, date installed (if known) and source of information: OVER 25 YEARS PER OWNER i Were sewagea g odors detected when arriving at the site(yes or no): NO l I Page 7 of d 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) r i Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 :BUILDING SEWER(locate on site plan) ` Depth below'grade: lb" I y Materials of construction: cast iron' _40 PVC Xother(explain): ORANGEBURG Distance from private water supply well or suction line: n/a Gomm:ents (on condition of joints_venting, evidence of leakage;etc.): 'TOWN WATER SEPTIC TANK: (locate on site.pIan) Depth below grade: n/a: Material of construction: concrete_metal_fiberglass._polyethyleneother(exp lain)n/a If tank is metal list age: n/a Is age confirmed by,a Certificate of Compliance(yes or no):NO(attach a=copy of certificate) Dimensions: n/a Sludge depth: n/a Distance from top of sludge.to.bottorn of outlet tee or baffle: n/a 4 Scum thickness: n/a Distance"from top'of scum.to top of outlet tee or baffle: n/a Distance from bottom of scum to bottoin,of outlet tee or baffle: n/a 1 .How were dimensions determined: n/a . Comments (on pumping recommendations, inlet and outlet tee or'baffle condition;structural integrity, liquid levels as related to outlet invert, evidence of leakage,eta): 1 n/a GREASE-TRAP: on site plan) s ` ` Depth below grade: n/a r I Material of construction:_concrete_metal fiberglass col}ethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or Baffle: n/a Date of last pumping: n/a Comrnents (on primping recoriimendations,,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related - t6outletinvert;evidence of leakage, etc): n/a a . •I l Page 8 of•11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PANT C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a - r I Comments(condition of alarm and float switches, etc.): n/a - j DISTRIBUTION BOX: _(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n/a 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.): NONE PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments (note condition of pump chamber,condition of pumps and appurtenances, etc.): n/a j - t Page 9ofII OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type n/a leaching pits, number: n/a n/a Teaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching•trenches, number, length: n/a n/a leaching fields, number: n/a 6' X 6' BLOCK overflow cesspool, number: 1 n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc): . THE OVERFLOW AND ALL COMPONENTS ARE STRUCTURALLY SOUND.PIT HAD 1' OF LEACHING LEFT AT THE TIME OF THE INSPECTION AND SHOWED NO SIGNS OF FAILURE AT THE TIME OF INSPECTION. BOTTOM IS AT 8' CESSPOOLS: X(cesspoolmust be pumped as part of inspection)(locate on site plan) Number and configuration:I Depth—top of liquid to inlet invert: 2" Depth of solids layer: 3" Depth of scum layer: 4" f Dimensions of cesspool: 6' X 6"` Materials of construction: BLOCK Indication of groundwater.inflow(yes or no): NO Continents(note condition of soil, signs.of hydraulic failure, level of ponding, condition of vegetation,etc.): j MAIN CESSPOOL AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING.EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFUL I LIFE. COVER IS TO GRADE ! I PRIVY: (locate on site plan) I Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding;condition of vegetation,etc.): n/a o � I i Page 10 of 11 i - I OFFICIAL,INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT'S ! SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building: • I • I Page 1 I ,of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOIE PART C SYSTEM INFORMATION(continued) Property Address: 85 OLD YARMOUTH RD HYANNIS 02601 Owner: LOU D'ARPINO Date of Inspection: 12/15/03 SITE EXAM _Slope Surface water —Check cellar Shallow wells Estimated depth to ground water 12+feet Please`indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record- If checked, date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain:.n/a You must describe how you established the high ground water elevation: .HAND AUGER- 12+FEET � t 11 a 13 ccrl—itcnweatfh of Massachusetts €xer.1iNe Office of Environmental Affairs w Department ® _ �, r: Environmental Prated'son Trudy Cate 4Vllllam F.Weld Argea Paul Calluecf Cavi SLBSUP-FACE SEWAGE DISPOSAL SYSTEM INSPECTION FOEL PART A CERTIFICATION Address of Omer .N7C Ni-ICiA trrj2� Property Address S C'='� 1�A�tnL'I 'J /wt�u�s t O Dsite of Inspection: lfz/, (If difreren ) PFsmeOflnspector. f`tcN T�1 AGgyi1SK1- , ,. J>>1CY N[�n Company Name.Address and Teiennone'lumber. /��La}t,�r J£.j t�iJ �l�ti l'l z vt� �S`` �✓.� -c12.3z - CERTIFICATION STATZ E•` , I'certify that I have persapaily_s?e`-'d the rs—ge din a.,>vtem at this address and that the uuaratiaa �?nr xio�is e ar"�te I had complete as of the time of -.on: The inspee-ion was perc=ed based an .my t_-ining and par: ten a=d maiateasaee of on-site sewage disoosai s?suems .The systea: Passes y Conditionally Passes Needs ua-_e:r ratuacoa By the Local Approving Authority Fa:1s Iaspeator's Signature. Date: The,Systea Inspee-0r shall sunm.a crop cf thig inspe�ro xt part to the APPtoviag�txtnorizS'Within thirty(.Ql days c�mpiet^..g t.s' isn. If the system is a shared system or.hsw a design flow of I0,000 greater, .gpd or the inspector and•rLe sys.�owner si,,;t sp�c submit'. :art to the appropriate regional QT=of the Deparmeat of Envam 9neatal Prctectzoa: ; The original should be gent to the systeta owner' and copies sent to thebuyer,if applicable and the approvit;mr-!10^?. INSPFZMON SU?tQJARY: Check A,B,C,or D: f A] SYSTEM PASSE not£Quad as prr.acoa which=dicates that the .em violates any of the failure=-tern as dP r�is 31.0 C,L? I5.3II3. � I have y s9s' f Any failure criteria act evaluated are indicated below. BI SYSTEM CONDITIONALLY PASSES: One or more gya'.eta ccsaonen:s need o be replaced or repaired. The system,upon camp of the sepia went or ae$mi:, iasPacdon- - 13dirsite pet,no,or not deterT*^ad(Y,N, or ND1. Des�.ba basis of&tW=i=3tion in an insraaces If"hot dsc ea,eralain''wey npt) The septic has is metal Backed sttue=:rraily unsound shoves sub =n iatiltraticn or etr�.'�am or•ank.fa:lure s imminent The system will Pass mspecson if the mdrjag septic tank is replaced with a f zor-=3 sepd: ank as approm by the Board of HealtIL Crevised 11/03195) I On®1i�inter Street ,maesachusetts=108 ® FAX(SM$56-1049 ® Telephone(fits e52-5S09 Boston, I� SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FOR! PART A CERTiFicATION (coatinued) Props Address 7 G�'� Owner, Dates of Inspacti®n: Bl SYSTEM CONDITIONALLY PASSES (canrZued) static water level observed in the distribution ba is due to bnke or oacaacred pipes) Sewage backup or breakout or hr3a will insoecaoa if(with approval of the Board of or due to a broken. settled or uneven distribution box. The syat�m pass Health). broken pipe(a)are replaced — o'omrt:cron is removed I disc-3utioa box s levelled or replaced morrtlraa four Imes a year due to broken or obBtruced pims�.. T':e r;�te_=will pats The apmem req=-ed pumping i ® i= ion if(with approval of the Boarel.af Health): s - brakes pipe(s) are replaced obstruction is removed CZ FURTHER EVALUATION 13 REQUIFM, BY THE BOARD OF REALT11t further evaivarica by the Board of wealth in order to deter-=iae if the sp ate=isfzil= to Pn�t Conditions wrt*r^ restBre ® public health.safety and the environment. 13 I) SYSTEM WaL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM �EU O NOT��ONL�iC=IN A DCH MILL PROTECT TEE PUBLIC HEALTH AND.SAFETY AND THE . Cesspool or prvy is Britain 50 feet of a aurace way rated wetland or a salt marsh. Cesmal vy is within 50 feet of a bordering ge THE BOAS OF.EEs3I.TH (t4ND PUBLIC WATER SUPPLIE�t.L APPROPRIATE) ®) SYSTEM WLLI.FAIL UNLESSTHAT PROTECT THE PUBLIC HEALTH AND DDT S THAT THE SYSTEM IS FUNCTIONIl`iG IN A MANNER SAFETY AND THE spetem , m has a septic tank and soli anaoriitic sad is within 100 feet to a terrace water supply or trautarp to a Mrrfacs water supply. a�i�within a Zone I of a pui9iic star=PPiy we ' '� bps a- pric task and earl aaaor ptio system `— The m a �` and soil acsorptiaa system.and in within 50 feet of a private Prater supply we, ® The }non a_sc9tie tank and soil abWrptiAn system and is lase than 100 feat but 50 feet or$are f . a well for. Hibrm bactem and volatile organic eomga<maa that the weII i�&ems ® �pPh°'� a well water ansl7zis and nitrate ra ogee is qual to or lew than 5 PPm m fro pollution from that facility and the presence of ammonia aitrogea I • I 3) OTHER I ) Crevisri 11103/95) SUBSURFACE SEWAGE DISPOSAL SYS-MM INSPECTION FOMM PART A CERTIFICATION.(oontinucd) Property Address Owner. Ct1�lCLILcH1 f�aP4r�'Trij ,=FCC. Date of Inspection: DI SYSTEM FAIL: for I have determined that the ay--violates one or more of the foI1¢wing failure citer:a as deE=ed a 310 C,L'. —. ,I5103. The basis the this deee: .i:.atioa is ides_ ea below. The Board of'Health should be contacted to determi.e weaz wiE be aerrssarF to nrrec L-aluret Baexur,or 'm fac y or sntem csmm eneat du to as overloaded or ciog9t SAS or a000 Disc:ar�or yam::3 of etDuent to the auraca of the ground or auraea waters due a an over^+rah or ciog^ed SAS or Static icuid level is the distribution box above cutlet invert due to as overloaded or�_' �SAS or zssponL I quid devzh`.:onspool is less than 6"below invert or available volume is less than LS day lnw. Re ruuea nz=::3 more than 4 wines to the last year NOT due to clogged or obst:.:-• ad;.Matt Humber of tWes pumped ® Any,portion of•'^e Soil Absorption System.cesspool or privy is below the high Povaduater eievatian., A=7 par.:na of a cessmol'or privy is within 100 feet of a surace water supply or tr.:scary•,a a suraca water supply. i clay portion of a===.I or privy is within a Zone I of a public west I Aay portion of a cewpool or pr.'w_is within 50 feet of a pr'vate avatar suttpiy well Aay portion of a rew=l or privy is Ie=than 100 feet but greater than 50 feet fr9a a,or^rate water aimplp well wiry ao ® ae prable water quality analysis. If the well has been analyzed to be acrantable,a=n,: c +of veil water aaalyas for coaarm taca volatile organic compounds, ammonia gem ia nitro Had ra nitrate aitrogea , E1 IaARMTEy The falIavriag e:stera at to large systems is addition to the criteria above: Tho CyCzerm serveg a fac7,it7 with a desiga flow of 10,000 gpd or greater(Tarr Systaffi) and the is a Hgniva_t threat to public Ilo conditions east: sal and the eaviavameat bemuse one or more of the fo wsag . health Had ety the Castes is within 400 feet of a m:rface cLnad lag water supply the system is within 200 feet of a tsiourary to a—face drialcag water supply the system is located in a nitrvgem sensitive area a=erim QFeIIhaad proton,Area or a r<aapped Zane a of a public Water aapply wen) �- The owner or operator of any Bach system shall bring the system and facu'itp into fma eompiiaaoe with the dwater treatment Fxo� . requirements of 314 C`.M 5.00 and 6.00. Please consult the loll regional Office of the Department for 5x her=sormatinn-. (revised 11/a/45) 3 � i Y- SUBSURFACE SEWAGE DISPOSALPART B Y,9-r—"A t INSPECTION FOF—M CEECI=ST PragarsyAdaress pJj OLD YN enlJ�1U RL) Owner: Date of Inspection; Chess if.the fallowing have been done: { / and Boar_of'.-1th v P :aging^for^arion was requested of the owner, oc=pant, �Noas of the systsm mcponents have been pumped for at least two weeks and the aystem has' r Lei.of normal'low rstes I ®t =g._4pt I,irge wm lues of water have not been introduced intO the aystem nrzat.'y or as par.of thin iaapec_ca IJIA As built plans have been o'ot-ned and examined. Rote if they are not available vftth NlA `/ll ocher or dwelling«as izjj�--d for signs of sewage back-up. 4 The c zmm does receive non.==tary,or iadust:al waste flow _✓The site Wan izsp¢czd for signs of breakout ✓� m cotsposeata, estluding the Sail Ahs stem, orption Sy have been Io=ted on tee site. � N.A.The septic task xaahales were uaboves ed Opened,and the interior of the septic tank Ards s:spec�d fzr condition of ba.Mea or. depth of tees,matBrai of CO.as�uc"-:on,dimensions,depth of liquid.depth of siud�, atone. Tba sip and 1==:ion of the Soil Absorption System oa the site liar been determined basted as i�formatina os A),A. y� a?pY by zon-imtT=ive toethoas- ,. The acute owner(and owapaats. if differ from owner)were provide$With information an the proper ffiaiatetianc�of Soh° 3urLum Disposal S?etem - I 4 (revised 11/03195) ji f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYST&M INFO RMATIO N Property Addre= CJLL) y4--->OLfN Otaaer. Date ofIasoectioa FLOW CONDITIONS RF3I1)E*R'IAL Design now ¢allons Number of bedrooms Numbar of racidenta:_ Garbage•U'-_der(ym or ao) Laundry r^••-e-zd to cyrters(pet or naJ:—. Seasonal Qae(yes or ao t Water aeter readi--;s, if available: Last data of oorstaarr. C O mM ERCIAL/INDUSTRIAL TYPO of eatablishme (l/'r�zN J�S �D/ST21UTlJ} i Design tlow:��llorBrdap Grease trap preae=(yes or ao)�J 6 i Iadueuial Waste coldisg Tang present: (yes or ao) 6—jo Noa-can ary vasm&zchaxpa to the Title 5 ar==tyes or no Water meter rcadinrs if available- /Ql�3 n�il� i 2tG��7p5 a- r l{t lZ7I AJ5i�> �i (���t 2 CA.. t�i'2 ioLrl9G= La=t data of==p=cp Gu Last date of o=nes07 h1.R GENERAL INFORMATION PUMPING RECORDS and source of iaibr=ation: iQrC '!J1�K `r7� tj'rr?!�"iTXF'z� t-tf4z--P° bi ;Jc� Ti System puapea as part of=spa= : (yes or= LO If yes,eeinme P=P ��Iloaa Bantam for puapi=g: TYPE OF SYSTEM1 ti I Septic taale(dis:ratsiou b=Jzc l absorption system, I Singia e�coot I a�r�a�avzl Shared syiccem(yes or aol (if yes,aItach prious itrsoa records.if say) Other(esnlaia) v xl 2 £rr�S APPROXn4ATE AGE of all mmposeats,date installed(if known) and source of iafo�a oar Si1T z b� Sewage odors date—=ad when a-intg at the site:(yw or no) (revised 11103195) 5 STJBSLtRFACE SE7WAGE DIS PART SY9TEh4 INSPECTION FORM SYSTE'41. FoELVEATION (continued) tnrty aadr �S o,> P Yrr3 -:^v�'t r Date of IwpectiO= SEP C'PANK-X)0 a=te on site plan) v Depth b:,aUm G ~~ 4 er IGJG Mater of mr t_-c:ciaa _rancerzmetal so X athenezpiaiat ial Dime^^^"' G Qphm e 4en 6 7 Sludgy depth: /' Djaz z=:from tap of siudt3e to bottom of outlet is ar battle- S,7S y Disr=ca from top of sa m to tact of outlet tea or baffle:N Diorama from boom of scs to bar.,om of outlet cep or baffle: cala==ta (�,•-pmmcnr;�rrm for ptimpiag,gci;iit:aa afialet and out cees.99r' �'•es,depth aiignd Ievel is:�:acaa to antler invert,sue' ' iatag�:sy, �: evidence of ie ete.t Re cc M�, H .L P .. so 2SSOcs i r�7-�-va r H cui.5 N GREASE TR.APt /JCS as site place) . Depth balo- mew_e ltp a-.herEer�laial Mmt�ial"of massa�iaa:�concete— �- . Dimassaz� _ Di==ce from top of t:aum to top of outlet tea or bafIle Disraate fx=bottom of ism to bottom of outlet tes or hatlle Ccmme3t depth of Lq=d level relation to outlet invert.saw pttt� (.tea for,pt_ condition of irlm sad outlet tee or 6atZes, WU=c&of at ) I 5 Q3 9 3 . (revised 4 1 / f i ' u SUBSURFACE SEWAGE DISPOSAL SYSTEM lNs?ECTION FOELM PART C SYSTEM INFOFJAATION (continued) Property Addres& OReaer. f�(4 kLI L F{i c�r?�'F:i n•is,=tj Data of Inspection: TIGHT OR HOLDING TANK/� (lxasa on rite plan! Depth below pade:® b6aeertsl of o7asa�eron _anncem_metal OFcZP ?�ather(esplain) Capes®.11nrs Dip flow•osalonsiday AhAm level: Comments: ._ (condition of islet tee. condition of alar= and float roitehes.ece.) DISTRMtMON BOX; /A6J�i (Io=ta as size plan) Depth of liquid level above outlet invert:® Ccmm@n= (note if lave and dis�inu oa is equal.evidence of solids car ,ve or, evidence of lead into or out of box, etc-) PUMP (locate on site plea) pups in working order:(yes or not Camauaass (note condition of pump chamber,reaaitioa of p=pz and app=teaances, ese.) (Pg++ised 11103195) T. f I SUBSURFACE SE�IACE DISPOSAL SygTE.l4 INSPECTION FORM PART C SXSTZX INFORMATION (continued) Property Address ' O•urner l�l�tt'�t4.11'_ �ospa,�21�45�. ' Date of I=P®atiG.= 10/o9/9& SOIL�BgpgyPIOP7 SYSTEM (SAS):�J)J� (�v�IOW ti b aan•�a--.tsive methods) (locate oa�Plan,if poesinle:�cavarioa not requiz�ed.but map be appztixima 9 g If not datermiaad to ba Present, e:PL"n: le,mr:lag piss. atuaoer:� . laat:ia�r�amnmr8,aumoes� Iraac�ia$gaileriee ==ber•— " ����acaea,"atzmber.laas�:®— t.a^ fiaids. asmmber,duaensions: jova eessxool,msmber.—L S eQ b E(o-ul Cosmaara(aoto condition of soil Cif of hydraulic failure.level ai pondin$, condition ai vegetation eec) SPOOLS:v (locate as aita plan) Naubersad DsPth-top of to isletavesm sS3 @fir L DePth of m ids Tager. Gu o NDu 6' k 6.7. e��ev ✓� ^'F D aoth o£ m layer C Dp'SS of c�snool: ( (� � �C �0 7 materiz a of Consaro= I.,;;� of dwasar ,)ate .na) 4 G�S��OtJL 2 l5 LIV — iafloW(col must be pamped P$- t in�w '1t ��4 Evan a!'' S3l]C fa:'Itb�.le�l of ponoxag, =ditioa of legecad=ate b soil Kr .) boa of sg hgdra J� N2n^ ,.r r5 p t a 2 �' AZC 1�c C� p F uav5_ phii 1 W Pam: (locate oa eta Plan} Dimensions^ Btarialrw o{mast: fas7 .yevel of ponding.madit3aa of non etc.) Death of=Hdrs:® c°., ==ram(sore condition Of (revised 11/03/45) ' I SUBSURFACE SEWAGE_DISPOSAL SYSTF-M IPISPECTION FORM PART C SYSTEM INFORMATION (oontinued) Property Address: yAaj,,DUy-� P,�), ¢(t/a),))3)5 Owner. (�i4NL14;1T Date of Inspection: to/'�9 f9i` SKFF:I'CR OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' y' PtPL - . �,r'C.3sr�.7ruW5 SkuiTxtey I e> ss-S�CTt, l { - 33' G1:�35->iGl�3� ' 3..75 �� �ov,zFcnw� � i Ni� l9-1 Z. / we Tut l9- i t re M,.1 G w ?mkt i� G w TARuL DEPTH TO GROUNDWATER ATER Depth to groundwater: (9-� feet method of determination or approamatioa ��?+t SjU�I�5 � A�z, L4 A"T T LL-L u (revised 11/03/95) 9 • `z--g, �:y3�x'k' •:.'. �q ,. ..'s•�"" r"m-.xi-.*r--^S° , r � ,y -«r � ' , .c - r -� ..�,��z ��+,• �.�. " v�.. ;4r'," '�„� � _ `'-- m`a i"°ggam .% - i �„'� :•-4" ,�.,-u,.,��`-E.0:�.a9r�•ris�•, ._ r,. £'�� .S d".t '..f�'i.,�,. k - 'y %a'1k +f xv� •4°wsi{ry.&t'F.. 43` `.. "' ' ,.: 'd 4 �"v.4 -.w �-`" i �, r2y{.. s.¢ v�-s`t ', f fik =x .r+.-w �• h §� �..' `� a3 e£ .�•S�-'.� c rr -�- z h`a' -r ti.;•a..y�- � +s���-• .,���€«���' ,�.z r sl �3 �3'�' s� #z�.� �� '� r-`t �w�al. r k; s f�'�-k � ✓� S � ..T;tea• i '* x�*�"'..r�-' ' a. "S-' s .:�'"x `s v�� s }� �_ � k €.^.?., ? g• "• n JOHN A. D'ARPINO PRESIDENT LOUIS H. D'ARPINO VICE PRESIDENT/TREASURER ERRY R. MASEEIELD VI PRESIDENT PURCHASING January 12, 1993 JAN 5 1993 L-- Mr. Thomas A. McKean Health Department 367 Main Street Hyannis, MA 02601 RE: Old Yarmouth Road, Hyannis, MA 02601 Dear Mr. McKean: As per our;;p�ne�„conversation of Friday, January 8, 1993, I an writing thisIetter : in regards to the above captioned property j as I did previously on August 13, 1992. I am writing to confirm that from _1980 until the time that it ceased operations at this property, South. Shore Packing, Inc. processed fresh fish as well as fresh meats at this property. It is my understanding that, as a result of the prior use, the Board of Health will allow future use of this property (by a. purchaser or lessee) as a fish processing facility without the requirement of ,any further approval or permit from the Board of Health, _ I hope that this letter will satisfy the Board. This problem is causing me severe hardship.- I have already lost two potential . buyers for this property and now I have a possible tenant that I don't want to lose. Please let me hear from you as soon as possible. Thank you agaj_ for' your cooperation in this matter. z Very truly yours, i •��-LL`� i �,�.� tom? 4. Louis H. D'Arpino, Treasurer i South Shore Packing, Inc( . LHD:seed Manufacturer/Distributor of Food Service Products Since 1955. gg�- GUARANTEED FRESH PRODUCE Parce2 Noo 344=51 -85 OLD YARMOUTH ROAD 1C71 11 AhWE9 Mao AUGUST g 2003 REVISED ®CFTC®ER 89 2003 REVISED DECEbSER 229 2003 344-08-2 0 329-13 a&, r / 344-42 344-09 ,�O/329-14 344-43/ 344-44 34¢. « tijry / 41 329-03 � ` / 344-11 344-40 344-46 329-12 / /j/ 4��3 344-22 `44— s7 / / / "Irv,�! o'a, 344-39 329-11 �G GO A/ Sty 344-77 4 / -se , 329-09 /dry c �o �? J44-J8 ? -78-1 344, / Of Al •rB 1 329-03 / 344-79 / /� �j`� C/�s•�d 344-81 d 344-80-1 / 329-08 ComV smerclol 44-17 _ z A 344-k -18 344-80-2 329-04 329-07 " Industrial 329-05 VAT Commercial 344-38 �r a 329-06 -18 343-21 328-124 �S3 Industriol � Commercial 3 343-22 43-18 343-f9 328-118 328-125 ffil gas ,yh 343-23 328-126 0/ 328-127 328-142-1 OF Mgss 328- 328-142-2 .�� WILLIAM 9�y 234 JOSEPH N c MCGOVERN y No. 39692 ss\G�P�� ®WMW 07RBdORD SUAWM"I R��r > Tti!E1'PROP2�TlB8,IIViw�7 A16M I MA.d216 A1.4 4- j a DOS q� DRAWNDY A cant tsrr td,p�rsar..s � TERENCE J. 9 STMOBM&TAY��Evc IAU&SGBRPWO v CHASE Mcbeimm D'A 129QiAtNE1'ROAD �eet'fider ZZ zac3 CIVIL 2 CleeddoloorPin ri It41Webrlr8ttsat 981emb8t�eat Y,MA.dW1 8otb9 PAt8 tm P1 1dOf-711-0➢00 �� s�' 7,Zoc3 L�os� ^ No.37136 9:Dr�abpodQoadfUoorAm �rpByD li}i0a�et<ILm A" / V' tiw�r x 1� rm�raceme xa r SO" : In Ia0' aF�"s s7� � Byeet&Qm�mtlmDae�P>.a Job Na 66�7-1 0 :a stop oo roo SIB A` JY®b No.607--1 sNresr ae oCOto ER SHEET ROADRao= 3TEMBCK&TAYI.®1 INC. Iare PAa+t�I. Nui"me aw-sj _8abs9 P.Qbas� im Nay ."ANNIS, MA sw Am • sw D'k"m Rr 7f1 >� / F. 7 i r nrStA■�e '� (J ��16 S60'15'00-E CB fnd. Ngp 15-0 "W 85.00' u z CB fnd 33.44' �e4 PARCEL NO. �*�Ug 11f�4P PARCEL NO. 344-50 sm.»� 344-80-1 NOTPB �+ �' 111d1K PARCEL NO. 344-15-2 'o N CS fnd None S55'41'00-E NMrN ilYD 116.32 N55 f 41'00"W Iilt �' CB Dms PARCEL NO. 344-51 15.00 M fndm YAW , 32,717.91 S.F. AW i fe IOOD D IOMs®MN 11�NN<0 � � w� e AID A DpuDDYD r mwa 1D111M p w p I I / o- A �a�oaeiioapraa afar � ' i m�tDO�/{N,G M ft/N PARCEL 160 PARCEL NO. /I `l 344-80-2 1 IIIM�pllll� wD1D m ODIIO�D LEGAL DEBORIPT 1ON I JAm a t N ao I I eurae>ny s UID M m Ma We L+ o W At INI lA mmm mkt I�Np�a AID avwArNammom o +Ile A.,IDM CATCH BASIN Ji afNOD1 RIM EL. =4 92 _ \N l �rM1 Dr no ule ASSUMED �WWI � • �i lot W OVA f Nell`I�e R� SLAP 10'0110 " 9� • • t Area XPP PARCEL N0. 344-55 M 42.1 ` 1 ie V c^aase J 'n Ex�f Buttmp ' I r-a Ho as N D ;, office s sw PARCEL NO. *W f� 344-20 CB fnd 12.0■k CB fnd W) 10 �'► PARCEL N0. 'o a 343-21 OF Mgs�q P EL N0. 344-52 o= WILLIAM HOme JOSEPH N �• McGOVERN No. 30692 � �'�CFESSIO�P� � °p � f. SUR yv PARCEL NO. 344-53 v 100.00' JL ewD D 1N0�� N52'44'10-W d I-ot f - ML Melwllvw eli S/4ce.�e�a z1,ZGv3 3�5363 �, wager oe p --�.►• M Nee weoe �r /Gc N. It sY: �xWAL ZGG3 vs CS � 1p�8,00 OF aosaee wlDe ��'�� �,� �• N1 wa apt 1 TERENCE aawwal oaaaD ...�_ CHASE i . MMe uts CIVIL No.37136 u�vuv eeee a�ooee a aera t�A�uu ;& QMr� waDeNr1� }wr� Alp �� ISTEoomtb ��Q � year a�awm sfoNaL M>r wllee ---- ® NleeNe Mr aI■eK .�. ��.. �o WAIJ t 1• m 20' �— mun wee a Mr •o.- E)MNo 0ONWONS PLAN Reo De S7WS&X&TAI' A%INC SNW BE 00 YANAMI NW : oP a PA�M�. 3"-51 "'' '� Rq�eoe<edP l eeaeoft ,p0 N06 HY�ANNIS, W ���►j �mn�o >�.■ca..■�,r I ee47 Lou it SW O'Arpbo v ! rip.rr L � °F. p�0 r �66 M fJ < 3( m 'Nl S60'15'00"E CB fnd. "W N80'15' 85.00' CB /nd 33 44' LOCUS AAAP PARCEL N0. PARCEL NO. 344-50 ��.3p 344-80-1 NOTES nols=maim PARCEL NO. N ;r 344-15-2 A AM tM�1 r�lto M sr 2 CB fnd rY'ir>f110 MMl St,,,.Tarr , ` S55'41'007 N� mot' 116.32' N55'41'00'W Nir! CB DrA+e PARCEL NO. 344-51 15.00 fnd 32,717.91c S.F. law t i°K I u ANI 8'Ook 0 0M® AtN/ItWN tam 4,%MO A"l ABC �`°�;!�J'i ,a t N �� t 7 10-Oak a OI��Ntl�1mow A11�lYlpf IO 00' TAangle a7� AM PARCEL NO. an ! 344-16 -U - ftd - O 0rovel MIN!M M IS .1MIN mit eltA M N O � PO +^9 N . wwt1r ua� N to. PARCEL3444-8 -2 11YaY�R 7ff .�.-r�r-�■ � �hn M� •N i n 7. No Pa np N •� :fN110�M P.B.M. a 8 0 b on N•iNl• I! CATCH BASIN or Nl NM v 0 Nlld RM RIM EL. - 49.92 a 01WM r> uo�W= ASSUMED 4. PC a m 1 NG IM MIS I Metbllkr �C to rrw tnwota��.�ift�i�i � IaY ��(s 3• II Etl�p ' T-12.Oak 1f. ! day Z 0 Light Oil� t N 1 Ate, Aq� A 1� t0 +' IwmlwlO aNar..tf IIIOIM PARCEL NO. EOP _ /L.011f 344-55 tz N ��OOSMI 10 NCB 1�1 v WMMII�L � M ' 42 f a trtHM >o wwaNs M/r lwAte 1p raM>d t�Ar luaNs to 11FA&MM"JI 1NLL t ONOItM ON M N A o T3 area;* �3 ExiNoBut 8s n9 �! sf. klf R N in DO" ———— DO" m Office (� N 7 S PARCEL NO. *W 1 SIGN INC Turf 344-20 �,� CB fnd M 12-Oak M 0 PARCEL N0. CS fnd 104 343-21 M P EL NO. 344-52 Hausa a h � a h Z PARCEL NO. 344-53 100.00' zz,z N52'44'10"W End Lol 383 g.F 3.05p A P.C. ��f r 7, '� 3 (A OF 104 tom". vN 1088� W OF Mqs� TERENCE J. WILLIAM qcy � CHASE ° JOSEPH N CIVIL f-!CGOVERN 14,0•37136 Q i +,.o. 39692 IS7E -� k``� �, CFESS\0� S/ONAI '. I' ■ 2W D&aoprmD oONonmw PLAN Revllrld m S722M&X&TAYWX M. SNW PARKING AND TRAFFIC OLROLA ATION _ R Aa�iaod eac�NdLod 3 OF a 80 OW YARVOM N1 344�f p � roe M iffMN/S, WLOU SM DArpho ism > mam 1r}tto,asla i >rie o� 6 CB fnd. cmi �Cc1 S60'1.5'00"E . ' CB tnd N60'15'0 "W 55.00' apt IrOCUS MAP PARCEL NO. NOTES PARCEL NO. 344-50 sm.:. 344-80-1 f.ai�lfe Kars-• I" aofl � PARCEL.N0. N !IaMal fa7 Aaih 344-15-2 �o N to X� laral f11af01aQ � 4a S55'41'00 CB fnd afaraf r�a �' 2 �Stons. '� N5 1 001N iasr aaiot all CB � 16.32' PARCEL N0. 344-51 15�' N ld fnd 32,717.91 S.F. /! M,laaa Of10N llOat aaa.0• 0► � Isr K/aM ON RYIL AMC I Mf aaa10 pOm�Atal�tlf0al ! >WMW gfaaao N 4 "MW M MM Wooer A t W� W N-7ifa WIN mix w , 1? 0' DFWN40E N07M PARCEL N0. 4f Ltiffs 1 Ali ors N aatr st aaaR of ar aororaa ar uaua 344-16 Z3 Pl1d !aralre agar�aro a�r rw aa�r aoa� l ' r h !emu[ M Ial�r a MFWAW N w A'°O ® ` PARCEL N0. 41 A11r#po :ra a Ptfl ® \l 344-80-2 OWW MM oo�w a�Mawr a omw a mir aa� !ALL dws f0 a[Sao Pa 0.0 m141a � aD 9 CID IL awls as»Pal s> oar agora m��or� saoa fas soar P.B.M. aaor as N f u CATCH a4S/N i 1tb1�1 i 0 1�i10M!00 RIM EL = 49.92 �a�AM Pat 1� ASSUMED pim aft am/4N am������1a/.0! � . - 50. El. a 50.0 Plp�i IaIOl1N m f II17�1a1 rA� y � > \ 4 i --r—r-- \• g'n Existing o Addft PARCEL NO. :344-55 ^ EOP 1�Pb PL.OLf 1 \1 C M 42.1> . MM M zEAL B.ft 4 �[1 0 2-M IF N M. FL - Ul Wice S 18SP1'IH 4 . SSMMiHI t 1. PARCEL.No. —w urf 344-20 CS fnd t M 12'Oak !n rt 44 10 PARCEL NO. CB fnd M N ,ti 343-21 /� P EL No. 344-52 f G -v• ae ct.ti At,— Z Z .?vo j ►ems' f 7 avo3 .to ;, a °f o 00 g �F MgSJ, 2 PARCEL No. 344-53 y WILIIACri q�y JOSEPH N 2ig NcGOVERN yqj 100.00' No. 39692 J. ✓�LCzn_3`�z 22 ZGI� 0 h N5244'10*W 90FESS���P + l>�gP z�3 `W End I-ot S F �NfJ SURVEy� I 83 3.p50•� A�• OF SOIL tDATA � �Vktn °8 a oo^N c, 2 5a I vTERENCE J. CHASE CIVIL x ar s No,37136 4r w d ■aro ��_--- los, OGLE i 1' • 20' N PROPOSED GRADING AND Sl�Y DRAINAGE PLAN Rav aw ' ST A T.9I'd R,INC. 4 or 6 Kahl rAod6i�aml teaoiodl+adSsfeyoia' 84/WaErtrBtieef 9 8dert rae nIa i��NIS, MA i�a,it �°lawn ��0�1 ' Lou t SW D'Arphio 5 Fm X14074= a i �p 'h6 ` m �Dc16 S60'15'00"E CB fnd. � S s N60'15-0 -W g5.00' CB fnd � 33. PARCEL NO. Lam(fS MAP PARCEL NO. 344-50 sue,a,�� 344-80-1 NOTES o MNKM PARCEL NO. :r N Irt ! yrt'en 344-15-2 o wi elwera toe srel e01 A�ANe�el MeI[ 0'ero 2 CB fnd No w N� a 4e !Mt. gene S55'41'00� N55'41'00"W w m s s err. B Drive 116.32 PARCEL NO. 344-51 15.00, NOTES fnd 32,717.91 S.F. . 1.A�wW WU W NIIOt fo M MMIR eo1NeNM[Ae1 r� AMC AAI°elt 74�ir °hem p MA�e�rR 1u as emL e� t0 !=Al e�N AM l NL M M L W�� 8'Oak ZWM NOAM M J Ne<10 ella�mw mm A 1 Ier I MILL w new ap AN 1p WM OM 1�1RNNeNM l�M�I�rNAN/NONNNt � F 10'Oak Mangle Qms PARCEL NO. Pad 344-16ftridng v " N ° / Area PARCEL NO. 10. - �. 344-80-2 O ° o !9 I 7. d � No n . y oadWg P.B.M. on CATCH BASIN o B. Sly RIM EL. = 49.92 N e ASSUMED Inlet Rim 4. EI. a 50.0 Z y Many 3. r-12.Oak _ n Gravel rkin Am ught PARCEL NO. W Epp 344-55 42.1 Z260 S.F. so 0 Fin. FL a 54.1 bo •- N paved in D/Ive jp Office Q C4 1• NNN � PARCEL N0. wS0 1 SIGN r"f. 344-20 w CB fnd 12'oak in 44 10 PARCEL NO. CB fnd M I cv 343-21 bo P EL NO. 344-52 House o '^ 1� 00 o 2 PARCEL NO. 344-53 y to 100.00' 12 N52'44'10"W a; y. ���cc-,n3te zz z�� ■W End dot S f `'`"'c�. ✓�Ge.,�i Zz o?wj C'd. GLy 3U58Po' 5 �,��.�•�• � a � 3 � -s� boo OF. fEREF�C J `. CHASE WILLI km CA"If . JOSEPH n Neln-GOVERN n, 1691 PRO ®LANDSOAPINO PLAN Rffhi oe STENBBCK&TAYLOX INC. smw Sa OLD 1'AR110M ROAD hdmimd ftbm endLodftwm S OF a PAM WINA R S"I ANNeNwetrtr"S[met 9ale� .Are MCL PREPAREDFORI , MA ;; .: Fm1a141rM 1�i :e�eM sw Lou ! SW D'Arpba : i PARIONO SIGN DETAIL a11nr-nD.er.�rs RT-so ormt oar PaMp _ Ir x ItOWN - W �w sex mw mm out smm Pm 61 LONG (18AT//YT&='OA) PAB+im W%PFIMER MID YEILOW.'w GROUND b L} •}• JOOapai CG VtM FOMM PAINTED HANDICAPPED SYMBOL sTTO W PABPim a+ALL 4. q s b �. TYPICAL PARIONO SPACE DETAIL allow N.Ammmo " 7YPJCW LoaaWV SPaoe DOW , TREE PL NTIAIG DETAIL w 3 2•so.rwra►ooD OF SrAM Mgs�9 �r h Po/aRff" . WILLIAIv1 ma WRw TOMW eRNwC JOSEPH tiN r eAIM YULCN ON wEm eARR1ER FAevnc NCGOVERNm+ (naIR asIU S ti - RN AIIOFR tJo. 39692. J-FAR ~ — GP" S'0 �P� UNM BURLAP s ROLL eAd:1/3 `+ FESS10 �NlJ SUR`1Ey� TYpe I D9lall a• ,pDP s'"'oG : �w Edpw Sue GRIDS TACK COAT 1-1/2' TYPE-1 TOP COURSEAHT AT SW axrm As PrtEvpuSLr MINERAL FILLER 2-1/2' — BINDER TYPE-1 12 TWO PtANRNG 1mc HANIM oR Wma+•amow 12" — PROCESSED GRAVEL OR RECLAIMED PAVEMENT SHRUB PLAJVnAG DETAIL —C4�sn Sc2 Z2 2GG� _ - I M — NON FROST SU B i LJC:72.> L CAPE CODS VM�DETAIL _F C� TEREtCE J. +:arrtE Raw mu swat /a v C � � GRASS OR CI'�11VIL LANDSCAPE DECOUMA_ WpWL No. 7'� DRIVEWAY OR PARKING °• r roPSDr �.��,�: .1) �IACI COMM s�oRIDe TOP.COURSE 1 112" JEEI +� TAYPm PIANnW MW BINDER 3" . COMAWaww REMOW CONTAM u: o P 6' LOAM Pt�AT�im+m0°�i rt�a�w�01�r OONMUCTION DETAILS SNW ss OLD R W RevtNaoe :,�' S7mmBqK k JrAI wR,INC A OF $ PAID= NOW 34"1 ReAlk dProfiffbw Bggloe�,adLodSarPeyo,a !M We811ers"d 9 8�eat .Iae Na BARNP�Iffi MM FOR STALE, MA ii o>aso „ tow LOU it Sw D'A► m '` �= - ,� eaeexitl�iia+