HomeMy WebLinkAbout0055 BRIARWOOD AVENUE - Health 55 BRIARWOOD AVE
HYANNIS
A= 289 - 086
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David N. Solomont
55 Briarwood Ave.
Hyannis, MA
P.O. Box 617
Hyannisport, MA 02647
617-694-5452
September 4, 2020
Town of Barnstable Board of Health
200 Main St.
Hyannis, MA 02601
Re: 55 Briarwood Ave.; Hyannis
Bedroom Determination
Request to be heard at Sept. 22,2020 Board of Health meeting
Per instructions, attached please find the following:
1) Variance Request Form for informational purposes only since no variance is
requested. (one page)
2) The previously submitted home sketch and affidavit now notarized attesting that
the home has 4 bedrooms and has had 4 bedrooms since my 1985 purchase. (two
pages)
3) Original MLS listing(fax paper copy, sorry)per the agency brokers involved
(James E. Murphy, Inc. and Kevin O'Neil Real Estate)and copy from pre-
purchase home inspection,both showing the home to be 4 bedrooms. (3pages)
4) Information from the property lookup tab on the town website for your
convenience. (three pages)
5) Email trail explaining my predicament. (four pages)
After 35 years I am contemplating at some point a transfer of the home to one of my
children or perhaps selling it on the open market; I need clarification to avoid
complications. Having purchased my home as a 4 bedroom and lived in it as a 4
bedroom all these years,reason would suggest that I should be able to call it a 4 bedroom.
Thank you for your consideration,
David N. Solomont
? _ DATE: 9 a av��
$95.00 FEE*:
> NAM AB Town of Barnstable
s"p, p�� REC.BY:
Board of Health SCHED.DATE: 601D
200 Main Street,Hyannis MA 02601
Office: 508-862-4644 '.
John T.Norman'
FAX: 508-790-6304 Donald A.Guadapoli,M.D.
Paul J.Cann$D.M.D.
F.P.(Thomas)Lee,Alternate
V_ARIANCE REQUEST FORM
LOCATION
Property Address: � ,.. fl iS
Assessor's Map and Parcel Number. =14Fb _Size of Lot:
Wetlands Within 300 Ft. Business Name:
Subdivision Name:
APPLICANT'S NAME: DCQv j Cl �l 61tajiD�17` Phone % •l �y.�
Did the owner of the property authorize you to represent or her? Yes No
PROPERTY OWNER'S NAME CONTACT N
`PPERSO/ f
Name: aQ y r e/ s p/D M D 17 /. Name: Da,Ui Gl \�o`/4dn o h
a r Ck.hwJCQI Jr
Address: Address: 80 a' G7!7 /yYU A,4;s A0.-
Phone: Phone:
EMAIL: �' A U COM
VARIANCE FROM REGULATION gnci Reg.code#) REASON FOR VARIANCE Way attach separate sheet if more space needed)
d4aaa, doleerm na6OA
ct ' uc e and. Eros,
NATURE OF WORK: House Addition U House Renovation U Repair of Failed Septic System
C/{ (to be completed by office staff person receiving variance request application)
Please submitJira four on No as S collated packets.
_ A. Five(5)copies of the completed variance request form
B. Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an UA system or
secondary treatment unit(S.T.U.).
_ C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email:
health town.bamstable.ma.us *(Pool Plan—5 hard copies)
D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic
version.
A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S.
Signed letter stating that the property or business owner authorized you to represent him/her for this request
Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or
local sewage regulation variances only).
Full menu—Five(5)copies of full menu submitted(for grease trap variance.requests only).
Fee Submitted*$95.00.for the following variances: 1)New construction, 2) Septic repairs with increase in flows,and 3)New
owner/new lesser applying for food, pool or body art variances. $xen10ons from Variance Fee: i)Septic repair hou an
increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a."variance").
_ Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED John T.Norman
NOT APPROVED Donald A.GuadapolL M.D.
REASON FOR DISAPPROVAL Paul J.CamuM D.M.D.
C:\Users\David\Downloads\VARIREQ Rev APR 4-2018.docx
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AFFIDAVIT OF DAVID N. SOLOMONT
(55 Briarwood Ave., Hyannis)
1, David N. Soiomont of 55 Briarwood Ave; Hyannis, MA, attest to the following:
1) That 55 Briarwood Ave. contains four bedrooms.
2) That it was advertised and sold to me in 1985 as a four bedroom home.
3) That other than minor handicapped accessibility measures, no alterations beyond
upkeep and repair have occurred during my ownership.
4) That I have in my records a copy of the original 1985 MLS listing as well as the
1985 report by Cape and Islands Home Inspection Service completed prior to my
purchase, both stating the home to have four bedrooms.
I affirm that the foregoing statements are true.
September 2, 2020
David N. Solomont
TERESA A.MACE
Notary Public
F Massachusetts
My Commission Expires
Jul 29,2027
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CAPE AND ISLANDS HOME INSPECTIOa SERVICE
P.O. BOX 664
WEST HYANNISPORT, MA 02672
1-800-462-8215
n .�
CONFIDENTIAL INSPECTION REPORT
PREPARED FOR:
CLIENT David Solomont
PROPERTY LOCATION . Briarwood Road
CITY Hyannis STATE MA ,
INSPECTOR Frank Capra
DATE OF INSPECTION February 25, 1985
STYLE OF DWELLING Cape
AGE OF DWELLING 10+ years old
WEATHER CONDITIONS AT TIME OF INSPECTION clear
w. '
CAPE & ISLANDS HOME INSPECTION SERVICE
"ON SITE INDIVIDUAL .SEWERAGE DISPOSAL SYSTEM"
All determination on design and size of system are* at best an estimate,
based upon the information conveyed to inspector at time of inspection.
# of bedrooms 4 Garbage Disposal no
# of bathrooms 2 Dishwasher yes
Laundry Tub no
Washing Machine Hook-up _ yes
Cast Iron Waste Line no PVC
Evidence of Previous Backups no
Butterfly or Baffle in Basement no clean out only.
N/A Yes No
Clean out on exterior f
Evidence of sewage
level round at seepage
( g )
Septic cleanout at
finished
grade
Size of tank (if known)
Septic (gallon)
Cesspool No.
Tank pumped within
last year
� 1 i
Repairs on system
Date
Type of repairs
COMMENTS: Tank should be cleaned and serviced.
Note: All sewerage disposal covers should be at ground level for easy
maintenance and pumping. System should be pumped out at 18-24
month intervals.
f
8/13/2020 Property Print
Print this.page
Owner Information
Map/Block/Lot:289/086/
Property Address
55 BRIARWOOD AVENUE
Village: Hyannis
Town Sewer At Address:No
GIS Zoning Value: RB
Owner Name as of 1/1/19:
SOLOMONT,DAVID N TR
P0 BOX 617
HYANNIS PORT,MA. 02647
Co-Owner Name
FIFTY FIVE BRIARWOOD RD REALTY TRST
Assessed Values
Appraised Value Assessed Value
Building Value $ 193,600 $ 193,600 j
Extra Features $ 23,200 $ 23,200
Outbuildings $ 2,400 $2,400
Land Value $ 121,400 $ 1219400
Totals $340,600 $340,600
Past Comparisons
2019-$315,000 kfiwl
2018-$ 300,500
IN
2017-$292,200
2016-$293,100 £"
2015- $288,200
" 2014-$274,000 ;>
2013 -$279,200
2012-$275,900 =v`
h
2011 - $273,900 `
2010-$275,500
Tax Information
Hyannis FD Tax(Commercial) $0
Hyannis FD Tax(Residential) $ 1,008.18
httpslt wvw.town.bamstable.ma.us/Departments/Assessing/Property_Values/print 20.asp?ap=o&searchparcel=289086&pdnt=true 1/3
8/13/2020 Property Print
Community Preservation Act Tag $ 66.47
Town Tax (Commercial) $ 0
Town Tag(Residential) $ 2,215.81
$V90.46
Residential Exemption Received=$104,121
Sales History.
Owner: Sale Date Book/Page: Sale Price:
SOLOMONT, DAVID N TR 2005-06-13 19930/45 $1
SOLOMONT,DAVID N 1985-04-15 4487/47 $94000
BOURQUE,DAVID B &LINDA A 1984-01-15 4000/29 $75000
COLLINS,ELIZABETH A 1978-06-13 2726/253 $0
Photos
Sketch
As Built Cards:Click card#to view: Car �
B2N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only
https:/twww.town.bamstable.ma.us/Departments/AssessingIProperty_Valuestprint 2o.asp?ap=O&searchpane1=289086&print-Ime 2/3
8/13/2020 Property Print
SAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium
BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished) SPE Pool Enclosure
BRN Barn GAR Garage TQS Three Quarters Story(Finished)
CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished)
CLIP Loading Platform GRN Greenhouse UHS Half Story(Unfinished)
FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished)
FCP Carport KEN Kennel UTQ Three Quarters Story(Unfinished)
FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic
FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story(Unfinished)
FOP Open or Screened in Porch PRT Portico WDK Wood Deck
PTO Patio
Construction Details
Building Details Land
Building value $ 193,600 Bedrooms 3 Bedrooms USE CODE 1010
Replacement Cost $251,419 Bathrooms 2 Full-0 Half Lot Size(Acres) 0.29
Model Residential Total Rooms 7 Rooms Appraised Value $ 121,400
Style Cape Cod Heat Fuel Gas Assessed Value $ 121,400
Grade Average Heat Type Hot Water
Year Built 1976 AC Type None
Effective depreciation 23 Interior Floors CarpetHardwood
Stories 13/4 Stories Interior Walls Drywall
Living Area sq/ft 1,670 Exterior Walls Wood Shingle
Gross Area sq/ft 3,058 Roof Structure Gable/Hip
Roof Cover Asph/F GIs/Cmp
Outbuildings and Extra Features
Code Description Units/SQ ft Appraised Value Assessed Value
WDCK Wood Decking 214 $2,400 $2,400
w/railings
BMT Basement-Unfinished . 888 $ 18,800 $ 18,800
FPL2 Fireplace 1.5 stories 1 $4,400 $4,400
httpsJ/www.town.bamstable.ma.usIDepartments/Assessing/Property_Values/prinI 20.asp?ap=O&searchparcol=289086&print=true 3/3
9/2/2020 55 Brianaood Avenue,Hyannis
From: sharon.crocker@town.bamstabie.ma.us,
To: dnsnhs18@aol.c:om,
Cc: Marybeth.McKenzie@town.bamstable.ma.us,
Subject: 55 Bdarwood Avenue,Hyannis
Date:Tu 1 1:e,Sep ,2020 05 pm
Attachments: VARIREQ Rev APR 4-2018.docx(36K)
David Solomont 617-694-5452
Hello David Solomont,
Marybeth McKenzie and Thomas McKean have asked me to reach out to you and let you know you will
need to go before the Board of Health for a determination on your bedroom count.
The procedure is as follows:
Mail in or email a letter to the Board of Health,200 Main Street,Hyannis,MA 20601, asking to be
placed on the next agenda for a bedroom determination.
We will need five copies of this letter,along with five copies of any backup you feel is pertinent to your
case(i.e.,any affidavits and evidence you may have,any building permits which might help your case,
and five copies of floor plans. Please collate so that we will have five individual backups to include in
the Board's packages prior to their meeting.
The next meeting is Tuesday, September 22, 2020 at 3pm done through a zoom meeting—online.
The cut-off date for submissions is Tuesday September 8,2020. There is no fee attached to a bedroom
determination.
Thank you.
Sharon Crocker
Sharon Crocker
Office Manager
Town of Barnstable Health
httpsJ/mail.sol.com/webmaii-std/en-us/PrintMessage 1/2
9/1/2020 RE:55 Briarwood Ave Hyannis
From: Thomas.McKean@town.bamstable.ma.us,
To: dnsnhsl8@aol.com,
Subject: RE:55 Bdarwood Ave Hyannis
Date: Mon,Aug 24,2020 4:25 pm
Hi,
Please provide the Health Division a neatly drawn sketch of the rooms in the home, showing doorways and size
dimensions of the bedrooms. Also,please a written affidavit describing the total number of bedrooms contained within
the home and the earliest date that you observed said number of bedrooms in this home.
This information will be reviewed by Health Inspector 1VMarybeth McKenzie. Then you will be notified how to proceed
forward. .
Sincerely,
Thomas McKean
From:dnsnhsl8@aol.com[mailto:dnsnhsl8@aol.comJ
Sent:Monday,August 24,2020 3:02 PM
To:McKean,Thomas
Subject:Re:55 Briarwood Ave Hyannis
Good afternoon,Mr.McKean,and thank you for your response. I did in fact try to reach Ms McKenzie and was refereed back to the
Health office which referred me to you.
Regarding the layout sketches,the best ones are still the"as built"(1976)sketches from the Property Lookup tab on the town web site.
The house has not been altered since my purchase in 1985;at that time it was actually listed by the MLS brokers and seller as a 4
bedroom,a fact which I have discovered since my 8/13 email to Ms McKenzie below,having found copies of the original listing.
There are two fast floor bedrooms and full bath;and the"finished 3/4 second floor"contained the second full bath plus two bedrooms,
quite common for a cape style house as I understand. I'd be happy to take photos if that is helpful. Again,I understand and do not
disagree with Ms McKenzie's response but am wondering if I do not have some further recourse.
Your guidance would be appreciated.
David Solomont
httpsJ/mail.aol.com/webmaii-std/en-us/PdntMessage 114
9/112020 RE:55 Briarwood Ave Hyannis
617-694-5452
-Oxiginal Message—
From:McKean,Thomas<rhomas.McKean@town.bamstable.ma.us>
To:'dnsnhsl8@aol.coiW<dnsnhsl8@aol.com>
Sent:Mon,Aug 24,2020 1:24 pm
Subject:RE:55 Briarwood Ave Hyannis
Good Afternoon,
Will you please provide us with a sketch of the current layout of the bedrooms in this home?
....I 1——1-1-11................ ....... ...........
From:McKean,Thomas On Behalf Of Health
Sent:Monday,August 24,2020 1:09 PM
To:'dnsnhsl8@aol.coiW
Cc:McKenzie,Marybeth
Subject:55 Briarwood Ave Hyannis
Good Afternoon,
You request was assigned to Health Inspector Marybeth McKenzie,R.S. After she researched your question(s),I see that
she provided a response to your question(s)in a timely manner. She indicated this property is limited to two bedrooms
maximum per the disposal works construction permit that was issued,due to the size of the property,and due to its
location within a State designated Zone 11. This site is limited to two(2)bedrooms maximum per the State Environmental
Code,Title V.
The 1986 year reference that you referred to in your e-mail is for town.designated zones only;not properties located within
a State designated Zone 11.
If you should have any additional questions,please contact Health Inspector Marybeth McKenzie at 508 862-4649.
Sincerely,
Thomas McKean
From:dnsnhsl8@aol.com(mailtodnsnhsl8@aol.com)
Sent:Friday,August 21,2020 10:50 AM
To:Health
Subject:Attn:Tom McKean/Fwd:55 Briarwood Ave-Hyannis
Good morning,Mr.McKean,
I left you a voicemail early this week,and not having heard back from you I phoned the office again. They suggested I email you at
this email address and explain my reasons for trying to reach you,which are outlined below. I'd much appreciate a response,phone or
email,and if you are not the person to whom.I should be speaking,just please let me know.
Thank you,
David Solomont
617-694-5452
https://mall.aol.comANebmail-std/en-w/PfintMessage 2/4
9/1/2020 RE:55 Briarwood Ave Hyannis
---Original Message----
From:dnsnhsl8@aol.com
To:Mmybeth.McKenzie@town.bamstable.ma.us<Marybeth.McKenzie@town.bamstable.ma.us>
Sent:Thu,Aug 13,20201.1.47 am
Subject:Re:55 Briarwood Ave-Hyannis
Good morning,Marybeth,and thank you for getting back to me;but I'm afraid I have more questions than when I began. When I
purchased the property in 1985 it was MLS listed and sold to me as a 3 bedroom. In addition the town construction details show it
built as a 3 bedroom in 1976. Have the standards so changed that what I bought as a 3 bedroom can only be sold as a 2 bedroom?
Have I been paying taxes for 35 years on a 3 bedroom when I should have been paying taxes on a 2 bedroom? The Bedroom
Definition file you attached says something about construction prior to 1986,so would I be grandfathered? I know you are quite busy,
but I could really use some further clarification.
Thanks again for your help,
David Solomont
----Original Message----
From:McKenzie,Marybeth<Marybeth.McKenzie@town.barnstable.ma.us>
To:'dnsnhsl8@aol.com'<dnsnhsl8@aol.com>
Sent:Wed,Aug 12,2020 4:02 pm
Subject:RE:55 Briarwood Ave-Hyannis
Hello,
So the building department did not have much.The health department has,on file,a 2 bedroom septic permit.Your
property is in both the State zone and the Town Ordinance regulation of wastewater discharge zone.It is not in the
estuaries.Due to your lot size, .29,you will be limited to a 2 bedroom.You would need.73 of an acre to go to a 3
bedroom.I am attaching the information to resolve the bedroom count.Please feel free to contact the office,If you have
any questions.Thank you.
From:dnsnhsl8@aol.com[mailto:dnsnhsl8@aol.com]
Sent:Monday,August 10,202010:43 AM
To:McKenzie,Marybeth
Subject:Fwd:55 Briarwood Ave-Hyannis
Good morning again! Hope I didn't mess up your email address that the office gave me. Could you either phone or email?
Thanks,
David Solomont
617-694-5452
---Original Message----
To:muybeth.nickenzip-@Lmbamstable.ma.us< ybeth mckenzie cl�r town.barnstable:ma.us>
Sent:Fri,Aug 7,2020 10:32 am
Subject:55 Briarwood Ave-Hyannis
Good morning,Mary Beth,just a reminder you were going to phone me yesterday after digging into the records per our conversation
last week.
Thanks,
David Solomont
https://mail.aol.com/webmaii-std/en-ustPrintMessage 3/4
McKenzie, Marybeth
From: McKenzie, Marybeth
Sent: Wednesday, August 12, 2020 4:02 PM
To: 'dnsnhsl8@aol.com'
Subject: RE: 55 Briarwood Ave - Hyannis
Attachments: Bedrooms Options for Recitification.doc; Bedroom Definitionand Bed roomCount-
2010-01.doc
Hello,
So the building department did not have much.The health department has, on file, a 2 bedroom septic permit.Your
property is in both the State zone and the Town Ordinance regulation of wastewater discharge zone. It is not in the
estuaries. Due to your lot size, .29,you will be limited to a 2 bedroom.You would need .75 of an acre to go to a 3
bedroom. I am attaching the information to resolve the bedroom count. Please feel free to contact the office, If you
have any questions.Thank you.
From: dnsnhsl8Caaaol.com [mailto:dnsnhsl8(&aol.com]
Sent: Monday, August 10, 2020 10:43 AM
To: McKenzie, Marybeth
Subject: Fwd: 55 Briarwood Ave - Hyannis
Good morning again! Hope I didn't mess up your email address that the office gave me. Could you either phone or
email?
Thanks,
David Solomont
617-694-5452
-----Ori Original Message-----
9
To: marybeth.mckenzie(a�town.barnstable.ma.us <marybeth.mckenzie o),town.barn stable.ma.us>
Sent: Fri, Aug 7, 2020 10:32 am
Subject: 55 Briarwood Ave - Hyannis
Good morning, Mary Beth,just a reminder you were going to phone me yesterday after digging into the records per our
conversation last week.
Thanks,
David Solomont
617 694 5452
CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open
attachments or reply, unless you recognize the sender's email address and know the content is safe!
i
OtC A T ION SEWAGE PERMIT NO.
VILLAGE
1NSTA LLER'S NAME V ADDRESS
B UI'LDE R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
q Appliration -for Dispuiittl Works Towitrnrtinn Vaulit
Application is hereb 'ade for a P mit to Construct ( ) or Repair ( } an Individual Sewage Disposal
Systprn : •5- � `'
-- --------------------------------------------------- ---------------------------------------- .............................-----------------�-d---------- - --------------------
Location-Address or Lot
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d Type of Building — / Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms....__:/ Expansion Attic ( �� Garbage Grinder�-+
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures -------------------------------------------------
W Design Flow........... d.................... ..gallons per person per day. Total daily flow......................._................----gallons.
Septic Tank—Liquid capacity _gallons Length---------------- Width................ Diameter---------------- Depth................
xDisposal Trench—No..................... Width-------------------- Total Length.................... Total leaching area---------------------sq. ft.
Seepage Pit No........�_-_____- Diameter____________________ Depth below inlet.................... Total leaching area-------.-__----_-sq. ft.
z Other Distribution box A) Dosing tank ( )
aPercolation Test Results Performed by-------------------------------------------------------------------------- Date..................--------------------..
Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water--------._--_-_--_.-__--
(� Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water_..__._--__--_.--.--___.
P4 ----•-•-------------------- ----------------------•--....--------------..........---•--•._....------.....................................................
0 Description of Soil------ ----- ----------------------r----------------------�-
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U Nature of Repairs or Alterations—Answer when applicable._-----------------------------------------------------------------------------------------------
--------------------------------------------------------------••---•-------•--------------•-----------------•---------------•-----•-•--•------------•---•--•-----------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article \I of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has oeeei isi ue/dythe oardof�healthSigned__'" ' _ ` s i.�r. ��%S— ' 7
Date
)I -..Application Approved By------------ - ......... ............................................... --------•- --------------//7.!�
Date
Application Disapproved for the following reasons:-----•-----------------•-•-•-•--=•-------------••-------------•-•-•---------.._.....--------...-----......----•-
-----------•.------•----•--------------------------------
Date
PermitNo......................................................... Issued-----_-----------------------------------------•--•--
- Date
- `u_.� .----------
Ali ........................ Fs$..........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ ... _.... ......OF...................................I. .......I........I..................
................
Appliration -fur Uiipuiittl Works Totuarurtion rrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Syst t: /�
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------•-----------•-•----•---•-------••-••-----'-•--------------------------••--••..-- -------••---------••-•-•---•••--•-•---••------- ..---�------------------......------•-------
/// Location-Address �/,� ! /or Lot Ny°.
.......... .. . /�lic..� .. .....-•---•-•-------•-----•-•------------------•--•-----•- .................................� ( ` 1 �./i_e..._- fbra.......!.1:
W / Owner ,/�� f Address
L G/ G ( ll/ //i%� r�i
------ -•----•- �. ---- .... /
� Installer / Address
Q Type of Building Size Lot----------------------------Sq. feet
Dwelling—No. of Bedrooms-------------------------------------------Expansion Attic Garbage Grinder ( )
per, Other—.Type of Building No. of p Showers ( ) — Cafeteria ( )
a
Other fixtures -------...................---------------------------------------------------------------------------------------------------------------------------
W Design Flow-------------<, U._____.._...._...--__--gallons per pel•son per day. Total daily flow..........................................._gallons.
WSeptic Tank—Liquid capacity/'U .gallons Length---------------- Width................ Diameter................ Depth....__._-------
x Disposal Trench—No -------------------- Width-------------------- Total Length........_........... Total leaching area....................sq. ft.
Seepage Pit No.-..—___-�________ Diameter.................... Depth below inlet-------------------- Total leaching are.------------------ ft.
Z Other Distribution box (n) Dosing tank ( )
aPercolation Test Results Performed by------------___........................................................ Date----------------------------------------
Test Pit No. L_______________minutes per inch Depth of Test Pit-------------------- Depth to ground water....----_-----.--.--._.
f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-----.-.-_---_-.--__-._.
fYi ----------------------------------------------------------------------•---------•-----------•--------------------
•------------•-----------------------------
ODescription of Soil-------------- ------------------------------------------------------------ --------------------------------------------------------------
W
VNature of Repairs or Alterations—Answer when applicable-------------------...............--------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed_ .Ile
! �
3------------------------------------------------------
✓f Date
Application Approved By________________- c - ` 'Date
Application Disapproved for the following reasons----- -------------------•-------•---------------------.-.---------------------------------------------•-•-------
-------------•------------------------------------------------•-•-•---------------------
-----------------
Date
PermitNo......................................................... Issued........................................................
Date
1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
/,
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oF......>�....L%............... ...... .... -..............
..........................
G.rrtif iratr of Oontpliatta
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by......`...................-
j �. Installer , ,
i
has been installed in accordance with the provisions of Article XI of The State SanitaryI-Code as described in the
application for Disposal Works Construction Permit No------------- _.._�_______________ dated_----------'. ___---11 ------ ..........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.............. ---------- ......./.., Inspector
----cFa7IA!!��—-------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OFs ........................................................
No.......................... FEE........................
�i��u�ttl_ urk,� �utt�trttrtiutt rriatit
Permission is hereby granted-------------�__._.._ , �=
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to Construct (' ) or Repair ( �) an Individual Sewage Disposal System
at No.
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Street
as shown on the application for Disposal Works Construction Permit No..___:_____---__-__- Dated.....:'-__-:_- -7/__........
------------------ .................................................................................
-
Board of Health
DATE...............................................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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R FT fox . • a • • ff
° ° o EFFECTIVE. . °° 3/4� t I/2`
. DEPTH WASHED STONE
° of . ® o • • o . . PRECAST SEEPAGE
° ° " • 0 o f PIT OR, EQUIV.
VERT jo ELEVATIONS 6 FT DIA• l
INVf. AT BUILDING ��� FT. 10 FT. DIA. �C (SEE TABULATION)
INLET SEPTIC TALK FT
OUTLET SEPTIC TANK _Sr- FT. GROUND WATER TABLE
SECTION OF
tn7! T DISTRIBUTION taoX T. SEWAGE DISPOSAL SYSTEM
T DISTRI13UTION BOX 9 6"V, FT SCALE 1/4 /=O
SAWT SEEPAGE PIT 5- / FT. TABULATION"
DIMENSION A FT
DESIGN CRITERIA DIMENSION ® ��s FT
NUMBER OF BEDROOMS '2' DIMENSION C 1� -FT A4� %+
` GARBAGE DI�SPOSAt.FLNV:UNIT
TOTAL ESTIMATED ��GAL./DAY r SOIL - LOG_ SOIL TEST
.. -
' NU OF SEEPAGE PITS / ELEVATION DATE OF SOIL. TEST
SIDELEACHING PER PIT %1$8 SQ FT.•. '�� 0 RESULTS W ITNE�SSIED BY
BOTTOM LEACHING .PER PIT 79SO. FT. 1� ® �� PERCOLATION RATE`S-_;; MIN/INCH
TOTAL LEACHING AREA ESQ. FT
RESERVE LEACHING. AREA 1 4 SO. FT.
}ate V� ROBERT
BRUCE
ELDREDC�E
ELDMiZ ENGIKERING CC1. IIVC,
33 NO �=8'1Gr. T� MAIN ST
Ili. ¢FEET .OI'�,
Assessor's map and lot* number .... .1...:....( �. stp fC ✓, g
M p.4USr _
L
' � '`°' (( r � //• �s` 74 v;9`l i•°tL l_;=1) ;r� CCir'JlPLIgNCt
Sewage Permit number .......................................................... SAivs'�' !1 Si .A..
T
�►�Y COD. E ,
� �4' " E AIVD TOWN,
4HEt TOWN OF
TIARNST11
�Y bE
B9BH9TdDLS, i
QED tlPY a'
�C[ r "'•cfv�"l
APPLICATIONFOR PERMIT TO ........ ....L.......................................................................................................
TYPEOF CONSTRUCTION .........1r:�.....................................................................................................................
..........................l� .�......19 .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereb applies for a p mi according to the following ' for nation:
�l�l�t �(/ Gia .............. ..... .Q...............LI J/ ���.............................................................
Location
............. .... . .... ...........
fProposed Use ..... .........................................................................W.............................................................
Zoning District ....... .......... ............ ...............................Fire Distract .......... ,/4/V/!!.l ........... ........................
Name of Owner . /. ........................Address s� `� S�
....... . .. ..
Address ...c..��`` �—
Name of Builder ................G�.cQ/C- f ........../......................................................
/f
Name of Architect . ..........................Address ....j .......e2G..G
....... .... . ........ ........................................
` W e '�`L}t�L e_
Numberof Ro ms . ............ ...................................................Foundation .... ....... .
.. .... .Exterior ...... .................................................................Roofing ..,���....... ...... .. ....................................................
PFloors .. .. ............... ...............................................................Interior ....................................................................................
Go""� ,/
Heating ,y/ .........................................................................Plumbing .......".........................................................................
Fireplace / Approximate. Cost ....................................................�b
.f�..............................................................
..
Definitive Plan Approved by Planning Board _________________________ ----19--------. Area ........................�..•.••• ....•�
Diagram of Lot and Building with Dimensions Fee ......... .#. ...••••.••••
SUBJECT TO APPROVAL-OF-BOARD OF-HEALTH_ _
i I�
III
c
I hereby agree to conform to all the Rules and Regulations of the Town f Bainstabler arding the above
construction.
Name
u
Q Ir� 11
r,
'
i r
aj 4100 .
'l
r
, :
1. lury
o
�^ F
h
-. �.
v
:.t aft;" g�
A
kf.
�. ,
:A, r C�RT'IFBEb": ,: PINT PLAN : .
41,
I' ��. C ��ST UCTIOB� OB��Y
kL
TGR-`GF FOUNDATION AS,_. FEET
ABOVE LOAN POINT OF f ADJAcEN' x D
-LOAD. r ,
SC�►IE _DATE �o�J
(F
�� a ,
f�f D 8E `ENGINEERI NG rCO.°off I CERTIFY THAT THE ���-,�`�.;�8�ti
CLIENT `" -- S"QWW,, 0N. THIS PLAN:,"IS' LOCATED:
n ' t2ECISTERED RE®ISTER D
CIVIL LAND
ON ,THE ,ROUND AS INDICATED AND
CONFORMS TO THE 'ZONIN LA1fllS
rlNG1��EER SURVEYOR DR.'�Y= OF ®AtdNSTASLE, MASS.
CH.®Y'
33 NCB MAIN ST " 712 MAIM S.T.'
SCE 'YARMOU.TH',WAS HYA.NNIS,-t,,.ASS. SHEET J OF LAND SURV,EYOI :`'
ATE REO:
11