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HomeMy WebLinkAbout0059 MIDDLE POND PATH - Health 59 MIDDLE-PONOTATH Marstons Millis 061''' 030 ; ell v '4 �r F *Town of Barnstable Health Inspector TME ours Regulatory Services office x f- 8:30-9:30 30 Thomas F.Geiler,Director .�P ®PI -� 3:30 4:30 BARNSPABLE, Public Health Division MASS. 9 i659 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 . Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date:June 1,2012 1. General Information: Size of Property 1.12 acre Address: 59 Middle Pond Path Marston Mills,MA 02648 Map 061 Parcel 030 L Ia�7C�1��YYIC In T Name:Arthur J.Torino Phone#: 508-420-8910 3 l� �uSc P e v(oI U S( yVict2a. How many bedrooms exist at your property now? .4 ( — r-f-me lrtt fZ�Yrt t l JV hv�onf 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 1 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an Public Water? 7. Is a disposal works construction permit on file? YES or NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ---------------------------------------------------------------------------------------------------=--------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Si _ Date: Z IZ .�' I f 7 0 { ! f I pp 4 .. ,,__,...I i f 77 .., .I - , .,i... [ i I J ! 1 ALA oil f � i tC t ;1 ! _ i. ! d # 1 I. i J t i f j �' J - 1 •�' I:.,. f . t s { Ems... ., . i , r..., m7 ter. # J I 4' � + i t ' t t i J { f j iiS ATI ) t ! i t ; i I I gg t # I Vo nj ! Pk F J'. t 9 t _ • � i I I � � f 1 # i _ ! .... �.. 1-7-7 _.. ;w f t , I. �. a �� ��!'�, •� , , � i r� l-�6 .� �#f� I\i�� ,..Y�`�..�''. f t ? f � TITII ' *, ICI � L i 1 / • TPA O -/ ` ME � 7 r a I I I I i I Hk 13665 Pg9O #19430 03-26-2001 @ 01 : 35p DEED RESTRICTION WHEREAS, Art Torino,of 59 Middle Pond Path, Marstons Mills, MA is the owner of 59 A /ly9 AiPTNv X ?'Ol�ii�o Middle Pond Path, Marstons Mills and being shown on a plan entitled "Subdivision of Land-in Barnstable, MA, Property of Art Torino duly recorded in Barnstable County Registry of Deeds in Plan Book�d 0,3 ,page -52 WHEREAS, Art Torino, as owner of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a variance from the 310 CMR 15.214 State Environment Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage and to obtaining a building permit for this lot: WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting the variance from 310 CMR 15.214, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this lot is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, NOW, THEREFORE, Art Torino does hereby place the following restriction on his above referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. 59 Middle Pond Path, Marstons Mills, MA may have constructed upon the lot a house containing no more than four (4) bedrooms. Art Torino agrees that this shall be permanent deed restriction affecting 59 Middle Pond Path located on Marstons Mills, MA and being shown on the plan recorded in Plan Book Paged_ For title of Art Torino see the following deed: Book_Mb A Page 1+ 77 Exec d as a sealed instrument this 26th day of March of Two-thousand One. 1 S�AgLE DEEDS .3 - l gpRN IM OF �ESZ Art Torino Date uEGOpY;A ` 'TERMTRY OF --------------------------------------- ----------------- .............. ----------------------- � N --------------------------------- U 2'� z ,I Mt� FIRST FLOOR PLAN ILLJ o P.T.BLOCKING 3/1'TtG COX PLYWOOD oa K D.C. Fa 1/1'LEXA�CLEAR PANEL 2 X I F.T.NAILER 1W O.C. ryy GENERAL REQUIREMENTS: PITCH 1/4 OVER Oo. I ALL ..R— ARE.TO FA.OP—.11.RUCATE.—R.. 2 X 2 TOP RAILS AT 12*O.C. x"P.T. 2. EXTERIOR HUERG SHALL Of 2 A I CON57-01 It—M—RETEDI LIALL IR— I—L EE I.I LOrvSTRI.CTOn—ElIS ALL E..ILODI ALL 6-4 E—L OR I A.I E—l—E. ..—El ROTED. 6 NIL.POLY VAPOR BARRIER 1 11 1 RAILS AT 12'O.C. ALL I'TIFA VLO4l`=bTT`0U'4!T—­E­ITA'E—,,.A�CODE—o"A.E IL am W-- CIA DRELLM COO-E ALL I Cd,,A I ALL�—ARE BKDEI lAleRI—SkAlL—T�EXCEED RECO—ED M—IRY X 8 CFZ035 BEANS —.ARDS FEACI A I—E 6'BATT INSULATION R-19 RE—ONS S.E—R TO OTHER GR-EOl A 'ART 0'1"'.1 IOA""DEIA"'CIETO,T—Tl _—OiNG BUROR RI EE— DETECTOR —E EE,. p T;. E ITT A' A Rl E R."A.M^ ­ I—IA INTO I AR, RE D RE Ar PROCEN—01 T-1.1E.OLD 11 �D .... E'BOXED OUT P05T ALL�TI�1,1' TRELLIS g'117 SMILE DETECTOR C. E U, 5(5 KAI DET­OR EIR Ell—D—REINSTALLED EllTI"l—1 2 FLOOR INFILL DETAIL le TRELLIS DETAIL SCALE:1-1/2' =1'-0" L fey 0 SCALE:3/4' 1'-0' OF� I / ( TOWN OF BARNSTABLE LOCATION ./ a; eliW1 SEWAGE # VILLAGE 4<5'2 a—1 4 l��` ASSESSOR'S/MAP & LOT INSTALLER'S NAME&PHONE NO. On SEPTIC TANK CAPACITY LEACHING FACILITY: (type) - (size) NO.OF BEDROOMS_ ,BUILDER OR OWNER PERMITDATE: `ai= ' "� COMPLIANCE DATE: j-30 AP-7 Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 > iJ 6�sV ?��- � � •< r to a THE COMMONWEALTH OF MASSACHUSETTS FEiR BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Biupuutti Mor1w Towitrurtiutt ramit Application is�heyL, de fo�r'a P�n�o Construct (V) or Repair ( ) an Individual Sewage Disposal System at• � /�!^-o f'-J oc -Addre r Lot No. O ner �jJ/� Address f ......•.. ....... Installer Address U Type of Building �./ Size Lot----51Z_0 ....Sq. feet Dwelling— No. of Bedroom's,_/___.__._.-Z________________________________Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type of Building U 4&. _FL44P!.,(_No. of persons....................._..__. Showers ( ) — Cafeteria ( ) W Design Flow-Other fixtures l �____gallons per por tl per day. Total daily flow.:..__ (�____________________..gallons. WSeptic Tank—Liquid capacity-0U 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 area..................sq. ft. Z Other Distribution box ( ) Dosing tan ) ~' Percolation Test Results Performed by.......... ... -_ _........1�_____.___._ ._ ._.. Date----.�2-.-.._1_^.... Test Pit No. 1....a ___ ...minutes per inch Depth of Test Pit ............ --...... Depth to ground water_ -.... 44 Test Pit No. 2................minutes per inch Depth of Test Pit--------------------- Depth to ground water.. .. �+ --------------------------- O Description of Soil......... •• ••--- f'v ------------------------------------ U .............................................. ••••-••--•••-•----•-•-••••--•-•••••••-•------•--••...•--•---•-----------------------------•••-••-- W -- ---------------------------------------------••---------------------•---•--------------------------•-----...----------•------------•------------•--•----••-•-••--•--•--•......•-••••--•-----•---•••- UNature 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 TITLE°5 of the State Environmental Code—The undersig ed further agrees not to place the system in operation until a Certificate of Com as bee issued ley th and of health. Signed.----- -- - --- Dace Application.Approved By .._...... - � K'" ------------ -----------------------.�.t' '`�- ........------------------------------------ Dace Application Disapproved for the following rearonf: . .............................. ................................ . . ---------------------------------------------------------------------- ---------------------------------------------------------------------------- ----------------------------------------- ---------------------------------------- Dace PermitNo. ............�.` ---- -5 J S-------------- Issued --------------------------------......--------------------------- Dare L �� TOWN OF BARNSTABLE LOCATION SEWAGE # 257-3 J� VILLAGE,& <��9/ ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE N0. 2 SEPTIC TANK CAPACITY LEACHING.FACII.TTY: (type) 1 (size) NO.OF BEDROOMS BUILDER:OR OWNE IbXL. __ Q!h PERMITD:ATE.: ::�� -COMPLIANCE DATE: / rlcti - "7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility. Feet Private Water.Supply Well and Leaching Facility (If any wells exist on site ormithin 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 3:00 feet of leaching facility) Feet Furnished by 00,17 �� ( �j} 1 No.. ........... Fss.............................. _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ` Appliration for Diij-pagal lVorlai ( omitrurtion ramit Application is 1P here made for �a P �6to Construct ( V/) or Repair ( ) an Individual Sewage Disposal ; System at: .... ... ..---•-... .. ..................................... ...................................................... oclli�ow.,Ad.lrQ. 1 r LotNo:--------------- ----- ------------------ -••• ---------- __._.__--------.er Address a --�• ........................ ............•-----•_ ?.� ...................... •---• J------ Installer Address ec�� U Type of Building Size Lot____ !_e__��._._Sq. feet Dwelling— No, of Bedrooms___________________________ ___________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures _______________________________ _ _ W Design Flow..........................11P......... per p444n per day. Total daily flow.......�q0........................gallons. WSeptic Tank—Liquid capacity./3UU_galIons Length________________ Width---------------- Diameter................ Depth______________-- x Disposal Trench— No_ ____________________ Width..._................ Total Length.................... Total leaching area....................sq. ft. 3 Seepage,Pit No-------- ----------- Diameter-------------------- Depth below inlet.................... Total leaching area......._..........sgrft. z Other Distribution box ( ) Dosing tank2( ) '~ Percolation Test Results Performed by---------- ---------- Date.....l Z �..................... aTest Pit No. I---- _._.minutes per inch Depth of Test Pit____________________ Depth to ground water....._ _... (14 Test Pit1No. 2................minutes per inch Depth of Test Pit..................... Depth to/ground water.........�-��_- lx " ------------- -4..--•--••----•--•------•--.._...-•-------•---•-------------............................................................... D Description of Soil �/ Q�l ^ x _- -•••--•---•-7-- _ _l_? ____________________________-------------------------------------------------------------------------•---•-•----•--- U ...........................................................................-•-----•-•--------•---------•-••------...-•----••------------------•--•-••--•-••--------•--•-....._•--•-----•-••--•-•--•--•- W UNature 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 TITLE 5 of the State Environmental Code—The undersigpped further agrees not to place the system in operation until a Certificate of Com� as bee issued �.y/thn bard of health. Signed .-- -- -- - --. .............. .... : ... Dare i Application.Approved By ........... J ..'t'I,."'' ............................. --------- ------------------------------------ Da e %5- Application Disapproved for the following reasons: . - - ..............._.-...... ............_-.-......-.......... ..--_...-.......-....... P :?..--..-....------.---......................_-.--.....e.�........----...----------'---'--.........---.....------........-.......-----------------------.....-..-.........-........_........... ........................................ Dace Permit No- ------------- -_-.-------- - Issued Dace 4� --._--z-_-. -,�-o» -.�.-..-.�..��.,-..,-,.-.�.,4.o....,e—..�:�—..v�._...�—..�.-..,-.--..-.——�...::—-..a�...�.—_.->--... -a---- - �-.a-_ - _u-vs a•._rars•.� - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�Pz#ifir�x#E of C�nmpItttr><ce H�IS, 0 CE �­, That the Individual Sewage Dis sal S s em constructed (V ) or Repaired ( ) g P Y P by -------- ....... -- - hT� � f ���f•.. �--�-- r --o-------__-------------------------------------------.-- at _....-.- -.}` _-.._3 - --------- y1 - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. -..-���C".--:, -.1���_-..-._..--_ ` dated .............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNC ON SATIN CTORY. DATE----- ----- -... - .. Inspector --- .... - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE NO......��--—✓,1� FEE....b�--.0......... �i��nstt1 I�r�� �la�a��tr irr �rrutit Permission i f hereby granted......- `' ---- - ------- to Construct ,v) or Repair ( �)r an Individual Sewage DisposalSystem, .$�!' /'�7/00 P pot .... Street p as shown on the application for Disposal Works Construction Permit No._!_ 'Jy Dated____________________________!-._..._.... ....................•----------------------------------------------------------------------------------- Board of Health DATE-------------------------------•------•--•----------------•-------------------- FORM 36508 HOBBS&WARREN,INC.,PUBLISHERS r o L° / T �) �_.._ _� "— '�• --- $�� :tip—�� 6PAv 0P - PST. 9 ss,DOO i \ Per L o 7- -?. : �LpvIi F? � 3Z3 To vu fH I C &r �i►�1s1A GRnp� LIU .P a .; tUv•Cc�.O ►AEU.• v e ! Ate. -5-)9UcT'v v.� P�Ts + '.' �A D 5�►fp, W c r a SCr• (AO� T?-A -J 4-' .}Z� I/4 A L IZ 'oa Eh vG STOW (i(/�Q 4 y pvcC SG �,4� LC- . .._ A t b U Pt _r_ L 2 ►-�1►n l.� tiG Design Data Single Family - bedroom ._.. _.._.__.__.. No disposal, Daily Flow = 4-xll0=.Q1I,6GPD. Septic tank = Al.5=660 gal. Use /:CYS gallon septic .,tank. DisposaL _ Use 2-6x6 leach pits - ----- w/1' of stone. Bottoms = too sf @: !i /�., 1.0 GIs.f. = 1.�� G/D. Sides /A� C.-1-�- v s.f. @ 2.5 GIs.f = 7�% G/D. =65a Tr - ilk AAl I certify the proposed dwelling ,t+ c conforms to the sideline and setback / w�CUAM ti� � ( �� !�L S MA requirements of the.Town of Barnstable C. and is�not located��in the .f loodplain. v i +� Y E Professional:..L�urveyor Date Z41 c�A-1760 s �4569 c-N 7-0 i oxj o r � N s TA l3tc-- d, s S, M A)e5 I' 0 t L �iU Ca/ti G5 STD° L4.6�'