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0029 PEONY LANE - Health
ri(29 Peony Lane Marstons Mills A= 043 —007 - Ol 3 tsmE A® No.2453LY UPC 12934 s�ruaad aom� * Mada In USA `srs ` `( / / TOWN OF BARNSTABLE e LOCATION 4G; /3 G oti SEWAGE # �L VILLAGE#/f'% cn ASSESSOR'S MAP 6T LOT INSTALLER'S NAME & PHONE NO. t�� ;� P��� c1,¢ 477-�7�T --G +�SEPTIC TANK CAPACITY �Da c LEACHING FACILITY:(type) ,' (size) 0 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �, � � �prt� � �' f�Uvf L �� 6 2s � �� �6 33 �S y7 r — Town of Barnstable Health Inspector �pFTHE roy, y Reg ulator Services Office Hours 8:30—9:30 Thomas F.Geiler,Director 3:30—4:30 lAMSrABLE. * Public Health Division 9 MASS. g �ArFc 39. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ANtNIS STY PRO RANI APPLD CANT.= SEPTIC Q. S,TiONNAI '. Date: March 13,2009 1. General Information: Size of Property: 0.31 Address: 29 PEONY LANE MARSTONS MILLS MA 02648 Map 043 Parcel 007-013 Name: FALCONIERI,DEBORAH Phone#: 508-420-0225 2a. How many bedrooms exist at your property now?4 Bedrooms 2b. Are you planning to add any bedrooms? If yes,how many? 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 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? YES or NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an ONSITE WELL or to 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. J Special Conditions: ,�;( � ,� '' CIS r wa SI.�(( ,n�,�� 0 (w�,,,o�fi doarS �. '�n a 3— r0,)M . Signe /M Date: -3 r0 '20iy Q:\GMD-Housmg\Accessory Affordable Apartment Program\ADMIN\FORMS&LETTERS\Blank Forms amnestyappl.DOC 7 SKETCH ADDENDUM File No. 6482470C Borrower Deborah Falconieri Property Address .29 Peony Lane Caty Marstons Mills county Barnstable state MA zip code02648 Lender/Client New England Merchants Corporation Address 1173 Mass Ave Arlington Heights Arlington Ma 02174 Fk- C � 10 ©5� i b --------------------------- S E P 2 3 RECT Wood Deck First Level By 36' Full Bath cl Kitchen Bedroom 26' bsmt� 24' st cl fp Living Room Family Room 16' 20' 36' Second Level qq Full Bath Master 17' Bedroom Bedroom 17' Q , CI CI strs CI 36' 3(-/ (n,aa,o door') R cob.:. , v 2. 5 scl le CLiI SKETCH CALCULATIONS Al Al : 36.0 x 24.0= 864.0 A2:20.0 x 2.0= 40.0 First Floor 904.0 1/ A3: 36.0 x 17.0= 612.0 A3 Second Floor 612.0 Total Living Area 1516.0 ClickFORMS Peal Estate Appraisal Software by Bradford and Robbins(800)622-8727 a SKETCH ADDENDUM File No. 648247OC Borrower Deborah Falconieri Property Address 29 Peony Lane city Marstons Mills county Barnstable State MA zip codeO2648 Lender/Client New England Merchants Corporation Address 1173 Mass Ave Arlington Heights Arlington Ma 02174 ----------------------------- Wood Deck First Level 36' Full cl Bath Bedroom Kitchen ci , 26' bsmt 24 � �LA AVdr,4 r1 stGo .V `� Y° Family Room P Living Room 16' 20' F 36' Second Level Full Bath Master 17 Bedroom Bedroom 17' . V2 U CI Cl strs CI r® r C- a �(� 3�� 1 U VA i 6?00�` A-1 2 5 SGt . v +> SKETCH CALCULATIONS Al Al :36.0 x 24.0= 864.0 A2:20.0 x 2.0= 40.0 First Floor 904.0 A3: 36.0 x 17.0= 612.0 A3 Second Floor 612.0 Total Living Area 1516.0 ClickFORMS Real Estate Appraisal Software by Bradford and Robbins(800)622-8727 TOWN OF BARNSTABLE LOCATION a9 .,�CPOAJy LAJ r SEWAGE # >1LLAGE rY11146 ASSESSOR'S MAP & LOT oy3-607-0/,7 INSTALLER'S NAME & PHONE NO. ,%�l.,6r� Fob SEPTIC TANK CAPACITY LEACHING FACILITY:(type) / / (size) NO. OF BEDROOMS zffF- PRIVAT LL OK-PUBLIC ATTE�Tj BUILDER O OW E G �� DATE PERMIT ISSUED: �/ , DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No l YA Hood i � I ...... .. ....... No.- - - Fps. . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Oar, AROVjo TOWN OF BARNSTABLE ' ,2 ppliration for Diripwml Wur1w C omitrurtt 9j = a vZ Application is hereby made for a Permit to Construct ( ) or Repair (�an Individual Sewage Disposal System at: ...... .......................�— �.........�..�.. ............................ .a. ..--------------------------...------------------------------------ ocntion-Address or Lot N P. �'L �ti �... P�..1.� /�Y9- -•------••--,�- ,. 1.4/cam_ c".-�����.�- .�-.---..... y .-cln a ���7 Clrsncr — ......................................J� n��!`.X� ._._. Installer Address d Type of Building Size Lot............................Sq. feet aDwelling— No. of Bedroo s ? �. .. .................___ p' ( )Showers ge Grinder ( ) aOther—Type of Building --- ____._.____ No. of personsnsion Attic (Ga>ba Cafeteria ( ) dOther fixtures ----------------------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. CY' Septic Tank—Liquid capacity tM.galIons Length................ Width................ Diameter................ Depth................ 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 tank ( ) `4 Percolation Test Results Performed by........................................................................... Date............ :...._...................... a ,� Test Pit No. I................mmutes 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........................ P4 .............................................-............................................................................................................... 0 Description of Soil.........................................-.............................................................................................................................x U --------------------•------•••--------•------•------•-•--------------------........------------•----------•---•-••--•-•-----••'•----------'-...•--------•-------....._.................................. Uw ------•-•-•-......--•.............•--------------•------------......------------------•----------------------••-------.......--...-•----------'-..... .................. Nature of Repairs or Alterations—Answer when applica e.____.._._.� ..__.__ � Q..... �� 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 undersigned further agrees not to place the system in operation until a Certificate of Compliant as en issu,d b the board of health. Signed ..... ... ......... ....... .. .. ................... .......... . .... ....... ....`� ... 9 / Due ApplicationApproved By ..:. _......-. .... ............... .a _ti. ..... .............. cc.................. . Application Disapproved for the following reafons: . ........................ .. ..................................... ............................�................. ................................................ �,,...,, ....... ... -- ... ...... - -------Y)...�... ......., � �„ � ....01...........ire. Permit No. t ... .�''............. Issued ...... .. ... . ..... .................... Dare ------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE - � (fertifirate d CITIIzti tianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�i) by .................... .. ... �...... .... -�T... Ins�I r ... ... ....- has been installed in accordance with the provisions of TITI,E-5 of The State ED3J onmental Code as described in the application for Disposal Works Construction Permit No. ..-..... `�-. dated ...... ........................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT 1BE CON""TR E S A GUARANTEE THAT THE _ SYSTEM WILL FUNCTIO S ISFACTORY. DATE............................ I V ....._... Inspector .. .. ..-� ...-�...... .-- u._.L ....�-. ... ... ..... . ................. _--- -•---- -------- ----- - - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CJIO8 - OU7 ()1 3 TOWN OF BARNSTABLE No...... FEE---•Jf- 0......... ,�r�� �>aai��� ilan �r�utit �.3a rG o.... C...-".S-1-------------------------------------- Permission is hereby granted........................... to Construct ( ) or Repair (Y-,-) an InAvidual Sewage Disposal System at No.... ./i r � _ / `� ......... i ✓lit 11`S ------. . .i .._._._ street -- ,� (� as shown on the application for Disposal Works ConstructiontIP�er)m�it _Nof.. .__.�D t dd.�...__1..�C ��_!.._.....J /� / ........................ Board of Hcaltl r _ .DATE-------------�__�..--•-•-----;----•----- -- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS _ Town of Barnstable Health Inspector F'94E Regulatory Services Office Hours g y 8:30—9:30 Q, Thomas F.Geiler,Director 3:30—4:30 BMW STABLE, i Public Health Division 9 Mass. 039. A�0 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax:, 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date:March 13,2009 1. General Information: Size of Property: 0.31 Address: 29 PEONY LANE MARSTONS MILLS MA 02648 Map 043 Parck-013 Name: FALCONIERI,DEBORAH A Phone#: 508-420-0225 2a. How many bedrooms exist at your property now?4 Bedrooms 2b. Are you planning to add any bedrooms? If yes,how many? 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 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? YES or NO If the dwelling is connected to public sewer, skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public su, fly wells? rr- 6. Is the dwellingconnected to an ONSITE WELL or to PUBLIC WA r� � 1 � d 7. Is a disposal works construction permit on file? YES 4or NO,. 8. If yes,how many bedrooms were approved according to this permit? Bedrooms.Q r�'fi�a 9. Were any building permits obtained for construction of additional bedrooms? YES or NO%A 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 ---------=--------------------------------------------------------------------------------------------------------- ' D FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: Q:\GMD-Housing\Accessory Affordable Apartment Program\ADM1N\FORMS&LETTERS\Blank Forms amnestyapp 1.DOC •• i�ni �� d . s Pam` PP(V jab �.� TOWN OF BARNSTABLE LOCATION :c SEWAGE # /'�}- IALLAGE - sY1/LG S ASSESSOR'S MAP & LOT 6$o. -602-U/f ' .j INSTALLER'S NAME & PHONE NO. ,(-iyt�tel1j Cd rj-s- e SEPTIC TANK CAPACITY /t5z)vo I LEACHING FACILITY:(type) A-, '% ,� (size �n ) NC). OF BEDROOMS PRIYT LL O PUBLIC ATE BUILDER O OWTVE , DATE PERMIT ISSUED: DATE. COMPLIANCE ISSUED: I VARIANCE GRANTED: Yes No�" �ed;J7' ra r d. t !_ :rF17.Fi �" l " a:.` .`.•fir m '� .._.._ '; ii itt c i t y _77777-77-7-7-7- i 1 j i t i ,i .i -... ,.., - ...... .t I a S • 4 . N >ussr- 7,7 I iw ae4 `rlEA��N l of I o014APDs' r 4J I' 1 cif. NI. C iI f I P ,GCC SETBAC,�° ••' � j� T .LAA1 •2E����.t/C'� 4O.C,g A10 7— lyiTy/.t/ Th/4' .�.Coar�,oG4/y, ,B,AXT,E 2 96 /NST'eUitlEic/T '4,{/. . �'• AEG/STE,eE'� ?�"'SS'E'T-S'�"h'vt�/�YSh�t�L� .. QSTE.2Y/.�•,Crr�a �l,4Ss.