Loading...
HomeMy WebLinkAbout0565 WHISTLEBERRY DRIVE - Health f 565 WhistleberrY Drive Marstons'Mills A. 061.. 045: �I I� �i �,-• j , ' Bk 16632 P981 437100 03-26-2003 a'1 11 :28a SAMPLE To be used as a Guideline NOTICE: The Town of Barnstable recommends that the applicant seek legal advice to prepare a properly worded deed restriction document. DEED RESTRICTION WHEREAS, IZr b,,s Sk i of (owner's name) (address) is the owner of 5�5 �h;sTih SfN6� 1= located (address) O at MA (hereinafter referred to as s(,� W (, (i2rc�, Dy-)_ks N"P"Tor", m��1s AAA and being shown on a plan entitled "Subdivision of Land in 'Ak\s MA, Propertyof2o��� k Shy � rr�trAmI, et al, duly recorded in Barnstable County Registry of Deeds in Plan Book �� ,Page Or on Land Court Plan Number WHEREAS, 2abeJ i Chea;i C-' rnm,iA as the owner of said lot-has (owner's name) 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 disposal works construction permifln compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compiance with 310 CMR 15.200, 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 property, 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, deed- ,STOWN OF BARNSTABLE Y (�0 V,5,e NLOCATIO1.6 �pq '(� ,� q SEWAGE VILLAGE ILUL i ASSESSOR'S MAP & LOT 0�01�® 1 LI S •; ' \INSTALLER'S NAI & PHONE NO.��� � SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ; (size) NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATER L BUILDER OR OWNS `DATE PERMIT ISSUED:DATE . CO3IPLIANCE ISSUED: VARIANCE GRANTED: Yes Noy\ L All THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -----.....ro a..........OF......... 6'.i�l�" � -�- ..,�. A411I iratiun for Biupuual Works Tonstrnrttun Perm* it -flloApplication is hereby made for a Permit to Construct (VS or Repair ( ) an Individual Sewage Disposal System at: ......... Location-Address •- or Lot No . . ...... OtE - . k� 4.. ri-r4 i A------------ - n Address �/ a ..... .. ± ±d......__.... Installer Address .................... Type of Building Size Lot..._112tA!-Sq—€eet ►-+ Dwelling—No. of Bedrooms........... ...........................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building a Other—Type g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ......................... Design Flow...................... 5�'5..............gallons per person per day. Total daYy flow...................... .....................gallon !! W Septic Tank—Liquid capacity/Q�Ca.gallons Length.- ..�_._ Width.-4 V Diameter................ Depth.,5,A-.; x Disposal Trench—No..................... Width.................... Total Length.................. Total leaching area....................sq. ft. 3 Seepage Pit No.........1..._.__.. Diameter Depth below inlet_.__. Total leaching area_ ._ &4/„9, Other Distribution box (&,I- Dosing tank ( ) Percolation Test Results Performed by......LAA1r�-�Y•- S�S'CyC:I/-}?�` Date....-.7J 110(Q_...__..... Test Pit No. L,2,,...._..minutes per inch Depth of Test Pit.____/. __ Depth to ground water.�Yv _. fsa Test Pit No. 2................minutes per inch Depth of Test Pit----- ........ Depth to ground water_.AJ0J9,;d0 PG ----•---------- -----------------------------•--------•---------------------.............------......................................................... O Description of Soil...!?_JT _�.. -_ P �- :�.. V ................................••--------•------....--•---------.....--------------���%5. � �0_...sS' 1�Y vz3: /�- R.. 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 upXJWions of iIT:s, of the State Sanitary Code— The undersigned further agrees not to place the system in o ratio u t> C sate Compliance n issued by the board of health. ------------------- ---------_ ------------D..-----•---- App ' pprove Y r ...................................................... -•-- �_' . ..� .... Application Disapproved for the following reasons:..................... `.... D e ...-•..................................................•-•---•••-•-----------...... _.._...------------------•-...---------....-----•-•-------•-------------•-•---•-------••-----•---•--••----------- ^ Date PermitNo.................................1.1_ ... .---- Issued.....................................................- Date Noll_-•1? d Fs�_T-� THE COMMONWEALTH OF MASSACHUSETTS a =•'BOARD OF HEALTH 4 ...........OF rlirtttiian for Disposttl Works TonstrurtiuAi ramit Application is hereby made for a Permit to Construct ( V or Repair ( ) an Individual Sewage Disposal System at: ' ................------__....... _......................... r�?tZY �?�, � s t .:........... --.....:....... Location-Address -- or Lot No. ��---• f�� t - .. -IIer` Address �-- W (. 7r ,.a .............................................. } ....................... •-----•-•--••-•-••--••••......•----•-•-•---------- Installer Address Type of Building Size Lot.... sq.-feet �-+ Dwelling—No. of Bedrooms............ .............................Expansion Attic ( ) Garbage Grinder ( ) W Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a d Other fixtures ------------------ - W Design Flow.....................:•�-4.............gallons per person per day. Total daily flow_____......_.. _......_._...._gallons. WSeptic Tank—Liquid*capacity/04.0.gallons Length_.P_ 6... Width..':q_1.10' Diameter................ Depth.i:_� Il x Disposal Trench—'No..................... Width.................... Total Length..... Total leaching area....................sq. ft. 3 Seepage Pit No---------/......... Diameter.........J040"Depth helow inlet..... _ -�`.�. Total leaching area.=::��._---2�---�..sq=ft.GAw. Other Distribution box (&o'5_ Dosing tank ( ) Percolation Test Results ' Performed by......�-A itl7 SKY ti Ssc C°,✓r�!T S Date....... � % ---•....... x. ` •_. Test Pit No. 1...-2..._':minutes per inch Depth of Test Pit _--k5 /__.__ Depth to ground water.......G±t G4 Test Pit No. 2...............minutes per inch Depth of Test Pit.................... Depth to ground water..&0.•N a.Q ---------•- --------------------•-------•-------•---------•-- ------------------------- M Description of Soil....Pi:rj .Z.. 'D ���.....Fn.�':=. ? C1A, ' x V .-----------•---•---••----------------•----•-•------------------- .- .U. . ,��9i1/c�`l. S iJS'©/2- -------------------------------------------------- _ 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 pro dons of:ITii P 5 of the State Sanitary Code— The undersigned further agrees not to place the system in o ation u ti C �' sate Compliance issued by the board of health. Signed .:....... ... .... ..... P PPro .... .k.. APved`BY-=- - � � '-.......•..........---------------•------•-••------•-----�-� -------�'1 ��a�e�-�-��---- Da6 Applicafioii Disapproved'for therf og,6wtng reasons:------•--------------------..................................................................................... LI, ........... / k r Permit No....:.. '� .. .__��-: - Issued .nau..... r Date r� 1 r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH oF...... ITt .L....47........................... (ffrrtifira#r of Tomplitturr THIS IS TO CERTIFY That e Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................••-•••• -�'!~�• tr� 0: 1 ....... -_... Installer I• at..............`- .C7,............w1�_a1__!�S_ <��.:: j '��� ----------------------•------ has been installed in accordance with the provisions of S,of The State Sanitary Code as described in the application for Disposal Works Construction Permit No____________ &1....J'7?.2 dated_......���1...-���_��ra........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................-1--....2.�• .......................... Inspector............ ............................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH "/22c% ........--VOW(N...........OF....................C.R. ........ �..._.............. 4 FEE......y... Disposal Works Tonsfr ion"Vern it Permission is hereby granted.......... �1__1G-.... ------•--------------------•-------------------•------•----...-•••................. to Construct ( ) or Repa•r ( ) an Iud'uirival Scarage Disposal Syst .._.. street as shown on the application for Disposal Works Construction Permit No._�--------r.-_?V D�1ted�_`._ ._h`�����?�?_........ _ --------- ------ --=�=------------- y DATE. i�C I �j C�" 130.Lrd of i rilth.... .. ,.-t r v - •. ::..... . ...r- to - ... 1 .•.. ,a.. _.- ..r. '..: .... ,. r_ .. _ S a..h.. .�.....,.,.r.. OE•S !G!�l : - t ,SIIlGLE FAMILY Dwr-LL//VG wl B�RoaMs� Q. GARBAGE D IS P0, A L 12D DAILY FLOW = l l O x G. Pr D. { T.aNx < VOL . P\,C- ) ` I►o . !' G.!? D , x l.5 4°°5_ GALS. 2.0-00 GAL . TANK.- 0,4<, — FIN,FUK,r:L goo•o DIES POSA L-P/ T 100 USE w_ DIA. x f]P. E FFF-C71 VLP 1DF-P-r N CAP'T Y : Ir x -ZO x _ ' . :.7 TOTA L CAPACIT `(, GALS. 16 0 I.' Q L' 0 1 aD BO (oD 4CQ p ' . t 'FROFILE A_ A %b FIN. FLOOR S !T'E PL A N EL. Lo_o_4 TE sT PI 7s 0 PLE02 T,fs r- �AsSUNiEDI t SCALE : VI = ' FIN.GR.F-L. °.6.0.__ - . .. - - - - TOP-or✓WA7L- ri. - - � �G 'S?n5 P.ISERvECDED LOTE IR.4 PVC "=-0- A ' P.CConeCELLAR I OMlN — D I S Po�A L Pt T ► V EL` - SEPTICi<l �zc AND :- TANK � W � I o� '.3! n d I -2�-r� �t z 2Nc�ryliNr SEWAGE DISPOSAL SYSTEM rJESIGN I c- .q�E F o R-20�MrN. ,� WASS F-b STO N E F ;Z 61 z I TO UL� 4 S VA EK I CA7A N I A ALL ARODNID W�2 '';, SCALE LAYr-R Pc AS rQ Nc NO RZ. I�� = 10' r-L. ado I _.._._.�.r do cr0 T t l I T, .r A. O 2 ��I �o ON TOP. �� VE Rt. l"= 4 ('t o N LOT I o9 NN VA 12)T-L IST LESEY : I PR O F i Ll: bF-` U I S PQ SA L_ SY S_T E M -C>Ph Pv11 LLS NIA _ _ r L A NTERY A S SD C. No7E : ❑ ISPpSAL �YQTEM TO BC- GON3-rRUCTEb IN STRICT ��•o_ r10 � Nc� N20 J,o CCORbAN0, nV (;I�MM . OF (`�AS.�. k. hIV1R0 �; F CONSULT, E"nlfl E.SANd, MA , I`I, GobE TITL_�. It . TESTED:�17.1n I- ., DATE ; ------------ .w x .,:, . •F -.. a4 ,. do nx- :trn,• �, u. .use. o,. .•,. ,. ,.k,. , ,.... .. '. _ .... ..tip. :.uY�! ..,.: , - , r, a. x :$' ,z y� ..1 ...k .. ,c ..•r� `1.` . N�'+, i' SUBJECT TO APPROVAL N dTES BARNSTABLE CONSERVATION, ` l• Su 2V�Y DATA, if, STA Ks5 C3Y K\1\lb5 B�)RY sUrLVEYNr� 5'.SAND•, MA. OT".�,9 -PLAN c�r LAN D C_K-rl r LE I> " \0 4.\sT Ljq F tF+2 Y Sc�S�D1\J• ,PLAN 04F LAND !ti[. Mk1Iz.SToNs MiC14, B�l2h/STAI!, , AAA, , DATED N a ov 198�° 12EcraRbED i� '• IN PLA/U. F_Zook 349, PA6553 TW2oUGH 63. D"rY G .4. } .. x'•u. ,},. I. ,.-). ,1.. a iB�.F a. F' LCUT . r F .1 t , ` < �.. ` { ire + r-sr'tALI AN 'fir .� � s 3: 1 r\ �••� � ;:FI� •����4 V eaURY ` — 0 0 i c is \ l H wj ,.. � \ *, SCWAGE iD ISPOS�L`S Y.�TEP✓Z��pE5lfsN k'F Fd2 Fln E):F_RT 1 SW-- Kl C P\7 P\\A l A -7 3 M 1 CN-ELLE Ail E- L 15 IT F PLA .` L_ T. -7 O COT 0 7-/ M A • 0 Zlo35 . -- ► tj L DT 9 %VkJWb STL.F__5E9jR_Y LP- �t W M I STLE-E>F 2Y . a ` YYI A IZST�NS M 1 L(_S; hIA. tI _ LANTEI2Y ASSOC, COINS•O LT E)V(-.'/ E_. SA IVh r, Nt fl- K_ : «, .. m, n, �ti • rr �r d-yry � 3�r` +F charrgtte 14 �.r r T fQ $l0 PfD 5TO 2A(,ti ta-Or a 9 r) STEEL Aeu WrNDoa c13 $fNIrIS rr�y* > -•/D�' at 9 1. ��."�'F�.. t�JgC- City' �/•�' c +� � ra srre+��«a� V I 4 � .w'rFF . S�AT�� {l lrN 1 b C1f z w« x ' ".'.;,:• NEcd 70 Df Q M b _ _ •.�tr N« ,'�.� 9 - r "x°`" CITE o0 Exr�T Ivr r7ooJ•tjTAVS - / _ f )T r�.LAfL f-rA2N F_ Y..'.�' ..�a+r#c, I 2 ✓ :?,,0 4.'._1 _,ira'�x...- - ^ex�} "`..aie^,*°" "`FYI 3 : - 7 � rr+g�� � ' r{X � �"F�CT' 4 �� ,� ���P7N`ma mow' a�-,*..• •r Q x u a M A(& ` � x qLT • d � k .�w,aoo,� �? ,gl F � � e STe o - � �• � � ,I 7�" '�' �� � � a n�31-1. CW d'f W �xb 8 GIS J 9X`ON. 6A2 00A wl 9 $)rDRrlAjoAty ot/ite 1 Y x� t� � r~ 3_ r•7-�"-fir' lT 10 C✓•4°�!DE p rr u rr n q ,,,T" 1 Co 4'm ro 3- r S 9= r ' is o = a yF� * '. ' a/ a Gs 2a�1' � 02 AiA nl GALE �/�a!-O" a�" 1 � ,.M +� 4 `�,.r'�."!?r= � r$.' �' L�.,•,,,.re ,„r„ "w,"t,"". „,. . xf• ,r,,, ....rti. p A *rT' m � _ fi O ip 1 r-----------------------—' FAMILY ROOM S 8T� � PANTRY 35'�r• fl,��° 4 IL ' - i re•. Cli IIBATHi i /BATH PINING AREA ®® s O4 KITCHEN ® ® TWO GAR GARAGE ram• t+• � � 4 ' b 4 r;• t� , vr------------------- --------------------, ' BEDROOM ? 4 LIVING Room r Q Yd f6° 6'A' 9'f°° 5'.9' 2'6' S'-0' 4'6' b'-b• r o. - MO. 24'O' 7-0' 21'•O' TY-0' F-XISTINCs FIRST FLOOR PLAN PAG S .C 1 , 1 1 . 1 1 , 1 , 1 1 1 1 1 1 1 1 1 1 1 � 1 1 1 1 1 , I LL I I i I � 1 1 1 1 1 1 1 1 4r-O 1 , 1 , 1 4 - ---------------------------------------------------------------=-------- Cl ' BATH 1 1 1 , 1 , 1 3 1 --- J 1 ROOF Yi BEDROOM 02 d i.y NEW .Q OFFICE _ s� � � te• ' l ------------------------ 1 1 - ------------------- ---------------------------------------------------- j r.• ----------------------------------- F-- - ------------------------------------------------ - EXISTING SECOND FLOOR PLAN t r .