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HomeMy WebLinkAbout0023 TROTTINGBRED LANE - Health 23 Trottingbred Lane W. Barnstable A = 152 054 ._ ip {I i7 fl i RECEIPT Printed: June 13, 2016 @ 15:25:19 i BARNSTABLE COUNTY REGISTRY OF DEEDS I JUHN F. MEADE. REGISTER SAMPLE Trans#: 149316 Oper:MONIQUE PAUL used as a- Guideline Book. 29722 Page. 221 Inst#. 29572 NOTICE: The Town of Barnstable Ctl#: 1206 Rec:6-13-2016 @ 3:24:26p recommends that the applicant BARN 23 TROTTINGBRED LN seek legal advice to prepare a DOC DESCRIPTION TRANS AMT properly worded deedrestriction document. R DEED RESTRICTION UL WHEREAS, of �� � • on er's name) n A(/ )_C r j MA (address) ram- is the owner of G� l I"t o � �!!J�L°J (/��t= located (address) at 4 - MA (hereinafter referred to as and being shown on a plan entitled "Subdivision of Land in MA, Property of , et al, duly recorded in Barnstable County Registry of Deeds in Plan Book , Page ; Or on Land Court Plan Number.. WHEREAS, ?ROc- 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 permit in compliance with 310 CMR 15.000 State Environmental Code,.Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; u WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.2.00, 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: NOW, THEREFORE, i does hereby place the (owner's name) 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 hand and be binding upon all successors in title: 1. _ J 0 �/ivL) 2l: U may have constructed (address)` upon the lot a house containing no more than j (.3) bedrooms. Tom- (:�;`)2R agrees that this shall be permanent deed . (owner's name) restriction affecting located on MA, and being shown on the plan recorded in Plan Book , Paged Or on Land Court Plan For title of see the following deed: Book � Page Or Land Court Certificate of Titl�Number t �1 Executed as a led instrument day of f G�C�� Owner's sig ature Owner's signature Owner's signature COMMONWEALTH OF MASSACHUSETTS ss 20 Then personally appeared the above-named known to me to be the person who executed the foregoing instrument and acknowledged the same to be free act and deed, before me, Notary Public My commission expires: (date) agar BARNSTABLE REGISTRY OF DEEDS John F. Meade, Register TOWN OF BA/RNSTABLE LOCATION 7-folng ��°� /� , SEWAGE # �T VILLAGE ���� �/�' /ASSESSOR'S MAP & LOTI�� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I S 0,0 L LEACHING FACILITY: (type) 5d0 6*1 G eWf L'4"J �:��(size) &.l X r �0 NO.OF BEDROOMS 3 BUILDER 012! PERMITDATE: p`" 7 COMPLIANCE DATE: y Separation Distance.Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility :SSA Feet Private Water Supply Welland 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 Rear ��Ppb 3-V O i I S 9 'r /.v Fee No. THE COMMONWEA H OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Digool *p5tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(V )Abandon( ) El Complete System Lid'Individual Components Location Address or Lot No. Z 3 7 ,e Owner's Name,Address and Tel.No. Assessor's Map/Parcel Wi �Qr�r����/� v Installer's�,vvame,Address,and Tel.No. Designer's Name,Address and Tel.No. 0D17`o/'�7`i 7 7/ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder 41i5l Other Type of Building ) e4G e-No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank EY 7'-A4 /®�®��� Type of S.A.S. 7— Description of Soil /Z•�X Z jr Z Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued this Bo d o ealth. Signed Date Application Approved b Date Application Disapproved for the following reasons Permit No. Y ,- Date Issued l l�f No._9 / , o.�Ij Fee�" U THE COMMONWEAL H OF MASSACHUSETTS Entered in computer: Yes f PUBLIC HEALTH DIVISSION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipprication for lbigogal &pgtem Congtruction Vermit. Application for a Permit to Construct( )Repair( )Upgrade(VAbandon( ) ❑Complete System L"vidual Components Location Address or Lot No. �', � / Owner's Name,Address and Tel.No. 1 C G%l1YJ% .'7.4� Assessor's Map/Parcelt Installer's ame,Address,and Tel.No. Designer's Name,Address and Tel.No. e of Building: g: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( � Other Type of Building .� ��!'_ C No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow fl gallons per day. Calculated daily flow gallons. I Plan Date Number of sheets Revision Date I Title Size of Septic Tank //J ".,P, Type of S.A.S. Description of Soil �7,,5'X 7,5/Y Z Nature of Repairs or Alterations(Answer when applicable) Date last inspected: ` Agreement: d , The undersigned agrees to ensure the construction and maintenance of the afore described on-site sews"ge disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b this Bo d o ealth. Signed ^ Date Application Approved b Date gw Application Disapproved for the following reasons Permit No. y 7,-4 Date Issued v ------- ------- ----.----- —?---�.—/ ---- THE COMMONWEALTH OF MASSACHUSETTS zJ 457 BARNSTABLE, MASSACHUSETTS Certificate of Compliance l THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( � v Abandoned( )by A01- at 2 3 71,0 ,k r iG4 Gf/ AQ/NS G%./ has been constructed in accordance with the provisions offitle 5 and the for Disposal System Construction Permit No. dated LO . Installer Designer The issuance of this permit shall not be construed as a guarantee that the systemm will function as designed. Date g - 7 Inspector \11 t No. lr----------------------�Z-, _D,5 7 Fees THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwigpogar *pgtem Congtruction Vermit Permission is hereby granted to Construct( )Repair( )Upgrade( *I Abandon( ) System located at -3 7`41& /,. and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this jLer it. Date: Approved « j j � M NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH :IYD APPLIC ATION FOR a DISPOSAL WORKS CONSTRUCTION PERMIT (`ITM01-7 DESIGNED PLAINS) L . ®�/�/iG' - ,ebb ��'riT_T% _Fiat?he arriicaiion `OI 'isresal :Q �u CtiC Le=?t nez -i e daze l /��Y/� 7 � ��IIC.`�� '-I` C1Q�C�ina �:_te^a: �� -:� .•,�. ---< it �I' - . - --- - - .. _IcyE� DA : LICENSED SEPTIC SYSTEM INSTALLER IN—HE TOWN OF BARNSTABLE NU BER LAttach a sketch plan of the proposed system. Also if die !icensed installer posesses a certified plot piar.. this plan should be submitted]. q:6eaft fal �. . r Gam' C��S L4 r tT 4" i . i i i TOWN OF BARN,5TARLE LOOATION 'd C� SEWAGE # Q 3-B 3 VILLAGE Ulf-( M~,kk� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.� . ' �AN. nnP. 4 3^,)� 3106 SEPTIC TANK CAPACITY i t LEACHING FACILITY:(type �� CV 6 (sue) NO. OF BEDROOMS _PRIVATE WELL OR UBL -WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes " No t } 3� ��- ia �' JG ai w 517 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH. .............7' W!4...........OF.......... Q` :,4�!�-�Tr4BL .............................:.... Appliratiun for Disposal Works Tonstrur#iun Permit Application is hereby made for a Permit to Construct (a) or Repair ( ) an Individual Sewage Disposal System at: ..........: a - :. ...........L.�..1 ......�:.e. .............:. 4oT Zo ..7...................` ... ratiAs t N •------». � -•--•-••----------------------I-— .......Y4W.j?Ar-----�:.... Address .......................... ..........•--•-••-----•---------............ .............---.............................»...................._ I r Address ��// Type of Building Size Lot.... !Bj.Z,3.1.-----Sq. feet U ,.. Dwelling—No. of Bedrooms.......... ..............................Expansion Attic ( ) Garbage Grinder (#\) Other—Type of Building No. of persons............................ Showers — Cafeteria Other fixtures WW Design Flow............... ...........................gallons per person per day. Total daily ily flow.--.......3��d......................gallons. WSeptic Tank—Liquid ca.pacity:`49�.gallons Length... Width.._:...'L.. Diameter.....:.......... Depth..s.lie. . x Disposal Trench—No.....:............... Width....................Total Length.................... Total leachingarea...`�......9...s ft. Seepage Pit No--------- Diameter....1!2.......... Depth below inlet................Total leaching area.---...-1:.......sT.+. 4. Z Other Distribution box (�) Dosing tank ( )Percolation Test Results Performed by...bOW ....42+e ...�ZJ4..,.W................. Date...-...-�` ,.?"4 ......... Test Pit No. I...4Z.....minutes per inch Depth of Test Pit..../&Z........ Depth to ground water..-PP ... Test Pit No. 2...�Z____minutes per inch Depth of Test Pit....A5... Depth to ground water....1� x .......... ........... r --- ....----•--• •---•--••..............................................................»....----- 0 Description of Soil.------.....� ......� ll.I......................•----------•-••-----..:-----•-•-----•--...--•--•----•--------.......:__........... -..:............ ............................•--...---...---•--.............--------•-------------•-----•----•---•---...._.. :----------------------- •-•------.-:----------.-..-----........-..-. --.--..---...... UNature of Repairs or Alterations—Answer when applicable..............................:.............:.................................................. Agreement: I' The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu=by e ar of health. a Signed...r/ ------ l .•--•----- f t �:...... Date Application Approved By........----F 3- -- - - --•-r----.. ...........: Date Application Disapproved for the following reasons:---•---••......:................•--•--••------..........................--•---------............_........»»» ..............•------•--...-•-•------....GG.............................................--..............................................................................................................» a Permit No....... ........................ Issued.» ....� .. .- •� ^—J Date r - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................OWE)..._.......OF..._.........:.4!r�A. ?. .1..................................... Appliration for Disposal Works Tonstrurtion lirrmi# Application is hereby made for a Permit to Construct (A) or Repair ( ) an Individual Sewage Disposal System at: /• LRPa/t�ion,Address `fir p✓f _ (� or Lot No 41 CaC /��— 10�CS,I/U........................................... .Y) T,� 1....��:..1 .M LI - !�V7 (dG la Owner Address a ....------ T.. �:�� 1.1Ma �: �: 1/t�C.:.......................... ......... ........................................................... Installer Address Type of Building Size Lot....!&Z 31-----Sq. feet U g— .Expansion Attic ( ) Garbage Grinder (0�, Dwelling No. of Bedrooms-------- -=------------------------------ `4 Other—T e of Building No. of persons............................ Showers — Cafeteria R" Other fixtures ------------------------------••----•--•-_--•• WW Design Flow............... .....................gallons per person per day. Total daily flow..........:3...®......................gallons. WSeptic Tank—Liquid'capacity.Z0 gallons Length...�3� .��.. Width..4'14 . Diameter................ Depth... l x Disposal Trench—No..................... Width....................Total Length.......(/.........Total leaching area....................sq. ft. Seepage Pit No......... .... Diameter.....-:�..... ._ Depth below inlet. .......Total leaching area.:26..&.. ft. 1? z Other Distribution box (X) Dosing tank ( ) - `" Percolation Test Results Performed by...2'DW (':c4 p It76 0K.'p-+................. Date........ ......... Test Pit No. 1...L.��_......minutes per inch Depth of Test Pit.... '�._-_- Depth to ground water.... 4�............ Li, l Test Pit No. 2..<.7--.-minutes per inch Depth of Test Pit....Z:.2"�.2....... Depth to ground water......kb,: �UZ_:_. a0 ,/ ..-•................•---••---••---•-....---......................-•---•-----•--........................................-----•--............._......._........ Description of Soil._......___. SEf.....15�A L W ------------------------------ ---•--------------------.-------•--•.---...._-._.--------.------•----.---......- --.---/------ ----• •...-.. .. ------ ..--•-•--•--•--•---------------------------•--•---...--•--••-•-•-••.......--------•----••----------••-•-•-------••-•---•--••-----------••--•••..................:..-•----------..................._..... V 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 A. L j '5 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...... t .�at _��-' P Date ApplicationApproved By........---.Jam-J_ ...*.:t: �-=.y...............•---------------•----._ ..-•--------------........--•-•-........ Date Application Disapproved for the following reasons:.......................................................................................................... .................•---•-----•---..........pp...............-•-•--•--•--....--•-•--•----......---........_.......-•-------•------•-----•-.........�.............-•----•---••----••......••-•.............._ Permit No....... ..�.�.?? ... .............. Issued....:!1:.1�..( . a D ---------------- ---------------------------------- IN THE COMMONWEALTH OF MASSACHUSETTS -:a �jp�J BOARD OFHEALTH ..........C....`:.::': "'...........OF.......a.. r?r- e! �, _. (Irriif iratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (x) or Repaired ( ) at.......... -?`... -7._.? �.�.:61......�-r�r staller ----------------••-----....--......-•-•--•--...------•--•-•-•-----•------•--..........------ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ ` THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. A �TE..........- . ...r. ..7...........-•---...•---.........••---- Inspector..... �_.:Z-.��. .r. :.:;r...:..:.. ...................... ----------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ..... . . . ....................................... No... FsE.. Disposal Works Tonsfrnrtion fermi# Permission is hereby granted.................1()..... cr? ..�c. ............................................................................._.... to Construct Q<) or RepairJ_ ) an Individual Sewage Disposal System at No........ .d:7... L .....Fe: !�I .._ ��.....1 a.:a c.. ............. Street as shown on the application for Disposal Works Construction Permit No. - 7�_.. Dated.... .,.-.:' .... ........... C/ J Board of Health DATE.......... '-�--••----•...---- TOWN OF BA.RNSTA.BLE LOCATION �i3 7�!'Dl�r9 lj �y , SEWAGE # �7 S7S— YILLAGE If , C%Q'/i1 v7`Qd�� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.A422Y,011 SEPTIC TANK CAPACITY I Sod L. LEACHING FACILITY: (type) r,)d6-a eccf ,4wIs-J�.2�(size) NO.OF BEDROOMS 3 _ BUILDER OF(( �'IS P$RMTTDATE: Ir- /g _9 7 COMPLIANCE DATE:_ c Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility S Feet Private Water Supply Well and Leaching Facility (If any wells exist on siteor 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 r r� a SZ � FL.P 0 5 1!,,-755l .30 so , 4d dL _ N O 7'E . EkTE/l/a _ FILL 49PPL1CFa4+4-E - `cj C r / O .AJ ------- VE R T SCFaLEr / "'= /o' MA�II IOLE..G4VE,e5 To w/THIA I ' OR/z. S C F��,E : / � /© -�-------•�-- /2" U F,;,�/iV/S/•-/E D .�'E' --o-- o—o--o-- �orv�oosed ground Prof'/le , .. , i ----- -- F L o 4,•1 ---•-r- - �I"l,-7. %4"per f'-1-) FL Oh/ A 4vPo OFe Crrninim4rM per foo- �SC z- lay erof EQlJr9L To T/c: 3/6 PeciS'f ne MAL . � ,� :ji,ft,4 3„ all_ —�--- `: D/S7" BOX 7 �\ iQoO Gf�L: S�PT/C TAN/G 3/4=l%Z•, _l � • � washed stone y I a LEACH P/ r Lc�ii �� ` �� 5� , � .9� _. �,, � �- , , /�►_/ _ .. a �� � LSO r-I-1 \ F L GZzv f�T� _. �C� _ Gi9LS.�DAY �.o p„ o. - _..._. c2 ��1 s ; 1, ` Y I. 5'� PT7C 7-,-9AJI:� . � � x ,l.5= �9 - _Tof' � • ` >/sue • J_Q� � _ _ - � �J / I �/ j ' 5�•0 5�18so�L. 2¢• S&,8 56SS I L- � a3 8.S < Z,5 = 4 71 . 3 �/�, SIDE G�.fjLL, l - - :6oTToM s u 78 E Ili - . 1 0 ,5 1 TOT"F9 L a , �D Lo �. TZ7 - �8tz3 T ` . _ _ of 1 /? 511✓T Z �F k e ! I THAT THE 8U/LD/NG � \ } ? O E ON THE G�20UNG7 ASi i 7' 415 PL AlV DOES \ I l �OA./FO,2&7 7-0 . THE 8v/LD/wG s�= l�l /2 F_ C, r2 E M E wTs OF THE I T01n1 N O F 13A STALi L-E. -FOR : LOT 2 7 -T!z oTT►►�G�6�� ID�.IE �l l� 13Ak�sTABt_E, t�I ASS. ,wi III NPI L11 OF ORGE V SCALE. S OTED D E r FO ya. Leo 24700LO 3 ,A N AT FF,B, loi t37 su AL _...., . VIEW D�aTE • o o e x s-/-! n 9 e be va-/-/on B.L_D:.G. .. o.o o proposed a/e vatio r� M.E N.T S _ A P/>)20-V E-D �-- _._ . _ LO h/ �E L L E,?, Inc . 'coast 7.5 •Ff �oFl.�:. of HEAG.TH 7/4 MF-1/ti/ STA2EET S/-de 7 _ , MASc• YF-�,QMGUTH PO/2T MASS . ..5 ,� -----••-- •,, + s PRoF�55lONi9G_ENG/NEE�25 �r LAND 5V2VEY.Oa25 87-o3S ,