HomeMy WebLinkAboutPending Deed Restriction and Application t_6 �-;r F':�3,:�'�`r S�]: :.ai-'-�:`�'�'*�-
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.��'Y'�.� TOWN OF YARMOUTH
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"` ,� 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-24451
����� Telephone(508)398-2231 ext 1240, Fax(508)760-3472
BOARD OF HEALTH
NOTICE OF DEED RESTRICTION
RESIDENTIAL
Notice is hereby given of the applicability of the Town of Yarmouth Health Department for a
deed restriction, to 80 White Rock Road , shown in Town Assessors Book dated 2017 , Map '
115, Parcel 224. As Deed is recorded at the Barnstable County Registry of Deeds, on the Deed
Book 28383 , Page 44 .
As plan of land is recorded at the Barnstable County Registry of Deeds on a subdivision plan
� titled "Subdivision Plan of Land in Yarmouth, Mass. for Robert W. Lubv" Lot 75 dated 7ulv
0 20, 1964, and recorded on the Plan Book 187 Page 149.
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�" The engineered plan prepared by Flahertv Environmental Services , dated July 30, 2017
oapproved by the Health Department on Au�ust 9 , 2017 __ , requires a maximum, not to
� exceed:
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x° (1) the number of bedrooms not to exceed Two ( 2 )per design restrictions,
� (a) Title 5, 310 CMR 15.214, Nitrogen Loading Limitations, Zone II Areas of
� Wellhead Contribution
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a Yarmout lth Department:
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a Bruce . M hy, Health i tor, R.S., C.H.O. Date
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o Owner/Representative:
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� I have read and fully understand the conditions of the above restrictions
Q and accept them as written:
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� Richard C. Green, ' er Date
� 11815 207�'Aven South East
.� Snohomish, WA 98290
on
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sTATE or wAsxiNCTON
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coUN7'Y OF ��bl�ar�'sl�
� Un this day personally appeared before me �iG1'�aY'�j C• 6(�i}1, , to me known
i to be the individual(s) described in and who executed the within and foregoing instrument, and
acknowledged that he/she/they signed the same as his/her/their free and voluntary act and deed,
; for the uses and purposes therein mentioned.
Given under m � hand and seal of office this S� ,
y a,` day of �tJ,�iUst 20�.
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Nc�tary Public residing at CS��'o� (�v� �
Notary Public
Printed Name:��6C, �qh',C� Pc?riG�. State of Washington
RODRIC DANIEL PENCE
My Commissian Expires: MY COMMISSION EXPIRES
September 27,2p19
�1< 7/2ot �
BARNSTABI.E REGiStRY Ogte�EDS
lohn F. Meade, Reg
.�F�Y��, TOWN OF YARMOUTH
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"" .� 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-24451
��.s�� Telephone(508)398-2231 ex� 1240, Fax(508)760-3472
BOARD OF HEALTH
August 11, 2017
Richard C. Green
11815 207�'Avenue South East
Snohomish, WA 98290
RE: Two Bedroom Deed Restriction 80 White Rock Road,Yarmouth,MA
Dear Mr. Green:
Please find enclosed the Two Bedroom Deed Restriction which is required as part of the septic
system approval process for the replacement of the septic system at the above address. The Deed
Restriction must be signed and dated by the current owner(s) or legal designee. Once the
restriction is signed,please have the original restriction recorded and stamped with the new
Registry recording information at the Barnstable County Registry of Deeds, Route 6A,
Barnstable. The recording fee at the Registry is currently$ 75.00. A copy of the stamped
Restriction must then be returned to the Health Department as proof of the recording prior to
issuance of the Title 5 Certificate of Compliance which is typically issued upon insta.11ation and
approval of the septic system.
If there are any further questions, please contact this office at 508-398-2231 X1240. Thank you
for your prompt attention.
Sincerely,
f
Am . von Hone, R.S., C.H.O.
sistant Health Director
cc: file
°� ` TOWN � F � ARM � UTH Boardof
� Health
� E�! ]146.ROUT.F..?S, SOUTH YARMOUT:t-1, MASSACHUSF.,TTS Q2664-24451 -
+�,o Telephone(508)398-2231,ext. 1241 Heaith
Fax(508) 760-3472 Division
APPLICATION FOR TITLE 5 DEED RESTRICTION
The information requested below must be accurate and completed in full to ensure the deed restriction
can be completed properly and in a timely manner.
� 1. Town of Yarmouth Assessor's Book(most current): � �/
Map�/S Lot Z2� Address $p �,�j�P._�I��2�. /�l�
2. The property deed is recorded at the Barnstable County Registry of Deeds in
Deed Book 2$�Page_�or Land Court Certificate
3. The 1 t indica,,�t ve is sho n pl�o�f1 lan en 'tled:.f(/d�l��/%S/4� G�`�
] p.+'K'�7+�l� s �� .�-�/Q �=� , dated �' ZO
The lan of 1 d for the lot is re orded at the arnstable County Registry of Deeds in Pl _
Book Page--1–�-�—or Land Court Plan �,�� %�
4. The engineered septic plan has been prepared by���r-�C.t En�;t-onrn�,�la...�
and dated `1 -30• 1''1
5. Board of Health approval date �– `��'' � J
6. The number of bedrooms is restricted to ,~
C.
7. OwnerName: R'��hae�l. �rezc�,
Address: �o �,�1�,�-�c Rc�c.K F�aA.
�c�r,r�n�d�:�t-�
The required information supplied to this department for the application of a Title 5 Deed
Restriction is correct as shown above.
Applicant ��,gQ�,� Date $-/O- 1`�
05,20„o RECEIVED
AUG 10 2017
HEALTH DEPT.