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TOWN OF YARMOUTH HEALTH DEPT.
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• 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-24451 •
• Telephone(508)398-2231 ext. 1240, Fax(508)760-3472 •
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BOARD OF HEALTH •
DEED RESTRICTION
Date: .February 12, 2019
• Owner: Hazel McKenzie Schirmer,Trs.-McKenzie Nominee Trust •
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E Address: 60 Eaton Court,Cotuit, MA •
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• PROPERTY ADDRESS: 5 Franklin Street TOWNNILLAGE West Yarmouth •
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Assessor Map: 22 Parcel 389 •
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Barnstable County Registry: Book: 13323 Page: 154 Lot:#284
Certificate: LCP: Lot:
As required by the Town of Yarmouth Health Department, I/we, Hazel McKenzie Schirmer hereby acknowledge that the
approval by the Town of Yarmouth Board of Health for the installation of the new septic system requires that a deed
restriction be placed on record with the Barnstable County Registry of Deeds for the above referenced property, in
accordance with 310 CMR 15.000: The State Environmental Code, Title 5, and/or the Town of Yarmouth Subsurface
E. Sewage Regulations.
Per engineered plan prepared by Down Cape Engineering and dated December 4, 2018 the following restrictions
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apply:
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• 1. Maximum number of bedrooms not to exceed two (2) per design restrictions, Title 5, 310 CMR 15.214,
Nitrogen Loading Limitations,Zone II Areas of Wellhead Contribution
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2. Title 5/Town of Yarmouth Approved Variances:
Variances requested:
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15.405 ■
• (1a) Reduction in setback,SAS to lot line(10'top 5') •
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(lb) Reduction in setback, SAS to foundation(20'to 12.8' & 13.4')
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Yarmouth Health Department:
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Bruce G. Murphy, :11th Director, R.S.,C.H.O. Date •
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Owner/Representative:
I/W• e have read and fully understand the conditions of the above restrictions and accept them as written:
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John F. Meade, Register
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RECEIPT
Printed: March 20, 2019 @ 11:56:25
BARNSTABLE COUNTY REGISTRY OF DEEDS
JOHN F. MEADE, REGISTER
Trans#: 65849 Oper:PCHALLIES
MAURICE
Book: 31898 Page: 142 Inst#: 12098
Ctl#: 448 Rec:3-20-2019 @ 11:54:54a
YARM 5 FRANKLIN ST
DOC DESCRIPTION TRANS AMT
1 SCHIRMER, HAZEL MCKENZIE
RESTRICTION
County.Fee $ 10.00 10.00
Surcharge CPA $20.00 20.00
State Fee $40.00 40.00
Surcharge Tech $5,00 5.00
Total fees: 75.00
*** Total charges: 75.00
CHECK PM 2347 75.00
��Y TOWN OF YARMOUTH
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Te 1" 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-24451
: . - G"-.' Telephone(508)398-2231 ext. 1240, Fax(508)760-3472
"' BOARD OF HEALTH
March 6, 2019
Hazel McKenzie Schirmer, Tr.
McKenzie Nominee Trust
60 Eaton Court
Cotuit, MA 02635
RE: Two Bedroom Deed Restriction 5 Franklin Street,Yarmouth, MA
Dear Ms. Schirmer:
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, 3195 Route 6A,
(P.O. Box 368) Barnstable, 02630. 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 installation and approval of the septic system. Your septic installer may be able to assist
you with processing the paperwork, if needed.
If there are any further questions,please contact this office at 508-398-2231 X1240. Thank you
for your prompt attention.
Sincerely,
y L. von Hone, R.S., C.H.O.
Assistant Health Director
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