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HomeMy WebLinkAbout2010 - Assessors Info; T5 Insp Pages; 1976 Building Permit Info - 3 vs. 2 Bedroom Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface =; c--ti: Sewage Disposal System ROM-Not for Voluntary Assessments : `1,1+ 75 Sullivan Road Property Address Bernard SherwiN Owner Owner's Name informationefor re requid for South Yarmouth MA 02664 07/20/09 every per. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? 0 Yes 0 No Is laundry on a separate sewage system?[if yes separate inspection required] 0 Yes 0 No Laundry system inspected? 0 Yes 0 No Seasonal use? 0 Yes Q No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes 0 No Last date of occupancy: current Date CommerciaYhtdustriai Flow Conditions: Type of Establishment Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft, etc.): Grease trap present? ❑ Yes 0 No Industrial waste holding tank present? 0 Yes 0 No Non-sanitary waste discharged to the Title 5 system? 0 Yes 0 No Water meter readings, if available: Last date of occupancy/use: cafe Other(descxbe): ADJUST•Owns Tins 5 Mel Ynpatlan Fonn Subsurface 8seeps Disposal System-Pape 7 d 15 41 Commonwealth of Massachusetts - „'.. - - Title 5 Official Inspection Form r Subsulrfa a sewage Disposal System Foran-Not for Voluntary . _ ,, AUG 1 4 ?x,99 _f �V • H yt! r . . „� 75 Sullivan Road H .R; .iir — Properly Address Bernard Shewill _ ,I- 4 Owner owner's Name Is South Yarmouth MA 02664 07/20/09 required for wry page. City/Town Stale Zip Code Date of Inspection inspection results must be submitted on this form.Inspection forms may not be altered in any way- A. General Information INhen Sling out fauns on the eonly the l 1. Inspector: to move your Michael Kellett cursor-do not ,. - use the return key. Aardvark Environmental Inspections Compan y Name All P.O. Box 896 Company Address IF!".1I East Dennis MA 02641 City/Town State Zip Code 508-385-7608 813742 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my trebling and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CUR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 711 t cij °Y13607/22/09 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if app icable,and the approving authority. """This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system win perform in the future under the same or different conditions of use. ADJusT•0E505 Tis Oficial impaction farm 8ianaria.Sumo Disposal Sysiwn•Page 1 or 15 r • e"Iii , Commonwealth h of Massachusetts ,, Title 5 Official Inspection Form r S ce Sewage Disposal Form-Not for Voluntary Assessments ,_ 75 Sulivan Road Thoparly Address Bernard Shored . Owner Owner's Name Kanrafion is &Nth Yarmouth MA 02664 07120/09 required for wen/rte- stab EP Code Date of espsaflo% D. System Information (cont) Sketch Of Sewage Disposal System:Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate an wets wllhin 100 ice. Locale where pubic water supply enters the buirg. L...... .1 1 - (Q- 1 8111 (41N:12 r NI �Y �-(1 ►a mew-ause Vies Mid irpacillonFan 9 Sinew Ofspossi ilyalem-Paw 14E15 - as i A o A o V o ��N g o g e3 �3�pp g $ �gp �pop 00 en y bpp O, y N 7 N 00 +.. N N M ANN kn 4.) 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Cj m I i. 00 ok 314 = hi - — o 0 a1C4 11 El> fs. m I lin ww,am c, cZ dQGT.D 'fs+ i °o d a...0 .+ m o a 0 ..t O 0 A 61~ N E a k WWFW"' NN O `c, 0 aaDCp•A 3LW .... 3 y � 9.9 °' � 4, F_, aaraxxx; ) - • • ww000, ° o00o om 1aoC mOa 0 V. 3 8 ., ° ° - 3 « 2 g 8U Q'W0E j 0:1 - V .a ) / dor. No. *6.--,:„. ., pplication for a Permit to Bu' e ' ,.� - F /Afifit PANS 41;rflx H1 11 ARD �''�`` ' i: Fee must accompany this application DATE ��26 GL' • D.f./c- �liiYarmouth • 4....19 AC "O a0 -::i5 rpm'T IS VOID DISPOSAL INSTALLERrF5�D WITHIN 40 DAYS, p TO THE BOARD OF SELECTMEN V ` ��/� The undersigned hereby applies for a permit to build, according to the following specifications: / - /(:A.:=-' 1. Name of Owner MR.. 4-fr\ S. manse"- CI f2LTC u Address n1 flt=.ELK‘NiS `�T �� . pie..t.Ra se... MA , 2. Name of Architect (if any) GE 0 Q4r► P1. P(.1".I Ps ..1 t, 3. Name of Builder (t'-ti . (16111.1544. ' MAiNT'ftNAtrC 4 SALCCS C . / Py° 4. Precinct No. Lot No. a % Plan: Name or No. C•N r1)hitt ft id � S. stAnci'. - svRvievoti 5. Name of Stre ,I P—41 . ;f:, Mild C.ii/l : 6. Purpose of Building (' wit t.l i 1,4 i 'SitA r: , L `T. ' JK �7. Material . T / '^ 1..0. is _T5 BET if ) <—ii `C —! 8. Estimated cost of building IF 3*,%.1.3 V S 4l i=�� w o �e e� ►�O M S 9. Dwelling Y s 3 �® STu4 v 4 Y _ ,�v of � I 10. Cottage N n / 9 s �� �4eIQA0- L /r /n t0 11 o° �'� 11. Heat pier- WATER. I ey • . PC)t � / J Jobe-,S•ccs 12. Basement YRS 1, . r c.c.., P ' B*?"h S 13. Garage 3. 4 YES , s2 j O . 9 0 i D. 1 IC 0 Vr C e l I zI'e 14. Store 044 15. Shop N sr 16. No. of stories I ' 17. Is there to be a Store in the lower storey t I 0 18. Size of Lot. No. of feet front 1,4.(I.:.(i 1.). No. of feet rear ...1.1.r it No. of feet deep I' ' 1 19. Size of building. No. of feet front .. .:Z.`•4 ' No. of feet side ..3.4./iL"s!" Noof feet rear i3let's' 20. Distance from nearest building: Front ft.; side ft.; side ft.; rear 21. Distance back from line or street 1.$'I , from rear lot line .....t2..!...t , side line LSi Show by diagram the location of propsed building with relation to distances from adjoining lots, on reverse side. Name Az- a.w.f b.l.a a,.. m.A.t.tta:IChtx!s!IG.G..d'...5A!. Address Tk .V *. 11.4a—. 0..s.1•►ClWonst.0 (" O.'!r . 7,:e I•r',.,T i5 voID i a 7 ' _ .1 , 1 i 7'77- --- r3 A r - I I • 1 , J r� '71-, • 1nod �_� _,:--r-7,_om - __ � 3 - _ { -'- \... } r- om- - ' , ..,A \• - cv . r � =.1.- y — \ - -- - -1- ----i-CI i 1 JW �_ - - _ - 0. tj -gin --4- . N - - —- 7 1 _ Ii 1--1 i :i -- -1.?. , ------- kl_i i _fi . -,\ i -II- . , . ., ! ...t• • • __•-, _,_:_____,_______ tr 0.. . . -I\' '---':ri -0 : . - . \ ,___ • (I? N 1 '(‘) . . • A , _•_:-. ,_., . r . t r ,--: , , , _ ,.. -I 7N u� L I- i.i,„ _.J- : , 4, 1 1 , T: i : -.: ....E. . . _ - - ---,- .. nZ s � � NI k ±=I__:;;A-71- I i• - JI . _t q ‘ . - L./ . L t 01 T . 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