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HomeMy WebLinkAboutDeed Restriction Bk 17857 Ps 121 126001 10-29-2003 a 09 = 59a. "O1.•Yg141` ; � o , TOWN OF YARMOUTH '0taA `3f 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 ,uc_MATTACMEES �% '0*"m.uio0 66g; Telephone(508)398-2231, Ext. 241 — Fax(508) 398-2365 BOARD OF HEALTH NOTICE OF DEED RESTRICTION RESIDENTIAL Notice is hereby given of the applicability of the Town of Yarmouth Board of Health Department for a deed restriction,to 35 Captain Dore Road ,shown in Town Assessors Book dated 2002,Map 67,parcel 171 . As Deed is recorded at the Barnstable County Registry of Deeds,on the Deed Book 6404,Page 133 . As plan of land is recorded at the Barnstable County Registry of Deeds on a subdivision plan titled "Subdivision Plan of a Portion of Captain's Village"dated December 17, 1970 . The engineered plan prepared by LaBarge Engineering ,dated October 6, 2003 , approved by the Health Department on October 28,2003 ,requires a maximum,not to exceed: (1) the number of bedrooms not to exceed Two (2); per design restrictions,Title V, Section 15.214,Nitrogen Loading Limitations, Zone II Areas of Wellhead Contribution. Amy L.Von Hone,Assistant Health Director,R.S.,C.H.O./6% �/eell fii Date /a -- 3 EXECUTED as a sealed instrument this date, (O b-Qi-d r )� . f.Ann P 'dotkas,owner 35 Captain Dore Road, South Yarmouth,MA 02664 COMMONWEALTH OF MASSACHUSETTS Barnstable,ss (&Ober a F ,2003 Then personally appeared the above named A II h?lC it 0 I I� and acknowledged the foregoing instrument to beX free act and deed,before me. eV Ct-A Itze-m- Nii Public My Commission Expires: !o ^ 61 - No it Printed on Recycled Z. Paper Of:1 1 .1:SI' e "i? 3:319 = 9 C.1 -� - TOWN OF YARMOUTH �, j gl _,�� 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 MATTACMEES `24 �'j Telephone (508) 398-2231, Ext. 241 — Fax(508) 398-2365 BOARD OF HEALTH APPLICATION FOR TITLE V 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 O irJ Lot 11 I Address 3 5 t ., port IZOAL 2. The property deed is recorded at the Barnstable County Registry of Deeds in Deed Book&gOly Page /33 or Land Court Certificate 3. The 1 tt indicated above.is town on a plan of land entitled: __SiAdi 1?S l"C4 f e.7 z\) G 1 CI t'/.3 i,ti1S V11!4C , dated /22 /2�/77G. The plan of land for the lot is recorded at the Barnstable County Registry of D6eds in Plan Book Page or Land Court Plan 4. The engineered sep 'c lan has been prepared by ,/ A ,uct+j cK'/ OC and dated (a e 5. Board of Health approval date . 6. The number of bedrooms is restricted to C 7. Owner Name: Ail /34# O f S Address: 3$ (4 7/7 01-/7 a2(,6-4 • The required information supplied to this department for the application of a Title V Deed Restriction is correct as shown above. Applicant Date 5/02 Printed on L S Pape ( Recycled r