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Home My WebLink About0253 HUCKINS NECK ROAD - Health Centerville 132 N SMEAD No.2453LOR UPC 12534 smead.com • Made In USA .AT& ANN MUS®NMSNIODWLN SFI ' om -- YOU WISH TO OPEN A BUSINESS? r For Your information: Business certificates [cost$30.00 fo YOU must by M.G.L.-it does not give you per r.4 years]. A business certificate ONLY REGISTERS Town Clerk's office*,mission to operate.) Business Certificates are available at the e Main Street, Hyannis, MA 02601 [Town Hall) ERS YOUR NAME in town (which 1"FL., 367 Z DATE: G W 1 I APPLICANT'S YOUR NAME/S: Fill in please: tRz�a�Liar? p; Y' BUSINESS YOUR HOME ADDRESS: Q C I'DSI n x E �en�-erv� le 0�( �f..- x �3� TELEPHONE # Home Telephone Number �- ��:�.,� NAM5;OF CORPORATION: NAME OF.NEW.BUSINESS IS THIS.A HOME OCCUPATION? L ES NO. TYPE ADDRESS,OF BUSINESS OF BUSINESS J $ r V S 2 iC S er' s?�Ov� �hc rPSs �Cn� � a 1j'JVU 1 MAP/PARCELNUMBER ' I�Z?ClSP CIr'7 p C'2�T&Vdj Y??A- 0�(p3 2 ' (Assessing .. When starting a new business there are several things you must do in order to be in compliance with the rules and re latios �� Barnstd'ble. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 "f Town of Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. Main St.•— (corner o outh I. BUILDING COMMISSIONER'S OFFICE ~' This individual has been informed of any permit requirements that pertain to this type of business. COMMENTS: Authorized Signature** 2. BOARD OF HEALTH This individual has informed of t rmit re i ments that pertain to this type of business. Itz ✓Authorized Signature MUST COMPLY WITH ALL COMMENTS: (HAZARDOUS MATERIALS REGULATIONS 3, CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of-the licensing requirements that pertain to this type of business.: COMMENTS: Authorized Signature* IJ Hazardous Materials Inventory Sheet Checklist ate ✓ I ysical Street Address-Check database to ensure it exists Working Phone Number c/Actual Amounts -( ie. gas being used to fuel machines, thinner to f clean brushes all count as hazardous materials-no blanks) (� Storage Information -location of storage, how long is storage for? /If none, note that. Disposal Information -where and who? If none, note that.. Applicant Signature -understand what is listed and noted Staff Initial -any questions, know who to ask Ve,icle Washing/Rinsing? -give a vehicle washing policy and xplain it Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures l they are doing. Notes need to be left to explain what you discussed with them. TOWN OF BARNSTABLE Dater /I / %�•• `� TOXIC AND HAZAR _D OUS MATERIALS ON-SITE INVENTORY ;R NAME OF BUSINESS: #ef (lf'Yl fY1 (S BUSINESS LOCATION: okb S f,�3' �NVENTORY MAILING ADDRESS: Wi R&? �/3 PI'UiTOTAL AMOUNT: TELEPHONE NUMBER: Q - 16g J � 7P CONTACT PERSON: 05 EMERGENCY CONTACT TELEPHONE NUMBER: aJ J�� MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/REC MMENDATIONS: Fire District: 6 — Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED e Cesspool cleaners Automatic transmission fluid Disinfectants pa-vf Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil & stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers l C� Windshield wash 3 to WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signatur Staff's Initials YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: Fill in please: APPLICANT'S YOUR NAME/S: a r BUSINESS YOUR HOME ADDRESS: 2.S 3 0r `- x ��-LB��eSZ� �(� 4UCCc�tL ivM6F d le TELEPHONE # Home Telephone Number 5 8- 7 - r Z NAME OF CORPORATION: NAME OF NEW BUSINESS F2,, C�®+ro 6,46 TYPE OF BUSINESS So t=i tga$Q,t_� o.�, IS THIS A HOME OCCUPATION? YES NO n �g -� ADDRESS OF BUSINESS %�y c�l i / �/� iC �yi� ' K/IAP/PARCEL NU BER o�S - 3 (Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S This individual has be or d of any mit requirements that pertain to this type of business. Signature** MUST COMPLY WITH HOME OCCUPATION COMMENTS: AND REGULATIONS. FAILURE TO Q. q Y RESULT IN FINES. 2. BOARD OF HEALTH a ` MUSTC0WLYWTHAL1L This individual s b me o qaf irements that pertain to this type of business. I'�AZAMUS MATERIALS REGULATIONS t, ^ Authorized Signature(** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha en} if rrr�� of the licensing requirements that pertain to this.type of business. je Authorized Signature** COMMENTS: FEB THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .............. 0,114w ........OF.............. ............................ Appliration for Uhipasal Works Tomitrurtion ramit V/ Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ............ &.... ..................1001604.8.lu.................................. Location-Address Lot No. ...V&0. —AN Arht .Xf......41 .................. ..............9�t.A%W.-Ske------ 6Y.4 . ...---- Owner Address ................. ------------------*--------------- .................. .........Installer Address Type of Building Size Lot-_- ......Sq. feet aDwellings.No. of Bedrooms...................5?.............. .....Expansion Attic Garbage Grinder ( PL4 Other—Type of Building ............................ No. of persons.__..__.__-_._____.__._.--_. Showers Cafeteria ( 04 Other-fixtures ...................................................................................................................................................... De-ligii Flow.......................S:$...........gallons per person per day. Total daily flow.............MAO.................gallons. 94 Septic Tank—Liquid capacity/4-ft.gallons Lengthl.dnk.. Width. -.4.... Diameter................ Depth.__ Disposal Trench—No_ .................... Width_____._.__.__--___.. Total Length......................Total leaching area....................sq. ft. Seepage Pit No........../...... Diameter----/d.---4... Depth below inlet...'/.--!3...... Total leaching area...'?2,.,;r.....sq. f t. Z Other Distribution box Dosing tank ........... 4. ;7d-77 Percolation Test Results Performed bylo .. ................. Date---- A,--------- Test Pit No. 1A M_ ..;k.minutes per inch Depth of Test Pit....ZZ........ Depth to ground water. Test Pit No. 2................minutes per inch Depth of Test Pit__-__-._..._._______ Depth to ground water.--__--_:__________...- ...................................................................................4V..................... 0 Description of Soil............JN�C..JbA-7----- —---------- --- ---------------• ------------------------ e--& ----------------- ........ ---------------------------• ------ ot-F------------------------- W---------------------------**"**"*............ (.00, � 8 40 ��A — M k �4 ............. -------------- ......... _47 U Nature of Repairs or Alterations—Answer when applicable.........................................•.-._-___-___-__-_-_-.....___._..__._._-_______.____... .....................................................................................................................................................I.................................................. Agreement: 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 issued by the board of health. Signed.. •................. ate ApplicationApproved By......... .................................................. ---------------------------------------- L;- Date Application Disapproved for the following reasons:.............................................................................................................. ......................o.................................................... ............................................................................................................................. Date PermitNo.....V?%/....................................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH •-----...-T /YY�.....OF............ T�� r. Appliration for Dispaii al Murkii Ton,vtratrtion Prrutit l pplacation is hereby made",for a Permit to Construct ( " ) or Repair ( ) an Individual Sewage Disposal System at .................._.... ----- .................. 8 .............................................................. Location-Address Lot No. - -.-- - Owner Address W G• ,Z3D% hI'G ........Sao �,��', ' _.- 'D........x�YQtI� ,.� ----- .....----•......................•--••-•••. Installer Address UType of Building Size Lot_.�7✓r6a-------Sq. feet Dwelling—No. of Bedrooms...................................._.......Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------•-------------------•---------•-------•-------------------------'-------------------- --- ................................... Design Flow.......................-��__J`V.........._...gallons per person per day. Total daily flow.............�". .0__................_gallons. W Septic Tank—Liquid capacityAV gallons Length A—.4... Width-.��..... Diameter................ Depth... S:.a x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.............___._..sq. ft. Seepage Pit No-----------/------- Diameter.../A--4.... Depth below inlet-1.-Z....... Total leaching area..3..'._.....sq. ft. z Other Distribution box ( ) Dosing tank (0-4 ) Percolation Test Results Performed by�! �".----------------- Date-- .3�3... Test Pit No. 1� ._&-minutes per inch Depth of Test Pit___/?�......... Depth to ground water--- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... a O Description of Soil...•-------�r3 4� ,r52.1$ ...... PA;t-•--•-•----•---------------------------.................-•-•••----••-••------- x w .....;.._...... U 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 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 issued by the board of health. Signed---------•--- - - -- -----•.. - -- - = ................ Application Application Approved By....... Date Application Disapproved for the following reasons:---...•--•••-•••----•------•••--•••-----•••-•--•--•--•------•----••••---•=•-•--•---•----••-••---•---------•--••- J/ Date PermitNo. .................................................. Issued...........--------------...................---•-•-•--- Date riS�T THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF..................................................................................... QTrrtifiratr of Tontplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by-------------------- ?A...------..0I.O.—tj -•----.--•----••--•-------------- Installer +'" has been installed in accordance.with the provisions of TIT.LE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.......... ......................... dated_...._ _.; ».. r'"_ 7.: THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE... K ................... Inspector Inspector •• a ----•---••-••-----•------------•--------•-••--•_...•. = t � J � „ "'THE COMMONWEALTH„OFa.MASSACHUSETTS :s- BOARD OF HEALTH ........,OF.......... i ' !C 'p! !� 1w-----...--•.............................. No......................... FEE..I...::............... �i��o�tt1 ork� �on�trnrtuan �erntit - ,� Permission 's hereby granted......... � to Construct (A) or Repai ) an Individual Sewage Dl posal Sy tem at No.•---•-•-----..k �1.......----•� .... . /ec ._....__. G= ! � 0 a -•.. ..---•----- -------- •-----------------------•-- f a ;, Street as shown on the application for.Disposal Works Construction,;Permit No..... ..... Dated-------------` ----.....-•----•-----•--•--------------------•-----------------•--------•------•--------------•••-.---•- Board of Health DATE.......................................................`a FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS LOCATION PERMIT MO. 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