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HomeMy WebLinkAbout0014 BACON ROAD - Health 14 Bacon Road , o Hyannis z . A= 309- 159 0 O f ill I �0 4L 11 ` Sewer Permit No. ---�--�- Name Location - 114 r&c v-,kj PLmA 6LWW k Ca--.r l V tj \� \4:S rz Ll(- . l Installer's Ne'ym�c�and Addressryq ` Builder's Name and Address -- Date Permit Issueds ! ,� Date Compliance issued: ,) � � �! ,- � �' s �, � cA rfi ASSESSORSMAPNO: rARCEL N0:���_v Fz��........!........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilan for Diinpnittl Workii Tontitrnrtinn rainit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at:/ S (� -0- (0 & ..... 1.... .........Q .`.`... �.:1.:.. Loc . a.... -.\ddr ss `c� / ��� L No. � , Ow r ` (� .1 Add { --�`.. -- d����:�-- ------... cgs--- �� wl4S.^ :t!-... Installer Address d Type of Building `� Size Lot............................Sq. feet U Dwelling—No. of Bedrooms________ ______________ __ _Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ _ _ W Design Flow--------------------------------------------gallons per person per day. Total daily flow_...........................................gallons. WSeptic Tank—Liquid capacity............gallons Length________________ Width---------------- Diameter_------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area----------..........sq. ft. Seepage Pit No------_------------- Diameter-------------------- Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit____________________ Depth to ground water______._.____-__--____-- (%, Test Pit No. 2................minutes per inch Depth of Test Pit._._____-_______-_ - Depth to ground water...______-__--__----___. 0 Description of Soil...... ►v- U -----•--•-•-••----••....•--•••-••-•----------•-------•--------.-• ----------------------------------------------------------------------------------------------------------------------•••-- W --•-••-----------------------------------•.............----------------------- ........................................... -----•--••-•-----=-------------•--••......-- I UNature of Repairs o Alterations—A wer h n pplicable.............�°.��__ -�- .--gz�k.is`�`z_.... CCS} (juk Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of m iance has been issued by the board0.of health. 11 � J.n -� --------------------- ...2`� �� "41 Sign �•.�:................ Dare Application Approved By ---------- -------------- . ........... - .-.. .-----------r-------------------- Date ...... : - -�a.- APP lication Disapproved for the following reasonr: ....:........................ .............................................. ----------------............... ......... ------------------------------------------------ ------------------------------------------------------_:.-------------------------------- � ' te Permit No. Gl�.-----�.- ----....`�.. .......-. Issued ..... ��..... �1�..,? ... Dace THE COMMONWEALTH OF MASSACHUSETTS t - BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Uiopoottl Warlai Touotrurtioit rrrniit Application is hereby made for a Permit to Construct ( ) or Repair ( Individual Sewage Disposal System at: ----- ----- Location- 1 � o No. �� K.......................................................L r `�.. Ow er- � .� Addres 1r ••---7 !--- ---- Installer Address UType of Building Size Lot............................Sq. feet ►.. Dwelling—No. of Bedrooms---__._. -----------------------__..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures __________ _________________ _ _ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity........_._gallons Length________________ Width---------------- Diameter---------------- Depth................ W Disposal Trench—No- -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date...................................... a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ �X4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 .._ - .......................................................................................................................................... D Description of Soil..... ...0� �a...... .... __ U ..................................................................•i—___--____-------•-------------•----•_-_-_--______-_---_--________-----._.---•.-----------------•----------------------_---------. W -------- -. i............................ U Nature of Repairs or Alterations—Answer when Applicable______________ _ _ �.__._. _......_��'1.;.54`�. (.-CeSgr vv boo -4 k Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of C©m iance has been issued by the board of health. ----------------------- ,,+ Dare Application Approved By ---- ------ - z _z�: _ '...... ...51�.� �, ..... . ....�. * N Dare Application Disapproved for the following reasons: ............................................................. ------------------------------------------------------------------" - - - - - - � --------------- --------- ...-----...----.............------- ---- ----------........------------------- ------------ ------._... _------- --- ---- .---/ �ry /��`' / Dare Permit No. ...... ✓.....T..'....... Issued ._...�... '... .���.... .f--�'....-s---...------..... f Dare THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE Certifi ate of CII1<t plianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by � � _ In taller at -------------- -"[.. ... 1`�:t.,._�..-cz ------------- _......�ht11J__W_. ... has been installed in accordance with the provisions of TITLE 5 otate Environmental Code as described in the application for Disposal Works Construction Permit No. � .....��. ...� .��.- dated ,� r ...-:9---7-..�� 14-1 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. "' DATE..... �� �'tr -- c"z"' :.. /. — 1 y Inspector - .f -...�: _-- V THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �i TOWN OF BARNSTABLE A No.l.:.� '".--•-�1-�� FEE....... �2 0 Ropoo-al Workii Tono#,ndinn Permit Permission is hereby granted..... '�� �. to Construct ( ) or Repa r ( an Individual S� ge Dis oSal System ------------------------------ Street �?/ Q� as shown on the application for Disposal Works Construction Permit N,d/...!�-`�__.:_.. I�ated.....� .."a .-�......`?.... ---------------------- _ Board of Health DATE=w...---- i ? 'P? :5. FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30 00 or 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) W. iwr! .. DATE: WE=W 'S Fill in please: i APPLICANT'S YOUR NAME: J z0 iCod�h� o �T�►+►e��z BUSINESS YOUR HOME ADDRESS:_ � Xz� is -MA- 016.0 � s TELEPHONE # Home Telephone Number 5OR-30-Y63 NAME OF NEW BUSINESS n ers TYPE O.F BUSINESS tiose ; IS THIS A HOME OCCUPATIONI' YES �"� NO ADDRESS OF BUSINESS /Ll coS L.. a T .- - MAP/PARCEL NUMBER 309 5� 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 - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your usiness in this town. 1. BUILDING COMMISSIONER'S OFFICE 1 This individual hadb it requirements that pertain to this type of business. Auth i d Signat r COMMENTS: 2. BOARD OF HEALTH This individual has bee informe f t4swrmit requirements that pertain to this type of business. Au orized Si ture** COMMENTS: . 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: r. r .. Date: ,� /2�-/ 0� TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: Aj eteen er.5 BUSINESS LOCATION: k 3sac,sn R c - 14y_anhiS - eYA INVENTORY MAILING ADDRESS: 4'4( 3z cor, '1?c{ #Lann%<s ? m,4 - ®a60i TOTAL AMOUNT: TELEPHONE NUMBER: 509-36q' ?61 9- CO A, CONTACT PERSON: -)oao lme ida EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: douse e(eAlh ey INFORMATION/RECOMMENDATIONS: Fire District: 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 materials 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) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants.. 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 Misc. 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 Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor& furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers Sw� (including bleach) Spot removers &cleaning fluids i (dry cleaners) Other cleaning solvents.) Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS