Loading...
HomeMy WebLinkAbout0153 BACON ROAD - Health 153 Bacon Rd a 310-036 Hyannis 0 it t TOWN OF BARNSTABLE LOCATION "C) SEWAGE # -q3-- VILLAGE ��� /�� ASSESSOR'S MAP& LOT- 03 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ,- LEACHING FACILITY: (type) (size) NO.-OF BEDROOMS BUILDER OR OWNS tf��d r PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom.of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist " within 300 feet of leaching facility) Feet Furnished by Y J z - r � No. Fee _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppYication for -Migogar *pgtem Congtructfon Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System 11individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel � --N-d�k,S — ) Installer's Name,Address,and T .No. NN Designer's Name,Address and 1 d JTel.No. Type of Building: �— Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 7 gallons per day. Calculated daily flow S 7l gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank � i 5 Type of S.A.S. "I �A C&46�4 s a 44 , Description of Soil QS Nature of Repairs or Alterations(Answer when applicable) �ST � k > Ca <i G 7VQ Ye__S LA—, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been Signed Date Application Approved by Date Application Disapproved for th ollow' g reasons Permit No. �%- S, Date Issued 4e No. ��.. `� Feed THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for ;Digpo!5a1 *pgtem (fow6truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System T*ridividual Components Location Address or Lot No. o i, LA,0 Owner's Name,Address,and Tel.No. _ s l L Assessor's Map/Parcel :�l o— Installer's Name,Address and Te:No. N Designer's Name,Address and Tel.No. Type of Building: �^ = Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Zp C2 gallons per day. Calculated daily flow S 7� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank rc ) cd Type of S.A.S Co N k_�� _on'tS (cC Description of Soil rep SL Ci t Nature of Repairs or Alterations(Answer when applicable) 7711-"X4 A\ G•_. �--^`�c-� Date last inspected: 'x Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is Signed Date - APPIicaUori'Approved'by-­------, Application Disapproved for th olio Rg reasons Permit No. Date Issued s THE COMMONWEALTH OF MASSACHUSETTS �. BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(. ) Upgraded Abandoned( )by S at. . ?—_Z, C ON V1 0 LA,0--A-\ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. - 3 dated Installer Designer ,/I A A f The issuance of this pe t-s ill of e,construed as a guarantee that the sy�tem�vill function as des'ned_✓f,� l / Date . 11 Inspector s %� --------------------------------------- No. Dl— Y�� Feed THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1=igozar *pztem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( andon( ) System located at l ? Z A c_ r`Iti Q^V and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: "?' a :1 Approved by s 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, hereby certify that the application for disposal works construction permit signed by me dated �`� concerning the = property located at 0c �� meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system • Aere are no private wells within 150 feet of the proposed septic system • There is no increase in flaw and/or change in use proposed There are no variances requested or needed. d• The.bottom of the proposed leaching facility will not be located less chart five feet above the ma..dmum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted goundwater table elevation, Please complete the following. (� A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation the Ytr1 C. High G.W. Adjustment DIFFERENCE BETWEEN A and B SIGNED : DATE: 7� [Sketch propose plan of system on back,11. q:health folder.cet r i c� ai �. �� � �' �, TOWN OF BARNSTABLE LOCATION ©'L' � � -�3 SEWAGE # VILLAGE �:� -' S ASSESSOR'S MAP & LOT3 -03 INSTALLER'S NAME&PHONE NO. LAD C SEPTIC TANK CAPACITY LEACHING FACILITY: (type) C3�r1 C itpc`� ��� (size) NO.OF BEDROOMS BUILDER OR OWNS � i PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by si C RIX o; 0 _� ;kl- Date: / / �5 / or' TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: l S '�;�Q� f PA 1✓� BUSINESS LOCATION: 'b INVENTORY MAILING ADDRESS: Cblyx& abn=4 TOTAL AMOUNT: TELEPHONE NUMBER: e,-0B s 15 3-)-_6 -1 CONTACT PERSON: �A- t C LIQL..�S W.A^�O EMERGENCY CONTACT TELEPHONE NUMBER: � U�`� 7 3 2�81 MSDS ON SITE? TYPE OF BUSINESS: P,AIlvTo\4 � 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 (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Cn , , Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS t +w. r r--- - i I ,�U \� j�' I �z ��� ��. �� ��J �° • C � � S'T t ice • - - q� � 1�- ia C�J � 1 � O F ��� "� ,^Y: �� �. % XI % • � �� .f�*;��y&��y� ��� ;��. 1%7 � !� . • .;. . . ... i. { � !Cn�� —� `� 7 I � a � � .€ f ` � Aft, jJL i � / I ',b 4 \ � ,� (�lr �V`1 I} V'`v �� 1 o s 1 i� .� JS ♦ji. r r rM r� u �BAYs.JE P$P1S7L _v '',bpi. .:arr „.r• � . �- _ _ i v� :} c��� G� �w l I��- � �� �: _� �. �C - , � I'� '• Sl�ll ,1 )! jr v i I .� ��) /�� /Q� L? I( �\W ^1 1 o'r \l.'� ' V �L 1 ,� �_ I � 4 Town of Barnstable Public Health Division 200 Main Street Hyannis,M.A.02601 f r I 1 e? d t 1 T a Health Complaints 19-Mar-04 Time: 9:50:00 AM Date: 7/2/2003 Complaint Number: 4139 Referred To: DONNA MIORANDI Taken By: DONNA MIORANDI Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: Business Name: Number: 153 Street: Bacon Road Village: HYANNIS Assessors Map_Parcel: 310-036 1 Health Complaints 14-May-04 Time: 10:48:00 AM Date: 4/22/2004 Complaint Number: 17383 Referred To: DAVID STANTON Taken By: DENISE WITTER Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 153 Street: Bacon Rd Village: HYANNIS Assessors Map_Parcel: 2 TOWN OF BARNSTABLE BAR-Wry Ordiniance or-Regulation WARNING NOTICE Name of Offender/Manager 01 4 Address of Offender .Q ;,,v 3 '12 MV/MB, Reg.# Village/State/Zip bOl _ _�Ipm, on, t�1 Business Name ,7112 0 Business Address Sigftdture of Enforcing Officer Village/State/Zip Location of Offense /5-3 Reworl AA' Enf o5ccing/Dbpt/Division Offense 0,A I r (4 (lei Facts �0,jr- vfAJ'0Jfrf A6wrl, 0, Ad -),o Wrcy P/01-(r ffl-,iAvMo iv L)j r q b ILI This 'will serve only as aI! warning. At this time no legVl action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER . GOLD-ENFORCING DEPT. :TOWN OF BARNSTABLE BAR-W i 'Ordinance or Regulation WARNING: NOTICE Name of Off ender/Manager >� �':�' " :, .._, .. Address of Offender r � '` MV/MB Reg.# Village/State/Zip �� :� Business Name r• `/am%pm, on- /ff 20 , Business Address Signature of Enforcing Officer . ,. Village/State/Zip Location of Offense ,°5_3 UC r f= .'+ Enforcing iDbpt/Division Offense v' Facts ,rs ;r J r�� fV' This will serve only as a warning. At this time no lega`1 action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are -attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. M 4 CA WHITE-OFFENDER . NARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. Health Complaints 04-May-04 Time: 10:48:00 AM Date: 4/22/2004 Complaint Number: 17383 Referred To: DAVID STANTON Taken By: DENISE WITTER Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 153 Street: Bacon Rd Village: HYANNIS Assessors Map_Parcel: .erg. '�"# ` L+».�YDoYrtRl!?• l+.S,7f�lp'F�`'-"�`af''�";� �.�`,��,�uu 7� �- g�'� ' aytu �^etti` w� l c^pMI �� f �w�$ •,Iy CY�A.»e .2"4t71 "`t�'+ x�' x 's1' 9 � 4 � 'S fAiTir?f�, r�p�al �`37 '1r ` w,tfE'�` $Nt �'yggr Yr " 1 .A'� ��:� !�7M�f1�� .•��;,�� 1p��rl� � 1.k.�1e t �d#a1 ( , ..�^«.� - �.7?-/!'4�� 4 6.. /.�aAila+a.•!� «Afi ,p(� tA l ��y�t �� -a. 4� ! p�`r `-N•'j�l-�`� 14,p'.���#I � ��'^R"AA �1`''r����.. ti, ON t.� �`�./�"'a� ��� �p� �?��"������off.• � �, K. _ �: ♦�'+t+ w ,Vyj jty� F�${'fit/ � 1 '1r t�!'# ,� �{jJ�'ati n1 � .....+-•.t g'#"3 -. �9 ///����vrrrjj' !!lam++ wG■ �` `Yqy�� �� Y5 VVV f r S ♦ �LT 4t� d f c"1 .- '- y.�. �1 �e,'- �w,,Y.,�l �.g��� �.i y`L ,v�'"`C�s�"y�,,}, ' •"�I�ii?+,�'f'�-A}r�% ,�". .t ,# - _ LIN,a'p ��,�'LI�" Vf cgif a+�r� F z .p•+ ',>3+aT\�a t[�Ird4C"p,Y". '_� _ '�. t �d wp^ a ES'�A' t'L �RiVq 1�T � W� t, l•1 1 .����. l to♦ .:tit'.�\ F1 L p A ! l�y �y +� � �y;, an S' ` ASI ti Ypr- am v-�ySS�l.�� �" �- �"w,1 �'-i:�Ha +�, 'sue " Y fa+rr" rlr�! a M L} ate' [y� J o,