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Home My WebLink About0080 CONNEMARA CIRCLE - Health to Connemara Circle -d . -� . Hyannis s-.,FIR - - A = 291�"286 II ' N � I I P - ' i Five Star Painting 80 Connemara Circle, Hyannis Cynthia Martin, DPH January 10,2012 A visit to the above address revealed that the business is no longer there. I spoke to the new owner, last name Acharya, who indicated that the residential home was purchased a year ago. Town "Parcel Info' verified this purchase. I i • Town of Barnstable °Ft►+E, Regulatory Services ti Thomas F. Geiler, Director '"MAM Public Health Division ArE1639. Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT S NAME OF ESTABLISHMENT I yt ac qu(�&s ADDRESS OF ESTABLISHMENT SO G('C k , �Ww IS MA OZ60) TELEPHONE NUMBER SOLE OWNER:AtYES NO .__ ,_._ _. _. ... _ .:..• . ._.� _-.. . _ __.�._ _'' � ._ M J i _ IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: 1 w _- rn IF APPLICANT IS A CORPORATION:. FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF-APPLICANT..__. RESTRICTIONS: HOME ADDRESS�COM(Y'a ' CC l P� HOME TELEPHONE# R Q:\Application Forms\HAZAPP.DOC MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please.include the required fee of$100. Make check payable to: Town of.Barnstable. Allow five to seven (7) working.days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Q Upplication FormsNEAZAPPMOC _ I I i I _ I Number Fee 210 THE COMMONWEALTH ,OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health i This is to Certify that Five Star Painters 80 Connemara Circle,MA 02601 ! Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -----------------------------------------------------------------------------------------------=------------------------------------------------------------------- I ------------------------------------------------------------------------------------------------------------------------------------------------------------------ i This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. I June 12, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r �G ( Date: 5 'TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: f:ue= - eff,�,A�_s BUSINESS LOCATION: 190 Can_ ina caot.cl- Ci in Al_ _ A7' 4 � — MAILING ADDRESS: 0 INVENTORYTOTAL AMOUNT: TELEPHONE NUMBER: rc7S SRG Z— G 319 2- CONTACT PERSON: EMERGENCY CONTACT TELEPHO NUMBE 52r ai- ZZ44--we_ FIRE p�57�1� TYPE OF BUSINESS: OTHER INFORMATION,4t dCAe, 3R Cr -f ue -rmorn ris�fiamb! notes' c2 e c eg aA.t esa-eS Wimp ov-e,� uJl. o-r i aA� 'ad.s M r'�►c�E•u'�� c�,�� '� •t'!�- /fe.�h ��'Y"� .a,s.a.� ��er�l-� apt �zdlutcs Waste Transportation: Name of Hauler: Destination: Waste Product: Licensed?:Yes No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. - NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor.oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ' NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote). Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car wa;k s and polishes Leather dyes Asphalt& roofing tar Fertilizers � 0-..cLA Paints, varnishes, stains, dyes PCB's 2 0 Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride)- .10 6aA Paint&varnish.removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform,formaldehyde, + Floor&furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be-toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: _� (dry cleaners) LyaoAg_ i 5 Other cleaning solvents Bug and tar removersLAU �� Date: -TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: be-IJG51_HG3 a�'GCyG U88 EiQP1 S+Qc youMtfl-)), BUSINESS LOCATION: 10 Cyr e mCt�G Ci-r 9Qo,MV, MA OolboA MAILINGADDRESS: 9-0 C.onmEnCc-CG U GIe. 1.1�c�nn;< Dd�o�1 Mail To: - TELEPHONE NUMBER: C5-o8) `6(oa-G Board of Health Town of Barnstable CONTACT PERSON: TUr` sA P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: (S 6) g6a Hyannis, MA 02601 TYPEOFBUSINESS: nt- Does your firm st a any of the t cy or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. . If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics.and must be registered regardless of volume. Please estimate the quantity beside the product that you-store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) .Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's mil. Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint &'varnish removers,- deglossers Any-other products with "poison" labels 0 Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS . �. � COP � date: ,P TOXIC AND HAZARDOUS MATERIAL" ,ON-SIT - . ENTORY NAMEOFBUSINESS: �i ve: 5tr P�,ceA^s BUSINESS LOCATION: 190 .MAILING ADDRESS: INVENTORY "TELEPHONE NUMBER: 6-c78-SS(,Z— (0 3 8 Z TOTAL AMOUNT: CONTACT PERSON:' EMERGENCY CONTACT TELEPHO NUMBE _54,�aea- 4.�e. FWE TYPEOFBUSINESS: ,� 1 OTHER INFORMATION ,4-t�t(cAe,jq o-b 44w- `rar-�m ri��u�bl may' ee_ r e (AA r es aAA- e a a-eS wi i ow--t- . cast• ai ova a 'adss jgere M SAS o0 .� . P?'1 cam'Fiu'�{�,, Ce<v15� l�c�') '!�i-e- /•�fQa6P�Yh �P.ga�: Gi.5.�t.� 'C'e� �Y' Waste Transportation: zrrc Name of Hauler: Destination: Waste Product: Licensed?: Yes No LIST OF TOXIC AND HAZARDOUS MATERIALS .The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST-IN TOTAL LIQUID VOLUME OR POUNDS:'" Quantity Observed (gallons): U've C" Antifreeze(for gasoline or coolant systems) ac4-L#_ � NEW USED Automatic transmission fluid ' Engine and radiator flushes f 74,f$ f Hydraulic fluid (including brake fluid) .!j Motor oils - NEW . USED Waa— �i6r�e "/Z��'/ Gasoline, Jet Fuel , Diesel,fuel, kerosene, #2 heating oil ' Other.petroleum products: grease, lubricants, gear.oil-' _ Degreasers for engines and metal . Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery,acid (electrolyte) Swimming pool chlorine Rustproofers - Lye or caustic soda Car wash detergents Jewelry cleaners Car wakes and.polishes Leather dyes Asphalt& roofing tar Fertilizers F�+ Paints, varnishes, stains, dyes PCB's 2-O qA Lacquer thinners .Other chlorinated hydrocarbons; NEW USED (inc. carbon tetrachloride) 10 Paint&varnish.removers, deglossers Any other products with "poison" labels Paint brush'cleaners ; 't (including chloroform;formaldehyde, Floor&furniture strippers ' f hydrochloric acid, other acids) t Metal polishes = Other products not listed which you feel `f Laundry soil & stain removers p (including bleach) may be-toxic or hazardous (please list): �. Spot removers & cleaning fluids Misc.' (dry cleaners) Other cleaning solvents Bug and tar.removers " ''' - o'�tCtc`l., azA_-* irl awce—" D CC 0 tayte: �� 5�0 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: be-JGS+;Ga EEgcr ULNA Fib 5+Qc Q0iM,eA_1-, BUSINESS LOCATION: 10 CCrC� e-mAcc► Cimle— MA Olbdl MAILING ADDRESS: 90 Gc c,le-. Mail To: TELEPHONE NUMBER: C 5-08) J6 6a-G_:;sRa. Board of Health Town of Barnstable CONTACTPERSON: � Aq P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: (SOS) g(Oa 638. Hyannis, MA 02601 TYPE OF BUSINESS: Qc6 r>t' t Does your firm st a any of the t or hazardous materials listed below,either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of ayes or no answer. Use the enclosed envelope for your convenience. If you answered YES above,please indicate if.the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ' NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) .40ok, Paint & varnish removers; deglossers Any other products with "poison" labels 10 Paint brush cleaners Floor&furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids ' (dry cleaners) I Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS .L l } Town of Barnstable o�tN'E Regulatory Services Thomas F.Geiler,Director Public Health Division CIO /\ % ✓X.ak .� 1!d V d *3 *RNSTArB,',* Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Phone: 508-862-4644 Email: health(E�town.barnstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—5:00 Five Star Painters Attention: Sebastiao Braga June 14, 2004 80 Connemara Circle Hyannis,MA 02601 RE: Hazardous Materials License Required and OVERDUE Dear Mr. Braga: The inventory total from your Toxic and Hazardous Materials Inventory form submitted to the Public Health Division on April 15, 2004 shows that you have approximately 120 gallons of toxic and hazardous materials being used/stored/generated/disposed of at your place of business (Please refer to your copy of the Toxic and Hazardous Materials Onsite Inventory). The Town of Barnstable Board of Health has determined that using, storing, generating and/or disposing of over 111 gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials License. This license should be purchased by your business as soon as possible from: Town of Barnstable Town Offices Public Division of Health 200 Main Street,Hyannis Passing your Hazardous Materials Inspection and obtaining your license will keep your business compliant with the Control of Toxic and Hazardous Materials ordinance(Article 39). Following the recommendations given after your annual inventory can prevent contamination of Barnstable's existing and future drinking water supply,prevent environmental contamination which can bankrupt site owners, lead to,future regulatory, and possibly,legal problems,lower or destroy land values,drive out residents and industry, depress local economies and endanger public health. You will receive your Hazardous Materials License certificate after you have passed your inspection and paid the license fee. Your continued cooperation is greatly appreciated. If you 't have any questions or need further information,please do not hesitate to contact the Public Health Division. Thank you, Thomas A.McKean,RS,CHO Director of Public Health enc. Hazmat license application 3 Fee'-� Number' r `s t I.4t i r r j i + F THE C- 'MMONWEALTH�OI 'MAS i4�H;US TTS { g oo oo : a ,. A'. Town Of Mar . b1b ;Board_ ;ofirHeaih y3 t : a This is,to CerEi#y that Five Star Painters - � 80_:Connemara Carcle,'MA --0260I a 3 ! 4 L ;t t Is.Hereby Granted a License FOR STORGib HANDLING 111 GA4L6 �.N NS OR MOIRE•O,F HAZARD'US MATERIALS -------- _____ ___1____ _ _ _ _ __ _ ____ ___ _ _ _ _ _ ___ _ . : This h�prise is granted in conformityyvith ,the Statutes and,ordinagces xelating there to,and and expires JUtie 30,2005 unless sooner suspendetl or ret>oked: • F � F' SUSAWG�RASK,RS EHARM AN .WAYNE MILLER,M D JUf 1,-2004' SUMNER KAUFMAN MS y THOMAS MCKEAN,12 S,cHO Al).irector of Public Health G` r ¢. i i Town of Barnstable Regulatory Services Thomas F. Geiler,Director ` '" MA&SB' Public Health Division z6gq. �0 039. Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Oilice: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE Oro I d W 0 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS.OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT k�5}jgnf � NAME OF ESTABLISHMENT n. 5.A F i V, PG•i r)+er-,S ADDRESS OF ESTABLISHMENT YO' I2. a o, w o TELEPHONE NUMBER SOLE OWNER:--.,/YES NO J1 all IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF Alm. PARTNERS: - a) w r' o rn IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT " TREASURER CLERK SI ATURE F LICANT RESTRICTIONS: HOME ADDRESS 5?0 (Qbret M GCC1_- HOME TELEPHONE# �SCT�, �oat�3ti� Haz.doc/wp/q i `s^ MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven (7) working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FQR FAXED.REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 nay. �- ,�y � . s vfi ��' _ . . ,. w�� -----_ � � ..�, a :� •� x . ` Date: 5-//-d y TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: F BUSINESS LOCATION: O o. ell• 1Z .MAILING ADDRESS: INVENTORY TOTAL AMOUNT: TELEPHONE NUMBER: .�� c78—4��2-- (0 3 s Z. , CONTACT PERSON: /a® EMERGENCY CONTACT TELEPHOWiNUMBEFV 5Qii Rim- 42-4a-dy _ TYPE OF BUSINESS: V? FWE r)(57-RICT OTHER INFORMATION: A-twcAe.3 0-6 4'hW- -r0T rrj C7 o�ata° C e,_. a c,wr e g � �.c�'r�Pv.�-e 5• c.�r'/'�'� c�e�' - ,,�. asl• a � � � 'ads � MSS oh �ife� r' j a,*ea •�- ct,S,R-�• Q'I,.f GC Zu.�(�ts Waste Transportation: Name of Hauler: Destination: r�aP�aAs u Waste Product: Licensed?: Yes No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of'Health has determined that the following products exhibit toxic or hazardous character- sistics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR,POUNDS. Quantity Observed (gallons): Antifreeze(forgasoline or Coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) .Dieselfuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar a Fertilizers 1 Paints, varnishes, stains, dyes PCB's Z Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride)- Paint&varnish removers, deglossers .� Any other products with "poison" labels Paint brush cleaners (including chloroform;formaldehyde, CJ Floor&furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or.hazardous (please list): Spot removers & cleaning fluids Misc.: (dry cleaners) Other cleaning solvents Bug and tar removers rA-arzW 07a,*ftliax s,0-JA emeCA4 s. Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: be-bG_S4i63 229Cfo b8A FiQ2 S+Qr 00Lifl1'Q1t1�. BUSINESS LOCATION: -90 GOnrV_,mGrG Grc.'12 N,AG(v)%, MA oabo/I MAILINGADDRESS: 90 ConMMGc-G Ur—C kP_ Inc, oaboA Mail To: TELEPHONE NUMBER: (508) $(ga-G3 Board of HealthRa. Town of Barnstable CONTACT PERSON: �U(`Uu _ Aq P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: (S L) g(b-a rb38-, Hyannis, MA 02601 TYPE OF BUSINESS: IQGu Cyl- Does your firm st a any of the t ' or hazardous materials listed below, either for sale or for you own use? YES NO ` This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. . If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antif reeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes - Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil - NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers �C Paints, varnishes, stains, dyes PCB's oa0 oiL Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels 10 Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS I I TOWN OF BARNSTABLE BAR_W NQ 3389 Ordinance or Regulation. WARNING- NOTICE Name of Offender/ManagerQti .rr7,ald �v�tfi Address of Offender 's ( co-'VaAa� ,�..�+a� � „�� MV/MB Reg.# 4 Village/State/Zip tA t: s+r1yL n, . / ]A p 2 40( Business Name Fr,kle _ _gyp f/pm, on M","e./r20pc Business Address '90 C olitlt e-r1�0L UmAe Signature of Enforcing Officer Village/State/Zip �,�,� �^- , /y j (yz66,1 Location of Offense o / '�(a �'_.�rt n Py�Ctit�.. t..w',r''�G�t.". [-'�c�.�� 14 eX.A.A-ln Enforcing Dept/Division Offense Facts I�p�► T h a,,� w, ( xri r.�sdc�,.*r�.l . n -Wry vr.�!-E,�l i r� �a��Li �i►'h t ..J _.� This will serve only as a warning. -,Kt th6 time' nolegal 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 -8 LOCATION CaN,�/&MAIF'.# CIA SEWAGE # VILLAGE.1WN11PE eASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. � 19`ks7 SEPTIC TANK CAPACITY /000 LEACHING FACIL=: (type)1' ��C 1'ae � (size) .I31X q'7'0C NO. OF BEDROOMS L BUILDER OR OWNER Wv �t 5,,1 PERMIT DATE: o 15 ° 2 COMPLIANCE DATE: Iv •� �� 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 u �� . �� ,�� s l( � �� r, � �� '� � ®'°_ - � _: �� No. y a , S Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0ppYfcation for 30t!5pool *pgtem Construction Permit Application for a Permit to Construct( . )Repair(V)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.90 1CCWN6%W ICAO Owner's Name,Address and Tel.No. (;(IN,�16 e4jtT14 Assessor's Map/Parcel / b In taller's Name,Address,and Tel.No. /f j�� Designer's Name,Address and Tel.No. ao- nr� ergs �t sccs C- w 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 ?30 gallons per day. Calculated daily flow ?GCS gallons. Plan Date Number of sheets �' Revision Date Title Size of Septic Tank ldOO Type of S.A.S. k S �i46 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: c 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 E nmental Co a and not to place the system in operation until a Certifi- cate of Compliance has been issued by5ois Bgar of ealth. _ Signed Date /0'`c�; Application Approved b Date .0 Z Application Disapproved or a following reasons Permit No. 2C�� / Date Issued r - _ .— ... l • , �` • n 4� , •--�_.Qv-• ,t �iry1-.�.� F^1. tu. ^""" 'C';t..r �. ' 'No. C�CJ ► f. ,: tip THE COMMONWEALTH OF MASSACHUSETTSr Entered in computer: �.. Yes r E PUB 1.LIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS Zl pprtcattop f or M[gpont *pgtem Congtruction Permit Y Application for a Permit to Construct( )Repair((/)Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No.gO CCW y46 A0 6/2, Owner's Name,Address and Tel.No. Assessor's Map/Parcel (N7N� ?/� —m6 C/ In taller's Name,Address,and Tel.No. /��O 6 Designer's Name,Address and Tel.No. 43AAR l yat 01324- RoUr�E��TAL . Type of Building: ' Dwelling No.of Bedrooms {. Lot Size sq.ft. Garbage Grinder( ) Other Type df Building NO.of Persons Showers( ) Cafeteria( )zr Other Fixtures t 6 k, Design Flow ?30 4allons per day. Calculated daily flow �ZFQ gallons. Plan Date'"''°°"9-/ _a-� Number of sheets Revision Date Titleh a Size otSeptic Tank /OQd Type of S.A.S. oZ sw Cif/ coyw 9-0&)�6 Description of Soil Nature of Repairs or Alterations(Answer when applicable) ` 1 � • i ` 1 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 E nmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b is Boaz of ealth. Signed Date /0�—B� t Application Approved b Date Application Disapproved or a following reasons — Permit No. 2oo;e Date Issued 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 at�) ! ra�1 v �^ a lr� C c has been constructed i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. D 0o 7_49/A dated 1 u Installer Designer The issuance of this permit shall not be construed as a guarantee that the s�te wil}functio as designed. Date 10 1?Sr w l Inspector"�1,11 _. No. 2 o O Z _t d >/ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS M!5pogal ongtruction Permit Permission is hereby granted to Construct( Repair Upgrade( )Abandon( ) System located at Wo cr% ^nvr� rl raj-- 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 per Date: l / S i Approved by jTOWN OF BARNSTABLE LOCATION 80 C.Q&R&r*?AA# CIA SEWAGE # 0,2 I VILLAGE &n yl5 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO._�"h%T16 SEPTIC TANK CAPACITY /000 J ' d LEACHING FACILITY: (type) 50 (size)'] NO. OF BEDROOMS BUILDER OR OWNER wo ^t Soy^' 41 PERMITDATE: o f S .�2 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 4 on site or within 200 feet of leaching facility) Feet Edge of We and Leaching Facility(If any wetlands exist within 300 feet o f_leaching facility) Feet Furnished by r4 / i i i I f • 4 ` Commonwealth of Massachusetts Executive Office of Environmental Affairs De artment of •,q 8 v Environmental Protection - I' 199e a, William F.Weld Gwemor Trudy Coxe Seueta y EOt A Davld 0.Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address:'V�o Cb Address of Owner: J �(}y CV,�I_e Date of Inspection: — t&-'j (If different) Name of Inspector Zi-e 4 D � y Company Name,Address and Telephone Number: W&V"PtiJ o IV\A-i -�•o ��,��' Pam- 1-�� CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage disposal system at this address apd that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes �!I`�ii '�Co 1i N;i±hditionally Passes 1eds Fuither Evaluation By the Local Approving Authorityt fails' Inspector's ,S,•tgiiatur� Date: _ d The System Inspector shall submit a copy of thi ins lion report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should ue sen, w.me system owner and copies sent to the buyer, ii applicable and the approving authority. INSPECTION SUMMARY: Check A, B,C,or D: A] SYSTE SESr I have not'found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. 81 SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not,determined(Y, N,or ND). Describe basis of determination in all instances. If"not determined", explain why not) The septic tank is metal, cracked, structurally unsound, shows substantial,,infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with.a conforming septic tank as approved by the Board of Health. (revised 8/15/951~' 1 fhre YVlnter Street a Boston,Massachusetts 02106 a FAX(617)556-1049 a Telephone(61/)292-Wo 40 PMted on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 76 coA/wGYV�wt��Cl Owner:'"ZW , C�r�� Date of Inspect on: B]SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health):, broken pipe(s) are.replaced obstruction is removed i distribution box is levelled or replaced _ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public.health, safety and the environment. 1) SYSTEM WILL PASS UNLESS'BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING.IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. Z) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH.(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: PN > I he.wsiem nas a septic tank anu soli absorption system anu is within.iOG icec to a su��a.� 'rater su or tFlbUtaij to,a surface water. supply. _ stem and is within a Zoned of a public water supply well. The system hay a septic tank and soil absorption sy _ The system has a septic tank and soil absorption system and is.within-50 feet of a private,water supply well.. _ The system hiss a septic tank and soil absorption system and is less thaii 100 feet but 50 feet or more from a private water icates that the well is, supply well, unless a well water analysis for coliform bacteria and volatile organic compounds ind free from pollution from,that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D] SYSTEM FAILS: /1 .I have determined that the system violates one or more of the following failure criteria.as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will,be necessary.to correct. -the_failure. _ Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent-to the surface of the ground or surface waters due m to a overloaded or clogged SAS or cesspool. (revised ,8/15/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: TO Owner: S n-j Cue 1�74 Date of Inspection: D)SYSTEM FAILS(continued): Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. j` liquid depth in cesspool is less than 6" below invert or available volume is less than 112 day flow. i Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped G Any portion of the Soil;Absorption System, cesspool or,privy is below the high groundwater elevation. Any portion of a cesspoof or privy is within 100 feet of a surface water supply or tributary to a surface water supply. dAny portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any.portion of a.cesspool-or,privy is less than 100' feet but greater than 50 feet from a private water supply well,with no acceptable water quality analysis. :If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following:criteria.apply to large systems in addition to the criteria above: The design'flow of system is 10-1000.gpd or greater (large System)and the system is a significant threat to public health',and safety and the environment because one or more of the following conditions exist: the system,is within 400 feet of a surface drinking water supply the,system is within 200 feet of a tributary to a surface drinking,water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone 11 of a public water suppiv well! The owner or.operator:of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office.of the Department for further information. (revised 8/1S/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART.B CHECKLIST PropertyAddress:'70 60/41't?MAv,:,,-C, t-e Owner: Date of Inspection:- Check.if the following have been done: L�'Pumping information was requested of the owner, occupant, and.Board of Health. None of.the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. /`! s built plans have been obtained and examined. Note if they are not available with N/A. the facility or dwelling was inspected for signs of sewage back-up. , �'[�ie system does.not receive non-sanitary or industrial waste flow, tf t e site was inspected for signs of breakout. .LeAI system components, excluding.the Soil Absorption System, have been located on the site. "e septic tank manholes were uncovered, opened, and the interior of the septic.tank was inspected for condition of.baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. L--rhe size and location of.the Soii Absorption System on the site has been determined based on existing information'or approximated by non-intrusive-methods. ; _4 faci;ii: o.:r,""! ;X,J o.cupants, if dif?e-� from ov:ner, were provided with information on the proper maintenance of Sub Surface.Disposal System. n ,, .(revised 8/15/95) q j SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: CON I-cw s"', c4 rc-�-t— Owner: Date of Inspection:. FLOW CONDITIONS RESIDENTIAL: 3 Design flow:�gallons Number of bedrooms:' .7 Number of current residents: Garbage grinder(yes or no)f Laundry connected to syste (yes or no):4 Seasonal use (yes or:•no): Water meter readings, if available: /U (A- Last date of occupancy: COMMERCIAUINDUSTRIAL: Type of establishment:. Design flow:laallons/day Grease trap present:•(yes or no)_ Industrial Waste Holding Tank present:;(yes'or'66)_ ! ' Non-sanitary waste discharged to the Title 5 system: (yes or no)_ " Water meter readings, if available: Last date bVoccupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION r, PUMPING RECORDS and source of information: N Q SyS1'Ci� c L,r4S D -9•ecorY System pumped as pan of inspecti n: (yes or no) If yes, volume pumped: gallon, Reason for pumping: 5L TYPE OJAYSTEM , Septic tank/distribution.box/soil.absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (i(yes,attach previous inspection records,;-if any) r Other(explain)' 4l, r; r APPROXIMATE AGE.of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) (zivised 6/15/95). 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION, (continued) Property Address: CO N/ucWttt _GC•^��— ��(� Owner: Date of Inspection: 2c�-C7 SEPTIC TANK: (locate on site plan) t't Depth below grade: Material of construction: "concrete —metal—FRP —other(explain) Dimensions: Sludge depth:_ !/ Distance from top of sludge to bottom of outlet tee or baffle: 1 L Scum thickness:' ( Distance from top.of scum to top of outlet tee or baffle: 011 r �4 Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation:for pumping, condition•of inlet and outlet tees or baffles, depth of liquid level in relation t o}itlet invert, structural integrity, evidence' of.leakage, etc.) GREASE TRAP: (locate on site plan) Depth below grade: Material of construction: concrete —metal_FRP —other(explain) ;• Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom ni cr,orn in hnttnrr cit owle! tee or battle. Comments: (recommendation for pumping, condition of inlet and outlet,tees or baffles, depth of liquid level in relation to outlet invert, structural integrity,.eviderice of leakage, etc.) Cr r` (revised t3/SSL95) 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART C SYSTEM INFORMATION (continued) Property Address:"90 GO N ti ew kV«�ti J c Owner:77�6�4. &J✓ -)e Date of Inspection:. TIGHT OR HOLDING TANK:i (locate on site plan) Depth below grader Material of.construction: _concrete_metal _FRP—other(explain) Dimensions: Capacity: Qallons Design flow: sallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX—A—/" (locale on site plan) Depth of liquid level above outlet invert: , xY Comments: Mote ri levei and drstriburu.i, t•yua:, a%;dunce of iulid: cou u•,er, gwdence of leakage into or out of box, etc.) �U �✓•v�G�i,vS` PUMP CHAMBER: (locate on,site plan). ' Pumps in working order.(yes or no) Comments: (note:condition of pump:chamber, condition of pumps and appurtenances, etc.) 7 (revised 8/15/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i PART C SYSTEM INFORMATION (continued) Property Address: 70 OwnerL_�4Y 6jftvy Date of Inspeetiori: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If.not determined to be present, explain: Type: leaching pits, number:L leaching chambers; number-- leaching*galleries, number: i leaching trenches, number,length: leaching fields, number, dimensions: overflow.cesspool, number: Comments: (note condition of soil, signs.of hydraulic failure, level,of ponding, condition of cvegetation,etcJ L)Y.y`lam M KID ll✓� CESSPOOLS: 14 (locate on site plan) Number and configuration: Depth-top of liquid.to inlet.inven: Depth of solids layer: Depth of scum layer:. Dimensions of cesspool: Materials of construction: Indication of groundwate,: inflow(cesspool must be,pumped as part of inspection) ,t Comments: (note condition of soil, signs of.hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate on site plan) Materials,of construction: Dimensions: Depth of,solids: F. Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition.of vegetation;etc.) w B (revised 8/15/95) r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C' SYSTEM INFORMATION(continued) Property Address:gQ Owner: —�Sv x- Ce,✓I�� Date of Inspection: a-7(o-`i�p SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or,benchmarks locate all wells within 100' 19 b� 300 U i ' t ,DEPTH TO GROUNDWATER Depth to groundwater. Y/feet Method,of:determination or approximation: PVT tS O vev �-{ A bogie t4w� trevised 8/15/95) 9 • i LO. CA-TIONs - SEWAGE PERMIT_ N0. 4 L L AG E INSTA LLER'S NAME 6 ADDRESS r M ® U I- L� OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED vi -r' r- `e� J D No.......... ��.... F�$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town.......................OF.............Barnstable.. ... . Appliratinn for Diipnotal Works Cnnnutrnr#iun Errant Application is hereby made for a Permit to Construct .(X ) or Repair ( ) an Individual Sewage Disposal System at: Connemara Circles Lot 67 ................_ .................----•----------.......-----------.......••---- ---------••-•---•....----••-•-.---•--........---......------•---...._----------------------------- Locat'on-Address or Lot No. G� �l...-ar .1....... � ------....C.0.1?p-•-......... -----•-- -- •....... Owner Address W .....................................kt--�Phl-------------.---------------------- -------------------------------------------------------------------------------------------------- Installer Address 20 799 Type of Building,,- Size Lot........................... feet 6 Dwelling�o. of Bedrooms................._......_3.................Expansion Attic ( ) Garbage Grinder (no) 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'capacitylOO.O._gallons Length$...6 t..... Width 4._.10._.. Diameter________________ Depth 4___0....... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........I........... Diameter----IQ!........ Depth below inlet......6............ Total leaching area.... 61._....sq. ft. Z Other Distribution box ( X) Dosing tank ( ) / '-' Percolation Test Results Performed byCape-.-GQ-d--5> xX--COnultantsDate....l/z4l7.5................ aTest Pit No. 1.......Z......minutes per inch Depth of Test Pit.......12 r___•• Depth to ground water...... 0_'............ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil.0-.0,2a_Q..)-QaM...&...stybz.Q . ._,_._. _.4-$_.0•__m_ed..__.brown-•-aand•-:wi OFM � ------------------------------- gravel__ C--;�tQnes� $_._Q-_1Q_-9__me_d.A---white----5and ......1 --- -- caarse...s.axid graue�......................................----- ---- RENgwicK_ ................................. UNature of Repairs or Alterations—Answer when applicable_________ ________ ..................... 4 ____ „AP MA - y .............•----..._._...--•-••--••------••-----....---._...-•-•--..._._....:...._......._......--••••..... ................ .. Ywa?gF/ Agreement: 'The undersigned agrees to install the aforedescribed Individual SDisposal System in ac A the provisions of TIT 2 5'of the State Sanitary Code—The undersigned further agrees not to place the s operation until a Certificate of Compliance has bee sue by the board of health. Si �... .• .•. ................................................... /••--.--•-- Date Application Approved B . . . •-• ��—�3_7�,� PP PP Y Date Application Disapproved for the'following reasons:................................................................................................................. --•-••••••-•••-----••--••--•-••-••---•-•••••-•-•-•-•--••---------•-----••...••-••••--•-••---------••---...•••----••••------•••-- ------------------------------------------------------------•. ^�� Date --- Permit No. '---•-.::..•---••-----•----•-------...._•----._...--- Issued--•---------•---------------'------.......-•----•-•--... Date i No..( � FES....... .~.......... THE COMMONWEALTH OF M`ASSACHUSETTS BOARD OF HEALTH Town.........................O F.............Barnstable .................................................................... Applira#iun for BiipuuFal Works Tomitrurtiun "rrmi# Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at Connemara Circle Lot 67 Location Address or Lot No. �' F-_ // % _�-�-•.-^•_-... --••-•--•------------•--•-•-•.......................---......................................-- :....................__.... ........... .....-• � Owner, Address ,Wl -------------------- .;! ,..a._ '! .h.................------...__.......... ---•--•------------------------- ---..... -- � Installer Address 20 ?99 d Type of Building Size Lot............................Sq. feet Dwelling-a6�o. of Bedrooms.......................•.......__.....__..Expansion Attic ( ) Garbage Grinder) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtu e W Design Flow............................................gallons per person per day. Total daily flow__._._...... �...................._�lons. WSeptic Tank—Liquid capacit}.QCI.U...gallons Length$.t. ....... WidthV10". Diameter................ Depth4.-Ott x Disposal Trench—No..................... Width............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......l........... Diameter...10 t......... Depth below inlet.....6............ Total leaching area...267......sq. ft. Z Other Distribution box (X) Dosing tank ( ) Percolation Test Results Performed b;ap?e._.Cod...5.ur.vey...G9315u1t.411t$Date... 4/24/79................ ,aa Test Pit No. I......2.......minutes per inch Depth of Test Pit.._._.12........ Depth to ground water.....10�........_-. tT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •-••-•-••-••-----•----•••-•••••••••••---••--•-••-••-•••••--••••.....•••••••••••................................................................. O Description of Soil. -2_. ... .QaiR__ G..s111?_SQ 1. ...2aQ-$_. _.. .4'�.nd._Witi... •�,,SN oF.Mgs x _..........gravel._&...stones,.._ .R4.- .Q-O. !�d...... hAtv...sanC-•-1Q.f0-12.. �?`-`----•-•---.-. U o RENWI_CK ya ............................. oareQ...aard...&---gravel..----•-.. ..�.............. ........................... ..................... �• ----------8 m UNature of Repairs or Alterations—Answer when applicable.......... ............. .... . ...... .................... v_ _.._£FittPtAN v -•..............•---••--•-•-••-------••---•--•-•--•-•-------•-•---......_.._..._.........-•-•-••--•••-••••-. . •. . •.. ... ....-.p•No.-,27654 O Agreement: z 90�FG/STEFi��rc� The undersigned agrees to install the aforedescribed Individual'-Sewage Disposal System in accor FpyyANG� the provisions of TITILE 5 of the State Sanitary Coder The undersigned further agrees not to place the sy t�mvart'+� operation until a Certificate of Compliance has been issued by the board of health. �} �j , i Sln d._...... _...+----------------•---......---•--•-•-'•-•--- �_..,,Date-`.......... Application Approved BY ..... ; M i'�-,. .7 r Date Application Disapproved for the following reasons:.....................................................................................•..... ._.........._ - ..............•-•-•----.......---•----•--.....-----......-----.....---•---•------•------•--------•-•-•--•'-•-----••-'•••-•-•-•---•--••••••••-•---•--•.--••••••-•••••-----•-•----•••--•--•-•-••••••-•-•--- '� Date PermitNo........................................................... Issued-....................................................... Date THE COMMONWEALTH OF MAS,StACHUSETTS BOARD OF HEALTH • r .............. ...OF..........; ... C9rdif irate of um�lianrr THIS IS TO CERTIFY,That the Individual Sewage Disposal System constructed 1 4--or Repaired by................................................. , ------.....�............._ --- ---•••---•-••--••--•-._.........•-••••---••-•-•--•......••-•-•.••••.. .............._...._(......).. aLArf Installer N 4 .� . _...... .. -_......---•-------------------•---------•-•-•-•--................................... has been installed in accordance with the provisions of TITr 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__ . .� , JI..-___- l------- dated......�1«�(�!t.-�i--•--------•----- THE ISSUANCE OF THIS CERTIFICATE SHAL OT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE__. .. Inspector .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EA No. 76/ 2�� ry�4 .....OF................ ... .GP .,.-............-._...::........ / FEE......X �iu�rusttl. ga~k� �un��rnr#iun rrmit Permissio> to C914t is hereby granted..------...............................................................--•--------------------------------•---------......................... u t ('{1) ),or tepa r�.(,��.j,,ap.J,ndividual j$gwage DP'��sal ,Syste� atNo...........................................................................................................................................•................................................... Street as shown on the application for Disposal Works Construction P it N .: ----- Dated-------�=�S:'.Z�a........... 1eBai.�.� oa of'H 1 DATE �f 9' ----------------------------- , FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �� a ' • - A , _ SOIL LOG,' _ { • '''rTjf. ►IASTOMt LOAM • SILL If•MAX • ' f . '.-1 01 4 C.I. GIST. I.`.:;• ° ' I �'eJita Q O J 1000 BOX i;:�•; t 1600 GAL. . ` : i T 10 MIN. 1• . • , e ° • SEPTIC . PRECAST OR � �E` 24 i�i4++ _- TANK _ �. .%.• BLOCK ' • '1 MIN . - �3f d5 90.0 6� •. •` SEEPAGE . I l( i• .• .• • . . I )t •.tee.• IrAf 20' •MIN.' • •'8 `'1 w>.+�'! .,Cn �c .; .� r FOUNDATION 1 *!sr J6 a G< a I1�2� WASHED STONE ��. ELEVATION SKETCH .I Do' 1 PERC.•RATE= SCALE I = 4 TEST BY : vim• xAC444'19 TOWN INSPECTOR T'• •0�� •x.`*'�+ 1 BACKHOE OPERATOR TEST MADE ONE 0�_ 271 ts. toe / q Ile /. q o ` 0� •;, �� .� � .Lam G.7.1 ! ./ °� � � -i ` r ' . • ". Zoe°7 9:9¢ $. F: . �. --/00-- Eris`T'v. CONroiiiZ.` a roo '¢oPasimO Cou'Tou.2,, '' f f 1 •I � N � . ., • • .q - ` /r�• �. it � / + :�. ! � ` � 41491 JN to •� Oj AA 109 �a i ;. 1 / � � � �'• -fly �; Z �.=�• �.�, r , �¢ . .4,1e 3 8ao,�a�,ez .►�¢,o4M4E B�x�io 4VAA114 ? = 3<30 ew/m! e / C'mNC. . 0- �� r� , ,�a a�•� oJV0Aw*"wrj /88 S,F x ?-? GR4�lk o _ 4L70 04G OR�I ` 9 •<* �at16 4f^ fir di0e/J S.9 x AO ¢,AD,/,s • / 7V,9ft ZG 7.tf, S¢ 9 0.44 0#4 •pit? C,tdt�r+i,si.Cl'`. Gir j,17 lr l,v�TE,E ,04144&4 —,-;o rf!/s 40-7o, , E L,E VAT i.ON SCHEDULE _. PROPOSED SITE PLAN p • I. 'INV. AT FOUNDATION _ 99<O$ ///. •� a SEWAGE SYSTEM DESIGN 2. INV. INTO" SEPTIC -TANK • ON 3. 1 NV.. OUT OF.,SEPTIC. TANK B•57 t 4. INV. ; 'INTO, 0ISTRIBUTION'BOX _ 98.37 �avrv!5, �?s S. 5. INV. OUT OF DISTRIBUTION BOX _ _ qg•?0 C -7 Z T. 6. INV. 'INTO :SEEPAGE PIT , -9B•00 ., CAPE COD SURVEY CONSULTANTS • ' ' 9P oo ROUTE 132 -k , 7. BOTTOM ,OF PIT HYANNIS,MASS. R -ASSESSORS MAP : _ I -- _ _ - TEST HOLE LOGS PARCEL: 2 (ri SOIL EVALUATOR: { 1.FLOOD ZONE: HOT �V�1LI�k1 �j— - WITNESS : (1 I G�QG REFERENCE: DATE: i �� I, ( =�-t ��1 PERCOLATION RATE: 1 m,3) ZI. _}�' �'` ram'- '` �✓ _ E�� ' t _-. TH- I TH-2 . - - - Iwo LOCAT I ON MAPS -'ZIvp W/ 4�V_AWQI J� U1,�� rJ P. � �; /� �1v �,wn. to ZlrZ2j - -- - ---- - -- Buz- --� "4 n. _► ?'�- SEPTIC SYSTEM DES I GN —Fr 4P - 1 FLOW ESTIMATE "� �--�- �- I `J BEDROOMS AT +d GAL/DAY/BEDROOM - 3?;DGAL/DAY - SEPTIC TANK GAL/DAY x 2 DAYS - f � � �, GAL USE !��UGA,LLON SEPTIC TANK T_ Ile SOIL ABSORPTION SYSTEM 2 v SIDE AREA: .� �C ,Z� # l -xZ 1►' , -7 s !6 2 +OTTOM AREA: x 13 x o 14 0 v S PT I C, SYSTEM SECT I ON (►� S, :TK r . I �'� l p,� ►b` + " X Z Or'3/g '2Z7 ',� 9 �� 7bY�/� , Ali ., 4 MACI O r 4 /2200 GAL ,�O.O Z D-80X , �I i - # co :SEPTIC TANK t"OF f ( L l mooN #loss SITE AND SEWAGE PLAN 8 LOCATION : Nq6mwq oJeal: Do PREPARED FOR : Ikl SCALE: / "I \ DAV I D B . MASON 'Rs DATE: J - DBC ENVIRONMENTAL DESIGNS DATE HEALTH AGENT EAST SANDWICH . MA z � / ( 508 ) 833- 2177 ASSESSORS MA". TEST HOLD LOGS PARCEL: j SOIL EVALUATOR j FLOOD ZONE: WITNESS : V� 1 — i C �{ tK1Q REFERENCE: � 1� �a� 'I' �Js ��C _ DATE: - Ur2C PERCOLATION RATE: 1 _ Loll LOCATION MAP 1-47n 23 rb�111 --� 01,03 cc) j - _ Co2G�/� ✓ -1�..,1 5 / (p>� u� �, UJc� ,Lwr�. w�- _ _-- - --- ---- --- p k SEPT I SYSTEM DES I G N - _ ------- all-1, 11 JS> - -- - iilt -' - - ----- FLOW ESTIMATE BEDROOMS AT I GAL/DAY/BEDROOM 33DGAL/DAY SEPTIC TANK 00 / GAL/DAY x 2 DAYS GAL 16 l�n USE �C�GALLON SEPT 1 C• .TANK F SOIL ABSORPTION SYSTEM a y f 'I DE AREA: I X Z a' = J�2 t T l t € ( (►� T.QM AREA: X l 7 Z • ,� ��►q�� ✓ �, SEPT I C; SYSTEM SECT I ON �jq V . .: j 3/�3 . Lt MYri /lX�� SAL SEPTIC TANKIL 5f - -� IUD — 1 gives i SITE AND SEWAGEOF PLAN ° LOCATION MAI I PREPARED FOR : U hl 1 SCALE: o / W DAV I D B . MASON 'R DATE: DBC ENVIRONMENYAL DESIGNS / DATE HEALTH AGENT EAST SANDWICH . MA ( 508 ) 833-2177 Z A