The URL can be used to link to this page

Home My WebLink About0063 CRAIGVILLE BEACH ROAD - Health (2) raigville Beach Road Hyannis I i v Commonwealth of Massachusetts _ ■ 100160875 �_0_.__j Asbestos Notification Form ANF-001 Decal Number Important:. Men filling out A. Asbestos Abatement Description forms on the computer,use 1. a. Is this facility fee exempt-city,town, district, municipal housing authority, owner-occupied only the tab key residence of four units or less? Z Yes LINO to move your cursor-do not b..Provide blanket decal number if applicable:' use the return Blanket Decal Number key. 2. Facility Location: t [CRAIGSVILLE BEACH RD.� 63 CRAIGVILLE BEACH RDA a.Name of Facility b.Street Address annis MA H -, 02601 ! I is i C.City/Town d.State. e.Zip Code f.Telephone Number INSTRUCTIONS 3`,. ,WOrksite.Locationf 1.All sections of this form must be a.Building NamelBuilding Location b Building# c.Wing d.Floor e.Room completed in order to comply with 4. Is.the facility occupied? i-P 3i Yes :(✓! No DEP notification ' requirements of 310 CIVIR.7.15 5: Asbestos Contractor: and the Division of ccupationa NEW ENGLAND SURFACE MAINTENANCE' 850 WASHINGTON STREET I Safety(DOS) a:Name b.Address '.notification WEYIVIOUTH �T�' 02189' 178 733721.17 i requirements of 453 I I CMR 6 12 c:Ci /Town d Zip Code e.,Telephone.Number- _ AL - z iE'�W. Ve f DOS-License'Number '= g. den E l rbal Contract Type'- ; h Facdi Contact Person i.Contact Person s Title JOHM P:.VALLIQUETTE : : AS060773: � 6. a.Name of On-Site Supervisor/Foreman b:visor/Foreman-DOS Certification'Number N/A .__.. N/A 7 '. a:Name of Project'Monitor b.Project Monitor DOS`Ceitification Number. NIA IN $' a.Name of Asbestos Anal ical Lab _ b.Asbestos Analytical Lab DOS Certification Number 07/2012 10/23/2012 , a.Project Start Date(mm/dd/y_yy_y) b.End Date.(mm/ad/yy �0 N c.Work hours Mon-Fri. d.Work hours Sat-Sun. _o 10. a.What type of project is this? o Demolition Renovation , I Z Repair ['Other, please specify: b.Describe 1.1. a: Check abatement procedures: o EIGlove bag ❑ Encapsulation _ —o E] Enclosure '�✓1 Disposal only — t � ]Cleanup Other.specify: Full containment - b.Describe'- = �__ —z =Q 12. Is the job being conducted: Indoors? Outdoors? anf001 ap.doc 10/02. Asbestos Notification Form•Page 1 of 3 F- 6�inr�hZ� � c,- Yn�V'0�5 Commonwealth of Massachusetts _ _ ■ 1.00160875 i i Asbestos Notification Form ANF-001 `Decal Number A. Asbestos Abatement Description (cont.) 13. Total amount of each type of Asbestos Containing Materials.(ACM)to be removed, enclosed, or encapsulated: -------) 112 a.Total pipes or ducts(linear ft) b.Total other surfaces square.ft) c.Boiler,breaching duct,tank {!� surface coatings �in� Sq.ft d.Insulating cement Lin.ft. Sq.ft. ( e.Corrugated or layered paper I--------- -_1 f.TrowellSprayer coatings pipe insulation Lin.ft. Sq.ft. Lin.ft. Sq.ft. g.Spray-on fireproofing h.Transite board,wallboard Lin.ft. Sq.ft. Lin.ft. Sq.ft. i.Cloths,woveriJabrics --� ):Other,please specify .: ' 2 - Lin.ft. Sq ft Lin.ft. Sq.ft. _ TRANSITSIR W k Thermal,solidi core pipe insulation Lin.'ft. Sq;ft. I..'Speafy, i -1.4. Describethe decontamination system(s).to be used:. 15. Describe the containerization/disposal methods to comply with 310 CMR 7.1'S and.453 GMR U1RED 7777 77.7 1;6 For Emergency Asbestos Operations, the DER and DOS officials who.evatuated the emergency:: f € - -- - 1: a Name of DEP Official' b Title .771 c Dafe(mm/dd/yyyy)of'Authorization d_pEP WalVer# x iTitle,f.D� S Offic al _ O e.Name of DOS,Officia1 N g.:Date(mm/dd/yyyy)of Authorization. h.DOS Waiver#.. o , 17.. Do prevailing wage rates as per M.G.L. c. 149, §26, 27 or 27A-F apply to this project? [.7]Yes-I No B.Facility Description �0 1. Current-or.prior use of facility: STREET �o 2. Is the facility,owner-occupied residential with 4 units or less? ❑Yes Ev]" No TOWN OF HYANNI9 __ - 3' a.:Facility Name b:Address-` o c.City/Town d.ZipCode; e.Telephone Number(area'code and extension) emu_ : 4. ( _ - - a.Name of Facility Owner's On-Site Manager b.On-Site Manager Address _Z � I Q c.City/Town d.Zip Code e.Telephone Number(area code and extension) ■ anf001ap.doc-10102 Asbestos Notification Form•Page 2 of 3 { Commonwealth of Massachusetts [I00160875 Asbestos. Notification Form-ANF-001 Decal Number B. Facility Description (Cont..). 5' a.Name of General Contractor b.Address _ c.City/Town d.Zip Code e.Telephone Number(area code and extension. f.Contractor's Worker's Comp.Insurer g Policy Number h.,Exp.Date(mm/dd/yM. 6. What is the size of this facility?.-. a.square Feet b:Number of floors - I C. Asbestos Transportation and Disposal 1. Transporter of asbestos-containing material from site to temporary storage.:site(If necessary): NESM LLP: 1...<_�.� a Name of Transporter Note:Transfer ,, b Address . f --! Stations must � .: i comply with the c.Citji/Town d:Zip Code 6.Telephone Number Solid Waste . Division -2:' Ttansport6f,6 asbestos contaming waste material from removal/temporary site.to. final disposal site Regulations 310 P CnnR 19.000 RERE CHNOLOGIES 1: a Name of Transporter b.Address c:CitylTown d,Zip Code a Telephone Number 3 a.Refuse Transfer Station and Owner- b-Address c.City/Town d.Zip'Code e.Telephone Number 4. IMINtRVA ENTERPRISES INC a.Final Disposal Site Location Name b.Final Disposal Site Location Owner's Name_ 9000 MINERVA ROAD �.. WAYNESBURG C.Final Disposal Site Address _ d.Cityf.Town OH 44688 -- e.State f.Zip Code g.Telephone Number. =0 D. Certification N The undersigned hereby states, under the I ENN FURTNEY �✓y penalties of perjury,that he/she has read the a.Name _m__. •__ b.Authorized Signature _ �o Commonwealth of Massachusetts regulations { 0/9/2012 for the Removal,Containment or c.Position/Title d.Date(mm/dd/vvW) Encapsulation of.Asbestos,453 CMR 6,00 and 310 CMR 7.15, and that the information ! I COntalned in this notification iS true and correct e�..._??LQPhone Number f._ReQresenting - o to the best of his/her knowledge and belief. ' ^� O g:AddressLL _ h.City/Town _ is Zip Code �z Q anf001ap.doc•10/02 Asbestos Notification form•Page 3 of 3 r-)-- OWN OF BARNSTABLE, / f e .oNrlChfiP WAGE # LOCn i10N VILLAGE / 4? ASSESSOR'S MAP& LOT "l INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY G 0,0 LEACHING FACILITY: (type) (size) CF O `S NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: COMPLIANCE DA � Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 Faige of Wetland and Leaching Facility(If any wetlands exist within 300 feet of,leaching facility) Feet Furnished by 4 - `� � �<< �0,� G �, z � �� e � �� -�--- �' � r i, �� Ir w 1 NO.J, + -- Fmc$....3 0..0 0...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Bi_npnial Work,6 Towitrurtion Permit Application is hereby for ern�it to�C, "1 onstru Its ('�) �I pair )(XN an Individual Sewage Disposal System at: �� (G 7 ..............••.........51._..Q.raigv 11e---Beach_..Road_.Hyannispor...-•--•----•...----••-•----......--•---•............---•----._.....---•- Location-Address or Lot No. ......................._. 1 sbz_...Kunn.i ng)as m---------------------- ....•........... owner Address a J-�P.xMacombar & Son.-•Inc_.t........ Installer Address Type of Building Size Lot............................Sq. feet .., Dwelling XXNo. of Bedrooms--------------2----------------------------Expansion. Attic ( ) Garbage Grinder ( ) Other—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 ( ) Percolation Test Results Performed by-------- ------------_- ------------------------------------------------- Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water...._................... Gi. Test Pit N.o. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ------------ -------------- --------------------------------................................................................................................ 0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------ U -------------------------Sand ---•--•------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- UNature of Repairs or Alterations—Answer when applicable.--Omit..existin-g...sys_t.em._--.Inat.a11.......... .........................]..=1_D D.D...gallon.._tank-,-1_-.distribution._box---and...3...f low...diffuasors....... 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 Compliance has b ,nn* sued by by the b and of health. Signed :-. .. .. . /d _ ....... ............_ V 2 9-/9 5----------------- .._. .... .--.-.d. Dare Application.Approved By - --- . . .----------- ---- ------ -------- ----------------------------- --` ..................--- -----;-Dace Application Disapproved for the following reasons: ..-------------------------- __........ ..... -............--------------------------------------------------------- - - ............. .............. _..: .. ... Date Permit No. ,� � � - Issued ..----` .'T..-.�.�...�.�.��..... ..... ..._........_---- Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CErtifirn' to of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or RepairedX(XXX) J.-P_..Ma.com.ber....Jr ---- at ---------------------5.1---.0.aigville--Bea.ch --RO.a.cd----HYann 1sl?crt------------------------------...----- ------------------------------------------ has been installed in accordance with the provisions of TITLE off The.;, tate Environmental,Code as described.in��, the application for Disposal Works Construction Permit No.' rl _.f�7...... dated :� .% f��'�-� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT T-HE SYSTEM WILL FUNCTION SATISFACTORY. DATE ..------ .. "" --------.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE �i FEE--. --•3�.-�Q.. Dispnoal Works Tamitrudion "rrmit Permission is hereby granted...... ...................................................................... ................... to Construct ) or Repair (iX) an Individual Sewage Disposal System at No. 1 Craigvi le Beach Road HWaztri-annrt-.---�---------------------------------------------------•-----....... Street; r' r,, a' ./ �-- as shown on the application for Disposal Works Construction Permit o -.C /- -ated_ a.-''-------------- r 4Q ra Board of Health DATE.------ ...................................... J--------------------- FORM 36508 HOBBS h WARREN,INC.,PUBLISHERS THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiuu for Dhip j ial lVar1w Toutitrurtiuu Famit Application is hereby made for a ermit to Construct ( ) or I•epair `.(X}S) an Individual Sewage Disposal -System at,: ,1 � ---.51 Craiavl.le---Beach- Road Flyannisoort. •--...----•--•-----------------------•--------•-----•----••--•----•--- Location-Address or Lot No. --------------------------------------•---•-----------....----•-------..._...............•--•..... Owner Address J..p.Macomlaer &.._Son-.Inc. Installer Address d Type of'Building Size Lot............................Sq. feet - U.* f Dwelling X3to. of Bedrooms--------------2 Dwelling-K3No. Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ---------------------------- No. of persons----------------..-.-:.----- Showers ( ) — Cafeteria ( ) Q' 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 ( ) Percolation Test Results Performed by------- ---------------------------- ............................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-----.--_..------.-- Depth to ground water.............----------- f Test Pit No. 2................minutes per inch Depth of Test Pit.-.-.--.-.---------- Depth to ground water........................ R+ ------------------------------------------------------------ •-------------------- •... -... ---- ------...-... ------••---------- ••-------- •...... ----------------- O Description of Soil-----------------------------------------------------------•--------------------------------------------------- . -------------------------------------------------------- U -•--•-•-•-•-•---=-..••• �and...•-•------•-•.....----•-•---------.-- W ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--•---- UNature of Repairs or Alterations—Answer when applicable--D6n ,t...-ex.3 Stt_it1.a-... .......... .. ......................... hox....n d...1---fl-ow--- tffjas ars•.•--- .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 Compliance has b n issued by the b and of health. Signed . Y'JL 3/2 9/9 5 .t ----- ------- ---- -..f........................ ......-----.....Date................. Application.Approved BY ...... - i � D�ace �.. .. ..: Application a` Disapproved for the following reafonf- -----------------------------------------1...---------------------------------------------- --------........................ .. ........ ..........................:.. .._...----------------------------------------------------- -------------------.f...:'------------...- ------------�. /fir-'� �. Date - .....- Issued -----,- Permit No. ... Date D C _ O • Fill ri hD � I r,- I I� IF, in � I_ I rP � I fir , n fill I - lII � I I m l Nm � ICI I I i I I prI I d THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0 F..........A4r,4tjj_,-L...T 51 ,� lirtt#i -for Dhipviiat Works Towitrurtion Prruid /No `Application is hereby made for a Permit to Constr or Repair ( ) an Individual Sewage Disposal System at: 14 LocaJion Addres s r LaaotT No. •------•-- - --�-•---- ..................................... W V"I?"s-<-----�SFJ'.GZtQ g n -- y �,�-..� S2 �SS - -•-•----- ------Y �t _ T _________ Installer Address UType of Building Size Lot____________________________Sq. feet ., Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building _______________________ __ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________ WDesign Flow_ .....................................,,,gallons per person per day. Total daily flow-----------------------.-----------:........gallons. WSeptic Tank )acitvl vP-_"-gallons Length................ Width-_--.--_.--.- Diameter---------------- Depth-------_--_-_. x Disposal rench No______ _____________ Width.................... Total Length.................... Total leaching area--------------.-----sq. ft. Seepage Pit No____ ___________ ___ Diameter.........._--------- Depth below inlet__.___________.$._ Total leaching area------------------sq. ft. z Other D tribution ox ) Dosing tank ) e! P� �- �" Percolatio Test R is Perf b - - - - - ----•----------------------------•---•--------•--.•--- Date---------------------------------------- Test No. 1 ____ ___ i t �e th of Test Pit____________________ Depth to ground water-____________-_-_-_--- fi Test Pit o. 2__________ ___ _ 'ute per inch Depth of Test Pit.................... Depth to ground water........................ ------------------ O Description of Soil....... P�- ---•--•--••- ..............- --- -------------- ------ U ---------- ------ ` 01 .. ------- I- )_ U Nature of Repairsvor Alteratio Answer when applicable...... bAl Hofof---------- .....iA---------`- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further rees not to place the system in operation until a Certificate of Compliance has n t b e bo of hea . ........ 8/, ; ate Application Approved By--- f ` •- -- -----------------•--•-•---•--------- ••. j ��— -------------- Date Application Disapproved for the following reasons--------------------------••-----____-•----------------------------------•-...................................... ......-••-•-••--•-•------------------------------------------------------••-._.__••----•--•-•----••-•---•...___..._...--•-•-••---•-••--------------------•------•----------------------•••------•--_-•--- •-••-••-•-Date / .Permit No-------------------------•--------------------------.._.. Issued-------�t`' - O -----• i ate �..-�.. /�• ors` �,��j+ - a� :.:................. THE COMMONWEALTH OF MASSACHUSETTS BOARD F- HEALTI-1 OF........ ..1., ....--------------------------------------------- Appliratiaan -for Diiipmal lVarks Taamitrnrtiaan Prrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: • Locat-o -Address � or Lot No. W Y �►��.._----- 1? -!' 11`,-C o l __ G'I ,J�Toss -i 05.. ------ ------------- •--- -- -------------•--------••--•---•-- 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 ( ) Q' Other fixtures ------- ---------------------------------------------------------------------- --------------------------- W Design Flow............................................gallons per person per day. Total daily flow.........:----------------------------------gallons. C?� Se uric Tian apacitv__-__--__-_gallons Length................ Width----------:..... Diameter--------........ Depth. -___-._.... Dtspo rench No.___ .............. Width _-_-______-_--_-- Total Length_______--_-_•---•_ . Total leaching area--------------------sq. ft. '-Seepag Pit No___ __________ Diameter_.________._________ Depth below inlet_t:_.________/___ Total leaching area ...... it. z Other stribution o ( ) Dosing tank ) C / uf )D c- aPercolati Test R s Its --Pe :..- •--•-•-•--•-------------------------------•----•------- Date.....----------------------------------- Test t No. -___ - �i u r r�i D pt of Test Pit.................... Depth to ground water..-_--_____---_.__.-. 1:14 Test Pit No. .......... ut per inch Depth of Test Pit.................... Depth to ground water---------_---__-_______- P-I' Description of Soil---- -- U ---------- ( - Yr (-A' r -----------------•-------------------------------------------•------•---------..................------. -------------------------•--•----•-•-- - 44 U Nature of Repair b or Alterations—Answ r when applicable------XPS—r4_4•4__-____- - �7 l�__ .4mr Z�----- --------- f ----------"""---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage'Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned furthe grees not to place the system in operation until a Certificate of Compliance has den ;he b of he ' r---- ate Application Approved B ''''ww,A� � '7 - Date PP PP Y y - Application Disapproved_for the following reasons_______________________________________________________________________________ -••-•-•-•----•--------•-•-------•-----------------------------•---•--------------------...--•-•---------- ---------•------••----••-•-•-•---•--••----••--•---•-••--•••••---------•---.....••----._...._.. Date Permit No............................... Issued 7J ate THE COMMONWEALTH OF MASSACHUSETTS , r BOARD 9f HEALTH � *................. r (9rdifira#r of 19aamplianrr T Z TO RT Y, That the Individual Sewage Disposal System constructed ( ) or Repaired ------- --.-•-•---•-..•--- bY {) -- ---- ---- ------------•- Installe�.�� ----- • ✓ has been installed accordance with the provisio s of .Artic'le XI of T State Sanitary"Code as described in the application for Disposal Works Construction,,Permit No.___-__�.r S""`1........... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO NST UED AS A GUARANTEE THAT THE SYSTEM W I L - ON SATISFACTORY. T � DATE.......f-. - -----------------------------• ...... Inspector--•---• --------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALT - ................•O F.... . ...GZ"1...:�'.... .. ............... No ., f .......' FEE ..... Or if Anstruition Prrmi# Permission is hereb rant d__ a.� L Y g ----------------------•-------•------------•-•••...----•----••----•-- to Construcl,( ) or R p ' ) an I dive I Sew e Disposal em at No.-3 1->`/�f4CSr, r 7----- . - f �,�5 e.... ---- -•-- Street C3 as shown on the application for Disposal Works Constr ction e it No...f ...___.. ated.� ............... -- - < &7_1(e7.. .............. � _ oar o Health DATE =--=-=_---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS