The URL can be used to link to this page

Home My WebLink About0063 DUNN'S POND ROAD - Health 63 Dunns Pond Road Hyannis A= 249-097 i YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Cleik's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: f l7 Fill in please: OW LOVE 7 APPLICANT'S YOUR NAME/S: ` E% 2 < F_L&I BUSINESS YOUR HOME ADDRESS: U tj N 5 P o N 0 5yuO•- 77/- 975 H �APN1S MA 6)266f TELEPHONE # Home Telephone Number C P i3— 7 6- 0 Z 2 NAME OF CORPORATION:'. NAME.OF NEW BUSINESS �� 4 h1 - TYPE OF BUSINESS `A;Y r 7 1 IS THIS'A HOMEOCCUPATION? YES NO' .. ADDRESS OF BUSINESS N S o N [Z MAP/PARCEL NUMBER',. " 61-7 �L (Assessibg) . When starting a new business there are se eral things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMM S 10 ER'S OFF1 E MUST COMPLY WITH.HOME OCCUPATION This individual ha a infar d an er it require ents that pertain to this type of business: -�I_ES AND REGULATIONS. FAILURE TO �. (",)MIDLY MAY RESULT !N FINES. Auth iz i atu MMMENT t'f1 2. BOARD F'HE LTH This.individual has been informed of h e�rrfit r uirements that pertain to this type of business. _ MUST COMPLY WITH ALL Authorized Signatur 3** HAZARD()!'0) MATEMALS REGULATIONS 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: 4 TOWN OF BARNSTABLE Date: 3 l I(p l TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: P'I NTI rT BUSINESS LOCATION: 63 bu d tJS PyN D IZ!) INVENTORY MAILING ADDRESS: S74 Mf- TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: PE EMERGENCY CONTACT TELEPHONE NUMBER: SOB - Z9 2-767 6 MSDS ON SITE? TYPE OF BUSINESS: F�-1 07-i N G- 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 material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides Ll NEW ❑ USED (insecticides, herbicides, rodenticides) Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ly NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes 5TO(Z Laundry soil &stain removers (including bleach) 'M I 7 e uck. A 0 ® D IN !T D 9 Spot removers&cleaning fluids (dry cleaners) S T Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Sig ature 0 Staff's Initials o --TO"NN OF BARNSTAB'� ,Y SEWAGE # �I V I—AGE �_�yASSESSOR`'S MMAII & LOT` t' INS'AL.LER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHJNG FACILrrY: (type) �� '(_�J� (size) NO:OF BEDROOMS 4 BUILDER OR OWNER ' Le M yA& 'I 'PERMITDATE; 1 .� rTCOMPLIANCE DATE: 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-: Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 4`` `' Feet Furnished by r ,��... t ASSESSOR'S MAP NO. L�q PARCEL oqj Lo�o LO-CA 10N SEWAGE PERMIT N0. V(.1LAGE I INSTALLER'S NAME i ADDRESS S U I L D E R OR OWNER rp /tea-c��t - A*ey, L. Z4 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Xy A No. - W-2 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for 3Migpo!5a1 *pgtem Construction Permit Application is hereby made for a Permit to Construct( )or Repair( ,<an On-site Sewage Disposal System at: Location Address or Lot No. 4,3 Z1.,eVbVS P&I-0 6,-/ Owner's Name,Address and Tel.No. Assessor's Map/Parcel �y _0,7 7 Installer's Name,Address,and Tel.No. / Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms_� Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ,� gallons per day. Calculated daily flow C4 k-ey gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs or Alterations(Answer when applicable) �Lv�-5 �4l� l.�aD G't9-�G=v O 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 ironmen�7tal Code an not to place the system in operation until a Certifi- Cate of Compliance has Z _ Signed Date `7 Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued / �� No. Cy a"' Fee 7`D THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Miopoar *pgtent Conotruction Vermit - Application is hereby made for a Permit to Construct( )or Repair( Pj`an On-site Sewage Disposal System at: Location Address or Lot No. 3 tiw5�p`t aA/� Owner's Name,Address /and Tel.No. Assessor's Map/Parcel �� ay -09� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. M O•C IA SrPXkC_r �p Q Iq ve-- Type of Building: ,/ Dwelling No.of Bedrooms� Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Mu: Other Fixtures Design Flow S '�'� gallons per day. Calculated daily flow L1/jq gallons. Plan Date Number of sheets Revision Date Title l Description of Soil *-=a Nature of Repairs or Alterations(Answer when applicable) -'rA-ST,4-// 150D 49 �IG&r, DD V t Date last inspected: R 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 ' onmental Code an not to place the system in operation until a Certifi- cate of Compliance has -issued f 1• Signed Date Application Approved by _11Date 1n S- f 4 Application Disapproved for the following reasons Permit No. - yy-3 Date Issued ? THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(L-�on by AA t Se \C_ Installer ''Ty AA tnn Idn at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. G' yy� dated S - 9C Date Inspector ----s C THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. --Q---- --------------- — ---- —No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi0pozat *p.5tem Construction Permit Permission is hereby granted to < ( G- to construct( )repair(V)-an On-site Sewage System locateJ at No.# /n_7 Z2,., S Sueet and as described in the above Application for Disposal System Construction Permit: 9� 3 9 -S --94 No. Date The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within three years of the date below. Date: ' S" Approved by � "' �i' Board of Health I- CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL 1VORKS CONSTRUCTION PERMIT (WI'1'110U'F DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated 7 —J �� , concerning the property located at ( Q v r,'0--5 00"'C� meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. I SIGNED: DATE: LICENSED SE IC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. T-j