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0016 GARDEN LANE - Health
- 16 Garaema� Hyannis 292-082'-Q02 M1 r. r��� •`, , •• �` + = x ' , 1 it i Hazardous Materials Inventory Sheet Checklist _ __t_ d Date / Physical Street Address-Check database to ensure it exists 0- J Working Phone Number =Actual Amounts -( ie. gas being used to fuel machines, thinner bo Lan brushes all count as hazardous materials-no blanks) Storage Information - location of storage, how long is storage for? If none, !rote that. Disposal Information -where and who? If none, note that. Applicant Signature -understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and _explain it Attach the Business Certificate with your sign off and comments **The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. Datei0i / iS /oV,1 f TOWN OF BA►RNSTA►BLE TOXIP 4.N® HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: -"�\_jI¢ U® A lot/U-T' u F, BUSINESS LOCATION: \6 Gpi2aP.,u L kl kJ /A.►.S INVENTORY MAILING ADDRESS: ,6 6AQAP, LA/ k-A v -A Abvi 9 TOTAL AMOUNT: TELEPHONE NUMBER: "7,3 i ct®I ovat CONTACT PERSON: f d.y w�2�_, '�7 DR,0+ EMERGENCY CONTACT TELEPHONE NUMBER: 7 $ i 64,E q 6-n ,55 ! MSDS ON SITE? TYPE OF BUSINESS: + INFORMATION/RECQMM DATIONS: L ire 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 0 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 ❑ NEW ❑ USED (� (insecticides, herbicides, rodenticides) o Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) ❑ NEW O'.U'SED Diesel Fuel, kerosene, #2 heating oil Miscellaneous petroleum products: grease, Photochemicals.(Developer) , o lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink C'D Degreasers for driveways&garages Wood preservatives (creosote) a Caulk/Grout Swimming pool cl4lorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers in Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes 0Fertilizers Asphalt& roofing tar 0 PCB's Paints, varnishes, stains,-dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ 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 Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids © (dry cleaners) © Other cleaning solvents 0 Bug and tar removers (0 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS App icant's Signature Staff's Initials YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS 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 Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. Fill in please: Date: ( 1 / t / (90 mjft mr ? APPLICANT'S NAME: Vo� YOUR HOME ADDRESS: QaC-A_/ t. ,kJ a (-7�? l )ao1 01 of BUSINESS TELEPHONE # , HOME TELELPHONE�#: NAME OF CORPORATION: FID NAME OF NEW BUSINESS TYPE OF'BUSI'NESS IS.THIS A HOME OCCUPATION? x r.YE, NO ` S U0 aADDRESSOF BUSINES � A (Assessing) When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of Barnstable. This form is 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 opera a your usiness in town. 1. BUILDING COMMISSIO ER'S OFFICE This individual has n,i for a of ny per it requirements that pertain to this-type of businesa�UST COMPLY WITH HbMt OCCUPATION ' , ,. I _. , p 1�� RULES AND MMULAflON& I�AILO=l4 TO Auth ed , ' n tur-e" _t COMMENTS: ' rl 2. B OARD F O HEALTH H This individual has been in for e f�te pe requirements that pertain to this type of business. Authorized Sig ature"" COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" y COMMENTS: h of��+E row M�ftedca CRY Town .of Barnstable Barnstable �. Regulatory Services Department I tRARNSTABLE. � � N ,'a,� �900�,"639 � Public Health Division �7x fo Mom/ 200 Main Street, Hyannis MA 02601 200 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 7007 3020 0001 3429 8035 April 6, 2009 Geraldo Cardoso 67 Delta St. Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.060, STATE SANITARY CODE II—MINIMUM.STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 16 Garden Lane, Hyannis was inspected on April 2, 2009 by Jaime Cabot, R. S. Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a rental inspection. The following violations of the State Sanitary Code were-observed. 105 CMR 410.482- Smoke Detectors: No Carbon Monoxide Detector Provided for Habitable Space in basement. 105 CMR 410.450- Means of Egress: Basement Bedroom lacks proper egress. You are ordered to correct the violations listed above within twenty four (24) hours of your receipt of this notice by installing a Carbon Monoxide Detector according to Mass. Fire Codes in the basement. You are ordered to correct the violations listed above within thirty (30) days of your receipt of this notice by pulling any required - permits to remove an illegal bedroom by opening the door-way entrance to the basement room lacking proper egress to a minimum five foot wide opening. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute.a separate violation. Should you have any questions regarding the above violations,please contact the Town Health Division and ask to speak with the inspector who performed the inspection. C&ROF THE BOARD OF HEALTH c{ean, R.S., CHO Director of Public Health Town of Barnstable cc: Tenant �►� �r �i— V �� �o � '� �� � � � 1+� :g �� �1 �d� �G�Z �1���'��dc4�'� ''� �?�i t. ,:., �. t V1 \ _�) r� 4� t `h n[� � 1 TOWN OF Br�ItN.TAB LE LOC:4:4.<:N ,� 6�m 2 C'/ao, ka SE AGE # Q-Q vi'i,L1 EiNO�u ASSESSOR'S MAP & LOT �Z INSTALLER'S N &PHONE NO. �h A-S ^' 97-7 L SEPTIC TANK CAPACITY LEACHING FACILITY: (type) VL— S-9—;;t. (size) /2.-;ZS"-7— NO.OF BEDROOMS. A BUILDER OR OWNER —Z L'-14 PERMITDATE: - COMPLIANCE DATE: :2 3® >Separation,Distance Between the: MaXimum Adjusted Groundwater Table an/Botto f Leaching FacilityFeet Private Water Supply Well and Leaching Fany wells"exist on site ur within 200 feet of leaching fac Feet Edge of Wetland and Leaching Facility(Ifds exist within 300•feet of leaching facility)- Feet Furnished by 1 o � . Q S� a � o fi F No. �� 6"0 `1 - _. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS �- Zipprication for Migogal bpotem Congtruction Vermit Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) El complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 16 Garden Lane , Hyannis Dezelle Assessor's Map/Parcel Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service P 0 Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Sand. Nature of Repairs or Alterations(Answer when applicable) T it l— leach syst eta consisting of a D-box and. 2 leach chambers with stnnp alp grr)1wd 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 issued b s BB d of H lth. /..�Signed /.c'� ��.. Date C' Application Approved by pw. !D I' Date Application Disapproved for the following reasons Permit No. -3- Date Issued TOWN OF BARNSTABLE LOCATION R 2 e 1"Z4-- SEWAGE # 0-0 VELLAGE fv ASSESSOR'S MAP & LOTglo INSTALLER'S N &PHONE N0. tih i,�.�a •`- 17 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) !7— S —;L (size) /-.-49S- NO.OF BEDROOMS -3 BUILDER OR OWNER Dz: Z L=�%C= `` PERMUDATE: COMPLIANCE DATE: Separation Distance Between the: .Maximum Adjusted Groundwater Table and Botto 'Leaching Facility Feet Private Water Supply.Well and Leaching Facili (If any wells exist , . on site or within 200 feet of leaching faci ) Feet ` Ede of Wetland and Leaching Facility If wetlands exist � 8 g tY( Y within 300 feet of leaching facility) Feet Furnished by. i w _ . �No. .G3'l/y —�.,��i� 0+ _✓' Fee 50 J ` :THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF,BARNSTABLE., MASSACHUSETTS 3pprication for Mi0pozaY 6pgtem Construction Permit Application for a Permit to Construct Re air )Upgrade( Abandon ❑Complete System ❑Individual Components . � ( ) ( ) ( )Abandon( ) P Y Po PP P Pg Location Address or Lot No. Owner's Name,Address and Tel.No. 16 Gard.en Lane, Hyannis Dezelle Assessor's Map/Parcel taller's ame Ad refs,and Tel.No. Designer's Name,Address and Tel.No. m. _i inson Septic Service P 0 Box 1089, Centerville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Sand Nature of Repairs or Alterations(Answer when applicable) Tit 1 P_K leach gTgt em consisting . of a D-box and 2 leach chambers with stone all around_ 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 issued b �s�B d�of Signed_d.1 11, Date •"'•C d t Application Approved by beut--�- Date Application Disapproved for th�g reasons Permit No. Date Issued ----------------------------------,----- THE COMMONWEALTH OF MASSACHUSETTS Dezelle BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(X )Upgraded( ) Abando ed( )by Wm. E. Robinson Septic Service at 115 Garden Lane, Hyannis has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2M... '� jz dated Wm. E. Robinson Sr. Installer Designer n n The issuance of this e t hall o be co strued as a guarantee that th st ixiy i fun, do as.designe Date ` Inspector ,�� ' 0 U 1 -Ae- 41 f ——————————————————————————————————----——— No. Fee $5 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Dezelle lwiopozar *pgtem couttruction Permit Permission is hereby r ted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at Y r Garden Lane, Hyannis 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: - (V - ee,07 Approved by LOCATJON �+ SEPIACE PERMIT CIO. VILLAGE 1 N S T A LLER'S NAVE b ADDRESS Ca�S l BUILDER OR 0VC3 ER DATE PERMT ISSWEo DATE COMPLIANCE ISSUED jJW i L cis rn a i J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............OF..............:. ie4477".4 ............... Appliration for Displaiial Voikii Tonstrn.ettnn ranfit Application is hereby made for a Permit to Construct (be-) or Repair ( ) an Individual Sewage Disposal System at• .. . ............................... ./Location-Add r or t o. Owner Address W -------------------------- Installer Address Type of Building Expansion Attic Size Lot__Garbage Grinder feet Dwelling—No. of Bedrooms_._.:_:.---.•--"� No. of ersons_____________________(.___)Showers g Cafeteria ( ) q• P.,., Other—Type of Building p ( ) ( ) Q' Other fixtures .----•-••-•--•-------•----•---•• • - W Design Flow...............S __........--.........gallons per person per day. Total daily flow..............-V3.P..................gallons. WSeptic Tank—Liquid capacity/W__gallons Length___ .. Width._........... Diameter................ Depth.........4_.,.... x Disposal Trench—No..................... Width.................... Total Length.......... .__..............Total leaching area....................sq. ft. Seepage Pit No......./............ Diameter...,/0 -6 Depth below inlet.-_...1 Total leaching area...?�e.4�t. cep . Z Other Distribution box ( ) Dosing tank '-' Percolation Test Results Performed by-_K®G-s1.....¢y_ ? 5-4 E ..._....r ... Date...I...... ..........--. Test Pit No. 1.______ ...minutes per inch Depth of Test Pit--- Depth to ground watevL®Q .Ei!J . vN�i. � Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground Ovate . .._..._.._._..._._... P ........ --••----••------•---•--------------------------------------------- ------------------ ---------- •------ ------------------------ Description of Soil------- ..--..I--- J.) ----------------------------------------------•-•••. x w --------------........................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ....••••• ••-•--•• -----•---•-•-----••••-••••••-•-••••••-•.........................•••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of ITIU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by the board of health. Signe -••... (lr .... z4. ...L -1-14---... _..._ ApplicationApproved . .......----••-•-•--. ••••--•••••-•----••...-•---•••-•-•-•----•---•-•-•-•-•••••.............. - =� A---------------- Date Application Disapp v or a following reasons:................................................................................................................ -•-•--•............................... ...........••-----.......-•-•---•----..........................._.....-•--•-•-••-•---••---••••--•-••--•-•--••-•-......-••••-..............Date-----•......-- PermitNo......................................................... Issued.------....------------------------------------:........ Date No.. .r" l_:... "� F�s..:' .o....R........ _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /...P?! ----.....OF................ ............... Appliration for Uhipuuttl Works Tonotrnrtion ramit Application is hereby made for a Permit to Construct (k) or Repair ( ) an Individual Sewage Disposal System at: 1 / .......:. `h /S....................... ..........•--------•-•--•--......--T---......•---.....---•--•--.................••.......---- Lo.ation-Addres or Lot o. .... ! .L .c T._....... r EI_../............ .../..:----Wig...... 7-'--..f� !'L'o v }:�............--•-- Owner Address W Installer Address d Type of Building Size Lot....04..7j� .._._Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ... No. of persons............................ Showers a YP g ---------------•--------- P (....>•-- Cafeteria ( ) Otherfixtures --------------------------------------------------------••-•••-••--•--•--•••••--••---------••--••............. .......••-- W Design Flow............... .55......._._.._,..__..gallons per person per day. Total daily flow.............. -?. ................gallons. WSeptic Tank—Liquid:capacity/010iLgallons Length....8...... Width....4....... Diameter................ Depth.....fq- . x Disposal Trench—No. .................... Width.................... Total Length.....................Total leaching area.....................sq. ft. Seepage Pit No..................... Diameter.._./a,.6'. Depth below inlet......./V......... Total leaching area.57 l:_ s -ft. Z Other Distribution box (><) Dosing tank '-' Percolation Test Results Performed by---4�2W..... )•_.W E. �- ....... Date.....1.I.ne.z.............. W a Test Pit No. 1.. Z....minutes per inch Depth of Test Pit.__14g.':... Depth to ground waterA_JQ_7.7 ....4�." Li. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground waters" ....>=.... P ------------------------------------------------------------------------•--.......•......----•--------•--------•--•---•---------•--•--••............•--....- ODescription of Soil........SEE------ f}C - ....... ------•---------------------------------------------------------•-----. x V •--•-•-•-•-•---•••..............•-•--••-•-••.....-•-•---•--••-••-•-••-••----•--••--..........---•--.....-•-•---••-•------••••--.....----••----•-•-----•••--•-••-•-•••-•-•-•--••--••--------------•--•- W -----------------------------------------------------------------------------------------------------------------•.....-•-•----•--••--•-•............................................................. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...•••-- ----------------------------------------------------------------••--•---•--. Agreement: The undersigned, agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beep J§sued by the board off` health. „ Signed ..._ I!� �._.... -�f _---- ate Application ApprojBy.- ei► `, oD Application Disapp following reasons---------------------------------------------------------------------------------•------------...-----•-•••••-- .......................................•• -•-••••-•-•--••-•••...............••••-•---•••...--•---••••--•-••-•-••-••--••-•-•--•-•-•--••••••••...................................... ............ Date PermitNo...... .............................................. Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOA D OF H H tl�efn. .........................OF . .. eta .:.. . ........................................ (9rdifirate of Tomplianrr THI, �F,'RTI Th e Individual Sewage Disposal System constructed or Repaired ( ) bY-... `' l ........ ..... ......_... .....................: ...--•--.....-•---.._... _... �„ Installer '3- _- at ..... -------- -fir ............. t �s�ere.�r`-----------------------•--••---------------- has been installed in accordance with the provisions of TITLE 5 0 ' tate Sanitary Co a escribed in the application for Disposal Works Construction Permit No.�/-..r„x_. .... ............... dated,f% !_y ......................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE... Inspector----------------------- THE COMMONWEALTH OF MASSACHUSETTS �{ G`! BOAT- _ ..................................... ............................... F..0 Nl-................. i v 1. rk onion ernti Permissi n is hereby granted-. -'`-.::. ......... .......................... ---------------............... --- ............ to Con4ruSP or Re r ( an Inds sal Sewage Disposal Sys atNo.-( ..............--•- trc......(. --------.----- . 7==4-& ................... - Str7t y as shown on the application for Disposal Works Construction Per t -s._s. /....__ ....................... ...................•••...... ---------------------------------------------•-------- B and of Health DATE............................. •r--------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS , f Y i. .?° 5 k 2 -"gym k e t lfrx ry. &y ` I-1,t 4, a .r'#'2 i ;" ''t ! r - .+ } Kftg.,ram p' 1 P ;•,.,,�, 'r ;A E 1. !r , t 1 # J P 1 t. %11 sr r r A al r c. 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