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HomeMy WebLinkAbout0097 HARBOR BLUFFS ROAD - Health 97 .Harbor Bluffs Hyannis A= 325- 122 SEWER 0 No / FeeS THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppritation for �Disposar Opstern Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon ❑Complete System ❑Individual Components Location Address or Lot No. I ri wner's Name,Address,and Tel.No. Assessor's Map/Parcel Sol /,Za Installer's Name,Address,and Tel.No.SU$- a18- 89Xo Designers Name,Address,and Tel.No. Yrx 6 N�v� A6AV� Type of Buildin Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) S. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintena f the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environment l G e and t to place the system in operation until a Certificate of Compliance has been issued by this Board of ig Date ! .Z�6 Application Approved by Date 7 Application Disapproved by Date for the following reasons Permit No. Date Issued Y e •• No.r'�""" Fee THE COMMONWEALTH;.OF MASSACHUSETTS 'Entered in computer: PUBLIC HEALTH DIVISION TOWN OF-BARNSTABLE, MASSACHUSETTS Yes ftplitation for Misposal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon� �❑Complete System ❑Individual Components Location Address or Lot No. Of f Owner's Name Address and Tel.No. '� > p— v Assessor's Map/Parcel-.zo %da :. •J A-i j,J ,r .,,•: , Installer's Name,Address,and Tel.No. j G'15 ��o�c - �i Designer's Name,Address,and Tel.No. r ix 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(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. i i Description of Soil Nature of Repairs or Alterations(Answer when applicable) J``t E Y��,�,l`!1?, �C i n t 1C 01-0 1'1.d-n!-Y-)i 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 Certificate of f Compliance has been issued by this Board of Health.' $gied ., '!"'� \ \-^`� -±�,.,.,r» :._ Date 4)r I Application Approved by �_ �^ Date Application Disapproved by 7� Date for the following reasons Permit No.r"p� ` C2 L5 Date Issued " j { /� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS •l Certificate of Compliance THIS IS°TO CERTIFY,that the O/r/site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned 6( by , r' 0/� ;w l/a; at 1117 f`tCx,2. nr'' i 4/�..��t t., /Yf• has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No: 5 dated1 f G�'✓' Installer � tUi(ai.l•t �.{,h�< 'i .i�l CSl`t C�v�c ' Designer #bedrooms Approved design flow gpd The issuance of this 0ermit shall not be construed as a guarantee that the system will function as designed. �� ('� Date `1 L Ins ector1 m -#--�' (l P Noa+Tl ! ''` y Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct( r) Repair( ) Upgrade( ) Abandon System located at q r7 J Ia rhr, and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must b-e--com'leted within three years of the date of this,�permit. / 1 / Date -,,i Approved bye 1 YOU WISH TO OPEN A BUSINESS? v" For Your Information: Business certificates(cost$30.00 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.) Business Certificates are available at the Town Clerk's Office, 1"FL.,367 Main Street,Hyannis,MA 02601 (Town Hall) DATE: 6?Hk sa Fill in please: APPLICANT'S YOUR NAME: FL-cE v-, ry\Vl�,J p_e> BUSINESS YOUR HOME ADDRESS:G`i I A FIBO I? BLL,(_IFS - 5©a• t 2-36t i TELEPHONE # Home Telephone NumberJS-O 8 CQ I. S 23q I1506—7-7 ,5 6_1-7.0 NAME OF NEW BUSINESS �t�(S"C/-\C3Lr�. �L�. �i��'t� 'Y'YPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO Have you lean given approval from the buildin .'division' -YES—NO / ADDRESS OF BUSINESS q-1 4^a-so ai—u F I�ARf PARCEI. S NUMBER When'starting a new business.there are several 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 Is* ally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has bee forme f t rmit requirements that pertain to this type of business. Autlionzed Sig ture**. COMMENTS:— / h /ra 72 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature**. COMMENTS: Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON—SITE INVENTORY a` NAME OF BUSINESS, i3^re-�kSTABL-F-- BUSINESSLOCATION:ELI RAPOcP— �'-� `� �� ��������Ig INVENTORY MAILINGADDRESS: �/`� � TOTAL AMOUNT: TELEPHONE NUMBER:-�5_O5 CONTACT PERSON: Pe t e p— EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYP E O F BUSINESS: �=�i�TiZ/°<C- O 'E-, INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous_waste: Name of Hauler: __Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. UST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum _ Antifreeze (for gasoline or coolant systems) Misc. Corrosive Tr­ NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers ouink 2S , I ,�S k) (including bleach) 6 " Spot removers &cleaning fluids fi (1 � (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS