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Home My WebLink About0015 NEWTON STREET UNIT UNIT 2B - Health E15 Newton St.Hyannis A= 1 1 i I 0 i { y 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.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: /\\�'jFi I i /p(ease: /'1 y/nt�y, V V ��L �4 11 t LLFI J1 � L .iW•Mc: _ l lJ vL �/ r,h,Calr�, rw, 4d" APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: I� Mie�r1"Y(f4R U�1A7;1}�IfY m S�F�i71 ` �1�� • �'i�� ffr t5+ k�i ixt TELEPHONE # Home Telephone Number c� NAME OF CORPORATION: NAME OF NEW BUSINESS 'v TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES UNO -(Assessing) ADDRESS OF BUSINESS i P D MAP/PARCEL NUMBERO �lo DOu ( ng) -starting a new business there When are several things you must do in order to be in-compliance with the rules and regulations.of the Town of nformation you may need..,You MUST GO TO 200 Main St. - (corner of Yarmouth Barnstable. This form is intended to assist you.in obtaining the i RBI. &Main Street) to make sure you have the appropriate permits and licenses required to legally 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 - . WST COWLY WITH ALL This individual has bee fo e of the permit requirements that pertain to this type of business. REWILAT Authorized Signature* 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: 9 / TOWN OF BARNSTABLE Date� /qt TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: C_ CaltrV ' BUSINESS LOCATION: G_, rl rl' e0d INVENTORY MAILING ADDRESS: 16 r(1 e. � n SSV W P, 02--6& TOTAL AMOUNT' TELEPHONE NUMBER: 66 G_5flK_D � = D�3 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATIONIRECOMMENDATIONS 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 ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) 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) ❑ 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 �sundry soil &stain removers ncluding bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash • �1 WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant'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 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, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall). k DATE: 0 F J ry Fill in please: APPLICANT'S YOUR NAME: C'L.py v 1) 1`p GA/Z T7,A L NO rr g BUSINESS _ YOUR HOME ADDRESS: I j V& vv r- N X I MI ti TELEPHONE # Home Telephone Number: T �D Z _ �6`Z2 632 NAME OF NEW BUSINESS-'" r � r✓� o rt��.'�T c ;° TYPE OF BUSINESS IS 7H15 A HOME OCUPATION YES. O lave you been given approval from the burl, I ng 4IVIS1on? YES N!O AD[)RESS OF BUSINESS MAPfPARCELNUMBER When starting a new business there are several things you must do in order to be incompliance 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 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 as een ' formed of the De� equirements that pertain to this type of business. A horized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual een inf rmed of P 1' e si g requirements that pertain to this type of business. Authorized Signature" COMMENTS: Date: l 2 _ o f TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM '{ NAMEOFBUSINESS: rW C.9j F "1)&7L boo BUSINESS LOCATION: T A,FL,-r O Al S f�/ yAI f j - /1itiR - O 2 601 MAILINGADDRESS: 90 k Z3 Z ) Mail To: TELEPHONE NUMBER: Board of Health 9-Of _ `�`� ;(` / 3o Z Town of Barnstable. CONTACTPERSON: CZ 4(/6%0 R*¢/?-8fa P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: SC�f - w 6 Z 2 6 Z Hyannis, MA 02601 TYPEOFBUSINESS: ��&2!t `� CP�4i•✓up rT'Le.�{-Na%NG r Does your firm store any of the toxic 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: )I— TELEPHONE: _ 7-_�S i 3v't— C- 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) 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 (includin Sye may be toxic or hazardous (please list): Spot rem eaning fluids (dry cleaners) c� Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS r -�-•� Ln:r��:.s�cL��k3ass�nusetts � � ��.;�� :-r� �f ,I - .; ; €ro[ircatlon Fcrm— ANF-001 s a<ti Asbestos Abatement Description 1. fa:il:;,-Ixca:ion: _ .�CL Y.Y—CU...............__............_......................._ . �.....Iv. s i ......_" xrc. ..._..........._..._.......---...... U(;7RUCrGYs - arnrrslbeCC.-4:•.ie! G'.y,Ta.n Iv cue- rdeouro neO1;3Arn laf _........_..._...._.._.._... .L6- �� . EmlroMnonlol µts(r ry wage Lvean7 drQrdtry rrt,/..(:;orr,rowo ?rcl eci l on mil iCYUn - reyuirnerts of 2;0 C1.ta 2. Is the la:ility oe:upied7 !Yes 0 tla r.Is 1ke+ Vllvarn priorr4urceaona 3. Asbestcs Contractor. reGuiedofi-ry•` ,na7 P(oJmt.>nd'A New. En-gland Surface Maintenance, LLP 850 Washington Street 0a;anment cl Lihor Atvn Ad&= am Ind"Itrial nct:l'dicA Weymouth,mouth, MA 02189 781-337-2117 reRiar..sts - al/e_1 C1.4Z 6.12 (:anCry/Ta.a Ib cur ldephorr *yspriana( aiar3 . repuiad d AMY AC 000196 - aGlemr,r;Wo.—y„�.. .........................................-....... ............................................ ........................_....._....................:........:..............................._............_._..._.......__ ar(trv/ Conrr�fryelwrt+Nr-.� a'in three lirYsr or -,we fee). 4. On-Site Project SupervisoriToreman: 2.S Lmi 0rigaul Farml l��_— _ ��`� 1c: ofOUC.rla�ao+/ -- Gomaoa..a(LL . Yaaaehus.tts S. .Projec:Mcnitar- P.03.120037 U3K -----_--- - _ But*.,trA=12. A1ae,r txrava�n,/ �----- 0067 _ `. ......... . 6. Asbestos Analytical lab: C. 's lcrm Zay`e s i:Ate ad to nott h�+s t 2 _ US.Enr/a.-rW al tsrtt _ CX1C9e1=017/ -- - PrcteG:enAoft-CyRegion :: , ,:,s ;; IclaeresoamconJ T Praje_tsartdate�lk7�enddat!I/N/0specificworkhct:rs {-tYri.) _ __.-_._ -- - �� -�- (Sat Sun.)-_._.._. ;aurdon coer;tiora s+ j a to N:S-WS(40 CF-,, ubpart M)- f! What ty,,e of project is this? (arc a e) "aas °„ rn- mnraern hom„p-�,I Describe the asbestos abatement proced:res to be used (circle): �o.��N encaan laararry,,,ra aatrt� ._`_— ..:. - .'CL^edY(ou � � �.T1 o>fy aaerr(eq�GhJ - 10. Is the job being conducted (Rind::rs ❑outdoors 1 11. Total amount of each type of Asbest:s Containing Materials(ACM)to be handled an pipes ar ducts(linear'L)_� arather ��.... surfaces(square It.). ""0 to be removed,enclosed or encapsulated: l oeadsgwre feet Goiter.diaeLv.dt 09atrsaksaLd core;kw i YAiort......_� cuvGredu�YarsdPaGerDq+ eec.... J iwla:rp=7W................... s ray an&rpraoGna.....................—/ tra+e!/sraya—&Vs...:.......... / daft.ro`err tthre... ...._.........._/ Pasha board,W20;od.............—J aver(pism ci zaribe)...................._! 12. Describe the decontamination systems)to be used: -As reguired- 13. Describe the containerization/dispcW methods to comply with 310 CMFI 7.15 and 453 CMR 6.14(2)(g): Two layers/labelled , 14. For Emergency Asbesids A`atement C,enuans,the DEP and OLI or`ltcals who wattiated the emergenry Mary " ................................................................................................... ................................._.......................__«........._._.._.............__._. C.L ofA.1WVYdl 1V.9—/ -Y.. —_ 15. Do wevaiting wage rates a—,,.y as a 11.u.1.c.I d9,§26.27.cr 27A -F:o this project?, 0 Yes "'No 'tyM t z .. - Facility Description- - 1. Current or prior use of facility. rn p 2. Is the lacitity owner-occupied residential with 4 units or less? A,Yes O No 3. Facility Owner. ` rJh/ra»n 4. Facility's Owner's On-Site Manager. Ubfrwn S. General Contractor. Xame Addntt Ury/ro.e Zb cM� .. T�MDeon Conu'Ae,ors wawa Como.lnrunr poky/ - Emuko 6. What is the size of the facility? (sq It) Z(J of floors) . 13 Asbestos Transportation and Dfspvsal 1. Transporter of asbestos-containing waste material from site to temporary storage she(d necessary)to final disposal site: _NESM.• LLP $50 Washinaton Street Xrmr Adoresi _021.8.9••----•-•_____. 781_337_2117 Gry/Tae, rap mac myna r 2.• Transporter of asbestos-containing waste material from removal/temporary storage site to final disposal site: Waste 'Manactement 209 Pickering Street Nam06480 860-342-0667 Portland; CT _ _ Hats.Transfer Gry/Tae -- zhmae• t�eaor Slatlons must 3. Refuse transfer station and owner(d applicable): comply with the Solid Wises Divisionregula- Ad*= lions 310 CMR I Lo0 rb mer t�err,xx 4. Fuel Disposal Site Valley Landfill USA Waste Services toosor wmr arsaltanr Pleasant 'Valley Road Irwin, PA 15642 412-744-4000 C110— Certlf 3fipn r The undersigned hereby sales,under the penalties of perjury,that he/she has read the Cemmairoulth of Massachusetts Regulations for the Removal.Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310 CMR 1.1 S.and LW the Information contained In this notification Is true and sorted to the best of his/her knowledge and beLef. t 2 4-O' szfaww mr - PrG+war . � ._ Hole:Contractor LL P 7 81-3 3 7-2117 Must Si nthi: Partner NESMr farm for CU f4==WkV rrm+ar Aaulri�nee ' natdiwian purpose: 850 Washington Street Weymouth, MA 02189 Aodra:r - Uly/Ta.o lb aaae . Fee exempt(City.Town district•municipal housing authority,owner-occupied residential of four units or less)7 es a no I Iw �l w PIw l ,I o Pi qj o ImoU, , I � IJ1 �I (Y Iw Q I �I w I a 0 - I � I �,� � — IIIo �- J > I ? I � � I l 0 LA -�- 0 rr Pk .. n it T F�s....�*.... ......... THECOMMONWEALTH OF MASSACHUSETTS BOARD HEALTH O F..............: . �, -� •� Appliratio t for 15itipm l Warkii Tomilrurtion Vrrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 14 .... - ......._. ....•--••--•-•-•--••-...•-••---••-----_---...�...... ... •• -•---------------•----•----------------------------....................._ Locations-Address or Lot No. 0( .....................................' y^._...S.T:.. l --------------------------------- 6�-Jf 1V•t3S v-�'odhAd e �dr 0....- ' ------------------ 1. - S __4 --------•--•-•---•------- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.................... .Expansion Attic ( ) Garbage Grinder ( ) 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 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........................ t� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 --------------•----------••--•------------•-----------------------•--------------------•••-•--......._...._..--•-•----••••-----•--------------••-•.........•. 0 Description of Soil.............••------------•----•--......-----------•--•-------------------....------------------------------------------------....---•-------------------------•-•----. x V -----•---•................•-••-•-•••-••••-------------............-----------•---••----....------....------------•-•-----•--••-•------•-----•.......................................................... W --•---...-••------•----=----•--------•-------•-•--•-•------•••-------••-----------•--------------------•••------•---•-----------•----•--•--------------------- ---. UNature of Repairs or�Alt:18ions Answer when applica.ble...... '±. .' '�.�J__._�o d. ....... ..7 ... .....g_.�- _. 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 agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. late Application Approved By....... .... ....&gne ... --. ......f Date Date Application Disapproved for the following reasons------------------------------ ----------------------------------------•------------••- - = ............................................................................................................................................................................................. Date PermitNo.......................................................... Issued.... .......... Dane Nov .... THE COMMONWEALTH OF MASSACHUSETTS BOARD Application is hereby made for a Permit to Construct `( ) or Repair ( ) an Individual Sewage Disposal System at .... .. .. ...................................J � ... .... u, ... .....................� ......... Locatio ddress ` �r --or Lot No ... Y .......1 �; ?Sv gel..............•---•--•-.....-..•.... 1 .. ! ?'�"�.a +► ..., "- t--••••-•-••-..............--•-•-. Ow'n �r Address i...............!? ..................... 1�_�! ":1�+1' 3s,c Installer Address d Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms......... ................_..............Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons------:..................... Showers ( ) - Cafeteria ( ) Otherfixtures •-------•--••••--••--•---•------------•--•---------•-•.-------------------••••••------------•------------•-•-••••----•----......-_._-------•-------___ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic 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 a Test stResults Performed b --• ......••-•-______--•_________________________ Date........................................ T Pi minutesper inch De th of Test Pit____________________ Depth to ground water........................ Test Pit No. 2................minutes per inch, Depth of Test Pit..................__ Depth to ground water____.______________.___. .----•---•-•---•-------------•-•--•-•••••-•-••••-....••-----___----•---•-•••-------........-•----............................................................O Description of Soil.....•-•-•-------••-•--•--•-•--•--------•••-------------------------------•--••••------------•-------......•------•••-••••------•---•••______._-••••--_..__........... x •---•-•---------------•---•-•---_______._____._..___ _._.... --___.. -----••. -••••-. ----- . V Nature of Repairs or Alte�ions Answer when aQplicable '" 10 a a 'b .f `C 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 agrees not to place the system in operation until a Certificate of Compliance has been issued by,,the board of health. .f gne • -•------------------------------- f Date Application Approved By....... . "' ............. M . �. " _7Datc Application Disapproved for the following reasons______________ - ................................•----•-•-•---•-•---••••-•-•-•-••-••-••......----...._........----- Date Permit No................... -•••••...................•---.............................. Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O EALTH'�... . ' ..........OF..... .r•- . ... ............ H S IS T04'CTIF , Tjiat the Individual Sewage Disposal System constructed ( ) or Repaired bye... ,�' c"J -hey w - -•-•••----......................•---------...-•--•--•---•-•----•----••-- Insf ll ye has beenaristalled in accordance with the provisions of Ar�ii le XI o he State Sanitary. Code as described in the application for Disposal Works Construction Permit No&__._....MX_________________ dated. f' __:' ................. THE ISSUANCE OF THIS C RTIFIC TE SHALL NOT BE CONSTRUE® AS A.GUARANTEE THAT THE SYSTEM WILL FU CTION TISF RY. DATE l C .......... Inspector ... ...............................................I. .................. THE COMMONWEALTH OF':�MASSACHU5ETTS BARD OFee ' EALTH x O.. it.. �� 's y FEE . �i�� 1 rk��r � i�� • pruti� V Permission is hereby granted... ... -• ......... -�•----- --. ..... ...........•-........ � So Cnr or n Ind' dual ew e Dis ystto at Now_ '._.....__. ..a_.''� � / Street as shown o e application for Disposal Works Constructio mit ated,_:—y/. `"_`:. �.._-.-. • Board-of Health DATE_.. :. .. .. ......----•----: FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS ^