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0058 PLANT ROAD - Health
i � y a 294 076 001 is F i ro 37�fi js1.0 • 1 $0,. PROP. %/1`—,2 4 W'AREIiOUSE ' / (N0 C.ELLAR) ,Co 0i l 52, / f' _m 1.11 I MiN 0 fly L' z 39'_ 0/� �,� <<.• ��'ti.. .,\�� R.M. CCN rL- R <<� „ GAIc.H BASIN l ` E�E V. '= 4?.0 8 DISFANCE ASCERTIFIED {ZTIZg Lnc:vS SITE PLAN I = 200 n -�-•' Locus:. NZ ROAD Lo I' ll f i--- — - _...... HYAN-N115-, MA. REF: BK 320 R(oq _ down cape engineering PREPARED FOR: r� CIVIL ENGINEERS �'`,� L- ' 7 /E-}-T ' LAND SURVEYORS r`-' V C. 1 926 Main 8l. BEG.LAND SURVEYOR 7 30" 1 6 YawMmW UA SCALE ATEL- TOWN_ 7iOF BARNSTABLE 4LAGE ATION 6'8 flr� C,f SEWAGE# }�(���i ASSESSOR'S MAP&PARCEL c;2 —' INSTALLERS NAME&PHONE N� SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size).- NO.OF BEDROOMSWER OWNER z PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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) Feet FURNISHED BY °a IKE r, Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • sn MASS.LE. • 200 Main Street• Hyannis, MA 02601 039. MASS. � TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: LJt►e++►S kvt-Alv oo s Date: 7 !� 'I b Location/Mailing Address: ✓► Contact Name/Phone: Lvsz i 2Ak, taS 'z f - y Zq 2- Invent Total mount: MSDS: e4 License#: —T�&�> I Tier II : Labeling: _C--AAA 1&VtA V Spill Plan: o a5+ mb Oil/WaterSeparator: Floor Drains: �b Ergency Numbers: Storage Areas/Tanks: 1 qS Emergency/Containment ui ment: v%S V- -K'S 0 v 'Vo Waste Generator ID: yk I J Waste Product: Date&Amount of Last Ship rent/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages 1 Pesticides: aJiayeLc��Q,— k Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar ISwimming pool chlorine 9-1A Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible kZT(Io Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" Sx 1 �� Poa1 A�C��� uc5 �Kt^ca���et (including chloroform,formaldehyde, lA }rtak k LA X t hydrochloric acid, other acids) VIOLATIONS: OR R C� b1 1 rn� c 2 w 2 v.C o`a CMS S INFORMATIO /RECOMME ATI N kS S )VA 7VQV Inspecto;r:---r, L&v t Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °FINE r Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • enRMASSBLE.g! 200 Main Street• Hyannis, MA 02601 f639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT CFO MP'�e Business Name: vean ool s Date: Location/Mailing Address: 58$ A R a""\%s Contact Name/Phone: �x�►�eyy— tf %s,V1 Inventory Total Amount: I� I lT—fig MSDS: a Dbiaiw _ License#: Tier II : k Labeling: qvoA Spill Plan: — Oil/WaterSeparator: Floor Drains: oAJ.. Emergency Numbers: OK Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: -6 A3,00s,— 69C of LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. 10 Antifreeze 10 - Dry cleaning fluids Automatic transmission fluid 16 Other cleaning solvents&spot removers *k� � Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils 10 Miscellaneous Corrosives r^-e-J,e- &r- Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine ", YP°`k�`�t.' Paints, varnishes, stains, dyes Lye or caustic soda ec,e-►,I°rk4.hs �notbs Lacquer thinners I Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" ,all cklcr,�- (including chloroform, formaldehyde, 316 P� (ta�ic! �a�o 1� �c hydrochloric acid, other acids) — te,10 `J VIOLATIONS: D ,M6JbS DEERS: OL%A kt,( 114<00k,+ NAk k WO 0,c %&% Imo INFORMATION/R OMMEND TI NS: t c� A)A, 'Ctoo& 114%)J4 AW X'o *Q(' tA,d 1` Inspector• I--a`�4,e, Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °F1HE A Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ' &'RMASS. 200 Main Street• Hyannis, MA 02601 1639. �0'FOrAn+�` TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: V,av,s Date: -7 I q Location/Mailing Address: Y g rn I S Contact Name/Phone: ti n n. Inventory Total Amount: 1 MSDS: 0K License#: M Tier II : K)o Labelina: Spill Plan: Oil/WaterSeparator: WA Floor Drains: Q0 Emergency Numbers: �S Storage Areas/Tanks: Emergency/Containment E ui ment: Waste Generator ID: tAJ �11 D 0 12 Waste Product: Date&Amount of Last Shipment/Frequency: 5a�w— l W o 2a I4 D4yA5 Licensed Waste Hauler&Destination: Other Waste Disposal Methods: viA,g}p- A-JaVn!$R �01-12C'122 LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants JMiscellaneous petroleum products: Road salts ✓ grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: � a a 42(-54 -,WAVJl Inspector: Gvz- Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: // /,Z� /!3 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 9r,6,w5 BUSINESS LOCATION: .5�8> �(aw�' oe� S INVENTORY MAILING ADDRESS: TOTAL AMOUNT- TELEPHONE NUMBER: sb$-7 Ro - o l l 2. 2Lo 1ki CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: is aUgl 6 wKk- INFORMATION / RECOMMENDATIONS. _Cf-ea —,6 t VK&K, Fire District: 11�.5 r��g ol,/1�1�ti10�gD���5 4 U" •jAywj �l'oe.e 15 C1e4L RYAhn 16 Waste Transportation: ,MU96%j qD of I Z Last shipment of hazardous waste: 5-l'-t1ye Name of Hauler: l Destination: A6, 1 ja(4-y- waifs o- I KI Waste Product: *A5 cJtms Licensed? Yes 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) 5 lubricants, gear oil ❑ NEW ❑ USED s" 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 Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash 1 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials 1 i o e Ulare ' F f1 eA S VE NLY POOLS, tN . 58-B PLANT ROAD,HYANNIS,MA 02601 WW W.LUZIETTIPOOLS.COM DE5IGNER AND 5UILDER OF PINE GUNITE P TEL.508-771-4141 ODLS FAX.508 711 6834 TIMOTHY R. LUZIETTI EMAII:TIM.LUIIETTI@GMAIL.COM PRESIDENT INAAa 6x/E-1,JuWbA-iV A-A1P rzF_v&-)LJ 4 441JS Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: Business Name: Z/E .S 1/&WL / 0>01-5 G. Business Location: J�� PLA'N7' P .t1�tJ/S Mailing Address: Telephone Number: 'IS' -70I- ff X�1 2_ Contact Person: / Af o Zft 114Zle- 777 Emergency Contact Telephone Number: J-2)t-7 Z/- �ez*,L Type of Business: POO'- 1)E516,4) A-AJQ 6N5103UX_ 6V HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts,gallons, Shed,retail store, drums,tank,etc... cabinet,closet,etc CWtt oN 5HZA_V1A-)q, q6A'?e\ C07A-/a C 6 oac .P6UN 5ifrZViN6,9 5 >S PO IJst1/�$ ,q{ 5 OF- 4 k4RC C BAY 6 A4 �v �r Rrtk_ 6ON 741A)CX,3 01: 6_ . j�Or�d/ICE SHE")x6, kk_Ak, of G&RA4t= 6X� � Z�"n 0/ �ovNos of G �� 3 72N •rib JVJ- E /Ir >'6ce.iF s VE pol,UD . tec OF VTWA 0 4*ek4 E-6 '5/d b� d1�C �d� S�fit"L�d R 6�Y4 &1.? OS'1V6 4Alt"A)s do,#7q-1A),W_S Culk �!4 PDUND •N- �2� ��o /0avAJI�S 6 . S �)Ur VJ - 1 - Misc. Combustibles Misc. Corrosives Misc.Reactive Misc.Toxics Inventory Total Amount: A-n/o bs Hazardous Materials License Posted?Yes No N1A Contingency Plan Posted? Yes No Fire District: 11Y-4A1N1s Fire Extinguisher Service Date: Metal Covered Rag Bin: Yes NoAgkbsorbent Material Available? Yes Type of Absorbent: Speedy Dry Pads Pigs Other: MSDS on site? Yes No Hard Copy Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: 440 /wit 4,41e6a [S Lt1,jS1LC- Type(s) of hazardous waste product(s): Date of last hazardous waste shipment,type of waste and quantity: Hazardous Waste Transporter(s): Designated Hazardous Waste Facility: Hazardous Waste Storage Area Description: Is hazardous waste storage area labeled: Yes No Are tanks/drums/containers labeled with the words "Hazardous Waste",the type of waste and the associated hazard (i.e. ignitable,corrosive,reactive or toxic) Yes No If hazardous waste is stored out of doors is it covered from the elements? Yes No Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floor? Yes No - 2 - FLOOR DRAINS (Chapter 381) Town Sewer Account Number: Indoor floor drains: Yes If yes,circle one,does it discharge to a: holding tank dry well on site septic. Outdoor surface drains: Yes No If yes,circle one,does it discharge to a: holding tank dry well on site septic. FUEL AND CHEMICAL STORAGE TANKS (Chapter 326) Underground Storage Tank(s) on site? Yes 69 Age: Is removal required? Yes No If yes,when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on site? Yes 6) If yes,is it protected from the elements? Yes No If yes,how? Is it on a foundation larger in size than the tank? Yes No COMMENTS/RECOMMENDATIONS/CORRECTIVE ACTIONS '' d,9,V;r a6 -/-T 37T 9.6 0001— &/zfl cis S CP.494 *Ub /AJ A it NO17F� 77ft� AGfNye,4jA2-z-r�/ *hl6 &4ArV&'?tj f�'�-Lf�ONs )rVA44C .4AJP &Yuuc. Ue' ©F SwiMM`Aie- �pe� IV yocC )voac'g— cz'NyEYA-AXE► ARE 7Z) 6E u---' TU DA 7K AANP AVA1"6 CE 0,4j s 1 TE" Date: �� Public Health Inspector: Facility Representative: - 3 - 7� �/ 1 No ..............L.- - 7d .............. THE COMMONWEALTH OF MASSACHUSETTS �.j� BOARD' O _• !-i E L 1 T �/. . ........OF........ _ -- ------ "-----7i----------------------- ApplirFation for Uisvao al Works Tnnitrnrtinn Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: , ................_........P.1 T'.. . 12..................._.---... --.....t Q._.�_...�......----- ---------------....._.....---.._.......--- - ------------ Lo 'on-Addres r t No. - r�:1 �,f---------------•--------..... ......../ 2.�_ 62 1. � ��,. -VA1.r.-f................... r ..... Owner , A dress ---------- � ---•-- --------------------------------------•------.....--• ------------------------------------------------...... Installer Address ��'yy Type of Building '�wtiw v P Size Lotajj.4..9.6-_..Sq. feet f�l�Riw6 Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p., Other—Type of BuildingllP��.C.�,.-TI.0./9lv"C'No. of persons____________________________ Showers ( ) — Cafeteria ( ) Q' Other fixtures ........................................-•- W Design Flow............:' _ ................gallons per person per day. Total daily flow.__....:.- IxSeptic TankLiquid"capacitya?(1DQ.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 ( ) Dosin tank• ) / �r ` Percolation Test Results Performed b ._ ._ _>__:_. _CtNl.t.l.(l.S................................... Date____-l®..�..�(.._ :. ...-.-__.. Test Pit No. 1-----------.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ... -- --------------- :_. ....... ----..---. ---- ----------.......-----------------------------------------...... O Description of Soil.....C2-_l __._..P x c, = . •. ••------- -- - 1 W ---------------------- ---------�u--/ -- .........................® a--- -- ------ -- --------•••--- ` ' i U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------__.__________. ......................... �f� Vi a.------. �''--�s . ... ! ........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue by the board of health. S- ed Gvr -----•--- ................................ Z Date y = Application Approved B ------ ---•- 7 Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------....................... ..............••---•-•-•-•--••-•-------•-------•---••--••-•-••---••----•-------•••-------••----------•---••----••----••--••••---•----------•-------•-••---•-----•-•-••••••---------•-••----•-------•--•- Date PermitNo......................................................... Issued-....................................................... Date Date: q 2-`b,/ TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: Awn :r5/9�twd BUSINESS LOCATION: • :5 A &cz, - INVENTORY Of sr MAILING ADDRESS: • TOTAL AMOUNT: TELEPHONE NUMBER: ® e'i® — `-I�6 a CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBS : TYPEOFBUSINESS: S' L^' FWe 0(57�IG�r OTHER INFORMATION: V 5r ja4 �Qtia0;q_ .s 92z " E: of s M S L75 oh �rf� Waste Transportan. ��1-7 ,il�. Name of Hauler: f ; Destination: Waste Product: s Licensed?�No 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. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): 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 5:Motor oils Pesticides +'NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Dieselfuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ' NEW USED Degreasers for engines and metal 2 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 SPaints, 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 Floor&furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid, other acids) �I Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or.hazardous (please list): pot removers & cleaning fluids Misc.: (dry cleaners) c� Other cleaning solvents Bug and tar removers Patrick Dowler arTees Island Designs, LLC .10JD�--, Screen Printing and Embroidery Custom and Wholesale arTees Island Designs,LLC•58A Plant Road•Hyannis,MA 02601 Telephone:1-508-790-4800 Fax:1-508-790-1366 E-mail:arteesislanddesigns@bigfoot'.com www.artees.biz - I TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2. Printers 3.Auto Body Shops Q unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores (( 6. Fuel Suppliers ADDRESS SIC �� t Class: Z 7. Miscellaneous �C>\ S QUANTITIES ANDSTORAG (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers X S Miscellaneous: 1 S �I,n X DISPOSAURECLAMATION REMARKS: 1. anitary Sewage 2.Nyater Supply QF kLQ1 Town Sewer Public �5 O On-site OPrivate {-U 3. Indoor Floor Drains YES NO n „ O Holding tank:MDC tc� O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0)L ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product Licensed? YES NO 1. 2. Person(s) Interviewed Inspector Date 35-- 133 LOCATION SEWAGE PERMIT N0. VILLAGE I N S T A LLER'S��]]-- NA /M�E fA ADDRESS e U I L D E R OR OWNER ��.� A,r & e4�ti;s DATE PERMIT ISSUED DATE COMPLIANCE ISSUED i \i i i � ll�P41 s 6 rc �� Xy'. :• 3. { - - , � I F Y. f xr 'S �.+5r f} x r r \�rOzi ���x p,Y °r,E•S,r ,tL ° 4 s m l) C � C �r� ^ � Y Z C �' C �• � ' � t `Y � �-------�� ��� ��� ,�F t:— r S}z Y 1! 4 1 -i. }. ':Y • 2i, \ r r y O f11 ni D ZZ � - . *(q �• R 1 `t2r y\`+ to y y z ,{ I A 1 .sr :.0. �c'�� .�+ q'. ` { � �^"=x•11 z^^ P {�j by �;0'a v r �;' x -6 � 4 tr� ,ty sq�c: � �.�- < •�-s. ..I ' - I � � I I N � `t) � r' `~ ���1M}i��l'sJ a"� is 4' '�, �t .}t!. •-. '4 ! N.; .a w '.. I��//��I��(l�Y � �Ii ,. s y '..s_R � \„•. 7v. <`�yr.°xtd a°`"b p� per, -1 -'n,.• t � I ,� ,OQ ICJf1 I - `L (,� l��I\1I_ 1 I� ,r. •t3 t' ,,. ,+.� 1 v. s' {C.:. �M ^ 3,.. " }% Lr� I ��I V � a f�;'_ tr `y Q�� •, \ ,: r•, �T�i�,��r���ij-, :w ,1.r Q�I�I� - � �I�1I �y�I..�I Cj - a jrg , r _ Qe� 0� t g O ef'�'*'•V.�'�r; .'I.y O l #:.. '" t I }` 4,r `( i�t`S P• {y 2 i1��&S 4` i ! 3\ r#y�'�u, ��.: i 'd ��`. 4 �•-F � � t s' � - kK <. \ �� ,•j � 4 a b „��. `�`SA' � �.s f � .�fl � �hP ,,. ,. �� � +: e � ` we t�s ti;.• a .t t �d C,,; �i.y,'ir r� .. L MW,: '.,<r�.� "�•.}y��. (� �"• •�1�M_ S ^ f� _ � I� =per i• ,. ,-�i ,la.t�u t o ^' f nr�i��l rye.�4�-{�.C, '�",�;: pV k 1 17 �.�,.s 4 F e 4 d G i �,�ys� d� �tN� `� f+ ��+_ �1� �� \ /� - \� � p .O fin /�1J ` '�S `•� � M � �_� � •t �r �' co L "� , ,�V y... a _ F..• Z O ,r - ti l J` i p \ r�' q'S ��: cr¢# ';,: � �^11 !'.-� (� � Z ' -,1 y t'' \ :p' •! 0. ° t �' ,� K x�Yr s ar I O lyd `.rn � � � +4' (tt� `� e F vl �+� -9 0.p._V 9V .�._.0 7,,:..- �• yS�n :�''a:��s� �' � i:. �� � 1 0< +, - `y 5- ;i 'tr ��•(� -•l �. � �iQl� ,E. s �• • •�_• • \1 y�CV `��, �:` ,�i, Ib ��t �, d't`+` i � .>.. _. R,� Q.\ 1 t �^ O I•� I� � • •*• •� � . • • r >t - �` 'A.;r� �,�t�,k1 }- A N. � � � y y .�, o �o. s • , D s oZ ,'Fty3n � a3 \•� � . _ � °,FaeaiY y_ tzzl VA 'N ph tz ck 'Q =4 a e rt f i�m °bEL ,y t o 3 j t. Fig 1 ".t¢° ra ,ti'N..�+{A._ a �r.k'` ( ° ti:, x P il• '7 L x .� #' t � .°E1?''$ K.� 3, ".;�,. .[,«•:. "x` _-v�.`�.f .a. .r„�.a,..i; r :.Ar-^�.++�' a c�:� H*-., r 'r t� �5.. °-t y�ax?�� LOCATION S E W A PERMIT N0. VILLAGE INSTA LLER' NAME & ADDRESS `. 0 U I l D E R OR OWNER D A T E PERMIT ISSUED DATE COMPLIANCE ISSUED c3�© N3 ------------------- o , /Olt)f.7 o '�. r, THE COMMONWEALTH OF MASSACHUSETTS ....................of ................ ......... ....................................... ........... (7^ eu—ii� No......................... ............. ..................jqtT� APPLICATION FOR PERMIT TO OPERATE A FOOD SERVICE ESTABLISHMENT To the Board of Health of: ._._..-dq----- .......4.......2ff!�a2du e...... ... .. .... Application is made for a Permit to operate a Food Service Establishment in accordance with the provisions of 0 Z Chapter 94, Section 305A and Chapter 111, Section 5 of the General Laws:— ------------------------------- .......O.A..Rn.�tj-.A j-c...................................................................... t Full 14=0 0 P1 t �.Xa.. ................................................ .......... ..................... .........................................................-Z 't. T 0 "1 'shment ....................................... .............. T-17A---44..!2.>.................................................... M Business reas M o If applicant is a partnership,full name and residence of all partners x ................................................................................................................................................................................................... .............................................................................I.......................................................................................................................... ....................................................................................................................................................................................................... IfApplicant is a Corporation ............................................................................................... .................................................. Stateof Incorporation ................M.A.S,&./q..Chs.4- ell...................................................................................................... Full Name and AddrMs of. PRESIDENT .............70 i4�.... ..J�V.aazalz.......L4 .............TREASURER ---------114v " �:kwk-,.. 4?.'f-... 0 -AX.r -A CLERK ......... ------- vt...... ............. �-� Signature ............... ------------...... ..... - -•---- .......... ..........41�- ................. j City or Town /g�- l THE COMMONWEALTH OF MASSACHUSETTS •...................of-•-•••..._..............••••--...._.......••-••----•................_._..... No......................... ....Ca.e� ...,�.��.1........19.0q®. APPLICATION FOR PERMIT TO OPERATE A FOOD SERVICE ESTABLISHMENT To the Board of wealth of: . ...-- •--•-------------------------------------- ••--•--...._..---.-_------•-- Application is made for a Permit to operate a Food Service Establishment in accordance with the provisions of z Chapter 94, Section 305A and Chapter 111, Section 5 of the General Laws:—. y Full ame of Applicant g ......-•-•-•-• �.�.��._1 1 d. i/z ........................•••---••-•-••••••••..............-----•--......---......... �_..._. _n - /� T e of Establishment " � nl 1C : pp BHsiness Addres-1 o If applicant is a partnership,full name and residence of all partners a . ..............................._.................................................................................................................................-•---...._._........_................ w -................................. ----•- ---•- ...----,•-•-•------------------------------------ --------- •-------------- 77__ If Applicant is a Corporation .......•..•-••- '&41.� ..�-�c��Cl,.....�°__._r�'! !. =•- C:........................ State of Incorporation Full Name and Addre s of: n PRESIDENT ...---... U ? 2%_..K...�. ..........1-- t�1� �,.a «..._ �1-.e�_.l} d,......0 TREASURER Ns�...... o.�.......... �` CLERK ....__.��_C'�Ze2 _... = ?_t14.c1�4.! 1 [�'l�r..........dl?;to`.$!:...... ,.E3✓...Meg. ff����.�3.......4'�f�o........._. Signature .............� IB......:..............----_.......... ............................................................•-•--...._.... ._....... City or Town�� No.._..... _....... Fss... ✓............... THE COMMONWEALTH OF MASSA USETTS BOAR® O s-i E LT ... .. ---....OF........ :. ... . . ... .....•........................ , ppliration for DisposA'lVorks Tontrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: UAL Lo on Addr s gr Lot No. .... i2 A�_�_..RA_r. ... A. --••---•••-•-•............... •• ± .t.! :._. ' ..._ dhaJ._-_/��T[J.I!!!A..lr_..� ................... Owner • Adddress R....0 u- .------ - . Installer Address // Type of Building (t�Tc:ft-I v� �t �vt's F' Size Lot j._ _i�....Sq. feet`"' U Dwelling—No. of Bedrooms....._ .Expansion Attic ( ) Garbage Grinder ( ) p-1 Other—Type of Buildin yp �� '+�i";����-1��'No. of persons............... :.:...... Showers ( ) — Cafeteria ( ) QI Other.fixar d W Design Flow- '..................... _:... gallons per person per day. Total daily flow............................................gallons. WSeptic Tank Liquid capacif _._.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 ( ) Dosi t ) "�j ~' Percolation Test Results Performed by. __� .!_ . 11. .................................. Date...../1 _ ___ _ ►.._..... Test Pit No. 1...............minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G4' -- -. .. ODescription of Soil O � . --------------------------••----------------------------•--•----_----- pp --------•--------•-------------------•--------------.------•••----------------------- x -------- ��A l- --- -- --------------- •--- ----- . -••••-.._...`---.....----•----- U Nature of Repairs or Alterations—Answer when applicable.____C __ Vo ..._ A-r-w3 c.....mtq.p................... Agreement: .. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLSJ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been fissue by th board of health. AP Plication Approved BY ---------•------ p Date Application Disapproved for the following reasons:-....................................................................................................------------ -•----------------••.....-----------•-------------•--............................................................................•-----------------------------------•------------------------------- Date Der-nit 1`10:._...............=-------====---------------------- -- N: issued_.......................................... ti 3 y- Date THE COMMONWEALTH OF MASSACHU-SETTS BOARD OF HEALTH''°/ .... ..0. W.'.1j....OF..1?.. f...4:.. ..Lof.............. Tntif irab of Tontpliattrr F THIS ,IS.,TO CERTIFY, That the Individual Sewage Disposal System constructed ( ") or Repaired ( ) by :.. C •• ................••-----------•-•.......•--•--._....._......._ Aw. Installer Isi at... ..__ ..:..._. -! '- - . �- .................................................................. has been installed in accordance with-,the provisions of ) 1r,of The State SanitaryCode as described in the P - . 11�._ .. application for Disposal Works Construction Permit No __.. '�.�.__-___..... dated- -. -.._. . __. _._.__.__.. THi 1`SSOdANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F NCTION }SATISFACTORY. J DATE............. -............................. Inspector,,,_�._.1.._- -----�`� ................................. THE COMMONWEALTH-OF MASSACHUSETTS BOARDOF HEALTH ......OF.. .. .- '... .... ./ .............. No �!:...... FEE.ZJO..'"!....... iDsposal Works Tonotrurtion prrmit ��. Permission is hereby granted............................... to Construct ) ore air (:) a�Idividqa}}� Sewage Disposal S�jk e; atNo 14 J!_• ----- -•---.....^4 h!---•---- •--_..... _.lCR _. /tf ,{tY.................................................. --•-- Street as shown on the application for Disposal Works Construction PermVN ...-.__ -- Dated. ` +js ' .�_.... . "/4a Health DATE -.. :_---//-------------------------•-••-•---------•--•----• VVVVVV ` FORM 1255 HOBBS & WARREN. INC., PUBLISHERS .Towne of Barnstable , Date �'' J1_, �'Pe 'rime Inspection Form for Food Handling Establishments Town of BARNSTABLE Name /��': ".. , ,/� Address ,-? r Licensee Owner Item Regulation Item Yes .No Remarks 1 14 Floors—Construction,clean,good repair 3 2 15 Walls&Ceilings—Good repair,cleaning methods 3 3 14 Doors&Windows—Screened,self-closing 2 4 16 Lighting—Adequate,fixtures shielded 2 5 17 Ventilation—Adequate,systems maintained 3 6 8 Water source—Safe,hot& cold under pressure 6* 7 _ 11 Toilet Facilities—Self-closing door, clean,good repair,waste cans 3 8 12 Lavatories—Hot&cold water,signs, soap,drying devise 3 9 6 Construction of utensils&equipment 2 10 7 Cleaning of equipment 4 11 7 Cleaning of utensils 4 12 7 Bactericidal treatment of utensils 6* 13 7 Storage&handling of utensils 4 14 13 Disposal of waste—Covered,adequate,vermin proof 5* 15 3 Refrigeration—Temp.off floor,food covered 5* 15a 3 Thermometers present 2 16 2 Wholesomeness of food 6* 17 2 Wholesomeness of milk products 5* 18 2 Wholesomeness of shellfish 5* 19 3 Storage of food&drink 5* 20 3 Display/serving of food&drink 5* 21 14 Vermin control 4* 22 5 Cleanliness of employees 4* 23 3 Storage of toxic chemicals 4 24 Miscellaneous 5 Total ' out of possible 100 *Critical Items require immediate attention— Reasons for compliance on reverse Received by Inspector f' d.. Health Department Regulations Require Conspicuous Posting of the most Recent Inspection Report ! i f }f. AREAS OF CONTROL FOR FOODBORNE ILLNESS Reason numbers refer to item numbers. #16 Wholesomeness of Food:To control foodborne illness and food spoilage,which may result from improperly processed or handled food,the food service establishment must be concerned with the sources of food which are to be used. The safety and wholesomeness of food is a,basic requirement for the protection of the consumer's health. Accordingly,the provisions listed under Compliance are intended to insure that food in general,as well as certain food which may be potentially hazardous, is obtained from sources which have been approved or are considered satisfactory by the health authority. #15 Refrigeration: Wholesome food, if mishandled, can become contaminated from a number of sources. Food protection measures are designed to eliminate the contamination of food from any source within the establishment, and to prevent the growth of disease-producing organisms,and the production of bacterial toxins,in the event that pathogens are present in the food.Proper food-protection measures should include(1)strict observation of personal hygiene by all food-service employees;(2)keeping potentially hazardous food refrigerated or heated at all times to temperatures which preclude the growth of any pathogenic organisms which may be present; (3) application of good sanitation practices in the storage,preparation,display,and service of food; (4)adequate cooking of certain food of animal origin to assure destruction of pathogenic organisms which may be present;(5)thorough washing of fruits and vegetables; and (6) the provision of adequate equipment and facilities for the proper conduct of operations. In addition, food must be protected against accidental contamination with any toxic substance. All food, while being stored, prepared, displayed, served, or sold in food-service establishments, or transported between such establishments,shall be protected against contamin ation from dust,flies,rodents,and other vermin; unclean utensils and work surfaces;unnecessary handling;coughs and sneezes;flooding,drainage,and overhead leakage;and any other source.Conveniently located refrigeration facilities,het food storage and display facilities, and effective insulated facilities, shall be provided as needed to assure the maintenance of all food at required temperatures during storage,preparation,display,and service. Each cold-storage facility used for the storage of perishable food in non-frozen state shall be provided with an indicating thermometer accurate to—2°F.,located in the warmest part of the facility in which food is stored,and of such type and so situated that the thermometer can be easily and readily observed for reading. b. Temperatures:All perishable food shall be stored at such temperatures as will protect against spoilage.All potentially hazardous food shall,except when being prepared and served,and when being displayed for service,be kept at 45°F. or below, or 150°F. or above. Frozen food shall be kept as such temperatures as to remain frozen, except when being thawed for preparation or use.Potentially hazardous frozen food shall be thawed at refrigerator temperatures of 45°F.or below; or under cool,potable running water(70°F.or below);or quick-thawed as part of the cooking process; or by any other method satisfactory to the health authority. #22 Cleanliness of Employees: Disease transmitted through food frequently originates from an infected food handler. A wide range of communicable diseases and infections may be transmitted by food handlers to other employees and customers through contaminated food and careless food-handling practices.Boils and sore throats are sources of organisms which cause staphylococcal food intoxication, the most frequently reported type .of foodborne disease in the United States.It is the responsibility of both management and employees to see that no person who is affected with any disease in a communicable form works in any area of a food-service establishment where there is likelihood of disease transmission.Clean personnel with clean habits are essential to sanitary food preparation and service.Clean hands,clean clothing,and hygienic practices reduce the likelihood of contaminat- ing food, drink, and food-contact surfaces of equipment, utensils, or single-service articles. Hand-washing'is necessary not only before starting work and after visiting the toilet,but also at any other times when the hands have become soiled or contaminated.It must be recognized that hands often become soiled in the performances of routine duties in and about the establishment. The use of tobacco while preparing food or serving food may contaminate the fingers and hands with saliva, and may promote spitting, thereby permitting transmission of disease organisms present in the saliva to food or food-contact surfaces. #12 Bactericidal Treatment of Utensils:Regular,effective cleaning and sanitizing of equipment,utensils,and work surfaces minimizes the chances for contaminating food during preparation,storage,and serving,and for the transmission of disease organisms to customers and employees.Effective cleaning will remove soil and prevent the -- -accumulation of food residues which may decompose or support the rapid development of food-poisoning organisms or toxins.Application of effective sanitizing procedures destroys those disease organisms which may be present on equipment and utensils after cleaning, and thus prevents the transfer of such organisms to customers or employees,either directly through tableware,such as glasses,cups,and flatware,or indirectly through the food. Improper storage of equipment and utensils,subsequent to cleaning and sanitizing,exposes them to contamination and can nulify the benefits of these operations. Accordingly, storage and handling of cleaned or sanitized equipment and utensils,and single-service articles,must be such as to adequately protect these items from splash, dust, and other contaminating material. #21 Vermin Control: Insects and rodents are capable of transmitting a number of diseases to man through contamination of food and food contact surfaces. Accordingly, their presence in a food-service establishment creates a potential health hazard which can be guarded against only by effective control of such vermin. Since vermin require food, water, and shelter, control measures should be designed,to deprive them of these require- ments. #23 Storage of Toxic Chemicals:Only those poisonous and toxic materials required to maintain the establish- ment in a sanitary condition,and for sanitization of equipment and utensils,,shall be present in any area used in. connection with food-service establishments.All containers of poisonous and toxic materials shall be prominently and distinctively marked or labeled for easy identification as to contents.When not in use, poisonous and toxic materials shall be stored in cabinets which are used for no other purpose, or in a place which is outside the food-storage, food preparation, and cleaned equipment and utensil storage rooms. Bactericides and cleaning compound shall not be stored in the same cabinet or area of the room with insecticides, rodenticides, or other poisonous materials. Poisonous materials shall not be used in anyway as to contaminate food, equipment, or utensils, not to constitute other hazards to employees or customers. - - -,Town of Barft9tAbIb " I" . Date z 6z l elf/ Type Time Inspection Form for Food Handling Establishments Town of BARNSTABLE Name Address � Licensee '" r Owner Item Regulation Item Yes .No Remarks 1 14 Floors—Construction,clean,good repair 3 2 15 Walls&Ceilings—Good repair,cleaning methods 3 3 14 Doors&Windows—Screened,self-closing 2 4 16 Lighting—Adequate,fixtures shielded 2 a �I 5 17 Ventilation—Adequate,systems maintained 3 6 8 Water source—Safe,hot& cold under pressure 6* Y 7 11 Toilet Facilities—Self-closing door, clean,good repair,waste cans 3 /�'1SQt ►� "`' r 8 12 Lavatories—Hot& cold water,signs, soap,drying devise 3 9 6 Construction of utensils&equipment 2 3 10 7 Cleaning of equipment 4 11 7 Cleaning of utensils 4 12 7 Bactericidal treatment of utensils 6* 13 - 7 Storage&handling of utensils 4 •- 14. 13 Disposal of waste—Covered,adequate,vermin proof 5` r 15 3 Refrigeration—Temp.off floor,food covered 5* 15a 3 Thermometers present �. _ 2 Ilk 16 2 Wholesomeness of food f 6* 17 2 Wholesomeness of milk p oductts/ 5* t t 18 2 Wholesomeness of shellfish 5* 19 3 Storage of food&drink 5* 20 3 Display/serving of food&drink 5* 21 14 Vermin control 4* 22 `.;5f Cleanliness of employees 4* 23 3• ' Storage of toxic chemicals 4 24 Miscellaneous 5 ' Total out of possible 100 `Critical Items require immediate attention— Reasons for compliance on reverse 7. ..A l A ..�`��• X� Receivel;'by -. f aInspector �� Alf Health Department Regulations Require Conspicuous Posting of the most Recent Inspection Report AREAS OF CONTROL FOR FOODBORNE ILLNESS Reason numbers refer to item numbers. #16 Wholesomeness of Food:To control foodborne illness and food spoilage,which may result from improperly processed or handled food,the food service establishment must be concerned with the sources of food which are to be used. The safety and wholesomeness of food is a basic requirement for the protection of the consumer's health. Accordingly,the provisions listed under Compliance are intended to insure that food in general,as well as certain food which may be potentially hazardous, is obtained from sources which have been approved or are considered satisfactory by the health authority. #15 Refrigeration: Wholesome food, if mishandled, can become contaminated from a number of sources. Food protection measures are designed to eliminate the contamination of food from any source within the establishment, and to prevent the growth of disease-producing organisms,and the production of bacterial toxins,in the event that pathogens are present in the food.Proper food-protection measures should include(1)strict observation of personal hygiene by all food-service employees;(2)keeping potentially hazardous food refrigerated or heated at all times to temperatures which preclude the growth of any pathogenic organisms which may be present; (3) application of good sanitation practices in the storage,preparation,display,and service of food; (4)adequate cooking of certain food of animal origin to assure destruction of pathogenic organisms which may be present;(5)thorough washing of fruits and vegetables; and (6) the provision of adequate equipment and facilities for the proper conduct of operations. In addition, food must be protected against accidental contamination with any toxic substance. All food, while being stored, prepared, displayed, served, or sold in food-service establishments, or transported between such establishments,shall be protected against contamir ation from dust,flies,rodents,and other vermin; unclean utensils and work surfaces;unnecessary handling;coughs and sneezes;flooding,drainage,and overhead leakage;and any other source.Conveniently located refrigeration facilities,het food storage and display facilities, and effective insulated facilities, shall be provided as needed to assure the maintenance of all food at required temperatures during storage,preparation,display,and service. Each cold-storage facility used for the storage of perishable food in non-frozen state shall be provided with an indicating thermometer accurate to—20F.,located in the warmest part of the facility in which food is stored,and of such type and so situated that the thermometer can be easily and readily observed for reading. b. Temperatures:All perishable food shall be stored at such temperatures as will protect against spoilage.All potentially hazardous food shall,except when being prepared and served,and when being displayed for service,be kept at 45°F. or below, or 150°F. or above. Frozen food shall be kept as such temperatures as to remain frozen, except when being thawed for preparation or use.Potentially hazardous frozen food shall be thawed at refrigerator temperatures of 45°F.or below;or under cool,potable running water(70°F.or below);or quick-thawed as part of the cooking process; or by any other method satisfactory to the health authority. #22 Cleanliness of Employees: Disease transmitted through food frequently originates from an infected food handler. A wide range of communicable diseases and infections may be transmitted by food handlers to other employees and customers through contaminated food and careless food-handling practices.Boils and sore throats are sources of organisms which cause staphylococcal food intoxication, the most frequently reported type of foodborne disease in the United States.It is the responsibility of both management and employees to see that no person who is affected with any disease in a communicable form works in any area of a food-service establishment where there is likelihood of disease transmission.Clean personnel with clean habits are essential to sanitary food preparation and service.Clean hands,clean clothing,and hygienic practices reduce the likelihood of contaminat- ing food, drink, and food-contact surfaces of equipment, utensils, or single-service articles. Hand-washing is necessary not only before starting work and after visiting the toilet,but also at any other times when the hands have become soiled or contaminated.It must be recognized that hands often become soiled in the performances of routine duties in and about the establishment. The use of tobacco while preparing food or serving food may contaminate the fingers and hands with saliva, and may promote spitting, thereby permitting transmission of disease organisms present in the saliva to food or food-contact surfaces. #12 Bactericidal Treatment of Utensils:Regular,effective cleaning and sanitizing of equipment,utensils,and work surfaces minimizes the chances for contaminating food during preparation,storage,and serving,and for the transmission of disease organisms to customers and employees.Effective cleaning will remove soil and prevent the accumulation of food residues which may decompose or support the rapid development of food-poisoning organisms or toxins.Application of effective sanitizing procedures destroys those disease organisms which may be present on equipment and utensils after cleaning, and thus prevents the transfer of such organisms to customers or employees,either directly through tableware,such as glasses,cups,and flatware,or indirectly through the food. Improper storage of equipment and utensils,subsequent to cleaning and sanitizing,exposes them to contamination and can nulify the benefits of these operations. Accordingly, storage and handling of cleaned or sanitized equipment and utensils,and single-service articles,must be such as to adequately protect these items from splash, dust, and.other_contaminating-mate rial. #21 Vermin Control: Insects and rodents are capable of transmitting a number of diseases to man through contamination of food and food contact surfaces. Accordingly, their presence in a food-service establishment creates a potential health hazard which can be guarded against only by effective control of such vermin. Since vermin require food, water, and shelter, control measures should be designed to deprive them of these require- ments. #23 Storage of Toxic Chemicals:Only those poisonous and toxic materials required to maintain the establish- ment in a sanitary condition,and for sanitization of equipment and utensils,shall be present in any area used in connection with food-service establishments.All containers of poisonous and toxic materials shall be prominently and distinctively marked or labeled for easy identification as to contents. When not in use, poisonous and toxic materials shall be stored in cabinets which are used for no other purpose, or in a place which is outside the food-storage, food preparation, and cleaned equipment and utensil storage rooms. Bactericides and cleaning compound shall not be stored in the same cabinet or area of the room with insecticides, rodenticides, or other poisonous materials. Poisonous materials shall not be used in anyway as to contaminate food, equipment, or utensils, not to constitute other hazards to employees or customers. FOR OFFICIAL USE ONLY TOWN OF BARNSTABLE Received Payment $ . . .. ... .. .. . .. .. . .. . .. .. . . .. .. .. . HEALTH DEPARTMENT Expires . .. . .. .. . .. . . . . ... .. . . .. . . . . . . . . .. . . . . .. .. . . License # . . .. .. . . .. . .. . .. .. .. .. . . .. ... .. . . .. ... ... . APPLICATION FOR LICENSE TO OPERATE A PUBLIC.EATING AND DRINKING ESTABLISHMENT Application for license renewal shall be made at least one month before expiration date of existing license.The license is not transferable. Application is,hereby,made for a license to operate.By this application it is agreed that the establishment will comply with the provisions of the Town of Barnstable health regulations and article X of the state sanitary code applicable to this type of establishment.It is further agreed that said establishment shall be open to inspection by the-O milky Health Department. Paie'2Tt, _l C"eo ('�l�/E'f 'C, PLEASE PRINT ,Di6; 60u-R nA ,Tj 6® ] ESTABLISHMENT NAME ...................................... PROPRIETOR'S NAME .. 4.�.eE�J.....!�r.. ®`J......... ESTABLISHMENT ADDRESS . ' '!!' ..R018:......... -e PROPRIETOR'S MAILING ADDRESS. ../.Wy!!�.. S� ....... ............ ......©..?lze�.l........ ��/�1Yit1.�S".j. .,....D, ................ TELEPHONE# .... ~..) 1�................ PROPRIETOR'S TELEPHONE# .... .......... TOWNSHIP, CITY ESTIMATED NUMBER OF PATRONS TO BE OR BOROUGH ..............................................:. SERVED PER DA ...................... .............. ...o�,�- ...................... Signature of Proprietor'................... �mbPe jo.;i P wAPST gA�'nl�Ab1P fit. D�1�4 The inspection form that follows must be completed by the Proprietor or by a consulting Sanitarian employed by the Proprietor prior to inspection of the Health Department.Insert N/A if question is not applicable to your establishment. YES NO YES NO 1. Is this an application for renewal? ....... .....• 11. Are all poisonous and toxic materials stored separately from food? � ....... 2. Is valid license visible to public? 6VA: ....... •..••.• 12. Are custards, cream fillings,egg salad, 3. Perishable food is from approved tuna fish salad etc. stored below sources? /. 45 F.? . ....... 4. Milk products are pasteurized? ✓,. 13. Persons with boils,open sores, or communicable diseases are not 5. Milk products are in original V/ - permitted to handle food? ..!/.... ....... containers? ••••••• ••••••• 14. All persons working in establishment / / wear clean apparel? ✓..... 6. Shellstock and shellfish are properly ,/ identified? •••• 15. All persons working in establishment wash hands before starting work and 7. Shellstock and shellfish are from then when necessary? approved sources? ...!... ....... 8. Thermometers are in all refrigerators / 16. All persons working in establishment do not smoke while at work except and cold storage facilities? ...V.... ••••••• in specified smoking area? ....... ...... i a. At what temperature are dairy refrigerators 3 0 17. Is installation of equipment such that maintained? it is easily cleanable? ....... ....... b. At what temperature are meat refrigerators 18. Does equipment meet NSF standards 8 maintained? or equivalent standards? ... ... ....... c. At what temperature are e cold storage Facilities maintained? �......L(� 19. Is all dishware free of cracks and chips? XP........ ....... 9. All frozen foods are kept frozen? ....... V 20. Counters, shelves,refrigerators,meat 10. Thawed food is not refrozen? .. blocks, etc. are kept clean? . ....... 'The word"Proprietor"as used in this application refers to the legal owner of the related establishment. YES. NO YES NO 21. Utensils such as knives, dippers,etc. V/ 35. Sewage system functioning properly? . _ ....... kept clean? ....... ....... 36. - Garbage and refuse are stored in 22. Are utensils,kitchenware and dining- ' ,/ metal containers with tight fitting / 'ware stored properly. +�.... ....... covers. 23. Are dishes washed with a mechanical 37. Garbage and refuse storage are kept / dishwasher? Y4:..... clean? ...!... 24. On mechanical dishwasher is rinse 38. Cockroach control maintained. ....... ....... pressure at 15 to 25 PSI? �A...,., ....... � 39. Rodent control maintained? .. If., ....... 25. At what temperature does thermo- meter read for rinse water in 40. Flycontrol maintained. ....... dishwasher? /xY/a..... .:..... 41. Live animals and birds are prohibited 26. Is a three compartment sink used from premises?(except seeing in dishwashing? K A..... eye dogs) . ....... 27.. Is water for sanitization at 180°F. 42. Floors,walls, ceilings are kept or above? ��...... clean? ....... ....... 28. If no facilities for proper dishwashing ,/ 43. Toilet rooms are available for are single service articles used? ....... ....... employees? V... ....... 29. Hot and cold running water under V 44. Toilet rooms are kept clean? pressure available? / 45. Toilet rooms are well ventilated to 30. Water source is from a municipal the outside? system? !!//Y / 31. Do you have copy of bacteriolog�'cal 46. . Doors on toilet rooms are self dosing? ....... ..V. test results of water supply on file? ....... g 47. Hand washing fecilities have soap 32. Do you have copy chemical test and clean towels available? ....... ....... results of water supply ly on file? ....... ....... -48. Hand washing facilities are available 33. Ice purchased from an approved ✓ in food preparation areas? source? ....... ....... 34. Sewage system is connected .1 49. . Construction or remodeling plans g, Y ����.. z were approved by the Town of Barnstable / to municipal system? �r`a'C ...... Health Department? �/ Any deficiencies noted must be corrected within a reasonable period or action for correction be submitted to the Department. ..................................................................Being duly sworn according to law that the facts set forth in the foregoing Name—Print or type inspection form are true and correct and are in accordance with the standards outlined by the current Rules and Regulations of the Barnstable'fmmema* Health Department. RX . ............................................................... *Sworn to and subscribed before me this Signature of Proprietor or Consulting Sanitarian ................................. day of 19...... Address ............................................... *If the form is completed by a Sanitarian who is registered by the Board Notary Public for Registration of Sanitarians in Massachusetts, he may enter his Registration Number here in lieu of having a Notary Public Certifica- tion. TOWN OF BARNSTABLE LOCATION�Q`�"� .�� �'I�,� �-�SEWAGE # VILLAGE wl ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 4,a� i ,� ( SEPTIC TANK CAPACITY Zen" amg2 LEACHING FACILITY:(type) , (size) Z~ NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: - .•-� � DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No No.. ..:. Fss..... THE COMMONWEALTH OF MASSACHUSETTS 'I ' BOARD Q On F HEALTH ... dW N.................0F..f3..A.!S.N.s TA.B.LE........-•--------•---............----- Appliratinn for Uispuuttl Works Ton.strnrtiun JIrrutit Application is hereby made for a Permit to Construct (Ik�or Repair ( ) an Individual Sewage Disposal System at ....PI—A ML R d.......H. N I.S................... ..1-01.#8.......(6 K..3.ZO.,.E6.:..64) ...._.... Location-Address ••�t No. TT ..�0 M...........!.......- ----•--------------•-- `CIS�....ZT#13Z.... N. 1 .....M.. ................ Owner Address A!:? ................. ......... .............. ..... ...... Installer Address Type of Building Size Lot.].Zz.........Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building W.Aq— duS- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixt es .. .... d ............... ....... ------------------- ------------------------•-------.--.........••-•-...........------...... W Design Flow.7.�..�At-.1���.�,_.gallons per person per day. Total daily flow..ZIL3...�.?.........................gallons. WSeptic Tank—Liquid capacity.K!0 allons Length_ Z._. Width_ .yZ.... Diameter................ Depth_.. . EFF x Disposal Trench—No..................... Width...l.............. Total Length..........t........ Total leaching area...................sq. ft. Seepage Pit No..................... Diameter....a........... Depth below inlet...4_............ Total leaching area.3`1 :Z..sq/t. U/D Z Other Distribution box ( ) Dosingtank ( ) aPercolation Test Resumes Performed by... OlA/N. .....CA�£...CIN6................. Date.c)./J/ ................. 4 Test Pit No. 1_.__.......minutes per inch Depth of Test Pit.....g�_._..... Depth to ground water.P..O ....... Test Pit No. 2................minutes per inch Depth of Test Pit...�-ZO..... Depth to ground water.,VPA&....... ............... •............... O Description of Soil.. . .........�.-. ....�-Q�4M.. .. �1 ��...... -.�----•-j 4__... r 2 I t ... w Z O— G 2A V t............. — UNature 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 bee ' su d by the boardd of yhlth. igned..... .........- C .-_..... .......................... Date --•---•--•-- Application Approved By..........- :....:..o��G Date Application Disapproved for the following reasons:.............................................................................................................. ---••.........................••-•-•--........•••-•----••••---••-•••-•••----.....-•----....._............--••-•-•-......._.._......---•-••---•--•....-•--••••-••.....••-••-•-••••-••........•--.._..._Date Permit No.... ............................. Issued........ . )Date .A. No �1 FEs...... ... ..�... s: w+ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' - ° .... OF. T Apphration for i-4pniia1 Wore'Tomitrnrtinn rrmit pplica:ti- is'hereby *trade~for a Per'init'to'Construct ( or. Repair ('. ) an Individual Sewage Disposal System at YC ..... ` 'Location-.Address r Lot No. Owner Address a .................................................................................................. •-••---------•----......•..... ------••... Installer Address � i. v .,� UType of Building Size Lot__1_.. � `F____,Sq. feet Dwelling.—No. of Bedrooms......... ... .....................Expansion Attic ( ) Garbage Grinder ( ) 04 0 Other—Type of Building 4SAHOUS No. of persons......................... Showers —' Cafeteria Other Design Flow i ). .w r� .gallons per person per day. Total daily flow _ .,.__gallons. W s 04 Septic Tank—Liquid`capacity,j allolis Length__ .¢a��.L. Width Diameter__. _.__ Depth � . x Disposal P t No..... �To______._ Diameter. __ �' De tli below inlet__.__:: Total l Ching area sq ft. ..... Width Total Length Total lea p eacl ing area � 4.sq tt. Kul Z Other Distribution box' '( }>) Dosing tank,( ) .. Performed by.- - 4Wi ...: _-_ 6 :--------••-•-• Date.. Q , Percolation Test Results :. Test Pit No. 1 f� - minutes per inch Depth of Test Pit_ .. .."Depth to round water_41 f= Test Pit No. 2................minutes per inch Depth of Test Pit_ ___26...... Depth to ground water. f+ a,. D Description of Soil '_: "" <;r' ?t °P --' •_"._:l5r �r 5 --� . ._ �'4� .. wy ....... ... . g ....y gg . F jq, (�:• ?B.'Y`-:. ___"s. '! .:. l7rt�- `:1.--6Q.A U6d\.4. ._ '+--.°.d.4: !�Y __ ;+ C1.# 4 ? '_-- - --------- ?. U 'Nature of Repairs or Alterations—Answer when applicable .:.....................................................:..:....................... ' .........__z.................................._--------------------------------------------------------------------------------------------------------------- ..... _ Agreement*. The undersigned agrees to install the'aforedescribed Individual.Sewage'Disposal System in accordance with +the,provisions of i�T y g g p y 5 of the State-.Sanitar Code—The undersigned further agrees not to lace the system in •ope'ration,uritil a Certificate of Compliance has bee " sued by thhee^�board of li y 1lth. APPlication:APProued;By-------- _ - :.. - e� ---- --- -- � lj : . . + •.tM,• ate - a` ;Application Disapproved for the following reasons:...................... .... . .................................................... -------•---------•--------- -......-............................................. ' Date . t No. `k:' _ -•------------------ Issued----------_- - Date S " THE COMMONWEALTH OF MASSACHUSETTS BOARD `OF HEALTH :1 , ..........................:...............OF.-............... ................ - � Tr ifirtttr of Tomixti�nr�e: THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (,> ) or Repaired ( ) by �...._... .... ---- `--•=-==. ---- ;- --------•----- ------ ............................. .. Installer at /a r .........................................=....................................... has been installed in accordance with the provisions of ` j of The State Sanitary Code as"described m the application for Disposai Works Construction P ermit 'o _ �1 41 1 THE ISSUANCE OF THIS CERTIFICATE SHALL`14dT BE COIdST UED AS.A`-GUARANTEE THAT THE , x SYSTEM WILL FUNCTION SATISFACTORY., DATE .... - -- g Inspector - t THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH „- No... . I+�i. f :��'A� �nn�� inn r�nt�� F y g --•--•-----------------------------------•••-••....................._.. j Permission is hereby ranted_____________________ _ 1��;• to Construct ( ) ox Riepai ( ) an Indio' ual Se�Tage Disposal System /�fn , at No. `► , i`` Street as shown on the application for Disposal Works Construct - erm't IS&_1::r-%:9_ Dated-__ ��s ----------.................. Board of Health DATE------ :.. . . -•---------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS /Das�)Cjr)_ + - �'J i , R > u�� -. 1 (" -.'l i 1; ., i..LJ v i tro A. itiuC j�_ ?+3IX� j .iRMy C C_ •"^-'Y'1Cc t�1caXl - •Tanuary 9, .i985 Mr. Timothy,R. Luzietti 79 Arbor Way 'Hyannis, Ma. 02601 Rei Lot' 8, Plant .Road, Hyannis - Dear Mr.. LuzzietttA You are granted .a variance' to install an sewage dt osal.- system . for 'a commercial butlding.on,Lot 8, plant Road, Hyannis, in .lieu .0. connecting to Town .'sewer with the following conditionse (1). The system must be_inatalled in .strict accordance with the ' aubmitted.,plan. (2j The designing- engineer must supervise construction and submit certification in writing to the =Board that the system was installed . ' in' strict accordance with his plan .prior to• issuance of -a certificate of compliance arid' occupancy permit: (3) , This variance 'expires February 1,, .1986. ?, The building is within 3000 feet of.Town sewer; however, the Department of -Public Works'will not allow;a, sewer connection."'at this...time.- very ruly yours;:. , be �2_ rt L.' Childs CHAIRMAN BOARD"Op. HEALTH .JMR mm �,. D..TE /al-;29 s y FEE_�S GOi ��TH[Tu TC%Av'N OF BARNSTABLE to OFFICE OF bA&t 3TLMM BOARD OF HEALTH rAJL AfD i639' 367 MAIN STREET T MAY�' HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance .requests must be submitted five (5) days prior to the scheduled Board of Health meeting. NAME OF APPLICANT 7- -0777 y R. L UZ ( ETl' TELEPHONE N0. ADDRESS OF APPLICANT 7 9 / ?1?460/Q Ct),';�� /7 �i'�iViU/S� /�'f/9_. 02601 NAME OF OWNER OF PROPERTY NE D (31`NNE TT LOCATION OF REQUEST ,I—OT *j�3 ptp07- RD H r141"AitS41yA 0.9-60 f VARIANCE FROM `PIEGULATION (List regulation) `IJI�cdyo�G'�rtir7 /� i2eyA/afiow— ?o Co/Jwec.7`" Tc> 70,-J -/ rSe�ez i � c.�i77i (3c.), VARIANCE REQUESTED (Specific request) '. REASON FOR VARIANCE (May attach letter if more space needed) f j PLANS - Two copies of plan must be submitted clearly outlining variance requested. VARIANCE APPROVED NOT APPROVED . 1 REASON FOR DISAPPROVAL a V Robert L. Childs, Chairman Ann Jane Eshbaugh H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE 362-4541 92.6 main street yarmouth mass. 02675 down cape engholeerhy civil engineers& land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys January 2, 1985 site planning To: Barnstable Board of Health sewage system Re: Request Variance for Tim Wzietti. designs Commercial structure in "Zone of Contribution" and less than 3000 feet from town sewer. inspections Reasons: 1. Flow rate is less than three-bedroom house; nitrate loading is,--low. Although in zone of contribution, nearest wells are 4000 feet to permits the west, and ground water flow is to the south away from wells. 2. In a previous conversation with Bill Maravel of the Barnstable D.P.W. concerning property owned by Edwin J. Bennett I was informed that there is presently no sewer which could receive effluent from the site. The closest sewer is apparently on Route 132 near "Dennys". It is, however, upgradient from our site and it is not permissable to use a private forced main in a public way. 3. In conclusion, it therefore would be a great hardship on our client in that it is impossible to connect to the town sewer at this time. The impact on public water supply is in all probability non-existant due to the great distance involved. I believe that public water supplys will be adequately protected by the provisions of Title V. Arne H. Ojala, P.E. , R.L.S. Cy S B98 THE 9TABL&, o y MASIL pp pp >639.� ` a66aolau3 0 MAY er• u3 �vnc1� a 02601 COMMISSIONERS: (617) 775-1120 Ext. 123 14 KEVIN O'NEIL, CHAIRMAN JOSEPH J. CAMPO, P. E. JOHN J. ROSARIO, VICE CHAIRMAN SUPERINTENDENT THOMAS J. MULLEN MILNER D. MELODY PHILIP C. McCARTIN January 2, 1985 John M Kelly, Dir of Public Health Town of Barnstable Hyannis, Mass 02601 Dear Mr. Kelly: Please be advised that the DPW Commission has voted to deny sewer connections for areas north of 132 until the sewer master plan has been updated. In any event, connection of said lot is not feasible under the existing sewer sysem. Sincerely, J J'C PO, P.E. uperin'ten nt JJC/bw January .2, 1984 , :•Mr: -Joseph"Campo, Superintendent' Department- .of. Public.Worke Town of.Barnstable. H.yann is',:Ma. Re:: Lot 8,-.Plant Rod`,"Hyannis :Dear Mr. Campo: Enclosed-;As a, request for a variance' from the- Boa=d of Health' regulation requiring .sewer,connections for commercial buildings: Please advise, us Af this is feasible .at this time.. ... We wquld., appreciate return of the plan. Very trulq.yours, r } .John ri. Kelly- Director of.Public ge,aTth' JMKIMM encl. .2 �. '; ..• • FEE— 'j _5 Z�- F'THE r TOWN OF BARNSTABLE PyO b ��f ra �` '� OFFICE OF i BAIld9Te.Ili, s - BOARD OF HEALTH s M ABt 'oO�lE 3639.. D yAY 11. 367 MAIN STREET HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance requests must be submitted five (5) days prior to the scheduled Board of Health meeting. NAME OF APPLICANT ADDRESS OF APPLICANT 7 9 11,,?,a,oe WA ��,�,u,UjsP /�,q_ 0 2 601 NAME OF OWNER OF PROPERTY NE D (3 F—NNE TT ! LOCATION OF REQUEST_/_(jT pt n07 /2 D H Y/4 XW 13 ,�-j/� Oa �,O ( i VARIANCE FROM TEGULATION (List regulation)�/uLciaj�r,�J � i2�prrjaftoW�- To Co/✓,uec,7` � VARIANCE REQUESTED (Specific request) i 9 REASON FOR VARIANCE (May attach letter if more space needed) t PLANS - Two copies of plan must be submitted clearly outlining variance requested. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPPROVAh Robert L. Childs, Chairman Ann Jane Eshbaugh . H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE N GEORGE C . TEPtV F_% .SS_N '1'/F � II Lim � o cg c �" w� -r Q/- V -- �� o � 1.�1 a • r F y � � 60� p h\ o h oFFtcE Pa p .� . 4 ` Q l Low y 7 !_. 4v N*l s, / I Z ern. /. v I C p<c,ta b^s1�1 ' I '—�---DISTANCE AS CERTIFIED SITE PLAN LOCUS: -p.^►T FAO REF: DK . ''SM& P.(VA /A?ss"o.t 5 MAC 2,9q A1A' QLf/�II CQp� ��I�fN�BIII18 PREPARED FOR: NMt> 03;wNir—rT- CIVIL ENGINEERS e LAND SURVEYORS ----=--- --- me.'main gL REG.LAND SURVEYOR vbmoaw SCALE ' f/= S.(J0 iojig8 DATE EkA --Z _: 1 SECTIO,N' - SEWAGE -SEPTIC TANK - - "D"BOX - - LEACH T�EIJGH � TOP OF FDN SZ.O (MSL)• n 12"OF rreTO Vz" WASHED STONE C..Z'. CoV4zr' +0 41 4A e . 'Sc►,.40 . TFPvc. PIP H-20 / IN• +�P 14 OUT.. IN• I 000 G OUT• IN• _ + 0 48.25 _ TANK 5.00 4�•45 ELEV. O 7 - ELEV. ELEV. 4.1•SO ELEV ELEV. ELEV. ELEV. EIEV,iI ..... OF%, •1 Vt'. WASHED STONE TEST HOLE LOG TEST BY T.�\ . pv7gg_S 'Sr•'TAc.Uc3� t3 o•!-i . Pp_aR OFFIC-E 1E, TEST GATE g WITNESS WORKSHOP DESIGN 300o s.f. T.N. r 1 , T.H. +� 2 /'ZSgal.P�t too `o r's.. ELEV.51.3 0 ELEV.S(� �2S 90.1•/ .1a► 1 NO PERC RATE 2 MIN/IN. DISPOSER DISPOSER za ~ 5a•3 FLOW RATE 22S (GAL/DAY) SEPTIC TANK ZZS X (15)= I 000 E 0. REO'D SEPTIC TANK SIZE 1 oo0 C AR @ C q LEACH FACILITY SR. SIDE WALL 3x %4x 2 84 (2.5) Z% O G/D. BOTTOM Zx 14= Z8 I,p) Z8 G/D. TOTAL >) 1 2 g.-� 238 G�p • USE: ONE LEACHING �'EN C•H . o. 4 t•� {`� _ 3 {� �Q� Lo►oG X Z� �J.1►DE x 3� DEEP • NO WATER ENCOUNTERED NOTES: (UNLESS OTHERWISE NOTED) �11• Of ` r 1.DATUM(MSL)=TAKEN FROM.....C1Y9.NN -%__.-_.QUADRANGLE MAP �'s`H OF AI'�fT��. Ip� f1,R!�f_ N. -� 2..MUNICIPAL WATER 1�.2 _^_.AVAILABLE `V ��� rf 3.PIPE PITCH%VA"PER FOOT �� _ yl� 0 G.A�1 I 4.DESIGN LOADING FOR ALL PRECAST UNITS: AASHO• +H-2'O •44 p'Ii. J j v CIVIL v+ 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1) FT. OJAL.A v� No. 30792 6.PIPE JOINTS SHALL BE MADE WATER TIGHT 7.CONSTRUCTIO DETAILS TO BE ACCORDANCE WITH-COMM. MASS. V �2 N 6348 STATE ENVIRONMENTAL CODE TITLE S s \ $,VERaFY ZON{NG SETQAcFt REQu{t�EME►JTS � '�fG)STE y0 / P�►oR To Co"STR`1G'T1o1J• 9/��SU F. . C REG.PROFESSIONAL ENGINEER 1 BOARD OF HEALTH ' CONTOURS (EXISTING)............. , BAR.NSTA6lE (PROPOSED) -O-O-O- APPROVED DATE MA 362.4541 926 main street yarmouth mass. 02675 down CdPe engilleeri#,f civil engineers& land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys site planning sewage system May 20, 1985 designs Town of Barnstable inspections Board of Health South Street permits Hyannis, MA 02601 RE: Lot 8 Plant Road, Hyannis On April 31, 1985, Down Cape Engineering inspected the installation of the sewage system for lot 8 Plant Road, and found that it complied with the. intent of the approved plan # 84-432" , Sincerely, G;vo.4.�� Arne H. O,jala, P.E. kmk TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY Q2 Rom'S � ��` (see"Orders") 5. Retail Stores 6.Fuel Suppliers ADDRESS 5SA P\AoJX Qh Class: 7.Miscellaneous E1C1r QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground Tanks IN OUT IN I OUTI OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers IC►� C� S Miscellaneous: DISPOSAI✓RECLAMATION REMARKS: 1. SS itary Sewage 2.Water Supply Town Sewer (--&ublic O On-site '\OPrivate 3. Indoor Floor Drains YES N0\,2L O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO2�1 ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 1• NO 2. L4 �l 4�erson)R) Interviewed Inspector Date (508)790-0112 Brian Stanley,Prop. Brian's Alignment Computerized Four Wheel Alignment Hunter 58 Plant Road Engineering Co. Hyannis,Ma 02601 rxl r r� TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops P�Tnsatisfactory- 4.Manufacturers COMPANY "� /'�1,�� ee"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS T d2kt w L' 0�/` 4,u ' Class: � 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS C se lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: 15.—) kv- waste motor oil (C) new motor oil(C) IT l Cs yj transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: Pc,.,o Ga-u-s t�-- C��au� U4 7_90 oc DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 6,"4 4" W J ^- 9-fown Sewer Public 10 VOWo 6� z - F/Pa G6-ai, (—)(A„ vS;a- Q On-site OPrivate ' S'e✓+,�ZR r' S I o4%/� Gt�c. � /�✓�® ilil so is 3. Indoor Floor Drains YES N0� O Holding tank:MDC_ `fie.�l 'A"� �� �� O ` .—or, . O Catch basin/Dry well V,-Po( kr-e O On-site system 4. Outdoor Surface drains:YES NO ORDERS: Q Holding tank:MDC DaCx wjA Lr-1,,1e S-Aytt^ x1&Vj A 0,' , Q d1P O Catch basin/Dry well � re Celi p O On-site system 5.Waste Transporter 6�� D Name of Hauler Destination. Waste P roduct Licensed?, YES NO 717 2. Z Person (s) terviewed Inspecto Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH 16 satisfactory 2.Printers 3.Auto Body Shops a O unsatisfactory- 4.Manufacturers COMPANY �l (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS �CMP Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums OVe Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil (C) /a ara,". �. transmission/hydraulic s � Synthetic Organics: degreasers M,iscellaneo s: 4eLl a ewz, DISPOSAL/R.ECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply v S'- & Town Sewer Public On-site OPrivate 3. Indoor Floor Drains YES NO>_11 O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO O ERS: nn O Holding tank:MDC �v► 020 V O Catch basin/Dry well S � 3 0 . O On-site system 5.Waste Transporter Name of Hauler 1 Product, ILicense YES NO 2. Person (s) Interviewed Inspector Date FEngineeringCo. 112 Biian Stanley,Prop. Brian's Alignment-. Computerized Four Wheel Alignment y --�- 58 Plant Road Hyannis,Ma 02601 `' V TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops J O unsatisfactory- 4.Manufacturers COMPANY . ,h< WA*Z (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS /�. I Class: / 7.Miscellaneous — Z'�'�/Al/Gv QUANTITIES AND STORAGE (IN_ indoors;OUT outdoors) MAJOR MATERIALS ,• .-round Tanks IN OUT IN OUT IN OUT #&gallons 777 Test Fuels: Gasoline,Jet Fuel(A) 'i Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) ;7 trans ission/hydraulic Synthetic Organics: degreasers DISPOSAURECI AMATION REMARKS: 1. S nitary Sewage 2. Water Supply •� Town Sewer Public 0 On-site OPrivate 3. Indoor Floor Drains YES N0 —V 0 Holding tank:MDC_ - l O Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NOZ ORDERS: 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 5.Waste Transporter Name of Hauler Destination Wkiste Product YES NO 2. Perso s) Interviewed n ctor Date V; TOWN OF BARNSTABLE c MPL[ANCE: CLASS: 1.Marine,Gas Stations,Repair atisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops �* �J unsatisfactory- 4.Manufacturers COMPANY/ r/,7/ /�Yy � �`� O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS -r2E Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATLMRIALS r � IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) el ne ) Heavy Oils: Noste motor oil (C) tqAve_iryw AV new motor it (C) transmission it IC�i144 v� Misc llaneous: / 4 AO DISPOSAURECLAMATION REMARKS: / 1. Sanitary Sewage 2.Water Supply ✓ 4 ` O Town Sewer Public O On-site OPrivate 3. Indoor Floor Drains YES N0—Z O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO Z ORDERS: O Holding tank:MDC O Catch basin/Dry well . O On-site system 5.Waste Transporter Natne of Hauler Di�Ainati6n Waste Product 1. I 2. Persons n e ed Inspector Date E, li TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY tff ® G�s� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 0 Class: 2 1 7.Miscellaneous ,6V-�/QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATE M LSDrums Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) 'Wad A ul W_ Synthetic Organics: degreasers Miscellaneous: DISPOSAL/RECI AMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer OPublic O On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC_ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination: Waste Product YES NO 1. 2. 14f �"' Person(s) me ewed Inspector Date (508)790-0112 �` Brian Stanley;Prop. Brian Alignment Computerized Four Wheel Alignment Hunter 58 Plant Road Engineering Co. Hyannis,Ma 02601 TOWN OF BARNSTABLE C MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores C OMPANY13Yi5;' 6.Fuel Suppliers ADDRESS a-'8'6;ems'`- .'-'d Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALSUnderground T,OUT IN OUT IN OUT #&gallons Age 1 Test Fuels: Gasoline Jet Fuel (A) ✓ Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: Y DISPOSALIRECLAMATION REMARKS: 2 1. anitary Sewage 2.Water Supply —" Town Sewer ublic O On-site OPnvate 3.Indoor Floor Drains YES NO loor O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO O S: O Holding tank:MDC �! �- O Catch basin/Dry well O On-site system 5.Waste Transporter Nani6 of Hauler No 2. Pell e o (s) Interviewed spector Date SE CTION - SEWAGE 1 i V S 1 ' —SEPTIC TANK — — "D"BOX — S — LEACH PIT �-�8 TOP OF FON \ \ Q (MSL) REMOVE ANY UNSUITABLE "2••OF I18TO Vz•' MATERIAL w ITHIN A WASHED STONE C,z. GOVER 10' :AnIUS. 14E ---- -F0 BRA DE -- ---__ \N-i S2.0 IN- OUT- IN. (�prry lZ�EPTIC Cl GOUT» PROP (Q�Pf` t r� /� Z`f'�+ 5©.Sro 5013Z NK 5o1C7 p �� o ' �� / v��AREl4o�1s ELEV. ELEV. ELEV. ELEV. ., ' c ' 49.97 49, oa 4 g4� , . oCLLAR} 1 ELEV. ELEV. rj.70 M o all, 0 ^0/ F-IEa -Iz �a T" ' IO of Y. •142;.� J/ � j WASHED STONE �� # r8 + / TEST HOLE LOG s/,e ✓/ '" �y� r ~1 q\ TEST BY E A-D MAS J. J A�O B I t�.U, #�#. i m CROP, WAf7C.F1AUS� (� Zoe WITNESS I TEST DATE DESIGN T H a'p M to `C "s` t to T.H. # 1 T.H. 2 7 L ELEV.t3c.1.Zi _ ELEV.51•r/ 500 5.P." &2-'5 C.3/� I=L.F-v—L Z-3NO M� �,L ! 7y \ < Z DISPOSER DISPOSER PERC RATE MIN/IN: { , G LFLOW RATEZ-4-Z.5 (GAL./DAY) 393,7 CH 5015 SEPTIC TANK2Co2.5 (I'SI= 1000 �~ 1>1 w �9/* g "8 6RA7F REO'D SEPTIC TANK SIZE L_ C AR LEACH FACILITY �_ a � �'`� AN rtAf��D SIDE WALL Zf0 fT 4=12S165.�(2 SI 31'{ G/D. y� BOTTOM 0 Tl = 7 .5 ( 1.0 ) _ -76• S G/D. TOTAL -2-c4•I S.F. = 39Z.1a. 6jo US - ,�- �. USE: UN-E LEACHING PIT T ,,,3 A NQ WATER ENCOUNTERED \ B,M. CENTER O Q�x GATC..H [3A5IN NOTES: (UNLESS OTHERWISE NOTED) ELEV, 49.08 1. DATUM (MSL) +TAKEN FRQM--N_Y'�.!Yf`.�.j.5--------------QUADRANGLE MAP �7 M �► �f/,n - \ 2.MUNICIPAL WATER ----------1_:?-------------------..........AVAILABLE �te M.H. 'a 3. PIPE PITCH: Id••PER FOOT � � // �.�""""' � ,2 4.DESIGN LOADING FOR ALL PRE-CAST UNITS: AASHO • H - -44 ARMS 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. r-.; OJALA ��} /..4�� �t l,, — DISTANCE AS CERTIFIED` 6. PIPE JOINTS SHALL BE MADE WATER TIGHT 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. CIVIL STATE F' STATE ENVIRONMENTAL CODE TITLE 5 ' Na. »x `�, :6;,r3 V ---'' LoG�s SITE PLAN 8. VE-RIFY RON►NI� 5F-78AC l-- RE IRE- E-NT'5 �d`T - 2a4a �_ i a Locus: PLANT RDAD LoT S PR l f-, To7��O�r�:�T R TT I G sit. se°I���- '' - '�� = �� - H YA N N )5� MA, 9• U r- H-Zn ! OP,5 (Pl 1• �TL\N K) REG'.PROFE H�� /yil:£ER I REF: �KI b R4oI CAST IRON Q�l1� 5 �f c RY� down cdpe. enggineeiin't PREPARED FOR: I - CIVIL ENGINEERS Tltj LUZ l El_T - BOARD OF HEALTH LAND SURVEYORS REG. LAND SURVEYOR " Ub1 �" SCALE Q CONTOURS (EXISTING) -----•_--. �.WA I /�= 3Q' I $rj (PROPOSED) O-O-O n APPROVED _ DATE MA DATE F3l-_43Z T q a .'� �tr t:^�a 6 '� i ' :'< v �:• t} a tik -q � i+.1'.: t 1,� i•: �` '. !- F � - p 'I / . .. ti. SECTION SEWAC, i � f SEPTIC TANK - S/ _ ••D•'BOX - 5 - LEACH PIT '} -...TOP OF FDN (MSL)o REMOVE. ANY UK50I7ABLE 2*1 of„eTo Ut^ nna MATERIAL W ITFjIN A WASHED STONE - I' l>p t'� v 37�+ 10' RADlUS.� _ _ G.I.. COVER �.. /Sz ! RA E _ -To cr p �. OUT• .. IN-- ,I - 1/ / r R O P // 7 )CX?c IN OUT c -G q�j 50.56 SQ 3Z SEPTIC 5a.0 q ! e ( J j 1nr/"' REJ I0��E: /! ' -1 ELEV. TANK "Q ,10 °� Tj p0. i �� �N ELEV. ELEV. ELEV. qoo 0o I ` /` / 49.97 47, gp I n 1 0 • ELEV.. ELEV:. 5-�� a�' b° \ la jil E LE_V. -. !- WASHED STONE TEST'HOLE LOG 1 si �j� A• MAS J. JACyBI f3.C). ! �. PROP. WAREHOUS` N i iTEST BY I- I WITNESS 1 t an I I TEST DATE184 n E?� DESIGN. 75 SAL.�000 5,F L s.T`'�; �-� z�'�_ 5 r T:H. w 1 T.H. 2 _ _ -� o° _ 500 5A= ZbZ.5 G/D LTV rj ; l t ELEV.51; / " ' S ELEV. 55 2_;3 it u ` < Z DIS ER DISPOSER 4 �' ; �.. �. RA� PERC TE MIN/IN. =" t • . � 1 �I/N fo C z44 - 50,3 " G SEPTIC TANK2-4- (GAL./DAY) "'�l'1 - I K 3� 8.7 L(o2,$ 393,? U; // ^I r �r _, "' . 3'_ 8 "8 v ATE j 51- I _ � y � REQ'D SEPTIC TANK SIZE I OUO �, t1 `� i _ \ - ��1 _ .- �` C. AFC A E LEACH FACILITY _ CC R _ BOTTOM D 7 ,5 l� G/D. _._. ANiD SIDE WALL IOIT '4 -'125,G S. 51 3t'#'o G/D __� - _ Z _. - j TOTAL =204•I S.F. 39Z.G �3J ;� s r. .. � � _ � � / flr. ._- 1 ��a�,���'�,c, s \ � .� 11..E 5 •-_._.. .._ai h �- k f l USE: f�fJl�- LEACHING PIT '�'� 0 4 I: { D J A M E'r R x DEEP • _ ! �. B.M. T �,` ` N WATER ENCOUNTERED Q tl /n \'' , " `� C?. H SR I ` t�. j GAT�.-.H F3 E\� l N ;NOTE;. (UNLESS OTHERWISE NOTED) a 1. DATUM (MSL)`TAKEN FRgM.-(-!_l.A.`_ll!.�_?-A.............. AILABLEQUADRANGLE MAP ..2.MUNIdPALWATER......----Ls................... 3.PIPE PITCH:u.'•PER FOOT - 4.'DESIGN LOADING FOR ALL PRE-CAST UNITS:.AASHO -44 " Rf1{dE ��' � ` I / aP P^ ;..I, �tih --DISTANCE AS CERTIFIED S.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. sllRlrs. r : C PLAN 6.PIPE'JDINTS SHALL BE MADE WATERTIGHT GIVI_. �r h•t"p `� , SITE rL/1N 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. �!M t (y� 4l c. i V I Q STATE ENVIRONMENTAL CODE TITLE 5 �": � r .•+°�' �''` " ` ' �r1 •-•• "' P, '� •T'� \\ ` ---- �.• _ - LOCUS: --- f� ' $.. u�RI Y 2.oNintG SET BACK REG2U'IR�MENTS � fs - f �i �:�ItZt �` AN - � PRIOR T CONSTRVC.TIO�. - REG.PROFE AL 9. U5 E IA-Z(3 TD P� (F 1T '� TAt�rK) ,���' op D® � REF: —p� G.AST I R.dW C&ER5 �1 o G�1/'1:Dt,.._- C pe PREPARED FOR: _E._.I L- ----- � -------'- own � engsneerrn • 1 � .� _ �l }, CIVIL. ENGINEERS /'1_ LOZIE I I s BOARD OF HEALTH y ! 1-AND SURVEYORS - G.LAND SURVEYOR _------'' ._.----- FOR o2d �� St. , RE VO I _ r f (EXISTING) .._-...... MA WIVE SCALE T DATE w .CONTOURS (PROPOSED)-0-0-0-0- APPROVED -DATES--.- 41 M�u3. , , " t C; i , i t V C '/ j t i s• cJ �. �r{ Af ;�. � 5 1` ��. •cam � � a z.s` 4. 51 Avc r yr k +{. RE•67. 'C/Vi,/ _ '7I2 MA /rV ST MAI/rj-`+ �