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HomeMy WebLinkAbout0165 YARMOUTH ROAD - Health 165 YAI MOUTH ROAD S. E-WE-R e G YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to 1he Town Clerk's Office, 1 st. FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: J?l Fill in please: APPLICANT'S YOUR NAME/S: V160 4 air BUSINESS YOUR HOME ADDRESS: A4 „ j TELEPHONE # Home Telephone Number NAME OF CORPORATION sS NAME OF NEW BUSINESS D ?G� T1PPE OF BUSINESS -rfi/�lr<<�iL IS THIS A:HOME OCCUPATIONS YES NO „ ADDRESS OF BUSINESS Z! %S� O�bo! MAP/PARCEL NUMBER 7 (�lJ (Assessing] s When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST _ ,[7 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 has be n i o the permit requirements that pertain to this type of business. �.�t`� e �fi 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: L5 CAT [ON SEWAGE PERMIT NO.. 01-7 VILLAGE INSTALLER'S NAM'E & ADDRESS A&-/L B U fL D E R OR OWNER C.i`/ c _ FL /4 DATE PERMIT ISSUED A_ �� _ 7� DATE COMPLIANCE ISSUED � ' .- n o Q-� LTH THE BOARD AOF FHEALTH rs �" �/�"✓'' /� J ... .....:.....OF.................................. .......... ....... Apphic ation -for �i,4poottl Worko Tom4rurtion Vamit Application is hereby made for a Permit to Construct (14 or Repair ( ) an Individual Sewage Disposal System at: Loca,' ddress �il��'.AKLot No./� ...........� /�l. Own Addres W hanLO- o .......................... tip°?' , ! � 1�``/•- Installer AddvCss Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms ............. . --------Expansion Attic ( ) Garbage Grinder ( )U ,. pa, Other—Type of Building .__� of Persons--------1. ------- Showers ( _ ) — Cafeteria.( ) --- ---- . Desi n Flower allons per erson per day. �otal Bail flow_______________ ___�___ gallons 1 y f --/ --------_-- tic I ank—Liquid �aclt��O�lo� ,Len th___!' � X g Y g� P P P _ a; =' q 1 Y� - g g L. Width-a ..._.. Diameter Depth Wi x Dis al Trench—No. .................... Width...... ..---------- Total Length.....:............ Total leaching area--------------------sq. ft. . _--_--Seepage'�Pit No.__._.2�_____-- Diameter../ .......... Depth below inlet___.......... Total leaching area..:FZ5-..sq. ft. s�, Other Distributiion box (7O Dosing tank ( ) Percolation Tesf�'Results Performed by.-.-. ------------ ._-_-- -_�_.____ Date___�P� --Z2;Pc ;,- Test Pit No ..............minutes per inch Depth of "Pest Pit-.._________--____-- Depth to ground water. .--. ............... (te r¢N est.Pit~N`o 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ ---------------------------•-------•--------••-•-----•-•----------................... O Description of Soil-------- _F4Wf• - ....- i' t� G- � ;..... x . ._... �----------------------------•--------••------------------- --•--_-_.---- - .�1-!/--_....�_4_: O / - U ��T> drat�.... / :.._.. •--••-------•----------- --•-------------------- .-----•-- -•-- --------• •-------------•-••---•----_-_--------------------=----------------•---•-•--- --------------------------•-----------••--•--- V Nature of Repairs or Alterations—Answer when applicable..--------------------------------------------------------------------------------------------- -------------- ----•----•-•-•------------------•---•--•----•------------------------•--------••-----•------- .-----_-----••-•---:---------------- -----.--•-----..-_--------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agr not to place the system in operation until a Certificate of Compliance has bee, iss y the d of ealth. Signed--- - --. .... ......... // ate Application Approved By------- )k_ Date Application Disapproved for the following reasons:-.--------------------------------------------------------------------------------- ............................ .................•-----..................--•-•--------------•_...--------..........._........-•--••........•--..__._.......-----...:---------•-----•-----------.--•--•---------------•--=-•------------- Date PermitNo......... s'3----••----•••........................ Issued........................................................ - .; NcS. -� FEiz.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .._ .. _. _...._..........OF..........................................................---------I.................... App iratiun -fur Uhipuuai Workii (foutitritrtiou Puniit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...•....---•---------------•----••-•---•-----------•--•----•----•--------------..-.•.....-._.....• •-•-•-•--••-•-•-------•----•-•••---•----•-•-••----•-----•••-•-----•--•-•-••-•-•-----..•...•- Location_Address or Lot No. -•------------------•----------------------••-------•-•--.•....---._._...-...--••----•--••-••••--- --•-•--•---•-----•---•-•--•••-••-••-••..-..---•----•--••-••••---•-•--------•--•---•--•--••••-•---- Owner Address W Installer Address d 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 ( ) 44 Other fixtures ------------------------------ W Design Flow____________________________________________gallons per person per day. Total daily flow--------------------------------------------gallons. Septic Tank—Liquid capacity.__..___.__gallons Length---------------- Width................ Diameter................ Depth-_.-__-___-__--- xDisposal 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 ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---_-_--_-_----------------------------. Test Pit No. 1................minutes per inch Depth of "Pest Pit_--_________..______ Depth to ground water............-__--_.___-. (i Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water._-____--__--__--___._.. P4 ------------------------ -------••-------------------------------....._-'----._._..---------•--•-•--......................................................... ODescription of Soil----------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ U /„ N- .- - '_--•-•••------------- - -••••---------------------------------•--••--•----•------------- :. -. W --------------------------------'----------------------•---------------------------------••'________•----------•----•-------•----------------------------•--•--•----------------------------•--_______-- 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 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. - Signed-------------------------------------------------------------------------------------- •-----------------••••••---•••- Date ApplicationApproved BY•---..�t---l�-----••---._.._•------------------•--------•----------------•--•--...._..-•----- Date Application Disapproved for the following reasons____________________;.-_._.-.-._..._____________.._....._.._..__-.-___.____.______.__.______________________----- --•.............•----------••-------------•--•---•--•---------.•-•-•-•'-'---••----•••----•-------................................................... .................................................. Date PermitNo......................................................... Issued-----------------------................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF............................ ................................................. ...... Tprtifirutr of Talimphaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.............................................................................................. --------............................................................................................. Installer at..................................................................................................................................................................................................... has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------------------------------------------ dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED 4S A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. • DATE................. .................... Inspector---• - -- r THE COMMONWEALTH OF MASSAC S S BOARD OF HEALTH ............................................................ No.......=•.................. FEE... FEE•-= = �i��u�tt� �vrk� �uu�tr�trtiu$t rrutit Permission is hereby granted-----------=- -- ��`�` ' S = -------•-"'-----------------------------------------•••./-••--••••-•-- --------------------- ----------.----1__`..____ to Construct (T ) or Repair ( ) an Individual Sewage Disposal System atNo .� / ��i /...........................................f'1 --------•••-•-•--•-----•---------------------------------------•---'•--•-------.. Street as shown on the application for Disposal Works Construction Permit No....!__?_._%........ Dated..-./r_ ............:_..__•_...-__ /� / �� Board of Health DATE --------------------------------------------- /f FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - 7 1 CAS& Numsig Nl/-6393ev 8 R46 F. / MAP 64 P�QOOEQT Y � B C 34 i syE oN✓EYED Ro Sze rW. BLAnrcyErTE,Er,41- USTEES OFTHEPROOERTYD/�' ' Prow CrovmwL Zu#vs vogrAr/ON COMPAHY rO N L � CiyARlES /r-�/LL a b , M.N.B. O I S.B. f PENN CENTRAL TRANSPORTATION COMPANY - �, Ln ( nd.) l� � Ste. 173 t 51.46 Lr) ol u MONUMENTED RAILROAD BASELINE S 290 02 8"W -- --- '-5 I434.89 ` D -- O $ta. 159+04.59 " I N 2 9° ------_ -- - - -_----_ --- --- - --- — - - -- o I - a 4 E ----_— �_--- ,t ,� � w — - - _ - ---- 29-OI -04 2 -3 2 2 5. 54 __ _______ E N � _ J � Q � ,. 1= // , ' __ _ =---- - - N 26 -57-53 E - o 1I 1 U) N 22 - � 171 21 -- - 13Q.22 0 4 c o -42 - - 'w3m ¢ n� O rn 61.00 Q I _ 1 1� ----- a) in ate• / •x '� _., eate, q _- Q ,D H Z7- 0 F-- p r t � c `n ry �� Cam,<..�.i� ��„ �� �O `•� SEtEl r coo S30°-2 2'O 2 I,W - _ - 310.40 (fnd Bnd. S 27°-33=40" W , RAILROAD 40 W► oE PUBLIC AV E N U E - cQ O1p S30'2202„W o� �r 8.00 - zI Conc. Bnd. Conc. Bnd. 136.16 • I, (fnd) J ,OV - ^O w f LOc,,,-T I ON v . . . % „SCALI� __ :.. , '14-'76. fiNOMAS E.�iCFLLEY C � LAND SVRVEYORS C-IL.AN. 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