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HomeMy WebLinkAbout0105 CONSTANT LANE - Health 105 CONSTANT LANE Cotuit A= 039 - 060 0 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 the 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: �� Fill in please: ;:. APPLICANT'S YOUR NAME/S: . �,. BUSINESS YOUR HOME ADDRESS: .TELEPHONE # Home Telephone Number NAME OF CORPORATION: ea p NAME OF NEW BUSINESS TYPE OF BUSINESS ('qd lwP t IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS — C.� ..N e 6 tvv'l MAP/PARCEL NUMBER_ ��`/ ���� [Assessing] 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 assst you in obtaining the.information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd- & Main Street] to make sure you have the appropriate permits and licenses required to legally operate your business in this town. - 1. BUILDING COMMISSIONER'S F�l This individual has bee or of any er it requirements that pertain to this type of business. 'orized Sign e**COMMENTS: MUST COMPLY WITH HOME OCCUPATION `j 2. BOARD OF HEALTH This individual has.been'iin ,rdf the permit requirements that pertain to this typo of business, w MUST COMRtY WITHXL Authorized Signature** HAZARDOUS MATERIALS REGULATIONS 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: i - y TOWN OF BARNSTABLE Dated?-/ S / 1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 10/� BUSINESS LOCATION: INVENTORY MAILING ADDRESS: / �� C��,�;ST fi I C �� ��` TOTAL AMOUNT- TELEPHONE NUMBER: — CONTACT PERSON: _ EMERGENCY CONTACT TELEPHONE NUMBER: cf,�:-- (1MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product- Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW ❑ USED - Degreasers for engines and metal �- ( rent nl g ink De reaser_s driveways&garages Wood preservatives (creosote) 6F 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 le A WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Apph Signatu Staff's Initial OL NoO-------------- w FEi&.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .rO.W tj._---- - ------ OF...i'+P S t.-........................................ Appliration -for Uhipviial Workii Tomitrurtion Vrrufit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: Location-Address o Lot --------------------- Jdd_ ----- ------------------------------------------------- . . ..1 � Owner Address es •--•-------------- ---'--------..................•.....-----------------•--------- -----------•----•------------------------- -----•-----------------------------•--•- Installer Address UType of Building Size Lot_1_9,__�L_ _.....Sq. feet ., Dwelling—No. of Bedrooms_---___3_______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ------------------•_--_-____ No. of persons.--___--_--._.--_-_--____-__ Showers ( ) — Cafeteria ( ) GaOther fixtures ---------- ------------------------------------------- W Design Flow.........55..........................gallons per person per�dhy. Total daily f;ow----.---.---------- ------_gallons. WSeptic Tank—Liquid capacity_1-06.0.gallons Length__'__._____ Width4-_...1..._.. Diameter_- Deptli45_.'_4-.. x Disposal Trench—No..................... Width---------fD----------Total Len gth___._......._...N_ Total leaching area--------------------sq. ft. Seepage Pit No-----I-------------- Diameterl __" ..... Depth below inlet__ a_` ----- Total leaching area.Z.(__77_.__sq. ft. z Other Distribution box ( r/j Dosing tank ( `` II v r- S�-0 G Percolation Test Results Performed by__�k-�tt�J -/- ¢• !<at'____---_------------------ Date.-�./.d,-. )9131 . Test Pit No. 1....... _--__minutes per inch Depth of Pest Pit-./__'t .._..... Depth to ground water.PWI�1--.ewE .-.'V.?fvrl LL, Test Pit No. 2.......Z.__minutesper inch Depth of Test Pit.-/_.'5��...._. Depth to ground water_-E?v7___efja0e,',v/vju, ------------------- -----•------------------- - -•--•••------ ......•--•�i .........---•-----............ -------•-- ---- O Description of Soil---- .-- '-T_____l�l .cvL.-- .'Opt._-- �tb` �� Z---_-' `...tY x 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 Tel hE-�;"',if the StateeAV Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance en iss ed by th board of health. Signed -• --------- Date Application Approved By....... -:. t..,��� - ?:_ .—6_.__. ------ Date Application Disapproved for the following reasons:................................................................................................................ ---•---•-------------------------------------------------------------------------------------------------.--=--------------------------------------•---• ......-•-•--••---••....••--•----•••--------•--- Date PermitNo.......................................................... Issued........................................................ Date NO .S!1 =7_�.. 7 Fas. "/......... THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH 01N tj.. ............OF....BAZA1,%7Ah Liz .. , ppliration -for Ui5pviiAl Workii Towitrurtion Urrmil Application is hereby made for a Permit to Construct ( V or Repair ( ) an Individual Sewage Disposal System at: L-0� a !`` i,�U`+�V t T-t y trt 9 L5-------------------------------- -• -• •-••--•-•------ Location-Address o Lot ____•� � i ��-••- -----• ........................................... , wner Address Installer Address ''`` UType of Building . Size Lot_P 9,--7- ?------Sq. feet ., Dwelling—No. of Bedrooms-_______�_______________________________Expansion Attic ( ) Garbage Grinder ( ) `k Other—type of Building _________________________ No. of persons Showers Cafeteria W Other fixtures ------------------------------------------------------ W Design Flow..........5.5_.........................gallons per person per day. Total daily flpw------------------ ----------- p1lons. WSeptic Tank—Liquid capacity_J-0-00gallons Length_8-_"_�__- Width4'-'./o_._ lliameter__-.""'""""_ Depth-�` __ --- x zl Disposal Trench—No_____________________ Width�_.______��________ Total Length-.------- Total leaching are a--------------------sq. ft. Diameter q_____O. below inlet__.frt._____._____ Total leacliin trey- -` _ _ ft. Seepage Pit No•-•-•�•--•---•-•--• _ _... -Depth © g � stl• z Other Distribution box ( ✓j Dosing tank ( y50 ~' Percolation Test Results Performed by "0-y_1&!C___..__.j____________________ Date---J!Mg.a?�r_ a Test Pit No. 1_____ '_____minutes per inch Depth of Pest Pit_-�_*f_______ Depth to ground water..YlB- _.Ci!tecyti/1 rr rZ4 Test Pit No. 2.......:In...minutes per inch Depth of Test Pit._11-_54_._.__. Depth to ground water..!.'%p___��_CDv�t �+ r� r/ -----------------`--- --• ---(••-............. [�--(-•....... �` ------------- - Description of Sto oil_---Q- -~-- -.T______/0�_ ! _.! !�` ...... .��r :-Z-�_I/"/'T .1/'__ 'f ----� .---_�"__----- U --•----------••----------•--------------------------------------------•------•-•-•-------------••------•--•---------=-----•-------•------•-•-•--•-••---••-••--••....................................... 0 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 r$ fah*_�of the State _ Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance en isstjeqJ by th oard of health. Signed _-...... ___ - •• ___. __ _ _ .____-•--__.. ...... --- ------------- Datf, Application Approved By------- --•• -- +- -- ----•% -"- -------------------------•---------- . . ..- ----------•-- Date Application Disapproved for the following reasons:..................:Z--------------------------------•-------------------------------•---------------------------- ..••--•=--•-••----•---•--•--•---•--••-••-••-•-------•----------•--••--------------•-.--...-.-•-••-•-•----.•••------------•--•---------- --••-----••-------•••----•---...-----------------•------._____.._. Date PermitNo......................................................... Issued............................-------------------------•-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........� . .................................. 0.1rrtif irtatr of TOmpiiattre THIS I TO CERTIFY That the Individual Sewage Disposal System constructed ( �r Repaired ( ) ------ -----------------------------•-_____.-•--------•--••••________--__-________-__. staller at-----.------•---- - ......,3 _w_- - - ---•- __..-_•_ ---------- <��­ ....-.---•.-----•..-•-------------------•---••-----•-..---•-••---..--- 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---- /_. ._ ->Aff--------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE - / �'`" Inspector•_____________ " / THE COMMONWEALTH OF MASSACHUSETTS r�''' BOARD OF HEALTH .........../....�"V'"�:..........OF.-........- . ... - - . - -------------------- No.. �_.._.. FEE....._-__................... %spniiat ork,i Tonstrortion f rrmit Permission ij hereby granted............. --• •••' ,—---------------•-••--- ............................................................. to Construct ( ory air ( ) an ndividual Sewa Dis osal System at No, Street as shown on the application for Disposal Works Construction Permit No------------- ______ Dated.......................................... ��- •-) �B..realth DATE ___..___ -••-•• • J -•- --......•----•__________________________ r FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS • 1 0 - 0 oil \ot j D CR V 1�it� -- 9; ` gx° y9x0 '_ a�E� U ►�a, sr P+�` ell, 49D ��.ct4UE o°,.r.eot i t PC-PT1b o00 i10'4",'011 D UG Z y s0) 9 of 4G 53D 37; 50.�' � W f`1 0� RN ST/�,T3LE. �QTV t q91< awN � x-0 O F pfiry�. Q j r�y G-� 2 &5'5 o c, , . WALTER E. SMITH, Jr2. 415128 G15TER�� �S�/ONAI. i 10 �� . 3 z 9 v t; p c ST. AA.. a o0-4p C7iZo�1N�Q,�� a ' c V, g9, ` L�rrc�-�xT JJAJE ;'z, ! ?9 q Crow2ll 4 : ay or 1vt'��1k1� � •_ '�PAGf:7"y. �r�,r��'1a � D -78.5 SA x z.s = -7V1 P ` ..-- �--y�--., - + !V vT D t5 PO At- 5\�:S`T C..caSt �NC +✓`t 1 T# 'fZE� rStOS d� . - _ '•: .'�"'t�'�„� �..� �� .�.�. . ��v �-�� I�d�BEN .�L_iro v r� wLL f n�e rcd R A rA' LOCATION SEWAGE " RMIT NO. VILLAGE INSTALLER'S NAME i ADDRESS JOHN A. ALTO BACKHOE SERVICE West ,Barnstable, Mass. 02668 B U I L D E R OR OWN ER DATE PERMIT ISSUED DAT E C0MPI I A N C E ISSUED /2