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Home My WebLink About0839 MAIN STREET (OST.) - Health (2) 839 Main S aka 845 Main St 117-103 Ostervi lle - a P 1 I� J AM s/ ,y Date: � /Z 1 /' l� TOWN OF BARNSTABLE TOXIC AND AZAR OUS M /ATERIALS REGISTRATION FORM NAME OF BUSINESS: d_ � ( SN(9-- BUSINESS LOCATION: ' INVENTORY MAILING ADDRESS: TOTALAMOUNT- TELEPHONE NUMBER: - � CONTACT PERSON: EMERGENCY CONTACT TELEPHON UMBER: Q MSDS ON SITE? TYPE OF BUSINESS: / S 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 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) f Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Ap icant's Signature Staff's Initials B ,ram BARNSTABLE COUNTY �' 'r° `' ARWS T E1.E DEPARTMENT OF HEALTH O ` And The SEC 26 I S ENVIRONMENT SUPERIOR COURT HOUSE POST OFFICE BOX 427 SACHU BARNSTABLE, MA 02630 508-375=6614 Ah December 7t", 2006 sha Parker,Assistant Health Agent Barnstable Health Department 200 Main Street Hyannis, MA 02601 Dear Alisha, At the request of the Barnstable Health Department I conducted a preliminary Indoor Air Quality(IAQ) assessment of Painted Nails in response to some health concerns raised by several tenants. This assessment was conducted on December I't. In order to evaluate the internal air quality we used a TSI Q=Trac IAQ meter which measures: Carbon Dioxide, (CO2) - a measurement of fresh air exchange ef6ei ncy, Carbon Monoxide(CO)'- a hazardous byproduct of combustion,Relative'Humidity(RH) ;a measure of air moisture, and Temperature (T). In addition,we used a TSI P-Trac IAQ monitor for total ultrafine particulate levels. Total ultrafine particulates have been identified as a general indicator of respirable airborne materials that can be problematic to IAQ. This instrument measures airborne particulates in particulates per cubic centimeter of air. Samples for all parameters were taken continually throughout the areas as I conducted the assessment. The area is a collective of several retail establishments that share a central air handling system, a closed loop re-circulating type system that has no mechanical means of active fresh air introduction. This means that odors introduced into the internal environment don't actively or mechanically diffuse but only passively through the opening of windows and doors. As a result, in these types of systems any materials, such as those used in the Painted Nails Salon,that are allowed to enter into the general ventilation freely circulate throughout until they passively diffused. These types of problems are particularly problematic in that odors appear to "come and go" dependant on whether there are windows open(seasonally appropriate)or even internal Relative Humidity levels. Although you have some localized exhausts in your system located in your restrooms .they were found to only work when the lights are turned on with a sign that says "please ,turn off lights when not in use". As a result'they are only actively-.removing inside air when the lights are turned on. The other direct exhaust was installed over the work table in the nail salon as a means of attempting to address the problem but was found to be inappropriate to the purpose. The work table is the area that is the source of odors when a client is receiving services. This exhaust is a simple bathroom type fan that wasn't sufficiently designed or sized to entrap all the odors being generated. As a result most of the odors are allowed to still circulate into the general ventilation. Recommendations: Install a direct and specific exhaust over the nail work table. I recommend a small flexible hood system that can be moved directly over the client and source of the fumes while the work is being done to most effectively and efficiently entrap odors while they are being generated. It should be sufficiently sized so it will entrap all odors being generated while the nails are being painted and drying. The system can then be turned off when the process is complete. The goal is to prevent any of these fumes from ever entering the general ventilation system. The exhausts in the restrooms are barely pulling air and may need servicing. In the future your may wish to put them on a routine and regular maintenance program to ensure proper function. It was mentioned while onsite that there are also odors entering the general ventilation from the first floor hair salon. This should also be evaluated and the same theory of direct exhaust applied to the source of those odors. If you have any questions or concerns, or if we can be of any further assistance,please don't hesitate to call. Sincerely, Marina M. Brock, Senior Environmental Specialist Barnstable County Department of Health and the Environment Work(508) 375-6619 Fax (508) 362-2603 Mobile(508) 737-0633 Email: marina.brock2@verizon.net Town of Barnstable CFTHE Tp� Regulatory services 'b Thomas F. Geiler,Director Public Health Division * BARNSTABLE, * Thomas McKean,Director �$ a6S 200 Main Street, Hyannis,MA 02601 Phone: 508-862-4644 Email: healthntown.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 December 15, 2006 Mrs. Jessica Mahler Painted Red Nails 839 Main Street Osterville, MA 02655 Dear Mrs.Mahler: Thank you for your time and cooperation during the site visit at Painted Red Nails on December 1, 2006 that was conducted by Marina Brock, Barnstable County Department of Health and the Environment, and I. The site visit was in response to an ongoing issue that had originally been filed with the Health Department as a complaint on January 18, 2006. The complaint was based around the use of specific chemicals in a nail process at the facility during regular business hours, which are 9am-5pm. Side affects of the complaint consisted of: nausea,teary red eyes, headaches, shortness of breath, and strong scents of acrylic throughout the building. I requested the assistance of Marina Brock to complete an Indoor Air Quality assessment of your place of business,Painted Red Nails. During her assessment, she identified problems with the existing exhaust vent located in the room where acrylic nail services are provided. She also assessed the localized exhausts in the public restrooms. Marina made recommendations for each of the areas assessed and I fully support each of them. It will be necessary for all tenants to be communicated with to be fully aware of and to understand the issues at hand. Having all salon establishments vented properly with Marina's suggestions and other local exhausts maintained and working properly,the issues can be minimized if not depleted entirely. If you have any questions about the recommendations,or if you need further information, guidance or assistance,please do not hesitate to contact the Public Health Division. Si erely, � �� li ha L.Parker Hazardous Materials Specia 'st ks c ean,RS, CHO Director of Public Health Cc: Jamila's Natural Beauty Town of Barnstable �114E r, Regulatory Services Thomas F. Geiler,Director Public Health Division BARNSTABM Thomas McKean,Director 9 MASS. Qy i639• 200 Main Street, Hyannis,MA 02601 �rFG MP'1 a Phone: 508-862-4644 00, Email: health(a)town.barnstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 January 26,2006 Mrs. Jessica Mahler Painted Red Nails rs'Main Street Osterville,MA 02655 9 Dear Mrs. Mahler: '-C Z3 Thank you for your time and cooperation during the site visit at Painted Red Nails on January 19, 2006. The site visit was in response to a complaint that was filed with the Health Department on January 18,2006. The complaint was based around the use of specific chemicals in a nail process at the facility during regular business hours,which are 9am-5pm. Side affects of the complaint consisted of: nausea,teary red eyes,headaches, shortness of breath, and strong scents of acrylic throughout the building. Upon entering the facility on January 19, 2006,there was no sign of acrylic scents in the facility. There is one room that is specifically used for this process and within that room;the HVAC system has been changed. The in-take vent near the base of the floor has been sealed off and a new exhaust vent has been installed directly above the table used for the process. This exhaust vent is not connected to any existing HVAC systems and vents directly out of the building. I observed the application process of the acrylic and the procedure for one hand took less than one minute. The only scent the acrylic gave off was at the point of application. The windows were closed and there was no other source of venting in the room. I went into the other rooms . within Painted Red Nails and did not smell the acrylic at all. I walked around the building, where other tenants are, and did not notice the scent coming out of the heating system at all. I spoke to the neighboring tenant, Jemila at Jemila's Natural Beauty, and she had mentioned that after the HVAC system changed with the installation of the new vent, she has not smelled the acrylic since. I entered Jemila's Natural Beauty and did not smell the acrylic at all. My only recommendation is to store the very small quantity of the materials used, acrylic nail .t liquid,acrylic nail powder,acrylic nail primer, and acetone in a small approved flammables cabinet. Mrs. Mahler has a strong knowledge of the products she is using and understands the importance of storage and has all Material Safety Data Sheets of the products she uses on site as well. If you have any questions about these problems and recommendations, or if you need further information, guidance or assistance,please do not hesitate to contact the Public Health Division. Sincerely, Alisha L. Parker Hazardous Materials Specialist Thomas A. McKean,RS, CHO Director of Public Health �. r i ti i `U - 77,� a c ni I r . Y V�C, eff � S r6 PV U� , f -7 &44 c&,,(4 t � No -- --------- Ise- No Cc 7GC ,2 m('K f:r �k w c, rr� -ALD w7v, Orr. 0&j PvtnitA LG NaV l Inspections r Contact/ DBA 1 Address/Location: Phone# Visit Letter sent License? Contact Person ' Sears Auto Center Route 132,Hyannis 508-790-7328 12/9/2004 12/21/2004 paid-05 Mike Coska Sears Product Services 1336 Phinne 's Lane,Hyannis 508-790-4912 12/16/2004 12/21/2004 aid-05 KathyRan Big Wave Marine 30 Cit Ave.Unit,16,Hyannis 508-771-9988 12/14/2004 12/16/2004 paid-05 Craig LaScola Acme Laundry Company 124 Ridgewood Ave,Hyannis 508-778-6929 12/22/2004 12/28/2004 paid-05-06 Charles Dow All Cape Auto Sales 711 Yarmouth Rd.,Hyannis 508-775-0507 12/22/2004 12/22/2004 no John Trapp Classic Coachworks,Inc. 138 Thorton Dr.,Hyannis 508-771-1981 12/15/2004 12/8/2004 refused Robert Davis Auto Repair 50 Airport Rd.,Hyannis 508-775-8823 12/30/2004 12/8/2004 paid-05 Andrew Hunt Shepley 216 Thorton Dr.,Hyannis 508-862-6258 1/11/2005 12/30/2004 paid-05 I Mike Cipro E&B Marine 1166 I annough Rd.,Hyannis 508-790-1425 1/20/2005 12/30/2004 paid-05 Mike Dahill BJ's Wholesale Club 420 Attucks Lane,Hyannis 508-568-4035 2/8/2005 no paid-05 Tony Disomone PI mouth and Brockton 17 Elm St.,Hyannis 508-775-5524 2/17/2005 2/8/2005 paid-05 Nancy Misiaszek Reliable Fence Co: 123 Falmouth Rd,Hyannis 508-775-4124 2/9/2005 Stanley Pratt Acme Glass 508-778-2334 2/9/2005 John McMahon Buckler's GMC 116 Ridgewood Ave.,Hyannis 508-775-3443 2/17/2005 2/10/2005 aid-05 Gary Buckler Town Paint and Supply 206 Barnstable Rd.,Hyannis 508-771-4290 1/12/2005 complaint aid-05 Valerie Cashin 'duality Instant Printing 195 A Ridgewood Ave.,Hyannis 508-771-6118 3/2/2005 2/10/2005 no, Paul Harro Cape Cod Auto Connection 152 Ridgewood Ave.,Hyannis 508-778-9696 3/2/2005 pop in no Tom Lindquist Nelson Coal&Oil 180 I annough Rd.,Hyannis 508-775-1190 3/2/2005 2/9/2005 aid-05/06 Gordon Nelson Cycle Services JD signs 100 Ridgewood Ave.,Hyannis 508-771-1414 3/31/2005 pop in paid-05 Dan Marrs Radisson 55 Engine House Rd.,Hyannis 508-726-8020 3/23/2005 3/10/2005 aid-05/06 Mike O'Brian Settles Glass 234 I annough Rd.,Hyannis 508-775-0526 3/15/2005 3/10/2005 no Rosann Bailey KAM Appliance 201 Yarmouth Rd.,Hyannis 800-649-2221X120 4/6/2005 3/10/2005 no Kevin Gralton Amerigas Propane,L.P. 193 I annough Rd.,Hyannis 508-775-0686 3/22/2005 3/10/2005 aid-05-06 Gene Dziedzina All Cape Aluminum Products,Inc. 192 I annough Rd.,Hyannis 508-775-4299 3/15/2005 3/10/2005 no Ben MacPherson Foreign Motor Car of Cape Cod 82 Ridgewood Ave.,Hyannis 508-778-1118 3/31/2005 3/10/2005 paid-05 Mark Hayes NE Marines Power 232 Main St.,Hyannis 508-790-4000x 3/15/2005 3/10/2005 aid-05 John Crowell Sam's Gas 258 I annough Rd.,Hyannis 3/15/2005 3/10/2005 no Ocean State Job Lot 390 Barnstable Rd.,Hyannis 401-295-2672x130 4/6/2005 called us paid-05 Bill Rike Airport Exxon 230 I annough Rd.,Hyannis 508-778-1790 3/15/2005 3/10/2005 no I Buu Phu Centerville Cleaners 82 Willow Ave.,Hyannis 508-771-5500 4/20/2005 4/14/2005 paid-05 jEmiliosRigas West Main Gas 577 W.Main St.,Hya nnis508-778-1945 4/14/2005 po in no Tim Rifai SteamshipAuthority75 Yarmouth Rd.,H 508-771-9340 4/27/2005 4/14/2005 paid Paul Sampson Old Cape Village 160 W.Barnstable 508-420-1535 5/12/2005 4/18-4/26 no Gleison DeSilva TOB Water Pollution Control 617 Bearse's Way, 508-790-6335 5/18/2005 5/17/2005 aid-06 Peter Do e Morrison Motorworks 38 Warehouse Rd., 508-771-0406 4/20/2005 called us aid-05-06 Justin Morrison S uier Construction 86 Ridgewood Ave. 508-771-5211 4/26/2005 4/14/2005 no Michael S uier King's Coach 86 Ridgewood Ave.,Hyannis 508-771-1000 5/18/2005 4/18-4/22 no John Boyle P.R.Cleaning 279 North St.Unit 111,Hyannis 508-778-9839 5/19/2005 4/27/2005 no Keisser Reiha Treesca es 130 Rosary Lane(po box 721)W.Barr 508428-5053 6/2/2005 5/17/2005 no John Merlesena All Cape Pro Cleaning 23 Chase St.,Hyannis 508-778-7238 6/2/2005 5/17/2005 no Claudinei Miranda ACR Painting 104 Quaker Rd.,Hyannis 508-775-8452 6/2/2005 5/17/2005 no Adelino Santos Perira JL Painting 3 General Patton Dr.,Hyannis 508-367-1670 6/2/2005 5/19/2005 no Joao Lima Trans-Atlantic Motors 25 Falmouth Rd.,Hyannis 508-7754526 6/16/2005 5/19/2005 paid-06 Michael Franze Crowell's Lawn Mower&Rentals 207 I annough Rd.,Hyannis 508-775-2036 6/15/2005 5/19/2005 paid-06 Jack and Carolyn Bell Cape Codder Resort and Spa 1225 I annough Rd.,Hyannis 508-771-3000 6/15/2005 5/31/2005 aid-06 Alan Love Cape Cod Community College 2240 I annough Rd.,W.Barnstable 508-362-2131 6/22/2005 5/31/2005 aid-06 Paul Knell Cape Cod Lincoln Mercury 556 Yarmouth Rd.,Hyannis 508-775-1444 7/21/2005 5/31/2005 paid-06 Tom Fitzgerald Bortolotti Construction 45 Industry Rd.,Marstons Mills 508-771-9399 7/6/2005 5/31/2005 aid-06 Bob Bortolotti Cape Cod Commercial Linen Service 485 West Main St.,Hyannis 508-771-5033 6/22/2005 5/31/2005 paid-06 Jeffrey Ehart Advanced Body Science 41 D Bodick`Rd.,Hyannis ., 508-778-5541 6/21/2005 5/31/2005 paid-06 Richard Hatfield Air Cape Cod LRC 110 Mary Dunn Way,Hyannis 508-771-5725 6/15/2005 5/31/2005 aid-06 Dan Lyons Cape Tire Service Inc. 45 Falmouth Rd.,Hyannis 508-771-1111 8/4/2005 5/31/2005 aid-06 Robert E.Wallace Jr. D.C.Utilities 86 Ridgewood Ave.,Hyannis 6/1/2005 5/17/2005 no Scott Condinho Osterville Auto Service 138 Osterville-West Barnstable Rd,Os 508-428-2738 6/2/2005 5/17/2005, paid-06 Drew Tomkinson . Cape Cod Times 319 Main St.,Hyannis 16/9/2005 5/11/2005` paid-06 Jeff Pimental Cape Cod Times 40 Communication Way,Barnstable 508-862-1281 6/9/2005 5/11/2005 paid-06 Michael Fabia Cloutier Supply Co., 445 West Main St.,Hyannis 508-775-6100 6/15/2005 aid-06 Tony Raggio Everett Corson,Inc. 1040 I annough Rd.,Hyannis 508-775-3600 6/15/2005 aid-06 John Cooke Beard Motors Inc. 22 Ridgewood Ave.,Hyannis 508-775-1843 s 7/13/2005 6/15/2005 paid-06 Jim Mueller Executive Sunoco 1617 Rte.28,Centerville 508-775-7171 7/27/2005 6/15/2005 paid-06 George Youssef Francisco's Auto Repair&Detailing 31 Thornton Dr.,Barnstable 508-778-0329 6/29/2005 6/15/2005 paid-06 Francisco Pereira Hyannis Car Wash 506 Bearse's Way,Hyannis 508-771-1877 6/16/2005 paid-06 Gary Levesque JT's Pool and Patio,Inc. 35 I annough Rd.,Hyannis 508-862-2440 6/29/2005 6/16/2005 paid-06 John Tremblay Joyce Landscaping 68 Flint St.,Marstons Mills 508-428-4772 7/6/2005 6/16/2005 paid-06 Jeremy Gavin Mid Cape Tire&Auto Service 426 Yarmouth Rd.,Hyannis 508-790-2400 7/12/2005 6/16/2005 paid-06 John Knetz Midas Muffler and Brake 74 I annough Rd.,Hyannis 508-771-2637 6/29/2005 6/16/2005 paid-06 Dave Litchman Miskinis Motors 460 Yarmouth Rd.,Hyannis 508-790 4455 6/28/2005 6/16/2005 aid-06 Bar Oliver Neves Auto 11 Cit Ave.,Hyannis 508-771-7700 6/16/2005 paid-06 Charles Neves Orleans Auto Supply,Inc. 333 Barnstable Rd.,Hyannis 508-778-7956 8/24/2005 6/16/2005 paid-06 Richard Fairbanks Robies Refrigeration,Inc. 279 Yarmouth Rd.,Hyannis 508-775-3083 7/12/2005 6/16/2005 aid-06 John Robichaud Rotary Collision Center 345 Barnstable Rd.,Hyannis 508-775-1353 8/24/2005 6/16/2005 aid-06 Jonathan Porkka w:cl{c— WI ak, NO �fle S,C71 dA VL L kj VO FD w,� '/rg Not wed�vu -01 .�,v�n off ♦ ii�th �e♦yd V Solo , KI D C, i iow". Ii 1 y 1\'fir. �Y :c ------------------ - rrl 'RM�I w— —w — — w n ry^il� r -uu V4 W�) J MAIM 6�*yv �tt, a,� r \� J s-. � P ryu�Fd6) tel I [yk- I P,u�,� a(c U �- 74, cAof ma� P� � � Nis M", � os� ��— .f 201260 1 SI079/028 W �W G 1n ro m y 201260 QN R ; ,. _ CASE Holt rLLI HERBAL LIP BALM W < C _ l _ a ,,a. l/h Liy tid ♦ ti . r 7 .y, r • � 1 � VKOL V),--h kd-4x , .�,� ��^v-� o�✓► ��t-e�v� ^ mil, --cam�r a t'r c e-h-dAtr PINASanitation Services,Inc. LOCALLY OWNED& OPERATED SINCE 1968 s Your Cans in •Container Service Available Good Hands •Residential •Commercial l4 •Construction Debris Removal (508)428-2062 (800)282-2062 Fax(508)428-2057 I jamila s Natural Beauty Skincare ❖ Waxing Perfect eyebrow shaping Jamila Kovanda 845 Main Street (508)420-1912 Osterville,MA 02655 PA I NT E D R E D N A I L S 508.428.2577 WA _ C . At The Designer's Walk www . pal ntedrednalls - corn r i I C, A !Desrgne atn�S;�'�; ste a Pamtedredn �ra�" tD U 4�Ak ad-WStY�Lj cval oujd. I CRo cv--VDuh"�� v 4 Ut C��..C�� ,t�i� �� r�P vil I OA0 ,�� CMG OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE ANITFREEZE GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM (GEAR OIL/GREASE/ LUBRICANTS) FREON ACETYLENE CAR WASH CAR WASH PAINTS/ WAX DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID FERTALIZERS WASTE SOLVENT BLEACH DISH WASH AND MSDS DETERGENTS MANIFESTS t R TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH Satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY 4;45 (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS f Class• 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS == •• - 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 Miscellaneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer Public )�fOn-site OPrivate 3.Indoor Floor Drains YES N0 O Holding tank:MDC O Catch basin/Dry well O On-site system ' 4. Outdo ce drains:YES N RD S: O Holding tank. DC O Catch b 1 O 0 ite system 5.Waste Transporter 4 f YES NO 1. 2. r o (s) Interviewed nspector Date Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: G" /`� �' 7"S�%✓� - BUSINESS LOCATION: q,5 � 7`" aye r✓`✓ MAILING ADDRESS: 7- '(I /� 0� 7f Mail To: TELEPHONE NUMBER: G/;? 5- r//S' Board of Health - CONTACT PERSON: Town of Barnstable` �� y� P✓'� ' P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: tt lq ) ti Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or,.' answer.,. Use the enclosed x envelope for your convenience. a� , ?� f If you answered YES above, please indicate if the matefl. S.arestored at a site other than your mailing Address: ADDRESS: x`' TELEPHONE=: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic orkhazardous character- istics and must!be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antif reeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid _ Disinfectants- ,.,.. Engine ano radiator flushes RoPd Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants ;"��`' ' Motor oils Pesticides !r NEW USED (insecticides,(herbicides, rodenticides) Gasoline, Jet Fuel P,V9 =.dheffii6a'is (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, � hotochemicals (Developer) lubricants, gear oil �, I "'r: NEW USED Degreasers for engines and metal A Printing ink 5 1 Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's. , Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform; formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids a (dry cleaners) ' Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS, TO ALL NEW BUSINESS OWNERS Fill in please. . YOUR NAME: NPPLICANT'S At A ® ,,® � YOUR M AD RESS: BUSINESS J r "TELEPHONE Telephone Number (Home) 6 ' Y` I[[ �a �N _ q O. '::.:.:�. ;,.N: ... O N . r .. :r,. j � :.. �... P. : ��...� r�.r:, 1TY�a - � BUS.. s � ES IS „. .:d 'R ... L AP PA , M�ER - P � . • Aregulations PR. . .s1 ass Town a new business there are seve al things you must do in order to be in compliance with the rules and tsienatures f When starting Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required 9 listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). 1. GO TO BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL) This Individual has be n informed of ryMermit requirements that pertain to this type of business. Authorized Sign ure COMMENTS; 2. GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL) This individual ha een informed o the rmi.t requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. GO TO CONSUME R AFFAIRS (LICENSING AUTHORITY) - (3RD FLOOR SCHOOL ADMINISTRATION BUILDING)This individual hm b n o e of the licensing requirements that pertain to this t ype of business. Autho zed Signature,, COMMENTS: t. After obtaining the required signatures you must return to the Town n e town Clerk's fl which you obtain must do by M.G.L. ificate (cost$20.00 ft does not give you , for 4 years). A business certificate ONLY REGISTERS YOUR NAME i st get that through completion of the processes from the various departments involved. permission to operate -you mu L COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS mum DEPARTMENT OF ENVIRONMENTAL PROTECTION SOUTHEAST REGIONAL OFFICE WILLIAM F.WELD TRUDY COXE Governor Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt. Governor Commissioner PO P November 22, 1996 Stephen A. Haas RE: BARNSTABLE--Subsurface Eagle Surveying Industrial Waste Disposal, 923 Route 6A Proposed Industrial Waste . Yarmouthport, Massachusetts 02675 Holding Tank for Designers Walk 845 Main Street, Transmittal No. 115195 /1 Dear Mr. Haas: The Department of Environmental Protection has completed a Technical Review of the above-referenced. application for the installation of an industrial waste holding tank for the proposed beauty salon .at the referenced. location. The plan is titled: n SITE PLAN OF LAND IN BARNSTABLE, OSTERVILLE MA. PREPARED FOR: HIGH POINT TRUST SCALE: 111=201 APRIL 4, 1996 EAGLE SURVEYING & ENGINEERING, INC 923 ROUTE 6A YARMOUTHPORT, MA 02675 n The plan proposes the use of an industrial waste holding tank for the disposal of beauty salon waste. The Department is of the opinion that there is no other feasible alternate industrial waste disposal system that could be installed at the referenced location. Therefore, the Department hereby approves the plan subject to the following provisions: 1. The local Board of Health must certify that the system will be monitored by them to see that it is being properly operated and maintained. 20 Riverside Drive • Lakeville,Massachusetts 02347 • FAX(508)947-6557 9 Telephone (508) 946-2700 4 -2- 2 . Failure of the owner or person having control of the system to keep it from overflowing and properly maintained will constitute grounds for the revocation of approval for the use of the industrial waste holding tank. 3 . Construction shall be in strict accordance with the approved plan and Title 5 of The State Environmental Code and no further changes will be made without the prior written approval of this Department. 4 . A Disposal System Construction Permit must be obtained from the . Barnstable Board of .Health prior to the start of any construction. 5. Written certification that the industrial waste holding tank has been constructed in accordance with the approved plan shall be submitted to this office. with a copy to the Board of Health. Said certification shall be submitted by a Professional Engineer who is registered in the Commonwealth of Massachusetts. Nothing in this provision is intended to interfere with the right of the Board of Health to inspect the holding tank at any time during construction in order to assess compliance with the final plan, as approved by the Department. 6. The industrial. waste holding tank shall not be utilized until .a Certificate of Compliance is issued by the 'Barnstable Board of Health. 7 . A copy of the contract shall be sent to this office upon renewal with the hauler. 8. The Department's approval for the proposed system will be dependent upon the recording in the appropriate registry of deeds of a notice that discloses the existence of the industrial waste holding tank and the involvement of the Department of Environmental Protection in the approval of the holding tank. No Environmental Notification Form is required to be submitted for this project since it is exempt under the Environmental Protection Regulations of the Executive Off ic-_. cf -Environmental Affairs and the project has, therefore, been determined to cause no significant damage to the environment. Enclosed herewith are stamped approved copies of the plan,- a copy of which must be kept on-site and used for construction purposes. If the Department can assist you further or if you need additional information, please contact Brett Rowe at (508) 946-2754 . . Very truly your Jef r uld Chi f . Wa er P t on Control a{ -3- G/BAR/cb Enclosure cc: Bernard Wilber P.O. Box 300 Cummaquid, MA 02637 Thomas A. McKean, Director Board of Health P.O. Box 534 Hyannis, MA 02601 ' - I J 20 00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ......Town.................OF..............Barn-s.table ----------------•--.....-----......---...........•- Appliratiou for Dispviial Worka Tomitrurtiou Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (X)o an Individual Sewage Disposal System at: Designers Walk Main Street Osterville ............ ....r..... ............ .• ............. .....................•.1. .... ........................................_ ......................................... Location.Address or Lot No. H.i-P o i n t...T r u s t, Company.....--•--•. .. ....------•-----•................... . .............................. ........ •- --•.. Owner Address W J.a ,. .... r...Jr............................................. ............................................................................................ Installer Address e of Buildifi Size Lot------------------ U Type g ..........Sq. feet �--� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 4 Other—T e of Building No. of persons............................ Showers — Cafeteria a, Other fixtures ...................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow......_.....................................gallons. WSeptic Tank—Liquid'capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No--_----------------- Diameter.................... Depth below inlet.................... Total leaching area...................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date................ .-•........ r------ -... aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ PL Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 --••---•--••---•----------- •-•••--•--•-•-•----•..................•--................_............•-•-•.._............---...---•--••----............r 0 Description of Soil................................................................................................................................................................. v .........Sand..................................•..................................................................... W UNature of Repairs or Alterations—Answer when applicable................................................................................................ ----------------------------------------•--•----------• ----------------•------•...I..........----------•---- 1_-.141..... each_ing...pit..:............--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITTIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beep issued t bo• -d of healt . Signed. .. ._ _ ...'---��.�ZZ .. . -- •--•--------------- ..7/2118.0--•........ Date Application Approved By...............0 , .-J .. .- ............................. ...--•- 0.�..t. Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date Permit No......... ............... IssuecL Da No. - Fps......'....._:....:.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TTn ................ F..............: ...-......:_........... Appliratiun for Disposal Works Toustrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (XV, an Individual Sewage Disposal System at: ...... .. Location•Address or Lot No. ............... ..._ �.�.----_-_--�±� i l: �:C3S_qLianlf .... .... .-•----..._..---•------...._..........----• -------______.------ ------- ..._..----- »----- owner W tl i P Address Installer Address UType of Building Size Lot............................Sq. feet )_4 Dwelling No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal "_Tench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) •-' Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................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........................ 0 04 ......................•----•----------............------_.__.---........__............-•-•--.....---......................................................... Description of Soil..........................................................................................----------•--••--------••--------•••••-------•....-----------....------------ x v e.. �.l MW ............................................................................. ----•----......---•------._._....------•--•---•-----•---••--------•------------..__._....__...._------•-•---------•------- . U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ., v ______________________________________________________________________________________________________________________•.________..._.___...___............_._.._.................._..........._._........ Agreement: The c.ndersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be nissued by. tWe board of healtV. / 9 g Si ned i 51 =r "t off f,� f ' ri K Date Application Approved By..............D �_.. - ---------_-___-_-•--------- e nate_�sr._.... Application Disapproved for the following reasons-.............................................-•...--•-•----•------•------_..----••--•--•------•--._...___------ --------------------------- -••-•-----••---------•_--------------------- •-------- ------------------- PermitNo.._._._._ ..:_.- C Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH m,,m....................OF... ...earn t..abl ............................... %Twrriifira#r of Tompltanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Rep iIred CXf L+.F:�., f ly laY� tI r . z t by ••..............•--.....--------._...........•-•..................--------....__....------- -----••....._._.......-•---•--•---....--•-•._.----._........._.._......._. ._......••---•-- •!+� > qp t t- yy c�+11.. ry 5. l�r y Js[,Z.,rir.'Ina-,rs ;'fall-- ,i'ai�n S-trce-n-✓ 0� rsVV l.i.:j`.!�ii',!,I aJ .. at.. =' has been installed in accordance with the provisions of T!.TILE 5 of The State Sanitary Code-as described in the application for Disposal Works Construction Permit No---------- _� -.�"S._L ...... dated-.-------_---._-_-•---------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector...................................................................................... } THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,. 60 FEE. •. Disposal Works Tonstrnr#ion rrntit Permissionis hereby granted......................................................-------...---•-•--•--•--•--•--•---•-----..............-----............................ to ConstructRepair an Individual Sewage DisPgsn�,l System ct at No. • ` Street as shown on the application for Disposal Works Construction Permit No. �):�� _ Da-•-•••-------•..`...•----------•--• - DATE--------------------------------- ............................................... oard of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS f t l �l AsBuilt Page l of 1 � M TOWN OF BARNSTABLE LOCATION crs walk" SEWAGE N Mvh h� VILLAGE ASSESSOR'S°MAP & LOT INSTALLER'S NAME & PHONE NO. J �� N1aCo•-,,6F✓ SEPTIC TANK CAPACITY LEACHING FACILITY:(type)_;fj 7 (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER }^�� t��-�' �•�•.�� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_ VARIANCE GRANTED: Yes No f� r^a� 4 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=l 17103&seq=2 2/15/2011 f Massachusetts Department of Environmental Protection 115►95 Bureau of Resource Protection—Water Pollution Control Transmittal 1 BRP WP 56 Facility 10(tiknown) Permit to Construct and Install Non-Sanitary Non-Hazardous Industrial Wastewater Holding Tank Facility Information (coot). 7. Type of holding tank: 9. List raw materials and products used.Include any and all products or chemicals used in processing,cleaning,etc.: ❑ mobile tank trucks ❑above ground xin-ground if in-ground tank,provide name and signature of appropriate local board of health and official: t4-o-t�-�� Pdni p B Signature 8. Does/will wastewater receive pretreatment? ❑ yes �no 10. Provide name and address of transporter(licensed septage/ waste hauler): If yes,is treatment O continuous ❑ batch ❑ both P. IA'e Name r?v. W 461 Address 62 City/Town np Code Engineer Information C.¢6 t yz3 lz-6U7 �� 1. Name and address of Massachusetts Registered Profes- — ....._------�--'— Address sional Engineer designing the proposed industrial t�fl � I-IA. QZ&7S wastewater holding tank: ----------- — -- City Stale lip Code 5TEANC- A . 1-hA-AS� 36 ?- �/ z_ Pan,Name Tetephone Signature P.E. Certification "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision PtialName in accordance with a system designed to assure that qualified __ personnel properly gather and evaluate the information Aumodredslgnature submitted.Based on my inquiry of person or persons who manage the system,or those persons directly responsible for Nile gathering the information,the information submitted is to the best of my knowledge and belief,true,accurate,and com- plete. I am aware that there are significant penalties for submitting false information,including the possibility of fine =---..---.----------- and Imprisonment for knowing violations." Type of Applicant(corporation,company,gowmmeniagency Clryllam tltsrrlcl,omer) Stale ollncorporallon and pdnclpa/address Page 2 of 2 TOWN OF BARNSTABLE �S LOCATION ` %�-� SEWAGE # V ,IsAGE ipi�l,��, �AJSSESSOR'S MAP & LOT Es',S T ALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY j t S •�1�1s "� SS LEACHING FACILITY: (type)- J (size) NO.OF BEDROOMS �� BUILDER OR OWNER i CCd�i� PERMITDATE: __COMPLIANCE DATE: �� Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Welland Leaching Facility (If any wells exist on site or within 200 feet-of leaching facility) Feet Edge of Wetland and Leachin Fa ility{If any wetlan exist within 300 f t of leac ' Mali Fret Furnished UZ g ZI AA AM/ .9Q1Z qr s � 10 o M TOWN OF BARNSTABLE LOCATION ykf ,SEWAGE # ° ., lviaiy s� 1 VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 1_EACHING FACILITY:(type)'-- L j (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER Bi)ILDER OR OWNER DATE PERMIT ISSUED: 77 DATE COMPLIANCE ISSUED_ ^ VARIANCE GRANTED: Yes No__,,--' �, � � � I% , � \ � \ / �-�� /� � � i � � _ ' 'r _ �e �' LOCATION SE ACE PERMIT q0. �� r �7-- V 4LACE FIST IIER'S. ANE ,ADDRESS BUILDFR OR Ow kill T, 6141� PL F DATE PERISIT ISSUED 2- � ee� DATE COMPLIANC,U ISSUED M u _ p7fNo '.... ....... F.Es.._..Ly ................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® O HEALTH -------------- 11 'j ......OF......... . :,!:::;fet,�. ............................................... Appliration for Diipoii al Workii Tonotrnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at r. :...... ................................ ............................................. ...............__._...._......_...........--- Location-Address or Lot-No. ..... ---X ••------------•---------------•••-•-••--•-_. .........__.._.._.... ...----•-••-------............... --._...........--- f /�[�� .....16 1!_i____�vk_!_Oc�_ ...................................... -•-•-•--•-•----•----......._..........----•.Address---.._....-------------•---•-•---•--•--._.. Inst Address Type of Building Size Lot............................Sq. feet U Dwelli No. of Bedrooms. _Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin `��-77 —Type g __=flf__ _ .A�'_ No. of persons____________________________ Showers ( ) —.Cafeteria ( ) Otherfixtures _-----_----------------------------------------------------------------------------- -- W Design Flow...................._ _ _ .....V_gajlons per person per day. Total daily-flow...........�__y __:—___.__..____gallons. WSeptic Tank_`Liquid capacity/w___gallons Length________________ Width---------------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....................: Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G Test Pit No. 2................minutes per inch depth Test Pit.................... Depth to ground water........................ ' �et ----•• - ---------------•-----.._._.__.....--•------__._..__......---•--•------••--- 0 DescR4V ___ -- ---- U - =:_: _.:_.: - ------ -------- -- - --- -------------------- -----------•--------•••••-•••------•---------•--------••------•---••---•-••--•------•••----•------••••-----•-•------.._.._------ U Natur Al ations—Answer when applicable................................................................................................ ----•-------------------•--------------------------------•-•--••-•-------•-•----•---•-•--........••--•-••---••-----•••-•-••---•-----•-•-------------•••--•-••--••-•----•-•--••••-••-........--••--•. Agreement: The undersigned agrees to i install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code—T ndersigned further agrees not to place the system in operation until a Certificate of Compliance h ee* ue t e oar of h d Sig ....... ------------............. ........................ Date ApplicationApproved By....................---•-•-- •-----••-------------------------•-•-----------_----- -------- ---------------------------------------- Date Application Disapproved for the following reasons:------•-------------•-••-------•-----------------------------•--•------- ....................................... -•------------•------------------- ---------- •----------------------------------------- ------- ------------------------------------------ ----------------------------------------•------------ Date Permit No......................................................... Issued.......�_j._..2?,.........-•-----•--- Date NFEB..... .............. THE COMMONWEALTH-OF MASSACHUSETTS BOARD'µ0 HEALTH .. . ............. OF......... . .................................................... ... ........ Appliration for Dispoiial Works Tonstrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal system at ------- -------------------------------------------------------------------------------------------------- Location-Address or Lot No. .......................................................... ................................................................................................. er, Address . .....................le --------------------- -----------ler �d---------------------------------- -d're-s's------------------------------------------Inst .r Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms ...... ----------Expansion Attic Garbage Grinder OtherType of Building �-37i;7i.amo. of persons............................ Showers Cafeteria Other fixtures --------------------------..................................................................................... i---------------*------------------- * Design Flow ......... j.g,*ons per person per day. Total daily flow.......... ..............gallons. WSeptic Tank Z ....Liquid c'a'paci- t !--gallons Length................ Width.__............. Diameter_____._......... Depth................ Disposal Trench—'No..................... Width..............._._.. Total Length....._.............. Total leaching area....................sq. ft. Seepage Pit -No.......................Diameter...._......_.__.._.. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) - - Dosing tank ( ) 4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit._____._............ Depth to ground water_.______.............__. Test Pit No. 2................minutes per inch e Test Pit.................... Depth to ground water........................ I....................... - r. . ............. ......................... .............*------- -------**------------------------------- 0 Description of Soil ........... . . . ........... . -------- ---- -- - �4 I? 7-7. ------ ..... . .............. ............................................................................................ ----------- ----------------- ............................................................................................................................ U Nature of Repairs or Alt afions—Answer when applicable.-,,-:,,,----------------------------------------------------------------------------------------- ........................................................................................... ................................... ............................................................ Agreement: Theun&�rsigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T!Z- 5 of the State Sanitary Code—The-undersigned further agrees not to place the system in operation until a Certificate of Compliance.has n i ied th oard. .f healt Signe ..... ...................... ....... ApplicationApproved By............................... ......................................................... ........................................ il Date Application Disapproved for the following reasons:.......................................................................... ...................... ...............................................................................................................---------------------------------7------------------------------------------------------- Date PermitNo...................... ................................. Issued----- -1......................................... Date THE-COMMONWEALTH OF.,MASSACHUSETTS BOARD OF/ H E A LT H; .............. ... . .. ....OF.............. IS is TPOE TIM ,� t the Individual Sewage Disposal S Repaired ystern constructed' or by.- .......a. .. . ......... -------- ....... ........ .. ............................................................ 7...... ..."77:9,taller /11 S..... at... ....... ................ 4-r-1.17... .. ... ........................................................................ has been installed 5�naccordance with the provisions of 5 of The State Sanitary Code as described in the application for Dis"'osaf Works Construction Permit N6.... ........ ............. dated—.7—A-0 ------ I p 19- -1-11,--------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE-CONSTRUED AS A GUARANTEE THAT THE SYSTEM wiLL FUNCTION SATISFACTORY. DATE.......................................................................... Insp ector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF;�11EALTH .................. ................................ ..... ..OF.............. N .......... FEE........................ Permission is hereby granted....... ..... ................................ at.to NConsucP or i�tepir... ...... 7Ivlf -iv-i/dual �ey,.age Dispo- l Fkt en . .................. ........ Street *A:)VW.C- - 7 as shown on the application for Disposal Works Construction Permit7. d.......OT-------------------------------- o ....../ ------- 2 21 ........... -tA A- 4 ........ -----" ........ .... ...............s. .. Board of Health DATE---------- 'r................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS No.........` !_0.... Fps............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF :HEAL H ApplirFatiuu for Bi-spuual Workii Towitrur#inn rprutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal steGi at•. . .....................•-•--••-•-....---....--•--•--•----•--......•--...... ......-•••----•--•....._...... ...........a................................................... tion-A ss r/ or t No�� «... ... ................................................... ...._.._._... ..... .__ ... .. ............ ne_r Address a = ........................................... ...... _ .P... :. .. ----...-----..... ...-- a er Address e of Building Size Lot............................Sq. feet a Dwelling No. of Bedrooms...... .. .__..Expansion Attic .( _ ) Garbage Grinder ( ) ---------- a Other-=Type of Building..... No. of pe sons........-0_____________ Showers ( ) — Cafeteria ( ) d Other fi tures . ------ ------------------------------------------ ---------- W Design Flow..Z�� . ? i ........gallons per @rson per day. Total daily flow......... _. .......................gallons. WSeptic Tank—Liquid/cap city!l1�.-J.--gallons Length................ Width................ Diameter...............- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet..................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. I................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 Descri 'o of Soi ._...... . V �- � ----- . .. ._.____ W. 0._..-��..., ._ ..... ----------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT L- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in -operation until a Certificate of Compliance has en i ed by b r of ealth. Sign Date Application Approved By.......... � ------ �.� ' 7 Date Application Disapproved for the following reasons:................................................................................................................ ....................•------•-----------•----•-------------------=-------.....------..........------.........------.........--------------------------...------------------------------------------------. Date Permit No......................................................... Issued.---'&---/r?��.._./..__... ------ Date j No.. Fx$............._............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL H w - ...••--- OF............. ~ Appliration for Disposal Works Ton#rurtion rermit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal steinat N ............................ ............................................- ---------------.•---- .... -----• s. .ion- ss o«+. w � .. h! r t N 9 W ......... Address --.I "7 n / J�/ a er Address e of Building Size Lot.......:....................Sq. feet V ..` . .....Expansion Attic ( ) Garbage Grinder ( ) { _�. OtherT e of Building a Other >z yp o. o il roms J' No. of pe sons �Z---0............ Showers ( ) — Cafeteria ( ) Other fi tures ...................•--•-• ,r W Design Flow-1c /_I'_ d..____..gallons pe Arson per day. Total daily flow......... t +.................gallons. 1:4 Septic Tank—IKquid ca city>Ofi'1.0_..Rallons Length_............. Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x� Seepage Pit No....:................ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution''box ( ) ' ; Dosing tank Percolation Test Results Performed bY---•----••-••-•••......--••=..............- •------•----••----•----- Date........................................ Test Fit 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-------_................. R+ = ��,,,� ..................................................... 0 Descri 'o of So' _ '� , ..it t ..... + ......................................... --•--•------------•-----. W ----------------------------------------------------------------- / ....._.. = �..-----••--- UNature of Repairs or Alterati s—Answer when 1 cable-" � - --.-- •-- , ...•____________________•-. --__ •-,:- .:___•---._._--•-•---•-•-.•-----•--•--............___-_.. 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 li'een issued by AIR boar' o ealth:- . r. Signed -• --- ' Date ' Application Approved B ... *' ' �.. '._ Date - Application Disapproved for the following reasons:......................................-----•------------------------------.................................... Date PermitNo..........................'.............................. Issued....................................................... x Date THE COMMONWEALTH,OF MASSACHUSETTS BOARD OF HEALTH,.. ..,; 1 to"..- �'"t.... ..O F........ .......... ......... TrrtifirFate of ToniptiFanrr TH r TOr,CE I Y, That Individual Sewage Disposal System constructed ( ) or Repaired by------� ..... ..... ............................................... ......_..... .._......_ t - Insta11 has been installed in accordance with tht�*provisions of 5(�&jhe State Sanitary de as described in the application fir Disposal Works Construction Permit No, �4__7_j9--------------- dated.... .- . ''__�_ ,................ a THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WI&JL FUNCTION SATISFACTORY. DATE. ............'.�.. .�..`�................ Inspector -----------•-- ..........---•- -•------------ ` 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF/--HEALTH �y - .. } .. ......OF..---•--•.-- -- . ...:, -fir - ............................ . .. . .. FEE..... ..... .. ........ �t��ro� � ork� n , ion rrani� Permission 's ereby granted....... . ._: . to Constr ( ai ( ) dividual rage Dlspo st *- at No.(.1,' s .- .. _ x Il ..... Street as shown on the application for Disposal Works Construction rt No. ._. ... ._ Dated_.__ ."."' . "/�. . :_.... r 6t '.� �� _.t ,' �• oar of Health "`'p DATE..... • ...............T FORM 1255 HOBBS & WARREN, INC.. PUB ISHERS �yy. 5/16/2021 ShowAsbuilt(1700x2800) 5CATION 9 T ION �G/ S6 E PERMIT M0. VILLAGE G NST ll R'S I ME ADDRESS SUl R OR OW r��l3T7 cc'"I I? DATE PERMIT ISSUED 2,j 7 i DATE COMPLIANCE. !SSUED 1 � i i https:/fitsq ldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=117103&sq=1 111 :,I _. �;'�- try-..._- ,- ,, ` - t . t_�, , ,." , , , , I , I If- , ,i, , , ,, � - - I ' �, .,� , ,, l . I r I , -f 1 . - , ,I q, - . .I I - . �t . I I I� ,� . . I," l � .l.i.,. � 1 .. , I1I- I-:I�Z1��-1I Ii1 1,,1,' I� II 1 .,4. j .I I I 1' �A . I I -- I � 1 I ,I ,I I- .1I . ..I . I I AII 1 I I.l I I1. I.I I . I��I.�1 I II,II�I .II�1 ,I �. I - lI I.IlII,7I I1 I,I . 1 --,,-1 . �1" .r.I .I -� , �. I � �I , , II1 � l .� ' I I . . � 14 - '5 � , - ,, � � :...I . , I ' - 1. . I —II ' - f �. , Ik--� /{l Y. HEAVY DUTY CAST IRON I FRAME AND COVER To GRAVE � N . ,4'.PvC INLET 4 MERCURY FLOAT C SW!TCH , BAY S IN $TREE9J.0 - . I NV ALARM ON . op l 01 $ " 4 0 3 1 CHERAY . 0 %. I - :t, TANK DETA J L : NOT To SCALE : / — , 1 SEPTIC-TANK I C TANK H-20 � TOR WATERPROOFED 051 CHERRY ,, EXISTING' p L OCVS MA P WATERTIGHT AND, FACY -SET ON LEVEL STABLE BASE BUILDING � �, . I ' ' NO TES ; I. 'THE TIGHT TANK MUST HAVE A BELL AND LIGHT ALARM IN A I 0 61 8I CHERRY ASSESSOR'S MAP 117. PARCEL 103 . ZONING DISTRICPS.,.BA & RC CONSPICUOUS LOCATION AND MUST START AT THE ELEVATION SHOWN, 0 GROUND WATER PROTECTION OVERLAY DISTRICT: AP U TIGHT TANK IS'FOR USE OF ONE SINK FROM THE BEAUTY SHOP FLOOD ZONE C. ,MAP;, 5b00I 0016 D. DATED 712192 2. \ OWNER: HIGH POINT TRUST WHICH MUST BE CLEARLY MARKED AS THE ONLY SINK To BE USED ) . COLORING OF HAIR. A �� -44- � I ONE INTERNATIONAL PLACE , A, - 04o p-1 i 45 th FLOOR * J BOSTON. NA 02110 3. BUILDING INVERT D OR To -CONSTRUCTION. 40 DRAIN � A UP 13518A ; ! I ' 1. .1,, ,:. I � - ." rI " I � MH CONC $LAOS TO e6A , -,�'�I ,. t, - .� I, I ,.� -` :. l" I " l� ." ,- IIII�' .�- e � . l 1- . 4. TIGHT TANK DESIGN FLOW - I SEA T X 1 BE REMOVED. AREAI *$� IGI z / TIGHT TANK PROVIDED 1500 GAL. WITHEEVGREEN SHRUBS V/, e �s � ...*1� \ 'D SIMILAR TO ME EXISTING �1 � 1 PROPOSED DRYMFLL . . FOR ROOF RUNOFF \1 / )' I \ DUMPSTER 1 . /0 --fiXISTING SHRUBS . j 1 1.:.��I .,-II.1 , �- �, , \ PAYED PARKING �L PARK ING .CAL CUL A T I ONS * \ -- - I 1000 GAL . EXISTING OILTANK .' TNK ... ( .,- TO BE REMOVED . EXISTING REQUIRED: SPACE / 200 S.F. RETAIL USE - * \ PLUS I PER SEPARATE ENTERPRISE I kk 10.000S.F. RETAIL / 200 - 50 SPACES &sr. , . 9 SPACES . CATCH RAS/Ao . 0 . $l I SPACE / 300 S.F. OFFICE USE TOWN OF BARNSTABLE +/p PLUS I PER SEPARATE SUITE EXISTING SEPTIC SYSTEM , ,* / ;< PUBLIC PARKING FOR THE NORTH WESTERN 1% x./* -5I.*0 OFFICE / 300 - /I SPACES HALF OF THE FRONT . ..;f p� , P0 l 4 I SUITE I SPACE BUILDING r, �*0j, 'ill ,,, /* wr 106 1 TOTAL PARKING REQUI RED 71 SPACES . . � 6 I04 O,o �oo,p 1, 6 I . . L. ,,0,`� 00*;4"c -Ipc Co AREA CAULATIONS " . *0 6p- -* LlI LOT AREA - 19.284t S.F.c I TOTAL - 11.080t S.F. - 57X OF SITE, � EXISTING BUILDING 10 PIT: t9 \ f H I D RTMENT OF 1 0 PROPOSED DRYWELL AC :11i, I - .. � FOR ROOF RUNOFF IRO TECTION `l 7\ Z , .I - � ! � - , ,�� III11 I-I 1 . I l- � I A'� tI' 1 � .1; A..:-. , -,� .,i .1, l I . I, I l �. :1l,4 � ,1 1 - " � " . . 6 _date l TE. I I: . . . S / PLA OF LAVD - EXISTING DRYWELL PROPOSED 1500 GA O 1: i 1 TO of USED FOR TIGHT TANK FOR - b ROOF RUNOFF FROM BEAUTY SHOP 31 0..1. . IWO 44L / TH E R BUILDING - ft . WASTE ONLY. 11 TANK ISEPTIC •SYSTEM V FOR CCOAT0 0 4 A M OSTERV / LLE "A. 1 1, , .. & R /VS 7A. & LE o - : v .. I I104po .. 1= . v� $ PAVED PARKING AREA - /" - . 3-10 PIT .*4. r / / / / P0 / V7 TRL5T . . EXIsTi#& SEPTIC SYSTEM . 0 . ." - Fog r* SOUTH EASTERN 1," , r LEGEND 0 HALF OP THE FRONT BUILDING S CA L iF : / - - 20 . A R R / L 4 . / 9 ?e - 11 . ,,I ,e . AND ALI OF mr REAR BUILDING ",;, RE- V I SFD . MA y 7 . / 99e CONCRETE BOUND FOUND,". �. 11 , - , *,I � . 1 . RE V 1SFD , MAY 29 . / 95 6 I . W GAT k) � �N,ATERE i � � , ,•" ll� I. �. I," PUBLIC cz1 5,uj V.,E-rlvc & s vc zm.,6-. Ja? 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