The URL can be used to link to this page

Home My WebLink About0291 POND STREET - Health 291 POND STREET Osterville A= 119-034-001 /Jr r a YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (vvhich;you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Tale the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis; MA 02601. (Town Hall) and get the Business Certificate that is required by law.. DATE: ✓ .6 Fill in please: � :� APPLICANTSYOUR NAME/S: N^ ej iW1 P. BUSINESS YOUR HOME ADDRESS: 7 SLl TELEPHONE # Home Telephone Number o ? 7 0 OR E1 N #: _ (a E-MA I L: E r r NAME OF CORPORATION: M NAME OF-NEW BUSINESS �J S TYPE OF BUSINESS " Is THIS A HOME OCCUPATION? n1 YES NO - G /� `1 't 1 ADDRESS OF BUSINESS. : S?' ' MAP/PARCEL NUMBER l lJ l �U l[Assessing) a,. When starting a new business there are several things you must do in order to be in compliance with the rules and regufations,of the Town of Barnstable. This form is intended to'assist you in obtaining the information you..may need. You MUST GO TO 200 Main St.'— (corner of Yarmouth ' Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER' OFFICE. MUST COMPLY WITH HOME OCCUPATION This individual has been' or of any p is that pertain to this type of business. RULES AND REGULATIONS., FAILURE TO uthor e i t COMPLY MAY RESULT IN FINES, 0 COMMENTS: AA 2. BO OF HEALTH (MCA GO7�1� Y-VUITH All This individual has been informed of the Aer quirei rents that pertain to this type of business. NA?ARDOU$MATERIALS REGUiATI( 15 ' 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: . a TOWN OF BARNSTABLE Date:I3L/;2 7 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: M ,,/ BUSINESS LOCATION: /V ® o ^4 INVENTORY MAILING ADDRESS: e-0 Sex 2(0 a i4uwt/�,,t/2's C-acoa / TOTAL MOUNT: TELEPHONE NUMBER: Sal 7,3 Q`7 2 6 CONTACT PERSON: pn.� EMERGENCY CONTACT TELEPHONE NUMBER: -j 7 I l,0 6� _ MSDS ON SITE? TYPE OF BUSINESS: C4 -, 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) Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas 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 ' M (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash 9T� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials TOWN OF BARNSTABLE rl�� LOCATION/ /�Urtf/� �`j SEWAGE # VILLAGE lt.yru� 0, = �� ASSESSORS MAP � LOT INSTALLER'S NAME & PHONE NO. R C07- SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) Cj /d NO. OF BEDROOMS PRIVATE WELL O BL1C WATER—, BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: G '/ 041 VARIANCE GRANTED: Yes No '� •- 4 � "`� f/� No ( � �! T Fps..... 1 THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH V� 3voorataun for DaupuuFai Works Tunttrur#tun F.mit Application is hereby made for a Kermit to Construct (x) or Repair ( ) an Individual Sewage Disposal Sys gp at: q ...c '�! rtA _...... .-•-- -•---...----••---- 'r. ._.._ ` `.!...I.......................................... Location-Address or Lot No. ..................�1bE. CSs .... x...J�4clylG_! ............................ .............. ............................................... i Owner Address a •.... SN.`...?!!. _...._ ....................... ......... ......•-••--- T_ SJ!LL ..................................................... Installer Address Type of Building �_ Size Lot.....Z.ZjAC.-0t�.Sq. feet U .-� Dwelling—No. of Bedrooms....... __ ___________Expansion Attic (A) Garbage Grinder aa Other—T e of Building ............... No. of ersons...._............._.._...... Showers —Type g --------••--- p ( ) — Cafeteria ( ) QOther fixtures ..................................................................................................................................................... Design Flow..................................:S�..gallons per person per day. Total daily flow-------------_--.-.----_-- ......gallons. i it WSeptic Tank—Liquid capac t ,/.act.0.gallons Length./O::-k-__- Width......-8.... Diameter................ Depth..,5"'_Bh.. x Disposal Trench—No. } Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..-.-7NZTrTQ Diameter.....,CQ_'...... Depth below inlet._ .7`-.... Total leaching area... /4-....sq. ft. Z Other Distribution box (X Dosing tank ( ) aPercolation Test Results Performed by4,..4//-sao___,7...Ann A � i(/c_-_-�c____ Date....G:i:�::�'�.............. 04 Test Pit No. I....�.......minutes per inch Depth of Test Pit---Z `__... Depth to ground water_. 0-4 ..,.Test Pit No. 2................minutes per inch Depth of Test Pit._......________._.. Depth to ground Ovate ------ �L�`t QFA�f, , s a ---------------------------------------- ....----------................ �` O Description of Soil....C2--•Z! _. L.ewscai{_.�:..�Q.?za,cii.L...........................................-......................... � ......+4tt Y-,,4 U 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 TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i ed y th oar he lth. Signed... . -- - _= ................ �� .. . ---- •� � Da ApplicationApproved By ' ••---•. ..-- ....... • .. ....._. ........................................ Date Application Disapproved for the following re s:-••••-......•-•-• --•••--••---•-•-•....-•----•-••----•--•••--•-•••--•••----•--•..............................- .......--••--------------•--. ..........------------------••----------....------•------------------- ---...---------------------•-•- Q Q� - l Permit No.-SJ..�?.--...-�� ................. Issued----- .. [ D9- = -_-. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............77!rU_A./.................OF....... ke/' C ............................................... Appliration for Disposal Works Tonstrurtion Permit Application is hereby made for a Permit to Construct (x ) or Repair an Individual Sewage Disposal System\at: "J�0 6)--S-7- ....................... .............................................................. Location-Address or Lot No. .................. .......1'1'.'42L",i.Ze:-.��:............................ . .............. L'CF�=�7............................................. Owner " Address L I rj, � .......... ....... Installer Address U Type of Building Size Lot.... feet Dwelling—No. of Bedrooms._......... Z:....................Expansion.Attic Wo ) Garbage Grinder WO) Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other fixtures Design Flow.................................... z..gallons per person per day. Total daily flow............................. ......gallons. 41 ft 1:4 Septic Tank—Liquid capacity4�i:,20_gallons Length./a' 6 . Width�.��.-.e.'.. Diameter......... Depth.tZLE.... Disposal Trench—No. .................... Width.................... Total Length................_._. Total leaching area...................sq. ft. Seepage Pit No....:7&.,,c:>..... Diameter.....1-n.......... Depth below Total leaching area... .....sq. ft. Z Other Distribution box (k ) Dosing tank ( ) Percolation Test Results Performed .. �4 7...' ..... Date._. .............. 14 Test Pit No. I....�,q.......minutesperinch Depth of Test Pit._Z��-Y........ Depth to ground water....— - 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................__. Depth to ground water. F P4 .................................................................................................................................. 0 Description of Soil..C ....... .......................................................................... Wr!l 7. ......AL+-*N... U ......................................•...... E3......wil-sm.. W 3AII.- ............................................................................................................................................................................. No. Nature of Repairs or Alterations—Answer when applicable........................................................ q U YRT- .................................................................................................................................................................................. Agreement: r The undersigned agrees to install the aforedescribed Individual Sewage Disposal Systemin accordance 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 been iso d y th oard-6f h Ith, ..........................................................................................................--- Signed.. .................... . .............. ................. at4f ............ ............... .. Application Approved By...&I 14�1------- ........................................ Date Application Disapproved for the following re ....................................................................................................................................................................................................... <-- Date Permit NO.6.z- '�/' ............................................. Issued..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS OARD OF HE �T�' .........��Uj;.OF.....64M'-7.A.... 'te.Lc............... Traifirate of Tompliaurr THIS IS TO CERTIFY, That.the Individual Sewage Disposal System constructed /\') or Repaired e , _ by............................................................ ' Inta at............................. ......POND ................ s .............................................................. has been installed in accordance with the provisions of TITLE cc, of , ��,S to Sanitary Code as described in the application for Disposal Works Construction Permit No....9-0 4 ------ 4.1-2- dated..............I.................................. THE ISSUANCE OF)THIS CERTIFICATE SHALL NOT BE C07TRU AS A GUARANTEE THAT THE SYSTEM WILL 'U, RY. DATE.--'...... ............. Inspector....... ............................................. THE COMMONWEALTH OF MASSACHUSETTS BIDARD OWE �L' .... ......... A 19.............. ..................... ................................. ...4 NOE.?. Fay. ...... Disposal Vorks Tonstrurtion Permit ..Tb.... h .. ......... Permission Is herebygranted ... ..................................I.............................................4........................................... to Constr or R 0......W11 e an-Wividu S tsysl y em ..... ... ....... A at N . .... ..... . .... ............ ...... Street as shown on the application for Disposal Works Construction Permit No... ...... ated.e. ................ ................................. ....................................................... 1_/ Board of Health DATE........... .......................................... FORM 1255 A. M. SULKIN, INC.. BOSTON j j 4S /7 Gor L R9 � P' t..• �r '� t 22,-4.009 5R.- \= t ti . \ cP�jk%OF Af4 �? 5TEPHFN `Z � � •�� ALLYN h �' UJt_SO XT �91 I e a/9 et V • \ � 9 S'v I 5 i Nit,-E ��rtl t_Y ..'¢ pS� M �•��:�;��_.tom I�Id GAJz�GE Gi�11�1DeC-'jZ � , . • �� G✓efei�irvicG bAiLYKL WJ 110k 440......GjpD USI 1 sae 1 �. TA till Pt-5 P>0SAL T'IT ''ti U5e t.z 1000_.�"p4(,. "L�'74c.►1 PiT$ 51DEWALL.�_ -/76 ._.5, F. -6' x6'�!lit, W z.' u� t PoMMM #4iVA S F ?r h 0 -.. .�...7 q..!z.�? d. • TOTAL �5 _ io.¢t3.__ D, bed Es"F'OTAL t)W LY MdW= 44-c 61 RD, D a�c_:._..ro-is-88 Icst Topt TO/� OF foiiJ- SSOO 5^3b- 1.00 /Nv 29�— —Sq,I /000 _. tp1 ST _ Wit-, .I L+y 4S / t ' 4—Wr-7X 9E3.64. 48:89 b WI'TN INu, �Iw. TANK 77 � 01 y�1A6HL� 2 Z' ELB✓. q2��'O C '�� - - R-07 RAW � � L.OT 1 PaND._.STRESS I LE: No wOT�: rcol� �.tt _oyi_ Los 8 rl -G97/> ` Go r 3 0�-Gci7z). .�fiocv- v 9roondwohr.. _ c%✓ --35:3 J`�.C�.__.�95 f: PSe %� N W 1'T f 4 't-4 A E 5t D E f:-.I N E RGG ST Ez.EA �.,41.�b StJ�zvt aFZ� �A f lies•SET rzEQUtR�NIt=N'TS-<:)I=. THa OSTETV-vi .LIE:�.M�55, ley Towns OF b I S ova�-_ /4Pl�C.aG�►�'1"' ./Q, .� M. �wy� -- QD 1-oc-d-Teo WI-rw N -r HE! p"I tJ / '5{4byV N V SEATO E:5 S 13 1 S H L-c'T L-1 t%je'S, 84 3 17