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Home My WebLink About0004 WIANNO AVENUE - Health 4 Wianno Avenue, ®sterville a r 0 p _ 8 I� 1 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 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. t DATE: /'f io Fill in please: APPLICANT'S YOUR NAME/S: El fi_ .ba tl,. c C-A4LT i4 R6672_. AIA 6Z63a x ,k BUSINESS YOUR HOME ADDRESS: I(/ S+vne A. r- r. at. Sop 31-A ;L7;.3 , TELEPHONE # Home Telephone Number 6'D r 5 G /4&Z NAME OF CORPORATION: Kinlin Grover Realty Grouip LLC NAME OF NEW BUSINESS_ Kinlin Grover 2-41- ,Esr742:j� TYPE OF BUSINESS Real Estate IS THIS A HOME OCCUPATION? YES NO X ADDRESS OF BUSINESS 4 Wianno Avenue, osterville MA MAP/PARCEL NUMBER - 0 d (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 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 CO SSIO ER'S OFFICE This individ a! h s n ttf e o any ermit requirements that pertain to this type of business. Aut rized Sign re* -COMMENTS: ✓�Qp �t fcmi� � o yt ca Q 2. BOARD OF HEALTH This individual has been ' or f the permit requirements that pertain to this type of business. 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: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 1��3� ohs ��2y-y° Mail To: BUSINESS LOCATION: l/- c, /✓-} ,JrJ6 4'-' (DST ILc,� Board of Health ` Town of Barnstable MAILING ADDRESS: P.O. Box 534 . TELEPHONE NUMBER: ya- — Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: 75-7 y Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NOS_ This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils- - Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business LO AT ION SEWAGE PERMIT NO. V1- LAGE ^ INSTA LLE 'S NA E d A D 0 R F S S �-� OR OWNER DATE PERMIT I.SSQEQ F `3 QAT E COMPLI.ANCE ISSUEQ '� �j-•- � 3 I t � - PJA r a No.�-_-2S,0, FimicA...................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............................_.... ---...-.OF...........-...-.......-...-_--........--,-----------------...._..-...-...-..-...-------•- Appliratiun for Disposal Workii Tonstrurtiun trrutit Appli tion is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal !� -. Q ................•----------•------•----.... •--.........---....---.......-..------•-- -. ocation•Address or Lot No. •-•-•-••---•-------••--•-.._.._--•-••-•----••. •......-••-••---._..._•-- •••--•.............•---------------•-......... Owner Address W Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms_________________________________________Expansion Attic ( ) Garbage Grinder ( ) U pa, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .................................. - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity___.........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 ( ) Percolation Test Results Performed by--------------------............-......................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-----------------_...... fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --•--•--••-------------------•------•.____.••-•---•-••-----•••_..-•-•---------••-•---------------- --------------------------------------------------------- 0 Description of Soil............................................................................................. ----------•--•••-••--•-••-•---••-••••--------------•--•---••----•----••--- x U •-••-__.______•--•---._...-••••________________________••--••••-•-•••.._._.._.....---•-••-•-•••..___________---••--________-•-••----•-••-•-___.____-__--•--______-___-•-•-•-•-•-••-----•-•-.._..--•--••- w ..............................................=.................................................... --- • ' 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 iITI.L 5 of the State nitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance _ beeenn issued 'byytthe board of h lth. Da Application Approved By_______ _______ ______ Date Application Disapproved f o the ollowing reasons:-•••-•-••---------------•--•••-•-•-•-••-•-•---•-----•------•---••••-•----•••-••-•--._...--•••-••-_......._--•--- ------...-•---•-'•.............••••----------------•---------•--•---•--•----•---•--•--........--------•...I..••-••--------------------------•-••--••------------------------------------•-•-•--•------•--- Date PermitNo......................................................... Issued....................................................... Date Fimis.............................. THE. COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF Appfiration for Disposal Works Tonstrurtion "truth Application is hereby made fora Permit to Construct or Repair an Individual Sewage Disposal 5y§tem.a,eut ............. . ................... .................................................................................................. location-Address or Lot No. location,, ................................... 0 0 ----------7--------------------------------- ......... ........--------------------- wner Address ... . .................... .. .............................................. .................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons.....................__..._. Showers Cafeteria Other fixtures .................................................. ---------------------------*---------------*--------------------------------*----------------------- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid*capacity............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. f t. 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_.__.................... P4 --------------------------------------------------**-------------**............"----------------"---------------*......""-------------"---------- 0 Description of Soil...........................................................................................................I............................................................. x ......................................................................................................................................................................................................... U W .1------------------------------------------------------------------------------------------------------------- 0 ...... �4 �_4--- n... -?� -- ---------- Nature of Repairs or Alterations—Answer when applicab U le.... ...... ......................................................................................................................................... -----------------------------.-------.----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITILj 5 of the State "itar Code— The undersigned further agrees not to place the system in operation until a Certificate of Corrtplianc�ShaS ben issued by the board o?fe 11th. Sned- --- - - ---- I--------7-44 ce ......1Z----------------------- a;.- � ............. A plication Approved By....... ......... ............................................................................. p .....................7................... Date Application Disapproved fo 11 he Rowing reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (9rdifiratr of Tompliaurr T IFY, That the Individual Sewage Disposal System constructed' or Repaired by------- ............................................................................................................................................................. Installer at......... ......2 ...... . ............................................... ----------------"--------------------------*------------�j.)�4es, 'e4 in the has been installed in accordance with the provisions of TI E 5 of ;rhL-S-tate Sanitary .* 2, Z 3........... application for Disposal Works Construction Permit No bbr..................... date........... ............. THE.ISSU kNCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE A GUARANTEE THAT THE SrF Cc SYSTEM YWV)) FV TION SATISFACTORY. ...... .... ................ Inspector...-:- ..... ..................................................................... DATE....... ........ .. .. .................................................... THE COMMONWEALTH OF MASS I ACHUSETTS BOARD OF HEALTH No.__ ....................OF..................................................................................... ...................................... FEE....1................... • ks Permission is hereby granted . . ....................................-----------------*............. ................. to Construct jo;Roer�air v.�'an Individual Sewage Disposal System at No................... Street as shown on the application for Disposal Works Construction Permit No................ eff<K�.� tZ .......................................... ...................................... DATE-------------------------....................................................... Board He alth FlIR14 1255 HOBBS a WARREN, INC_ PUBLISHERS 4-A,LFx5u 5 vj/ Aw LAkAil i e ; GA�-- / 7 i h f l 6 VA S t I ' scat l l ►..0 3 i f ` • II - � ►�.,�/, / oo Gad. 1 N �u �C � ' ,; �, , r � , r t � F 1 r • r i j . TOWN OF BARNSTABLE COMPLJANCE: CLASS: 1.Marine,Gas Stations,Repair + 2•Printers Q satisfactory BOARD OF HEALTH 3.Auto Body Shops �yy unsatisfactory- 4.Manufacturers COMPANY. G , O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS i Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks UndergrouridTank4�1 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 44:0e1J;k1y are Miscellaneous: 4�y'w DISPOS=ECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply 1: G; , t _ O Town Sewer JVPublic t` ---� XOn-site-11.4'6'4-<`.1�7 OPrivate 3. Indoor Floor Drains YES NO �. O Holding tank: MDC Catch basin/Dry well - O On-site system rAl —72- 0 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank: MDC IfA 41 c ¢?G f' A4 Catch basin/Dry well O On-site system ` 5.Waste Transporter Name of Hauler Destination Waste Product �yt YES NO 2. erson (s) Interviewed Insp ctor Date �4, N� /.....,... a Fps.. .-_Q...®. THE C MMONWEA H10FASSACHUSETTS BOARD OF HEALTH Appliration for Ua ipati al Works Totutrurtion Urrmit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal stem at: - ... � .......Zr .................... ' ......... ............................................................ coon-Address or Lot No. .............................. .................................... ....................................................... Owner Address a .... � �t------------------------------------ ------ ....................................................... M Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms........:...................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of BuildingNo. of persons............................ Showers — Cafeteria a' Other fixtures .................................. d ------------ 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........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water----_---_____-__--__-_-. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-••...•-•-•••••••------------------------------------------------------------------------•------•--........................................................ 0 Descri tion of Soil................••••......••• -•.••-• ......-•--•-.• . 0-`?55 t.... .t om..---------cr&---q---4_49. ----------------------------------------------------- w �----- U Na of Repairs or Alterations—Answer when applicable- - - � a� ................................® Lr�� ' A ------------------------------------------------------------ - 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 issued.by the boar of health. r D e Application Approved By--••----•-••... ` -- •-s... . ...••...................... .........•--•�� . ....... Dat Application Disapproved for the following reasons:.............................................................................................................. .................•------••---•••••-•-••-... ...:.....••........--•••••......_..........-•-•-•---•-••--••••-••••-••-•--••••••••••-•---•••-•--•-•--•-•••••...--•-•--•--•----------------------...._.._. Date ---,-.• Permit No w,!<_..--.... ............... Issued.-------•--•----•-..................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH O F ,,:�' Tatifiratr of TompliFanrm , THIS t=RT1Y, That,the Individual Sewage Disposal System constructed ( ) or Repairedby-----------� <' _-------------------------------------------------•.._........-----------------------------.........: �yJ r Installer at. .. .�!!�, f. &e —5---------- . has been installed in accordance with the provisions of TITLE j 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 AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... No` �. ................... THE COMMONWEALTH OF MASSACHUSETTS BOA OF H TI-I rL�4! '�.....- ....OF..:................: ..... ... Appliration for Disposal Works Tonitrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( Individual Sewage Disposal System at ....._.. ._ : . .. ...::: .. .................... ............................................................ n-Address or Lot No. �! + ..........,��"r?!1 _•=-............................. .................................. --- -•--•---------------------..-.-.-._----•- wner Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of'Building Buildin ._... No. of persons....................... Showers 1� YP g ----------------------- P ----- ( ) — Cafeteria ( ) Otherfixtures ---- .............................................................. 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.......................... f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth.to ground water................._...... 9 -•-•--•-•-••--------•--••-••-•-•--•••••---•--•••--••-•-----••••--------------------•••-•....._------...._..........••-------•••--....-• -------• ------. ODescription of Soil............................................................................................................................................-----...................... UW •----------------••-----••-•--------...•-•---------------------------------.. ^........•--••-•••-- ----• •.119 -- -- Na r of Repairs or Alterations—Answer when applicable uG `""" Agreement: a The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLi: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued y the board f health. ..................I... ....)..�t ...Afz te ate Application Approved B PP PP Y = = ------------------------------ ........................................ Date Application Disapproved for the following reasons:--•---••••--•••-•-••-=-•••-•-•-----•---••••--•-•••--•-•••-••--•------------•--••-•........................... f ...........................•-•---•-•-•....•--•-••---- -.----•---•-•--•----••------•- -------------•---....__.._.....--------------------•---------------•---•---._...------•-"Date--•-------.._. PermitNo. r!-.._____. ............... Issued................=...................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA T .........oF.:..:... ............ :........................ (9rdifirate of fT mpliFanrr THIS IS jAMTIEW That,the Individual Sewage Disposal System constructed ( ) or Repaired ( � by........... - .....................•----•-••-•--- ------• ..0...... .................................................... f Installer r at.......f '' . -- ----• = ... ----•--••----- •. .............-• ...... --•------••---•••.................•----•••--••---- has been installed in accordance with the provisions of TITLE; 5 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 CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARDF HEALTH ......... ...fT'L.. .......OF...... ....... FEE No. 7 c.� ...-._..... ......... ......... Disposal IVr ftliaotrmflon frrmit Permission is hereby granted .... to Construct ( ) or Re air ( �an Individual Sewage Disposal Syst , at No. .«,,... t'' ,'. -------SQ as shown on the application for Disposal Works Construction. Permit No------- ------------- Dated......................................... ' ................................................. "Board of Health DATE................................... ----�- ---�-•---..._..... FORM 1255 H0,B8S 3a WARREN. INC.. PUBLISHERS ,r i f f �� '\ �� 7/ �� \�/N O \ �� ` 3< � � � � �� } � �� j� ,� „ . , , r e c..t�a 11� ��— - y i ii