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Home My WebLink About3675 FALMOUTH ROAD/RTE 28 - Health f 3675 FALMOUTH ROAD MARSTONS MILLS A=058-018 I LO CAT ION/F 'r6LA04 P9AqEWA G E PERMIT NO. VILLAGE ��G S INSITA LLER'S NAME ADDRESS 1�&-d-1 roe—S7 7f- S U I L D E R OR OWN ER DATE PERMIT ISSUED ZZ / ill DATE COMPLIANCE ISSUED O 1 1 = °s-?-o� No .:..�J. �Fis............... ......_ THE COMMONWEALTH OF MASSACHUSETTS �- BOA OF HEALTH � �(� 0Sou/.N...............oF....l .�91!� �`%/✓./ .....----------.................. Alipliratiou for Disposal Works Tnnstruriiun Vantit - Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at, -46- ;................ f- ------------------------------ n-Address — o t No....... ^........ _G. ! .�..._^• ' ` `�1 ' !L! 5 -------•- -------------— :. ...!1-`�1 Ad rfss W .......... . ---. � l....... ............. ...................................... In'stalle4 Address / Type of Building Size Lot__�!�_!ZS---Sq. feet Dwelling—No. of Bedrooms........... ............................Expansion Attic ( ) Garbage Grinder (Aj)D `4 Other—T e of Building No. of persons............................ Showers — Cafeteria 0.' Other fixtures ......................... ................................................................................................ -----•-. - ... W Design Flow........MO..X-3................gallons per person per day. Total daily flow__._..��.........._.._.-..........gallons. WSeptic Tank—Liquid capacity.AM.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.Z5 ..........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ►-a Percolation Test Results Performed by-----------------------------------------------------••---•-------------- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.......................... Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------------------------------------------------•-•--.........._......._...--•........................................................ 0 Description of Soil........................................................................................................................................................................ x U --- •-------------------------- ••--•-------------- ....._..--------------------------- ••--••-------------- ----------------------------------------------------- -------------- .------- •--------•----------- W ----•----------------•-------•-•-•-----•--------•-••----------------•-------------------------------•-----------•--••••-...---...-------•------••---•------•--------•--•---------•---------------------- UNature of Repairs or Alterations—Answer when applicable................................................................................................ --------•-------------------•---------------------------•--•--------•---------••--•-•......._..----•-------------------•-------•---------•-----------•--••--•----••-•-•-----•---------•-........••-•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a C -tificate of omplia_e has been ' ed by d of health. �i ned........... .?;AK..4 •. ................. ...... at Application Approved By..................• ....................••------------•---•--.......... ! tea--------- Application to Application Disapproved for the following reasons:------•------------------------------------------------•-----•----------------------------------•---....---•--•. .....................•-•-------------•••-•-•.........•-------------------.....------•-----------......------------------•---•--•------------•----•----------•------•-••--•----•••-•--------------•...... Date PermitNo.---- -------------------- Issued..---•-•--•------------------------------- ----------- Date THE COMMONWEALTH OF MASSACHUSETTS .—•— BOAS.®E HEALTH Pt ,f/rr.............OF...r°r�,?'�.<.... ll�a oy,G/G .................................. Appliration for 14opos al Works Tanstruriion rumit Application is hereby made for a Permit to Construct (11<0r Repair ( ) an Individual Sewage Disposal System at, .._� WrJot No. -•. ......... = .................... �...... 7f S % Addgess J —,5 nstalle Address ,t` . Type of Building Size Lot./#_!r_ :E....Sq. feet V Dwelling—No. of Bedrooms.......... .Expansion Attic ( ) Garbage Grinder (/vb Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 0.1 Other fixtures ........................................••..•--• . Design Flow..•....f11.__ ,. `.................gallons per person per day. Total daily flow-__-.-!Z'O--......................•....gallons. W 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_ ...5�.'.........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by--•-•-----•--•-••---•.............•-•-••-•••-••-•-•.....-••••-......••-• Date........................................ W Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 1� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•••••••-•••--------•--•---••-•••-•............••••--•---•--•••••••........---•-•--•......-----•...................•-•-...-••••-•--....--•-..........-•------ 0 Description of Soil........................................................................................................................................................................ x V 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 TIT IS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of omplia has be`is ed by-,the-•lioa d of health. •..... / signed ....._�_ ! _ ."."` ... +?.T--r�.�.__ .4= ............... { . -"� - ate Application Approved•By•••-..... . .:. . .. Application Disapproved for the following reasons:............................................-•••••••-•----•-•--•••••----•••-•••••-••-•-•-•..................... ,TR., _ Date Permit No...... �` r _ Issued- Date • THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH -�� d /f .......- A;...i(/ill..........OF.............. ....4> r P ....................................... Tn#ifiratr of Toutph atta THIS IS TQ CE�zTIFY,Ott t the Individual Sewage Disposal System constructed )�or Repaired ( ) by- - .. '- AL't.. .- ..........a � staller has been installed in accordance wiih the provisions of TITLE of The1�. te SanitaryCode as described in the application for Disposal Works Construction Permit No-____-_¢ _7 ....:w. �"...... dated .. /r/P:'� -• ......-••-•-•-•-•------•-- ' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE COfASTRUED.,AS TIARA TEE THAT THE S`Yt TENT WILL F NCTION SATISFACTORY. d D, E.... .............. •- ... .......... ................................ Inspector......... • ....... ... r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH r_7 11.d...................OF. � �V✓Vj ;46 ' .................. .... ..................................................... T .. No..` `...........::�O FEE.� ............ Disposal Vq ks Tono#rnrtion rrmit jw. . Perm>.ss>.bn,>.s hereby granted....____i_._._ �_____________________________.._.____....._... to Construct )-or Repair ( ) an Individual Sewage Disposal System at No..-•...._.fit!: . ! -------�.�_. � g fL�'..............._ Street --`�-. - - �yV/r as shown on the application for Disposal Works Construction P_e.�t,t No.?�.�"_::�. Dated_.__._=_ _;!_.::'__________________ . E� (• (�! �S Board of Health DATE - ' / 9?1� FORM 1255 A. M. SULKIN, INC., BOSTON """'^ t M Fq 103. l(7z 3. v I r rN. r14 r0L•2. /oz•z J 1023 O �5 � � s �i�•3 Pia' I - ol r af P/z0?- . T+4 Nip f9.3 N (v LcriAc- 1g I 1o3 1 /6 'C.APETER RICHARD . Q d r: A o SULLIVAN - BAXTER " v,l I Na 240*3 Nc. 29i33 ?a� ,�� ti'°��F Vic, `t• as i 7 o�,y f CE2T/,cy TNAT Tf1� ~ '�+�..�.� , r!.+� �0C+4T/O.t/ . S-/OW/v 1-1E,eEO,I/Co11-IO.G YS W122y SCA L G- ; 5.._ 7"lr,14C-S/OE.c/it/E A//,,:::'SE TBA Ck iC EQU/.2E�'!E�/T.5 of 7,,41 71 I .4 a CA T6.C> Wi7-IIII i LL, t :f ,&4X7;�- eE IV2�5)7" B•QSE"O d11 A,,V i2E"G/sTE.2E1� l �O SU.eYEYat�� /NST,2U/�/.�it/T SU.eYE}i Th/,C D�,<SETS Sya1,�/y S,�vL1� .t/o7- B,/-- +...,., A�i�� S/N6L:E FAc y/L.Y -- 3 BEO,eooM /VO GAo2B•44SE G•e/.UOE.2 0�4/LY FLOW = //D X 3 t 330 G.P.O. O/.r�S,4L O/T•—USE /,400 6'.d1. . �E�+ �'�.�^1J c.^� ..��f/,� �-:F"� r4)E"� ToT.4L_ OL/LrFLo►-r/= .3.306•Po. OE.S/G•c/ 1-E•eGOL4T/O,V.2412E / /.t/2•y/�t/ G�[�LE rG' Jr, A�'/�.� 1. A. L� .innTCR t: No.M48 ' i r tin ti Tff1"/.�a�•E � / �j¢.rcQE9�� /,000 •.,. 4493 ` /,aoo BoX /.v✓. GAL. f��o { �a�a Pir 99Xw- .7 /c�.3 SEPr�G W-/ '.may• P T�o.�rc 7b/%a " I if � .5+ ., 99 4 /ob G EST/i/EL7 �L l�T'" ®L.Cr✓ 93• / LEeri�y TN.4TTf►'E �v>��,-�% SNovc�.v ,yE,c'EO.v GGLti1PLY.f W/T//Ti'/E S/1JEL✓�t/E B.4XTF,2 �NJ�E /.vL. AAvO.rc—ng 44 ,eE4v/�EMENr.S o� Tiy� ,eE6✓srE,�O.«o.Slie✓Ey�S /S NOT L OG.QTEO {�1//Ti5///✓ E . L y� . . i p ' TWA�L..ev /s .VoT a.4rEv oov,a,v / ,rz- . shbWv yE•2Ea�✓,S, A9,6 v sEv To E.fTW�L/S.S/ LoT' L�i✓F,S TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: A - Board of Health MAILING ADDRESS: e4 Town of Barnstable TELEPHONE NUMBER:_ ,r� ` 2 f% P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 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 NO 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 characteristics and must be registered when stored i Please put a check beside each product that you store: 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 i +i TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY 1A.vdYX �� W '3--r (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATE R `� fCase lots Drums Above Tanks Underground Tanks IN OUTI IN OUT IN OUT #&gallons Age Test Fuels: f Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: � waste xAotwvR*KC) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: OW 'fif oot kj DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer )Public fon-site OPrivate 3. Indoor Floor Drains YES V NO O Holding tank:MDC 0" ,$latch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0—LZ ORDERS: 0 Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 2. Person (s) In ewed Inspector Date r