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HomeMy WebLinkAbout0037 GOOSEBERRY LANE - Health 37 GOOSEBERRY LANE, MARSTONS MILLS A=102-196 J YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: _ Fill in please: p) APPLICANT'S YOUR NAME/S: J R BUSINESS YOUR HOME ADDRESS: S ,4 Q14g TELEPHONE # Home Telephone Number S—O - NAME OF CORPORATION: NAME OF NEW BUSINESS m c TYPE OF BUSINESS_ L l�dl 1� I Q y);1 IS THIS A HOME OCCUPATION. YES NO ADDRESS OF BUSINESS- _ ► P/PARCEL NUMBER-IQ ZL- jq 1,0.(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 COMMISSIONER'S OFFICE This individual has been.informed of any permit requirements that pertain to this type of business. Authorized Signature'r COMMENTS: 2. BOARD OF HEALTH This individual has bee�►� ied of the permit requirements that pertain to this type of business. MUST�,OMPLY WITH ALL L . T (�lf��V iA7ARbous MATERIALS REGULATInNq Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has f 4n inf0-a d f the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: rwve TOWN OF BARNSTABLE Date: $2103 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: C P ` ; BUSINESS LOCATION: 1" i VENTORY MAILING ADDRESS: 37 &oo��kq- TOTAL AMOUNT: TELEPHONE NUMBER: '77Y,)02 &?� CONTACT PERSON: Sos--qa&-�g EMERGENCY CONTACT TELEPHONE NUMBER: — �--jq,� MSDS ON SITE? TYPE OF BUSINESS: L,e,4e - comf-""52l 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 af4EW ❑ 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) ` 1 NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant' ignature Staff's Initials No. " ' Fee $ 50 l THE COMMONWEALTH OF M SACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZippYicatfon for Migogal *potem Construction Permit Application for a Permit to Construct( )Repair�X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.37 Gooseberry Lane Owner's Name,Address and Tel.No. klars,-Qng N11il1s,Mass. Charles Peters ssessors aOarce 37 Gooseberry Lane Marstons Mills Installer's Name,Address,and Tel.No. 7S�77 33 Designer's Name,Address and Tel.No. Jospeh P Macomber & on3Inc Joseph P Macomber & son Inc. Box 66 Centerville Ma 02632 Box 66 Centerville Ma 02632 Type of Building: Dwelling XXXNo.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 0 gallons per day. Calculated daily flow 3/1 1 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I n n n Type of S.A.S. 1000 p i t Description of Soil Loamy sand to medium sand Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon chambers to existing 1000 gallon tank,distribution box and 1 -1000 gallon precast leaching pit. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Co and not to place the system in operation until a Certifi- cate of Compliance has been issue by thisYo alth. Signed Date 915197 Application Approved bL Date '`�,'Z Application Disapproved for the following reasons Permit No. 50 Date Issued r` 51 Cf Fee $ y THE COMMONWEALTH OF MA SACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS a, Zipplication for Migoal *pgtem Construction Permit Application for a Permit to Construct( )Repair(XX)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.37 Gooseberry Lane Owner's Name,Address and Tel.No. Marstons Mills,Mass. Charles Peters Assessor'sMap/Parcel 37 Gooseberry Lane Marstons Mills Installer's Name,Address,and Tel.No. 7 7 5—3 3 3 8 Designer's Name,Address and Tel'No. Jospeh P Macomber & Son Inc J08�Qh P Macomber & son Inma Box 66 @enterville Ma 02632 Box 66 Centerville Ma 02632 Type of Building: Dwelling XXXNo.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flowi 060 gallons per day. CalculatTd daily flow 3/1 1 0 gallons. Plan Date t Number of sheets Revision Date Title r; Size of Septic Tank. 1000 Type of S.A.S. 1000 pit Description of Soil Loamy sand o medium sand Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon chambers to existing 1000 gallon tank,distribution box and 1 -1.000 gallon precast leaching pit. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described lon-site sewage disposal system ' in accordance with the provisions of Title 5 of the Environmental 7"11. and not to place the system in operation until a Certifi- cate of Compliance has been issu by this o rf ealth.Signed r" Date 9/5/90,,11 Application Approved b Date Application Disapproved for the`following reasons E Permit No. Date Issued �- 4t 0 THE COMMONWEALTH OF MASSACHUSETTS t BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired 1-X-7 Upgraded( ) Aband ed(( 1by, J.P.Macomber & son inc. at 3� Gbo eberry Lane arstons i s, as has been constructed in cordance with the provisions of Title 5 and the for Disposal System Construction Perm�t �*" G dated 4 7 . Installer J•P•Macomber & Son Inc. Designer t The issuance of this ermitc hal ql be construed as a guarantee that the system Will function designed. Date ' © � 7 Inspector --------------------------------------- No. ��io Fee $$at THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,, MASSACHUSETTS lwigpo!5ai *pgtent Construction Permit Permission is hereb granted to Construct( )Repair(XX)Upgrade( )Abandon( ) Systemlocatedat 5.J Gooseberry Lane Mars tons ills,Mass. and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constru ct=must be completed within three years of the date of this ermit. �Date: �� " Approved b r_ • .O i w CERTIFICA'1'l ONO r SKETCII AND A I'll LICATION FOR A DISK,.. WORKS CONSTRUCTION PL (NY11'HOUT DESIGNED _LANS) I joseph P.Macomber Jr. certily that the application for disposal works construction permit signed by me ;i:: 9/5/97ted _ , concerning the prjperty located at 37 Gooseberry Lane Marstons Mills meets all of the following criteria: • There are no wetlands within 300 fc.t of the proposed septic system J. There are no priv;.!te \vdis %vitlii" 151 t'vct of the proposed septic system �• The observed groundwater table a t ltct or greater below thu bottom of the leaching facility • There is no increase in Ilow and/oi change in use proposed There are no variances requested or needed. SIGNED : / DATE: 9/5/97 LICEN D SEPTIC SYSTEM !NSTALLER IN THE TOWN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed s;>:em. Also if the licensed installer posesses a certified plot plan, this plan should be sub:niticd). r � . �. 0° � O -- i TOWN OF BARNSTABLE LOCATION 3 76 OOSP����'y �4He SEWAGE# - �d VILLAGE/t''1 � SONS AA LL-1 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ✓. /p�� A f 6P SOA/ SEPTIC TANK CAPACITY Da - LEACHING FACILITY: (type) Row CAA-4 size) SOD. G NO.OF BEDROOMS 3 BjJII,DER OR OWNER PERMIT DATE: `I - / COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by e h ox LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S "A ME & ADDRESS B U ILDE R OR OWNER DA T E P ERMIT ISSU Ep _ DATE COMPLIANCE ISSUED �, � O TOWN OF BARNSTABLE LOCATION 3 76 ®osed me L SEWAGE # / �d VILLAGE 0 A 1? S 0 --5 M d Zf ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ✓. /< A4 A C eM fief* 50,41 SEPTIC TANK CAPACITY O 00 LEACHING FACILITY: (type) AY6&J C&441f!Q5(size) ®®^ NO.OF BEDROOMS 3 BUILDER OR OWNER C" PERMIT DATE: 7 A- 1 7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by IN i J