HomeMy WebLinkAbout0158 LAKESIDE DRIVE - Health 158 Lakeside Drive
Marstons Mills
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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: — b Fill in please:
1 x APPLICANT'S YOUR NAME/S:
' BUSINESS YOUR HOME ADDRESS: ► C
TELEPHONE # Home Telephone Number -
.... . -
'NAME-.OF CORPORATION:
�J NAME OF NEW BUSINESS .r, e� C� TYPE OF BUSINESS u 0
ISTHIS A HOME,OCCUPATION? YES NO
AODRESS OF BUSINESS \54S ; Yhf-IA i0S MAP/PARCEL NUMBER - (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 44 '
ER'S FI
This individerH- r an r it a uireme' is that pertain to this type of business.
rized SigDzaeur
COMMENTS:
2. BOARD OF HEALTH
This individual has been informed of the permit requirements that pertain to this type of hi isinnss.
Au orize Si nature
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: tp8'V Ndli AON
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heriy certify.
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s. Gen:eraL Iaws 40 Yf1�t t, `' - 40
PLEASE TE: The structures:ac shown on thin Iot Ian ' �—
dctcrminatiE4p.of.lhe buildin FiI No .ohs 7
P .. P are approximate onl}: An actual curve
used for recordingg hon and encroachments, if any exist. either .way across propet4p Lines. This 1
purposes o for use in y is n essary for a precise
purposes. This.plan.must not be uscd'.to locape prop��deed deVerification
or lot configuration can only b p and' must not be used for variance oranbuil8st nnot be
shown hereon. please oteethat thptii isedNOTan accurate instru building iocations, property Line dimensions.,ffencan
A BOUNDARY SU curve which may reflect different inforr4�ation h
1'. aind is -FOR.'MORTGAGE PURPOSES ONLY".t an What
C�LQNIAL LANs �t � tr� T, T� ,�� .r . _
OWN OF BARNSTABLE
��PS: v� —
j LOCATION /S (Q`' SEWAGE # �� o
VILLAGE_ ASSESSOR'S MAP & LOTI��
INSTALLER'S NAME & PHONE NO. e1q1;'25 lPx 0 SEPTIC TANK TANK CAPACITY /,-,X7C7 c)P/ m,
LEACHING FACILITY:(type)
NO. OF BEDROOMS PRIVATE WELL R�PUBLIICATER _
BUILDER OR OWNERw
DATE PERMIT ISSUED: 3 < 3
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No. cI
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No......1.31_h ,� Frrs.... ... -.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH nn
13
TOWN OF BARNSTABLE A' 102_-�J
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AVVHrat 4? for Diripoottl Vork.6 Tonotrnrtion ramit
Application is hereby made for a Permit to Construct ( ) orRepair (' an Individual Sewage Disposal
System at:
Or
........................ ..--..... --- ..fix -----------
Location-Address r Lot No.
� � - ------------- - a� --------------.......-----......-••-----.................fir= -----
Owner A ress
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling— No. of Bedrooms._:___________________..._.__......_Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ------- ---------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
a' Other fixtures
W Design Flow..._..._.___'���.. ................gallons per person per day. Total daily flow..... , ...................gallons.
1:4 Septic Tank 4I_iquid capacit.1-0 flons Length---.- .. Width.----- Diameter................ Depth................
Disposal Trench—No. .................... Widt ...._............... Total Length.................... Total leaching area....................sq. ft.
�.......... ,/O....... Depth below inlet_._...�a.._._.... Total leaching area..................sq. ft.
Seepage Pit No..._:... . Diameter.___ �
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.---•------P----------------------------------•---------------- ------ ground water
• Test Pit No. 1.............. minutes per inch Depth of Test Pit-------------------- Depth to round water...._.._................
Pro Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Pr ---------------------------------------------------------------••----------------•--•........................................................................
C) Description of Soil......................................... -•---------------------------------------...---------------...--------------------------....•..----............_.........••---
W --•------------------- ------------------------------------------------------------------------•---------------------•------...-----------•---•...-------•--------.............._............----..----
U Nature of Repairs or Alterations—Answer w en applicable.--' .d..l� �..__�__(�C{;1 - �I_�.. ...........
(�
�- �.�4_ .........� 7..••---•----••----••-----------------------------------------------..............................................
Agreement:
The undersigned agrees to install the aforedescribed Individual.Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned f rther agrees not to place the
system in operation until a Certificate of Cotia-noe- ued t e o heals
.
Signe .....A��
............... ................. ......... .. ...._.. . .._.... .. - --
......� Date
Application Approved By ---------- ------- ----------------------------------------------------- --------
Dare '
Application Disapproved for the following reason... ............... ... ...............................................................................................
........ ............ ......................pp.................. ..................... ..... . .............. . .- . .................... ........................... ........................................Date Permit No. ...../-...3......�0.`J------------------------ Issued ..... .... .....................................................
Dare
No..... ./ba Fas ...�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
4
�.: _5 3 TOWN OF BARNSTABLE 4-) 2-I
Appliration for Di;ipwial Works ( owitrnrtiun Permit
Application is hereby made for a Permit to Col'istruct ( ) or Repair ( an Individual Sewage Disposal
System at:
............... .........................
------.................................. --•---...•••••---•-••-•--•-•-•---•-•----------•........_...........------............----------...
Location-Address or Lot No.
owner -� Add-ress r
a ••••......••••.. ::
Installer Address
go
VType of Building Size Lot............................Sq. feet
�.� Dwelling—No. of Bedrooms........ .............................._._EXpansion Attic ( ) Garbage Grinder ( )
a Other—Type of Building ............................ No. of persons-------------------------- Showers ( ) — Cafeteria ( )
Other fixtures..... -----
W Design Flow........... ................gallons per person per day. Total daily flow.......... ....................gallons.
Septic Tank Liquid capacity/ gallons Length._-__ ._.._ Width_:5.7 ..... Diameter................ Depth................
0-11
W Disposal Trench-- No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------/.......... Diameter...., 0------- Depth below inlet..... .... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No.. I................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.___ rt"t .:.. .; __ti_..._.e..Z-n ,._c-"- ?'�-.).._(.:............
t/ t C"[TZ .................
--...._....--------.....__.........---•--•--..........__........_...................---•.------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has.been issued by the board;of health>
Signed"`.. ,...... v..... ..py,e' �c.._�
Application Approved By .............� - .. ..... ) y Dmte
...... .-...........
Application Disapproved for the following rearonf: .................................................................................... .............................................
....... ............................................................................................................................ .... ..................................................... .. .....................I..................
Dare
Permit No. .....g... .......L/C..`......................... Issued ......................................................... ate......
Dace
-- .—--_— .—_....,-._ —
—..... — ,.—_ — ---_ ————— —.--._-----.-._—_-------I
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
CZ.er#ifirate of Tomplianre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by . ..................................... - `� ... W+ .... '-s°.. .ti_t_.............. - ...........__
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. .......7,3.-_- .....-....... dated ..........................................._.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE .........- �.51.. ................_-------_..........._ Inspector ,._.�.....
---------- 1* ---- --------- ---------------------
THE`,` OMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
V0 TOWN OF BARNSTABLE
Disposal Workv Tvniitrnrtilan Permit
Permissionis hereby granted-----------_C- 0 ...................................- ` 4 �/C_ ........................=................................�
to Construct ( ) or Repair ( (_),..an Individual Sewage Disposal System
atNo. ---••-----• o ..................................
as shown on the application for Disposal Works Construction Permit No. ........Q�__ Dated.......,5e_-.y .......
................................... -�--------------------------------------------•--•--
1/DATE---------------- -- •-�-'- Board of Health
FORM 36508 H0813S 11 WARREN,INC..PUBLISHERS
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