HomeMy WebLinkAbout0095 ROSELAND TERRACE - Health I 95 ROSELAND TERRACE, MARSTONS MILLS _�
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YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$40.00 for 4 yearsl. 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:O Z6 l2 Fill in please:
y" APPLICANT'S YOUR NAME/S: Q�l✓ 7iJ �'�
BUSINESS YOUR HOME ADDRESS: cicr ff
JO-d 5673i 7:?
TELEPHONE # Hbme Telephone Numbers 7
NAME OF CORPORATION: Crr SS I-- l o
NAME OF NEW BUSINESS Ei) FR-24-0 Go eei✓.'r TYPE OF BUSINESS cPx/F7��
IS THIS A HOME OCCUPATION? NO
ADDRESS OF BUSINESS c '�EAzl ' ✓V azG'-(.P MAP/PARCEL NUMBER 10 (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 BOO 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 ISSIO R'S OF E MUST COMPLY WITH HOME OCCUPATION
.�
This individ I e infer eo an er it re uire nts that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO
* COMPLY MAY RESULT IN FINES.
ize n tm
OMMEN
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2. BOARD OF 11TALTH
This individual hasbeen infer t e per it re u' ements that pertain.to this type of business.
Authorized SX nature** MUST r:OMPlIo COMMENTS: ATERIALwR ITHALL T"
ErZTi0N....
i 3. CONSUMER AFFAIRS(LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
LOCUTION SEWi!iC,E PERMIT MO.
-4*v
VILLAGE
IW571%LLER5 U&ME ADDRESS
BUILDER 'S W [ MF- �- ADDRESS
- — — — —Z�T 1 y 1L j ohs �1�NJ — _ —
DN-TE PERMIT 15SUED 75- - - -
D ATE COMPLI &MCE ISSUED ;
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
./...�..�..�--------------OF....[�.��4I^ 3.,�.�.................
...
Appliratinn -for Biapofiai Workii Towitrurtion Pprutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: _
G�1 J21 G ...................
w-.---------------- n5% i/�d -�` 1j1LJ_5� �.........................
4�-'-- -Z.7r......_ 3 :d.a.r ��✓ ................ .K-_ J �------G.CI�I%_`-_or_ //V•G �4•-_-•-..................
O ne.r o. Ad es
Installer Address
d Type of Building Size Loti � q.___ _ ___ ___ S feet
U Dwelling—No. of Bedrooms----_--,_a-____•-----------------------Expansion Attic ova—S arbage Grinder (A10
per, Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fi. tur
w Design Flow____________ ___ _______________ ___ -------------------
aons per person per day. Total daily flow...............--.--gallons.
WSeptic Tarrk/-Liquid capaci---/ allons Length. Width _... Diameter Depth----------------
Disposal x Disposal Trench—No_ ____________________ Widtl ____.________ _ - _ t L h_-- _ ____. Total leaching area------------.-------sq. ft.
Seepage Pit No..--_�----..------ Diameter. .__ e� w t ef`��-f- Total leaching area.. sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by------- -------------------•-•--•--•---•------•-•----•••......•-•...••••• Date---------------------------------------
Test Pit No. 1................minutes per inch Depth of "Pest Pit-.-_____--__.._-__-- Depth to ground water-..-----.----.---.-----.
4q Test Pit No. 2________________minutes per inch Depth of Test Pit-------------------- Dep.....................................................water
I.
O. Description of Soil--- --- .....�•• ---------•- - � ....
-
x f
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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has Deep issued by the
/boar ealth.
all
A Date
Application Approved By----------- --."4.-• ---------------•
Date
Application Disapproved for the following reasons____________________________
----------------•--------••--••-•---•--•-----•----- ------------
--------------------------------------------------------------------------•-••---•-••...------••-•---•---I-----------------------------------------------------------------------------------------------
7 Date
Permit No.......................................................... Issued.---- �---6\1 l/''............
Date
No.. f ---=--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
/. _w.../v.. ..........OF....l /5 2 eV.ST�'9-- .......................
Appliration -for Diopooal Works Tutu# rurtioo Puntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: _ _
..�-�±.tiD...._/. /?l2 `" M�'�S%D -s--••-- L ......'•----LOB �
.......................17 )-�-C-a..__,4VA✓✓G,v "' j— lJl��iV li'7��G-
W //v L�`�eL /�d9 ,7 C"
• /t�e J'/
Installer Address O73fJ .
d Type of Building Size Lot��....................Sq. feet
U Dwelling—No. of Bedrooms----------aG_.---..-•--___---------------Expansion Attic (Y415 Garbage Grinder ('''/p
aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Otherturs
---------------------------------------------------------------------------------------------------------
W
Design Flow_ ___________ _ ______________ 111ons per person per day. Total daily flow________.__________-__--____-__-__----------gallons.
WSeptic Tclnk Liquid capacity ..._.___gallons Length---------------- Width................ lliameter___._.......____ Depth._...._--.._..
x Disposal Trench—No- -------------------- VVidtl ___.•--_-__-. PepD-'thq,,
L h._�_ .._._ • Total leaching area--------------------sq. ft.
Seepage Pit No-----/............. Diameter. �--fwin et'^0 ...... Total leaching area------------------sq. ft.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by-------------------- ..........................-•----•-------•--•-•'--•-- Date--------------------------------------- i
W
Test Pit No. 1----------------minutes per inch Depth of Test Pit-.-_____.-__---••-_. Depth to ground water........................
f� Test Pit No. 2_______________•minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------
D Description of Soil---- --- 0--- y...-•------ � h f G
x
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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has issued by the boar of ealth.
igne �M / ........................................ �f ----�----��
Date
Application Approved By--- ------ -- ---•------ ----- 1 ........: --7).......
Date
Application Disapproved for the following reasons:...........................
......................•---..._....................... .--•---------.
..--•-----------------------------•---------------------------•-------------••-------•--•'-•--•-----•-'••-••------------•------••-•-••-----------'-•----•--••--•------------•----•----•--•--••--•-------
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
f''- 4 1..............OF....... ................................................
(Ierfifirate of Tomplittttre
T IS I TO C TI That the Individual Sewage Disposal System constrix
epaired ( )
by -•-- .....-- r � -----------------------------
Iat.'-• - -- �-• -•----ld.��,./.
has been installed in accordance with the provisions of Article XI of The State Sanitary Co e as described in the
application for Disposal Works Construction Permit No.`....... ................. dated_._._. - !/_-n-zs .........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. L
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DATE. Inspector l/ -----------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD ,QF HEALTH
......OF (j./.�I1 1.........................
/// J.
No.- - .../.....----- FEE'/d..............
Bis:ro at Work Cho rurtioti Perutit
Permission is hereby granted. .. _Gl -- !,� -
to Constr t ) or Repa' ( an vidual e Disposal S stem
�j _
"/.�.f
at No. � �6�'�G
Street
as shown on the application for Disposal Works Constructio ermit Dated..-'�" '.�.1.............
// \..i oar o t
DATE...... _`-_.5
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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' TM THE COMMONWEALTH OF MASSACHUSETTS
FORM CH&W HOBBS&WARREN
BO)kRP%,� H
CITY/T WN ,
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`c ADDRESS y, � /�rr+ x 'w
GSM s<�o y1 � /"
,.- {�� ' ! ` f TELEPHONE C, / �7
Address 110 l�tJ 3ii 9� P..Y.F o j''Oc n ,c1�1 ��..� J1 Yam.
Floor Apartment No. No. of Occupa _.
No. of Habitable Rooms No.Sleeping Room '/0, j
No.dwelling or rooming units No. St�a�ies ^' � ����•/ , n�,f,�-, �/��Y
Name and address of owner _ J („
Remarks Reg. Vio 'Roab3)
YARD Out Bld s.: Fences:
Garbage and Rubbish
Containers: „
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches: t I U I C W,I/V UO22 �
Dual Egress:and Obst'
❑ B ❑ F ❑ M Doors,Windows: ( ( f a� :► ):1
Rom" ) QQ i. Clf� ": +a
s, rains: _
Walls:
Foundation: }Pf �l <'`
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
v• Lighting:
y STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑ Y ❑ N Equip. Repair
TYPE: Stacks, Flues,Vents:
PLUMBING: Su ply Line:
❑ MS ❑ ST ❑ P Waste Line:
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 11220 Fusing,Grnd.:
AMP: Gen. Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind: .D. Lock
Kitchen
Bathroom �) -Mfi c
Pantry
Den
Living Room J,
Bedroom 1
Bedroom 2 a
Bedroom 3
Bedroom 4
Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.:
Stacks, Flues, .qnts,Safeties:
Kitchen Facilities --sip
Stove , _. �. lid
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.;,,,, )Uv,
Wash Basin,Shower 7rTub:,')// h( )LOU)
Infestation Rats, Mice, Roaches or Other: ,�,, • „�
Egress Dual and Obst'n: ( );JJJ 7 '` >p is ,j/ 1 M( .
General Building Posted , , J , r h
Locks on Doors: , (
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE I
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECTION REPORT ISTS'IGNED AND CERTIFIED UNDER THE PAINS AND
PENALTI=S'O PERJURY." C'
INSPECTOR ;' V " d TITLE
DATE �f� 3
TIME PX
THE NEXT SCHEDULED REINSPECTION_ P.M.
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or
impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those
items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for
human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so
in every case and therefore is not included in this listing Failure to include shall in no way be construed as a determination that
other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local
health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to
include affect the legal obligation of the person to whom the order is issued to comply with such order.
(A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary
needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer.
(B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as
prohibited by 105 CMR 410.200(B) and 410.202.
(C) Shutoff and/or failure to restore electricity or gas.
(D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com-
mon area required by 105 CMR 410.254.
(E) Failure to provide a safe supply of water.
(F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR
410.150(A)(1)and 410.300.
(G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object,
including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452.
(H) Failure to comply with the security requirements of 105 CMR 410.480(D).
(1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar-
bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests
or otherwise contribute to accidents or to the creation or spread of disease.
(J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public
Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.)
(K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or
other dangers or impairment to health or safety.
(L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating,
gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352,
so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety.
(M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release
of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105
CMR 410.353.
(N) Failure to provide a smoke detector required by 105 CMR 410.482.
(0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or
knowledge of the owner of said condition or conditions:
(1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven
or any defect that renders either inoperable.
(2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any
defect which renders them inoperable.
(3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of
generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard.
(4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as
required by 105 CMR 410.503(A)and 410.503(B).
(5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550.
(P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con-
dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner
to remedy said condition within the time so ordered by the Board of Health.
PAR ] Real Estate System - General Property Inquiry] Help [ ]
Parcel Id: 103 126- - Account No: 52409 Parent :
Location: 95 ROSELAND TERR MM Neighborhood: 20AC Fire Dist : CO
Devel Lot : 17 Lot Size: .46 Acres
Current Own: CARPENTER, RANDALL S State Class : 101
25 PEN LANE No. Bldgs : 1 Area: 2040
Year Added:
CENTERVILLE MA 2632
Deed Date: 080194 Reference : 9339/274
January 1st : CARPENTER, RANDALL S Deed MMDD: 0894 Deed Ref : 9339/274
Comments :
Values : Land: 29100 Buildings : 83900 Extra Features :
Road System: 95 Index: 1383 (ROSELAND TERRACE ) Frntg: 295
Index: ( ) Frntg:
Control Info: Last Auto Upd: 072295 Status : C Last TACS Update : 011795
Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000
Tax Title : Account : Taken: Account Status : Hold Status :
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UNITED STATES POSTAL SERVICE First-class Mail
Postage&Fees Paid
uSPS
Permit No.G-10
® Print your name,address,and ZIP Code in this box
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Public Health Dlvlslon
'own of Bamstable
p 0.Box 5M
Hyannls,Maw
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SENDER:
:22 ■compiete items 1 and/or 2 for additional services. I also wish to receive the
y ■Complete items 3,4a,and 4b. following services(for an
41 ■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you. ai
■Attach this forth to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address Z
permit. d
y ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery, to
■The Return Receipt will show to whom the article was delivered and the date
C delivered. Consult postmaster for fee.
3.Arfic Addressed to: 4a.Article Number
CL E �
E 4b.Service Type
❑ Registered Certified
co
tW ❑ Express Mail ❑ Insured e
LU co
I ❑ Return Race, so ❑ COD
a7.Date of
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5. eive : rint Name) &Addre a ' : 1 quested c
W and'fee r t
6:-SSi tt re:.(Addresse or Agent) ?
PS Form 3811, December 1994 102595-97-a-0179 Domestic Return Receipt