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HomeMy WebLinkAbout0315 WALNUT STREET (M.MILLS) - Health T w j 315 WALNUT S T.'�f-,,� --, ` MARTSTONS MILLS 4 t YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 ears). 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.) Business Certificat es are available at the Town Clerk's Office, 1°`FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: f U I�f iU Fill in please: ' APPLICANT'S YOUR NAME%S: SC�y�? In ��1�I( rx BUSINESS YOUR HOME ADDRESS: ser h t+ TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS 'S Pam. TYPE OF BUSINESS P>Cf* Pl r . IS THIS A HOME OCCUPATION? _),_NO --YES ADDRESS OF BUSINESS 315 i 11( Iiu9 `i t YY1�.�YShgs k-n it S I Y1 q Q,2L JJti MAP/PARCEL NUMBER 1 SO O (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 R O 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** COMMENTS: 2. BOARD OF HEALTH This individual ha e n inf rme oft rmit requirements that pertain to this type of business. horized Signature t. COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. 00 1 1 9 RE Authorized Signature** j1!•.' a COMMENTS: ! 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.) Business Certificates are available at the Town Clerk's Office,,1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) w' DATE: 101 3 H 10? EN NO -n Fill in please: r APPLICANT'S YOUR NAME S: ,/ �nx-aYn Ica V©,nca BUSINESS YOUR HOME ADDRESS: P_)�SIS Mn TELEPHONE # Home Telephone Number _ yQ.a- saCo CA NAME OF CORPORATION NAME OF NEW BUSINESS' TYPE OF BUSINESS SarU G� YV 10E'_ 1S THIS A HOME OCCUPATION? YES. NO ADDRESS OF:BUSINESS&& S1n► i s1r. ki s �n�rYi'►1\5,rY11=1 C�i„U55 M/XP/PARCEL'NUMBER IrJ �o (Assessing] U.� When starting a new business there are several thin you must do in order to be in compliance with the rules 9s Y p es 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** . COMMENTS: 2. BOARD OF HEALTH This individual has b50 informed of per i requirements that pertain to this type of business. a-t` rvt Authorized Sign re MUST COMPLY WITH ALL COMMENTS: HAZARDOUS MATERIALS REGULATIONIS r, 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business.. Authorized Signature** COMMENTS: Ha rdous Materials Inventory Sheet Checklist Date Physical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts—(i.e.gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) Storage Information—location of storage,how long is storage for? none,note that. Disposal Information—where and who? If none,note that. ✓Applicant Signature—understand what is listed and noted. � ­�Staff Initial—any questions,know who to ask. n ( ( Vehicle Washing/Rinsing?—provide a vehicle washing policy and u U IJ K explain it—note that it was given. Attach the Business Certificate with your sign-off and comments. "The Inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them Date: ay /og . TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: BUSINESS LOCATION: `fl INVENTORY MAILING ADDRESS: 5CIM e TOTAL/AMOUNT- TELEPHONE NUMBER: 15009 _e9_N_(Qq 0Li / CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NU R:r)02) 4020-5o20 MSD4 ON SITE? TYPE OF BUSINESS: 5Pr160e 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 materials 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) Misc. 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 NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. 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 Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) ` Spot removers &cleaning fluids I/ (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash _ _ WHITE COPY-HEA)THMPARTMENT/CANARY COPY-BUSINESS CAPE & ISLANDS ENGINEERING SHELLBACK PLACE• BUILDING 2, SUITE E 133 FALMOUTH ROAD(RTE 28)• MASHPEE, MA 02649 (508)477-7272• FAX(508)477-9072 December 27, 1995 Mr. Ed Barry Barnstable Board of Health 367 Main Street Hyannis, MA 02601 RE: Lot 2 Old Stage Road, Barnstable, MA Dear Mr. Barry: The septic system has been installed in accordance with the plan on file. The site inspection was made on December 22, 1995. Sincerely, David Sanicki DS/cma RECEIVE D7� DEC 2 8 1995 HEALTH C,rF_r TOWN or E A .. .. _ } TOWN OF BARNSTABLE LOCATION„ �f� W a''u u7" SEWAGE # VILLAGE AG�S'P ��� ASSESSOR'S MAP&LOT oC Mal' ISD INSTALLER'S NAME&PHONE NO. �J�1�'!�°S ClAel r L��� SEPTIC TANK CAPACITY (act I (Szea) r5 LLEACHINGFACILITY: (tYPe) NN 3 � S 1 a NP NO.OF BEDROOMS 3 dFSTx, ON &,t6M BUILDER OR OWNER PERMITDATE: 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 97 (0" os 0 I `TOWN OF BARNSTABLE LOCi.70N g I ) SEWAGE # � VILLAGE Mu,V s ��'� f�'/i 15 ASSESSOR'S))MAP&LOTt2 W C 6 INSTALLER'S NAME&PHONE NO.�/YI PS CAG C P SEPTIC TANK CAPACrrY In= 7 a L TT c/ clt� F S ) LEACHING FACILITY: (type)r.J�A 3. 1 t� (size) NO.OF BEDROOMS 7 BUILDER OR OWNER _a, PERMITDATE: I — 4 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 'S 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 bye/�C s�Z , t 14� 4 � 17 ,63 Ficz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................OF ..................................... Appliration for Disposal Workii Tomitrurtion 1hrutit Application is hereby made for a Permit to Construct ( Repair ) an Individual Sewage Disposal System at: (315 SVe-tA K 'S [A 5.T ....qt ..1p#tp.............. R7'.' *-------!!�&............ Location-Address A -------------- or Lot' .............................................................................................. .. . ......0.1 ...................... Owner Address ....... ir............................................... ................. . ........ .. ...... .... ......... ........................ Installer Address ess Type of Building Size Lot.10_4V.51......Sq. feet U Dwelling—No. of Bedrooms............... ........................Expansion Attic Garbage Grinder Other—Type of Building ........................... No. of persons..........G............. Showers Cafeteria PL4Other fixtures ...................................................................................................................................................... Design Flow...........55........................gallons per person per day. Total daily flow.........5_1W.....................gallons. 1:4 Septic Tank—Liquid capacitylOOO..gallons Lenjth.6."nfa"._ WidtAt].W. Diameter---------------- Depth..5_'.4... Disposal Trench—No. ......I............ Width... ... Total Length....Zj5....... Total leaching area_.­0.?_.5.9---sq. ft. Seepage Pit No--------------------- Diameter.........___.__..... Depth below inlet........._.......... Total leaching area..................sq. ft. z Other Distribution box +� DOSI - tank ( )Y:?A Lt� Percolation Test Results Performed b .......P.P Test Pit No. 1......1�....minutesperinch Depth of Test Pit...1.15�0..... Depth to ground water......t4a"----- f14 Test Pit No. 2.......3....minutes per inch Depth of Test Pit.... Depth to ground water-____ -------------------------------------------*......**---------------"................................ . ..................................................... 0 Dqee.cription of Soil.....I.... ...4r7TP!Qt� a.ffly 5 "' W 4. r- - -­----------- EVIU11----16A0,V---JdA-TtA-Q..A(a.............z.....LZ', aN -)( " AW V j. .. ....96.. .1-5.0.....01W.101.1..... ............... MUST SUP RVISE U Nature of Repairs or Alterations—Answer when applicable........:�,\..'j��TALLATJJONAND QE4-f( 44"WiVTING------ .....................................�TR[CT..... ...................................................................................................................H.E..SK: ,5-jEM..WAS INSTALLED IN ............................................................ Agreement: —ORDANCE TO PLAN. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE IE 5 of the State Sanitary ode —The undersigned further Agrees not to place the system in e " e of Compliance has b operation until a C issued by the board health. rt*f - Date .... ........ ...... .. .......... ... .... .... .. .......... .......... 75 Application A ............ ..........pplication Approved By...... fiem....... ............. ...... ....... Date Application Disapproved for the follo g reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date Permit No...... .....4LfZ(�a_.— Issued....................................................... 7y— )L 3, DESIGNING ENGINEER MUST SUPERVISE G r Fnic............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................OF..... . .��.� �------------.----------.----- ,Apure#ion for Biopoottl Works Tonotrnrtion lbrutit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. 121631 ti Owner`` Address a )e'en n.e� �1. Installer Address UType of Building Size Lot_!©.&-2.�J.......Sq. feet �., Dwelling—No. of Bedrooms................--.......................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons......... .............. Showers ( ) — Cafeteria ( ) 0.1 Other fixtures ------------------------------------------------•---...-----•-•-•---•----.....--------------------•--.......... -------------------- ----------- w Design Flow.......... �J........................gallons per person-per day. Total daily flow.........5.A.0.....................gallons. WSeptic Tank—Liquid capacitylOap.-.gallons , Length?.-k..... Width ' t Q.. Diameter................ Depth 4__... x Disposal Trench—No. ------I............. Width•-�:G7._.___ Total Length.. ........ Total leaching area.... .3-......sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (✓S Dosing tank ( ) Percolation Test Results Performed b --A ,aa ... --?U,tJ a 5 �U 1ZF_1WO6� )6. . .. ae_ G :.. ­--------------- Test Pit No. 1......�........minutes per inch Depth of Test Pit....��o___. Depth to ground water_._._ �_�____.__. fZ Test Pit No. 2••--- ` ��..: minutes per inch Depth of Test Pit................... Depth to ground water........................ 0 ----------------------------------------------•---------------------------- D De cription of Soil1 Z"- t f4 GOg�3LE 15109eS `-�-•t*,o11• i_1_, 1j_4-'..'-i �•- 0" V _� EDiv('i....6A1, 12 VE\�i (Z,Q IGF(r� Z •-IZ"_._ GOF ` ....__ Ir.yA-rf< 4.......----------------------------------------------------- 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 TITIE 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 board of health. Signed.................................. -� Application Approved BY ....----.•.....................•--••-••... --• ...../_Da te....-••---•,••- Application Disapproved for the following reasons:----•---------••------•---------•-•---------•-•---------------•--•--------------•••-•-••-••-------............- ....................••------------------......_.....------------------------------------.....-----------.._.....--•------------------------------....................................................... Date Permit No.........��'�.-�...... -------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH _-- ...... (9rdifirate of Tomptionrr T4ISIS-T-0-fERTjFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ., .._.. ^...--�-e----....-��..:............•--_----• --------.-------------•-•----------•---•------•---••-•-------•--•--•-----••---------•-----•---•------------•-- In taller at_......... .. C = ```��- -`---- ---------.....�=.....•..•....------•--------------------------•------•-------------------. has been installed in accordance with the provisions o ITIE 5 of The State Sanitary Code as)esc�i ed in the application for Disposal Works Construction Permit No .__..1.0?7.lq_ dated----------!_ _ _�_ �-•--••--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................•-•-•--••--••---•---.....---•------.........•----......----•---- Inspector.................................................................................... THE COMMONWEALTH OF MASSACFAWIWM INSTALLATIONNG ENGINEER AJUST St pERVISE AND:____BOARD..-OF HEALTHrNE& IN WRITING tZ ._.P� A WAS .s-�J.1x)...0F........................................•.---- 7OpL4K N��-•--�-�...... FEE..........-7...�:Y Diop000l,Works TIMtrudion ramit Permission is hereby granted.........' ................_...-_. to Construc�, ( ) or Repair, a,) an ividual Sewage Disposal��Gt at No. � ?-- - �C (mod .... kJ Street as shown on the application for Disposal Works Construction PermiJ_No..:."p...f 76 Date ..... _v . k. ......... ..................... ........ .....-.. _........................._ Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS • SY STEM TEM PROFIL E - VIS EN GIN EE R MUST SUP NG NOT TO SCALE , IGN► WRITING .. , ' DES IN ,. .� AND CE RTIFY ._ 710N A TALLA STRICT :!�� STR , ED 1N TOP FD SIN STALL FINISH' TEM WA GRA V GR�•�YS _ .EL . 89.5 FINISHDE O ER LAN. GR - FINISH GRADE OVER OVER TREND ... ... FINISH ADE avg_ � .;DIST. BOX` �,`�.3 o Pa .v SEPTIC TANK o.: e VARIES �tQ77VIA `: `\ - '. d o• A s . • .a .n .o •. .o.p• o .v p.d,a .•.o• o. • .b . '.e..�,.4, a t� .O . , a .o o e d •.- i TOTAL -LENGTH OF TRENCH 2 8 U 5Ew 5 e O JE F ) OUTLET ;PIPE LEVEL 3 0. ' 0 8 -Q . .° FOR 2 FT. MIN. P• .► G. b e v •. oo ♦• :: •. GAT EUD -C. I. OP P VC TEES10 n 0 '. 0 0 e.. ,. •.Q p L 4CaoDD of O U r3 a v ,b 9 o r Q 0 v.• 0. 0 0 c� D —6 OF 3/4 TO l—s/2 WASHEO♦ CRUSHED STONE o cZ C+ gcy opo t>2o D. Q L'' o .o G o of o v o BELOW FLOW'DIFFUSORS o 0 o io p. ,eo Q© PLACED BE O o � { 000 GALLON ICI S TRIBU TION BOX �- &'` p o• o.D,O 31 0. M T F'L .�o>. o. °a t /{ FLOW DIFFUSORS E�- £� .C7p eo INSTALL ON LEVEL BASE cl Pf�ECA S T CONCRETE a p. b, p. p o , . d 0 0 -' 0: N D.J V S t tV ��..../V 14 c)W a I ff;Z L �.. t`D.G o' H 10 REINFORCED ._�_ _ � --- _ _ _._ _ .O O• .o. r G .4'd o.o.o.v,..o•A '4: •b :O '..Q•G.O V •.D o.D,0'LS'' P ' ?.4::R'. es.•o. • o . TIC TANK TRENCH SECTION SEP I INSTALL ON L E EL BASE NOTE. EXCA VA TE ° TO EL E V. �1 �. �,fOR f LOWER TO REMOVE ALL IMPERVIGus a A T R L ENEA TH THE LEACHING, (Z M E IA B a DIAhf. r REPL ACE EXCA VA TED MA TERIAL WI TH 3 OF 1 6 -1 2 eoa i r CLEAN, CLAY FREE SAND _ n,,, , ° WASHED PEAS TONE 1.n — �� - 3 4 1-1/2" WASHED � - .•; A s O G7 e p CRUSHED S TONE o TRENCH WID TH GENERA L NO TES V T N SHOWN ARE BASED ON t E 1. ALL EL E A IO S S a U i C� NUMBER Cl TRENCHES ^ �_ F M UST BE CAST IRON z 2. ALL -PIPES IN THE S YS TE M NUMBER OF DIFFUSORS 3 . t- ._n L _ _ _ _ R SCHE Y_ --}_ UBSEF�VA TION f,I T _ THE BOARD OF HE. L TH MUST BE- NO TIFIED _•,F_ T COMPLETE PRIOR WHEN CONS TRUC I DN IS CO L E E PERGOL A TION RATE: r- F L L ING , '- TO 'BA CK I , Q1 5 MIN. IN. N TH LA UST BE APPROVED �9 4. ANY CHANGES I r LS PLAN M Y , W TNESSEO B . T AN CAP 6ISLANDS . I t BY THE BOARD OF, HEAL H D E 4f d !4 '•• SURVEYING CO . INC. [(// t r _ be - . c _ �'A AT N SHALL" BE IN 5. ' -MA TERIAL S ANG INS L L TION _ �Ll. BRO. OF HEAL TH DESIGN DA TA 32 COMPLIANCE WITH THE S TA TE SA TA Z A ' A T 2C? _ D E._ _ - - ..1n A _CODE TITLE. V AND LOCAL APPLIC BLE GU TONS 57 RULES AND RE LA I JL Ai2, 3 Tl"ST EL 5 TEST [ .5 OF BEDROOMS Mr _ � � NUMBER , w IS F�30M RECORD. PLANS AND 0 ..F 6. NORTH ARRO k a r J S3DISPOSALQ , A GARB GE � • {— 30 - R S LAR .PURPOSES Z tz IS NOT TO BE ...USED FOR O I - ' Y W -, GA L 7 FLOOD HAZAR.7 ZONE � DA IL FL O SAL PP Y t.,Ji�.! Gil AT cCZ: - A fl B. ' :WATER SU L . � SEPTIC TANK REO_ D. -�.��� , h GO T lL �T _ 1� ,r _ D GAL . GALLON U 3000 �Q D A -.SEPTIC TIC - TANK PRECAST`CONCRETE . f GPD rt H N EOUIRED SEPTIC TANK - L EA C_ I G R a p .. ., •.:.. :. .: :... 7 ; A� i. x v wa .�, - SIDENALLRA S. F. 10 a 2 4•7 S.F X ��r G/S.F. GPD. _.. -- ► F t {Vd. 4 t;16 f a ltl ,,q TT AREA S. F. - i BOTTOM R �— �.24 GP . S.F. X G S.F. D / L EGENDzouwv Q._. f R VIDE •4- GPD r : LEACHING PRO D _ __� f tIJ , 15� � , /y FFUS AS IN SERIES I' 3 FL OM DI O ,, 1- ROPOSED ELEVATION . SURROUNDED BY 2 —0 OF STON ! .._ 86 EX.1''STING CONTOUR - • t L � s - ._ •FAM L Y RESIDENCE _ 6 . �z � ...SINGLE I ...... (.. OBSERYA7ION PIT : 7 _ _8 CF , _ DISTRIBUTION `BOX * `"'-------�.✓`�'. 2?7 Oda . , •� +. n I�VA GE DISPOSAL SYSTEM PROPOSED SE K e r _ co n z w }h �-� • .,, FL OW DIFFUSORS ��'�,e ,e PREPARED FOR �, , IT T TANK s 0 o sEP .�c �,� , � � U ROBINSON I RESERVE AREA T D ,.—._. LOT 2 : OLD STAGE f�OA T BLE MASS. �.��.I� � BA RNS A .; 1 CHAR US V TON , INVERT ELE A I »PIPE I ., ul U I T o DA E. �► CAPE & ISLANDS <,�'URVEYING INC. c PLOT PLAN _ �T ; _ � SCALE AS NOTED_ - . P. 0. BOX 334 SCALE. 2 J T S ; ' PLAN_ NO. _ 3l : TEA TICKS MA SS.' . M S CL LOT t1SE ,