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HomeMy WebLinkAbout0251 WOODSIDE ROAD - Health 251 Woodside Road W. Barnstable A = 152 024 ra a 1� i i i 0 i 1 1 yf n 1 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 Fl., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: dot 1 Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: C922oe GJ �R T t o�2 6 C7� ¢ f� TELEPHONE # Home Telephone Number C/ 275/ vl NAME OF CORPORATION. 0R SS. NAME OF NEW BUSINESS Z:: `- TYPE OF BUSINESS IS THIS A HOME OCCUPATION NO ADORES8 OF BUSINESS . T MAP/PARCELNUMBER D Go (Assessing) 'F 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 rmed ny permit requirements that pertain to this type of business. MUSTOOMPLY WITH HOME OCCUPAT��I� ��„ Authorized Sig ture** RULES AND REGULATIONS. FAILURE T -v� COMMENTS: Q - v 2. BOARD OF HEALTH ,.. This individual has peen r f the permit requirements that pertain to this type of business. MUSLAMPLY WrM ALL ^ l . Mf V HAZARDOUS MATERIALS REGULATIONS Authorized Signature** 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: TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 6Ed=-1,*l ? s BUSINESS LOCATION: coo ,, psfo. INVENTORY MAILING ADDRESS: -'shole TOTAL AMOUNT: TELEPHONE NUMBER: 77N. Move CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: tC1C, INFORMATION/RECOMMENDATIONS: Fire istrict: 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 ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) S y4 Gas t fuel,Aviation gas Photochemicals (Fixers) u erosene, #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 preservatnves (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) ❑ 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's Signature Staff's Initials TOWN OF BARNSTABLE LOCATION 5I l �7F[`1�����' R�u�' J SEWAGE # o VILLAGE-` 6�-�� ASSESSOR'S MAP 6z LOT a '-CQ4 INSTALLER'S NAME & PHONE SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) lbw NO. OF BEDROOMS- RIVATE WEL OR PUBLIC WATER BUILDER OR WNER DATE PERMIT ISSUED: (d /I qJq I DATE COMPLIANCE ISSUED: e °" VARIANCE GRANTED: Yes `'No �J yt4 -1 !&tIsxI NNC iocoapa-TI' .t°7 J R -limb sl a • No...7L.7:5.1 FEB.....30..... '_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for DhiposaflVorks Tongtrnr#iun Permit Application is hereby made fora Permit to Construct ( ) or Repair anIndividual Sewage Disposal System at � �l . �,1i.. .. ._ 'fir oc ion-A r s ...............................or Lot No. .. ...i O n d -e Vial s alter ` Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.................. ....................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons.......................... Showers — Cafeteria a g Other fixtures ................... -••---------•--------••--•--•••---••-•--------------•--------•----- ............................................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 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..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water________--_-_•__•---__-. (i Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ a --••-------------------•-------------•---------------------•---.....--------•---••--•--•------•-•••.......................................................... ODescription of Soil...............................................................................-........................................................................................ x U ---••----••••-•--••-------•------•---••--...-----•--•-•---••--•-------------------------------------------•--•--•----••----••-••-----•-•-------.... -----------------•-•------------•-----•-•--•--•-_.. -------------------------- -------------------------------------------------------------------------------------------------1®�----- ,--5,f- -------------- U Nature of Repairs or Alterations—Answer when applicable.____-_..... f,Yf L______ ____1 _._._._. _________________________ •.........................••---•-•--••-•---•--------._..............----------------........--.•--•-----••------•--•----••-•-------....••••----------------•---•-•••••-•--••••----•-_....••-••-•--•_.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmen Code—T ndersigned further agrees not/Date lace the system in operation until a Certificate of Complian has n i sue by th board of health.Signed --- ------- - C� ......1..... Application Approved BYr `J Due = � .Application Disapproved for the following reasons: -- ----- ------------------------------------ ---------- ------------------------------------------------ -- ------------ - ---- ----------------------------------------------------------------------------------- -- --------------- --- . -------- --......................... . .- Date Permit No. �� ---..X..,S-.T------------------ Issued .............. Date = - 0024 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilan for Disposal Works Tomitrnrtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: ..-- L..... .s._.� . .. ,..._. ....................... oc ion-A r s or Lot No. -- -- . U........ .............. ------.............. a ............. .. ... ........'�..n. ..S`.... ........ �— s aller Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................. ...._Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures .-------•------------------------------ - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 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..................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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------•--------------------------------------------------•-----•--------------------------------------------------•---------------------------------------- 0 Description of Soil-...--------------------------------------••---•------...-•---------------------------------------------------------•-----------------------------------............._.. x �., U Nature of Repairs or Alterations—Answer when applicable_______..__S f L__... _ __._1_ `...._._.-5......................•.. -----------•--------------------------------------------------------------------------------------------•------------------------------=---------•-_--••------••---•----••------------•-...----......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions,of TITLE 5 of the State Environmen Code—T ndersigned further agrees not to place the system in operation until a Certificate of Complian has n i sue by th board of health. ` Signed - - .. .. . -- --- ------ -------------- ---------------.. ...... -.- ... .. � Dare Application Approved BY � �- .... .- ... - G.-Date /... Application Disapproved for the following reasons- --------------------------------------------------------------------------...........------------------............................. ----------------------------------------------------------------------------------------------------------------------- Date PermitNo. ....... 1-------r- �o ---------------------------- Issued ------------------ . ----------- -- -----------.............. Date h THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certtfira e of ComlaCinna IS TO CER -IF hat the Individual Sewage Disposal System constructed ( ) or Repaired t � . by- --------------- ------ . .... ............... -- ----------------------------- ------..............--------..........------. .--.... -------------------------------------------- w nstaller at .-/'-... ... o��'�t------ 54 -.------ .. -------------------------- ---------------- --------------- ------------------------------------ has been installed in accordance with the provisions of TITLE 5 o The State En ironmental Code a des bed in the application for Disposal Works Construction Permit No. .........��.-... --. -.. dated ..---...- .-�. c ........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARAN E THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................ --1- --; Inspector ............ -------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.......::............. FEE..:,,•-----.......... t [` a ' rk #rMnan rrntit Permission is hereby granted..--• ....... --- --------------- ------ ---- ------------------------•-----------------------....---------...................... to Construct ( ) or Repair ( ndividual §'eva e Di osal System -------------- atNo Street ,2 as shown on the application for.Disposal Works Construction Permit No...</_._q/_ t__ __ Dated.......................................... ................................ --in---------------------------------•------------------------- DATE_ Board of Health FORM 36508 HOBBS at WARREN.INC.,PUBLISHERS t pi c A T o wo 19 VILLAGE, &IMS -0 A LLER'S NAME ADDRESS J. CRAIG Mfir--I'DEIROS 4 142 CorRoration Street,_ �U U I L 0 F R Hyannis,/Ass, 775-0828 /I jr--7 e-p v 7 z1 woe ds/ d-9 W-�—. T—E ew-. Rml,-T ISSUED OAT f C 0MU' Ll ANCE ISSUED ---/ZZ� X b-A/ /J,00 X J0 2v�p pej No7"a :_y y; .� z THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH Appliraffou for Dhipa i al Narks Tuntitrurtilatt 1hratit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ,\ l. ------------------------------ ---- Locataon.Address t No. \ . Owner Address Installer Address UType of Building Size Lot_ �� . .......Sq. feet Dwelling-No. of Bedrooms___3....................................Expansion Attic 4($ Garbage Grinder '4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ............................ DesignFlow...... ............................. allons er erson er da Total daily flow__._.. .gallons. Wg P P P� zay. , y 'A` e , WSeptic Tank—Liquid capacity 5W.gallons Length.��- a_... Widths_- ;___ Diameter-------__•-_- Depth_5__-�__.. x Disposal Trench—No. .................... Width..........._........ Total Length.................... Total leaching area....................sq. ft. Seepage Pit 'No.___�-............. Diameter.... -___--__- Depth below inlet.._�.�.._...._. Total leaching area ......sq. ft. Z Other Distribution box (V) Dos1 nk ( ) A °—' Percolation Test Results Performed by r��.KZm� 1` E---- L.................. Date..-z.. --- ,.a Test Pit No. 1... 3......minutes per inch Depth of Test Pit---- .......... Depth to ground water._K1%".V..._00 � (i Test Pit No. 2-_4.3.....minutes per inch Depth of Test Pit...A.2.......... Depth to ground water�614_ K a .................. •-•-• .....••-•----. .......... •-•--•••�.......... •.. iODescr* tnf Soil -- ,i IL U Nature of Repairs or Alterations—Answer when app icable.________________ ________________________________________________________ ---------------------------------------•---•-----------.._...----------------- ----•••--•--••••--•--••••-•---------••-•----••---••-•--------------•-•-------------•----------••............----•--- 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 Certificate of Compliance has been is y the oard of health. a ' Signed_.......................................... . ............................... Application Approved By....... --�: _ -••••......••--......•..... -------•---sn/y-$S......... Date Application Disapproved for the following reasons---------------•--------•----•------------------------------------------------------------------------........... ........................••-•-------•----.......---•----------•-•--------•----------------....---------------------•--•-••-•------•---------............................................................ Date PermitNo......................................................... Issued-...................................................... Date Lc3i ZS �. Aa 0 t7 op i r to Lea c+��•c ► -t o t-v,ftz of�.�.c aHE�tC•? �- 9 , j _ A. �.� .�. ',, ► f1- 1 r r -_ ... Lea C'f LoT 0� LOT' 30 CZ 0.35 f 93•Z - G 1� ELL �D'3�0 to 4 *� d �LjN F 414,s9 OFVmw t PETER `' yr RICHARD SULLIVAN A. SCALE; 1"_-40' �sT L�h�t�Sm-VLE BAXI ti . h'o. 29733 "� No.24048� �,, �T o ��► o�.239 �}ie 137 �• �,� ��s,-�A� go-. ��s��` � �"SrpNA _OE.S/G/V .4 -4 �11.1�6r1.��aMt1-`(- 3�3Eb�M w tr+ C�-ae � G-,z�Nv . �-2�z. roe 1� 7LOU4 = 1 ►o x 3 k 50/a '19 5 Fs , 5s7 TtL`7T Y, : 110' 3X200%+ 6CO6r"'7i S w. moo oo GrAo.. ' \j� L IE AC.ld'� L.l 1� `,7E 1000 VT W 3 •STo"c P`TER SULLIVAN' 11U. cyla3 1j Pp�- i;�STF•�'' .\�0.r� (r2,ZS (?/r# = 5Oe) G'PJ ie;aa�t�.. AL.j� : - 113 ►(_ c�.91 be/rb - 10 3 6pl'�. • r p''i+bF hj4 RICHARDA. G\ 0 BAXTER No.24046 b Q/STv-Tl � CyyvW 34t? z.g.&A EL9S.6 9�� FG -, 97 46110046pisr. ��• �No� ISOO ��) ' ,.. /.Y� 94.G, �/.tJ;/. "�, 9q ,-A �17 � OF 3q'To e TAn//G soave /it/r/. INV. �KsI •+ '�►•a=f •f ''J��G -' 93.E3 94.0 G'E.2T/F/E.O PGOT ,oLA.✓ ,SGGL�c ASMOM D 0,472=- 3•ZG-8S f�L-Q.V ,2.EFE,Q�.Vc� �2' EL 83.Co +JovJA �aoP / e /�Y TN,4T TNE'-DvJ��I..►u SHavciv �AN�'. �Z39 Ge V37. </E,�Eav GrJMPL.Y,S (.�i/TX/Th��'.SiOE�iv� �,exrF,e AivO,fETI�/aGlc .2E4V/�Ek1ENrS Off' Tiy� f` �t/rEi /�uc. L oc.�rE.o W/T.y/lV 3 T//ls P�,v /s �Vo�-- I3.4SEG�G�✓A�v y ...THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................OF...... '? . .�,. .� .k. • ............... 4` ApplirFation for Uhipaii al Workii Tomtrurtion Vrrmft Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System it:ff / 6j Ey` ................__......... ...... ..'t. -r�''........._................... ................___...._ ......--- ...... --- ..._. ...............-_._......... s• p�-�Locat�.� es ddrs No-, .... ... l�ro`.M t n i if tti 6G, � •�c.A -�\ ,...._1 ..I. ^?M 3•� (�,_ VOwner,,,. Address IAC 1� ............................................................ ...---•---••-••.........._.........--•-•---•-...------....--------.._.._.._._.._............-•-•-• Installer Address ,. d Type of Building Size Lot __L x.......Sq. feet U Dwelling—No. of Bedrooms___ ________________________ Expansion Attic Garbage Grinder (} Other—T e of Building No. of persons____________________________ Showers Cafeteria QI Other fixtures ____________________________ _ W Design Flow_____ .............................gallons per person per day. Total daily flow__-_"..) ..........................dons. WSeptic Tank—Liquid capacity_! X?.gallons Length_d ' �____ Width_�a_'..-.�=__._ Diameter---.--------- Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length........... _ Total leaching area.................... ft. Seepage Pit No____ _____________ Diameter....'.'..___.___ Depth below inlet___- _ .._.___ Total leaching area_:` '��__...sq. ft. ,Other Distribution box O Do�siig4nk ( ) Percolation Test Results Performed by.. ._ _ E' _ _ � t>___________________ Date _ _ _ . ,aa Test Pit No. 1_.?r'�_-_3.....minutes per inch Depth of Test Pit t. .......... Depth to ground water Test Pit No. 2...' .__._minutes per inch Depth of Test Pit---- ......... Depth to ground waterKW _iM'_ 1 ,- T5��;V .......................................... ............. !D� Description of Sorb,. l - •` �''1^. ,� g,.: '_-�', "' $� ' t, .-- t "'�__ ' t _�,_ ' Z.�-" !' ,` •--•;------ ^ '�.�.•4. 1- F"' `>.. I L� d._k 0.: .FPS $�.! W •--•--- - - '"�r ...••...•--_.___- --- 4..a_•-_?" ---------•------------------------------"---•-•- UNature of Repairs or Alterations—Answer when app,cable_:.______ .________ _________ ________................................................... -•------•---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--__•-•-•••. Agreement: x The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T'I'I.: 5 of the State Sanitary Code— he undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is y the and of health. T'tied......--•-•---------------------- -------- • .............................. ................................ atCD ApplicationApproved By................................................................................................ Y Date ..._._._ Application Disapproved for the following reasons________________________________________________________________________________________________________________ .................._....._..-•---------•-••--•-••--•----•----------------------••-••••-------•----------•-•----••••-•---•--•----••-•--••--•-----------•--------------------...----..-------------------- Date PermitNo......................................................... Issued------------------------•-• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trrtifiratr of ToutpliFattrr TH, ISYTQ C�RT'TIFYVTh^at the�I;ividual Sewage Disposal System constructed ( ) or Repaired ( ) �., �. Inst tier at--•---4^z.. -__ ©_._._.�"..,.."-"`_:.!...---• �___--------�-•.p N -•----------------------------------------------------------------------- has been installed in accordance with the provisions of r" L LE of ne State Sanitary Code s�de� ribed in the application for Disposal Works Construction Permit No�6 _'�-•___=__ ._�"______________ dated___.._.--5 . Y`� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. J 1 f � DATE... ------------------------- Inspector -...... 1 . -' �`= t...................... 1 J r1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................OF................................................................................... F...-•------.........._...._.....----........_......._..._....----............_..... No.�..��. ....-.�� F El✓. 1 apopFal Nor %a0witrurtion Pumit Permission is hereby granted...... !'......Q..____.�t���1.1_��_____________________________,,, to Construct (-c, I or-Repair,( ) n Individual Sewage Disposal System ; at No..-•-=•-�=r�•-••---_______•_c�'z::-e... Street as shown on the application for Disposal ��'orks Constructon ?ertnit N,o. _ '��_ ted.... ........................ _________________________________________/"��• _ _............................................... ._ -------•-•-----•-------••----•--•----••-------•-•----------•----' Board of Health DATE:---------•--• . . FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS _