HomeMy WebLinkAbout0767 INDEPENDENCE DRIVE - Health 767 INDEPENDENCE DRIVE
- ` Barnstable
A= 332 -010 -001
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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, "I st F1., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
DATE: Fill in please:
APPLICANT'S YOUR NAME/S: CAI /7r% (', nn D bell
BUSINESS YOUR HOME ADDRESS: :7D =r,�12_flcar -�o,cP )S r_ I CL2
On if IN
€ in S
' ?e
TELEPHONE # Home Telephone Number '7'—
NAME-OF_CORPORATION-
NAME-OF NEW BUSINESS e i13F TYPE OF BUSINESS PR)n i nz
IS THIS A HOME,OCCUPATION? YES NO 22
ADDRESS OF BUSINESS ro7� Snc\ Drive- i u7 MAP/PARCEL NUMBEQJ: 61o'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 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 ISSIO ER'S OF E
This individ al h n rn-fPr ed a er ire itr nts that pertain to this type of busind&ST COMPLY WITH HOME'OCCUPATION
4 u RULES AND REGULATIONS. FAILURE TO
thoriz Sin a** COMPLY MAY RESULT IN FINES.
ffMMEN
M 1T I _ - -
f 2. BOARD OF HE TH `
This individual has been nfor ermit requirements that pertain to this type of business. MUST COMPLY WITH ALL
Authori ed tur ** �0 HAZARDOUS MATERIALS REGULATIONS
COMMENTS: 7,1
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature**
r COMMENTS:
Hazardous Materials Inventory Sheet Checklist
Date
Physical Street Address-Check databasekto ensure it exists
Working Phone Number
Actual Amounts -( ie. gas being used to fuel machines, thinner to;
clean brushes all.count as hazardous materials-no blanks)-
,--,"Storage Information - location of storage,,how long is storage for?
If 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.
Vehicle.Washing/Rinsing? -give a vehicle washing policy and
h explain it o
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.
p
TOWN OF BARNSTABLE Date:
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF"BUSINESS: May V e.,IbcLs Prof�ss;ono-j Poory-- ir)12
BUSINESS LOCATION: 1670 \(1epen6o nce_ Dyr INVENTORY ,..
MAILING ADDRESS: S4:,Mi TOTALAMOUJ]T:
TELEPHONE NUMBER: 619 '749- (.Or7 '2-
CONTACT PERSON:
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SILT?
TYPE OF BUSINESS: P0,-1 1+- 3 n94
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
U(NEW ❑ 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)
❑ 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 _
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
SOUTHEAST REGIONAL OFFICE
20 RIVERSIDE DRIVE, LAKEVILLE,MA 02347 5087946-2700
MITT ROMNEY 'ROBERT W.GOLLEDGE,Jr.
Governor
Secretary
KERRY HEALEY ARLEEN O'DONNELL
Lieutenant Governor Commissioner'
September 13,2606
Patrick M. Butler RE: BARNSTABLE: -- Sewer Connection
JDL Housing Development, LLC . Permit, BRPWP 18,Village Green
e
1513 Iyanough Road Apartments
P.O. Box 1630 Transmittal No. W066621
Hyannis, Massachusetts 02661
Dear Mr. Butler: u
This letter is in response to your application for a sewer,connection permit to discharge
into the sewer system located at Village Green Apartments in the Town of Barnstable,
Massachusetts. After due public notice, I hereby issue the attached final permit.
No comments objecting to the issuance or terms of the permit were received by the
Department during the public comment period. Therefore, in accordance with 314 CMR 2.08,
the permit becomes effective upon issuance.
This Permit is an action of the Department...If you are aggrieved by this action,you may '
request an adjudicatory hearing. `A Notice of Claim for an Adjudicatory Hearing must be made
in writing and postmarked within thirty (30) days of the date this permit was'issued=Pursuant fo ?�
310 CMR 1.01(6),the Notice of Claim shall state clearly and concisely the facts which are
grounds for the proceeding and the relief sought. ; ,
_.
The Notice"of Claim, along with a valid check payable to the.Commonwealth of
Massachusetts in the amount of one hundred dollars ($100.00),must be mailed to: { �f
Commonwealth of Massachusetts
Department of Environmental Protection
P.O. Box 4062 '
Boston,MA 02211
The Notice will be dismissed if the filing fee is not paid,unless the appellant is exempt or
granted a waiver as described in 310 CMR 4.00:
I
This information is available in alternate format.Call Donald M.Gomes,ADA Coordinator at 617-556-1057.TDD Service-1-800-298-2207.
MassDEP on the World Wide Web: http://www.mass.gov/dep
LJ Printed on Recycled Paper
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--- -- -- ------ If you have—any-questions please-contact-Chnstos-Dimisions-at(508)-946-2-736._
Very truly yours, ,
t
Han A. Dudley 4
.
= Bureau of Resource Prote ion
D/CD/ k
Enclosure
cc: Daniel Campbell, P.E.
Level Design Group '
365 East Washington Street F
Unit 2
North Attleboro, MA 02760
Barnstable Public Health Division
200 Main Street
Hyannis,Massachusetts 02601
.DEP-Boston
ATTN: Wastewater Management
Massachusetts be of Environmental•Protection D,EP use Only:
Bureau of Resource Protection —Groundwater Discharge Permits
Sewer Connections/Extensions 1& 94
Li I Permit Number
BRP WP 13, 142 .17, 18, 55
Application for Permit for Sewer System Extension
Town
or Connection
The original of the transmittal form and this application, signed by the appropriate municipal official,
should be submitted along with one copy to the appropriate Regional Office. The signature of the design
engineer or other agent will be accepted only if accompanied by a letter of authorization. A copy of the
Important: transmittal form and fee (if applicable)should be submitted to the Boston Office.
When filling out
forms on the
computer,use If connection is to be made to the MWRA sewerage system, indicate WWRX in item 11.
only the tab key ,
to move your If the project includes sewers,pumping stations,.force mains, or siphons, construction plans must be
cursor-do not submitted with the application.
`
use the return pp
key.
If additional space is required to properly answer any questions, please attach additional sheets and refer
to the attachments in the space provided.
A. Applicant Information
1. Name and Address of Applicant:
JDJ Housing development, L.L.C. c/o Attorney patrick butler, Nutter, McClennen & Fish, LLP
Name
1513 lyannough Road, PO Box 1630
Street address
Hyannis r 02601
City/Town Zip Code "
508.790.5407.
Telephone Number(include area code and extension) E-mail address(optional)
2. Name of Sewer System Owner:-
.
Town of Barnstable
Name
Barnstable 7
Municipality or Sewer District
Department of Public Works
' Department`
B. Project Information
1. Type of Project: . E Sewer Extension ® Sewer Connection
2. Number of Residences to be served 148
3. Number of Bedrooms: 273
RUM
wp1355ap.doc•6/02 "� 9 BRP WP 13-55•Page 1 of 7
AUG 302006
.._.�
sc€UrnD.E.P. N
.1
Massachusetts Department of Environmental. Protection DEP use Only'.
Ll Bureau of Resource Protection — Groundwater Discharge Permits,
Sewer Connections/Extensions 0(n6l, 22
Permit Number
BRP WP 139 14, 17, 18, 55
Application for Permit for Sewer System Extension
Town
or Connection
B. Project Information (Continued)
4. Other establishments to be.served:
a. Community Building
Name
Independence Drive, Barnstable
Address
12 seat dining facility
Type of Establishment
10 gpd/seat= 120 gpd
Design Flow'
b.
4 Name
Address
Type of Establishment
Design Flow
5.. Design Flow: r
'Sewage 30,150
Gallons per day
Industrial Wastes 0
Gallons per day
Total 30,150
Gallons per day
6. Location, Length, Size and Capacity of.Sewers to be Connected to the existing system (attach
sketch):
a. Independence Drive
Name of Street
1,748 t If longest run 8" 1.09 cfs
Length of Sewer Size of Sewer l, Flow Full Capacity
b.
Name of Street
Length of Sewer Size of Sewer Flow Full Capacity
C.
Name of Street
Length of Sewer Size of Sewer Flow Full Capacity
wp1355ap.doc•6/02 BRP WP 13-55•Page 2 of 7
Massachusetts Department of Environmental Protection DEP use only:
Bureau of Resource Protection - Groundwater Discharge Permits
Sewer Connections/Extensions VJ Q to 669.1 Ll
1
B RP WP 13, 14�, 1.7, 18, 55 F Permit"umber
Application for Permit for Sewer System Extension
Town
or Connection
B. Project Information (Continued)
7. Location, Length, Size and Capacity of Pumping Stations to be Connected to the existing system:
a.
Pump Station Location
Number of Pumps Pump Size Pump Capacity
b.
Pump Station Location
Number of Pumps Pump Size Pump Capacity
8. General Description of Sewers and Pump Stations within the existing sewer system which will
transport the flow from the proposed sewer extension of connection to the receiving Wastewater
P P P g
Treatment Facility:
See Attached Exhibit'A'
9. Receiving Wastewater Treatment Facility: .
Name Town of Barnstable Wastewater Treatment Facility
Average Daily Flow 1.7426 M.G.D.
Million gallons per day
Design Flow 4.4 M.G.D.
Million gallons per day
10. Does the discharge contain any industrial.waste? ❑ Yes ® No
If yes, list any pollutants which you know or have reason to believe are discharged or may be
discharged. For every pollutant you list, please indicate its approximate concentration in the
discharge and any analytical data in your possession which will support your statement.Additional
wastewater analysis maybe required as part of this application.
Pollutant Concentration Analytical Data
wp1355ap.doc•6/02 BRP WP 13-55•Page 3 of 7
LMassachusetts Department of Environmental Protection y DEP Use Only:
Bureau of Resource Protection — Groundwater Discharge Permits
Sewer Connections/Extensions . Permit umber BRP WP 13; 149 171 % 55
Application for Permit for Sewer System Extension
Town
or Connection
t
B. Project Information (Continued)
11. Does the discharge contain any industrial waste containing substances or materials which could harm
the sewers,wastewater treatment process, or equipment; have an adverse effect on the receiving,
water; or could otherwise endanger life, limb, public property, or constitute a nuisance?
❑ Yes ® No
12. Do the wastewaters receive any:pretreatment prior to discharge?
❑ Yes ® No
13. List, in descending order of significance,the four(4) digit standard industrial classification (SIC)
Codes which best describe the facility producing the discharge in terms of the principal products for
services provided. Also, specify each classification in words.
SIC Code Specify
A.
B.
C.
D.
14. Is the'Proposed Discharge Consistent with Existing Sewer Use Regulations?
' ® Yes ❑ No
15. Is there a site of historic or archeological significance, as defined in regulations of the Massachusetts
Historical Commission, 950 CMR 71.00,which is in the area affected by the proposed extension or
connection?
❑ Yes N:_No,
16. Does this project require a filing under 301 CMR 11.00,the Massachusetts Environmental Policy Act?
❑ Yes ❑ No." .
If yes, has.a Filing been made?
❑ Yes ❑ No .
wp1355ap.doc•6/02 BRP VVP 13 55•Page 4 of 7
s
f
Massachusetts Department of Environmental Protection DEP Use Only:
Bureau of Resource Protection -,Groundwater Discharge Permits
L
Sewer Connections/Extensions' �,(/6666c•Q
Permit Number
BRPWP13, 14,, 17, 18, 55
Application-for Permit.for Sewer System Extension 2Ns�A�LE
Town
or Connection
B. Project Information (Continued)
17. Name and Address of Mass. Registered Professional Engineer Designing Proposed System:
Mr. Daniel Campbell
OF Mgss Name
Level Design Group, L.L.C., 365 E. Washington Street #2
03 DANI L Ft. G� Street
cpAP -a North Attleboro 02760
CIVIL y City/Town Zip Code
o No.46245 508.695.2221 46245
ago 9FQISQ►��`�`� one Num Mass.P.E.Number
/0NA1���
C. Certification
"I certify under penalty of law that this document and all JDJ Housing Development, L.L.C.
attachments were prepared under my direction or Printed Name of Applicant
supervision in accordance with a system designed to Manager-Joese 'h/J,Keller,.
assure that qualified personnel properly gather and Title �/
evaluate the information submitted. Based on my inquiry _F
of the person or persons who manage the system, or Si tore of Applicant
those persons directly responsible for . 917-1 Ie(, '
gathering the information, the information submitted is, to Date SigneA
the best of my knowledge and belief, true accurate, and
complete. I am aware that there are significant penalties
for submitting false information, including the possibility of Daniel Campbell, P.E.
fine-and imprisonment of knowing violations." Name of Preparer
(I will be responsible for publication of public notice of the Principal
applicable permit proceedings identified under 314 CMR Title
2.06(1)(a)through (d).) 508.695.2221
Phone Number
D.•General Conditions
1. General Conditions y,
a. All discharge authorized herein shall be consistent with the terms and conditions of this permit .
and the approved plans and specifications. The discharge of any wastewater at a level in excess
of that identified and authorized by this permit shall constitute a violation of the terms and
conditions of this permit. Such a violation may result in the imposition of civil and/or criminal
`penalties as provided.for in Section 42 of the State Act.
} b. After notice and opportunity for a hearing, this permit may be modified, suspended, or revoked in
whole or.in part during its term for cause,including, but not limited to,the following:.
(1) Violation of any terms or conditions of the permit;
wp1355ap.doc•6/02 BRP WP 13-55•Page 5 of 7
.1
Massachusetts Department of Environmental Protection DEP Use Only:
Bureau of Resource Protection — Groundwater Discharge Permits
1� '
Sewer Connections/Extensions �/��'�W/'
Permit Number
BRP WP 131 14 175 18, 55
Application for Permit for Sewer �pp System Extension Town
or Connection
D. General Conditio
ns Continued
' (2) .Obtaining a permit by misrepresentation or failure to disclose fully all relevant facts; and
(3) A change in conditions or the existence of a condition which requires either a temporary or
permanent reduction or elimination of the authorized discharge.
c. In the event of any change-in control or ownership of facilities from which the authorized
discharges originate, the permittee shall notify the succeeding owner or operator of the existence
of this permit by letter, a copy of which shall be forwarded to the Director.Succeeding owners or,
operators shall be bound by all the conditions of this permit, unless and until a new or modified
permit is obtained.
d. The issuance of this permit does not convey any property rights in either real or personal
property, or any exclusive,privileges; nor does it authorize or relieve the permittee of any liability
for any injury to private property or any invasion of personal rights; nor any infringement of
Federal, State, or local laws or regulations; nor does it waive the necessity of obtaining any local
assent required by law for the discharge authorized herein.
e. The provisions of this permit are severable, and'the invalidity of any condition or subdivision
thereof shall not make void any other condition or subdivision thereof.
f. All information and data.provided by an applicant or a permittee identifying the nature and,
frequency of a discharge shall be available to the public without restriction. All other information
(other than effluent data)which maybe submitted by an applicant in connection with.a permit
application shall also be available to the public unless the applicant or permittee is.able to
demonstrate that the disclosure of such information or particular part thereof to the general
public would divulge methods or processes entitled to protection as trade secrets in accordance
with the provisions of.M.G.L. c.21, s.27(7). Where'the applicant or permittee is able to so
demonstrate, the Director shall treat the information or the particular part(other than effluent
data) as confidential and not release it to any unauthorized person. Such information may be
divulged to other officers, employees, or authorized representatives of the Commonwealth or the
United States Government concerned with the protection of public water or water supplies.
g. Transfer of Permits
(1) Any sewer system extension or connection permit authorizing an industrial discharge to a
sewer system is only valid for the person to whom it is issued, unless transferred,pursuant to
314 CMR 7.13. Such permits shall be automatically transferred to a new permittee if:
A. The current permittee notifies the Director at least 30 days in advance of the proposed
transfer date; and
B,. The notice includes a written agreement between the existing and new permittee
containing a specific date for transfer of permit responsibility, coverage, and liability
between.them.
(2) Any sewer system extension or connection permit not subject to 314 CMR 7.13(1)
automatically transfers to a subsequent owner, operator, or occupant.
wp1355ap.doc•6/02 BRP W.P 13-55•Page 6 of 7
Massachusetts Department of Environmental Protection DEP use Only:
Bureau of.Resource Protection —Groundwater Discharge Permits
Sewer Connections/Extensions
Permit Number
BRP WP 13, 14117118155
Application for Permit for Sewer. System Extension �R�Ns�,6�L
Town
or Connection
D. General Conditions (continued)
112 n n_ra
2. Special Conditions P
15 Uly
E. Approval Recommended
Signature and Title of appropriate Municipal Official:*
.10
Printed Name of Official
Titl Pho7244N,
Nr
d
Sig a Date Signed
} DEP Use Only
l
jatssued Regional Sewer Pe itsCoordin• /3ve Date of Permit
r -
wp1355ap.doc•6/02 BRP WP 13-55•Page 7 of 7
Permit No. W066621
Town Barnstable
DEPARTMENT OF ENVIRONMENTAL PROTECTION
DIVISION OF WATER POLLUTION CONTROL
(22) SPECIAL CONDITIONS
1. Sewer line and water main separation shall conform to guidelines in TR-16,
Guides for the Design of Wastewater Treatment Works, 1998 Edition;
2. Manholes shall be designed for watertightness if located in areas subject to
flooding and for any anticipated loadings; F
3. Provide a check valve at each 4" service stub;
4. All sewer piping and structures crossing within the buffei zone (100 feet) of
any wetlands or surface water bodies or impoundments;`shall be built using
watertight construction methods; ;
S. The permittee 'shall seek, obtain, and adhere to, any local conservation
commission approvals required prior to construction of this sewer;
END OF SPECIAL CONDITIONS
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