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HomeMy WebLinkAbout0011 THORNTON DRIVE - Health ,..., _ ___ _. +w„r-n ;. .:_ ,. S. _," ;3. mxe�p=:_. .,� ;: .r., ..:.� Y..z sj?�r �F.'"+w'b .a•: 3 ._.s ii;_,fit,---. � :•: .'.-; '._: t'�'as, ."....5� :,'-.. '=. `k. �>.,�.,. .. .. .. Y,�f•'s.iK�!' �$".ap 'Ma", ,., ,c�'..+s' S' - �r �'"dx' .;.;,•_ ,..t 3. .. .''.:� , . � �sv�+t x;:4 �"� . d a� .F• �e e;x tic ;:;: e ^�# - a. "� ,i. y r ai- ;,c... �. ...•.: -. . .�, . ktk..>�. .,,k.: '`."i-,",I+.+ r... .. r.,., .-•�<:;. r- k. F:e :ax -t�SA .` .�,.h.nw.; .,�-,. •�: .:-.,... ..,.. .. .,..:53-. -.::k.�fat ars "t�: ,... e' :p �. N+§'.. .V' ,t".' n t •r+ti. •. •i+ i......� -. ...-5... q'•.;,._ ..._ ::.: R _. .. ta`...y.�. .. _E. 0. e.�; t b �F. MA m r. Yam..�',.•�/ ..,>` ✓ µ `�. 9�y(„',��it J Ins :.«. ., -v.�.,, . .,r {.,�s-�pxn,.a.� a rF '" -•'- k. - _ ;$fit X '.� �..: ,. •: :- s' Y , .. i .,,. . �° Y,3 y:�i`. 3 Sri:f.7 _ - :'+e. O�yi:fi r Thorton Dr. ---- - ------- r x ° i a � a UPC 17734 Now 2-1_R NA8TINOS.ON j Hazardou aterials Inventory Sheet Checklist e Physical Street Address-Check database to ensure it exists 1_,Working Phone Number �c ual Amounts—(i.e.gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) • V11"'§torage Information—location of storage,how long is storage for? If none,note that. Dis osal Information—where and who? If none,note that. pplicant Signature—understand what is listed and noted. Staff Initial—any questions,know who to ask. Vehicle Washing/Rinsing?—provide a vehicle washing policy and explain it—note that it was given. *A 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. v'� S TOWN OF BARNSTABLE Date:! TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: al Lj It, BUSINESS LOCATION: INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBE d a' CONTACT PERSON: ! EMERGENCY CONTA TELEPHO E NUMBER: P1117 J - MSDS ON SITE? TYPE OF BUSINESS: 05-61 1- .U.S LEr INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazar us waste: A) Name of Hauler. IVIA 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"Il'a�l 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 LZ 0 4-L6 (including bleach) �.�,�,� ^/ -.lioz I Q en Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents V t Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT./CANARY COPY-BUSINESS TO ALL NEW BUSINESS OWNERS DATE:Fill In please: imp, APPLICANT'S ,hYOUR NAME: 'BUSINESS YOUR.HOME ADDRESS: �o Z�in`..�' �''-9TELEPHONETele hone Number Home / ? — 9" NAME OF NEW BUSINESSvn~'�' �v+� �►oo ,tie TYPE OF BUSINESS NoJ 4r4/ IS THISA HOME OCCUPATION? YES N. Have you been given approval fr rn the Abild ing'division? YE NO° d• hF a�ns MAP/PARCEL.NUMBERZ` ��5� ooADDRESS OF BUSINESS 5"O �cl�S 1 R . When starting a new business there ar 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.. Once you have obtained the required signatures, listed below, you may apply for a,business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the business certificate.first you MUST go to the following office to.make sure you have all the required permits and licenses.. GO TO 200 Main St.—(corner of Yarmouth Rd. & Main Street) and you will find the following offices: . 1. BUILDING COMMISSIONS 'S OFFICE This individual has bee info a of any permit requirements that pertain.to this type of business. Authorized Signa a** COMMENTS: 2. BOARD OF HEALTH This individual s been i f rme of t e eSm't r quirements that pertain to this type of business. orize ignature"* _ �4TCOI�LYWITHALt '�" . COMMENTS: NS 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain.to this type of business. Authorized Signature** COMMENTS: Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. . "SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. �, Q:\CONSUMER\Lois\CA.Formslnewbusfrm.doc 3 s "D OLJ-LA.� (� i Health Complaints 03-Aug-98 Time: 12:15:00 PM Date: 7/24/98 Complaint Number: 1453 Referred To: GLEN HARRINGTON Taken By: KATARINA SOLDATOV Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE Article X Detail: Business Name: MEDIA-ONE Number: 350 Street: KIDDS HILL RD. Village: BARNSTABLE Assessors Map_Parcel: Complaint Description: THE POLICEMAN CAME INOTIFY THAT ON PROPERT�350 KIDDS HILL RD. (MEDIA- ONE) OCCURED SPILL ABOUT 5 GALLONS GASOLINE. Actions Taken/Results: I was beeped and I called back but the phones in the office were still out from lightening strike. I returned to office from Cotuit and responded to the spill by 12:45 pm. The spill occurred due to a rusted gas tank seam in a White Mountain Cable truck parked in the Media-One lot. The gasoline spilled onto a blue-stone gravel surface. The truck was, reportedly full , 35 gallons, when it was left the - night before and only a few gallons were rported by Ron's truck Stop who drained the remainder of the tank. I spoke to Carl Winquist, manager for Media-One. He spoke with White Mountain Cable and they said for him to do what was necessary to take care of the situation. I explained that a private consultant and clean-up company had to be hired by a responsible party. DEP was notified but did not issue a RTN. Dan Bourque, owner of 350 Kidds Hill Road was present at meeting in Carl's office and was explained all options. The spill area was secured by covering with a J Health Complaints 03-Aug-98 rain proof tarp by the Fire Dept. At 4:00 pm, I stopped by the site and Nick Christiani of Envirosafe and Tadd Wollenhaupt of ENSR were excavating PCS. Soil was stockpiled on poly and covered with poly. Tadd said thatDEP said that he could handle this as an LRA unless he had conditions that warranted an IRA. Investigation Date: 7/24/98 Investigation Time: 12:45:00 PM 2 Health Complaints 24-Jul-98 Time: 12:15:00 PM Date: 7/24/98 Complaint Number: 1453 Referred To: GLEN HARRINGTON Taken By: KATARINA SOLDATOV Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE Article X Detail: Business Name: MEDIA-ONE Number: 350 Street: KIDDS HILL RD. , Village: BARNSTABLE Assessors Map_Parcel: Complaint Description: THE POLICEMAN CAME IN TO NOTIFY THAT ON PROPERIY350 KIDDS HILL RD. (MEDIA-ONE) OCCURED SPILL ABOUT 5 GALLONS GASOLINE. a Actions Taken/Results: Investigation Date: Investigation Time: 1 1 I�� �Z%'!f� a.w�.�oQ @ �Z1eG�i�-�"© ls� , _° G✓G�.i vie sF��vk� � � ��v� III S[ a� II� A�z #I� i {1 �f I� !I 1 �,' ,,� ,.a ,I 1 _r ; , �, !� I , � �, ti �yyS� III 4 i �; 1;+ I•i A f[[[[[[ I jj ' 7 11 li E� I +!� ��� I. 14 � ,�J ,�, f(f ��� `Y. ` ' /Il } i�� �€ ��� s �� +' , �,41 _. " _ �. t r, S I r .�• '1 t4 y 1�1 ` i .' .� �� ,� •�� �j� �� -- ��� ;r Health Complaints 01-Nov-04 Time: 3:37:00 AM Date: 10/26/2004 Complaint Number: 17793 Referred To: DONNA MIORANDI Taken By: Sally Shea Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: Business Name: Number: Street: Thorton Drive Village: BARNSTABLE Assessors Map_Parcel: Complaint Description: The caller states the following: There are dumpsters on the next building up from the caller's on each side of him. One is on the street one is back from the street. They are always full and contents are blowing around. On his back lot the abutter has somehow piled a whole bunch of junk onto the caller's r property. They used a bobcat and cleared this junk onto his property. Also the auto repair shop next to him which is adjacent to his parking lot, he saw them taking the engine of a car and there was leaking all over the place. This was he suspects gasoline. Actions Taken/Results: DZM investigated and took many pictures. It is going to'be difficult to find out who the responsible parties. This area is a disaster and should never be like this. Investigation Date: 10/28/2004 Investigation Time: 3:15:00 PM A1�F TOWNO i Arm I , IBM JOOc6 mall _ 1 � OCT 20 2004 _L 3 _ a• � �-`�`"'r- :• / � ..•u-+yam' i � ♦w•, I# 910 ��; • - I -.c •�„��_' s •.i lb aw .o- �' "n - � ! �T n . �• >> n.y �• .tom •. .i •� • r:- Sir �t _ • 1 I N _ •� I♦ r :47i'm fz 0 Nol t� ^;, •� I �;t,:••- `.,._ }'', ! 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PkONC : 508 —775 - 6575 mom 1 19 B ` THORNTON DR _ MiNa. b i ram_. it i MediaOne;,- a�, .r,35 ( This is Broadband.This is the way. ' 12 Campanella Parkway Karl Winquist Stoughton,MA 02072 Project Coordinator pager/978-803-4699 i v �'4F Hit CERTIFICATE OF ANALYSIS c - Page: 1 Barnstable County Health Laboratory Report Prepared For: Report Dated: 10/29/2007 Robert B. Our,Inc. Order No.: G0743907 P O Box 1539 North Harwich, MA 02645 Laboratory ID#: 0743907-01 Description: Water-New Main Sample#: IA Sampling Location:S350 Kidds Hill Rd.Barnstable,`MA^7 , Collected: 10/24/2007 Collected by: D.Eldredge Beginning Received: 10/24/2007 Test Parameters ITEM RESULT UNITS RL MCL Method# Tested Total Coliform 0(32) CFU/IOOmL 0 0 MF-SM 9222B 10/24/2007 Laboratory ID#: 0743907-02 Description: Water-New Main - Sample#: 113 Sampling Location: 350 Kidds Hill Rd.Barnstable,MA' Collected: 10/24/2007 Collected by: D.Eldredge End Received: 10/24/2007 Test Parameters ITEM RESULT UNITS RL MCL Method# Tested Total Coliform 0(66) CFU/100mL 0 0 MF-SM 9222B 10/24/2007 Approved By: _.._.. (Lab rector) z> IE7 ,"`'z V- • 7 V ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 I • ;�l�is �cwco c .�'D8 — �t k Date:Z/Oijoy 5-�- XIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY N EOFBUSINESS: ✓q*✓ Q 57t 1 BUSINESS LOCATION: 1 1 1 o�yl�krs� �i�ir°tae � /�is .MAILING ADDRESS: P,l�, �a>e INVENTORY TELEPHONE NUMBER: 5 0V — "'7'7/ — .32- 5` TOTAL AMOUNT: CONTACT PERSON: Da v i A e2&V' L6,"-4- 3 EMERGENCY CONTACT TELEPHONE NUMBER: TYPEOFBUSINESS: 7"c -CJ�� /�� s FliRe 0t57-RIc,T OTHER INFORMATION: �Ee_O. � oz'c.._ �o�•�nn sie Z esvc_s 'c $ ad <»u�v-1 s Cv✓ed�ho�vi�t rsn -cr-t e_Iisl-c s � �1�/l�u--sn[,c�gG�l l'/���/1btC Lv�S �•t� �'�a.� 7�t���� ✓��2 et7N�� Waste Transportation: Name of Hauler: L)a4' '-s4, Destinatio Lem, Waste Product: Licensed?(Yes No wcAJV+� 6,tA LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners .NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils a?b Pesticides -7 (NEW j9p& USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) .Diese[fuel, kerosene, 42 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink 4 Degreasers for driveways & garages Wood preservatives (creosote) Battery acid'(electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's p Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc: carbon tetrachloride)- 15A Paint &varnish removers, deglossers �✓ Any other products with "poison" labels Paint brush cleaners Floor&furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers ✓ Other products not listed which you feel (including bleach). may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: ,r.e S� (dry cleaners) �'t w,,h.ryia�-� 2— a Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS I— Date: ! / y / TOWN OF BARNSTABLE--�rvtg �t0JA- TOXIC AND HAZARDOUS MATERIALS IkEelfffbkTiGN FORM NAME OF BUSINESS: &a l BUSINESS LOCATION: 3A Kt INVENTORY MAILING ADDRESS: $QK,,, TOTAL AMOUNT: TELEPHONE NUMBER: J-D$ --7 1 5- CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: $��4 s1,\okAzr lmlk-,M %Ov, INFORMATION / RECOMMENDATIO -1N _S: o �� a��-�•�5 �b�.�,o�•. Fire District: CA\)'�4 41oA w� �5 vvkc a �0 f.• . t>rJw%.S ev } QtLk 6< 1S-cc 0' c- a1 \V J 6t jas.A knot- NO Co. Lj �70.y\ a.11�/ iy5-� �lccl'�.wcuC.� ��oc� ,k`�,►S ��cau Waste Transportation: IJ IAu 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) 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 TOWN OF BARNSTABLE OMPL/ANCE: CL SS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops 'O unsatisfactory- 4.Manufacturers COMPANY ` 6'�e 4 ed (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS � / !�Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MAS IN OUT IN OUT M77 Age Test Fuels: ne Jet Dieb , B) Heavy Oils: ' waste motor oil (C) a0,441 e*fr4 new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: ���� •� III h DISPOSALfRECLAMATION REMARKS: ,yet 1. itary Sewage 2. ater Supply V ! Town Sewer Public Ile,, O On-site OPrivate 3. Indoor Floor Drains YES N0� O Holding tank:MDC_ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES-ZNO ORDERS: 0 Holding tank:MDC � �`� �` _7� Catch basin/Dry well On-site system 5.Waste Transporter J _ Name of Hauler Destination Wast e od 10 6Z, YES„ NO 2. Person 7ewed Inspector <r Date TOWN OF BARNSTABLE OMMANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores COMPANYf��'� ,�,��lJ�� r, 6.Fuel Suppliers ADDRESS 4/Z,L; 44Mg V� hags• 7.Miscellaneous �11�Z ,Sd ``t UANTITIES AND STORAGE (IN=indoors;OUT-outdoors) MAJOR MATERIALS Case lots Drums Above Tanks I Underground 7 /-' "V,-Z,5, IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Craso.'„o Tot-Fuel-( Heavy Oils: waste motor oil (C) VensmissiAXhydraulic Synthetic Organics: degreasers Allvef vwt-Xit, rV Miscellaneous: e. �ry DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply Town Sewer Public Q On-site QPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC Q Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO O E : Q Holding tank:MDC Q Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste ProductLicensed? ImoI,,,J 1�9- ;►' /vYS /� S NO 2. ers Interviewed Inspector Date Health Complaints 30-Sep-98 Time: 12:00:00 PM Date: 9/23/98 Complaint Number: 1560 Referred To: GLEN HARRINGTON Taken By: LS Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE Article X Detail: Business Name: Number: Street: THORNTON DRIVE Village: HYANNIS Assessors Map_Parcel: Complaint Description: WHITE MOUNTAIN CABLE TRUCKS ARE LEAKING OIL NEAR MURPH'S RECESSION. Actions Taken/Results: GH - I went to Media One parking area where White Mountain trucks are parked. I spoke with Karl Lindquist, manager. We walked around site. There were no White Mountain trucks leaking fuel or hydraulic fluid. Some surface stains were observed but were not of a reportable amount. Investigation Date: 9/23/98 Investigation Time: 4:00:00 PM 1 Ai TO ALL NEW BUSINESS OWNERS: Fill in below: 1,0 NAME OF NEW BUSINESS: ' TYPE OF BUSINESS L6 coh,3CCA O C4 IS THIS A HOME OCCUPATION? dJC7 - ADDRESS OF BUSINESS 19) Tyy-)r k i1 17i� N" .n n MA MAP/PARCEL NUMBER 7_G ti 00 5 >/ ��� U �"r, N1,11 rlhd If you are starting a new business there are quite a few things you need to do in order to be in compliance with all rules and retulations of the Town of Barnstable. Once you have been checked off on this sheet you may apply for a business certificate at the Town Clerk's office (Ist floor- Hall). . GO TO I ILD G ECTOR'S OFFICE(4TH FLOOR TOWN HALL) is indivi al is in c m iance6pbd has been explained the procedures needed to start a busin ss uilding Inspe 's Signature 2. GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL) This individual has been informed of any permit requirements that pertain to this type of business. e ff V-0,- Health Inspector's Signat re 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY)-(3RD FL SCHOOL ADMINISTRATION BUILDING This individual has been informed of any licensing requirements that will pertain to this type of business Licensing Authority Signature After being checked off by all of the above-remember to return to the Town Clerk's office to actually obtain your business certificate. =f Date: q 30 1 9-7 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: 'Q zm, f BUSINESS LOCATION: MAILING ADDRESS: R . by Rim CMICEVilte oz&30- Mail To: TELEPHONE NUMBER: 116a - 47!a—547-I Board of Health Town of Barnstable CONTACT PERSON: RiChnird A. QbSe�C_3n. P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: 5(M- N,ZSs -G-79!9 Hyannis, MA 02601 TYPEOFBUSINESS: L � ►vim �Lcc. +� �1a,,., .�.hesz. Does your firm store any of the toxic o azardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline orcoolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers NTTSroP-Iff►0 Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: Ci 30 r ..> 1 �( TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: BUSINESS LOCATION: MAILINGADDRESS: `fl X 2iso caq ruwe MA nz&3z- Mail To: Board of Health <> TELEPHONE NUM �t2 �. t Town of Barnstable CONTACTPERSON: 1�ic VY)rd A< nSar-,M . P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER-,, 5C8- �28 -G-749 Hyannis, MA 02601 TYPEOFBUSINESS: o6sent onri;- y+L.cwr, e Does your firm store any of the toxic o hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed i envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity k r Antif reeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners. _ Automatic transmission#luid; M - . `" Disinfectants Engine and radiator flushes rtRoad Salt (Halite) Hydraulic fluid (including brake fluid) a Refrigerants Motor oils ( Pesticides- NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other-petroleum products: grease,:_.. -. Photochem- icals(Developer)- . -_- lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda r Car wash detergents Jewelry cleaners ICar waxes and polishes Leather dyes i Asphalt & roofing tar Fertilizers NO T STI RED f Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, a NEW USED (inc. carbon tetrachloride) I� Paint & varnish removers, deglossers t Any other products with "poison" labels Paint brush cleaners f including chloroform,; (including formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY BUSINESS r TOWN OF BARNSTABLE LOCATION Qyj� ., _ SEWAGE # VILLAGE � ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. 44��- r SEPTIC TANK CAPACITY mww LEACHING FACILITY:(type) -t✓�-Gy�`J� (size) NO. OF BEDROOMS PRIVATE WELL O LIC WAT-fit " BUILDER OR OWNER kl-Sbco DATE PERMIT ISSUED: 10 DATE COMPLIANCE ISSUED: 16 �- VARIANCE GRANTED: Yes No a � �I 2X IS'�Ge���'Gli I l W Age NOVs LO�C AT IONo, � S E Wes-. G E �P MIT .-NO� VILLAGE / I NSTALLER'S N,"E & ADDRESS our B U I'L D E R OR OWNER �v�sk2 awe S V DATE PERMIT ISSUED , DATE COMPLIANCE ISSUED 7 D No THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH vE® TOWN OF BARNSTABLE Appliration for Biipnsal Works Tons u1°-= t� Application is hereby made for a Permit to Construct ( ) or Repair ( �an Individual Sewage Disposal System at: rr ` ................I 1....1...1!kA lit CAL... Z","9— jA_- c�k CSC dS �..... .._........ .......................................... - Location_Addre or Lot No. !��` ......... ��. . ttcs� . : =� cam...................................................--..... Owner /,�� Address W � dr.—d==.................... •-•••-••-_--_V-=-=�_ �«�.•.............................................................. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms____/ 113___________________________Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building No. of persons____________________________ Showers ( ) — Cafeteria ( ) dOther fixtures ._._._____ _Vvv11v............................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow..__._............v______-_______._.___gallons. WSeptic Tank—Liquid*capacity----------__gallons Length................ Width................ Diameter__._____________ Depth................ Disposal Trench—No_ ____________________ Width___._i___-__________ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......I............. Diameter.....lj(;�........ Depth below inlet___............. 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 Test Pit.................... Depth to ground water........................ Gi, Test Pit No. 2................minutes per inch Depth of.Test Pit...:................ Depth to ground water........................ 9 -•---•--••--------------------------------------------------•-•...•-----------------..._••-••_-_............................................................. 0 Description of Soil............................................................................... x V ------------------------ •-------------- •-------------------------------------------- ......----------------------------------------- •----•------------------------------------------•-•--••--------- W U Nature of Repairs or Alterations—Answer when applicable.__ G a4�1�-Lk_.....QW- �"______________ •------•-----••-•-------- ----------------•--------------•----•----•------.........-----•-- 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 boajrd of health. Signed ---- ------------ ----------------D-- ---------- ate -, Application Approved By -- --------- ---------------------------............. -- Dtte D Application Disapproved for the fo lowing reasons: --------------------------------------------------....-...--. --.-.................................. ---------------------------_---- Permit No- -------- ��- - Issued ......................... Date.........................................................-- ....... No. a- V FICs THE COMMONWEALTH OF-_�MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE A n ltratio for Day aii al nrkii Tous#r�n Ofrint# Application is hereby made for a Permit to Construct ( ) or Repair ( t) an Individual Sewage Disposal System at: Location-Address , or Lot No. �.........:�_.�:/•( _ ra_F:�..�..:f�..•. r 1�L1 L ii d� !1—�✓V - : C4'Ck t l..................................................... Owner Address w ............••...._ �!. ,n n__C.�..l,..f.%I RC i,�( -. f l[ R_�. ��c V `i`\I `'�" V ' Installer U Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......p,1,hAz........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building .... of persons____________________________ Showers ( ) — Cafeteria ( ) GI Other fixtures --------+?�^_�(n._�.a n_ Q . -----••---•--•-------•--.... •------•••••-••-••-••--••••-••-•-----•---...••_•-••..... 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.........i.......... Diameter........I_t?_..... Depth below inlet....__(s?_.......... 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 Test Pit.................... Depth to ground water_.-____--______-_____--. LZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •---••-•-•-•-----------------•-••••••-••--••--------••••-----•--.....--•----------•-....._-_•_-_............................................. =.............. 0 Description of Soil....................................................................................................................................................................... x w U Nature of Repairs or Alterations—Answer when applicable._ .____O1 .............. ..............................................................P J 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 - ._u� •r�, i. �� Dare : . Application Approved B'� ----...N................ ^^� _Y�� .�... .e,- � Application Disapproved for the folaowing'rearonr: -------------------------------------------------------------------------------------------------------- --------------------------------------------------- -- -- ---- -- -- ------ ---- --- ----------------------------------------------------------------------------------------------------- ------------------------ .....w... PermitNo. -------- ............... Issued --•-----------.......-----...---------------.-... - -[e--...- Datc THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE QuIEr#ifirate of (ILlomplinure THIS IS �((P TO( t_ERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( L---)- by.............................. --�..1��. --- ---.- ..-----------:f5r__ 1�1r!L----- -- ---- ------•-------------------...-----------------------------------------------------............------ -- Installer ........................................................................ 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. ....�a........ ..---.:. dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................... _ ...�d�.... Inspector ........ .-...: .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No... ..��- •---°�,F C1 TOWN OF BARNSTABLE - FEE. ....'..- Disposal Works Tnno#rnr#ion ramit Ct l� L,tn�rl� S� e C Permission is hereby granted ---------------------•....---.---------------.._..---•------------------.....--••--••----....-•--------...... to Construct ( ) or Repair (clan Inpdividual Sewage Disposal System 1 �nv�`C�rt - e !` --X ly(vi) at No. I----••-�--•..................................•-•--••--------•-Y --•-••-•-•-•.._..-•--••--......--••--•----•-•-••••••••-.........•..... Street e� as shown on the application for Disposal Works Construction Permit No g-D 7. Dated...:...................................... , �----------------------------------------•--......... r�O ��n Board of Health DATE........................... ------•...................•--•-+�--,-----------•---- FORM 3850E HOBBS Q WARREN,INC.,PUBLISHERS LO• CATION SEWAGE P MIT - -NO. VILLAGE �ljG — �3J INST: A LLER'S NE & ADDRESS c%/v BUILDER OR OWNER �rk4e L DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Lt-i�I c2� /VGvs� t s I TOWN OF BARNSTABLE CF TH E Taw OFFICE OF HAMSTAM : BOARD OF HEALTH y MAM ,, 0o 1639• ��� 367 MAIN STREET MAY k HYANNIS,MASS.02601 March 8, 1990 William Meyer 43 Mayflower Terrace South Yarmouth, MA 02664 RE: Unit 2 Thornton Drive Hyannis, MA 02601 Dear Mr. Meyer: The Health Department has no objection to granting you permission to utilize the above referenced building unit for the purposes of automobile storage with the following conditions: 1) Maintenance, repair, and servicing of vehicles is not authorized. 2) Washing of vehicles is not authorized. 3) Gasoline and oil separators (MDC Traps) are required inside the building. A licensed hazardous waste transporter shall maintain the separators on a routine basis. if you should have any questions, please do not hesitate to contact me at 775-1120, extension .182. 1 Very truly yours, Thomas A. McKean Director of Public Health Town of Barnstable TM/bs January 1 , 1982. The following persons or establishments were issued Class I, II & III Auto Agents licenses for the year 1982. These are straight renewals unless otherwise noted. NAME CLASS DATE ISSUED A-1 Auto Sales II 1/l/82 158 Corporation Road Transferred to Hyannis, Ma. 416 Yarmouth Road, Hyannis Airport Motors Inc. I 1/l/82 Lincoln-Mercury-Mazda 556 Yarmouth Road Hyannis, Ma. Airport Motors Inc. d/b/a II 1/l/82 Airport Auto Body Route 28 Hyannis, Ma. Airport Motors Inc. d/b/a I 1/l/82 Central Cape Dodge --�- 600 Yarmouth Road Hyannis , Ma. American International Rent-a-Car II 1 1/82 538 Bearses Way Hyannis, Ma. Anchor Auto Sales II 1/l/82 380 Yarmouth Road Hyannis , Ma. Barnstable Auto Rental II 1/20/82 d/b/a Payless Car Rental (Transferred From Barnstable 287 Iyanough Road Hyannis,Ma. Auto Sales) Bayside Motors II 1/l/82 143 Old Yarmouth Road Hyannis, Ma. Ray Blackburn's Auto Salvage III l/l/82 Airport Road Hyannis, Ma. Bob-Ric's Auto Parts III 1/l/82 Straightway North Hyannis, Ma. Bob-Ric's .Auto Parts II 1/l/82 Straightway North Hyannis,Ma. Dick Beard Chevrolet I 1/l/82 Ridgewood Ave. Hyannis, Ma. r _2 Barnstable Road Auto Sales II 1/1/82 Corner of Louis St. & Barnstable Road Hyannis, Ma. Bilkin Auto Salvage III 1/1/82 800 Wakeby Road Marstons Mills, Ma. Buckler's GMC I 1/l/82 100 Ridgewood Ave. Hyannis, Ma. Cape Auto Sales Inc. II 1/l/82 68 & 69 Center Street Hyannis, Ma. Cape Car Mart Inc. II 1/1/82 84 Barnstable Road (Change to Corp. formerly Hyannis , Ma. Charles Mitchell d/b/a) Cape Cod Motor Sports Center I 1/l/82 353 Stevens Street Hyannis, Ma. Cape Motors Inc. I 1/1/82 Airport Rotary Hyannis, Ma. - Cape Wide Auto Sales I II 1/l/82 730 Bearses Way Hyannis, Ma. Cape Wide Auto Sales II II 1/l/82 93 Falmouth Road Hyannis, Ma. Chris Bullock Toyota Inc. I 1/1/82 1020 Iyanough Road Hyannis,; Ma. Everett H. Corson Inc. I 1/l/82 1040 Route 132 Hyannis, Ma. Jack Ellis Foreign Auto II 1/l/82 515 West Main Street Hyannis, Ma. Dick Garbitt Investment Auto's II - l/l/82 118 Thornton Drive Hyannis, Ma. Gillis & Tivey Inc. I 1/1/82 362 Yarmouth Road Hyannis, Ma. i -3- Harley Davidson Cycle Center I 1/1/82 100 Ridgewood Ave. Hyannis, Ma. Hillshire RV, Inc. I 1/l/82 55 Airport Road Hyannis, Ma. Hyannis Auto Inc. II 1/l/82 478 West Main Street Hyannis, Ma. Bourne Bridge Auto .Sales I 1/l/82 d/b/a Hyannis Saab 163 Barnstable Road Hyannis, Ma. Hyannis Kawasaki of Cape Cod Inc. I 1/l/82 405 West MainStreet Hyannis, Ma. Earl T. Legeyt Used Cars II 1/1/82 Bearse Road Hyannis, Ma. European Car Service II 1/l/82 63 Cit Avenue Hyannis, Ma. Hyannis Porsche Audi Inc. I 1/l/82 Phinney's Lane & Route 132 Hyannis, Ma. Hyannis Porsche Audi Inc. I 1/l/82 830 West Main Street Hyannis, Ma. Hyannis Texaco II 1/l/82 Route 132 Hyannis , Ma. Imported Cars of Cape Cod Inc. I 1/l/82 Stevens & North Street Hyannis, Ma. Jim's Arco II 1/l/82 792 Main Street Osterville, Ma. Jim's Gulf Service II 1/1/82 831 Main Street Osterville, Ma. Meadow Pond Inc. II 1/l/82 Lot 47 Thornton Park Hyannis, Ma. Merrick Inc. d/b/a II 1/1/82 Hyannis Auto Sales 61 Falmouth Road, Hyannis -4- MidCape Motors Inc. I 1/l/82 332 Falmouth Road Hyannls,Ma. Mike's Cape & Islands Gulf Service II 1/l/82 Route 132 Hyannis, Ma. Moore Motors Inc. I 1/l/82. 13 Main Street Hyannis, Ma. Pilgrim Auto Sales II 1/l/82 416 Yarmouth Road Transferred to Coyne Motors Inc., Hyannis, Ma. 587 Iyanough Road, Hyannis Rotary Auto Body Shop Inc. II 1/l/82 Barnstable Road Hyannis, Ma. Thompson Motors II 1/l/82 740 Bearses Way Hyannis, Ma. Thornton Drive Auto Sales II 1/l/82 Building #23, Thornton Drive Hyannis, Ma. Tracy Volkswagon Inc. I 1/1/82 Route 132 Hyannis, Ma. Trans-Atlantic Motors Inc. I 1/l/82 Route 28 at Airport Circle Hyannis , Ma. Warren Buick Inc. I 1/l/82 100 Barnstable Road Hyannis, Ma. Webb Auto Sales II 1/l/82 95 Corporation Street Hyannis, Ma. Yarmouth Road Auto Sales II 1/l/82 202 Yarmouth Road Hyannis, Ma. Lebco Enterprises Inc. I 1/l/82 77 Flint Street Marstons Mills, Ma. Puritan Pontiac Inc. I 1/l/82 460 Yarmouth Road Hyannis, Ma. Robert's Auto Wholesale II 1/l/82 100 R Ridgewood Ave. Hyannis, Ma. -5- Village Auto Sales II 1/l/82 R.Q ute 149. Marstons Mf11s, Ma, r Coyne Motors. Inc. II 4/2/82 Paul R. Coyne Transferred from Pilgrim Auto Sales 587 Iyanough Road Hyannis,. Ma. Thomas Brown d/b/a II A-1 Auto Sales Transferred from 4/2/82 416 Yarmouth Road 158 Corporation St. , Hyannis Hyannis, Ma. I �_ i THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M A-C&, LIL-. DATA I a:` � � .^`d is .e;n � �•.�,� �. �';� �, r., n. ,r' .at 3 4 4 ':� ".• s - r� THE COMMONWEA TH OFCMASSACHUSETTS .: .. d e F ; BOARD"s OF_tKE . a r ' pNOTICE ;I O tBATE,A NUISANCE F owner f dx '4 -z` As occupant ofc you are hereby notified'to remedy the."conditions named below wifhm 24 hours of= -he servi-e of this notice, according to Massachusetts. ' General Laws,Chapter I'II,Section 121 i e`3 ''t�,y�{��9. ,.�.,�1'^"�� .w✓,(�. ,+T .�'v a...f��r,.�. � e r� d�..n�tr� �� a, �', y 7 k� ' "4�` t Yf r lam'• �ar17 !' �:..•7 :✓ ,�. i rt z ' it l���'^: f� -�. �I.,+P^;'�`! >,;�'� •��X '^.! `.ft 111�,.,Yr'G"• r 4 V. r y rt If at the,expi ation of&&'lime 'allowed°these,conditions have not-been remedied such further action ill be,taken as the'law requires and a f, ,. fine of,$^ .00 er day in $ harged By.Order of,the Board of Health A', Ins .ector- d °FORM 80dk088S 8 WARREN INC REMISED 1979 p9° 4 ;4 v ..�' r° ; �'�! eW G E E ! @,3'e° a�}„, �'' '.3�i.P,s .w„t - { '� ° >.' am+•�' an��,r cv i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NOTICE TO ABATE A N/UISANCE ;owner As occupant of •!� 7^• T., ;,.,�, you are hereby notified to remedy the conditions named below within 24 hours of the service of this notice, according to Massachusetts GerTLaws,Chapter III, Section 123: %r ../i._�.•.� •..^�.•,.,/,.. ,� .mil�r'�.1/Jam., •�,s•; �-u�,.� j If at the expiration of time allowed these conditions have not been remedied, such further action will be taken as the law requires and a fine of$20.00 per day may be charged. By Order of the Board of Health Inspector FORM 600 HOBBS&WARREN,INC. REVISED 1979 I a °a� e' 1 ' : s . DATE fr . �"Z ❑ URGENT SOON AS POSSIBLE BOARD o HEALTH H FILE NO. ❑ NO REPLY NEEDED 367 t13in Street F. U. Box 534 1 HYANNiS, FAASSACHUSE s i S t32 t3I ATTENTION 1 TO SUBJECT I MESSAGE /61//1 WIA1,0 �ds.� ss�s f,2E" .,�ic�•+�cr� /illwaaex `" ,NICK �l�kB�7'T /�/t��sT���T �v�v S 3 " fh�D�2MTo,� ���E/t" �✓j .5�9,1Ef Are° ,�fl'",, 3" . �3r/rc�/�✓6 'tea 3 T/�'a,P,vro� l�.P / C�" Do ►� APAIV AWL .°" wQ u� ��(��,� T�= Y�u� 60Of x,#//D,v /oT `/7 T�W7-aAl IAI 617-1,44 r/Vs,,c7 11-OX ar?a n1 SIGNED.. REPLY D loj�RIEY SIGNED SENDER. DETACH THIS YELLOW COPY FOR YOUR FILE. MAIL WHITE AND PINK COPIES WITH CARBONS ATTACHED. �v /u LOCATION J SEWAGE :PERMIT NO. lc�xilir o�_ ✓ VILLAGE INSTA. LLER'S' NAME i ADDRESS' t UILDEA OR OWNER DATE PERMIyT ISSUED DATE C,OMPl1ANCE ISSUED ti ° • r - j J J LOCATION 5EWACZE -PERMIT U( VILLAGE WST.QLLER-S ► NME ADDRESS L� ILDER 5 1a MF_ ADDRESS DATE PER"I'T. I55UED D ATE COMPLI &MCE ISSUED , s _ r/ J FEB _W THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TO.�V...W........OF...... ................ ....................................................................... Appliration for Di-4paiial Works Tomitrurtion antit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: Ir ... .. .. A 7o)v . U A./..... ............................................................................... .................. .. catidd ss Lot No.................... ....L T&. ...... . — . ................ Owner Address ........................... u ................. Installer Address Type of Building Size Lot- ------------------•......_Sq. feet U Dwelling—No. of Bedrooms.,_, Attic Garbage Grinder ( pa., Other—Type of Building ............... No. of persons.....�Z�......... Showers Cafeteria ( Otherfixtures ------------------------------------------------------------------------------- ........ .............................................................. Design Flow......................ln,.$ ..........gallons per'person per day. Total daily flow---------- '.......................gallons. 1:4 Septic Tank—Liquid capacityJ0.0...gallons Length....__4!...... Width..E-7......... Diameter---------------- Depth.........._.._.. Disposal Trench—No. .................... Width.................... Total Length..............._.... Total leaching area... -------sq. ft. Seepage Pit No...................... Diameter._.................. Depth below inlet.................... Total leaching areaA6_0.......sq. f t. Z Other Distribution box Dosin I"�i " ) Percolation Test Results Performed by..-A a :......YN.i......k ............................................ Date... .............. . Test Pit No. 1....A--------minutes per inch Depth of Test Pit---�le.�........ Depth to ground water._V�f�:'_P!........ GT4 Test Pit No. 2................minutes per inch Depth of Test Pit............._._..__ Depth to ground water......_..__........._... ............................................................................................................................................................. 0 Description of Soil....0.7.3..... ..............V-A ......... ............................................... ....................... . ---------------------------------------------------------------------------------------------------------------- 0___ - / ........ -------------------------------------lym. .................. - -------------- -------------------------------- U Nature of Repairs or Alterations—Answer when applicable-___-_---J__k�p,-----41 _C............................................. .............................................I..................................................................JWX---------- ............................................... Agreement: - V 1 Je The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT!�E 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 hea th, A ,... .. . . . ......................... ................................ Signed Date ApplicationApproved By..:.....).../(............................................................................. ........................................ Date Application Disapproved for the following reasons:------------------------------------------------------------................................................... ........................................................................................................................................................................................................ Permit No. 7.3..7 Issued............. Date . .......................................... /...................................... Date No -- ._._....... ........................... THE COMMONWEALTH OF MASSACHUSETTS SOAR® OE HEALTH . .._........ .._ 1.........oF....... .... liratiou for Uhipuua1 Workfi Towitrartiort ami ,5 F#4 Applictiol:I is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage blspbsal System at: ors >�. +� ....70 ,�� "�? . ............................................................. -....... U i� ' ../ r-e cation Add ess r Lot No. ' r�-r- ti - -B , � ...-•-•--.- _ �.: ......� .... _ .. ........ -•- ---•--- j / Owner � /p p t y— Address a 1 0A _1i.vL.d l ...................... ... C .._P )1- Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( ) t pI Other—Type of Building __�L.w.__�............... No, of persons._._. __..________._.. Showers ( ) — Cafeteria ( ) A4Other fixtures ----------------------------------------------------------------------------------------------- W Design Flow_______________________________ .____gallons per person per day. Total daily flow..............................................gallons. Ri Septic Tank—Liquid capacity jOvq_._gallons Length....... ...... Width_-�:___________ Diameter.................Depth Disposal Trench—No_.................... Width.................... Total Length.................... Total leaching area___ " G..: sq. ft: Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area2h.._(P.......sq.'ft. Z Other Distribution box O Dosing tvn ( ) Percolation Test Results Performed by.. ....::_. .-V ..._k_.:_1�.°.....:.............................. Date__./�! ..f. ._ ____...,__.... aTest Pit No. L__.AA-----_._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........................ ----------------- -----------•=--••----••-----•••-•-----•--••------•----•---------•---------•------------------•------•---------••---•-----•-•------••- O 'Description of Soil C1 •---• �•---• _®_! .......................... x ° - ......... � !`: f �! :.1_............. ....... __ _-_t.t�__..5 ?.. :_G. _ ? _. ........................................ v 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 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 issued by the board of health. f Signed.., .� ........................ ,. j/- . + "� "tl Date Application Approved By--- -tj- Date -• ---------------------------••-----------------•------•---•---•------------------ -•--•-•----•------- ----------.......-- Application Disapproved for, he(following reasons_____________________________________________ ----_..--•---•---•----•---•-•----•-•-...•-.-- .............. .........................•-••----•----._...-•----•-----------.._...------•--------------....---':::::.......--------------•------------•----------------------------------------------------------------- Date 4 Permit No... - e ........................................ Issued............ t?it- -' Date ,. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / ..! .. .............OF... �.. f :" ...�.. ...! .. _..L. ......................... , a:J Trrtifira#t of Tompliana L.- THq IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) 1 ( by............S'� a >_. _ ......... J Y": ••-••------ --•-••-------- -------------------------- ---------------------------••••-•--•---------•---- _.i,, ) r Installer 6 at "_IZ ._._�.... ��<fJ. _ t^d.!_ 11 a v }i d .= } .- _ has been installed in accordance with the provisions of TITLE; 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No___...................................... dated------------..........................,......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE AT THE SYSTEM MILL FUNCTION SATISFACTORY. - -� s DATE... •_. Inspector--- .---- 2 •, ,. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No....... FEE 7 Dispo, 1 Works Ooitutratiou amit Permission is hereby granted_______._'�_.Q......%.":.✓`:__,( ..........................................""' b_ to Construct ) or Repair ( ) an Individual Sewage Disposal stem i Street as shown on the application for Disposal Works Construction Per -__ .''..__:_____ Dated--------- _ _ __ _____________ a L / _ Board of Health DATE.......E/�-- j ...:...........•----•------......... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 1 r7l p e✓C,^ r t h:r 'y•G" _ -r..__ .. -rr' --_ - — .:-l.a T _..e-•"`"°r`r'"C� �.,^-.A ^S.:x,+ 'F fx 'v`+'�r`t`''' F F•, r�t"i u g f'i f =• a y'. F - vt n I _. 3" ,g{ � n �.r„t � TV i �,� f. ttpl 'It' rtiti 1/<f { } l , A, r , €7� h. 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Y ,�► `9* 4"•' a.i y1tr4 �> r n � r P a i u / k vu",darYr,: L0T•'. I s. , ' M It 'lr1f,;ci1 1C- , r,°,'f$`cv �jr ? ,� ,pRsil'�d�, kxt 1_ T •crY �' '>"e x 4 P= z r ,?. ..i. - r * T "'z•# a3# i "};}1. ��,� 4 ti' ` e �` �p�.,�`r ��^;� u S i r /42'.3 ,„l ,:r rtsT•,�vn� �"+"yr� �,j�,�'�'�j � > s A ArvCt"4ki. R M; {{VV 4' ��iarS! Sir .lqY k wv ,* F 1/ �. " -g'• .�a xt1 Z t � �` !„ E rlf Wfi 4f A S{J� rJ• Fte a �e y < ; g �. qy e a x`( z. a''� YAz,f tb # 'r' # s' .� °.•, ;6, a+ ,�,R��!. r° '�,>}d" 1,° x�.4 t�.�•��,t, sd w„ r ,�. �� ,®.p v yiv ` `N ri •h'F" 7+ 1 .e, r r .� ' t1 ``�� zv M '' n Y �; rt .. ? - � Fnf.... { vp p{} ;Sf u.Va ' h£ f t } `:. I ,•x ' f , C3 ��F1� �i¢•r��,,,,��7 z�, .* x '�-.4 �'�? /{ .f,r r - 4 -r X:3 x L] .. Fi �V i'���S ' —t' {� 4.,ars �p ��,S�' M No.22162,p ��„ t +r A F }I f� .. .9F,pS, 6 � t k s� <N o r. « x ONAL z. 5 P k r ##z,i yF `iP " r"r� ��li� Nis+nip 4 ! r : � '•.s/ z � '�,. f �i:��r.4 h�lr+��t.`w� Y LEVEND st i 1 itf to, + 9 TINrQ ;1S1P0.TI, E�L,EVATION' Ox0 I C,ERT,IFIED , PL'OT It,,"! b �4 O.N:TO U R', i };O .� Est r ,' �' 7ff'Qp � w i ;v�,Fy� d�SNE��� SPOT .ELEVATION �.] -- —.�. <- "�{ r ' FwGi ONT0UR ^ � , rt r i� i .t�` c`g r� 1 r r v a t t. f a" s'•;r:7r s�Yt ng l,pf n S,t ` I Naai ®OARD OF HEALTH y t • y t ,i A. #y r f f All, - I �D. JAwlt tfr x a rv - .`m ;..1 m r — � A GENT :'i~ t a t SCALE :I 0 DATE Ig4D`GEIVG/NEER/NG CO. ING��' MAcG42TN r CLIENT I -CERTIFY THAT THE 'PRO'POD ` s,' ISTEREC i �REGISTERED�' 7�0 w " �$ Y, I J08 NO. .- 97 BUILDING SHOWN DN THIS` PI C hV t''L t!A N p r i +`� i CONFORMS T0' THE ZONING i, ' s .AtG1WEERS�, SURVEYOR DR. BY /4 .�� : OF BARNS ABLE , MA5 OS�� IAfiN STJ 712 MAiN T. CH. 8Y StlV��UTH, MASS. `MYANNIS, 'MA .' Zr ,n. >, :1 SH;EET_1 OF ___ ipATE R G . LAND ''S'�R11'EYOR -rsc y] 17 4-1- 777 Nq� 4 Aee ZIA 6,0*05 -a*A vt=_i 4e,mo a. .74 77� 14— -N.-,4 V Y CA-S-7--:/,T 0' co livIeNs C Z EA A/ -5*A NAO Ll(pulo LEVEL 'LAY-R. 4"CAS7 OF Z, FD 570N,-- je�,q 6A4. WA 5 Hk MIN pl/r4c D 7.' 0 a Go A. S,6pr1C -.rAAIX BOX 'D Rem WASNEP STONE 0 a 0 a 0 ILI 4 0 -0 0 PI 7 R EV411 V 6 --r. 1AWIEN7 AT 04111-DIA16 FT -rqdL1l-A 7-),OV 04/*7/-,=- 7' SER71C 7A/VX F7- F/r 7ABLIE IAzFr P157R145arlo'y Box 9 0,6 �=7 GROUND WA7-2 o4j7ze7-D157,-,s?lail-r1oN -9f,v-47-7 I �p/jV4a=T I-.RA C H I NCx 4=-.07- 27� FT 7A- 801—ATIDA". LEACH11V6 .JC3'/T -7- A -T, DE5161V CdR17',C-MIA SOIL 707-AL 1=40W G,41.1,9A Y" SOIL. /.0 -7 1 kii�7- : 0,= 40ACLNIIVa Plr.:� OA 7 _7 4=;r SID,0 A.,--ACAllVCr ApeAt R117"-1 S-149- RESULTS PVIrA'- 'ay 40 o-r-rolw 4�94 CAflAlcr xwR P1 7' 7 E--'SQ. L-,0 RA7,,L-r TOTAL J-e,4CH1W4fr- AREA '2-1�fP SQ. ',F77 FL-kCol-A C,Y/AeCT AREA. 10 SQ. FT. V5 L EA .13 0 tv 7. BERT, P. C3 BUNIKIS t, C3 jn( rV o.2!2;A2 4 .im,tv A I C. AV 7� , MA rA-RYA- VI!, --M��o VIV 7-,4rA- r w- ,47Z 514 P- -7. to miry J t� (r , TN.E�S—PT�`C TA•iVk. DR :`., , 20 FT `M//V w LEACHING PiT ARE '/"LORE .Tf i9.N-"/2: BELDN/ /N S GR.a1 OEM i4 24.'p/AM ET.ER; Co,/� G'RT.E CO!/ER y 770 T/�!q. a . "PVC i4► J � .• - ELM/''l z- + • �M/N• P/TCPN � co, P/ V'LY C DNCC RO sVE /F/A' DR/VEWA y0/ COY I8"PFR FT a 4 L CJ S E N AC.rG�LL r ' - LeQcII-® LBYEL _ d, AYER -0-CAST IRON PIPE /DU t� GAL. ` v •a o , • • •, . • •p• MIN•P/TGN p'/ST, 4 j W.!,iSHFD 57OME SEPTIC TANK , , • • . r o d 4 I A • 1 $ 1 11 •� r n•,0 a 'j • - �; 1 I •EFFECT/VE o r.l • DEPTH • • •' r 1YA5HED STDNE D •... r _ o c r • 1I GE . e • • • a: o: n PGRECAS T SEEPA - •• On 4 t /N!/BRT EL E!/AT/oN.S - . E% :v, /N.Y.ERT AT BUILDING 9� FT. �.- —j ' ice s_� - . - -- SE TAB LAT10 6 FT D/AM _.r SEPT./C TANK /- j' FT. D%AM,� :_ C E u h� OtJ74ET SEPTIC TANK 98, /IVGET D/STR/BUT/ON BOX 9,Y,D SECT/QN'O F GROUAIP W,ATEA- TABLE' OlIT4E7-D/5TR/BIIT/01V®OX 97,9 FT INLET LEACHING P/�,: 97, S fT. IS O/SPOSAt SYSTEM -A494� ,�4T1��'h/ - L EACH1/V6 PST vJr/ENS/o neA F ' l SCALE Y4 _ ?�-� O T.. SIGN CR/TEfIA D/��as/ r GY NA -.l v/"1 2 0 PE s.o/VS D/MEN"S/ON C ¢ f T M{n! . S S 41 _ SOIL LOG{ GARe.4GE DISPOSAL uN/r E. -7- TOTAL 'E.ST/MATED FLOW `5 L.IDAY SO1 L TEST 16E/ SO/L T6'ST�2 /{(UMBER OF L,CrACHINGr P/TS__._� i ,f^L�"LE✓ / �ELEY 9�.a ,DATE aF".SOIL TEST _� �a 3 7-� - 5/0E AIC,4CH/NG PER P/T �� PLRCOL�TA N RAE /BY 3 2 - Z•Py Aforom 464CN/IVGPER P/T $;- FT. y/".J/✓/�V��ciISN- CK - FlLL.� C-DA•M' Gash M � TOTAL LEACH//YG AREA z� �' SQ• FT. _ � Svc 5 or Z.,. ��13.5��� ��COLA;T/GN RATE�2 ! —2•y MJN�1NCH RESERVELE.4CNI/VG AREA SQ. FT. _ 3 i_ 4 ' Z i_7 m �� fi,✓c— SAn�p p�ni 549N1� /v1 q GC. R7"N Y L a r U R ¢7 OF AYE`. ... H S d2 C2 tt.r v+ 08ER T 1 A5 - �o RTi � t3di✓y �A /V% g F. rn �R Fi✓F L '7co { • w'O � o ,�• EL`OREDCsE EJ1kr/NEER/J1/G CO ING. _ ELEr/;' 86; O 712 MAIN Sr. 33 NO.MAIN S9' �WO GRO[JND YI/�4TE`l4 E/VCOU/VTEI�'EO j NY�4NN/3 MASS SO. YARMOUTN�MASS _ • . f ND..�� SHEET 0A GGO uvo w-47ER ATELEv ' i - r- - "` r , r U� No......vA--•-•---.... F�s........ ..r� ............ THE--wMM-0-NWEALTH OF MASSACHUSETTS BOARD OF HEALTH �ULcI� ........------- OF...... � ..fT�I�L� ApplirFati>o n -for Di,s oiiaal 10orkii Tutuarurti n Vrrnift Application is hereby made for a Permit to Construct ( ) or`Repair ( ) an Individual Sewage Disposal System at: c * ; Lor tion.Add r s or It....... No. m ,�'�'Ul= �11.t _� .? 111 U�►�_,(f^N A�_ .1 ►.(�.i ,c.�_ ►: E� ��/l C �wni r A _-------------- Installer ddress Type of Building ,^^Size Lotdcq.jc�. .........Sq. feet U I,'" Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage`Grinder ( ) p.., Other—Type of Building No. of persons....::=............... Showers Cafeteria (kJ) dOther fixtures -----tulz----------------__----- ------- -------------------------------------------------------------------------------------------------- W Design Flow................ ......................gallons per person per day. Total daily flow_--_-._-._.=1.d4?---------------------gallons. WSeptic Tank—Liquid capacit.V 0000_--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. It. z Other Distribution box ( ) Dosing tank ( ) '-, Percolation Test Results Performed bY.......................................................................... Date---------------------- ----------------- 1-1 ,� 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.......----.--..------.. 0 Description of Soil---- (> ------------------------------------- 2 j ------ —1�?'" �c.I/ ...---•--...--------•------- ----........---...............------------ 44 U Nature of Repairs or Alterations—Answer when applicable.-.-------- -- -- ---- --------------------------------------------------------------_--- -- _ r ---------------------------------------------------------------------------------------- r .------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article \I of the State Sanitar Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has n issued bbyt rd of 4kalth. Signed-- --- ----------_------------------- A lication Approved By------- ................... " Date Application Disapproved for the following reasons----------------•--------------...--------------------------- ------------------...........----•-•--------------• . -----•------------------------------------------------------------------------------•------------------ ---------------------------------------- ------------------------------------------------ Date PermitNo.--------•---------...................-.........-........ Issued..-./.---------------- ---- -•-- ---------- Date THE'&)MM*NWEALTH OF MASSACHUSETTS BOARD OF HEALTH .1 4C,t.-1... ..........0 F....... fJA�Sr11'di'L 19 .......................... Applirntion -for M!ivuiittl Works Tot.mtrnrtinn Vrrntit Application is hereby made.for a Permit to Construct_( )' or Repair ( ) an Individual Sewage Disposal Sy tern at : ) T' '1"" 1 a R v t ,fin /f 1 �'r. ---- -------- -T Lo tlo--Add r s or Lot No. kJ l9.tkt_� _ s.tLt:.. ' �1 � _Qw . ............................ R Owner 't s ; ,,,. Address Installer / ddy dType of Building Size Lot ! ''_ --------Sq. feet aDwelling—No. of Bedrooms---__ '"."_`------•______________________Expansion Attic ( ) Garbage Grinder ( ) pi Other—Type of Building W#L_1y0.WC*___ No. of persons............................ Showers Cafeteria (A04 Other fixtures .....III 4.0-------------------------------------------------------- = W Design Flow----------------90...................gallons per person per day. Total daily flow..............1Q ________--.-.--..-..gallons. .•_:P; Septic Tank—Liquld capacity _-_gallons Length................ Width................ Diameter__-_.......-____ Depth---------------- 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...-_-__--_-__-__------- (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to grounc water........................ a ---•••..._----•-............................................------------ D Description of Soil----- -- cxj ------------------------------------- -----/ �1'. �c.c .,---------------------------------------------------.------------------------ ----------- VNature 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 Sanitar Code—The undersigned further agrees not to place the system in operation until a Certificate of-Compliance has n issued by t rd of 4alth. w _. .I. Application Approved By------- ------------------------••-•-•-••--------•-- Date Application Disapproved for the following reasons.............'.............................................................................................._...... Date PermitNo.--cp -�--------------•-----•----------..... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF ,HEALTH ............................... ................................ Tatifirate of Tamphaurr THIS IS TO CE /PTIFY, That the Individu 1 Sew ge D-sposal System constructed or Repaired ( ) l/It .....�. c S ------•---•- nst 1 r I at---•------------r-• ---------•----------•-----:R.Tdw h/tfC' i-- has been installed in accordance with the,provisions of Article XI of The State Sanitary Code as described in the ,z .. /.� i application for Disposal Works{Cons.truction;Permit N.o------ 4- dated.....s........................................ THE ISSUANCE OF THIS CERTIFIC",, E SMALL NOT BE`CONSTRUED AS A GUARANTEE THAT THE SYSTEM Val L�CTION SATISFACT®'RY ^ DATE--------_.--•--•-•••------ ------------•--------------------------------- Inspector............................................==---------•-----------..._................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF""'H.EALTH _ T� ................................ ......o .......�........... No... ........ `��" - .• � . �i��n�ttl nrk,� Cnnn�trixrtinn �lermit Permission is hereby granted...------- ��---_•--- •. ..�___ _ � % to Construct ( x) or Repair ( ) an Individual Se a e Dis osal System d - at No. d er .�io, f�•�`1�. � i Street as shown on the application for Dl pos l'Works 67onstructian hermit '.......Dated_:.--------.------ -. .< - ..... ........ -•--_...- 1 �/ B DATE" 2 --------7 ,7. yt oard of, alth, FORM 1255 HOBes & WARREN. INC.. PUBLI04:ER3 t . ','_02!Ibb•" :..i.,u.JI DAHl7,PIeL w n �t039•'t b YAll b' PAUL C. MURRAY r HEALTH INSPECTOR BOARD OF HEALTH TOWN OF BARNSTABLE OFFICE HOURS: 8:00 - 9:30 A.M. 1:00 _ 2:00 P.M TELEPHONE 778-II20 EX. 36 s 1. i S. n d Clem f .. , . i Planning Board Re: Details slid Sections Town of 'Arrstable "Thornton Bark" Paul 3rownt Chairman J. Lanza Associates 4"Yannis, Mass. H vannis, VISSR. n t I eiren 11'aa B#--a rr% if Health approves this subdivision (Comercial) subject to the following stipulations: T�Im vmtor rosy; be made avallatale tt) lot:. dispi.)Say, Jmlsf: Im 5ui 1AJLtUA2(7 'Co ,Vnd approver-1 h,,F the !")onartment beforta con structIon can 'Oke. started on each Individual lot. JK Ioard of Health k No..N.:....M:.... Fxs.... 5. 00........... THE COMMONWEALTH OF MASSACHUSETTS i BOAR® OF HEALTH Town: ....:.OF.......Barnstable....---------------------•--------..........----------- Appliraa#ion for Uhipoii al Workii C omarur#ion ami# Application is hereby made for a Permit to Construct ( . ) or Repair (x) an Individual Sewage Disposal System at: ....Thornton.D.xl.Y.v..... yaDnja,.--MA....Q?60.1....-•------ -•---............................................................................................ Location-Address or Lot No. ..... BC O Tool ail_Die..G om� 3t................................. --. .....02b01............. Owner Address a A & B Cesspool Service.-•---------------••-------------..--•--- -12$..aisbQ.9--T.erxaae.,...Hyannia....ka....Q260.1.... Installer Address Type of Building Size Lot.......................:....Sq. feet V Dwelling—No. of Bedrooms..................:............ .Expansion Attic ( ) Garbage Grinder ( ) yp g . .z�-.._.---..._ No. of persons............................ Showers ( ) — Cafeteria ( ) Other—T e of Buildiii � .__..� a 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------•------••-----------------------------•--•-.....----•------------......................................................... 0 Description of Soil...............Sand.............................................................................................................................................. x --------•------•-•-•--••-•---------•-----------•--•...••----...----•---•-----•----------------••---...---------•-------••----•-----•••---------------•............-•------- U W •-------------------------------------------------------------------------••--.... ---..........-------••-•------------------------------...--------------•----••-•-------•-•-----•-------...---.----•- UNature of Repairs or Alterations—Answer when applicable.-_------lWital atiga..Qf.a._l.,-OQ.0_.gall Oxl..pxe--oast ....stone_-packed_•leach_pit....(overflow)-.___.__._. ........................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T= 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; Sign --- ---•- .... =�- .-----------•--•---- .�7 •---11 31.8Q .... Datf Application Approved By------. - -------•--•----•-- -------•--••11.3....Q------.... Date Application Disapproved for the following reasons:....................... --•-------------•-•-•-•-......--------.....------•---••---•----•-------------......._._. Date PermitNo...........80.......................................... Issued_-... 11..3�80---------------------------- Date No...ao......A& Fu$.....�x�.:p.0.......... THE COMMONWEALTH OF MASSAIGHUSETTS BOARD OF HEALTH. ............... ---Towri........OF........Tarnst ble;.................................................... Applirtttiou for Uigpugai ,arks Tomitritrtinn rruti# Application is hereby made for a Permit to Construct ( ). or Repair ( X) an Individual Sewage Disposal System at: .....: .... ............ ..•--•--......-----............--•-----------•-•----- r•incmrxve- Hvanr�s fi;k f3'z'St�i .................................. `LocaMon- re3s or Lot No. A;t E3 t�ov� and I3ie dW any �`izc nt,7n-Lr.•ve-;--1;W s;---I^,{t.....0'26fll............. r aA,° OessPc>ol belle--.......--- 32,�' y'exe�; dari l�;..;� .....0a3••• oa Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedroom ................._.......................Expansion Attic ( ) Garbage Grinder ( ) No. of persons............................ Showers — Cafeteria aal Other—Type of Building .................. p 1 ( ) ( ) a Desi Flow.Other fixtures ...............gallons per person per day. Total daily flow........_.........._....................._ to d W gn g P P P Y Y 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit..................._ Depth to ground water--__--'_-_--_____---__-_. GL, Test Pit No. 2--__----•_-____minutes per inch. Depth of Test Pit-------------------- Depth to ground water.--___-____-___-.--____- i DDescription of Soil...............&alfd............................................................................................................................................. x . W ••-•------•--- ----------------------------------- -=--------------------- -:-- .......•.................................................................................................... V ,,,,,, Nature of Repairs or Alterations—Answer when aR 1icabl4.--------ingt$11at11on---of---a--]:0 000--ga11o:2--pre—east ...... tone---pac&ex--3eavlr p E e � ��F�4... '- ------------------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with '^ the provisions of f'1T/'1 .a, i 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 b ar of,jkealth. g �lDl 4 Application A r, ed B /�-- .........•----•1 ---J -80•--•---- PP PP4Q Y �, f� ;,- ��+ � • �Dat� Application Disapproved for the following reasons:--•--•--•- === ------------•------•----------------••-------- ...................... ---`................ ............................................... ..............................'.20,01---------•-------•--•---•---•-•-•------•-----••-•--•.................Date % s .. Permit No.--------.saQ-.........:....... ---- :-...: Issued.-----------�--�1-�3Q.............................. Date THE COMM. NWEALTH OF MASSACHUSETTS BOARD OF HEALTH f ...............`D own................OF..............Tar23sta-ble.............................................. C�rr�i�irttile of f�nut�rlitt�irr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by A ...R._CeSspno7._. e�u:;c �...12ti.. ishQps.:�' xaCa�...ri;►annxs ....1.12:a01----------�,-7-=L264............. *'Installer at......i'h n�� n ,� Ye_s `-"v ==''1 s-•---....-•L_ Ai_i:(,..2oo1..and_..Die_.aompa V........................................................ has been installed in accordance with the rovNons of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No---------&0-....____._M..___... dated_..._------ ----7 _.0.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFAfTORY. dZd DATE............... 3/18Q........................{ Inspector - uS,i• a~l 2 yV�„ tt''w: < r'" t,,i i '� � ,� ".hrY3'ls'�^eVxS "�"E�Op���`�•"5.r*?;�n:Y � �._,.....: �:�:;��»_;�' 1 THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEALTH .....................T.Wn..........1OF..............Fsa,Mnstab.le.................................... ........ FEE......� Q...... rruti# Permission is hereby granted.... to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at No. A-^CU.-Took and._D _.Qpjnp! ........................................... Street as shown on the application for Disposal Works Construction Permit�I�T ._80-..._ _.__�at ......�..1/..-.��9��................. a odd" A FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Date: J-lct���aolcrus /���•"�!s S�ec�at,�s-E TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: BUSINESS LOCATION: oxyt�-�s� �i�,tu�e ,� ��.�-tn�i .MAILING ADDRESS: e. D; �aX �-�lS$ INVENTORY TOTAL AMOUNT: TELEPHONE NUMBER: 5 08 -- -7'79 - .32-�S CONTACT PERSON: Da y I at R,o-.�g _�_ 4W 3 J� EMERGENCY CONTACT TELEPHONE NUMBER: FIDE 0(57RIC.T TYPE OF BUSINESS: OTHER INFORMATION: �Gon-�/yi,cry )) WorC- Z C' e beiLs C Q.L MCc�-1 5 G2�J a�, Waste Transportation: Name of Hauler: Uni'Q;W-w, CaAit'ric,Sf.%e- Destination`- Waste Product: - 4,, — Licensed? Yes No wp Pa- 6-A LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . ' NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils a1 a Pesticides ANEWqg& USED' (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) mA Diesel.fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil , NEW USED Degreasers for engines and metal Printing ink 4 . Degreasers for driveways & garages Wood preservatives (creosote) Battery acid'(electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes ' Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes r PCBs Ate. Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride)- (_ga,� Paint &varnish removers, deglossers Any other products with "poison" labels �✓ ` Paint brush cleaners ~• (including chloroform, formaldehyde, Floor&furniture strippers , hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers ✓ Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: (dry cleaners) � � Z ��• Other cleaning solvents ; Bug and tar removers j WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS - 1 t r Town of Barnstable Regulatory Services® . � g Y * * Thomas F.Geiler,Director * BARNSTABM 9 MAC-i639• Public Health Division ♦� rfp Mp'l A' Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Phone: 508-862-4644 Email: healtKDtown.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—5:00 April 21, 2004 Dear Mr. Bourque: Thank you for your time and cooperation during my site visit to your business. I appreciate your assistance in taking inventory of all hazardous materials stored, generated,handled and disposed of on-site. Enclosed is a copy of the Toxic and Hazardous Materials On-Site Inventory list from your shop. Please note the highlighted recommendations. These are listed in order to assist you with regulation compliance. I will mail one of my business cards to you when they are printed(in the next week). Thank y6u:-­ , for your patience and understanding while I update our forms and contact information. If you have any questions or need further information,please do not hesitate to contact me at the Public Health Division: (508) 862-4645. Sincerely, Amy L. Wallace Hazardous Materials Specialist ..,.. Y - ..-.-.. .'.w..-...v�..-`-^---•-••--v--+�sr..- �p.,i�.....;w..r..r�'""�' '`a(°b.^�'.`�`+"s^'.-�...�y+'* P.` TOWN OF BARNSTABLE - 'UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. � ADDRESS OF TANK f 1 .f7 Ole-OV 7-0'-V -4 VILLAGE: m b w r a t r.0 m! . MAILING ADDRESS (�'I°F"`D I FFERENT FROM-A,H.OVE-)-.- OWNER NAME: I Q '' / U C 4 './��- �r C PHONE: w �/�_32.7 /"j�9 BY INSTALLATION DATE: : t I":STALLER-ADDRESS: CERT.NO. *TANK LOCATION: i fR A,,c, (OKSOR I Ut TANK L-OCAT I ON, W I TM RR001-PaCT ITO HU I LO I NO) CAPACITY /00,, 441JYPE OF TANK S AGE f eN) YRS. FUEL/CH rM-ICAL STING FCERTIFICATION PASS [ ] FAIL DATE TE ) C ] LEAK DETECTION C - ] CHECK IF N/A TYPE/BRAND ! ZONE OF CONTRIBUTION [ ] YES C ] NO DATE TO BE REMOVED I FIRE DEPT. PERMIT ISSUED [ ] YES [ ] N O..-.•DATE—.___�_ t CONSERVATION C ] CHECK IF N/A DATE . HOARD OF HEALTH . -TAG N0. C ' - ]. DATE" " ° X * PLEASE 'PROVIDE A SKETCH SHOWING THE-:)rANK ,L CATI .ON THE BACK OF THIS CARD ����� Win . w f • t , Oy J"ul�e 27, /970 5 ZX 0,0 a / ,:Yl;v 51, -aO 7' eve Q �� ' . om h ' r0l, -CX> zoo• C> > N b � � lb M N 03 0 47 Zo, /9 SS3 o � . , I I , 6y.2 3. IQ - ZOS•oo _ 2oB-vv - _ - zogS.vu - oo A�,'y �9 Zs.o - � 2 �►� oo Zvo.C�C> � P8_4o— 3o C— — 9 74 . 03 o� 1� ! 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