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HomeMy WebLinkAboutRIteway Construction - 12/31/2019Commonwealth of Massachusetts Town of Mansfield Board of Health Disposal Works Installer's Permit This is to certify that: RICHARD BREWER JR Doing business as: RITEWAY CONSTRUCTION 691 NORTH STREET RANDOLPH MA 02368 Town of Mansfield 6 Park Row Mansfield, MA 02048 is hereby granted a DISPOSAL WORKS INSTALLER PERMIT to construct, alter, install, or repair individual sewage disposal systems. This permit is granted inconformity with the STATE ENVIRONMENTAL CODE., 310 CMR 15.02(2) and expires December 31, 2019 unless sooner suspended or revoked. LICENSE NUMBER: 53 FEE $100.00 BOARD OF HEALTH MichaeCHeaCey, Chairman Town of Mansfield - Board of Health Disposal Works Installer Application 1j9APR-1PM2:14 Town of Mansfield 6 Park Row Mansfield, MA 02048 LICENSE NUMBER:�_._,_2 APPLICANT: v� _�.{�- lA1 � T 2 BUSINESS NAME: 2/ MAIL ADDRESS: �/_ %art h�% L fa7 CITYITOWN: ✓r CI D l G®� STATE: ZIP CODE: 6_Z 3 L 0 Z I Z— yyyy BUSINESS PHONE: 617 R"°°`BUSINESS CELL: SC n�Y�A BUSINESS FAX: E-mail: j2 i �e I v✓>ry LOl/5� /�T /%L cc� Alt E-mail: EDERAL ID/SS NUMBER: ©/ 3 .5�2-_/:� LICENSE HELD: Town r o # Year Licensed Z- arJ % LICENSE HELD: Town (f0 boo/C LICENSE HELD: Town �IGt✓ %lf Year Licensed Z vl % Year Licensed Z 01, I have read 310 CMR 15.00, the State Environmental code; Title 5, Minimum Requirements for the subsurface Disposal of Sanitary Sewage and the Board of Health regulation titled "Minimum Standards for the Subsurface Disposal of Sanitary Sewage". I understand that deviation from them may be cause for revocation of this permit. Permit Expires December 31st yearly. FEE: $ SIGNATI DATE: Please make appropriate changes. Sign, date, and enclose check for $100.00 payable to Town of Mansfield. Mail to: Board of Health, Town of Mansfield, Six Park Row, Mansfield, MA 02048 TAX CERTIFICATION FORM I certify under the penalties of perjury that I, to my best knowledge and belief, have filed all state tax returns and paid all state taxes required under law. /f ""Social Security No. (Voluntary) or Federal Identification Number *This license will not be issued unless this certification clause is signed by the applicant. ** Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non -filing or delinquency will be subject to license suspension or revocation. This request is made under the authority of Massachusetts General Law Chapter 62C, section 49A. CAUsers\sleite\Desktop\ScotVs Documents\Food Establishments- Temp\TAX CERTIFICATION FORM.doc The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information r� Please Print Legibly Business/Organization Name: r % liC/ Address: 6 Are you an employer? Check the appropriate box: Business Type (required): 1. ❑ I am a employer with employees (full and/ 5. ❑ Retail or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment 2. ❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales (incl. real estate, auto, etc.) employees working for me in any capacity. 8• ❑ Non-profit �io workers' comp. insurance required] 3. ❑U We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4), and we have 10.❑ Manufacturing no employees. [No workers' comp. insurance required]* 11.❑ Health Care 4. ❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp. insurance req.] 12.0 Other *Any applicant that checks box Nl must also fill out the section below showing their workers' compensation policy information. **If the corporate officers have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an organization should check box 41. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy information. Insurance Company Nar Insurer's Address: City/State/Zip: Policy # or Self -ins. Lic. Expiration Date: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations ofAie DIA for insurance coverage verification. I do hereby c rti ,under !r pains d penalties ofp ry 1/:al the information provided above is true and correct. c;�,,,an,rP• � ,! Harp• � 7 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Cleric 4. Licensing Board 5. Selectmen's Office 6. Other Contact Phone www.inws.gov/dia RANDOLPH DEPARTMENT OF PUBLIC WORKS Telephone (781) 961-0940 Fax (781) 961-0945 41 South Main Street Randolph,MA 02368 TOWN OF RANDOLPH INC. 1793 October 16, 2007 To whom it may concern: This letter shall serve as a letter of recommendation for Mr. Richard Brewer and the Riteway Construction Co. Riteway Construction has completed many drainage, sewer, and water projects in Randolph. All of these projects were completed in a very workmanlike and professional manner. If you have any questions please do not hesitate to contact me, Very truly yours, 71-4 C _ David A. Zecchini, Supt. DPW 0 Iry Town of Holbrook Office of Joint Superintendent (781) 767.1800 Fax (781) 767.0705 December 21, 2017 To Whom It May Concern, RANDOLPH-HOLBROOK JOINT WATER BOARD 50 North Franklin Street Holbrook, MA 02343 Riteway Construction Co. has completed various water and sewer projects including septic installs and repairs. All projects have been completed professionally and have met all expectations. This letter shall serve as a letter of recommendation for Richard Brewer and Riteway Construction Co. Sincerely, William Corkoriy u 'Dbwmo'� Office of the Superintendent (781) 787-1800 fax (781) 767.0705 December 26, 2017 To Whom It May Concern: v t� W 4l 't �"vwrvva ixbltr Parke &V trtUwrtj SQ North Xxrxnh in Street �nl6rnuis, �Afittssttc�rusetts 02343 This letter shall serve as a letter of recommendation for Mr. Richard Brewer and the Riteway Construction Company. Riteway Construction has completed many drainage, sewer and water projects in Holbrook. All of these projects were completed in a very workmanlike and professional manner. If you have any questions, please do not hesitate to contact me. Sincerely, Benja ' R Ecord su �.. perintendent Public Works Department * « THE COMMONWEALTH OF MASSACHUSETTS iaeo �Zp TOWN OF PLYMOUTH x PUBLIC HEALTH DEPARTMENT bC M. .. 2019 BUSINESS LICENSE RITEWAY CONSTRUCTION 691 NORTH STREET RANDOLPH, MA 02368 DBA: RITEWAY CONSTRUCTION CID #:217261 LICENSE #: 5065 Your 2019 Business License for A "DISPOSAL WORKS INSTALLER'S LICENSE" TO CONSTRUCT, ALTER, INSTALL, or REPAIR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS is printed below. Please retain a copy for your records. If you have any questions, please call the Public Health Department at 508-747-1620 ext. 10118. m u THE COMMONWEALTH OF MASSACHUSETTS FEE PAID o 'p TOWN OF PLYMOUTH $226 e PUBLIC HEALTH DEPARTMENT 2019 This is to certify that: RITE' WAY CONSTRUCTION BL ID #: 102276 Doing Business In: PLYMOUTH, MA 02360 Has been granted: A "DISPOSAL WORKS INSTALLER'S LICENSE" TO CONSTRUCT, ALTER, INSTALL, or REPAIR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS This License is granted in conformity with the State Sanitary code Title V, 310 CMR Regulation 15.222 and expires on expiration date noted below unless sooner suspended or revoked. Expiration date: April 30, 2020 Signature l, � Or— a LICENSES ARE NOT TRANSFERABLE Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards C o n s t r U, .cfi i�i rl I$ O pQ r v i s o r CS-063085 - E$pires:11/13/2019 RICHARD A BREWER A 7 - 601 NORTH STD RANDOLPH MA:02368 tO71'�..I:A1}Zl` Commissioner Commonwealth of Massachusetts —� Division of Protessional Licensure Hoii'7 NiTer HE-128421 >' 1t; EKires:11/15/2020 RICH10 ARD A BREWEq, 691 NORTH 5Ty, RANDOLPH MA:02368 Commissioner v""' PERMIT NUMBER: DWI-2019-0469 FEE: $200.00 THE COMMONWEALTH OF MASSACHUSETTS Town of Middleborough Board of Health This is to certify that; Richard Brewer Jr 722 Plymouth Street Middleborough Ma 02346 IS HEREBY GRANTED A "DISPOSAL WORKS INSTALLER PERMIT TO CONSTRUCT, ALTER, INSTALL, or REPAIR, Individual Sewage Disposal Systems This, permit Is granted in conformity with the State Sanitary Code Title V, Regulation 2.2 and Expires on December 31, 2019 unless sooner suspended or revoked. Issue Date: 411112019 For the Board of Health Robert E. Buker Health Officer THE COMMONWEALTH OF MASSACHUSETTS TOWN OF PLYMOUTH PUBLIC HEALTH DEPARTMENT 0 2019 BUSINESS LICENSE RITEWAY CONSTRUCTION 691 NORTH STREET RANDOLPH, MA 02368 CID #:217261 DBA: RITEWAY CONSTRUCTION LICENSE #: 5065 Your 2019 Business License for A "DISPOSAL WORKS INSTALLER'S LICENSE" TO CONSTRUCT, ALTER, INSTALL, or REPAIR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS is printed below. Please retain a copy for your records, If you have any questions, please call the Public Health Department at 508-747-1620 ext. 10118: This is r certify that; Doing Business In: THE COMMONWEALTH OF MASSACHUSETTS TOWN OF PLYMOUTH PUBLIC HEALTH DEPARTMENT 2019 RITE WAY CONSTRUCTION BL ID #: 102276 PLYMOUTH, MA 02360 FEE PAID $226 Has been granted: A"DISPOSAL WORKS INSTALLER'S LICENSE" TO CONSTRUCT, ALTER, INSTALL, or REPAIR INDIVIDUAL SEWAGE DISPOSAL SYSTEMS This License is. granted In conformity with the State Sanitary code Title V, 310 CMR Regulation 15.222 and expires on expiration date noted below unless sooner suspended or revoked. Expiration date: April 30, 2020 Signature LICENSES ARE NOT TRANSFERABLE *k CONINiONLTII OI MASSt4CLIUSI TTS Board pfHealth, Plymouth , MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) RepairN Upgrade([4 Abandon( - Complete System O Individual Components Locati99618 Bourne Road Qwocr's Name Brendan Brewer Map/Parcel# 124—(100-003-034 & Address691 North St. Randolph 02368 Lot# ' 124-000-003-035 Telephone# i617-293-9541 Installer's Name �:y W ... ^ lob Designer's Name •Collins MRE ( Address (0Cr) A)Oi S t :. 0 , rlfk aukapLAddress 226 So. Mdn W,Y%dAd�B5t18kf Telephone# 12 -: - Telephone# , . (608) SM332 ' Typeof Building Residential HOpse Lot Size.22.333± eq. ft. Dwelling; No. of Bedroom's =2 Garbage grinder ( ) Other.Type of Building No, of persons Showers (,), Cafeteria j ) Other Fixtures Design Flow(min. required) 220 'gpd Calculated design flow•=220 Design flow provided 294 gpd Plan: Date 9-22-17 Number of sheets 1 Revision Date '12-6-17 Title Plan and Details Subsurface Sewage Disposal System Upgrade Description ofSoil (s) 0-1 8" Fill/A;1 8-36" Loamy Sand; 36-1 00" MED. sand. Soil Evaluator Form No. 11 Name of Soil Evaluator G.R. Collins Date of Evaluation 8-16-17 DESCRIPTIONOFREPAIRSORALTERATIONS Install new '1,500 Gal., 2—compartment septic tank, Distribution, box, and 14.2' x 28.0' leaching bed with rows of Srgned�-'r`-'�%`CC• V i!'�^'7t�'Y Date ti i Inspections 0929-926 (t9l) XVj EMayu 6y9b-ggg y� a3 J.NHol d il8L) M3N8'VOWyyHOILi 898ZO VW'HdlO4NV8 S uoILLan�IisNo,,N dVMU.LI?I SlVLN3U 1N3Wdf�03 VOON3U #3SN3Oil ONIMOld MONS `JNimine 3WOH lV 1N301OS3 1 NOLLOIlH1SNOD lb83N3O