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HomeMy WebLinkAbout0006 CENTERVILLE AVENUE - Health 6 Centerville Avenue Centerville A = 246-032 I S M E A D UPC 12534 _ smead.c®m Made in USA J��CYC�a o� w FLSfitUm64 wROMlM CFI I�sHROMAM soummuQup rs CER11RED SOURCWG 4+i�91�.1LSFir"��if`t9,J416j2� TOWN OF BARNSTABLE ��� LOCATION SEWAGE # VILLAGE ,t 7 (2 aAz ✓ ESSOR'S MAP & LOT ' V INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 200 v LEACHING FACILITY: (type) (size) 2 /I X _ NO.OF BEDROOMS S BUILDER OR OWNER j P$RMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 4)- ,33 - o A y -y3 y 9 No. _ Fee_, s—e-) THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zippli ration for Migooar *pgtem Con.5tructton permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) *.Gomplete System ❑Individual Components Location Address or Lot No& C.V_,rf-yV J Owner's Name,Address and Tel.7whiTc, Assessor's Map/Parcel --2 1� ^� C�� � ���\`� -TY-19 (�g�/ 3 Instal'Aer�sAddress,and Tel.No. Designer's Name,Address and Tel.No. is t 4\A Sr Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow _ gallons per day. Calculated daily flow �� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank O Type of S.A.S. y Description of Soil StAw Nature of Repairs or Alterations(Answer when applicable) NJ t L— Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has be y is Bo ----- Signed Date Application Approved by Date — Application Disapproved for the fo owing asons Permit No. Date Issued pst-" No. 1' 3 7 ""' Fee d THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pprication for Migogaf *p.5tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) 4womplete System ❑Individual Components Location Address or Lot No/ �`t,�a✓�) A ` Owner's Name,Address and Tel.Auhl-Tq 1.Assessor's Map/Parcel � Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ON C Type of Building: Dwelling No. of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1r1 5 gallons per day. Calculated daily flow S gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank © c. k Type of S.A.S. t� cc, Y Description of Soil S Nature of Repairs or Alterations(Answer when applicable) xS-r 4\" �C�LX3,c1 Wr� ti/ 6�t l Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the-provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has be su is o _ _ \ Signer d'�,.. Date + �dr3-� Application Approved by Date (5-23 - `/ Application Disapproved for the fo owing asons Permit No. 7T/ 5_3 7 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded Abandoned( )by 10 =C A c— at (a ?: i=- r ift Qtl-p has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. -S dated , Installer Designer d The issuance of this permi sh 11 no coMtrued as a guarantee that the syqte . Ul function as igriAd, Date Inspector r'9 i � I C No. /�— �-------------------------—��----Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1i!5po.5ar *pgtem Construction Permit Permission is hereby granted to Construct( )Repair(' )Up rade(�+A'6andon( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date: Approved by '� 1 ti t ` -— 1/6i99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - _ 7 CERTIFICATION OF SKETCH AIND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANSI I, r hereby certify that the application for disposal works construction permit signed b p y me dated �'ri� concerning the property located at �6 ' Cr-�w� �2u l\�2 (( � meets all of the following criteria: C,-e. • The failed system is tonne✓ed to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. 7"• ere are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system �/• , There is no increase in flow and/or change in use proposed ' ere are no variances requested or needed • The bottom of the proposed leaching facility will not be located less than five feet above the ma..-amum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor ethod when applicable] If �;the S.A.S. will be located with_.0 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(1.1) feet above the maxi mum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation J ro the MAX. High G.W. Adjustment .r '� DIFFERENCE BETWEEN A and B r t O SIGNED : DATE: (Sketch proposed plan of system on back]. q:health folder.art j o i �f d ti S_ `� d v r �VL51o � — 'Eldz �� � 3I� Ce"'� PrL U A� ! o 00 � � e f AJN� \ i i LXI U Kipj i JCS � II — i YL y TOWN OF BARNSTABLE9 LOCATION SEWAGE # �O VILLAGE � ESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. S-&A J(.e SEPTIC TANK CAPACITY ,2 o c) LEACHING FACILITY: (type) (size) / NO. OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by C /33 ck r p � y� yam- al ' Town of Barnstable OFTHE T Regulatory Services Thomas F. Geiler,Director Public Health Division * BARNSTABM * Thomas McKean,Director MASS. �a 00 16g9. 200 Main-Street, Hyannis, MA 02601 ArFO��A Phone: 508-862-4644 Email: health(a,town.barnstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 June 4,2009 Howard and Marjorie Whitaker RE: Underground Storage Tank Removal 39 Charlotte Street Order,6 Centerville Avenue,Centerville,MA_ Kingston,N.Y. 12401 Map Parcel 246032 Tank#1 To Whom It May Concern: The Barnstable Public Health Division is in receipt of a copy of an Application for Permit for Removal and Transportation to Approved Tank Yard issued by the Centerville-Osterville-Marstons Mills Fire Department, and the"tank yard"receipt demonstrating that the above referenced underground storage tank was removed on or about March 14, 1997.Also of note is that the address of the tank location at the time of its removal was 610 Craigville Beach Road,Centerville. The Public Health Division appreciates your attention to this matter and has updated its data base to reflect this fuel tank status change. Should you have any further questions please contact Cynthia Martin of this office at 508-826-4645. o s A.McKean,RS,CHO Director of Public Health Page l of 1 Town Of Barnstable April 21,2009 Thomas A. MP►taan Reference: Whitakerffiremper property t►rsriw rnE_n- etrir a tank 6 Centerville Ave.Centerville, lira. Regarding your letter of April 1,2009,please find enclosed copies ofi permit and receipt of disposal or underground steel storage tank which was removed HUM�0 hi 3sf's71gvjjj&fjeawj 3Udu3-Vvijx:i3 is auw o CiblILVIVI11's3' dyv— Poi v-j i:T�UliJ1►S3�3.�. "v a.uv ir+v vvpe a, iaoi u.v.j i vasvi ie v, w�:iv'v M AA A^^f If you require any additional information,please contact me at 39 Charlotte St Kingston,N. Y, 12401. Yours truly, I - Joseph H. Tremper i� ►mot W4� cn w —i r.l r'tt Tuesday.,April 21,2009 America OnIme:TREMP ADV&N0E0_ . ENVIRONMENTAL SERVICES 800/974/430.0 (508) 385/6100 FAX(508) 385/6622 March 2T 1,997 Mr. Joe Trempef 39 Charlotte Street Kingston; N:Y.-12401 Project>tocatioro 610 Craigville Beach Rd. Centerville; MA Dear Mr.:Tremper; Enclosed please find copies'of your Permit and Receipt of Disposal of Underground Steel Storage Tank. The original Receipt of Disposal`has been sent to your:Fire Department for their records, we will'al"So keep a copy in our.files The copies enclosed are for your.records: we:'want you.to know we appreciate your business.and we hope that we . may serve you_with your.environmental needs in the future. Sincere) Denise Mowles Office•Manager. ' Advanced Environmental Services, enc. i P.O..Box 472 South Dennis, MA 02660 0472 FORM F.P. 292 a, _ l` e�arrr�es� o Pu�ii ^ Safety Division =)f Fire Prevention end Res�ula ion c.�n N F;DR � P�-,W, wa SOACl/AL. avo TRANS;:C�r�,;'c �i Ta �ovn Tawc YAFL FDI.D 11n r 9_0 ___ Permit. D ':. e 19 Centerville(C-0-MM Fire District) Gty, Town or C . a S . -;1 H . G'. L . F a e Paid: sta 12/19/96 171 acCC n c e ':_th he CrCV_-S_CnS C_ Ct(^ C `1 -� _Fnvirnnmonta i o _ PO Box 472, So Dennis.- MA - .., - C A-'C1;Cantz name ?� For Fer-:_SS_.^r an'c i..-_S`C'_ Ci,:2 Cw;,ar• Joe 'Tremper c.t _ s5 610 Craigville Beach —Rnad . Centerville, MA '.-1 L" _;,C Advanced_ il'�S7_rrn -_ -= T'1C. *WT5(1R'24CClnr]-_ :aralcuS Was - MZ.^,1.Z?S:. A. i Approved tank yard: J.C. Grant i-m sni — Readville,. MA Wank, yard rccr=_ss : .�.._ — Ir monk ca>✓ac,- 275 gallonIf 2 GI i s,= n Dec 19 996 �zt_ C_ eYy-===--•-} Jan. 'c " ,.ire Prevention Officer �..uF ULF WHOM RECEIPT OF DISPOSAL OF UNDERGROUND STZEEL .STORAGE TANK NAME AND ADDRESS JA MFSjr qkXNT d' ,N OF Q 22 W01 GOTT er: - APPROVED TANK YARD APPROVED TANK YARD NO. #(}Q Tank Yard Ledger 502 CMR 3.03(4) Number: Gt I certify under penalty of law I have personally examined the undeigrauid s forage tank/ delivered to this "approved tank yard" by firm, corporation or partnership`/T(/l//4/5 r2 e 5A1,e,1 and accepted same in oonfonance with Massachusetts Fire Prevention Regulation 502 CMR 3.00 Provisions for Approving Undezground Steel Storage Tank dismantling yards. A valid permit was issued by LOCAL Head of-Fire Department FDID# Q L ��to transport this tank to thi Nacre and off' al ti of appta c yard o or owners authorized representative: IGNATUF� TITLE DATE SIGNED This signed ipt of disposal must- be returned to the local he of the fire departrnent FDII#4�;' / C qig pursuant to 502 CMR 3:00. (EACH TANK MUST HAVE A RECEIPT OF DISPOSAL) FORM F.P. .291 (rev. 11/95) (OVER) STATE FIRE MARSHAL'S OFFICE Tank Data Tank Removed.From-. Gallons Q7J ( No. and Street: ) Previous Contents ( City or Town ) Diameter__ _Length Date Received �7 Fire Dept. Permit # Serial # (if" available.) Tank I.D. # (Form FP-290)' Owner/Operator to mail -revised'copy of. Notification. Form(FP-290,f or. Fp 290R) to..UST Compliance, :Office of. the State Fire Marshal, 1010- Commonwealth Avenue`, Boston, Ma. 02215. I • / � + �, I��` ��, /r 1 ''��► � �`� � � � .. �� � �� �� ,,L�„ � � � ,., � ,� ' � � � � � �i r !� ♦ d" Imo ♦! - �' � f� � "� .-._ �. %� I � • 1 I �. i ♦` _ �- 1( _ . II A 1�r � '��`. � ;1