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HomeMy WebLinkAbout0181 ELLIOTT ROAD - Health 181 EI LIOTT ROAD(CENTER V�IILE) a '� ��t�4 4i F �� c � ns rL•�t�6 11't�.�. IN UPC 1253a . hio.2�153�LQR ' sr NASTINOS,UN Ta 3 F"'. nom'--j, I'll 71, C01111A I REr, rEPAPTMENT FA.?� 11 0 E 7'j r,J Make application to local Mire Department FTirp Department retains original application and issues dupffic?Lw as.Permit. 5 APPLICATION and PERMIT IFet $ . for storage tank rerrtcvz--J and transportation to approved tank disposal yard in accordance with :he provi-siolls of M.G.L..Chapter 14-8,Section 38A, 5217 QMR 9.00, application is hereby rnafe by'. Charles Buc,kier lank Owner Name(pleasa print) x ZVI ii�U ?y—Ip V711-3 Ne—Pd Address ---1:7- .181 Elliot Road, Centerville,. MA 02632 $root cry S ale 411 Company'Aame Auto Body Solveqt Recovery Co.or individual Auto Body Solvent Recovery Address n- r,,,X.23 Address 4aapplying:wood 1U 0`06')Boston, MA 02114 8igrature i irf-Eer'nl�t Signature lfll appiyfi 0 IM 0arb-&:: Other cefVied Tank Location 181 Elliot Road, Centerville, X'a 02632 Tank Cap&--iry(gailcoz- St Tank Dimensions 1diar-a=--r x lergil)) Remarks: UndQrg.rojn Tank fiAJ Firm transporting was,- Auto Body Sol-vent Recovery Stat. l ic.4i_-._.__iIAR00QS09331�— H 4 atardous waste V18 0':)00 E-P-A,Approved lank disp<r a -r PC_o�r ,t',2q_1 Tank yard# Type of inert gas _,_-____,,_.TanK' yard acdress Brockton, ltk City or Town Con,erville ----FDID* 01920 —Pernirig Date of issue -;Q, 'it) _Weir-ate of expiration APK-ti 12 2005 Qig safe approval num ,,r: 2 0 0 6 112 6 14 5 7 A 1) Sefe '11 ter 5C0-.322-4844 /1 A ----"-- Signature Title of L c.,-zi ting permit After removal(s)send Fo:-n s!qj--e-.J by Local Fire Dept.to UST Regulatory Ccmpiiajrxz Unit, One-Ashburton Race, Room 1310, Boston,W.--Z-.:8-1611 (revigad 9/261 11w , Find"Map7P arce1 228197 Town of Barnstable Health Department Wealth System ` tN wS&� � AAa�plPar�cel � 228197 � , � � � � s ank�i�Fbr 0� Tag N�br 00926 �� I�►stallil 03/18/1986 Location �estJot�tication Date 08/23/1996 F sStat Date us �Remov�al NctiticationI)ate � � r 11/04/19961 70 ee es F ei Store FO Fuei St rage,Keason� J Ca ci , �, 3 p sty Canstructio�i Leak�et�ction .:Cathodic Detection Storage<Tank Info 002000 Add�tt�otal Detaifs BARNSTABLE COUNTY 77 lim.......I ,� ter- r^• � Tc � � i ... �asi97 oFINE Town of Barnstable • sM Board of Health r A i639 rEnniw+a P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Ralph A.Murphy,M.D. Sumner Kaufman,M.S.P.H. To: BUCKLER,CHARLES W&EL Date Monday,March 05,2001 100 RIDGEWOOD-ELLIOTT N 181 ELLIOTT RD CENTERVILLE MA 02632 RE: Underground Tank at 181 ELLIOTT ROAL�Cey1.�`(\jMe) Map/Parcel 228197 Tank NO: 01 Tag NO: 00926 The Town of Barnstable Public Health Division records indicate that your undergroud or chemical storage tank is 15 years of age,and has not been tested as required under section 07:(5)of th health regulation regarding fuel and chemical storage systems. You are directed to have each tank and its piping tested within thirty(30)days of the receipt of this notice. Results of the testing shall be filed with the Board of Health and the Fire Department. You are reminded that you shall have the tank and its piping tested during the loth, 13th,15th, 17th, and 19th year after installation,and annually thereafter. Failure to comply with this order may result in a fine of up to$300.00.Each day's failure to comply with an order shall constitute a separate violation. You may request a hearing if a written petition requesting same is received by the Board of Health within ten(10) days after this order is served. Per Order of the Board of Health Thomas A.McKean, RS, CHO Health Agent No.. ..........16` Fss............................_ Ilk— r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. .......--....--.----.....OF.............--.......................................-.................................. ApplirFation for 11ispos al Works Tonstrnrtion ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -------------£aL .ed! ,---------------........---------. ......................................... ocatiot Add ss or Lot No. :: -------------------------•------- Owner Address Installer Address — Type of Building Size Lot. 1 2,_YYU---------Sq. feet ,., Dwelling—No. of Bedrooms........Z...............................Expansion Attic ( ) Garbage Grinder (� Other—Type Type of Building __�1 z-.............. No. of persons........... Showers (L) — Cafeteria ( ) a v p-' 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.__ e ._ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •--•-•-••------•-•-••---•-----------•••••-.....--••---••---•...........................•-•••-•_.............................................................. ODescription of Soil........................................................................................................................................................................ x 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 TITU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the board of health. SigneI . . . .. .........-•_-•.... ...................... ................................ G Date Application Approved By........................................... -----•---•---•--. /_�_--.L �_.i�'�....... Date Application Disapproved for the following reasons:______________________________________......................................................................... ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued_....................................................... Date y y V. N �t...._...._._... F n.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................O F..........................---....................._..._.... ........................._. Appliration for Disposal Works Tontrarction rrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal lSystem at.: ��x ••Ge - --, ' ---.. ._..------•...................... ----•-------------••.............-•------• ✓ ��' Loc�'on•yddress or Lot No. e ,y /Owner y _ ! . 1MI Installer Address , Type of Building Size LgtL;=.p,% ...............Sq. feet U Dwelling No. of Bedrooms.._ Expansion Attic �Garba e Gr' er p,, Other—Type of Buildinegw ..................... No. of persons.... __.................. Showers ) — Cafeteria ( ) dOther fixtures •----- ---------------------------------------------•---------------._...--------------._...---------..----.---.............-•-•--.............__.. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capaoft}?........gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. > Seepage Pit N44d__(. W... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---•------•...................•----•--•---•-•-----••--•--•-----••------- Date........................................ a Test 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............................................................=........................................................................................................... x , - U ••-•------••......•--- -••---••••••---•••-•-----•--•-••---•-•--•--•--••--••--.......•----•••-•-•-•--------•-•--•--••--•-••-•---••----•--•-•-••-•--•--••-•---......••---•---•-••----••-•------•-•--....._ w ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature 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 TITIE 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. g Application Approved By................. ---------------------•••. _ -------- -----------------------------------•--- Date Application Disapproved for the following reasons-----------------------------------------------------------------•----------------=---••-•-••---•••--.........--- --•-•....................•-•-------•-•----•-•--.....---------...........---------..._........------•-•--- .........................................................-............................... ., Date PermitNo......................................................... Issued-.` -•---•-............•----__-. --•------- Date y THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH r ..........................................OF...................................................................... f............. ... (9ertifirFate of TootpliFanrr THIS IS TO CERTIFY„That the Individual Sewage Disposal System constructed ( )` or Repaired ( ) by---------------------_----- -------------...........**------------•------- ..-•--------------� Ins�+ llez! C." at--•---••---........-••••-••--- ---- ---- --- . !` ••----. -----�.---tate---. ......._........................................ has been installedin accordance with the provisions of TI _ 5 oL& $� Sanitary Code as described •n the P 4V application for Disposal Works Construction Permit No.--!__._ dated_...___ _2-- .__:.._.__'_________....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.._.... 1:.. _.2. ...........................•--------_. Inspector...... .. ..._..._.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......................... FEE........................ Disposal Warts%p trnrtion rrnttt Permission is hereby granted................._....................................................... to Construct ._.. ._..4.. or �' an I d3 :i ���ev'va��Ui ,sal System � 1 atNo......................•------._...----------•---------------.........•.......-----•-----------•......--•-------------------•-•-------------•------------------------•--•---••.................. Street as shown on the application for Disposal Works Construction Permio../-F..........._ Dated.......................................:.: ---.......-•---•.................•------------------------------------•-•-••-••--•----•--...:..._...-•--- DATE._. C1 a / Board of Health FORM 1255 A. M. SULKIN�INC., BOSTON LOCATION SEWAGE PERMIT LoNfs &AD VILLAGE boos-c INSTA LLER'S NAME a ADDRESS s U 1 L D E R OR OWN ER DATE PERMIT ISSUED DAT E C 0 M P L I A N C E ISSUED L t � L 4v /g::5:P _S , +2 Q ' a IT _ vim"'• U L�- � �'� __ ="- ! A/ / —2V cr` ?'`Y"�" �j '`��'• �` �, \.`\ %;iJ_ — ' _ _ _._ — -- - — -- T©7-;d Agg T/ 7 W 3 G"LEsI,�/ NI W-ef rzFle L A�-_-)L ILJ I G : F / G"�'J'i�"/- T.4,�T Tom`' /�.C-�©/�•' i"�.:'J. ..f.�•�Lf�i�% {{ y���� c©�•�L y� r�,�7,y T�,E .._s��-�.4crc,�z�v �C.�,l� . ,%����,a' � ,��"i�.° �- ►.1//y'�-/� T�`/E ,%L max '/�t,Q/.cf Io iCs`T�.�_-.�I� ILLIIAIMA SEI�.Ltlrat3 z `'-rtt ...S�/�.r��y .11itil� /"�''�✓� G�.�'�G_ ,c"� sllG��'f.� /��'E"�w� ° �4,,,„ .w