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HomeMy WebLinkAbout0189 PARK AVENUE - Health 189 PARK AVENUE,CENTERVILLE A=187.031 SAff �QECYCtEp� J oy� UPC 12534 No.2-153LOR HASTINGS,MN . r 03/ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town" ....................OF.........Barnstable App ira#ion for liapoaal Works Tonotrnrtion Fermi# Application is hereby made for a Permit to Construct ( ) or Repair ) an Individual Sewage Disposal System at: Ay.eT7us....oentEry ille ---------------- ------------••••••••........_....._.._...._..----•••••._......-•-•------------•-•.._........------ Lo ation- ress or Lot No. � 0 ` 001 e....................................... • - T Owner, Address a ------•'txa-Pa11d.�i.QJJJ,A!_Pi_�`'---------------•---•------------------------•--•-•------- ---•--•-••---------•----._....._..--------.....-•--•--- Installer Address UType of Building Size Lot............................Sq. feet Dwelling K No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building --------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ---------------- ......•---------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 14 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-.---.-.-----.-._..-.--- f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ---------------------------------------------------------••-------------------••----....---•----•--•............................ ------------------•-------- 0 Description of Soil...........................................................................................................................................-............................. U ..............................................- _V�al�a............................... W ---------------------------------------------------------------------------------------•-----.--••-----------------------------------------------------------•------•-------------------------•-------- U Nature of Repairs or Alterations—Answer when applicable........-- tank --------------------------------------------- -------------------- --------------------------------------------------------------------------------------------.2"'1000--gallon ................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTI2 5 of the State Sanitary Code—The undersi ned further agrees not to place the system in operation until a Certificate of Compliance has been issued by e bo of h lth. ----------- --9/ / .._..... Lp $ Application Approved By........................55i--. ................................. ----.ct[` -�r. �....._ Date Application Disapproved for the following reasons---------------------•--•------------------------------...-----•------------------------------------------------ -------------------------------------------------------------------------------------•-.....--------...--------.....------------•----------------------------------------------------------------------- Date Permit No....... .� •--•-------- - ........ Issued................------- ----�"''--�$3----------- Date TOWN OF BARNSTABLE , LOCATION 9 l 0rlC Aver( SEWAGE VILLAGE e J)Te�U� I ASSESSOR'S MAP & LOT 03/ INSTALLER'S NAME Sk PHONE NO.j1✓ma cc3p-n L Cry 7-Sp ki SEPTIC TANK CAPACITY l,6 C-0 o L LEACHING FACILITY:(type) � �� (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 6TC>C)) _ DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: -2 S^o 7 VARIANCE GRANTED: Yes No -- ���.. T� ____ _ _. l V �. s �� �� L \/ \ /' �• �ti' u. �s � :) _��� ,��� �/g No..........—.. .. Fps..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................------.. OF Appliratiun for Disposal Works (funstrurtion umit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. .........:....:........•...V•...=t =`r'='=-----•-•--•------------•---•--- -----------•--------------------------------- ............................................... Owner Address Installer Address Q Type of Building Size Lot----------------------------Sq. feet Dwelling.—No. of Bedrooms........... ...............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................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........................ OP' ---..........-.............................................................................................................................................. Description of Soil....................................................................................................................................................................... x U -•----------••---•••-•--------•-••-------...-•-----•--••----•----------•----------•------•--••----•-------•--------------------------------------------•-----------------------•----------------------- W c:' k . i v . 1. x .........--•------------••--------•..........................••---------•--••--...---••-----•-••••--•-----••-•-------.......-----•-------•-•----••-•••--•--•--•---...•-•••-..................---......_. U Nature of Repairs or Alterations—Answer when applicable............................. ................................................................ 1-1._ _ . i. a.. t ...................................................•-•------•----.....----••-----------•-•--.......--•-----•------•--------•----•------•---•-----.........--•------•--............------------...... Agreement: ` —1— U ' 1 .J., ,I L.'d The undersigned agrees to install the afor edescribed 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. Signed ---------------------------------------------------------------- ................................ D to Application Approved B .. ' ...... ... 1/ ....... Date Application Disapproved for the following reasons:............ ---•-•----•-------------------------------6........................................................ .................................•---•----------------------....-•----------------.........-•----....---•..--•-------._...-------------------------•------------------------------------------------•--•- Permit No.... -•--•-�--..:....„;�.�._�.-----• Issued..-----•----._..�.... ........... 1;::! Date Dato Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................................:.................................................... Trrtifiratr of Toniplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY-------- -•--•-,...... ...............................................•------------------•---------......------------•----•-------•-•--...-----------------••-•----•------•----•. Installer PP 1 1 ^. mT ^ , _ `7__.. dated r has been installed in accordance with the provisions of T I i of The State SanitaryCode as described in the application for Disposal Works Construction Permit No.._...�_... ..._. - '7_____________• THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE ......5...... ..................... Inspector------------------ - ----------••----------------•---•---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... F 17i1 IBC'" :f M' No FEE.................... ..-�% Disposal Workv %unir ion ;Crrmit Permission is hereby granted.:_,._.: .........------------------••-•-•------------- ---------••-----------,-------.--------.----•------------ . .. . to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at 1�'�. {' 7."y' Y ^^yt� y "�r^sue,'!.r O' j t street _ as shown on the application for Disposal Works Construction Permit No' _`�:�:.��'.. Dated......... __.?..... ` — Board%of Health FORM�11z\. HOBBS & WARREN. INC.. PUBLISHERS •wi From town of. Wirnstabte r�ax 53 RZ: Underground Tonk at 4 45 Out retords 'I"dicats that �' tsr 40der re �4 f�;zet � storage M tank is over 30 a ers o de � ���.,:ra'��r+t TPiT �' `3t J@ �. {9' i :iw" Rl �'ist f4fdt:'_ .�#=-•aa.uF ? -e' f+� Fc�-._ , ,. tb*c u�q.t •qn_ Ae ar6_ nq +4�,,e ,_ . rid C to __.. t « Yoo. are direct4do r*4* 40 MQVe this tan SiztY t . ys rov the daze of tbis w0tice. " After your tank it :repoved, p ea_r>e furnish this off-ice evid4-ace in the form of a permit from ywr tocat. ftr ' dVpartoertt : t n ninety (40) days of,7 receipt of t his to Ovv All � ���-,i'��„�ty: v�•5 ��iR, F"�'G'.�:�1�"f�� ��t,ft±�'`:��x� � E:6� ��t��'�1 '"� + 1��3 s �`; ,,T� 5 '�= h'd .`�'� �. ".�4"" 4'�6'il,Y iw#� $i S+F FdF - ..7�'.4 ♦ L .� 4�"t ." �F4',: alt i } y7 1i'�" } ■' K • t� -� a :, t� � -0..v%� ,k� Y�,�,.'":YI e �[� J a, � ct a3�, a��'-�� a a. +�� �+�'S,y.s.5 J�F _ �,1 S ,4 ,a t '� r si[-,� t'.n "'�-t *..w.. r a• }'C .',�aa Yi` ,'�,.a r'kr s s,.. $ ,a'r, a .-1 4? "C f d e _ w ,� "ad' ^'"_f •r = q .'�` a ate' c.n try' :�� ."h,L 1 �L �, r - �, a 1xi+M s'+'FT. 7A Kea c A .`v i' �irct r r f`ron ' Town ov., 33rn tabu Iyaltry:II1 3/v8 5 S V Pr: ,tieryrojmd Torok .at T"o£ 1 45 our rrcorer indicate that your undor rounS feet (or- :?iCiit`l ue' tank is ?Vet 0 l r�{`^. Q d& and �!��t�1"1 required by Section 0 . Zubsc�c3 ran � of the Town of . .igutation ReZaroinq fuel. and Chemivat Storage 3y-.-LtMSO ' You Ore directed to rt*move this tank. ,ixty ( ) days: fraza the date of this notice. Altor your tank is removf—de pterse forms this Offi've avije.os.e in then form of a permit trot" your tacit fire , , T,art oo . , _ ,within ninety C43D days of receipt of this rap cep You '10f request a hoaring brovilpd �/;ri pert. ���z �oA . .r questiin se*e isf r`eceivici the Fio-a c� of�'A6-a°t. tL within 4ever. (7) disys after this or`der,, Is 50rvatz, ,} Per Order a f -Vie CO D000:` _ . ~ ga11.4 v ' 94rn�ta��:«� u4ergroona lonk at ; to ae tank Is i r t` �t r of Tho town . of 2,ef,arcling h et and, therm c u S-tor e 3y t��,��r direttes to re,�ve this€ tM°�"1k. si: ty � aa s ' You arefrom the dare of 'thisnotit.e. Aftor your t tnt is r emavea.4 pJo se f urns this of f 1�: evinr min ryAth-# pform of y0({(C*per��mit. fr�(*4zfn,$y�_o� rg��,.,�ay�.�c l ,y.firo+, pAr�tr,�e nt i f ec Rn pub T�F'1 t �L� s W, 'z t* F- +.• Yov oaf request a h4�gr ing provilpd writl t, Qy% : ,within ,evar, 7) devs ittt . this O€dtr is ser At Pt so G r : rd of e ano eft a S rector x 'can of W.'stobto H��r�z s fA Undt*r9rouod Tank at ` art Tag 453 11 +}�q py��Tsyr�`#ryCh 4 tca R- Stor 04+�. t,,to �.��y yS t� �:��1��y ,i*1, +�6-¢��y. � �°p�y '�'��°s���d ji-a�'+-y A y.�.p... aec L! or. '0 : �� sl'. _: �# s"����^169i' "'?r'�,�Vr� 4T� �.�it �`w..�:ard J:''fi' ' +�''iWl�f �. +1�n C °,«�{���'h"ni t Spar ay� SHUTS,,TS,, `. �L4u arc dir Atod to ha;+Fo eath `ink yAnd t'S Ojoing t.eS[`t�'r'�" &Q�'�' -�'d�i �{:hirtW3 Y w f rywQt " &S *a 0 xh4 jt t file+ psi th the 8040 Of Roots abVin You are rta inded t t you s-hatt have the tattk ant $t4 piping tested Ourinv the t O�� ± RUA. I(P� `� � '� ���� r�,a VON tb:fi Order § OOK s p*F.- 4 +a- t!' t .-, lent, t S.,r, } w �3. 4 l �.•K.r t '� i 7_,: �' h.Y_ 7jr - „z,:- i t �t ,� s _ + r it -3- t .F,.. x r 7;• t _ a� .I Ar,l :, .s 'J (/��''K/�(✓`t /*,� / L) 1: ` S j.>f'R r 'ur El.: � �q `Nf t i ��1 '« E" } rrJ�;a`Y 3 s R�A,k 7 :4; •f r �'Coty 14 ;..;ri ?I. S r u �+., c t. �, r S ".if.. c ny # wr s�E.J I„ Y' "� e Or l�,A.. �xi r"* icy. S '4 R- M "k,,.$� }:'.'r a 4y �^+d' 'z 1; i t x z erg •�z' /l s"' yr , n �+Y '��r' ,h r i 'y_ ?,"ems..•.Y.�.a� [ 4i,,, - �- g ,¢,= r ..� 3„ rF� •.� r jyf, r�. -.�.' � � a <. f� � "�#`t� �`'.}t��,1��' 'up "xS :.5 � s �°�-' � :n `t:_✓ i' . � .. .. 4e&stth Oep6rtbentt " U: Unjrr(!rounrd Tank at r log rt 45 �a Tho " arrastabt�: Health OeP4rMent .-reC Je66 �ndye�tc* tt��t y*�aur. ' �rnda�rgrt+u, . f tt'i roc ica # s# ra a task k S 'Tot been t $t c �s :��«� # reti un�tir - ecty an U � cr the H4)okt q e �r at *st e �zr lNg Fue,t . and Chemicat tor5r +R You ?rP oirectod to, have e-) ch tack and its otpin$ toa -ed within thirty' 4*J0 of rece'vot �f this notice t4asvtts of t-he testing s.1e0Lt_ be fitt'd with tits: rtloard of Rootth and the f7ro deportmont . You ire re #ndod that you shut (*�L the taark and ,# ts_ °piping tested ourinq tray "t;�ttt. 1 . tha #nth, 1 �' Carr d f y aft s tl0 d ornurtLy 'therc aft4.>r. You -gay requtst c hear�� no if ra'written O'e tidn rmoe�:s-ting sane is received by th- 3oard trf R�soty, " t �.►s v+�� (12t�t 3�. niter th:i3: •order is served, i To., i'homas Pc.Kt,4nlr• Oirector 6 • Vox S3 ac t stars taa� h s *l O a . rr s # th nAt uta Mtn ptord ng F �hOir C.6, You r tr ter a V. O nd i t t D i n it -s't- d i t 2 3. ,O,f -€eC,e1 t of t�� +� ��� � �� �� Svtt.s 4-al v * t o ti , srt t . .tie hO.'d W- t f; o t ,0(t # 8 4.E t h 0 F if-t A ,gyp yg ^ ans ,}q µ. ,g y�;� y, �{yy •r�yy +l }� per• y� 4��w, yy �r g a 5_T p,�"•,�y: Clive sA You are 1� �ft i d d o I h 4v u it a t t r T i 4. g h '1+O n k a n a i Tj:•.i ?+f ��'T Q Y i t v's t XG'a 'u i A C ri ve Y(p Y - _ i f a wri t er "Itt n r s��-*- -tir��� � �� ,is r z �m s� r . < : t * O r of p.i� � � s � �� �����- ter ref - rdr., v .1 2 :.'T` � 7$$"f vaLL'.C�gg yn���•�F`f �fq',pG.��}:p.d+�,� -tic Yyt yr ' - � _ ���� M P.O. Box 1121 P.O. Box 450 est Springfield,MA 01090 Pocassel,MA 02:559 Phone:(413)781-7474 (508)564-6607 _ FAX:(508) 564-6610 Masson 21 South Main Street 1-800-834-2330 IE/TVIIO/�IlIBII#8I Se/'V1CeS Inc. � 5haron,MA02067 r! J Phone:(617) 784-1326 DATE: 11-10-94 S TO: Dr. William O'Toole RE: FUEL STORAGE TANK REMOVAL RECEIPT LOCATION: 189 Park Ave. , Centerville, MA OWNER: Dr. William O' Toole TANK SIZE: 50 gal . t FUEL TYPE: #2 fuel oil FDID## 01920 DIG SAFE ## T9411806-41 MASON ENVIRONMENTAL SERVICES, INC. PROJECT # T 1053 DATE REMOVED �11-9 4 , TANK TRANS,'ORTED TO: Mid City 'Scrap Iron and Salvage Co. ,548 State Road. - Route 6 gInc Westport, MA 02790 Permit #003 .21 INSPECTOR: MacNeely COMMENTS: No contamination was observed at the subject - site aL- the time of the tank removal. FOR: MASON ENVIRONMENTAL- SERVICES, INC. Environmental Servicts Tin k-Services 21 E Sit(r AssvS%mentc Site Remediation FORM FP. 292 = rev.9190) p `(�vuintniiwttlf of �� ttr�ur##� Depart.me. of Public Safety Division of Fire Prevention and. Regulation APPUCATION FOCI PERMIT, AND PERMIT, FOR RFIAOVAL AND TRANSPORTATION TO APPROVED TANK YARD FDIDJ 01920 permit Date November 2, 19 94 . Centerville Ctty,Tb,,,,r,or pistric: C . 82 s . t 0 N ..c . I . '. DIG SAFE 2JUMBER - - • � ��U� 941180641 Fee Paid:$ 10.00 - - _ _ 10/17/94 start date j. In accordance with the provisions of Chapter 148, Sec. 38A, M.G.L. , 527 CMR 9 . oo - application is hereby made by: Mason Environmental Services, Inc. 50 Rt. 28A, Cataumet, MA 02534 Street Address & City or Town: � ',�¢ Signature of applicant: Applicants name printed: Robert Cote For permission to remove and transport one' underg round, storage tank from. William O'Toole Street Address • 189.Park Avenue, Centerville owner: Same MAV000011224 Firm transporting waste: State Lic.I Hazardous waste manifest E.P.A. # Approved tank yard:. Mid City Scrap Yard 128fi9 548 State Road, Westport, MA Tank yard Address: Type of inert gas: Nitrogen UL tank Tank capacity: 500 Substance last stored: November 2, 19 94 Date of a irati November 16, 1-9 94 Date of issue: 10 Signature/Title of officer granting permit: i . KEEP ORIGINAL AS APPLICATION AND ISSUE DUPLICATE AS PERMIT .RECIPT OF .DISPOSAL ©F.,IIIIDERGBQIIND ._b �. .� b - TP.I3R=.. � NAME AND ADDRESS MIT CTTP e _ . , OF va•�sub ---_ APPROVED TANK YARD Road,tate APPROVED TANK YARD NO. 1 _8 cL 904 � (� • Tank Yard Ledger 502 CMR 3.03 M Number: v 4_•4 1 I certify under penalty of law I have personally examined the underground steel e delivered to this "approved tank yard" by firm, corporation or partnership and accepted same in conformance with Massachuset Preven 'o Regulation 502 CHR 3.00 Provisions for Approving Underground Steel Sto a G���k di ling yards. A valid permit was issued by L head of Fire Department FDID# _ f transport . this to 's T Name ff• ial app yard owner or owners author' ed re//pr��esentative• �V SIGN TIT4,E DATE SIGNED This signed disposal must be returned to the local head of the fire department FDID# suant to 502 CMR 3:00. (EACH TANK MUST HAVE A REt�f OF DISPOSAL) FORM F.P. 291 (rev. 9/88) (OVER) DWSSACMSETTS STATE FIRE MARSHAL'S CFFICE, • i l DIMENSIONS Tan move m , Width L gth ---- -- ----------------------- ------- (no. eet) Tank 1 - -- X - -- ---------- --------------------------------- Tank 2 ----- X ----- (city or town) Tank 3 ----- X ----- Fire Department Tank 4 X Permit # ----------------------- (if applicable) Tank 5 ----- X ----- (feet) (feet) 171 VFW DRIVE vto"t A� ROUTE28 ROCKLAND ' +1�1MIDDLEBORO (317)878-2955 (508)948 0717 ROUTE3A � ROUTE 106 SAGAMORE EASTON (508)888.1021 `® (508)238-6977 SAND&GRAVEL i B 9 4ve o ��2 C,U TOWN OF BARNSTABLE LOCATION)?9 �a�u 1`ilr�'n SEWAGE VILLAGE CP y�`Te�'Ua �' ASSESSOR'S MAP LOT. ��- 631 INSTALLER'S NAME & PHONE NOJ I✓// �Cc C©f-n Ja ts© y� JiGLCr SEPTIC TANK CAPACITY 1�5 C q L LEACHING FACILITY:(type) � Z) (size) 000 NO, OF BEDROOMS PRIVATE WELL OR PUBLIC WATER------------ (� BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No I lip �O � '