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LO ATION SEIIV AG/E P'ERMIT NO.
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INST 11 R'S ME & ADDRESS
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DA T E P RMIT ISSU E
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DATA~' COMPLIANCE ISSUED
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THE COMMON`XEALT.Ho OF MASSACHUSETTS
BOAR® OF EALTH
.-.----
OF........
ApplirFa#ion for Dispoii ai Works Towitrurtion Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: 1
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......... ••----••---- -...._ ----••••- -- ----------------------- ••--•••-•-----••-•-••-•-••----•••-•....•... ....-•-•-••------•-_.. ........_.....
9 r� l LX?t�on.Address 1 or Lot o.
dC(3&Y $ d J eC l�cLaWJ iZI e_
.....•.........••• ....
Address
Installer Address ��
Q Type of Building Size Lot...__......1...............Sq. feet
Dwelling—No. of Bedrooms_._. ...........................Expansion Attic (- ) Garbage Grinder (Ic )
aOther—Type of Building ............................ No. of persons._______...-.--__-____ Showers ( X) — Cafeteria ( )
QOther fixtures ........PiJ.A`�'S4e v....--••--......--•-•....... .......... .............. . -•-•--------------......--•-•-...................
W Design_ Flow. ._...___... _-...... .......gallons per person per day. Total daily flow__._r�3.6_..............._--------gallons.
WSeptic Tank Liquid capacity gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width_..._._ .......... Total Length.........._.r_. .... Total leaching area.-___-_--••-_ _/_..sq. ft.
Seepage Pit No. ��- ._.... Diameter _. Depth belnleVG2...`Total leaching area ��- •.sq. ft.
Z Other Distribution box (� Dosing to ( ) ���//
`" Percolation Test Results Perfgrfned by.. "-- ...... ..................... .......Test Pit No. I................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................
Jz .. ........ ..........J. ---
O Description of Soil ..•� _`.... '; �/`' -. ...�.. w
�.,
x ••---------•--------------------------••-----•-••---•••--•---•......-•-••---•---......•---•••----•------•----•----------•---------------•--•-----------••••--•--••---•••••..................--••-----•-
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 iITI:;,. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b9M issued by the IfNd of health.
.Signed.... , .._ . .. . ... .....-••------------- ......................'� `r
V Dt
Date
ApplicationApproved By.................................................................................................. .......................................
Date
Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------•--••-
---------•-------------------•--•----------------------•--•-•-••---------------................--•••-••..-•--•.......................---••---•••••---••......••-•••--•-•-••••..... -------------•--•-
Date
PermitNo......................................................... Issued.-.....................................................
Date
No............ :—z
---•-•- Fss..............................
THE COMMONWEALT-64 OF MASSACHUSETTS
BOARD OF EALTH
.........
-.. . ......
.OF........... .. . ----_....----.-----.._......_-•-•-•.......-...----•
Appliration for Uhipvii al Works Tonotrnrtinn ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
1,144
..----�! .._... .. ._...._.....A......................... ......................................................�f ---------
________Lo as`on dr ss t or Lot,,/�`�o.
C? Oda /t• it �( ( J .... .......... `� `khc��+.w. �r��` ............ .#?�
O ner Address
a ......................... ........> �*� ! --------••'--------...............'---------
Installer Address J�
Type of Building ,rr1 Size Lot._._.:_..._x...:_V_........Sq. feet
V Dwelling No. of Bedrooms.___?_ .__. ,_____________ _Expansion Attic (,w Garbage Grinder (I )
U
Other-,Type of Building ......______________ ___ No. of persons_ _._______________ Showers (iIf) Cafeteria ( )
Other fixtures .......,�ht Gu<,��►e!!.............................................................. •+ -••-------- ...._... ..... 1.
W
Design Flow.._.______;'____�._�.__.. gallons per person per day. Total daily flow_...c�-.�_ ____.....................gallons.
'
C4 Septic Tank—Liquid capacity .......gallons Length................ Width................ Diameter----------'..... Depth................
Disposal Trench No ___________________ Width_._ ._._._ Total Length........ Total leaching area____ sq. ft. m
x - l •
Seepage Pit No ........ Diameter_______.j/ _. 'Depth below,(�nl .. ___ Total leaching area..-,.?... sq. ft.
Z Other Distribution box ( '� Dosing to k
Percolation Test Results Performed by �,L� ¢ .-•---'� ""=-----------------------
aTest Pit No. I........:.......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........................
Description of Soil• P ' i '" `� � '' �---- '-- C_
x >
V :.._.._.....;--•--------------•••--•-------.....------------•..........__...-------------..._.....-------------------------------------------------------------------------------------•---------
UNature of Repairs or Alterations—Answer when applicable...................................................................................................
•---•--•---•---•-------------•--....----------------•-•----•---.......__........•--•........_•-'-••-•---'------------•----------------=-••--•-••-----•••---•-••.......................................
Agreement:
r.
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 b issued by the d of health.
Signed.... . --- •-----•--Da Y
te
ApplicationApproved By................................................................................................... -------------------------------------•--
Date
Application Disapproved for the following reasons-...........................-...............
..------•---•-•-------------------------•-•--•----...---.._...._..............---•---------------....-•-----------------•------. ---------------•----------------------------------------------••-•-'---
Date
PermitNo..�........................................................ Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD .11 OF H ALTH
_...........��.... ....oF....................' ...... ;......_............-.-........
Trrtifiratr of f omplianrr
THIS I 0"R �"
hat the Individual Sewage Disposal System constructed ( ) or Repaired ( )
r
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ali
{ IA
has be n installed in accordance with the provisions Of 'r 5°of The State Sanitary Code as des&rrib m the
application for Disposal Works Construction Permit No.- _ t'� dated__.._7!'/7-__f_.- :...........
PP Pe
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
.THE COMMONWEALTH OF MASSACHUSETTS
BOARD OFF#EALTH
l ....... ..OF................ ...� ...............................
N .........��(-• ..._ FEE..... ..---.....
uiflvaoal rk udian Pamit
Permission 's hereby granted..` t # - ..........
to Construc ) or R it ( ) an idi ual Se e 'os�Sy
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atNo. "-- . _.. ���•._. r ...... t � ------ -------�- ........__
Stree y>>
as shown on the application for Disposal Works Construction Per f o__ __________ ___ Dated___!__` _ ..__._..._....
. �� f oard�of Health
DATE......"'-=-......................................................................
FORM 1255 HOBBS & WARREN- INC.. PUBLISHERS
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Town of Barnstable
oFTHe r Regulatory Services
Thomas F. Geiler,Director
Public Health Division
BARNSTABLE, Thomas McKean,Director
Sop i6 S. 200 Main Street, Hyannis, MA 02601
ArFD MA'S A
Phone: 508-862-4644
Email: healthQtown.barnstable.ma.us
Fax: 508-790-6304
Office Hours: M-F 8:00—4:30 �C 0
� IPW
July 2,2009
Jason E. Sturgis RE: Underground Storage Tank Removal
80 Overlook Drive . Order,80 Overlook Drive,Centerville,MA
Centerville,MA 02632 Map Parcel 188083
Tank#1 Tag#00769
Dear Sir/Madame:
The Barnstable Public Health Division(BPHD)is in receipt of a copy of the"Application and Permit"
for storage tank removal and transportation issued by-the Centervilll-Osterville-Marstons Mills Fire
District,and the"tank yard"receipt demonstrating that an underground storage tank was removed from the
above referenced address on or about July 20, 1998.Although the capacity of the tank documented with the
BPHD(two-thousand gallons)differs from that noted on the permit for storage tank removal(one-thousand
gallons)there is no information to support that there was more than one tank on the property.
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 c ct Cynthia Martin of
this office at 508-826-4645.
T omas A. McKean,RS,CHO
Director of Public Health
Barnstable
�IHEA�� Town of Barnstable
�R"R Regulatory Services Department .
�7 i639'A�0
Public Health Division 2007
200 Main Street, Hyannis MA 02601
Office:508-862-4644 Thomas F.Geiler,Director
Fax:508-790-6304 Thomas A.McKean,CHO
To: Date: April 1, 2009
Jason E. Sturgis
80 Overlook Drive
Centerville, MA 02632
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RE: Underground Storage Tank at. U
a
80 Overlook Drive
Centerville, MA
Map Parcel: 188083
Tank NO: 1
Tag NO: 00769
Our records indicate that your underground fuel (or chemical) storage tank is over 30
years old, and has not been removed as required by section 326-3: subsection 2 of the
Town of Barnstable Code regarding fuel and chemical storage systems.
You are directed to remove this tank within sixty(60) days from the date of this notice.
After your tank is removed,please furnish this office evidence in the form of a permit
from your local Fire Department within ninety(90) days of the receipt of this notice.
You may request a hearing provided 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
One more time! Page 1 of 1
Martin, Cynthia
From: Pulsifer, Francis [FPulsifer@commfiredistrict.com]
Sent: Friday, May 08, 2009 8:06 AM
To: Martin, Cynthia
Subject: RE: One more time!
Hi Cindy:
I am working on these. I am in training until Friday of next week, so follow up will be a little delayed. What I have
found so far is...
31 Parker Road, Osterville 275 Gallon Fuel Oil tank Removed 11-17-95
51 Bunker Hill Road, Osterville 1000 Gallon Fuel Oil tank Removed 06-11-04
483 Eel River Road, Osterville 1000 Gallon Fuel Oil tank Removed 11-09-90 (Address is 472 Eel
River under same owner name)
80 Overlook Drive, Centerville 2000 Gallon Fuel Oil tank Removed 07-20-98
I will try to get paperwork from the stored archives, but it will take some time.
Hope this helps,
Frank Pulsifer
From: Martin, Cynthia [mailto:Cynthia.Martin@town.barnstable.ma.us]
Sent: Thursday, May 07, 2009 3:37 PM
To: Pulsifer, Francis
Subject: One more time!
Frank,.
Please add this info to your list for verification of a UST removal.
Tank#1, Tag #769,80 Overlook Drive, Centerville. I have a copy of a Permit for removal of a 1,000 gallon tank
in August of 1998, our records reveal that the tank currently in question is a 2,000 gallon tank.`
Later,
Cindy
5/12/2009
w r
Barnstable
INEA, Town of Barnstable AWAMNINCft
9HARNSTMM9. Regulatory Services Department .
Public Health Division 2007
200 Main Street, Hyannis MA 02601
Office:508-862-4644 Thomas F.Geiler,Director
Fax:508-790-6304 Thomas A.McKean,CHO
To: Daie: April i, 2009
Jason E. Sturgis
80 Overlook Drive
Centerville, MA 02632
}
RE: Underground Storage Tank at-
80 Overlook Drive 4
Centerville, MA
Map Parcel: 188083
Tank NO: 1
Tag NO: 00769
Our records indicate that your underground fuel (or chemical) storage tank is over 30
years old, and has not been removed as required by section 326-3: subsection 2 of the
Town of Barnstable Code regarding fuel and chemical storage systems.
You are directed to remove this tank within sixty(60) days from the date of t is notice ;
After your tank is removed,please furnish this office evidence in t11e fOrnl of Perri tr m
from your local Fire Department within ninety(90) days of the receipt of th!sIhotice. -.-
You may request a hearing provided a written petition requesting same is r—'ived by,thes
Board of Health within ten(10) days after this order is served.
Per Order of the Board, Health
Thomas.A. McKean, RS, CHO
Health Agent'
FPO MARTIN O. MacNEELY cation to local Fire Department.
CERTIFIED FIRE INSPECTOR
inal application and issues duplicate as Permit.
CENTERVILLE-OSTERVILLE-MARSTONS MILLS ZZG�cJ
FIRE-RESCUE AND EMERGENCY SERVICES _ .�c�aa��/o� re ✓, � cooz
Business: 508-790-2375 ext. 1 1875 Route 28 iTI O N and PERMIT Fee:4 1() 00
Fax: 508-790-2385 Centerville,
mmacneely@commfiredistrict.com MA 02632-3117 approved tank disposal yard in accordance with the provisions
___...R 9.00, application is hereby made by:
L
•
Tank Owner Name (please print) John Kontautas
X
i �.ddress 80 Overlook Road Centerville, MA gnerureiapym agorperm
sneer. cxy
'Mill
• Slate Zip
.ompanyName Enviro—Safe
Prnr' Co. or Individual
Address P.O.-BOX 810, E.Sandwich, MA
Address �
Pnnr
Signature (if in for p t mit)
Signature (if applying for permit)
LXIFCI Certified Other ❑ IFCI Certified ❑ LSP #
Other
Location 80 Overlook Road Centerville , MA
Sleet Address
City
Capacity(gallons) 1000 Substance Last Stored #2
nk Dimensions (diameter x length)
marks:.
Firm transporting waste Enviro=Safe 329 MA
State Lic.#
H dous waste mantles(# E.P.A. # MAD 9 8 5 2 6 9 3 2 3
Ved tank disposal yard Turner Salvage Tank yard# 002
i plc: of inert gas r
Tankyardaddress 235 Commercial Street Lynn , MA
Cit; )r Town Centerville FDID# 01920
Permit#
Date of sue July 10, 1998
Dale of expiration
Dig safe approval number: 98270 6792
--__ Dig Safe Toll Free Tel. Number-800-322-4844
signature/Title of Officer granting permit
wai(s)send Form FP-290R signed by Local Fire Dept. to UST Regulatory Compliance Unit, One Ashburton Place,
0, Boston, MA 02108-1618.
92 ,;-ised 9M6)
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ENVIR®-SAFE CORP.
P.O. Box 304
SAGAMORE BEACH, MA 02562
(508) 888-5478
77�CUSTOMER'S ORDER NO. PHONE { DATE
-7 � 1
NAME
ADDRESS
SOLD BY CASH C.O.D. CHARGE ON ACCT. MDSE RET D PAID OUT
AM'aUNT
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uSl inooad I
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TAX
RECEIVED BY -
TOTAL I
All claims and returned goods
MUST be accompanied by this bill.
1490 - �
PRODUCT 610
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RECEIPT OF DISPOSAL OFSUNDERGROUND STEEUSTORAGE TANK
:Form FP
NAME AND ADDRESS OF APPROVED TANK YARD Turner Truck�nq &savage o ; Inr
t+ z' 22
k 5�CornmerclalJSt
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� y' ynn, MA O19QO5
77,,777
t APPROVED TlANK YARD NO Tank Yard Ledger 502 CMR 3 03(4)Number a x,
sir Ar
Pcerti ;under erialty of la`w I have,personally examined the underground steel storage tank delroered to this approved tankyard by;firm corporation or 4k
fy p
partnership and accepted same in conformance with Massachusetts Fire Preue'ntion Regulation 502
CMR 3`00 Provisions for Approving Underground SteeljStorage Tank dismantling yards 'A valid permit was issued'by LOCAL Head of Fire Department
h
FDID#� a to transp6tf,thislarik torrthis,yard
Nar0e and i I title of a prove tank yard'owner or owners authorize."tl representa�ue , M
'^ .This signed receipt of disposal must be returned to the local head of the fire department'FDID#� � ,� � �Pursuant to 502 CMR 3 00
xr :EACH TANK MUST HAVE A RECEIPT OF DISPOSAL` �" - ' "
07-20-1996 08:43AM CENT OST FIREDEPT,� 5087902385 P.02
. .••-•••� -"t','••-'+•w.• •v w�.as 1 UC VCtJ41►IIICIII. - '
Fire Department retains original application and issues duplicate as Permit. 0 V
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rya �xa3v��'s�la :`
� " • APPLICATION an
d PERMIT- F o -
'torage tank removal and transportation to approved tank disposal yard in accordance with the provisions
Of M. . .L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by:
Tank Owner Name(please print) John Kontautas X
Iaddress 80; Overlook Road Centerville, MA
saner ck
Satre Zb
umpany Name Enviro—Safe
„ Co.or Individual
Address P•O•BOX 810, E-Sandwich, MA p1hu
Address
Sr.,nature(if i for p it PfW
Signature(if applying for permit)
C IFCI Certified Other1711 0 IFCI Certified O LSP# -
Other
y-
- Location 80 Overlook Road Centerville, MA
S/ee(AOdvss �
Capacity(gallons) 1000 r
Substance Last Stored #2
-ink Dimensions,(diameler x length) -
marks: —
Firm transponing waste Envi ro=Safe 3 29 MA
. Stale Lic.it. .
Ha: -dous waste manifesuJ E.P.A. 11 MAD985269323
-ed tank disposal yard Turner Salvage Tankyard a 002
I �,colinertgas Tank yard address 235 Commercial Street Lynn, MA
Cir; )rTown Centerville MON 01'920
Permit# _
Dale of sue July 10, I998 Dale of expiration
Dig safe approval number. 982706792
Oig Safe Toll Free Tel. Number-800.322-4844
.lignature/Title of Officer granting permit
(val(s) send Form FP•290R signed by Local Fire Oopt.to UST Regulatory Compliance Unit, One Ashburton Place,
0, Boston, MA 02108-1618.
1•xo oaa�
TOTAL P.02
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