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HomeMy WebLinkAbout0489 BEARSE'S WAY - Health MlBearses H annis � 5r Ay 292 — 077—OOC`' r X; 489 Bearses's Way Sewer Acct# 0527 Hyannis A A = 309 -077 t 489 Bearses's Way Sewer Acct # 1055 - Hyannis A = 309 -077 489 Bearses's Way Sewer Acct 1056 Hyannis A = 292 -077 489 Bearses's Way Sewer Acct #1057 Hyannis A = 292—077 . 489 Bearses's Way Sewer Acct # 1058 Hyannis A = 292—077 489 Bearses's Way Sewer'Acct # 1059 Hyannis A = 292 -077 1. ' 489 Bearses's Way Sewer Acct # 1334 Hyannis A = 292 —077 S T,ONNN OF BARNSTABLE 1� r LOCATION 7`PL -► GE # WOUZI we VILLAGE /4�yd7�1 ASSESSOR'S MAP & LOT019oZ`,P.5 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS p R-@R OWNER C/?�c-a PERMITDATE: 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 TOWN OF BARNSTABLE LOCATION99 ���� , I SEWAGE # aKul — VILLAGE /4C dLx� ASSESSOR'S MAP & LOT �2 '0f7,7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS Q ) WURL R—@ OWNER O-Jail /1 P APe:/ .— 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 1 Olde Northeast Realty Limited Partnership 22 Christy's Drive,Suite 4 Brockton, MA 02301 Phone: (508)427-6111 Fax: (508)427-4333 January 27, 2016 Certified Mail/RRR 7014 0150 00014480 3433 i Town of Barnstable Public Health Division Attn: Timothy Lavelle 200 Main Street Hyannis, MA 02601 Dear Mr. Lavelle, In response to the attached notice dated,January 14,2016, 1 have enclosed the following documents: • Letter dated October 6, 2004 from Response Environmental, Inc.; • Letter Dated May 3, 2004 from Response Environmental, Inc.; and • Ground Penetrating Radar Survey dated September 27, 2004. The documents enclosed establish that no underground storage tanks exist at the property at,489 11Bearses Way,Jaka 345 Falmouth Road, Hyannis, MA. Please call me with any comments or questions. Very truly yours, l - David A.Goodman,VP Enc. i Res Anse E nvoronmental May 3,2004 Mr. David Goodman Christy's Realty Limited Partnership 130 Liberty Street,Unit 4 Brockton, MA RE: 345 Falmouth Road Hyannis,MA Dear Mr.Goodman, Per your request, Response Environmental, Inc. [REI] has conducted research relative to a potential former heating oil underground storage tank[UST] at the property located at 345 Falmouth Road in Hyannis,Massachusetts. REI conducted a review of data available from the Hyannis Fire Department [HFD], on or about 1975 a permit to store 500 gallons of #2 fuel oil was recorded. According to information provided, Christy's Realty Limited Partnership has no record of utilizing fuel oil for heating at the property. A site inspection was conducted on April 30, 2004. No evidence of a fill port or vent pipe servicing a UST were observed. Various manholes were present on the property, found to be associated with grease traps. Review of Sanborn Fire Maps was not applicable since the most recent survey was listed as 1960. A review of the Hyannis Building Division was conducted to inspect any site plan which would detail the installation of a UST. None were observed. If you have any questions please contact me at(508)795-0110. Sincerely, Glenn S.Goral, LSP President Cc: REI Project File 563 Main Street • Suite 211 Worcester, MA 01608 Telephone 508-795-0110 FAX 508-795-0910 October 6,2004 Mr.Angelo Russo Sovereign Bank 75 State Street,4"'Floor Boston,MA 02109 RE: Christy's Realty Limited Partnership 345 Falmouth Road Hyannis,MA Dear Mr.Russo, Mr. David Goodman of Christy's Realty Limited Partnership has requested that we provide this report directly to your attention to expedite the process. In response to your letter of July 23, 2004 to Christy's Realty Limited Partnership, Response Environmental, Inc. [REI]discussed the issue of the 1975 permit for a 550-gallon fuel oil UST with Ms.Susan Peck of Sovereign Bank's environmental department. Since there was no evidence that the tank was ever installed via building plans and visual observations at the property, it was determine during the conversation that a ground penetrating radar [GPR] survey of the parameter of the properties two buildings would verify to Sovereign Bank that the UST does not exist at the location. On September 27, 2004 the GPR survey was conducted. The GPR survey has concluded that no underground storage tanks were observed in the data. A copy of the final GPR report is provided. If you have any questions please contact me at(508)795-0110. Sincerely, Glenn S.Goral,LSP President Cc: Mr. David Goodman Christy's Realty Limited Partnership 130 Liberty Street,Unit 4 Brockton,MA REI Project File 563 Main Street • Suite 211 Worcester, MA 01608 Telephone 508-795-0110 FAX 508-795-0910 :a .t.`�. + r,....t -_ +t cf-..a•.,,' -."� :"'-tsi'.;.. � Via:� ram:�r�.� ;>: :�irr.—ar�•..,:4.`..... -..... ._.:%�-;�"a k�-:3:�::ai.=_.cjis.r'�'L ._ -. .s.,.,:• _ _ t n GROUND PENETRATING RADAR SURVEY .- RESULTS FOR THE INVESTIGATION FOR THE LOCATION OF: Underground Storage Tanks AT: Falmouth Rd Hyannis, MA PREPARED FOR: Response Environmental Worcester, MA PREPARED BY: SUB-SURFACE INFORMATIONAL SURVEYS INC. 143C SHAKER ROAD, SUITE 206 EASTLONGMEADOW. MA 01028 i September 27, 2004 R.cover.2004.sw -�SZ-%rA._.......al: .... �._'Y'_..�-`w�'.k�"f�.,,....a.?�i+_.. ... - .. ., ...d_...:`^c....:t:. ..k.-,'x'+:•c.. `*y.".Y:��.. .s.:_-...:.,..a.is}.�Y'.; ..�.:..71.s",.�"4:.<_r..!:- _.�..ilu �;.. �;H:.......c . .GPR TABLE OF CONTENTSY - , 1.0 INTRODUCTION 1-1 1.0 Introduction 1.1 Purpose and Scope of work 2.0 GEOPHYSICAL SURVEY 2-1 2-1 Geophysical Survey Procedures Explanation of the equipment used during this survey 2-2 Geophysical Survey Results Outline of the area(s)surveyed with explanation of collected data Reference to match File Ws with collected data Reference to photo's taken on site(if applicable) 3.0 ANALYTICAL RESULTS 3-1 Data with applicable annotations 4.0 COPIES OF GPR DATA OBTAINED IN THE FIELD 4-1 Site maps(if applicable) Attachments for anomaly locations(if applicable) Copies of digital photo's(if applicable) Data by File Ws 5.0 ACQUIRING PROCEDURES 5-1 GPR Principles—Dielectric Constants Report Notes Blank �` ` J.,,, ��?-1r.;ya:-t>•: .,...�,.s._ L"... v... ��. k„'t`a.-x. _...:..ve i..�. :..� 5-S`L`--.,'A aar.3:. .::ti:', � _ .kht. -_ Fac.-._.xt". .,.t'.,�. �_'..L'r �.tYyt.:c-.sa..__.:.E.. !`9 t�L..Y.3h � 1�_.%J31 .P i4 � .$�.i� f _. 1�AL Sl �'i t;T��' .�T`a_'S, 143C Shaker Road Suite 206 Post Office Box 452 E.Longmeadow,MA 01028-0452 Phone-413-525-4666 Fax-413-525-2887 Web-www.subsurfaceinc.com Email-bacari te.net 1.0 Introduction In accordance with your authorization, Sub-Surface Informational Surveys, Inc. (SIS) reports to you the results of the ground penetrating radar survey performed on September 27, 2004 at 345 Falmouth Road in the City of Hyannis, MA. This survey was directed by your approval of SIS quotation #1.2448.04 dated September 3,2004. 1.1 Purpose and Scope The purpose of the survey was for the investigation of suspected underground tanks around the parameters of two buildings. .. 9�� fat x',r pt �try i�•;3 �l9 �' �W. , E� � , 3, r ,�.., . _ y 11 Rpt.1.1.2004.Response.06750 �.'c.t c.-...:.:•�:�... .,.y^. -..' _....,_,i�t.u,`..-..i_vu<v.:. :"?sx_:r, *cii�.e.. _a....m���,r_a-.-..,•.w ._..=�- t-;_s..,��-�-..;:.l'.s+'.=.- :•4_ -_• _-_ :i�iis:•.•.j.'_s+Y!�vsY _ GROUND,PENETRATING RADAR SURVEY, 2.0 Geophysical Survey The geophysical survey was performed by Sub-Surface Informational Surveys, Inc. A transducer operator along with a supervising GPR technician performed the survey. 2.1 Geophysical Survey Procedures The depth setting for the GPR survey was approximately 10.0' to locate any potential underground storage tanks. Traverses were conducted in both relative north/south and east/west directions at a minimum of 3.0' and maximum of 5.0' parallel intervals depending upon the surface conditions at the time of the survey. (I.e., trees, bushes,vehicles,etc.) The following is an explanation of the equipment used during our survey: 1. Pipehorn 500 Dual-Transmitter,Dual-Frequency Locator: This unity has two separate transmitters. One operates at the highest frequency available in sweeping an area of tracing poor conductors such as iron pipes, fiber optic cable or tracer tape. A second,low frequency transmitter enables us to quickly isolate a single conductor in congested areas,or to trace for a long distance.NOT USED 2. The Subsite 75R/75T: This unit provides digital signal processing for a variety of applications. The unit offers Active, Passive and Beacon locating modes. The unit transmits via direct line connections, induction clamp or induces broadcast signals. An 80 kHz frequency facilitates locating metallic lines with insulators that weaken or block low frequencies. In passive mode,detects signals generated by 50/60 HZ power as well as radiated radio frequencies.NOT USED 3. SIR-3000. The method also used to conduct the geophysical survey included GPR equipment which consists of a sub surface interface radar (SIR-3000) computer manufactured by Geophysical Survey Systems, Inc., power supply, graphic recorder, video display unit and transmitting/receiving antenna. The equipment is known collectively as a GPR system. The transmitting/receiving antenna transmits electromagnetic signals into the subsurface and then detects, amplifies and displays reflections of the signal on a graphic recorder and a video display unit. As the antenna is moved slowly across the ground surface or surface of contact, a radar image of the subsurface is produced. The maximum depth of penetration of the GPR signal and the resolution of the reflections are a function of the antenna frequency and the electrical properties of the subsurface. As electrical conductivity of the subsurface increases,GPR signal penetration decreasies. GPR reflections are produced by spatial changes in the physical properties of the subsurface (I.e., type of material, presence of any subsurface fluid and porosity) and related changes in the electrical properties of the subsurface material in the path of the signals. The greater the difference,the stronger the observed GPR reflection will be. Characteristics that are considered in the interpretation of GPR data from a given site include the size, shape and amplitude of the reflections. Metallic UST's,utilities and conduits have electrical properties uniquely different from those of the soils in which they are buried.As a result,the GPR reflections are usually of high amplitude and have distinctive shapes. For GPR profiles orientated perpendicular to the long axis of a tank, the signature is similar to a hyperbola. The signature is also a function of the tank diameter. 2-1 Rpt.2.2.04.wn.nt.pb.Response.06750 ,..•�.+-.-:c _ •�__. _i{:�tr:�.1;.:=C-... i.,.=._ :1±..:',:. x: t'.ti+ :3.cyca4.. - --. -. - -. -�::. .. .�,_.r.=.+. ,i.. .. "i:;��.�!'�.3, -^?'.y'.%�-dux �f�--�.. . .-�_^h.-�'ri:,'"'—:=.-,:� GROUND PENETRATING RADAR SURVEY LIMITATIONS: Pipes and/or conduits under favorable dielectric conditions must maintain a minimum of one inch hyperbolic feature for each one foot of penetration. Metal pipes have very defined subsurface reflections. Plastic is far more subtle due to the physical structure of the conduit. Other types of pipes such as clay, RCP, Orangeburg, etc., are very difficult to identify in the surrounding geology due to their very subtle make-up and porosity. They sometimes clone themselves to the surrounding soils which will not show enough of a signature different to identify the pipe from the surrounding geology. The higher the conductivity of the soils,the less in the depth of penetration. S A►hiV Above represents three(3)definitive parabolic features common to underground storage tanks. Data was collected in southern Connecticut using a 500 MHz antenna 2.2 Geophysical Survey Results The asphalt, concrete and vegetation areas surround the two commercial strip buildings were surveyed. The "buffer" zone varied from 15' minimum to a maximum of 25' from the building. Some of the areas were limited to 15' due to the property line fence. NOTE: This is an active parking area throughout the day. Scans were conducted in all open spaces,not including where vehicles were parked as seen in the attached photos. A number of small parabolic features were found in the data which are that of underground utilities. No parabolic features common to underground storage tanks were seen in the data. � � h ,.�r,5.r_,...r_,...� :s... �._�:�s'27�.�1 •,n.. �--.a._.::L.�:,, i '.5" .. �,�.'4"�-.w.. Collection of data on the northern side of Anchor Pool—No tanks found 2-2 Rpt.22.04.wn.nt.pb.Response.06750 L('YM_3�.,.. ',.:A.A'' -ac..?sr'.`^LY._ szn._-,ir.�-.u— �-.F'`i'..ak,k�E.. ... _ .— ..._.L.." ^ ti3' ..y}, {.-�..Y'�X-��� 't •. �`Jrlf. "a•.�'+F--'�—.�—,.-'_."�F ' GROUND PENETRATING:RADAR SURVEY fyP��y,N i f. it 21 s I i. wn310 ..,.�..�. Data points of survey in rear building to the west of the property-Utilities nuu ng down this corridor 'H'A�t`'' s� ��p gAd, t �a 4j tar`y 'Gvq � f -ff z r T r ��•j f., v'�i!{r�3"•.�.t'y"��h.�q{�`"s�c^�=�+rt�.�> - � �' Y f t z Y; �✓" u- �, `f��'� It q w z it ._ i4u Y' 7 /}�:.. ✓- - r2 x t sils.5=5�-� ;1w :, �.. � ,w.�u�,�?��•S.iY ��e�`�,4,sy.�1:: �"��_a.. Multiple data points during the survey—NOTE: Data was collected between the vehicles. This is an active strip mall and traffic was continuous during the survey. i b -fB 5 'hx �kld18ranr 4�v' SIR-3000 GPR Portable System 2-3 Rpt.2.2.04.wn.nt.pb.Respons e.06750 GROUND PENETRATING RADAR SURVEY,_ ,i r" x pp� yy v SURFACEmliou RADAR gJ n END OF REPORT I 2-4 Rpt.2.2.04.wn.nt.pb.Response.06750 _ _ __ �:.,'��"�.':iy+:��;M>`ate? - - �ii,'.^p�,i:4g.!x,>._:v.^ro:i- �: ._ ....�,.-." .�a ._::Z:ar-.x.. .. --"-.-,'u,t j -_:��i'a_•:,!f.�3'�a gal..... ; .t.c.;.�:�_x: -- _ GPR ANALYTICAL.RESULTS=SIR.3000.,.;'y-- _ The attached analytical result are copies of GPR Data Files collected in the field and reproduced at our corporate office. After reviewing the data,selected samples are taken and duplicated for this report. Copies are made under the following guidelines: A. When there are distinctive differences in the collected data. NOTE: When one traverse is almost identical in characterization to another, only one copy would be reproduced: B. If there is a significant difference with suspected anomaly found within the data. C. In the location of anomalies,such as pipes,and/or conduits,underground storage tanks or other specific characteristics important to the investigation,such data is copied and annotated. D. Samples of sia cal refusa4(water,clay,or some other highly conductive sub- surface interface). E. Requested data. F. Specific locations of rebar and conduits using encoder wheel with measured bench marks. 3-1 - � �y r '^•- t 7n s •+yam.., wt � sf�[tp�.¢q�T+�7 _Ch:`•',' t 4 'T ._�� ' �. � _ ea?K'ti�-3x'-•:,r. ✓ '"-`z-�-�--ri.-o•.^e�,t.'yh.a `8U$la�VSJ` dJ{ r'dTB88H7dtIIIId�6A3ldffONBL HIB9BP8,.38C 7 .s'. ��n c� zr. ,a,,, 'r`.L' '�+'•` r�sTF•y'ry.��q"w�"'-- ��-pi�6eiB-6arPnoo Rradar; s - �. � � �; �.- r+:• ,s t '�`as-a$a-asce ���� °�...-1® .`t, �®,�,: �k, s•���'�'.�'�6,,�$red�,? cm i"rf� �$yr� �t "Ro e9F79 ��,a'.:�� •c. 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"al �' '� i - 4 w1 t �4 S'« y. r K. ,'�--"t�'p'• r" � 111 � 111 � 111 � 11/ • � 111 1 r•�[ y _ _ f F -t'J.V� A i` v. _.— aF,•= .: .I •S` /^' Jv, i 1 t._ i'1 U( i fx 3r�pt 1� rtiY �N .: � � �'a5 A F �'S•l�}``''j,T� -'V w .. . •.ar1 Zy f�s., ,�M +_o,� f�l,,u3,. }$`ir qit a v. '� >f t C 7 a� r � t I •• i ���r.f•"�J 6�, i..�t i •€���•F.�y,a _ 2 2d f.�I.-. ..4C�Y §. :Ls zt--. Y .°e,i�s_. r_.'.�5�s:Fa�:i�:�_ a-n« 'a'... �.d:4.: ,4t=.-.>�•K-,;7'_ 111 111 111 111 111 I -c �. > �t -c.-ai 't .k":" ,y a °_ ,..i'.?Y:-"ic �r�kTM �gx?�'�-?« i,i:...:. ":1 ' - t�Fa�zr`•V�W.13�"z'P'RY_,.-sf^x -A:-"�i -'_---• : r ,+.— �ypt^.�+i r.�-M•r es � Y�;'��,� ra r�' r xr a r� }��•. � r. i r'�_`. er'� '�' y ,�� iY"a`-�-5�' w• .CF �w>•:t rf � - T �r . �.:�+- t d �/'To�•a� s x+.y.. ry1r--� .3 r'�.T{ 1 Sm. � �, SlN7 ? 1' c'E .y �5. 3 u'r t fv ,fix 4 � ! s�t ,t•` - Rk{Tr hMwct f. Y.n.. DSC00036 DSC00037 DSC00038 DSC00039 DSC00040 .,. -...::'_:r,.'{'�'4..�Y'Y�F"�r?.�-cr+.r+. '�" :�c�;-,+.:.;'.s .as;.%�.. .. ,•,fi s.•ir� . . .. �.i.k::.r�;._;:s•': .. �...;r.��,=• - ^i---f�'S..:�,rf-%^,_i...... _ _ __ _ y� The profiles shown below represent copies of real data collected in the field. Each collected piece of data is issued a FILE on the information tab to the left of the data. This FILER is referenced within the report Each piece of data is annotated from the information collected in the field such as estimated depth, length, direction or any other information that may be helpful to the subsurface investigation. The computer settings such as dielectric values, range in nanoseconds etc., is part of the information tab. The vertical benchmarks indicate points designated on the surface for the purpose of pinpointing a particular anomaly. This is used to estimate sometimes width or length or even distance between surface points such as fence posts, white lines in parking lots, centerlines of vehicles etc. The lc� sign indicates 180 degree change in direction such as from a northerly traverse to a southerly traverse within the same piece of data. The profile below (FILE134) represents a perpendicular'traverse over three 1.000a underground storage tanks at approximately 30" below the asphalt surface. The vertical benchmarks represent the centerline of each tank which was marked withh marking paint on the surface per customer request_ FILE138 is traversing overthe Iona axis of one of the tanks with the vertical bencbmarks at 2' intervals. The tank shows a profile of 10.5 in length from end-to-end. 0 i.. �. 4M.. ? — N`— y Af Rj yJ d H I c _ ,p ffDD m Upp C N {L L @ CL K ^ O '���. A. ;a E .yam �l qCp ~• ,y .� `�.'mod. > yeli'ooaa`n IL l d' SAriIPL E.PROFILE.2002.W in.`'IE.pb .«.�. ... z_.....,s.,.: u..,::.t^r -`'6„3r 4 '>�•- c?c! •4 t .. "a-._ •.sr^- .t �zi�.+�Et ,k .,-�r''-f....er9..M "'�^t.::,•, 7-':t-.d...t b.-•.�e•r..-.-�--..,..,n«s ' = CPR PROFILES OBTAINED IN THE FIELD ,tic field from the r_SSr The attached copies are reprauuc[iun; iruu, oats i�cy� rc;, in -, c.,ru 3000 Geophysical computer. The original copies are downloaded on a T-104 thermal printer and reproduced on our commercial copier. Photo's are taken by a Sony DSC-F707 Digital still camera, using a 128 M-B memory stick- The camera has the ability to take pictures in a no-light environment, which is useful for inside low light or no light building interiors,or during overcast days. The pictures are downloaded in a Photo Suite program and reproduced at 640 X 480: 035 mega pixels. In addition,a disc is supplied with most reports of all the important photo's taken at the survey site. The image size duplicated makes it easy for e-mail attachments to be sent to your . customer. c=f— fY ' 1 y F i � ��� t�' "�"� '} � � :� ►cam COX J���'�..� L � � e,-S ... ' _ .�-:`�:�— Y � MMI,53 r �► F. ggg ±� .�y..• - ^o ems&\ ��3'b 'us '=A � i,_ i. •.a �" � t r. Fri ��'ti b CF'�'•1'mv_'> l r xv -ca f f J 9• aa4Wui�� �t J � }} � ��y1�'ij . is� !�i.� _ wry'•'8"�.'•.�"]�=1 �4�-�../���} B tf•. "� � 4.H- - YTJ i � *�� �-�k �l���i�,e�.v7'•��F�b;�,cr'�� „'`�edP R - � ,;A Sri� � '�•acZ�l��� €,pf'�'€+"�^< ;��'ti�',. � e . x, i -1 3Lh'•' > yq� o -Pr 'fir � ^17. �%�`•. —:. _ 4 2, yi f _ ..•..w�. 'fir i I �I I I I I i I I 3 J t � ,� • it .� ".^+tea, h'+ ' r A'_�- ''�7y':\ay. .=sr �• Z`.. _ �� 4 Y_ zl N �a '',.. �. i x'41(st^.•c9.L �Y-+•`^Cf� „�yy ice"' -'r� �. \ �' �' t,a•.�-fir y 4 ,,X��yy�� 'r. a y.• � � T�T M � t I I .:•�_ - m `A • .. .. ay .. ct .... 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M.�.-1.::.+f P�1 , 1 �-•�1 -� �,(� �.:��l; :'v'•I'� •� 4�J�,�.'F.r Jl -'� t i d � � �:-�{- � t n }a �.f T_ _; + e {' f�4rr t. 3,��•.:.c I� nf.Fh41y f�`c� ,,.� 1-: tf. - I i -WF I� �- l• Jam, t1t..EY;ttrf r° ))�� •.,� q .: :#� rr v'.trtr•t'4.'t .i.. �I�4.{} � f�,}�.. ,_;:�i,� .f�ra,f•!lu -j ¢„P U 1..; {,., I �7 F F. _.°1.��j Fs'�, -4 r i,yi , ,fI ,*k. t..: I. .t �I...,s. r y �.1.. '� .4 Lt.FT'..'.��.II' r a JI�.SI d .,1 tl Ah,�6. `.��d A •I} lu ', .;. _ ..� .:. ... � - - i .....i.....::.d:.i"'... ..sue::y.i':•y 9. ... -_ �.. � ... ... .. ...... _..�_. � _ Page 6 of 180 190 210MINNOW do 6i 19ir V�pi 00 ' w 641 k � to Pikt � t� S # jNL I 0 No* ' II l r � ` F kr a „ r _ -Y n( rr''`+� t r 35.� � fir �� xr � •_,./uyi�rr�' '- ,t.,.•� }� [} '1r. a. ui`t'fit t l ` ��� �' f��`J=frt5f�.� � � I r µ` .� ��'��;{ � � �:t_ • T� t� �' F .tw `t ..� 1'. 't t•fj}�flr' �.•, ��+ -� f f � �tAyi`, ��� ��adYT�.1���•�� �/j,,lJ _i .� j., , J�, i r5•v Ve IN, F. 4�.. . r �7 �4 Ir �,�' � a ��n � �a.�"• t F rc h,r1t, .1 � xkFr�isl�- rR�r��S..�'��} �(: � ''� } •ryr �` fiP�j••`� v-�f� :`fir+.�,��,•.t��tar (�-, 1 � r, .� ly s: f• �- r�,h , { , l i� +` I ti• r F 1�-i �.. � i �r'� y 7 _,t i{. h Y7 .,fiJ� ' i,: � c r , •'rfr^ ?��1: 1�1T r'r llf I�. l e : e •e ee .� ,� ,fif�.!• h rJE�.1 I � `� 1 r i " 4; 1 +1 ) 1 r la• Y' A' �,i �` F y� � 5 ur I, ! a k, 1 1� t d _ ;r r r y �C d, _ - r - � t I�a t• 1 h } r �2 f � I �� til 41 �arrfr L�� 0.1 A-414,ii }a.:%1_ -v �r wi-. 0a:I• +���•�,t `r .. r f { RE10 Sep, 27 2009, 10:97:35 Page 2 oft RE10 142' southerly traverse down the western most corridor behind Hancock and Star Laundramat 0 D.— - •�}'. •i;_ showing an equitable distribution of the subsurface with no unusual anomalies. Created Sep, 27 2004, 10:45:42 Modified Sep, 27 20D4, 10:47:36 Channel s 1 Sam les/Scan 512 Bits/Sam le 16 aAVo,„rv° qs°'_x �a�r �ttFFvv''y t° tStti y�y k, •:' pti ( ) P P �, n Ka ' >' Scans/Second 100 Scans/Meter 59.0551 Meters/Mark 2.4364 oyic � P„.,+�r.�, m: a,A,+.,�.,,` t w r ' �� .• a '��• Dial Constant 9 �+"'wl4i+agz�+-`.��...!" 6•'v ,e'� CHANNEL 1 400pIFiZ Position 0 nS Range 40 nS -t t " ,i �-f n4; 4r 7 � kIa �a�yti x �' Range Gain (dB) -20.0 13.0 40.0 Position Correction 1.1 nS - 4a8i. pp 9 a h• �'�` �" ly"rr r a� Vert IIR LP N =1 F =800 MHz , F� 7 if' `t * � .x .LrV fd 4p `cIr�`�+t t Vert IIR HP N -1 F =100 MHz - , E, )•�*" '- x { p r < ,F' - '( r :sj x�: i , Structure ID ►ej 7�k,) f s a ,r�9 Time Zero Adj. (Thres. 3000) �C ' Background Removal ? F fli b R r k 4 ,P Antenna Type = 5103 0-� d �C+•�J � p F� s.�'' � E � i �t'{'�' �' J� 1 . -it td '2y�{� �}: �1 "`45ee' . t ,•GOka s92W$, / •c : :r 1. `15 h 1 we 1 ' � a • K r '�Q � �� t 6 � V �Y�1s�i a�f���£ n� �Yyt��f�h,,,µa� �wSS�,,) lei � �,burr 4 y '11� i � A•^ Ff ,c � �� t Y. ' ' �� ...• �,� �. a; a F, I.J �'•.,_�-'.""�..` ;..-�. -:..a.,._:... x�=fix x�:� �.-.: .:c�.,,...r•�:;d'.'.ra.._'+�•.'rx.�.:�`-__..._ :.:.++,:....-i:�yt. -_-:cc...a4++�Y�_: .�ek' .a�.Lr.� ,..r•.�'.�v-r"���?�t�vxiaxn.:i=;'L:t•.. y-� [ � - �_ �P t �4'1wr! �b�S �'x1•'4Mu-t.'G.'y4�^n 1( ,y�,s7^ �'k�yq +.'9r:3PRv 'tS,R .r�_R Yac C��`iG..:F 4YrY� �fK."' y] - � j yi[wa4 fr ✓h s• 9'�Fi'A' � i""�F 4.vb. "-!i. Y� '*'Ax' ..8` r�� �r�" _ '1�5s"�'-. '$£+Ta°''y �ri� ry F,S�r4d?G �r✓."3+ � � .. a. L� '�`�.'• 3a,` ' .>i°' ;v. v fi�'a r-j nYti A HY. F YF. 3 S1 dF '[y 'ydI . N t' a "F'' ''F� ='fix. '°tea...:' �,� �Y �' ��J`F.3, t � yro��.+R�a �"'.� L'a-w��a+��'J��C��.?�!r� '�3J � •L`'C t3a�'�..�' �K -�. � zm Y s3ea 4'6 * Y ,{yr" Es � �x., _ h,r g. he .^ ,• -.:s .,�Ws. _ CE$Y3` } 9 0 pLa" 4t . r ��a � --.'✓✓ .�`_.�� rr,:tee. v:'t�,R catvf'���`� �b 't°r� c, mn � �' •`',-�y u� .�.:N°�''., 's$� "".`'• �.�`*v,>[ s ram,.. 4 a v.i "�„" I IPA N �e`�'3•_v4� � 'i�i�15fP����••' � r�r'31?`L^.c'F'�L+14 .1L`J`.KC �� .ry' ,"a{t>t,".073' 9' .ege�nri. v� i•- 1 �" 7.s{ _ _ Wig3k _iY'a•. _ � 30U _.y,�y�14�C}F�.^"'.m`�4'9•YF'as S S sin•' . •' " . y, e m' Nw ...,`' 'r" r .'�.ys `�`fit%• ,� �' sin '$ �•X'� ���•�mV°`-- �"i�'. 14 � e ''€ * �, ,s,� •� `� � ..-� �l •� � r^, r �' ern-,°�t `l t'�r d ��sY'°"`+ �p"'C'• �LL� `y''tp�,y�{�^'^ We �� r � i��c��ri_b I r, ^,-�".�._-.:._. �__ 4-,�..:T'r „��r:••r-'M__�:_�T. Tza..s_...�..:;"ErTxr_?`'.,:��.t __:� ..`i__...:.. -..: -�',;:r'?•e_�'i'-..,.;.j�°a�-a`Y a-::.�...,1's"i.- �5'. =� _. ..- i 1 1 i N O N N D� ti W .D A'° 11 405"iw- 7 _ � y� � C^�' °F`Y M �' "ic'`i�:+r�`ytl � fit•^F'S �., j 0 4H. �—L o: s xcc YM, MW RE14 Sep, 27 2004, 11:04:34 Page 2 of •6 RE19 185' of southerly data collected 20' east of Star Laundramat building showing no unusual • - gt:.:.;.:.: .. r R anomalies to indicate any tanks. 40. Created Sep, 27 2004, 11:03:24 Modified Sep, 27 2004, 11:04:34 0 0 ' Channel(s) 1 Samples/Scan 512 Bits/Sample 16 t'h ^ <'• y; ssg 6 y :'r'4) �. Scans/Second 100 Scans/Meter 59.0551 Meters/Mark 2.4384 ` y Diel Constant 4 '°"`eMO CHANNEL I 4 oOMHz r t � a c .. e �i ca, �� r t�,tt Position 0 n5 Range 40 n5 AA i P � - a ¢vr '� Range Gain (dB) -20.0 13.0 40.0 ���V25) A ( Ftl' �,..;P"' Position Correction 1.1 nS (�_`� k,*�jP?'P �.. �r•5 ° u Y 'P �� „q n Vert IIR LP N =1 F =800 MHz $°Sa r 1 ;y r� � .,,ry r s� '�+{ •'! , Vert IIR HP N =1 F =100 MHz S Structure ID i we^' A Time Zero Adj. -(Thres. 3000) :. 'a U ?a a ` �,..,' E ,., �+..,i : 6y�1 rw") BaeY,ground Removal 2 00 - '? �, e .� � ' tr't(, ' '4: �5 Antenna T e = 5103 —. ? r{W� 1 €td '2 "t ' h Twij& & ',fad V. 1� e � 4 °3t 4x YP $ ffes� �% �.•F4``�i"„ ` !� Pµ'� `" i. �•`-�,.. �t �F(F g T:G Yfa,! }ern r !� n-S1),' t k Slk ohs � k ��i�,(Ey if+3 i r���lx t . °�I � r•'`��"P -}; •�-7I �}� .. :S4pg� 5�^ �" e � 5i4 vg� dj r- " PARIN'to NOW 14 1 f, L 'r ��,: � ° .. � '��� fit.► `( � � ,* ,� �,, t AN AM 9l a (4. a:: � �� ,'... 6i` s.' r d ^�7 f"r1( t r. ..c_�.s..:-c. .�._--�_:_.x_a,.'.� .. -�[ - -_-�.-.:,.:. c.:... c...,:-:. � .. _..-: r.-_�a-.`—...,- _.. .- -_•..er _ YnrY-.cj .a ..._ .. - _�.arir '=a.,gu....�.-_=r._ t _ .. ,N 31 �' �St�� �r'"�`•r- ..fs•� �' i Ms �',3-rT$ v'r,�w'�"x �x�� ,H�Y`F`s" � - ,� ,o 27-1 Ift +u, ZP- 4�"�"`' +" ��-f� s` "S 'z <a� `�'_' `�„n, qz — NM vV�'ywst•��. ��-Y' :fe�5 �Cl'a -{y p '.y. ,d 1{�? �"TVT- >Y15 '�1Yt '�`i 4+9Pet •A'9➢ c4'i•"`t r 'aK.,per. .vle n°�, ._ ;Zs a A�i14....?,,.. �,^� .j,s'Si{•��y,�,, ��•` VTI��;':,4�4,5�V.�y,_N x��''N' •�yri�3 � srjd121,� '.nyyd.. 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'�� Wa •-�.:, ..' . . s*�. :J a''j[''�+ .'-eS - a,tk-, C57- Pt ��,•�,t �' •apt _r oww- L tr- :g;;} y"l• Oro Gl - iT d 9 .,T .y OS ry a ra 0 0 nt .. m r1J M O ti ry i a t` SY, s+. w .��4.�5��'��_14"'. ..h ._ Y"•LP:r i:�3_3 �. �'L -Y, ?. ¢� r^tom: e.• `r � ...., ._may..'� u � ,#+�' -�. sty �± i RL MUM i �.,..b, F7 ag, tas G 'gE`>� v `^N7 `�r'Srtta. � S�f�..i Ai IF �t°.� '"'` �. ��"�;x%•' .,cam''-' �� a ti y ��. ��. � E�' �� �.m j �� '•9+Y_'.�' - tU +Bch: '-t �`� kv Elm V9.oz . g� 1 _ „ d y rYt io I t r ! } / h i�q`Y�•a w �4�'`T t r S ti T i 1� cf�� �s 4�'' �f a �i.��*fit ti rl<I �, r f 'i4 Rt4 f\1•h I ;, df t rru ( 1 ” t a t V 1tvl t Sr +. �� ��' t ,�-'t.^ I' 7 ��wr rl ' s /t ,t y� �s��' �"it t�I+ I�y 1• �' �.�lya y S���, t�1`i �' \ �1 '•� Fn '} t 1 r r S In r ,4,1 �aI} { 1 d( Si J I 1 1� � ) �It �l �,1 1 t •� � �1�t J'�1� j /14 4 �Y 4�g 4� �' - fi ,��1 Y Z ^I,I t' r ly ri 1 � � 1 Jjl t .rat/rry// 1 L t � � / t24 1H !'1• '�) � t � ,� ♦)-� t' , rl V is .dLa,/-1r '� a r 1 1l 7T Et>Er �t J n r1 1 t It f c sj ;r rr a rt s) � r� f t (. ru r j/ �n l ✓ �*'iYt"6y �-�, I,'.":'::'h..eK...n s - $' inu�3f ':Ya as kr F So:_ 6,r -t'. r.�t3z �t(- x � ti+�""'t3 cr ram.�.,4� 4�, �,gz^ X�'' � '�. 'xz,.•. 14 .n:x via s ^�:' t �-- .c '. a r`•v�'_. Ak y r `k _.:�.. '�: `� .yy it �t � '„� ,�` c `• ,�.. 3 g � � _ �'�'y`•ems } a Jhf , s 7106 to Zi ff 1 I 'E t 4 1 - 't '1 •� J - ' ..xn �'' } -Fz.{ C`:`•:�r -:2."i �J -.. 7 s ,H. 'S - '.r L �r�-:?s'.,. •�r��J � 3' 3l ���� i .r%`,! �h z hr - ,,-�� y Z; r=r.-.Yy S l 'F'L'�'" .15.-�dd'l -+��--�-�-�-,� °-•• .,Pa. fiz +r '-4S 1` ai r'K.vg�l�r'""�``'^"'•^'_ ��'1E�'�y ��� ���'�r ,yi:i�r- - '��i_ gip+ i1�k 1 r z 7 7 rt,� �x'�1-r^.: •n m�.a��r�l..�'�y�t � 3-�ra. 1` { n o vF -� I`�. .3 sky" ;� e'•rr `r��n�,sa`S� l' ', ' � -#` � -x. Ai a. 7s4k s„�--+c-..y'�"�`° r`�r��m "fir"_`'" -r- '�- '�• s� y,.-mkt,.''pr-. + ' '�.�' k.:. e:��? i - . r � -�- ti.x�r r'-'.�����lux-.s-z�J -�-a :-F•.-�--�� . q4,�: F Iz H ^? t e t �s; c s x k r r r u~t 2 {pj b 4- t t r5'r � 11.51 . t , ` Pp A. e r ins �: '+ i•. � � ^—r�fi,��" r f 6 � - l � �� � �b !• S 1 d f r_ r e IJ ; t�� tOt�5,-e is i nV a' i ai h e: RE18 Sep, 27 2004, 11:45:44 page 7 of 7 ' I t sAi r ��I ;4i } S (f CPR REPORT-,- 5.0 ACQUIRING PROCEDURES The acquiring of data from the field for the location and orientation of underground storage tanks,'utilities, conduits w/in slab, rebar location, grave sites and other specific anomalies has been I established by the ground penetrating radar for many years. Since 1988, Sub-Surface Information 1 Surveys, Inc. has completed a multitude of successful investigations covering most phases of the ground penetrating radar profession. During an investigation, a cross-section of the project will be recorded on the hard drive of our computer. The data is then transferred, copied and duplicated to be made part of this report We do not necessarily record every traverse in most of our investigation since most of the information viewed on our monitor is related to the previous traverse. Traverses (I.e., profiles) are monitored on a constaLt basis. When a traverse is collected on the hard drive, it is also played back in the field for a second look. Where there is an out-of--p/ace characteristic, it may be played back a number of times to determine its location and origin. This is recorded on the hard drive for further analyzing at our office. When specific anomalies are located, all are documented for reporting. Anomalies are marked in the field if requested to do so. Measurements are taken to identify the exact location such'as a tank or utility. During the start of all surveys, site characteristics and features must be documented to set the standard for that particular site such as soil conditions,conductive features,etc While the survey is being conducted, there are periodic documentations which are used as a permanent visual comparison to confirm the standard of that site. After the completion of our survey, it must be reasonably assured that the information is a true cross-section of the project and the information obtained is accurate according to our best professional efforts. �-1 AQ1PR.2003.Win.ME.pb .':•s.x,.cs}ca- ,:ar��7e.u:T-`:'._ �-^. �;�;:.f••.-a.'.a.. :ts; - _r__.: o;-..u-!s•q. F. :.a^a:w ".s-... r._.;�-s`.k. -sue �r`hSSci_:�s.r�� v, `:'S":;n.. ;r..-:�3 w w GPR PRINGI]PS _ 'IELEC'I`YtIC'COPdS`I'A-N"d'S TWO-WAY SLOWNESS f Dielectric Constant=This parameter is the value of the dielectric constant used to convert two-way Dielec travel time to depth. The value ranges from 1 to 81 and depends upon the dielectric properties of the subsurface materials-being profiled. {WARNING: Dielectric constants for various materials,and thus the resulting depth scales,are only approximations. Additional approximates of various materials are as follows: MATERIAL D/C MATERIAL D/C Air 1 Wet Granite 6.5 Snow Firm 1.5 Travertine 8 Dry Loamy/Clayey Soils 2.5 West Limestone 8 Dry Clay 4 Wet Basalt 8.5 Dry Sands 4 Tills 11 Ice 4 Wet Concrete 12.5 Coal 4.5 Volcanic Ash 13 Asphalt 5 Wet Sands 15. Dry Granite 5 Wet Sandy Soils 23.5 Frozen Sand&Gravel 5 Dry Bauxite 25 Dry Concrete 5.5 Saturated Sands 25 Dry Limestone 5.5 Wet Clay 27 Dry Sand&Gravel 5.5 Peats 61.5 Potash Ore 5.5 Organic Soils 64 Dry Mineral/Sandy Soils 6 Sea Water 81 Dry Salt 6 Water 81 Frozen Soil/Permafrost 6 Syenite Porphyry 6 Wet Sandstone 6 MATERIAL T/ns/meters/ft MATERIAL T/ns/meters/ft Snow 8/2.5 Water 59/18 Asphalt 14/4.5 Dry concrete 15/4.5 Wet concrete 23/7 Dry sands 13/4 Wet sands 25.5/7.5 Saturated sands 33/10 Dry sand& gravel 15.5/4.5 Frozen sand&gravel 14.5/4.5 Dry loamy/clayey soils 10.5/3' Dry mineral/sandy soils 16/5 Organic soils 52.5/16 Wet sandy soils 32/9.5 Frozen soil/permafrost 16/5 Tills 22/6.5 Peats 51.5/15.5 Wet clay 34/10.5 Dry clay 13/4 Dry granite 14.5/4.5 Wet granite 16.5/5 Wet basalt 19/6 Volcanic ash 23.5/7 Potash ore 15/4.5 Dry bauxite 33/10 Syenite porphyry 16/5 Travertine 18.5/5.5 Coal 14/4 Dry limestone 15.5/4.5 Wet limestone 18.5/5.5 Wet sandstone 16/5 Dry salt' 16/5 i Complimcuts of Sub-Surface Informational Surveys,Inc. E. Longmeadow, MA 01028-0452 r✓�::u�-=;.�—:sa:r:--_ _- . �.�.s� :>.y.�d;:.� >x-= - _._.^•�_-''i.__.- .raL-y!'��-: g�;rl- _.�a..r:�........ _s:�•'Y .•-�--v�._r._ ,_ �- ri�fi^4 •�-�.�n-Yip ti: REPORT NOTES - i i DAM�— DAB! •'�°TL'S SEEK VM F-'M- FZME 1ph, Town of Barnstable ti Regulatory Services Barnstable vMASS. Richard V. Scali, Director 039. �• Public Health Division 11111. �f0 MA'S A Thomas McKean, Director 2007 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 January 14, 2016 OLDE NORTHEAST REALTY LP 22 CHRISTY'S DRIVE RE: Underground Storage Tank SUITE 4 489 BEARSE'S WAY BROCKTON,MA 02301 Hyannis, MA 02601 Map/Parcel.: 292077 Tank Number: 1 Tag Number: UNREG. Board of Health records indicate that an underground fuel(or chemical) storage tank at the above location exceeds thirty(30)years in age and has not yet been removed as required by the Town of Barnstable Code Chapter 326, Section 3, Fuel and Chemical Storage Tanks. You are directed to remove this tank within sixty(60)days from the date of this Notice. Upon completion of the tank removal and within ninety(90) days of receipt of this Notice, please submit to this office a copy of the permit for storage tank removal issued by the local Fire Department. This permit is required to be obtained prior to the tank removal. This copy of the removal permit serves as documentation that the underground storage tank was properly removed and disposed of. Should you be unaware of the existence of the above mentioned tank or its possible previous removal, an independent third party (i.e. oil company, tank removal company, or environmental services company) may be able to assist you in physically locating and/or verifying the current existence of the tank. Should this be the case, a written document from the independent third party is required within ninety (90)days of receipt of this notice as verification that the tank had been previously removed and/or does not exist. You may request a hearing before the Board provided that a written petition requesting same is received by the Board of Health within ten(10)days after this order is served. Failure to comply with an order of the Board of Health will result in automatic scheduling of a hearing before the Board at the next public meeting. Thomas A. McKean, RS, CHO Public Health Division, Director Q ViazmaAUnderground Tanks\2016130 yr old UST 489 Bearse's Way HY.doc V�by'V#1:: •'9�'b:: p;;.;5.�.;• ` '`q:.?,•i �;J.•!� ti,:�ls`a:K �y�' �`�1n.. �;�'i c':� .,�ybJl� y,:.A'a'.. C'T�•,•'. t•. F:�.....>.�,...:�.:lYir:. �.., 1 •�i �• •`{ 1i. .a\ .s Sim..°.. '�' �`i 1• �-` V2`{$5y{I'r 1...�i A' :f• i.^ .9h .Y� ..�•. �1y ,k '�� ��si r.,, ..ii.•..>i'L.:::'i1..�'.e�:/.}:,�jj„�`t�.''�.`p.. ' ?f;�;;.,�'••X. ` tf" 's•� ...ii3.,..$fi:,.,�?�. �'ye���?'fy,.:.. 'ii . mnmL %.;....1.i.`4�a p .'�;..•; •�F.. � a,a,.,i.,_Y ,,,o-,,i• ,•�VVVV' �i`. } ' La ie, :..,: -�;se: :r::r•;, :�', : ,� _..•- ._�,,� .. • _ ,: . ,. fib,. •�'�:, i:�'... ,�. � .;,� sp•:i`= •' ,�r's»b,�r�tire•:of; C`iEJ't'� f�4 �''�>'�t' ,fir', permit No,-- :,�W .� Addrsso A _LMI � .N. V y CertffiMtb of CoXpetency No. CERTIFICATION OF CCMPLE'TIO .Date- ua- q.7 To: Head of Fire Department i Subject: Certit;oate of Completion—lnstalIatign or Alteration of Fue - ing �quipmet�t The undersigned bore j Instal r alteration) of fuel oil bu under authority of.;e Y, &W sued by you and apD Ping to thejnstallation visions of Chaptor 148, G I,., mud re€ulatz thereof now cur in effect and pertaining thereto. F , fen tested 3n accordance with finch require. meats, is now in proper operating condition and complete iaetruetiona as to its mz�a and maintenance have been ftm&hed to the person (or persons) for whom the instalktion tr (/ was made. . . :.: 0. . �L .The 9calowing data. applying to such installation is submitted for record: '+ �R !UA'i' BURNER Name ..,.,,� JYF� �....� ...��.._............::.._.. Mig- by type �.. _ -Af ddel 140. or Size To use not heavier than ��-.~ •fuel oh AN !�/�f. _. Capacity i�..�Il gala.Type --�-�1l ��� Y-_- )* ` 1' Location ,vws[• ,,., NTROL Type (automatio'gr Manual) Ta '�7fC Automatle shut-off valves at W.a=r & Laa)c r Installed by Manual shut-off valve at tanJlA010 YOU WISH TO OPEN A BUSINESS? For Your Information: 'Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You'must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,.1 st PI., 367'Mai'n St., Hyannis, MA 02601 (Town Hall) and get the Bbsiness Certificate that is required by law. L ..V�l4a DATE: �'G/^/ Fill in please: ° APPLICANT'S YOUR NAME/S: y' BUSINESS YOUR HOME ADDRESS: 3 J^ Gl-le'ce TELEPHONE # Home Telephone Number k• 77- NAME;pF`CORPQ�AjION �' - :.�`1 • � 7`'.��• //� Cl� ::..:.: ti EW,BIJSIt�]ESS::... s,. {;.:::::,.: • . e >•..•�:.. .... . .• _ Tl(PEOF'BUSINESS C©rY/•'Y`r'��'?•/�YLG`� ",,Jo Si-� IS�A'H(]M ��DCCU iq'•I Nam:>=`> ;�� -YES_ O /,�:ADDRESS°.OF°BUSI . ESS4".:` *'J.:. a -lr 'MAP%Pi4RGEL NUl1/IBER t' gssessin' (. g);.;.... In —p d When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. i 1. .BUILDING COMMISSIONER' FFI This individual has been I r f any permi ments that pertain to this type of business. Authoriz F a** COMMENTS: /�/��_G���7 2. BOARD OF HEALTH This individual has a nformed re uirertain to this type of business. I ll G MPLYWITH.4 RDQU MU IERIALS AEGUlA Authorized Signur `[�f ll�• COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY] This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS:. I'""'=^`�?�iti�=;.y�.r:•a'!'y.►�:"v{,�'F't.''R.!•.�,,�Y�ti�'I.wD4�t Sti:`'�.��1��",•nd+�Jlf`"`'�>' `^n.+"�`�'�"`�'���'r.�.:�C:tiXa.,:j{.i�j,,r>�!�-''�..j5,,.,'i•�':"��e�..rr'J�'�y:'n`�='"'� ''�', �`�#��;. Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 60M, -Ha Cor • IkYAIPWotiveflruid, BUSINESS LOCATION: S t f INVENTORY MAILING ADDRESS: J TOTAL AMOUNT: TELEPHONE NUMBER: 1JK-- -77 >'` 70 c ' ?t� G1ct, CONTACT PERSON: (, h pc, k1f. EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: ; INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month're uires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts(Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Photochemicals(Fixers) Gasoline, Jet fuel,Aviation gas , Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) r ❑ NEW ❑ USED Any other products with poison"labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents - Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Y4�> TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops nn unsatisfactory- 4.Manufacturers 5. l Stors COMPANY Cpw-(N�a (see"Orders") 6.Fuel Su pliers ADDRESS Class: 7.Miscellaneous Q,;�nt S B4 Pc- QU�ANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATEAMLS i Case lots Drums Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSALIRECLAMATION REMARKS: tS.�T 1. Sanitary Sewage 2.Water Supply A S .Town Sewer �*ublic ( - _ b( ,• O On-site OPrivate 3. Indoor Floor Drains YES N0� O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0l�_, _ ORDE . S: 0 Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter ProductName of Hauler Destination Waste •d YES INO 1. 2. Person s) Inte ed Inspector Date TOWN OF BARNSTABLEids COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory g.Printers y Shops unsatisfactory- 4.Manufacturers /�bg ���� (see"Orders") 5.Retail Stores COMPANYCL %se CU1S 6.Fuel Suppliers ADDRESS Sg• 7.Miscellaneous QU TITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Above Tanks Underip-ound Tanks IN OUT IN OUT IN JOUTI#&gallonslAge jTest Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers 1� 1 Miscellaneous: — r h 1 3444 � � 1 - - l BISPOSALMECLAMATION REMARKS: 1._S itary Sewage 2•Wpcter Supply own Sewer ublic O On-site OPrivate 3. Indoor Floor Drains YES N9(_ O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0 ORDERS: O Holding tank:MDC ,ak_oa� .(M%. S) O Catch basin/Dry well O On-site system 5.Waste Transporter Nanic of Hauler Destination Waste Product • , YES NO 1. 2. e son W Interv—e Inspector D to TOWN OF BARNSTABLE . COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 1)0 satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY M I f)- ,iA p� mty(-Ac (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 90 f Class: 7.Miscellaneous M 1- A V QU TITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS 0"ise lots Drums Above Tanks Under6n-ound Tanks IN OUT IN OUT IN IOUTI#&gallonslAge 1Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscella eous: fio r VV� DISPOSAURECIAMATION REMARKS: 1. Sanitary Sewage 4Wter Supplyown Sewer ublic p 0 A— & kak�d_- 0 On-ste Onvae 3. Indoor Floor Drains YES—,)( NO ' 0 Holding tank:MDC ` do m`S1 S 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES N0_X_ ORDERS: 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 5.Waste Transporter Licensed?Name of Hauler Destination Waste Product x CkAt u;,C0_t,:;, YES NO 1. 2. 7 &7R �U R A 1,04 W k) P nterviewed Enspector �— Date `A Health Complaints 29-Jun-98 Time: 9:25:00 AM Date: 6/25/98 Complaint Number: 1404 Referred To: GLEN HARRINGTON Taken By: GLEN HARRINGTON Complaint Type: ARTICLE XXXIX HAZARDOUS WASTE r Article X Detail: Business Name: MID-CAPE MEDICAL CENTER Number: Street: BEARSES WAY Village: HYANNIS Assessors Map-Parcel: Complaint Description: Mercury spill occurred due to failure of a wall- mounted blood pressure gauge. Cause was said to be a child that was left unattended in Room#2 played with the cuff and exceeded the pressure of the glass gauge. Spill occurred at end of day with last patient in the room. Spill was not noticed until after the first patient the next day. Actions Taken/Results: FD was notified. Chief Brunell consulted with Yarmouth FD because they had recently cleaned up a mercury spill in a parking lot. Yarmouth FD advised to vacuum up and then dispose of vacuum. Capt. Farrenkopf stated that mercury was piled up below gauge on floor and that it was not tracked through the office. Mercury was vacuumed up with an 85-gallon Shop-Vac, then disposed of in Haz Waste Over- pack drum. Clean Harbors was contacted with the permission of Responsible Party. Bill Howard of Clean Harbors explained that necessary clean-up included washing of all surfaces with dawn or strong auto soap, then disposing of cleaning materials in haz waste drum. Room was sealed with tape until cleaning service came on Friday.morning. 1 Health Complaints 29-Jun-98 Receipt of cleaning service was provided to FD and Health inspector. Clean Harbors will dispose of drum.Room was given a final inspection after cleaning by Cheif Brunell and Glen Harrington, Health Inspector on Friday, 26 June 98 at 2:30 pm. The patients that were potentially exposed were contacted and were told to monitor for effects of mercury exposure. gave Kathleen Kenney, R.N., copy of toxological effects of Mercury from"Handbook of Toxic and Hazardous Chemicals and Carcinogens". Lab Safety info on mercury spill kits also provided. Investigation Date: 6/25/98 Investigation Time: 9:30:00 AM a 2 �- � 3-0 IL 1 ✓� "'"7 c'Gy`y 4.� cfTLt.��` CA.�.aU' 4`L C?'1�►l�W✓`cyC � }� S�4[�/ �t ('i�/ III (✓C S E, G4a( �-a- -��o� &-,671-4 F7 vvd evejJro-a cc., Ir9 d v vp otw-o� �yc�o C�c,LecQ �/l�r.e d7 y� ill � II o crd- V,�e C INJ a- CA/ c ti s L,L j'ly�. I t cJ�s ",o 4- -+r-a C,GEC, III �I Tf ii e'rilm lie 6, I f (�?v�- l/�2�v✓�yr So c! o.�l ;` ���� .. t,v,`// r� r�e_waz, ISO II c 6a-zic Scc3 6 / z cam- /--Pv - d ICI ill III II Id �1 �� 1' j -� ! ;� ��_ �, :� �e� K ,. '' � - r 4 � - f ��_. . � � .. _ �� . '� �, l .Jti ,. - .4 e _ � - i� �I _ f - �' �' . � I � .'. . .�.a �,. I • � �. L i 37867 CUSTOMER'S ORDER NO. DE RTMENT, DA _ Zu,19 , NAME ADDRESS , 49 Wo Uruz ,l1- y CITY,STATE P .7444nnw-, ,CIA SO BY ' '_CASH 1 C. D CHARGE ON ACCT 'IviDSE PAID OUT' •;.+ �.I tii �1 k�i-::. a '.�5 � •,,�' � t 1 �ti QUAN. DESCRIPTION _ PRICE AMOUNT• 2 33 -- I a�iti 3 _ 4 _ _aow_CL�CIQ ✓L- 5 — - 6 - - 7 -- 8Q/rYL 9 10 12 —Z a.-— 13 14atntQ.4Qm����_� � 15 16 17 18 19 20 0133 — RECEIVED BY KEEP THIS SLIP FOR REFERENCE DC 5805 d I 019.22 A210730 7/ 2 Sunday 1❑ 18:18 18:24 20:40 Address Zip Census Tract 4 8 9 Bearse's Way 48-499 Hyannis 4 0 • Type of Situation Found Type of Arta Taken Mutual Aid 40 Hazardous Cond., Not 4 0 4 Remove Hazard Classified Fixed Property Use nition Factor "road, Parkin Property Not 9 6 9 100 No Fire Found 0� Occupant Name Occupant Telephone Christ 's Plaza Owner Name Owner Address Owner Telephone Christ 's Of Ca a Cod I 105 Pleasant St. Hyannis, M F 5 0 8-7 71 -0 9 0 0 Method Of Alarm Shift No Of Alarms # of Personnel Responded 1� © ® Hazardous 1 Telephone Materials Engines Tankers Aerial Other Vehicles Present 001 0- 001 Yes AffimW Fire Service Other Injuries Injuries Fatalities 0� Injuries 00 Fatalities � Rescues 0� Mobile Property Use Is Car Stolen Insurance Company Mobile Property Make Year Model Color License Number VIN 0 0 0 E • Complex Area Of Origin Estimated 0 Loss Equipment Involved In Ignition Form Of Heat Of Ignition 77771 0 0 If Equipment Was Involved In Ignition Material Ignited Year Make Model Equipment Serial Number 0 Method of Extinguishment Level Of Fire Onig n Number Of Stories Construction Type Detector Performance Sprinkler Performance 0 Extent Of Damage Flame F Smoke Material Generating Most Smoke Type Of Material Generating Most Smoke 0 0 Avenue Of Smoke Travel Weather Conditions Commanding Officer 0 G.I.e"air.................................................................. F Cat C. Farrenko f Report By JCapt C. Farrenkopf • HYANNIS FIRE DEPARTMENT - INCIDENT REPORT COMMENT PAGE • ,-incident No. A210730 Address 489 BEARSE'S WAY 48-499 Date of Report 17/22/20011 Commanding Officer Capt C. Farrenkopf Report By lCapt C. Farrenkopf RECEIVED CALLS REPORTING A LARGE POSSIBLE SEPTIC SPILL IN THE PARKING LOT CONTAINING SOME TYPE OF GREASE AT 489 BEARSES WAY CHRISTY'S MARKET. ONE CALLER REPORTED VEHICLES SLIDING ALL OVER THE PLACE INCLUDING INTO TRAFFIC ON BEARSES WAY. ARRIVING ON SCENE,CHRISTY'S PARKING LOT OFF BEARSES WAY WE FOUND A GREASE SLICK RUNNING DOWN BEARSES WAY IN BOTH DIRECTION AND A 1/3 OF THE PARKING LOT IN FRONT OF THE CHRISTY'S STORE COVERED WITH GREASE AND SEWERAGE. A CANCO SEPTIC TRUCK WAS ON SITE PUMPING OVER FLOWING GREASE PITS IN FRONT OF DOMINUS AND THE CHINESE RESTAURANT. INVESTIGATING WE SPOKE WITH THE DRIVER OF CANCO'S WHO TOLD US APPARENTLY THE PRIVATELY OWNED SEPTIC PUMPING STATION HAS SHUT DOWN OR FAILED TO COME ON???? HE ALSO TOLD US THE TWENTY-TWO THOUSAND[22,000]GALLON ON SITE HOLDING TANK WAS OVER FLOWING TO THE REAR OF THE COMPLEX. WITH THE NUMBER OF VEHICLES USING THIS PROPERTY,{NUMEROUS ONLY USING IT AS A CUT THRU],THE ODOR OUTSIDE AND SEPTIC BACKING UP INTO SOME OF THE BATHROOMS WE DECIDED TO SHUT DOWN THE PLAZA UNTIL WE COULD GET A HANDLE ON THIS SITUATION. WITH ASSISTANCE FROM BARNSTABLE D.P.W.MR.BRUCE HURT, WATER POLLUTION CONTROL MR. RICHARD EKROSS, BARNSTABLE BOARD OF HEALTH MR.ED BARRY,MR.RICHARD CANNON FROM CANCO • AND HIS EMPLOYEES WE CONTAIN AND MITIGATED THIS INCIDENT. MR.HURT HAD THE TOWN SANDER SAND BEARSES WAY AND THE PARKING LOT. CANCO PUMPED DOWN THE HOLDING TANK SO WE COULD OPEN THE PLAZA AGAIN. CANCO ALSO PUMPED ONE PRIVATELY OWN CATCH BASIN WHICH AT ONE SOMETIME PRIOR TO OUR ARRIVAL HAD FLUID LEACHING INTO IT,AT THE REQUEST OF THE BOARD OF HEALTH. MR.BARRY ALSO CHECKED ALL FOOD OPERATED PROPERTY PRIOR TO OPENING THE PLAZA AGAIN. CANCO[MR.CANNON]IS GOING TO CORRECT THE PUMPING PROBLEM IN THE A. M.AND CLEAN THE PARKING LOT SOMETIME TOMORROW NIGHT 07/23/01. PLAZA WAS CLOSED FOR ABOUT TWO[2]HOURS. WE USED TWO[2]BAGS OF SPEEDY DRY TO DIKE A CATCH BASIN,HAZARD TAPE,CONES,AND SAW HORSES DURING THIS INCIDENT. PROPERTY OWNER:CHRISTY'S REALTY LIMITED PRT. 22 CHRISTY'S DRIVE, BROCKTON MA.02401 CAUSE:PUMP STATION FAILURE. FF.JONES, FF, MEDEIROS. WEATHER CONDITION:CLEAR,WARM,WIND OUT OF THE SOUTHWEST ABOUT 7 MPH,T 750 F. FARRENKOPF, C. CAPT. 07/22/01. • Town of Barnstable ;;o��tHET Regulatory Services Thomas F.Geiler,Director a * Public Health Division * S;B�trt�rABi.Ew Thomas McKean,Director 200 Main Street, Hyannis,MA 026 1 Phone: 508-862-4644 Email: health(o town.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—5:00 Mr. Tim Farrell/Current Manager August 13,2004 Hancock Paint&Decorating Supply 489 Bearse's Way Hyannis,MA 02601 NOTICE TO ABATE VIOLATIONS OF THE TOWN OF BARNSTABLE GENERAL ORDINANCE.ARTICLE XXXIX,CONTROL OF TOXIC AND HAZARDOUS MATERIALS The business/property managed by you at 489 Bearse's Way,Hyannis,MA,was inspected on May 24,2004 by Amy L. Wallace,Hazardous.Materials Specialist for the Town_of Barnstable. The following violations of the Town of Barnstable General Ordinance,ArticleXKXIX, Contrdl.: of Toxic and Hazardous Materials,are observed: I Section 6-2: The Health Department shall require, after reviewing the submitted. registration information set forth in Section 4,an owner to obtain an annual license. Section 6-3: It shall be the responsibility of the owner and/or the operator to apply annually for such license. Section 6-5: The owner and/or operator shall submit a contingency plan prior to the issuance of a license by the Health Department. A contingency plan shall meet the requirements set forth in sub-sections A,B,C,D, and E of this section. You are ORDERED to correct the above listed violations within twen h of receipt of this letter. You may request a hearing before the Board of Health if written petition requesting same is received within ten(10)days after the date this order is served�day's Non-compliance could result in a fine of up t 0�O. Each failur�toZ5W� ly�th,a3-8 order shall constitute a separate violation /�' PER ORDER OF THE BOARD OF HE TH<01yv- �d4 e Thomas A.McKean,R.S.,C.H.O. Director of Public Health Town of Barnstable LP I�'v S 5 ga oKcG�'�' �rr�- i I OPWn is Timothy Farrell Store Manager Stores Division ICI Paints 489 Bearses Way Hyannis,MA 02601 Phone:508/862-2410 Fax:508/8622=9" 2-30a Representing the Brands: . cr., idden DUIUX•SINCL.Al wir LSl u+�+y ;x copy - g��Z��`� i� Date• ,7`� 2t'1 -p`/� TOXIC AND 'HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: l 17 BUSINESS LOCATION: `'18 MAILING ADDRESS: � INVENTORY TELEPHONE NUMBER: 509- Sao 1- - 24-f16 TOTAL AMOUNT: CONTACT PERSON: -rZ/h �� �'Ic�t c .r �, 2 Zfo. SSa"Wa. Cj EMERGENCY CONTACT TELEPHONE NUMBER: Ftf�E p(57IC'T' TYPEOFBUSINESS: OTHER INFORMATION: Op/ear- � � w� s v 1 M SAS o� �i{�• CE 3 9 �-he- 07a4;-�c�d - /ea ara .5 cr_ ( ewe o. Waste Transportation:( wa,. � Name of Hauler: rC= s Destination: Waste Product: Licensed?.. Yes No ? LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed.(gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners .NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants ✓ Motor oils Pesticides al -J NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diese}fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil , NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car wakes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, IN,V--ooi NEW USED (inc. carbon tetrachloride)- 4k Paint&varnish removers, deglossers Paint brush cleaners -% . Any other products with "poison" labels (including chloroform, formaldehyde,. Floor&furniture strippers hydrochlgric acid, other acids)- . Metal polishes . Laundry soil &stain removers Other products not listed which you.feel (including bleach) may be.toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: a (dry cleaners) SC \ ak Other cleaning solvents Bug and tar removers - �� �b-c� ��s c� Town of Barnstable-Health Department Page 1 4 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Hancock Paint&Varnish Fax: ;, `a — Corp Name: Mailing Address /" Location: ,Hyannis Street: 180 Falmouth Rd.. mappar: City: Hyannis �r ��S Contact: erRese Tf� / GRZ Btit /�In� state: Ma Telephone: 862-2410 Zip: 02601 e">a"- n Emergency:==8111111134 Person Interviewed: Business Contact Letter Date: Category: Miscellaneous Inventory Site Visit Date. r,V Yf 04 _. _ Type: .Retail Follow Up/Inspection Date: 0 public water ❑ indoor floor drains ❑ outdoor surface drains license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc 0 currently licensed W town sewage ❑ indoor catch basin/drywell W outdoor catch basin/drywell expir 8/12/2004 ❑ on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: _. 7/9197 Remarks: MSDS sheets on site. Spill kit on site. REMARKS: compliance: 6/3/98- Paints,printers+accessories. All waste paint goes back to Satisfactory Braintree in 5 gal pale max. Mens+Ladies bathes. ORDERS: MOVE ACIDS AWAY FROM FLAMMABLES OR OTHER CHEMICALLY REACTIVE MATERIALS. 12-G , ss� lu 17 1-7 y0 27 y ( y'.) , 30 Zo yzl. 2- 6 6-7 2 al. ad z • �-� ' 20' a, .3 ate, j .3 p� $ 11 b U� .-� ca•l !>o�. �y�a�. (Sty,, ��'�D O�% � ���A,/, �� /2�i�„�/• � �(. � J�,� • paps Qj� Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials Q gty's>25 Ibs dry or 50 gals liquid but less than 111 gals ❑ qty's 111 gals or more description: qty: unit of measure degreasers for engines and metal _ 5_gallons car wash detergents �31gallons paint,varnishes,stains,dyes 50001gallons varnish removers,deglossers _ _1011gallons_ Misc.paint product 191gallons paint,varnishes,stains,dyes 8gallons Waste Transporter: Fire District: q,144Us Last HW Shipment Date: Waste Hauler Licensed: _/0... ..........._...... r 5 �. ol ZK ►z �. Jc- U C 5 3 �7 ea4-•e.., 5`A 219 -7 y TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY kAYAK)COEK �h I Nyt (see"Orders") 5.Retail Stores " 6.Fuel Suppliers ADDRESS 49 abUS CJ I/y)°`a Class: 54 7.Miscellaneous Uti�r 3 QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS - IN OUT IN OUT IN OUT #&gallons 1 Age ITest Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Misr 1L nnn�i_I Z6tt 0 DISPOSALIRECLAMATION REMARKS: 1. itary Sewage 2. ater Supply C&taL Town Sewer Public O On-site OPnvate 3. Indoor Floor Drains YES NO-X— O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO O ERS: ,,�n O Holding tank:MDC Q.Q G°�- t `� LV �'�- � O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product Licensed?i� YES NO 1. 2. -a W/s PAersons) rvie ed Inspector Date Town of Barnstable r Regulatory Services V- Thomas F. Geiler,DirectM IM 0 Public Health Division y aRNSrAeLr_ Y• Thomas McKean,Director, SEP 13Pm lr: 9 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application f®®:$100:00 uil�lSlQ ASSESSORS MAP AND PARCEL NO. DATE O� 3 APPLICATION.FOR PERMIT.TO.STORE.AND/OR UTILIZE.MORE.THAN. 111.GALLONS.OF.HAZARDOUS MATERIALS FULL NAME OF APPLICANT _ NAME OF ESTABLISHMENTi� 1-M o I ADDRESS OF ESTABLISHMENT � iT� TELEPHONE NUMBER 2- SOLE OWNER: YES y NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION CIfJiIQJ/'1_�Y1dT� FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE O APPLICANT RESTRICTIONS: HOME ADDRESS '� A C4 Y�o HOME TELEPHONE# H=doc/wp/q MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include a copy of your contingency plan(to handle hazardous waste spills, etc). In addition,please include the required fee of$100. Make check payable to: Town of Barnstable. Allow five to seven(7)working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also,please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition; please mail the required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call(508) 862-4644 Town of Barnstable ''� °Fz►+e Tq,,� Regulatory Services Thomas F. Geiler,Director '" MASS.' ' Public Health Division •9 i63 ♦0 Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 9A-1&0C 1/, PA//V NAME OF ESTABLISHMENT 14 AW CDG I.L PA- 7 ADDRESS OF ESTABLISHMENT yS 9 1J c�-�5�.s w�4 �N Nt® iy1 A TELEPHONE NUMBER SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: RECEIVED AN HEALTH DEPT. IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 0'1/ ,2-7oo 717 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF. I�, .2- 8�os i b c- PRESIDENT �-z tr z, o l� re Hewn o✓e4 /0,4 �y TREASURER I ueba� ,jq6 1�3 CLERK z� ►�-�'t`1.505 r ,� ,' J-ge71'e- . SI NATURE OF APPLICANT - .✓v(e.r-P.7 y Y-,e RESTRICTIONS: HOME ADDRESS 1-7--- Pv5 r- av-, ,9-t4to,let/ HOME TELEPHONE# 7$1- 'a 4- ),6 77 Haz.doc/wp/q TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY �J 2- aiA&i� (see"Orders") 5. Retail Stores 6.Fuel Suppliers ADDRESS ' S L Class: 7.Miscellaneous (lrll S ��,�QUAN TIES AND STORAGE (IN- indoors;OUT-outdoors) AJOR MATE M IALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene,#2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers r W Miscell neous: DISPOSAIJRECLAMATION REMARKS: I 1. Sanitary Sewage 2.Water Supply Town Sewer 08(Public O On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system J 4. Outdoor Surface drains:YES N6' ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Narne of Hauler Destination Waste Product Licensed?, YES NO 1. �. Person(s) IfiterVliewed V Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair Q satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores G'OMPANY� �) � r/ 6.Fuel Suppliers ADDRESS Class: / 7.Miscellaneous QUA9TITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Dh-unls Above Tanks Under6rround Tanks IN OUT IN OUT IN OUT #&gallons IAge 1 Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: pOW �° Pawidw Snu b b$�1 - 7 DISPOSALIRECI.AMATION REMARKS: S itary Sewage 2 W>�iublic ter Supply � - PUd Town Sewer O On-site OPrivate 3. Indoor Floor Drains YES N0—Y— O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product Licensed. , YES NO 1. 2. Person(s) In ewed Inspector Dat t a TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY/ ``f_� �� O (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS deOKkS G✓ Class: 7.Miscellaneous x_ QUANTITIES AND STORAGE (IN=indoors;OUT=ou doors) MAJOR MATERIALSUnderg)-ound Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel(A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: Z- DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 4— — vl C1Y c1 ik a XTown Sewer Public O On-site OPrivate S !mot®vi < 3. Indoor Floor Drains YES N0 O Holding tank:MDC S G CA eesved C- O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES,X.NO ORDERS: O Holding tank:MDC O Catch basin/Dry well FlOn-site system 5.Waste Transporter Name of Hauler Destination. Waste Product Licensed?i u. . , YES, NO 2. -Person(s) Interviewed Inspect r Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repai BOARD OF HEALTH )k. Satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY &`� Law (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS y F9' 8­ec,�J W2: Class: 7•Miscellaneous Lam. QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MANOR MATERIALS Case lots ]JI-LIMS Above Tanks Under&n-ound Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers V fo(U yew Z-Ic� q W a,I 4- Z-avix �. Miscellaneous: ?Sy DISPOSAURECLAMATION REMARKS: ff 1. Sanitary Sewage 2.Water Supply ctv, S "u'" a, Town Sewer APublic la C't V-0-u-1 _4 re- —f v a�- O On-site OPrivate at,, ( 3. Indoor Floor Drains YES NO _ O Holding tank:MDC_ Y O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES-K—NO ORDERS: O Holding tank:MDC fo , o�dQ v .r O Catch basin/Dry well On-site system 5. Waste Transporter Narne of Hauler Destination Waste Product Licensed? YES NO 1. 2. Person(s) Interviewed Inspe or Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 5`Tf+2 14 u" bA04►A-r Mail To: BUSINESS LOCATION: ti P 9 - bg a952515 WA)( fVV,4A1 ,.-r In,# Board of Health MAILING ADDRESS: S'/�n Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: ,r v d' 9 W - Hyannis, MA 02601 CONTACT PERSON: b E7&,aA D i3,4/ziz"C EMERGENCY CONTACT TELEPHONE NUMBER: fPP - Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalli g, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO V This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case _,do Antifreeze (for gasoline or coolant systems) w _ Drain cleaners 11,0 Automatic transmission fluid kf Toilet cleaners Engine and radiator flushes M v Cesspool cleaners Hydraulic fluid (including brake fluid) /4 0 Disinfectants k a Motor oils/waste oils Ntv Road Salt (Halite) ,hi a Gasoline, Jet fuel It U Refrigerants k Diesel fuel, kerosene, #2 heating oil t v Pesticides (insecticides, herbicides, I Other petroleum products: grease, lubricants rodenticides) _X,0 Degreasers for engines and metal Photochemicals (fixers and developers) 0 Degreasers for driveways & garages Aj o_ Printing ink _/,0 Battery acid (electrolyte) IUu Wood preservatives (creosote) Vy Rustproofers to y Swimming pool chlorine j Car wash detergents r, Lye or caustic soda _fir y Car waxes and polishes A-2 v Jewelry cleaners A,c o Asphalt & roofing tar A j Leather dyes Ai y Paints, varnishes, stains, dyes A) a Fertilizers (if stored outdoors) _fa Paint & lacquer thinners ig o PCB's 10 Paint & varnish removers, deglossers .4z 0 Other chlorinated hydrocarbons, 40 Paint brush cleaners (inc. carbon tetrachloride) 0,J Floor & furniture strippers A! U Any other products with "Poison" labels _ o Metal polishes (including chloroform, formaldehyde, 1�(. ✓ Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Aio Other products not listed which you feel may -1 D Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) 00 Other cleaning solvents 06 Bug and tar removers 1.1 J Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business } u� Date: / TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: 2-A121qA-_ t A =M e, a. s /„yv,�,D/Z� BUSINESS LOCATIOW" '/,P9 agd&s¢s lsi,4y MAILING ADDRESS: Mail To: TELEPHONE NUMBER: 5-0op- j9� --� y6a2 Board of Health Town of Barnstable CONTACT PERSON: b OVA/2� 3d 2/zu P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBE6:`9e , Hyannis, MA 02601 TYPE OF BUSINESS: dC,o u��2 air,, T'" Does your firm store, ny of the toxic or hazardous materials listed below, either for sale or for you own use? YES.. NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope-for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity No Antifreeze(forgasoline orcoolant systems) 80 Drain cleaners NEW USED _j0 Cesspool cleaners u o Automatic transmission fluid &t2 _ Disinfectants io Engine and radiator flushes Road Salt (Halite) N (2 Hydraulic fluid (including brake fluid) Refrigerants —k 2 Motor oils V 0 Pesticides NEW USED (insecticides, herbicides, rodenticides) t Gasoline, Jet Fuel Photochemicals (Fixers) a Diesel fuel, kerosene, #2 heating oil NEW USED ti2 t2 Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED jjjJ Degreasers for engines and metals Printing ink N Degreasers for driveways & garages A10- Wood preservatives (creosote) h0 Battery acid (electrolyte) 4(o Swimming pool chlorine PO Rustproofers Al d Lye or caustic soda ti J Car wash detergents /V 0 Jewelry cleaners N 0 Car waxes and polishes A(O Leather dyes —,, 0 Asphalt & roofing tar Aj 0 Fertilizers IN Q Paints, varnishes, stains, dyes A ( PCB's _ 2 Lacquer thinners OMO Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) l Paint & varnish removers, deglossers _�/ Any other products with "poison" Ibis —&0 Paint brush cleaners �(� Floor & furniture strippers (including chloroform, formaldehyde,, hydrochloric acid, other acids) 61)1 Metal polishes ('A� Laundry soil & stain removers —�� Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): A(J2 Spot removers & cleaning fluids (dry cleaners) At Other cleaning solvents —,Ut2-- Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS 1� Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS:�pA/Z S& f U1,6V „ 4 uA,Syrzg,;,g`- =At e. D. S� s7A2 /,gyp v,vDi2_� BUSINESS LOCATION: yjaE 2 MAILINGADDRESS: V IF Mail To: TELEPHONE NUMBER: ,sod- �/� - � y6�. Board Health Town off Barnstable CONTACTPERSON: b 0,0Al 3.0�2/Zv P.O. Box 534 I EMERGENCY CONTACT TELEPHONE NUMBE1 :0�fR/-2 Hyannis, MA 02601 y' TYPEOFBUSINESS: �.,,�� Does your firm store ny of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the prod�uct that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. J Quantity Quantity , Z-) ; Antifreeze(for gasoline or coolant systems) 80 Drain cleaners NEW USED &0 Cesspool cleaners ; F4 0 Automatic transmission fluid N t2 _ Disinfectants mo Engine and radiator flushes Uo Road Salt (Halite) N u Hydraulic fluid (including brake fluid) At o Refrigerants _ Motor oils N 0 Pesticides NEW USED (insecticides, herbicides, rodenticides) No Gasoline,-Jet Fuel JV0 Photochemicals_(FixeF4' { r? Diesel fuel, kerosene, #2 heating oil NEW USED 6)0 Other petroleum products: grease, Ivan Photochemicals (Developer) lubricants, gear oil NEW USED o Degreasers for engines and metal Printing ink �jU _ Degreasers for driveways & garages A10 Wood preservatives (creosote) No Battery-acid (electrolyte) t Swimming pool chlorine _A) O Rustproofers Al a Lye or caustic soda ,v J Car wash detergents V0 Jewelry cleaners N 0 Car waxes and polishes At 0 Leather dyes r' N 0 Asphalt & roofing tar N y Fertilizers Paints, varnishes, stains, dye&, - N o PCB's ' N C2 _ Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) v Al y Paint & varnish removers, deglossers Any other products with "poison" labels 0 Paint brush cleaners (including chloroform, formaldehyde„ �3 ND Floor & furniture strippers hydrochloric acid, other acids) A_ Metal polishes Laundry soil & stain removers 'a Other products not listed which you feel (including bleach) A may be toxic or hazardous (please list): A((2_ Spot removers & cleaning fluids ` (dry cleaners) d Other cleaning solvents No Bug and tar removers WHITE COPY HEALTH DEPARTMENT/CANARY+COPY-BUSINESS f TOXIC AND HAZARDOUS MATERIALS' REGISTRATION FORV) NAME OF BUSINESS: G!a — — & , Mail To: BUSINESS LOCATION: qpq 4 s of Health ' Town of Barnstable MAILING ADDRESS: ar�lyl�— P.O. Box 534 TELEPHONE NUMBER: ,,AV,6 Hyannis, MA 02601 CONTACT.PERSON: bn AJ EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS -� The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils / °�6 Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) 6vdmyo FZe ,a, "A r �jn _/I Other cleaning solvents ,qny"Id , g CAfA.rs (IC, ew Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business r G TbWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops I � 1 O unsatisfactory- 4.Manufacturers COMPANY �-�-Q� Laun4.)reaw4 (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS ar Class: 7 7•Miscellaneous '' QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) /V transmission/hydraulic Synthetic Organics: degreasers Miscellaneous / X blet-W- J-0 s '1 �jjm- wax — x or t 'x DISPOSAL/R.ECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply Town Sewer Mublic O On-site OPrivate 3. Indoor Floor Drains YES NO X O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YESX-NO ORDERS: O Holding tank:MDC '71catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product 1. 2. Person (s) Int ewed Inspector Date TOWN OF BARNSTABLE I,0CA TON 17t, V SEWAGE # VILLAGE lcrnrl�' ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 9��NIC-CAPACITY /Dav C,1 j LEACHING FACILITYAtype) 5-e 2, -r- (size) -NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER I BUILDER OR OWNER DATE PERMIT ISSUED: r ' DATE COMPLIANCE ISSUED: 7 YEE VARIANCE GRANTED: Yes , y .No I', L �. �,. 0 � ,��� w. .. �> 2 U (E P o®p iE tR3 r v STREET -ADDRESS OF PROPERTY BEING SURVEYED; NER : PPtPr kT, Miha� Mihos Realty PHONE: 508-587-6402 ADDRESS : 22 Christy's T1ri»c _ Rrn��tan44 9A9I OCCUPANT:"christy's Plaza PHONE: ADDRESS : 471 Bearses Way - liyann;s ran PRESENT FLAMMABLE PERMITTED STORAGE AT PROPERTY; TANK . PRODUCT LOC AGE CONSTRUCTION SIZE (GAL) T500-gal:-- - - # 2 fiiPl ni i - ?R1975 Round / Steel I i h Permit issued 2/11/81 - To store and retail flammable solirlc_ i ; „iac -�--4----0-tease s TANKS REMOVED FROM THE PROPERTY; TANK PRODUCT LOCATION CONSTRUCTION DATE SIZE (GAL) REMOVED None reported SPILLS / LEAKS AT THE PROPERTY; DATE: MATER I AL AP PROX. SIZE OF RELEASE None reported wfD INFORMATION PROVIDED BY; DATE ; 3/3/94 En ee1S6i4s°a3�eBX' � rn .r l::: hNi•;iai�: �7.; u�uJ1. HYANNIS FIRE �' APPLICATION FOR PERMIT DISTRICT TO I SIV TALL—ALTER FUEL OIL BURNING EQUIPMENT To the Head of the Fire Department: Application is hereby made in aecordane'e with the provisions of Chap. 143, G.L., and Regulations made under authority thereof by the undersigned for permit to install- 9 t o w w m ti o `� y ° alter, for the person or persons and at the location named herein, certain equipment for a d �b a $ = 0 ° 0 !h m .4 r 0 p �3 CD asedlescpbed below.e or use of fuel or other inflammable liquid products used foirfuel a o m 0 r3 y p m a p TI w �.. 0 0 mwc .� Co �'-o°° m .. a NA prn c p po [ t MM Win -,< 0 `4 cop mna M r.... ........ ....E f��' t..S:T........ s o.A S. o. ... wcr �' o o � o CD + p 1:,•`< ap c00 ADDRESS C..... �� ° ° _.o _., Q.a........... .. .R. .... ......w.4 Y T..!..L.c 1.Q...v...T........�L�1?................ CPV ID ;l 8 < p cyo coo p'*,w �. o Description— Name ..........(.. ..Tr... .N ... `.Q..N..... ....................................................................._.._.... GQ < oFBo :C'f .;rvl opo m �.�� Manufacture W Y '..�_............(l..0A..jE........�.... .../.��..........�....�............. . ;. QN p m °° m p y Jrisb �' °v �] Burner: TYPe U.a =� m >... ......... ...................................................Model or Size.................................... w <� c wp i l� y p '' R �, v� M m 1 0-4 7 0 — fJ p K,is ro p c� A: ti n 3 _ Locate n .. .T.i..1....T- .....L..l..................... .... Mass. Approved No. .r..Y......... m m C ; --:� F b W_m �'r:is p m o S _ .............. ... c Rv € w av v Storage Tank: T of 0 /V. ...�._k O gals. (or) Size........................ Type .....al...........1....... ............•Ca acity.,?................... °. yam o 6rc. av �c:p Location ...... .N.. .l ..��.................................................:...................:..........................................................._...... p : o p Amount of fuel required for testin '•. :P cn 0 0 0 p Cp i. i_.' �� q g purpose.. .......................:gals. M'€ y p w �, a 1.p' 0 0 — This application is made with full knowledge of'the current requirements of the �n �: O i ? Cr-, p ° m -1 ,, L. & �• - regulations governing' such installation, which will be made in compliance therewith. CD ; 't ' > f t i W0 9 0 ==' 0 m �+ Note: If this application involves alterations to existing equipment, y 1 o -T g -O.; CZ I i' C b o m w y p Z i O I ( ! 70 0 p 0 �'°�' m G describe fully on reverse side. �0 �� { � 0 dam ° p y0 nITJ r w c� C w `duo �. o Z O .�, — O O CD , rr N , o 1 y p 0 Cr �.: �' m l ice' CD .y :. cn °p O•C, 0 CD •bid m 0 p i ? i i / L „C,3 '`:�) O �i .!� .� \yI:•RL ..... ......_............................................... .� 0 ice'. o o a a o t;).tll Signature of Applica t r: f V m R 0 w 0 . w Appl. Reed(':::.... ...._::'........................- 6,: aria,. E ! !,�• Cr' ............ ................................. ....._................. .... ., Permit Issue ............................................ a y �` .. ° N8 op E d f �"3 By � •= :.n, i o :cam .°, B �, ..w '' fD l Permit No. Address k ............. rll.......l...l......V f= ' eel i ... •,�,.�•� Re•�' `< <' t`� v !. _.._.............................................. o . R o ~ i 5 Z Certificate of Competency No. ®.l..U.. ...-t�.••••.3 iv, T"� �' ; o EL a En 3. p2 R-j U3 ij J ,C — _[ ' pp.��. Imo, qq �• AREA 17 PO PO T ,-L GUOILD MUMS & SOMONG 00, e4e3777 t r: WAINTRIE, WASL BARNSTABLE SURVEY CONSULTANTS If APRIL 1973 ' ............................:.DATE...................... ................... 411 MAIN STREET WEST YARMOUTH, MASSACHUSETTS PROPOSED BUILDING SITE BEARSES WAY HYANNIS MASSACHUSETTS SITELOCATION............... .......... .... ........................................................................t. . . ... ....... .. .................. ABOVE -•ATTN - MR. WELLER RHP19TeE 0 ►rr TO...............................................................................................................::........ 11 DATE... APRIL 1973 .................. SAiAKEeUNT TO ............ABOVE ../4TT.. MR• WELLER ................... ......... DATE...II APRIL I973................... BORING LOCATION DRAWING TO BE FURNISHED BY OTHERS eaw I or....6............. Joe NO...33I35.............. ` ^ . . BORING .REPORT C. L. ��NDNB �� ����QN 0 I���� �� BORINGCO, U���� �«��yy��� REPORT ' amAImrnsE, MASS. . B^nwcar^oLs ��uevcv CONSULTANTS. VVcsr `/^nwourH. K4^ss^c*uscTrs . '~ ---------------------------------'--------'----------.-----�---.-----.-------------'--' / pnoposco Bu/Lo/wa SITE -- BEAnscsVV^r -- H~/ANNl�� K4^ss^cHuscrrs SITELOCATION ------------------------------------.-----. - -------------'/----------------'' scAo r=-'4--'rr psnaswcs o�ru�----r�'��'r���^!`s�s�'���'�T��������--�----_---'---_—_----------- y ` ' 2 BORING mo-'............... BORING mo.................... oox/wswo------' BORING mo..................... , anovwo sunp^os spou.o sun�^cc O,O o`v ` � {LO` ^'^ �- SANDY� - 3 - 4 - � -2 -4 �- , TOPSOIL si� O` -- ,o ' no -- SILT TRACE OF SAND SOME _- -- MEDIUM GRAVELSILT S2 5 - 9 - 7 -- 3,01 o`v -- 3,5` -- ' _ _ s`v � ,`v _- 13 - 15 - 16 37-2� -25 -- « n'v � -- -- -- GRAVEL -- 8,[Y -- v,n ' -- ' FINE To MED.IUM {5 - 18 - }4 -- GRAVEL -- � m'o �OLCp /o,v -- oorrow op oon/wa ^O - 25 1-�4 [[.O` .u`o - REQUIRED osprHGRAVEL -' wors - ns« ocs/swArcS SAMPLE wuMosn, -- worc - wo w�rsn cwcouwrsnco uw�sss /woic�rco, -- J5,Cy /o.v SEE NOTE I 1 - 25 -23 � Nors -�sso 2-1 /2n oAs,ms uAVV noos, 8� I6,5` /o,o ` . oorrow oroomwG 16.5' . -esQu/nco ucpr* -- worc / - nwEroMcmuw S^wo urr�snw� roCOARSE snAvsL -- wors - nsn oss/s"ArsS s^MpLs wuwacn, NOTE - NOwArcn cwcouwrsnso uwLsss -- ' . ^wo/cArso, wOrc USED 2-1 /2n CAs/ws �' AVV =pos, � ' ^ ' * -, -ro ^ -* -ra -- */woICATE5 moo LOST IN THIS LAYER OF nou----------...-----roorAoc OF ooxwo THIS SHEET----.2S~5`................................................. WATER nEAomm INDICATES SURFACE OF WATER AT COMPLETION OF BORING UNLESS NOTED OTHERWISE. FIGURES IN LOG COLUMN INDICATENUMBER OF BLOWS TO DRIVE�?.11...S.P.L I.T...S.A.M.P.L.E.R 6......INCHES WITH...14.0.....LB. WEIGHT FALLING.-N INCHES UNLESS OTHERWISE SPECIFIED. SHEET AJ `-------CLASSIFICATION—_ ........... -_----...................... JOB '-_-_ .......... BORING REPORT C. L. GUILD ®RILL6NG & WRONG CO., INCH BORING REPORT BRAINTREE, MASS. BARNSTABL.E SURVEY CONSULTANTS WEST YARMOUTH. MASSACHUSETTS TO ................................................................................................................................................... SITE LOCATION ,,,,,,,,,,,,,,,,,,,,,,,,,,,PROPOSED BUILDING SITE -- BEARSES WAY, -- HYANN1S. MASSACHUSETTS SCALE 1"=........4.....FT. REFERENCE DATUM..... ., TO BE FURNISHED BY OTHERS .......... ... .. ........ ......... ........... ........ ...... BORING NO.......... ......... BORING NO...:................. BORING NO.......... ......... BORING NO..................... 0.01 GROUND SURFACE 010 0.01 GROUND SURFACE 010 _ FINE SAND 3 — 3 — 3 SOME SILT' SANDY, LOAMY SI 1 -2 — 2 SI 1.51 TRACE OF LOAM I 6 1.5 I TOPSOIL FINE TO MEDIUM � FINE SAND 116 -- 6 — 8 — 9 SOME SILT S2 6 — 9 — 8 SAND TRACE OF S2 310 3.Q1 TRACE OF LOAN310 - = FINE TO MEDIUM 4.01 GRAVEL FINE TO ,MEDIUM 510 FINE TO MEDIUM St0 SAND TRACE OF 7 10 _ 9 _ FINE TO COARSE S3 S3 12 — 9 — 12 'GRAVEL SAND TRACE O 8.01 FINE TO MEDIUM SAND TRACE 816 816 _ FINE GRAVEL MEDIUM GRAVEL S4 8 — 9 — iQ S4 9 - 1Q — 1Q 10.01 TR�kCE OF SILT 1010 10.01 10v0 BOTTOM-OF BORING - BOTTOM OF BORING 10.01 10.01 REQUIRED DEPTH — — REQUIRED DEPTH — — NOTE — NO WATER ENCOUNTERED UNLESS INDICATED. NOYE — NO WATER ENCOUNTERED UNLESS INDICATED. NOTE — USTI DESIGNATES SAMPLE NOTE — IISII DESIGNATES SAMPLE NUMBER. NUMBER NOTE — USED 2—1/2n CASING &'AW RODS. _ N®TE — USED 2-1 /2 A . CASING & AW RODS. 4 —3 —73 4 —4 —73 — 1 *INDICATES MUD LOST IN THIS LAYER OF SOIL................................:...............FOOTAGE OF BORING THIS SHEET..........�Q•Q WATER READING INDICATES SURFACE OF WATER AT COMPLETION OF BORING UNLESS NOTED OTHERWISE. FIGURES IN LOG COLUMN INDICATE NUMBER OF BLOWS TO DRIVE 2.n...M.P...!T....+5.!�!^PLER.......�?......INCHES WITH....140LB. WEIGHT FALLING..30..INCHES UNLESS OTHERWISE SPECIFIED. SHEET........3.........OF........6.......... FOREMAN........!4!...........................................CLASSIACATION BY..........A4..&..ffYR.....................RA. JOB No.33135........... . BORING.REPORT C. L. .GUILD DRILLONG & BORING CO., INC B6RING. REPORT BRAINTREE, MASS. BARNSTABLE SURVEY CONSULTANTS WEST YARMOUTH, MASS�t��USETTS TO ....................................................................................................................................................................i�� *------ SITE LOCATION ............................PROPOSED BUILDING -S'ITE.-: : -- BEARSES Y— HYANNIS MASSACHUSETTS ..................................................................................................:........................................................?......................... .............. SCALE I ........FT. REFERENCE DATUM..............To B E:...FURNISHED...BY...OTHERS.................................... ........................................................... BORING No....:.�............ BORING NO...................... BORING NO........6 ............. BORING NO....:................ *................ 0.01 GROUND SURFACE 010 .0.01 GROUND SURFACE 010 SANDY, LOAMY SEE NOTE I SI 2 - 3 -3 1.0' TOPSOIL SI 2 -2 - 5 116 116 210 SEE NOTE 2 2.51 S2 5 -5 - 7 Sz 8 - 8 - 9 -310 316 FINE To COARSE FINE To MEDIUM sto 510 S3 10 - 11 - 13 S3 8 - 8 - 9 SAND TRACE OF 616 SAND TRACE OF 616 FINE GRAVEL 816 FINE GRAVEL 816 S4 11712 - 11 S4 7 - 8 - 9 10.0, 1 1 1010 10.01 1010 BOTTOM OF BORING BOTTOM OF BORING 10.0' 10.01 — REQUIRED DEPTH REQUIRED DEPTH NOTE I — FINE To MEDIUM NOTE —2 — FINE TO MEDIUM SAND SAND SOME SILT TRACE 'LITTLE SILT TRACE OF FINE OF ROOTS. GRAVEL TRACE OF ROOTS. NOTE — NO WATER ENCOUNTERED NOTE — NO WATER ENCOUNTERED UNLESS INDICATED. UNLESS INDICATED. NOTE — ITSTI DESIGNATES NOTE — IISIT DESIGNATES SAMPLE NUMBER. SAMPLE NUMBER. NOTE —USED 2-1/2" NOTE —,USED 2-1/21T CASING & AW RODS. CASING & AW RODS. 4 —3 —73 4 —4 —73 *INDICATES MUD'LOST IN THIS LAYER OF SOIL.....................................:..:.......FOOTAGE OF BORING THIS SHEET............... WATER READING INDICATES SURFACE OF WATER AT COMPLETION OF BORING UNLESS NOTED OTHERWISE. FIGURES IN LOG COLUMN INDICATE NUMBER OF BLOWS TO DRIVE..2."...Sfl_..I T...S.A p!7.1:R........6...INCHES WITHA49.1B. WEIGHT FALLING..N..INCHES UNLESS OTHERWISE SPECIFIED. .. ...... .. .... SHEET....... ..........OF......... ........ FOREMAN....................... ............................CLASSIFICATION BY..... ....... ................... JOB NO....3.313.5........ • BORING REPORT C. L. .GUIL® DRILLING & BORING CO., INC. BRING REPORT BRAINTREE, MASS. TO .... BARNSTABLE SURVEY CONSULTANTS WEST YARMOUTH. MASSACHUSETTS .......... .. ........ •........ , ............... ................... ............................. ............................................. . . PROPOSED BUILDING SITE -- BEARSES WAY -- HYANNIS MASSACHUSETTS SITELOCATION .................................................................................................................................................................................................................................................. 4 TO BE FURNISHED BY OTHERS SCALE1"—................FT. REFERENCE DATUM........................................................................................................................................................................................ BORING NO........7........... BORING.NO..................... BORING NO............8...... BORING NO....:................ — O.OI GROUND SURFACE 0�0 0.01 GROUND SURFACE 010 — SANDY, LOAMY SI 2 — 2 — 3 SEE NOTE I SI 2 — 3 — 7 TOPSOIL I.0' I.0' _ SEE NOTE 2 S2 I1 6 6 - 7 - 7 2.51 SEE .NOTE 3, 52 116 7 - 9 — 9 — — 2.51' _- 310 310 FINE TO MEDIUM —" FINE TO COARSE SAND TRACE OF 5o0 Sr0 5$ 13 - 14 — 14 SAND TRACE OF S3 7 - 7 - 8 — FINE'TO MEDIUM 616 _ 616 FINE TO MEDIUM { GRAVEL '- 816 GRAVEL 816 — S4 12 - 15 - 14 54 12 - 12 - 14 - - 10,01 1010 10.01 1logo —_ BOTTOM OF BORING BOTTOM OF BORING 10.01 10.01— REQUIRED DEPTH — — REQUIRED DEPTH — NOTE 1 — FINE TO MEDIUM SAND NOTE 3 — FINE SAND LITTLE SILT — SOME SILT SOME LOAM. TRACE OF FINE GRAVEL TRACE OF LOAM. NOTE 2 — FINE SAND SOME SILT NOTE — NO WATER ENCOUNTERED UNLESS INDICATED. — TRACE OF FINE TO MEDIUM GRAVEL TRACE OF LOAM. NOTE — "S11 DESIGNATES SAMPLE NUMBER. — NOTE — NO WATER ENCOUNTERED NOTE —USED 2-1/211'CASING &"AW RODS. — UNLESS INDICATED. NOTE — f1Sn DESIGNATES — SAMPLE NUMBER. ' NOTE — USED 2-1/211 — CASING & AW RODS. _ 4 —3 —73 — 4 —3 —73 *INDICATES MUD LOST IN THIS LAYER OF SOIL..................: ..FOOTAGE OF BORING THIS SHEET............ �r�1 WATER READING INDICATES SURFACE OF WATER AT .COMPLETION OF BORING UNLESS NOTED OTHERWISE. FIGURES IN LOG COLUMN INDICATE NUMBER OF BLOWS TO DRIVE..2... SPLIT SAMPLER 6 INCHES WITH...140.LB. WEIGHT FALLING..3.Q..INCHES UNLESS OTHERWISE SPECIFIED. SHEET.........5........OF.........6........ FOREMAN..:..............:...:°:�.......:.....:.. AJ & Rve RB..... JOB NO:.....33135..... CLASSIFICATION BY.................................. BORING REPORT C. L. GUILD DRILLIMG & WRONG CO.., INC. BORING REPORT BRAINTREE, MASS. TO ..................................................B.A..R..N..S.TABLE.. . ...SURVEY. CONSULTANTS WEST YARMOUTH, MAS.S.ACH..U.S.E.=..... . . ......... .... ............. ........ i�!­...*...­­....*....*...*...**...*­­­.....*'­'....**...­­­*....*.................................. PROPOSED BUILDING SITE -- BEARSES WAY — HYANNIS,...MASSACHUSETTS SITELOCATION ..................................................:....................................................................................................;................................ .......................:........................... SCALE I_=......4........FT. REFERENCE DATUM.............To ............T0...B..E....FURNISHED...B..Y...OTHERS .................................................................................................... 10 -BORING NO 9 BORING No....................... BORING NO..................... BORING NO...................... 0.01 GROUND SURFACE 010 O.OT GROUND SURFACE 010 FINE To. MEDIUM sl .3.-4 — 5 SANDY, LOAMY sl 1 —2 — 1 SAND TOPSOI.L 116 116 LITTLE SILT 2.01 • LITTLE LOAM FINE SAND TRACE Z" FINE TO MEDIUM S2 4 — 7 — 7 3.5.1 3.51 GRAVEL 316 FINE To COARSE FINE TO MEDIUM _9*1 0 slo SAND TRACE OF S2 12' — 13 — 13 SAND TRACE OF 18 —20 —21 FINE To MEDIUM 616 616 FINE TO MEDIUM GRAVEL GRAVEL 816 816 S3 6 - 8 - 9 S4 16 — 19 -21 —. 10.01 p 1010 10.01 lob BOTTOM OF BORING BOTTOM OF BORING 10.01 10.01 REQUIRED DEPTH REQUIRED DEPTH NOTE- NO WATER ENCOUNTERED NOTE.- NO WATER ENCOUNTERED UNLESS INDICATED, UNLESS INDICATED. NOTE IT Sn DESIGNATES-SAMPLE NLiMBER.' ' NOTE - its DESIGNATES SAMPLE NUMBER. NOTE - USED 2-1/2". CASING & AW RODS. NOTE USED 2—1/20 *CASING & A RODS. 4 4 73 4 -4 -.73 *INDICATES MUD LOST IN THIS LAYER OF SOIL........:.................................:.....FOOTAGE OF BORING THIS SHEET..........2.0..91...................................................... WATER READING INDICATES SURFACE OF WATER AT COMPLETION OF BORING UNLESS NOTED OTHERWISE. FIGURES IN LOG COLUMN INDICATE 2" SPLIT SAMPLER -6 INCHES WI TH14P...LB. WEIGHT FALLIN09...INCHES UNLESS OTHERWISE SPECIFIED. NUMBER OF BLOWS TO. DRIVE................................ ................................. SHEET..;....... .......OF....... .......... FOREMAN......... .......... . CLASSIFICATION BY........A.J..&..R...V...B.........................R..B 10B N033135 ...................... 01/04/2011 14:17 5087786448 HYANNIS FIRE PAGE 01 95 High School Rd. Ext. Hyann;s, MA 02601 Hyannis Fire and Phone: 508-775-1300 Rescue Fax: 508-775-6448 x To_ (9-..L� From: Fax: bate: Phones Pages: Re: 0 UryeF%t ❑ For Review Q please Comment ❑ Please Reply ❑ Plea Re Recycle •Comrmm�ts: / J& Zoio 6wm6-e- S�RP ����7 �tkuvi LF 01/04/2011 14:17 5087786448 HYANNIS FIRE PAGE 02 h HYANNIS FIRE DEPARTMENT x'nry �s 95 HIGH SCHOOL RD. EXT. HYANNIS,MA. 02601 (O 04M]ICAL — artN HAROLD S. BRUNELLE, CHIEF aT AT'AWA*1.-' "l-HATM FIRE PREVENTION BUREAU BUSINESS PHONE:(508)775-1300 FACSIMILE PHONE:(508)778 2143 I—T. DONALD H. CHASE,JR., CFI LT.ERIC R.HUBLER,CFI FIRE PREVENTION OFFICER FIRE PREVI NllQN OFFICER FACSIMILE TRANSMITTAL SHEET THIS FAX IS(.GOING T �..... . . '/. '.?... .... BEING SENT BY: ...................................... .... --.��............... SUBJECT OF THIS FAX: ................ .. .......��.... ..... ........ , , . s ......................................... ... DATE: FAX NUMBER: NUMBER OF.-PA 1 �.f2........ :/./. . .............. S �� y.... .......�.......... (INCLUDES COVER NOTES: .......... ..................... .............. .� ........... ........................ ....................... ............. ....... ............................. ..... .... .7� ... ....r ,*1i... ..�.: .. .. 01/04/2011 14:17 5087786448 HYANNIS FIRE PAGE 03 IRK ,, y�•;.w •b:'L.i,W.W •.l„ : •IS;,•.,•S:. ••.. .-. � 1,i/��'� '7 �`4.�, �� 1J:_JA1 ' 'To,tbo. WA. of a dislOn of:Gha A D1tc8tion is:;)be�rft.I1 0 0-;U"dCoor[�ande with th. •.>?FP, p. @gull;tiotis 2adeni3d . litt#� f : eiegf by Lb@•�ad$reigiiedoi'•p�>!tttit �dyt'. ;`..jc'sn:•�:�;::: 'p #•. r in,.cmriatn.'ptli� 'tern x'or.tue p'�i tsoifi'nr:�»i§paB;a041t th • t ..0'-AcieDingr.stor�g� .o so•de@erlbed t?81aw 3`. y� .;`.•;, Y ..r 11' ', '�j i•.z)F�f�: 04, �tifr�glE•�Taftk� '�Y?Si? h" ..;. ' .�, • r '•• •••• -' ;:..�.':.:;.. ' to rit•a£.'u j�ret�lred E k 't. .h&= e ~ _—�,'�'=;',¢� :•�. cataRh�.• msae i '. .. p�'e �or:t> c�ri eq".M ttlil::v t " : X}8 'cdt►1t?tIA ';,#h',� (�_, tx►-.':::',:`:; .; :.. r:t4iilatiO4 overniv., 4U411 tests lat Aipp1. Reo'd r�„r_.,a�-�'. de�c Xb Signature of Applica t"r , Permit Issued Permit No. .P,.Adreas •--. i Certiticate of Competency No. ���..�.�.•� i. CERTIFICATION OF COMPLETIO Date T 141. V i S� To: Head of Fire Department Subject: Certlfioate of completion—Installation or Alteration of Fu ing Equipment The undersigned here inet I x e]teratiop) oY fuel oil bur under authority of.Der dated , sued by you and _D➢Ying to the inatallation f t •� s .u?9 F1!EP1LZtP visions oY Chapter 1411, L., and regulations ma under authority thereof now c F'urt in effect and pertaining thereto. en t®et8a 'in accordance with suc>r require.ments, is now improper operating condition and complete ingtrvctiona as to its use and maintenance have been furnished to the person (or persons) for whom the Installation � J was made. The following data applying to such Installation 1s submitted for record: `� BURNER MaAde Ar,. FiM•A Meg. t1' .��_•-' �.W Model No. ur Size --- --- ���� Zuputw uu6 ho`Lvior than --.-- NO nil Type ......,.W., ..L r ,6 jkAl_ Capacity ••-a• 0 gals. r) Sizes.,,.,,,.,.....— �rJ� Location f� �.'W .,•--...__ ... -. /i Type (automatic pr manual) I W rd•114 TO Y Automatic sb,ut-Off valves at UrTler & ta3l Installed by? ' vannnl ahnc•nfP valve at tank• �L E....- --- lQA a A,A,-a ��40PZ .-W"r•Tr l NO TE �jas mess is qo 7 e �voyn la_..-_47Lior,e viubhz/�� /en�eY Date: i� s&-rvice. TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: BUSINESS LOCATION: `.'8 .MAI LING ADDRESS: it INVENTORY TELEPHONE NUMBER: 5_08- 96 TOTAL AMOUNT: CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: FW8 0(57-RI1rr TYPEOFBUSINESS: P OTHER INFORMATION: a-wi uls 32 l-h,e- I e el Waste Transportation:��lazMc - way Name of Haul Destination: Waste Product: Qcaz,;,_* L_� Licensed? Yes No ? LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners .NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants +� Motor oils Pesticides ,� _� NEW USED (insecticides, herbicides, rotlenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diese}fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid'(electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, 73P,V NEW USED (inc. carbon tetrachloride)- `-AS Paint &varnish removers, deglossers Paint brush cleaners -- Any other products with "poison" labels Floor t furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach) may be.toxic or.hazardous (please list): Spot removers & cleaning fluids P g Misc.: °VIC- _ (dry cleaners) �Seuil gq 5 94k Other cleaning solvents Bug and tar removers YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 ears). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate. 'You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take-the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is req u i red by law. ,- DATE: 2&10 7 Fill in plea . APPLICANT'S YOUR NAME/S: ctv BUSIN S YOUR HOME ADDRESS: -20 _ „� ;'•sow 3� TELEPHONE # Home Telephone Number - NAME OF CORPORATION: NAME,OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES--' NO � -� ADDRESS OF BUSINESS MAP/PARCEL NUMBER CU�`- 66(: (Assessing) When starting'a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 ain.St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1., BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature*.* COMMENTS: 2. BOARD OF HEALTH This individual hak bee = orme j the mi requirements that pertain to this type of business. �j Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS LICENSING AUTHOR This individual h en infor of the liry�sin r' r ments that pertain to this type of business. rr � Authorized Signature** - 7G COMMENTS: r 0 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and et the Business Certificate that is req u i red by law. DATE: 3 0� Fil in please: j APPLICANT'S YOUR NAME/S: _ I ` . BUSINESS YOUR HOME ADDRESS: a r TELEPHONE # Home Telephone Number O - NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO ; ADDRESS OF BUSINESSH s "`�'" MAP/PARCEL NUMBER ' (Assessing) • When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of theNof. f Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (cornrMouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING-COMM R'S OFF CE This individuaK� b n inf r e (1) y p rmit requirements that pertain to this type of business. A th ized 3gnature** COMMENTS: C r LVtl:� 2. BOARD O EALTH This individual has een (nfor ed oft per t quirements that pertain to this type of business. Au rized Signature* COMMENTS: CQ . CJ)i W iQ 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) CD This individual 6s been informed of the licensing requirements that pertain to this type of business. ( =u i Authorized Signature** ; �„� y COMMENTS: r rn ' ..COMMONWEALTH OF MASSACHUSETTS'- -"OF COSM TOLOGISTS As.AN OPE ATM - TYPE 2 # ISSUES.THIS LICENSE TO MAR LA:,.-.-;A ,FARIAS REZENDE ldV, �., 159 AR:ROWHEAD_ DR - - --� HYANN,I;S .. MA 02601=2416 1 i YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS NAME in town (which you must do by M.G.L.- it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1s` FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. Fill in please: Date: (n/,-3O/O9 APPLICANT'S NAME: YOUR HOME ADDRESS: P !� f, BUSINESS TELEPHONE # (S HOME TELELPHONE #: ( 50% 3P- �S NAME OF CORPORATION: NAME OF NEW BUSINESS Ka, )2l kxA, V-t�b�- TYPE OF BUSINESS >'1/?G �L I ►LCc.,p( ` IS THIS A HOME OCCUPAT ON? YES d O ADDRESS OF BUSINESS Y►ryh . W,4- O COf MAP/PARCEL NUMBER,,2g2 -O (Assessing) F F i G,4,C, =y 92 0 j3e W When starting new business there are several t gs you must do to be in co pliance with the rules and regulations of the Town of Barnstable. This orm is to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally ope a your iness in town. 1. BUILDING COMMISS NER'S OFFICE This individual ha tee f any, permit requirements that pertain to this type of business. pp 1� uthorized Signatu a** COMMENTS: V� ' o 2. BOARD OF HEALTH This individual has be n informed of the mi�requi ents that pertain to this type of business. uthorized Signature** ! -' COMMENTS: ------------ 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. i Authorized Signature" COMMENTS: YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost�$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permis�ion to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) -. DATE: 5 /� ill in please: (>w�'��, k�" �- >" APPLICANT'S YOUR NAM E/S: A, lvul .��rYl r BUSINESS YOUR HOME ADDRESS: ) I TELEPHONE # Home Telephone Number NAME OF CORPORATION: a f NAME OF NEW BUSINESS i r (n an 5 TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES O t/ ADDRESS OF BUSINESS 142 G n I'lti0 G� � � MAP/PARCEL NUMBER 74 2 '3 Q3 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth i Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. j 1. BUILDING COMMISSIONER'S OFFICE i This individual has been informed of any permit requirements that pertain to this.type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH �p(NpLy WITH ALL This individual ha ' been i�o ,cc�� f he permit requirements that pertain to this type of business. MUST T , V YiAZARDOUS MATERIALS REGULATION Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSINVd HORITY) This individual has bee . nfort e licensing requirements that pertain to this type of business. L 0.S u riz �i ign l� I �Ir /1.C5 COMMENTS: �{ Q Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: AG�f S BUSINESS LOCATION: CA Y� INVENTORY MAILING ADDRESS: TOTAL AMOUNT- TELEPHONE NUMBER: `¢0 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 31QrA A, Nt INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials No...-- ..... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEAL OF....... . ....................... .... Appliration for Bisposal Workii Tom34rartivit Prratit Application is hereby made for a Permit to Construct 0<) or Repair an Individual Sewage Disposal System at: --T0%)TWWG'5—r ez;1ZAje1Z Oic -�2_j X— -7 7 .............. ........................................................................ Loration-Address or Lot No. . .............. ................ ...... ... .................................................................. Owner Address ...... ......... ..............................................Installer------------------------------------------ - ----------- --- ---- ..............Address........................................... U . Type of Building ize Lot./-"4,/ .Sq. feet Dwelling—No. of Bedrooms............................. ............. Yp sion i Garbage Grinder Other—Type of Building ------------- of pers ................. .1..... Sho rs Cafeteria aOther fixt U/S .................................. - ----------------- ------------- ............... ..................................................... Design p erson per Y. Jo dail� fl ........47.7--_-5 ............................ ..gallons. P4 Septic' Tank L Liqt06 capacit . _!Pt�.gallon e gth---/01.y,;,p..ViVth. .7.. .... Diameter................ Depth... Disposal Trench ... .. ........... Tota Total leaching area--------------_----sq. f t. OnA----------- ------ Seepage Pit No......., Dia er................... Depth below inlet...4:5�.......... Total leaching area"M9.6..S�. f t. Other Distribution Box sing larl,.( � 7 -1- Percolation Test Result me by.......... .......................................... Date---------------------------------------- Test Pit No. 1.... ....... 11 tes er inch Nft-at Pit.-*................. Depth to ground water------------------------ Test Pit NO. 2.... ....... mu per inch th of Test Pit___-..........__.__. Depth to ground water...------____________._. ... ..... ....................... . .............................................................................. 0 Description of Soil............ ....... .... ......... . .......1.ers;..........0.;9_7.........--&�----- .......................... , 91c=.0 ----- ------- 9, U ......... 3................................. --------;----------- .................................................................... ............I................................ --- + - -------- - -------------- U Nature of Repairs or Alterations— er when applicable____________ .................I--------------------------7.......................... .................................................. . .... ... ................................................................................................................................... /1k,greement: The undersigned agrees to i _tall..the aforedescribed Indivrid "al Sewage Disposal System in accordance with er� the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be ssued by th................ Sign ........................ ................................ Da.t,_., Application. Approved By.- .... ... ....... . ...... 7a te Application Disapproved for the following reasons:............................... .............................................................................. ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued........................................................ Date .............................................................................................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD) 0 HEALTH 77. . ..........OF.. mulia Tutif irate of Tjaomplianre 4 THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at..............a�­ ------ .has been installed in accordance with the provisions of rticle XI of The State Sanitary Code s describtd in the application for Disposal Works Construction Permit No-------------X.S�...7.......... dated._______ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G6IARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... ............................................................................................................................... THE COMMONWEALTH OF MASSACHUSETTS .12... ........ . .. BOARD.. OA aHEALTH......OF........ .No..... .. . . .. .. FEE�... ............. .......t 4-27277 7Permission reby granted . � . ................ ................... . to Construct or Repair Individual Sewage Disposal System at No..-., - o .... .. . ... ...... ----- ----------- --------------------------------------- Street t --------- d Hea as shown on the application for Disposal Works Construction/t)rnit N;o ated DATE.................................................................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS X No......2- Fps... .. ...� THE COMMONWEALTH OF MASSACHUSETTS w . BOARD OE HEAT_ 'T s y........OF............. ..... . .'... . .. ApplirFation for Disposal sal larks Tomitrur io'w Pumit Application is hereby made for a Permit to Construct (v) or Repair ( ) an Individual Sewage Disposal System at: So v ThF W 6 ST• l 7 7 Location-Address or Lot No. j� _-.-•-----------------------------•---------•- ... Owner Address Installer Address U Type of Building Size Lot.j. .....*G&..Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garilage Grinder ( ) 04 Other—Type- of Building No. of persons............................ Showers ( ).— Cafeteria ( ) C� `32�� � Other fixtur s ........................................................................................................................... = Design Flow�� ./ap...S p gallons per person per day. Total daily flow---- __ _ gallons. WSeptic Tank¢--•Liqu capacity�_�_gallons Length.../,ycr..... �Vidth.._J—�.�..... Diamete ................ Depth..�_�.... x Disposal Trench— o..................... Width.................... Total Length.................... Total leaching area_______.___..__.____sq. ft. Seepage Pit No...... .......... Diameter....y Depth below inlet._.�._____._ Total leaching area__ :gg Z Other Distribution Cx Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date-------- _ �.. a Test Pit No.,1................minutes per inch Depth of Test Pit.................... Depth to ground water__________--_.-.__.-_--- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... p :-••........-•--------------•••••• • ---•-•-•--••------........-----------------------•-•-•----••••-•--••----•---------•-••---•••......-- x Description of Soil E'oi = ---------- --- W "?'"s '�° l -7z ;-----•------•--•-•------------•--•-- -••-•-•••-•-----------------------•-----•---•---......•••••-••••••••••••............--•-----•---••-•------......-------•--•-••••••--••-.....••........._._..----•-......------------------------.....--- V 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 Article XI 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---•--•._.•._ ••••••:--•••,-••-••••-••••-••---••.................•••••......--•-•-. ' Date Application Approved By- -- rea ----------- y ate � ® � Application Disapproved for the following sons----------------•---•---•..... . -•-•-•--............•-•••••---•--------------•----•--•--•-•-••......---•----- -••...................••-----••••-............••••-•-------•......•-••••..........------.--•••-•--•..._.................._-••••-•--••....••••....••••••----------------•--•--•-......•--------•-........ Date PermitNo......................................................... Issued.......................................................... ram.. Date a 'r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF........ .. ..:'...... ........... `adf�. 'f .rr#if irttr>af �tB�tltttrg �-_ THIS IS TO CERTIFY, That the Individual Sewage Disposal System co cte�'( �) or Repaired ( ) by... ..............................••....--••••••-•.._............................._-_.._ Installer has been installed in accordan e'"with tl a vvW.-_ rtric: - of The State Sanitary Code as described in the application for Disposal Works Construction Permit ....... ... ._ ......... dated.___._ _- _......:......./'_.__.._.. _.._.__._.. THE ISSUANCE OF THIS CERTIFICATE SHALL Rl�I �@ NSTRUED AS A U'A&14 � TH"E SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ... No _: ...... sue.. L E Y--- Vifivolial Ivor,ks (IT 114 itrur#ion 10 Permission is hereby granted.---'--•----------------------------•----..•...._....._...---------•----------•---......=- ._.... .. to Construc ) or. Repair ( ) an' Individual Sewage Disposal System atNo.•.... -•-• ••---- - ------------ - ' - trees as shown on the-application for Disposal WorksXonstruction Permit No.................... Dated __ .______ ._ ----•• J %/-7 DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ' r �i, .� . , _ , I '. V � � � � � �� . , ,., . 1 No...../-d .... A Fins....f A... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD .OF HEALTH N..................0............ ?.................................................... Appliratiuu -fur Diipuuttl Morko Tomitrurtiuu Vrrm t Application is hereby made for a Permit to Construct ( !or Repair ( ) an..Individual Sewage Disposal System at: ...Gt/ .............................. .........uiz....��'1 �7`�!9rvi✓ Sla.! Cow�?�.� ' 2= , n•Addr % /i✓o5` / Lot N --- ----- ./ c------- --------------------- -------�-do-- -�Y�' --- .�oG�l�'ofit. Owner dress Installer t Address Q Type of Building Size Lot_��YI__f 14 -------- feet U Dwelling—No. of Bedrooms----------------------------- -- -Expansion Attic ( ) Garbage Grinder ( ) per•, Other—Type of Building No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures .........:............................................ Design Flow.......Sgq...�T�,......:: y. Total daily, flow.......�p0..........................gallons. W i �/ ii WSeptic Tank—Liquid capaclty.� �.gallolas Length��________. Width................ Diameter---------------- Depth._. ...�.,��.... x Disposal Trench—No. ___________________ Width.................... Total Length-------------------- Total leaching area.--.-.-.---__-----_sq. ft. Seepage Pit No.._.,_�(.....___.. iameter. �............. Depth below inlet__�'�.....:. Total leaching area---9041.__sq. ft. Z Other Distribution box ( � Dosing tank ( . ) Percolation Test Results Performed by---- :_La.ultF:.1........................................... Date------?!A�....�X11... Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1.... . . -•--------•----------•------- O Description of Soil ' 't'� G<- — 5- TI!9'e �� �v C.................. � 7 ' . x c, ---- - ---- - ----=----- xo a -z ' < ' .......... V Nature of . rs or alteration er w applicable.... ------ � = = Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanb itary de—,The undersigned further agrees not to place the system in i operation until a Certificate of Compliance has n issued by t apftf healt S 6�y. Sign -• -•-------------- ...-...--•--...... Date Application Approved By-------- L --- •. 7e.�1� ----••--•-••-•--•----- `- _... Date Date Application Disapproved for the following reasons----------------------------- --------•--------•---------------........------------..............-----•------.. -------------------•---•---•-------•----------------•---••---------------•---------------•--•-•--•-------••---......----•---------•--------------...-------•••------------=----•••-•••-••---•-......--•- • Date Permit No.----••.A/Y Issued. .....,P- ... �-•P-? • ,•I Date v No ....... .. X..... FEB..f fl................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. ... ---....OF............... Gf,.ciL............................................... ApplirFation -for M-4poii al Workii Tonstrurtion Vrranit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst at c, ` 7 .....:........... ............ --•-.................................................... Locati Address �� or Lot No. .................. - ------ ----- .... .............. ..--•--•--••••......-•-•-•---------•-•........•-••............................................... Owner - Address q Installer Address Type.o"f Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other=Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Qt 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........................ G4 Vest Pit No. .............minutes per inch Depth of Test Pit..................-: Depth to ground water........................ O Des ription of Soil.......................... 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 Article XI of the State-4nitark_ode The undersigned further agree not to place the system in operation until a Certificate of Compliand by th oa lth. Si .............. ,.....••••.. .... Application Approved B /00 tt ,,�� 6D�S Date Application Disapproved for the following reasons: -•---------•--•-•---------------------------------------•-•..-•••••••-••-.........-----•-- ••-••••••-••-•--••••-----••----•-•-•-•••-------•-•••-••--•--•••••--••••••-•...............•••••......••-'---------------------------------------------------------------------------- Date PermitNo.......................................................... Issued...................... ................................. Date �a � •r.l THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H H OF... �........................ y ='" Qrrtif iratr of f�n�m littnre THIS IS TO CERTIFY,,Jhat the Individual Sewa e..Disposal System constructed ( �or Repaired ( ) by ------------ --at.91.174,0—r.... ---- ......................... . :�_. M-W. Insta has been installed in accordance iwith (he-provisions of _ e X/I� H�of//The State anitary Cod/as escribed in the application for Disposal Works Construction Permit.NO .J.Q-_I�------------------ dated.. ��IO• .........._..... THE' ISSUANCE OF THIS CERTIFICATE SHALL'.*NOT BE CONSTRUED AS A_GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........................=...............................................-= `s Inspector-------------••-•-...... .. . . •.fir•.. ,,,,.;«, v. � .,;., . ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �.. t. O F, )�y :...... .... .......;.. J f/ , N ..-..... .-- --•--- : FEE. .................. Bi-spoottt Marko Tonitrurtion rprmit Permissionis hereby granted...........................'---•--•--•-•-•--•---........----....--------------••--------------..............---•-........_,.........••-•..•..... ' to Cons r ct ( or Repair ) an Individual ag tsp sal System . f>�� f- A Street as shown on the application for Disposal Works Construction P No Dated-.- �--.7 ........... f� Board of He DATE................................................................................ FORM 1255 HOBBS & WARREN,INC.. PUBLISHERS - S ' > - . - fix ,.... � .....e.+-,.., a�fi^+F,-:..:-.e. v...,.�.em'�.-t,rT=r•.±+r.m..m,.-.,rtrn>;^.-..?cer^r�+v-^.�-+.. .m__.,..-,_,,..,. ,M,-,-.a-^-�-...;,,--,,,,::';v..mY. em.-�r-,.rT'^»�,r*.�..T.�— ,^�,^*'.v6n^'-v,t'r..,'.nm,"*.'+.^+r ate.•^ �,t,- n` `..,^'*.' �-+"`t,�'�' �^ v e , ii (J,! 71,1 ss i r JQSEPH Im"". � �R1 i o >. -A4C)��F,HAR Jll. u9 ar SURO �o c. T" n 8 G G _ - n w r o c✓.r,c,Qs R.c E..9 3 `' S'�c�c� t , .'.. .- � AG:,. 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