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Home My WebLink About0030 MASSACHUSETTS AVENUE - Health (2) 30 MASSACHUSETTS DRIVE, HYANNIS A= cv 4 Make application to local Fire Department. Fire Department retains original application and issues duplicate as Permit. IQQ�I�'!/J9'LQ�JZZLti�Cz�fi1'L 4� ��i��d.�22'l/.lP��/S _ : P—xe CJ�ccea /— /Mr�Q/!�L �.. APPLICATION and PERMIT for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: • t Tank Owner Name(please print) Anderson X gnafure ap Ym9 arpermn Address 30 Massachusetts Ave. Hyannisport, MA &rn3ef CNY state —zip 7Company Name E nv i r o—S a f e Co. or Individual Prinf. Address P.O.BOX 810, E..Sandwich, MA PM" Pnnr Address Print Signature(if applying for permit) ` Signature(if applying for permit) 11 IN IFCI Certified Other ❑ IFCI Certified ❑ LSP # Other Tank Location __3.0....Massachusetts Ave. Hyannisport, MA � -��y"-Sfeef Address — o�- Cil y Tank Capacity(gallons) Substance Last Stored #`2 0 i 1—) Tank Dimensions (diameter x length) Remarks: Firm transporting waste E nv i r o=Safe State Lic.# 329 MA Hazardous waste manifest# E.P.A.# MAD 9 8 5 2 6 9 3 2 3 Approved tank disposal yard Turner Salvage Tank yard# 002 Type of inert gas Tankyardaddress 235 Commercial Street Lynn, MA City or Town G' /K FDID# �m 3 —QL��_Pertt��, d� Date of issue Date of expiration Dig safe approval number. 9 8 2 0 0 7 3 50 f Dig Safe Toll Free Tel. Numllef,,�0ps3�7� 4, Signature/Title of Officer granting permit "10 `� 6 A. . r `X o � (ter removal(s)send Form FP-29OR signed by Local Fire Dept.to UST Regulatory Compliance Unit,One.Ashburton Pface��oom 1310, Boston, MA 02108-1618. s ` 2(revised 9/96) / _ K TOWN OF BARNSTABLE - UNDERGR0646- FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INSTALLER INFORMATION ADDRESS' — l��? ITS S-j{/� /7ya,✓NHS f,d/2 MAP NO � .? 7__ PARCEL O. „5 - OWNER NAME: e;/.? 'e .� /1/�.Ca !' cf1 VILLAGE: INSTALLATION DATE: P'I,r�l / BY: ADDRESS: - .�. NO._ ,l 7175, TANK INFORMATION a. c^c , . LOCATION OF TANK: CAPAC I T � TYPE S, ,<L.c1,�, <tii AGE 0 FUEL/CHEMICAL TESTING; CERTIFICATION C ] PASS. C ] FA.IL. . .,.DATE r LEAK DETECTION1 C ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C ] YES �] . NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C ] YESX. 3 CNO DATE CONSERVATION ] CHECK IF N/A DATE. BOARD_ OF HEALTH TA NO.0. T ]C ]C ]C ]. DATE PLEASE PROVIDE A SKETCH-SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD TOWN OF BARNSTAHLE - UN°DERGRUUND FUEL AND CHEMICAL STORAGE REGISTRATLON MAP NO. PARCEL NO. 0 /V 4?J crG r y r�' ADDRESS OF TANK: ,,�I�l �� VILLAGE: tvumb�r Ytr��t C - MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : . OWNER NAME: � Q-i 1� G �I l�G2. PHONE 7 73- 10 (- INSTALLATION DATE: /= !� BY: f�I✓ -t" I'oGE'. � , INSTALLER ADDRESS: �'G/ ��1t /� /_ � -CERT.NO. *TANK LOCATION:' �,..- -•* -,. - (DG�QPt S D��C-�n�TANIG^ LGQAT I ON WITH 1!'QOPQCT TO mU I L"'DS NO,) CAPACITY .��5 TYPE OF TANK 9141-6 01AGE YRS. FUEL/CHEMICAL S -' TESTING. CERTIFICATION C ] PASS C ] FAIL DATE LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [V] .YES C J NO DATE CONSERVATION C J CHECK IF N/A DATE BOARD OF HEALTH TAG N0. [ ! ,3 } DATE . .. :*- PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD - .dr._ -, _ ,`T„ '-s,.r _ _.n .zr-'1j,�.s.- la •,r*a^"'4es,�^�p►*"'*:,r�Ti-wK".q.:r,.r_- ,..-.. .., ---,•+`�°+3:..,,;r----:,... ---- _ TOWN- OF BARNSTABLE - UN•DE-DE AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. f ') f r , ,, t e f zr' ', !ADDRESS OF TANK• C ? f V�I LLAGE• r ' Number titr��t ' MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME: ' ' + '' PHONE: INSTALLATION DATE: �r ��IX BY: INSTALLER ADDRESS: � �'''��'� ' ` + r't � r� J r `1 U -CERT.No. *TANK LOCATION: _. r /•- - (Damon S aG TANwF'_, -OQAT 2 ON W S TH PtQOPQCT -'TO -mU 2 LD-t NO;) CAPACITY TYPE OF TANK /. ". lf�SAGE YRS. FUEL/CHEMICAL TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED � FIRE DEPT 'PERMIT ISSUED- [VJ YES [ ] NO DATE CONSERVATION [ ] CHECK 'IF N/A., DATE 7z .... BOARD, �OF HEALTH TAG NO. C J .,0 -,�``] DATE_ 1Z-7�� r Al P.,LEASE .PROy..:IDE,-.:._SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD r. -.. a.'1.. .,. 1.:L:i.r.... ,9 u p'•...e � J: ..tee..:.. . ....w...a .. .. YP - Town of Barnstable o� STAB Department of Health, Safety, and Environmental Services 1639. ,0� Public Health Division ATEDN1°�a P.O.. Box 534, Hyannis MA 02601 Office: 508-8624644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health September 14, 1999 Robert and Tamara Anderson 30 Massachusetts Ave., Hyannis,MA 02647 RE: Lturlerground Fuel Storage System located at 30 Massachusetts Ave.,Hyannis and listed as Assessor's Map 287, Parcel 025 Dear Sir/Madam, Our records indicate that you have a#2 fuel oil above ground storage tank that is presently unregistered with the Health Department. Please complete the enclosed Registration card(s). Include any evidence of the date of purchase and installation,a copy of the permit from the Fire Chief within ten(10)days of your receipt of this letter. Upon entire completion of the Registration card(s),you will be issued a brass valve tag(s)by the Board of Health. These valve tags shall be picked up by you or your representative at the Health Department located in the Barnstable Town Hall. The tag(s)shall then be attached to the filler pipe/cap of the above ground tank(s). Please return completed Registration card(s)to: Town of Barnstable Health Department,P.O.Box 534, Hyannis,MA 02601,as soon as possible. If you have any questions, please telephone(508) 862=4644. Office hours are Monday through Friday from 8:15 -9:30 a.m. and 1:00-2:00 p.m. PER ORDER OF THE BOARD OF HEALTH Thomas A.McKean Director of Public Health Find ap Parcel 287025 0000000 59AA .5 00 SPORT 00-000 Jan ary 1st ANDERSON, RT A&TAMARA 1070001 0000000000 MASSACHUSETTS AVENUE Road Name 1 1 j 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 ao J: �.vdllG'CHIEF Sit ohe Oetectori Save .elver BUSINESS: 775-1300 EMERGENCY: 775-2323 To / Town of Barnstable , Board of Health - T. McKean J Town of Barnstable , Conservation Commission - From ; Fire Prevention Bureau, Hyannis Fire Department Subject ; The installation of above ground storage tanks . Date Persuant to the applicable sections of 527 CMR - Fire Prevention Regulations , this Department has inspected the following location for above ground storage . ADDRESS achusetts Avenue OWNER/OCCUPANT Robert Anderson ' PHONE : 775-1060 SIZE OF TANK (S) 275 gal. Steel.Oval / BASEMENT COMMODITY STORED • : # 2 fuel oil PURPOSE FOR STORAGE Heating THIS INSTALLATION IS . PRE-EXISTING A REPLACEMENT NEW X NEW 500 GAL.UST This installation complies does not comply REMOVED 5/98 with the required installation regulation listed below. FIRE .PREVENTION OFFICE For: PAUL D. CHISHOLM, CHIEF HIAkti'\IS FIRE DEPARTlfE:,;T LOCATION SE AG E PERMIT NO. VILLAGE INSTA LLER'S ME & ADDRESS BUILDER OR OWNER 0 DATE PERMIT ISSIfED T �� DATE COMPLIANCE ISSUED 6- a 1t . � .. �� . � �� , � " � i r . + F � j,. ��+�� a R No........ Fiz$..............................._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® . ....T 1—I EA T ............. dr b`fl........OF........ ..Z�-` f---.........._ Appliration for Uioposal Works Tunstrnr#ion ranfit Application is hereby made for a Permit to Construct ( ) or,Repair (✓�an Individual Sewage Disposal System at: c r ///2% — Loc�jo -Ad ss �j ,¢,.� or Lot o. _....17 ..... .........4C jef-$..� 0�_• ...__ ��. �t�/I�`/ ne Address. W stalle Address Type of Build g ^�= Size Lot... ...Sq. feet Dwelling No. of Bedrooms...... .........................Expansion Attic ( ) Garbage Grinder ( ) A4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_____-_______-__--_____. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W •--•--• -------- -•------ I'll --- -------- •------------.----------•-------------.-----•-----•---------•----------•---------------.----- ODescription of Soil.................. ---�e��'--+�----------------------------------------------------------------------------•-------•--------................................ "W W U Nature of Repairs or Alterations—Answer when applicable... ___l ti ------- __._. .C.........gid.NAz ,� =�?-----------•--------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITi U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been !>Wed by the board of health. Sign 4 /' — ate Application Approved BY ��€ J ��.� _f ............................. �:�" DZ.� }+ Date Application Disapproved for the following reasons------------------- •----------------------------------•--....--•---------------------...........-------------•-------------------------------------------------------------------------------------------------------•---- 77 9 Date Permit No................................................... ............... . Date No........ -_ - F>s......'........................ THE COMMONWEALTH OF MASSACHUSETTS BOA F2® !-i E LT .........OF....... : ........ ....... y Appliration for Disposal Works Tnnstrnrtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (V') an Individual Sewage Disposal Syst at -� .................._.. --------------------- -••• ---•---•--.._......_•------.......---- . ,�' Lo}}o A ess - r Lot�Tg,. •--- ........ Owner Address W Installer Address UType of Building Size Lot_.✓ 10_.0_ ... feet Dwelling No. of Bedrooms....,...............•__...__._..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures -------------------------------- - d --------------------------------------------------------------------------------••----------•--------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter---------------- Depth................ ___---_ Width.................... Total Length Total leaching area.._.......-._..._.__s ft. x Disposal Trench—No. ............. g g q. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-•-- ---•-----------------------------••-•-------•••••-••--••----••-•-• Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit................... Depth to ground water--___:_______-__-----__. Test`Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... -----------I--------------•----•-----•-••--••------......--•--------•----•---•--......................................................... ODescription of Soil:-•---••--• = mod•c--•-----------•--.......-•----•--------------------------------------•------------•---------------........................... W --------------- ----- _ ------------------------------------------..................................... .-- ------------ Repairs or Alterations—Answer when applicable._; ......... .�e- ................. U Nature o ... �-^� ----------- --fit:-l ------ ................................................................................................................................:........................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE: 5 of the„State`Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ed by the board of health. Sig. -•- �---------•------•---•--- ---------•...................... Application Approved By--------- ----- ... " -•- ... ---------- Date Application Disapproved for the following reasons:.................. ---•--------•--------------- .......................................................... ---------••---------•--•-•-------•----------•-------•----•---------------------------------•--•-------------•••-••--•-••••-•-••--•----••••-•-•-•---•--•-------•••-•-••---•----••----•--••----•-••-•----- Date PermitNo...............••-••-•::.•--.._..__-•-••-.:. _.. Issued..------•----•----------------•--•---=---• Date .;THE COMMONWEALTH OF MASSACHUSETTS BOARD.ffO HEALT��' .....OF........ '................. Trrtifiratr of Tomplianrr 1-100 THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (" ) by--*- In has been installed in accordance with the provisions of6/.fi e State Sanitary C�gde s d cribed in the �AA, application for Disposal Works Construction Permit N ......................................... dated_._..ff___.____ � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE o SYSTEM'.WILL FUNCTION SATISFACTORY. r � Inspector -DATE. L--- / /�/ ------- THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALT `t .........OR...... "................. b No......................... FEE ...................... Disposal Worko T-5onstr iaan ;Irrmit Permission,is hereby grante -•---- ---•••......•-•-------------•--- ----•• --••--------••-•• ---••-••-••----•--•. . • •- to Constr ('4o;r epa' -( Ind' dual Sewage D al System , at Street as shown on the application for Disposal Works Construction it No Dated.._�'____7_"-'•:".7 ............. oard of Health�l� DATE.__. ` ffff FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS