HomeMy WebLinkAbout0866 MAIN STREET (OST.) - Health � 6Y�.c.+'J ��,�
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TOWN OF BARNSTABLE—?-UNDERGROUND FUEL AND CHEPII C,AL. STORAGE REG I STRAT I,..ON
MAP NO. ---PARCEL NO.
ADDRESS OF TANK: c��v� i Y) !` � i) ST �•,t1.ItL'`LAGE: r �j{'�ZtJ i/f�' I'y -
i Number otr��! '`
MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : �/�% 54,E at�I IF ✓`z
OWNER NAME: PHONE:
INSTALLATION DATE: BY: 'J/*'Y fv;L
INSTALLER ADDRESS: f �Y/i N> ��7 � ' 'CERT. 0.
r ..
'k. *TANK LOCATION: l G2'�' t � / t� r` r't ; ,U•7 S' f=7 JZo)' t ,( ;�;�o�� /�QG,L•
(owsomium TANK LOOAT=ON WSTH mKoP¢CT TO nux"DXN0)
CAPACITY �' TYPE OF TANK J7 AGE I YRS. FUEL/CHEMICAL
TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE — ---
LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND-
NO
ZONE OF CONTRIBUTION [ ] YES [ ] DATE TO BE REMOVED S Fir A-� f, !
FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE
CONSERVATION C ] CHECK IF. N/A DATE
BOARD OF HEALTH TAG NO. C ] DATE ✓�°"""' "'° i
* PLEASE P:ROVIDE.- A; .SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD.
IWO
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} 03-25-1999 04 07PM CENT OST FIREDEPT 5087902385 P.02
' --" • �, u""&U14 co".
Fire Department retainsoriginal application and issues duplicate as Permit.
APPLICATION and PERMIT Fee:
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:
Tank Owner Name(please print) Mr. Davis
X
Address 866 Main Street Osterville, MA
sneer Q,
Scare L'p
Company Name Enviro-Safe 7Co. dividual
Pml
Address P•O.•BOX 810, E.Sandwich, MA Pmt
P, Address
rtnr
Sig lure(if app ' f r it) a Signature f
9 (i p ' g f r ermit)
® IFCI Certified Other D IFCI Certified p LSP#
Other
Tank location 866, Main Street OSterville, Ma
Swot ad*m
Gry
Tank Capacity(gallons) 275 Substance Last Stored #2 O i i
Tank Dimensions(diameter x length)
Remarks:
Firm transporting waste Enviro-Safe State Lic.# 329 MA' ,
Hazardouswastemanifest# IM �. LS�Q14 E.P.A.# MAD985269323
Approved tank disposal yard Turner Salvage Tank yard# 002
Type of inert gas Tank yard address 235 Commercial Street Lynn, MA
City or Town Centerville FDID# 01920 Permit#
Date of Issue 2 9 Date of expiration April 5, 1999
Dig safe approval number. 19 9 913 0 0 9 DigMfeTolleumber-600-322-4644Signature/Title of Officer graniing'permit
After removal(s)send Form FP-290R signed by Local Fire Dept.to UST Regulatory , ne Ashburton Place,
Room 1310, Boston, MA 02108-1618.
-292(rev(s®d 9196)
49
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TOWN OF.' BARNSTABLE UNDERGROUND FUEL AND CA,ti WL STORAGE REGISTRA �.ON
MAP NO E NO.
ADDRESS OF TANK: W;I~L•LAGE:
MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) :
OWNER NAME: PHONE:
INSTALLATION DATE: 't r•i <• ,,L•,v BY:
INSTALLER ADDRESS: Y-� % r /i"��' -CERT.iJ0.
*TANK LOCATION: S
(ommon i aP. TANK ILOQAT I ON W Z TH mm=mKcT TO aU S LD i NO)
T:`-',CAPACITY TYPE OF TANK J._1 -a L AGE 1 YRS. FUEL/CHEMICAL-
TESTING CERTIFICATION [ ] PASS . C ] FAIL DATE
LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED S "el
r
FIRE DEPT. PERMIT ISSUED C I YES [ ] NO' DATE
CONSERVATION C ] CHECK IF N/A DATE
BOARD OF HEALTH TAG NO. C � ] DATE
PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
ef-
07
„,03-13-2001 11:43AM CEIIT OST FIREDEPT 5087902335 P.01
h rice uepartrrterat retains original application and issues duplicate as Permit,
APPLICATIOCLA
N and
PERM
Ssi
for storage tank rernovat and transportation toe appyardroved IT �0_0 _
of M.G.L Chapter 148, Section 38A, 527 CMR 9 00, application is y
hereby made bdance with the provisions
:nerNa.me,(�pleintS)
Tank O r. Davis
X
Addres6 'M ain treet Osterville, MA'
sneer Orr
•
Company Name Enviro-Safe
— Co.or individual
Address p•0•'BOX 810, E.Sandwich, MA
per, Address '
Sig ature(it app t r it
Signature(if ap g f r permit)
/j
® IFCI Certified Other „` C7 IFCI Certified 0 LSP#
Other
Tank Location 866. Main Street OSterville, Ma
S7ee1 Address
Tank Capacity(gallons) �y �7 Substance Last Stored *2 0 i 1
Tank Dimensions(diameter x length)
Remarks:
Firm transporting waste ' Enviro-Safe StateLic.# 329 MA
Hazardous waste manifest# WA PLIQ :'” E.P.A.# MAD985269323 T
Approved lank disposal yard Turner Salvage Tank yard# 002
Type of inert gas - Tank yard'ai&ass 235 Commercial Street Lynne MA
7ate
Town Centerville FDIC)# 01920Permit#
issue Marrh 2,7L 19.2 —Date of expiration. APri1 5, 1999
Dig safe approval number. 199913004.IA3dig to Toll e ,el,iVurTtbet-860-3224844
Signature/Title of Officer granting permit
After removal(s)Send Form FP-294R signed by Local fire Dept.to UST regulatory pliance Unit, One Ashburton Place,
Um IM,8oO%Mk unt.1 sjs.
a r�vtged MG)
TOTAL P.01
�FTME R�CEI V E®.
Town of Barnstable
�,ST,B Iti�6 K i 5 2001
�. Board of Health
Apr 1639. a`e P.O. Box 534 H ariri1S MA O2C)O1 TOWN OF BARNSTABLE
FD MA'S y HEALTH DEPT.
Office: 508-862-4644 Susan G.Rask,R.S.
FAX: 508-790-.6304 Ralph A.Murphy,M.D.
Sumner Kaufman,M.S.P.H.
To: DAVIS,HOLBROOK R Date Monday,March 05,2001
P0 BOX 572
OSTERVILLE MA 02655
RE:Underground Tank at 862 MAIN STREET(OST.)
Map/Parcel 117077
Tank NO: 01
Tag NO: 01066
The Town of Barnstable Public Health Division records indicate that your undergroud
or chemical storage tank is 25 years of age,and has not been tested as required under section 07:(5)of th
health regulation regarding fuel and chemical storage systems.
You are directed to have each tank and its piping tested within thirty(30)days of the receipt of this
notice. Results of the testing shall be filed with the Board of Health and the Fire Department.
You are reminded that you shall have the tank and its piping tested during the 10th, 13th, 15th,17th,
and 19th year after installation,and annually thereafter:
Failure to comply with this order may result in a fine of up to$300.00.Each day's failure to comply with
an order shall constitute a separate violation. -
You may request a hearing if a written petition requesting same is received by the Board of Health
within ten(10) days after this order is served.
Per Order of the Board of Health
Thomas A.McKean, RS, CHO
Health Agent