HomeMy WebLinkAbout0056 PARKER ROAD - Health 56 PARKER ROAD
Osterville
r� A= 117 - 110
+ TOWN OF BARNSTABLE
1 '7 UNDERGROUND FUEL AND CHEMICAL. STORAGE SYSTEMS
ASSESSORS MAP NO., PARCEL NO. N0
ADRESS.' 6 /��/� �?� VILLAGE -�!
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NAME;. d
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CONTACT PERSON:h%oom .- /I-� .�l?J���LL- PHONE NUMBER . ' i
LOCATION OF TANKS: CAPACITY: TYPE OF FUEL. AGE: ._ TYPE: LEAK
i OR CHEMICAL DETECTSYSTEM ION
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DATE-OF PURCHASE OF. EACH 1. 2. 3. 4. 5.
DATE OF: FIRE DEPARTMENT PERMIT* fi kf'( -
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS
PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. -
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r ,� „r, JAIL 01 '91 15:34 CENT.OST.FIRE DEFT: P.2i2 �
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Department of Pubiic Safety
Division of Fire Prevention and Regulation
AMUCAM FW PMW,, AM RMWo MR IMMAL AM MbWSPMXMc ,BARD
rmin Dk,�'3-0 Permit t- _-- Date � � 1• � I
at%Imn,mr �r-�' c . 82 S . 40 N . c . L .
r•
DIG SAFE NUMBER
Fee Laid:$ (0• 00 �IdbSl��
7— start date„ i��✓ ;.
in accordance with the is one of Chapter 8, Sec. 38AO. M.G.L. ,
527 CMR 9.00 application is hereby made bar:,T Coastland Tanks Inc.
Signature of applicants �zV, �/i -
Applicants name printed: Kenneth Trojano
For-permission to 'romove and transport one underground storage tank from.
Owner: S, sb M cl to a1S AL e Street Ladd ress:
Enviro-Safe Corp. State Lic. 3
• Firm transporting wasted 29---
Hazardous waste manifest # - - E.P.A. #
Approved tank yard: Turner Salvage Co. # 111490
Tank yagd Address: 247 Commercial Street, Lynn
Type of inert gae8 UL tank
3 C�
sTank capacitor: c ' Substance last stored:
,,Date of issue; Date of expir, tion: - ' .L
'Signature/Title of officer granting .p+ermit:
4
,0 KWP ORIGINAL AS APPMATION ,AM ISSUE DUPLICAM P,ROOT r
TOWN OF BARNSTABLE
LOCATION ��'�� �0� SEWAGE#
VILLAGE QS4v'\ d J�t, ASSESSOR'S MAP&PARCEL t (-7 1 (6
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY.(type)) (size)
NO.OF BEDROOMS �n3
OWNER JAVlVt o6 f( S+
„..; PERMIT DATE: 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
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7^7
TOWN OF BARNSTABLE
LOCATION E��' �'��'kz:- V'�C�+�� SEWAGE#
VILLAGE j)"�. L',` �� ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO.OF BEDROOMS
OWNER;_)(;y11,1
A
PERMIT DATE: 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
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