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HomeMy WebLinkAbout0009 WIANNO CIRCLE - Health 9 Wianno Circle, Osterville A� L—,6- 1--o!!R`e3 r P 1 d h . E � I Commonwealth of Massachusetts 9 road) Executive Office of Environmental Affairs 4 Department of m REcEivEO Environmental Protection MAY 2 7 1997 'OWN OFBARNSTA8 ~ William F.Weld HEATTH OEP7 N Governor Trudy Coxe i Secretary,EOFA David B. Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: ci Ul}�c���.it> G�w c�c� try:. Address of Owner: h ;i `_1"'o�r Date of Inspection: 4-30,1t - (If different) Name of Inspector, V2_00f f` C. VI-L&)(I?A > Company Name, Address anJi Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _10 Passes Conditionally Passes _ Needs Further Evaluation By the local.Approving Authority _ Fails Inspectors Signature: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority,within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of i0,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sen•. lc,. :ne >\stem o%%ner and copies sem to the buyer, it applicable and the appro%ing au,,`,ority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: V I have not.found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more.system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not) The septic tank is metal, cracked, structurally unsound,;,shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of.Health. (revised 8/15/95)- 1 t Winter Street- e -••Boston Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500 i, Printed on Recycled Paper SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM -- PART A CERTIFICATION (continued) Property Address: Owner: bM',��r�,«.:;•`j� i Date of Inspection: B) SYSTEM CONDITIONALLY PASSES (continued) t' Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box.. The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): -T broken pipe(s) are replaced - obstruction is.removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment, 1) SYSTEM WILL PASS UNLESS BOARD OF 'HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PK0•IIC1'1HL PUBLIC I-ILAIIH AND SAfI'IY AND 1111 INVIKONMIN'I: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONA1ENT: _ the wsien) na,. a septic lank anu soli absur.ptluli 100 foci ( •a<Sul a:c...;roicr...SuNNI:�..Gr..iributafl;to a surface %%aler supply. _ the system ha, a septic tank and soil absorption system and is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The system hay a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a•well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 . ppm. DJ SYSTEM FAILS: _ I have determined that the system.violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. _ Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. _ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. - 2 (revised 8/15/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM_INSPECTION FORM._., PART A CERTIFICATION (continued) Property Address: cA N'a-z' C.: , C)'-;; , Owner: , Date of Inspection D) SYSTEM FAILS.,(continued): fy Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. /y Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. 4Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. I Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet pf.a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia:nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flogs of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is \,\ithin 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Aiea (IWPA) or a mapped Zone II of a public water supply well'. The owner or operator of any such system shall bring the system.and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: bj�uo_':UC. C.e r:''"'C)cz' Owner: Av1LV\cti. O� Date of Inspection: Check if the following have been done: L"'Pumping information was requested of the owner, occupant, and Board of Health. _ one of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. �`1 kAs built plans have been obtained and examined. Note if they are not available with N/A. ,/The facility or dwelling was inspected for signs of sewage back-up. L/The system does not receive non-sanitary or industrial waste flow _L/he site was inspected for signs of breakout. I II system components, excluding the Soil Absorption System; have been located on the site. _L/fhe septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for conditionof baffles or tees, material-of-construction;-dimensions; depth of liquid, depth of sludge, depth of scum., ,/The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. TI e (aci;i;; �..;,c ;�, ' o:c ,w ;:, if from ov.; )er' were provided with information on the proper maintenance of Sub- Surface.Disposal System. k ,.; > 4 , (revised 6/15/95) 4 . s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION , Property Address: Ct Owner: OV, Date of Inspection: FLOW CONDITIONS RESIDENTIAL:'1 Design flow: —110 allons , Number of bedrooms: Number of current residents: Garbage grinder(yes or no):-,,—/ Laundry connected to system (yes or no):1 Seasonal use (yes or no): Water meter readings, if vailable: N Last date of occupancy: ( 5cw COMMERCIAUINDUSTRIAL• Type of establishment: Design flow: sallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ "later meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy. GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as pan of inspection: (yes or no)_ If yes, volume pomned gallons t' Reason for pumping: + . TYPE OF STEM. Septic tank/disteibution--boz/soil`absorption"system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: a� Sewage odors detected when arriving at the site: (yes or no) � (revised 8/15/95) S �a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: (:7l f,.i7� C'�rUl ._ Owner: 't\,1- ko. Date of Inspection: SEPTIC TANKuz --(locate on site plan) r - :., m....,.,_y,.,Y...,.,_..._. ... .. . . .._. Depth below grade: Material of construction: —concrete —metal —FRP —other(explain) Dimensions: ti Sludge depth: Its y t Distance from top of sludge to bottom of outlet tee or baffle:_ Scum thickness: & Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: r Comments: (recommendation for pumping, condition of inlet and outlet tees orbaffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP:/Y (locate on site plan) Depth below grade: Material of construction: concrete —metal —FRP —other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Diclance from hottr— n crlim In hnt!nrn of OW'Pt !PP or ha!IIE" Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.'• (revised 8i=5/951 6 i -- StJ65URFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM_r-,- PART C SYSTEM INFORMATION (continued) Property Address: •+ccrvyvT� Owner: tx( `,LV,%, Date of Inspection: TIGHT OR HOLDING TANK:i`/ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP—other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: _.... i Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:• (locate on site plan; Depth of liquid level above outlet invert:/'4QPZV'`�— Comments: (note ii ievei ano ciistribut,�,(, o t•yua , e%iucnce of;ulid: evidence of leakage into or out of box, e.c.). PUMP CHAMBER: (locate on site plan) Pumps in working order.(yes or no) Comments: _-_.(note-condition_.of pump chamber;--condition-of pumps and appurtenances, etc.) (revised'8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: (�&':L- k Date of Inspection:- SOIL SOIL ABSORPTION SYSTEM (SAS):" (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) j CESSPOOLS: (locate on site plan) _ Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of grounds%atcr. inflow.(cesspool must be pumped as part of inspection) n f hydraulic failure, level,of ponding, condition of vegetation, etc.) Comments: (note condition of soil, signs o � , PRIVY:L (locate on site plan) ,___.._.__..^_...__...,.._ Materials of construction: Dimensions: Depth of solids: -Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) $ (revised 8/15/95) r, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Q W%gj')e'e) AVe_ C)";tc°rvl�� Owner: M•A � �� Date of Inspection:" SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks- locate all wells within 100' e.30; C� DEPTH TO GROUNDWATER .Depth to groundwater: feet method of determination or approximation: (revised 6/15/•95) 9 s 21 E SURVEY FORM STREET ADDRESS OF PROPERTY BEING SURVEYED: OWNER: PHONE: ADDRESS: 9 Wianno Circle, Osterville OCCUPANT: PHONE: ADDRESS: PHONE: PRESENT FLAMMABLE PERMITTED STORAGE AT PROP RT Y TANK SIZE PRODUCT LOCATION AGE CONSTRUCTION Our records indicate .no underground storage tanks at this location. TANKS REMOVED FROM PROPERTY J- EM D R : . TANK SIZE PRODUCT CONSTRUCTION AGE '': ;.•DATE REMOVED Our records indicate no underground storage to removed from this location. SPILLSILEAKS AT PROPERTY: DATE MATERIAL RELEASED APPROXIMATE SIZE OF RELEASE Our records indicate no spills or leaks from underground tanks at this location: 3 INFORMATION' PROVIDED, BY P. L. ZarrelliM 10/16/98 , C-O-MM FIRE DEPARTMENT DATE 1875 ROUTE 28; CENTERVILLE, MA 02632 RECORDS OF UNDERGROUND TANKS ARE ALSO LOCATED AT TOWN HALL, HYANNIS, MA AND BARNSTABLE COUNTY COURTHOUSE, ROUTE 6A, BARNSTABLE MA. C-aMM FORM#88B 45� Na, Fee BOARD OF HEALTH TOWN OF BARNSTABLE Applicat ion Ar vell Conotruct ion permit Application is hereby made fora permit to Construct Alter ( ),- or Repair ( . )an individual Well at: �h ( — OCR C -_�� ________ Lo tion — Address AFire — d Parcel — Owner t, ,q i y --+��`LCAi�ln-AcsviY .1(�(1,�t1 -- �,��(A, _�IJC��1 < 9 In's alter Driller Address Type of Building welin --------------------------------------------------------- Other - Type of Building ---- --- No. of Persons------------------------__—_—_______ Type of Well--'Irl --`A-� -- VC.- - . YP ------------- Capacity------------- Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Prote tion Regulation - The undersigned further agrees not to place the well in operation until a Certific to.txf'Complance has been issued by the Board of Health. /V_ _f_ 1 Signed .`' - - -------- ------------------------ -------- -- ate I — — Application Approved By -- - -- ------ -:--------- i/_ date Application Disapproved for the following reasons.:-----------------------------------------------------------------_____—__________ ------------ -- -—---- ---- - ------------------------------------------------------ y,� -----date------_ Permit No. --1 --- - Issued—�� — -- - ---— -- ---------- date 1 R D OF HEALTH BARNSTABLE :le Of Compliance onstructed (^ Altered ( ), or.Repaired ( ) b' l-------------------------- ------------- f Installer i at - ---------------------------------------------------------- --------------------------------- h '= if the Town of Barnstable Board of Health Private Well Protection i Rj Construction Permit No. -------------------------Dated----------------------- . T VOT BE CONSTRUED AS A GUARANTEE THAT THE WELL S' r DATE-------------------—- ------------------------- - -- Inspector- - - -- - --- --------------------------- ��� � T No.J 0`®-4- 036 Fee--- BOARD OF HEALTH TOWN OF BARNSTABLE Application jbrVe[[ Construct ion Permit A lication is hereby made foSr permit to Construct �/ ), Alter ( ), or Repair ( )an individual Well at: -pP - �fLA_—C-1_X_ Lo tion — Address A andarcel _ — i 2�n if14�C- -- Q l - ---- - i 6 v1�c19 Owner ress dn -- l.L ,w w 026 ---- -------------------------- In aller Driller Address Type of Building welins------------------------------------------------------------- Other - Type of Building----------------------------- No. of Persons------------------------- Type of Well--'�L- LA" — R fC— ---- -- - Capacity------------------------------------- Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Prote tion Regulation — The undersigned further agrees not to place the well in operation until a Certific to . Compl ance has been issued by the Board of Health. 3 SignedZt�" ,da Application Approved By \ 92 -- - -------------------- -_ date Application Disapproved for the following reasons:----------------------------------------_--_------------------ ----------------------------------- - --------- ---------------------—------------------------------—------------------------------- Permit No. -- -------- Issued —_ -D date- ------------------------ date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (—I Altered ( ), or Repaired ( ) by---------------------------------------------------------------------- ---------------------------------------------------------- ---------------------------------------------- Installer at----------------—-- --- -- --- ---------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ---------------------------Dated--------_----------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------—-------------------------------— - -- Inspector--------------------------------------------------------------------------- --------- - - ---- No.1�200T Fee-------- BOARD OF HEALTH i TOWN OF BARNSTABLE 2 0"plicat ion ArMelt Con!9tructionPermit - Application is hereby,made for a permit to Construct (/ ), Alter ( ), or Repair.( )an individual Well at: P . - - - --- i_q � ——-- --— --- !ACC 4, Lo anon — Address A ad Parcel — --___—_--_ t Owner ress iclNas�t�__ gs�c� ? }un------- 1 L C _(_�U2�� - c ,C__1Z - �rws ev C Installer Driller Address f Type of Builing Dwelling----—---------------------------------------------------- Other - Type of Building ---------- No. of Persons--------------------------------------------- Type A - of Well-- �--L -- V C'- ------ - --- -- � --- Capacity----------------------------------------- Purpose of Well - i ` Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. Signed "' c - /U Z 2. -- -; - --- --- - - - -- ---- -o-- I� ate _ Application Approved By-- date t ` Application Disapproved for the following reasons:---------------------------------------------------------------__----_____ -- t date i: Permit No. --l - ---------------- Issued ---------- — date j BOARD OF HEALTH TOWN OF BARNSTABLE t (Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (-<'Altered ( ), or Repaired ( ) Iby-------------------------------------------------------------------------- Installer Iat------------------- --- ----- --- -—------------------=_-------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the,application for Well Construction Permit No. ---f----------------------Dated------------------------- I j THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL ' SYSTEM WILL FUNCTION SATISFACTORY. f iDATE--------------------- - ------------------------- - - -- Inspector------------------------------------------------------------------------------ ---------------------- --------------------------------m------------------------------------------- BOARD OF HEALTH I TOWN OF BARNSTABLE G Yell (Congtruct ion Permit No. 315 Fee- Permissioniss ereby granted------- ----- ----------------------------------------------------------------------------------------- to Construct (V), Alter ( ), or Repair ( ) a Individual Well at: ----- -- --- Street as shown,, llon the/ap lication2for a ell Construction Permit No. -----wd 4 _`_�sZ - - --- - - Dated ------------------------------- -----------------------_ - ll bar a th DATE---!_ - -- Y t,, The Town of Barnstable ` Health Department 367 Main Streef`Hyannis, MA 02601 ■Yt Y Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health COMPANIES AVAILABLE TO REMOVE VNDERGROVND STORAGE TANKS Shoreline Tank Service, Inc. (508) 428-5529 87 Pond street Bruce Macallister osterville, Ma. 02655 -------------------------------------------------------- Advanced Environmental, Inc. (508) 358-6100 P.O. Box 472 Arthur McCormack S. Dennis, Ha. -62660• . (508) 364-5453 Mobile - -------------------------------------------------------- American Environmental (508) 385-5040 industries Corp. James A. Anthony P.O. Box 22 (800) 447-0096 So. Dennis, Ma. 02660 -------------------------------------------------------- clean Harbors (401) 461-1300 85 Aldrich street 1-800-641-0007 Providence, RI 02905 -------------------------------------------------------- Enviro-Safe Corp. (508) 888-5478 P. 0. Box 304 Heather M. Atwood sagamore Beach, Ma. 02562 -------------------------------------------------------- Mason Associates, Inc. 1-800-834-2330 P.O. Box 450 Lester Mason Pocasset, Ma. 02559 778-0860 -------------------------------------------------------- J.E. Kennedy & Son Excavators (508) 36273005 575 willow street Joe Kennedy west Barnstable, Ma. 02668 -Coastland Tanks 1-800-675-0144 Hyannis, Ma. 02601 Also called Environmental Tank Services (508) 457-4600 Falmouth, Ma. Ken Trojano --------------�+---------------------------------------- Lew Mac Tree Service (508) 428-2531 osterville, Ma. 02655 Philip Macallister or ` (508) 428-2403 -------------------------------------------------------- Dennison Oil, Inc. (617) 294-0453 Box 311 Dale Dennison Hanson, Ma. 02341 -------------------------------------------------------- J.J. Driscoll & son James Driscoll Box 573 (508) 428-4086. Marstons Mills, MA 02648 -------------------------------------------------------- Mark J. Coleman (508) 432-7152 24 Cherokee Road Harwich, Ma. 02645 -------------------------------------------------------- Kelley Landscape. & Tree (508)760-2040 155 Upper County Road George Kelley Dennisport, MA 02639 ------------------------------------------------------------------------ Arch Construction 48 Rosary Lane Hyannis, MA 775-1362, or 896-5921 ------------------------------------------------------------- w.g. Robinson P. o. Box 1089 Centerville, MA 775-8776 MID-CITY SCRAP CO. . . . . . . . . . . . . . . .800-334-4789 OR 508-675-7831 FREE UNDERGROUND STORAGE TANK DISPOSAL. YOU DELIVER TO SITE ANY SIZE STEEL TANK PROPERLY CLEANED. rt' 1 ' FUbliC Health®IviSI®91 ' • gown of Barnstable ! osa P0 Box534 U.SAS AGE ti QUESTED Hyannis,Massachus0s 02601 sEr sse « Z 203 498 567 6138443�___Y_— i� eTu .4-P.-1 all .t t NO A (All SED ED OTK w tic RE&S ai SENDER: I also wish to receive the v ■complete items 1 and/or 2 for additional services. following services(for an M ■Complete items 3,4a,and 4b. d ■Print your name and address on the reverse of this form so that we can return this extra fee): card h you. 59 Z Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address Z permit. -- d ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery to ■The Return Receipt will show to whom the article was delivered and the date o delivered. Consult postmaster for'fee:" •� d ,.. ,,_. 4a.Article Number Art�icle�Addressed to: 263 y�� o. /tii �Fy) /�` 4b.Service Type m Ds o ❑ Registered' Certified ��.: 7 u � / 7 Z /Q 41 vJ f������// (�C-�� 0 Express Mail ❑ Insured� 26 5'S:. ❑ Retum Receipt for Merchandise ❑ COD(oll7 O 7.Date of Delivery > Z 8.Addressee's Address(Only if requested 5.Received By: (Print Name) oW and fee is paid) 1 6.Signature: (Addressee or Agent) ° X a I " 102595-97-13-0179 Domestic Return Receipt i PS Form 3811, December 1994 I Z 203 498 567 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not lse for International Mail See reverse Sent to ��C�' Street 85 N14mber P ce,State,& 1 Code Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee Ln rn Return Receipt Showing to Whom&Date Delivered n Return Receipt Showing to Whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees $ ch Postmark or Date 0 a Stick postage stamps to article to cover First-Class postage,certified mail fee,and charges for any selected optional services(See front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return I address leaving the receipt attached, and present the article at a post office service I window or hand it to your rural carrier(no extra charge). Q) I 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the a�i return address of the article,date,detach,and retain the receipt,and mail the article. LO 3. If you want a return receipt,write the certified mail number and your name and address rn on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article Q RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. c�0 M 5. Enter fees for the services requested in the appropriate spaces on the front of this IF] receipt. If.retum receipt is requested,check the applicable blocks in item 1 of Form 3811. LL' 6. Save this receipt and present it if you make an inquiry. 102595-97-B-01 45 d i i a� Town of Barnstable snxxsrABLE. ; Department of Health, Safety, and Environmental Services Public Health Division ArF p�.l p P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health September 2, 1998 I Mr. Bernard& Martha Foley 9 Wianno Circle Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF THE TOWN OF BARNSTABLE REGULATION REGARDING FUEL AND CHEMICAL STORAGE SYSTEMS Our records indicate that you have an underground fuel oil tank located at 9 Wianno Circle,Osterville, MA 02655. This tank is listed on Parcel 139 on Assessor's Map 006 and registered as tank tag# 1189. This tank is not located in a critical zone of contribution to our public drinking supply wells but is 30 years old or older. You must have your underground tank removed within 30 days from the receipt of this order letter. For the removal of the tank you must first obtain a removal permit from the Fire Department, I have enclosed tank removal information for you. Upon removal of your tank, please return valve tag#1189 to the Health Department. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days of receipt of this notice. Sincerely yours, as A. McKean Director of Public Health Enclosure: Tank Removal.Information LOCATION Wo,CE' SE � PERMIT UO. IA1 TQLLERS IJ�,N�E � ADDRESS BUI DER 5 1J &MF- ADORE SS ANTE PERNA T ISSUED D ATE COMPLI & 4CE ISSUED : — — — �� prp► � r _ C��S