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HomeMy WebLinkAbout0235 TIMBER LANE - Health (2) 235 TIMBER LANE,.MARSTONS MILLS ,. A= 149.044 BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f Compliance THIS IS TOO!! Tat the Individual Well Constructed ( , Altered ( ), or Repaired ( ) �� Gv>✓�// .�-. / --------------------------- - -- Installer at /00L1, .,,---, ,`//J------------------------------ has been installed in accordance with the provisions of the Town of Barnstable Board of HealtVrivate Well Protection Regulation as described in the application for Well Construction Permit No. --------Dated--VM- v----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------———-— —------------- -- Inspector-------------------------------------------------------------------------- TOWN OF BARNSTABLE - UNDERGROUND FUE '•-AND CHEMICAL STORAGE REGISTRATION ' ji.. j'' OWNER AND INSTAL ER I NFJRMAT I ON i f ADDRE . r .�~" Y7 9 � _ •f/'J MAP O. "€1 PARCEL NO. #" OWNER NAME: _ J � � VILLAGE: � _ :�1 V INSTALLATION DATE: ADDRESS. l�. /� _ yPt/ CERT: !/�jNK I OR AT I O� ,k, ,.yam LOCATION OF TANK: CAPACITY E TYPE _ )le AG � FUEL/CHEMICAL TESTING CERTIFICATION ,C�];PASS ` C"'7 FA'rL-- DATE--'--`" LEAK DETECTION 5 '3 CHEEK IF N/A- TYPE/BRAND ZONE OF CONTRIBUTION C ] YES Ck] NO DATE TO BE PEM VED 73 FIRE DEPT. PERMIT ISSUED YES C ] NO DATE n '' A F 4,^ L'UNSERVAiION 1/3CHECK .IF N/A .DATE • 40 BOARD OF HEALTH TAG NO. ]C ]C ]C ] DATE 1 ! PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD t Vev �rA Y2 1� -T 30 rMA ou5e- o t--z,o 1 CENTERVILLE • OSTERVILLE FIRE DEPARTMENT PERMIT FOR STORAGE OF FUEL OIL In accordance.with provisions\V Chapter 14'8, G.L.. and Regulations made und'e,authority, thereof. Name .Bi1.7....Li.ebeman...........�'... Name .Qi=QAs..�'�.g�...+...F�� (owner or occupant) (Installer) Address 235-2imbex.. 4...W Address .N!a 3n S t! W!„Yar.,••• Rurne'r Stora'& Make ''4'ekett................................:. Ty'pe of Tank ........................ Steel J Man'ufa`cturer ..BaCk-ett..... .................... Capacity .Jr.QQ..... gals. (or) Size............ Model No. or Size .....A.t t................. Location .TMq;PgrOund •• pp ...... 6 . Type...x:�.............. Mas . Approval N'o. �...�.... Permit issued ...... . ...............4TQhn M.. Far ngton. Chief (Hea f ire De a^rt 'e^nt J ............................................................... By :. ....................... ..'!.` ... (THIS PERMIT.MUST 4 CONISPiCUOUSL1,POSTED- :.1POP2.THS P!'mmsu) • I No.- ---- --'__/ �-------------- Fee- ' BOARD OF HEALTH TOWN OF BARNSTABL. E f Applicat ion, for Vell Construct ion Permit Application is hereby made fora permit to Construct (A, Alter ( ), or Repair )an individual Well at: .— a 3 5 �r, l� lIM ---4-1?4 N lhr��s - -- --- ` --_- V f ----------------------------- Location — Address Assessors Map and Parcel M V3 Wes- -'�/ -- - Owner Address 5hL"!�� y(��CL scut, T -'�o----- 83 O�LE/�/5 /�i'4 - _ - -- - ----- - - ------ Installer Driller Address Type of Building Dwelling--------------------------------------------------------------- Other - Type of Building-------------------------------- No. of Persons------------------------------------------------- J1o/yirsn Type of Well------ ---- - ---------- - Capacity O dd ��-Gc�� 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 Protection Regulation - The undersigned further agrees not to place the well in operation until Certificate f Compliance has been issued by the Board of Health. -------------- ------------- date ;;z Application Approved By. - - - --- -r— -- Y 7 - Application Disapproved for the following reasons:---------------------------------------------------------------------------------- ---------------------------------------- ----------------- date PermitNo.---—_-- - ---- --------------------- Issued----------------------------------------------------------------------------- date { w ..r"-"�'Rft.. ...+=..r .- -r. .-� .,. a�c. ..,..�.+M6..•i,.. .t .. ''^� � ....o..*c. ., ...,f�'..A�a r Y.r; ,[ter.- a..-. + j� rNo--------------------- Fee-�---------------- C BOARD OF HEALTH !� TOWN OF BARNSTABLE Applicat ion-for lVell Construct ioni3ermit Application is hereby made for a permit to Construct (/), Alter ( ), or Repair )an individual Well at: d3 5 --------------- `- ` ` ------------------------------- Location — Address Assessors Map and Parcel M ks w'rn - a-7,0//7 q Rl -C4'VF- �G,rr /,jrG� Owner Address r -' / _- %_7C- .. 83 ®r Cc errs �� ------------------------------------------ r Installer — Driller — z Address O J� Type of Building Dwelling </ Other - Type of Building ------------------ No. of Persons--------------------------------------------------- ,�p/1/�STI Capacity Type of Well-------------------------- --------------- --- -- ----------------- --- ------------------------------ , Purpose of Well----- f� � --- -- 'gL T /I��i�GE`�/T CGC.q?/d.11 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;untiltificate 'f Compliance has been issued by the Board of Health. -- { Si ne -- — - -- -- ---— - - g date Application Approved Bye< =— = '— — 3 � t -------- date Application Disapproved for the following reasons:----------------- ---------------------------------------—-----------—- -- - - r ______-_____—__--___—_--_---_---_— _---_— --__—_---__—_ y __T date PermitNo.-------------------------------- Issued---------------------------------------------------------------------------- date + BOARD OF,HEALTH TOWN OF BARNS-TABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individiffa1 Well Constructed ( Altered ( ), or Repaired ( ) by----- - --------- In staller 2 35` lw� _` .-e --- --- -----__► -------------------------------------------------- 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-------------------------------------------—--------------------------- 4 � amra��4.srik.r.'7KtS�-+�Rrayos - mac• __-� °�s�' '' �`.w.a- - �4 1 BOARD OF HEALTH ¢# TOWN OF BARNSTABLE U)eC[ Constructionpermit No. ----------------- Fee------------------ Permission is hereby granted__——---- - ---------------------------------------------------------------------------------------------- to Construct �Alter ), or Repair ( ) an Indivjdual Well at: -------- ------- - ---r-'--------- --- Street as shown on the application for a Well Construction Permit /9 9 f ------------ .Dated-------- - ---------------------------- - — Board of ealth j DATE--- -� ------------ - ----------- ; i 02-05-1998 11:37AM CENT DST FIREDEPT 5087902385 P.02 MaKe appucauon to rocai Tire uepartmenc Ftue Department retains original application and issues duplicate as Permit. r �- - Elf APPLICATION and PERMIT Fee: In nn for storage tank remcv-d 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 rye by: Tank Owner Name(please print) William Lieberman X . gnsnas so Ay a�Dema, Address 235 Timber Lane, Marstons Mills street C!ry sera Zip ■ 1 . • Advanced Environmental Advanced Environmental Company Name Co.or Individual P.O. Box 472, S.PDennis, MA Address Address printPent Signatu ppi ' r_e Signature (if applying:rr=ermit) IFCI CertMec Other C IFCI Certified Z # Other Tank Location 745 Timber Lane Marston Niil 7 s MA stoatAaatem Tank Capacity(galicns; 550 Substance Last Storms- #2 Fuel Oil Tank Dimensions(diar-. x length) Remarks: . M Firm transporting waste Advanced Environmental State Lic.# MV5083856100 Hazardous waste mar,69s:.-,4 E.P.A. # Approved tank dsposrJ!Srd J.G. Grant Tank yard# 03501 Type of inert as V YP 9 �� Tank yard address Readville. MA_ 2 City or Town Centerville 01920 FDID# Permit# Date of issue February 5, 1998 Date of expiration February 19, 1998 Dig safe approval numbs-. 980600384 Dig Safe To7 F Tel. Number-800-322-4844 Signature/Title of Of5= anting permit After removal(s)send Fcrt �n-290R signed by Local Fire Dept.to UST Regulatory Complia' -:Unit, One Ashburton Place, Room 1310, Boston,MA:1.08-IS 18. FP•292(revised 9196) TOTAL P.02 U .HA Department of Environmental Management/Division of Water Resources WELL COMPLETION REPORT W 99�10 WELL LOCATION GEOGRAPHIC DESCRIPTION Address N S E W of (feet) (circle) City/Town 19�41e57VN /jJ/GGS Well owner 1Nm L��3C-���� (road) Address �'.3S �1,*b r3&A_ e171V E N S E W of /yJy h'67DN /h/GGS /27 h' O-�6 49 (mi.in tenths) (circle) Board of Health permit obtained: yes 9-1" no ❑ intersect. w/ (road) WELL USE WELL DATA Domestic Eg"Public❑ Industrial ❑ Total well depth 1-10 ft. Monitoring❑ Other Depth to bedrock ft. Water-bearing rock/unconsolidated material: Method drilled `S /act�r Description Date drilled 3-//' ` Water-bearing zones: CASING 1) From To Type OGt! 40 pUC.. 2) From To Length_e�7_ft. Dia(I.D.)__!!�K_in. 3) From To Length into bedrock ft. Gravel pack well: dia. Protective well seal: dia. t Screen: Grout ❑ Other Slot#—Zc?—length .96 'from 121 to_i� STATIC WATER LEVEL (all wells) Static water level below land surface Z ft. ' Date WELL TEST(production wells) Drawdown © ft. after pumping a hr. .30 min. at la- gpm How measured A Recovery r t�-Qa4t�r -lir_ min. LOG of FORMATIONS COMMENTS 0 Materials From To F=YA-C 0 Ro `7 sr�an r� �R k Driller r-yh-� oZ0 .3J LZI Firm -S/rl�nc� I�G-zc�I�ki�ur�S Address City/Town Gi4C�gNs A/ 4 6d&6-' Supervising Driller Reg.# nn Signature 'supe i g regi ered well driller Please print firmly l r. 'BOARD OF HEALTH COPY \ 4 Town of Barnstable OFIHE t Regulatory Services Thomas F. Geiler,Director Public Health Division BABNSTABLE, Thomas McKean,Director .� MASS. OD i639, ��� 200 Main Street, Hyannis,MA 02601 ArFD MA'l A Phcne: 508-862-4644 r Email: healthPtown.bamstable.ma.us O Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 May 12,2009 Mr.David Gady and Ms.Amy Gady RE: Underground Storage Tank Removal 217 Timber Lane Order,217 Timber Lane,-Marstons Mills,MA. Marstons Mills,MA 02648 Map Parcel 149044 Tank# 1,Tag#00466 Dear Mr.and Ms.Gady: The Barnstable Public Health Division is in receipt of a copy of the tank removal Application and Permit issued by the Centerville-Osterville-Marstons Mills Fire Department demonstrating that the above referenced underground storage tank had been removed in February of 1998. The Public Health Division appreciates your attention to this matter and has updated its data base to reflect this fuel tank status change. Should you have any further questions please contact Cynthia Martin of this office at 508-826-4645. T'lia as A.McKean, S, CH Director of Public Health 11/MAY/2009/MON 16: 16 C-0—MM FIEE DEPT FAX No, 5087902385 P. 001/001 Make appilcation to local Fire Department Fire Department retains original application and issues dupfcate as Permit. o ��:: c.� — �aa�x� C�ax���43�tLeo?.�.ia12 _,•_ f/ylZPilt� �I/J�4i V 0�1�1Jf.Ce6 ...� APPLICATION and PERMIT JFee._, for storage tank remavzl and transportation to approved tank disposal yard in accordance with the provisions V. of M.G.L. Chapter 148,Section 38A, 527 CMR 9.00, application is hereby Made by: ;Address wner Name(pfea`�print) William Lieberman X • ygnalur9 i eD yn9 rDe/71U1) 235 Timber Lane, Marstons Mills crty mete zm. - Advanced Environmental Advanced Environmental ny Name Co.or Individual Prinf Print P.O. Box 472, S. Dennis, MA Address Address Signatu Signature(if applying ixr_ermft) O IFCI Certified Other I/'P ❑ IFCI Certified - L P# Other Tank Infor.mafion Tank Location 235 Timber Lane. MarOtons Mills, MA Stew Address CLY Tank Capacity(gallons: 550 Substance Last Storer- #2 Fuel- Oil Tank Dimensions(dierr�ar x length) Remarks: � Firm transporting waste Advanced Environmental State Llc.# MV5083856100 Hazardous waste mangy E.P.A.# Approved tank disposal ysd J.G. Grant: Tank yard# 03501 Type of inert gas t/ Tank yard address Readville, MA City or Town Centerville FDID# 01920 permit# Date of issue February 5, 1998 Date of expiration February 19, 1998 Dig safe approval number- 980600384 Dig Safe Tog-;ze Tel. Number-800-322-4844 Signature/Title of Officer zranting permit 0 After removal(z)send Fcrn-�?-290R signed by Local Fire Dept.to UST Re latory Com liarre Ugit,One Ashburton Place, Room 1310, Boston, MA C.2'08-1618_ FP•292(revised.91961 S-. I O ( I -TM ti r - Bams[able 9 MAS&L Town of Barnstable 1639. Regulatory Services Department 2007 Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Date: April 1, 2008 TO: David & Amy Gady 217 Timber Lane Marstons Mills, MA 02648 RE: Underground Storage Tank at: 235 Timber Lane Marstons Mills, MA Map Parcel: 149044 Tank NO: 1 Tag NO: 00466 Our records indicate that your underground fuel (or chemical) storage tank is over,20 years old, and has not been removed as required by section 326-3: subsection 2 of the Town of Barnstable Code regarding fuel and chemical storage systems. You are directed to remove this tank within sixty(60) days from the date of this notice. After your tank is removed, please furnish this office evidence in the form of a permit from your local Fire Department within ninety (90) days of the receipt of this notice. You may request a hearing provided 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 a��r * * Barnstable Bm Town of Barnstable Regulatory Services Department 2007 Public Health Division 200 Main Street, Hyannis MA 02601 Office:. 508-862-4644 Thomas F.Geiler,Director FAX: . 508-790-6304 Thomas A.McKean,CHO Date: April 1, 2009. TO: David & Amy Gady 217 Timber Lane c O p IV 1 arstons Mills, MA 02648 RE: Underground Storage Tank at: 217 Timber Lane Marstons Mills,MA Map Parcel: 149044 Tank NO: 1 Tag NO: 00466 Our records indicate that your underground fuel (or chemical) storage tank is over 20 years old, and has not been removed as required by section 326-3: subsection 2 of the Town of Barnstable.Code regarding fuel and chemical storage systems. You are directed to remove this tank within sixty(60) days from the date of this notice. After your tank is removed,please furnish this office evidence in the form of a permit from your local Fire Department within ninety(90) days of the receipt of this notice. You may request a hearing provided 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 Town of Barnstable Health Inspector oF11HE Tp� Office Hours tia Regulatory Services 8:00—9:30 : Thomas F. Geiler,Director 3:30—4:30 I: BMWSTABLE, * Only 9� MASS. Public Health Division Thomas McKean,Director - 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: 235 Timber Lane; Marstons Mills, MA 02648 Map 149 Parcel 044 Name: Amy L. Gady Phone: 508-428-6030 2. How many bedrooms exist on your property now? 3 Are you planning to add any bedrooms?NO 2a. Please include a copy of your floor plans for the entire property. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer, skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 5. The dwelling connected to an ONSITE WELL WATER 6. Is a disposal works construction permit on file? YES 6a.If yes, how many bedrooms were approved according to this permit? 3 Bedrooms. s 7. Were any building permits obtained for construction of additional bedrooms? YE N 8. Is there an engineered septic system plan on file at the Health Division? YES , =' 9. Has the septic system been inspected by a DEP certified inspector within the last=o year YES 2-1 FOR OFFICE USE ONLY O TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY c n �- The Public Health Division h no objection to bedrooms at thi:Frty' Signed: � Date: Inspector(Print): Mc l` cr--- Q;/health/wpfiles/amnestyapp o � Town of Barnstable Health Inspector Office Hours Regulatory Services 8:00—9:30 } Thomas F.Geiler,Director 3:30—4:30 * sntuvszns . * Only Public Health Division �Fn MAC Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: 235 Timber Lane; Marstons Mills, MA 02648 Map 149 Parcel 044 Name: Amy L. Gady Phone: 508-428-6030 2. How many bedrooms exist on your property now? 3 Are you planning to add any bedrooms?NO 2a. Please include a cop., of your floor plans for the entire property. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer, skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? 5. The dwelling connected to an ONSITE WELL WATER 6. Is a disposal works construction permit on file? YES 6a.If yes, how many bedrooms were approved according to this permit? 3 Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES r' I 8. Is there an engineered septic system plan on file at the Health Division? YES ;,• 9. Has the septic system been inspected by a DEP certified inspector within the last two.years? YES z�]1 , l -----------------------------------------------------------------------------------------------------�-----------` FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public Health Division has no objection to bedrooms at this prope . C' j Signed: Date: Inspector(Print): Q;/health/wpfiles/amnestyapp y. k 1 ! L `4 ---- --------. 16 s- f r� G I ' I _..... _...... _...,_.__.._.._ _. ZIA t t3iZP -Y ` � M �► N ls�z tt/ 1Nc� I I�OOto, z� t I t � ' _ r , I j --f I ` I 1 I I , I '_. _; � .._ _ ._' _I___I _I;_... _ -l.�T•1 l".:t T i __ i- _.__. +_._..,__.-I_ �_ -,. .._L_-_I ` `..__;....__i ___'_._ ._ ..._; __ .� .__ _. .._ -_.-j._�i _ ._' i I I I I I i I , I � : , I f ` i MPrtV Neu SE C4 N rRY - _. I z 1 --i-- - L W I�Jl� --RooN. G.6.....,�ey TZF<s Gab,ds { _ — _. 4t t,b et S ITGGSSSOhY _ �'I�A;jjjI 710"A. v pe-je- CB/DH , MARSTONS MILLS A.M. 125 (FND oFF) 0 PAR. 47 `� r RACE LANE � \ y CB/DH y� W W $ 52`� LOCUS 40� A.M. 125 0 A.M. 149 b �' PAR 48 PAR. 46 0 o 10 0 0 LOCUS MAP pogC� A.M. 149 \ DPLAN REF EED REF 247182 30 PAR. 45 \ 1325 ZONING: "RF" AREA=20,250E S.F. SETBACKS.- 30-15-15 $Qpo�A CB/DH ASSESSORS MAP 149/45 vz / RESOURCE PROTECTION DISTRICT c- WELLHEAD PROTECTION DISTRICT LOT COVER BY DWELLING & CARPORT = 199 n PLOT PLAN D OAF LAND d�fl (FNI7 OFF) #217 TIMBER LANE VZ HOUSE — =,- - - - Ev #217 MARSTONS MILLS, MA. PREPARED FOR. DAVID GAD p SCALE. 1 "=20' AUGUST 30, 2007 A.M. 149 0 1 PAR 44 1 ( AAA REV r�_ 1 , ►� as or I"-E, ®® REV 30 1 °a��G\sTc.3�v REV STEP HEN No �� 1 FIRE i " HYDRANT DOYLE P ® .o y37a-� � P ` YANKEE SURVEY CONSULTANTS A®�qN s u�0 y��® UNIT 1, 40 INDUSTRY ROAD !i MARSTONS M�LL. MASS. 02648 UTILS TEL. 428-0055 FAX 420-5553 SHEET 1 J# 53834 GM