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HomeMy WebLinkAbout0290 PINE STREET - Health 290 PINE STREET, ;__ - - -- A= 176.001.001 WEST BARNSTABLE FIRE DEPARTMENT ush 2160 MEETINGHOUSE WAY P.O. BOX 456 WEST BARNSTABLE, MA 02668 JOHN.P. JENKINS Chief of Department EMERGENCY. 362-3131 BUSINESS: 362-3241 FAX: 362-3683 April 5, 2000 Thomas A. McKean, Director Health Department Town of Barnstable 367 Main Street Hyannis, MA 02601 RE: Underground Tank Removal Notification Dear Mr. McKean, This .is to notify you of the removal of an underground storage tank. The following information is provided for your convenience. WBFD Reference: #2000-032 Date of Removal: April 5, 2000 Street Location: 290 Pine. Street Property Owner: John Renner Type of Tank: Steel, round Capacity: 1000 gallons Product: #2 home heating fuel ` Tank Reg. Tag: #992 Chief Jenkins from this Department observed the removal of this tank. The tank was solid and there was no indication of any leakage from the tank. To the Department's knowledge, there are no other underground tanks on this property. No application has been made for the installation of any new underground tank on this premises. Sincerely, ' 7 J . Jenkins, Chief of Department Jlj v \<CATION AT --� SEWAGE PERMIT NO. � � VILLAGE Opl-- ao/ Gl-esl arm I N ST A LL R'S NAME i ADDRESS Y'c ro n S' BUILDER OR OWN ER DA T E PERMIT ISSUED . DAT E COMPLIANCE ISSUED tv b No.........J�S A >._ fA 1 Fxs.......A. ............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® F HEALTH ----- .---.....OF........ ......or '� -CQ-_------•••----•----••--•.-----•-•---- App iration for Disposal Works Tomilrnr#ion- rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ------------- Location-Address or Lot No. ................................................... ..........................................................................................._- a A a Owner Address ........................Gliw.s.�-------•-•----•---•--................................... ............................... ................................... ...... - Installer Address �� � Type of Building Size Lot----fe..��______r____ V Dwelling—No. of Bedrooms.._......,,?..............................Expansion Attic ( ) Garbage Grinder (jcc Other—Type 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 capacityls`f allons Length................ Width................ Diameter_------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...1_____ _________ Diameter........1.1...... Depth below inlet. ...A2.......... Total leaching area..................sq. ft. Z Other Distribution box`( I ) Dosing t �)� Percolation Test Results F rformed b ............ ...... l......_.__._...... .................. Date. _• a Test Pit No. 1... ..........minutes per inch Depth f Test Pit..... .............. Depth to ground water / . ---•- --. (Tq Test Pit No., 2---__:-_.....minutes per, inch Depth of Test Pit.............,/ t�th,¢�f gr d r____ _. ,.y 0 Description of Soil---:...... ._ ------- - -•�� -----=;:, ; -------------- - •- � r ....... txj Nature of Repairs or 1 er ions— saver when,appl' e..________._ .... ............ -- - - - - - - - -•-- - ,- -- �� _ - , ---- ------1 ---- Agreement: � � The undersigned agrees to install the aforedescribed Individual Sewage isposal System in accordance with the provisions of iITi 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 issued by the board of health. Slgn -----••-----------------------------••---•-------- Date Application Approved BY----- -d' ........................................ Date Application Disapproved for the following reasons: ==•=............................................................................ ................•---•------------..................-•-------•------------...---. .......------........--------•--------------------••-•-----•---------------•-------•-•--••----------•-•-----------•--- Date Permit No......................................................... :x A;; Issued_ 1-'..-----� • .. Date - A .k` No.. . Fiat.............................. THE COMMONWEALTH OF MASSACHUSETTS ,•. BOARD F HE L H • . `..... ------..OF....... `r. , r rlir t# �aaT fur 11iipusFal Works T. nstruri uu 1hrmit Applica` 6 is,"`hereby made for a Permit to Construct ( ) or Repair ( ) an"",Individual Sewage Disposal .,., System at: a t `� Location Address 1 or Lot No S_ ..................................................... ••••••----- ......................... .......................................... Owner Address w s •-- i a .._ .....-- --• -- G:r Installer Address �.y 1� d Type of Building Size Lot_._._ '................... q.... eet U Dwelling- No. of Bedrooms_______.___. ______________________:.____Expansion Attic ( ) Garbage Grinder (�J a , Other--.Type of Building No. of persons____________________________ Showers — Cafeteria, Other fixtures ------ s••------ --- W Design Flow............ ',�" "_______________________ lions per person per day. Total daily flow.___._._ '.' ....__:`_.___________gallons. WSeptic Tank JLiquid capacity._jr--Bons Length................ Width................ Diameter................ Depth____ .. x Disposal Trench '�To ____________________ Width____ ............ 'Total Length.................... Total leaching area....................sq. ff: �r below inlet , ; . . q.See Seepage Pit No t------ Diameter._._.__.___ Depth _..._. Total leachin area___ ft. z Other Distribution box ( Dosing to Percolation Test Results Performed by.. __. :._._ _________________ Date.:. . � , - t a Test Pit No. 1 .... mutes per inch Depth'. Test Pit____________________ Depth to gro d . te1�..,. ; (i Test Pit No. 2______ {____._minutes per inch' Depth of Test Pit............ r` .......................•- O �a+rw - // - J .. Descr>ption of Soil ', P' '4: ' " IL.. ' .................................`�'. :_... x .. .......................I................ ­/------------- .. ........./Y]i... U Nature of Repairs oAagrees —A wer when appli l r ____. .................... __ .. .-•---•------------•.•-•.._. _._ j �+ .;..- Areement: ,�.,,�„�.-+ /� 11>t• Ld �� � The undersigneinstall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI2 5 of the State Sanifary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ­- 7' Date Application Approved BY =` - - ...... 'Poe•wr------- ........................................ Date ' Application Disapproved for the following reasons_..................._.......................................................................................... _ -------•------•...............•-•----•--..._..--•----._..__......._...._.....----•------•--------......•-'•--------------•-----•--------•---•---•---•-•--•---••----•--------------•• -----------••- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS B, D OF HE LTH ' } ............. ... F..................... 4444--%�............................ rdifiratr ; of TuaaaytiFaurr THIS TO_G RTIFY,,That the Indiv>dual Sewage'YDisposal System constructed ( ) or Repaired ( ) - } ...... - _. �..a/!ih -. `� �d tFstat a' has been installed in accordance with the provisions of T jic �Tle� State Sanitary Code as described in the application for Disposal Works Construction Permit No___ _ _______________________________ da.ted_...__._w ......7a._�.... .._... THE ISSUANCE OF THIS .CERTIFICATEi SHALL NOT BE CONS UED A GUARANTEE THATTHE SYSTEWL WILL FUNCTION SATISFACTORY. DATE.............`._v�. .: . Inspector________ ___ THE COMMONWEALTH OF MASSACHUSETTS BOARD HEA17 ..............OF................ . t � <<I ....�. a ' FEE `�. ........ �t1 `_ air#' rraati# .� . Per 'ssion eby_ granted.._.._ fii/ r ...................... r to Cons c ( ) r R ) an Indlvldu eve at� stem at No.. -- - ;, Street w /• U as shown on the application for Disposal Works Construction Per o. �ated # r Board of Health DATE... ------ ------------•..... .. ................................ 4q FORM 1255 HOBBS & WARM N-. INC..-PUBLISHERS t. ., � r -. �,�^. tom• t y'< ; ,� � SNE� r /of Z-•._ �� f 37•Z / � a l 43.z Act �-rpEKV/o u S 0 _ y M�►r� i.4� rb dt 457 7 n�E GEAGN f>i T,e}v D 40• �f�L4C Cr> Lv/T7�/ 38.2 Ez.:4o 0 c Ez.4/.7 x 44 3 7 � ,� � r-S , Eze`T r/"� �3 /�!o Tcr- EL�V�77o�s• G'�.�6=D o,� l ,tr B,9 nL� CERTI FI ED PLOT PLAN 3 c LOCATION r Bvsr.9 PAGE. . � SCALE �. ��. �. . . DATE d' 391, l3��.vG LoT ./ PLAN REFERENCE . .. . . .. .... . . . . lZeA•.v f a e ,PE�IJ�O� 38-0 I CERTIFY THAT THE . .. ... SHOWN ON THIS PLAN-1 ON THE GROUND AS SHOWN HERE IT CONFORMS TO THE SETBACK RE OF THE TOWN OF . . . . . . . . . . WHEN CONSTRUCTED. GATE . . . . . . . . . . . . . . PETITIONER: C'-.7an.� �-1/��1. 0%//6 ��.........�......,•._.,.�,.._.�_.REGISTERED LAND ..SURVEYOR' . r • Y3 .. - NoTF_ .9LG //1PE7eVio uS NRT�K/AG. .SNEZT Z. 0,1�- Z .5t1EZT3 L. 4z.Sv eAD��S Feo� THE TOP OF FOUNDATION o� T71E LE�iGN P�7- s D �Epl�'iC�-D wiT1/ GICE-A� Spa CONCRETE COVER CONCRETE COVERS "• 4"CAST IRON 12"MAX. �� • 12"MAX. v� PIPE (OR 4"ORANGEBURG(OR EQUIV) ` PITCH — MIN. PIPE- MIN. LEACH PITCH I/4"PER. PITCH 1/4"PER.FT. PIT e,o PRECAST NVERT a LEACHING ''� EL..3.B•oo PIT OR INVERT INVERT e . • SEPTIC TANK 74 7� DIST. l -�G w EQUIV. EL.. . . . . . . . EL... >x o INVERT BOX —� �: .,•. /Soo . _ GAL. INVERT �' e; EL.:3G Z INVERT 9 �o �: i, 3/4��T0II/2 EL 3�:7.3. • EL._.'.�� WASHED 0 Q/ •. w STONE o >Z �4-/ .• � �6 DIA. �— o• •.. . �"�z� D I A �/oitt PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATEM'9Y. i7"978 TIME.9'3o'9'�: c.G �c�, . . . . . BOARD OF HEALTH TEST HOLE I TEST HOLE 2rfifS �`• � P.E. ENGINEER ELEV. .¢z.60. . . ELEV-4Z.'yO DESIGN DATA ' \� CLAY/S o W CC'QY NUMBER OF BEDROOMS 3. . . . Sad- Sa/e- \\• �� \�\ 330 ,,`` �i�Xr�eE 4L , TOTAL ESTIMATED FLOW GALLONS/DAY BOTTOM LEACHING AREA .//3/O. SQ.FT. /PIT/3z Lay"Ts of SIDE LEACHING AREA . .z'2(O'.20 SQ.FT./ PIT SA-"r) GARBAGE DISPOSAL . .(50 % AREA INCREASE) SAID Gv�L TOTAL LEACHING AREA .35 3O SQ.FT /80 / PERCOLATION RATE LESS R? TWo. MIN/INCH S LEACHING AREA PER PERCOLATION RATE �'� SQ.FT. NO .WATER ENCOUNTERED -fP/T' 1W 1771 71-YeL`C- NUMBER. OF LEACHING PITS �T of .STDv✓�"' av Ht-L SIDE ' 1.�.4 Tatis f - APPROVED . . . . . . BOARD OF HEALTH s, of s��v�- )ci--Z R17 DATE . . . . . . . THOMAS E.KELLEY CO: = AGENT OR INSPECTOR ENGINEERS—SURVEYORS 346 LONG POND DRIVE SOLJT\H yARMOUTH,MAS P�,JH OF MSS / : `% A 02664 TNO �T i! „i E. Ii0 F40 G1STS �•� 2-5 Z �E�Co.v -ST. /}�,T- 8 �', . ` Ss'ONAL�a� PETITIONER 'oti Tod/ /JA f rN TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL' S-TORAGE _REGISTRATION r MAP NO. � � PARCEL NO. !�Q! ADDRESS OF TANK: �. © �l'1 AJJ" VILLAGE: 61� � ! 4 Xu MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : �� !--1�W1 s�lrrw10 L f � OWNER NAME: €� ` Imo. PHONE: INSTALLATION DATE: BY:104clae(Ji co j INSTALLER ADDRESS:- 7'Gt / fi: iWM7 / /! -�'-S� -CERT. JO. *TANK LOCATION:)-` i P DCl90 Pt S�aG TANK ILOQAT S ON . W S TH mommacT TO mU I LD I NO)/ CAPACITY /00 6 TYPE OF TANK � - AGE_�YRS. FUEL/CHEMICAL 0// TESTING CERTIFICATION C I PASS C I FAIL DATE LEAK DETECTION [\j] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C I YES [A NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C l YES C I NO DATE CONSERVATION CHECK IF N/A DATE 1 BOARD OF HEALTH TAG NO. C ] DATE /4! 15- 121 PLEASE PROVIDE A SKETCH SHOWING THE TANK)LOCATION ON THE BACK OF THIS CARD