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Home My WebLink About0238 INDIAN TRAIL - Health 238 INDIAN TRAIL, BARNSTAB „ A=336.094 17 zo - =. n n , Y , e a. a , r r z t' v v ' , , e. ,r r n. v " • s n , W M1 ' i } n• . , � P •""'"'""' BARNSTABLE FIRE DEPARTMENT f ' s 3249 Main Street - P.O. Box 94 s o y 1927 0 Barnstable, Massachusetts 02630 1%y4cwu+��y 508-362-3312 FAX: 508.362-8444 WILLIAM A.JONES III,CHIEF GLENN B.COFFIN,CAPTAIN FIRE PREVENTION UNDERGROUND STORAGE TANK REPORT Property Address: 238 Indian Trail, Cummaquid Property Owner: Mark Nichols Removal Date: September 30, 1999, 1030hrs COMMENT: Witnessed the removal of a 500 gallon U.G.S. Tank used for the storage of No. 2 fuel oil from this location. The tank appeared to be OK, with no signs of leaking. The excavation site appeared to be clean with no residual odors of fuel or discoloration. The contractor was advised to remove the tank from this location and to backfill the site. William A. nes, III Fire Chief Make application to local Fire Department. Fire Department retains original application and issues duplicate as Permit. y e_1 I qi� APPLICATION and PER tVIIT 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) g 21� �I )to X p at .' Pit,ng rpennr!) . Address �3( b l f��.i R (`f�. ��A�n f3��r' Street City State Zip Company Name S Co. or Individual - Pruir AddreSs '�` d' Pnnt. S Address Print Print.. .. Signature(if applying for permit) Signature(if applying for permit) FCI Certified Other ❑ IFCI Certified,. ❑ LSP# Other .. �1rI /� Tank Location3( ,� A��Jb/C S:eetAc es, /'74 City Tank Capacity(gallons) Cal, - Substance Last Stored Tank Dimensions(diameter x length) 7 oC S A �fb`��3rri�/�/' Remarks: - o Firm transporting waste State Lic.# 14h}'3 �J Hazardous waste manifest# 00 0 0. E.P.A.# -B ct a 6�j Approved tank disposal yard `�V r � Tank yard# 0 Type of inert gas Tank yard address— Q 3., Cn (,MQ,r r-i City or Town FDID# Per it Date of issue Date of expiration C� Di safe a L �G1— 3 L9 � � , 9 approval number: 6 D' fe To . Number-800-322-4844 Signature/Title of Officer granting permit After removal(s)send Form FP-29OR signed by Local Fire ept.to UST Regulato C mpliance Unit, One Ashburton Place, Room 1310, Boston, MA 021 08-1 61 8. FP-292(revised 9/96) TOWN OF BARNSTABLE 0 LOCATION � � LO y 4�i�/SEWAGE # 9�_ VILLAGE o � ,ASSESSOR'S MAP & LO'1� INSTALLER'S NAME 6a PHONE NO. 1 SEPTIC TANK CAPACITY /�®® A LEACHING FACILITY:(type) � (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER y��(� DATE PERMIT ISSUED: —/z --� DATE COMPLIANCE ISSUED: ' VARIANCE GRANTED: Yes No ,3� �y � � �; . � i � A �� . � � nC A • f �� \�1 A � t¢ N�� ! FEE.... . THE COMMONWEALTH OF MASSACHUSETTS -.61Ioul g,L- _ZZ �L 7 BOAR® OF HEALTH 01-4 - -z yK� e ....................... Appliration for Ui"viial Workri Tamuurtivn Vrrmi -t 5 Application is hereby made for a Permit to Construct ( ) or Repair (�n Individual Sewage Disposal System at: G� .....---.Z. r......-..... � v�' -------------- ---------•--------------...--.........---- L_ atio t- dd s or Lot No. ......................_......... ------ .._...._ l_ o net dress /�� a - tuil-di-fi. _o..Gi0......... �0__ -... �y _. f c.�' C�r ,f_.Installer / 2 Aa a� Address � Type ofg �,b,� / Size Lot...........................Sq. feet aDwelling No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p, 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 capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width... Total Length.........._......... Total leaching area.._........-__......s Seepage Pit No.......I—........ Diameter..... Depth below inlet.............. Total leaching area..�� t. Z Other Distribution box ( ) . Dosing tank ( ) aPercolation Test Results Performed by -----------•----------- Date Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..................... GX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •-•••-••-•••----------------•--••••-••••-••-••••-••••--•-•••••••-••--•••............-----•--•---•---......................................................... 0 Description of Soil............................ ......................,............................................................--------.............................................. w x •---•••••----------------------------------------------------------------------------------------------------------------------•----------------------------------.::�------.e --------...----1 U Nature of Repairs or Alterations—Answer when applicable.___�7 ............... �-! . JEEP-� - v��--------- ---------------------------------------•••-•----•-•--•-- 00MA10.................................... Agreement: (�±±�� The undersigned agrees to install the aforedescribed Individual.Sk"MR l System.in accordance with the provisions of THTI 1� 5 of the State Sanitary Code— The undersigne furt per agrees not,to place the system in operation until a Certificate of Compliance has ee issued �theoard o e t E 15ZSigned... r Date Application Approved BY — �`�c .............................. Date Application Disapproved for the following reasons--------------------------------------------------------------------------------------.......................... ----•-----------------------------•-----....----...-----------•-••---------•-----•-•-----•-•-----•----------•-----•-----•------------------------------------------------------------------------....... {� /� Datc Permit Noll� ....$./ �3----------------•-.. Issued.... �, > -�f-----------ate..----- V e NV�o .�I. Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -'_" ""p 1J. :?-.-........ OF...... ...:............---!.............••------•---•---••--••-•-•---- Appliratiun for Disposal Works Toustrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (J,�an Individual Sewage Disposal System at: 2 3 .............:.._._... ---........ ....................................... •....••--•••----•---•--•---•-••-•-•---...•--------•••----•----------...............---.........•-- /�j/�q /� catiyn-Address or Lot No. --r— wnAr a Installer� Address UType of Building Size Lot............................Sq. feet ,., Dwelling_—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building .............. No. of ersons....................._..._.. Showers — Cafeteria a YP g -------------- P ( ) ( ) Q' Other fixtures .......---•-•-•••••-••........•• - w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No................:.... Width..T..._............. Total Length.................... Total leaching area....................s t. Seepage Pit No......../........... Diameter....7............ Depth below inlet.._........... Total leaching area.. t. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ LT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....__---_-.___---___-_- 9 -------------------------------•---------------------------•------------------------......_.................................................................. 0 Description of Soil....................................................................................................................................................................... x wl _ _ E Nature of Repairs or Alterations—Answer when a licable._..,`0/4.,1_�> 42.6.1 a Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT11-� 5 of the State Sanitary Code— The undersigned,further agrees not to place the system in operation until a Certificate of Compliance has hegn issued/y the board o jhealtl. t r SignedZ v � '�G� ---•----- . `'u../.._ Date Application Approved BY•••••-••••-••---•.d...�.-.-•-•p•-'--•-A•-�•l•'-•�-•--°-•-••••••`•-•--�•-••-•--••-••-•-•--•-•-•-•--•••••......-- �� Date Application Disapproved for the following reasons----------------••--•-----------------------------------------------....----------------------------------_..._. .................................•----------•--------------....----•------------------......------------.--------....--•••-••-•-••--••••-•--••-•••-•••------------------•............................... Date Permit No.--�}--.J n...4t.1 ?1� `" ................•-----•--••••---.. Issued.... / ... ..--•--..........--•--- Date t �f1A �(%vs.T -~ THE COMMONWEALTH OF MASSACHUSETTS C C_IV< 1, 17ovA—L, BOARD OF HEALTH 1 c- —_._ . .........OF....... ............Frr `.........I.. ............:::o...n frrtifirate of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- :7' - `0� "•�^" � Installe� has been installed in accordance with the provisions of T "'1Z 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No:'f'` --.__!1'__ ___ _________ dated-....�r_./-�-,�-.�,"+/•��............. -./ '* THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO R E® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.... 7-11 i raj{�t'r'oJ •�. Cji ' Q c f'�. THE COMMONWEALTH OF MASSACHUSETTS mil — 7"" --BOARD OF HEALTH ....fir ►� !Yi�,l t� ........................O.w:e�......O F. .......................... .............................................................._......... No........................... FEE:� ................ �iu�ruu�l . u�k,� �un��tiun rrnti# Permission is hereby granted... -------•---•..........�= -- - -- -------------- to Construct ( ) or Repair an Individ.ual..Sewage Disposal System Street as shown on the application for Disposal Works Construction Permit No._�±___`-L�- Dated.- '�1 Board of Health '" — DATE.----- t=' t = .................................. FORM 1255 HOB & WARREN, INC.. PUBLISHERS' J l Asp 6 i