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Archived 21Eto: fax T: from: I date: I subject: I pa_es: I NOTES: a-c t= .Safer Fire Department Fire Prevention Division �.9 Fort Avenue Salem, Ma 01970 tel 19181745-7777 fax q l;s; 745-9402 4t3 C 3Clo ^ za Lt. Erin Griffin_ Fire Marshal 1toy , Ib t toy. e 1- r' This facsimile conta;ns privileged and confidential information intended only for the use of the ,ndividual or entity to whom it is addressed. .It the reader of the facsimile is not the intended recipient or the employee agent responsible for delivering it to the intended recipient. you are hereby notified that any communication. transmission, dissemination or reproduction of this facsimiie or its contents is strictly prohibited. if you have received (h:.: facLimrle in error, pease immedrtel, nit: • us by telephone and return the original facsimile to us at the above address via the U.S. postal service. Thank You. • .104 SALEM FIRE DEPARTMENT Fire Prevention Bureau 48 LAFAYETTE STREET, SALEM, MASS. 01970 PASTED Date Certificate of Completion - Installation or Alteration of Oil Burning Equipment The undersigned hereby certifies that rtthee installation to terrationl f fuel oil burn equip ggt or (Name of Owner) r c (' ! v / s E c rO /�� at (Address) / C ( :Ogie / V St tank and applying to the installation for Floor heated by system (1st,2nd,all) has been made in accordance with provisions of the Salem Fire Prevention Code, of Chapter 148, G.L., and regulations made under authority thereof now currently in effect and pertaining thereto. (Ref. 527CMR4.00) Furthermore, this installation has been tested in accordance with such requirements, is now in proper operating condition and complete instructions as to its use and maintenance have been furnished to the person for persons) for whom the installation (or alterations) was made. BURNER Name Type :0 / C To use not heavier than Ot fuel oil Kind of heat Mfg. by // Mass. Approval No.. F & ../. 3 STORAGE TANK (D.H.W.; F.H.W.; STEAM; F.H.A.) Type of Tank �q ( J New Tank No. of Tanks ( Total rapacity p� Cr 0 0 IgEaisting Tank Location 1..n S It Y0 0)1 cam'(/ j ) No additional storage, using same tank as another unit. Note: New underground tank installations, require a plan and Form 81G to be filed. ,' U7 %%/4+ t./C. Location of automatic shut-off valve ! / et-c S e Location and type of manual shut-off valve Special requirements Company By ....j..G.e7C Type (automatic or manual) control Cert. atComp. Rec'd.. . ,.`� : P"1. Permit issued.... ��'�9 Issued By Pt'.!yrr 12. Adjustments or Corrections Marla, lam€ - 13. Parts Replaced in f ' `t ogOf /i`'X_ vd sey ape LECTTRICA CONTRACTOR: C,J ff/(J S©it zS Address I... g �'`�" f Installer's Certificate of Competency No. Y' / ( 6 0 , v DO NOT WRITE BELOW THIS LINE _ _ 14. The Inspector suggests the following .necessary... -improvements, repairs, nor replacements. These suggestions are not the result of an Engineering Survey. 15. Inspector suggested improvements, -repairs, replacements were ,discussedwith the undersigned owner or owner's representative 0 Yes 0 No 126..A. 16. Explanation of "No" Answers =4:aP CONTINUED PAGE #2 0 Yes EY .A. SIGNATURE INSPECTOR SIGNATURE OWNER OR OWNER'S: REPRESENTATIVE ".,(PRINT NAME) DATE In accordance with NFPA guidelines, you the subscriber must retain =n copy of the report on the premises for at least,5 years. FORM F.P. 292 (rev, 9/90) 011r (Qmmnmnwruiill of tifessttrlmsrffx Department of Public Safety Division of Fire Prevention and Regulation APPLICATION FOR PERMIT, AND PERMIT, FOR FDID# 09 ZCS S(ssc.cv• City, Tbwn or District le y/00 Fee Paid : S . GC 18115 A, ii 0ave•v of US i el" ?..c‘c_ Permit # PC), In accordance with the provisions 1 Date -1, \2- 1994- C.82 S.40 M.G.I. DIG SAFE NUMBER gesr l (o O SAAI start date 4\ 21.0\g4 of Chapter 148, Sec. 38A, M.G.L., 527 CMR 9.00 application is hereby made by: &w$gzG eP-c,ewr, wc. Street Address & City or Town: ) i t-ct w- S;, ---Z,�vcR , (9)92z.-agUo Signature of applicant: Applicants name printed: 3"g.i C10+�3 j �i rtcitncarr- eiQArinao.r ► PuNcE For permission to one underground storage tank from. Owner: r lc,-v12.1 Street Address: \ifl1 ST Finn transporting waste: ("Pg51-,E,J, a« State Lic. # \MIS SZ Hazardous waste manifest # VIOA,A 3933o Approved tank yard: Tank Type Tank capacity: Date of issue: Signature/Title yard Address: N`� of inert gas: No. �: E=i u. ►mot ►c 19 E.P.A.# 145' 9o4o # N\N- w ‘'n-+- S LJzez1 UL tank #: Substance last stored: 2 Date of expiration: of Officer granting permit: vcrn noIr nuAI 0 Lt.- 7 45 19 `J-/ Iz ih� AC APPI irArInN AND ISSUE DUPLICATE AS PERMIT POWER BURNERS FORM 24 Date March l ,1977 Pastor, St. James Rectory Name Location 161 Federal St. Name of Burner 2000 Gals. Stored U.S. Carlin Location of Tank Underground Installed by Thomas J. Cote Inspected by D .0 . Sosnowski Date July 3 1963 Name Location No. of Tanks 1 Mass. Approval No. 1213 Kind of Heat Hot Water Kind of Oil #2 C. of C. # 17857 Date Approved 3-11-77 POWER BURNERS Hgg St . James Rectory 16I Federal St 4-/�419c4-z5 // n3//''5> Name of Burner Kind of Heat Gals. Stored 2,000 Steam Cap. of Tank2000 Location of Tank Out side undergroun!ind of Oil #2 Installed by Bursaw 0i1 '(-3-b3 (Tank) Inspected IO-5'3 .. (Burner) Gals. Approved 7-3-63 ( Tank) Page No. 13 03/07/2005 Address 434 ESSEX STREET 50 ESSEX STREET 11 FAIRFIELD STREET 3 FAIRFIELD STREET 10 FAIRMOUNT STREET 17 FAIRVIEW ROAD 27 FAIRVIEW ROAD 6 FAIRVIEW ROAD 138 FEDERAL STREET 140 FEDERAL STREET 156 FEDERAL STREET 159 FEDERAL STREET I* 161 FEDERAL STREET 18 FEDERAL STREET 183R FEDERAL STREET 56 FEDERAL STREET 63 FEDERAL STREET 2 FELT STREET 45 FELT STREET 9 FELT STREET FELT STREET WAY 72 FLINT STREET 11 FORRESTER STREET 24 FORT AVENUE Salem Fire Departme Fire Prevention Bur Underground Tank Remo Business Name Size of Type Tank Tank CREEDON'S GARAGE CITY OF SALEM GAUDREAULT RESIDENCE JAMES LYNCH SANDRA CAHILL MRS. RITA VOYER - BEKERITTS MR. GIANELLI PEABODY ESSEX MUSEUM RESIDENTIAL (JERRY MARIO) ST. JAMES CHURCH JIM HENDERSON ST. JAMES RECTORY/ABANDONED TANK MRS. CONRAD MARK PELLEGRINI FIRST BAPTIST CHURCH MR. SERAFINI MR.RAKOC ELLEN QUINN MR GUINTA FRANCIS GRAY SALEM SUEDE INC. PHILIP BURNHAM NEW ENGLAND POWER 3000 S 10000 S 1000 S 1000 S 50 S 2000 S 1000 S 1000 S 2000 S 1000 S 5000 S 1000 S 2500 S 500 S 500 S 5000 S 1000 S 275 S 500 S 275 S 1000 S 10000 S 275 S 5000 S POWER BURNERS Egg Date July 3 1963 Name St ,_ja nes Rectory Location 161 Federal St Name of Burner Kind of Heat G r t & 8.- Gals. Stored 2,000 Steam Cap. of Tank2000 Gals. Location of Tank Outs ide undergrOUfPmd of Oil #2 Installed by Bursaw Oil '(-3-63 (Tank) Inspected 10-5-3. (Burner) Approved 7-3-63 (Tank) FORM 24 POWER BURNERS Date March i 977 Name Pastor, St. James Rectory Location 161 Federal St . Name of Burner U.8. Carlin Gals. Stored 2000 Location of Tank Underground Installed by Thomas J. Cote Inspected by D .0 . Sosnowski No. of Tanks 1 Mass. Approval No. 1213 Kind of Heat Hot Water Kind of Oil #2 C. of C. # 17857 Date Approved 3-11-77 .f;12 nrx C71°10 (2_ -6 -3e_,;kvA 44111-, ILE CO Make application to local Fire Department. Fire Department retains original application and Issues duplicate as Permit. Veyinrovorietweizea, cia/tez/Joackuzela APPLICATION nd PERMIT IF., : ivo cot for § ca« g,,t4.i;.nit removal and transportation to approved tank disposal yard ir.accordance with the provisions tglaikO1 ter 148, Section 88A, 527 OAR 9.00, applicatiory is hereby r€ acte by: cif ytHq yyocf- X Tank OwnermeName (please print) 7"; c%, 1- Addreae . 14, /� cd P- J1 Ci. / V!- spser /re a_ 06, CompanwNerrie:...o.rn rn tan W r 4: /A4 i Ic n>I .T-,: c. Co. or Individual phil Address ' //le 4e.> LCe,.%..,-2 �Ssl. 6G-loz,e4- 24-c /..L. Address Pmr Prix ' Siarrattira ('if§ p i 1 .for permit) 441 .4a " ' 2%ci0 Signature {it applying for perrnti) O ff t Oartifred other > CI Certified ❑ LSP # Other 5grigtot d asarnp kW Rerr.+el /h1et, S+S storm zi anion • Tank Loifa'1tbYi Prig /to . .1 .' 4. / (s is iJ ./gym �tx ss Inca Sn�at.s�Y Tank Cepaoityf.(941l0i9s). /- e 9.. //.. n Substance Last Stored c / /oct' Tank Dimensions (diameter x length) /- ci a. r/ta /1 -.IS'% Remarks: Shall measure for presence of contaminants. All documentation shall be forwarded to this office, i.e. any copies of remediation. 'i1,�+(esFi3 • FrrifrY`rarrapdfii ' re r om m e, 44, r / ii 094 � 4C State Lie. # a o Hazardous waste manifest# Approved tank disposal yard dYPe of inert gas City or-Ttiiwn PINY) Date of issue Dig sale approval number. „ ra„�j c9Jm 45/ Signature / Tne of Officer granting permit E.P.A.# /e al c9,30..1 t, tTd,..,: Tank yard # pa of Tank yard address Co .27.4 e / 6; ' Q / lff y..1 i1 FDID# ro JS Permit# Date of expiration 7i 1110 Dig Safe Toil Free Tel. Number • 800-322-4844 1 After rernoval(s) send Form FP-290R signed by Local Fire Dept. to UST Regulatory Compliance Unit, One Ashburton Place, Room 1310, Boston, MA 02108-1616. •d 80SS-1,2 •- t . A-' '(r ,f) ONI `NNE-11 H L 1H f'IfJOWWO:'l s?/. T : I t /.n n 'any Form 24 Date Name Location Power Burners august 18,1981 Health & Education 162 Federal St No. of Tanks 1 Name of Burner Beckett Mass. Approval No. 969 Gals. Stored 1,000 Kind of Heat Steam Location of Tank TTnderground Kind of Oil `-2 Installed by malnadge Gallagher C. of C. # 018515 Inspected by R .Bansreau Date Approved 08-18-u1 Form 24 Power Burners Date august 16,1961 Name , or t Shore E ental Health Ser . Inc . Location 162 Federal St No. of Tanks Name of Burner Sun -Ray Mass. Approval No. 988 F.H.W. Gals. Stored 1,000 Underground Location of Tank Installed by Richard Bilo Inspected by R .Dansreau Kind of Heat Kind of Oil C.ofC.# 1 ,, 2 18490 Date Approved 08-18-81 POWER BURNERS Date December 2n , 19(5, Name t ® Jam= s S cb.00l Location 14,0 Federal Street Name of Burner ?e t ro 111 Kind of Heat St e a? Gals. Stored '' y Unit 1:1 Cap. of Tank -Gals. Location of Tank0utS_de ��n er rou,I ind of Oil Installed by Inspected pe rti FORM 24 Date Name :".esnowski. Approved 12/20/65 POWER BURNERS February 28,1980 St James School Location 16o Federal St No. of Tanks 1 Name of Burner U.S .Ca rlin Mass. Approval No. 1213 Gals. Stored 10, 000 Kind of Heat Steam Location of Tank Basement Kind of Oil #2 Installed by Paul J Lyons C. of C. # 016038 Inspected by R .Dansreau 02-27-80 Date Approved FORM 24 POWER BURNERS Date November 17,1978 Name. Saint James Roman Catholic ,tC W, Location 152 Federal St No. of Tanks 1 Name of Burner U.S.Carlin Mass. Approval No. 1213 Gals. Stored 5,000 Kind of Heat Steam Location of Tank Underground Kind of Oil #2 Installed by Charles W Doyle C. of C. #09.315 Inspected by insp. R.Dansreau Date Approved 11-17-78 Form 24 Date Power Burners NnvPmhtr 22. 19R; Name St. James Roman Catholic Church Location 152 Federal Street Name of Burner Carlin Gals. Stored 5,000 Location of Tank Underground Installed by Bursaw Oil Corp. Inspected by D.C. Goggin No. of Tanks 1 Mass. Approval No. 1213 Kind of Heat Steam Kind of Oil #2 C. of C. # 9315 Date Approved 11.22.85 , FORM F.P. 292 ,(rev. 9/90) The Ulmunumwculill of l9fagBurltuseits Department of Public Safety Division of Fire Prevention and Regulation APPLICATION FOR PERMIT, AND PERMIT, FOR REMOVAL AND TRANSPORTATION TO APPROVED TANK YARD FDID# OR2_S8 Permit # a0 1 Date 112 1944 City, Tbwn or District C. 8 2 S.40 N.G.L. #4,700.2 Fee Paid:S 2*3 �_ DIG SAFE NUMBER 94 Go S45S start date A2,\EV 4 In accordance with the provisions of Chapter 148, Sec. 38A, M.G.L., 527 CHR 9.00 application is hereby made by: C-10LossG„c�LG,A VAAAG-E.wm,.vr, w q. Street Address & City or Town: -1-PN'ik,u� 5(.1k9'Z2-E9150 Signature of applicant: Applicants name printed: Y163 Ckuvb3e.. , 10sd: For permission to remove and transport one underground storage tank from. owner: Street Address: 156 5— Firm transporting waste: l S Cs .. Cu State Lic.1 VAA 52 Hazardous waste manifest # Wisork 833\O E.P.A. # '08-14-S7cio6o Approved tank yard: ,i o\ C. \--bomIRk . # 14.901 Tank yard Address: 2 01 VIAN Type of inert gas: UL tank #: Tank capacity: SPo u Substance last stored: Z o` Date of issue: 7/ . 19 94P Date of expiration: %/i.— 19 5( Signature/Title of Officer granting permit: A/ri„ti c � sic= noir_wet AR GPPI.irATIr3iJ AND ISSUE DUPLICATE AS PERMIT alla _ F FUEL OIL AND FUEL OIL BURNING EQUIPMENT accordance with provis►ons of Chapter 148, G.L:, and Regulations made under authority thereo S.t. Jamei acr ° Name Pahl , J LYoh Ol:b0. Suite No Address (Owner or Occupant) all "� ferso OR,A Type of Ta Capacity. `? :.....'..."".�1. Y. i;o` ::::.........:.::......:..:..:....:Location. . :::;'. ' Kind of hea Type of fuel 43E CONSPICUOUSLY PO is Permit will expire on change o of/+ire' HE PRE$I DATW'SI • ntto 502 CMIRUG: Fii:FP 291 ,_A'aaLd 110 ud / (69cvnvozanwea, ateziciaduaeat Doeuraceet o 70:€ £e djice ae 7ege2/ta/m441 •RECEIFTDETIMP9SALpf UNDERGROUND STEEI,ATQRAGE TANK NAM., .:E-AND ADD Aga.. OF APPROVED , . • .-1'.'-',.277.6tnt:V.itz4.,-. ' • , . e. . • • •.; , APP..139VEPLTANK4,9NRqN0,.-,... I certily nder Name:a PerlaitYv.f toy: it@ .„... -..---•:-TS4W4raledger:5° 2 cmli-3;030).0,01)-er; • ,s, .ve7,perepnally-eiarriined 0470i:di • underground steel itOrage tank•detivered.to this 'approved tank yard". by firm, corporation or , tedtptesidtaMeiliii Tee' - ChtisettsFfireiR6VehtiOn3Elegulation 502 c.....,1„..,---7 - ----z: . • - -,- '-,,w7-2405egf.,,:..sVp.t -,. • • , ''• n .1- 1 rid ir Steeil-Stoii ' ankilit - '..... 0.tag,ke,00,444iyAfoR.Ot0#1#Rimt tlyi,kpp_40A04ritppfme.m.,, 4 - 16,.-etittiis .;;... -iter0-: -,7-i.-,4, .. ' 4- 4-"Q';-17:5:--: --,t..-•'&- , _...7,J..14;21: . '':-,--f4:: ''', ,:,,4,t,-„,,,,, `9,,,:&?;, rd RN* of.i'gwriers40tiforiVed representative • .4;--....t. ..,,,:.,....,z,.....,;._. , .. . tftie EACH TANK MUST HAVE A RECEIPT OF DISPOSAL tr ,r-ir//irv- (-//rr.r. r/ ,/ -re //rr r eVi-/i7 - //r-_,'(7j ,-)A)e/r//re/e, irrc 7//ri/ Notification for Removal or Closure of In Place Storage Tanks Regulated Under 527 CMR 9.09 Forward completed form, signed by local fire department, to: Mass. UST Compliance Unit, Dept. of Fire Services, P.O. Box 1025 - State Road, Stow, MA 01775 Telephone (978) 567-3710 (Fire Department retains one copy of FP-290R) This form is to be used for notification for removal of Underground Storage Tanks/ Piping. If a storage facility has UST's which are to remain in use, an entire amended FP-290 (long form) must be filed. Note: "Facility street address" must include both a street number and a street name. Post office box numbers are not acceptable, and will cause a registration to be returned. If geographic location of facility is not provided, please indicate distance and direction from closest intersection, e.g., (facility at 199 North Street is located) 400 yards southeast of Commons Road (intersection). 1. OWNERSHIP OF TANK(S) Owner Name (Corporation, Individual, Public Agency, or Other Entity) P 1 eC.Z -1 1 L ''S Sireel Address "Bi?tfe_tfi4,i C,ly County Slate 0 i (ZIp C ode Phone Number (Include Area Code) Owner's Employer Federal 10 a Date Received: 10 t O Fire Dept. ID# Fire Dept. Sig. bit A. Facility Number B. Date Entered C. Clerk's Initials D. Comments 11. LOCATION OF TANK(S) If known, give the geographic location of tanks by degrees. minutes, an< seconds. Example: Lat 42, 36, 12 N Long. 85, 24, 17W Latitude Longitude 0 stance and direction from closes! intersection (see note above) r� li/l Eci6ix,colity3 a,..if S. Facdy Name or Company Sue idenf,her. as applicable City County M. TANKS/PIPING REMOVED OR FILLED IN PLACE Tank Number 1. Tank/Piping removed or filled in place (mark all that apply) A. Substance last stored B. Tank capacity gallons C. Estimated date last used (mo./day/yr.) State Tank No. / Tank No. Tank No. Tank No. / 06'C09 cI07 0 i r'l '%or' Z.p Code Tank No. D. Estimated date of removal (mo./day/yr.) Si 07 E. Tank was removed from ground .F. Tank was not removed from ground Tank was filled with inert material Describe material used: I "es I I — I i I I I I I I I I I G. Piping was removed from ground H. Piping was not removed from ground "Other, please specify FP•290R (revised 5/98)-- 1 I 1 I I I I ! 1 I I I I I I 0\ dccoraance with 527 CMR 9.00 es No • Yes No Yes No Yes No w. Yes t 'A. Evidence of leak detected No Yes • No Yes No Yes No Yes 'IVr BB Mass. DEP notified No ' Yes No Yes No Yes No Yes I` 1. Mass. DEP tracking number 3 - '70 23 2- Agency or company performing f' contamination assessment' �' Opa "' t' " *527 CMR 9.07 (J), see "Commonwealth of Massachusetts, Underground Storage Tank Closure Assessment Manual" April 9, 1996 DEP Policy ItWSC-402-96 I declare under penalty of perjury that i have personally examined and am familiar with the information submitted in this an all attached documents, and that based on my inquiry of those individuals immediately responsible for obtaining the inform tion, I believe that the submitted information is true, accurate, and complete. 9 A Name and official title of owner or owner's Signature: Date: authorized representative (Print) FP-290R (revised 5/98)