HomeMy WebLinkAbout0395 BARNSTABLE ROAD - Health 395 .BARN S
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Town 61 lsaarnstme
Regulatory Services
Thomas F. Geiler,Director D '(6 �'
'^ Public Health Division I
Thomas McKean,Director ate 6I3010(a
200 Main Street, Hyannis,MA 02601
Office: )08-862-4644 Fax: 508-790-6304
Appllcatlon Fee: $100,00
ASSESSORS MAP AND PARCEL NO. DATE 05 1/D(
AU LICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT •E . Autu V m Co., I nr,
NAME OF ESTABLISHMENT kibuchon. Na Uar , 157
ADDRESS OF ESTABLISHMENT 2'�15 ►'J`���t Y1�115�'v Wes'
TELEPHONE NUMBER
z�
SOLE OWNER: YES NO 1
IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF A,LLu'i
PARTNERS; ° v,
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 024- 050290
STATE OF INCORPORATION
FULL NAME AND HOME ADDRESS OF:
PRESIDENT 73
TREAS C;RE 1
CLERK c- d uni a
CEO
SI(�NATUAE ',1pLIC.�lY
RESTRICTIONS; - HOME ADDRESS o5 ernam^Rdna 015�()
HOME TELEPHONE•#C 110-Z 6 i �p
Haz.da W'wp:;
NV GV:L£'.8 900Z/l U9:a1ea £/£ :96ed 06L9 06L 909:WOJJ
Number Fee
353 THE COMMONWEALTH OF MASSACHUSETTS $loo.00
Town of Barnstable
Board of Health
This is to Certify that Aubuchon Haidwar*e ':
395 Barnstable-Road, MA .02601
Is Hereby Gianted.a License
FOR: STORING OR HANDLING 111 GALLONS--OR MORE OF HAZARDOUS MATERIALS.
---------------------- ---------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------- -------------- -----------------------------------------------------------------------------
This license.is granted in conformity with the Statutes and ordinances relating there to, and
and expires . June 30, 2007 unless sooner suspended or revoked.
----------------------------------------
WAYNE MILLER,M.D.,CHAIRMAN
SUMNER KAUFMAN,M.S.P.H.
May 30, 2006 PAUL J. CANNIFF,D.M.D.
THOMAS A.MCKEAN,R.S.,CHO
Director of Public Health
W. E.AUBUCHON CO., INC.
WESTMINSTER,MA 01473
DESCRIPTION INVOICE INVOICE AMOUNT DISCOUNT/FREIGHT NET AMOUNT
DATE NUMBER
HAZARDOUS PERMIT/HYANNIS May 11,2006 060511 100.00 .00 $.00 $100.00
__ ..._ _..._ . ........ ...... _ .. . ..................... __ ... ......... .....
Z,A,\
1
Total: $100.00
724 DETACH BEFORE DEPOSITING NO ACKNOWLEDGEMENT NECESSARY 588481
1
TOWN OF BARNSTABLE Date: $/ZLy/ Oc/
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
lio-�1 j4aa
NAME OF BUSINESS: ,Astl_famAa do a,
BUSINESS LOCATION: 3 9S Glit,{-1 54a-lb( e- 0-ad, a47-fti INVENTORY
MAILING ADDRESS: TOTAL AMOUNT:
TELEPHONE NUMBER: 5_09 - -7-75 - 00 2 5- Z• SZO qa l,/ar�5
CONTACT PERSON: 6;N ea,04U�lt (S ha.w�_ �h.�r►a s .c.
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: / 4aAot4ya,,e Pam-- 60�.)
INFORMATION/RECOMMENDATIONS: ranii Pny Fire District:
5 L2..yLYL(is�
E v
Waste Transportation: Al A Last shipment of hazardous waste:
Name of Hauler- Destination:
Waste Product: Wade Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use,
storage and disposal of 111 gallons or more a month requires a license from the Public Health Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS (Q-1 eazA `n' 30 A s .
The Board of Health and the Public Health Division have determined that the following products exhibit toxic
or hazardous characteristics and must be registered regardless of volume.
Observed/Maximum Observed/Maximum
Antifreeze (for gasoline or coolant systems) Misc. Corrosive
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils d Pesticides
/S. :57 NEW USED (insecticides, herbicides, rodenticides)
G line, Jet fuel, Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil NEW USED
3 Misc. petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil NEW USED
I
Degreasers for engines and metal Printing ink
Degreasers for driveways & garages Wood preservatives (creosote)
Caulk/Grout Swimming pool chlorine
Battery acid (electrolyte)/Batteries Lye or caustic soda
Rustproofers Misc. Combustible
Car wash detergents Leather dyes
Car waxes and polishes �`�� Fertilizers
Asphalt & roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
-6aegter-thinners (inc. carbon tetrachloride)
NEW USED Any other products with "poison" labels
Pairs#-&varnish removers, deglossers (including chloroform, formaldehyde,
S Misc. Flammables hydrochloric acid, other acids)
Floor &furniture strippers Other products not listed which you feel
Metal polishes may be toxic or hazardous (please list):
a Laundry soil & stain removers e,
(including bleach)
Spot removers &cleaning fluidsi1GG?i1'.cx�.�-/ `1 5 �2P
(dry cleaners)
Other cleaning solvents Z3
Bug and tar removersiy��t ,� �-Y' r�-
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
TOWN OF BARNSTABLE MPLIANCE: CLASS: 1.Marine,Gas State ns,Re air
satisfactory 2.Printers /l
BOARD OF HEALTH 3.Auto Body Shops v
O unsatisfactory- 4.Manufacturers
COMPANY AU/;7U� G ,z/ /� (see"Orders") 5.Retail Stores
�� 6.Fuel Suppliers
ADDRESV / <-, F lass: 7.Miscellaneous
QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors)
MAJOR MA'TERIALS Underground
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Heavy Oils:
waste motor oil (C) x
new motor oil(C) '
transmissioonn/hydraulic_�;?
Synthetic Organics:
degreasers
s
� 3s
Miscellaneous:
VL�
� _ �v
DISPOSALIRECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply - 3
O Town Sewer W, ublic
l'On-site OPrivate
3. Indoor Floor Drains YES NOT--/
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES_�ZNO O S: _
O Holding tank:MDC Xv� L ,
atch basin/Dry well
O On-site system
5. Waste Transporter
Name of Hauler Destination Waste Product
1. iY6�
2.
—� Person (s) Interviewed Inspector Date
/,S'7 cRr1 t-A 1 i Y' S e/' C r C%cl` r 02S'
TOWN OF BARNSTABLE OMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH satisfactory g.Printers
o y Shops
O unsatisfactory- 4.Manufacturers
COMPANY (see"Orders") 5.Retail Stores
f,046.Fuel Suppliers
ADDRESS lass: 7.Miscellaneous
QUANTI IES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MXIPIMIALS Case lots Drums
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel(A)
Synthetic Organics:
degreasers
Miscellaneous:
1!� 9, 94
.zi loa4.z
DISPOSALARECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply
O Town Sewer OPublic
O On-site OPrivate
3. Indoor Floor Drains YES NO
LL
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
1. ..
2.
Person(s) Interviewed Inspector Date
Lair 041�.-ipru ct o t . Co, W e /. /9 -
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEnters
ALTH O satisfactory 2.3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY�J _ (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS � C18SS: 7.Miscellaneous
/ L_1.fJ QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underp-ound Tanks
IN OUT IN OUT IN OUT #&gallons 717T Test
Fuels:
Gasoline Jet Fuel(A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil(C)
tf1121 u-ai.ow 101
�C
new motor oil(C) �(
jy
transmission/hydraulic
Synthetic Organics:
degreasers
,W ?
/- one aC
Btexe-1,
h.owui— Id 2 x
Miscellaneous:
x
vvsr St,A. - ! X
`�'�•{ire- � � �_ k ��/
j, X
DISPOSAUR CLAMATION REMARKS: _ � �� /6s .qV
1. Sanitary Sewage 2.Water Supply r'h�t - o z
Mtn
2
own Sewer ' f-
O On-site OPrivate Oa. 1,a4W_r l6l / �S �9 �
y
3. Indoor Floor Drains YES N0 Z 7 �s
O Holding tank: MDC
O Catch basin/Dry well &4446a2 o r� a
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC S'
O Catch basin/Dry well
O On-site system
5. Waste Transporter
Name of Hauler Destination Waste Product
YES NO
1.
2.
Person(sl Interviewed Inspector Date
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
/�, unsatisfactory- 4.Manufacturers
COMPANYAbV� �� (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS • C9 Glass: 7.Miscellaneous
4---`6 QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground
IN OUT IN OUTI IN OUT #&gallons Age Test
F, l'ZS dC
Gasoli Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
S�
new motor oil(C) G S
cr. 1 10
transmission/hydraulic L
Synthetic Organics:
degreasers
i
I
Miscell neous:
ID
� 11 ►ti.��d� cn-� I l-e�i�.�
DISPOSAL(RE(:LAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply m msbf 1.cv4V W der? "o,
Town Sewer 'ublic 6 o �flo i �! C/ �"�,; g'�i�i I- f.
O On-site OPrivate
U GA.-.r o/e o% e- e_%�ev11- 120 44-'
r-1 o4
3. Indoor Floor Drains YES N0_A_
O Holding tank:MDC �/ �64�. S °' �d fk✓/4
G3 •�J ,
O Catch basin/Dry well 6- � G/.Pa L*ce . Zlo bias 4L
O On-site system ygad uo�e -'.4"
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC Lcew 44 J 0-f rerl Q- vc d
O Catch basin/Dry well
fKon-site system
5.Waste Transporter
Narne of Hauler Destination Waste Product
YES NO
1.
i 2.
UL J
(� Person (s) Interviewed Inspe or 'Date
r
Town of Barnstable , -I
�IHE Regulatory Services 1
Thomas F. Geiler,Director
B^MSr& ' Public Health Division
1
9� 163
Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-8624644 Fax: 508-790-6304
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. 10603-116 6867 DATE 9/23/04
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT W. E. Aubuchon Co. , Inc.
NAME OF ESTABLISHMENT Aubuchon Hardware Co.
ADDRESS OF ESTABLISHMENT 395 Barnstable Road, Hyannis, MA 01160 r-
! �' r
TELEPHONE NUMBER 508 775-0025
SOLE OWNER: YES X NO -70 yJ
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF A L' co
PARTNERS: un rn
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 04 1050290
STATE OF INCORPORATION ' Massachusetts
FULL NAME AND HOME ADDRESS OF:
PRESIDENT M41Flarcus.Mdran�h3r,:f`" °
TREASURER M. Marcus Moran, Jr.
CLERK Gregory J. Moran
GNATURE OF APPLICANT
RESTRICTIONS: HOME ADDRESS 95 Aubuchon Dr ,
(Nd HVE) 015lac HOME TELEPHONE.# (978) 874-0521
az.d /wp/q llj7
671 9 DCf)
MAIL-IN REQUESTS
Please mail the completed application form to the address below. Also include a copy of your;
contingency plan (to handle hazardous waste spills, etc). +In addition, please include the required fee
of$100. Make check payable to: Town of Barnstable. Allow five to seven (7)working days for in-
house processing. Our mailing address is:
Town of Barnstable
Public Health Division
° 200 Main Street
Hyannis,MA 02601
FOR FAXED REQUESTS
Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a
copy of your contingency plan (to handle hazardous waste spills, etc). iln addition, please mail the
required fee amount of$100.00. Please make the check payable to: Town of Barnstable. The check
must be mailed to the address listed above. Allow up to four days for in-house processing.
For further assistance on any item above,call (508) 862-4644
I
i
11
Number Fee
353 THE COMMONWEALTH OF MASSACHUSETTS $loo.00
Town of Barnstable
Board of Health
This is to Certify that Auchbuchon Hardware
395 Barnstable Road, MA 02601
Is Hereby Granted a License
FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS.
----------------------------------------------- -------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and
and expires June 30, 2005 unless sooner suspended or revoked.
----------------------------------------
SUSAN G.RASK,R.S.
WAYNE MILLER,M.D.,CHAIRMAN
October 4, 2004 SUMNER KAUFMAN,M.S.P.H.
THOMAS A MCKEAN,R.S.,CHO
Director of Public Health
i
Date: $/7-'1/Oy
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: c—.1 L 4 T7Glidill ar.�
BUSINESS LOCATION: 3 96 6a t*1 a-k4,lb I; e- pj oad, �a.lJfU.5INVENTORY
/
MAILING ADDRESS: TOTAL_AMOUNT-
TELEPHONE NUMBER: 6_09 — -7-75 " 00 2--5- �15 ZU C-AerwanS,
CONTACT PERSON: �i( < e�� '�'� (S kalyU - T1'110"Cl s,
EMERGENCY CONTACT EPH�U BER: MSDS ON SITE?
TYPE OF BUSINESS: MM4� L,e.
INFORMATION/RECOMMENDATIONS• lea-" ewV Fire Pi strict:
cave w s e e a.0 /
�. �i►i�h�c -�'I-�,i s Lt.
�'i P',. Ver
Waste Transportation: N Last shipment of hazardous waste: AJId
Name of Hauler- Destination:
Waste Product: ScrLiG( wade Licensed? .Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use,
storage and disposal of 111 gallons or more a month requires a license from the Public Health_Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS ea��'.
The Board of Health and the Public Health Division have determined that the following products exhibit toxic
or hazardous characteristics and must be registered regardless of volume.
Observed/Maximum Observed/Maximum
Antifreeze (for gasoline or coolant systems) Misc. Corrosive
tyEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes. Road Salts (Halite)
/ Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils q Pesticides
EW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel, Aviation as Photochemi 9 Gals (Fixers)
Diesel Fuel, kerosene, #2 heating oil NEW USED
23AMY Misc. petroleum products: grease, Photochemicals (Developer)
i lubricants, gear oil NEW —USED-
Degreasers for engines and metal Printing ink
Degreasers for driveways & garages Wood preservatives (creosote)
Caulk/Crout Swimming pool chlorine
Battery acid (electrolyte)/Batteries Lye or caustic soda
Rustproofers 2'Rr1 4dMisc. Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt & roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
V/ ` -tm-gZrMhinners (inc. carbon tetrachloride)
8 N W USED �5 Any other products with "poison labels
Pai varnish removers, deglossers (including chloroform, formaldehyde,
�S3' Misc. Flammables hydrochloric acid, other acids)
Floor&furniture strippers Other products not listed which you feel
Metal polishes may be toxic or hazardous (please list):
LLL Laundry soil &.stain removers C• d cYi{
(including bleach)
5917
Spot removers &cleaning fluids 257 at iW
(dry cleaners)
-; Other cleaning solventstl�
Bug and tar.removers 3S
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
i
Hazardous Materials On-Site InventorylInspection 2i> Z,�C)
For ALL Shops and Businesses in the Town of Barnstable
Ln• �� Date:
Ci
Physical Features to Inspect:
Hazardous waste generation sites (production/manufacturing areasL_,
/N o
Waste storage areas: y 5 --
o .
Satellite accumulation points throughout:
N
b .
HazMat stored outdoors — CHECK OUTSIDE:
i
Shipping and receiving areas:
Run down of shop activities:
Housekeeping practices: /
c/
k
• r'
1 `
HazMat On-Site Inventory/Inspection:
Records to Review for SQGs and CESQGs
DBA:
Location:
Site visit date: a 4f
• Hazardous Waste
Manifests: '- o
• Employee training documentation (if required):
• Hazardous substance spill control and contingency plan:
t,,e4,,A- o_Yte4--
• . MSDS on site? ,
• . HazMat Inventory records (if applicable):
• HazMat Waste Shipping documentation:
• Spill records (if applicable): / Vo
Town of Barnstable-Health Department Page 1
HAZARDOUS MATERIALS INVENTORY SITE VISITS
DBA: Aubuchon Hardware Fax: +
Corp Name: Mailing Address E
Location: 395 Barnstable Road,Hyannis Street: 395 Barnstable Rd.
_................._..,..._. .._ .... -....... .
mappar: !— City: Hyannis
Contact: I r,�1%J't-e '1�� State: Ma
Telephone: ——] 7�:_ Bid S Zip: 02601'
Emergency: Person Interviewed: �`I/ CcQ,S�t,,��,
Business Contact Letter Date: 8/13/2004
Category: i Miscellaneous Inventory Site Visit Date: ---8t19h2A04r_ �{_"a Aa49 `L�-t
Type: ;Retail Follow Up/Inspection Date:
J public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license required
❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed
d❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir --- -- - ---
`/2� El on-sitesewage Elindoor on-site syste Eloutdoor onsite system date:
J 2 REMARKS: 5/20/98- o MSDS-hooked into computer&distributing compliance:
office-MSDS is faxed within 5 minutes_ No waste oil received.Repairs Satisf et ry
sent to Sandwich Aubuchon Store. No bulk storage gas heat. Retail
area clean. No waste prod iced_that requires
manifesting. ORDERS: Keep
MSDS file at site for all products. ORDERS: 1999-Needs a
container for waste motor oil.
cap _ 9 _ o y
i
Page 2 ,.
3 �
/V
Town of Barnstable-Health Department
HAZARDOUS MATERIALS INVENTORY
Chemicals: ❑ Zero Toxic Waste Materials _
❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals Y1
❑ gty's 111 gals or more t ,�
l 1-4
aste Transporter: Fire District: Hyannis
I st HW Shipm nt D e: Waste Hauler Licensed: No
13
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