HomeMy WebLinkAbout0800 BEARSE'S WAY - Health (3) 800 B_earses Way
Hyannis
A= 294-061-OEH
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l
Certified Mail#7015 1730 0001 4987 7435
Town of Barnstable
R^MAS& Regulatory Services
1639.
alFD MA'S A r
Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
May 23, 2018
William Baldic
24 Wyndlea Circle.
East Falmouth, MA 02536 ,
_NOTICE TO ABATE VIOLATIONS OF.105 CMR 410.000, STATE SANITARY
CODE II-MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
The property owned by you located at 800 (3WA) Bearses's Way Hyannis, MA was
inspected on Ma 22, 2018 b Timothy O'Connell, R.S. Health Inspectors for the Town
p Y Y Y � p .
of Barnstable. This inspection was conducted on the basis of a complaint.
The following violation(s) of the State Sanitary Code were observed:
105 CMR 410.190-Hot Water. Hot water temperature measured at 80 F.
You are directed to correct the violations listed above within twenty four (24) hours
by restoring hot water so it meets minimum standards of 110 F- 130 F.
You may request a hearing before the Board of Health if written petition requesting same
is received within ten (10) days after the date the order is served. Non-compliance will
result in a fine of$100.,00 per violation. Each day's failure to comply with an order shall
constitute a separate violation.
PER ORDER OF T BOARD OF HEALTH
Tho as 4A. McKean, R.S., CHO
Director of Public Health
Town of Barnstable
QAOrder letters\Housing violations\Rental ordinance\5-23-18.doe
TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION
Date �' � Time: In Out
Owner Tenant
�--
Address .�V Address
Compliance Remarks or
Regulation# Yes NO Recommendations
2. Kitchen Facilities
3. Bathroom Facilities
4. Water Supply
5. Hot Water Facilities
6. Heating Facilities
7. Lighting and Electrical Facilities
8. Ventilation
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use
12. Exits
13. Installation and Maintenance of Structural
Elements
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal
17.Temporary Housing
18. Driveway Width
19. Number of Tenants Observed
PART II
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
Number of Bedrooms Number of Vehicles owed (max)
Number of Persons Allowed max
Person(s)Interviewed Inspector
If Public Building such as Store or Hotel/Motel specify here
M TOWN OF BARNSTABLE
BOARD OF HEALTH
ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION
r
Date A Time: In Out
Ownerv -' Tenant
Address Address
Compliance Remarks or
Regulation# Yes � NO Recommendations
2. Kitchen Facilities
3. Bathroom Facilities t/ / n -
4. Water Supply '' "`
`! 4
5. Hot Water Facilities ) �` +
r
6. Heating Facilities
7. Lighting and Electrical Facilities `
8.Ventilation
9. Installation and Maintenance of Facilities
10. Curtailment of Service
11. Space and Use V
12. Exits V
13. Installation and Maintenance of Structural
Elements
14. Insects and Rodents V
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal
17.Temporary Housing
18. Driveway Width #
19. Number-of-Tenants Observed-,,
r�
PAR3T,1.1.
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
Number of Bedrooms Number of Vehicles Allowed (max)
Number of Persons Allowed (max)
Person(s) Interviewed Inspector .-
j If Public Buildingsuch as Store,or Hotel/Motel specify here
rr
pie,
7 ' ��ig
Citizen Web Request Page 1 of 2
RRV
! r OanM SS,
4 .
T N\oconnelt Citizen Request Management Tuesday,May 2Z2018
Route to Users Search Requests Create Requests
Request Information
Request ID: 59505 Created: '5/21/2018 10:30:36 AM
Status: Assigned To Staff .Assigned To: O'Connell,Timothy
Health Office
Anonymous: No Request Category: Chapter II ' Housing
Substandard edit
Routine work: No Estimate: No edit
Date scheduled: edit
Estimated 6/4/2018 Change Estimated June 2018 Jul
Completion - Completion Date:
Date: Sun Mon Tue Wed Thu Fri Sat
27 28 29 30 31 1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
Al25 1 26 27 28 29 30
1 2 3 4 5 6 7
Created By: Soto, Kathryn Priority: Medium. edit
Health Office w.
Citation Numbers: edit
Requestor Information
Requestor
Request Parcel Map: 294 ��Block: 061 - �� Lot: OBY �
Tenant reports they have Number
not had hot water in a week
and the toilet seal is leaking.. - Parcel Lookup
Email:
Edit Requestor Information
Track Request Progress
Request Work History: Internal Note History:
Entered on 5/21/2018 3:19:00 PM
by O'Connell,Timothy
http://issgl2/intemalwrs/WRequest.aspx?ID=59505 5/22/2018
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this format 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St.-, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
DATE: j' ��/� Fill in please:
APPLICANT'S YOUR NAME/S: ;4
16'"�lrHIC` P wfi. �f iktx4l B I INESS YOUR HOME ADDRE S:
�Ty FC
F4 F„� f r(t N uli'du vo -o000 iU/S /� 01
.
_TELEPHONE # , Home Telephone Number
Email Address: i1� L1-_L
EIN'or; '10
a,Fafn.J� tPl�r t��
NAME.OF CORPORATION:`
NAME OF NEW,BUSINESS` : AigAe62 i TYPE OF BUSINESS CleolA&1 f-_,ekzlC�
IS.THIS A HOME..OCCUPATION? LYES NO
ADDRESS OF BUSINESS '' 2 it) MAP/PARCEL NUMBER f 1( ssessing)
IVA C.44Qce
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is•intehded to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth
Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. :
1. BUILDING COMMISSIONER%9 FF E MUST COMPLY WITH HOME OCCUPATION
This individual has been o d of an i requirements that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO
COMPLY RESULT IN FIN S.
utherized Sig to e*
- C TS:
2. BOARD OF HEALTH
This individual has be requirements that pertain to this type of business. MUST COMPLY WITH ALL
HAZARDOUS MATERIALS REGULATIONS.
A4thorized Sig atur / /
COMMENTS: Row- ��C j ��r7fi)CY 1��1�Q' .
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
TOWN OF BARNSTABLE [Date:
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: CSk'Gf C�� �Z�1" ► ��� -U'�CSf
BUSINESS LOCATION: &JO V'4 dA6 INVENTORY
MAILING ADDRESS: f5 'C AEU v'4A- TOTAL AMOUNT—
TELEPHONE NUMBER:
CONTACT PERSON: ,AQL)e -06,l✓o —/ 1!/<�ic- v62 NO
EMERGENCY CONTACT T LEPHONE NUMBER: !�cj " -� ' ; MSDS ON SITE? ?i
TYPE OF BUSINESS: C��' �itJ ,G�ic _ a
INFORMATION / RECOMMENDATI S: Fire District:
Waste Transportation: Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material 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
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) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants mnt'lv C1,41Ur /'ad
Engine and radiator flushes Road salts (Halite)
.Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Photochemicals (Fixers)
Gasoline, Jet fuel,Aviation gas
Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease,
Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED -
Degreasers for engines and metal Printing ink
Degreasers for driveways&garages Wood preservatives (creosote)
Caulk/Grout Swimming pool chlorin_ e
Battery acid (electrolyte)/Batteries Lye or caustic soda
Rustproofers Miscellaneous Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt&roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous(please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers&cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESSCApWi
re Sta s Initials
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates(cost$40.00 for 4 years), A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town,Hall) and get the Business Certificate that is
required by law.
DATE -10 . o Fill in please:
_}te a APPUCANT'S. YOUR NAME/S- ,9!E4 E L /✓O_��C RW
' {� :;t BUSINESS YOUR HOME ADDRESS: b190 S e-S AJP,4 A�
I ' �—
I�lm
�' TELEPHONE # Hdme Telephone Number
/'
cct.i� sr tt. f E-HAILz
NAME OF CORPORATION: C ri C£ CUS )1Z _Sc K UI C6.
NAME OF•NEW BUSINESS TYPE OF BUSINESS Fj /E t jo
IS THIS A HOME OCCUPATION? YES NO
ADDRESS OF BUSINESS.'S� e sES -vim of 6 G Nlu is. M �AP/PARCEL NUMBE � P�� (Assessing)
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist.you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth
Rd. S.Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
'I. BUILDING COM IS ION R'.S OFFICE
This individu i has en i rme a �r qu e ens that pertain to is type of business. MUST COMPLY WITH HOME OCCUPATION
s RULES AND REGULATIONS. FAILURE TO
th a Sign tur ** COMPLY MAY RESULT IN FINES.
COMMENT
L
2. BOARD OF H .LTHI MUST,COMPLY WITH ALL
This individual has tebeen�* med a permit requirements that pertain to this type of business. HRDOU :MATERIALS REGULI±ITIOP+S
Au horized Signature* _
COMMENTS: 2 (, �_
3. CONSUMER AFFAIRS(LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business. '
Authorized Signature**
COMMENTS:
t. -
—, Dated' '/ /0 /Q O 4-
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS:
BUSINESS LOCATION: c �njE E)LSCS ��� �/�/� . P-/-1 21 Y)I INVENTORY
MAILING ADDRESS: 0gx2`(X,_-Q I S �1A . f2 TOTAL AMOUNT.
TI
TELEPHONE NUMBER: -- - (/-e,? _ /qc
CONTACT PERSON: D v E l ;
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: _y / /6 Q-)00
INFORMATION / RECOMMENDATIONS: Fire District:
Waste Transportation:I it�S f.'7 AAAt4f1njSce1R!s Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product- Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material 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
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) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel,Aviation gas
Photochemicals (Fixers)
Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease,
Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED --
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 Miscellaneous Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt& roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
C -
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar"removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS App icant's Signature Staff's Initials
I
Date:Lf I AO l I
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: _ 1. 9,;A . �GuL,-{; _� o�e y l„t�,►��c,n�y.�— ,may
BUSINESS LOCATION: �0'D &V,q6 wa AAg SQL .W6w-L;f Me 060 l INVENTORY
MAILING ADDRESS: god TOTAL AMOUNT, �
TELEPHONE NUMBER: So?
CONTACT PERSON:
EMERGENCY CONTACT TELEPHONE NUMBER: Ste- 36q- XTG MSDS ON SITE?
TYPE OF BUSINESS:
INFORMATION / RECOMMENDATIONS: I wJ1 c,•.,► Fire District:
Waste Transportation: Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material 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
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) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel,Aviation gas
Photochemicals (Fixers)
Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease,
Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED
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 Miscellaneous Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt&roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform,formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
/ Spot removers &cleaning fluids
V (dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Ap licanisliijnWure Staff's Initials
_'- YOU WISH TO OPEN A BUSINESS? �•
For Your Information: Business certificates [c st$40 00 for 4 years). A business certificate ONLY REGISTERS.YDUR NAME in town [which you
must do by M.G.L.-it does not give you permission tera"te.] ou mus first obtain the necessary signatures on this form at 200 Main St:, Hyannis.
Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St.-, Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is
required by law.•.
DATE: Fill in please:
YOUR NAME/S:
APPLICANT'S.
BUSINESS YOUR HOME ADDRESS: G`D 'PIP v,4, '�. aD� L � inwLi� , D?i✓01
sY ti c
TELEPHONE its NE # Home Telephone Number
,rc=JY,?,f11i��L'N'1�.�ta4y�� E—MA IL: a?.✓`2t�
NAME OF CORPORATION:
NAME OF-NEW BUSINESS a r� a�w TYPE OF BUSINESSdar_ —I��, I��� t v� N����f2•
IS THIS A HOME OCCUPATION. _ YES NO Assessin
ADDRESS OF BUSINESS. . c, N V. -l601MAP/PARCEL NUMBER ��I—�� [ 9)
When starting a new business there are several things you.must do in-order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you:may need. You MUST GO TO 200 Main St: (corner of Yarmouth • '
Rd. & Main Street) to make "sure ye.0 have the appropriate permits and licenses required to legally operate your business in his town
1. BUILDING COMMISSIONER'S OFFI E MUST COMPLY WITH,HOME OCCUPATION
This individual has been for e E an4pr t equirements that pertain to this type of businRifLES AND REGULATIONS. FAILURE TO .
COMPLY MAY RESULT IN FINES:
\ C�Ao ed Signatu e*
COMMENTS:
D OF HEALTH M,US� GEfpLY H LL
2. BOAR A
This individual has been info r; tf he permit requirements that pertain to this type of business. ARp �j . RIALS REGULATIONS
Authorized Signature**
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type-of business.
Authorized Signature**
COMMENTS: .
-i Hazardous Materials Inventory Sheet Checklist
Date
Physical Street Address-Check database to ensure it exists
Working Phone Number
Actual Amounts - ( ie. gas being used to fuel machines., thinner to
clean brushes all count as hazardous materials-no blanks)
qStorage Information -location of storage, how long is storage for?
if none, note that.
7 Disposal Information -where and who? If none, note that.
Applicant Signature - understand what is listed and noted
Staff Initial -any questions, know who to ask
Vehicle Washing/Rinsing? -give a vehicle washing policy and
_,.,—explain it
Attach the Business Certificate with your sign off and comments
**The inventory form should explain.what the business consists of and the procedures
thaw nnn inn Nntac naari to he IPft to axnlain what vnu discusseri with them_
JUL a'16P112.0 YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates [cost'$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office, "I st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
,1. ,,� DATE: 7/'s/ j� Fill in please:
a h t¢ its t 1 je/+ S -
.�''�' �� f���� � � APPLICANT'S YOUR NAME S• t-Nrr2�n
�' � `. BUSINESS YOUR HOME ADDRESS: evo firSeS tit/q
TELEPHONE # Home Telephone Number 7?P "'3b3y� SS 3y n 'n
kd . Ij
NAME OF CORPORATION:NAME-OF NEW BUSINESS V.C,f TYPE OF BUSINESS Avg -'hi
IS,THIS A HOME,OCCUPATION? V YES NO /' I
ADDRESS OF BUSINESS �lQo o►rS es S } MAP/PARCEL NUMBER 7 ��I 6C (Assessing)
When starting a new business there are several things you must do in order to be in compliance with the.rules and regulations of the.Town of
Barnstable. This form is intended to assist you,in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth
Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING CQ MISSI NER'S OF ICE `'``
This indivi al b e i r d ype mit requiremen s that pertain to this type of business.M UST COMPLY WITH HOME OCCUPATION
A thoriz Sin e** RULES AND REGULATIONS. FAILURE TO
CpMMENT In �L COMPLY MAY RESULT IN FINES.
2. BOARD OF H LTH
This individual hac info ed o jr m r dire hat-pertain to this type of business.
Authorized i n ure** MUST COMPLY WITH ALLCOMMENTS: H MATERIALS REGULATIONS _
3. CONSUMER AFFAIRS(LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
/ �
TOWN OF BARNSTABLE Date: �-/5 tee
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF'BUSINESS: V •C. cw�etp-f4E
BUSINESS LOCATION: 1?cO 4SO INVENTORY
MAILING ADDRESS: TOTAL AMOUNT:
TELEPHONE NUMBER: 7TI -3iP3 S'S3�f
CONTACT PERSON:
EMERGENCY CONTACT TELEPHONE NUMBER: 7Irl-3b3--Z:?y MSDS ON SITE?
TYPE OF BUSINESS: Drop S�,
INFORMATION t6 Y14� lti ll
Fire District:
Waste Transportation: Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material 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
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 04kserved / Maximum
Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel,Aviation gas
Photochemicals(Fixers)
Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease,
Photochemicals (Developer)
h lubricants, gear oil ❑ NEW ❑ USED -
Degreasers for engines and metal Printing ink
Degreasers for driveways&garages Wood preservatives (creosote)
fCaulk/Grout Swimming pool chlorine
Battery acid (electrolyte)/Batteries Lye or caustic soda
Rustproofers Miscellaneous Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt&roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
i Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials
Ha and us Materials Inventory Sheet Checklist
f Date
Physical Street Address-Check database to ensure it exists
Working Phone Number
Actual Amounts -( ie. gas being used to fuel machines, thinner to
clean brushes all count as hazardous materials-no blanks)
y' Storage Information -location of storage, how long is storage for?
If none,-note that.
PVT Disposal Information -where and who? If none, note that.
� 'Applicant Signature - understand what is listed and noted
Staff(initial -any questions, know who to ask .
Vehicle Washing/Rinsing? -give a vehicle washing policy and
explain it
Attach the Business Certificate with your sign off and comments
"The inventory form should explain what the business consists of and the procedures
they are doing. Notes need to be left to explain what you discussed with them.
11
2
YOU WISH TO OPEN A BUSINESS?
R �.
For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which
you must do by M.G.L...it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1".FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
DATE:
may; Fill in please:
APPLICANT'S YOUR NAME:
$USI ESS YOUR HOME ADDRESS: �Gr, /9/LSt�� / �~ D 2
h, _ TELEPHONE # Home Telephone Number 7 J D
( S�xv f C-L
NAME OF NEW BUSINESS�A/:!�-&-) d-/9-2 ?Jz5`7,11'/1-/ U TYPE OF BUSINESS Leh///C45
IS THIS A HOME OCCUPATION?, YES - NO—Z—
Have you been given approval fro the.b_Wding division?. YES NO
ADDRESS OF BUSINESS F0 O 5ectr3c_s A ' MAP/PARCEL NUMBER
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth
Rd. & Main Street) to make sure you have the appropriate.permits and licenses required to legally operate your business in this town.
1. BUILDING CO MISSI NER'S ONCE. �' -'. . MUST COMPLY WITH HOME OCCUPATION
This indivi ual a e n info, ed f ny p .m't r qui ements t at pertain to this type of business.
RULES AND REGULATIONS. FAILURE TO
Au ho�i Si re** COMPLY MAY RESULT IN FINES,,
OMMENT
i )A rip0
r
2. BOARD OF ALTH U
This individual has permit requirements that pertain to this type of business. M�1STCO MPLYWIT
HAZARDOUS MATE H ALL-
R1ALS.REGULATIOjyS
nn 1- uthoriz d nature*
CO AM NTS: /"l�Y���� ��( `�Q, 11 �GI 01�✓IC�IS vK2, — ..An 0q,0& a 2LL 1 k2_
a V7t
3. CONSUMER A AIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
Y Date: S/A
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: I /��,,i .fr Djr a7 el'h9
BUSINESS LOCATION: �,KP- 6 — LcV<)a 9* M�✓i k+, ,AJ 6-► 5 INVENTORY
MAILING ADDRESS: Op R-eetyst5 Vt TOTAL AMOUNT-
TELEPHONE NUMBER: --:44 S O
CONTACT PERSON: T Ov
EMERGENCY CONTACT TELEPHONE NUMBER: :1-70 2-1 2 o4 30 MSDS ON SITE?
TYPE OF BUSINESS: A404;Q2 6rrv:ce
INFORMATION / RECOMMENDATIONS: Fire District:
Waste Transportation: Last shipment of hazardous waste:
Name of Hauler- Destination:
Waste Product: Licensed? Yes No
NO
TE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use,
r n i storage e and disposal osal of 111 gallons or more a month requires a license from the Public Health Division.
g p
LIST OF TOXIC AND HAZARDOUS MATERIALS
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) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED -
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 Miscellaneous Combustible
�v4o r4 Car wash detergents Leather dyes
�`
Car waxes and polishes 16.55 -- Iv-ur4 Fertilizers
Asphalt& roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers&cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS pplicant's Signature Staff's Initials
YOU WISH TO OPEN A BUSINESS?
For Your Information) Business certificates (cost W.DO for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L.- it does not give you permission iso operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
F. DATE: ( Tl-0 5 >LL Fill in please:
APPLICANT'S YOUR NAME/S Ti60 W1 NJ b
BUSINESS YOUR HOME ADDRESS `�7 QoD ' /3d ��/ yTa H
-+LI-2-38-21y 2
' TELEPHONE.# Home Telephone.Number 34-Y—Z-15 rL 1L 2
NAME OF CORPORATION:
NAME OF NEW BUSINESS —rHi- PHIN T1"G M 0AJ TYPE.OF BUSINESS VHl/V TnC
IS THIS A HOME OCCUPATION? YES NO
ADDRESS OF BUSINESS O �� /� / S �-1 MAP%PARCEL NUMBER Z�1�l ' D�(/I O F I (Assessing)
When starting a new business there areseveral things you mustdo in order to be in compliance with the rules and regulations of the Town of
Barnstable-This form is intended to assist-you in obtaining the information you may need. You MUST GO TO 200 Main St. = [corner of Yarmouth
Rd. & M.ain Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING COMMISSIONER'S OFFICE
This individual has been informed of any permit requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
2:. BOARD OF HEALTH MUST COMPLY WITH ALL
This individual h t-ce uirements that pertain to this type of business. HAZARDOUS MATERIALS REGULATIONS
Authorized Signature**
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business. .
Authorized Signature
r� COMMENTS:
-~- Date:o7/OS 1.�2
TOWN. OF �ARNSTA�LE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: 7/4&7 pfttjtn/GQ mil/
BUSINESS LOCATION: HYiW"5 --M-6 INVENTORY
MAILING ADDRESS: 6?00- /236�5 iklq V 1,910T of r TOTAL AMOUNT:
TELEPHONE NUMBER: 777LI _ 2,,3 -2/1.42.
CONTACT PERSON: -,,=�560957/RO
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: -PA/I r7r_—,Q
INFORMATION/RECOMMENDATIONS: Fire District:
Waste Transportation: Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material 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
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) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED
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 Miscellaneous Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt& roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes NOT 570Q-nu Oi WV
Laundry soil &stain removers
(including bleach) mRTf-ZtALs. Pup-cloaE
Spot removers &cleaning fluids
(dry cleaners)` Y` ftTC-2/PLS ?P— 500.
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS A liaant's Signature Staff's Initials
� t ,
Town of Barnstable
�FtHE T
Regulatory Services Barnstable
�P` o Thomas F. Geiler, Director ;mericaCity
" Public Health Division Q O 8 B BARNSTABLE,
9 MASS. g Thomas McKean, Director
1639. �0 2007
A 200 Main Street
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
December 14, 2009
Michael P. Murphy
366 White Oak Trail
Centerville, MA.02632
RE: Assessors (map-parcel) 294-061-013P
As of October 1, 2006 a new rental registration ordinance was put into affect requiring all
property owners of rental units to register their rental units with the Town of Barnstable Health
Division.—According to our records, you own the rental property at[800-B-earse s Way_; U t
3-SF Hyannis;-MA-O_601
Enclosed is an application. Please use a separate application for each rental unit you
own. Should you need more applications, they are available online at
www.town.barnstable.ma.us. Go to the Health Division page by looking in the Department
Menu. There is a link to the Rental Registration information on the Health Division page. You
may print out as many as you need, and return them to the Health Division with the appropriate
2010 fees included.
Please contact me to schedule inspection of the property as soon as possible. If there are tenants
presently occupying the property please provide the contact information being sure to include a
daytime phone number for all tenants. For your use an occupant's permission form has been
included to allow for inspections to be performed in the tenant's absence.
Failure to comply with this ordinance will result in the issuance of a non-criminal ticket
citation in the amount of$100. Each day of non-compliance is considered a separate offense.
Should you have any questions, please feel free to call 508-862-4072. Thank you in
advance for your cooperation.
Teresa Wright
Division Assistant
Health Division
Direct#508-862-4072
MbHealth Master Detail Page 1 of 1
Health Master-
Logged In As: TOWN\wrightt Health. Master Detail Friday, Decemb
Application Center Parcel Lookup
Parcel Septic Perc Well Fuel Tank
Parcel: 294-061-OBP Location: 860 BEARSE'S WAY, HYANNIS Owner: MURPHY, MICHAEL P
Business name: Business phone:
Rental property: [J Deed restricted: 0- Number of bedrooms
Contaminant released: F Fuel storage tank permit: F
i
Save Parcel Changes r�Return to Lookup
Parcel Info Parcel ID: 294-061-OBP Condo unit:UNIT 3SF
Condo complex:CAPE CROSSROADS Building: BLD 3
Location:800 BEARSE'S WAY Primary frontage:
Secondary road: Secondary frontage:
Village: HYANNIS Fire district: HYANNIS
Sewer acct:0506 Road index:0109
Interactive map t
Town zone of contribution:GP (Groundwater Protection Overlay District) 'State zone of contribution:IN
Owner Info Owner: MURPHY, MICHAEL P Co-Owner:
Streetl:366 WHITE OAK TRAIL Street2:
City: ENT-EBVhLLE State: MA Zip: 02632 i
Deed ate:03/27/2008' Deed reference:C33-3SF
Land Info Acres: 0 Use: Condominiu MDL-05 Zoning: SPLIT Neighborhoot
Topography: Road:
Utilities: Location:
Construction Info Building No Year Built Effective Area Bedrooms Bathrooms
1, 1974 1152:. 3 Bedrooms2 Full
Buildings value:x182,300.00 Extra features: tt0.00 Land value: 90.00
http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=294061 OBP 12/11/2009
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,.,I OFFICIAL USE
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Postage O
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rO Post
Return Receiptcequir e) O G Her b
_ (Endorsement Required) � i
Restricted Delivery Fee
(Endorsement Required)
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Total Postage&Fees $5 54 1 Use
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MO Sent To -
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Certified Mail Provides:
o A mailing receipt (as-ea)zoos eunr'ooes wjod Sd
o A unique identifier for your mailpiece
o A record of delivery kept by the Postal Service for two years
Important Reminders:
o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail&
e Certified Mail is not available for any class of international mail.
o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
a For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is
required.
c For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
o If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.
Internet access to delivery information is not available on mail
addressed to APOs and FPOs.
■ Complete items 1,2,and 3.Also complete
item 4 if Restricted Delivery is desired. A Agent
® Print your name and address on the reverse X ❑Ad ressee
so that we can return the card to you. B. R Pn t d me) C. Date of De very
■ Attach this card to the back of the mailpiece, c r�l
or on the front if space permits. Gl`
1. Article Addressed to:
D. Is delivery address different from Rem 1? ❑Yes
I If YES,enter'delivery address below: �No
Michael P. Murphy
366 White Oak Trail 3. se Ice Type
D�}
enterville, MA. 02632 Certified Mail 0 Express Mail
0 Registered ❑Return Receipt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑*s
2. Article Number {{; + 7�11��6 0,000 '07,90 '998t4
(Transfer from service labeq f s,
PS Form 3811,February 2004 Domestic Return Receipt ]A2595wW-M-1540
UNITED .STATE .T�t S First,
`
:,Q r a id
j • Sender: Please print your name, address, and ZIP+4 in this box •
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Town of Barnstable
Public Health Department
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200 Main Street
Hyannis, MA. 02601
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