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HomeMy WebLinkAbout0035 SCUDDER AVENUE - Health 35 Scudder Hyannis VISTA DEL MAR SP t4� r r i Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: TN//� /�/e��S t 41g�- eov euc BUSINESS LOCATION: INVENTORY MAILING ADDRESS: _ �' V-C TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: Al VD AA I 1�O�trU�S EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: G vLF 6V94C -�L-aP- !0"1& INFORMATION/ ECOMMENDATIONS: AS- r OIL, r-A-IJ �� Fire District: 17 Re iA- 1,4AI-ktb®uS WASTE 57VO-A66 /44E�X 7v BC 11XAx1AJ "C%--AIS c 720 96- A PPu L5?> ro/Z fl S hS off' S/Ar ,SP/U_X1 f 0AI 517E. Waste Transportation: Last shipment of hazardous waste: -1 Name of Hauler:.-- 0/i- Destination: dvW �`1e-- SrvcL 1J Waste Product: /�� c.�k ®/�/uf., s �cLicensed? es 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. UST 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) _. Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) 904 Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides /6' NEW USED (insecticides, herbicides, rodenticides) 40,40 asol' , Jet fuel, Aviation gas /N /{ST Photochemicals (Fixers) To iesel uel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal ?Aar5 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 S Fertilizersr�i`i8 S'a Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison labels Paint &varnish removers; deglossers (including chloroform, formaldehyde, 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): Laundryso stain removers il & ) �d��A��C�/i!✓� �4/X fLt�E��O.F'--�/�i{'G�,,c�G (including bleach) Spot removers & cleaning fluids �1 WC777W- (dry cleaners) / Other cleaning solvents 5VRea /N Fz4-,4{�,6a-3 cA*S,a)&TN Q/ Ve� Bug and tar removers Atno�us i-/S la c tJ O 6X-�?L 0Ca-tktV/)*77 aw$ ' Windshield wash A-6d yr 4*w- f�c� �HRL&-� S or—j-l--ub1" ITE CO solvents DEPARTMENT/CANARY COPY-BUSINESS J Town of Barnsta S 1b0. 00 Regulatory Services C m 4 ti Thomas F. Geiler,Director ' MAM' ' Public Health Division 1639.RFD NIPS Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO._p� � DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Af - ` NAME OF ESTABLISHMENT JQ V, '&&eAaJ n ADDRESS OF ESTABLISHMENT 96- < �d '-P.8" loll-�a 1ltY)111S,liw� TELEPHONE NUMBER ( b Q-,2-77 - 77 SOLE OWNER: YES P/ NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: CD a � IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION CD N ray FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT 0(s:,17eY.IS ,ry RESTRICTIONS: HOME ADDRESS e, ea. Y) �I HOME TELEPHONE# . 0 �Qe►� C.1m ,S�l�ioi��Q Oo Haz.doc/wp/q }{tT11R� i �� Y 4 ..- Date: / A / O TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS JON-SITE INVENTORY. l) NAME OF BUSINESS: eSo rc-1 7Z+,Vb �a1Ft'f4�,[� &W77 kr-?! yeA-0,015 BUSINESS LOCATION: 3S sc.yaDv2 Ave. 1y,,4xN/,5 INVENTORY MAILING ADDRESS: A-S A-►3evC- TOTAL AMOUNT: TELEPHONE NUMBER: _ 5-as' ��x " �9 CONTACT PERSON: � '� EMERGENCY CONTACT TELEPHONE NUMBER' MSDS ON SITE? TYPE OF BUSINESS: 472L YCS INFORMATION/RECOMMENDATIONS: Hs" W SE' aPbAlzb wi-rw *bbyM0 1Fiire District: /k47*0ZiA1_S. j-#6- bkgK oy= WIMM6wA) AjA7WIAI. iS -rep ACAAfe L,y'7,a A-" 6�A-AfnliS 1SisRvsEn �G p2oPE7?r�, oLh H 47r-*iAL -Pd /3C 615P TC1 of A-S HAVAA-leomrs Md7zEge,4t�'Z so z.� 11�e��o�iu � rax Zagem. C R�cnrvA. WR,M- �cc�on� l�4T1Q�v dF 'T/o�c- b6Srmus 4L, 61= /4qi1- 0 A1jtTZ7ZiA C is 8—&iJ1R.t3'n. 4 UPS 1AtSP&Z'n0,j V1,L_ SC,�- Waste Transportation:—, A 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 materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LEST 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) -7 Misc. Corrosive `k rmhex)SuPPi►ES) NEW USED Cesspool cleaners Automatic transmission fluid cal 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 Misc. 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 Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, S /,VCCV06S 60&AL-C P4,C 17 Misc. Flammables(wai4AA-O V& c1 &*1V / *-AJ hydrochloric acid, other acids) 34A,, 9c,cet-1s oG os.® OProm1r) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers rl� 3S Gar- OA) &OAK o/-UAt/'b eAfT/rbL-d (including bleach) Spot removers &cleaning fluids 1(oo G 4U04S of oe-b 1IA-rERlAr:.LPA-iA/1 (dry cleaners) srPrv0vs /kbhZIV S. araiWrcor*'PVV,�r, ..e©�tr�a�G.S� Other cleaning eed ts(H0V5CKrE'P1F3&) Gorc�T e ` tie' 24P€12 c Bug and tar removers &S AIJAW— ®F At*rM., 4 L• Windshield wash �r��� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS . . All , t tip • /�� iC'Gr ,�%s of o ,� - r (AA-; t��PPt'7? ��=r /�-l�-cfH-��s ,�A��cuc✓r'Zt L�¢-���ccG - $Ci}G f�//���18.tI�y • rL -cM 1�1,Z3 "I91Arrr'r > i-�c t,C. MOST e s A C-. ®ll-s "Z 8�" rUt-- r G vo l �Sii9'A1tey, LAr"DSc PtR, 7kl - 57 319a- �NcE �rLLtl�t 15 /��7�LOY / ��rnIL T •,�ALi�t VVII-L /04 AYC— a/ ' 1." ENVIRONMENTAL SERVjrE6% Clean Hubors of Braintred,juc 1 RM Avenue B Twee,AA 02194 ?f�1-38�-g1(EG www Aaailaarbors.com Nwac; �,'J 171 t`� Sir�c G1 S�r i Date: Street: Types of Materials(C."hec k all that apply): Latex aint �``�. p Pesticides Resins&Adhesives: Oil based PaAt: Aerosols: 'PVC Monitors..� Anti e ze� Adds . is cyffiez.�--�--�- motur oih I'uoi Cht;6 als to Oxidizers)- Pool 1'c)r Urov-cuff. h�Eizmn : . der: o F," .. ''.,�...i:�� '�'„ `• tJ'�»_.:1*'r."S� �ixr s;�f is r'�� i �_.e 1✓- .t ..i. Cl -Harb6 P,e�,iy� Number Fee 873 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Four Points by Sheraton Hyannis Resort 35 Scudder AvnueMA 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, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 7/1/2007 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health VEN Four Points by Sheraton Hyannis Resort DATE CHECK 18 KEY 0145C 06 12 2007 14501418 145628 INVOICE# INVOICE DATE AMOUNT DISCOUNT VOUCHER# NET AMOUNT Payment is made on be alf of HY IS-FOUR MI MS, Hyannis. HAZ MAT PE IT 06/05/ 007 100.00 0. 010 3000046953 100.00 I i iI i i I TOTALS,> 100.00 0.001 100.00 — --------- _------------------------ -------------------- -- --- --- - - ---- -- - --- - To Remove Document Fold and Tear AlongThis Perforation Ns ME A iRi mg- w�MI ,��r�IIr�s .p��i� o/D ii��i o ��he7►�/� t M R ► RK �"�i• « ��r\� IY Yf.�jr �U�i"jlri c4 /f• �\,•I• f flAp MMMUS��i\V ♦.♦ rAOI� �1 . 1�♦ ►,✓ani�• v �,/!• y�Jii ylin a �L���► i ii ♦ S' Ar. s ♦afJ \ �1 V J.� wa �o 2 • '.i � . y rc. ' ..�j' ���� cr ♦�V��r�� Fes,��.Y i /a�►�►YiiitaJ rl a ��♦� I Y �' i' A�\ i�! r♦Ei r ♦ �I�jf-c� � r O►��ll' ���.%n4 Q�p t�L♦' a v��{� /L♦♦ 1� \ +1,,�.���-�1yr w 1 v I���'�f'.R%li O�ii �`a!• �1f�wp. 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'x Town of Barnstable zHE Regulatory Services ,f� °s Thomas F. Geiler,Director D U • RARNSTABLE. . g Public Health Division '°�eaFnp�10 Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. O DATE 5 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT OP&I NAME OF ESTABLISHMENT )PC) ADDRESS OF ESTABLISHMENT c TELEPHONE NUMBED 0 e -' S G SOLE OWNER: YES NO w IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS 01i LL 3- PARTNERS: Kenneth S. Siegel r � rn 57. Greenfield Drive Weston, Ct 06883 IF APPLICANT IS A CORPORATION: FEDERAL,IDENTIFICATION NO. STATE OF INCORPORATION California FULL NAME AND HOME ADDRESS OF: PRESIDENT Theodore W. Darnell 914-640-8100 TREASURER Peter Morrow 602-852-3900 CLERK Jared Finkelstein - 914-640=810 kn- ".. 11 Pm Ap AX I, SIGNATURE APPi l A RESTRICTIONS: HOME ADDRESS -�0 -3L� R-1 A44 HOME TELEPHONE I f�a�r� pv� � -���s�•tv�c� Ip�S�one S � YOU WISH TO OPEN A BUSINESS? 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, V FL.. 367 Main Street, Hyannis, MA 02801 (Town Hall) a.d 200 Main Street Offices at the Licensing counter. DATE; Fill in please: APPLICANT'S YOUR NAME; BUSINESS YOUR HOME ADDRESS: _ q 4 � �(,"�� fzo(�Z5 -- CD TELEPHONE # Horne Telephone Number: bI- •lo-1 —f NAME OF NEW BUSINESS IS THIS A HOME OCCUPATION? TYPE OF BUSINES,yES NO -- Have you been given approval from the bu ItiT division? YESADDRESS OF BUSINESSav P n i MAP/PARCEL NUMBER — When starting a new business there are several things yo 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 Mein St. (corner of Yarmouth Rd. & Mein Street) to make sure you have the appropriate permits and licenses required to legally operate your,-business in this town. 1. BUILDING COMMISSIONER'S OFFI This individual has n infor a of any permit requirements that pertain to this type of business. uthorize ignauce COMMENTS; 2. BOARD OF HEALTH This individual b an infor t a 't re i menu that pertain to this p q p type of business. o Authorized Sig ure* Q COMMENTS: o 3. .CONSUMER AFFAIRS (LICENSING AUTHORITY) - This individual h een infor d of he lipensing requirements that pertain to this type of business. Authorized ignaturo* COMMENTS: Town of Barnstable 413 P� F11HE 1pk, Regulatory Services fA P Thomas F. Geiler,Director 5/ l0� + sn MASS. = Public Health Division 1 39n. Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 2 8 9/110 DATE May 5, 2006 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT SLT Realty LTD. Partnerships d/b/a/ NAME OF ESTABLISHMENT Four Points by SHeraton Hyannis Resort ADDRESS OF ESTABLISHMENT 35 Scudder Avenue, Hyannis, MA 02601 TELEPHONE NUMBER 5 0 8-7 7 5-7 7 7 5 zz SOLE OWNER: YES NO -- `�,'d :: t IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALIE j _ PARTNERS: Kenneth S. Siegel - '- Fj 57 Greenfield Drive Weston, CT 06883 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 9 5-4 5 0 9 414 STATE OF INCORPORATION California FULL NAME AND HOME ADDRESS OF: PRESIDENT Theodore W. Darnell 914-640-8100 TREASURER -.Jared,_Finkels,tein, 914`-64:0--'8.LOD CLERK Peter Morrow 602-852-3900 SIGNATURE OF APPLICANT b e-"Xi" RESTRICTIONS: HOME ADDRESS DDRES 8 Cocheset Path, W. Yarmouth HOME TELEPHONE# 5 0 8=7 71-3 8 7 8 Q:\Application Forms\HAZAPP.DOC 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). In 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 Back to Main Public Health Division Page Q Upplication Forms\HAZAPP.DOC Town of Barnstable OF114E TOY Regulatory Services '4o Thomas F. Geiler,Director Public Health Division BARNSTABM Thomas McKean,Director pn„ 9 MASS. g /% Qj 039. 200 Main Street, Hyannis,MA 02601 </ Phone: 508-862-4644 Email: healthna,town.bamstable.ma.us r Fax: 508-790-6304 L Office Hours: M-F 8:00—4:30 r y. May 12, 2005 Mr. James Cook Four Points Sheraton 35 Scudder Ave. Hyannis,MA 02601 Dear Mr. Cook: Thank you'foryourtime and cooperation duringthe'site visit.atthe Sheratomon May`10,-2005. Due to the renovations on site,please keep us informed on the status of the new storage facility and any new hazardous materials being brought onto the site. As part of the renovations,we require you obtain a new flammables cabinet to store the gasoline which will replace the old metal cabinet currently stored outdoors with no bottom containment. The Board of Health has determined that the using, storing, generating and disposing of over 111 gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials License. Enclosed are copies of Chapter 108: Hazardous Materials ordinance, and an application for permit to store and/or utilize 111 gallons or more of Hazardous Materials Please refer to the Town of Barnstable General Ordinance: Chapter 108, Section 6(A-H). A Contingency Plan must be submitted with your license application. Reviewing your contingency plan for hazardous materials spills and related emergencies(and its location throughout the facility)is highly recommended at this time. Once the new storage facility is complete, we will perform a hazardous materials inventory and site visit at that time. If you have an questions or you need further information guidance or assistance lease do not Y any Y � g �p hesitate to contact the Public Health Division. Sincerely, Alisha L. Parker Hazardous Materials Specialist David W. Stanton,RS Health Inspector Enc. Chapter 108 (copy) Hazardous Materials Permit Application V-Oy 1 (-.)WN t6rloRNSTABLE - UNDEFRGHUUND FUEL S101ROUE RCE(- NU. IM ADDRESS OF TANK: VILLAGE : MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME PHONE: INSTALLATION DATEt BY : INSTALLER ADDRESS: CERT.140. �Aj*TANK LOCATION: E � er 7^1"K -C-6-6^-rxc3," wx-y-" mwmmw=-r -ra =uxC CAPACITY 10�)d TYPE OF 'I ANK ii�ip AGE ZJ—YRS. FUEL/CHEMICAL TESTING CERTIFICATION IV] PASS I I FAIL �DATE'� LEAK DETECTION L��JCHECK IF /A TYPE/BRAND ZONE OF CONTRIBUTION YUS� [111'NO DATE.—TO- BE REMOVED FIRE DEPT. PERMIT ISSUED [,�� YES NO DATE CONSERVATION �CHECK IF N/A DATE I BOARD OF HEALTH TAG NO. DATEV N A-10. AT -Q' Q ,_TANK C-13. Q N—�, �� l �� ,_� �,�� � o N�u�� .W`'�'�4 � �— /ID Make application to local Fire Department. Fire Department retains original application and issues du pH 90a Wm,m t��we ee .— 0 �c1 APPLICATION and PE for storage tank removal and transportation to approved tank disposal yard in a"'= rovisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by. 0 Tank Owner Name(please print) `50F' DM 9A4� u U 15 X o emre apt y permd Address �S 5c u�D e2_ A� t Uts MA- OZ60 sneer MY stare zip . HOISTING LICENSE # H P_v,�j.) Company Name LIU-1q!j P Erl v t Q n n rn e��3_1 7Co. dividual Rim Pram Address C446190-V IIIfL& Address Pf°'r M9 o1Col `W Signature(if applying for permit) Signature(if applying for permit) ❑ IFCI Cerjed U &er ❑ IFCI Certified ❑ LSP# Other Tank Location steer Address city Tank Capacity(gallons) _ l 000 Substance Last Stored G0-5 Tank Dimensions(diameter x length) Remarks: Firm transporting waste 0lspaSAL TFCtFKJol,ojy' State Lic. # MA S'odry,n 400 a t a�-�-` -- Hazardous waste manifest# m( k o 8 `l Ce f E.P.A.# I - Approved tank disposal yard &)-M- l2- P(Sn P tc Qe,.eQ Tank yard# 01.t \Z, Type of inert gas D P�j I C E Tank yard address ELm CL i ril o 0 Q!2Al S 09� FDID# City or Town �to�S 1'r fof Date of expirationDate of issue Dig safe approval number. 1 9 9 2 S 8i 3 0o Dig Safe Toll Free Tel.Numtiet' 8130-32Z=4>3 4, Signature/Title of Officer granting permit After removal(s) send Form FP-29OR signed by Local Fire Dept.to UST Regulatory Compliance Unit,One Ashburton Place, Room 1310,Boston, MA 02108-1618. 1 Ida 7, '.'1.,. TOWN OF BARNSTABLE BAR-W 3874 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager 11UPLIy,is A41)1#4.jt^ N&,i � :� a �tu,C"+ 1/0, Address of Offender 5, fAr ' - A,,P , MV/MB Reg.# " Village/State/Zip t`f /�.��n x. C [� Business Name J .3'0) amtt on 1 ;0 2002, Business Address 'Signature of Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense 10 0 � q3S Facts 1.���c� s Hain+ [�.j'' +�e^x E ��fit,j�1 �!s � ��'Y"U",G'"n r r t'�ti tt+. t 1�,�1'�ft-� , ��.g•--a0 � This will serve only as a warning. At this time no legal action has been taken. -?It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and, Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in ' appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.. rt: s Y TOWN OF BARNSTABLE BAR-W N.D. 3874 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager ljk4rf .;so JIJJ',. Address of Offender 'r-A , r. MV/MB Reg.# Village/State/Zip d fir. fj -. L. - ... .r. s ;��a.s; "1 am/rpm; on Business Name '# #} 20t� Business Address Signature `of Enforcing Officer Village/State/Zip Location of Offense _'. 1c .. a 1i :, Y• yr, rr d !till Vr. CC Enforcing 'Dept/Division r �• Offense`�y�� t - 0'a 1 - ,< ° : ot� Facts � ` f !c :s+r-. x, P!•t a<. � Yc+ �` ; _'°' r r-� +; t4 t; " !: {. Tr a ..r t This will serve only as a warning. At this time no legal action has been taken. JIt is the goal of Town agencies to achieve voluntary compliance of Town r Ordinances, Rules and Regulationst Education efforts and warning notices are attempts to gain, voluntary compliance. Subsequent violations will result , in iappropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. DEC 16 ENT'D TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date l) Owner �� ttiS l�� iC- lcLj Tenant 14 0 u -� Address. SG� 1-l� n `s Address Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities A- 3. Bathroom Facilities �(- __ ,� �< 4. Water Supply owe, VJA q9 5. Hot Water Facilities Q« 5 6. Heating Facilities r hf1,S $l.Yl Sa.n,� 7. Lighting and Electrical Facilities 1010W C lea"0 0,1� i_ _ 4/WVV71 8. Ventilations` 9. Installation and Maintenance of Facilities Molt _1 YY 10. Curtailment of Service a r W 0-M 4` 15, 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural / Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal �, v`,,Q t �C cu v l o'- I 16. Sewage Disposal V/ 17. Temporary Housing PART II p 37. Placarding of Condemned Dwelling; rv�f Removal of Occupants; Demolition Person(s)Interviewe (.(ti Inspector If Public Building such shore or Hotel/Motel specify here #041 tf.S tr!'t HOBBS&WARREN,INC. �/ nFC 16 ENT'D TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date !2 10 0S Owner n I SAfh1p, lie- Tenant Address S hVt- 1�144741Y Address Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities o NHS 3. Bathroom Facilities 4. Water Supply . / 1 0—WVX 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service wt 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents CV hqyr' ' 15. Garbage and Rubbish Storage and Disposal zsl l5c ,N� 1 16. Sewage Disposal 1 � � 17. Temporary Housing N PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition d Person(s)Interviewed Inspector e If Public Building such as St or Hotel/Motel specify here T ya.l 4-C ��j7 tc HOBBS$WARREN,INC. t EC 16 E TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date t -L" Owner '`tTG�tt�I S eJ� Lk Tenant ` Ale—, c� Addressr gq/ 6/, 6Ltt Address Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities i 6. Heating Facilities 7. Lighting and Electrical Facilities 5�y� 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 PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demoliti Person(s) Interviewed Inspector s If Public Building such as Voe Hotel/Motel specify here HOBBS$WARREN,INC. MAP I ,PARCEL .Z ft _ 2%� III TOWN OF BARNSTABLE OMPLIANCE: CLAs 1. Man s a ,ons, epair satisfactory 2. Printers BOARD'OF HEALTH 3.Auto Body Shops O p� unsatisfactory- 4.Manufacturers Stores COMPANY rL,� €S L �� (see"Orders") 6. Fuel5. Re �Suppliers ADDRESS SCE Class: 7. Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATE IALSCase lots Drums Above Tanks Underground Tanks IN OUT IN OUT 1 1 OUT #&gallons Age Test Fuels-.—De l - AD (� SLli e t Fuel (A) XCL CID erosene, #2 (13 Heavy Oils: waste motor oil (C) i new motor oil (C) transmissi n/h draul' x Synthetic Organics: degreasers Miscellaneou O _ nD L.Quvhsad 420rj DISPOSAIJRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply I t cn_� CTown Sewer .�ublic O On-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC_ c O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES N0�L Q Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destinat I ion Waste Product .d NO 1. AAjiis 2. r P o (s) Interviewed Inspector Date Date: r TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: BUSINESS LOCATION: MAILINGADDRESS: � 3 b *_040 v (Z - Mail To: TELEPHONE NUMBER: Board of Health Town of Barnstable CONTACT PERSON: P.O. Box 534 EMERGENCY CONTACT ELEPHON NUMBER: :H V 8 " I '� Hyannis, MA 02601 TYPEOFBUSINESS: Iq ( /\,)tEA Does your firm store any of the tox pr hazardous materials listed below, either for sale or for you own use? YES NO 1/ This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers ( � Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels U Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TO ALL NEW BUSINESS OWNERS � Fill in please: ` APPLICANT'S Aff YOUR NAME: p5E �(.UlZ Jr Lv/� [�/qS BUSINESS YOUR HOME DRESS: .�o yo o �� �7y 836 oA 0� vi CGS -M TELEPHONE Telephone Number (Home) So c7O61 ,X - - NAME OF NEW BUSINESS - - TYPE OF BUSINESS !,✓ ,� IS,THIS A HOME OCCUPATION? P.D ' ADDRESS:OF BUSINESS MAP/PARCEL NUMBER W • � Whe n starting anew busin ess Hess 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. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office Is' floor - Town Hall). ( ) 1. GO TO BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL) This individual has been informe d of any permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 2. GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL) This individual ha g�n�' d�f he permit requirements that pertain to this type of business. Authorize ature COMMENTS: 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) - (3RD FLOOR SCHOOL ADMINISTRATION'BUILDING) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: After obtaining the required signatures you must return to the Town Clerk's Office to obtain your business certificate (cost $20.00 for 4 years.). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate - you must get that through completion of the processes from the various departments involved. YIP-6 ,006�%VP—yer(1-5P"� T a 1\/oTOWN OAR1V STABLE . COMPLIANCE: 1.Marine Gas Stations Repair 2.CLASS. p nters BOARD F HEAL H o satisfactory 3.Auto Body Shops / o unsatisfactory- 4.Manufacturers COMPANY /V"M& loL___ (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS �(' Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATE=/SI/dkS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAIJRECLAMATION REMARKS:A thfiP / WAS 1. nitary Sewage 2�4,ub Wter Supply CJ Town Sewer lic O On-site 0Priv to 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well C O On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank: MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES I NO 1. 2. Al a e Person (s) Interviewed Inspect TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory BOARD OF HEALTH 2.Printers3.MAuto Body Shops unsatisfactory- 4. anufacturers COMPANY ., !�t r�� O (see"Orders") 5.Retail Stores r� � 6.Fuel Suppliers ADDRESS �l')61,4k/,Ue, Class: 7.Miscellaneous (� IV - QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Caselots Drums Above Tanks Underground Tanks IN OUT I IN OUTI IN OUT #&gallons Age ITestj Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) ' transmission/hydraulic Synthetic Organics: degreasers I k 111 Miscellaneous: DISPOSAL/RECLAMATION REMARKS:1. Sanitary Sewage 2.Water Supply N( I 1!!'i�1 /i / 1�1 I, OOTown Sewer OPublic ten/ C t�('f�A/ /CZ On-site OPrivate PCOU P-, 1A AJ l lP 7 3. Indoor Floor Drains YES NO )' "` O Holding tank: MDC rvl O Catch basin/Dry well /,•+i/�,. .1T1 t�7�� � y ,�, r O On-site system r 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 TOWN OF BARNSTABLE COMPLIANCE: CLASS 1.Marine,Gas Stations,Rep it BOARD OF HEALTH 0 satisfactory 2.Printers 0 u 3.Auto Body Shops unsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores COMPANY7Z t V 2�-C J L: 6.Fuel Suppliers ADDRESS3S: , 6V,1fti�rr/ 1�.�� lass: 7.Miscellaneous QUANTITIES AND STORAGE (IN- indoors;OUT_ =outdoors) MAJOR .11 MATERIALS . an s IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Diesel, Heavy Oils: waste motor oil (C) new motor oil(C) 1414 transmission/hydraulicl 4. Synthetic Organics: degreasers /t f 0'k� Miscellaneous: wou 4G1 wt re i� FlEi DISPOSALIREC:LAMATION REMARKS: 1. itary Sewage 2.Water Supply x `Town Sewer ,public _ 0 On-site OPrivate 3. Indoor Floor Drains YES_j!LNO 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO O S. 0 Holding tank:MDC - d� Catch basin/Dry well On-site system 5.Waste Transporter Name of Hauler Destination WasteYroduct Licensed?, � YES NO 2, 1�i•�G,�ZlY'��JfC . Person (s) Interviewed Inspector - Date M� ..C�EzU TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops _ O unsatisfactory- 4.Manufacturers � COMPANY z / "'r / � (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS /%� Class: 7.Miscellaneous IfitS QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) ne RIO drfSwi 0 thetic Organics: - �trrpfl Cprs ��Gr- f � s jwlk )0 Miscellaneous: 24 __10eZ17 dxl -d� d 2 y- x 1 YI—UHA� 6Lad �-- X DISPOSALlRECLAMATION REMARKS: _. 1. Sanitary Sewage 2.Water Supply Town Sewer kPublic S .fpon-site OPrivate 3. Indoor Floor Drains YES__YNO O Holding tank: MDCj/ O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 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. C A Ad kll - Person (s) Interviewed // I specto Date C Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: I L) BUSINESS LOCATION: MAILING ADDRESS: S ail To. TELEPHONE NUMBER: 7 4r 'hoard of Health + Town of Barnstable CONTACT PERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: n C Does your firm store an the oxic or hazardous materials listed below, either for sale or for you own use? YES Z NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids afln (dry cleaners) 3 0IZIOZZ6J Other cleaning solvents 0 Bug and tar removers IG l WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS -7 2 f- d ?ce � D 1-7� TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH X �' 3.Auto Body Shops VIJ4A, ! O unsatisfactory.- 4.Manufacturers COMPANYV I l / ' ��4'- (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS I�SGtr� � Class: '7 7.Miscellaneous It QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERULS Ca se lots Diums"'� '41:` : ,,Above Tanks Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: wL'1 4,4; 1 a,r-7� 1 f DISPOSAURECLAMATION REMARKS: 1 ;Sanitary Sewage 2.Water Supply _,Town Sewer Public O On-site OPrivate V 3 Indoor Floor Drains YES-No X O,Holding tank:MDC p Catch basin/Dry well F'"O On-site system 4. Outdoor Surface drains:YES Y/NO ORDERS: O Holdingtank:MDC S ati Catch basin/Dry well O On-site system 5. Waste Transporter Destination.Name of Hauler Product YES NO �4 1. 2. Person (s) terviewed Tngpeictor Date ro C Number Fee 1107 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that COASTAL GOLF MANAGEMENT, INC./TWIN BROOKS 35 SCUDDER A VE, HYANNIS, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------------------------I------------------=-------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town.of Barnstable °FAME rq,,, Regulatory Services ti Richard V. Scali, Director MA� .g Public Health Division i°rEo 39. ° Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT p �o r f rA4NifkpT�-r-- . NAME OF.ESTABLISHMENT ADDRESS OF ESTABLISHMENT C TELEPHONE NUMBER CD SOLE OWNER: YES ' NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OFPLL w PARTNERS: %0 M IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Z7- 5 L1o35� STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT -LZ o c GAY S � 1�)w-e—f 6�►ticJ g m�� y�i(C LST,yIAf� V TREASURER . �, CLERK P /1 RE OF APPLICANT RESTRICTIONS: HOME ADDRESS 13 fiv,-e�t6(e,,Q Kc� HOME TELEPHONE# 57)�;- qOc') 3k;? Q:Wpplication Fonns AZAPP.DOC o i I�a dous contingency plan for Twin mks Golf Course exists as having a spill response,lit av for easy access tlndtg: For spill eonm : .4bso*M, socks *OSO 'Pods -dtob go vert !Ospcedi, y Personal Protective Equipment �protcodve- coves 'P�Qggies goves for disposal: -2 poly hags w/ties Posted in shop area �_emer cy contact information: Hyawus Fire MONOV51MOOV -Cyn Environmental M Ds Sheets/Book i i i