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HomeMy WebLinkAbout0329 WEST MAIN STREET - Health E329 West Main St. Hy i A= r � o 6 o a y a � o a YOU WISH TO OPEN A BUSINESS?_ For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS 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, 1" FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. $t Fill in please: Date: 14_2. n px APPLICANT'S NAME: S- r--V erjO ' g YOUR HOME ADDRESS: ` Zq tjt7,,--j-- AJAI 0Z } 44- BUSINESS TELEPHONE # 3D8- 907 33 HOME TELELPHONE #: S68-775-_Z3S-7 NAME OF CORPORATION: DN NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES'' NO ADDRESS OF BUSINESS 5, fVA 4,61 MAP/PARCEL,NUMBER :310--0/3 (Assessing) �r When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of Barnstable. This form is 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 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 This individual s een i rme oft permi�reuirements that pertain to this type of business. Authorized ignature" COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" 60 COMMENTS: Wd' us Materials Inventory Sheet Checklist ate Physical Street Address Check database to ensure it exists ng Phone Number Actual Amounts—(i.e.gas being used to fuel machines,thinner to an brushes all count as hazardous materials) Storage Information—location of storage,how long is storage for? ,�none,note that. � L osal Information—where and who? If none,note that. !/Applicant Signature—understand what is listed and noted. taff Initial—any questions,know who to ask. Ve 'cle Washing/Rinsing?—provide a vehicle washing policy and plain it—note that-it was given. Attach the Business Certificate with your sign-off and comments. . **The Inventory forin should explain what the business consists of and the: rocedures the are doing Notes need to be left to explain what you discussed with them. Date: 08 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: Hgk-Tt(-Q LTv ice*L (4 BUSINESS LOCATION: ZS !✓ A y e 41dr-saiS. NA INVENTORY MAILING ADDRESS: t1, ✓✓ `At^j S _ I yp1 NN+ S TOTAL AMOUNT: TELEPHONE NUMBER: SOB— W07` f3c>3 5 CONTACT PERSON: S-1 t V L=" 69,-N✓t & EMERGENCY CONTACT TELEPHONE NUMBER: �S —7 7 cq- 9 3Z MSDS ON SITE? TYPEOFBUSINESS: D`t=5iGitit ?LArr 11 fPjG 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 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 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. Obs rved/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 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, 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): Laundry soil & stain removers ll I (including bleach) Z S_U L,9 5 13 J�Tf -S Spot removers &cleaning fluids V�-t L I z.EV2, (dry cleaners) Other cleaning solvents ZyA &6N I j-4 L�2_5 Bug and tar removers ® vr� Windshield wash s ,� /�ttNDL� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS 11 \ / CFRTIFICATL OF ANALYSIS g � ` Barnstable County Health Laboratory ff�Lti / Report Dated: 8/1/2005 Report Prepared For: Order No.: G0531932 Cape G o's 29 West Main St. -#25 Hyamlis, MA 02601 Laboratory ID#: 0531932-01 Description: Water-Pool Sample#: 31932 Sampling Location: 329 W.Main St.Hymmis,MA Collected: 7/26/2005 3 Collected by: M.Malloch Swimming Pool Received: 7/26/2005 POOLS ITEM RESULT €NITS R.L MCL . Method# Tested LAB: Mierobiologv Heterotrophic Plate Count 1 CPU/mL 0 200 Pour Plate 7/26/2005 Pseudomonas spp. 0 CPU/100 mL 0 1 MF 7/26/2005 Total Coliform 0 CFU/100 mL 0 2 MF 7/26/2005 Water sample meets the recommended limits for swimming pools for all above tested parameters. .� " Approved By:—.-. Director) i cn .cs a 1 C=j ., C� CU s RL = Reporting s P b Limit MCL--Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 �' CERTIFICATE OF ANALYSIS Page: 1 Y•fY 5�'1 Barnstable County Health Laboratory ssti Report Dated: 08/01/2002 Report Prepared For: Cape Glen Condo's Order Nu 365 329 West Main St. -#31 1 5 2002 i Hyannis, MA 02601 AU G OF BARNS V"OLE HEA ' Laboratory ID#: 0216365-01 Description: Water-Pool Sample#: 16365 Sampling Location: Swimming Pool Collected: 07/30/2002 Collected by: M Malloch Received: 07/30/2002 Test Parameters ITEM RESULT UNITS MDL MCL Method# Tested LAB: Microbiology Heterotrophic Plate Count 0 CFU/mL 0 200 Pour Plate 07/30/2002 Total Coliform 0 CFu/100ml- 0 0 MF 07/30/2002 Approved By: �a�a...�—•--- (Lab Director) ff1glzooz F r 4 Superior Court House, PO.Bog 427, Barnstable, MA 02630 Ph: 508-375-6605 4� 9 CERTIFICATE OF ANALYSIS Page: 1 �39 Barnstable County Health Laboratory Report Dated: 6/6/2005 Report Prepared For: Order No.: G0530284 Cape Glen Condo's 329 West Main St. -#25 Hyannis, MA 02601 Laboratory ID#: 0530284-01 Description: Water-Pool Sample#: 30284 Sampling Location`329 W.Main St.Hyannis,MA n Collected: 5/23/2005 Collected by: M.Malloch Swimming Pool Received: 5/23/2005 POOLS ITEM RESULT UNITS RL MCL Method# Tested LAB: Microbiology Heterotrophic Plate Count 0 CFU/mL 0 200 Pour Plate 5/23/2005 PseudomOnas spp. 0 CFU/100 mL 0 1 MF 5/23/2005 Total Coliform 0 CFU/100 mL 0 2 MF 5/23/2005 Water sample meets the recommended limits for swimming pools for all above tested parameters. Approved By: (Lab hector) RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Massachusetts Fire Incident Report Hyannis Fire Department • Date of Time Of Arrival Time In FDID Incident No. Exposure #. Incident Day of week Call Time Service 01922 A210457 � 5/19/2,6� I Saturday 7❑ 19:30 19:39 20:00� Address ; Zip Census Tract 329 West Main Street #110-889 Hyannis 30 Type of Situation Found Type of A ion Tal Mutual Aid 47 Chemical Emergency 47 F 4 Remov azard Fixed Property Use Ignition Factor "uncovered Parking Area." 9 6 5 00 No Fire Found 00 Occupant Name Occupant Telephone Mroczkowski, Stush 508-775-0547 Owner Name Owner Address Owner Telephone Trustees 329 West Main Street 508-775-0547 Method Of Alarm Shift No Of Alarms # of Personnel Responded 1 Telephone © 0 Hazarus Materdoials Engines Tankers Aerial Other Vehicles Present 001 �_J 07 � Muria Fire Service Other Injuries Injuries E Fatalities C Injuries 0� Fatalities 0� Rescues 0� Mobile PropertV Use Is Car Stolen Insurance Company Mobile Property Make Year Model Color License Number VIN 0 0 0 ❑ Complex Area Of Origin ❑ Estimated Loss Equipment Involved In Ignition Form Of Heat Of Ignition ❑ ❑ If Equipment Was Involved In Ignition Material Ignited Year Make Model Equipment Serial Number ❑ 0 Method of Extinguishment Level Of Fire Origin Number Of Stories 0 ❑ ❑ Construction Type Detector Performance Sprinkler Performance 0 0 fi Extent Of Damage Flame ❑ Smoke Material Generating Most Smoke Type Of Material Generating Most Smoke • Avenue Of Smoke Travel Weather Conditions Commanding Officer 0 C.I.aax................................................................. Capt C. Farrenkopf Report By JCapt C. Farrenkopf Comment Page for l • Incident No. A210457 Address 1329 IWESTMAINSTREET #110-889 Date of Report 5/19/2001 Commanding Officer Capt C. Farrenkopf FIRE ALARM RECEIVED A CALL FROM A CONCERNED CITIZEN REPORTING A POSSIBLE HAZARDOUS PROBLEM AT 329 WEST MAIN STREET,CAPE GLEN CONDO'S. SPOKE WITH CALLER WHO ADVISED US THAT SOMEONE WAS PUMPING CLEANING PRODUCTS OUT OF A SWIMMING POOL INTO AN ON SITE CATCH BASIN. CALLER ALSO TOLD US THAT THE PRODUCTS WERE MURIATRIC ACID AND CLOROX. ARRIVING ON SCENE,SIDE ONE OF A"U"SHAPED DRIVEWAY/PARKING LOT, I OBSERVED A GARDEN HOSE LEADING INTO THE POOL AND ONE RUNNING INTO A NEAR BY CATCH BASIN. INVESTIGATING I COULD SMELL A CLOROX TYPE PRODUCT ISSUING FROM THE GARDENING HOSE LEADING INTO THIS CATCH BASIN. ALSO THERE WAS A POWER CORDING RUNNING FROM THEIR POOL HOUSE TO A PUMP WHICH WAS RUNNING. SPEAKING WITH A TENANT OUTSIDE,HE POINTED TO THE OCCUPANTS CONDO WHO WAS CLEANING THIS POOL. SPOKE WITH MR.STUSH MROCZKOWSKI TENANT OF APARTMENT#16 AND ADVISED HIM TO STOP THIS OPERATION UNTIL I CHECKED WITH THE BOARD OF HEALTH. MR.MROCZKOWSKI TOLD ME THIS WAS THE NORMAL PROCESSOR THEY USED WHEN CLEANING THIS POOL IN THE SPRING TIME. BOARD OF HEALTH WAS NOTIFIED[MR.ED BARRY]WHO AFTER I EXPLAINED THE SITUATION TO HIM TOLD ME TO PUT A COPIOUS AMOUNT OF WATER IN THE BASIN AND HE WOULD MET US THERE. WE USED ENGINE 822 AN PLACED 1000 GALLONS OF WATER INTO THIS BASIN. INVESTIGATING FURTHER[MR.BARRY, MR.MROCZKOWSKI,ANOTHER GENTLEMAN{WHO WAS HELPING}AND MYSELF]WERE TOLD BY MR.BARRY THAT THEY NEED A CERTIFIED POOL CLEANER OR COMPANY[BY STATE STATUTE]TO INSTRUCT OR DO THE JOB FOR THEM. THIS COMPLEX DEALS WITH LUZIETTI POOLS AT THE PRESENT TIME. MR.BARRY WAS SHOWING THE POOL AND WHAT WAS REMAINING IN THE BOTTOM. HE TOLD MR. MROCZKOWSKI TO DILUTE THE REMAIN PRODUCT AND FINISH CLEANING IT. HE[MR. BARRY]WILL CONTACT HIM[MR. MROCZKOWKI]LATER NEXT WEEK. CAUSE:MURIATRIC ACID,CLOROX BEING PUMPED INTO AN ON SITE CATCH BASIN. OCCUPANT/MAINTENANCE: MR. STUSH MROCZKOWSKI [WIFE SUZANNE]329 WEST MAIN STREET UNIT # 16 HYANNIS, MA. 02601, 508-775-0547. LUZIETTI POOLS: 955 ROUTE 132 HYANNIS, MA 02601 508-771-4142 FF. MEDEIROS, FF.DARDIA. WEATHER CONDITION:CLEAR,COOL,WIND OUT OF THE SOUTHEAST ABOUT 5 MPH,T 47°F. FARRENKOPF,C. CAPT. 05/19/01. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: /CAC AJ L& �I/' -J—e7t✓CcEf Mail To: BUSINESS LOCATION: 3 IAA, //7 a-bV f,' Board of Health �® 1,.. ] .� ., �J Town of Barnstable MAILING ADDRESS: —T ® �/ P.O. Box 534 TELEPHONE NUMBER: 7J' 77J o Hyannis, MA02601 CONTACT PERSON: 1c�L —01emnill EMERGENCY CONTACT TELEPHONE NUMBER: `7 7/ — o / no Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in uantitie totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES q 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: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners ` Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's ' Paint & varnish removers, deglossers Other chlorinated hydrocarbons, " Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach] Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: S ` C&-1w/ A"6 BUSINESS LOCATION: Z. qp219 iP.41S ' MAILINGADDRESS: �1.0^ an,'t —« Mail To: TELEPHONE NUMBER: ® Board of HealthTown of Barnstable CONTACT PERSON: P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: ( Hyannis, MA 02601 TYPEOFBUSINESS: n � Does your firm store any of the toxic or ardous materials listed below, either for sale or for you own use? YES NO t� 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 otherthan 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) T 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(dry cleaners) cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS