HomeMy WebLinkAbout0669 YARMOUTH ROAD - Health 669 YARMOUTH RD. ,HYANNIS
A Barnstable Auto Sale
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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 sigm3tures 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 (hat is'
required by law. -
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2 r r l DATE: ° T in ipl se: rf c H
.. 'la �h to �. APPLICANT'S YOUR NAME/S: h is "To �� S +� G9w .�Z-
..... � Suf G .�
BUSINESS YOUR HOME ADDRESS: a /P fq
TELEPHONE # Horne Telephone Number
7
NAME OF CORPORATICIN'. L
y' : e E/ ore, SS 5 3o ,)
NAME OF NEW BUSINES TYP
S '
E'OF BUSINESS'
IS THIS A HOME OCCUPATI N? YES NO
ADDRESS OF BU IIV SS .�6 �: ^i.� u ry !S ,.MAP%PAR EL NUMBER (Assessing)
-When starting a new usiness there are sever al things yoG mu sdo`irY order to be in complia ce 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 mare sure you have the appropriate permits and licenses required to legally operate your business in this tovvn.
1. BUILDING COM2I abinfor
S OF�dl
E
This individu hampolan per it requirements that pertain to this type of business.
tho ized Si natu
COMMENTS: C�
2. BOARD OF HEALTH
This individual has be ormed of th �e mit req e ents that pertain to this type of business.
r MUST COMPLY WITH ALL
-A-uThorired Signature-** ---------
'HAZARDOUS MATERIALS REGULATIOn!S
COMMENTS:
3. CONSUMER AFFAIRS(LICENSING AUTHORITY)
This individual has-(,I�en ifbr reO of the licensing requirements that pertain to this type of business.
uthori d ig ature*
COMMENTS: AIaA
Date:j I /el
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: Oq k w� A-a6 )-e_. /.", 1+k ! 4J ) u)c ,f/It Z" ,
BUSINESS LOCATION: /7 yin j , ��1NVENTORY
MAILING ADDRESS: C5,�?1Z -C TOTAL AMOUNT:
TELEPHONE NUMBER: So 2�r� o �7 g,4L
CONTACT PERSON: 6'� e c` v n"i c v`
EMERGENCY CONTACT TEL HONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: CJ,I -e yO C ) �--
INFORMATION/RECOM MEN DATIONS: Fire District:
o Cy9 V
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
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Appli Signature Staff's Initia
NOTES TO THE FILE
March 20, 2012
Barnstable Motor Wholesale
669 Yarmouth Road
Hyannis, MA
Cynthia Martin, PHD
Russ, Barnstable Motor Wholesale
Barnstable Motor Wholesale, was inspected due to the concern for the use,
handling and storage of hazardous materials (automotive fluids). The only hazardous
materials on site were two automotive batteries and approximately three gallons of
antifreeze. The building space consists of a single garage bay, two offices and a small
room with a work bench.
Based on the above the business is not subject to the Hazardous Materials
licensing requirement of the Town of Barnstable.
V/
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY ga.,,4" " /� (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS yanVAL Vd Class: 7.Miscellaneous
at f--IV'i-t I S QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums
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:
9r�1
DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply A10 r 'OC/qr• &rawt S 4,0 7-1 �
O Town Sewer �5Public S t/ .S /4/0
AOn-site OPrivate
3. Indoor Floor Drains YES NO
O Holding tank: MDCrtEJ
0 Catch basin/Dry well
0 On-site system
4. Outdoor Surface drains:YES NO ORDERS:
0 Holding tank:MDC / dv,C '
O Catch basin/Dry well
O On-site system A
5.Waste Transporter
DestinationName of Hauler
YES NO
2.
1z-3i-
Person(s) Interviewed Inspe or Date
L
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH O satisfactory 3.Printers
3.Auto Body Shoes
unsatisfactory- 4.Manufacturers
COMPANY (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS_ Kefi> 1� Class: 7.Miscellaneous
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MAT IALS I
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:
DISPOSAL/REOLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply �.
Town Sewer Public
On-site OPrivate _
3. Indoor Floor Drains YES_--NO 61,
O Holding tank:MDC_
O Catch basin/Dry well 2 ✓
O On-site system >�� rLi
4. Outdoor Surface drains:YES NO O S:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5. Waste Transporter
asW
Name of Hauler D es- nii
�d icensed
YES NO
1.
2.
>
Person(s) Interviewed ) Inspector Date
Pot V" — 3,LV4�'A.&A(". /
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TOXIC AND HAZARDOUS MATERIALS REGI TRATION FORM
NAME OF BUSINESS: / �� ,1 �!� '� d� r r It s Mail To:
BUSINESS LOCATION: X22 v v ! �J Board of Health
Town of Barnstable
MAILING ADDRESS: 174 yA jj,,j�1 11'74 a 6- e/ P.O. Box 534
TELEPHONE NUMBER: 7,s Hyannis, MA 02601
CONTACT PERSON: 4 C ` a
EMERGENCY CONTACT TELE HONE NUMBER: 35 L` -3)®3
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for
your own use,
.��49- YES 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
VQ Antifreeze (for gasoline or coolant systems) Drain cleaners
/I/() Automatic transmission fluid fy// Toilet cleaners
Engine and radiator flushes PO Cesspool cleaners
Hydraulic fluid (including brake fluid) - &0 Disinfectants
erg Motor oils/waste oils _ Road Salt (Halite)
U Gasoline, Jet fuel tV�) Refrigerants
Diesel fuel, kerosene, #2 heating oiler Pesticides (insecticides, herbicides,
Other petroleum products: grease, lubricants rodenticides)
Degreasers for engines and metal Photochemicals (fixers and developers)
11VU Degreasers for driveways & garages Printing ink
1t1c Battery acid (electrolyte) _ V Wood preservatives (creosote)
Rustproofers Swimming pool chlorine
Car wash detergents Lye or caustic soda
Car waxes and polishes Jewelry cleaners
�Q Asphalt & roofing tar Leather dyes
Paints, varnishes, stains, dyes 0 Fertilizers (if stored outdoors)
/v d Paint & lacquer thinners WO PCB's
Al Paint & varnish removers, deglossers ItId Other chlorinated hydrocarbons,
Paint brush cleaners (inc. carbon tetrachloride)
Alo Floor & furniture strippers N� Any other products with "Poison" labels
Metal polishes (including chloroform, formaldehyde,
)k/d Laundry soil & stain removers hydrochloric acid, other acids)
(including bleach) p Other products not listed which you feel may
t"�o_ Spot removers & cleaning fluids be toxic or hazardous (please list):
(dry cleaners)
d Other cleaning solvents
"o Bug and tar removers
/Ve) Household cleansers, oven cleaners
White Copy- Health Department/ Canary Copy-Business
r
• • iCOMPLJANCE: CLASS: 1.Marine,Gas Stations,Repa
• 1 • �. satisfactory Printers
um 3. . Body ..
[ unsatisfactory-
Suppliers(see"Orders") 5.Retail Stores
6.Fuel
7.Miscellaneous
• Case lots Drums Above Tanks Underground Tanks
oil • .
MA DIN ft
FifflA
too #1
• •. 1 �_Lr l.�li� • t 7ILIMMUNE
4LI41
Name of Hauler Destination Waste Product Licensed?
®®
-A -
TOWN OF BARNSTABLE coMPL/ANCE: CLASS: 1, Marine,Gas Stations,Repair
satisfactory 2. Printers
BOARD OF HEALTH 3.Auto Body Shops
\ O unsatisfactory- 4.Manufacturers
COMPANY 1 � \`1CC�` (see"Orders") 5. Retail Stores
� - 6. Fuel Suppliers
ADDRESS W„9 \482 d`�iC'���C Class: Sb1eS - -7 7. Miscellaneous
l�c. ); QUANTITIES AND STORAGE (IN- indoors; OUT-outdoors)
MAJOR MATERIALS UndergroundCase-I ots Drums Above Tanks
IN. OUT IN OUT IN OUT #&gallons 777 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
ti
Miscellaneous:
ra X
DISPOSAUR.ECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply ��'� Ca kC -
�0-Town Sewer Public jam' Pk A C U Ck -1 0K
O On-site OPrivate v
3.Indoor Floor Drains YES NO X. `
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
l
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Narne of Hauler Destination Waste Product
YES NO
1.
2.
P&gon(s) Interviewed Inspector Date
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LOCATION ' 5EW6,C;E; PERMIT UO.
IW5TALLER5 U&ME ADDRESS
BUILDER'S 1J &MF- ADDRESS
DATE PERMIT ISSUED
DATE COMPLM 4CE ISSUED :
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No. ------�-_�-•-•-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD QF HEALTH
_.... . . ...........OF....... ... ...... .. ..: ......................... 3�
ApVtirtttiun -fur UWVoiittl Works Tunwtrurtiun Prrutit
Application is hereby ma for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: 4e
...................... ....................4- A.................
�/y� ,r Location-Ad/dreesss. �or Lot No.
..........{�.aev..4�f.21 .J .l..f.l..G--------------------------------
Address
.....
l Instaler
W S®-Sr`hTS Address
VType of Building e fy$,t Size Lot----------------------------Sq. feet
Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ...... No. of persons.....,A.- fit.............. Showers ( ) — Cafeteria ( )
dOther fixtures -----------------------•----------------------------------------------------------------------------------------
W Design Flow...........................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank i Liquid capacity�-oG_ allons Length---------------- Width................ Diameter-----....-...... Deptii---.----__.-----
x Disposal Trench—No. _-A.............. Width-------------------- Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No_________________--- Diameter-------------------- Depth below inlet-------------------- Total leaching area.._-------_.--..--sq. ft.
Z Other Distribution box ()C ) Dosing tank ( )
aPercolation Test Results Performed by...... ---------------•._.........------......._..----------•-----_..... Date:•-------------- -----------------------
Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water------------------------
L14 Test Pit No. 2................minutes per inch Depth of,Test Pit.................... Depth to ground water....._-..--.---._-__----
P4 -----------------•------ ---------••--•----------------------------------------- ........................................................................
ODescription of Soil---------------- - El/-----------------------------------.......... ----------------------------- ---------...----------------------------------
x
W
V Nature of Repairs or Alterations—Answer when applicable...----__---_ . _ -�ff ......�&��..._r�gvv�
----------7`6-------------a-------- -X A............. r's-------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed
Date
Application Approved By---------- �C-- ----------------------------------=------------------------------------
----------------•--' .................
-------•------
Application Disapproved for th following reasons:-----•--------------------•------------•-------•-------•-----_-------------------------------.----------•-------
----------------•--•-----------------------------...... •------------•-....--------------•--•......--------------•-----------------•----•------•-....----------•---- ---------------•-•-•---------------
Date
PermitNo. ............................................... Issued.......................
Date
��
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEALTH
..........oF....... .... ........._.................... 3..
Appiiration -for Miipoitti Worko Tonotrnrtion Vrrntit
Application is hereby mrnadq for Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
...................... -- =j '...�?....... �{' ! ... .. ------- ..................
Location-Address or Lot No.
s y
Owner Address
A7 /y ��r
Installer_s�-Jj 7 S Address
Q Type of Building ? „y�i' r Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( )
�____--_-_-_ No. of ersons..._.A_t________________ Showers — Cafeteria
Other—Type of Building _�_._.: _ p `. ( ) ( )
a Other fixtures ....._----------------------------------------------
w Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons.
Septic Tank/Liquid capacity..4-°'_1- gallons Length---------------- Width................ Diameter---------------- Depth.__.--_-__-----
xDisposal Trench—No. __4.............. Width-------_--_------ Total L'ength_...._.____....__.. Total leaching area--------------------sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet-----------_........ Total leaching area..---.___---.----_sq. ft.
Z Other Distribution box (7- ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date-----.---..-----------------------------
a Test Pit No. 1................minutes per inch Depth of "lest Pit.................... Depth to ground water_..-_--..----.---.--.---
444 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-_._.._-_--._----_---_
P4 ----------------------------••------------•-•---••--•--•--------•-----•....-•-....-------•----••----......................................................
0 Description of Soil--- --------_--- �.�-!/F'
x
w
------------ ----------------------------------- --------------------------------------------- --------------------------- -------------------------------------------
-
.0 Nature of Repairs or Alterations—Answer when applicable.......... �_r.• %/ ------
r.-C------_--...----- -
� y --- - 0 01-
----...... ..�------------- ------. ` -----------! ' j -- --------------------------------
?
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed__ ------------------------
� Date
ApplicationApproved BY C----------------------------------------------------------------------------- ---------------------- ---------------.
Date
Application Disapproved for tlt following yeasons--------------------------------------------------------------------------------------------- a-t.c..............
--...-•••--------•-•-•-------.....••--------•----------------•--•-•--•-•---•••---•---•--•----••----•--••---------••••----•------..-•-•-------------------------•----------------------...---......•----•
Date
PermitNo-----f `�------------------------•.............. Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS 006
u
f BOARD OF HEALTH
..ail..........oF.....?0./...f!tfr.9..c L
Tutifirate of f�omViinnrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by.........
------- --- - - - - --------- - ---
i'Gv T<' �j(J p Installer` n L
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.._._../i-�__ ______________________ dated......:?::._'3_-Z
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A gUARANTEE THAT THE
SYSTEM WILL�FUNCTION SATISFACTORY.
DATE------s
Inspect __._...
-------------------------------------
THE �
COMMONWEALTH {OF MASSACHUSETTS -1OGI
BOARD OF HEALTH _
..................1..................OF........................------........................
No...................... FEE---- :.:..�,
�i��o�tti ork,� Cnon�trnrtioat �rrmit
Permissionis hereby granted---------------------------------------------------------------------------------------------------------.----........----------------•-----
to Construct ( ) or Repair (A) an/ Indivi ual Sewage Disposal System
at No--------------- �. `�lL�!r.........Ae v-------------•-!�•!//3----%:rJ
----------------
Street
as shown on the application for Disposal Works Construction Permit No. 7y_________-- Dated......;4------
/, r --------------------------------
DATE----------------------------
J 3, D-------------------------------------------------- Board of Heal
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS