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0981 MAIN STREET (OST.) - Health
��1 � �i� ���- �sV��I�.. _ � � �� i i 7 i 1 r t 1 1 1 ,, �, /✓/iiJ - Wady a .4 c 42-383 d 4L VI '► :7 A eAb COS 6 r. lam. C a so 1.1 ov �VIO .4 A4f i OF row Ooo Uevs, C v y �� P�o*1METo�y TOWN OF BARNSTABLE OFFICE OF Bea MASIL = BOARD OF HEALTH .� A6Y. � ' O� i639. M 0 M 367 MAIN STREET FA'S k` HYA_NNIS,-MASS. 02601 December 2 ; 1980 Mr. Francis Harding .Mid-Way Garage 981 Main -St: >. Os.terville..,Ma. Dear' Sir: On August 141 1980, you.. were notified to have your under- ground fuel storage tanks tested,using the Kent-Moore Pressure Test, - by November 20, 1980. To date, we have not received the results of any testing performed. If this testing is not done immediately, the Town Clerk' s -office will be notified by this office to withhold your registration for storage of fuel underground. In addition, you are subject to a fine of twenty (20) dollars for each days failure to comply with a Board of Health order. Very trulyy.�.yours, John M. Kelly Director of Public Health JMK/mm ECC—IV ` HEALTH DEPT. TOWN Or SARNSTA ij_E JA N 1 9 1882 Sow, of e ft" Oman � 'pown. Rolf: t 1 V16 to Intm you the all 1 $ . oil M€ �. wiln. be %oatoa withluthey "o of the data of t .l our �osjnj 1,00V weak wAS uGeAd And, I f the t coy of fbio kqttOr VUl, be sent to the Board of Sealth in bare of 46m Iguy v , tnoroly s + #; ft .a - OP,65., 'Y r law ean ar Ul 5 C Ll H b inc. OIL POLLUTION CONTROL/TANK FARM MAINTENANCE CERTIFICATION OF PRESSURE TEST DATE : February TANK # : 10 SOO COMPANY NAME : Midway Garage ADDRESS : Osteryill . MA LENGTH OF TEST : 4 hours METHOD : Nitrogen Purcre PRESSURE TESTED : 5 12ounds CLEAN HARBORS , INC . Company Representative : { i F 24 HR. SERVICE (24 HR. RI OFFICE) 617-585-5111 P.O. BOX 193 • KINGSTON, AL4 02364 401-351-6090 ean arborS. inc. OIL POLLUTION CONTROL/TANK FARM MAINTENANCE CERTIFICATION OF PRESSURE TEST DATE : February TANK # : 10,;r00Eez�z COMPANY NAME : Midway Garage. ADDRESS : Os.terville, MA LENGTH OF TEST : 4 hours METHOD : Nitrogen Purge PRESSURE TESTED : 5 pounds CLEAN HARBORS , INC . Company Representative: 24 HR. SERVICE (24 HR.RI OFFICE) 617-585-5111 P.O. BOX 193 KINGSTON, MA 02364 401-351-6090 1 AOL r,i.eanoarborS inc. OIL POLLUTION CONTROL/TANK FARM MAINTENANCE CERTIFICATION OF PRESSURE TEST DATE : February TANK # : 12,500 U / COMPANY NAME : Midway Garage ADDRESS • Osterville, MA LENGTH OF TEST : 4 hours METHOD : Nitrogen Purge PRESSURE TESTED : 5 pounds CLEAN HARBORS , INC . Company Representative: 24 HR. SERVICE (24 HR. RI OFFICE) 617-585-5111 P.O. BOX 193 • KINGSTON.MA 02364 401-351-6090 Aw Aft bu ar I'&ft] a r u ' leaL inc. OIL POLLUTION CONTROL/TANK FARM MAINTENANCE CERTIFICATION OF PRESSURE TEST DATE : , February e TANK # : 2 Soo '✓ 2'.Z% COMPANY NAME : Midway Garage ADDRESS : Osterville, MA LENGTH OF TEST : 4 hours METHOD : Nitrogen Purge i PRESSURE TESTED : 5 pounds CLEAN HARBORS , INC . Company Representative : 24 HR. SERVICE (24 HR. RI OFFICE) 617-585-5111 P.O. BOX 193 • KINGSTON,MA 02364 401-351-6090 L AIM leanHar uo6r inc. OIL POLLUTION CONTROL/TANK FARM MAINTENANCE CERTIFICATION OF PRESSURE TEST DATE : February � � TANK Il : 5 , 000 COMPANY NAME : Midway Garage ADDRESS : Osterville, MA 1 LENGTH OF TEST : 4 hours PIETHOD : Nitrogen Purge I PRESSURE TESTED : 5 pounds CLEAN HARBORS , INC . Company Representative : 'lei d .24 HR. SERVIC.E (24 HR. RI OFFICE) 617-585-5111 P.O. BOX 193 KINGSTON, MA 02364 401-351-6090 CLEAN .HARB ORS., INC 1' ' '1 100 Joseph Street . P.O. Box 193 • Kingston, MA 02364 (617) 585-5111 CERTIFICATE OF PRESSURE TEST �COMPA.NY —m&ky-�q 6 1 LOCATION MRX:h) 0 TANK �l}1QQ \M)rvpCIA TIME START__' LBS. PRESSURE TIME 'COMPLETE RESULT � TESTED BY WITNESSED COMPANY WITIIESSED - - r a '.LEAN HARBORS ' INC. M I 100 Joseph Street • P.O. Box L93 • Kingston, MA 02364 (617)555-5111 CERTIFICATE OF PRESSURE TEST COMPANY. LOCATION TANKS Q \ TIME START LBS. PRESSURE y;,s TIME COMPLETE_ RESULT r 1 TESTED BYJ �- 1-go-Pea, INITNESSED COMPANY WITNESSED 0 CLEANHARBORS ' INC '1 100 Joseph Street - P.O. Box 193 Kingston, MA 02364 - (617)585-5111 CERTIFICATE OF PRESSURE TEST COMPANY LOCATION TANK#2. e TIME START q,.2;Q. LBS. PRESSURE y y TIME COMPLETE RESULT a, K. TESTED BY 6AJITNESSED COMPANY WITNESSED f CLEAN HARBORS. ' INC.- 100 Joseph Street • P.O. Box 193 • Kingston, MA 02364 • (617) 585-5111 CERTIFICATE Of"PRESSURE TEST COMPANY G LOCATION � �� �� C��121 TANK# Q ° TIME START ' LBS. PRESSURE t i TIME COMPLETEI'` �-. RESULTo , TESTED BY 1 UITNESSED COMPANY WITNESSED r /. ,.1. CLEAN HARBORSI1\TG'. 100 Joseph Street • P.O. Box 193 Kingston, MA 02364.• (617) 585-5111 N CERTIFICATE OF PRESSURE TEST COMPANY G LOCATION �+n� TANO.S .,r.., TIME START :.. 1' 0 i LBS o PRESSURE TIME COMPLETEl?�O� RESULT �r TESTED BY 1- WITNESSED COMPANY WITNESSED CLEANR ARBORS, ; I1\lC q 1 100 Joseph Street • P.D. Box 193 a Kingston, MA 02364 • (617)585-5111 CERTIFICATE OF PRESSURE TEST COMPANY LOCATIONn} F TANK# uRA, TIME START 2-L6' LBS. PRESSURE LA, TIME COMPLETE , RESULT TESTED BY WITNESSED COMPANY VVITNESSIi;D QFW: UST LIST Page 1 of 2 Martin, Cynthia From: Pulsifer, Francis [FPulsifer@commfiredistrict.com] 'Sent: Wednesday, September 16, 2009 11:18 AM To: Martin, Cynthia Subject: RE: UST LIST Hi Cindy: Sorry for the delay in responding back to you on this. The results for.the attached list of UST's are as follows: 190 Bridge Street, Osterville: 500 gal fuel oil tank removed 981 Main Street, Osterville: 4-8-83 (2)- 1,000 gal. tanks removed 7-18-86. 5000 gal gasoline tank removed 7-18-86 2500 gal. gasoline tank-removed 11-7-88 500 gal. fuel tank removed 8-14-89 12500 gal. fuel tank removed 5-9-91 275 gal. fuel tank removed 5-10-91 300 gal. fuel tank removed 5-10-91 500 gal. fuel tank removed 11-9-92 4000 gal. tank removed 10-26-93 32 gal. hydraulic oil tank removed 3-21-97 - 110 gal. gasoline tank removed 10-8-99 something removed u/k tank size/quantity Unfortunately, I have no information for the other addresses that you have listed, so the tanks are probably still in place. Hope this helps. Frank From: Martin, Cynthia [mailto*Cynthia.Martin@town.barnstable.ma.us] Sent: Thursday, July 30, 2009 3:36 PM To: Pulsifer, Francis Subject: FW: UST LIST Hey Frank, any updates on the list of.UST Removals. I received a response from the owner of 376 Parker Rd, Ost, who states the UST is not on site. I looked in our file and a hand written note seems to indicate that the owner contacted.COMM Fire in 2001 but that you folks had no record of removal. Thanks, Cindy -----Original Message---- From: Martin,Cynthia Sent: Thursday,July 09,2009 2:23 PM To: 'Pulsifer,Francis' Subject: UST LIST Hey Frank, l 9/17/2009 y FW: UST LIST Page 2 of 2 ` ,<C-O-MM UST.doc>>Attached should be the list of USTs whose current owners have not responded to the UST Removal Orders as discussed earlier. Enjoy, and as we say in dive circles-Happy Bubbles. Cindy 9/17/2009 USe F ; ; UST ADDRESS LIST FOR C-0-MM On data base as over 30 years old 1. 190 Bridge St, Osterville 2. 97 Outpost Ln, Centerville 4 3. 55 Scudder Bay Circle, Centerville 4. 594 Main St, Centerville 5. 473 Pine St, Centerville 6. 485 Pine St, Centerville 7. 376 Parker Rd, Osterville 8. 450 Race Ln,Marstons Mills 9. 6 Centerville.Ave, Centerville On data base as over 20 years old 1. 540 Old Falmouth Rd, Marstons Mills 2. 981 Main St, Osterville (This is Mid-way Garage; I sent you,a long 'winded email about this situation a bit ago. In a nut shell there appears to be a Tank. #8, Tag #206, installed in 1986 that is still there..They are in the process of removing two, 10,100 gallon USTs as well.) ► Office:508-862-4644 °Fz Town of Barnstable Public Health Division Fax:508-790-6304 7 RARMAWS. ` 200 Main Street• Hyannis, MA 02601 �p'FOMA+a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: M vj Date: �f Location/Mailing Address: i Contact Name/Phone: 50S -Wo l ffi- �dwa Q01W Inventory Total Amount"'-.Qca MSDS: 14 License#: Tier II : Labeling: Spill Plan: of Oil/WaterSeparator: 90 Floor Drains: Emergency Numbers:_ Storage Areas/Tanks: `""300 Emergency/Containment Equipment: i on C Waste Generator ID: Waste Product: far Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers t— Hydraulic fluid (including brake fluid) Windshield wash V Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants V Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible VPaint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/DECOMMENDATIONS: 6to S' u Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS • C; r' Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage ................................................................................................................................. 981 Main Street, Osterville, MA .----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. Restrictions: ------------------------------------------------------------------------------------------------------------------------------------------------------------------• This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ----------------------- -- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN, R.S.,CHO Director of Public Health L Town of Bamgtable Inspect onaII Services BARNSTABI,E -Publio, HnealthID.Msion, BARMASM, Thomas.IbMcKean,.Direc0rMAIM j �8vM 9. 200 IVIain Street,Hyannis,ILIA 02601 W5 Office: 568-862=4644 Fs x 508=Z90 G304` APPLICATION FOR PERMIT TO STORE AND/OR{UTILIZE HAZARDOUS MATERIAIIS,. IN ACCORDANCE WITH THE TOWN"OF BAR14STABLE GENERAL ORDINANCE,CHAPTER I(?"8,, HAZARDOUS IvMATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS"MATERIALS" GREATER.THAN HOUSEHOLD:QUANTITIES ARE REQUIRED TO:OBTAIN AN•ANNUAL PERMIT(RUINS` JULY Ist-JUKE 30th). APPLICATION"FEES CATEGORY I PERMIT 26— 110 Gallons. $ 50.00 Cl CATEGORY 2 I'I<;I2IV[I 1.11—499 0allons: $125;G0 ❑ A .. CATEGORY 3 PERMIT' 500 or more+Gallons: $150.00 *A Iate charge of SIO.00 will be assessed if my-&lent is not received by duly 1st. I. ASSESSOR'S MAP AND PARCEL'NO.: 2. IS THISA PERMIT RENEWAL'. ^ YES:�NO. IF YES;SKIP Q>ilESTION 3. 3. FOR ALL NEW PI'rRMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVALFOR HAZARDOUS�MATERIALS STORAGE%tJSE OF GREATER THAN BOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: � - 5. NAME"-OF ESTABLISHMEW. r 6: ADDRESS OF ESTABLISHMENT:. 7.. .MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER.OF ESTABLISHMENT: 9. EMAIL ADDRESS: 10. SOI;Et?WNER: ✓ YE$ NO IF NO,NAME OF:PARTNER.- I L. FULL.NAME,HOME ADDRESS,AND TELEPHONE#OF; CORPORATIOrj NAME -� PRESIDENT TREASURER.. CLERK 12. IF PREPARE'6 AY:OUTSIDE PARTY: NAME: . TELEPHONEIV COMPANY ADDRESS EMAIL: � SIGNATURE OF APPLICANT � DATE Q:1App1ication F&ms\Haz"Mat Appii Craft Jan2G19.das:x . :__ Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage LLC 981 Main Street, Osterville,MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------------------------------------------------------------------------------------------------------------------------- ------------------------ ------------------------------------- -------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. --------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health � I Town of Barnstable oFT KWE, Inspectional Services BASTABLE Public Health Division .15 1 J.::3 F•S1 LO O� i:: 5c:5'P.U1S:.:.= • r i 763S..201.1 BARNSTABLE, • 9 MASS. Thomas McKean, Director , z63q. �0 a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 'G APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS 01 IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS, ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st—JUNE 30th). APPLICATION FEES CATEGORY].-PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ;VSi *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. ! /-- IT'S 2. IS THIS A PERMIT RENEWAL? ;/YES NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: _ G r 6. ADDRESS OF ESTABLISHMENT: � _! $� (9� (n` :. JkdJ J 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE # OF: CORPORATION NAME PRESIDENT TREASURER ` CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: *SIGNATURE OF APPLICANT DATE �4 Q:\Application Forns\Haz Mat App Revised 09-10- Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage LLC ? 981 Main Street, Osterville, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -----------------------------"------------------------------------------------- ---- -------------------------------------- -------------------------- -------- ---------- ---------------------------------------------------------------------------'----------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Vowof Bogrnstable I egiaatory Services Richard V. Scali,Director Public Health Division BABSTABLE n� . 2:: snaxBTABie = Thomas McKean Director M1g5TOP$vLL3.OSf0.V]E•R4584p 5T4CE MASS 1639-Z014 Cn AjFO ,�p� 200 Main Street, Hyannis,MA 02601 573 MWa the Office: 508-862-4644 Fax: 508-790-6304 r APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE fD� HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, =' HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 x V S *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL?V YES NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 1 ,"QQ 6. ADDRESS OF ESTABLISHMENT: n4l,-g 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: , 8. TELEPHONE NUMBER OF ESTABLISHMENT: rQg 4 7�a�. O 9. EMAIL ADDRESS:: 10. SOLEOWNER: V YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION N PRESIDENT TREASURER CLERK 12. IF PREPARED BY/OUTSIDE PARTY: NAME: t 9,7,iLr TELEPHONE#: 77 —9-7!� • COMPANY ADDRESS I EMAIL: SIGNATURE OF APPLICANT DATE j Q:\P,pplication Forms\HAZMAT APP 2017 REVISED.d0 1 Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage LLC 981 Main Street, Osterville, MA Is Hereby Granted a License \` For: Storing or Handling 500,gallons or more of Hazardous Materials. I" - ---- --- -- ---- ---------------------------------------------- ---- --------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health To of B nstable P � ` 73� Renato ervices ` l +-,3 r b Richard V. Scali, Director �t o� Public Health Division BAB TABLE FIPHNSiA6lE•CHlYv:VttLF,.COTUR•NYVM1I:I; "^ '• BAMSTAsr.B. Thomas McKean,Director i 39°za 4wt639. CD sle<:N;t¢e 200 Main Street,Hyannis, MA 02601 a� Office: 508-862-4644 WOR- o76 6 Fax: 508-790-6304 X. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD,QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT- -26-'110 Gallons: - $ 50.00 'El 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 M V'S *A late charize of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. D 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS - ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: VYI �+'C`H'�l 5. NAME OF ESTABLISHMENT: M 1 9 IAI'A y ��A42kG e- 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: M(A,1 i/1 8. TELEPHONE NUMBER OF ESTABLISHMENT: 540 C" -42.20 9. EMAIL ADDRESS: n r ery eO � �'' `�` � ' �0 10. SOLEOWNER: YES NO IF NO,NAME OF PARTN ER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION / PRESIDENT TREASURER CLERK - 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE Q:\Application FormsWAZMAT APP 2017 REVISI DFdocx Number Fee 1312 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Emergency Contractors 981 Main Street, Osterville, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. -------------------------------------- --------------------------------------- =----------------------------------- ------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------:---------------- t� PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r ' owr of Barnstable TROeg atory Semces Richard V. Scali, Director " r ��►+e r� Public Health Division BARNKABLE � • BnNn5ra11tE•iENrEt:VILLE•CdNli•NYn:::15 BARNffrABLE. Thomas McKean, Director "r"�ua nWs:39a/�v�,,o arsr ean;rst aMA-S& '°ren a 200 Main,Street, Hyannis,M.A 02601 , .11 Office: 508-862-4644 �"/ �C2,o``? Fax: 5(18-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE_ r HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY Ist-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT •26— 110 Gallons: -$ 50.00 V " CATEGORY 2 PERMIT 111.—499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A,late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PER /YES MIT RENEWAL? _NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGMUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES�(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 1 -orr �7 C.L7'0 9(f 5. NAME OF ESTABLISHMENT: E�T�Cy 6. ADDRESS OF ESTABLISHMENT: 05k/?/`Ily, O s n^1 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 720451 ()24�S 8. TELEPHONE NUMBER OF ESTABLISHMENT: O S 17�-11 26) 9. EMAIL ADDRESS: 1,� � �y�l�l� rIC� ('(M reZe7UZ 10. SOLEOWNER: AS NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION N PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\App(ication Forms\HAZMAT APP 2017 REVISED.docx �W of B nstable co egu at0ry�erVICeS Richard V. Scali, Director �1 f 'I ME • a Public Health Division ' BARN 'TABLE xr�as"rywz�wus`".ceiuyiui°Rrs{"e.',n41.ns''.rrtee y,�q I BARNSTABLE, r Thomas McKean,Director 363i;1014 167q 10� - �ED N►A'� 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 6 �z -0?a�(g Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE I HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 3 Oth). APPLICATION FEES - `CATEGORY'I PERMIT' 26-- I10 Gallons: $ SU:OU � t CATEGORY 2 PERMIT 111.-499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO.- 2. IS THIS A PERMIT RENEWAL? /YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEJUSE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: r'lC�� S. NAME OF ESTABLISHMENT: ��,ir,, �C^Tj `1 7 IV*l .T 6. ADDRESS OF ESTABLISHMENT: 2� 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 7G i-� �'t f''� 5' G'i G'' 5 8. TELEPHONE NUMBER OF ESTABLISHMENT: G� 9. EMAIL ADDRESS: ri'� � � ) j flL"y �C}'7 �( '/'s �'Q y�7 10. SOLEOWNER: V YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION N PRESIDENT TREASURER _ CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLICANT DATE Q:1Application Forms\HAZMAT APP 2017 REVISED.do °F1HE Toys Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMAN�.� 200 Main Street• Hyannis, MA 02601 ,b M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MA'S Business Name: V� W l7'�'( Date: Location/Mailing Address: 1 4r►u-5 Sf-ec.n 11 Contact Name/Phone: M4 OvvtRyt- A& ,r Sd - 20--1�2o ct..�, b4 Inventory Total Amount: ^'?2�J4 f'+I$K MSDS: No License#: to 5 Tier II : /v o Labeling: S�- 045 fe:of Spill Plan: G Oil/WaterSeparator: A Floor Drains: �J O Emergency Numbers: fTo- - Storage Areas/Tanks: 3-4 K VST5 - 2 4&3- + has/oQiese l yt-<1Z K r Z.-s-o.>i A6-,r R STs - cjqs fc o,1, Emer enc /Containment ui ment: s e-e2,oQ< Waste Generator ID: Waste Product: Ot Date&Amount of Last Shipment/Frequency: "o r r r b ASD •tJ I- ZX1 yr Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS �o wtA, Dr CA, vim- �tti- rx��-��� St+��/45f- irt�}%�. NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous Lerial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers -1 Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) V Windshield wash LMotor oils { Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners ie6 e-Ruel, kerosene, #2 heating oil Disinfectants ill/ems Ilaneous petroleum pr d ts: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents >�,� �� Printing ink Car waxes and polishes bae-v<%ov.1#Q1-7 Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine —� Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: w tJo M SAS aVcokabl zw, l©yee-5 tog! -o ,a u,k TA51 d4„ yv4 1oy.c,cS yy�0.w---Cf,a�- s P,0 P<-& .cs2--24. v x" RIDERS: �e wzc-a�o.r on. ,Nu,s � w.w,ti• es-tS �5 cr \ a%I t&-ti w« S rysttCpoq v'� e.r Coo - S�,(e.6ot oyeeS vt--3 oL3 o acce55 . kk�o�' INFORMATION/RECOMMENDATION <��tS �►t �5-CS 4- n a�iX .caQ. ,no �o vtt.e� �.c-ttiy Inspector: Wk .ewu-r�ro w� rS , 05A- Cn�eel-Ge / a�� :1-� ov1.a l I �J a$}�e.Facility Representative: ,(�� - fig ,Mart f�e�kg • agk.er 0, 16JAXttV\IZ9S -`14k aarA'S WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS PI !A Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage LLC �. r 981 Main Street, Osterville, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------- ----------------------------- --------- _--------=---------------------------------------------------------------------------------------------------- - ------ -------- --- ------- ----'-- ----- ------ ---- --- ------- ----- ------- ----------- --- -------- ------- --------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable �t ►°,,ti Regulatory Services Richard V. Scah, Director ' `�� Public Health Division E*: ,X" �A 1639• a0 � W Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 (� Office: 508-862-4644 Q / Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE.WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1-PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 � ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE b FULL NAME OF APPLICANT:� � A Dxv, 90 NAME OF ESTABLISHMENT: �A l�W R`J ADDRESS OF ESTABLISHMENT: 6'1�S v\ C�S7c2'V 1 i�t E MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: S�> 0 EMAIL ADDRESS: M � D U,'A `Y SOLE OWNER: YES NO IF NO,NAME OF PARTNER: ,%FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME � PRESIDENT �TREASURER CLERK • IF PREPARED BY OUTSIDE PARTY: 11 SIGN APPLIC T Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Rev16.docx Page 1 of 2 0*1HE p Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. 200 Main Street• Hyannis, MA 02601 FOMa+°�0 �nA�TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 44f Z'k) Date: /Z Lsa 1.S Location/Mailing Address: I Contact Name/Phone: NMo.rk- 74-ZO -72- �7 Inventory Total Amount: �-rbW0 MSDS: �ezfog�& License#: � Tier II : Ajo Labeling: OK Spill Plan: Yv S Oil/WaterSeparator: .R-t ,pfloor Drains: NO Emergency Numbers: e-5 Storage Areas/Tanks: oo< 5 ice- Gov+rYa� -- e�otLt�`�an�-t e.l a awk efe vto� �Dro�ec� Emergency/Containment E ui ment: ra 5 m'A.51te� 4,ro,A.-+-t-eele xis ` Waste Generator ID: Waste Product: 61 Date&Amount of Last Shipment/Frequency: tiz Licensed Waste Hauler&Destination: f. S av +oK— Other Waste Disposal Methods: 61 LIST OF TOXIC AND HAZARDOUS MATERIALS +q�g o 3-6,00094 V5'15,� 2 25, 1,90- s�If y000/2 000 NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, haza dous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. l D Antifreeze +n Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers ',- Engine and radiator flushes Bug and tar removers It Hydraulic fluid (including brake fluid)7.0- _�('� Windshield wash 6 a - 0 Motor oils!C4, N k l o j,6 k 2-7,5-0as te Miscellaneous Corrosives Gasoline,jet fuel, ' tion W Cesspool cleaners Diesel fuel, ke ne, �ieating oil 22�5 Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil . Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides S Battery acid (electrolyte)/batteries 1?7 Photochemicals(Fixers) �" Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) T— Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Z Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: a.�_buclu7. Lit ov4'-Ax,,cs ,,'> bJele-`{' UK.-A-, c.4 s 0 a - ORDERS: Al ►1 d - v e ✓h 0-f—w- P to ve— Q 5 n, ,e+-,L o, / INF RMATION RECOMMENDATIONS: o� ,Lk- v or f2 . , < %.)VKvj o ��1 v� an�C ea, vv P1�. 4 tel D co m-ae--f 2 �p��'aQo�r���� sl��� b� A0VV,,, - 1t �D��L`}"Y�-�CorM.`f►u, -a-J2rkzo-4$� Inspector: I P I WQg'I'2 6 Facility Representative: WHITE COPY- HEALTH DEPARTMENT v 7'ANARY COPY- BUSINESS i /-�a Ifoo0 / 2ood �t— IKE*oJyti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • en MASS.LE. ` 200 Main Street• Hyannis, MA 02601 2639. �'DTEOMrt61 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: M1 �72�C� t\kC.\V t, I.A J- CA<kAa,) Date: Location/Mailing Address / MqqvL 5 ew- 12 Contact Name/Phone: ash HomovL M 4< sog-420--7220 , Inventory Total Amount: ^� y✓l� Q) MSDS: �ZS License#: SL. ' Tier II : Labelinci: OK Spill Plan: e_-, Oil/WaterSeparator: Floor Drains: IJo Emergency Numbers: Y4-5 Storage Areas/Tanks: o AA\ t ,ske v, 92VS-eec—Ae, &r V40,-V\AaV0r o6400r5, w.-K. <ooQ. Emergency/Containment Equipment: _SB ���t� RJa.�wlolt -w,. 5AC, Waste Generator ID: MAP Vol-9 7 i 2-8 Waste Product: 01 I Date&Amount of Last Shipment/Frequency: 2So 9 4-1 4 1 b 1 -X X Licensed Waste Hauler&Destination: C ►a- Q, 1 '1'ov aK A MA o D3 Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS A46 citemseals �� �-ja.�� j sko 4& 14S4'i►ty�-- ioK rc�.lert��i�. 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 requires a license from the Public Health Division. M°` % Antifreeze Dry cleaning fluids Ia,$ ow- Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils �, Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) 1 Car wash detergents Printing ink 3 Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Z Miscellaneous Combustible �k Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: QvWQ-vn! X,/eM,d-.5 w 'I•k 504 o wJA"+ ,ev< 4P.Oro•aecv CDII�C�i ovL s S�eJvl ORDERS: 5ylom,k olrv,, -Fof gq(&v4 -Feow,- Soo r Aa�'�c. �5� 1 J?.h,GI�W �n 0 SI INFOR ATION/RECOMME DATIO S. t�1oQ- t rbtw 5 f -fa OAL,ko ! ivy kv� vPkA w , r•-� .e SkkoSt't'j-, �ti1n,L6aG Inspector: ��Qlbyz�s. Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date:/0/ g /43 TOWN OF BARNSTABLEg -►o,t— TOXIC AND HAZARDOUS MATERIALS R FORM NAME OF BUSINESS: A - k)& 6-,?<A � BUSINESS LOCATION: `TS/ IWA j- 6-t-. 96fery-II-e— INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 5-00 - Y Zo - 7o :Zo SS Tons CONTACT PERSON: ,lea{k Pe>✓V«K. , A4a At%e-r EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: gas sta-�"io.ti /rvta►rt�eKanc� L/ar�y�. es t� L Fire District: Ay 511 fl10'IA%V1 Q►• �k,)I�.�C Inw crdCoyS n'10.�2�f+w�S A-Grv►� + Tor C - �/— ���( , Z ✓Vlo{�Z &-�erter-+-,r s� Waste Tr ertation: A1✓.r08V2079-Z0 Last shipment of hazardous waste: `/ /3-ZcYJga l Name of Hauler: yrt. 0, I Destinati;4. • ,/ �5' o� h oK z-if Waste Product: �&6+9� v, / Licensed . No 2303 7 7 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 tJ Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive LdNEW ❑ USED Cesspool cleaners Z Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) S Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides p YNEW 10'Li USED 2.5'0 (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 A,Rustproofers 18"'9Ja 3 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 LS Windshield wash WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Number Fee 1312 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that- Emergency Contractors 981 Main Street, Osterville,MA It Hereby Granted:a License for:Storing or Handling 26 - 100 gallons of Hazardous Materials: --_ ----- - - ---- - This license is granted in conformity with the Statutes and ordinances'relating there to, and- and expires *06/30/2017 unless sooner suspended or revoked. --- ----- -------- t PAUL J.CANNIFF,D.M.D,CHAIRMAN DON ALD A.GUADAGNOLI M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO ' Director of Public Health ° :V c° $So,ov �h y Town of Barnstable �INE rokti Regulatory Services Richard V. Scah, Director .fit • r RMMSTAB�. = BA�NSTABLE ,�: �0r Public Health Division NAMHI 9AALE rED'"P� Thomas McKean,Director . 1639-2M 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 07 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE . HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00TL . CATEGORY 2 PERMIT 111 —499 Gallons: $1215.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late`charze of$10.00 will be assessed if payment is not received by July 1st. y • ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: r NAME OF ESTABLISHMENT: ,C L ADDRESS OF ESTABLISHMENT: / MAILING ADDRESS (IF DIFFERENT): `?20 B1 Jkt'2 Lis etq 0'�6s�� TELEPHONE NUMBER OF ESTABLISHMENT: %5Pe -77,5^ /la EMAIL ADDRESS: D jei'' e SOLE OWNER: OYES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENTX TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SiGyaa OF APPLICANT Name: • x Company Address : Telephone#: Email: QAApplication FormsUlAZZAPP Revl6.docx Page 1 of 2 Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage LLC 981 Main Street, Osterville, MA 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 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Gi 11 r Town of Barnstable A low Regulatory Services Richard V. Sc4 D vaor MAW ` Public`Health Division r Thomas McKean,Director . 200 Main Street,,Hyannis,MA 02601 Office: 508-862-4644 Fax: ,508-790-6304 'it Appiication-Few-- o0 0© ASSESSORS MAP AND PARCEL NO, I � 0� DATE tolZs[(5, APPLICATION FOR PERAHT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT141� 1S NAME OF ESTABLISHMENT I y)l D-art A /.,AI2 l G L1_L • ADDRESS OF ESTABi ISMV ENT9 AAA ,6 2� ,SS TELEPHONE NUMBER. ._5'0 SOLE OWNER:'- YES NO IF APPLICANT IS A PARTNERSHIP,FULL.NAME AND HOME ADDRESS OYALL PARTNERS: « F p—kse_i t A OKI QAW LLO- A (tom( 6-r 651ehp-VLL.►j�,AAA IF APPLICANT IS A CORPORATION: FEDERAL IDEN'TMCATION NO. 04,3 5-PO9)CD STATE OF INCORPORATION "A FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK :. jj SIGIqATUkE OF APPLICANT RESTRICTIONS: HOME ADDRESS 7'70 cat tAAiQ s-r 0sTe?sJ I u.-�,�q HOME TELEPHONE# C:\=che\T=pmwy latemet FilesWLK MAZ.A"ReV2015.D0C IT, Town of Barnstable office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 ,, ; Public Health Division IMTAIR 9. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 6/30/2015 lCheck number: 5252 Check amount: $100.00 Name on check: Mid-way Garage 'Business: Midway Garage LLC Owner: RICHARD P TR CALLAHAN !Address: 981 MAIN STREET(OST.), Osterville t i • c I wY Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage LLC 981 Main Street, Osterville, MA 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 6/15/2015 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 . y Town of Barnstable i 1 °F1MEra,, Regulatory Services Richard V. Scali,Director MAMSTBLEMASS. r Public Health Division 039• ♦0 . °rEa Mai" 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 �AMS NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT (6� TELEPHONE NUMBER tDo SOLE OWNER: YES 'NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: �15 tX& TD,`- S `7.!5 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF:, PRESIDENT' TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q\Application FormsUiAZAPP.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\Application Forms\HAZAPP.DOC MidWay Garage LLC ! 4 t ^ 981 Main St. Osterville=MA / S08 420-7220 , Emergency Services Fire Department: '508 790-2375 508 862-5235 Police Department: 508 775-0387 . DEP Office: 888 340-1133 617 338-2255� CIA (Corp. Env. Adv.): 800 358-7960 i CYN Environmental: 800 242-5818 SPLASH: $0 - 0 74 63 835 i ' MidWay Garage LLC 981 Main St Osterville-MA 508 420-7220 2014 Spill Procedure Plan • Evacuate the immediate area, if necessary. • Shut off valves, pumps, and electrical equipment as appropriate. • Remove or restrict any potential ignition source from the area is the material is flammable. • Cover or dike all existing sumps,and storm drains if not already covered. • Contain the spill by use of absorbent socks/booms,them apply appropriate absorbent material. • Contact spill response firms, if necessary,to assist in these activities. .• Remove all absorbed material or contained liquid and package in DOT approved container. Used absorbent materials should be packaged separately from liquids. • Label all containers with the type of waste and.the start date of accumulation. • Notify the appropriate agencies. • Once the spill has been controlled-and materials collected and secured, inspect the area. for cleanliness and decontaminate all equipment used in the clean up. • Replace all used materials and ensure all response equipment is in good working i condition. • Manage and dispose of collected absorbents and Liquid in accordance with Federal and State environmental regulations. • Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. • For any spill greater then the reportable quantity or 25 gallons,whichever is less,this plan shall be implemented and proper records on action shall be kept on-site. • Spill cleanup equipment is located is the garage. • The following is a List of the equipment on site: o Spill response kit . o Fire extinguishers o First aid kit C r Town of Barnstable �FTFiE r Regulatory Services Richard V. Scaii, Director BARNSPABLE, f p MASS* Public Health Division :6y9. ♦� aTf°Mai'' Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: .508-862-4644 Wayne Miller,M.D. L Fax: 508-790-6304 Paul J. Canniff,D.M.D. Junichi Sawayanagi NOTICE TO ALL BUSINESS OPERATORS WITH TIAZARDOUS MATERIALS IN BARNSTABLE The Town of Barnstable Town Council .adopted, Chapter 108: Hazardous Materials, a requirement for each business operator to obtain an annual permit and to remit a fee of$10.0.00 if one-hundred and eleven (11.1) gallons or more of hazardous materials are stored, .transported, utilized, and/or disposed of at a particular site. STEPS 1 — 2 - 3: 1. Please complete the attached application form 2. Include a copy of your contingency plan (to handle hazardous waste spills, etc 3. Submit the fee of$100.00 payable to the: Town of Barnstable. MAIL all of the above to this office on-or before June 30,2014. A late charge of$10.00 will be assessed if payment is not received by July 30, 2014, Please feel free to view the above Code, Chapter 108: Hazardous Materials on the. Town Website, www.town.barnstable.ma.us , which is located under the E-Code.. section if you should:have any questions or concerns. QAHazmat\Fm Mat Permit Lettcr.DOC i Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Mid-Way Garage LLC 981 Main Street, Osterville,MA 02655 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 6/30/2013 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 10/17/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 4 � - - Town of Barnstable Barnstable Regulatory Services Department A&AnmdcaCft Sr,,H . ; Public Health Division RMW `"reap �' 200 Main Street Hyannis MA 02601 2007 Office: 508-862-4644- _ Thomas F.Geller,Director FAX: 508-790.6304: Thomas A.McKean;CHO Application Fee: $100.00 i 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 �ffG�'/9'H/9/I! O NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER DO 7i4 72_2�0 d26 S SOLE OWNER: YES_,�KNO IF APPLICANT IS A PARTNERSHIP,FULL NAME.AND HOME ADDRESS OF ALL PARTNERS:: /�l A sT !/ice W GCE D � Igoe 010-9 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME HOME ADDRESS OF: PRESIDENT '' 5/S TREASURER CLERK GNATURE OF APPLIC/ANT rr RESTRICTIONS: HOME ADDRES Jt �f'. HOME TELEPHONE# JAinspection handouts\Haz Mat Applicabon2008.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 time for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR.FA ED REQUESTS Our fax number is 508 790-63.04. 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 of$100. Please make the check payable to: Town of Barnstable: The check must be mailed to the address listed above. Allow time for in- house processing.. E For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page JAinspection handouts\iai Mat Appiication2008ZOC' r IKE*og� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 a" MAC`E. ' 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Cmf, ►^z Cort4r-ac,-}or5 Date: 13 17 r Location/Mailing Address: qel Contact Name/Phone: N�� : �5k o toy t.F .,! w►u+c r�°st k -`)��n S"D��'77�11g �n sA / � ►in�vs Inventory Total Amount: ^� y(>-SD a 1 MSDS: ti5 r 54aA VD License#—N� Saar 1 Tier II : o Labelina: CU cV-tt Spill Plan: +6, o5'k- Oil/WaterSeparator: Floor Drains: No Emergency Numbers: " Storage Areas/Tanks: .1 ei o, S t,I. CowEaoy"-e- Emer enc /Containme tE ui ment: V:� 54cA, A<4 Ary B 5Ae- aw�.Q ��-Acjc14S Waste Generator ID: N I A I IWaste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils —� Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine .. Paints, varnishes, stains, dyes Lye or caustic soda —.v/ Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: e, -e I -,I-Lcr!l I CAA 1 Ow AbN W1 V%- 06 lw 5p *5 �c v5-t. nVL S ��. Av��,Q o (u, Inspector: �IA s,Facility Representative: 1Q�tt � ' WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 865 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify,that Mid-Way Garage LLC 981 Main Street, Osterville,MA 02655 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 6/30/2010 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health t� Town of Barnstable ,. Barnstable ypf THET ,o Regulatory �ervicc� I)cp�rt��n� A"maicaMY Public Health Division 9 200 Main Street H annis MA 02601 � Y m pl�D A�A�A 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fey: $100.00 ASSESSORS MAP AND.PARCEL NO. DATE APPLICATION FOR PERI 1IT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS 4e-, FULL NAME OF APPLICANT / ! y 'e9C(� L L K 'G�R 1 CA((A�AN NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT F5 1 M A- rj S l 0 S TC L • TELEPHONE NUMBER �JS 7 2 Z SOLE OWNER: X YES NO IF APPLICANT.IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: c1A,-7d 6/9-4� --kA,^ 39-5— 1 8-e-ach PC 3 3gffo f3 o IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION N0 4' � "� STATE OF INCORPORATION f FULL NAME AND HOME ADDRESS OF: - PRESIDENT TREASURER E, CLERK arn • SIGiti` PI JCANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# QAHaziriatiHzz b.fat Application2008.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 time 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 its a copy of your contingency plan (to handle hazardous waste spills, etc.) In addition,please mail the required fee of$100. Please make the check payable to: Town of Barnstable. The check most be mailed to the address listed above. Allow'time for in- house processing. For further assistance on any item above, call(508) 862-4644 Back to Main Public Health Division Page QAV!azmaAIrJaa NAat Apphcation2003.DOC MidWay Garage LLC 981 Main St Osterville—MA • 508 420-7220 Spill Procedure Plan e Evacuate the immediate area, if necessary. o Shut off valves, pumps, and electrical equipment as appropriate. o Remove or restrict any potential ignition source from the area is the material is flammable. o Cover or dike all existing sumps, and storm drains if,not already covered. o Contain the spill by use of absorbent socks/booms,them apply appropriate absorbent material. e Contact spill response firms, if necessary,to assist in these activities. o Remove all absorbed material or contained liquid and package in DOT approved container. Used absorbent materials should be packaged separately from liquids. e Label all containers with the type of waste and the start date of accumulation. o Notify the appropriate agencies. o Once the spill has been controlled and materials collected and secured, inspect the area for cleanliness and decontaminate all equipment used in the clean up. o Replace all used materials and ensure all response equipment is in good working condition. o Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. o Manage and dispose of collected absorbents and liquid in accordance with Federal and State environmental regulations. e For any spill greater then the reportable quantity or 25 gallons, whichever is less, this plan shall be implemented and proper records on action shall be kept on-site. o Spill clean up equipment is located is the garage. o The following is a list of the equipment on site: o Spill response kit o Fire extinguishers o First aid kit S MidWay Garage LLC 981 Main St Osterville—MA 508 420-7220 Emergency Services Fire Department: 508 790-2375 508 862-5235 Police Department: 508 775-0387 DEP Office: 888 340-1133 617 338-2255 CIA (Corp. Env. Adv.): 800 358-7960 ' CYN Environmental: 800 242-5818 SPLASH: 800 746-3835 ..+.-•. _...-...........:...f.,...r-.r t.,•=.n:'^w`�-"'^-'-••r..,-r".,m-X•--w.'-o•+.-.-e-.^.''.ry-.�-.^*""-'wFY.7iz".,'l+r,�,v ..,,_,,,,.,.,.,y ..,,..,;;^,,,,,,..q-...._...,.�&�'•�`^,--....M, ,•,F„*.., ..-'.;5-, TOWN OF BARNSTABLE BAR—W 5194 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager `� " ' �` 4 I Address of Offender MV/MB Reg.# Village/State/Zip Business Name (i2Y1�� +;rtt' �i t� ''fa /, (� Q/pm, on1 20 1 7 Business Address r3 ► 4, 4 ,.�+ Signature of,-,Enforcing Officer Village/State/Zip 0j //z r " A 0 --Location of Offense ►`i'�-{:�-�✓��k/ �.,,e�rt'�('�G`f���t s � { - w Enforcing Dept/Division Offense Vt ���r� , �,,,� 4 �� 'G, . e,?r/te)4 U�z e4 •r 7�� l / Facts �.)AO.s�- 4 ild4f► � 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. .• .C'^' -. .-:_,,,,,,y..,.r,,.K..,_Ib.-*`w-✓*.Fr'rse^„$T'•cG,"r...,,r...'`-'..,y'.-_W.'.".....p,...�..^F Vs.:..--..� ..v...l..--_.._.r- Y^+,,.^d'.a.,.. TOWN OF BARNSTABLE BAR-W 519 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip 20_? r ' Business Name r! .' � �i r s '� f am/pm,, on Business Address } - Signature of/Enforcing Officer Village/State/Zip 1j . v i i Location of Offense C+' ~+' f, ir k� , , r r �< Enforcing Dept/Division Offense U t 1 'k.'T. a vlk !� fly L^ r f -! 'nt 4'C Facts il3 #+ I7 ' t r_ * i i t r•bl 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. ti t {� TOWN OF BARNSTABLE VA,Ve /rA yam`' UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS ASSESSORS MAP NO.' PARCEL NO. 0 ADDRESS: V$ � VILLAGE: NAME._..../J-e ftY CONTACT PERSON Q ON A-4. D 4-: PHONE NUMBER 449 e- �946-0 LOCATION OF TANKS: . CAPACITY: TYPE. OF- FUEL. AGE: TYPE: LEAK OR CHEMICAL: DETECTION 5 511,4p IA)6i-rJUf-b cN Lit,i )01 SYSTEM! 5r1p,3,r,4iY / iNG :vdvhE�s .30 f a�f�t� CVO �. 0� �� o�vgc lr�, ay-lw1,oA s"�."�yi��,/3•t f ycr�c0 Ervoe� cy,�s% ✓�� N@ y- 4 .�a WA i-- A ST/�3��f-f�i•-�i.�•G7�i l.� ��L, STEF'L- :� .�. ovIVYR si#"g-W,41 DATE OF PURCHASE OF EACH: 1. �`d �' -X 2. 3. V,-,f6'X 4. 6�r�� 5. DATE OF FIRE DEPARTMENT PERMIT: AA, ,5s60 �l D�}Y/tD l.�iQ,QI �-Co/ya-)41 E AEP7, TESTING CERTIFICATION SUBMITTED: Cf�'�' x PASSED DID NOT PASS XZANI\-�5-A/A Ye-� Vh&o jq 0 1 /4-14--c-PACF- 9,e ,.EFH WA-U,S /--/,? 46- P/f-1;-SAD PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. I TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS ASSESSORS MAP NO. PARCEL NO. ADDRESS; /N,, ;/' VILLAGE s Lsq l '/L LE 14AME',20 1�L��..r /�A/ �rs �a /�/ �/ /G 6/�7f�.. /.1-f17^`y � ��/4���'1�V L-• CONTACT PERSON PHONE NUMBER LOCATION OF TANKS: . CAPACITY: TYPE--OF- FUEL AGE: TYPE: LEAK OR CHEMICAL: F DETECTION -_ SYSTEM' 6TiGhT4,11- / ` .Jl Z1A1C A*DOF ��T NG 7.�d o G, DATE OF PURCHASE OF EACH: 1. 2. 3. 4. 5. DATE OF FIRE. DEPARTMENT PERMIT: ^^L- - 19�}YiD �Rel&R -�d if j� PZPj TESTING CERTIFICATION SUBMITTED: �`'Q /� PASSED �~ DID NOT PASS ��i9�.� fli��i�•�c��%ia��gN �1/�LL.� i- its�s�-A����� PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. L i c /TERV/LLE- 05reR VIZ LE S - -ri,41-cr U /S7R16 71 0io to, FAA 1 3 L IONS Y. is 8ARN�r�01-F coOM71 pLt 171. CLEAN HARB ORINC'• 1 100 Joseph Street • P.D. Box 193 Kingston, MA 02364 •.'(617) 585 5111 CERTIFICATE OFa PRESSURE TEST COMPANY \Aab LOCATION . j1w `T. �(�rz1��1�e TANK# r7 1\�I�� ' TIME STARTt. LBS. PRESSURE !A y' Y TIME COMPLETEISLJ,� 'Tt RESULT__�ar, _��� H - -=----_ TESTED BY WITNESSED COMPANY WI TN. S SED i August 19, 1982 Mr. Francis E. Harding Mid-Way Garage 981 Main Street Osterville, Ma. Dear Mr. Harding: Underground fuel tanks twenty years old that have a capacity of over 500 gal- lons must be tested each year for leaks. The Kent Moore Pressure Test is the preferred test; however, an empty tank can be tested by a 5 PSI air pressure test held for a minimum of two hours. The air pressure test can only be done on an empty tank and is not the preferred test. One of your tanks is 22 years old and two are thirty-two years old and were tested on January 20, 1982. You are directed to have the tanks tested by ' October 15, 1982, and a copy of the results must be sent to the Health Depart- ment. Failure to have the tanks tested could result in a fine of not more than $200. Each separate day's failure to comply with an order shall constitute a separate violation. We would appreciate your cooperation in this matter so vital to the water quality of the town. Please call if you have any questions - 775-1120, extension 182. Very t J yours, R t L. Childs, Chairman 7 �_�L_ Ann fane Eshbaugh /FT, H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE JMK/mm CERTIFICATION OF PRESSURE TEST 9 - 3 - � 2 DATE: J1 Va japer (InIeacZe . 7l<S loo 1 l r/rlleacled 74S 1-6-2yoo �26 0� � Two rks- the l vc -���ooU � r-- TANK #• cr h !SS' COMPANY NAME: ox ADDRESS _ / f `l az LENGTH OF TEST: — 6� METHOD: PRESSURE TESTED: CLEAN HARBORS, INC. Company Representative: � ' i y . ..••.�.. `^'. .•....��..... .+..l...........Y.............11.Y1........I'..ti' ..1111Y.1...Y..1.Y.......06..0696...ob r1..60008.00666.9• The Commonbveartb of ag2;aCbU!5ett!9 DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION O Health Dept 1010 COMMONWEALTH AVENUE. BOsTON Town of Bamstablg D CP.]1t_.-Osteryille M r 19 3 A 8 (City or Town) IDate) PEW R M 1 . In accordance with the provisions of Chapter 148, G. L. as provided in _SEC: i O,C� M A R 2 8 1883 this permit is granted to Name _ Francis Harding d/b/a Mid-Way Garage (Full name of person. firm or corporation granted permit) tom_ install (1 ) 5000 gallon gasoline storage tank State clearly tQ 2) 1000 gallon gasoline storage tanks purpose for Which are being removed. which permit is granted Restrictions: orl-a.m i r R ocLi-Racd Fz?Onr, r;RE - EPT Ta I 'rZEctr-,ou C } �►�d -rtz A t.>s�o tzr u s Fd -r a t4 k r To `Z04%A of N P-c4t A i at 981 Main Street, Osterville, Mass, 02655 (Give location by street and no.,or describe in such manner,as to provide adequate identification of location) Fee Paid (Signature of o ici granting per ill } This permit will expire 19 C�� C ( yo (Title) C-�' (THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES.) `%:--9 i t "0 THE TO� TOWN OF BARNSTABLE OFFICE OF t snaasTsars, = BOARD OF HEALTH MA68. D pY k�e� 367 MAIN STREET HYANNIS, MASS. 02601 April 6, 1983 Mr. Francis Harding Midway Garage 981 Main Street Osterville, MA. 02655 Dear Mr. Harding: You are granted a variance to replace a new underground fuel tank 1650 feet from a public water supply, in lieu of the re- quired 2000 feet, at your station, the Mid-Way Garage, 981 Main Street, Osterville, with the following conditions : (1 ) The new tank will be a STI-P3 tank system which has been approved by the Centerville-Osterville Water Commissioners. (2) All other conditions of the Town of Barnstable Health Regulations to Prevent Leaking of Under- I ground Fuel and Chemical Storage Systems Regu- lations must be strictly complied with. I (3 ) This variance is granted because the old tanks over -20 years of age are being removed and re- placed by tanks less likely to leak. The Fire Department, the Centerville-Osterville Water Commissioners and the Conservation Commission agree to this variance. This variance expires May 1, 1984. V ry my e% _ , bert L. Cliilds Chairman Ar1ra- shbaugh H. F. Inge,, )M. D. ' BOARD OF HEALTH , �mm G: Fire Department Centerville-Osterville Water Commissioners Conservation Commission r April 6, 1983 Mr. Francis Harding Midway Garage 981 Main Street Osterville, MA. 02655 Dear Mr. Harding: You are granted a variance to replace a new underground fuel tank 1650 feet from a public water supply, in lieu of the re- quired 2000 feet, at your station, the Mid-Way Garage, 981 Main Street, Osterville, with the following conditions: (1 ) The new tank will be a STI-P# tank system which has been approved by the Centerville-Osterville Water Commissioners. (2 ) All other conditions of the Town of Barnstable Health Regulations to Prevent Leaking of Under- ground Fuel and Chemical Storage Systems Regu- lations must be strictly complied with. (3) This variance is granted because the old tanks over 20 years of age are being removed and re- placed by tanks less likely to leak. The Fire Department, the Centerville-Osterville Water Commissioners and the Conservation Commission agree to this variance. This variance expires May 1, 1984. V71, by yours, Rolbert L. Childs, Chairman j ugh H. F. Inge, M. D. BOARD OF HEALTH JMK/mm cc: Fire Department Centerville-Osterville Water Commissioners Conservation Commission BOARD OF WATER COMMISSIONERS CENTERVILLE-OSTERVILLE FIRE DISTRICT OSTERVILLE, MASS. 02655 I March 25, 1983 j Chief John Farrington Centerville-Osterville Fire Dept. 999 Main Street Osterville, Ma. 02655 Re: Gasoline tank replacement - Mid-Way Garage Dear Johns Mr. Harding of Mid-Way Garage in. Osterville has submitted shop drawings to me for the installation of a new gasoline storage tank. This new tank will replace + two older and smaller tanks at his garage. This new tank will be a Sti-P3 tank system which this department does approve of -to -be installed within the 2000 foot radius of our public water supply. If you have any questions, please do not hesitate to call. Very ,truly yours, .= ?ell � Donald F. Rugg Superintendent ect Mr. F. E. Harding Mid-Way Garage CERTIFICATION' OF PRESSURE TEST DATE: ti TANK #: C01j'ANY N�AY"E: ' ADDRES a k . k LENGTH OF TEST: . J^�' METHOD: l PRESSURE TESTED: .�. ✓ �'/ l CLEAN HARBORS, INC. LLC-11 Company Representative: CERTIFICATION OF PRESSURE TEST 0DATE• f . i TANK #: / COMPANY N YE z ADDRESS: Ile- LC LENGTH OF TEST: METHOD: IN, cl000e PRESSURE TESTED: k CLEAN HARBORS,: INC. Company Representative: 1 < CERTIFICATION OF PRESSURE TEST DATE t f - COMPANY NAME; ADDRESS_ . LE'NCTH OF TEST: METHOD: PRFSSUPE TESTED:: _57^ I �r CLEAN HA.RBOR.S, _INC. Company . Representative: . co CERTI FI CATIOW OF PRESSURE TEST DATE: AIvT Y, #: �� G e COMPANY NAM'.• �- ADDRESS. i •s • z _ LENGTH .OF TEST: METHOD: w PRESSURE TESTED: CLEAN.HARBORS, INC.. Company- Representative CERTIFICATION OF PRESSURE TEST DATE `i TANK #: &,Z . �S COMPANY N1�'!E:. ADDRESS Q'/ LENGTH OF TEST: �. METHOD: PRESSURE TEST.D: CLEAN' HARBORS', INC, Company Representative: 1 Z Y FORM F.P. 292 y' (rev. 9/90) Department of Public. Safety- Division of Fire(Prevention and .Regulation APPLICATION FOlk PERMIT, AND PERMIT, FOR REMOVAL.AND TRANSPORTATION'TO APPROVED TANK YARD FDID# 01920 Permit # Date October 26', 19 93 Centerville(Town of Barnstable) City,Town or 01SWct C . 82 S . 40 . c . C DIG SAFE NUMBER' n/a Fee Paid:S 10.00 1 start date In accordance with the provisions of Chapter 148, `Sec. 38A', M:G.L. , . 527 CMR 9.00 application is hereby_ made by; Traco Sales & Service 9 Jan Sebastian way. , Unit- 4b, Box 1663, Sandwich,M.A Street=.Address & City or Town: Signature of .applicant: Applicants` name ~printed: GPra14T Tr rPy, Tr ' For permission to remove and transport one underground storage tank. from. . owner: IftIrDon Harding,, Midway Garage Fe�'Lc Address: 981 Main St�Osterille.,l"MA Firm transporting waste: tank,abandonment State_ Lic° # Hazardous waste manifest. 1 T.4 a E.P,A.# Approved tank yard: tank abandonment # Tank yard Address: n1a Type of inert gass UL tank #: Tank capacity: 32 gal hrlranl i r final Substance„ last stored:''' : tank Date of issue: October 26 19 93 Date of expiration• n/a 1 Signature/Title of officer granting permit: KEEP ORIGINAL AS APPLICATION AND 19SUE DUPLICAT2 PERM ..y SALES & SERVICE 9 Jan Sebastian Way • Unit 4B • Box 1663 • Sandwich, MA. 02563 • (508) 888-5766 . Oct. 25, 1993 Midway Garage Fuel , Inc. 981 Main .St, Osterville, MA 02655 (508) 428-2296: ATTN: Don Harding RE: In-ground System Closure Dear Mr. Harding The following report will document observations made and actions taken to facilitate the proper closure procedure 'for the in-ground hydraulic system 32 gal . reservoir located in the service bay of the forward garage at 981 Main St. 'The reservoir closed tested tight, no ruptures noted. The reservoir cap was exposed and removed. Dimensions. 16% X 53"h. Approximately. 32 gals. of. hydraulic fluid was transferred from reservoir to waste oil holding tank via 1" .um diaphragm p p Operator observed transfer.. Five (5) gals. of sludge/residual removed by hand tool , reservoir washed down with biodegradable degreaser and approx. three (3) gals.. of water/residue recovered via pump. This waste will be transferred to Barnstable .Co. Solid Waste Recovery Facility by operator. Reservoir was inspected by FPO Wilcox and Deputy Chief Whitely prior to abandonment. Due to proximity- of adjoining chimney.-base, removal of tank may have resulted in weakening of structural integrity of such. Reservoir excavated depth noted at. 76". Chimney base excavated adjacent at 40". Visual inspection of washdown product removal completed.. Reservoir filled with concrete/slurry mix (RE: 527:9). Above ground reservoir installed hydraulic system fully functional with no less of controlled substance. �r'11SSf�0J -To N40'Do ✓ Sincerely, �'IPv�) w4 rre q-y Gerard T Tracey, Jr. ' GTT/rlt Project Co-ordinato cc: FPO Wilcox c4azo[d gfzomai 67o. �NJ\FFONMEIV7. O [A:R® MgNAGEMEN� Nazo RECOVERY SYSTEMS AUTOMOTIVE LIFTS ' FORM F.P. 292 .t • (rev. 9/90) � t�1ip C�v�rinlmtwp�Ifh a� �t����r�u�rff�' Department of Public Safety Division of Fire Prevention and-Regulation APPLICATION FOR PERMIT, AND PERMIT, FOR REMOVAL AND TRANSPORTATION TO APPROVED TANK YARD FDID# 01920 Permit # Date_ November- 9, 19 92 Centervilie(Town of Barnstable) City,Town or District ` C . 821 S . 40 N . G . L Z> DIG SAFE ?iUMBER. Fee Paid:1 10.00 #92450827 start date 11/9/92 In accordance with the provisions of Chapter 148, Sec. 38A, M.G.L. , 527 CMR 9.00 application is hereby-made by: YelScot Street Address & City or, Town: 9B Appletree Lane, Bedford, MA 01730 Signature of applicant: Applicants name printed: For permission to. remove -and transport one underground storage tank from. owner: Midway Garage Street Address:�,_9881 Main Street, Osterville, MA* Firm transporting waste: Jet Line - State Lic. # 12 Hazardous waste manifest # E.P'.A. # Approved tank yard:_ Tnmhari i„ ' ' # In liani Tank yard Address: Lawrence, MA Type of inert as: 7�`� -Pt 6/ 0 ?-FY! yS U, L tank #. Tank capacity:- 4,000 gal. Substance last stored: gasoline Date. of issue: November 919 92 Date of expirations November 23, 19 92 Signature/Title of officer granting permit: LXZ'qt.` 40"' KEEP ORIGINAL AS APPLICATION AND ISSUE DUPLICATE AS PERMIT t Make application to local Fire Department Fire Department retains original application and issues dupfcate as Permit. cr U/ee 9/ev&1G eP/ — ✓U4CUI 0�.V'GY�✓ 94i91P/IG�GQ�f?i � —-�'- ,� •:.j APPLICATION and PERMIT � _� L Fee. r�l rin for storage tank rerncval and transportation taapproved tank disposal yard in accordance.with the provisions of M.G.L. Chapter 148. Section 38A, 527 CMR 9.00, application is hereby maite by:' • Tank Owner Name(plea-se print) Mid Way Garage X Signature(of apaying tor permit) Address C�981 Main Street, Osterville, MA�02655 Street City State Zip Removal • Mltl - • • • \.C--C� Company Name Shoreline Tank Service Co.or Individual Ground Water Anal y ;r•a 1 Print p nt 87 Pond Street, Osterville, MA 228 Main Street, buzzards Bay, MA Address Address Print Print Signature ppl g?er- mit) Signature(if applying-cr_ermit) IF _ _^ 1 L CI Cari;ne. Other ❑ 1FC1 Certified _ _._.� -. Other InformationTank Tank Location 981 Main Street, Osterville, MA 02655 Steet Address :r Tank Capacity(gallons. 110 Substance Last Store_- GaGol ine Tank Dimensions(dia,:a er x length) Remarks: • • life -:1116-1 Firm transporting waste Cy n Oil State Lic.# MA=40 Hazardous waste marr°�=s—., E:P.A. # Approved tank dispesaj yard Mid City Scrap Yard Tank yard.# 1 2RR9 Type of inert gas Tank yard address Westport, MA Ior Town Centerville-Osterville-Martons Milt� 01920 tY17ID# Permit# Date of issue March 21, 1997 Date of expiration April 4, 1997 Dig safe approval nurrter_ 971104057 Ding Safe Toil =: Tel. Number-800-322-4844 Signature/Title of Offic _ranting permit ,"�Q�-�+�dL� ri After removal(s)send Fc�:,;--,-1-290R signed by Local Fire Dept. to UST Regulatory Compiia-- Unit, Vine Ashburton Place, Room 1310, Boston, MA :c'08-1618. 3 a . cy FP-292(revised,9/96) Make application to local fire Department. Fire Department.retains original.application and issues duplicate as Permit. �j��iayCin Q-1 71-rte C7. AP'PLIQATION. ,gnd PERMIT Fee: $25.Oo for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section.38A,:527 CMR 9.00, application is hereby made by: F.TRIXG Tank Owner Name (please print) Adam Hostetter X Signature(d apptymg[of permit) - Address 770 Main" Street., Suite A, Osterville, 'MA� 02655 Street - - .:.rciry'''- - `State ZIP Company Name ".Global Remediation Svcs: 7PO vidual Bennett Environmental Assoc. Print.' _ Pant. Address 700 'Richmond Streetu,,�tt Box 1743, Brewster, MA 02631 East _ unton, 1. Pnni Sig ture (if applyin for mit) Sign ure (if appi ing for permit IFCI' Certified Other 0 CI' Jertified . 1 LSP# Other Tank Location Midway Garage, 981 Main Street, _Osterville, MA _ •Steel'Address - city Tank.Ca acit (gallons) >_ 10,000 UST diesel fuel .. .., P y(g. ) ,- Substance Last Stored •- : -. Tank Dimensions(diameter x length) Remarks:_1n,Mn gallon nnderornnntj etnrAgP' *nnk Firm transporting waste Global Remediation Svcs State Lic.# MA 492 Hazardous waste manifest# ` 004792955JJK E.P.A. # MAR000503623 Approved tank disposal yard James G. Grant" Co. Tank yard# 008 Type of inert gas Tank yard address R28 Wolcott St. , Readville, MA 02137, CityorTown Centerville FDID# 01920 . Permit#_2q©7 Date of issue January 26, 2010 Date of expiration February 9, 2010 Dig safe approval number: 20100400408- Dig Safe Toll Free Tel. Number- 800 322 4844 Signature/title of Officer granting permit /� P After removal(s) ("Consumptive Use"fuel oil tanks exempted)send Form FP-290R signed by Local Fire Dept.to UST Regulatory Compliance Unit, Department of Fire Services, P.O. Box 1025,State Road, Stow, MA 01775. .International Fire Code Institute FP-292(revised 4/97) �7 , Make application to local Fire Department. - Fire Department retains original application and issues duplicate as Permit. fl C-%!/Lfr/lSGG�!il2t(/l�:e I Gfi�%'ayfinr��n/r �ii,e r ev vi6ej L" ce 'r.v4, r ral A P.I` L I CA TION: and _"PE1`lMi Fee: $25.00 for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A; 52TQMR 9.00, appiication,is hereby made by: Tank Owner Name (please print) Adam Hostetter X ignature(A applying for permit) Address 770 Main Street, Suite .A,' Osterville, MA 02655 ., Street City - Stale ZIP, p. Company Name Global Remediation Svcs • Co. or Individual P Y Bennett Environmental Assoc.. Print Print Address 700 Richmond Streetti:�r� Address PO Box ;1743, Brewster, MA 02631 " East rXpinton, 181 Pnnl Signa re (if applying for permit) Signa ure(if applying f r permit) IFCI'Certified Other O I Cl' Certified .0 LSP# Other _ Tank.Location Midway Garage, (981 Main Street,_ Ost.erville, MA' _ •-Steel Address - --. Ciry - Tank Capacity'(gallon 10,,000 UST diesel fuel P y(g ) Substance Last Stored: Tank Dimensions(diameter-x length) r Remarks: 1fl (lAfl i,nrlP'rgro,mtl Storage tank' Firm transporting waste Global Remediation Svcs State Lic.# MA 492 Hazardous waste manifest# 004792955JA E.P.A.# MAR000503623 Approved tank disposal yard ,James. G. Grant Co. Tank yard# 008 Type of inert gas "'Tank yard address,-R28 Wolcott St., Readville, MA 02137 City or Town Centerville FDID# _01920 Zl.�o$' Permit#_ Date of issue January 26- 201V Date of expiration February 9, 2010" Di4 safe approval number: 20100400408 Dig Safe Toll Free Tel. Number '800 322 4844 Signature/Title of Officer granting permit After removal(s) ("Consumptive Use"fuel oil tanks exempted)send.Form FP-290 signed by Local Fire Dept.to.UST Regulatory Compliance Unit, Department of Fire Services, P.O. Box 1025,State Road, Stow, MA 01775. 'International Fire Code Institute r FP.292(revised 4/97) TOWN OF BARNSTABLE — .UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. ©� ADDRESS OF TANK: VILLAGE: D.sT , Vrl L Number �tr��! MAILING ADDRESS ( IF DIFFER�EfNT FROM ABOVE) : OWNER NAME: �0/Ui4d.D f3i�l/rYEr 040Y�i�+�% U 11V6 PHONE: INSTALLATION DATE: ��I� J Y�Z' By:- ^!STALLER ADDRESS: '`> CERT.NO. STANK LOCATION: -- - + //' Dt YCR'I at TANppK LOCAT Z O�'N/ W I TN P16 e.f��CT TO HU Z LD Z N`O> CAPACITY (oJ ©PO TYPE OF TANK I'Q,0�/� z> AGE fil 1 YRS. FUEL/CHEM I CAL f TESTING CERTIFICATION [ P-31 1PASS [ ] FAIL DATE LEAK DETECTION [ CHECK IF N/A TYPE/BRANDcofL.. c. ZONE OF CONTRIBUTION [ ] YES [ fi7 NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ j YES [ ] NO DATE CONSERVATION [ ] . CHECK. IF /A> DATECc- BOARD OF HEALTH TAG NO. [ -4 ] DATE = "( � I '+ " * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON .THE BACK OF THIS CARD ��R��� G=T�,Pry a � ��,J , !V'" ���- D � t. f�/ D 'CAI' 1-' b TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICALS STORAGE SYSTEMS ��� �J ASSESSORS MAP NO. PARCEL NO. ADDRESS: ��'� /7/��/���� VILLAGE CONTACT.PERSON PHONE NUMBER LOCATION OF TANKS: . CAPACITY: TYPE. OF- FUEL AGE: TYPE: LEAK OR CHEMICAL: DETECTION SYSTEM, DATE OF PURCHASE OF EACH: 1. 2.. 3. 4. 5. DATE, OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. AhCA O � � s L Rives . C� 65VT,-e q wL L L 00 G 'G�ono" ( .2A IAP � v � /.7q.'b GA�e ;G� OSXLL-RvlG,, E ,1191 4OA6ss i.z _ 9 99: coON7y INVOICE FROM 42200 MID-WAY GARAGE FUEL F.E.HARDING&SON Accessories Heating Oil Auto Repairs ACCOUNT FORWARDED Recd. by I� TOWN OF BARNSTABLE vrA G UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS ASSESS ORS MAP NO. PARCEL NO. "" ../ q7 ADDRESS; O ig `YAIAI -S/ VILLAGE, CONTACT PERSON PHONE NUMBER LOCATION OF TANKS: CAPACITY: .TYPE- OF- FUEL AGE: TYPE: LEAK OR CHEMICAL: DETECTION SYSTEM! DATE OF PURCHASE OF EACH: 1. [F' ' �® 2. 3. 4. 5. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. (I l TAN TOWN OF BARNSTABLE vlitV6 UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS /�y ASSESSORS MAP" NO. PARCEL NO. � � J .7 ' � � � `�. ADDRESS: /✓ `S� VILLAGE r CONTACT PERSON PANAZ,p Z . IIAA iVOG- PHONE NUMBER LOCATION OF TANKS; . CAPACITY: ..TYPE OF* FUEL AGE: TYPE: LEAK OR CHEMICAL: DETECTION SYSTEM DATE OF PURCHASE OF EACH: 1. - 2. 3. 4. 5. _ DATE OF FIRE DEPARTMENT PERMIT: sLaffm TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE- PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE 'BACK OF THIS CARD. X F J�