Loading...
HomeMy WebLinkAbout0096 LOMBARD AVENUE - Health (2) f _ - - Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Beacon Building Products .-------------------------------------------------------------------------------------------------------------------------------- 96 Lombard Ave., West Barnstable, 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 i .y► s Town Barnstable tE Inspectional Semlices -i ,lic Health. Division t{, f'f y FtAfi92t 3IsS36L f�!�. Thomas McKewi,Ditector {- ' r� E&PPLICNrION FOR.1 ERMI'I" O STORE,ANDIOR UTILLIZE . .. k:&AZAR3t9OUS..3'YA.A..18..8`.+.&na. A.S.,e IN ACCORDANCE,WITH THE'roWN OF 11.,AAPdM A,UU (wNtmAl.oR,[)1N,N(.'I, i%lyrrKR 108, 1'€AZdiN? )t1is MA'Yls1 IA1.,'3i,A.1.5. H A,R€ LE(-)R S*F(-)R H t.f OU,,' MA11,R'.I I.,5 GR 'g6.'TER'rliAN III) SE>-10.1.,E)QL"ANI'tl.'[�'i�,1'RP, Qt.)IUT 1`O OEiT.'AIN AN AN.Nsc1'Ah..IILRMT T(Rl,,NS JULY 1st....� KE 30t€.). APPLICATION F17:4 S CAT�+j{ORY I PERMIT 26— 110 Gallom 50,00 � CATEGORY 3 PERMIT 500 or more Gallons: $1.50.00 ..: NO ILFV.'�'S, iKll'QIIEV17-IC).N3. 1� o FOR ALL NEW P°El€ !4fr APPIAC A'I'IONS, IDIC ,`l`.EWH.ETHIR BUSUNUSS HAS A��1K�,'ifA�t�p�`�k�s[ylU�(lgLl&�pi�l�HOUSEHOLD F'g�j�$1tp���A �fA D+9O�yT'Sd P�¢1g�.y'1'�@`;i��7��ytIs LS S'�1J;'��y�31RAGEF��Q SE l+ z,RA,`kfcbA A'A;.R�,8,.$:3.lXN�A3.''.'R.J i3,3G&II�4.,P.&.t89'�RJ 19iQ�X.3F.+3f..�J.9C/i.]`�+Gt�b.t:f'B.IC.,L$:`t�d'SP epee .t4 R�A't7� w'O. i FULL NAME OF APPLICANT. . .".MF,OF E aS'TAL.I�I.,USHM-IIN Ta4. �C�. . � ; �µ£ . g� �& ADDRESS OF ES TAB .S- 4IEN T. %� ..SwL....�. 3 < a, MAILING ADDR E SS(IF DW FERENT FROM ABOVE. TELEPHONE NUMBER OF F,,S"fARMSTJWNT-. !EjL)L-, - � w SO�p�•ps� py,�,y Jp�p,gay q� � �q.,�:.:: �T,�r�p �q+��y ,�p,p� y�y,Iy,g�rg�7p�,n ,�s� .I.i.a"F.3'+i�l'.l'b hTi.d6.� ___-____ .V.F7.-.. 3.��,..P1'4`i.5,NA-8�,(YFA.�0.9.�.b:.,NFRc'..: 4.' 9`6- .... ... .S.lr FULL NAME, .UM-F AIMIR SS,AND TE.LET° ONE?*E.3.F CORPORATION NA.-ME 118}� T _.. '�Lg�t� qq���E`` sppyy((y��yyt .. .:.. ........ ..:...:. .. CLERK ... ... ....:. i2. 'IF PREPARED BY oursim PARTY: NAME: TELEPHONE IJ- 'Y ADDRESS ------ SIGNATURE VN9 � £,1:1�;sus€a:.,stiazt'Fthttsr:iB�tr�P4�.<i,�,,��?'f�rs£33�s2ts��3:s€z?a.x Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that Beacon Building Products ................................................................................................................................. 96 Lombard Ave., West Barnstable, MA ........................................................................................................................................................................ Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ....................................................................................••----....-----......------............------......---.......------............. Restrictions: .................................................................................................................................................................... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2020 unless sooner suspended or revoked. --------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2019 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Y Inspectional Services BISTABLE t Public Health.Division Y.4SSTY"ki%TiS.OSATVA45.WW'NTr0CX8 "� Thomas McKean,Director 200 Main Street,.E(yannis,M.A.0260`1 Office: 508 862 4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AN:D/OR UTILIZE HAZARDOUS MA`T ER.IA.LS 1N AC`'ORUANCI'WI'I'It'I'tit TOWN Or. BARNSTABLE GENERAL OM)INANCE,CHAP"I'ER,108, IiA7 . "DOUS MATERIALS,ALL tJSINESSES THAT HANDLE OR STORE HAGARDOt1S MA.TERJAI..S GREA MR MAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY I:A-JUNE 306). APPLICATION FEES CATE60,I1-Y1. PERMIT- 26 40 C►atlons:- -$ 51):OO C7 CATEGORY 2 PERMIT 11 1 - 4h9 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons S. 00 C7 *A late charge of $10,00 will be assessed if:laaytnent is not rec ived by July.,,,t st. �O Gc.I.P.•'�GW�' t. ASS, SSOR'S M;AP AND PARCEL NO.. 2. IS T. ITS A PERMrr Rl,NT!,WAL?J—YES_NO. IF YES,SKIP QUESTION 3. 3. FO 'ALI,.NEW.PERM:I,7'APPLICATIONS,INDICATE,WHETHER BUSINESS IIAS ZO' IN,G/BtT1LUlN(:,' NPPROVAI,1~ORR TIAZARDOUS MATERIALS STORAGE:/USE,OF GRIE ATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. � • 4. FU L ;NAME OF AYPLICAN I'; O eaceti 13✓:�d n_l f ro aw c 5. NAN11 t OF ESTABLISHMENT: i'3taton u,la�+nucS 6. ADD ItE.SS OF ESTA.BLIS'IIWNT. -t a Loin PrYr _ wesIp /aSfeh hG 7. MAJ LING ADDRESS,(IF DIFFERENT FROM ABOVE: 8. TEL +PHONE NUMBER OF ESTABLISHMENT: �D$_' 36 X"._71 O 9. EM IL ADDRESS:. _*Ta nn eS. KC-04111 b G C n C o_fi .. 10. SOL OWNER: V YES^0 IF NO,NAME OF.PARTNER: 11.. FV1 U.,NAME, HOME ADDRESS,AND TELEPHONE#OF: CO ORATION NAME i[rt[yn,_ 1bud inct lirootuaf PRE;JDENT . _,'Tg1-reA ,,Fr'knCf,5 TIt.T: SURER CLERK, 12. IF P. EPARED BY OUT SIDE PARTY: NA"" :Et TELEPHONE#: CON PANY ADDRESS.:. _: EMAIL:...... *SIG ATURE OF APPLICA DATE —2-0 Q%Appl cation Formsdiw Mat App Revised(00") } ocx Town of Bamstable ImpCedolual services Public health Division s.. r........� „)w T.howas McKean,Lax im?r t,�.g�ii:r:.:.�iQ9,-�P:2.-• €-s � :�sx: a@:S-7fti 7,3t::t MWt:grION FOR PFRMrf AN-91 R.U'3'3�:U.AiA df E 1b%ZARDQy_fS MATERIALS rN ACCORDANCE WITH THE TM' Or,rDiRNS'$B€B 0zA1RAL ORD-NNA;CE,('311iiER.ii ,, 12L)AnDVppS YAM� € US, Z31 3UIy3yry -M THAT 3di "r og 8 i .Rr lA tigyp AI.I GRR'AMR'IZM 'r3OUMB OLD 01W x"° MS ARE RFC,?€.[RED R)t:'?RTd+IN AN ANNUAL 1'FIIMIT(RUN !€,j°LY !iEm T[3_NR 3ft). fe Ahy g gCd rgON FURS . PERMIT €C$TF(IOR 2 P..Rrr € C11VU Xy V 3 t ` Ik 0 ST iafhmmC�eGi ZI'�3Li 1 2. IS,`WHIN A;€DA;kaM.IT RENEWAL? YES........NO, IF%V9,SKIP QI:fMMC$.N 3 3, FOR ALL€` EW PERMIT Aid111C ATIONh,IN C'A`M,WIIXTHER BIISMS88 H&q ZO.WNG)DUH.TBING AIaIPR83'&AL FOR .ZA9I)01J,4�*Kd'a'P .C;'LN:S`.S.`€.3RACYPA)SK OF NAME OF VSTABUSHkO_N'T� a1 a0>, �Yl7>�XtR.��'�n-_��, y gy NO F NO,NAME OF P—RTNEIy ........ C10TWORATION NAME I5i8 E SIT)KNI I' TM XF110NE 9- ..,:, SIE NA#'€€RR OF APP'LICANT......:::.... ::..::.:::::::.:.. � J �`�WW............................. ................ . 6,x:�l4 � x1fz�1'ta xs1P$ux Ps9ss App%ev#act M-W-13 Amm • Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Beacon Sales Acquisition Co. 96 Lombard Ave., West Barnstable, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------------------------- ------------------------------------------------------------------------------ ----- -- ------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO ` Director of Public Health � y r. I TRowx o£$ rnsxable 'TV atory Semees ojtKE r Richard V. Scali,Director A.VA Public Health Division BARNSTABLE J i RAWMAM. t Thomas McKean,Director �JOren �a�� 200 Main Street,Hyannis,MA 02601D� I Office: 508-862-4644 FR: 508-790-6304 i 1 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 Ist-JUNE 30th). 5 APPLICATION FEES CATEGORY I PERMIT 26--110 Gallons: $ 50.00 ❑ .i CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ a CATEGORY 3 PERMIT 500 or more Gallons: $150.00 i *A Iate 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 STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: �to [�C�rJ h 7 4MOw�k. ry� �� . ttlQ`�`/ r ! , 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8, TELEPHONE NUMBER OF ESTABLISHMENT: 6—o C6 3 z 9. EMAIL ADDRESS: 10. SOLEOWNER: YES—NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: 1 CORPORATION NAME PRESIDENT TREASURER 3 CLERK 's 12, IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE ! :/, Q kApplicalion FormsV AZMAT APP 2017 REVISED.do c 3 A) Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Beacon Sales Acquisition Co. 96 Lombard Ave., West Barnstable, 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 06/30/2018 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 FCC:SITF' hKo__ 0/13(R19 \ TRo°v7n�of Bunstable egu atoxy Nefvices iRichard V. Scali,Director Public Health Division BAMSTABLE Thomas McKean Director16394014 " "rc "` ` ' "` ` 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 O[q —2-01 Far,: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE -3 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 3 0th). — APPLICATION FEES CATEGORY 1 PERMIT 26—110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111—499 Gallons: $125.00 ❑. CATEGORY3 PERMIT 500 or more Gallons: $150.00 *A late charge of 510.00 will be assessed i£pavment is not received by Julylst. 1. ASSESSOR'S MAP AND PARCEL NO: 2. IS TIIIS A PERMIT RErWAL?:' . _YES. NO. IF YES,SKIP QUESTION 3. 3. :FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDINGAPPROVAL°FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES_(25 GALLONS)? YES. NO. _.. .._ .._ 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: pl)(`Qj4 1 P l 6 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER..OF ESTA.BLISHWNT:. R— 3n-a 9. EMAIL ADDRESS 10. SOLEOWNER: YES' NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER ' 'CLERK • 12, EF PREPARED BY OUTSIDE PARTY. r' " ? , TELEPHONE#•".. _ COMPANY ADDRESS _ EMAIL: SIGNATURE OF APPLICANT DATE G --6-17 QMPPHcation Form$NHAZMAT APP-)017 REVISED.docx Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Beacon Sales Acquisition Co. 96 Lombard Ave., West Barnstable,MA 02668 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 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health e <y of Ba ofiHE Re tart SenlC-es Thom F, Gamer,D3TPdlof P-abhc Health D1TB10-E A - iho-g325 McKeon,Dind-o3' 2D(D 1ijaim St z-; ET=-,�,MA 02601 F� 5m-790-6304 Gff, cz: 50$4 2-4644 Applicaton Fee: MIN DATE n 15 nSS�SSORS �. A2P1 TCAT30-t FOR PERIL El TO STORE A 3/QR MORE lHA-NI 111 GA LLONS OF HA�,AR.DOUS A.�RIAI�� OF APPISC_A-N7 NAAE of ZsT-�-BL=a r: A�7DBESS OF EST�� +'� 9 s l@ =PHONE E& 50% 3GO^ �7/®q - SOIL OWNS.: YES NO TF APPLICAI�1'T IS A PAATN=,T= ADD HOT ADDRESS 07 A� P d�TN�-AS: APPIlICAiv l IS A CO�PO�ATIO�T: i AT IDEN==CA?ZON No. STATE OF 2 CORPORA-=N /_(,J✓ FTI.,_L NAME ANT HOAfE ADDRESS OF: Cl= l -IG'AT RE OF A �idCA T �.5' ICTIO�TS: HOME ADDRESS i HO?i�, T=EONI 9 �a �nctwp/q Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Beacon Sales Acquisition Co. 96 Lombard Ave., West Barnstable,MA 02668 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------- ------ --------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN f' PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health BarnstablL Re lat6t- • Public 1, ea;7th r W6 ° g 200;1Vlaiza-$ireet;.)1 .2�01. . .� ofjkfl StT »$S2.4Qd,1: `fhtatrig GatTor Dtrcctcir (, P.Ie ►: r,o X NkKcm Clio t Appicativn Free $100;00 1. ASSES 3QFt5 F,ARCEI.NO. AT lie ;23., 2009 A 'FZ CANON P"PER MT T't STO :,A Nb/" T'IX.XZ C1R T AIL, 1 ' CA .L:{J S.t F A E QU ',"MA' )kI'A' FULL P Beaaan Sales Rcqusltioxa Co ; Inc:; Beacon Sales cd: fF ES"T'AiLLStYT ' __.. .. -- -- - __ .. . .- • 96 'Lombard Ave. iarnstable; 13 ADDR;ESSS�l�`E��A.BLSSIiftYtY�EEN�' T' Ll"HONE NUMBER t�©8 j s�2-7109 SOLE 0" N(7 A,PA.�L7't+t�I�u�'�TTj �rL�AME,�l��`��(�i1!�� D�t� ON FILE: m. 3 is A CO P044pp X'E�F�r�������'�CA�'�Ql''��Y 'ON LE aW r ! A" '00x-1 C?k"Qj CAN FILE 12, .r 1. PRESZIET�F'I' f)N FILE -- h .ERE 5. r T t>F.t1 P ��1i`t7 1 ! Q.14#a�rr�caFi��bt�it A,p�tECar�tn�(tG�� : 1 �1- oiva of Barnstable I.KE Reglilato �Crv(ces ti 1 _�- �� - Tlionias T. Geiler, Director * BARNSTABLE, 400 69. ,�� Public Health Division ATE�MAtA Thomas i1-lcKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Wayne Miller, M.D. Fax: 508-790-6304 Paul J. Canniff,D.M.D. Junichi Sawayanagi NOTICE TO ALL BUSINESS OPERATORS WITH ITT HAZARDOUS MATERIALS ERIALS 1N BARNS ABLE The Town of Barnstable Town Council adopted, Chapter I08: Hazardous Materials, a requirement for each business operator to obtain an annual permit and to remit a fee of$100.00 if one-hundred and eleven (I 11) gallons or more of • hazardous materials are stored,transported, utilized, and/or disposed of at a particular site. STEPS I — 2 — 3: I. 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: Torun of Barnstable. MAIL all of the above to this office on or before june 30, 2009. A late charge of$10.00 will be assessed if payment is not received by July 1, 2009. Upon receipt of the fee and a completed application form, an inspection may be performed by the Hazardous Materials Specialist to complete the Hazardous Materials On-Site Inventory. A permit will be issued once the application, contingency plan and check are received. Please feel free to view the above Code, Chapter 108: Hazardous Materials on the • Town 'Website, Nvw)A/.towii.bai-n.stable.i-na.us , which is located under the E-Code section if you should have any questions or concerns. Q:\F'azrraAHaz Mat Pe unit Letter.DOC 4 • Emergency Action Plan West Barnstable 96 Lombard Ave West Barnstable, MA 112668 In.the event of a Fire, Hazardous Material shill or other emerpenCV that requires evacuation of the building or the property the Following procedures will be used: I. Marc Donnelly will be the Emergency .Response Coo rd[nator to notify the West Barnstable Fire Department andlor Police Department by calling 911. 2. Rick Walden will be the back up person to make the call. 3. It the buildings need to be evacuated the coordinator will assign a person to make the announcement to evacuate over the PA system, (Verbal announcement if you don't have a. PA or lass of�power). 4. A11 employees: must immediately exit the buildings by means of the nearest safe exit. S. All employees will.meet at the concrete!wading dock Ideated in front of building S. in the employee parking areas 6. The coordinator will perform a head count to insure everyone has evacuated the building. Z No one can reenter the buildings until permission is given by the West Barnstable.Fire Department I.n the event of natural disaster (Hurricane, Tornado, Blizzard etc) I. All employees should meet in front of the sales office of building number S, then perform a head count to insure all employees are accounted for. 2. Refer to local radio, TV or websites for instructions on evacuations and any public service announcements. Leave only when conditions warrant. Under no circumstance will our employees perform. medical or rescue duties during emergency situations. My Marc Donnelly will also notify , and Gerard Bill as soon as possible. Gerard Hill: 508-208-9198 V IKE r° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BA MAS qB ` 200 Main Street• Hyannis, MA 02601 1619-+°�0$ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: &a-&Vt. ocu�g Ae-iyt;5 +#ova-- Co. Date: Location/Mailing Address: Do L e..Joa rX Au,9- , i,J. (3a rns fia,b la Contact Name/Phone: Lie%,1 Lies, , b�t� -3�*1-?jog cerl sog�� 9S`$-OSI-► Inventory Total Amount: Oa QAI 2?5 OEM MSDS: �JEGaL� License Tier II : 0 T 1-151�1 Labeling: VL A Spill Plan: eS Oil/WaterSeparator: Floor Drains: P o Emergency Numbers: e 5 Storage Areas/Tanks: a1 q of CJ\,o,1-As-( ,4, \6s ,kf d y, . ��-IA-e_ e.i�•K�Eet� Emergency/Containment ui ment: o+n. S+e , -wtl\eA wove" Waste Generator ID: K� Waste Product: IAA Date&Amount of Last Sh6ment'Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: -}��loh-�� a T4,4 LIST OF TOXIC AND HAZARDOUS MATER ALS 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. i v 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 I6 C,,1 3 Motor oils 3 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petro'eum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages 43o Pesticides: 7.,%o Caulk/Grout ao�ltia.�.•.rc s -o.0tiy'r15 insecticides, herbicides, rodenticides Battery acid (electro yte)/batteries A! kt'< Photochemicals(Fixers) Rustproofers Wy Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar �'� Swimming pool chlorine )� Paints, varnishes, stains, dyes �� A,a2� Lye or caustic soda l 4S Lacquer thinners ♦ Miscellaneous Combustible q 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: p INFORMATION/RECOMMENDATIONS: t" was 2 FrpvK, S. +I! 1 S ;If 5 o r =} vim. fin, g vVa,S .e. Co Inspector:-- nspector:-(c'� S�afi�oti.-� 1M o✓k-c. 3 u���o ��" ('eC� P-�'. e- Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS I: Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Beacon Sales Acquisition Co. 96 Lombard Ave., West Barnstable, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. --------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------,-------------------------------------------------------------------- ------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health . y ; . - 'a _. __ .. --i� -- - .. . I . . . . . . . .. . , . .�. . . I. . ..�...: I , ' . . I I I . � I I , . I, . . . . . . . . I.I. . ..,.. .. . I . . . .. � . � .. . . . . ... . I.. ., . . .. . .. . � ,. I I G_ . . I � . �.. . . .. I I ""..�. I ..�.. I.�..-. .��.I. �..�.�..:..I......­�..........:......1.,..­....I.I...,:.....i..­I...,�.;,1I—..1.-�i.-.,��......I 2�.I.-IF..-...1...1.'—�.9—....�1...�1 I..I,.......I.I....I-....:.I.................... I 1. . � 1. . ..I I I I �....I....��I:I.I.....-......:........�..]..I.�.,:.3:.,:::I.:.....1-:..,. TOwn o Baxnstable ....I..:......-...:....­.,:.I.I-.:I,1,.I.-.I.�I..:...I:�....�..:.�I—­.I.1—�.­.­I..�..._.....1..I.:..�*I.: .I.... '� Regtaratory SCrv�ces I. Richard V j Sca> ,:Director . . - wncarwets . ARN TSB . A*. P4bh Health Di�vy:sion ,� , .L y E .. .. -may t647�$]�6 . Thomas M;cK6a 046::t �t/V7�-J .j7Yd 00 Ivlaiti SOeet Hyatuus,MA'.02ki ( :: OfScei 508. 4G44 : - 4 Fax 508. 00 G304 :.. *O.�I-.�1...�.I.�r..�6I I..II.I...I.I.r.16...I1...��.r.III��I..I�-�......r..1.I..�I.I.I 6...-I...I..I.�...66.�.­...��,..�1....�.II.1­.I....�I......1.I...�.�.rI.6...�9......­..��_�I..,.6..­��.I.��6...I...�.....I...I.,.--.I.......,..��I.......'.r...I..�.............I...I..r..rI..�.I��..�...I�.�7�...1..r9.....1'..,......br9...I.I....�.­ .. APPLICATIUN FaR>PERIYIIT TO STORE AND/OR UTIL..�!',.:.­­...;..i­.'::.........:...:::...:1:.:.,:.:.,:.:.,:.:,/I..."r.:.�4.�­.:";r�:._-­..:.:..:.I:.:�.::...:...:,:.:.:, HAARDOi75 ►TES . .. . ' IN AC ORDAN.CE WITH THE TOWN OF BARNSTABLE GENERAL ORpN.A E,Ompm. I09, "..'..I....:,,�:.....,.,::k...I-......!-1,�:�-.�.:Z::.:­.q.I..:.: HAZARDOUS hUTERTALS,ALL BUSINESSES THAT DANDLE OR STQ HAZARDOUS - 1VIAT1✓RIALS GREATEk THAN HOiJSEHOLD QUANTITIES ARC T2EQU REp TQ QBT .VAN II ANNUAL PERiVI1T(RUNS JULY Ist_JiJNE;30th).: ,:. APPLICATION FEES . CATEGORY 1 P , 26 '110 Gallons $50'00 . ... .. " CATEGORY 2 PERIV�IT' I I1:= . Gallons $125 00 Cl CA 'EGOIZX 3 PERMXT S00 ox more Gallons $I50 QO A late cha fe of$la OO y�tll.be assessed:if va ent is not receivedty JWI lst ASSESSORS":AND PARCEL NO DATE Fi1LL NA ,.O APPLICANT y; NAME QF ESTA�BLLSIXMEIVT� $fir :A O �Q+ S �O . �`` II� _ n,.. I ' ,I_ ADDRESS bP ESTA$ dS�IIVm", IItp l�(J aJ T�11��/LU��� Q I(I��C-t741d('I MAILING ADD�SS()p.! _RNT) 6:_ TELEX' IONE NUMBE..R OF ESTOPS NT .�b0<I :3UJa . :' . ... EMAIL ADDRESS: . ; . SOLE OWNER: YES. NO t IF Nd NAME 4F PARTNER FULL NAME HOME ADDRESS,Al? TELEPHONE#,OF. >, . CORPORATXQN NAME PRESIDENT ;' TREASURER: ;: CLERK: ' IF PREPARED BY QUTSJAE'PART ' S lATU12E OF APPLICANT Name, Company Address Telephone;# .<.. ..... Ennail . Q:Wpp teation Forms) A72APP.Rey 16 doaX Page l of2 :: . . .. ..I.rR V .:.;. . Number Fee 1072 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that Beacon Sales Acquisition Co. 96 Lombard Ave., West Barnstable, 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 t i Town of Barnstable +++� Regtitl lqr Services Richard V Sca�i,Director I�ublic Health DivAison Thomas McKean,Director 200 Main Street, Hgannis,I4 02601 Office 508-862-4644 '' Na 509490-6304 Applicoon.Fee $100 0p ASSESSORS MAP AND PARCEL NO aG DATE' APPLICATION FOR PERAUT TO STORK AND/OR UTILL'LE MORE THAN lii GAUONS OF SOUS MATERIAI S - FULL NAME OF APPLICANT NAME OF ESTABLX5HMENT .fl/1 (� lid • ADDRESS OF ESTABLXSH111ENT:Q� l_6ml tt ill Ib�e aYslolp_, M T : 1 IMLEPECONE NUMER �08--ab a-4 I n9 SOLE OWNER: IF APPLICANT IS A,PARTNERSEI$,FULL.NAME AND 110MR ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CO].tPORATION. FEDERAL IDENTIFICA .....TON NO STATE OF INCORPORATIONU Q;yW(LLi� FULL NAME AND HOME AUDItESS OF - PRESIDENT TREASURER.. . CLERK'. SX AT[JRE O ARPIGxC�NT - RESTRICTIONS: HOME ADDRESS , HOME TELEPHONE C.lcachelTtmpormy 1nte�aet F�les103.�CD3IHAZAPP ReVZO1S.D0� °FIB r° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARN STABLE.`E ' 200 Main Street• Hyannis, MA 02601 �'°'FOMrta,O� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: iZacovA- Z5 4c9,Ji5 'T,-I.- Co - Date: '2I5— Location/Mailing Address: % L.o,N..ba, -a Aw— . o. frl5tab Contact Name/Phone: rova La<, 6fAvt,l- !"e SAS _3�2-710 Cel a$-`jS8-O$1 Inventory Total Amount: ^--�2�-�2p�1� MSDS: 25 - 3 License#: 10'7 Z Tier II : o Labelina: T'Ljv.,\ Spill Plan: )�cS Oil/Water Separator: NIA Floor Drains: No Elergency Numbers: yf. Storage Areas/Tanks: Oore.A l.A I ,a\+Sal bod&as w, Emergency/Containment Equipment: As d- o �S 0.\)k• a � Waste Generator ID: NIA Waste Product: Date&Amount of Last ShipmenVFrequency: 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 I /yMjRr1-�s insecticides, herbicides, rodenticides Battery acid (electrolyte)/bat eries 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 Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain iremovers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: f, ("ZC Vh-tom - Inspector: "�--� Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 3/r 3 �¢ TOWN OF BARNSTABLEs t00— TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: sale-5 Co. BUSINESS LOCATION: J& Lo,• y�,r� �{ �, r,Jes-� Btrobdole, INVENTORY MAILING ADDRESS: sarrt— TOTAL AMOUNT- TELEPHONE NUMBER: s-o8 -3b2.-71o9 -�-?,00 1 b CONTACT PERSON: 4-+oK-e-1 L&-rove-e— brahGk r EMERGENCY CONTACT TELEPHONE NUMBER: cell o - 5-08 17 MSDS ON SITE? TYPE OF BUSINESS: Ye3- Ce 4,'lprdd�+ s INFORMATION / RECOMMENDATIO S: i ►4/I hk.Xxed'fvra I t'" -4�Q+ on P1eq— Fi a District �r5.c.�ox.s i�'� a�sP+l l 2b 5vr}�.+•ti�s ada,ltb►c., w, ,�t✓�s�f•� It D I In+tom I S 1005�'� , ��/V o SG Gov-yX-V-ok-A ',o r-IS ,�`�' '�'��s +."",e— 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 IV. VK4I've Ck4sri ,o ►yt �h�Lvcfo� sl►1c�/�ts-��n ors The Board of Health and the Public Health Division have deterrrSined that the following products exhibit toxic or?/111 � 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 P 9 (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicants Signature Staff's Initials Date: TOWN OF BARNSTABLE :T � TOXIC AND HAZARDOUS MATERIALS 3t3TFhkT1W FORM NAME OF BUSINESS: BUSINESS LOCATION: 31 INVENTORY MAILING ADDRESS: 0 'jn� 13�p TOTAL AMOUNT. TELEPHONE NUMBER: Soa- `17-> a MG3 < Ilt 1G-llovls CONTACT PERSON: -?&u 11461 prl EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: jp1fCoars-e_ /r��r7o� IMa�✓t4e�av>r�_ eav�lk�ert�) INFORMATION / RECOMMENDATIONS: �1- kola- Dot, %L eovc5�L v\o Fire District: ti 4raAs kc-Pox5-Ve- d1r, �,5 r?Sa� Z� ol�.+.c 'ci v+ &avvj ICE `` "o Co710 �-}2�3�M�vtot�rte✓wt;'s o�.F'ec�',l��e.r v,.c�J o 1 I M�a G �I t►+,.K„�t�g (se `l �a�--�+rtc.. �q�.l to r� vJaa�a o,16.�clwk Is lllclltt�=00�-k�l oi' ri- v�r�- AVL 13 laWaste Transportation: Last shipment of hazardous waste: NameofHauler: Destination: Waste Product: -o< (,u-A-s.1 ot,S o- 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 LEI NEW Q 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 r (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 �JI'S, 4 cowlpan�1 �ca2s de..5�',�+fie ap�l,cy,.�,vti.., Laundry soil &stain removers (including bleach) 'ro gc,e,e,ns . /�►n De�l'+�,�5 tc•c,p�' eK s,�'.a. . Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials �'