HomeMy WebLinkAbout1080 FALMOUTH ROAD/RTE 28 - HAZMAT 2S 0
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Number Fee
1144 THE COMMONWEALTH OF MASSACHUSETTS $100.00
Town of Barnstable
Board of Health
This is to Certify that CVS PHARMACYINC. #1869
- AL
1080 FALMOUTHROAD, HYANNIS,MA 02601
Is Hereby Granted a License S
FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS.
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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.
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WAYNE MILLER,M.D.,CHAIRMAN
PAUL J.CANNIFF,D.M.D.
4/3/2014 JUNICHI SAWAYANAGI
THOMAS A.MCKEAN,R.S.,CHO
Director of Public Health
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141-17-2014 NON 03:43 P.1 FAX- P.002
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Town of Barnstable
' Barnstable
a Regulatory Services Department
s Public Health Division
200 Main Street,Hyannis MA 02601
►� 200?
Office: 508.862-4644 Thomas F.(3eiler,Director
FAX; 508-790-6304 Thomas A McKean,CHO
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Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. DATE
I
APPLICATION FOR PERMIT TO STORE AND/OR U'TII,I,ZE
' MORE THAN III GALLONS OF HAZARDOUS MATERALS
FULL NAME OF APPLICANT C .Pia'KrV&J.- :17r)c-
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NA.M OF ESTABLISWVIENT C US/o ha(n yi. -A 60
ADDRESS OF ESTABlLISH1VIENT L) �Cc,�l'YIC>"?�t�✓� - )Wj 1t 1 A
TELEPHONE NUTVMER '. dr' 7
SOLE OWNER: YES�NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
1F.APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.
STATE OF INCORPORATIO9—AL—r
FULL NAME AND HOME ADDRESS OF: SEE ATTACHE®
PRESIDENT
TREASURER
CLERK
S 4A OF APPLI
RESTRICTIONS: HOME AD SS
" HOME TELEPHONE#
7:\inspection hrndcw\H=Mat Applicatioa2008.DOC
1g1•17.2014 NON 03 42 PM FAX- P.001
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MAEL-EN 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 S 100. Make check payable to:Town of Barnstable. Allow time for
in-house processing. Our mailing address is:
Town of Barnstable
l
Public Health Division
200 Main Street
Hyannis,MA 02601
i
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 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.
For further assistance on any item above,call(508) 862-4644
Bak to Main Public Health Division Page
1,1i4spwion handoutsG=Mat Appli=ion2C08.DOC
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ENTITY NAME: CVS Pharmacy, Inc.
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-
,�w,�PersonrielNamesMan'a ement TitlexBus►;neSs Address ' Phone '
One CVS Drive,
Helena B. Foulkes President Woonsocket,RI 02895 401-765-1500
Senior Vice One CVS Drive,
Carol A. DeNale President/Treasurer Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Thomas S.Moffatt Vice President/Secretary Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Linda M.Cimbron Assistant Secretary Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Melanie K.Luker Assistant Secretary Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Jeffrey E.Clark Assistant Treasurer Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Jason D. Desrochers Assistant Treasurer Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Laird K. Daniels Director Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Carol A. DeNale Director Woonsocket,RI 02895 401-765-1500
One CVS Drive,
Thomas S.Moffatt Director Woonsocket,RI 02895 401-765-1500
,O V S/Pharma y
2�
Dear SL/Madam:
Enclosed please find completed application(s) and/or invoice(s)
along wish payment in the appropriate amount to cover the cost of
the renewal for the CVS%pharmacy store(s) in your area. Please
note any changes made on the application regarding trade name
and or mailing- address, and include store numbers.on invoices
and permits as indicated on the application to insure correct
payment to the proper store.
Please send the permit(s)/license(s) and any future renewal
applications for this store, with the store number on it, to niy
attention at: One CVS Drive. Licensing Dept Mail Drop
23062A, Woonsocket, RI 02895. After receiving the licenses, I
will make the 1iPrPCCa;y conies, fo:- M— files and foru�ar�? the
originals to the stores for posting.
If you have any questions, please contact me at 401-770-5772 or
by fax. 401-552-0008.
Sincerely
Joanne P.Amitrano
LICL'nSif2� C OGrC'iinLdiGf` 'V
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One C ijS Drive/Yzail drop 23062A
Woonsocket, RI 02895 . a
16i1'1'11191i MON W U P_.m FIX P.U62
down of Barnstable
Barnstable
a Regulatory e ces Department '
Public Health Division �
MASS
200 Main Street,Hyannis MA 02601
2007
Office: 508462-4644 Thomas F,Geilcr,Diredor
PAX' 308-VO-6504 Thomas A Md(we CHO
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Application Fee:$100,00
ASSESSORS MAP AND]PARCEL NO. DATE
I
APPLICATION FOR FERMI T TO STOREAND/OR UT=E
MORE TRAN III GALLONS 0F'HAZARD0U8A1ATERL4LS
L NAAJM Off+'APPLICANT pial , enter
NAM OF ESTABLIS NT 0V/S l J 6t
A1('DDIRESS OF ESTABLIS)< NT /6 Pl)'ACZh�frk -4&"W�j AM
TELEPHONE NUMER � 7 7 -"-
SOME;OWNEP- S-1--NO
IF APP LICANT'IS A PARTNERSE V,FULL NAAM AND HOMM ADDRESS OF ALL
PARTRS
IF APPLICANT IS A CORPORATION: FEDERAL]IDENTIFICATION NO.,
STATE Of'1N"COf8PQRATIO1?-A-
YU1.L,NAME AND ROM ADDRESS OF: SEE ATTACHED
JPRISIDENT
TREASURER
CLERK
$ A OF AF7PLPC
RESTRICTIONS: XXONIE AD SS
MOME TEl"HONE#
lvnsp=c h=4co t\8=Mat Applitwoa2008.DOC