HomeMy WebLinkAbout1620 FALMOUTH ROAD/RTE 28 - HAZMAT (2) /�3g �c�lmac�i �., CRn�udl�
�'--d" f
TOWN OF BARNSTABLE BAR
-W
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager "' % ` i
Address of Offender MV/MB Reg. #
Village/State/Zip j
Business Name m`/pm;. on- 7/7'�' 20
Business Address pile ���\-4
Signaturelof/Enforcing Officer
. Village/State/Zip �
Location of Offense
Enforcing Dept/Division
Offense P&-,rA4-kZ-AJ VIA A+-,0-T c, 16-P-Vt k 101,-`}")0VL 0
Facts Lire l0?�-ko . 4EV'-c—J 1 �GL>Ul���c �t)rTV�IV. - J k Silt
r
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 inappropriate legal action by the Town.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFER. GOLD - ENFORCING DEPT.
TOWN OF BARNSTABL
Ordinance or Regulation BAR -W 6024
WARNING NOTICE
Name of Offender/Manager
of
Address of-Offender MV/MB.Reg. #
Village/State/Zip J
Business Name �- f "�-�--i ��7 -� i rl ' '' /am/pm; _on 2010
Business Address ,? �---
Signaturd of�Enforcing Officer
Village/State/Zip ;f-Vt
Location of Offense
l Enforcing Dept/Division
Offense Jcl � d -C—L {c ��-� c".+� 11 lit-e ,tt� se eV 1 ��Ir' r�..`�''0VL
Facts
. .. �f�i L' 1U�5-jc . 1 "V'Jo } ,l_ b� 1.ati` ty�. '} iy',�btC!a eo f
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 OFFER GOLD- ENFORCING DEPT.
°p{ME TOk Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
�RAR.Sq E.�' 200 Main Street• Hyannis, MA 02601
�AfFOMA��`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name: Cefgfrjle. r Date:
Location/Mailing Address: ,i-I
Contact Name/Phone: 7N- S5L)-- i
Inventory Total Amount: MSDS: License#:
Tier II : d V Labeling: Spill Plan:
Oil/WaterSeparator: t Floor Drains: IVOJ Emergency Numbers:
Storage Areas/Tanks: VIM
Emer enc /Containment E ui m t: o
Waste Generator ID: Waste Product:
Date&Amount of Last Shipment/Frequency:
Licensed Waste Hauler&Destination:
Other Waste Disposal Methods:
LIST OF TOXIC AND HAZARDOUS MATERIALS n0 C ,,
NOTE: Under the provisions of Ch. 111, Section 31, of th�Mal�Laws A, 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
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: -
Inspector:
Facility Representative:
WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS wvo
Number Fee
1313 THE COMMONWEALTH OF MASSACHUSETTS $5o.00
Town of Barnstable
Board of Health
This is to Certify that Tedeschi Food Shops (7-Eleven) Store #37410
1638 Falmouth Road, Centerville, MA
Is Hereby Granted a License
For: Storing or Handling 26 - 110 gallons of Hazardous Materials.
l�l --- ------------------ --------------- ------------------- - --------------------------------------------------------------
l� ------------------------------------------------`--------- ----------------------------------------------------------------- -.-------------------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and
v 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
�� 10 •
Tow of Unstable
egaatorvlces
THE Richard V. Scali, Director m f
o Public Health Division BARNSTABLE
� 9n4N5i4tllF•i.ExfENVILLi•COiUii•HYnS'i:15
• ■ARNSTABLE, ' Thomas McKean Director HR5145 HW5ILLF•YIiSf PS?Nif592 �
9 MAgg q ) 1639-1639-2014
�OTp16 A 0 200 Main Street, Hyannis,MA 02601 575 �
�.a
T1
Office: 508-862-4 Fax: 508-790-6304 �
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE =�
HAZARDOUS MATERIALS Cri
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). �'
-31 � APPLICATION FEES
CATEGORY 1 PERMIT 26— 11O Gallons: $ 50.00 �s
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. R E C E I V E D'
1. ASSESSOR'S MAP AND PARCEL NO. ± i;. , - 2217
2. IS THIS A PERMIT RENEWAL? V YES_NO. IF YES,SKIP QUESTION 3. LICENSE DES T,
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:
Tedeschi Food Shops (7-Eleven) " ��Q
1638 Falmouth Road
i
6. ADDRESS OF ESTABLISHMENT: Centerville, MA 02632
7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: ' Q V
8. TELEPHONE NUMBER OF ESTABLISHMENT:
9. EMAIL ADDRESS: ► ' ``� J2 � 1 L D ✓�
10. SOLEOWNER: YES N IF NO,NAME OF PARTNER:
11. FULL NAME,HOME ADDRESS, TELEPHONE# F:
CORPORATION NAME, e
-SU � vvA
TREASURER
CLERK
12. IF PREPARED BY OUTSIDE PARTY:
NAME: TELEPHONE#:
COMPANY ADDRESS EMAIL:
SIGNATURE OF APPLICANT DATE l a (gyp t O
Q:\Application Forms\HAZMAT APP 2017 REVISED cx
01 ,
Number Fee
1313 THE COMMONWEALTH OF MASSACHUSETTS �so.00
Town of Barnstable
Board of Health
This is to Certify that Tedeschi Food Shops (7-Eleven) Store #37410
1638 Falmouth Road, Centerville, 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 06/30/2019 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
i
� f
r yvIGI, Led S)ults b%3
' owrl�of Unstable b 212.
egu atory ervices
Richard V. Scali, Director
t KME
t �, Public Health Division BABST ,BLE pp5
� CA»YS'�..5{tt3R_.0.1YiY Chi f4-n*A.A"5 �1�
'b4S"6'&4Lt'^tfi RRWJtE-jS3•6 ¢S1tSP
BARNSTABLE. " Thomas McKean, Director
MAS8.
s639• �0
200 Main Street, Hyannis,MA 02601 i
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE f, 1
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 �c (Ji
ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th).
a
APPLICATION FEES �, 40,
CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 C
CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑
CATEGORY 3 PERMIT 500 or more Gallons: $150.00 . ❑
*A late charge of$10.00 will be assessed if payment is not received by July 1st.
1. ASSESSOR'S MAP AND PARCEL(NO.
2. IS THIS A PERMIT RENEWAL? - YES_NO. IF YES, SKIP QUESTION 3.
3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS
ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF
GREATER THAN HOUSEHOLD QUANTIT..IIErES (25 GALLONS)? YES NO.
4. FULL NAME OF APPLICANT: :��W
5. NAME OF ESTABLISHMENT: —'� `wt� S�LH y�
6. ADDRESS OF ESTABLISHMENT:
7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: A� Ids �3
8. TELEPHONE NUMBER OF.ESTABLISHMENT:
9. EMAIL ADDRESS: 01
,(�'.�C:'
10. SOLEOWNER: YES 11V0 IF NO,NAME OF PARTNER:
11. FULL NAME,HOME ADDRESS, D TELEP ONE#OF:
CORPORATIO,N,_NAME C
PRESIDENT
TREASURER
4 R svp
12. IF PREPARED BY OUTSIDE PARTY:
NAME: TELEPHONE#:
COMPANY ADDRESS EMAIL:
SIGNATURE OF APPLICAN DATE
'!" C:\Users\Decollik\AppData\Local\Microsoft\Windows\7'.Oc po a Internet Files\ ontent.0utlook\BMQD49H2\HAZMAT APP 2017 REVISED.docx
°p IKE ro Town of Barnstable Office:508-862-4644
• °� Public Health Division Fax:508-790-6304
• BA MAC LE.$ 200 Main Street• Hyannis, MA 02601
�"IED MA'�p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT J
Business Name: ►eaQeSe-n.► 7FoeeQ S"° 5 Date:
Location/Mailing Address: I Vb?7 Ga Z R- tit e} ,J,\ e
Contact Name/Phone: 7 a G J&sU
Inventory Total Amount: .� ��Dolb DS: License
Tier II : o Llbelina: a Spill Plan: DK
Oil/WaterSeparator: N Floor Drains: d Emergency Numbers:
Storage Areas/Tanks: itVVV- \ n.\
Emergency/Containment Equipment: s ,(✓1�� Cow�q��u.r
Waste Generator ID: P�I& Waste 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.
1� Antifreeze 1� Dry cleaning fluids
Automatic transmission fluid Other cleaning solvents&spot removers
Engine and radiator flushes Bug and tar removers kvl�jorer`1
Hydraulic fluid (including brake fluid) S- t Windshield wash i o 9-1 Gl 1V7
I- Motor oils 7- Miscellaneous Corrosives
Gasoline,jet fuel, aviation gas Cesspool cleaners
Diesel fuel, kerosene, #2 heating oil Disinfectants y
Miscellaneous petroleum products: po Road salts C-00 110
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
Lacquer thinners Miscellaneous Combustible
Paint&varnish removers, deglossers Leather dyes
t Miscellaneous Flammables 1% Fertilizers
Floor&furniture strippers 1 PCB's
Metal polishes Other chlorinated hydrocarbons
Laundry soil &stain removers 5 (including carbon tetrachloride)
(including bleach)y Any other products with "poison labels"
(including chloroform, formaldehyde,
hydrochloric acid, other acids)
VIOLATIONS:
ORDERS:
INFORMATION/RECOMMENDATIONS: -L 1-r I A.0 006 e, Y•4- c.2x�K— I
inspector:
Facility Representative:
WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS
r
TOWN OF BARNSTABLE BAR-W
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager
Address of Offender MV/MB Reg. #
Village/State/Zip
Business Name am/pm, on 20_
Business Address
Signature of Enforcing Officer
Village/State/Zip
Location of Offense _
Enforcing Dept/Division
Offense
Facts
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.IREG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT
TOWN OF BARNSTABLE BAR-W !
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager - ;
Address of Offender MV/MB Reg.#
Village/State/Zip
Business Name r•-j r•- r am/pm, on 20 E-7
Business Address ,/
Signature of Enforcing Officer
Village/State/Zip
Location of Offense---!-'-.,
lE l
Enforcing Dept/Division
} 1 t
Offense 1t , r - .{
Facts ' -� . ,r + 1 - t•i s� �. d
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.
e;
Number Fee
1313 THE COMMONWEALTH OF MASSACHUSETTS $50.00
Town of Barnstable
Board of Health
This is to Certify that Tedeschi Food Shops (7-Eleven) Store #37410
1638 Falmouth Road, Centerville, MA
Is Hereby Granted a License
For: Storing or Handling 26 - 100 gallons of Hazardous Materials.
------------------------------------------------------------------------------------------------------------------------------------- -------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and
'and expires 06/30/2017 unless sooner suspended or revoked.
---------------------------------------
PAUL J.CANNIFF, D.M.D,CHAIRMAN
DONALD A.GUADAGNOLI,M.D.
07/01/2016 JUNICHI SAWAYANAGI
THOMAS A.MCKEAN,R.S.,CHO
Director of Public Health
� I .
V
ls�
�O
_C0
5*vr e 3 7'i 0
Town of Barnstable
z Regulatory Services
Richard V.Scali,Director
""R°S"B'$ Public Health Division BARNSTABL
.s
n {', Thomas McKean,Director. " 4
200 Main Street,Hyannis,MA.02601
O Rce. 50$-862-4644 ^ "05 rl� 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—JUKE 30th).
• APPLICATION FEES
CATEGORY 1 PERMIT 26—110 Gallons: $50.00i�.
CATEGORY 2 PERMIT 111—499 Gallons: $1 25.00 ❑ �6b 2-I'IC'4 l3�
CATEGORY 3 PERMIT 500 or more Gallons:$150.00 ❑
A late charge of$10 00 will be assessed if payment is not received by Julyi Ist.
ASSESSORS MAP AND PARCEL NO.� DATE
FULL NAME OF APPLICANT:
NAME OF ESTABLISHMENT: ( �1 n- �
ADDRESS OF ESTABLISHMENT: J QV I fet A.
MAILING ADDRESS(IF DIFFERENT): Rivtj
TELEPHONE NUMBER OF ESTABLISHMENT:
EMAIL ADDRESS: ® 1 It C
SOLE OWNER:—YES—NO IF NO,NAME OF PARTNER:
FULL NAME,HOMIE ADDRESS,AND TRI. P� ��_��
CORPORATIO M AE, IInP� '
TREASURER
CLERK
• IF PREPARED BY OUTSIDE PARTY:
T QF• ICANT Name:
Company Address:
i1(,�pti(pGtV Telephone#:
b Sw/64 SCE Email:
QA1Applicaf on Fomis1HAZZAPPReY16.dorx Page 1 of2
y TOWN OF BARNSTABLE BAR--w 5195
Ordinance or Regulation
' WARNING NOTICE
i
Name of Offender/Manager_ 17�r
Address of Offender MV/MB Reg.#
Village/State/Zip
/� S1�
Business Name�J24esck r �'foo a q oa pm, on Z z3 20!7
Business Address �o 4:;_) i19,RA
Signature o nforcing Officer
village/State/Zip Cew1- ✓�l�e-- 2 32-
Lgcation of,Offense cJ�[ `ell
,r �Enforcing Dept/Division
Offense Vlo�a��oweir (U ora Vie Cr>✓ e� 7�kwo2� ri� OKS d
AA
Facts �/t�af M14a•T2-!'ram. S I A 1/ r� ! S D 4tit
(i�•Lvt W,�'Vl.,x. 5� �5,�-t55 Goa 5.
This wall serve only as a warning- At this a 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.
w
•
•
THE fOk'� Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
BARMASS. 200 Main Street• Hyannis, MA 02601
1639.
�ArFOMA'� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name: 4nio&/TO,5 Wi Date:
Location/Mailing Address: 1,b 91 FAM OUA TX1 Lvkc& 102 A 2
Contact Name/Phone: 77
Inventory Total Amount: MSDS: 0 License#: 13YI
Tier II : ho Labeling: Spill Plan: 2
Oil/WaterSeparator: M/A Floor Drains: N Emergency Numbers: JJ
Storage Areas/Tanks: gployq q
Emergency/Containment Equip ent: b
Waste Generator ID: Waste Product:
Date&Amount of Last Shipment/Frequengy:
Licensed Waste Hauler&Destination:
Other Waste Disposal Methods:
r
LIST OF TOXIC AND HAZARDOUS MATERIALS fiO C)ILLI, Ih�
NOTE: Under the provisions of Ch. 111, Section 31, of the G�heral Laws of , 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
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: 3 i ;Ve-
Inspector:
Facility Representative:
U-L/V
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS