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HomeMy WebLinkAbout0369 SOUTH MAIN STREET - HAZMAT 0-7 - b'-� D �,I TOWN OF BARNSTABLE BAR—W 5165 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager bt ure v-' D11 111 r Address of Offender MV/MB Reg.# Village/State/Zip .- I Business Name C. r'n ry �f_ E't�_1... ! n,n. 'j:o cram/pm, on 20ell t �v Business Address Signature/of/ Enforcing Officer Village/State/Zip Ar;:u��v 1` , 02- (,, J?- Location of Offense / Enforcing Dept/Division Offenses o �,� �t^ �w r1 1p - �, J- nt���� .I U'� a rF+'ar� 4at- � Facts 14It1A �4�v�s WlA �J {, J >,�" n, a�z d )Ic 1= G 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. •� — i ... - - _+. Y ... .r_. ...,...4.,-.d.. e:.- ..-;. :r..vryr�r.w,�t w.-*c.,.M.ryy..P�..Y... -r-r.'._....�..•..r^' .,---- ..r. .. i.._.-�, TOWN OF BARNSTABLE BAR-WJ Ordinance or Regulation WARNING NOTICE Name of Offender/Manager . {V�r' 'j Address of Offender MV/MB Reg.# Village/State/Zip �� -1� i;1, s 20 Business Name :`"� • �� � t. tax '� .�,� am'/pm, on _ Business Address Signature,"of Enforcing Officer Village/State/Zip Location of Offense 14tL l Enforcing Dept/Division Offense Facts ma's i; } (. ! +, �: �; : �, .f� k r - a; _• �.c , ; 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. °FINE►okti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMs��e.� 200 Main Street• Hyannis, MA 02601 A'FOMP'�a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: croAtutilt Date: l Location/Mailing Address: 924A Contact Name/Phone: p, Inventory Total Amount: < MSDS: License#: �tf Tier II : p Labeling: Spill Plan: Oil/WaterSeparator: Aro Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Ot' [Date& aste Generator ID: Waste Product: Amount of Last Shipment/Frequency: icensed Waste Hauler&Destination: ther Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS �p (j� in t ry NOTE: Under the provisions of Ch. 111, Section 31, of the G neral 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 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 °FtHE)ON Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-7s0-6304 • BA MASSBLE.9• 200 Main Street• Hyannis, MA 02601 1639.�ptEOMP+p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT ,,r1 Business Name: le P Date: o6nW16 Location/Mailing Address:^ e ct Contact Name/Phone: Inventory Total Amount: cr SDS: XN License#: laff Tier II : N0 Labelina: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipm t: E aste Generator ID: Waste Product: ate&Amount of Last Shipment/Frequenccensed Waste Hauler&Destination: ther Waste Dis osal 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 flushesBug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils V 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 V 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:() Icp�� ` `M�� Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS IB*owe Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BA LE.MASS. 200 Main Street• Hyannis, MA 02601 9 MASS. 0p 1 6 391. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rf0 MPS Business Name: (&, Vli t`f, ( _Inyl Date: 71211 Location/Mailing Address: M . Q U�y�U Contact Name/Phone: S c)!� :177 -7211 Inventory Total Amount: 5 0 SDS: oa&m License#: Tier II : N () Labelin : '(12 0�; Spill Plan: thts— 30✓ilck Oil/Water Separator: Floor Drains: NIS Emergency Numbers: Storage Areas/-ranks: a\,)Mw room, 06d C hemm Emergency/Containment Equipment: 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 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 utomatic 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 ------7Paint&varnish removers, deglossers S Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers CB's Metal polishes Other chlorinated hydrocarbons 9C) loo Laundry soil &stain removers�5 (including carbon tetrachloride) (including bleach) Any other products with "poison labels" 5&" g}, (including chloroform, formaldehyde, 1 np�h"yd��r��ochloric acid, other acids) VIOLATIONS:. S1 GlS n �5 O r Sp;j� Ki+J l"n IGt,() , u-� s 4�r a P& 'F►mf . ORDERS: co;. a SD � Pla-n INFORMATION/RE MMENDATIONS: ( dr ` P.khf Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °PINE►, Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. • 200 Main Street• Hyannis, MA 02601 Fo 9. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C V-A-' J`I le- -Rea ck 1.. , Date: 9 27 Location/Mailing Address: 361 M t%, :5+ CeYct• Contact Name/Phone: Inventory Total Amount: �`'�41`f'l b MSDS: No - `x-e VD5 4W-e-k License#: I Tier II : o Labeling:,04- &-A Spill Plan: obbs Oil/WaterSeparator: NSIA Floor Drains: N o Emergency Numbers: Storage Areas/Tanks: yA, &1 e-. , L k.—o Emergency/Con ainmen E ui m nt: 4w--cis vv\,--k\ z 15 Waste Generator ID: tj Ilk aste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination:Other Waste Disposal Methods: av,\ �"A H v Td/,c-kv5 W 4,0-G %5 \0 c� o vo,%AA"s ak - 0.vv6 aL,I,Ary. 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. 2 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) 1 Z Windshield wash 2- Motor oils % Z Miscellaneous Corrosives v Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil L Disinfectants -I- Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: ! — Caulk/Grout/. ,IkA,- 1 p-+S insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creos tt l Asphalt&roofing tar o A S � Swimming pool chlorine SS Paints, varnishes, stains, dyes'L Lye or caustic soda 't'3 Lacquer thinners Miscellaneous Combustible3 67A\ Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables;' Fertilizers Floor&furniture strippers PCB's Metal polishes qa` Other chlorinated hydrocarbons Laundry soil &stain removers 20 1 (including carbon tetrachloride) (including bleach) Z Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: o v,-t V,&o e! G ` sreA,,4 04�'&04 iL-_ ORDERS: INFORMATIO /RECOMMENDATIONS: &A k5 ot4, rwk oo 1 G k t.4 S ' ova 5 a r //cC�LA 2s . 1 c-ov,, con Q�.u-r l�A�c try 1 CL 41C a A 5 e e Inspector: �2 VC.aa-,ov- w.�,vti '7 y9. agV g ��� Qpwki v� k1tvl., Nw 14,\>4c Facility Representative: KA4 � t'oowt��2wA poor. roowl• 0b�q\� S'6 4-o Ite.tP av` -5 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS �&< a�\ 4�n wvt,ca-(_ 7 SPILL CONTINGENCY PLAN Emergency Coordinator, Name: L gLjaEA) bAL'/ Address: 3C9 Sa. f4&'ia '�,ocrv� �6 ' ►r cr, Daytime Phone: Evening Phone: Fire Department: ty4c y Barnstable Public Health Division: 508-862-4644 DEP 24 Hour Spill Hot Line: 888-304-1133 Waste Cleanup: Name: A 0r N)"c.14C-it s0^' Phone: S'b E- 34,7- 9yL Building diagram indicating hazardous material/waste storage area, location of absorbent scavenger materials, fire extinguishers, fire alarms (if present), and evacuation route (if applicable F"�4' 1`e \<J�-"IN le" J Actions to be taken to control a spill or release,. and preventing it from reaching a catch basin, sewer system or the ground. �, gin.-���, ��.s � � �� �r�.;�► �� � r� 4 W e a- - r °.IKE r° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 . enaN^SABLE. • 200 Main Street• Hyannis, MA 02601 059. �'D�EDMP�p`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C tea+ I�� �e � ►�✓� Date: 7 I Location/Mailing Address: :9,6 c;�. 4,A CzY44rv,lht a, -Ile- 6e4611- ti2e-g Contact Name/Phone: vcc+ti, oLl M o --776- 23 n' Inventory Total mount: MSDS: o License#: f� Tier II : o Labeling: Spill Plan: Oil/Water Separator: Floor Drains: Mn Emergency Numbers: Storage Areas/Tanks: e� otokt oil 7 bco.,114 +o ,61rk.av-, Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods-'6,J*, AQ&& LCPI kd-ln oK111AV • �C V 0-4 e- a,w 4 `' -r6�t k. J alkce�4ti. • O• ba �s•,�.{5 ,-o�I.�rtiti�r�a� w•llly`b<. 1� t e•11ect�©K �r Pt+ r�l�s�sal 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: '7 CaulWGrout/,%dh",,,e5 insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) 1 '1/ Asphalt&roofing tar a 4 o Swimming pool chlorine 70164t1 3^16 _ 30 Paints, varnishes, stains, dyes `*hx) Lye or caustic soda ��as' Lacquer thinners Miscellaneous Combustible I Q Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons 2O Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: Motaorpil PA5f1-12, ) S-FoceXoJrS•ot!Er ,.�►-F�erl sc�o �N �►����� en�• /vim ORDERS -5JCX 41-t , 0egie, r CPLJ4,ASX C K 41 MgLce o, sz Ia eet. qoe— O to S. � t ,vu�•2. Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS li • LI Number Fee 1288 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Craigville Beach Inn .-------------------------------------------------------------------------------------------------------------------------------- 369 South Main Street, Centerville, ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons 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 b.09 03:17 PM Atlantic Coast Drywall 5088214772 #1833 P 2/ 3 Town of Barnstable . Inspectional Services BARNSTABLE �- t Public Health Dlv�ision ' `" D "� 1�""` 6i0-07 wwaTASUC, g Thomas McKean Director KA MA®& , S439' ``� 200 Main Street,Hyannis,MA 02601 Office: 508.862.4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE ell, 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 gd vw-Pd c,� 1404 S CATEGORY 2 PERMIT 111 —499 Gallons: .$125.00 .O CATEGORY 3 PERMIT 500 or more Gallons: $150.00 CJ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. rk I- P 7V 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 STORAGEWSE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: a Lr 5. NAME OF ESTABLISHMENT: Or, U1 ((e &t&L �;,n 6. ADDRESS OF ESTABLISHMENT:JL q S. ruin sr Qt a4erU, (Q. 3�- 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER OF ESTABLISHMENT: SlI�" 7 add 3 9. EMAIL ADDRESS: f(d,CLCdP R 0,p t. Coin 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION AME rz F' Aa( LLr_ PRESIDENT Oat d a a "- O M4 IV 7 q 'TREASURER i a v CLERK r a c50 - q 7-,S li- 12, 1F PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT 4WA14 DATE Q:\Application FormsWaz Mat Appli Draft Jan2019.docx Number Fee 1288 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Craigville Beach Inn 369 South Main Street, Centerville, Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. - ---------------------------- ---------------- ---------------------------------------------------------------- _-------------------------------------------- This license is ranted in conformity with the Statutes and ordinances relating there to,and g tY g and expires 06/30/2020 unless sooner suspended or revoked. -- - --------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADA_GNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health i Town of Barnstable "THE Inspectional Services BARNSTABLE pF �, anawsme=•ccmrc.,L.cwmrY+vu�rci=-.• Public Health Division Thomas McKean, Director MARK i639 6.`�� 200 Main Street' Hyannis,MA 02601 tE0 Mn+ Office: 508-862-4644 Fax: 508-790-6304 r*..,+ t„7n; 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 MY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 .®'VST" 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 UANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: \ OF ESTABLISHMENT: - n 6. ADDRESS 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: J 8. TELEPHONE NUMBER OF ESTABLISHMENT: 5C)0- 11 J� (� � 9. EMAIL ADDRES . 10. SOLEOWNER': YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS AND ELEPtIO OF• CORPORATI NA,�ME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • jj SIGNATURE OF APPLICANT DATE Q:\Application Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1288 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Craigville Beach Inn 369 South Main Street, Centerville, Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ------------------------------------------------------------------------------- ------------------------------------- ---------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted is conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r� PC, Ch K-7t 3 e-3-3 ' owl of UnslIblea eg atoervces Richard V. Scali, Director �'THE ' ' • �, Public Health Division BARNSTABLE r B4RNSTpELE•fBlfERY1LLF•CDf11R•NVAt3i15 • Thomas McKean, Director NA0.SiDHSnS160S3E90.2 0 E14w56uxS4CE -200 IVlairi Street,-Hyannis,-1VIA 02601____ Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS :�i IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT -26- 110 Gallons: .$ 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. 1. ASSESSOR'S MAP AND PARCEL NO. �/I'1'f.L� - 620 2. IS THIS A PERMIT RENEWAL? ' YES_NO. IF YES,SHIP 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: dais V 6. ADDRESS OF ESTABLISHMENT: o 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: G U� //A�i 4y . /Q,f.(iNw -m4 od 7o 8. TELEPHONE NUMBER OF ESTABLISHMENT: �5vU-lJ CIS /adI✓2 9. EMAIL ADDRESS: /o( tap P aO l`- cp'h- 10. SOLEOWNER: t�YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,4ND TELEPHONE CORPORATIO NAME ff�C ,® r� PRESIDENT (n#lnot. TREASURE CLERK A4r- 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT fjlDATE Q:\Application FormsUiAZMAT APP 2017 REVISED.docx r Number Fee 1288 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Craigville Beach Inn 369 South Main Street, Centerville, \ � 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. ---------------------------------------- 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 ' owr of Unstable eg atoervices Richard V. Scali, Director e IKE, , ` o Public Health Division :rs- ftAARNSTABLE sranxN�isLE. Thomas McKean, Director W5163i9-2014` f 2 HsrasE 94' i639 s`e� 200 Main Street� Hyannis, MA 02601 575 `rEo ram+ Office: 508-862-4644 p� —C;207 Fax: 508-790-5304 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-DUNE 30th). APPLICATION FEES \.C11 LlJ l7 Y\1 11L1 ii 1lV "t.il101iJ.-"-'-'-'--y':J"v:V v— "_—.._ V�-.1 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? W YES_NO. IF YES,SHIP 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. � 9� 4. FULL NAME OF APPLICANT: ('Y al1 5. NAME OF ESTABLISHMENT: V I lam, Ch tf)n 6. ADDRESS OF ESTABLISHMENT: lufk I / 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: 1 n�P �'(;Q Q v l I'L6 f J-%I n n v � r 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: - DGl -? 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATI NAME `Z 1�1 L� C PRESIDENT 1 - 6-a-776 TREASURER_ %eAX2 CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: 08- 397- S711 • COMPANY ADDRESS EMAIL: Vb A G U Q ol►-5-°''� SIGNATURE OF APPLICANT DATE `- / 7• 7 QAApplication Forms\HAZMAT APP 2017 REVISED.do c Number Fee 1288 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Craigville Beach Inn 369 South Main Street, Centerville, 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. ---------------------------------------- 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 S For Town of Barnstable • � T Regulatory Services do Richard V. Scali, Director () " MAS& HealthDivision 0 rnA4RNSTABLE -+ Public ° Thomas McKean, Director '6'9-z°" 200 Main Street,Hyannis,MA 02601 t, Office: 508-862-4644 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/may 1st. ASSESSORS MAP AND PARCEL NO. ':�®-7 07'0 DATE FULL NAME OF APPLICANT: lza.A4rnon(k NAME OF ESTABLISHMENT: 4 ADDRESS OF ESTABLISHMENT: oil 0alo32 MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: In o P �r���>>,Q �`►h� 60m SOLE OWNER: `/ YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 1Z, V PRESIDENT 21 Ta.> 6a-7w 6*39 5712— TREASURER CLERK �- • IF PREPARED BY OUTSIDE PARTY: NAT OF APPLICANT Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Revl6.docx Page 1 of 2 r Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 Public Health Division XAS& Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 fb MA'S Payment Receipt !Hazardous Materials Payment received: $50.00 (Cash) on 10/12/2016 i i is I Business: CRAIGVILLE BEACH INN Owner: R F DALY REALTY LLC Address: 369 SOUTH MAIN STREET, Centerville ;Note: Category I Permit 2016-2017 I • TOUT ©F BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2. nters BOARD OF HEALTH 6satisfactory 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY `1010 1 (see"Orders") 5.Retail Stores -� 6.Fuel Suppliers ADDRESS ` 9 Class: • 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks I Underground Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: 6� _.tz L_ 4 DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer ublic On-site Private 3. Indoor Floor Drains YES NO O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank: MDC O Catch basin/Dry well O On-site system 5. Waste,Transporter Name of Hauler Destination Waste Product YES NO 1. 2. 1J EITIitiw�� r .s. Person (s) Interviewed —CJ . Inspector Date TOXjC. AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: ��nv�`�o w� � Board of Health MAILING ADDRESS: 2•0, 20L SOIA Town of Barnstable TELEPHONE NUMBER: "(�1�- �1ZZ-� P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 2 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: S �c ADDRESS: NA o &r— 2. C-e.16$1-akXa TELEPHONE: '-N 5 ---I LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, _ Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business e