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HomeMy WebLinkAbout0489 BEARSE'S WAY - HAZMAT (2) 6a)%" *vl--mac, tT- 1 q ADD SMEA ® KEEPING YOU ORr4N17Fn No. 10230 H 163 I SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE. CONTENT 10% Certifiel Fber Soeming POST-CONRI IMFP vnrw Ufi lcgrem org n Prm MADE IN USA GET ORGANIZED AT SMEAD.COM 1 °FtME jog Town of Barnstable Office:508-862-4644 Public Health Division,. F :Sosaso-ssoa swRMASSRLE,g` 200 Main Street• Hyannis, MA 02601 �p1 6 39 s�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rFD MA'S I; Business Name: &1 1r 5 1 M o Date: [Location/Mailing Address: q R eezr5-,- s ya V1 n I S. Contact Name/Phone: Ahvle c%y {�2L.uvlgvbte So$ - S - 23 6 Inventory Total Amount: '�� '� °� MSDS: y¢5 -t' s-!"a�-a ��`J License#: Tier II : o Labeling: vlo�:� Spill Plan: Oil/WaterSeparator: VIA Floor Drains: A)o Emergency Numbers: V Storage Areas/Tanks: t ax- f -i*w Emergency/Containment E ui me t: 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 Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash / W%vOe-x 1 Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants I 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 1L a,r if r Lacquer thinners 3 Miscellaneous Combustible 4tet'o5c1ss Paint&varnish removers, deglossers Leather dyes + Miscellaneous Flammables A�k„ Fertilizers Floor&furniture strippers a1o�` PCB's Metal polishes c�l5 3 Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, -7V,,-,1..1&RV4S-r v-44. -j hydrochloric acid, other acids) VIOLATIONPe "'I 3 ORDERS: INFORMATION/RECOMMENDATIONS: a, a a \VtX-C`6 -e- a }z-cla l5 lI cev e- �- Or'CLaQ-�'-fv1i5'f'i .0 Inspec Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS w.M 079d -O F/? Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BAR NSTABLE. MAC, g, 200 Main Street• Hyannis, MA 02601 �" i639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MP'� I Business Name: .�� 6eos A s de Date: Location/Mailing Address: Contact Name/Phone: 7 7 Inventory Total Amount: MSDS: License#: Tier II : no Labelina: Spill Plan: � Oil/Water Separator: Floor Drains: �� Emergency Numbers: Oki Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: o/p Date&Amount of Last Shipment/Frequency: � Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS i�� MLA �CQ,)--,, NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws 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: b 6^�h Inspector: Facility Representative WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °FTHero� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9B""MASS. 200 Main Street• Hyannis, MA 02601 SA 1639.MA TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rf0 y Business Name: AM-PM CGAVWeAct, Date: 11 / 1 O2D Location/Mailing Address: 993 Contact Name/Phone: Inventory Total Amount: 7 � MSDS: License#: Tier II At Labeling: . Spill Plan: Oi[/Water Separator: AIZA. Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: VI Cate&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: F 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 j 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: INS I n IS, VDIIS Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS �5616 bt 4& °FIKE r°w� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B^aMASS. ' 200 Main Street• Hyannis, MA 02601 'DrfOMF+�,e� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: . 'PIA j enck Date: Lin- Location/Mailing Address: Contact Name/Phone: Inventory Total Amount�v < NCOOnS SDS: `f-Aefi'n License#:-J aA — Tier II : Labelina: rt4a i I Spill Plan: Oil/Water Separator: A Floor Drains: n, Emergency Numbers: ND Storage Areas/Tanks: NIA n S Emergency/Containment E ui ment: Waste Generator ID: Waste Product: IVJAC r Date&Amount of Last Shipment/Frequency: WA Licensed Waste Hauler&Destination: , AVA 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 Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons i/I'- 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: , S to • Inspector: . Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS °F INE r°k� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 •\BARMASS. 200 Main Street• Hyannis, MA 02601 i639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rE0 MA'S Business Name: A 04-+°✓►'( Copt ven i ,-K e--e Date: Location/Mailing Address: q7 ,05e S A;'A 1 5 Contact Name/Phone: Cl� k a��-1 so$ - - 6- Inventory Total Amount: A- MSDS: License# o➢ Tier II : Labeling: 4V-ka, 1 Spill Plan: }'41 05 Oil.NWaterSeparator: 1�\ Floor Drains: ° Emergency Numbers:Q— Storage Areas/Tanks: \- 1 �c1A,c o e�w�C ,o vto � I Ca►uc t'S Emergency/Containment E ui ment: Waste Generator ID: 01A 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. 'b Antifreeze $ Dry cleaning fluids Automatic transmission fluid `I Other cleaning solvents&spot removers 2- Engine and radiator flushes Bug and tar removers -h S�'I G1µ�.e- Hydraulic fluid (including brake fluid) Windshield wash t`4 Motor oils I +�""y` Miscellaneous Corrosives 1 �ca,tio Gasoline,jet fuel, aviation gas a`'f,\,J%p Cesspool cleaners Diesel fuel, kerosene, #2 heating oil I 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 2- Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes 1 �— Miscellaneous Flammables y Fertilizers Floor&furniture strippers �\V PCB's Metal polishes Other chlorinated hydrocarbons 1- Laundry soil &stain removers (including carbon tetrachloride) (including bleach) 2 Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: a i- wt a ee r5 a i,J t� ctnn �o t,C-e-5 S • A �- ov e r r Uvl6<LtyA. gam, wt, O ) e d..�-� W\` tom- - - '-7 15 �o g 1 g •11 avV Ovt-5 • Inspector: 1 Facility Representative: �� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1324 THE COMMONWEALTH OF MASSACHUSETTS $50.0o Town of Barnstable Board of Health This is to Certify that AM-PM Convenience ...------------------------------------------------------------------------------------------------------------------------------ 489 Bearses Way, Hyannis, MA .-----------------------------------------------------------•............----------------------------......------------------------------------......................... 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 ty 0 '�`�► 't Town of Barnstable c Inspectional Services BARNSTABLE OF t1�E . • CLW4.iSiCIIJS WIL5 SERY(LL ,F SAMSSnEiE Public Health Division 1639-2014 ,;, 1RARMN Thomas McKean,Director 0 3> 200 Main Street, Hyannis,MA 02601 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, F` 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 w47 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. 2. IS THIS A PERMIT RENEWAL?JZYES_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)? jj YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 'M El 8. TELEPHONE NUMBER OF ESTABLISHMENT: t - �22 cir - 27-' 1 9. EMAIL ADDRESS: f'1 ��:yt �,/ t S l• �d' r ( C-r h o 00 �o ' 10. SOLEOWNER: YES vRO IF NO,NAME OF PARTNER: 10r� Y'EU C17_ 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME O//1-n _Z:,tA�-a S 1 l 42,a42 cb PRESIDENT^e C Gi TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE C( - 2 0 t-2-,0 Q:Wpplication Forms\Haz Mat Appli Draft Jan2019.docx i Number Fee 1324 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that AM-PM Convenience 489 Bearses Way, Hyannis, 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 06/30/2020 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 Town of Barnstable Inspectional Services BAMSTABLE OF SHE a STAS---wljr.i:--1a 7-r 1-- Public Health Division "vsc. uius.asExrue-a_1�nn—aef p s-xnia . � ,.0 Thomas McKean Director ArEo ,�A 200 Main Street, Hyannis,MA 02601 CID 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 1 st—JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ,� V CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ f 414 S 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. C;2-902 2. IS THIS A PERMIT RENEWAL?_ZYES_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: 6. ADDRESS OF ESTABLISHMENT: Z �Gf— ��,p.��S G 1C 7 sa'�`ji�,a2-6'o 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 1 9. EMAIL ADDRESS: /'1-z c�h t� C,� Cam' 10. SOLEOWNER: YES_LXO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME in by fn V-N PRESIDENT TREASURER G kx-�� i CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: + SIGNATURE OF APPLICANT DATES 'L q Q: Application Forms\Haz Mat App Revised 09-10-18.docx Number Fee 1324 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health - This is to Certify that AM-PM Convenience 489 Bearses Way, Hyannis, 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 low11�� of Unstable egulatoervices Richard V. Scali, Director Public Health Division BARNSTABLE • BAIINSfpBLE.fEtRERYILLE.COiUR•MVPXNIS BARNbTABM = Thomas McKean, Director i639- -- — —-- -- ,, s3 �0� -- ------ -a) x: 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 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 'g V.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. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL?_ZYES_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: p cry, CV`�Y'L 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: �'�- © �S"� 7;7- 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—�A&,—/C- DATE -5- -2/79— Q:Wpplication Forms\HAZMAT APP 2017 REVISED.docx IKE ro Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 91BARMASS. 200 Main Street• Hyannis, MA 02601 O MA TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT f Business Name: Se'-".!* C,, k a-,A 5&L Date: Location/Mailing Address ayse_% aryl .Contact Name/Phone: a. o e © - S^1- .InventoryTotal Amount: 25 R I SDS: v� ' D at License#. 3� S C-4`�' Tier II : K10 11 Labeling: e' Spill Plan: ZS Oil/WaterSeparator: NIA Floor Drains: o Emer enc mbers: Ile,5 Storage Areas/Tanks: ,-5' 6i \nocLAS mtx - 14s 60b k 5 5 Emergency/Containment E ui ment: c e C S I-�o.,J.,¢.I S Waste Generator ID: —� Waste Product: N�-�- Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: c.PA 10ti\k6 d ke. 0w ��e a� cowkk �SS vv�k sib- a G 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 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" N a-,I , .J is\r" V I s 4r Salks C,J� g,�5� (including chloroform, formaldehyde, A c eA hydrochloric acid, other acids) VIOLATIONS: ORD S: o< awk AA ewV_k_ kNcL• 1 a 1.•- a 1 tieS INF RMATION/RECOMMENDATIONS: o A,t ,.Q- v�{� old J 1%0 t_ , Inspector: L 4J Facility Representative: R d rVA/1 Aa�_ WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS -IKE r, Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BhRMASS. D` 200 Main Street• Hyannis, MA 02601 ��rEOMA+a`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 5ecvc.�, 1��,1 a" 'O A_ Date: Location/Mailing Address:( y7 a 15 a Vt'gl'S Contact Name/Phone: /v a& V g C.2/l "7y - y"70 Inventory Total Amount: 2- I MSDS: -o o�oka,V, / License#: $� Tier II : f Labeling: DK Spill Plan v os� Oil,'WaterSeparator: Floor Drains: /)o Emergency Numbers: t� Storage Areas/Tanks: <4,ql b1,4z-+5 Emergency/Containment Equipment: Q- -10 s Waste Generator ID: 6flik Waste Product: 014 Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Ot-ner 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 3 Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes T_ Miscellaneous Flammables Acek--- ' Fertilizers Floor&furniture strippers ��cblti°1 ' PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) ( Any other products with "poison labels" y�►NAQAV AeJ\g L (including chloroform, formaldehyde, w�C•�l< 0,1 3\Aa.\l �ol�I-L 2_4 ��p�C hydrochloric cid, other acids) f�mol�+n� yc1 S �p� i5�CN14 �1 t`� t caclyl,c l,��. fe-A,e-^re >&I1JQ-,Ax� VIOLATIONS: r ORDERS: INFORMATI /R COMMENDATIONS: �1 3 � 5 ��vt� rg V o,n, S . /.a,✓.,e_ e— k .-� �.�a�l ab l� Inspector: �.Q [ w Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1325 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Secret Nails and Spa 489 Bearses Way, Unit B3A, Hyannis, 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. c� 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 loTOWN OF BARNSTABLE BAR-W ab 19_T rdinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip Business Name S cto-te �� q, :00 /pm, on 3 23 20_"7 Business Address Signature o orcing Officer j Village/State/Zip �1140VI15 ' M 44, Location of Offense J`ee_-r a� S ��� f a- �e� Enforcing Dept/Division Offense I-<- W Q fe -Aa 2 ' a.1 k.X 5 d d� Facts kq.-J(b&,5 V- o4 s k)1 2 Ua- 4 S-c. • ,/�I JS-�". e b I vt- )16 e;45t, 01*1': '5---.b0s1"ss 40&W W i-ece-I This will serve only as a warning. At is time no legal action has been taken. It is the goal of Town agencies t 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. �— Town of Barnstable �t Regulatory Services ° MAL � Richard V. Scali Director ' MAE&�' ' Public Health Division BABSTABLE i6 y. 0� enwrnec•mimemit.mnm•wumrs $ �1 .unrrna wns-osrEnhue•wsr enFxsrrn eoMa+ Thomas McKean, Director 1639-2014 200 Main Street, Hyannis,MA 02601 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 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. 00 ASSESSORS MAP AND PARCEL NO. DATE 3 c1 FULL NAME OF APPLICANT: (� Q � NAME OF ESTABLISHMENT: ADDRESS OF ESTABLISHMENT.: qgq rc� IrS W &3 Cp YI Vk, �S f I �2 6 01 MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: —T7?1'- I / ® -2( 60 EMAIL ADDRESS: n on.,4400 Am. C o rvli 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: SIG ATU F APPLICANT Name: � ri/P.1' vll—�� Company Address : I -rv- V Telephone#: Email: Q:\Application Fonns\l-IAZZAPP Revl6.docx Page I of 2 Number Fee 1324 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health CA This is to Certify that AM-PM Convenience S (� 47�earses Way, Hyannis, 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 f Town of Barnstable �t HIE Regulatory Services Richard V. Scali, Director .n UU &"M "BLE' ` Public Health Division BABSTABLE 639. s Thomas McKean, Director 165754 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 a 676c-X 7 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 1 st—JUNE 306). 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. Z GI1—,0—71 DATE � 1 FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: eq W^ PM e::�2922 YM2171 u2'Z r P, , ADDRESS OF ESTABLISHMENT: SI t MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: / h 70 9'- EMAIL ADDRESS: SOLE OWNER: YES `VNO IF NO,NAME OF PARTNER: ��� ��%(�e• FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME ° PRESIDENT -TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIGNATURE OF APPLICANT Name: Company Address al, Telephone#: Email: Q:\Application FormsUAZZAPP Revl6.docx Page 1 of 2 I • L • • Number Fee 1324 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that AM-PM Convenience 489 Bearses Way, Hyannis, 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. --------------------------------------- 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 Number Fee 1324 THE COMMONWEALTH OF MASSACHUSETTS $50.0'0 Town of Barnstable Board of Health This is to Certify that AM-PM Convenience 489 Bearses Way, Hyannis, 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 i 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 J r d r-�6k Ll w of B stable Roeg1Aatory ervices IME Richard V. Scali, Director `. o Public Health Division BARNSTABLE I � f N�tgR510ASPHIIL-DSIEPVIl1tC�51P�N5RfltE � SMBLE• • Thomas McKean, Director 1639-2014 �fD A 200 Main Street, Hyannis,MA 02601 575 eD -n Office: 508-862-4644 Fax: 508-790-6304 X APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE t, HAZARDOUS MATERIALS Pq 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). C-�269 �_ 7� APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 11 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. 1. ASSESSOR'S MAP AND PARCEL fNO.. 2. IS THIS A PERMIT RENEWAL? V 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: ,49 M ? r `�2 G� 6. ADDRESS OF ESTABLISHMENT: Ate—,��-aeels,e.,5 +lee;J-7?713., In 19-_d2fiSo I 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 0,,,4�dr) 1,,7 �5 PRESIDENT D2CeY g,-,-X k TREASURER CLERK 2'7 GG 12. IF PREPARED BY OUTSIDE PARTY: • NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT - DATE Q:\Application FonnMAZMAT APP 2017 REVISED.docx klUmber y r ti .' #E' Nf(1IiQ iV1f ALTH �F 11�C�4S5A�HUS TTS � o �Baeos Abie ` h' Boas oalf�i t r hi :is'k�.�� fy that ` ::h n'rtto Paint Inc.'�'+ fd `pmF4ny K 48 8�krse�Wqr� ,I►�t 3, � OZ6Y11 ' fi IsH�r-ebyntecl a Lime: F f �13 Al L'FN '1 `GALk4PtrMOROF�H�A�L'ARD ;I�II�iERipk�;.Sr' , � ` +,- r s.�—__ ,F �.' -.a-'�-.z--�i .c +xa_': r c •-T-�1•_-y- ^'^6--s.,-ems+-- 7 V` i antes relatin < "ere.to"cud `71 r Tars hce�se�s granted:�n cdAf M. 1ty wtfk the�Ot�tis=ham}a d n S g� , ` arid'si ices Julie, irnless,soo ersutsp,d � `r vol ei. p a r SUSAN G.MASK,R.B. iN�iYNE•M I C M:b_,' r �RI' A ,SUMN K k4WFMAN,III S P N THOM' S As IIAZ;KFA�J,' Dgectof b well#h ` A _�` , `j � :- � �,ar-�i � } !rr �i `4 �� Y , �•1 r�� { � llt. q w I� Town of Barnstable Building Department ' Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.ma.us Pre-application for Business Certificate ,- t Date Mqg(� Parcel Applicant Information Applicants Name Applicants Address Sz.NM\�W E2Z_ Email Address. �f?� Vq%J`�c�GpMC Telephone Number TVA_ r %%k `-�.� Listed ❑ Unlisted ❑ Business Information New Business? �\ 5`�.Q__ _ e��� _S _. Yes No Business is a registered corporation? -------------------------�m U If yes Name of Corporation �Z.\ Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _________ Yes No Q)QA W ASS oU 1,1 If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business d`�1\SS\�O l Z.�A �c lC� �--'te_w �'SF-A LS AN C. Business Address Type of Business Building om issioner Office Use Only nditions (S�-in — Q i �� \ Building Commission k I 1 Clerk Office Use Only