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0061 BODICK ROAD - HAZMAT
4r 1 :1 } .I i i JUST ASICS 30% I e3__ Ft ►ok, Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMARSSR�e.� 200 Main Street• Hyannis, MA 02601 ,b,q TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT 711 S/b RFD MAC Business Name: o eyw..L,,' Date: Location/Mailing Address: /ol o / Q Nag ;ire Contact Name/Phone: E-e -Se - 78- - a Inventory Total Amount: A' 1 a) MSDS: 'S License#: Tier II : Labeling: ° Spill Plan: Oil/Water Separator: N I vk Floor Drains: Q O Emergency Numbers: �s Storage Areas/Tanks: ( w � Emergency/Containment Eq_ipment: r! t P• S Waste Generator ID: bw ( xkaste Product: Date&Amount of Last Shipment/Frequency: KIn 0k,�k4- % t Licensed Waste Hauler&Destination: Other Waste Disposal Methods: ,,\\ LIST OF TOXIC AND HAZARDOUS MATERIALS N o `^�`" ° LI Nv c w �'``� S 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" 0 4G Yf- (including chloroform,formaldehyde, AtA- ev-c, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATIO R COMMENDATIONS: C �1 ifs Go tJ V` r.,v 1 x- J /- cL 10 04 •e Inspector: 'Ir v kJ v�5(k������ _ ,rr_ .� Facility.Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Ir IKE Toque Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 enRMA-BR 200 Main Street• Hyannis, MA 02601 Fo + T//JOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name:��o+� �V�K.e - N1���v_0 Date: ° 1 S y Location/Mailing Addre s: 6 f Contact Name/Phone: 1- .Avt.2r .S-D$'-7-7 8 -7 Z YZ'- Inventory Total Amount: '" ( � MSDS: �Z 7 License#: I�Z1 Tier II : IJ o Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: /J o Emergency Numbers: o Storage Areas/Tanks: 1- <,>A& s � qi��-Gera �r�101��•� la,w�tstvw-k la Emergency/Containment Equipment: C _ , 1vq� e-14.4-,A. o-1 are fa.lc &o,&4,k"S Waste Generator ID: (V\ 50 2 Waste Product: Daiwk - M-e- /2nl\1,&AF Date&Amount of Last Shipment/Frequency: HLJ 1 Z 3 o a -Z Licensed Waste Hauler&Destination: ge)r ezv, Other Waste Disposal Methods: p LIST OF TOXIC AND HAZARDOUS MATERIALS o ���! Lka�r�c g -t v I AJev*v-e -11A�c.0— fh5t „ti s,1 NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous mzterial use, •7/3 011 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/"k"„,V5 ?-+,< 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 2� Swimming pool chlorine q'O / Paints, varnishes, stains, dyes 5 *�S Lye or caustic soda �- T Lacquer thinners Z� st3y�a Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables 3 o T�o 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: Ol g� IM Inspector: 1 L-A\W 1-e� Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 7 /30/ /3 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS s N FORM NAME OF BUSINESS: Vd :P—M vu - BUSINESS LOCATION: b I INVENTORY MAILING ADDRESS: f&oLf- TOTAL AMOUNT: TELEPHONE NUMBER: S09-7*75-72` S" CONTACT PERSON: EMERGENCY CONTACT TELE HONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: o 4, r �G S INFORMATION / RECOMMENDAT ONS:C 14as e-Orrev�,V 61-9YA sense., Fire District: .�Labs all �'�aw�►►ga tiles G�.b �s w i-i -t�, _ t�orox a ,���1,.,4 MIMAB�E'' (►►�I��,� �,b„�+����,t�,� ��.�.1�1 ��cor��aas�v�;�; (`X/l;.abG( a 118ecavto�y Gow�a�ntrS G�Inc or Waste feA: :,M✓So8-772 xqg r Last shipment of hazardous waste: y y /2 Name of Hauler: �a,-�'��l i�Ie�,ti Destination: Cv-4v.s4ort., ► ��x or ess Waste Product: Licensed No rQ� D bgy SaZBY 2- NOTE: Under the provisions of Ch. 111,Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes*�,/lus, Other chlorinated hydrocarbons, Lacquer thinners a- m�54 Sbfucn�s (including carbon tetrachloride) yp AEW LO 2 USED 30 Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials °Ft rod Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RARMASS ' 200 Main Street• Hyannis, MA 02601 s659. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 44tLAAt6 ACG4 Lat : 7 3 L Location/Mailin Addre s I -t F v % 0 ct Contact Name/Phone: .e Inventory Total Amount: MSDS: e-5 License#: gly Tier II : KMA Labeling: Spill Plan: o Oil/WaterSepara or: Floor Drains: 9 Emergency Numbers: J0 Dosf' Storage AreaslTanks: ¢.A� S w1 �v -k Emergency/Containment E ui ment: C ccx 4 .1- of \\ S, 5PAV5 Waste Generator ID: -O s.1 Waste Product: / Date&Amount of Last Shi ment/ re uenc : Licensed Waste Hauler&Destination: Other Waste Disposal Methods:t�XCt.*S ecS /4t�4 XAQ---A <tjkst-,<4 k.�e Q re ,e s LIST OF TOXIC AND HAZARDO US 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 k0 Motor oils I 0 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil ti Disinfectants y- g- Miscellaneous petroleum products: Road salts grease, lubricants, gear oil ?, Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides 1 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 %b Paints, varnishes, stains, dyes I-k Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglosaersx S, � Leather dyes 10 U Miscellaneous Flammables �- �1 3 �o Fertilizers Floor&furniture strippers 4,loo PCB's Metal polishes L0V 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: D&6tIS �C We- CWA5AC5. i Sa. INFORMATION/R COMM ND TI NS: a- �oVl & 4 `Lol e41 dri-- C ('L )I !l ?04 A�'1 1��t��` � acil epresentative: W TE COPY-HEALTH DEaTMENT/CANARY COPY- BUSINESS I °p IKE♦ Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-7s0-6304 • BARMAM 200 Main Street• Hyannis, MA 02601 Fo39. �°�� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: VIh 16 eJ� u10 Date: f 3 f Location/Mailing Ad ress: bf +` Ro , R 'COA r M 90 Ocu rg Contact Name/Phone: Inventory Total Amount: -9>0 a aJ r M DS: ZS License#: ti Tier II : No Labelina: Spill Plan: Oil/WaterSeparator: Floor Drains: V Emergency Numbers: Storage Areas/Tanks: l a wu,(-A)p• k Emer enc /Containme t Equipment: Waste Generator ID: W M % Waste Product: H Date&Amount of Last Shipmen Frequency: kl lyx- Licensed Waste Hauler&Destination: - -ro Other Waste Disposal Methods: r LIST OF TOXIC AND HAZARDOUS MATERIALS a Wl� o.( r,� ,s %� th5 NOTE: Under the provisions of Ch. 111, Section 31, of the General Law of MA, hazardous ma erial use, r o'*3, ,3 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 t 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: C� o C A Q.Q� D� WOLOe, tl'� X- �t `�'�Avl+01 fkk LAV��P, / Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: /30 / 13 TOWN OF BARNSTABLE -ems ,de, TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: -lylylis At-L4 (—lino BUSINESS LOCATION: (o I A t rX l .t o e- INVENTORY MAILING ADDRESS: y`I 0 O G.e_av 5+ TOTAL AMOUNT- TELEPHONE NUMBER: (o 17 — (Z-79— 6 1 OS � 00&6,t5 CONTACT PERSON: ��«, G� LQw so .ti EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: ye 5 R2 INFORMATION / RECOMMENDATIONS: �wtr ?� � gyi<� Fire District: a�11 Tn1S �, �1-) -�1J•TJ," - o,- of 3� �Zt,�e ► Sit o! 88 vim- S 5 ,n� a`+-�2�t X of .40a� Waste Transportation: /J/A a key cecojs Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month re uires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid $ Disinfectants Engine and radiator flushes Road salts(Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals(Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible 3 Car wash detergents Leather dyes 3 Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's /2 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, 3(p Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) `7 Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous(please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) 0 Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Date: TOWN OF BARNSTABL TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: A I I P0(Vlts /Aa<, ►-w Sic.,\L-e, BUSINESS LOCATION: _�I go��cL�-1�cQ� yAvl yl 5 INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: Sd°D-5q1-- 1 b4 gj \kk CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 610- f1,0,AVA-ev1A,,.c,a-- Y2,S INFORMATION / RECOMMENDATIONS: 1) Qbke,%,,,,�EPA 61AY-129 �,)e,sk� Fire District: Waste Transportation: 5e.Vr,,W5 P.A ac Last shipment of hazardous waste: Name of Hauler: -0(04 0 +o Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum A tifreeze (for gasoline or coolant systems) IMiscellaneous Corrosive NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants 7m or Oils 0 �USED Pesticides C�1 NEW�'�\ ��'�°�� (insecticides, herbicides, rodenticides) Q Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED S Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible 3 Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials °pIKETp Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 NST,eaRMASS .$. 200 Main Street• Hyannis, MA 02601 p ,6„ a,0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MP'� 1 Business Name: Iri Date: Location/Mailing Addreso: b1c M C Contact Name/Phone: OF Inventory Total Amount: MSDS: License#: 10941 Tier II : Al 0 LabelinQ: tA eA Spill Plan: Oil/WaterSeparator: AIAA Floor Drains: Emergency Numbers: Storage Areas/Tanks: igb lEmer enc /Containment Equipment: ' Waste Generator ID: 7 Waste Product: Date&Amount of Last Shipment/Frequency: D D Licensed Waste Hauler&Destination: - 1 ther Waste Dis osal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS W C',� l n Ihl��1yNOTE: Under the provisions of Ch. 111, Section 31, of the Geral Laws of M 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: " Insp for Facility Representativ . � WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine ................................................................................................................................. 61 Bodick Road, # C, Hyannis, MA ........................................................................................................................................................................ Is Hereby Granted a License For: Storing or Handling 111 - 499 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 l F v Town of Barnstable Inspectional Services BPRARNSTABI,E Public Health Division " ' ���" _ �• 7fi39.2014 K AM Thomas McKean,Director bt• 200 Main Street,Hyannis,MA 02601 h 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 1 JULY 1 st—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: $15000 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. i 1. ASSESSOR'S MAP AND PARCEL NO. ' 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES,SKIP QUESTION 3. i 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: U p cri NNE !( 5. NAME OF ESTABLISHMENT: _ LA f)Y 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: I 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 4 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: ®`TA tea- ' CORPORATION NAME 4 / Tl0 � PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE wX 2�jez Q:\Applicadon Formsftz Mat Appli Draft Jan2199.docx E i 1 i 1 1 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BA SSBLE.g` 200 Main Street• Hyannis, MA 02601 AlFOMA+,`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: S evorn5 - Date: _v 11 I4 Location/Mailing Address: G I fk&U�— R Contact Name/Phone: Inventory Total Amount: SDS: License#: Tier II : Labeling: Spill Plan: Oil/Water Separator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: I Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout 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/RECOMMENPAWNt: hOf e4no ,-k�Qr ou,S MQ�er �al�1j P►� �� rr za Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS A� IVY _ ock^F Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B""MA SB1E'g 200 Main Street• Hyannis, MA 02601 A 039•rED MP�6. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT �y n Business Name: 50 �WKi nt, Date: Location/Mailing Address: 6 ` Contact Name/Phone: 2 -71 Inventory Total Amount: SDS: License#: 102 Tier II :_ Labeling: Spill Plan: Oil/Water Separator: No Floor Drains: Emergency Numbers:�EE Storage Areas/Tanks: f6me llaw Emer enc /Containment E ui ment: r S i� Waste Generator ID: IAV�G 7? 7�%: Waste Product: Date&Amount of Last Shi ment/Fre uenc : V✓ t Licensed Waste Hauler&Destination: T 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 ry 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 fi 1�0 Lye or caustic soda /L acquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes r 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: no mhav Inspecton Z r: Facility Representative• WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS r Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 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 c-,., 144 • • • 1 Town of Barnstable Inspectional Services BAMSTABLE THE 1 aneasme:E•Mr::v•cQun..7axnr f,t o Public Health Division "5 "� "`` , :sae�/zn:a • BARNSTABLE, Thomas McKean, Director i639. �0 a 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 t,0 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS Est 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 :9 VG1'g � 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 O. Sq3-baa —Dbg4 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 QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: J�i D `d P"kf-rs— 5. NAME OF ESTABLISHMENT: �J `pJ�tiJ .r' ti�'1 d"Z 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE%NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRE S: e, 10. SOLEOWNER: YE NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: ___Cj9 P T CLERK' 12, IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN :�� DATE tion�A lica pp Q: pp' Forms�Haz Mat A Revised/�'10-18.docx Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Z) Town of Barnstablee Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 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 pd �k/3 �- o�s--� �toewgulatoryof Barnstable ervices � Richard V. Scali, Director m �Ao�o oF ram"• o„ Public Health Division BARNSTABLE • MRNST eLE•CEtfr[t1tiI--MTUIT•NV'4NNIi BARNSTABLE, Thomas McKean Director n>airo:+s Mit_s•os Eav L.w6TP Ns'- 9 MASS. A 7 1.699-2014 �Atf039. `0 200 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 DULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26 1 i 0 Gallons: $ 50.00 ❑ u� � 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 O. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: �1-U 6L 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: Gj — (' �r C �, t a A A A)c 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. 'TELEPHONE NUMBER OF ESTABLISHMENT: V 3C�2 9. EMAIL ADD SS: 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 APPLICA DATE 2 Ile Q:\Application Forms\I-IAZMAT APP 2017 REVI k.doocx 6�1 Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Judy FennerMarine 61 C Bodick Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 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 r' 4 � �7 o of Unstable TTwwi�g,,Regulatoervices Richard V. Scah, Director .� • o Public Health Division BABSTABLE a BARpSTABLE. NRRSiU:S'.6i5 C51"Va'ILIF�lU51 emn;rnaa MASS. Thomas McKean, Director 639-2014 9`bArEo ,�6`� 200 Main Street, Hyannis, MA 02601Dg S 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 ❑. CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 , ✓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. 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 QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5: NAME OF ESTABLISHMENT: r r� 6. ADDRESS OF ESTABLISHMENT: --� r 5 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: -_ �2 U Lc)- 9. EMAIL ADDRESS: A 4AVI A 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 DATE Q:\Applicatiom Forms\HAZMAT APP 2017 REVI .docx s� Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $125.00 r Town of Barnstable Board of Healthy This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. Y - •----------------------------------------------------•--_--_---------------_----------------------------------------------------------------------- •------------------------------------------------------------------------------------------------------------------------------------------------------------------. 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 f r Town of Barnstable "o Regulatory Services Richard V. Scali,Director `" MAS& Public Health Division BAMSTABLE J auNraoU•cvrtn.ue•mivmmarcrs 3 a. N� q wasrovsru.:s•osravtuE.wsrenmma Thomas McKean,Director ` 163 �4 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 \ Fax: 508-190-6304 W 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-NNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 Y`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.ASSESSORS MAP AND PARCEL NO. DATE Z Z (`/..,, FULL NAME OF APPLICANT: F2 A F(1 e NAME OF ESTABLISHMENT: � �,� TeY1Y1 er V 1 1(Rr\►1 -. ADDRESS OF ESTABLISHMENT: -C `U S d a W MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: "M EMAIL ADDRESS: -Qyr ' SOLE OWNER: V YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: 9NAT, IF'APPLICANT Name: Company Address Telephone#: Email: Q:\Application Forms\HAZZAPP Rev16.docx Page 1 of 2 - _ J A' V Number Fee 1239 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Hyannis Yacht Club 61 F Bodick Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D.. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health a Town of Barnstable Regulatory Services Richard V. Scali, Director C ` .ARNSTABLF, ' �l` BA�NSTABLE r ALAS& 0$ Public Health Division �„ 8�. � .m S aasroa nns•os ewue•wa swsrsa �fD ►t Thomas McKean,Director 16Dg 200 Main Street, Hyannis,MA 02601 �� Office: 508-862-4644Q Fax: 508-790-6304 W 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 DULY 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 July 1st. ASSESSORS MAP AND PARCEL NO. )4 nl200f DATE r hCV4 FULL NAME OF APPLICANT: her- c'S NAME OF ESTABLISHMENT: �-�/AT(1,3 �� G q ADDRESS OF ESTABLISHMENT: (3 0�i cIC RA MAILING ADDRESS (IF DIFFERENT): -1 q© �C®g►� J�. TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: SOLE OWNER: ✓ YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATI0 NAME '+ a tiv��S Act i C-�,► b PRESIDENT &JJB c,6 33 aS TREASURER fj?o Sohy 9 41 7 111-Anes Pan 4 , m o i61i 7 ail 3_82z-0»1 CLERK `,�d, u,h�l.�"w �l 4��1i��C�'ktiEt. �v• �t�v.:s AMA o 263 2 77y-21Z•!� IF PREPARED BY OUTSIDE PARTY: ATURE CANT Name: Company Address : Telephone#: Email: Q:\Appfication Forms\HAZZ P Revl6.docx Page 1 of 2 Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r� y Town of Barnstable Regulatory Services �► Richard V. Scan,Director RARNSTABM KASL ` Public Health Division 059. Inn ` Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Q1 .C. Office: 508-862-4644 Fax: 508-790-6304 on Application Fee:$100.00 ASSESSORS MAP AND PARCEL NO3 3 Wa "ODQTE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �� i ��1(1 ne f r NAME OF ESTABLISHMENT V, y VQ��,`(LQi( O-4-(h 2 • ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER�S�p yp "�� ',a S l C 2 � ) S ��� � L1 SOLE OWNER: VYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK • SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS g �J Rd , �✓ew HOME TELEPHONE# G-ck — A-m) -� yp 0C) C:\cache\Temporary Internet Files\0LKD3HAZAPP Rev2015DOC r r Town of Barnstable Fare: 8-790-6304 4 Fax: 508-790-6304 Regulatory Services Department Public Health Division MASS. Thomas A. McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $100.00 (Check) on 6/9/2015 + Check number: 8298 Check amount: $100.00 Name on check: Judy Fenner Marine 1 ;Business: Judy Fenner Marine Owner: JOEL E TR ZEGER ;Address: 61C BODICK ROAD, Hyannis i • • Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health n Town of Barnstable °ptHE Tp�, Regulatory Services Richard V. Scali, Director Y i BAR MAS"BLE, + Public Health Division 9� 01 `fir ArF39. Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE 2 Z 7 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT � Ufj)—V:* A }� 2 NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT Cp C� TELEPHONE ER SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS.OF ALL PARTNERS: , IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK r SIGNATURE OF APPLICANT RESTRICTIONS: H ADDRESS <#1] e ' HOME TELEPHONE# QMpplication FormsT AZAPFDOC 2' TOWN I OF BARNSTABLE,, ' Date: 7/ —7,9 TOXIC AND HAZARDOUS MATERIALS REG1 -t- N FORM NAME OF BUSINESS: --) \f, v VG., (; " /14,- BUSINESS LOCATION: INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION RECOMMENDATIONS:,,,'*.-"-, Fire District: Waste Trins-'O'dii tIon',! Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes) f No i �4 11- -' -- NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed I Maximum Observed Maximum Antifreeze(for gasoline or coolant 'Systems) Miscellaneous Corrosive L3 NEW L3 USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides L3 NEW LI USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochernicals (Fixers) Diesel Fuel, kerosene,#2 heating oil Ll NEW L3 USED Miscellaneous petroleum products: grease, Photochernicals (Developer) lubricants, gear oil U NEW LJ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Bafteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers AspheR&roofing tar PCB's Paints, varnishes, stains, dyes, ,5 Other chlorinated hydrocarbons, Number Fee 1093 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that KARL'S BOAT SHOP INC 143 OLD YARMOUTHROAD, HYANNIS,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable 041 SE Regulatory Services 1 homers Y Gefler,Director A Public Health DIVisiola Thomas McKean,Dir-ector 200 gain Start, Hyam�s, MA 02601 F= 50&790-6304 Ofscz: 508462-4644 Appflca;:ion Fee: $100.00 ASSESSORS INSAP AND PA.RCIJ,NO, DATE APPLIGATI�3t�t FAR PERMIT TO STORE An/OIL�OGRE THAN 111 GALLONS GF HAZARD-O- TFRIAL6 T=NA -9 OF APPLICANT NANSE OF ESTABT 7SHi4i�-NT f- ADDREss ofESTABz1Is3ri _;/ 3 64 °-'%�►` ' .:i ���'S ....e _� �` `� T =ECNE N-nBZR GI-�2 _ SOLE ow-N=: ✓ems NO IF APPLICANT IS A PARTN.ERSHI,D,I= A + ADD H01YiE ADDRESS OF ALL PARTNERS: I CANT IS A CORPORATION: FEDER ATE IDICATION NO. D IF APPI.I STATE OF D CORPORATION m �T EITII NAB A�TD H0NIE ADDRESS OF: a PRESIDENT � e! 3o e�'n+ w' - CLL12K 810 ATUAE OF. P21 UU2U FFSTRICTIO tS: HOB ADDRESS i HONE TEI EONI# �2-dccfwq/q i ;i r Karl's Boat Shop Hazardous Waste Removal Plan WASTE DISPOSAL: ALLOW VOLATILE PORTION OT EVAPORATES IN HOOD BEING SURE TO ALLOW SUFFICIENT TIME FOR VAPORS TO COMPLETELY CLEAR HOOD DUCT WORK. DISPOSE OF CONTAMINATED ABSORBENT, CONTAINER AND UNUSED CONTENTS IN ACCORDANCE WITH LOCAL, STATE, AND FEDERAL REGULATIONS. DO NOT INCINERATE CLOSED CONTAINERS. Keep containers closed, tight and upright to prevent leakage. Keep container closed when not in use. Waste Disposal: Veolia ES Solid,Waste NA: 508-804-4806 Harwich Town Dump FIRST AID: IN CASE OF SKIN CONTACT: WASH AREA THOUROUGHLY WITH SOAP AND WATER. REMOVE SOILED CLOTHING.GET MEDICAL ASSISTANCE IF IRRITATION PERSISTS.WASH CLOTHING BEFORE REUSE. IN CASE OF EYE CONTACT: FLUSH WITH LARGE AMOUNTS OF WATER FOR AT LEAST 1S MINUTES. GET MEDICAL ASSISTANCE. IF INHALED: IF YOU EXPERIENCE DIFFICULTY IN BREATHING, LEAVE THE AREA TO OBTAIN FRESH AIR. IF CONTINUED DIFFICULTY IS EXPERIENCED, SUMMON MEDICAL ASSISTANCE IMMEDIATELY. IF BREATHING CEASES, RESTORE USING APPROVED CPR TECHNIQUES AND SUMMON MEDICAL HELP IMMEDIATELY. SMALL SPILL: ABSORB LIQUID ON INERT MATERIAL SUCH AS PAPER,VERMICULITE, FLOOR ABSORBENT,AND TRANSFER TO HOOD. LARGE SPILL: ELIMINATE ALL IGNITION SOURCES(FLARES, FLAMES INCLUDING PILOT LIGHTS, ELECTRICAL SPARKS.) PERSONS NOT WEARING PROTECTIVE EQUIPMENT SHOULD BE EXCLUDED FROM AREA OF SPILL UNTILL CLEAN UP HAS BEEN COMPLETED. STOP SPILL AT SOURCE,CONTAIN AREA OF SPILL TO PREVENT SPREADING, PUMP LIQUID TO SALVAGE TANK. REMAINING LIQUID MAY BE ABSORBED WITH INERT MATERIALS SUCH AS SAND,CLAY, EARTH,OR FLOOR ABSORBENT,AND SHOVEL INTO CONTAINERS. PREVENT RUN- OFF TO SEWERS,STREAMS,OR OTHER BODIES OF WATER. IF RUN-OFF OCCURS, NOTIFY THE PROPER AUTHORITIES AS REQUIRED THAT A SPILL HAS OCCURRED. Chemical or Oil Release (Accident) You must notify the following: 1. 911 2. 888-304-1133 (MA DEP 24 hours) 3. 1-800-424-8803 (National Response Center 24 hours) i r - Contingency Plan for Hazardous Waste Spills • Make sure all products are properly labeled and stored on the work shelf. • If there happens to be a spill use oil absorbent rags and the kitty litter to clean up the spill • Do not put the rags and litter in a trash bag and throw away. Dispose of in an appropriate manner and mark as hazardous waste. • If spill is to large contact the following, depending on spill. • Hazmat 617-527-6706 • EPA 888-372-7341 • Hyannis Fire 911 / 508-775-2323 • DEP Hotline 888-304-1133 • Veolia ES Technical Solutions 800-372-1020 / 508 804-4806 r Personal Protective Equipment Must be worn Tyvek Suits Respirators Dust Masks Gloves Head Socks Safety Glasses i _ _ i a1j1 Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable of� Reg-ohtorY SemCES Thous F. Geiier, Diredor 3AJuq5TaM j Pubb.e Health DlTisiola � A?�a � Thous McKean,Diredor 200 Main Strzzt, Hyannis, MA 02601 F� 5oB-79o-s3aa 0 ca: 5000462-4644 Applicadon Fee: $100•Do ASSESSORS iYIAP AN7�PARCEL N0. DATE APPLICATION FOR PERkSIT TO STORE AND/OR� MORE THAN 113 GAT j n- c, O-' TTAZAR,)DOUS HAJERLkLS Aries of APPLICANT �.0 N:A�U OF ESTABY 7SEMYNT ADDRESS OF ESTABLLSHNfL-' I p TELEPHO SOLE OWNER., NO T IF APPLICANT IS A PARTNZR=,T=NAVE+ AND HONSE ADDRESS OF ALL .Ln PARTINERS: 00 I I APPLJCANT IS A CORFORATIOtN: S AL IDF��1'TII+ICATIO�T�^T4. STATE OF 2 CORPORATION- S Tj=NAB AND HOtMI ADDRESS OF; PRESIDENT :' �.TK TKT C7� SIC,NATURE OF A2-?IU1CA-1U f. P�STRICTIOINS: HONE ADDRESS HOME TEIKPHONE# ���odwp/q Number Fee 1034 THE COMMONWEALTH OF MASSACHUSETTS $10o.00 Town of Barnstable Board of Health This is to Certify that Hollister Associates Yacht Repair 61 Bodick Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------- -------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2013 unless sooner suspended or revoked. ------------------ WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2012 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable pUTHE TQ Regulatory Services Thomas F. Geiler,Director i a BARN MAE&MB . i Public Health Division A�FD 39. Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT ) 44rj &r4DP cs®ki . NAME OF ESTABLISHMENT a4.4� _ Ln ADDRESS OF ES ABLISHMENT la's 4 TELEPHONE NUMBER SOLE OWNER: "ES NO &ATP�ACANT IS4i PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL I �RTIERs: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ©4 ;�4O7 S�—/ STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT J�e'I &rJherSo pl 5® 6",Qt: ye&er,J A A 6rwi G 11 F n ff dD.fo` r TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Haz.doc/wp/q r r Karl's Boat Shop Hazardous Waste Removal Plan WASTE DISPOSAL: ALLOW VOLATILE PORTION OT EVAPORATES IN HOOD BEING SURE TO ALLOW SUFFICIENT TIME FOR VAPORS TO COMPLETELY CLEAR HOOD DUCT WORK. DISPOSE OF CONTAMINATED ABSORBENT, CONTAINER AND UNUSED CONTENTS IN ACCORDANCE WITH LOCAL, STATE, AND FEDERAL REGULATIONS. DO NOT INCINERATE CLO(HD CONTAINERS. Keep containers closed, tight and upright to prevent leakage. Keep container closed when not in use. Waste Disposal: Veolia ES Solid Waste NA: 508-804-4806 Harwich Town Dump FIRST AID: IN CASE OF SKIN CONTACT: WASH AREA THOUROUGHLY WITH SOAP AND WATER. REMOVE SOILED CLOTHING.GET MEDICAL ASSISTANCE IF IRRITATION PERSISTS. WASH CLOTHING BEFORE REUSE. IN CASE OF EYE CONTACT: FLUSH WITH LARGE AMOUNTS OF WATER FOR AT LEAST 15 MINUTES. GET MEDICAL ASSISTANCE. IF INHALED: IF YOU EXPERIENCE DIFFICULTY IN BREATHING, LEAVE THE AREA TO OBTAIN FRESH AIR. IF CONTINUED DIFFICULTY IS EXPERIENCED, SUMMON MEDICAL ASSISTANCE IMMEDIATELY. IF BREATHING CEASES, RESTORE USING APPROVED CPR TECHNIQUES AND SUMMON MEDICAL HELP IMMEDIATELY. SMALL SPILL: ABSORB LIQUID ON INERT MATERIAL SUCH AS PAPER,VERMICULITE, FLOOR ABSORBENT,AND TRANSFER TO HOOD. LARGE SPILL: ELIMINATE ALL IGNITION SOURCES(FLARES, FLAMES INCLUDING PILOT LIGHTS, ELECTRICAL SPARKS.) PERSONS NOT WEARING PROTECTIVE EQUIPMENT SHOULD BE EXCLUDED FROM AREA OF SPILL UNTILL CLEAN UP HAS BEEN COMPLETED. STOP SPILL AT SOURCE,CONTAIN AREA OF SPILL TO PREVENT SPREADING, PUMP LIQUID TO SALVAGE TANK. REMAINING LIQUID MAY BE ABSORBED WITH INERT MATERIALS SUCH AS SAND,CLAY, EARTH,OR FLOOR ABSORBENT,AND SHOVEL INTO CONTAINERS. PREVENT RUN- OFF TO SEWERS,STREAMS,OR OTHER BODIES OF WATER. IF RUN-OFF OCCURS, NOTIFY THE PROPER AUTHORITIES AS REQUIRED THAT A SPILL HAS OCCURRED. I Chemical or Oil Release (Accident) You must notify the following: 1. 911 2. 888-304-1133 (MA DEP 24 hours) 1 1-800-424-8803 (National Response Center 24 hours) Contingency Plan for Hazardous Waste Spills • Make sure all products are properly labeled and stored on the work shelf. • If there happens to be a spill use oil absorbent rags and the kitty litter to clean up the spill • Do not put the rags and litter in a trash bag and throw away. Dispose of in an appropriate manner and mark as hazardous waste. • If spill is to large contact the following, depending on spill. • Hazmat 617-527-6706 • EPA 888-372-7341 • Hyannis Fire 911 / 508-775-2323 • DEP Hotline 888-304-1133 • Veolia ES Technical Solutions 800-372-1020 / 508 804-4806 Personal Protective Equipment Must be worn Tyvek Suits Respirators Dust Masks Gloves Head Socks Safety Glasses Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- --------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2012 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO . Director of Public Health r d �/�/► Town of Barnstabl VVC4- ��� �-lo�, O� THE I Regulatory Services ti Thomas F. Geiler, Director MASS. $ Public Health Division i639• ♦0 iOrE M Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 - ASSESSORS MAP AND PARCEL NO. DATE J I' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS _ l FULL NA OF APPLICANT ME lx� l9ri - nI1� E� NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT - \ TELEPHONE NUMBER SOLE OWNER: _&ES NO w.b IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HO ADDRESSI P6 . HOME TELEPHONE# V Haz.doc/wp/q i' Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of. Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS.OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2010 _ JUNICHI SAWAYANAGI -- THOMAS A. MCKEAN, R.S.,CHO Director of Public Health cP 1 Town of Barnstable �F11HIE Tp� Regulatory Services • y�P w ° Thomas F. Geiler, Director BA * ]Public Health Division 9 MASS.h1ASS. a , O i639 `gym oATForna+A t Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT U, �I ��hT�,( Yl l a� Y �e ADDRESS OF ESTABLISHMENT C�3 Udl ` • TELEPHONE NUMBER SOLE OWNER: V YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK If • 68 a I t SIGNATURE OF APPLICANT RESTRICTIONS: -j-jt,i-EHOfM,EA�DURESS yy1 W. At. HOME TELEPHONE # 4� -'w Haz.doc/k%p.'y Number Fee 146 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Hollister Assoc./Karls Boat Shop 61 D Bodick Rd/Mail: 50 Great Western Rd, Harwich,02645, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------- --------------------------------------------------------------- --------------------------- ------------------------------------------------------------------------------------------------------ ----------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2011 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER, M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2010 JUNICHI SAWAYANAGI THOMAS A:'MCKEAN,R.S.,CHO Director of Public Health e , Town of Barnstable Regulatory Services ti Thomas F. Geiler, Director (BA MASS' * Public Health Division hfASS. a i639• ,gym ATE1639. Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT c!'I &Nbf/^_,2>n NAME OF ESTABLISHMENT OD C. a44d z.4j�o�s • ADDRESS OF ESTABLISHMENT p �� 4nn.'5 00n A IoD 60) TELEPHONE NUMBER L 091— 2.?_ s/yIb— SOLE OWNER:_�&ES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION Ea FULL NAME AND HOME ADDRESS OF: PRESIDENT Arl � n�8r Q n � Great-we!�"rnJ A4,-.wit h 10n� _ -R 16> lZiver c/ CLERK SIGNATURE OF APPLICANT -RESTRICTIONS: HOME ADDRESS HOME TELEPHONE # Haz.doc/�.�p/q Contingency Plan for Hazardous Waste spills ® Make sure all products are properly labeled and stored on the work shelf. If there happens to be a spill use oil absorbent rags and he kitty litter to clean up the spill ® Do not put the rags-and--litter n`a trash bag and--throw away. Dispose-of in an appropriate_manner and mark as hazardous waste. If spill is to large contact the following, depending on Spill. • 'Hazmbt 617-527-6706 • EPA 888-372-7341 o Hyapnis Fire 911 J 508--775-2323 • DEP Hotline 888-304-1133 --- -•-----eol-ia-ES Tech-n-ica-1 Sotutrons 800-372-1020 / 508 804-4806 Chemical or Oil Release (Accident) You must notify the `ollow n ® 1® oil 2. 888-304-1133 (CIA DEP 24 hours) 3 --- 1-_800-42 = 803 (Natiori-a[-Response Center 24 hours) i WASTE DISPOSAL: ALLOW VOLATILE PORTION OT E `A O RATES IN HOOD BEING SURE TO ALLOW SUFFICIENT TIME FOR VAPORS TO COMPLETELY CLEAR .HOOD DUCT WORK. DISPOSE OF CONTAMINATED ABSORBENT, CONTAINER AND UNUSED CONTENTS IN ACCORDAICE;WITH LOCAL, STATE, AND FEDERAL REGULATIONS.:DO NOT INCINERATE CLOSED CONTAINERS. _ Keep containers closed, tight and upright to prevent leakage. Keep container closed when not in use. Waste Disposal: Veolia ES Solid Waste NA: 508-804-4806 Harwich Town Dump a _ I r FIRST AID: IN CASE OF SKID CONTACT: WASH AREA THOU ROUGHLY WITH SOAK AND WATER. REMOVE SOILED CLOTHING.GET MEDICAL ASSISTANCE IF IRRITATION PERSISTS.WASH CLOTHING BEFORE REUSE. IN CASE OF EYE CONTACT: FLUSH WITH LARGE AMOUNTS OF WATER FOR AT LEAST?S MINUTES. GET MEDICAL ASSISTANCE - 4 IF INHALED: IF YOU EXPERIENCE DIFFICULTY ICI BREATHING;LEAVE THE AREA TO OBTAIN FRESH AIR.IF CONTli0i"IFFICULTY IS EXPERIENCED, SUMMON MEDICAL ASSISTANCE IMMEDIATELY.IF BREATHING CEASES, RESTORE USING APPROVED CPR TECHNIQUES AND SUMMON MEDICAL HELP IMMEDIATELY. _ ..tex. - �����N A-`•E thin.tn _-L r y SMALL SPILL: ABSORB LIQUID ON INERT MATERIAL SUCH AS PAPER,,VERMICUUTE, - FLOOR-ABSORBENT,AND TRANSFER TO HOOD. LARGE SPILL: ELIMINATE ALL IGNITION SOURCES(FLARES, FLAMES INCLUDING PILOT LIGHTS, ELECTRICAL SPARKS.) PERSONS NOT WEARING PROTECTIVE EQUIPMENT SHOULD BE EXCLUDED FROM AREA OF SPILL UNTILL CLEAN UP HAS BEEN • COMPLETED. STOP SPILL AT SOURCE,CONTAIN AREA OF SPILL TO PREVENT SPREADING, PUMP LIQUID TO SALVAGE TANK.REMAINING LIQUID MAY BE ABSORBED WITH INERT MATERIALS SUCH AS SAND,CLAY,EARTH,OR FLOOR ABSORBENT,AND SHOVEL INTO CONTAINERS. PREVENT RUN- OFF TO SEWERS STR-EAMS;OR OTHER BODIES OF WATER.IF RUN-OFF OCCURS, NOTIFY THE PROPER AUTHORITIES AS REQUIRED THAT A SPILL HAS OCCURRED. Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $100.0o Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------- ----------------------------------------------------------------------------------------------------------------- --------- ----- --------------------- -------- ----------- ------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. ------------------ --------------------- WAYNE MILLER,M.D.;CHAIRMAN PAUL J. CANNIFF, D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health j 3 ' Town of Barnstable Barnstable Regulatory Services Department o Af Am�xicaGily AS Public Health Division HAANST200 Main Street,Hyannis MA 02601 m 2007 V Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508?90-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE Ce. IC� aq APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE . MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT y�Qnl n ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER_ ��g d,�� SOLE OWNER: S NO - C= IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS ALLY PARTNERS: a f+r r IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. / J STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT n RESTRICTIONS: HOME DRESS �. 13rewgA?� 0a V HOME TELEPHONE # S 3 b y q Q:\Hezmat\Haz Mat Application2008-DOC r. Number Fee 146 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable - Board of Health This is to Certify that Hollister Assoc./Karls Boat Shop 61 D Bodick Rd/Mail: 50 Great Western Rd, Harwich,02645, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------- ---------------- --------------------- --- ------------------ -----------------------'---- ------------------------------ ----------- ------------------ ---------------------------- ---------------------------------------------- ------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2010 unless sooner suspended or revoked. ------ WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2009 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 7 Town of Barnstable Barnstable Regulatory Services Department M-AinafimCft STABS Public Health Division 9 Mass 200 Main Street, Hyannis MA 02601 jOlFo��A 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT A�&R j- Ambers'a NAME OF ESTABLISHMENT J4 0/1 i S}er J4.SSaCi 4 BPS- 1-6,r I'S R,1-Sh o�f&C ADDRESS OF ESTABLISHMENT 17 3aD;[ _ H 44nn i S, ?r Ij d a 1,10 1 TELEPHONE NUMBER SO ff—q3 SOLE OWNER: �''i'ES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: 5= a - _ ch IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. ca tv CD rn STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT- 4!q!js?r-W1J 10 R,Vrr /Se Soon yarmpuylfmtf Dalo6y TREASURER CLERK • "—SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC Contingency Plan for Hazardous Waste Spills • Make sure all products are properly labeled and stored on the work shelf. • If there happens to be a spill use oil absorbent rags and the kitty litter to clean up the spill • Do not put the rags and litter in a trash bag and throw away. Dispose of in an appropriate manner and mark as hazardous waste. • If spill is to large contact the following, depending on spill. • Hazmat 617-527-6706 • EPA 888-372-7341 • Hyannis Fire 911 / 508-775-2323 • DEP Hotline 888-304-1133 • Veolia ES Technical Solutions 800-372-1020 / 508 804-4806 • r . ' �zj.6j l� j' .�y._1 "�J '�t .J*'.�y�` . +� �. 4'„L•+n_ f-iM A6�'f 1 ��«.�? �lCz t• x4�f i�'• 't+F�l�`4 �+f't...,�!.s���:d •�..a.,v Yw3 ,�.vd zu.'# .. r 9�. .,fi�'. i F.! ..o'a:� ri6 4 O kjgc s� Yh ,q lx,- c ; is ablibolyl Ps s Slue S hl l e. � a � �'�.l'N w^-Sl c;.� A k..3 SAI GIS 1016 y d .' e rr is rif -10hi 01 "Q AS V C Wr: GO :.L - p: ;gip' Z'1 e `; -,T�r "1 r �...,� i, ..:4 ,4a ?L 9 .rv.��.,r•�*aa. �� .��� .,�T ��' Y ,� ��.f�' � ,`e� ... \ \\ I (�I Number Fee THE COMMONWEALTH OF MASSACHUSETTS 146 $100.00 Town of Barnstable Board of Health if that Karl's Boat Shop, Inc. This Is to certify R 61 D Bodick Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS------------------------------------------------------------------------- ---------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- _ This.license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2009 unless sooner suspended or revoked. ------------------------------------ WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable j"E'° Regulatory Services Department o� ;eriea i • BARNETABLE. M Public Health Division ' 9 200 Main Street, Hyannis MA 02601 1639. 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. `�3 'ATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT I�G r I 14►�»e P��w NAME OF ESTABLISHMENT e <cQ fieS ADDRESS OF ESTABLISHMENT E. p:b;C 1jr 9j)K b c, TELEPHONE NUMBERy0!� — Q — Ll y�f SOLE OWNER: 'DES NO N o ri IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT K,;#-1 i4mDrr<o>a )a &Ver- br,Vi, ..Sa�,cma 2k- TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Q:\Hazmat\Haz Mat Application2008.DOC Win,•;�^r'.` - __ ... 4+, .. _ _ _ __ m COIng Ian For Hazardous Waste spills v asp F ® `Make sure all products are properly labeled and stored on the sy4 work shelf .. there happens t67be:a spill use oil absorbent rags the g - - - .; x ,;kitty litter to clean-up the spill ® Do not put the rags and litter in a trash bag and throw away. y Dispose ofjtj in approp is e-manner-and mark as hazardous -' r waste. _ - ® If spill is to large contact the following, depending on spill -__ Iazrriat 6`17 527 67Q6: - EPA 888 3.72-7341 _ __.z.. J `P t`.P e" f L _ Y Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------ ---------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2009 unless sooncr suspended or revoked. ---------- ------------------ WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable Regulatory Services Department �d p� AHlmericaCihl : Public Health Division RAMSfAB E 9$ MASM039. ��� 200 Main Street,Hyannis MA 02601 '°rEn µpal� 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT .( Q NAME OF ESTABLISHMENT Q, r\—z ADDRESS OF ESTABLISHMENT — aA'dc- 1S TELEPHONE NUMBER 5D� - 7]2 '2 a`i.-/ SOLE OWNER: i' YES NO N IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS O ALL PARTNERS: { f f N SS' IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. rn STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOM DRESS� ) w &Aos / pd(Q�! HOME TELEPHONE# _ -&) =e OA D Q\Hazmat\Haz Mat Application2008.DOC Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 1/1/2008 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 31, 2008 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 5/31/2007 PAULJ. CANNIFF, D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable °F Regulatory Services Thomas F. Geiler,Director t. s" MASS. Public Health Division 0. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 5087790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT � x �P�n rl�l Y I y►2- ADDRESS OF ESTABLISHMENT �k,—C � `�Gk +� �nYl Vim) TELEPHONE NUMBER �g'�_Ig` lakA5 SOLE OWNER: V YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: GA. r Ay `� Il 1 W � IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. �-- w rn STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS y(41 x. UoZ�3� HOME TELEPHONE 4 Number Fee 1027 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Judy Fenner Marine 61 C Bodick Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. May 15, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Regulatory Services 4 f Thomas F. Geiler,Director - =y Public Health Division :.: t 63.9Y_�, Y Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office:y508-862-4644 Fax:.508-790-6304 . Application Fee: $100.00 ASSESSORS MAP AND PARCEL N0. DATE 5 cl ( � APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �l R_ '�e� nP/ NAME OF ESTABLISHMENT 1�a aN,.n e i V-Y1C,t 1Y o-s—, (11 ADDRESS OF ESTABLISHMENT (Q - �i C,�C `,Q Y) 1 1 TELEPHONE NUMBER SD�-`71 g-'1 a -SOLE OWNER: te� YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL x-- PARTNERS: ! _ �- T a CD i co } Cy"p IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK c SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS �U' �(e c J� -✓ d 1e37 HOME TELEPHONE•# MAIL-IN REQUESTS Please mail the completed application form to the' address below. Also include copies of your employees food sanitation training certificates. In addition, please include the required fee amount ,(see fees at bottom of this page). Make check payable to: Town of Barnstable. Allow five to seven (7)working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FA)MD REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees food sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in- house processing. For R rther assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Date: o y TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: BUSINESS LOCATION: C ° MAILING ADDRESS: '' INVENTORY 1.TELEPHONE NUMBER: '7 7 S- -72`(S TOTAL AMOUNT: . CONTACT PERSON: J EMERGENCY CONTACT TELEPHON UMBER: TYPEOFBUSINESS: ®apt- Ft�E DcsT�IGT OTHER INFORMATION: P/ecv._2 4c kw_1 w �� , 7-oX 1 C. �t AJAZ,4-R()O-V S 1i0A,57-d`, err,.ap M SIBS oo 5if-f olz . Waste Transph Name of Hauler: Destination: Waste Product: c:.c �t �.ya. e_ LicensedT Yes No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): Antifreeze(for gasoline or coolant systems) Drain cleaners .NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants - -- - Engine and radiator.flushes .: Road Salt (Halite) _ Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel.fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways& garages Wood preservatives (creosote) Battery acid (electrolyte)., b�vy f,,,rtz_ Swimming pool chlorine V Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car wakes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride)- 50, 25 Paint & varnish removers, deglossers Paint brush cleaners Any other products with "poison" labels Floor&furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) maybe toxic or,hazardous (please list): Spot removers & cleaning fluids Misc.: / g, (dry cleaners) Other cleaning solvents Bug and tar removers �, 4 Number Fee 1239 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Hyannis Yacht Club 61 F Bodick Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 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 S� Voevg'aa o B 5e vic ble 'W h6)6t VA ( reee�vie � ✓ Richard V. Scali,Director Public Health Division BARNSTABLE K��. . T•I"�. MWS10N5 MIIS•�SIE0.t11E•WEST SM1RgSTPEtE Director 1639-2014 snarvsresr.E, Thomas McKean, 9�A 16 9. �`� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 0?/-6 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 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 39 �.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. 2. IS THIS A PERMIT RENEWAL? gr 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: tC�/� C," 6. ADDRESS OF ESTABLISHMENT: C6'T� < i' _�r =►� 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: jj°el � 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: ` !�iPs���ss�-r.�� rs`�• �'-��ti3 ®��- - c 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME ,v ' e1z"Z3 PRESIDENT TREASURER, T % _- , CLERK �/. s�l/ /�.G�rsS %�R.�^.ee�r �t1�T dam'•rr.� ,��/� �S,nF- � ' 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN`of - Q:\Application FormsUTAZMAT APP 2017 RE ocx JUN 20 2017 Pm 12:-1 Number Fee 1239 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Hyannis Yacht Club 61 F Bodick Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 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 tI 'T�own�of Barnstable egu atory ervices Richard V. Scah, Director od o� Public Health Division *, ,, BARNSTABLE• - Thomas McKeanMASS ,Director ra ArFD ,�A 200 Main Street, Hyannis,MA 02601 Office: 508-862-46440/ o/9 Fax: 508-790-6304 r' 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 ❑. . CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 Y U'�' 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? X YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS • ZONIl�GBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: o�eA.�ay1 oc�ec s 5. NAME OF ESTABLISHMENT: Cwe 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: �Aqb. 0 �A S. TELEPHONE NUMBER OF ESTABLISHMENT: Jam' '1`1g' Lc\tX7 9. EMAIL ADDRESS: .hu�cc�iS�4Ck,�C�� C7�Q 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT :l\ l2 d 11i N 055 TREASURE '"\ --, R O�,l q-n 1 \1-1\ CLERK ter\ s a �5 oZ 341 "7�� ;2ca-�jOCa 12. IF PREPARED BY OUTSIDE PARTY: . . NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE 1-111-17 QAApplication Forins\HAZMAT APP 2017 REVISED.docx TOWN OF BARNSTABLE BAR -W �� � Ordinance or Regulation WARNING NOTICE Name of Offender/Manager '' `I Address of.Offender MV/MB Reg. # Village/State/Zip. Business Name .a'm�/pm; on�/� 20_ Business Address. !' ^rt IBC. UL ��,; �'"�✓ � 75,/1 -�— J Signature•oeEnforcing Officer Village/State/Zip 1 �(�t �''�► =� t ► Y {� / Location of Offense Enforcing Dept/Division Offense jCx t% I (I- t r - Facts 1oWv�- ��.r�. 1t) � ' � . �et�tJ �t �ecrfj� W � +vim j ►>a �hc S yy5 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. l TOWN OF BARNSTABLE ��2 Ordinance or Regulation BAR -W WARNING NOTICE Name of Offender/Manager ^•"��l"^I ��L��^�_ Address of Offender MV/MB Reg. # Village/State/Zip . Business Name "Faml/pm; on t 20 Business Address . ,{ .� Signature of`Enforcing Officer Village/State/Zip Location of Offense < 4 Enforcing Dept/Division. Offense >( tom. Facts r �. �yt � GC.+� o g-6 . 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. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS:` - Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: `7 1-7$�.�". "� P.O. Box 534 CONTACT PERSON: S' 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 25 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: ADDRESS: TELEPHONE: 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 " 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 low TOXIC AND-HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: � �'� % - v'C � Board of Health MAILING ADDRESS: �A � Town of Barnstable TELEPHONE NUMBER: ? . - /'`. - P.O'. Box 534 CONTACT PERSON: Hyannis, MA 02601 r 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 25 pounds dry weight? YES NO f 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: ADDRESS: ' E.�1".Js ?` % , .�.>. .. t TELEPHONE: 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`sto:re=d_m qua.ntrties to#al.ling mor-e than- a#:on �hquid E Wuol me=or2 =oundsdry 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, herbi,cides, 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) T „ 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 Oil