Loading...
HomeMy WebLinkAbout0032 CORPORATION STREET - HAZMAT 3� � � o-�SF� _��j�vrr��'S � z�m� f - .\ C Number Fee 148 .THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable - Board of Health This is to Certify that Hyannis Auto Body 32 Corporation Road, 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 Town ®f Barnstable *; Barnstable Regulatory Services Department • i Public Health Division rrsraBLE 200 Main Street, Hyannis MA 02601 m 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. c M 0-2/ DATES// APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT 002 00A.P0/LA-77PV cSr. #V,,9- ,tits , /YiA �Z�C • TELEPHONE NUMBER klsloFf-7-7 I SOLE OWNER: YES XNO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS C F ALLY PARTNERS: Aj m IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.+- qi. 0 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: / 1 PRESIDENT iC Z. � ` 4)'R 4•J,c6t, /h,q TREASURER y E 9 � Tr-� ntig D< CLERK • SIGNATURE CA �! c RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# - Q:\HazmatlHaz Mat Application2008.DOC • MAIL-IN RE UESTS Pleas ail the completed application form to the address below. Also include a copy of your contingency plan (to handle hazardous waste spills, etc.) In addition,please include the required fee of$100./TvIake check payable to: Town of Barnstable. Allow time for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc.) In • addition, please mail the required fee of$100. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow time for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page • Q:\}lazmat\Haz Mat Application2003.DOC u BALISE AUTO SALES . HAZARDOUS WASTE SPILL CONTAINMENT PLAN Fire and Police Department or Ambulance: 911 Hazardous Waste Emergency Coordinators: Service Manager Alternative Hazardous Waste Coordinator Parts Manager If possible,Emergency Coordinator should first contact one of the personnel listed below and/or our Hazardous Waste Transporter before calling one of the numbers to report a release,spill or leak which may threaten human life or the environment: PERSONNEL TO BE NOTIFIED: Work Cell Home Richard Covington Ford of Hyannis 800-561-5835 508-737-2980 Edward Kardon Nissan/Hyundai 508-771-3636 267-784-2555 Jim Demas Facility Director 413-735-1003. 413-348-8689 413-781-1548 Stephen Fitts Risk Manager 413-735-1047 413-374-1664 413-567-9534 Steven Mitus CFO 413-735-1001 413-5304429 413-530-4429 • Hazardous Waste Consultant: Kristen Perkins 508-8244939 John Furrh Associates Hazardous Waste Transporter Safety-Kleen Spill Contractor: 888-375-5336 EPA Transporter#C fD021816889 Hazardous Waste Spill Kits are maintained in the facilities Parts Department. Fire and Police Department or Ambulance 911 EPA New England 888-372-7341 EPA National Response Center 800-424-8802 EPA Hazardous Waste Super Fund Hot Line 800424-9346 FOR PARTICULARS OF PLAN REFER TO: Hazardous Waste Contingency Plan • HAZARDOUS WASTE CONTINGENCY PLAN The following is our written contingency plan for each site, designed to prevent and minimize hazards to public health or to the environment from fires, explosions, spills or any other unplanned release of hazardous waste to the air, soil, surface or ground water. Plans have been prepared for each site and will be administered by the Emergency Coordinator. FIRE RESPONSE Use of Fire Extin ig� shers. In the event that a fire does start, associates may respond with ABC-rated dry chemical fire extinguishers if the fire is small and they can approach it without endangering themselves. The location of the fire extinguishers is shown in the"Evacuation Plan". In such cases one associate should call the Fire Department(911)while others try to contain the fire. If associates are alone, they are instructed to call the Fire Department-- not to fight the fire. If associates determine that they can use the fire extinguishers without endangering themselves, they should remove the pin of the fire extinguisher,point the nozzle at the base of the flames; squeeze the handle and direct the output to sweep back and forth at the base of the flames. During this operation it is important to be alert so that the fire does not cut off the associates' escape route, and that their lives are not threatened by smoke inhalation. If either of these conditions seems possible, they are instructed to get out fast, and leave the fire fighting to the Fire Department. Generally,water is not effective in fighting flammable and combustible liquid fires. Gasoline and • oil float on water, so pouring water on this type of fire may actually spread the fire. Natural Gas Line. There is a gas line coming into a shut off and meter located in the outside of the building as shown in the"Evacuation Plan". In the event of fire or leaking gas the Emergency Coordinator should close this valve if it can be done without endangering themselves. Otherwise they should alert Fire Department and Gas Company workers. SPILL PREVENTION AND RESPONSE Initial response and reporting spills. If there is a leak, immediately stop the discharge if it can be done quickly and without risk. Notify the Hazardous Waste Emergency Coordinator at once (phone numbers for the Emergency Coordinator are under"Emergency Information"). Whenever the Emergency Coordinator determines that there is an imminent or actual emergency which could threaten public health, safety, welfare or the environment,they shall immediately: 1. Activate internal facility alarms or communications systems to notify all personnel. 2. Refer to section"Emergency Phone Numbers"-Hazardous Waste Contingency Plan 3. Notify local agencies with designated response roles if their help is needed. Gasoline, Solvent and Oil Spills. • If flammables are present,use only non-flammable tools and eliminate all sources of ignition. If the smell is very strong evacuate the area. Windows and doors may be opened to reduce odors, but do not turn on fans or other electrical equipment,unless they are explosion proof when flammables are involved. If there is a fire, don't open windows and doors, since the air will make c the fire burn faster. • For small spills pour ground clay (e.g. Speedi-Dri) around the spill, building a dike to prevent its spread. Pour additional ground clay on top of the spill. Remove or stop the source of the spill. Often this involves transferring material to an approved non-leaking container, such as DOT specification 17E closed head drum. In some cases it may be possible to tip a leaking drum on its side so that the hole is on the top. After the spill is stopped and absorbed, shovel the ground clay into an approved container, such as DOT specification 17H open-head drum with a Hazardous Waste label filled out. Acid Spills. Electrical storage batteries are a potential source of sulfuric acid spills if dropped or otherwise damaged. Spilled acid from batteries is hazardous waste because it is corrosive, and also may contain toxic substances including lead and arsenic. WARNING: SULFURIC ACID CAN CAUSE SEVERE SKIN BURNS, AND BLINDNESS IN THE CASE OF EYE CONTACT! In case of contact with acids, first rinse skin for at least 5 minutes (15 minutes for eyes)with cold running water then go for medical help. There is an eye wash flushing station at each dealership. If someone else is present,then get medical help while rinsing continues. Large acid spills (more than a quart) can be confined by pouring a dike of ground clay around the spill. The subsequent clean up of a large spill should be left to professionals. Small acid spills can be neutralized with sodium bicarbonate (baking soda)or sodium carbonate • (soda ash). Wear protective clothing including eye goggles since there will be bubbling and splashing. Apply soda by sprinkling the powder, or an aqueous soda solution, on the aid spill gradually. The neutralization process is exothermic (gives off heat). Diluting strong acid solutions with water also generates heat that can cause boiling and splashing. The bubbles of carbon dioxide gas evolved during neutralization are not flammable but acids coming in contact with some metals including zinc generate flammable hydrogen gas. Always make sure that there are no sources of ignition at any acid spill and that flammables are kept separate. When enough soda has been added to neutralize the acid,the bubbling will stop even if more soda is added.Neutralization should be checked by dipping a piece of pH paper in the liquid and comparing the color of the paper with the chart on the package of paper. A pH of 7 is completely neutral,but a reading of 6 or above is acceptable. Clean up the neutralized spill with a mop and place in approved labeled Hazardous Waste containers. A DOT specification 17H drum is acceptable if a heavy duty polyethylene liner is put in the drum first. Rinse the area with mop and water. The first rinse water should go into the drum also. If you are certain that the spill area has been fully neutralized(use pH paper as described above) subsequent rinses may be poured into the sewer. • HAZARDOUS WASTE CONTINGENCY PLAN EQUIPMENT LIST Item Descnption :; Location Fire Extinguishers See"Evacuation Plan" Fire Blanket Over Parts Tech Window Eye Goggles Issue Baking Soda Parts Storage Rubber Gloves Tool Room Rubber/Plastic Apron Tool Room PH Paper Service Manager Office First Aid Kit Service Area Hazardous Waste Labels Service Manager Office DOT 17E & 17H Drums Service Area Polyethylene drum liners Parts Storage Flash Light Service Manager Office Ground Clay Service Area Drum Wrench Tool Room Brooms Tool Room Non-Sparking Shovels Tool Room • o � -^ Town of Barnstable °ZvE Tp� Regulatory Services • yw °� Thomas F. Geiler, Director BARNSTABLE, MASS. a Public Health Division 1639 `00 ATFDMP�A' 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 JyA�-/cS� �OLL�iS/rk,/ C EIvTL-;L ADDRESS OF ESTABLISHMENT m a 6zGa/ TELEPHONE NUMBER 771-/04Y- SOLE OWNER: YES ✓ NO s IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF--ALL t PARTNERS: t.a8 r 7 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.�,�-G 1/310 73 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT �i�}/y)� ,C S y r//L fly, LyL� ,�' i� �puWa�7►AoaJ AcA. TREASURER��TL-�cu /v► /►z�Tu�S Q CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME AD SSM/4a HOME TELEPHONE # /3 Haz.doc/\vp/y r Copyright 2000 ADP,Inc. CHEG'ir, B&SE FORD NISSAN HYUNDAI CONTROL NO. 27975 ISSUED BY: Lutzen,Christina HYANNIS,MA 02601 PAGE 1C INVOICE INVOICE: PURCHASE bIS000NT1 NET.. ST �K NO DATE ORDER NO COMMENTN I N AMO..UNT ACCOUNT NO AMOUNT _ 061410 HAZ MAT ANNUAL PERMIT 100 . 00 27975 34*20300 -100 . 00 HAZ-MAT 60*7205 100 . 00 i • TOTALI 20300 100 . 00 DETACH AT PERFORATION BEFORE DEPOSITING CHECK REMITTANCE ADVICE D 4 • BALISE MOTOR SALES 122 Doty Circle,West Springfield, MA 01089 (413)733-8604• Fax(413)781-0744 June 21, 2010 Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Re: Application for Permit to Store Hazardous Materials To Whom It May Concern: Enclosed are 4(four) separate applications for the above referenced annual permit. Also enclosed is the renewal fee along with a copy of our contingency plan to handle hazardous waste spills. If you require additional information or have questions please feel free to contact me at • 413-374-1664. Sincer ours, Ste�itts Risk Manager • BALISE AUTO SALES • HAZARDOUS WASTE SPILL CONTAINMENT PLAN Fire and Police Department or Ambulance: 911 Hazardous Waste Emergency Coordinators: Service Manager Alternative Hazardous Waste Coordinator Parts Manager If possible,Emergency Coordinator should first contact one of the personnel listed below and/or our Hazardous Waste Transporter before calling one of the numbers to report a release,spill or leak which may threaten human life or the environment: PERSONNEL TO BE NOTIFIED: Work Cell Home David White General Manager 508-568-3810 678-367-5905 Jim Demas Facility Director 413-735-1003 413-348-8689 413-781-1548 Stephen W.Fitts I Risk Manager 1 413-735-1047 1 413-374-1664 1 413-567-9534 Steven Mitus I CFO 413-735-1001 1 413-530-4429 1 413-530-4429 • Hazardous Waste Consultant: Fred Ramos 508-245-4267 Smith&Lamountain Hazardous Waste Transporter Safety-Kleen Spill Contractor: 888-375-5336 EPA Transporter 4CTD021816889 Hazardous Waste Spill Kits are maintained in the facilities Parts Department. Fire and Police Department or Ambulance 911 EPA New England 888-372-7341 EPA National Response Center 800-424-8802 EPA Hazardous Waste Super Fund Hot Line 800-424-9346 7i nD D A D rrl"TT AID C s DT AM D ii TiTT`i D r1r" 1 V 1\ \ 1\ xl 1 1 V Hazardous Waste Contingency Plan on Balise Intranet under Risk Management • f HAZARDOUS WASTE CONTINGENCY PLAN The following is our written contingency plan for each site, designed to prevent and minimize hazards to public health or to the environment from fires, explosions, spills or any other unplanned release of hazardous waste to the air, soil, surface or ground water. Plans have been prepared for each site and will be administered by the Emergency Coordinator. FIRE RESPONSE Use of Fire Extin igu shers. In the event that a fire does start, associates may respond with ABC-rated dry chemical fire extinguishers if the fire is small and they can approach it without endangering themselves. The location of the fire extinguishers is shown in the"Evacuation Plan". In such cases one associate should call the Fire Department (911) while others try to contain the fire. If associates are alone, they are instructed to call the Fire Department --not to fight the fire. If associates determine that they can use the fire extinguishers without endangering themselves, they should remove the pin of the fire extinguisher, point the nozzle at the base of the flames,. squeeze the handle and direct the output to sweep back and forth at the base of the flames. During this operation it is important to be alert so that the fire does not cut off the associates' escape route, and that their lives are not threatened by smoke inhalation. If either of these conditions seems possible, they are instructed to get out fast, and leave the fire fighting to the Fire Department. Generally, water is not effective in fighting flammable and combustible liquid fires. Gasoline and oil float on water, so pouring water on this type of fire may actually spread the fire. Natural Gas Line. There is a gas line coming into a shut off and meter located in the outside of the building as shown in the "Evacuation Plan". In the event of fire or leaking gas the Emergency Coordinator should close this valve if it can be done without endangering themselves. Otherwise they should alert Fire Department and Gas Company workers. SPILL PREVENTION AND RESPONSE Initial response and reporting spills. If there is a leak, immediately stop the discharge if it can be done quickly and without risk. Notify the Hazardous Waste Emergency Coordinator at once (phone numbers for the Emergency Coordinator are under"Emergency Information"). Whenever the Emergency Coordinator determines that there is an imminent or actual emergency which could threaten public health, safety, welfare or the environment, they shall immediately: 1. Activate internal facility alarms or communications systems to notify all personnel. 2. Refer to section"Emergency Phone Numbers"-Hazardous Waste Contingency Plan 3. Notify local agencies with designated response roles if their help is needed. Gasoline, Solvent and Oil Spills. • If flammables are present, use only non-flammable tools and eliminate all sources of ignition. If the smell is very strong evacuate the area. Windows and doors may be opened to reduce odors, but do not turn on fans or other electrical equipment, unless they are explosion proof when flammables are involved. If there is a fire, don't open windows and doors, since the air will make the fire burn faster. . For small spills pour ground clay (e.g. Speedi-Dri) around the spill, building a dike to prevent its spread. Pour additional ground clay on top of the spill. Remove or stop the source of the spill. Often this involves transferring material to an approved non-leaking container, such as DOT specification 17E closed head drum. In some cases it may be possible to tip a leaking drum on its side so that the hole is on the top. After the spill_is stopped_and absorbed,_shovel the ground clay into an approved container, such as DOT specification 17H open-head drum with a Hazardous Waste label filled out. Acid Spills. Electrical storage batteries are a potential source of sulfuric acid spills if dropped or otherwise damaged. Spilled acid from batteries is hazardous waste because it is corrosive, and also may contain toxic substances including lead and arsenic. WARNING: SULFURIC ACID CAN CAUSE SEVERE SKIN BURNS, AND BLINDNESS IN THE CASE OF EYE CONTACT! In case of contact with acids, first rinse skin for at least 5 minutes (15 minutes for eyes) with cold running water then go for medical help. There is an eye wash flushing station at each dealership. If someone else is present, then get medical help while rinsing continues. Large acid spills (more than a quart) can be confined by pouring a dike of ground clay around the spill. The subsequent clean up of a large spill should be left to professionals. • Small acid spills can be neutralized with sodium bicarbonate(baking soda) or sodium carbonate (soda ash). Wear protective clothing including eye goggles since there will be bubbling and splashing. Apply soda by sprinkling the powder, or an aqueous soda solution, on the aid spill gradually. The neutralization process is exothermic (gives off heat). Diluting strong acid solutions with water also generates heat that can cause boiling and splashing. The bubbles of carbon dioxide gas evolved during neutralization are not flammable but acids coming in contact with some metals including zinc generate flammable hydrogen gas. Always make sure that there are no sources of ignition at any acid spill and that flammables are kept separate. When enough soda has been added to neutralize the acid, the bubbling will stop even if more soda is added. Neutralization should be checked by dipping a piece of pH paper in the liquid and comparing the color of the paper with the chart on the package of paper. A pH of 7 is completely neutral, but a reading of 6 or above is acceptable. Clean up the neutralized spill with a mop and place in approved labeled Hazardous Waste containers. A DOT specification 17H drum is acceptable if a heavy duty polyethylene liner is put in the drum first. Rinse the area with mop and water. The first rinse water should go into the drum also. If you are certain that the spill area has been fully neutralized (use pH paper as described above) subsequent rinses may be poured into the sewer. • HAZARDOUS WASTE CONTINGENCY PLAN EQUIPMENT LIST Fire Extinguishers See "Evacuation Plan" Fire Blanket Service Area Eye Goggles Issue Baking Soda Parts Storage Rubber Gloves Tool Room Rubber/Plastic Apron Tool Room pH Paper Service Manager Office • First Aid Kit Service Area Hazardous Waste Labels Service Manager Office DOT 17E & 17H Drums Service Area Polyethylene drum liners Parts Storage Flash Light Service Manager Office Ground Clay Service Area Drum Wrench Tool Room Brooms Tool Room Non-Sparking Shovels Tool Room • MASSACHUSETTS FIRE INCIDENT REPORT r= DEPARTMENT Revise D 10 FDI 1..9 Hyannis Fire Department Report Form ' If EA jDate Alarm lArrivaiIn Service In # 452' Fire 005/1 5/96 Day Wednesda 4 13:08 13: 13 13:37 S AT ACTION TAKEN MUTUAL AID B Spil , k w/ No Ign 4 1-- Remove Hazard 4 FIXED PROPERTY USE (OCCUPANCY) IGNITION FACTOR C Paved Public Street lel� 6 2 NME OCORRECT ADDRESS ZIP CODE CENSUS TRACT D FAL RD. $ CORP RD. 1 02601 20 O11 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. F 12 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE G 13 METHOD OF ALARM CO. DIST PERSONNEL ENG RESP. AERIALS RESP.© 3 r i P 4 2 0 RESP. SHIFT HAZ MAT PRESENT? TANK. RESP. OTHER RESP. Radio NO. SUBSTANCE 0 0 1 ''''?, SPEC. EQUIP. USED? FIRE OI 20 SERVICE , 0, 0 OTHER ` 0 0 0 O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LOSS • TOTAL INS. CLAIM PD 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IIN IGNITION O COMPLEX AREA OF ` EQUIP INVOLVED IN IGN. � ORIGIN FORM OF HEAT IGNITION MATERIAL FORM g TYPE © ,, IGNITED l I METHOD OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE OEXTINGUISHMENT l EXTENT OF DAMAGE Flame Smoke op DETECTORPERFORMANCE SPRINKLER PERFORMANCE [] ,, O Material generating FORM TYPE no Material smoke WEATHER AVENUE OF SMOKE TRAVEL R CONDITIONS Officer in Charge: Date ROGER CADRIN LIEUTENANT 5/1 5/9 6 Comments for this incident have been printed on an additional comments page. Comments for Incident: 96 000452 Exposure: 00 Date: 5/15/96 RESPONDED TO AN MVA BY REQUEST OF R-827 kFEOR AN ANTIFREEZ SPILL IN THE ROAD. COVERED THE SPILL WITH SPEEDI-DRY AND DISCONECTED THE BATTERY OF A VOLVO WITH FRONT END DAMAGE. THE SPILL WAS SMALL AND WAS CONTROLLED WITH SPEEDI-DRY,ONE PERSON WAS TRANSPORTED TO CCH BY R-827. E-822 RET TO QTS 13:37. MASSACHUSETTS FIRE INCIDENT REPORT i y,• :'::::::': >< DEPARTMENT Rev is �A 10LFDI22.,,.. H annis Fire De artment Report Form D nt •• If Date Da Alarm riva n ervice 01,1.. . Fire 0011 /18/95 y Saturday16:07 16:10 16:30 F UND ........... ACTION TAKEN :;>:: :;;::; MUTUAL AID CB „s3 9 Remove Hazard ` FIXED PROPERTY USE (OCCUPANCY) >` IGNITION FACTOR C 0 0 Unpaved Street, Road '''9 6 4 '< NO FIRE : OCORRECT ADDRESS ZIP CODE CENSUS TRACT D RTE 28 & CORPERATION 02601 000040 O11 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. 012 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE G 13 METHOD OF ALARM CO. DIST. PERSONNEL ENG RESP. ........... AERIALS RESP. 3 IRESP. El E O 7 »» •• SHIFT HAZ MAT PRESENT? TANK. RESP. JOTI-IER RESP. 0 Telephone (Tie-line) No. SUBSTANCE 0 0 Eii 03 SPEC. EQUIP. USED? O 20 FIRE SERVICE O >< O<>>. OTHER O >> O x O :. O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LASS TOTAL INS. I CLAIM PD 0<> >> 0 0 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 1IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION O COMPLEX AREA OF .... EQUIP INVOLVED IN IGN. ORIGIN FORM OF HEAT IGNITION MATERIAL FORM TYPE © IGNITED METHOD OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE OEXTINGUISHMENT CEXTENT OF DAMAGE Flame Smoke OP DETECTOR PERFORMANCE SPRINKLER PERFORMANCE N CO Ij ............... Material generating FORM TYPE no Material smoke AVENUE OF SMOKE TRAVEL WEATHER CONDITIONS Officer in Charge: Date DEAN L. MELANSON LIEUTENANT 1 1 /1 8/9 5 • Comments for this incident have been printed on an additional comments page. Comments for Incident: 95 001184 Exposure: 00 Date: 11/18/95 FIFE ALARM REC'D A CALL FOR AN MVA AT THIS INTERSECTION&R-827 RESPONDED.AFTER THEIR ARRIVAL THEY 9EQUESTED AND ENGINE FOR ANTI-FREEZE IN THE STREET. I RESPONDED IN E-826 WITH FPS HOLIGAN AND LANMAN. WE *TILIZED ROADSIDE DIRT TO COVER THE ANTI-FREEZE IN THE STREET AND AFTER THE VEHICLES WERE REMOVED WE ASSISTED THE TOW OPERATOR IN PCIKING UP THE DEBRIS AND DIRT AND REMOVED THIS TO THE RAMP TRUCK FOR DISPOSAL BY THE TOW COMPANY.R-827 OBTAINED TWO PT REFUSALS AND BOTH UNITS RETURNED TO QUARTERS(REF. R-3206 DATA FOR RESCUE INFO.) LT. DEAN L. MELANSON 18-NOV-95 NIASSACIiUSETTS FIRE INCIDENT REPORT ti Rev EPARTMENT ised ® 10 FDID# 0. ...9. DHyannis Fire Department Report For"' Inc' 0 9 I Date DayAlarm Arrival In ervice 0 5 Fire 007/24/96 Wednesda 4 ' 10:07 10:10 10:25 SI TI ,,.......... ACTION TAKEN :::: MUTUAL AID B Spill, w/ No Ign 4 1 >' Remove Hazard FIXED PROPERTY USE (OCCUPANCY) IGNITION FACTOR C Public Service Station X>:'s5 71 :' I n Factor Undetermined 0 0 OCORRECT ADDRESS ZIP CODE CENSUS TRACT D RTE. 28 & BEARSES WAY 02601 40 O 1 1 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. HYANNIS CITGO. 508 778-2466 N/ A OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE F 12 SO.LAND CORP. CO. DIST. PERSONNEL ENG RESP. AERIALS RESP. G 13 METHOD OF ALARM 1 © RESP. E 0 1 13 SHIFT HAZ MAT PRESENT? Y TANK. RESP. ..•....... OTHER RESP. EE Telephone (Direct) No. ALARMS SUBSTANCE 12 0 2 1202 1 SPEC. EQUIP. USED? 1-GAL. JAN-SOLV O 20 FIRE SERVICE 0 ;. O << OTHER O ?` O <» O < >: Co O MOBILE PROPERTY TYPE VEHICLE STOLEN? N ESTIMATED TOTAL INSURANCE CO. DOLLAR LASS TOTAL INS. 0 CLAIM PD 0• 0 <' 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 JIF EQUIP INVOL., YEAR MAKE MODEL SERIAL NO. IN IGNITION O COMPLEX AREA OF ;::EQUIP INVOLVED IN IGN. ORIGIN FORM OF HEAT IGNITION :;:MATERIAL FORM TYPE IGNITED METHOD OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE OEXTINGUISHMENT Lj EXTENT OF DAMAGE Flame Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE Ll op 0 E Material generating FORM TYP ® most smoke AVENUE OF SMOKE TRAVEL R WEATHER CONDITIONS Officer in Charge: Date JOHN GRANT CAPTAIN 7/2 4/9 6 0 Comments for this incident have been printed on an additional comments page. X CoAvents for Incident: 96 000695 Exposure: 00 Date: 7/24/96 THro DEPT. RECIEVED A CALL FROIM THE CITGO STATION,THE CALLER REPORTED A GAS SPILL.ENG.822 WENT STILL ALARM. OON ARRIVAL WE FOUND A SMALL SPILL,UNDER A GALLON. COVERED THE SPILL WITH JAN-SOLV.WASHED WITH WATER. ENG. 822 ALL SET TO QTRS. 1025 HRS. R.K.PICKERING/LIEUT. • MASSACHUSETTS FIRE INCIDENT REPORT >•?< < %< DEPARTMENT Revised = OA 10LFI�o 0..1..9.2..2......... Hyannis Fire Depart ent Report Form c, # If Ex Date Day172 larm Arrival In Service 0885 Fire 008/25/94 Thursda l r14 21 :19 21 :39 S ON FOUND ACTION TAKEN MUTUAL AID I, Leak w/ No Ign ' 4 1 >'` Remove Hazard ''' LA FIXED PROPERTY USE (OCCUPANCY) ; IGNITION FACTOR C Paved Public Street 9 6 2 no ignition CORRECT ADDRESS ZIP CODE CENSUS TRACT O RTE 132 By Starbucks 02601 000020 O11 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. F, 12 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE G 13 METHOD OF ALARM CO. DIST. PERSONNEL ENG RESP. AERIALS RESP. "2 RESP. El. E 0 7 SHIFT HAZ MAT PRESENT? TANK. RESP 0OTHER RESP. ':D 1 Telephone (Tie-.line) NO. AL SUBSTANCE 0 0 1 : SPEC. EQUIP. USED? O 20 FIRE SERVICE O ?»?> 0 OTHER O< > O.. $....... FC L j; 0 O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LOSS TOTAL INS. CLAIM PD 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 1IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION OCOMPLEX AREA OF EQUIP INVOLVED IN IGN. ORIGIN FORM OF HEAT IGNITION ........:": MATERIAL FORM TYPE © IGNITED METHOD OF r= LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE OEXTINGUISHMENT ::. L] EXTENT OF DAMAGE Flame ........ Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE op 1777=1 O ........ Li Material generating FORM TYPE no Material smoke WEATHER AVENUE OF SMOKE TRAVEL R CONDITIONS Officer in Charge: Date ROGER CADRIN LIEUTENANT 8/2 5/9 4 Comments for this incident have been printed on an additional comments page. A CorrLmaents for Incident: 94 000885 Exposure: 00 Date: 8/25/94 RESPONDED TO AN MVA W/A REPORT OF AN ANTIFREEZ SPILL. J -0-` `THE CAR WAS STRUCK IN THE FRONT END CAUSING A SMALL SPILL OF ANTIFREEZ ON THE ROADWAY,WE COVERED THE PILL WITH DIRT TO CONTAIN IT AND TO PREVENT A SLIPERY COND ON THE ROADWAY. WE THEN DISCONECTED THE CAR BATTERY AND CHECKED FOR A POSIBLE FIRE IN THE CAR REPORTED TO US BY THE PD, WE FOUND THAT THERE WAS SOME STEAM FROM THE MOTOR ALSO TWO AIR BAGS DEPLOYED INSIDE THE CAR CAUSING A HAZE IN THE PASANGER COMPARTMENT WE DID NOT FIND ANY FIRE. AFTER FINDING NO OTHER HAZARDS E-826 RET TO OTS r MCHUSETTS FIRE INCIDENT REPORT n DEPARTMENT Revised ✓ I < 01I9 2......•. Hyannis Fire Department Report Form If Ex Date Alarm Arrival JIn Service In nt # '<:' ; Day 000053 Fire 1001 1 / 13/94 IThursday18:39 18:39 19:35 SITUATION FOUND © ACTION TAKEN � MUTUAL AID B ANTIFREEZE SPILL »>4 1 Remove Hazard „4 FIXED PROPERTY USE (OCCUPANCY) :» IGNITION FACTOR C Paved Public Street "9 6 2 '. NO FIRE OCORRECT ADDRESS ZIP CODE CENSUS TRACT D RTE 28/ WALTON AVE 02601 000040 O 1 1 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. N/A F 12 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE N/A G 13 METHOD OF ALARM CO. DIST. PERSONNEL ENG RESP. AERIALS RESP. (aRESP. E ..0 © �3 .. SHIFT HAZ MAT PRESENT? TANK. RESP. OTHER RESP. ,.......... iD 0 1 ENGINE 822 NO. AL SUBSTANCE 0 0 1 : SPEC. EQUIP. USED? O 120 OTHER FIRE 0 O INJURIES SERVICE RF•S�>' 0 ` DES F C O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LOSS 4 �^^ TOTAL INS. CLAIM PD 0 0 0 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION O COMPLEX AREA OF ?»»« EQUIP INVOLVED IN IGN. ORIGIN FORM OF HEAT IGNITION MATERIAL FORM `: TYPE .... © : IGNITED OMETHOD OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE EXTINGUISHMENT 1.1 EXTENT OF DAMAGE Flame ......... Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE COCN op Material generating FORM TYPE no mostsmoke WEATHER AVENUE OF SMOKE TRAVEL R CONDITIONS Officer in Charge: Date ERIC FARRENKOPF CAPTAIN 1 / 1 3/9 4 Comments for this incident have been printed on an additional comments page. 4^ Comments for Incident: 94 000053 Exposure: 00 Date: 1/13/94 6 RECEIVED A CALL FROM ENGINE 822 AT A-52 FOR A MVA RTE 28 AND WALTON AVE NO PI 822 REQUESTING 811. 822 BEING COMITTED AT A-52 CALLED FOR RESCUE 821 TO THE MVA FOR AN ANTIFREEZE SPILL. RESPONSE RESCUE 821 CAPT.E.FARRENKOPF, F/Fs COLTON,STORIE. UPON ARRIVAL HAD A TWO VEHICLE ACCIDENT WITH A ANTIFREEZE SPILL FROM ONE VEHICLE. COVERED THE SPILL WITH SPEEDI DRY AND STOOD BY FOR THE TOW TRUCK TO REMOVE THE VEHICLE RESCUE 821 TO A-52 TO ASSIT 822 AT 1935 ERIC FARRENKOPF CAPTAIN 01/13/94 3 MASSACHUSETTS FIRE INCIDENT REPORT } .................... ® z> z:>• Revised . ` DEPARTMENT . ....10 FDID# Form Report Hyannis Fire Department Incid If Date Day a Alarm riva In ervice 1 Fire 002/21 /96 Y lWednesdayL 18:05 18:09 18:38 I IO ,:.:............;:.; ACTION TAKEN ::: MUTUAL AID B it, o Ign 4 1 Remove Hazard ' PROPERTY USE (OCCUPANCY) » IGNITION FACTOR 0 C Paved Public Street '>€9 6 2 NO FIRE 0 .... OCORRECT ADDRESS ZIP CODE CENSUS TRACT D W. MAIN ST. & BETTY'S 02601 000040 O11 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. 012 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE G 13 METHOD OF ALARM CO. DIST. PERSONNEL ENG RESP. ........... AERIALS RESP. 3 ® RESP. a ..7 SHIFT HAZ MAT PRESENT? TANK. RESP. JOTHER RESP. LA 828 NO. SUBSTANCE 0 0 1 SPEC. EQUIP. USED,., O 20 FIRE 0 SERVICE OTHER C O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. DOLLAR LASS TOTAL INS. CLAIM PD 30 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 40 IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION O COMPLEX AREA OF >'<: EQUIP INVOLVED IN IGN. ORIGIN FORM OF HEAT IGNITION `:::MATERIAL FORM TYPE © .... IGNITED METHOD OF ILEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE OEXTINGUISHMENT EXTENT OF DAMAGE Flame .. Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE COOP Material generating FORM TYPE no Material smoke AVENUE OF SMOKE TRAVEL R WEATHER CONDITIONS Officer in Charge: Date KNOWLTON, RICHARD A. LIEUTENANT 2/2 1 /9 6 Comments for this incident have been printed on an additional comments page. Comrrlents for Incident: 96 000174 Exposure: 00 Date: 2/21/96 RECEIVED A CALL FROM RESCUE 828 REQUESTING AN ENGINE COMPANY FOR AN OIL LEAK AT THE MVA ON W. MAIN STREET AND BETTY'S POND ROAD.SEE RESCUE#432. 1 RESPONDED ON 826 WITH FF PINA AND FF OBERLANDER DRIVING. �WE ARRIVED ON LOCATION WITH 828 AND BPD OFFICER STEVE MCGUIRE ON SCENE.ACCIDENT INVOLVED A MID SIZE CAR AND A"B"BUS.THERE WAS A SMALL SPILL OF OIL UNDER THE CAR. IT WAS RAINING OUTSIDE WHICH WAS CAUSING THE OIL TO RUN.WE APPLIED JAN-SOLV TO THE OIL.THE CARS BATTERY WAS DISCONNECTED WHILE WE WAITED FOR THE TOW TRUCK. INFORMATION ON THE ACCIDENT DRIVERS AND VEHICLE INFORMATION WILL BE ON OFFICER MCGUIRES REPORT. THE VEHICLES WERE TOWED FROM THE SCENE.WE APPLIED MORE JAN-SOLV TO THE REMAINING OIL AND THEN WE COVERED THE SPILL AREA WITH SAND. 826 SECURED AT 1838 AND AT QUARTERS AT 1843 HOURS. WEATHER CONDITIONS: RAINING, COOL,45°F,WIND 7-8 MPH SE. RICHARD A.KNOWLTON 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 Date Magd5 Parcel f� Applicant Information Applicants Name Applicants Address Address Telephone Number Listed ❑ Unlisted Business Information New Business? O ----------------------------------------• Yes No Business is a registered corporation? ________________________. Yes No If yes Name of Corporation A AD Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _________ Yes No If yes then a Home Occupation Registration is required—See Building Division Staff Name of Businessl�al 15p ��J t�►b6o'l A r 4� CLA Business Address Type of Business i4�a Im o44 t e,—De4 I4—o c S t,�i g 1 1 Building Commissioner Office Use Onl ` onditi n oB — Building Commiss' ate — - Clerk Office Use Only L