Loading...
HomeMy WebLinkAbout0020 DUNN'S POND ROAD - HAZMAT ,�2.-® 7->�nn's R Number Fee 1321 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Absolutely Essential .••••••••-•-....•-•••••••••••••••••••-••••-••••••••-•-••-•••-•......-••••••••---.....•••••••--•-••............................... 20 Dunns Pond Road, Hyannis, MA .••••••••••••...........•••••••••••••••••....-•-•••••••-•-•.............•••-••••--....•••••••-••-....-•••••••--....••••••••••......-•••••............................... Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. •••••-•-••••••...................................................................................................................................................... Restrictions: .••••••-•••....-•-••••••••••••••••••••••-••-•-•-•••••-•••----------------•---•••---.....-•••••-••-...-•••-••••-•....•-••-•••••...................................... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. -------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health y! Town of Barnstable � r Inspectional Services BARNSTABLE Public Health Division P4RY.TnetE•[FAEEtYfIIF•[pNR•FYAAHIS `ta MS M'!L•O5'EMLi•Mg SAMSMLE 1639-2014 I s mirriiu, ' Thomas McKean, Director NAM 1639. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 C' r;> APPLICATION FOR PERMIT TO STORE AND/OR UTILIZEy 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 I st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ✓8r CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ 81 9 @L-, *A late charge of$10.00 will be assessed ifpUment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. "2 (' 0 0 0 I 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: R EIVL-- ON 5. NAME OF ESTABLISHMENT: 6,50 L U T�!ti S.S E ! L _ 6. ADDRESS OF ESTABLISHMENT: 20 D U N N S f�6 nl NN I S 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: .sO pg — 9. EMAIL ADDRESS: 10. SOLEOWNER: BYES 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 APPLICAN T & ,7 C7 Q:\Application Forms\Haz Mat Appli Draft Jan2019.do oilt a-to; �® oFt"E Kok own of Barnstable Office:508-862-4644 C �� - �or,mo(AQ�.T , Public Health Division Fax:508-790-6304 BA MAS,'; LE. ` 200 Main Street• Hyannis, MA 02601 39. MASS. $. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: M Date: 9 Location/Mailing Address: Rum','& 0 Contact Name/Phone: �d —7 4 0 Inventory Total Amount: 7a5 �SDS: ue S License#: l Tier II : Labelino: Spill Plan: W. Oil/WaterSeparator: 0 Floor Drains: no Emergency Numbers:1 - Storage Areas/Tanks: At/ Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning Sol , is&spot removers Engine and radiator flushes Bug and tar r Hydraulic fluid (including brake fluid) Windshield was � ,, Motor oils V Miscellaneous Corrosives -� Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerant 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: dak.,n . Inspector: Facility Representative• WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS OptME ro Town of Barnstable Office:508-862-4644 �• Public Health Division Fax:508-790-6304 • RnRM .S. .A- 9• 200 Main Street• Hyannis, MA 02601 1659. �pIfOMP�p`e TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: 46014-P-1v .3 Date: 18 t 7 Location/Mailing Address: oK was o di r�✓1 S r �Q f�7 Contact Name/Phone: •{'�a-c'•ew �7.O�gv�.� o 000 2°(d_ t¢,`� � e5a,�`�a,�g��,�, � Cal-c Ca# r Inventory Total Amount: MSDS: o �vw ti 40� 1 mv)�A1icense#: 4 ti G Tier II : o Labeling: w2A1 Spill Plan: Oil/WaterSeparator: Floor Drains: 511&ks 7 Emergency Numbers: Storage Areas/Tanks: Emer enc /Containment E ui ment: -ao..�e.� Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash 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) I Any other products with "poison labels" aIie-v J I o (including chloroform, formaldehyde, Color, a hydrochloric acid, other acids) VIOLATIONS: "l 5w�-,�t���C�r►,�,k,,�>�.^�s N t o �• �Iq�c wK.�s 2 � I -,wc� oarcS�Y���' 2- ORDERS: INFORMATION/RECOMMENDATIONS: GS 000 qth, aw o►c, . .� 1 t.J�S e. 4 }�j w I 1 Inspector: Lama-I l 2 �jV,dA2 �,� -�-d Qvp� �,� �� Facilit Representative: g WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date:y/Z-f 01V TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: �rl�,w� tit C=SCsiu�-t` BUSINESS LOCATION: aO L-_. n 'S PC-PI'A c�xot .MAILING ADDRESS: INVENTORY TELEPHONE NUMBER: -790 - 9`302 TOTAL AMOUNT: CONTACT PERSON: OA4 ev. Criss-x ea' _ EMERGENCY CONTACT TELEPHONE NUMBER: TYPEOF BUSINESS: FIDE Q(57 . OTHER INFORMATION: `S Waste Transportation: Name of Hauler: LA JM P5*-r Destination: Waste Product: Licensed?ine 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 0A 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) Dieselfuel, 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) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCBs Lacquer thinners. _ Other chlorinated hydrocarbons,NEW USED (inc. carbon tetrachloride)- Paint &varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners Floor &furniture strippers (including chloroform, formaldehyde, hydrochloric acid, other acids) Metal polishes Laundry soil &stain removers Other products not listed which you feel (including bleach). may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: A.g , /At4R_ (dry cleaners) Other cleaning solvents WO 0 �Z)ev-e_A � ! Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1321 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Absolutely Essential 20 Dunns Pond Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ----------------------------------- ---- -------------------------------------------- ---------- ------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health I J- Town of Barnstable ` Inspectional Services BARM TABLE W 5 CCiPGitl.5�u5'EF'I LL%�it Public Health Division :,39-201<STA . MASS. Thomas McKean Director ass. �. � � ArEn .�p`` 200 Main Street, Hyannis, MA 02601 , Office: 508-862-4644 Fax: 508-790-6304 rl X. 0 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE `' HAZARDOUS MATERIALS ' ' IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS MY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 V51 pd 6 El 2 PERMIT 111 —499 Gallons: $125.00 t CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charize of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 02 Qa BOO 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: row 5. NAME OF ESTABLISHMENT: SOT�C� .z 6. ADDRESS OF ESTABLISHMENT: t) O *11—tya 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9s4j 9. EMAIL ADDRESS: 10. SOLEOWNER: AYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TE EPHONE#OF: �" CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: Nn NAME: TELEPHONE#: COMPANY ADDRESS_ EMAIL: SIGNATURE OF APPLIC Q/E.Lti DATE Q\Application Forms\Haz Mat App Revised 09-10- 8.docx Number Fee 1321 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Absolutely Essential 20 Dunns Pond Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ------------------------------------------------------------------------ --------------------- ---------------------------------------------------------------- ------------------------------------------------------- ------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health rA# .. Vowegi2atotyof B n a Services Richard V. Scali, Director oFTNE Tp,_ Public Health Division BARNSTABLE • � BARNbTABLE, enw+srae .fvrteaiue.mrvn.xvuws Thomas McKeanMAR& , Director i °0 4" " °' -- i°reo�a 200 Maui Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE _ HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 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. 1. ASSESSOR'S MAP AND PARCEL NO d l 0- .Od ©D� 2. IS THIS A PERMIT RENEWAL? A---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: A6so w�C w �5� --/V`f rlkL 6. ADDRESS OF ESTABLISHMENT: s)O 0 21vo �jE/ILL� 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: 6 n v� 10. SOLEOWNER:�/rYES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT Al 2 HO Q-W A( TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLIC 'DATE Q:\Application FormAHAZMAT APP 2017 u S do" TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION G'•KDo-<1 # V= /V 7 OWNER AND INSTALLER INFORMATION 3 ADDRESS: Q U All MAP NO. .PARCEL NO. OWNER NAME: of A s 'A f<r_ ,+ ur5'. te"' to lir, VILLAGE-. dyls,�Ill/tS" fir►�J B INSTALLATION DATE: pBY: ADDRESS: CERT. NO. f-A' Rk< INFORMATION LOCATION OF TANK: h - CAPACITY as 75 TYPE � AGE ``"•`"_�f! FUEL/CHEM I CAL TESTING CERTIFICATION C I- PASS C ] FAIL DATE * LEAK DETECTION Cam] CHECK IF N/A TYPE/BRAND i ZONE OF CONTRIBUTION Cam] YES C I NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C ] YES C ] NO CONSERVATION N] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. 0 7C 71 ]C ]C J DATET�? PLEASE PROVIDE A SKETCMSOINS THE TANK LOCATION ON THE BACK OF THIS CARD �. � �� �� w . �re a ti ✓—