HomeMy WebLinkAbout1225 IYANNOUGH ROAD - HAZMAT '-
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SPECIFICATIONS
Q CONCRETE MINIMIIM STRENGTII: . 5.000 p.s.i. ai 0 days USE GRADED STONE tBASE- UNDER TANK
STEEL REINFORCEMENT: ASTM A - 615-68, GRADE_ GOB ,
DESIGN LOADING: STANDARD UNITS: AASHO-H2O
Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
BARN�`E'g 200 Main Street• Hyannis, MA 02601
1639.
p'ED MA'�A`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name: Date:
Location/Mailing Address:
Contact Name/Phone:
Inventory Total Amount: <6bo MSDS: S License#: cc
Tier II : Labeling: Spill Plan:
Oil/Water Separator: IYA Floor Drains: Emergency Numbers: "J�
Storage Areas/Tanks: I�" � �I cg&�(, j ro"
Emergency/Containment Equipment:
Waste Generator ID: Waste Product:
/ Date&Amount of Last Shipment/Frequency:A/ 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 4Dry cleaning fluids
Automatic transmission fluid a/ 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
VPaint&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 RECOMMENDATIO L
O L -�o 'ftAj
!VZI A
Inspector:
J
Facility Representativ . 1,71 AZ
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
°FINE roNti Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
• BARMA�q ' 200 Main Street• Hyannis, MA 02601
1639.
�A'FOMP+p`0� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT /
Business Name: �' C0 4P� S Date:
Location/Mailing Address:
Contact Name/Phone: 10 - 7. d®
Inventory Total Amount: <a 0 MSDS:t License#:
Tier II : Labelina: le _ Spill Plan: es
Oil/WaterSeparator: Floor rains: Emergency Numbers:
Storage Areas/Tanks: 60 n
Emergency/Containment Equinme : d
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 V Other cleaning solvents&spot removers
Engine and radiator flushes Bug and tar removers
Hydraulic fluid (including brake fluid) Windshield wash
Motor oils V Miscellaneous Corrosives
Gasoline,jet fuel, aviation gas Cesspool cleaners
Diesel fuel, kerosene, #2 heating oil Disinfectants
Miscellaneous petroleum products: Road salts
grease, lubricants, gear oil Refrigerants
Degreasers for engines&garages Pesticides:
Caulk/Grout insecticides, herbicides, rodenticides
Battery acid (electrolyte)/batteries Photochemicals(Fixers)
Rustproofers Photochemicals(Developer)
Car wash detergents Printing ink
Car waxes and polishes Wood preservatives (creosote)
Asphalt&roofing tar V/Swimming pool chlorine
Paints, varnishes, stains, dyes a 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/ ECOMMENDATONS: I Ael? 01
Inspector:
Facility Representative: �1'd
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
i
°FINEr°w Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
• BARMASS .. D! 200 Main Street• Hyannis, MA 02601
A 039.p�0
'FOMA+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT�--
Business Name: et nil A I Date: o�
Location/Mailing Address: Ve
Contact Name/Phone: 5 d
Inventory Total Amount: 4,Ali MSDS: o _`� 611y License#: N l
Tier II : Labeling: C>k Spill Plan:
Oil/WaterSeparator: Floor Drains: 1✓D Emergency Numbers: 'L
Storage Areas/Tanks: ��t
Emergency/Containment Equipment: e 9 0 1 X.Aj s 44,
Waste Generator ID: Waste Product: CG c, (06
Date&Amount of Last Shipment/FrequencX:
Licensed Waste Hauler&Destination:
Other Waste Disposal Methods: —i v e- 4-es
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
—:,::, aints, 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)
vlo�+efas•' -�` �a b--P �-�,1�e t ��r�o ►vim,— ` �1�>�, � [.� �P�v�}s
ORDERS:
INFORMATION/RECOMMENDATIONS:
Inspector:
Facility Representative:
WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS
Number Fee
66 THE COMMONWEALTH OF MASSACHUSETTS $150.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort and Spa
.--------------------------------------------------------------------------------------------------------------------------------
1225 Iyannough Rd., Hyannis, MA
------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Is Hereby Granted a License
For: Storing or Handling 500 gallons or more 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
Town of Barnstable
�.� Inspectional Services BARNS LE
QF�� PFRY.Tz%E-tE1EtvlLlf•COIUR•FYA'NIS
Public Health Division 1639 M SY'S. LE•'S B?A SA&E
-7J39-22014
I MAS� 1 Thomas McKean, Director
co
�iOIED�a`� 200 Main Street, Hyannis,MA 02601 r
h;3
Office: 508-862-4644 Fax: 508-7�90-6304
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE
HAZARDOUS MATERIALSi
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 I PERMIT 26— 110 Gallons: $ 50.00 ❑
CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑
CATEGORY 3 PERMIT 500 or more Gallons: $150.00 [NVb�j'
*A late charge of$10.00 will be assessed if payment is not received by July 1st. ��� -
1. ASSESSOR'S MAP AND PARCEL NO.
2. IS THIS A PERMIT RENEWAL?ZYES_NO. IF YES, 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.
W
4. FULL NAME OF APPLICANT: " I I t c n Cq�a I
5. NAME OF ESTABLISHMENT: O LD e�e�� cc�
6. ADDRESS OF ESTABLISHMENT: ee 6✓16 u 54
7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE:—
8. TELEPHONE NUMBER OF ESTABLISHMENT: V Q 9 7 7l 3560
9. EMAIL ADDRESS: t4 h b,p C,/i Gov . C C. "r,
10. SOLEOWNER: V- YES NO IF NO,NAME OF PARTNER:
11. FULL NAME,HOME ADD SS,AND TEL PHO # F:
CORPORATION NAME n i ` �f 6U
PRESIDENT 'I 1�✓r'1 a nip
TREASURER dkbm "I
CLERK
12. IF PREPARED BY OUTSIDE PARTY:
NAME: TELEPHONE#:
COMPANY ADDRESS MAIL:
io& :�SIGNATURE OF APPLICANT DATE Z G
For a*I iCcx1/J /
Q:\Application Forms\Haz Mat Appli Draft Jan2019.docx
C4,4e-
n
°ptME T°k, Town of Barnstable JO', v p A Yrl Office:508-862-4644
Public Health Division Fax:508-790-6304
• BARMT,q L .A $" 200 Main Street• Hyannis, MA 02601
039. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
rED MA'S
Business Name: We, Co � aQ S m- Date: 711119
Location/Mailing Address: aSS- T 110u BcNr► Ul e
Contact Name/Phone: DD Inventory Total Amount: _ SDS: S License#: cv['
Tier II : N Labeling: f '�- k Spill Plan:
Oil/WaterSeparator: A11A Floor Drains: Emergency Numbers:
Storage Areas/Tanks: I civ room
V' Emergency/Containment Equiom ntnt: uQCWV WS,
Waste Generator ID: �- Waste Product:
Date&Amount of Last Shipment/Frequency:
�IA Licensed Waste Hauler&Destination:
I� 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 ZO f-(40
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 ood preservatives(creosote)
Asphalt&roofing tar Swimming pool chlorine 70 del
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
VMetal polishes Other chlorinated hydrocarbons
Laundry soil &stain removers / (including carbon tetrachloride)
(including bleach) V Any other products with "poison labels"
SD 1 iu b e 2 v (including chloroform, formaldehyde;/'/�
G hydrochloric acid, other acids)-
VIOLATIONS:
ORDERS:
INFORMATION/R OMMENDATIONS: Z "
yNA'Vll, C
Inspector:
Facility Representative:
WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS
Number Fee
66 THE COMMONWEALTH OF MASSACHUSETTS $150.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort and Spa
1225Iyannough Rd., Hyannis, MA
Is Hereby Granted a License
For: Storing or Handling 500 gallons or more of Hazardous Materials.
-------------------------- ----------- ------------------------------------ ----------- - -------------------------- - -----------------------------------------
---------------------------------------------- ------------------------------------------------------------------------------ ----------------------- ---------
This license is granted in conformity with the Statutes and ordinances relating there to,and
and expires 06/30/2020 unless sooner suspended or revoked.
--------------------------------
PAUL J.CANNIff,D.M.D,Cl[AIRMAN
DONALD A.GUADAGNOLI,M.D.
07/01/2019 JUNICHI SAWAYANAGI
THOMAS A. MCKEAN,R.S.,CHO
Director of Public Health
Town of Barnstable
Inspectional Services E11R,
RNSTABLE
EPublic Health Division "'` 201143ena
BARNMBLE. ' Thomas McKean, Director
200 Main Street, Hyannis,MA 02601
:,
Office: 508-862-4644 Fax: 50.8-790-6304
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE �c
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 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 .®VV,�,d chlC
*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: 11�1�� ea-Inn)'(/ —
5. NAME OF ESTABLISHMENT: 4�qq
6. ADDRESS OF ESTABLISHMENT:
7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:
8. TELEPHONE NUMBER OF ESTABLISHMENT: �(�g" 77
9. EMAIL ADDRESS: ��
10. SOLEOWNER: ✓ YES NO IF NO,NAME OF PARTNER:
11. FULL NAME,HOME ADDRESS AND TEL HONE#OF-
CORPORATION NAME
PRESIDENT - '
TREASURER r ' '
CLERK '
12. IF PREPARED BY OUTSIDE PARTY:
NAME: TELEPHONE#:
COMPANY ADDRESS EMAIL:
SIGNATURE OF APPLICANT
QAApplication Forms\Haz Mat App Revised 09-10-18.docx
Number Fee
66 THE COMMONWEALTH OF MASSACHUSETTS $150.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort and Spa
1225Iyannough Rd., Hyannis, MA
Is Hereby Granted a License
For: Storing or Handling 500 gallons or more of Hazardous Materials.
----------------------------------------------------------------------------------------------- -----------------------------------------------------------------
This license is granted in conformity with the Statutes and ordinances relating there to,and
and expires 06/30/2019 unless sooner suspended or revoked.
----------------------------------------
PAUL J.CANNIFF,D.M.D,CHAIRMAN
DONALD A.GUADAGNOLI,M.D.
07/01/2018 JUNICHI SAWAYANAGI
THOMAS A.MCKEAN, R.S.,CHO
Director of Public Health
�r.
K
r Voegulatoryw of Barnstable
ervices
Richard V. Scali, Director o�aA I=Aa�
OF SNE tp�
Public Health Division BARNSTABLE
#
tt40.5 CAB • # Thomas McKean, Director npa�LEW
# Y M.IIS•OSIE0.YLlF-WESf BAPNSi0
A AS& 8 1639-2014
ArEo �p — 200 Main Street Hy 11A-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 . %VS .
*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.
. r
4. FULL NAME OF APPLICANT:' v/l�%'Q/y)
5. NAME OF ESTABLISHMENT: ✓!/o'/
6. ADDRESS OF ESTABLISHMENT:
7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:
8. TELEPHONE NUMBER OF ESTABLISHMENT:
9. EMAIL ADDRESS:
10. SOLEOWNER: AES NO IF NO,NAME OF PARTNER: .
11. FULL NAME,HOME ADDRESS, D TELEP ONE#OF-
CORPORATION NAME
PRESIDENT '
TREASURER
CLERK
12. IF PREPARED BY OUTSIDE PARTY:
NAME: TELEPHONE#:
• COMPANY ADDRESS EMAIL:
SIGNATURE OF APPLICANT E
Q:\Application Forms\HAZMAT APP 2017 REVIS
Number Fee
66 THE COMMONWEALTH OF MASSACHUSETTS $15o.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort and Spa
1225 Iyannough Rd., Hyannis, MA
Is Hereby Granted a License
For: Storing or Handling 500 gallons or more of Hazardous Materials.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
----------------------------- -------------------------------------------------------------------------------------------------------- -----------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and
and expires 06/30/2018 unless sooner suspended or revoked.
----------------------------------------
PAUI_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
rf _
x
rowwl1�,. of B Instable
egulatorye,,ces
Richard V. Scah, Director
SHE T
o Public Health Division BARNSTABLE '
PAFYSfaUlk••:BrFJ;YILLE•COTUrt•HTui:15
• BAMFr'ABLE. Thomas McKean Director
MASS ) 1639-2014 U)
°res6 200 Main Street, Hyannis, MA 02601 3175 CM
moo/ - �.v� 'Office: 508-862-4644 - Fax: 508-790-6304 '
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE '
'huh
HAZARDOUS MATERIALS
IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108,
HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS
MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN
ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth).
APPLICATION FEES
CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑
CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑•
CATEGORY 3 PERMIT 500 or more Gallons: $150.00 � V51
*A late charge of$10.00 will be assessed if a ment is not received b Jul 1st.
Pv Y y
1. ASSESSOR'S MAP AND PARCEL NO.
2. IS THIS A PERMIT RENEWAL?/YES_NO. IF YES, SKIP QUESTION 3.
3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS
• ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF
GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES_ NO.
4. FULL NAME OF APPLICANT: Gt 1211'aAr eall 40
5. NAME OF ESTABLISHMENT:
6. ADDRESS OF ESTABLISHMENT:
7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:
S. TELEPHONE NUM 3ER OF ESTABLISHMENT: ,��� �/� '✓��Q
9. EMAIL ADDRESS: d% z4 a Leo-r
10. SOLEOWNER: ✓ YES NO IF NO,NAME OF PARTNER:
11. FULL NAME,HOME ADDRESS AND TELE HONE#OF:
CORPORATION NAME Er (/
PRESIDENT A)1/j'a/3-)_V, &)• t4// L�
TREASURER
CLERK
12. IF PREPARED BY OUTSIDE PARTY:
NAME: TELEPHONE#:
COMPANY ADDRESS EMAIL:
SIGNATURE OF APPLICANT DATE
Q:\Application FormsU AZMAT APP 2017 REVIS*D.doc
`,
i
e
¢20.
ynnrtnuo rd.
i
Cape Codder Resort&�.ipa
V Bill Callahan \
Chief Engineer
office;1-508-568-2915
cell;1-508-221-8557
bcallah an @capecodderresort.com
HVAC Tech _
pQ+KE row Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
• BARMA `0g 200 Main Street• Hyannis, MA 02601
��EOMP� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name: C 2 (i.11/ Date: z
Location/Mailing Address:
Contact Name/Phone: S' -??! - Cel6zB--5? -goo
Inventory Total mount: ',500 a1 MSDS: �a,,��r `� "'�" License#:
Tier II : No Labeling: 04C Spill Plan: ,+o osk
Oil/WaterSeparator: Floor Drains: 0.0 Emer ency Numbers: 0K,
Storage Areas/Tanks: vim`-i wLe-�C�Dtak�! Q�ea�n•+�., ,Co L�t.Q+��.a P
Emergency/Containment Equipment: JDA Ww 4vo L�c.w�.aa1 S�,<ati,C.
Waste Generator ID: Waste Product:
Date&Amount of Last Ship ent/Frequency:
Licensed Waste Hauler&Destination:
Other Waste Disposal Methods:_1[� R' e0\Vf- Gov1- ` IVIJ 91-e macII( ky
LIST OF TOXIC AND HAZARDOUS MATERIALS yL +w � �eQ�'`� Y �4w 1� c.lA.Ilt' �$/ �¢+"� IN X
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 t/ 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
7�
Car waxes and polishes Wood preservatives(creosote) prl��k
Asphalt&roofing tar �� Swimming pool chlorine IS)c 9.5 ye�b �
Paints, varnishes, stains, dyes Lye or caustic soda
Lacquer thinners Miscellaneous Combustible
Paint&varnish removers, deglossers Leather dyes
V Miscellaneous Flammables Fertilizers
Floor&furniture strippers PCB's
Metal polishes Other chlorinated hydrocarbons
Laundry soil &stain removers 3�,(�` (including carbon tetrachloride)
(including bleach) Any other products with "poison labels"
(including chloroform, formaldehyde,
hydrochloric acid, other acids)
VIOLATIONS:
ORDERS:
INFORMATION/RECOMMENDATIONS c
O + W,4 Ac,a— o i kG w p0
Inspector: I
Facility Representative:
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS
�\ Number Fee
66 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort and Spa
1225Iyannough 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
T. ,
:r
Town of Barnstable
°,*THE Tq� Regulatory Services
ti
• °� Richard V. Scali, Director
RMMSTABLL
vqj ,eg'
Public Health Division
i639.
QED 39 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. L 40 3 DATE
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT �(/►11 i af/�2_�C�,��
NAME OF ESTABLISHMENT
• ADDRESS OF ESTABLISHMENT
TELEPHONE NUMBER
SOLE OWNER:✓ YES NO
IF APPLICANT IS A.PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION
STATE OF INCORPORATION
FULL NAME AND HO �SS OF:
PRESIDENT ' OF:
6—eh
TREASURER �o
CLERK
• SIGNATURE OF APPLICANT
RESTRICTIONS: HOME ADDRESS /
HOME TELEPHONE# �-
C:\cacheUemporary Intemet Fi1es\0LKD3\HAZAPP Rev20I5.D0C
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\ME►oK� Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
RnRMASS. .g` 200 Main Street• Hyannis, MA 02601
p 059.&,
�eDFA TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name: eS o-t4 Date: I I
Location/MailingAddress: 17.2 VAVX4V gr1-+1 s
Contact Name/Phone: ��� ('�.I��I�.�. S2 8- 7-71- 000
C L065
Inventory Total AmourtN�(,O 0 MSDS: 90 ✓144 ✓ License
Tier II : o Labeling: a ' Spill Plan: ZS
Oi[/Water Separator: Floor Drains: 00 Emergency Numbers: es
StorageAreas/Tanks: ADot )kq hk5 ge,�.�'r�.nti so14-0
Emergency/Containment ui ment: V tv&- 0001 4AA- C.-k
Waste Generator ID: Waste Product:
Date&Amount of Last Shipment/Frequency:
Licensed Waste Hauler&Destination:
Other Waste Disposal Methods: gi,AW VQCL-& R.Lw A t S 6-611(,UkA o `7<Arl 01
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 O Y S-F Sx Z
Motor oils '�7 Miscellaneous Corrosives I
Gasoline,jet fuel, aviation gas Cesspool cleaners
Diesel fuel, kerosene, #2 heating oil Disinfectants S C.o
Miscellaneous petroleum products: Road salts V '°`�
grease, lubricants, gear oil I D Refrigerants l�O11,
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 1$x4 al l2•S'/o
N��p Paints, varnishes, stains, dyes oo Lye or caustic soda
Lacquer thinners 7 to°Xt Miscellaneous Combustible
Paint&varnish removers, deglosserskob Leather dyes t0
Miscellaneous Flammables Fertilizers
Floor&furniture strippers PCB's
Metal polishes Other chlorinated hydrocarbons
100 Laundry soil &stain removers 3� '� (including carbon tetrachloride)
(including bleach)
�kw Any other products with "poison labels"
(including chloroform, formaldehyde,
hydrochloric acid, other acids)
VIOLATIONS:
ORDERS:
INFORMATION/RECOMMENDATIONS: G -c,k--
k w woo I l I+&CAA L COD 04,
k<p kk%M-tf5 Ck°i-/Ga f (V_ `a Inspector:, , `
Facility Representative: `
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
Town of Barnstable
• Regulatory Services
Richard V. Scali,Director Z
s"x" Public Health Division BARNSTABLE CA
16;9. �0� n&n M5Ia�osr"eanueCD "eansme
Thomas McKean,Director 1639
7014 a,.
200 Main Street, Hyannis,MA 02601 °1
Office: 508-862-4644 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 JULY 1st—JUNE 30th).
APPLICATION FEES 5�
CATEGORY 1'PERMIT 26— 110 Gallons: $ 50.00 ❑ G�
CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ V U
�II nn0 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 v
A late charge of$10.00 will be assessed if payment is not received by July Ist.
ASSESSORS MAP AND PARCEL NO. DATE 16 `--:5 —J�
FULL NAME OF APPLICANT: W/ / —
NAME OF ESTABLISHMENT: V6� kLC:
ADDRESS OF ESTABLISHMENT:
MAILING ADDRESS (IF DIFFERENT): �yQ�yy
TELEPHONE NUMBER OF ESTABLISHMENT:
EMAIL ADDRESS:
SOLE OWNER: YES NO IF NO,NAME OF PARTNER:
FULL NAME,HOME ADDRESS, TELEPHO OF:
CORPORATION NAME l/ 6ra1)
PRESIDENT S
TREASURER
CLERK
IF PREPARED BY OUTSIDE PARTY:
STATURE OF AP LIC Name:
Company Address
Telephone#:
Email:
QAApplication Forms\HAZ.ZAPP Rev I6.docx Page I of 2
I• � • i
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Number Fee
66 THE COMMONWEALTH OF MASSACHUSETTS. $1so.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort and Spa
1225 Iyannough Rd., Hyannis, MA
Is Hereby Granted a License
For: Storing or Handling 500 gallons or more of Hazardous Materials.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and
and expires 06/30/2017 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
pfIMEA . Town of Barnstable Office:508-862-4644
Public Health Division Fax:508-790-6304
• BARMASS. ' 200 Main Street• Hyannis, MA 02601
1619.
�prFDMP�a`� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT
Business Name: C Ca14-e /&_Sor� S o.- Date:
Location/Mailing Address; � •tN✓!yS
Contact Name/Phone: btfl
Inventory Total Amount: ^ `a`')��oC� SDS: �C-41 +r0\? -'1.4L0. ✓ License#:
Tier II : ' Labeling: 6° Spill Plan: m S'r
Oil/Water Separator: Floor Drains: - 'Kw&'-'< Emergency Numbers:
Storage Areas/ranks: ov\ �C 1 Vti �y� H tVK*.%1,A
Emergency/Containment Equipment: Iotll k%,V iA,, ool cln texk vcag
Waste Generator ID: Waste Product: V_g-,
Date&Amount of Last Shipment/Frequency:
Licensed Waste Hauler&Destination:
Other Waste Disposal Methods: v ra14W
LIST OF TOXIC AND HAZARDOUS MAT RIALS I o �1 ed &"Wy, .ivl �v1VgAj �IWp� .S-{� CK45e �o
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazard s material use, e-X" t'
storage and disposal of 111 gallons or more requires a license from the Public Health Division. Qaa t e ,e,(5
Antifreeze Dry cleaning fluids _ �eZ ho�4to
Automatic transmission fluid Other cleaning solvents&spot removers '
Engine and radiator flushes Bug and tar removers
Hydraulic fluid (including brake fluid) Windshield wash
r 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 V Refrigerants
Degreasers for engines&garages Pesticides:
Caulk/Grout/`aot,l,,-i,\1L3 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 xA Swimming pool chlorine MAX
T— Paints, varnishes, stains, dyes,4bo'I Lye or caustic soda CO._OG l
Lacquer thinners Miscellaneous Combustible too
Paint&varnish removers, deglossers Leather dyes QG��
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/RECOMM ND IONS: 0� i Z QaCG{ S .a
nspector:
Qa,v Cate�o�`r�°/eK •-we
1� p,l�� , 1-�,ea�1'k.V-w��J�... 2W�a,� Facility Representative: � ��----
WHITE COPY HEA H DEPARTMENT/CANARY COPY-BUSINESS
Date: / / /o /1 y
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS FORM
NAME OF BUSINESS: Gc e- 6 a_
BUSINESS LOCATION: /2 "J—YWAIA!.� �. VA s INVENTORY
MAILING ADDRESS: j4,n4.e. TOTAL AMOUNT-
TELEPHONE NUMBER: S0$- 771 —.3000 `//yg�llBKy .r
CONTACT PERSON: 2 vl ,.tic-e l yam/bs
EMERGENCY CONTACT TELEPHONE NUMBER: Of MSDS ON SITE?
TYPE OF BUSINESS: a9w]la✓HaQry, 1`i5�a��aw�, �+-tQ►+vforiart� %s_ e�,r���)
INFORMATION / RECOMMENDATIONS: ')be mj s,J psi- a 0,11 Fire District:
Cv►n`�i a �v►� a�e, obi 2, ee. 1 �zrd' 50 "s ►►� tq ya r►,i►S
v I e'I w+k� able., r�aQ.�� �.ww•�►ti '
2T Qool �Ic�awi��Ig,�+o��� ovt.s r e- Gmv�. a�n w� r.A�-c�'4'cc�►.,e_ -Foy Sf"a co►��-a�ness,
'/ � }-a+.n. J�j�!J��1 Poo'��I,�-wtu.215 �v► a q �-�-►'�e►1.1'�Gortt►n✓C r�ve�l-ro..c.o-�' 1�a�nr�'f
,Waste Transportation: Last shi ment 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 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) Z`5 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)
/2 lubricants, gear oil ❑ NEW ❑ USED
Degreasers for engines and metal Printing ink
Degreasers for driveways&garages Wood preservatives (creosote)
Caulk/Grout �l0 Swimming pool chlorine 41111 f"'A-7
n o 4-do IctS
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
100 Paints, varnishes, stains, dyes�M i'a.��X� 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)
30 Miscellaneous. Flammables e ov?,A }' Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous(please list):
Metal polishes
V►�►`VG o-I�.�rQool G��'►'�►Gtils--is g�J
Laundry soil &stain removers
6 O (including bleach)
Spot removers&cleaning fluids
(dry cleaners)
q Other cleaning solvents zo.
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials
Number Fee
353 THE COMMONWEALTH OF MASSACHUSETTS $10o.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort& Spa
1225Iyarinough 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 6/30/2011 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
Town of Barnstable
r �pF1HE Toq� Regulatory Services
Thomas F. Geiler, Director
1
` BA MASS.
o�
* Public Health Division
ASS.
v� t639. ,gym
ornAyA' Thomas McKean, Director
200 Main Street, Hyannis, MA 02601 tr
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
ADDRESS OF ESTABLISHMENT ao�� (, &aLd-
TELEPHONE NUMBER
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. �^j
STATE OF INCORPORATION
--o
FULL NAME AND HOMf/ADD/R_E,SS OF: /^
PRESIDENT I rrG 17�U/I
TREASURER
CLERK
SIGNATURE OF APPLICANT
RESTRICTIONS: HOME ADDRESSP,
HOME TELEPHONE # ;3 S&7=Vo — O� --•
Haz.doc/'wp,'q
c 11';a Catania Hospitality"Group, Inc c ^
CITIZENS BANK - 5-7017/2110 _ 00158384'
Massachusetts - -
141 Falmouth Road
Hyannis, MA 02601
CHECK NO. CHECK DATE VENDOR NO. .fl
158384 06/16/10 211 fl
a 0
PAY ONE HUNDRED AND 00/100 DOLLARS******************.**
AMOUNT c
$**********100 . 00
y,
TO THE TOWN OF BARNSTABLE u
ORDER
OF
200 MAIN S T
HYANNIS MA 02601
Authorized Signature
11600L58384ii' 1: 2311070175l: 1109465332112
r
CAPE CODDEP.,
RESORT &,flwl
Contingency Plan
Emergency Services
Hyannis Fire Department 508-775-2323
Hyannis Police Department 508-775-1212
Cape Cod Ambulance Service 508-775-0494
•
Local DEP Office 508-946-2850
Advanced Liquid Recycling 203-238-6771
Clean Harbors 617-849-1800/617-935-9066
Poison Control 1-800-682-9211
n
c
•
r
Contingency Plan Pool Area Filter Room and Laundry
✓ Shut off valves and pumps.
✓ Contain the spill using absorbent socks and then apply appropriate absorbent
material as needed. Contact spill response firms on page 1 if needed.
✓ Remove all absorbed material or contained liquid and package in D.O.T.
approved container. Used absorbent materials should be packaged separately
from liquids.
✓ Clearly label containers with the type of waste enclosed and the start date of
accumulation.
✓ Once spill has been controlled and materials are collected and secured, inspect the
area for cleanliness and decontaminate all equipment used in clean up.
✓ Replace all used materials and ensure all response equipment is in good working
condition.
✓ Manage and dispose of collected absorbents in liquid in accordance with Federal
and State environmental regulations.
✓ For any spill greater than the reportable quantity (or 25 gallons) whichever is less,
this plan shall be implemented and proper records of action shall be kept on site.
✓ Spill clean up equipment is located in the pool filter room and laundry room.
The following is a list of the spill equipment on site:
■ Spill response kit which includes absorbent spill pads.
■ An adequate amount of nitrile gloves, nitrile or rubber boots.
■ First aid kit
■ Eye wash
■ Fire extinguishers
r
Number Fee
66 THE COMMONWEALTH OF MASSACHUSETTS $100.00
Town of Barnstable
Board of Health
This is to Certify that Cape Codder Resort and Spa
1225Iyannough 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
Town of Barnstable
;> Barnstable
Regulatory Services Department
A&ftCft
Public Health Division
• STASM 1
MASM& 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. DATE
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE
MORE THAN I II GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT—
NAME OF ESTABLISHMENT jQ
ADDRESS OF ESTABLISHMENT
• TELEPHONE NUMBER
SOLE OWNER: 1/ YES NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
-zr
F
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. `j• L
STATE OF INCORPORATION
co
CO
A14FULL NAME AND HOME ADDRESS OF:
PRESIDENT-10-illialn
TREASURER
CLERK
SIGNATURE OF APPLI ANT
• RESTRICTIONS: HOME ADDRESS --L_� Q // _0
HOME TELEPHONE# d 3
Q:\Hazmat\Haz Mat Application2008.DOC
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1
•
MAIL-IN REQUESTS
Please mail 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. Make 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
•
r
Q:\Hazmat\Haz Mat Application2008.DDC
r -
• CA J DE- AFL,# CODDEZ
RESORT kipa"
Contingency Plan
Emergency Services
Hyannis Fire Department 508-775-2323
Hyannis,Police Department 508-775-1212
Cape Cod Ambulance Service 508-775-0494
Local DEP Office 508-946-2850
Advanced Liquid Recycling 203-238-6771
Clean Harbors 617-849-1800/617-935-9066
Poison Control 1-800-682-9211
•
• Contingency Plan Pool Area Filter Room and Laundry
✓ Shut off valves and pumps.
✓ Contain the spill using absorbent socks and then apply appropriate absorbent
material as needed. Contact spill response firms on page 1 if needed.
✓ Remove all absorbed material or contained liquid and package in D.O.T.
approved container. Used absorbent materials should be packaged separately
from liquids.
✓ Clearly label containers with the type of waste enclosed and the start date of
accumulation.
✓ Once spill has been controlled and materials are collected and secured, inspect the
area for cleanliness and decontaminate all equipment used in clean up.
✓ Replace all used materials and ensure all response equipment is in good working
condition.
• ✓ Manage and dispose of collected absorbents in liquid in accordance with Federal
and State environmental regulations.
✓ For any spill greater than the reportable quantity (or 25 gallons)whichever is less,
this plan shall be implemented and proper records of action shall be kept on site.
✓ Spill clean up equipment is located in the pool filter room and laundry room.
The following is a list of the spill equipment on site:
■ Spill response kit which includes absorbent spill pads.
An adequate amount of nitrile gloves, nitrile or rubber boots.
■ First aid kit
■ Eye wash
■ Fire extinguishers
•
Catania Hospitality Group, Inc"
CITIZENSANK 5r7017/2110 -.001.50744
,B
14.1 Falmouth Road Massachusetts
r
Hyannis, MA 02601`.- Y,
�� `—�V K DATE VENDOR NO. a
�Q1 to^(/' (/� Sr � I`\Y� ,.
is l/" G�ckY...l'L�01�.'1 :5G(. LyCJ ,(`:.., i O. CHEC ,...
,:.
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;1'50'744 06/2,4/09 211
� o
Y PAY ONE HUNDRED AND 00/100 DOLLARS
a
Il Z AMOUNT
$**********100 . 00
d
T
i TO THE TOWN OF BARNSTABLE
ORDER
i OF
2.00. MAIN S„T
HYANN is MA 0260
(`\
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Authorized Sighature -
1110015O ?1,1. 1: 2LL070175.I: L10946 5 3 3 2110
.
Commonwealth of Massachusetts` _ ■
1100122597
Asbestos Notification Form ANF-001 Decal Number
Important: A. Asbestos Abatement Description
When filling o p .
forms on the/
computer,use 1. a. Is this facility fee exempt-city, town, district, municipal housing authority, owner-occupied
only the tab key residence of four units or less? ®Yes ✓[�No
to move yo�r
cursor-do of b. Provi blanket-deeaka ber if applicable: Blanket Decal Number
use the retu
key. Facility Location:
«a CAPE COMER RESORT&SPA 1225 IYANNOUGH ROAD
.tea
Name of Facilityb.Street Address
H nis MA 02601
c.City/To ate. e.Zip Code f Telephone.Number
INSTRUCTIONS 3. Worksite Location: -- --�
1.All sections of-this TANK ROOM I l _
form must.be a.Building NamelBuilding Location b.Building# c.'Wing d.Floor e.Roorn
completed,in.order
to comply'v itn 4. Is the facility.occupied? ✓[ Yes` 7 No .
PEP notification -
requirements of 310
CMR 7..15 5. Asbestos Contractor:
and the Division
&Oocupational NEW ENGLAND SURFACE MAINTENANCE 850 WASHINGTON STREET ,
Safety(DOS) a.Name b.Address
notification WEYMOUTH 02189
requirements of 453
CMR 6.12 c;City/Town; 4 .• d Zi .Code _ e.Telephone Number
AC000196 1 9. Contract Type 0 Wntten E]Verbal
f DOS License Number - _
h Facility Contact Person i.`Contact Person's Title
PAUL W..BROWN AS061945
a.Name of On=Site Su ervisor/Foreman` b Su rvisor/Foreman DOS,Certification'Number
e
PENNOR AM060445 �"
T' a.Name of Protect Monitor b.Pro'ect'Monitor DOS Certification Number
FLI ENVIRONMENTAL AA000144
8. a.Name of Asbestos Analytical-Lab b.Asbestos Anal ical Lab DOS Certification Number
04/22/2011 0412V2011
9 St End Date mm/d�)U)a:Pro ect.,Eas+Date mm/dd �
0 8-4
�N
c.Work Hours Mon-Fri. d.Work hours Sat-Sun.
�0 10. a. What type of.project is this?
0 ❑ Demolition ✓[� Renovation
Repair [�Other, please specify: b.Describer
I 7;
11. a. Check abatement procedures: „ '
_0 ❑Glove bag ® Encapsulation t --
b Enclosure e _ 0 Disposal only
Cleanup _ . -Other `s eci } i�: ±r_�aV .
-LL ✓( .Full containment P �' b.Describe
-z
�Q 12 Is the�job being conducted..-0 Indoors?' Outdoors? � ,
■ anf001ap.doc•10/02 `r Asbestos Notification Form•Page 1 of 3
y :p
Commonwealth of Massachusetts ■
100122597 �
Decal Number
Asbestos Notification .Form ANF-001
A. Asbestos Abatement Description (cont.)
13. Total amount of each type of Asbestos Containing Materials(ACM)to be removed, enclosed,or
encapsulated:
0 200
a.Total pipes or ducts(linear ft) b. Total other su aces square
c.Boiler,breaching,duct,tank C 200
d Insulating
surface coatings Lin.ft. Sq.ft. . g cement Lin.ft. Sq.ft.
e.Corrugated or layered paper C �
f.Trowel/Sprayer coatings
pipe insulation Lin.ft.
(Sq.ft. � Lin.ft. j Sq.ft.
g.Spray-on fireproofing ——--� --J h.Transite board,wall board ---�-�
n.ft. Sq.ft. Lin.ft. Sq.ft.
J.Cloths,woven fabrics j.Other,please specify: L
- Lin.ft. S ft. Lin.ft. so.
k.Thermal,solid core pipe
insulation Lin.ft. Sq.ft. f:Specify
Y O ._
14. Describe he decontamination stem s to be used:..;
AS REQUIRED
15. Describe`the containerization/disposal methods to comply with 316 0MR'7.15 andA53.CMR
6•'14(2) ):.
AS REQUIRED
»' 16. For Emergency Asbestos Operations ttie DEP.and DOS officials who_evaluated the emergency:
a.Name of DEP Official b.Title
k.:
C.Date(mmlddXyyyy)ofAuthorization! d.,DEP Waiver#
LLJ
e.Name of DOS Offiaal f D.O ial Title
�N
g.Date(mm/dd/yyyy)'of'Authorization h.DOS Waiver#.
-0 17., Do prevailing wage rates as per M.G.L. c. 149, §26, 27 or 27A—F apply to this project? E]Yes[]✓ No
° B. Facility Description
N HOTEL '
�o 1. Current or prior use of facility:
=0 2. Is the facility owner-occupied residential with 4 units or less? ❑Yes: 0 No
SAME
�o
3' a.Facility Owner Name b.Address
o c:City/Town d.Zip Code $.Telephone Number area code and extension
LL . 4
Ll
a.Name of Facility Owner's On-Site Manager. b.On-Site Manager Address
Q c.City/Town' d.Zip Code e.Telephone Number(area code and extension)
anf001 ap.doc "10102 Asbestos Notification Form•Pa e 2 of 3■
Commonwealth of Massachusetts ■
E �100 122597_
Asbestos Notification form ANF-001 Decal Number
B. Facility Description (coat.)
5.
a.Name of General Contractor _ b.Address
c.City/Town d.Zip Code e.Telephone Number area code and extension)
f.Contractor's Worker's Comp.Insurer q.Policy Number h.Exp.Date(mm/dd
6. What is the size of this facility? I(
a.Square Feet b.Number of floors
C. Asbestos Transportation and Disposal
1. Transporter of asbestos-containing material from site to temporary storage site(if necessary):
NESM (�
a.Name of Transporter { b.Address
Note:Transfer r--
Stations must
comply with the C.C.ity/Town mod.Zip Code $:Telephone Number
Solid Waste
Division 2. Transporter of asbestos-containing waste material from removal/temporary site to final disposal site:
Regulations 310
CMR 19.000 RED.TECHNOLOGIES771
a.Name of Transporter b.Address
c.City/Town d Zip Code e.Telephone Number
3 - -�
a.Refuse Transfer Station and Owner ( b.Address
c:Ci /Town ::d.Zi .Code e.Tele hone:Number
4. MINERVA ENTERPRISES INC
a.Final Disp osat Site Location.,Name b.FinaLDis osat-Site Location Owners
9000 MINE .RVA ROAD WAYNE RG,:
c.Final Dis osal Site Address d.Ci /Town
OH 44688
e:State f;Zip Code, g.Telephone Number
ro
�0
_ D. Certification.',
�N
The undersigned hereby states, under the JJIM DOYLE
�0 penalties of perjury,that he/she has read the a.Name b.Authorized Signature
�o Commonwealth of Massachusetts regulations 3/17/2011
for the Removal,Containment or�T c.Position/Title d.Date(mm/dd/yvvv)
Encapsulation of Asbestos,453 CMR 6.00 and NESM
310 CMR 7.15, and that the information
contained in this notification is'true`and Correct e:Telephone Number f.Re resenfin
o to the best of his/her knowledge and belief. ..
o Q.Address
u.
�
h..Cityrrown i.Zip Code .
Z
anf001 ap.doc•10/02 Asbestos Notification Form•Page 3 of 3
.may Yr
Number Fee
358 THE COMMONWEALTH OF MASSACHUSETTS $loo.00
Town of Barnstable
Board of Health
This is to Certify that Cape Tire Service, Inc.
45 Falmouth Road, Hyannis,MA 02601 - —
Is Hereby Granted a License
FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. �S
-----------------------------------------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------
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
Town of Barnstable % 100,o 0
pUtNE t0 Regulatory Services
Thomas F. Geiler,Director
` '" MASS. �'RNSTAB
` Public Health Division
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< , 1 _C91 ��A CC
NAME OF ESTABLISHMENT
ADDRESS OF ESTABLISHMENT
TELEPHONE NUMBER l I
SOLE OWNER: YYES NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF AI. .
PARTNERS:
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 61 a7 d a
STATE OF INCORPORATIONK�SS
FULL NAME AND HOE ADDRESS OF:
PRESIDENT 1/tJ
TREASURER Gig
CLERK
SIGNATURE ,F APPLI ANNTJ
RESTRICTIONS: HOME ADDRESS 5 e60? �U
HOME TELEPHONE# 6
Haz.doc/wp/q
i
�l
Number Fee
67 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00
Town of Barnstable
Board of Health
This is to Certify that Cape Resources Co. 5 -
- S
280 Old Falmouth Rd., Marstons Mills,MA 02648 S�
Is Hereby Granted a License c
FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS.
_ SL
------------------------------------------------------------------------------------------------------------------------------------ -------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and -�
and expires 6/30/2012 unless sooner suspended or revoked.
----------------------------------------
WAYNE MILLER,M.D.,CHAIRMAN
PAUL J.CANNIFF, D.M.D.
6/30/2011 JUNICHI SAWAYANAGI
THOMAS A.MCKEAN,R.S.,CHO
Director of Public Health
`•J
Town of Barnstable �00.Oo jLa o ,
THE) Regulatory Services
Thomas F. Geiler, Director
' '`' AM.�•M i Public Health Division
y� 1IDI ,�$'
'0)fn 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. Ud 9 DATE ,
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT L(J/s /�
CAIZ„� Dl�C-eAt/)
NAME OF ESTABLISHMENT j�,A FF— 1ZE<6 u{ZC.E S 60 d
ADDRESS OF ESTABLISHMENT U 0�-17 ICE LY►�B 7� )ZQ
TELEPHONE NUMBER Srti g gag az /-:?
SOLE OWNER: YES V"NO
t
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
lug
!_• �
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.
Ln
1�
STATE OF INCORPORATION JE/;�',Ltd "1 DCZ.k-
FULL NAME AND HOME ADDRESS OF:
PRESIDENT z'EFF/`Zr V Lle•ULA W c.- \
CLERK
ATURE OF APPLICANT
RESTRICTIONS: HOME ADDRESS 1166 ZR KF XQ :5YV4-'- Nzf
HOME TELEPHONE# 3/,5" 9 7,1., 636.1
Haz.doc/wp/q
MAIL-IN REQUESTS
Please mail the completed application form to the address below. In addition, please include the
required fee amount. Make check payable to: Town of Barnstable. 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. 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.
For further assistance on any item above, call (508) 862-4644
I
CONTINGENCY PLAN
.Emergency Coordinator, Name: GUILLIA yyl �d na���
Address: /„cam,� ,p onk M A
Daytime Phone: S'd? 7 1
Evening Phone:
Fire Department: . e D
Barnstable Public.Health Division: 508-862-4644
DEP 24 Hour Spill Hot Line: 888-304-1133
Waste Hauler: Name: 5,/t7,F7—V- K
Phone: o/ •7 p/ d 8 0
Building diagram indicating hazardous material/waste storage area, location
of absorbent scavenger materials, fire extinguishers, fire alarms (if present),
and evacuation route if applicable).
.
�
A�V
vay
Actions to be taken to control a spill or release and preventing it fro_1n
reachin a catch basin, sewer system or the ground.
/. s��r�
3 c.� /I$SaIZ�A�v`r" So�i�S /nouru J PIZA-11V19 TP10, ®Iz s
u�L cc1�� l��soiz,3;q�-- ,oyes
r
��/
Fee _
/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Application for Migogar *pftem �Co tr ion Permit
Application for a Perm' to r ylt
e ) Upgrade( ) Abandon( Complete System
/ ❑Individual Components
Location Address or Lot No. ✓ Owner's Name,Address,and Tel.No. /n- yy��
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. vC! /24or �}— Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building O CC No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 446*) 1->A-J/�h �1fG�C�/
7 �Wi� f/�•' _ l( ? — /�dIO�e` ✓fir® is fbloryf. f0 - /G�i li � GS /J
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Bo Vke7.
Sig Date —0,
Application Approved by Date
Application Disapproved by: Date
for the following reasons
i
Permit No. Date Issued
e4AN . Fee
*3
7-4-ITHE COMMONWEALTH OF MASSACHUSETTS Entered in computer.
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,, MASSACHUSETTS Yes
2pprication for Migonl �§pgtem Co �tr f on permit
Application for a Pe to C c e ) Upgrade( ) Abandon( Complete System ❑Individual Components
Location Address or Lot No. ��� �t' r Owner's Name,Address,and Tel.No. �/�'r' h� n�4►{f /' t
rG�fivt f /�G.
Assessor's Map/Parcel Y�� d�� G sv�. -- 7-9J� 6°1�/
N�5 sr1
Installer's Name,Address,and Tel.No. /4V, ,.J Designer's Name,Address and Tel.Noa1-4 .
r
OY-y�4-rV6 /7 ry?D4, ��-
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building p e-6, No.of Persons Showers( ) Cafeteria( )
Other Fixtures
{ Design Flow(min.required) gpd Design flow provided fi gpd
Plan Date 1 Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil 6
Nature of Repairs or Alterations(Answer when applicable)' .�e � ic•)tl a i f�.,vJ L^eri�fC �/
Ta[l�� {+,d<•- ;/( 3i* /ro0 ��� Sri .c fav�. /o /,c G L `mot S �J
cr n d / - 17.3� /�.-�.. �.1.�•�i iSc.d rf. .
• Date last inspected:
s
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by thi�Bo alt .
Sig _r.� Date
Application Approved by ate ` 2
V
Application Disapproved by: ` Date
a
for the following reasons
Permit No. Date Issued ,
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO RTIFY,that the On-site,Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( )
Abandoned( f zfd/A 67w'1TyYX-1`/V
at "f t/ /5 / has en co str cted i a co ance
with the provisions
of Title 5 and the for Disposal System Construction Permit No. dated
Installer / rilY�L�, �v��G Designer
#bedrooms Approved d ign flow -� gpd
The issuance of this permi shall n t be construed as a guarantee that the sys�•will c ion a de 'gned.
Date . eol V ` Inspect,
——————————
---NO.
— � —�" � -------------------- Fee --
/ THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
ligpoal 6pgtem Congtruction Permit
Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon
System located at ,r9/q p p
/ �/ t
r
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions. t
Provided: Constructi n must Ye completed within three years of the date of thi e i
Date Approved by . /,
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OVERFL(ON'
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TRENCH
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X
x
XXXXXXXXXXXXXXXX
4, —07
RD4
,DATE
DESCRIPTION,
AP
EAKWAtEERN6COMPANY,
EN7Z.
coNsuLTYNG ENGINEERS,
CIVL STFUCTURAL MECKWAL MACHHM
e PA 1810
609 H* ilt Mall All ntown,
am on
T/SLAS 7
T/SLAB L �+O'
E
office: 616/433-1634'i Fa x 610/433-1636
WATER.
+0
EL 0"
: ROJECT-:
P
SPLASH P 'OOL
- �7-
J
RELIMINAnv
so
The Cape, C6dde'r Re' id
i6"
''S
'WAVF,,--POOL'
T/SLAB EL'�' 3"
BARNSTABLE-COUNTY
1jS,'MASQ ACHUS__
HYANN ETTS
i�%i�i� 7'
DRAWN E JPL
DATE.
313
s onsibility.'i�;
Pony, Len tz",Engineering Co mpany ocCep ts, no re p
�t, 4: "i
f -thi
e o uction-o s
f r
for unauthorized use 0 -this �'docu rn en t.': R p�
XED BY:
CHEC
SAP'
SCALE,
AS NOTED
i prohibited with6 u t Ahe w ritten
drawing or,,any portion thereof. s
'7�
E eeri any.- On y,,, ina
consent of Pony i& :Lentz, ngin ng Cd rh p
T,
DESCRIP ION:
SECTIONS
t signe d and sealed b the Engineer Q
constructi ri,.,doturn n s
0 e Y,
are v
Record a
"i
SEr
-ION
n
priority. a e sc ed,� dirn 6 sioh s�
e dimensions shall, take r -
All w ritt n
DWG Wo.
P2
701,
Al� P1
tractor shall �be re po e r �,veri ying a ,oco lons,",,'i
he on nsibl Jo
T c
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vo d' ditions .'pri 6 :constrLic ion.
'el 6' tions, imensions an _con or, ,
REVISION 'NO:
SHEET- NO,
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h roct�r s h a 11 n'* 6''t i y Pcjhy,:& e n ornpany
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GENERAL SITE PLAN
I TYPICAL /��✓ lGQ
Scale V-40' RD, Post HINGE PLAIN
- SERVICE PEDESTAL - ` •
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�-o—t l 9 1 -•: I i :: /i�ushroon7 Cgps on foo ins •., 11. ` •
Fh1OI Nam/ Wi/1 not be Aceepfcsble •: •�� • " \
_ 3' 2 (Min) 3 - Z (M/n,) \
.�
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IT
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EATS ��r't_
•. NOT TO SCALE
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P tom•
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6nd ohrd
PA ' p Gearner Post
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wi// ne/ be Areeptc6/e •:I':• Ir
It••
ELEVATION A —A
' ELEVATKN B-B
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1
SERVICE PEDESTAL DETAILS
�/ I �C 4 8
"1TYPICAL CHAIN LINK FENCE,
3z'C-b0/4
NOT T0SCALE
/5 /f' Auto ll-arls orrn e r 114 G - 4 :5 to
5 arfer service Pede$/a/
loo a. Alkko'rmTYat,So-rr►.ar 1=uo4 r C►rcLk%� 16ra2ker 110aa SE P VICE PEDESTAL AL KEY LEGEND
w:.. 1004—n� dr�conJ?ccf
irahs�[�r SW,1}ch broakQ
r cah�er Ma 1Z,0 240Y 1 3W 100 3 P LE 6100 V. MAIN BREAKER
M ,/�
_ • eder. 5 MocI - �,`•• `,
k�
_ — — ' — — — — — — — B. 30 A., 2 POLE, 6010 V. TRANSFORMER 'BREAKER �/ _ ay
C- 3 a __ 13oa 1 c-3 3 C- g �4 /2 c-6 14- / G 4 8
/q
C. 7. 5 KVA DRY TYPE 'TRANSFORMERboa
nt A 1 a r hn
LD gleaa hf Iron -el?ce E , n ! Pr1I. D. 100 A. AUTOMATIC 'TRANSFER SWITCH / C /4 to.
d onf�c t Role -- �` K
2 3 JJ ,� Ser v/ce Pedestal
- G � 20a . Power FaClor /q .,.
# KVA. S+rIp NtY. E. LIGHTNING PROTECTION UNIT
/ G-¢ Z CorreC//O/7 r
z Ileoi e 1
9 a 1 Con r- M th � kr. _ 2oa Telat�,�at1-y
Ca a c tor' �X/ 5 l /J� q
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4 P _��, ..- 3 loo a. 1 I Pane/
-, 20a 1, o -L.cP � ,
h ' 1 — — — — — P 1 G. . GROUND LUG
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L/ G�tid 1� 1 20a Spare Tale`ma-4•ry
9. 9 - ,J
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L11/ „ _ Pam /r� 5fa yfarfer 4;, ,
// G 4 3 �° 9 I i 4oa I ,� �` . Du/oJ'�x ,Pece/o;�aGJ'e
¢ Tt1co. v4vc(ac¢ C
K G. Bay//I c I. ALARM PANEL 314 Ji -
C d #14
,r n TELEMETERING E UIIPMENT
_ � _ t4 J . Q
,J L* 1,trlh 3 C 4 blare co per 1 C 4 t
sed /n a 3 9 9 /q p g 1 a
Gp/7du/fs fa be erica ro�e�-tor 1rouhA wire to rguha h, ELECTRICAL R E V I S I 0 N S TO
v�rn st - ,
/ ncrele enve�4 ,e ram the 5Er'///Gt: 4�O V. zo 4 w. P P P K. STRIP HEATER ( 1510 WATTS )
f r,d
o a v/r5t g 0.� torn tncor�,m serV►ce i- 9
/08 1° 5 fa / f 9 I �4 C 4 3 L. TELEPHONE TERMINAIL NETWORK PUMPING '.STATION
the ea' e o >he ark/r> 1674 t r, —
94tav 3t� 4W —I C.4 3 +0 1% e- 3#C 14 II/ e ullta a f or �� u
/4 � � 4 � P . P
M. DUPLEX RECEPTACLE ( WEATHERPROOF ) Scale 3/8 a I I-
O
nh.¢t9ancy Sarv. �m soh. to ah¢,ra�or ` t¢Ico s¢rvtc¢
ELECTRICAL SITE PLAN P P 9
Se
a/t: 6e�,"
� _ N. 3/4 PLYWOOD BACKBOARD
Pe
/ate /(/-
•' Scale 1 -20,
/75Pe icafio� .
ONE LINE DIAGRAM
� an
ns
Afegen y
I, DRAWING N0.
SEWER SERVICE AND
S —
o ORIGINAL
�• F 0 IGI L F RAW N
TN _
� FULL SIZE .D I G 4
,. _ � ti �• � PING STATION `IMPROVEMENTS
: ; �2 DENIS Gv, t� oy
� PUMPING
�•
�, o rub, D REPRODUCTIONS MAY BE: REDUCED SIZE JOB No.
1, 1 y
AN & . HOWARp INC: ,
W H I T M o N - I �� . ��� -
REND DESROSIERS V •
o INN
,pNo.28t08 � APPROVED CONTRACT /do. T N
REGAL
_ No. 291 t 8 E D S HERA O
•s J
1,
ST a F
MASS. .._-
45 WILLIAM STREET,'ON jr
WELLESLEY, ES o` ,STc •.L._ ,
Sr0
E
!
DATE
DESIGNED DRAWN CKEDSCALE
--.....YANNISMASS.IoN CHEEfD d SHEET,REVISIONS O
t
FOTOB
,.
____.._.. — _ _ - .. ,3��..•• .� rid __ � _ x
EAM BROOKSIDE 267 24x36-
_