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HomeMy WebLinkAbout1470 IYANNOUGH ROAD - HAZMAT 7c) L�, C Number Fee 1204 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Best Western Cape Cod Hotel .-------------------------------------------------------------------------------------------------------------------------------- 1470 Iyannough Road, Hyannis, MA ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: .------------------------------------------------------------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health .r Town of Barnstable MA dRA Inspectional Services BARNS TABLE Public Health Division PFkx.TaB E•E1639-f•[O UR•kYRkN15 P IMiSttNIS x1L5.95'EMLL_%•?fSf B?Nt151A9LE Y' 1639`-]]3019 �0 1 BMWffr"LF. : Thomas McKean, Director 1639. i 200 Main Street, Hyannis,MA 02601 s C5 Office: 508-862-4644 Fax: 508-790-6304 f f 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 gLf ✓8r CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ I *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL?_J,/YES_NO. IF YES,SKIP QUESTION 3. • 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 341S pc),�e 5; NAME OF ESTABLISHMENT: MC k: w e-s�-C�rYI cuw Coo �-k o�eI 6. ADDRESS OF ESTABLISHMENT: 1 Li2 0 Z' tAWAnU�Jk\ OJ Qhh S . h'l� 01 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: S®S -11 1 ^ L,$b L 9. EMAILADDRESS: c�c�� c�� I�d�el tio3� v��' •cowl 10. SOLEOWNER: YES✓NO IF NO,NAME OF PARTNER: 4r ct � b 1 ha 1Z `t a 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK • 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: � /Z SIGNATURE OF APPLICANT DATE / / o Q:\Application Forms\Haz Mat Appli Draft Jan20l9.docx `°F�He rohti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BA MATq LE.g` 200 Main Street• Hyannis, MA 02601 '° =as9• TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rF0 MA'S Q Business Name: Date: Location/Mailing Address: 0 Contact Name/Phone: —7rL-A 2 Inventory Total Amount: � � CSDS: License#: voq C(4;° Tier II : I N Labeling: -''t Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: 44% Storage Areas/Tanks: v Emergency/Containment E u' ent: Waste Generator ID: Nni QWaste Product: Date&Amount of Last Shi ment/Fre uenc : IVIA Licensed Waste Hauler&Destination: Other Waste Disposal Methods: ;AA- 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 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 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 V 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: Inspector: Facility Representative: yea WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS AKE T° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 Y BA BMAR .g' 200 Main Street• Hyannis, MA 02601 �p t639.s�0 'FOMP+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: &-sf w2s+Zfn. Date: S Z Location/Mailing Address: I a h o ;1 h 15 Contact Name/Phone: Ta, Inventory Total 4mount: �' «� c+l SDS: A. o�..`� License#: l2o4 CA+2 Tier II : ° Labeling: QSpill Plan: J-- 6tt Oil/Water Separator: f1i I Floor Drains: ° Emergency Numbers: Storage Areas/Tanks: hJa aw '� a� b���•-�S Emer enc /Containment E ui ment: Waste Generator ID: NIA Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: A%/7(, kk S`ju.AA4- Yovq\yA 4J Qo. 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 1;4L Other cleaning solvents&spot removers t0 Engine and radiator flushes Bug and tar removers S�e-f �'L.5Ae Hydraulic fluid (including brake fluid) Windshield wash 41 LA Motor oils t Miscellaneous Corrosives cl-eAw-ve Gasoline,jet fuel, aviation gas Cesspool cleaners 45'^415- Diesel fuel, kerosene, #2 heating oil Vb Disinfectants ?""- c uc--' Miscellaneous petroleum products: Road salts JvA`%A grease, lubricants, gear oil Refrigerants Degreasers for engines&garages 1 Pesticides: 1 Caulk/Grout s.-y j, I.r t 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 ;a,yea-�`'�� 0- Swimming pool chlorine �q Paints, varnishes, stains, dyes Lye or caustic soda I Lacquer thinners I 'L Miscellaneous Combustible k+ 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) 1-00 kti Any other products with "poison labels" 111,J- 5a`� 101b ti �I (including chloroform, formaldehyde, I �Sy hydrochloric acid, other acids) VIOLATIONS: O ERS: a,v, IN ORMATION/REC MM NDATIONS: 2 v ( W15 Inspecto r--1-1- 4v4. l ZY Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS °F IKE*o Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"" ��E. M ' 200 Main Street• Hyannis, MA 02601 v�0rEs639.la�O� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: Location/Mailing Address: 14 o T a riv.e a ri>^ t Contact Name/Phone: 'TOO-7 1 -14 So(-+ `may Inventory Total Amount: ""`� � MSDS: yG5 - S�% o Sys License#: 1 Z o4 Tier II : N b Labelina: Spill Plan: /,L {b b� Oil/WaterSeparator: t Floor Drains: a Emergency Numbers: Storage Areas/Tanks: kt .,--vw— o kk -,l ,5 fie. Emergency/Containment ui ment: rl-i 5 ive Waste Generator ID: MIJA Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: M\5 c. � o k� 5-}-z ��►ti� 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 CAtt`-�"V 4 Automatic transmission fluid I p Other cleaning solvents&spot removers,,,,fh Engine and radiator flushes Bug and tar removers e- Hydraulic fluid (including brake fluid) Windshield wash cl�auct 3 Motor oils Ib Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners -1'3 wvVAaJ "v-e- Diesel fuel, kerosene, #2 heating oil {. Disinfectants C- V%&tS-X 3� f Miscellaneous petroleum products: l Road salts lso lb grease, lubricants, gear oil Refrigerants Degreasers for engines&garages I Pesticides: Caulk/Grout I V%5 insecticides, herbicides, rodenticides, _ n Battery acid (electrolyte)/batteries Photochemicals(Fixers) �tA,51�`" Rustproofers Photochemicals(Developer) (ox Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creo te))Asphalt&roofing tar x2! Swimming pool chlorine � �� 'r�" ALA Paints, varnishes, stains, dyes� kb Lye or caustic soda `"e, � Lacquer thinners el, X�� Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes „r \v Miscellaneous Flammables Wood Qa�`'�Y Fertilizers ke�"'"`'� Floor&furniture strippers �oo�,,.c��`"� PCB's Metal polishes wgAu Other chlorinated hydrocarbons Laundry soil &stain removersJ�ly (including carbon tetrachloride) (including bleach) � �p k�5 Any other products with "poison labels" kk�" (including chloroform, formaldehyde, vvkqj hydrochloric acid, other acids) VIOLATIONS: C-e A5t-\S Qx Dal e ORDERS: 2 pfj 2 Ivk INFORMATION/RECOMMENDATIONS: •2 Q.t.& wk 1/� Inspector:` L •�<<�Q��9 k "n7 A&y Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS I THE*owe Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BA MART LE. MASS. ` 200 Main Street• Hyannis, MA 02601 '6 39 RFD s TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT MPS Business Name: Qv0,-1 J 7X7,-,, _ Date: 2 / Location/Mailing Address: o _L ,ti 4*t Contact Name/Phone: a� 1 Inventory �. Total Amount: ti 1 � MSDS: 651 f eoYa License# �� (Z Tier II : tb( Labeling: tt�, Spill Plan: �fl Oil/WaterSeparator. ►J � Floor Drains: N Emergency Numbers: `1' �+ Storage Areas/Tanks: t�ewe-—�'Q Tti�g , o n�rl.a�ti t, �a k �� S a al 14v Emergency/Containment Equipment: Waste Generator ID: Waste Product: M Sr- 1a, bX Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destinati n: Other Waste Disposal Methods: Z k S c° \Aw-�'W&e . 7 0,5 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 �hZ Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash a�oxk\`G Motor oils 0 Miscellaneous Corrosives '`lal 40 Gasoline,jet fuel, aviation gas Cesspool cleaners Z I L Diesel fuel kerosene, #2 heating se ea g oil Disinfectants A.1 Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: —� Caulk/Grout/aOA-l1V,* insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) o��k-e. Asphalt&roofing tar / �� Swimming pool chlorine 12,%�010�y Q° Paints, varnishes, stains, dyes 30 ? Lye or caustic soda d3 4,1 rs Lacquer thinners 3 Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers 32-4r7 Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach a�g,cb<,(, k o (' g ) ,o Any other products with "poison labels" 50�\e� (including chloroform, formaldehyde, � hydrochloric acid, other acids) VIOLATIONS: ORDERS: n INFORMATION/RECOMMENDATION avJ 5&A 4-4 o_- v Lb� -e v �JIZ.( vw<:' C G �• ilk �a•.,k po5k• ���r�.�C ��¢.utiS.�-- �Q Inspector: ���„r -i Facill Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS ­61&y TOWN OF BARNSTABLE BAR V Ordinance or Regulation y WARNING -NOTICE, _ Name of Offender/Manager — % r�.`� `t » Address o'f`xOffender MV/MB Reg.# Village/State,/Zip Business Namea't jK�jl l/,rf�`am�%pm; .Wonif I 20 } ,w. f 1 r• — Business Address �1.r j VI4h. �� 1��i�.; y;" �`"� ;` ��� '' Signature of,iEnfor-cng 'Officer , Village/State/zip Location of Offense (. `/ ..r- ►i ; . j 1 % 'Enforcing Dept/Division. ' Offense 1 t ? '�`r�.� ,'> ,''iJ °cif L( .: �A. i�d�!r3�s; i'?r �' Fffc, F`�, {� .f.l ka I �!4'�'?9G[✓ lr 1 ttTy• 4 +4. A, , 3 acts �,>t' .�' i r (,�}/{ �. .,� 1/ JY4 �t Y e This will serve only as a warning. �At 'this time no legal action has' been taken3`° It is thq .e goal of Town agencies to. , achicive., voluntary compliance.=. of yTown� Ordinances', .Rules and Regulations. Educat�i-on,. efforts and. warning notices. arerst .; attempts to ' .gain voluntary compliance, -�, S'ubsequent violations: will result 'in; appropriate . legdl: action by the Town WHITE OFFENDER CANARY ORD./REG PROG PINK ENFORCING OFFICER GOLD.-.ENFORCING DEPT , TOWN OF BARNSTABLE BAR-W 711 E?. Ordinance or Regulation WARNING NOTICE Name of Offender/Manager - � Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on '' 20_ Business Address V Signature of Enforcing Officer Village/State/Zip Location of Offense 4 � .. ►' ;w �r' Enforcing Dept/Division Offense T f + ! Facts ' 1 . ,t ' S i t ' This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. F IKE 1 Town of Barnstable Office:508-862-4644 `o Wr, Public Health Division Fax:508-790-6304 BARN STABLE,`E� 200 Main Street•Hyannis, MA 02601 1639. �0 FOMA+° TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: or hv. Date: 7 �� Location/Mailing Address: 1470 Contact Name/Phone: Coa<r 1 -7-7(—` SQ0 N tt 14 VA-V ovu AA,1 . A►•��es-►Kfjo� Mw . Inventory Total Amount: " lye t kltV�5 MSDS: h4n&j v�ellciense#:AV $� Tier II : o Labeling: OK Spill Plan: e U�i Oil/WaterSeparator: D Floor Drains: Emergency Numbers: Storage Areas/7anks: �V A)QXe5 G4D� -� •�- ,I`�a�W'C�nOuM�- Emer enc /Containment Equipment: Waste Generator ID: 1A Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: U`K- k2&( 4 Pm-yo—celke ,,oy. Xc,y a. 47%,-�v.6 . - 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: _t CauIk/Grout/`a � a� s 1-0(v-S 0 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,S's ga Paints, varnishes, stains, dyes Lye or caustic soda / Lacquer thinners 5 Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons 0 Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATON/RECOM ENDATIONS: ,(t4poU o-kW 6Z Ai\, e—(k1 % JS2 a tb Ao t�-V 2y — Inspector: I ,l I No C1 oc�-s5 gr -�'� ►�� o 7 �vkoc .!;p } Facility Representative: ("A N o Q�tgmk,k c �j�,c � 1� WHITE COPY-HEALTH DEPARTMENT/GRANARY COPY-BUSINESS Date: �1 / �3 / 13 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: ('o►�. 'o<a- BUSINESS LOCATION: INVENTORY MAILING ADDRESS: SkAi,, TOTAL AMOUNT: TELEPHONE NUMBER: ,��g_- 771 - 48D`f 16 2— 5w/lon.s CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: ge40-1 wrR- g6,01 INFORMATION / RECOMMENDATI NS: ') �IE a6 �x, �a�*eQo�s Fire District: c,niknibm �- S t'Ce a k vI S C�N►��-a � �0 3� Qt^c l ► p a vlo l M 5 f tivJ r—,,-�--�nL S /w or tit 'i e►1 wV�ASS o evw�toy Ge.S Waste Transportation: A Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No . NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. g p g � 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) I q Miscellaneous Corrosive /a 1%1+ 75-Ib ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene,#2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED ro Degreasers for engines and metal Printing ink t22��yGW � a Degreasers for driveways&garages Wood preservatives (creosote) o Caulk/Grout Swimming pool chlorine C�2w Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers ������ V Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Mist 3WjyK%4jkj pool T&41 A2S /KGIVaQI►,•j ; Laundry soil &stain removers �O ( � c,�including bleach) 'fSy a.� Y�/b ""�� pp � Q,cke,C5 i r0bf j L&L fey►to%kc5 - Z 44 Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS A plicant's Slignatbre Staff's Initials Number Fee 1204 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Best Western Cape Cod Hotel 1470Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons of Hazardous Materials. ---------------------------- --------------------------------------------------------------------------- ---- - ------------------------------------------ ------------------------------------------------------------------------------------------------------ -------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2020 unless sooner suspended or revoked. --------------------------------------- Y PAUL J.CANNIFF, D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health Town of Barnstablet Inspectional Services BABSTABLE FSNE Tn. �wsrne:=•�+�-s:L•^wrr•.nexxr �_.-, Public Health Division " "f3=5 �0< NSTABLE,MASS- p� Thomas McKean, Director _OArEo �A 200 Main Street, Hyannis,MA 02601 : Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 N:VS((H,,he--,j- CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ i 9-4�3 *A late charize of$10.00 will be assessed if payment is not rreeccei`ved by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. pC / 7 w ©/ 2. IS THIS A PERMIT RENEWAL? V YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD• QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: J G�3 �Aje.� 5. NAME OF ESTABLISHMENT: &-�y �J Q S�(y n C J 6. ADDRESS OF ESTABLISHMENT: 0 ! D ^1 i�-no OT60I 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: s O S -I-j ) L a Ll 9. EMAILADDRESS: Ct� Odf noel'. o GI -K 10. SOLEOWNER: YES Ue1 O IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDIkE S,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE G I R D • Q:Wpplication Forms\Haz Mat App Revised 09-10-18.do x Number Fee 1204 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that Best Western (formerly "Quality Inn") 1470Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ------------------------------------------I------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 `larch re- 31 ow of B nstable egulatorySemces Richard V. Scah, Director Public Health Division BARNSTABLE •A &1FNSTA2LE.CEMERVIl1F.fdfIRTNVANNIS BARNSPABL% ' Thomas McKean, Director ""ss�5"'p i a o;" S A " 4 --200 Main Stireet-,Hyaruiis�MA-02601--- - -- .. - -...-- - - 77— ;q ----- --- - Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE CAD HAZARDOUS MATERIALS yea, Uri IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-NNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 x I/'.S CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO 2. IS THIS A PERMIT RENEWAL? -L S YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? ✓YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: w c S y ey�) cu p e 6. ADDRESS OF ESTABLISHMENT: l o ��u1�1 OLt��-,— G�1�1 i S . ��1� ^ d 26 o r -7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: S 0 9. EMAIL ADDRESS: Cca�� Co�1�o�C1 do.l, gl�n�i�•cnyn 10. SOLEOWNER: YES _\,!!�NO IF NO,NAME OF PARTNER: C;�-Gyv 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME C t4 (3-e C d J H of e-1 , L1 C 21 of t� Pc41�+Kq ,F L- PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q\Application Forms\HAZMAT APP 2017 REVISED.doc Number Fee 1204 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to,Certify that Best Western (formerly "Quality Inn") 1470Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. 61 -------------------------------------------------------------------------------------------------------------- ---------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------- 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. ---------------------------- ---------- A\ PAUL J.CANNIFF,D.M.D,CHAIRMAN CZ C DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r0 _jk� co ' owr>�of Unstable egu atory ervlces o`T r Richard V. Scah, Director MAA.fti� Public Health Division BARM kBLE ♦ MANSiU SUN"S•CS0.�aiii':COWESIBARI—i.X • � 8 Thomas McKean, Director lb35 44 200 Main Street, Hyannis, MA 02601 -j Office: 508-862-4644 Fax: 50f'790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS +' IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHASTER 108, HAZARDOUS MATERIALS, ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st-JUNE 30th). � 2 a b�g 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 ❑ U *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? ✓YES_NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: LX cu 10 P o c l R p�e( LLC. 6. ADDRESS OF ESTABLISHMENT: o 110�0\4511 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBEWOFESTTABLISHMENT: S 0 6 9. EMAIL ADDRESS: Ct-kpP1Jb01d00AIj ,� txl�• �O�('� 10. SOLEOWNER: YES %AO IF NO,NAME OF PARTNER: G���( � 'q -il 11. FULL NAME,HOME ADDRESS,AND TE PHONE# OF: CORPORATION NAME CCA pe L r PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT WfAt DATE Q:\Application ForrnMAZMAT APP 2017 REVISED oc,, Number Fee 1204 THE COMMONWEALTH OF MASSACHUSETTS $125.00 ;? Town of Barnstable _. Board of Health Q This is to Certify that Quality Inn (Formerly "Comfort Inn") 1470 Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I , Town of Barnstable WE ro Regulatory Services 0 µ Richard V. Scali, Director * B-. Y Public Health Division BARNSTABLE MASS. .115 1639. �0� A In _1 0 SBRSTAUM LS��gS111111E*W�STWIST- HIED Mp`l A 39- Thomas McKean, Director 5D65 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304,E W APPLICATION FORTEIRMIT TO STORE AND/OR UTILIZE a' HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS, ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st JUNE 3Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 l M CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late charge of$10.00 will be assessed if payment is not received b • ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: C� NAME OF ESTABLISHMENT: (CtOf CO3 LC� ADDRESS OF ESTABLISHMENT: d IJ yh\i MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: 90 EMAIL ADDRESS: _Cf.�c�e.CocJ� h01e� Du3 (�i `�Mc�il• C�t"1 SOLE OWNER: YES__,,K'O IF NO,NAME OF PARTNER: C\q u FULL NAME,HOME ADDRESS,AND TEL PHONE# OF:CORPORATION NAME Cs, e- e o �- 0 W Q 1 L L C 20 t-i 1 S� S�rf p f PRESIDENT t�u1G�l<�.T L 39-11' TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: ® SIGNATUVE Q9 PLICANT Name: Company Address : Telephone #: Email: Q\Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 Number Fee 1204 THE COMMONWEALTH OF MASSACHUSETTS $125.00 — Town of Barnstable Board of Health This is to Certify that Quality Inn (Formerly Comfort Inn 1470Iyannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. --------------------------------------------------------------------------------------------------- ----------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 02/22/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable °FIVE loy, Regulatory Services Richard V. Scali, Director MASS. Public Health Division BARNSTABLE MASS. � 9Qj 1639. �0� md"a°+srosBws`"osEaLv`. `vi�Tiau—iras ° Thomas McKean, Director 16575 !.; 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 �.. q APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ✓`"1 •L CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late charge of$10.00 will be assessed if payment is not received by July 1st. ` • ASSESSORS MAP AND PARCEL NO. DATE 2 ' �' '1 6 FULL NAME OF APPLICANT: U N Y1 h to NAME OF ESTABLISHMENT: Q 11 U i 1 T OV1 C e h 4\ til ur^P C.c-i P e Co kot c\ LL.0 ADDRESS OF ESTABLISHMENT: k Lk10 I`I GV1V1ou h PJ. N`i c-rl)WS. M — 02-6 01 MAILING ADDRESS (IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: SO 9 T 7 I - LI goo EMAIL ADDRESS: Cu 1'C. Caj 1-yo oO3 (@ 3 fYlet l l•C o M SOLE OWNER: YES_✓NO IF NO,NAME OF PARTNER: f DI 1%4V-, Sc-iVN FULL NAME,HOME ADDRESS,AND TELEPHONE #OF: CORPORATION NAME Cy k3@ c of M u�e\ LAC' 2 of M 1 S� S+Ye Q+-1PG 1 u i-y_,' FL- PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIGNA U F APPLICANT Name: Company Address Telephone#: Email: Q\Application Forms\HAZZAPP Revl6.docx Page 1 of 2 r Town of Barnstable Office: 508-862-4644 Regulatory Services Department Fax: 508-790-6304 entuvrrn8t E Public Health Division M Thomas A.McKean,CHO ib 200 Main Street, Hyannis, MA 02601 Payment Receipt iHazardous Materials Payment received: $125.00 (Check) on 2/22/2016 I , Check number: 1117 Check amount: $125.00 Name on check: Cape.Cod Hotel, LLC 113usiness: Quality Inn Owner: CAPE COD HOTEL LLC !Address: 1470 IYANNOUGH ROAD/RTE132, Barnstable Note: Category II i _.---------- ---------- -----_-..-. --- - -- TOWN OF BARNSTABLE BAR-w 4533 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip ) Business Name �hi ' ' � v�v�_ �' r� (aim//pm, on 20 i Business Address 14-70 �—T�41V VAIO J41A --'� / Signature .of,,Enforcing Officer Village/State/Zip f +IVAyil'3 , rt 1 f ( ) Location of Offense Enforcing Dept/Division Offense �I , V<%e.. 4v n�-J 5Vr1 � � �r��5 �' a 1�C vt -e. ►r�( CC r� �%✓tC r,�i Facts .L.�{�K s �� 1 .�. e.. C:- are' i') j- ,44V This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Of f ender/Manager cam.;r r'f t ,•f' w- Address of Offender MV/MB Reg.# Village/State/Zip Business Name VN_ *- am/pm, on j 20 ff Business Address r Signature .of ,Enforcing�Officer Village/State/zip �,f Location of Offense „k, Enforcing Dept/Division Offense .. i , tl: �. }� .tYL �7 : = t , $`�.+ 1r.4 - + � .. :jr '. .,i15., f!� ! Ilex Facts ! of 1 3 kea. 1 �� f t �� r } �1. f .39 k Aj f ( I This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. Ly Number Fee 154 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Town of Barnstable-Hyannis Golf Course/Clubhouse 1840Iyannough 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. 06/30/2016 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health i ..f • Town of Barnstable oFt toy Regulatory Services Richard V. Scah, Director STABLE. BARNSTABLE M r Public Health Division 1639. ♦0 ui'3i i s wus o is uE�Qriii n"ia"m se '°lEowu+° Thomas McKean,Director 1639 201° 200 Main Street,Hyannis,MA 02601 +� Office: 508-862-4644 Fax: 508-790-630W APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS FE& do I(- Hyo IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ - A late charize of$10.00 will be assessed if vayment is not received by JuIv1st. ASSESSORS MAP AND PARCEL NO.. a 5y 016 DATE 3 a FULL NAME OF APPLICANT: /yw 0155 �-e- NAME OF ESTABLISHMENT: 6;01 Cou. Cv- ADDRESS OF ESTABLISHMENT: 490 _L •"67 ol.. 1. 4a � C-bn&4 MAILING ADDRESS(IF DIFFERENT): 6 �O �� �c �S �S �/� (� rq'q-oc- c q 0 TELEPHONE NUMBER OF ESTABLISHMENT: EMAIL ADDRESS: I C� ✓� ��✓` w7<<vt •"'' � 'c^ S SOLE OWNER: YES—NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SI A OF A P C Name:. Company Address : Telephone#: Email: C:\Temp\HAZZAPP Rev 16.docx Page 1 of 2 TOi1N OF BARNSTABLE /� � VA J 1 J�UNDERGROUND FUEL 24 ''CHEMICAL STORAGE SYSTEMS �/� AG� ASSESS ORS MAP N0. 5!3 PARCEL NO. O1 -HQO_ (�1 A � ADDRESS:1471 Rt 132 VILLAGE" Hyannis NAME'-- Frannk-R- -R.--t!athPri nP Mc Donough CONTACT PERSON Frank Md Donough PHONE NUMBEJJJ62-3217 LOCATION OF TANKS:. CAPACITY: TYPE OF FUEL AGE: TYPE: LEAK CAL® OR CHEMICAL: DETECTION Rainbow Motel (Near Room 10) SYSTEM' �q �AJFo \SEI1 DATE OF PURCHASE.OF. EACH: 1 1976 2. 3. .4. 5. - - DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS "PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. "- , 1 ��-- ��� � � " ? ' OWN OF BARNSTABLE - U DERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INSTALLER INFORMATION ADDRESS: T%W I4 Rt'132 MAP NO. PARCEL .253-01 Fj FrankR i�4thekne Mcdonvugh - j v£I e, r OWNER NAME: n 4, VILLAGE: r;-�, U nk INSTALLATION DATE: BY: ADDRESS: CERT. NO. TANK INFORMATION ���%'� ~ ✓� I' LOCATION OF TANK Presidential -otX1 ( eld Uf Building, Near Room7) I n� CAPACITY �000 GalSTYPE S 1 4A`GEA9Wt1` FUEL/CHEM'IC;AL �o z - 'r TESTING CERTIFICATION C I PASS C I FAIL. DATE''very Fall After 3Q in,> We rill Tank And Check In �,P LEAK DETECTION C I CHECK IF N/A TYRE/BRAND ZONE OF CONTRIBUTION CX] YES C ] NO DATE TO BE REMOVED T11Cj6L /h ---- FIRE DEPT. PERMIT ISSUED C I YES C ] NO DATE if CONSERVATION C ] CHECK IF N/A DATE J, 1 BOARD OF HEALTH ITAG, NO.-Cn�Z ]C ]C ]C J DATE PLEASE. PROVIDE .A, SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD �� J"�'� �• -� ��� TOWN OF BARNSTABLE ypf THE t0 OFFICE OF DARESTAM STREET BOARD OF HEALTH nJ i i (� rnet. 367 MAIN y / 0M HYANNIS, MASS. 02601 � �`I k• � I October 13 , 1988 �) Presidential Motel Frank & Catherine McDonough 1555 Route 132 Hyannis , MA 02601 Re: Underground Fuel Tank, Assessor's Map & Parcel #253-016 Dear Mr. & Mrs . McDonough: Our records indicate that you have a 1000 gallon underground storage tank on the above stated property. Due to the unknown age of the tank we must presume that it is twenty years old and the tank must be removed because of it's age and the fact that it is located within a critical zone of contribution to public water supply wells . You are directed to have this tank removed by April 13 , 1 n610 � fIr �+ obt In a removal permit from tl)e V�'i l� • Ycia lII CAU 11 :., 4'" v CAL Centerville-Osterville-Marstons Mills Fire Department . I have enclosed tank removal information for you. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7 ) days of receipt of this notice. Please be advised that failure to comply with an order could result in a fine of not more than $200 . Each separate day' s failure to comply with an order shall constitute a separate violation. Please attach the enclosed brass valve tag to the fill pipe of the underground tank until the tank is removed . After the removal , you are required to return -the brass valve tag to the Health Department. PER ORDER OF HE BOARD OF HEALTH rib-nas A. McKean - Director of Public Health cc : Chief John Farrington, C-O-MM Fire Department { TOWN-OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers' satisfactory r BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY Y&wdM SA (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous ANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots 1Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply ` O Town Sewer ublic - n-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank: MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter N�me of Hauler Destination Waste Product YES NO 1. 2. gk 4� Pe on (s) Verviewed Inspect r Date �4 TOXIC"AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: �o Board of Health MAILING ADDRESS: &20 R4 /3a Town of Barnstable TELEPHONE NUMBER: ­2 — Z) Ly P.O. Box 534 .-CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO_ This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store:-" Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants -- Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers /f�f Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's _Z Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes. (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy-Health Department/ Canary Copy-Business