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Home My WebLink About0206 MAIN STREET (HYANNIS) - HAZMAT a�G(/lp ��2�11 �+ �3a� - i� � _ I��n �s Number Fee 1273 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Americas Best Value Inn -------------------------------------------------------------------------------------------------------------------------------- 206 Main Street, Hyannis, MA ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- Restrictions: -------------------------------------------------------------------------------------------------------------------------------------------------------------------• This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN, R.S.,CHO Director of Public Health r. Town of Barnstable Inspectional Services BARNSTABLE Public Health Division E.�1639-2.«n ....,_ MniSi0�i5 N'1L5•D;�YYILL•1?ST 9ANtISl:4&E 3639-2014 1 BAM 1 Thomas McKean Director � r 200 Main Street, Hyannis,MA 02601 `' ha.:r Office: 508-862-4644 Fax: 508-790-6304 C' 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 Rf K, CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ - � CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS i ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT:. Alm C1101 _ 5. NAME OF ESTABLISHMENT: ' " 'e nZ o qeS T V C. VL �,\ 6. ADDRESS OF ESTABLISHMENT: J 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: q6v-cc t Co� e 10. SOLEOWNER: YES LO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,ANJ�TELEPHONE#OF: CORPORATION NAME e J PRESIDENT ctn Ckc,-h TREASURER r m,-k!1 °1 CLERK � E hC,,X Ckaa 12. IF PREPARED B ,OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS L EMAIL: OLk)V%LovpcCSa IP °k(// f C SIGNATURE OF APPLICANT 4 DATE Q:Wpplication FormsWaz Mat Appli Draft Jan2019.docx IME rok1 Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ' a"aM��E. ' 200 Main Street• Hyannis, MA 02601 �'"�FD►u+e`er TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Aye �� r, 1 VAye, I'm Date: Location/Mailing Address: Contact Name/Phone: - M -5 Inventory Total mo n : ,°L5 SDS: �� e, P►' i (� Out License#: Tier II : IN Q Labelin4: r�- ; J Spill Plan: Oil/Water Separator: IVA Floor Drains: Emergency Numbers: Storage Areas/Tanks: o a C S Emergency/Containment E ui ment: (A151 wOr ` lb Waste Generator ID: Wa a Pro ct: AiIA Date&Amount of Last ShipmenVFrequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar;removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives{creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes — Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECO NDATIONS: S i :r S Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS `°FTC lok� Town of Barnstable . Office:508-862-4644 Public Health Division Fax:508-790-6304 E`"M�LE.$ 200 Main Street• Hyannis, MA 02601 t639. ♦0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT CFO MP'�s Business Name: &54 Date: 9 30 ! Location/Mailing Address: 206 MetivL %54- ariols Contact Name/Phone: j414vL - I_ Inventory Total Amount: 10-7-t 150 lb SDS: N° ' +v Ab &"" License#:� D C '1 Tier I[ : Labeling:*14V,,-1 Spill Plan: Oil/WaterSeparator: A Floor Drains: a Emergency Numbers: Storage Areas/Tanks: o 4k&� Emergency/Containment E ui a t: 1 Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: OW, ILIAC-&S w"k-e. 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 `t�a.t ��'�o Hydraulic fluid (including brake fluid) I 1WLindsbield wash X J k-eA�^�� Motor oils Miscellaneous Cdrrosives 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 la.a k' sw"N insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink �0( Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar k S,Jo x k l o Swimming pool chlorine Sp l� Paints, varnishes, stains, dyes x1�s Lye or caustic soda Lacquer thinners Miscellaneous Combustible $1q1 SV Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons —'� Laundry soil &stain removers 1S�X�� (including carbon tetrachloride) (including bleach)t,la 1 Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFO MATION/RECOMMENDATIONS: 0. -e-, Q�,�e-C��S 1�l-2K�Y�, 1S C v�C,c�• 5v w�14'Wi`T tkapector: —r, (_a-v2l I-2 YVJ� 1 Facility Representative: Lxs WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS `°Ft►+E r°,� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS . . 200 Main Street• Hyannis, MA 02601 1639. �'ArFDMP TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: N 4,1--(,16 OA,k V0.�., '-r,�.,� Date: >� 21 �Itt Location/Mailing Addressd�a,.ti �� vt�g Contact Name/Phone: �,,� Inventory Total Amount: toWL1 0 �b MSDS: /)o — 44A,v- License#:�A Tier II : o Labelina: OK Spill Plan:�— Oil/WaterSeparator: "' Floor Drains: A)o Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: MA Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: o.m, U74 kle cv, kAD LIST OF TOXIC AND HAZARDOUS MATERIALS a 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) 6 Windshield wash b Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil 11, Disinfectants t $ fi`f 3 Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages I Pesticides: �— Caulk/Grout/4�5i� 4 k 1 in 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 t1 k tSo Swimming pool chlorine Paints, varnishes, stains, dyes ti?-O Lye or caustic soda I Lacquer thinners I Z Miscellaneous Combustible 2 Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons S-3 Laundry soil &stain removers I (including carbon tetrachloride) (including bleach) 3 t t o Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS:& �VIS � n✓l�i f-e- ORDERS: A114k1,td d 2 a\Jy ,M5TJS oK44,e- INFORMATI N/RECOMMENDATIONS: a1A-t-5J(-g-0 ►^ aou--< a<L 1,L ,�' 1 / Inspector: , L,av�� - / 11 Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee - 1273 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Americas Best Value Inn 206 Main Street, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ----------------- -------------- ------------------------------------------------------------..---------------------------------------------------------- This license is granted.in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2020 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A. MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable t Inspectional Services BARNSTABLEs co-un� osjCxt urns.ew.u?•+_zun—. [ Public Health Division :��i ` C'/ 4 BARNSTABLE, ` Thomas McKean, DirectorKASS- 1639. fs 200 Main Street, Hyannis,MA 02601 -�t Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE t 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 .19 VS► �t�{ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? v YES NO. IF YES, SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: a& GkA" 5. NAME OF ESTABLISHMENT: Ame'rFzIc'-.� gc-54 Vet(vc- Tn n v 6. ADDRESS OF ESTABLISHMENT: Z66 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: y�- 8. TELEPHONE NUMBER OF ESTABLISHMENT: `I 9. EMAIL ADDRESS: �v1 c e u (�` 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: 06 SIGNATURE OF APPLICANT DATE Id-q �� Q:\Application Forms\Haz Mat App Revised 09-10-18.docx I Number Fee 1273 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Americas Best Value Inn 206 Main Street, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2019 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I� ram, Tow of B nsxable egiBatoryVerviceS Richard V. Scali, Director " THE r Public Health Division BARNS LE B.OFHSTMIE.fFM91YlLLF.[OiUR•NYM'ti15 (= BARNUMBLE. I Thomas McKean, Director 16 9 0 4�� - ,erFo9�---a`0 --------- _-- --2001v1aiii Street,-Hyannis,-MA 02601---- ----..-.---------- Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 f V.S , CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 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 QU VTITIEES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: �k atl 5. NAME OF ESTABLISHMENT: Aeloiea,5 lj e5'f V`,t l `e -T11`7 6. ADDRESS OF ESTABLISHMENT: _'�� /of`) 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS: 10. SOLEOWNER: YES_NO IF NO,NAME OF PARTNER: 1.1. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT �,,,� cka- , TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS �j EMAIL: d SIGNATURE OF APPLICANT DATE t( b Q:\Application FonnsUiAZMAT APP 2017 REVISE ocx Number Fee 1273 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Americas Best Value Inn 206 Main Street, Hyannis,MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. -------------------------------------------------------------------------------------- -------------------------------------------------------------------------- C� ------------------------------------------------------------------------------------------------------------------------------------------------------------ - ,- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2018 unless sooner suspended or revoked. .� --------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D._ 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Ll Director of Public Health aChe ' owril of Unstable J egu atory ervlces oFz T Richard V. Scah, Director Public Health Division BARNSTABLE .� ♦ enunsrneat••sxreae..e.cmummuris ' 9eBscs •$ Thomas McKean, Director 1639-2014 �) . tj i639• ArED MPS 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 WITHHE 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 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�- N`oll--FYES,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 (2 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 'jq 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: S. TELEPHONE NUMBER OF ESTABLISHMENT: 8 34-5 52 Z 9.. EMAIL ADDRESS: v e co .. .�...._. r"tic` ��cn1 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,ANJ) TELEPHONE # OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT TE fJ �Z0�� Q:\Application Forms\HAZMAT APP 2017 REVISED. c S. ti • - a w of B able t s egatory Services Richard V. Scali, Director �T►IE h. ` Public Health Division BARNSTABLE ` aaaysrnnie•cH+nevie.cmun•mnxrns �� . r Thomas McKean, Director 20• nns.. '°rFn 039. s``� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-'73-0-6304 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 I-PERNvf1T - 26- 110 Gallons: $ 5C•00--— -,Va.s CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 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 STORAGEIUSE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: lcok A U. � 5. NAME OF ESTABLISHMENT: �`Jl" qe5 — 6. ADDRESS OF ESTABLISHMENT: t,o� 0 a,� S� �� 60-1 r� ` 4- 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER,OF ESTABLISHMENT: 9. EMAIL ADDRESS: a V7 C ,0 C®� 10. SOLEOWNER: YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND-TELEPHONE#OF: CORPORATION NANA PRESIDENT u� TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:Wpplication Forms\HAZMAT APP 2017 REVISED.docx r Number Fee 1273 THE COMMONWEALTH OF MASSACHUSETTS $so.00 C3 Town of Barnstable Board of Health This is to Certify that Americas Best Value Inn 206 Main Street, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 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 7 Town of Barnstable �t►+E Regulatory Services Richard V. Scah,Director `" MASS.M " Public Health Division BAMSTABLE 1639. Thomas McKean,Director 1639-2014 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 A � . ANNUAL PERMIT(RUNS JULY 1 st—JUNE 3 Oth). APPLICATION FEES n� f CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 '��' CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: U', ( � NAME OF ESTABLISHMENT: Aw ADDRESS OFESTABLISHMENT: ZOb Ma.' ✓' ' �T � jGh 6 MAILING ADDRESS(IF DIFFERENT): 11 TELEPHONE NUMBER OF ESTABLISHMENT: (Svc) `I S` �2 ZS EMAIL ADDRESS: rA j�erC pie C�c� tr►.,a i I . r C2 SOLE OWNER: YES_NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME ,1 /�G "a�f '')' � W o r,nk A)t,4t k Z j PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIGNATU F APPL T Name: Company Address Telephone#: Email: Q:\Application Forms\HAZ,ZAPP Rev16.docx Page 1 of 2 Number Fee 1076 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that A+HARDWOOD FLOOR SOLUTIONS 206 Barnstable Road, 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 I Town of Barnstable • ��,,,, Regulatory Services ti Richard V. Scali, Director wuvsrABM _ BARNSTAB MAS& Public Health Division XX•��•mN�• 1639• `�� wnnnoxswu�s•os��nut•wsraux 1639-2014 IM1'•, Thomas McKean,Director �� 2 200 Maui Street, Hyannis,MA 0 601 Office: 508-862-4644 Fax: 508-790-66 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS DULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 �s A late charge of$10.00 will be assessed if payment is not received by July ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: &Y'A C,h C&kc) NAME OF ESTABLISHMENT:_ ��(� Flw 1 ADDRESS OF ESTABLISHMENT: ja no MAILING ADDRESS (IF DIFFERENT):TELEPHONE NUMBER OF.ESTABLISHM —7ENT: - I -7 EMAIL ADDRESS: I(l C CM SOLE OWNER: .V, YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT - TREASURER CLERK ., IF PREPARED BY OUTSIDE PARTY: SIGNATURE OF APrjWANT Name: Company Address Telephone#: Email: QApplication Forms\I-IAZZAPP Revl6.docx Page 1 of 2 t�J q\ Number Fee 1076 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that A+HARD WOOD FLOOR SOLUTIONS 206 Barnstable Road, 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 f PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health E Town of Barnstable r Regulatory Services Richard V. Sc4 Director PIASL Public Health Division 1 1� Ec °e Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.0.0 ASSESSORS MAP AND PARCEL NO. DATE 5 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT �NIVAA Za k r�a-v) r 4 NAME OF ESTABLISHMENT /4 y r oo`��a� ADDRESS OF ESTABLISHMENT 2-0�s 05o +ro s k6Lt- Uyli t i S TELEPHONE NUMBER SOLE OWNER: ✓YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. �1 '�"�G��/ZZ 2 STATE OF INCORPORATION '" `b'S<'4c Vu FULL NAME AND HOME ADDRESS OF: PRESIDENT C-mad 2aln LIV'A 0q. 1,,,rv1y0fk H/ 02U13 TREASURER am CLERK S9M� - ' SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS 'M Cn-wd Pj1 2sk "A HOME TELEPHONE# Mcache\Temporary lmemet Files\OLKD3U AZAPP Rev2015.DOC TOWN OF BARNSTABLE COMPIJANCE: CLASS: 1.Marine,Gas Stations,Repair 2. nters BOARD OF HEALTH satisfactory 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY ,fa.osa Les. / Sc (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Undergroiihd IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (13 Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply �$rTown Sewer 'OPublic O On-site OPrivate 3. Indoor Floor Drains YES—NO— O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO C' ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. 2z erson (s) Intervlew—ed Inspectbr Date TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: A/11NAME OF BUSINESS j Board of Health MAILING ADDRESS: Town of Barnstable TELEPHONE NUMBER: 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 V Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored.outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, ---V<aundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may pot 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 yl-.Yr..._... 1(1Y...-n -1..:ti`.r..s.-r-.. ...' m..n,."'KTwY-*-.a`e'a,+1-J^( n!1-r•.^ a„n..+-••'.YY" 'l-"..a'.'.sFr ..-�'+'^^'K'.?'T^.1.�'> rah�.. i-w•.w.+w"`�✓^r.+w:-..^^' ` TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager AIP vi r k A K, Address of Offender MV/MB Reg.# Village/State/Zip t � Business Name 00/'am/pm, on 100 r Business Address 206- At in J- : <� Signature 6f/Enforcing Officer Village/State/Zip (..) ('5 d 1 Location of Offense AI►ni--r,6, ,a a5 .e;4 V4 )V-t.. 4VI ## Enforcing Dept/Division Offense Di.. ,r'10)(4rix'_ /0 e 'i f� tom✓ • � vl .{ �lnrf`r r Facts <ti k)V AA*, S I-),�L Var�� rX t � l. evt� p ot�� to- 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 Offender/Manager All, s, - t,, Address of Offender MV/MB Reg.# Village/State/Zip Business Name :r w, - r Business Address i .,a ', - ;J I rn Signature of 'Enforcing Officer Village/State/Zip � t Location of Offense 1 1,. ! 1 4 Enforcing Dept/Division Offense r • , , . ,<. Jr� °� a �� . ,r � %r � < l - t ,Facts -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.