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0020 RIDGEWOOD AVENUE - HAZMAT
�� �,r � � ����� _ ti �.\�. ���. I INE T° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 Y BARMA�,q_ ` 200 Main Street• Hyannis, MA 02601 �p f6M " TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rfD MAC Business Name: FrI, ti Date: Location/Mailing Address: i w '0 Contact Name/Phone: c5 Inventory Total Amount: 0 MSDS: License#: Tier Il : NO M Labeling: e ��S Spill Plan: Oi[/Water Separator: IVA Fl9or Drains: Jn\J Emergency Numbers: -00 Storage Areas/Tanks: L. , .Ai b. , a a.�l`h� nit Emergency/Containment E ui ment: _ ► Waste Generator ID: &AJ0 VQqJ4JyWaste ro uct: l mi_ Date&Amount of Last Shipment/Frequency: a® os Licensed Waste Hauler&Destination: "400QWon 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. V 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 V Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants kf Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides — V Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: nD rubminuhmd Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY BUSINESS • • ,r Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Prime Chevrolet Hyannis ..........................................•..........-----..........----...------------......------------------------......------ 20 Ridgewood Ave, Hyannis, MA .-------------------------------------------------------------------------------------------•-----...------............------------........----------------------------- Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------- ------------------------------------------------------------------------------------------------------------------------------------------------------ Restrictions: This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health r Town of Barnstable Inspectional Services BARNSTABLE Public Health Division •�H9F.`�...HHL, fMi$lOH5 H:LL5.�S:F.M1ViIL•.'tFR B?WVSih 63- &E 16392014 eAnxsrasrF. = Thomas McKean, Director ' 059. ►`� 200 Main Street, Hyannis,MA 02601 L� ram' Office: 508-862-4644 Fax: 508-790-16304 X. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE 9113 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` ❑l CATEGORY 3 PERMIT 500 or more Gallons: $150.00 E2 &Vw-O�0-? d Ch K- *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: L>7 Ilk A#fg&7-725- 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT:- 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: '70 �--7 7 9. EMAIL ADDRESS: .)V+k A-E&175a ve, ke p^-L 10. SOLEOWNER: e---'YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD SS,AND TELEPHONE#OF: CORPORATION NAME r1i. ►z��v `e L 2. PRESIDENT '7—,91)b TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICAN DATE & zoz® Q:Wpplication Forms\Haz Mat Appli Draft Jan2019.docx Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Prime Chevrolet & Subaru 20 Ridgewood Ave, 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,CHAIRMAN DONALD A.GUADAGNOLI, M.D. 07/01/2019 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health o + Town of Barnstable Inspectional Services OF tME MiNSTABLE Public Health Division 167;-2G I BAMRrABLE, 47�, MASS. Thomas McKean, Director :MOD 1639. 1�� 011 200 Main Street, Hyannis, MA 02601 P-0 Office: 508-862-4644 Fax: 508-790-6304 Q ,40 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE 63 HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS, ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY I st—JUNE 3)Oth). APPLICATION FEES CATEGORY IPERMIT 26- 11OGallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 El CATEGORY 3 PERMIT 500 or more Gallons: $150.00 x *A late charge of$10.00 will be assessed if payment is not received by July 1st. *40914 1. ASSESSOR'S MAP AND PARCEL NO. Z-2- 4-Zq. 9dz&V a Oa f 2. IS THIS A PERMIT RENEWAL? 1.,-** YES T 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:eprr",e- eAeoto Lt 6— 5. NAME OF ESTABLISHMENT:"Z7 e, c/-5t,., �&., 6. ADDRESS OF ESTABLISHMENT: ota 2�- Z51 ;ft-extjoodaPe�-, 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. EMAIL ADDRESS:17�nyn&C-4)d Aglefa ojgtc -Pn r1•r- 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME, HOME ADDRESS, AND TELEP1jQNE # OF: CORPORATION NAME—k& 159 PRESIDENT TREASURER CLERK 12. IF PREP,�JIED BY OUTSIDE P RTY: NAME .4)CA-- hr ex4e TELEPHONE 7 COMPANY AffliRESS EMAIL: • * GNAT'pn OF APPLICANT DATE Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Beard Motor Inc. 20 Ridgewood Ave, 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 ' towui of Unstable eg atory emces Richard V. Scali, Director ' SHE Tn Public Health Division BARNSTABLE • : BARNMBMi e4Reisae •rrrrte�hue•omrtr•wanmis Thomas McKean, Director """Mn.1�'°SEw '��T 9 BUS& p 1639-2014 --200 Main-Street,-Hya=--S�1VIA-02G01- - --- - ------ - �77�- ------- ---- - 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 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 x 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. 39 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: l�. 1C.r,, -ae�rd Cheuro Lt. I S UbcLrL1 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: 010 N a"=Ct C. Lw-- [�u a A ' 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:8. TELEPHONE NUMBER OF ESTABLISHMENT: L50O ) 11 S 9. EMAIL ADDRESS: 1j AAA C best rp n c t in • C 0+y'- 10. SOLEOWNER: VIYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME tY1 iS e r f�i PRESIDENT TREASURER CLERK r 12. IF PREPARED BY OUTSIDE PARTY: NAME TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE C� Q:\App(ication Forms\HAZMAT APP 2017 REVISED.docx T Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Beard Motor Inc. 20 Ridgewood Ave, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. ------------------------------------------------------------ --------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 unless sooner suspended or revoked. ---------------------------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health TRow1 of Barnstable C�/!�7 4 1-56.� egu atory ervices ��K�ET Richard V. Scali,Director Public Health Division BABSTABLE t 8ARx5(A6Ik••�xi[RY1LLE•0.7-HY—js • �A$ . • Thomas McKean,Duector xgSJSb 51 J'9a 2014Yr35 eaerra0t �L6 3�a`0� 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 DULY 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 Z y S . *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? t'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. c71-fo� 1 c'� 4. FULL NAME OF APPLICANT: r�i G�- ��G\ ��CA UQ z 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: c3 ' 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: S� $ 7 �'`1 3 9. EMAIL ADDRESS: 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME b e� /vkm�� M„ k ,/o l La kt�s itl e�� � �,`� 8 o a\S7 PRESIDENT r-5 TREASURER �'—e Ac YijQaK� CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: / SIGNATURE OF APPLICANT DATE 6A7/ f Q:\Application Forms\HAZMAT APP 2017 REVISED. x Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that DICK BEARD CHEVROLET 22 Ridgewod Ave, 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 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable � ti P� THE 1p Regulatory Services Richard V. Scali, Director ' '" MAS& Public Health Division A'Eo raa't' 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. 3Z,2 o V DATE J� 2 / APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN II I GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT AD &7r5 NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT U _ Y Pa TELEPHONE NUMBER `7 7 SOLE OWNER: YES NO rn IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. jQ V2 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: / PRESIDENT TREASURER '� z CLERK k v GNA E OF.APPLICANT RESTRICTIONS: HOME ADDRESS iv 1 L e5je OA f'6I-sI- HOME TELEPHONE# OZ/Y Q:W.pplication FormsUiAZAPP.DOC r v Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Beard Motor Inc. 22 Ridgewod Ave-P.O.Box459, 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 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health GV Town of Barnstable ofIME Regulatory Services } Thomas F. GeRer,Director } MASS . Public Health Division �. 13� Thomas McKean,Director 200 Main Strut, Hyannis, MA 02601 Offica: 508-862-4644 Fax: 508-790-6304 Applicaticn Fee: $100.00 ASSESSORS ASAP AND PARCEL NO.. ,)A DATE APPLICATION FOR PERMIT TO STORE AND/OR UTE= MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT `•'04/1" ���lQ✓ 4�� �j Y-ANSE OF ESTA37ISIB= N ADDRESS OF ESTABLISI fT',NT TELEPHONE NUAMR SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOMI ADDRESS OF ALL PARTNERS: LF APPLICANT IS A CORPORATION: FEDERAL IDEl`tTIFICATION NO. j�2a0 STATE OF INCORPORATION FULL NAME AND HOME ADD SS OF: / / n PRESID ENT iy, 2 t/ I c /�fe 'FJ i R CLERK / OF APPLICANT RESTRICTIONS: HOAU ADDRESSCQWoU �G H01ME TELEPHONE# . I , Haz.doc/wp/q r MAIL-IN REQUESTS Please mail the completed application form to the address below. In addition, please include the requized fee amount. Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Heahh Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS- Our fax number is (308) 790-fi304. Please fax a completed application form. In addition, you must mail the requited 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 I II i i i i I i I Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Beard Motor Inc. 22 Ridgewod Ave-P.O.Box459, Hyannis,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- 6 ------------------------ ------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2013 unless sooner suspended or revoked. =1 WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 6/30/2012 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health I Town of Barnstable °FIRE r° Regulatory Services ti Thomas F. Geiler,Director 9�A MASS. E. ��$ Public Health Division �fo 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. 3(�?—03 DATE 11 /a l APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT /� C �°iis✓1� (� l� Y ADDRESS OF ESTABLISITY +NT TELEPHONE NUMBER 7 �� SOLE OWNER: YES NO. IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS O .LL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. G 7 a�03 014 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT a-,, TREASURER Z CLERK I SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS Idl e,S HOME TELEPHONE# Haz.doc/wp/q NAME NUMBER DATE TOWN OF BARNSTABLE 70598 061l8/12 RENEWAL OF PERMIT I DATE ACCT# AMOUNT CTRL# DATE ACCT# AMOUNT CTRL# 06/18/l2 890 100.00 1 i i i i f a I � o 1 U i W y W E 0 REMITTANCK ADVICE CHECK NO. NET DETACH ANP RETAIN 71003 AMOUNT 00.00 i I � f NON-NEGOTIABLE-NON-NEGOCIABLE•NO NEGOCIABLE•NON-NEGOTIABLE - NON-NEGOTIABLE- NO NEGOCIABLE • DO NOT CASH • NON-ENCAISSABLE-NO COBRAR•DO NOT CASH • NON-ENCAISSABLE- NO COBRAR• NON-NEGOTIABLE-NON-NEGOTIABLE•NO NEGOCIABLE-NON-NEGOTIABLE • NON-NEGOTIABLE- NO NEGOCIABLE • DO NOT CASH • NON-ENCAISSABLE•NO COBRAR• DO NOT CASH o NON-ENCAISSABLE- NO COBRAR- NON-NEGOTIABLE• NON-NEGOCIABLE•NO NEGOCIABLE•NON-NEGOTIABLE• NON-NEGOCIABLE- NO NEGOCIABLE DO NOT CASH -NON-ENCAISSABLE-NO COBRAR• DO NOT CASH-NON-ENCAISSABLE•NO COBRAR• NON-NEGOTIABLE •NON-NEGOCIABLE- NO NEGOCIABLE -NON-NEGOTIABLE• NON-NEGOTIABLE• NO NEGOCIABLE •DO NOT CASH •NON-ENCAISSABLE'-NO COBRAR•DO NOT CASH NON-ENCAISSABLE-NO COBRAR- NON-NEGOTIABLE•NON-NEGOCIABLE• NO NEGOCIABLE• NON-NEGOTIABLE •NON-NEGOCIABLE • NO NEGOCIABLE • DO NOT CASH • NON-ENCAISSABLE-NO COBRAR• DO NOT CASH•NON-ENCAISSABLE- NO COBRAR• NON-NEGOTIABLE•NON-NEGOCIABLE• NO NEGOCIABLE• NON-NEGOTIABLE- NON-NEGOTIABLE• NO NEGOCIABLE •DO NOT CASH - NON-ENCAISSABLE-NO COBRAR• DO NOT CASH•NON-ENCAISSABLE- NO COBRAR • NON-NEGOTIABLE•NONNEGOTIABLE- NO NEGOCIABLE•NON-NEGOTIABLE, NON-NEGOCIABLE• NO NEGOCIABLE • DO NOT CASH • NON-ENCAISSABLE•NO COBRAR• DO NOT CASH-NON-ENCAISSABLE• NO COBRAR• NON-NEGOTIABLE •NON-NEGOCIABLE-NO NEGOCIABLE •NON-NEGOTIABLE• NON-NEGOCIABLE • NO NEGOCIABLE •DO NOT CASH • NON-ENCAISSABLE•NO COBRAR•DO NOT CASH-NON-ENCAISSABLE•NO COBRAR• NON-NEGOTIABLE- NON-NEGOCIABLE-NO NEGOCIABLE• NON-NEGOTIABLE •NON-NEGOTIABLE• NO NEGOCIABLE DO NOT CASH- NON-ENCAISSABLE-NO COBRAR• DO NOT CASH• NON-ENCAISSABLE- NO COBRAR• NON-NEGOTIABLE-NON-NEGOCIABLE- NO NEGOCIABLE -NON-NEGOTIABLE• NON-NEGOCIABLE• NO NEGOCIABLE •DO NOT CASH - NON-ENCAISSABLE-NO COBRAR• DO NOT CASH•NON-ENCAISSABLE-NO COBRAR NON-NEGOTIABLE •NON-NEGOCIABLE- NO NEGOCIABLE•NON-NEGOTIABLE• NON-NEGOCIABLE - NO NEGOCIABLE • DO NOT CASH • NON-ENCAISSABLE•NO COBRAR•DO NOT CASH• NON-ENCAISSABLE-NO COBRAR• __„-,_RON-NEGOTIABLE-NON-NEGOCIABLE- NO NEGOCIABLE - NON-NEGOTIABLE- NON-NEGOTIABLE• NO NEGOCIABLE •'tab NOT CASH- NON-ENCAISSABLE-NO COBRAR - DO NOT CASH•NON-ENCAISSABLE- NO COBRAR • - �' Town of Barnstable °EVE,° Regulatory Services � �� �a3/,y Richard V. Scali, Director + + + + MA �SS. " Public Health Division 9 ��. r 1639• iOTFc .ts 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. ��7. Oc7 ' DATE " APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT lie%` i� Ro 7�)r �,UL NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT U /� TELEPHONE NUMBER -7 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. ( y ayo G / STATE OF INCORPORATION / J} FULL NAME AND HOME ADDRESS OF: / PRESIDENT c . A, TREASURER a 4, ,` m z CLERK k SIGNATURE OF APPLICANT f . RESTRICTIONS: HOME ADDRESS iv t rt-i�E!SrQe �'�sr e HOME TELEPHONE# '06 7 i0 p2/J- Q:1Application FormsT AZAPP.DOC MAIL-fN 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 five to seven (7) working days 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 amount of$100.00. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Q\Application Forms\HAZAPP.DOC Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Beard Motor Inc. 22 Ridgewod Ave-P.O.Box459, 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 6/30/2012 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 �b L? CXW (o jZq /'Ob Town of Barnstable j Q _ © a �'THE►° Regulatory Services ti Thomas F. Geiler, Director " MASS. " Public Health Division 1639.�EDMA'�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. 3.� 7—O DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT QZ*Q AtAj" *40C. NAME OF ESTABLISHMENT 1p.t./ A&4j&,b &f tvIA144C 1,69404,0 ADDRESS OF ESTABLISHMENT I\ Q 97 -Vr 6-64PI TELEPHONE NUMBER .S�Vp ! `r /A YJ SOLE OWNER: YES NO ,� y o .-- ::E JIF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS O ;A ,L - `= PARTNERS: �.,.. IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Q 1/;,0 STATE OF INCORPORATION A4 AGIt�S s FULL NAME AND HOME ADDRESS OF: PRESIDENT /L C. 6 TREASURER ( 9 CLERK SIGNAT RE OF APPLICANT RESTRICTIONS: HOME ADDRESS /41 x fAe,5 j,1e Dr C4fr HOME TELEPHONE#,f7¢ 7f V j �J j" Haz.doc/wp/q CIO' ' ..r r 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 Contingency Plan Hazardous waste Spill Contingency Plan for Beard Motors For a containable spill (under approx ten gallons) 1) Get absorbant pads and materials from the spill center bucket located in each shop. 2) Contain and clean up spill making sure none of the spill enters the floor drains. If spill does enter the floor drains call Frank Corp. (phone 508-995-9997) and follow their directions. 3) store contaminated pads and materials in a sealed container to be picked up by Cyn oil Corp. (phone 1-800-242-5818) . For a uncontainable spill (over approx. ten gallons) 1) Get absorbant pads and materials from spill center and contain spill so that it does not enter floor drains. 2) Call Frank Corp. (phone 508-995-9997) and follow their directions. ---------------------------------------------------------------------- --------------- EVACUATION PLAN In the event of a building evacuation every employee should gather at the certified used car sign by the street in front of the building. This is to be sure everyone is accounted for. Page 1 Number Fee 33 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that Beard Motor Inc. 22 Ridgewod Ave-P.O.Box459, 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 PA_U_L J.CANNIFF_, D.M.D_._ 6/30/2010 JUNICHI SAWAYANAGI _ _ THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable °FINE rti Regulatory Services �P °s Thomas F. Geiler, Director • BA MASS. * Public Health Division y MASS. i6g9. ,q �ATEDMA�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.� �— Gj� DATE /1) APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT� GI IjaS -TA c- NAME OF ESTABLISHMENT D tL�, 2 D C 4EdOd O. • ADDRESS OF ESTABLISHMENT J�t� wa4�G{ hir, I�lI i'LmzGv� TELEPHONE NUMBER �"' 77r- Jkll 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. 6 U 4030 al STATE OF INCORPORATIONA _sSA12Ji u:fe 66 FULL NAME AND HOME ADDRESS OF: PRESIDENT *r TREASURER CLERK W SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPH NE # G�3 a Haz.doc/ p,'q Con t i ngency P 7an Hazardous waste sp 7 7 7 Contingency Plan for Beard motors For a con to ina,b 7e sp i 11 (under approx ten ga 7 Tons) 7 1) Get- absorhan t pads and ma toris 7s from the sp i 7 7 center bucket Located in each shop. . 2) Con to in and c lean up sp i 11 making sure none of the sp i 11 enters the floor drains. If sp i 7 7 does enter the floor drains ca 7 7 Frank Corp. (phone 508-995-9997) and follow their directions. .3) store con tam i na ted pads and ma teria 7s in a, sea led conta iner to ,be picked uP Eby Cyn of 7 Corp. (phone 1-800-242-5818) , x . nor a uncon to ina,b 7e sp i 7 7 (over �ppr®x, tern gal 1 ores) _ Page 1 f Contingency Plan 1 Ge t absor ban t pads and ma to r i a 7s from sp i 11 center and con to i n sp i 11 so that it does not enter floor drains. 2, Ca 7 7 Frank Corp. (phone 508-995-9997) and fo 11 ow their directions. Page 2 R_ oF7HE Tow s ,� � + r. ..... .. TOWN OF BARNSTABLE ,. Date: LICENSE APPLICATIONS ,❑ New Application BARNSTABLE, YwRenewal ME MASS. $ 200 Main Street p 039• �0 El Transfer h n/ Hyannis,MA 02601 ❑ Other 508-8624674 ► NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE PREIVII ES,f - Name of applicant/corporation: 17W�ft Home phone#: Address ofapplicant/corporation:------.-.----.--.-------..------.--------4--.--.--.---.---..----.__�_ _____... Business phone#: D/B/A ........ .. ........._.........................._._....._.......-.........-.................._..........._..._............--.... Business phone#: -----....-..__..............._....----.._..----- ... --- Business location: f r f' .._..------ --._....._.__...._.u.__._..._..._._._...._...._........................................................._............................ ...._...-......._............. Business,mailing address: ---....-----..._�l_ _.___...__..___._..._.-.-._...................._._._.........._.....--.---..._...--.-_........._.................-_......__..._._......................_..............................._.._.__........................................................_.................._............... Local business address: Local mailing address: ---------- ----/-j�---- --—u� �- --........... r' LICENSE TYPE:, C 1. S Q-le�., Annual ® Seasonal HOURS OF OPERATION: ._ _. ____.V- _ _ FID#: Name of manager: __�°'E • .__._S.-._ --.._.__...._.__._.....--- - --- Localmailing address: ..... ... .................................................................................................................................................................................................................. g 1 � � ..._ ._ _ __._... _ . .. .__ $h 9 a Manager's Permanent marlin address: _.__...._ ---...._...�.......... ._....._..._.__._tad �►�_� �. �_� �4��_a_..._.:_._._..._._..._..__..__...._..._..__..._...-----.._..__a.......__....-----------�-------- Manager's home phone#: 04f� �© © __ Business phone#: S_ ..........__.._._................._...........---._..... .... Name of property owner: _._..__ __...__�'f�_�1�}, R �*,,,►., ..........__.._............-_................._............._..._..............._._._._..........._........._:.................._............_....__....................................._...._....._........._........_..........__..._.._...._............._._...._ ASSESSOR'S MAP/PARCEL#: MAP '3 ►- PARCEL 41,1111*111*11*11, ©.ta .'%*� t � List any flammable substance or hazardous waste used in business(specify):1V\dtQk �,' t1► �e � i,�S1 Applicants must contact the Building Commissioner's office, (508) 862=4038, the Board of Health office, (�508) 862-4644, and the appropriate Fire District office .:to schedule inspections. ^• Signature of applicant , .................................................... ................................ .... .................................................................................................. Fox_Town use y _Y REAL ESTATE TAXES PAID IN FULL �(j �l 5U U �! �c � � s � r PAYMENT AGREEMENT IN EFFECT ON IS THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES N0 O INSPECTORS APPROVAL __...................................." Capacity set by Building Division.................._...................._..............................:. Building/Zoning............. _....._.............................._......_...._.................._......._............._.. .Date ....._................_.........................................._. ,> Board of Health._.........._.........._._............_._............................................._............. Date ....._......................__......_.................................. Wire ........................................................................... Date .-......-....._...__..._......_._......_....__._...... - Plumbing ._............_..............................._..................----------_---------Date ._........................................_.........._........ Gas -....__..._......_..._......._..............................._..... Date ._......................_................_................... ._..... Fire District Date Comments:... ....._.........._..............._...._._.._._..._._._...........__.........._._...._...__...._..- -...._.........-- ........_._..._.._......_...._......_.._.._................_..._.__.......................................................................__....................:............................................................................_......................................._...................-......... _...._........ .--t . White-Licensing Authority Canary-Health Division Gold-Building Commissioner Pink-Fire Department �...