HomeMy WebLinkAbout0086 RIDGEWOOD AVENUE - HAZMAT 11117UMAT, Ll C) /00
Number Fee
703 THE COMMONWEALTH OF MASSACHUSETTS $125.00
Town of Barnstable
Board of Health
This is to Certify that Foreign Motor Car of Cape Cod
82 Ridgewood Avenue, Hyannis, MA
Is Hereby Granted a License
For: Storing or Handling 111 - 499 gallons of Hazardous Materials.
----------------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------
-51 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.,CH
Director of Public Health
roe
io
I
pdCll�'" -5 gl 6
Town of Barnstable p 'r 12 4-
AWE Regulatory Services
Richard V. Scali, Director
L_
�STAB� BARNSTABLE
M Public Health Division
1639 �0 wansoarns•os E„v ut•v�enx„zme
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 AN
ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). _ - -
APPLICATION FEES
CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑
CATEGORY 2 PERMIT 111 —499 Gallons: $125.00
CATEGORY 3 PERMIT 500 or more Gallons: $.150.00 ❑
A late char a of$10.00 will be assessed if a ent is not received b Jul 1st.
• g p ym v v
ASSESSORS MAP AND PARCEL NO._326-2� j DATE
FULL NAME OF APPLICANT:
NAME OF ESTABLISHMENT: /J117O�� ale
ADDRESS OF ESTABLISHMENT: O2 /q//2E1--"y�lw-
MAILING ADDRESS (IF DIFFERENT):
TELEPHONE NUMBER OF ESTABLISHMENT:
EMAIL ADDRESS:
SOLE OWNER: YES NO IF NO,NAME OF PARTNER:
FULL NAME,HOME ADDRESS,AND TELEPHONE#OF:
CORPORATION NAME
PRESIDENT l�U
TREASURER
CLERK �S—Cos
IF PREPARED BY OUTSIDE PARTY:
SIGNAT F APPLICANT Name:
I Company Address
Telephone#:
Email:
Q:\Application FormSU3AZZAP Rev16.docx Page 1 of 2
Number Fee
703 THE COMMONWEALTH OF MASSACHUSETTS 100.00
Town of Barnstable
Board of Health
This is to Certify that Foreign Motor Car of Cape Cod
82 Ridgewood Avenue, 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
4
a �
Town of Barnstable
°FINE rti Regulatory Services
Richard V. Scali, Director
MARy 'M►ss. Public Health Division
s6gq. �0
ATfp ,�s 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 NOJ-26--OV0 (561 DATE z{
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT �� �� S� Z/2
NAME OF ESTABLISHMENT 46`1 - l2 11�70TD1-f
ADDRESS OF ESTABLISHMENT /,��� (j Old I/ , ���/ /j//lJ/s /,�� .
TELEPHONE NUMBER
SOLE OWNER: RYES NO
d_
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF
PARTNERS:
M1 a 4 4
I
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.
STATE OF INCORPORATION
FULL NAME AND HOME ADDRESS OF:
PRESIDENT
TREASURER
CLERK 11-711
SI NATURE APPLICANT
RESTRICTIONS: HOME ADDRESS,�,-5 Q0iU//���'W�C .l17EI-C//L, -
HOME TELEPHONE#
Q: Application FormsEAZAPP.DOC
f
Spill Contingency Plan
Mark S. Hayes
Foreign Motor Car
82 Ridgewood Avenue
Hyannis, MA 02601
508.778.1118
Date:
1) Evacuate the immediate area if necessary.
2) Shut-off main electrical breakers, heating system and air compression pump.
3) Remove or restrict any potential ignition source from the area if the material is
flammable.
4) Contain the spill by the use of boom coils, spill pillows and absorbent material.
Contract the Cyn Environmental Emergency Response at 781-341-5108.
5) Notify appropriate agencies: Hyannis Fire Department and Barnstable Board of
Health within one hour of detection of a release of hazardous material.
6) Remove all absorbed materials or contained liquid and package in D.O.T.
approved containers. Package used absorbent materials separately from liquid.
7) Once the spill has been controlled and the materials collected and secured, inspect
the area for cleanliness and decontaminate all equipment used in the clean up.
8) Replace all used material and ensure all response equipment is in good working
order.
9) Manage and dispose of collected absorbents and liquids in accordance with the
state and federal guidelines.
10) For any spill greater than the reportable quantity of 25 gallons, whichever is less,
this plan shall be implemented and proper records of action shall be kept on site
as prescribed in Section IX.
11) Emergency spill kit is located next to waste oil and used anti-freeze drums, which
are located near garage door entrance.
12) Drums are labeled with the type of hazardous waste and the start date of accumulation.
13) The following is a list of the spill equipment on site:
A. One emergency spill kit which contains 3 universal boom coils, 6 spill
pillows, 1 bag of absorbent material, 1 pair of chemical splash goggles,
1 pair of extra large pullover boots, 1 pair of extra large chemical resistant
gloves, 1 hazardous waste label, 1 non hazardous waste label, 1 hazardous
waste disposal bag and 1 heavy duty apron.
B. First aid kit.
C. Eyewash
D. Fire extingquishers.
Number Fee
703 THE COMMONWEALTH OF MASSACHUSETTS $100.0o
Town of Barnstable
Board of Health
This is to Certify that Foreign Motor Car of Cape Cod
82 Ridgewood Avenue, 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
s
'own of Barnstable
Rcgillatory Semcles
Thomas F. Geaier,Director
} Public Health DiTisioll
a �dRNC7'aAi� i
163�• ��
nfln3.29 MCKEaIlj Director
200 Ma-m Strlt, Hyamis, MA 02601
Fes: 508-790-6304
OE,cc: 508462-4644
App1icajon Fps: $100.00
ASSESSORS j3AP A-NT FARO+L NO, �o�(2 DATE
APPLICATION FOR PF1QN417 T® STORE AND/OR VTE= MORE THAN
111 GALLONS OF :RAZARDOUS MATERIALS
F=NAME OF APPLICANT
NAME OF ESTABT,7, _�1�Hi—=N'T �1
DRESS OF ESTABLIEJLKLNT ,0l/� lY 4�if�lU�S,
TELEPHONE NUMBER
SOLE Owe: YYES No
L+ APPLICANT IS A PARTNM:Z=,FUZL NA + ADD HOMI ADDRESS OF ALL
PARTNTERS.
IF APPLICANT IS A CORPORATION: + +DE�RA.L IDEN=CA.TION No.
STATE OF INCORPORATION
,r=NAME AND HONE ADDRESS OF:
PRESIDE?I
TRXA�a
Ci =
SIG�ti A OF APPI ICA.NT
HOATE ADDRESS
E=ZIC EONS:
Hmzdndwp/q I
I
f
Spill Contingency Plan
Mark S. Hayes
Foreign Motor Car
82 Ridgewood Avenue.. .
:Hyannis, MA 02601 .
508.778.1118
Date:
1) Evacuate the immediate area if necessary.
2) Shut-off main electrical breakers, heating system and air compression pump.
3) Remove or restrict any potential ignition source from the area if the material is
flammable.
4) Contain the spill by the use of boom coils, spill pillows and absorbent material.
Contract the Cyn Environmental Emergency Response at 781-341-5108.
5) Notify appropriate agencies: Hyannis Fire Department and Barnstable Board of
Health within one hour of detection of a release of hazardous material.
6) Remove all absorbed materials or contained liquid and package in D.O.T.
approved containers. Package used absorbent materials separately from liquid.
7) Once the spill has been controlled and the materials collected and secured, inspect
the area for cleanliness and decontaminate all equipment used in the clean up.
8) Replace all used material and ensure all response equipment is in good working
order.
9) Manage and dispose of collected absorbents and liquids in accordance with the
state and federal guidelines.
10) For any spill greater than the reportable quantity of 25 gallons, whichever is less,
this plan shall be implemented and proper records of action shall be kept on site
as prescribed in Section IX.
11) Emergency spill kit is located next to waste oil and used anti-freeze drums, which
are located near garage door entrance.
12) Drums are labeled with the type of hazardous waste and the start date of accumulation.
13) The following is a list of the spill equipment on site:
A. One emergency spill kit which contains 3 universal boom coils, 6 spill
pillows, 1 bag of absorbent material, 1 pair of chemical splash goggles,
1 pair of extra large pullover boots, 1 pair of extra large chemical resistant
gloves, 1 hazardous waste label, 1 non hazardous waste label, 1 hazardous
waste disposal bag and 1 heavy duty apron.
B. First aid kit. ® w o
C. Eyewash
D. Fire extingquishers.
co
ter y�:a
10 MIS
Number Fee
1046 THE COMMONWEALTH OF MASSACHUSETTS $loo.00
Town of Barnstable
Board of Health
This is to Certify that Francisco's Auto Detailing
76 BARNSTABLE ROAD, Hyannis,MA 02601
Is Hereby Granted a License
FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -�
----- - ----
--------------------------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------- -------------------------- --------------------------------- ------------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and
and expires 6/30/2014 unless sooner suspended or revoked.
----------------------------------------
WAYNE MILLER,M.D.,CHAIRMAN
PAUL J.CANNIFF,D.M.D.
8/5/2013 JUNICHI SAWAYANAGI
THOMAS A.MCKEAN,R.S.,CHO
Director of Public Health
Town of Barnstable
Barnstable
We Regulatory Services Department
> ,STaH►.E. - Public Health Division
MASS 1639. 200 Main Street, Hyannis MA 02601
�0a
a 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. DATE
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE
MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT F12*n ScQPt-Qe�,:7-1'8-4
NAME OF ESTABLISHMENT
ADDRESS OF ESTABLISHMENT 7l0 (2 de/A4/C� 4�A fI f ,
TELEPHONE NUMBER —90�' 30 O - a,-/ rb
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. Dq3— SyS — 7e 7
STATE OF INCORPORATION
FULL NAME AND HOME ADDRESS OF:
PRESIDENT
TREASURER
CLERK
SIGNATURE OF A'P/PLICANT '-
RESTRICTIONS: HOME ADDRESS
HOME TELEPHONE# 50 9 3 O -,PC/
f -
J:\inspection handouts\Haz Mat Application2008.DOC
f �
MAIL-IN REQUESTS
Please mail the completed application form to the address below. Also include a copy of
your contingency plan (to handle hazardous waste spills, etc.) In addition, please include
the required fee of$100. Make check payable to: Town of Barnstable. Allow time for
in-house processing. Our mailing address is:
Town of Barnstable
Public Health Division
200 Main Street
Hyannis, MA 02601
FOR FAXED REQUESTS
Our fax number is (508) 790-6304. Please fax a completed application form. Also,
please fax us a copy of your contingency plan (to handle hazardous waste spills, etc.) In
addition, please mail the required fee of$100. Please make the check payable to: Town
of Barnstable. The check must be mailed to the address listed above. Allow time for in-
house processing.
For further assistance on any item above, call (508) 862-4644
Back to Main Public Health Division Page
JAinspection handouts\Haz Mat Application2008.DOC
l
Number Fee
703 THE COMMONWEALTH OF MASSACHUSETTS $100.00
Town of Barnstable
Board of Health
This is to Certify that Foreign Motor Car of Cape Cod
82 Ridgewood Avenue, Hyannis,MA 02601
i
Is Hereby Granted a License
FOR:. STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS.
o.�
------------------------------------------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
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
l'1. -
r
Town of BarnstabV
�TNE fn Regulatory Services S1 I OC) y�
Q.
Thomas F. Geiler,Director
'" MA.S&`� ` Public Health Division
10rEn 39. 61 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. Fes/ DATE
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
I I I GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT � �
NAME OF ESTABLISHMENT
ADDRESS OF ESTABLISHMENT 9.2.
TELEPHONE NUMBER
$OL"V"iER:_XYES NO
co
II+'AA'LICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL
'PARS
ERS:
O `a (:>
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.
STATE OF INCORPORATION
FULL NAME AND HOME ADDRESS OF:
PRESIDENT
TREASURER
CLERK
SIGNAT OF APPLICANT
RESTRICTIONS: HOME ADDRESS 6-9 ,d/U//251C16/�'
HOME TELEPHONE# ice' s. '— w"L 3�
Haz.doc/wp/q
Spill Contingency Plan
Marls S. Hayes
Foreign Motor Car
82 Ridgewood Avenue
Hyannis, MA 02601
508.778.1118
Date:
1) Evacuate the immediate area if necessary.
2) Shut-off main electrical breakers, heating system and air compression pump.
3) Remove or restrict any potential ignition source from the area if the material is
flammable.
4) Contain the spill by the use of boom coils, spill pillows and absorbent material.
Contract the Cyn Environmental Emergency Response at 781-341-5108.
5) Notify appropriate agencies: Hyannis Fire Department and Barnstable Board of
Health within one hour of detection of a release of hazardous material.
6) Remove all absorbed materials or contained liquid and package in D.O.T.
approved containers. Package used absorbent materials separately from liquid.
7) Once the spill has been controlled and the materials collected and secured, inspect
the area for cleanliness and decontaminate all equipment used in the clean up.
8) Replace all used material and ensure all response equipment is in good working
order.
9) Manage and dispose of collected absorbents and liquids in accordance with the
state and federal guidelines.
10) For any spill greater than the reportable quantity of 25 gallons, whichever is less,
this plan shall be implemented and proper records of action shall be kept on site
as prescribed in Section IX.
11) Emergency spill kit is located next to waste oil and used anti-freeze drums, which
are located near garage door entrance.
12) Druins are labeled with the type of hazardous waste and the start date of accumulation.
13) The following is a list of the spill equipment on site:
A. One emergency spill kit which contains 3 universal boom coils, 6 spill
pillows, 1 bag of absorbent material, 1 pair of chemical splash goggles,
1 pair of extra large pullover boots, 1 pair of extra large chemical resistant
gloves, 1 hazardous waste label, 1 non hazardous waste label, 1 hazardous
waste disposal bag and 1 heavy duty apron.
B. First aid kit.
C. Eyewash
D. Fire extingquishers.
Number Fee
703 THE COMMONWEALTH OF MASSACHUSETTS $10o.00
Town of Barnstable
Board of Health
This is to Certify that Foreign Motor Car of Cape Cod
82 Ridgewood Avenue, Hyannis,MA 02601
Is Hereby Granted a License
FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS.
-------------------------------- ------------------------------ ----------------- -------- -----------------------------------------------------------
------------------------------------- ----------------------------- -------- -------------------------------------------------------------------------------------
This license is granted in conformity with the Statutes and ordinances relating there to, and
and expires 6/30/2010 unless sooner suspended or revoked.
-------------------------------
WAYNE MILLER,M.D.,CHAIRMAN
PAUL J.CANNIFF,D.M.D.
6/30/2009 JUNICHI SAWAYANAGI
THOMAS A. MCKEAN, R.S.,CHO
Director of Public Health
a
r
Town of Barnstable
�{ L Barnstable
oFINET Regulatory Services Department
o, A�-AmericaG�y
• i Public Health Division
■A NSTAS1.,L,
9$ �� 200 Main Street, Hyannis MA 02601
pT �b 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO.5-?F;A10-0a1 DATE 7-,&1 —7
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE
MORE THAN III GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT
NAME OF ESTABLISHMENT ///0; C'i�ij O C'i���6O
ADDRESS OF ESTABLISHMENT
• r�
TELEPHONE NUMBER "`29 g
SOLE OWNER: V YES NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS"OF ALL
S.-
PARTNERS: M.r
c) -71
r
r.
v rn
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.
STATE OF INCORPORATION
P
FULL NAME AND HOME ADDRESS OF:
PRESIDENT
TREASURER
CLERK
. I i T F APP AN
RESTRICTIONS: HOME ADDRESS,'C /6�
HOME TELEPHONE #
Q:\Hazmat\Haz Mat Apphcation2008.DDC
Spill Contingency Plan
Mark S Hayes
Foreign Motor Car
82 Ridgewood Avenuey
Hyannis, MA 02601 °
(508) 778-1118
May 2, 200? 4
1) Evacuate the immediate area if necessary. .
2) Shut-off main electrical breakers, heating system and'air compression pump.
3) Remove or restrict any potential ignition source from the area if the material is
sl flammable.
4) Contain the-spill by the use of boom coils, spill pillows and absorbent material.
a' Contact Cyn Environmental Emergency Response at 781-341-5108.
5) Notify appropriate agencies: Hyannis hire Department and Barnstable Board of
Health within one hour of detection of a release of hazardous material.
6) Remove all absorbed materials or contained liquid and package in D.O.T.
approved containers. Package used absorbent materials separately from liquid.
7) Once the spill has been controlled and the materials collected and secured, inspect
the area for cleanliness and decontaminate all equipnlellt Used In the clean up.
8) Replace all used material and ensure all response equipment is in good working
order.
9) Manage and dispose of collected absorbents and liquids in accordance with the
state and federal guidelines.
10)For any spill greater than the reportable quantity or 25,gallons, whichever is less,
this plan shall be implemented and proper records of action shall be kept on site
as prescribed in Section IX.
11)Emergency spill kit is located next to \waste oil and usad anti-freeze drums, wllicll
are located near garage door entrance.
12)Drums are labeled with the type of hazardous waste and the start date of
accumulation.
13)The following is a list of the spill equipment on site:
A. One emergency spill kit which contains 3 universal boom coils, 6 spill
pillows, 1 bag of absorbent material, 1 pair of clicinical splash goggles, 1
pair of extra large pullover boots, 1 pair of extra large chemical resistant
' gloves, 1 hazardous waste label. 1 11011 hazardous waste label, 1 hazardous
waste disposal bag and 1 heavy duty apron.
B. First aid kit.
C. Eyewash.
D. Fire extinguishers.
. 4
---._..- _. __..._ - _,.. -- - ------ -_- 53-447%113- -
REMITTANCEADVICE
FOREIGN MOTOR CAR OF CAPE COD
82 RIDGEWOOD AVENUE
HYANNIS,MA 02601 4251
508/778-1118
r
PAY
l00 DOLLARS' 8
� -4;L
DATE -•' O T ER�11F �- SCRIPTION ." ,E ,. .� CHECK AMOUNT
/d.
- /
=`Rockland Trust
-------_-_-.-._---.._____._._._..---____. -----___--.___.___. --_.-.-_
II°004 25 L11' i:0 L L304478l: 07603376 L811'