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HomeMy WebLinkAbout0152 RIDGEWOOD AVENUE - HAZMAT �a �cy� 40 Number Fee 1099 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that CAPE COD AUTO CONNECTION .-------------------------------------------------------------------------------------------------------------------------------- 152 Ridgewood Avenue, HYANNIS, MA ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- Restrictions: ..-----------------------------------------------------------------------------------------------------------------------------------------------------------------. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Inspectional Services BARNSTABLE �FTME • • �siST+ ``o�aMv --._COWUeaw°v°sine_e Public Health Division FY' 1639-2014 ! 1 Thomas McKean, Director MAW 9. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 T' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS o 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 El V d CATEGORY 3 PERMIT 500 or more Gallons: $150.00 C� *A late charge of$10.00 will be assessed if payment is not received by July 1st. 3(p5(P 1. ASSESSOR'S MAP AND PARCEL NO. 3a$ a 1 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: Th Oi'i'l al S to . L u n d g v 1 s l 5. NAME OF ESTABLISHMENT: Co-pe Cra ftu I U Off)O e Li bn T1k-L . 6. ADDRESS OF ESTABLISHMENT: Ri dG owd W . �I'- iwyiIS ►rd oacoo) 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: _5 6 7 1 8� 9 (O q 9. EMAIL ADDRESS: rn 0tC0d0jA0(,Q(111 e hQA (d ho MCU I • Cow 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAMECo d Au4 Conne(11 ar- .tom C PRESIDENT on\. Lun i5V la af{,o/d. t .e 0fyAPy >\ 557 7371-106 TREASURER Skq,� CLERK 154',#-4 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE G a a 0,9 0 Q:\Application Forms\Haz Mat Appli Draft Jan2019.docx Number Fee 1099 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that CAFE COD AUTO CONNECTION 152 RID GEWOOD 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 Town of Barnstable Inspectional Services BAMSTABLE �TFIE a PSTo ne Us,iE4-PU-ORI:i•nA— Public Health Division �pSC NNS•0.9-20BARNSr _•+:i dP SkE a h AB .NUSS, ` Thomas McKean, Director 9`1'AIEo1639. 200 Main Street, Hyannis,MA 02601 Lo -n Office: 508-862-4644 0 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 .g vgi *A late charge of$10.00 will be assessed if payment is not received by July 1st. Pd �� 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: I hbrnq.S ua j m sf 5. NAME OF ESTABLISHMENT: C��e CQ d Ay �o (b nneeh o r\ Vt-e 6. ADDRESS OF ESTABLISHMENT: 1512 61 d u)06 d &e - kfmii s MI aabn) 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 60 17 T- 9. EMAIL ADDRESS: C-tatCo8aubconneCh®n , �4mal l- Coto 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME Otat Cod AjFp (oime C on I;k-L PRESIDENT "rt1 Jn jo oj-f> Id X�Fdr f (+ q1A 0 S' .5d$737 TREASURER y®qo CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS A EMAIL: SIGNATURE OF APPLICANT DATE ,5 -j 6, - ►q Q:\Application Forms\Haz Mat App Revised 09-1Vex TME TOh� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARNSTABLE. 9 MASS. jA 200 Main Street• Hyannis, MA 02601 16 3 9. +"�0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C Qo . Aa v�wc-c* K, Date: Location/Mailing Address: SZ oo •G Contact Name/Phone: ow-. Lv{v� �,. .Sd - 'i7 ,50 -7 -7- Y6 IQ — Inventory Total Amount: ti 1 " �` SDS: 8�Vu-�L- e<<e% License#: lot- C�-�'3 Tier II : o Labelina: Sill Plan: 24 Oil/WaterSeparator: Floor rains: Emergency Numbers: ye-5 Storage Areas/Tanks: <uvo, — d ` �� �� 1 Emer enc /Containment E i ment: �� 'r d�^--'�► ru 04 Waste Generator ID: 9 OI Waste roduct: b I A , Date&Amount of Last Shi ment/Fre uen : 1 A, Licensed Waste Hauler&Destination: 05 D v%& QA-V, 5 1 V Other Waste Disposal Methods: h \ LLQ, 0 Lvk L �� t LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storageand disposal of 111 gallons or more requires a license from the Public Health Division. / v Antifreeze k ww5ke,- 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 X y2A5kU Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants ear oil Refrigerants 9 , 9 Degreasers eg easers 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/RECOMMENDATIONS: O t V l i Inspect Facility Representative: / WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS �J Number Fee 1099 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that CAPE COD AUTO CONNECTION 152 RIDGEWOOD AVE, IfYANNIS, 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 t �4 �� 'kg8atorywof nstable ! 00S�ervices 'THE Richard V. Scah, Director & Public Health Division BARNSTABLE • r BMNS'MlE•f&REiMtIF.mfUR•HYFt1i154 IAEN9rAM.F- • Thomas McKean, Director °"S""MAE& 16;0.oa"� " " --- - - -- -- 6 .0�--- -- - -- - - - - 3��- --- --- -- orEo y 200 Main"Street,-Hyannls�NIA 02601--- --- - --- �. `n Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE " HAZARDOUS MATERIALS .a 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- 1.10 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 f g V.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. 3,2 S j go I 2. IS THIS A PERMIT RENEWAL? ✓ 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: -__I r�Q n'1 Q S 5. NAME OF ESTABLISHMENT: C0.pQ a (we Choy) 6. ADDRESS OF ESTABLISHMENT: 15a R� el�Qt�oad AV-f• 141&MLS fA,+ 6a bo 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 56 `6 27 8 W G 9. EMAIL ADDRESS: CWC0JQA 4COnne0h6 k6h?Aa.+ ( cow\ 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME C&X rod A,4-0 (' -AntGho,n -ry t-. PRESIDENT�10&1 1.2 a od s 6b$41.93911 TREASURER CLERK gam- 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: 01 SIGNATURE OF APPLICAN=` -- DATE S I S 1 Q:\Application FormsWAZMAT APP 2017 REVISE .docx i Number Fee 1099 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that CAPE COD AUTO CONNECTION 152 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 06/30/2017 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 P � t Town of Barnstable • Regulatory Services Richard V. Scali, Director '"RMAM LE' Public Health Division BAMSTABLE 039. a��� nn s«s°uis�osna 'e vns ,. Director 1fi39-2014 Thomas McKean, 377� � 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 t!1 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 3 0th). 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. ASSESSORS MAP AND PARCEL NO. DATE (? ' FULL NAME OF APPLICANT: 1- U n'1115 W LV n C d. j+ 5� NAME OF ESTABLISHMENT: C p� Cod N io Co n e c h on T,1,c ADDRESS OF ESTABLISHMENT: i SoZ K dQ ty,-W j &t L4-i. a A A 1 MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: S 4 77 8' 9 7 L' EMAIL ADDRESS: CApe Cod a u•to Cohnecb on rv. 07wli Con►\ SOLE OWNER: YES ✓ NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADD;SS,AND TELEPHONE#OF: CORPORATION NAME o 0i1 Tic CPRESIDENT �-Atv l- 4-d i o,, a d 17S' TREASURER CLERK ' • IF PREPARED BY OUTSIDE PARTY: Z=FAPPILJCANT Name: Company Address Telephone#: Email: Q\Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 Number Fee 1099 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 Town of Barnstable Board of Health This is to Certify that CAPE COD AUTO CONNECTION 152 RIDGEWOOD AVE, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more 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 0 DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health 4 TROwrr1 of Bigstable Regulatory ervices Richard V. Scah,Director �'ME t Public Health Division BARNSTBLE t 6nRNS:pBtk• NIBF41LIt•G •R1'a.G15 BARN9rABLE. r Thomas McKean,Director RutSiwa.tGs 16 9 Z Vti1B4NiT5B:E CEO:Fg. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508 7-90-6304 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). tOR - av� 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 V,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. a I a 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: -r h o tnck 5 4) • L u n d A U,o j 5. NAME OF ESTABLISHMENT: C�fe Cod P o Com ech ors. '-l_C . 6. ADDRESS OF ESTABLISHMENT: f YP A I d q Qua o od Ale . lLj o,k-.,uS y4 A od w 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: q(o 6 9. EMAIL ADDRESS: C ae Co d aj 6 (64 e r.h ON 6 M 06 1 C o,- 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEP ONE#OF: CORPORATION NAME 4 O d eGj70� C PRESIDENT v ) Lun Iri. "H6,�4/-d La LL b S TREASURER S 441V. CLERK s� �-�- 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE / 7 Q:\Application Forms\I-IAZMAT APP 2017 REVIS A0 °FIKEro"'Y Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"RM�`e'g 200 Main Street• Hyannis, MA 02601 t639. �0 �iOrFDMP�a TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT / Business Name: CQ� 6 e,A A,A-6 co v,,,,A-01-. ,, Date: p!7 ! Location/Mailing Address: iS2- Contact Name/Phone: lows vt o - Cell v8 •73'I- o p Inventory Total Amount: J`f40to MSDS: /t 5 Jk ��evfk'5);75 License* t o4l a 3 Tier II : 0 0 1 Labeling: Spill Plan: 0t<- Oil/WaterSeparator: Floor Drains: -6 Emergency Numbers: e5 Storage Areas/Tanks:)XN,"S v•t, 7-&fV4 � �.7,47, 15,01,0 Emergency/Containment Equipment: 1Is..11 V-,4s a d S PPL a dc &Va Waste Generator ID: D Waste Product: v s I Date&Amount of Last Shipment/Frequency: 1131110 21-0 1 a l a, I, V Licensed Waste Hauler&Destination: *rYo" t,-&w (,tl 5 "vA Other Waste Disposal Methods:_ &1,4Lo 1 i„24--)kc, 0-,A,94,t.e-ic- 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) V 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 J grease, lubricants, gear oil �— Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers y le Photochemicals(Developer) V Car wash detergents I r5 Printing ink Car waxes and polishes 1,T:11 �- 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: izAa . Inspector:- Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS IKWE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMAN Le.� 200 Main Street• Hyannis, MA 02601 i639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT rEn�ya Business Name: Ca a AOi o Co vt Vte.C_ %o w Date: /S / Location/Mailing Address: I S2 tln•cQ9 ci,Joo A/c, , ygvl✓115 Contact Name/Phone LunAl gui n,+ <OS--770 -9165(o , e 11 ,T-O$-7S?- Y Inventory Total Amount: ^�150 c+a MSDS: C5 License#: 10 Ca�3 Tier II : M O Labeling: DarC Spill Plan: le,-., Oil/WaterSeparator: t� Floor Drains: O Emergency Numbers: Ye-5 Storage Areas/Tanks: 2.1� Emergency/Containment Equipment: 0, 1N2t-�y ,av, S < Waste Generator ID: M 0 °p aste Product: Oil , awl- cec;Z2.-+-��11e.cS Date&Amount of Last Shipment/Frequency: 11- l D Licensed Waste Hauler&Destination: o VK_ cee_VU , Other Waste Disposal Methods: lkroy,, C JI jlp I t6 &L ►�:J 52.���ceS S 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 5'S'x Dry g cleanin fluids 1\O Automatic transmission fluid �� Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers �— Hydraulic fluid (including brake fluid) 55 Windshield wash Motor oils 110 •l21S1k1 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 Vt Refrigerants ✓ Degreasers for engines&garage&�,�� Q Pesticides: Caulk/Grout Q°�,� a'� ��V insecticides, herbicides, rodenticides — Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Sys 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: 0 Inspector: La.V `•2i Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS I - a� � l Number Fee 1099 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that CAPE COD AUTO CONNECTION 152 RIDGEWOOD 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 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable dFti Regulatory Services • Richard V. Scali,Director XASL Public Health Division Thomas McKean,Director ' 200 Main Street, Hyannis,MA 02601 ' Office: 508-862-4644 Fa-* 508-790-6304 -.1 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. i I DATE 3 ` APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT T�G Li'1 A S NAME OF ESTABLISHMENT CQ r C U� + , 6 (0)JIle r ho,1 1 ADDRESS OF ESTABLISHMENT d G Q.u3 tio i� ryt � Q n(11 S 1114 6:-)U) TELEPHONE NUMBER �(J SOLE OWNER: YES \1NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: r IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION N0. - U °P 6 - STATE OF INCORPORATION VA FULL NAME AND HOME ADDRESS OF: PRESIDENT A -Ap 0 -Lj)A 4 - 'pIl Q S�rr��-Fc�� l,�ne riornG� FI\co($ h��1 oa�`7S TREASURER h,3,o�-t as CLERK 5a4V j- WS j/ SIGNATURE OF APPLI`C'ANT RESTRICTIONS: HOME ADDRESS 12 61-r,f rj La rLL, 7rt jew�-I\�E�� )Y1 HOME TELEPHONE# dab C:\=hrUemporary Internet Files\OLKWHAZAPP Rev2015.DOC `pf 1ME�op� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ' BARMAGN. ' 200 Main Street• Hyannis, MA 02601 Fo + TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Ca 02- (-o kAo CoA�c�-,a— Date: a Location/Mailing Address: 1 S2 R, ,)evoe1 Avg aAV%IS Contact Name/Ph--w—r�-w, � o yi�-F SOS-�78-9(09� . Gel) 59)A-?3-7-y0?Q Inventory Total Amount: —50D +0 MSDS: e_e7 License#: la e Tier II : IJo LabelingoK��t�\� Spill Plan: Oil/Water Separator: — Floor Drains: N Emergency Numbers: Storage Areas/Tanks: 1 e, v, Emergency/Containment Equipment: e, � ^c Waste Generator ID: Mq a -777 ` 16 Wa to Product: ol� Date&Amount of Last Shipment/Frequency: 2 t v' Licensed Waste Hauler&Destination: 5 ov k Other Waste Disposal Methods eAvmy", tfoL- -e 0.1 o �Ae p IrCLow-ekb o(; de-ak-Ag �vawt��i2.5 LIST OF TOXIC AND HAZARDOUS MATERIALS 0 o wA..c�J' of t1n�. S k v\ ��..�en-Fo C 5 tvtc� le.s-� tv\-1 NOTE: Under the provisions of Ch. 111, Section 31, of the Ueneral Laws of MA, hazardous m1terial use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids V74— 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 J 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/ COMMENDATIONS: Atkii d2 e� II''C6 ' 1 tt 4-tl f �f W*1(,&0 �� ' 'I o��L, Inspector: " 1 t. &Q tAVe— Facility Representative:_ WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS / .3 / TOWN OF BARNSTABLE Date:/D 13 TOXIC AND HAZARDOUS MATERIALS N FORM NAME OF BUSINESS: CoiZ A.Ao BUSINESS LOCATION: l 2. a-,d-%Lwovdl Ayf, INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: _Ob 1'1�5 kA(o CONTACT PERSON: Lv+n i5A` EMERGENCY CONTACT TELEPHON NUMBER: U-11 4cRO MSDS ON SITE? TYPE OF BUSINESS: ekcjat YVA4-,C-- e,S INFORMATION / RECOMMENDA ONS: Oke-Q logl d. Fire District: Art 1011 1A1"11`13 Waste Tparta :-1�s a�ol,�� �,,,, eke.Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: 44- ow0c, *� - &I col Licensed? Yes No �.avJl• NOTE: Under the provisions of Ch. 111, Section 31, of the G.eneral Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum ��t) Antifreeze (for gasoline�� oolant systems) Miscellaneous Corrosive 4NEW%%0 ❑ USED S Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Mo or Oils / Pesticides (� NEW��� O USED`5s (insecticides, herbicides, rodenticides) Photochemicals (Fixers) Gasoline, Jet fuel,Aviation gas Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal , Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine 3D_ 16 0.\ Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) Any other products with "poison" labels ❑ NEW ❑ USED (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 Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers y Windshield wash 5 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials Number Fee loss THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that CAPE COD AUTO CONNECTION 152 RIDGEWOOD AVE, 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 6/30/2013 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 9/9/2013 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health l } Town of Barnstable r' r Regulatory Services °s Thomas F. Geiler,Director Public Health Division i639. ♦� ' For ° 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. ' a DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 7 hom a 5 0 - Lu A&u i S NAME OF ESTABLISHMENT C�Qe &d N�o Corin e ch on Txc ADDRESS OF ESTABLISHMENT 15a R 6. e,,,000d ,fie 4� ovIAIS rn A-._©a.�.o 1 TELEPHONE NUMBER 50 S, 7 7 it- 9(0 9 L SOLE OWNER: YES ✓NO � o� IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS k0F ALL PARTNERS: h `.'x'7 r^ �J rn IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. y f STATE OF INCORPORATION m A FULL NAME AND HOME ADDRESS OF: PRESIDENT 'ThoolaS W -LurAhotS�- la 5�ra14ord LAne ��r�nou Do(� Mk oA- 75 TREASURER _-A/yK e- V . ._.. . ..._ } CLERK Sc�+ SIG ATUn OF APPLICANT RESTRICTIONS: HOME ADDRESS i a 5ra-+-1;rd Line y0krm0j4,po4 MA � '�S HOME TELEPHONE# .561 3 L a 3�f 1� o° f i j tI S, SPELL, CONTINGENCY PLAN Emergency Coordinator, Name: L ya) Eu 4 rt0 m c6d*� �/L��I CAS Address: u ,� Daytime Phone: -7 T 1 - 1-1 1 °7 Evening Phone: - z�t q Fire Department: Barnstable Public Health Division: 508-862-4644 DEP 24 Hour Spill Hot Line: 888-304-1133 Waste Hauler: Name: — n i l Phone: 773 (- 23 LI I Building diagram indicating hazardous materiaUwaste storage area, location of absorbent scavenger materials, fire extinguishers, fire alarms (if present), and evacuation route (if applicable). �F WtK4't be( - sp�l( k�-Ff 55 O per, S O jhou W�N 4 O -xb W,„►as�,«.lo wA-s��t I ti � Q SCR J a Actions to be taken to control a spill or release, and preventing it from reaching a catch basin, sewer system or the ground. LJt .hAVt 5p 1 r Kv+S 0(.41N 60m sl t4ND <peby bay Number Fee 1099 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that CAPE COD AUTO CONNECTION 152 RIDGEWOOD A VE,-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 �t Town of Barnstable • °FTHETpk, Regulatory Services Richard V. Scali, Director MUMSTBLEMASS. Public Health Division i659• ♦0 '°rfo new+° Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. - a DATE I APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 1 Y)0 m^$ NAME OF ESTABLISHMENT C,�- Cob (1,j1,9CC4i o,j .Z',s C'.. - ADDRESS OF ESTABLISHMENT 14'4nj—pj S TELEPHONE NUMBER SOLE OWNER: U/1 ES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. qb ` /66 79�oZ STATE OF INCORPORATION -'FULL NAME AND HOME ADDRESS OF: PRESIDENT �- TREASURER CLERK , (' SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS f 6 ,�/Gry�c✓ /1�J- HOME TELEPHONE# RSD 7.3 9 0 Q: Application Fonns\HAZAPP.DOC CAPE COD AUTO CONNECTION INC. 152 RIDGEWOOD AVE. HYANNIS, MA 02601 508-778-9696 508-778-9697 ((FAX) CONTINGENCY PLAN Two spill kits including absorbing pads and booms Large quantity of speedy dry DEP's 24 Hour Emergency Release Spill Notification Line available to all employees .- ' ()EP's 24-Hour Emergency Release. otificati n Line For reporting oil or hazardous material releases to the Massachusetts Department of Environmental Protection Local Calls: (617) 556-1133 Or I oil Free : (880' ) 3-04=1 133 For general information or assistance, call DEP's regional offices during business hours: Western, Springfield (413) 784-1100 Central, Worcester (508) 792-7650 Southeast, Lakeville (508) 946-2700 Northeast, Wilmington (978) 661-7600 Town of contacts: Emergency 911 e Fire Department (508) a Police- Department (508) a Health Department (508) �F1HE Tcy_ _•Y"o, TOWN OF BARNSTABLE Date: ...�..{.,d..f. .V..t...... ........ ❑ New Application BARNSTABLE ; LICENSE APPLICATION ® Renewal r MASS. $ 200 Main Street t6.39. c.39.t a Hyannis,MA 02601 ElTransfer 508-862-4674 ❑ Other ► NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE PREMISES f Name of applicanUcorporation: Toni.._ _ �,u n d k u j m- Home phone#: _11_a_ _._._.._.._._....... _..._........._........_._..._.__..__........._......_.......... ......L.a _ ......... ...__..._._. Spt�- -7,7r-.IL9. ...... Address of applicanUcorporation:A-A......,k� -..-.-.--.----..--.--__.- Business phone#: - - --.-- ---...___..__.__..._... -..__.........._._._......._._.........�.f._�-r rv>o�rF-h o r ... ............49—4,77.5"_._................................................_......._..........._. D/B/AA .._...._ '._.... °t�. .f.C+f', n............._.._........_....--..............._..._..........._................ --- Business phone#: -;3Q-g ..._ ._ ._g ... L ....__. Business location: --.C�_._..._ / ..._................. 'i►.._. .. 1��.. ....__._._...!' f}.. �io�7 D 1....--....-..- _.....-...._..._......... --..._..._...----- Business mailing address: ..._1..o?_....._....•�...._�"ct .�cr......._.._L . I C......._.._... rt_©vor f.r...._.... ..A_...._...... 5-....-- --- -- --- - Local business address: .r�...�_....._t�'V ........ -rl_lc M�_S.._..:_....__._ ....._...�a7.�._4..._1......................................._...............---...-._._...._..---------....— - Local mailing address: _.......... _.....--...................... .........._...._...__._....- .._....._....._...._.. - ..... -....--..._........_..._._._...._...__._..._....................._..._._..........-........................................................_......_....... .._...--- — --------- ....LICENSE TYPE: �,-.. .i•SS...... ...................................................................................................... Annual ® Seasonal HOURS OF OPERATION: T' _0-0.0--#-% ._. FID#:...._.. ..":...:3 ...�. � +�...�' Name of manager: Local mailing address: J-57,4......Ki.c..t... � .... -vt...:.......(`�-v0, ki..S...... 1�.....W(o G J �r ................................................................................................. Manager's Permanent mailing address: Ja....._� _.._.._ _�.._......... CLAt........._._._Imo._ _o_?_......... .....__�'�".. _._... 1.. — - ..................�._......................4 _s............_............. __......__.._..- ----...- -- Manager's home phone#: Lek_;3t�a?..-.3$!-_ ................ Business phone#: _5. ._..�' FS"-_..g�.l_�. Name of property owner: a _ .......... t.!__.✓!...._S_......... ASSESSOR'S MAP/PARCEL#: MAP........: ._g......................... PARCEL .... . . ................................... List any flammable substance or hazardous waste used in business(specify): 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 For.Town useo`nly� odj REAL ESTATE TAXES PAID IN FULL 0 s PAYMENT AGREEMENT IN EFFECT ON IS THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES ❑ NO ❑. INSPECTORS APPROVAL ................................._..................._.................... Capacity set by Building Division...................................._....... Building/Zoning..._....._..........................................._....._......:....:...:.:..............:..... Date ..............................__...................._ _._._......... Board of Health .................................... Date :..._-....._....._............._....................- Wire ................_.........................._........__.._..._.......... Date ._..._..._..................-.........................._....... . Plumbing ......_.................................................................................Date ................................................_......._.................. . .........-......_......._.............._ Fire District - . .....-- . ..._... _ Date ....... ................. _............................................ Date _........_..................---__----------_ ..................................a..:_........_......................................................._.........._............._.._..............._..._................................................. ............................._..............................................................................._.....__.._..... . White-Licensing Authority Canary-Health Division Gold-Building Commissioner Pink-Fire Department