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HomeMy WebLinkAbout0215 WEST MAIN STREET - HAZMAT v /C)o 2+ -T— _ _ _ °rT *off Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 i en MASSS8LE.$` 200 Main Street• Hyannis, MA 02601 039. °l f oNu+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: -Va2-A I Date: ( 1t Location/Mailin Address: 2,S I-}y 4 m A 1 s Contact Name/Phone: a��, �ckso�„ n,�gr Sob-?7�3--7t8'1 dQobcT� .�ae�Gsoh ,, asg�'• � Inventory Tot I.mount: r^' � � MSDS: av1 I��+�- License#: Tier II : Mo Labeling: V-kr�,1 Spill Plan: O�- Oil/Water Separator: Floor Drains: A)d Emergency Numbers: Yes Storage Areas/Tanks: CzAu I k Emergency/Containment E ui ment: ; v<\ whe, OA 5 +t- Waste Generator ID: A Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111 Section 31 of the General Laws of MA hazardous material use storage and disposal of 111 gallons or more requires a license from the Public Health Division. _ 0 Antifreeze 10 Dry cleaning fluids Automatic transmission fluid I Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash ►>y Motor oils$ Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil —�� Disinfectants 7— Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible 3 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) '5 Any other products with "poison labels" I (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDAT`IONS: c o v1 ani.e_ c ft"A A) OCAk-2, OILY 5 Pam. � . rb���'�s $A r-) i 6:5o e_ or e2 co t-,%-�d4j[ ►ovks JK Inspector: 4 �� Facility Representative- WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °p THE*off Town of Barnstable Office:508-862-4644 B3 MAR Public Health Division Fax:508-790-6304 .GLI;- p• 200 Main Street• Hyannis, MA 02601 2639. 00 �PrED AA111 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: CV"A0,--ek-, P- Date: 27 Location/Mailing Address: Z 5' ,es Ma .� c�✓Ir Contact Name/Phone: /04f-f' -j-djcksayu v►t -778-'7t oar{ �1a �n f ►M�r Inventory Total Amount: " � MSDS: 0'^-J1 V%.4- License#: Tier II : KJ 1 A Labelino: C00- l Spill Plan: Oil/WaterSeparator: Floor Drains: N° Emergency Numbers: ' Storage Areas/Tanks: Emer enc /Containme tE ui ment: �jorbc,�nkg ova Si�Q� Waste Generator ID: NIA Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. ° k2 Antifreeze b o 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 20 1 Motor oils 'W1 Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil 72 Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages I 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 'L Miscellaneous Flammables s� Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons '{- Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Z Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMM ATIONS: m w4an C-CVt-� e-- 5 o t.'e-. �� 1 Inspector: 1 LVe, Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS INE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RM M`E ' 200 Main Street• Hyannis, MA 02601 039. � TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C V"6e c�- ,^ \—a V-wLS Date: 'Z 2.0 15— Location/Mailing Address: .21 S+ Ma ,.L 64 a✓1•�,5 Contact Name/Phone: C,t nti < - 0. c�C o D -17 -� l Y�7 h r bctk Q sovL 453f:+"� Inventory Total Amount: ,,.-79�Aj MSDS: cb�a" cam License#: N A Tier II : Labelina: Spill Plan:�1 - Oil/WaterSeparator: Floor Drains: 00 Emergency Numbers: k1A Storage Areas/Tanks: w l l Qk#-1 Sko«� �a 1�-M 1. \.sa5tz o,I \D,)cl&Lk a-Jr l,t 'a cek.x.\S - Y\ L.•s Emergency/Containment Equipment: Waste Generator ID: �A Waste Product: —r-o Date&Amount of Last Ship ent/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. S Antifreeze S Dry cleaning fluids I Automatic transmission fluid l Other cleaning solvents&spot removers 2 Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash >�-3o 1 Motor oils 16" Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants S Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible S Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons _ Laundry soil &stain removers 3 (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: AN FORMATION/RECOMM NDATIONS: N t) S -2 Inspector: 1 , Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1132 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS #2221 215 West Main Street, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons of Hazardous Materials. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Number Fee 9 1132 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable �_- Board of Health This is to Certify that CUMBERLAND FARMS#2221 215 West Main Street, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons of Hazardous Materials. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO Director of Public Health i Town of Barnstable �t ►�,,, Regulatory Services ti Richard V. Scah,Director B" MASS.M ` Public Health Division BARNSTABLE s639 `�� sa4s°us aW uiCD :e nerna CFO MAC a 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 101, 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 � s CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: NAME OF ESTABLISHMENT: Cumberland Farms Store#2221 1- y ADDRESS OF ESTABLISHMEN 215 West Main Street Hyannis,MA ' MAILING ADDRESS (IF DIFFERLfv t fv'jvo CRossin� a/7Da,Z TELEPHONE NUMBER OF ESTABLISHMENT: 7776-- - 7/ 5�-7 EMAIL ADDRESS: �a��L 1�G1CCi P C �ee��li�ra�•�'� in c e�"'' SOLE OWNER: ✓YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT / 4 TREASURER l CLERK V IF PREPARED BY OUTSIDE PARTY: SIGNAT C Name: Company Address j Fourni Telephone#: Tax Manager Email: Q:\Application Forms\HAZ6.docx Page 1 of 2 Office: 508-862-4644 Town of Barnstable • ,. Fax: 508-790-6304 �. Regulatory Services Department :. Public Health Division Thomas A.McKean,CHO �b - s 200 Main Street, Hyannis, MA 02601 Payment Receipt Hazardous Materials Payment received: $50.00 (Check) on 6/14/2016 Permit number: 1132 ! j ;Check number: 393380 Check amount: $400.00 Name on check: Cumberland Farms I jBusiness: CUMBERLAND FARMS#2221 Owner: INC ;Address: 215 WEST MAIN STREET, Hyannis i i 3 --- - __._. _............. .......... __ ......._...... .....................-..... . a o\ Number Fee 1132 THE COMMONWEALTH OF MASSACHUSETTS 100.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS #2221 215 West Main Street, 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. 07/01/201 5J JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Cl" Town of Barnstable Regulatory Services Thomas F. Geiler,Director KAM = Public Health Division 1639. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 0 V -0` 3 DATE k.-_._ APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT / NAME OF ESTABLISHMENT ��,;�, ����;,� �/i'z5 G �J ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SOLE OWNER:_I,/YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. G� •�75f�i!3 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER v CLERK 7 S APPLICANTC'E RESTRICTIONS: HOME ADDRESSr�and FarrSs I1C; '_ ' ="$` HOME TELEPHONE # Crossing Boulevard Framingham, MA 01702 Number Fee 1132 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS#2221 215 West Main Street, 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. 3/18/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health !v l Town of Barnstable_ Regulatory Services Thomas F.Geiler,Director MAW Public Health Division + " Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Application Fee: $100.00s .y , � . ASSESSORS MAP AND PARCEL NO. DATE' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE •v� _ _ THAN 111 GALLONS OF HAZARDOUS MATERIALS"-,-� - s FULL NAME OF APPLICANT NAME OF ESTABLISHMENT � .�,,, ,� r ,,s; �2 ADDRESS OF ESTABLISHMENT — / si TELEPHONE NUMBER 3�D - / 7r - 2/L j'J SOLE OWNER: ✓ YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOMEADDRESS OF ALL` a PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATIONINO STATE OF INCORPORATION �f�Jr i-ems FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER CLERK -- Richard Fourriia Tax Manager_ l�f VbSIGCAT d Forms inc, RESTRICTIONS: MrADDRESS Tax Department HOME TELEPHONENAe# Vard Framingham, MA 01702 • O Y` Qu6iflard [Gulf) Date of Incorporation: September 14, 1984 State of Incorporation: Delaware Principal Address: 100 Crossing Boulevard,Framingham,MA 01702 Office Telephone: 508-270-1400 Federal ID No: 04-2843586 PRINCIPAL OFFICERS: - Ari N. Haseotes President&Chief Operating Officer 18 Lovers Lane Southborough, MA 01772 Howard S. Rosenstein Treasurer 9 Hickory Road Southborough, MA 01772 Mark G. Howard, Esq. Secretary 15 Greylock Road Wellesley,MA 02481 John T. Daly Assistant Treasurer 22 Thomas Road Berkley, MA 02779 Revised 1011113 Cumberland Gulf Group of Companies 100 Crossing Boulevard,Framingham,MA 01702 508-270-1400 MASSACHUSETTS FIRE INCIDENT REPORT ® 10n9, D ` ;' ......'>[ DEPARTMENT RevisedForm «'01922 Hyannis Fire Department Report • ::>::::>::::>::::>::»::>::»::>: If Date Alarm jArrivalrn Service ci # 000649 !Fire 007/ 12/96 Day JFriday117: 17 17:21 18:48 ION FOUND ACTION TAKEN :::: MUTUAL AID pill, Leak w/ No Ign `=4 1 COVER SPILL FIXED PROPERTY USE (OCCUPANCY) :: IGNITION FACTOR C Uncovered Parkin Area NO FIRE > 0 0 OCORRECT ADDRESS ZIP CODE CENSUS TRACT D 187 WEST MAIN STREET 02601 000040 O 1 1 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. MAESTRO RISTORANTE 508 775-1168 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEPHONE F 12 DEPALOLO MIKE 508 775-1168 CO. DIST. PERSONNEL ENG RESP. AERIALS RESP. G 13 METHOD OF ALARM 01 3 © RESP. 7 SHIFT HAZ MAT PRESENT? TANK. RESP. JOTHER RESP. FT TEL-B P D N0. SUBSTANCE 0 0 1 SPEC. EQUIP. USED? O 20 FIRE SERVICE 0 '':'.> O ' OTHER O' 0 S O MOBILE PROPERTY TYPE VEHICLE STOLEN? ESTIMATED TOTAL INSURANCE CO. �i DOLLAR LOSS TOTAL INS. CLAIM PD • 0 > >» 0 0 YEAR MAKE MODEL COLOR LICENSE NO. VIN# 30 40 IF EQUIP INVOL. YEAR MAKE MODEL SERIAL NO. IN IGNITION O COMPLEX AREA OFX. EQUIP INVOLVED IN IGN. ORIGIN FORM OF HEAT IGNITION "'':::MATERIAL FORM © . IGNITED METHOD OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE © EXTINGUISHMENT >... a EXTENT OF DAMAGE Flame Smoke DETECTOR PERFORMANCE SPRINKLER PERFORMANCE N . ....... coop Material generating FORM TYPE no most smoke AVENUE OF SMOKE TRAVEL R WEATHER CONDITIONS Officer in Charge: Date ERIC FARRENKOPF CAPTAIN 7/1 2/9 6 9 Comments for this incident have been printed on an additional comments page. 'Comments for Incident: 96 000649 Exposure: 00 Date: 7/12/96 l 10 RECEIVED A CALL FROM THE BARNSTABLE POLICE FOR AN MVA AT PITCHERS WAY AND THE ROAD WAY TO THE REAR OF THE WEST GATE PLAZA. RESPONSE:RESCUE 827 CAPT. E. FARRENKOPF,F/Fs STORIE,OLSON, PINA. UPON ARRIVAL FOUND THAT THE MVA HAD BEEN CAUSED BY A SPILL OF USED FOOD GREASE THAT HAD SPILLED FROM A DUMPSTER TYPE HOLDING TANK TO THE REAR OF THE MAESTRO RISTORANTE 187 WEST MAIN STREET. THIS SPILL COVERED THE BACK PARKING LOTS OF THE RESTAURANT ANDCUMBERLAND FARMS STORE, IT ALSO COVERED THE STREET AREA TO THE REAR OF THE WEST GATE PLAZA, PITCHERS WAY AND THE FRONT PARKING LOT OF THE WEST GATE AREA FROM VEHICLES DRIVING THROUGH IT. THE BARNSTABLE POLICE HAD CONTACTED THE DPW WHICH WAS SENDING A SANDER. I HAD F/A CONTACT THE BARNSTABLE BOARD OF HEALTH AND UPON THE ARRIVAL OF JERRY DUNNING IT WAS DECIDED TO CALL CLEAN HARBORS TO CLEAN UP THE SPILL ON THE PARKING LOT AND A CATCH BASIN IN THE PARKING AREA. THE DPW (BRUCE HERTZ)COVERED THE AREA INCLUDING THE PARKING LOT WITH SAND. SPOKE WITH MIKE DEPALO AND HE STATED THAT A DELIVERY TRUCK FROM JP FOOD SERVICE PO BOX 4937 BOSTON MASS. (617-389-3300) HAD STRUCK THE CONTAINER AND TIPPED IT OVER. HE ALSO STATED THAT THE DRIVER OF THE TRUCK STATED TO HIM THAT HE HAD NOT STRUCK THE CONTAINER AT ALL,AND IS NOT RESPONSIBLE FOR THE SPILL. BARNSTABLE POLICE OFFICER THOMAS CHEVALIER IS THE INVESTIGATING OFFICER AND IS DOING A REPORT ON THE INCIDENT.ALL INVOLVED(PERSONS/UNITS)CLEARED THE AREA UNTIL THE ARRIVAL OF CLEAN HARBORS. •I RETURNED TO THE AREA UPON THE ARRIVAL OF CLEAN HARBORS AND SPOKE WITH HARRY DAVIDSON GENERAL MANAGER OF CLEAN HARBORS.MR DAVIDSON REQUESTED THE RETURN OF MR DUNNING AND A SANDER FROM THE DPW. THE DPW WAS CONTACTED AND BRUCE HERTZ RETURNED TO THE LOCATION.A MASSAGE WAS LEFT AT MR DUNNINGS HOME FOR HIM TO CONTACT THIS STATION. CLEAN HARBORS IS GOING TO REMOVE THE SAND FROM THE PARKING AREA AN HAVE THE DPW SAND THE AREA AGAIN TONIGHT.THE TOWN DPW WILL SWEEP THE PUBLIC ROAD ON MONDAY. CAR 812 TO QTS 0850 ERIC FARRENKOPF CAPTAIN 07/12/96 Date. yr 1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: C_U�m.h_117ye BUSINESS LOCATION: = .. MAI LING ADDRESS:` c��S� �105 H-«J Mail To: TELEPHONE NUMBER: Board of HealthTown of Barnstable CONTACT PERSON: 6kk ' 4 c) P.O. Box 534 EMERGENCY CONTACT TELEPH04 NI IMB 51A 3 'C?C�i Hyannis, MA 02601 TYPEOFBUSINESS: (off 612vi sr&nc-Q S4u!2f Does your firm store any the toxic or hazardous materials listed below, either for sale or for you own use? YES NO .This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Ant'freeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes u\%. Road Salt (Halite) c�a Hydraulic fluid (including brake fluid) Refrigerants I ctsc,S Motor ils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED ,a Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) vv c c2e Other cleaning solvents � � J Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS y --TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops �1 O unsatisfactory- 4.Manufacturers COMPANY(ot/� �1 c:y10� G1� (see"Orders") 5.Retail Stores �— 6.Fuel Suppliers ADDRESS S' Class: 7.Miscellaneous ; QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel,Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) �i J transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: �- Q l\.vv-v"ld `s _ lC DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply O Town Sewer Public O On-site OPrivate 3. Indoor Floor Drains YES x NO O Holding tank:MDC T±' kAiv v O Catch basin/Dry well C'W (ev O On-site system 4. Outdoor Surface drains:YES-,k--NO O Holding tank:MDC (IxCatch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste ProductLicensed? YES NO 1 2. 114 -13r erson ( erviewed Inspector Date I_ H 15 West Main Stree ]F][- n EST GATE PHACY R v �l 1� V o YOU WISH TO OPEN A 13USINESS'D Fob Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by.M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. ' Talcs the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 211-2-11 e Fill in please: APPLICANT'S YOUR NAME/S: SSC BUSINESS YDUR HOME ADDRESS: g25lf ( . V. TELEPHONE #>` Home Telephone Number NAME OF CORPORATION: Y- _ NAME OF NEW BUSINESS 4 ZW6� 22 TYPE OF BUSINESS — IS THIS A HOME OCCUPATION? YES ADDRESS OF BUSINESS 2 MAP/PARCEL NUMBER 704)10,03 Assessing) W When starting a new business there are several things you must do In order to be In compliance with the rules and regulations of the Town of Barnstable: This form is intended to assist you in obtaining the.information you may need.. You MUST GO TO 200'Main St. - [corner of Yarmouth Rd_ & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this down. 1. BUILDING CO 15510 EA'S OFF -'^ _. This indivld al h e n h rfor e f any p mit requlremen that pertain to this type of business. A orized Signetur COMMENTS: �`� r -2. BOARD OF HEALTH This Individual has_4�en form d fjthe p� relit ants that pertain to this type of business,, Authorized Sig atI V r� MUST COMPLY WJTH ALL COMMENTS: y M ARDWS MATERIALS REG111,ATQNR J 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This Individual has been informed of.the Iloensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: Miorandi, Donna Page 1 of 1 From: Richard Boyle [RBoyle@cumberlandfarms.com] Sent: Friday, November 11, 2011 10:10 AM To: Miorandi, Donna Cc: Elizabeth Burt; Eric Caruso; Sheila Esposito; 2221, Store Subject: Cumberland Farms 215 West Main Street Hyannis Hello Donna, My name is Richard Boyle, Regional Sales Manager for Cumberland Farms here on the Cape. I know you've been in touch with Elizabeth Burt from my company's Facilities Support Department, as well as visited our site on West Main Street in relation to the problem referenced in your 11/7/11 correspondence to all the property tenants, Cumberland Farms, II Maestro Restaurant as well as Papa John's. have walked and photographed the property this week. We did additional removing and straightening of some debris still left, cardboard,an abandoned headboard to a bed, as well as removal of some items that have been left behind by whomever. The rear of our property, as well as all the copied businesses is in good order. We will check continually and arrange for disposal of anything that is left behind. We also have contracted with a Pest Control business and will be monitoring the situation on an ongoing basis. If everyone does their part as neighbors, infestation on any neighboring property from extermination should not occur. If there are any concerns on the local level, I can be reached through a variety of means; I will list them for you. Thank you for your attention and advisement on this matter. Sincerely, Richard Boyle Regional Sales Manager Cumberland Farms, Inc. rboyle@cur iberlandfarms.com 1-508-385-4639 (home) 1-508-728-9349 (cell) Johnston RI Divisional Office 1-800-452-0333 Cumberland Farms Facilities Support 1-508-270-1400 Thank you, Richard Boyle Region Manager#30 Cumberland Farms 11/16/2011 Page 1 of 1 Miorandi, Donna From: Richard Boyle [RBoyle@cumberlandfarms.com] Sent: Monday, November 14, 2011 3:58 PM To: Miorandi, Donna Subject: RE: 215 West Main St., Hyannis Hi Donna, I received your e-mail and will make the arrangements to take down the Old Papa John's enclosure, check for the furnuiture on the exterior of the fence acrross from Golden Fountain (can't imagine how I missed it!) and make arrangements for all the grass to be weed wacked short and cleaned out better. I should be able to have these matters in check for the end of the week, and will contact you if necessary. I appreciate your feedback and visit to the site. Thanks again, Rick Boyle From: Miorandi, Donna [Donna.Miorandi@town.barnstable.ma.us] Sent: Monday, November 14, 2011 3:37 PM To: Richard Boyle Subject: 215 West Main St., Hyannis Hi Mr. Boyle: I was back out there today after receiving your e-mail. There is still some debris as in old wood, furniture on the site on the outside of the fence across from the back side Golden Fountain but closest to Old Main Street. And on the other end behind Papa John's it is recommended that you take down the OLD wooden fence where Papa John's dumpster used to be located. The grass is very tall in and around this area and if it is plowed down then the little critters wo6't have a place to hide. 'If you need pictures of these cited areas I can send them to you-actually I shall try to attach them to this e-mail. Once again thank you in your continued efforts. Donna Miorandi 11/16/2011 Town of Barnstable t"E' tio Regulatory Services Barnstable Thomas F. Geiler,Director ;medaa M BA MAS&LE = Public Health Division f 039. MA'S A.�� Thomas McKean,Director Zoos 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 7, 2011 Cumberland Farms, Inc. 100 Crossing Blvd., V0742 Framingham, MA 01702 RE: 215 WEST MAIN STREET, HYANNIS, MASSACHUSETTS NOTICE TO ABATE VIOLATIONS OF THE TOWN OF BARNSTABLE NUISANCE REGULATION, & 353-1 o The property owned and rented by you located at 215 West Main Street, Hyannis was inspected on October 28th and November 4, 2011 by Donna Z., Miorandi, R.S., Health Inspector for the Town of Barnstable due to a complaint of rats. The rats and the rat burrows were observed behind the food facility known as Papa John's also of 215 West Main Street, Hyannis on the aforementioned dates. The proprietors of Papa John's have contracted with a pest control company by the name of Fowler& Sons Pest Control located on West Main Street, Hyannis: Fowler& Sons will be exterminating for the rats however, they have stated that the rats will migrate to other food sources and nesting areas. Thus, this is the reason for the letter being sent as already tenants in your building have'observed many large rats in the day time. 353-1: Responsibilities of owners and occupants, reads as follows: The occupant of any building used for business or habitation shall be responsible for maintaining in a clean and sanitary condition and free of garbage, rubbish, other filth or causes of sickness in that part of the building and outside area which he occupies or controls. The owner of any building, vacant or otherwise,or parcel of land shall be responsible for maintaining such building or land in a clean and sanitary condition, free from garbage, rubbish, or other refuse. 353-6: Violations and penalties. Any person in violation of this regulation may be fined $40. Any person who fails to comply with an order pursuant to this regulation shall be fined$40. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH A. cKeam S.. CH( Director of Public Health Town of Barnstable Cc: Golden Fountain Restaurant West Gate Home Health Care Il Maestro Restaurant New England Pizza House#1 Papa John's CERTIFIED MAIL: 7011 0470 0001 4525 6331 1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: e— Fyn" Mail To: BUSINESS LOCATION: / —Li. wq,o I3 Board of Health Town of Barnstable MAILING ADDRESS: V. 0' ° P.O. Box 534 TELEPHONE NUMBER: 7*>.5 f�'�l/ Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: Z� J� Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Gase Antifreeze (for gasoline or coolant systems) rain cleaners , Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaner White Copy-Health Department( Canary Copy-Business TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH �tisfactory 2.Printers >s 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESSa%S Mi ly\, Class: �� 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS Case lots Drums Above.Tanks Underground IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers T1 Miscellane s: e r00lyhemu - i DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply Town Sewer ublic O On-site OPrivate - 3. Indoor Floor Drains YES N0_k_ O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES—XNO OIR ERS: O Holding tank:MDC ,Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. XxZv_4, Perso (s) IntervieweA Inspector Date J, TOWN OF BARNSTABLE Co LIANCE: CLASS: 1.Marine,Gas Stations,Re air satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops —fit O unsatisfactory- 4.Manufacturers COMPA_ e (see"Orders" 5.Retail Stores 6.Fuel Suppliers ADDRESS,?/ 7 Class: 7.Miscellaneous � � QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MAT . IALS case lots Drums U IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) G tramnyissw�Vhydraulic f Synthetic Organics: degreasers -�` Miscellaneous: a DISPOSAURECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply O Town Sewer Opublic 6/On-site OPrivate 3. Indoor Floor Drains YES NO 0 Holding tank:MDC_ d�L� 0 Catch basin/Dry well `f 0 On-site system 4. Outdoor Surface drains:YES NO O R 0 Holding tank:MDC O Catch basin/Dry well 0 On-site system 5.Waste Transporter Name of Hauler Destination Was W- Product 1 YES No 2. T74hiterviewe-d Inspector Date