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0045 INDUSTRY ROAD - Health
45 INDUSTRY��.,MARSTONS MILLS ortolotti Constractions Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS loo.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., Marstons Mills, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to,and and expires 6/30/2015 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable �FIFIE rod, Regulatory Services Richard.V. Scali, Director 8, MASS. . Public Health Division �j 1639• �® �Pg twee 6. 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 5g `� DATE 6111113 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS t , l FULL NAME OF APPLICANT NAME OF ESTABLISHMENT c�� ulc�(_ � C ��h ; rc.1C.�/ � r . �, C / ) :! ADDRESS OF ESTABLISHMENT �Ilz TELEPHONE NUMBER f!)0(5 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. L)q-, 7-�j 7 3 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: ( f PRESIDENT P1 ,,. `iX�`� TREASURER. CLERK SIGNATURE OF APPLICANT - � l RESTRICTIONS: HOME ADDRESS iZ) '<-b?c i)� C/�I�lur"� F/l��A',AN`j HOME TELEPHONE # °7'� Q:W.pplication Forms\HAZAPP.DOC M 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 five to seven (7) working days for in- house processing. Our mailing address is: Town of Barnstable Public Health Division 200 lain Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00, Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Q:\Application Forms\I-LAZAPP.DOC HAZARDOUS. WASTE CONTINGENCY PLAN TELEPHONE IN AREA OF STORAGE EMERGENCY COORDINATOR # 508-737-7066 FIRE DEPARTMENT CALL 911 SOUTHEAST REGIONAL EPA # 508-946-2700 (OII- SPILLS IN EXCESS OF 10 GALLONS) MATERIALS TO HANDLE SPILLS: FIRE EXTINGUISHERS SPILL RESPONSE KITS WATER HOSE SPEEDI-DRY SAND ALL CONTAINERS ARE TO BE PROPERLY MARKED OF CONTENTS EACH EMPLOYEE HAS BEEN INSTRUCTED IN EMERGENCY PROCEDURES, PREVENTION AND RESPONSE Page 1 of 1 Martin, Cynthia From: Ben Fawcett[benfawcett@energypartners.com] Sent: Wednesday, June 06, 2012 9:41 AM To: Martin, Cynthia Cc: Stacy Antoniou; Tracy Gaudiano; 'mmacneely@commfiredistrict.com' Subject: Above Ground Oil Storage Tanks Hello Cynthia, My name is Ben Fawcett and my family runs Scudder-Taylor Oil in Hyannis. I have been working with Inspector MacNeely of the Barnstable Fire Department in an effort to (install-two aboveground 1,000 gallon storage tanks at the office of Bortolott Construction,located at 45 Industry Road in Martson Mills 7 I have emailed Inspector MacNeely information about the tanks and he informed me that the next step is to obtain approval from the Barnstable Board of Health. I called your office this morning and they told me that you are the person that handles this type of request. I would very much appreciate your assistance in the permiting process for these tanks. I have attached the information about the tanks that I emailed to Inspector MacNeely. Please let me know what other information you need from us in order to obtain approval from the Barnstable Board of Health. Thank you very much for your assistance. Sincerely, Ben Fawcett President Fawcett Energy Partners, Inc. (617) 395-6308 (Direct) (781) 831-3522 (Cell) (781) 658-2349 (Fax) 6/7/2012 Ii Map v i� Page 1 of 1 Town of Barnstable Geographic Information System New Search Home Help Parcel Viewer Custom Map Abutters Map Size ® Zoom Out IL1EIn JPG Turn map layers on/off by selecting check boxesxenbelow } rj Town Boundaries i ' 4 ri Road Names j Voter Precincts kk 13 Vv- r Map&Parcel Numbers F. Parcels F] FEMA Q3 Flood Zones(Current Maps) ut Not for official Flood hazard determination. 13 AE(100 yr Flood) AO(100 yr flood) A . 4 tg VE(100 yr flood w/wave action) ;^ � XS00(500 yr flood) �;k < ifs (- FEMA Preliminary Proposed Zones(subject to change) KIN w Expected Adoption:Summer 2013 ®AE-100 year flood ';h4 AO-100-year Flood AH-100-Year flood 0 VE-Velocity Zone 'X 0.2%Annual Chance Flood Set Scale 1"= 113 ; ' I April 2008 I MAP DISCLAIMER Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMAVv1.2.4379[Production] d http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=058024 6/12/2012 NOTE:ALL RIGHTS RESERVED.THIS DRAWING MUST NOT BE REPRODUCED IN ANY FORM WITHOUT THE WRITTEN PERMISSION OF HIGHLAND TANK®. HIGHLAND TANK®SHALL BE RESPONSIBLE ONLY FOR ITEMS INDICATED ON THIS FABRICATION DRAWING UNLESS OTHERWISE NOTED.CUSTOMER IS RESPONSIBLE FOR VERIFYING CORRECTNESS OF SIZE AND LOCATION OF FITTINGS.ACCESSORIES.AND 1 O'-9' COATINGS SHOWN ON THIS DRAWING. TOUCH UP OF FINISHED PAINT IS REQUIRED BY INSTALLATION WONT"C OR.TOUCH UP PAINT SHIPPED K. 12 12 12 16" 3'-4" 12' _____ _ __________ _____ _ ___-__ G CB A I C C I D I I I I I I iO4'-0' `\ INNER I I I I 1 1 I I 1 1 1 I I I 1 I / I I I I I I 1 E L____ ________________________________ ______ 33" APPROX. 2" ANGLE SKID DESIGN DATA CAPACITY — 1,000 GALLONS _ TYPE — DOUBLE WALL — TYPE I Q NO. REO. — — LEGEND ��cHLaao OPERATING PRESSURE — ATMOSPHERIC ` A K Highland Talk TANK MATERIAL — MILD CARBON STEEL 6" FITTING THROUGH OUTER SHELL ONLY THICKNESS — INNER— HEADS: 7 GA SHELL:7 GA A MARK WITH SPECIAL WARNING LABEL — tiFD co' THICKNESS — OUTER— HEADS: 10 GA SHELL:10 GA INTERSTITIAL EMERGENCY VENT USE ONLY CONSTRUCTION — INNER — LAP WELD OUTSIDE ONLY B 6" FITTING — PRIMARY EMERGENCY VENT USE 1000 GAL 48"0 DW SKID TANK OUTER — LAP WELD OUTSIDE ONLY TANK TEST — INNER — 5 PSIG C 2" FITTING OUTER — 2 PSIG AND FULL VACUUM CUSTOMER: INT. FINISH — NONE JE 2" INTERSTITIAL MONITOR PIPE PROJECT EXT. FINISH —SHOP PRIMER 3" x 3" PLATE w/ 1/2"0 (MIN.) HOLE ONCENTER GROUNDING LUG—ONE REO'D QUOTE N0 CHK'D HYLABEL — UL 142 3/4'=12' 01000SKDW48GA7 I 01000SKDW48GA7 Recommended Guide Specification for Aboveground Horizontal UL-142 Single Wall Steel Storage Tank on Heavy Duty Skids Short Form Furnish and install an aboveground, horizontal, single wall, steel storage tank on heavy duty skids. The tank shall be in conformance with the Underwriters Laboratories' UL-142 specifications and so labeled. Tank size will be noted on an attached reference drawing. Long Form Furnish and install a 1000 gallon aboveground, horizontal, single wall, steel storage tank 48 inches in diameter by 10'-9" long on heavy duty skids. Tank shall be fabricated from mild carbon steel with flat-flanged heads. Inner tank gauges: head gauge 7, shell gauge 7. Outer tank gauges: head gauge 10, shell gauge 10. Tank shall have supports that are welded to both tank and skids. Heavy duty skids shall be fabricated from 4" H-beam and 4" pipe. (for 300 - 4,000 gallon tanks) or 6" H-beam and 6" pipe (for 5,000 - 12,000 gallon tanks) All items included with the tank shall be coated with red oxide primer. The tank shall be manufactured in conformance with Underwriters Laboratories' UL-142 specifications and so labeled. The tank shall be fabricated with the following threaded connections : 2 inch, 4 inch, 6 inch as located on attached drawing, AND/OR 150# flanged connections with flange protectors. Flange sizes as follows (qty-size): , , , with locations also indicated on drawing. See standard fittings drawing (STDFTG) for quantity, size and locations. Thread protectors shall be inserted in all threaded openings prior to shipment. Highland tanks are air tested at the factory but MUST be retested at the jobsite by the installer prior to installation. Options & Accessories: Manway(s) inches in diameter with bolted and gasketed lid Loose-bolt Manway inches in diameter with bolted and gasketed lid (emergency vent) Support Saddles per drawing Emergency Vent External Ladder External Ladder & Platform External Stairway Pump Platform Walkway(s) with Handrails Commercial grit blast (SSPC-6), epoxy primer coat Exterior polyurethane paint Other exterior coating Internal Ladder(s) Internal coating (Must include interior weld. Minimum size 500 gallon.) Level Sensing System(s) Overfill Containment Chamber Warranty: The subject tank is warranted by Highland Tank & Mfg. Co. to be free from defects in manufacturing, workmanship and materials. Highland Tank will repair or replace, at its sole discretion F.O.B. factory, within a period of one year after date of shipment, any item of our manufacture. All other items shall be warranted by their respective manufacturers. Liability hereunder is limited, as stated above, and does not include labor, installation costs, indirect or consequential damages of any kind. Tanks must be returned to the factory and if found to be defective upon examination, will be repaired, replaced or credit will be issued at our option. Approved Manufacturer: Tank to be manufactured by Highland Tank at one of the following locations: Stoystown, PA, Manheim, PA, Watervliet, NY, or Greensboro, NC. "SALE EACH 2.00 0.00 1000 GALLON DW SKID TANK 7 GAUGE STEEL,47 DIAMETER, 10'9" LENGTH, PRIMER RED COLOR, FIFR311 EACH 2.00 0.00 FILLRITE 25-30GPM W/METER Whse: 000 JUOPW7H EACH 2.00 0.00 1"OPW RICHARDS 7H NOZZLE NEW- Whse: 000 JUOILM45 EACH 2.00 0.00 1"X 1" SWIVEL (205-1010) Whse: 000 EBW79722501 EACH 2.00 0.00 1" SAFETY SEVER (BREAKAWAY) Whse: 000 EMA0021-185 EACH 2.00 0.00 WHIP HOSE 1" NPT X 12" Whse: 000 JUM02440M I200 EACH 4.00 0.00 6" MALE EMERGENCY VENT 8oz Whse: 000 JUKR264 EACH 2.00 0.00 2"X 64" TYPE K LEAK-KRUEGER S Whse: 000 JUM05170100AC EACH 2.00 0.00 2"NPT 3.5 GAL SPILL CONT-MALE Whse: 000 SC04316 EACH 2.00 0.00 STANDARD CAP Whse: 000 SC04314 EACH 2.00 0.00 2" M ST. CPLG. Whse: 000 "SALE EACH 2.00 0.00 2" GALV VENT PIPE X 5' SCO0209 EACH 2.00 0.00 2"VENTALARM LONG Whse: 000 JUM03540200AV EACH 2.00 0.00 2" UPDRAFT VENT CAP Whse: 000 CE70067 EACH 2.00 0.00 260HS 30 TYPE 2 FILTER Whse: 000 CE 50004 EACH 2.00 0.00 1" FILTER ADAPTOR Whse: 000 SCO1439 EACH 2.00 0.00 ECON-O-GAUGE. 64"TANK Whse: 000 •SALE EACH 1.00 0.00 MISC DECALS, PLUGS, FITTINGS /LABOR HOUR 3.00 0.00 LABOR Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction -- 45 Industry Rd.,MarstonsMills,MA 02648 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2012 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 6/30/2011 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.;CHO Director of Public Health LzR d —m rm Town of Barnstable yto(K4 - 55Co Cr 00-05 Regulatory Services ti Thomas F. Geiler, Director MAW. " Public Health Division 9qj i6 q: `�$' '°lEn Mai° Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT 20 t 4-j - NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT C16 �'1h 1-g39°1f - o TELEPHONE NUMB 50$ ER _ SOLE OWNER: YESboNO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL v cx� I PARTNERS: y s IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO.6%tX*t3.KCk 3 STATE OF INCORPORATION MA. FULL NAME AND HOME ADDRESS OF; PRESIDENT . TREASURER . CLERK r SIG NATURE OF APPLICANT i RESTRICTIONS: HOME ADDRESS HOME TELEPHONE- ELEPHO o Haz.doc/wp/q `A , MAII_,-IN REQUESTS Please mail the completed application form to the address below. In addition, please include the required fee amount. Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. For further assistance on any item above, call (508) 862-4644 i HAZARDOUS WASTE CONTINGENCY PLAN TELEPHONE IN AREA OF STORAGE EMERGENCY COORDINATOR # 508-737-7066 FIRE DEPARTMENT CALL 911 SOUTHEAST REGIONAL EPA # 508-946-2700 (OIL SPILLS IN EXCESS OF 10 GALLONS) MATERIALS TO HANDLE SPILLS: FIRE EXTINGUISHERS SPILL RESPONSE KITS WATER HOSE SPEEDI-DRY SAND ALL CONTAINERS ARE TO BE PROPERLY MARKED OF CONTENTS EACH EMPLOYEE HAS BEEN INSTRUCTED IN EMERGENCY PROCEDURES, PREVENTION AND RESPONSE Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of. Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., MarstonsMills,MA 02648 J Lb 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 June 30, 2009 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/08 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable Barnstable TKE Regulatory Services Department o ;eriea i • � Public Health Division BARNSPABLE, 200 Main Street, Hyannis MA 02601 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. 05'8'aa� DATI+U�Qf, 33 c)00e APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT�Q bff -- "f • �3jr o /_0 Y'4 ' NAME OF ESTABLISHMENTjr 0✓1 �-�/�- ADDRESS OF ESTABLISHMENT L , V W,//< (off TELEPHONE NUMBER 6 ` 7 2 1 I C= SOLE OWNER: YES NO < _ cn S2 IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS: F ALE. -- PARTNERS: cn r -.j m IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NOD V -�&)o) 593 STATE OF INCORPORATION FULL NAM HD E RESS O PRESIDENT ( O ® 25 TREASURER .V. CLERK SWNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# 50 g- V0 Q:\Hazmat\Haz Mat Application2008.DOC Town of Barnstable °Ft Regulatory Services Thomas F. Geiler,Director NAME , Public Health Division t639, �8� 03g 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 NO. DATE V-9.9JO-1 _AQ6 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN I II GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT_ �Ierj""V, �j,!'�0)O ! NAME OF ESTABLISHMENT/ � t � [�p�� P if�j/� . ff V � ADDRESS OF ESTABLISHMENT 1,5 AS 1A0— -Ye TELEPHONE`NUMBER 7 7/ g SOLE OWNER: yYES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION N0,621,d cP V-3 STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT er .T C P-O&C . l- ybn I` �14..oga .? TREASURER 1,6ho e..(',]jr, . p U j CLERK - SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE BARNSTABLE - 2007 AUG, 16 AN 10: 06 DIVISION t! Town of Barnstable CF THE rpw Regulatory Services Thomas F. Geiler,Director Public Health Division * sARNSTABLE, * Thomas McKean,Director 9� 1639. `�� 200 Main Street, Hyannis,MA 02601 prFD MA'l A Phone: 508-8624644 Email: healthna,town.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—4:30 September 12:,2006 Mr.Bob Bortolotti Bortolotti Construction Inc. 45 Industry Road Marstons Mills,MA 02648 Dear Mr.Bortolotti: Thank you for your time and cooperation during the hazardous materials inventory and site visit at Bortolotti Construction on August 14, 2006. This letter contains information from that visit that will help you become compliant with Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials. Enclosed are copies of the Chapter 108: Hazardous Materials Ordinance, and a copy of the Toxic and Hazardous Materials On-Site Inventory form from the visit to your business. Please note the Problems identified at your place of business during the hazardous materials inspection and their corresponding orders or recommendations listed below: PROBLEM: • Oil releases observed along the bottom of the waste oil tanks. You are in violation of Section 108-9 of Chapter 108: Hazardous Materials,which states, "The'release of any hazardous materials and/or acutely hazardous materials upon the ground, or into any surface...within the Town of Barnstable, is prohibited." ORDER: • Section 108-5B of the Town of Barnstable General Ordinance states, "Provisions shall be made to contain the product(i.e. hazardous materials) in the case of an accidental release." • Utilize absorbent pads for the tops and use speedy dry underneath all drums and tanks containing hazardous materials. Once the absorbents are completely saturated,please dispose of properly. • Plan and conduct staff"refresher"training in hazardous materials identification, handling,PPE(personal protective equipment) and proper spill response. • Please instruct your staff to focus on taking a few moments during their workday to implement safety measures in order to prevent hazardous materials spills and releases of any kind. • Utilize a spill kit that is easily accessible to all staff members in the event of a spill or release. PROBLEM: • Cylinders are not chained. There are approximately 16 cylinders located near the middle bay garage door that are not chained securely. ORDER: • Please chain all cylinders securely to a wall or fixed structure to ensure safety of the staff and facility. These cylinders are located in a high traffic area and have the potential to be tipped over. PROBLEM: • There is no flammables storage cabinet in the shop. RECOMMENDATION: • Please obtain a flammables storage cabinet to house all miscellaneous aerosols and other flammable products. PROBLEM: • No contingency plan posted. RECOMMENDATION: • Please post contingency plan near telephones in areas where hazardous materials are present and maintain the list in each company truck. OBSERVATIONS: • Rag can with lid present • MSDS on site • Eyewash station in place • Waste oil is burned for heat • All waste is labeled properly On Site Inventory Total The Toxic and Hazardous Materials On-Site Inventory from August 14, 2006 shows that you have approximately 1,443 gallons of toxic and hazardous materials being used, stored, generated and disposed of at 45 Industry Road.,Marstons Mills,MA(Please see enclosed Toxic and Hazardous Materials On Site Inventory sheet). A representative from the Public Health Division will re-visit your business as a follow up to further advise you on your compliance. If you have any questions about these problems,the orders and recommendations, or you need further information, guidance or assistance,please do not hesitate to contact the Public Health Division. Sincerely, Alisha L. Parker Hazardous Materials Specialist All orders to correct vio tions of Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials shall be comp eted upon receipt of this letter. mas A. McKe ,RS, CHO Director of Public Health Enc. Chapter 108 (copy), On-Site Inventory(copy) n - 1*de: 6r10 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: bO IA �4�15fi'UC�Zb�I BUSINESS LOCATION: ` AA 464M(7 WlS t INVENTORY MAILING ADDRESS: D o S lS TOTAL AMOUNT: TELEPHONE NUMBER: - CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? ZIA, TYPE OF BUSINESS: d/Alh5t INFORMATION/RECOMMENDATIONS: Fire District: r LU A e a - Sit ansp rta oYn: Last shipment of hazardous waste- Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials 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 Antifreeze (for gasoline or coolant systems) Misc. Corrosive aNEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) 5 Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ANEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED o Misc. 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 Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS 2oo(o OI�I ;5A WASTE OIL OIL FILTERS ANTIFREEZE WASTE Sn �)L91 2So ANITFREEZE 1715 5 40 176 GASOL NE WASTE GAS DIESEL FUEL W/W FLUID ATF 0 �, HYDRAULIC/ MISC. MISC. MISC. MISC. RRAKEFLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM (GEAR OIL/GREASE/ 0 10 LUBRICANTS) Io 51 FREON ACETYLENE R WASH CAR WASH PAINTS/ WAX DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID FERTALIZERS WASTE SOLVENT MSDS �6� MANIFESTS Na PP X1, t5vy 4 Nrww II' �aAw I-D ok Vk"k KLclufS.tfcr. (3-lk �Yg L s Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., MA 02648 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 June 30, 2007 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. May 8, 2006 PAUL J. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable r �oF11"4Ea,. Regulatory Services I� / V Thomas F. Geiler,Director �IgId� ^B Public Health Division 9^ 1 `0g . A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO._9 7 DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT C - (Otp NAME OF ESTABLISHMENT �C 46 4-1 ADDRESS OF ESTABLISHMENT TELEPHONE NUMBER SOLE OWNER: YES NO x� IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: j{-5 co t Ln IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. C ` r l STATE OF INCORPORATION FULL PRESIDENT �}- 7-61 �L OMB DD S F. R 0 I/4 TREASURER CLERKZ— SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS QC) HOME TELEPHONE# � Q:\Application FormsUIAZAPP.DOC 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 five to seven (7) working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division f - 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax us a copy of your contingency plan (to handle hazardous waste spills, etc). In addition, please mail the required fee amount of$100.00. Please`make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in-house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page Y Q:\Application Forms\HAZAPP.DOC BJ BORTOLOTTI CONSTRUCTION, INC. P.O.BOX 704 ( ry ,f •trdl'��.vitl.l�Irt«.'�. � S �.N'i: Lf yi..1� .�.n: 't 3: 1.Cl..., MARSTONS MILLS, MA 02648 tl°'�nwumFs n "t'�`uncuAc+niA'�" s 2 �d i�=ti _i'� P °t4 4;w?': �'l�iai rllrtl . ssl�i.iai'ii'' s:�i����sss'��:i•ifsi�s���iis��:#ii'if.i'�'G� ( ! tti! tltlfttt! 1.tti ttttttt tt ttfti t tt t ttfttttt t ,� ''{ , �, i i i � . �--- __ - - - -Y - -- � - _- - -- � : - ,__ .. . :. _. R.__ .__ __ _. .. ._-- - - v..�.- (508)771-9399 F Fax(508)428-9399 (508)428-8926 .- - =BORTOLOTTI CONSTRUCTION, INC EXCAVATING•SEPTIC SYSTEMS .k LAND DEVELOPMENT•DRAINAGE e 45 INDUSTRY ROAD•MARSTONS-MILLS;MA 02648 1V pe'" P. .4 Date: / / 05 I' TOWN OF BARNSTABLE c�'4 I TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 0p*11fip r&mrhm e- BUSINESS LOCATION: �� INVENTORY MAILING ADDRESS: �- i ��6 UAW Q2A6 TOTAL AMOUNT: TELEPHONE NUMBER: 0— 71—�� /N47 � CONTACT PERSON: F569 �DI��D( �f EMERGENCY CONTACT TELEPHONE NU ,BER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECO�VIMENDATIONS: Fire District: JJ Af an . 1A s. ULe ahwrbetttnAds tau kattle ransportation: Last snipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. UST 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 Antifreeze (for gasoline or coolant systems) Misc. Corrosive -U L NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) 3 Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED v Misc. 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 Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. 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 (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor&furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Town of Barnstable pUtME t Regulatory Services —B Thomas F. Geiler,Director r • s s B" MASS. ' Public Health Division A�f1 39. Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT()b6t J, NAME OF ESTABLISHMENT2or tn[,)� GCY,� `00, Zn( ADDRESS OF ESTABLISHMENT �� T (/ , l TELEPHONE NUMBE �` -7-71. 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. STATE OF INCORPORATION FULL NAME AND HOME DRESS OF: ) . PRESIDENT �- (% 4, '� 0 0 �PJ , '- v- P- - CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Haz.doc/wp/q Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Bortolotti Construction Fax: Corp Name: Mailing Address Location: 45 Industry Rd,Marstons Mills Street: P.O.Box 704 mappar: 058-024-000-000 City: Marstons Mills Contact: ;Bob Bortolotti State: Ma Telephone: 508-771-9399 Zip: 02648 Emergency: Person Interviewed: ............__............__.........__.. ..__............ Business Contact Letter Date: 6/16/2005 Category: :Builders/Contractors Inventory Site Visit Date: 7/6/2005 _ ........... .- ......... . .. .... Type: Follow Up/Inspection Date: ❑� public water ❑ indoor floor drains ❑ outdoor surface drains W license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc W currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir — ---- - SE on-site sewage ❑ date: 6/30/2006indoor on-site syste ❑ outdoor onsite system - ---- --------------No toxic or haz.Mat.On site compliance: REMARKS:9/24/98-Repair of trucks and hydraulic Equipment. Oil Satisfactory filters drained!+recycled W.O.Heat. Speedy dry. Magnetic drum labels used. Antifreeze can go to Tirrells. NAPA takes batteries.Obtain MSDS sheets.. ORDERS: Label w.o.drums"TOXIC","HAZARDOUS WASTE"and"WASTE OIL".Obtain Material Safety Data Sheets from suppliers/retailer/distributors. Keep in file in office and 1 set in Shop. REMARKS: 1999- Building heated by waste oil and gas.Take waste oil from"Lube on Location". ORDER: Label all waste oil containers. Recycle Speedy Dri.Recycle used oil filters. 5/6/02 REMARKS: MSDS available. 5/6/04 Remarks: All manifests and MSDS on site. Now has a large shop to maintain/repair their company vehicles. All used oil&antifreeze burned in waste oil heater. Staff goes through basic company training once a year. Free flow eye wash has been ordered and is going to be installed. PPE onsite. Absorbant onsite. Unifirst comes once a week for uniforms and rags. New gas cans with CAPS have been ordered. ORDERS: Get a metal container for shops rags and keep covered to prevent fire hazard(people smoke in shop). Inventory total= License REQUIRED and they were instructed to obtain one.7/6/2005 alp eyewash station in place,msds on site,burn all waste oil,all waste oil is labeled,contingency plans in all trucks,compressed gas chained.RECOMMEND: lid for metal can that contains rags and uniforms(they recycle old 5 gallon buckets to have in the field to use for waste oil),obtain and use absorbent pads for the top of drums.ORDER:empty all waste oil catchments immediately and cap off all the containers,fax over contingency plan. Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gtys>25 Ibs dry or 50 gals liquid but less than 111 gals d❑ gty's 111 gals or more y y descnption 7 qty �un�t of measure motor oil 425 gallons ..........._.......__.__.._..................._............_........._..__........_....._.......__................_—---------_........._._..._...__.._............. ..... antifreeze(for gasoline or coolant systems) i 2 gallons - gear oil — ; 30 gallons waste oil _ 250 gallons _ . --_..� -..__....._........._........ -. _............__.._.........._............._....................... _......__...._._..._......._......._...._................._.....__......_........................ _ ._.._.._._..._..._....... Adhesives 1 gallons automatic transmission fluid 60 gallons — Lacquer/Sealer 47 gallons _ Ice Melt 13rgallons _-_ __ ___ . _ __---_....._-_------ _..._...._............._.___....__ ....._ ............................_.._.._....__............_._..I_____._....._. _......_._. __._._..--__. paint,varnishes,stains,dyes 24 gallons caulk/grout 0.5 gallons ...___...._.____..._.._....___....._.................................._.......__._.__._._...._._.._..__._....._._............... ......__...........{....._-...._...........____.__.___.._._..._._._.._..._._......._._.____._................ hydraulic fluids(including break fluid) 1 gallons new lacquer thinner _ 2 gallons - gasoline 5 gallons asphalt&roofing tar 1 gallons ._._.._-----._........._._.___.........._.................._.._..................__._.__..p.._-.._.....____.__-_. __._..__.______..........._...__...._____._._... Detergent 2 gallons Misc.Flammable E 1 gallons Lime _ 1 gallons Concrete mix _ 66.5 gallons refrigerants 5 gallons Waste Transporter: Unifirst Fire District: :Centerville/Osterville Last HW Shipment Date: ! 5/3/2004 Waste Hauler Licensed: Yes Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Bortolotti Construction Fax: Corp Name: Mailing Address ; Location: 45 Industry Rd,Marstons Mills Street: P.O.Box 704 mappar. 058-024-000-000 City: Marstons Mills Contact: Bob Bortolotti State: Ma Telephone: 508-771-9399 Zip: 02648. Emergency: Person Interviewed: Business Contact Letter Date: -412"804 Category: Builders/Contractors Inventory Site Visit Date 61649114 (4p5 Type: Follow Up/Inspection Date: Gpublic water ❑ indoor floor drains ❑ outdoor surface drains ❑d license required ( + ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc W currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir - --- - on-site sewage El indoor on-site syste ❑ date:outdoor onsite system 6/30/2006- --- ---- �ews' '�� No toxic or haz.Mat.On site compliance: REMARKS:9/24/98-Repair of trucks and hydraulic Equipment. Oil Satisfactory r, filters drained+recycled W.O.Heat. Speedy dry. Magnetic drum ® ��'�I t V a��/� labels used. Antifreeze can go to Tirrel Is. NAPA takes batteries.Obtain 3 MSDS sheets. ORDERS: Label ,C .��- �� �Z� J w.o.drums"TOXIC',"HAZARDOUS WASTE"and"WASTE OIL".Obtain . r-� U Material Safety Data Sheets from suppliers/retailer/distributors. Keep in r w� file in office and 1 set in Shop. K_&Ve LAA REMARKS: 1999- Building heated by waste oil and gas.Take waste oil r_ __ �"-� D from"Lube on Location". ORDER: Label all waste oil �1( ` a filters. 516102'REMARKS ,MSDS available. 5/6/04 Remarks: All manifests and MSDS on V�- site. Now has a large shop to maintain/repair their company vehicles. �Yn� �/� All used oil&antifreeze burned in waste oil heater. Staff goes through `LJ basic company training once a year. Free flowo eye wash has been ordered and is going to be installed. PPE onsite. Absorbant onsite. -b ��tr Unifirst comes once a week for uniforms and rags. New gas cans with O �-�f' Lk&ryvJ CAPS have been ordered. ORDERS: Get a_metal container for shops rags and keep covered to prevent fire hazard(people smoke in shop). /� Inventory total= 7,f�License REQUIRED and they were L J/] �(,{� a4 '� Lr� instruct d to o in one. �/ Q c� d rn s , g-rS x 3 -l60 x,& LIQ a K 5T \P 1� � (� ✓ 1b 15 7 5 0-1 \ to al t1 .. &)/ k L� -(mob�,v�-t f,�o X0 � in 0krI * t . Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ zero Toxic Waste Materials ❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals gty's 111 gals or more escnptfon „ ffi ty__._--_. Fx ;.. unitof xr�ea„„sure IW motor oil ( 425 gallons _.. ._.__._._._........_^_.........-__-...................... _....._._.__._.._.__..___.___.._._._........__ _..._____-.___.__.-._._......_........._._._. __-_--- __.... antifreeze(for gasoline or coolant systems) i 2 gallons_ gear oil 30 gallons waste oil 250 gallons .__...._............ ................_..__- ___. . .. ....................._.....__.........._.._..____...._.._._.._-.........._. _......._ ... _ _.__.._..._..___...._...._...._..._._.__ Adhesives _ 1 gallons automatic transmission fluid 60 gallons Lacquer/Sealer 47 gallons Ice Melt 13 gallons _...._______.._.___......_._.__-_._...._..__....._..._.............................._...._............ __...__..............._..__.._..._.......---_.._..___........__.. paint,varnishes,stains,dyes 24 gallons caulk/grout I 0.5 gallons .___........_._______........_._.._......................_.........__....._.____..__._...._.._ ___._...._._....__- hydraulic fluids(including break fluid) 1 gallons new lacquer thinner 2 gallons _ ._.................._..____........._._._..____.-._....._....._._.__.._...._....___._.._._.......... (..__._.._._-_____._.__...._... gasoline I 5 gallons asphalt&roofing tar - 1 gallons Detergent 2 gallons Misc.Flammable 1 gallons Lime 1 gallons Concrete mix 66.5 gallons efrigerants... ... .. 5.gallons.._. _ Waste Transporter: ;Unifirst Fire District: :Centerville/Qsterville.' Last HW Shipment Date: 5/3/2004 Waste Hauler Licensed: Yes ........_. rG, Fy -r� �C D te: —w--C9 TOXIC AND HAZARDOUS MATERIALS 0 NTORY NAMEOFBUSINESS: � 1 f r 9� „ BUSINESS LOCATION: � //S �]� MAILING ADDRESS: .® 64 AN /M.4 r 02-&IS INVENTORY TOTAL AMOUNT: TELEPHONE NUMBER: 0 CONTACTPERSON: 9.-37 EMERGENCY CONTACT TELEPHONE NUMBER: Fli�e 0(57RlC.T TYPE OF BUSINESS: O HER INFORM TION: 0,574f1cvfdle.1 M S 0115- .54e We d t2aq s 1'4'&V'4-� Waste rporta it on: Name of Hauler: Ulul ie"54- Destinatio : Waste Product: d9aigs " c ►JaW432 .s Licensed .Yes No 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. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): ✓ Antifreeze(for gasoline or coolant systems) Drain cleaners 1,�9.NEW USED Cesspool cleaners aQAAutomatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite)/__'e_e_/)jam Hydraulic fluid (including brake fluid) Refrigerants ✓ Motor oils Pesticides g2_!5�NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED 2-0--a,ot Other petroleum products: grease, Photochemicals (Developer) lubricants, ear 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 Oaf- ash deterdents/4-�7 atcca. sew Jewelry cleaners Car waXes and polishes Leather dyes jaar& Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's ✓ Lacquer thinners Other chlorinated hydrocarbons, ANEW USED (inc, carbon tetrachloride)- Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform,formaldehyde, Floor &furniture strippers Metal polishes hydrochloric acid, other acids) Laundry soil &stain removers Other products not listed which you feel (including bleach) may be toxic or.hazardous (please list): Spot removers & cleaning fluids Misc.: •� �+ �;v-e / C (dry cleaners)„ Other cleaning solvents Bug and tar removers e L« HazMat On-Site Inventory/Inspection: Records to Review for SQGs and CESQGs DBA: C-w - Location: y5 L2! l � RGd• Site visit date: 5---G - b y • Hazardous Waste Manifests: 0 Q/- • Employee training document ion (if required): J • Hazardous substance spill control and contingency plan: (/I e s- • MSDS on site? • HazMat Inventory records (if applicable): (A Piy �� 5 , LAZ- • HazMat Waste Shipping documentation: i1,-Li�et��.�- •---cam,0� • Spill records (if applicable): p,2�tP/l S - • �4�'v4z•�ze,e�,e �a.�4e � �hQiuc� P'c�ole., � Hazardous Materials On-Site Inventory/Inspection For ALL Shops and Businesses: DBA: . Location: _17- Date: Physical Features to Inspect: 1. Hazardous waste generation sites (production/manufacturing areas): 2. Waste storage areas: V A 3. Satellite accumulation points throughout: 4. HazMat stored outdoors — CHECK OUTSIDE: 5. Shipping and receiving areas: 6. Run down of shop activities: 7. Housekeeping practices: e9 Own r Town of Barnstable-Health Department Page 1 ,. HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: Bortolotti Construction Fax: — Corp Name: Mailing Address .. ........_ _ Location: '45 Industry Rd,Marstons Mills Street: P.O.Box 704 mappar: 058-024-000-000 City: Marstons Mills Contact: Bob Bortolotti State: Ma Telephone: 508-771-9399 Zip: 02648 Emergency: Person Interviewed: Business Contact Letter Date: 4/29/2004 Category: Builders/Contractors Inventory Site Visit Date �p Fj Type: Follow Up/Inspection Date: ❑� public water ❑ indoor floor drains ❑ outdoor surface drains ❑ license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑ currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir -- W on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system date: __._........................................._.. No toxic or haz.Mat.On site compliance: REMARKS:9/24/98-Repair of trucks and hydraulic Equipment. Oil Satisfactory filters drained+recycled W.O.Heat. Speedy dry. Magnetic drum labels used. Antifreeze can go to Tirrells. NAPA takes batteries.Obtain MSDS sheets. ORDERS: Label w.o.drums"TOXIC","HAZARDOUS WASTE"and"WASTE OIL".Obtain Material Safety Data Sheets from suppliers/retailer/distributors. Keep in file in office and 1 set in Shop. REMARKS: 1999- Building heated by waste oil and gas.Take waste oil from"Lube on Location". ORDER: Label all waste oil; containers. Recycle Speedy Dri.Recycle used oil filters. 5/6102 f' REMARKS: MSDS available. Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY CA! Chemicals: ❑ Zero Toxic Waste Materials gty's>25 Ibs dry or 50 gals liquid but less than 111 gals gty's 111 gals or more description qty unit>of meas'urer,, motor oil _ _._..._._.._...-_.. _.._ _................... __..___ ____. ___.....__......_ S antifreeze(for gasoline or coolant systems) gear oil .-6- s waste oil _ 350 gallons _ _ ...........__.__ _______ .___ _ . .. _ ............_ ,g �- motor oil 400 allons automatic transmission fluid Windshield Wash misc.petroleum products:grease,lubricants _ 2du1[l�s _.__....._____._—______.._._.......__._.______.._..______._.._._..._......___......._.____.........___..__..._........___._...>...._............._.._........._. paint,varnishes,stains,dyes — gallons Waste Transporter: �,c/j'�jjs� Fire District: C —y �5'.Fp��/, V...... Last HW Shipment Date. / G Waste Hauler Licensed: No t.Prt, % e/?j arc, �" �bx ve `�--- r� a x s n � s j �-(Y Date: 5-(.!—V L TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: P - elvl r¢C.t1611. BUSINESS LOCATION: ram► //s .MAILING ADDRESS: -7 6q � y6gs INVENTORY TELEPHONE NUMBER: ,6-0$— TOTAL AMOUNT: CONTACTPERSON:_ 957 � 5 EMERGENCY CONTACT TELEPHONE NUMBER: 1=lt{E 0(5717ICT TYPEOFBUSINESS: l' arm 0 HER INFORMATION: GL L_/Ct �` MS0S or? 511�_- � PA-Ca W fivil S uru- Wastel 1T V _ransporta ion: Name of Hauler: Uru6r'el�47 Destinatio Waste Product: ig Licensed Yes No 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. . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed (gallons): ✓ Antifreeze(for gasoline or coolant systems) Drain cleaners 1._�9.NEW USED Cesspool cleaners l Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite)/.re-e-/yle-l- etak Hydraulic fluid (including brake fluid) � Refrigerants ✓ Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Dieselfuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, g2ar 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 2— o�-G wash detergents/�„ofz". s�,4a Jewelry cleaners Car wages and polishes Leather dyes Asphalt& roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's ✓ Lacquer thinners Other chlorinated hydrocarbons, 4NEW USED (inc. carbon tetrachloride)- ail Paint& varnish removers de tossers ' g Any other products with "poison" labels Paint brush cleaners Floor'&furniture strippers (including chloroform, formaldehyde, Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Misc.: Av Ae0%p-c (dry cleaners) 117 Other cleaning solvents C'awe,c� o �C Bug and tar removers Vie., TOWN OF BARNSTABLE LOCATION ��u��rv.�� - SEWAGE # 7 Sri VILLAGE �p/'Sfo�S/�II��� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. dog ��l0�`1 �l✓� 271-93 SEPTIC TANK CAPACITY �� / AZ62 LEACHING FACILITY: (type) _ �9�/L�GL� Ci 4(size) NO.OF BEDROOMS BUILDER OlF'f!gj1)- PERMTTDATE: Z -?7 —COMPLIANCE DATE: c - 7- g 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by -6 �3 �7z 00 ' o �8�/y r TOWN OF BARNSTABLE C MPLIANCE: CLASS: 1. Marine,Gas Stations, Repair BOARD OF HEALTH satisfactory 3.A to Body shops O unsatisfactory- 4.Manufacturers COMPANY ' (see"Orders") 5.Retail Stores 6. Fuel Suppliers ADDRESS .� t- C1aSS: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT-outdoors) MAJOR MATERIAtg'�'"-51 cz se lots Drum-, Above Tanks Underground Tanks 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 l' Synthetic Organics: degreasers Miscellaneous: f DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 0 Town Sewer OPublic /On-site O Private 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system �/ 4. Outdoor Surface drains:YES Y NO ORDERS: - O Holding tank:MDC ,Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Des tina, tion Waste Product • • jiff YES NO 1. 2. F. Person(s) Interviewed Inspector Date TOWN OF BARNSTABLE c MPL/ANCE: CLASS: 1.Marine,Gas Stations,Repair 2. Printers satisfactory BOARD OF HEALTH 3.Auto Body Shops 0 unsatisfactory- 4.Manufacturers COMPANY-kJ (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Ak4/,, C1833: 1 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIAfF"-5 Case lots Drums Above Tanks Underg-round Tanks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline 94 Jet Fuel (A) Diesel, Kerosene,`#2 (B) Heavy Oils: waste motor oil(C) � Jp,f� new motor oil(C) transmission/hydraulic /AA Synthetic Organics: degreasers Miscellaneous: 54--7 Af 1 DISPOSALIR.ECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply _ '*— O Town Sewer OPublic /1"n-site OPrivate 3. Indoor Floor Drains YES NO O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES Y NO ORDERS: - O Holding tank:MDC „Catch basin/Dry well O On-site system 5.Waste Transporter Narne of Hauler Destination Waste Product 1. (iff YES INO 2. Person(s) Interviewed Inspector Date t (508)771 939 "" ",' Fax( 08)4 28 9399 #' 3 ` •'t �s(508)428�8926 t.�' ;��i t,�,>� ,�,.'• F ' * •� � Hc;v �' � � pert' BORTOLOTrTI}CONSTRUCTION, INC. rEXCAVATING A:SEPTIC SYSTEMS LAND DEVELOPMENT DRAINAGE* s � KA`` Y Eye A €r q; � -�; 45 INDUS CRY ROAD s, Represeniatsve +L� s MAR STONS MILLS kMA 02648 y.:�.a :�,�J,X� �,;,r.$"°4"fi'R. �+a ��'µ ��'� X d 4:•.f °n,�T�,y TOWN OF BARNSTABLE C MPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH Satisfactory 2. Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY o z, (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS ile4-S /t��Class: 7.Miscellaneous IC i. UANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons IAge ITest Fuels: Gasoline Jet Fuel (A) (B) Heavy Oils: waste motor oil (C) a (� new motor oil(C) transmission/hydraulic - Y Synthetic Organics: degreasers 7-2 Miscellaneous: �- 2d DISPOS ECLAMATION REMARKS: 1. Sanitary Sewage 2.Pter Supply O� ��T°°wn Sewer Ao ublic C (On-site OPrivate 7: 3. Indoor Floor Drains YES NO O Holding tank:MDC ` O Catch basin/Dry well ` O On-site system 4. Outdoor Surface drains:YES _NO O ERS: c0Colding tank:MDC � �4 atch basin/Dry well �'2 O On-site system . d 5.Waste Transporter YES NO 2. Person(s) Interviewed Inspector Date I TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair 2.Printers BOARD OF HEALTH satisfactory 3.Auto Body Shops /J unsatisfactory- 4.Manufacturers COMPANY �� L=G� (see"Orders") 5.Retail Stores 1 6.Fuel Suppliers l'// ADDRESS� '�ss�u� l�� Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS Case lots L)rUms: Above Tanks Underg' round'Tanks". IN OUT IN OUT IN OUT #&gallons .Age Test Fuels: Gasoline Jet Fuel (A) AIA 1144 Diesel, Heavy Oils: waste motor oil (C) new motor oil(C) d transmission/hydraulic 1/ Synthetic Organics: degreasers Miscellaneous: DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply — O Town Sewer VPublic On-site OPrivate �• 3. Indoor Floor Drains YES NO-z 0 Holding tank:MDC_ 0 Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: - 0 Holding tank:MDCyT `Catch basin/Dry wee-Y. / 0 On-site system 5.Waste Transporter Waste Narne of Hauler Destinati6h, 2. t5ldersoffs) Interviewed Inspector Date 111/� s TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Statio ,Repair Q satisfactory 2.Printers T" BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers /c COMPANY P-J,,+( (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS S' MS Underground Tanks 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 Miscellaneous: t- ��-� DISPOSALIRECLAMATION ,,REVIARKS: 1. Sanitary Sewage 2.Water Supply I`' A L 1 kL j r = L tv" ,C O Town Sewer RTublic '� e j t i-tC4djzfo 61. ' 38C On-site O Private v T we A-6e f' ✓'ee t, Af 3. Indoor Floor Drains YES NO O Holding tank:MDC ca '0 `� ✓`�� �� ` � � L�l � � f O Catch basin/Dry well (Jb VaA-!-% 44 rD S. O On-site system 4. Outdoor Surface drains:YES NO ORDERS: �f e, O Holding tank:MDC zotel 4-'o > c at I X i`C ��G �� ✓ O Catch basin/Dry well " e Q e,re ® O On-site system 5. Waste Transporter Name of Hauler Destination YES NO 1. 2. Pe n(s) Interviewed Inspec or Date TOWN OF BARNSTABLE LOCATION �S.rYr ,I`/v W — SEWAGE # .�� ✓�� ASSESSOR'S MAP & LOT VILLAGE /"'��515 INSTALLER'S NAME&PHONE N0. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) C�O (sFACILITY: NO.OF BEDROOMS /u/���y % BUILDER OI{ Gf PERMTT DATE: Z S—' �T COMPLIANCE DATE: ,S - -2 Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by 'Z 's 7z 00 � Z 0 0 No. - , Fee / -).- j 1. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: VY6, PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Mt!6ponl *pttem Congtruction Permit Application for a Permit to Construct(/,,<Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. N b u sTPL y Ro Owner's N D J Address end a No. Ci�i Ui O �- �T I Assessor's Map/Parcel S8 ��� a t-) 4 \ ^A c AA VA� ,7 1 Installer's Name,Address,and Tel.No. / J Designer's Name,Address and Tel.No. Q Itra— orn Ckt-m- `Yv4N/Ke2 Svrt/e� �eMSc3cT hAA d�ay Type of Building: Dwelling No.of Bedrooms Lot Size �/�io13� sq. ft. Garbage Grinder( ) Other Type of Building OFF,,e '1-f�'(+ot of Persons Showers( ) Cafeteria( ) Other Fixtures CJCA_'K Design Flow ly gallons per day. Calculated daily flow I Xr gallons. Plan Date 1 I'1 a.— `�! Number of sheets oZ Revision Date Title S S-e-WS%!9LQ = P1•4i>J Size of Septic Tank Type of S.A.S. A"''le Soo 6-t4d oev C lks4-1xlf Description of Soil S c-e I,aA.) * 81 A I Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title of the Envir nmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by s Bo d of Ark ., Signed Date Application Approved by Date 7 Application Disapproved for the ollowing reasons Permit No. 9 - S / Date Issued 2 7 p 0 0 No. / .o�� � _ Fee THE COMMONWEALTH OF-MASSACHUSETTS Entered in computer: Yes T PUBLIC HEALTH DIVISION -TOWN Of BARNSTABLE., MASSACHUSETTS Zipprication for Mizpogar Opgtem Congtruction Permit Application for a Permit to Construct(14kepair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. ;, Lis—!"Ay go A Owner's NSb s d deM 7W J—`— Assessor's /Parcel Ma P S-8 Q t. �8'Q G Z r o w `' Guar` �( 9lo� tM , M 1 v -1 , ✓1 4 ? '1 1 -5399 i Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. I Q/troL , 6_6N-7— I'Vv C�Sv�7vq�TS ncQ .loot, -701 Type of Building: Dwelling No.of Bedrooms _ Lot Size 7�a 3� sq.ft. Garbage Grinder( ) Other Type of Building OFF' Pb""```11e1111§0 of Persons Showers( ) Cafeteria( ) Other Fixtures y``i Design Flow �I��S G-P gallons per day. Calculated daily flow i aS� tr P 7 gallons:• Plan Date Number of sheets ;11 Revision Date Title S-eAoU /4 A,) Size of Septic Tank 1 Sow Type of S.A.S. �J "'e So0 -A1 01V C IAt4-4ls Description of Soil h Nature of Repairs or Alterations(Answer when applicable) r` a f r + Date last inspected: Agreement: - _ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title of the Envir nine tal Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by t s Boalvd of 1 � 7 Signed Date { Application-Appro4ved.by Date Application Disapproved for the following reasons ' Permit No. Jr Date Issued - ' g' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS i { Certificate of (Compliance 4 THIS IS TO CERTIFY, that be,On-site Sewage Disposal System Constructed ( Repaired( )Upgraded ( ) Abandoned( )by O�G Wi'T7 GO'.I.� t-+ "J J at LET d`1 has been constructed in accordance` with the provisions of Title 5 and the for Disposal System Construction Permit No. 9 7—S l dated -2 Installer Designer r The issuance of this permit shaltnot be construed as a guarantee that the s ste w function as de t ned. Date Inspector i —————————————————————————————— ——————— No. / 7-5 Fee b THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS wigpogar *pgtem Congtruction Permit Permission is hereby granted to Construct(4-)-Repair( )Upgrade.(_ Abandon( ) System located at U'C d `/ 9(o and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. i Provided:Construction must be completed within three years of the date of this permit. Date: Approved by ,l� i • Oz' ' Na.... ......... FEs. ...... ............... • �� THE COMMONWEALTH OF MASSACHUSETTS - (//) BOARD OF ; HEALTH , ..OF...... IMF d s�'D1v_v. ft'r' qflvn for Dtovoiial Workii Tiamitrurtton Urrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) ,an Individual Sewage Disposal System-at: , ?// M.ARs�OA3s....A.,tees.. ............................Lem' ......26 Locatioh .Address . ......................... or Lot No... .. Owner Addfess w ,�' -..-•----.....-•---..............................••- .................... f1!. �t�.................................. Installer Address Type of Building Size Lot............................Sq. feet U Dwell No. of Bedrooms................. .....Expansion Attic ( ) Garbage Grinder ( ) �/ Pk Other Type of BuildingOE'R�t$ �CIlL No. of persons____________________________ Showers (oSld) — Cafeteria (A/C� d Other fixtures ...---------------------------------------------------------------------------------------------------------------------- --------- 1wirW Design Flow............................................gallons per person per day. Total daily flow.....6 ..:......................gallons. Gd Septic Tank—Liquid capacity 1� ..gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Y x Seepage Pit No......Z............ Diameter.......(a......... Depth below inlet......_Es......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( )y Percolation Test Results Performed b ...---•-------------••-----..........---------•••--•••-.........--...--_.. Date........................................ � •. ; Test Pit No. 1.....Zr......minutes per inch Depth of Test Pit..... .74----........ Depth to ground water..... tWAT...... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ..........--•-------------•--o......•-------------•....o__..................----...----...•------..._..._.....--•---•-----•.....-........ .... -...----.....-- O Desscr!p lion of Soil............... .,t...._ 7...._.... ---9 r-----•--- ?FtSCt'G�---Sub�S t/.G I.---s��-L.---� �_....'? ....... x ?•— U -----... ...... ftLD-------------------------•---• W ---•---•-----------------------------------•----•---•-•---••-------•-•--•.-•---.-•-•-•-----------------••-------•-----------------•-----------•-••••------•------•-••-•----------------•--••......----- UNature of Repairs or Alterations—Answer when applicable............................................................................................... --------•-------------------•-........-•--••----•-•----------------------...------..........__----------•-------••--••------•...-----------------•••••---••--------•--•--•......._..................---• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by the boar¢, health. ..............�'I...............--...........-_...__. __.._ ' to Application Approved --•- -- . •.. ......`.. .....--- ----•- --�©--�-3-......... .................................................. Date Application Disapproved the following reasons: --•-•-------------•- --------------•--...........---------................._...•-----•-----.....------•-•--.................--••---------------------------------------------------•--•-----•..---------------------••-...... Date v Permit No....................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...........................I......................................................... CIrr#tflxtt#r of Tomplttttta TH TO CERTIFY, 'That-the Individual Sewage Disposal System constructed ( or RepairedPA ( ) by, ...... ................ -- Installer at--• .... , ... 46• . .. .-•------- .......................................•-......--------- .... I has been installed in accordance with the provisions of TIT 5 of Th State Sanitary Co . as sc ibed in the -_- ?.. ............. dated_. �0---- application for Disposal Works Construction Permit No.4 ... .................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE .r SYSTTEM WILL FUNCTION SATISFACTORY. DATE..V........ ........................ Inspecto ....--------------------------------•-------•-•-----•-------•-------.---------•---.- !.• !!!!!,!!l.. l.!l...l....•..l. !O..............1./.!!!!!!!! !!! !! !!!'!!!•!!!!!!!!!!!!!!!!!Y!!!.!!..!!l...�!!.!.!!!!!!.!l.1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE , KING ENGINEER MUST SUPZRVI^t_ LLATION AND CERTIFY IP I ; OF.................................I.:-..:-.SYSTEM WAS INSTALLED INX T No. .._.... ACCORDANCE TO:PLAN. FE .. r: tgtt oxk �ott�#rlu ton rrutit Permission is hereby granted = .... to Construct Re al ( ) an I ual ten .� -, Q atNo..----- --••--. - - -------------- -- --•-•--- ----•-••-- .................... Street as shown on the appltcatio kn for Disposal Works Construction Permit No.................... _.-:_... ........""_....._.......__ and of Health DATE........................................... ....................... FORM 1255 A. M. SULKIN, INC., BOSTON Nca....... ..... Fms.............................. THE COMMONWEALTH OF MASSACHUSETTS Cell BOARD OF HEALTH ...................... ....................O F.......................................................................................... Appliration for Bh4paiitt1 Works Tonotrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal '' System at: ----........::Z1Dvs . ..... �? f czsr . Ad.14.�s.. ...........................� ' 96.... -. Locatio?• Address or Lot No. 125.� _ �7 �i � ..---•-•.................. ............. .�: a iLd ltl..l t�1�. Owner Address ............................ W P�..... :. t'f .- -::.at` 'Tc4�3c t y!4... ,-� Installer Address Type of Building Size Lot............................Sq. feet Dwelling No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other e of Buildin �F� ��',�7�9r4.,.No. of persons............................ Showers QV Cafeteria A/ dOther fixtures ................•-•-. --•--•••••-•••----•--••-••••--••---•------...................----....._....................... W Design Flow............................................gallons per person per day. Total daily flow......6 .........................gallons. WSeptic Tank—Liquid capacity./54 ..gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width:................... Total Length.........._......... Total leaching area....................sq. ft. Seepage Pit No.__... .......... Diameter....... Depth below inlet.._....G......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I._.........minutes per inch Depth of Test Pit.....lZn........ Depth to ground water..__N� 5i7...... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------------•--------------------------..............-----------...--•-•-------............................................................... O Description of Soil..........-1...G�......... -7-- --....ZZ...-`T5.J--------- �r-jf,;LS.(p C_-1..._ G.....`�.�r :.-. ..._.. V ..... -- ....:M 6 lom_..Cl r ..:Se3AJ2)..................................................................................................... W ........................................-.............................................................................................................................................................. Z. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------•-----•---•-•-----------------------------------....._..........••-••••-•-•-•••-•-•------••-•••---•--•---•--•-••--•-••••---•---•--••--•----•------•-•-•-•--••-•----- Agreement: The undersigned agrees to install-the aforedescribed Individual Sewage Disposal System in accordance with the provisions of IT114,, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by the board.Qj health. Si ✓ -... _.... Application Approved `.' -. :�-... ........................................................ �� ......_ ••- Date Application Disapproved the ollowing reasons:----•----------•---••---•--.....----•----------------••---.....------------............,:..--•• .........-•---•-----•---------------------------------------•...........--------------................--------•------....--------..----- ----- ............... --•-----• ........---••••. ....... Date PermitNo......................................................... Issued-............................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trr#if iratr of TomViiaArr THI - O CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by,. *,;.'.' _./�`4 9, ?.--•----•---.. .. ...... ....... •---- •--------------•---.......................----•------------.........-•---•---...---•--...--••-•--------------•-- Installer at-- ' f• F ' ._.lJr% ¢ _ ----------------- has been installed in accordance with the provisions of TIT F 5 o The State Sanitary Cod as cl�ibed in the application for Disposal Works Construction Permit No.. . ......... "._...... dated_..�14... ... ..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................•-•---•---••----•--•-•-...................--•---.......... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAUCl AIG ENGINEER MUST SUPERVIUE INSTALLATION AND CERTIFY IN WWI ..........................................OF............................rp,=.-S`tST•EAi.-WAS..IMS.T'ALLED IN S�fF, T No I A .. ACCC: D%V_'_TO PLAN. FEE..: ••-••••............ �to�roo�rl orko Tono#rur#ion "rrutit Permission is hereby granted------.-- ... ..................................... -----.-----------------------._----------------.--.--------.--.•----- to Construct ( epair ( ) an In i* al =agE po S em at No.•-••••• .1��� ...�:� N�'` -... - --.- _- ........... Street as shown on the application for Disposal Works Construction Permit No..................... ,.._.._.�_a._._--._......_. •........................•--•-- == " --....-----•......-•---•----........._ rd of Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC., BOSTON Consulting Ensincct • I����,� / y`�r�� East Sandwich Masi . aN d�T - $fit W� g3�oj S� �S6.K's I� C _ •TMK -OZS 6A44-. -A I.5= 9�F'Z 6"•- use'I rl�c�. Nb iYIT - c crTf t�=0?-0,6ac.s• - usa �' x fib' t — r 2+ � -S-11CH C2 U IYZt >; testµ 6:per.-.G�p�,cl-t`f = 2�tr tv A [P A z.g)+ 7--WX 5L'' 1,D) 1140�- 7 - -: Tmq- :*- $� INSTAd#.t=�7 '�C, M,&lr T^lt4 �7��TL"1 WN 1.F5./3]TT'". l��+Nll�LriMSFiTi�L GAB -?1 Tl.� i ZH OF 4f��9. 0 ALAN yN W. JONES -' fl No. 25100 O .Ttor't,t�.--r� =2.M11�t�/�,•tc(� (�=-�cGt M�� - R,.,-ram. Hal,= PR'\� f'G cord:.. •1:;I! 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JV1YIW�TC::Z"COII��rr Consuldng Enginec East Sandwich Mas r y r�XO �. 4�1.� `t"fz � �oN� Mlc-Ls MPS sF= Inc-TM K -40 8 AN-4,-. -A t 1"•- use•I -� l,r+ we-* ;,IT - G ►cc>`f �b=�L0 6AZ,-- - u�a a"'4, A lo' � T + 21 s-ra-lam C2 c I f�tt i-��t'NEtN (o•t�FT.- nor t`f = /L�7t �c t v (P �c + �x 5Lx ►•�)�= I IQ� - 7 �v2 ��''L �TT� 5}{�1.L 1� I11S1"AL.}.{=�rJ #ID 1v�AINT�+)N�> �'T��1'L.'1 �N - V�/� �}{� CciMK.Y'�u1E�►1-Ti+ ¢ N�S�1.�55Tt'=5. L�•Nrp�oNM�KTaL Give -?1T1.✓✓ �j --Vr - FIT •MKT: 6R•�• �7� . "ZN Of Mgs�9 o ALA N cy G W. 1p JONES p No. 25100 O h!o W?c-naa- -I��t� p12�03 - � P• 22� ' v�„G .�acct.�.-nat I�-r� =2MIhK/�rtcN ��3cuM�� . Nil D . INd. 0 - �. �J�j.B 3 � I hN• � 1�'�'� Ion: ��.� INS!• �5�� _ Pi,. 1.33 1500 • P.c.c�r+�fTE r �e �rZ- TANK 2- to 7f((o ur lz�t -) �L.rcr�- �s+u Prr fi-r 2� m F w 3�¢� '10 ���a" �4 yn -5rCH'3 ALG p54-0/1fl+-2"a= v�(�d}l ry �EPBTGN�A'r "TL'f'• Q i LA`V OFFICES OF PHILIP M. BOUDREAU 39O NORTH STREET HYANNIS, MASSAGHUSETTS 02601 (617) 775-1085 PHILIP M. BOUDREAU August 11, 1988 PHILIP MICHAEL BOUDREAU MARK H. BOUDREAU Joseph DaLuz Building Inspector Town of Barnstable Towm Hall Main Street Hyannis, MA 02601 RE7, Lots 947- 95, and 96. Old Post Road; Industry Road, Marstons Mills, Massachusetts Dear Mr. DaLuz: In 1983, foundation permits were issued to Robert G. Kesten , Sr. , of Osterville, with respect to three parcels of land described as Assessor ' s Parcels 22, 23, and 24, Assessor ' Map 58. Commence- ment of work under these permits was rendered impossible by virtue of a la-w suit involving Mr. Kesten and others, in which said lawsuit a Lis Pendens or equitable attachment recorded in the Barnstable County Registry of Deeds rendered work on these projects impossible as a practical matter by virtue of rendering said lots unmortgageable and unsaleable. This Lis Pendens has finally been removed as a recent settlement of the above-mentioned litigation . See Exhibits 1, 2, and 3 annexed hereto. It is requested that .the original permits heretofore issued with respect to these three lots be reinstated by you at this' time. i s7Y o(�;p�s�-Y�cl • (,` Sincerely, lip M. Boudreau <I or DOI TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM Mail To: NAME OF BUSINESS: 04NZ i/LUCr7ovJ Board of Health MAILING ADDRESS: ?a44 M tom- 4- Town of Barnstable TELEPHONE NUMBER: VT_ 7 Z/ P.O. Box 534 CONTACT PERSON: Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO L. �r This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered wlren-starfe i alli°� oYe th 9gg lltrr> 1 ! t. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor'oils/waste oils Road Salt (Halite) - Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers 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 cleaners White Copy-Health Department/ Canary Copy-Business t, 7. Decontaminate the surface where the spill occurred using a mild detergent and water(;I.when appropriate. 8. Report all spills to Blh'Johnson and/or Robert Bortolotti. Our Spill Response Plan; An effective spill response procedure should consider all of the items listed below. a Y; 1 . Management and employees will review Material Safety Data Sheets (MSDSs) or other references for recommended spill cleanup methods and materials, and t'he need for personal protective equipment (e.g., .,.; respirator, gloves, protective clothing, etc.) These sheets have been placed in a yellow binder, readily accessible for employee reference in the showroom. 4' 2. Management will acquire and maintain sufficient quantities and types of appropriate spillcontrol materials to contain any spills that can be reasonably anticipated. The need for equipment to disperse, collect and contain spill control materials (e.g., brushes, scoops, sealable containers, etc.) should also be reviewed. 3. Maintain recommended personal protective equipment (gloves, safety glasses) and train;e`mployees in their proper use. Presently our spill control materials and:protective equipment are kept on the showroom V floor readily acces, ble,to most materials under discussion. Our spill response plan.also includes s. Names and telephone numbers of Emergency Coordinators to be contacted in the event of a spill: ` f` l Bill Johnson — 774-487;'8289. f� e, Robert Bortolotti — 508 7,,71-9399: DEP 24 Hour Spill Hotline: 888-304-1133 r f: Our new building featur�.es evacuation escape doors with panic hardware, multiple wall-mounted ABC`fire extinguishers; panic hardware on doors; audible & visual smoke';heaf-and'intrusion alarms; emergency escape . Q EVI_ Coas a1Retal>l AW .. � Ha�ardous�Materials Management Plana '.-��- 10 r , L • r Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction .-------------------------------------------------------------------------------------------------------------------------------- 45 Industry Rd., Marstons Mills, MA Is Hereby Granted a License For: Storing or Handling 600 gallons or more of Hazardous Materials. ------------- ...........................................................4.......................................................................................... 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 BarnstableOkAl Inspectional Services BARNSTABL,E eft TQ� nar.N'Tn E•c4nTea LU-COMU-4""LS Public Health Division 63' -201 1391-0 BAMMBM Thomas McKean, Director MASK 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 1 st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 R vs—, pGh *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. Os e- 0,C)C/ 2. IS THIS A PERMIT RENEWAL? AYES_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 GALLIO�NS)? YES NO. 4. FULL NAME OF APPLICANT: ° 5. NAME OF ESTABLISHMENT: 6. ADDRESS OF ESTABLISHMENT: (46- AC.(Jk&6&6! 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: r.O, ��� 1"lcT6" 8. TELEPHONE NUMBER OF ESTABLISHMENT: S091 -7 71 •9 0 qg 9. EMAIL ADDRESS: 10. SOLEOWNER: ✓ Y'ES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TEL PHONE#OF: CORPORATION NAME EQ U G 1) PRESIDENT mot- �Ir� t ) A � TREASURER CLERK • 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q: �7 �Application Forms�Haz Mat Appli Draft 2019 od cx _ J Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., Marstons Mills, 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 rr . Town of Barnstable Inspectional Services BABSTABLE �pTHE Tn_ wv"se.eg-a9brq, a� ;',W=!e Public Health Divisions 9&ARNSrABLE, Thomas McKean, Director �p i6;q �0 It`s rEo�a 110 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 r ' : APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE ' HAZARDOUS MATERIALS �w IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 1/�d Gh1L *A late charge of$10.00 will be assessed if payment is not received by Jules Q( Stp o( 1. ASSESSOR'S MAP AND PARCEL NO. `7 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: be-r`- k(40101-1", 5. NAME OF ESTABLISHMENT:-Ea aOmlo4cw-)40c) • C-` 6. ADDRESS OF ESTABLISHMENT: J-4 1006 W;/,9 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: �® �VV OdCO 8. TELEPHONE NUMBER OF ESTABLISHMENT: 50 9-7 71 9. EMAIL ADDRESS: 44; I � 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD SS,AND TELEP ONE#OF- CORPORATION NAME � ���'k' �� • U PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: t� COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANIk"' DATE :�,JD1 9 QAApplication Forms\Haz Mat App Revised 09-10-widrr _ Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., Marstons Mills, 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 ' rs 16 f B- nsxable 10ewgiMotyYervjces �oF Richard V. Scali, Director t r 'Au Public Health Division BARNSTABLE • z BARNSrABIX = Thomas McKean, Director ;�°0 4� _.. _ ASS. 'ham - - en Nw+'`0 - _:.--20-0_Main-Street;-Hyannis,::MA-02G01 _.. . _ _. -- _ t.w6 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS , IN ACCORDANCE WITH THE TOWN OF BARNSTABLE.GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st-JUNE 3 Oth). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons; ; - $ 50.00 .❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 0. 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. 2. IS THIS A PERMIT RENEWAL? YES_NO. IF YES, SHIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF - GREATER THAN HOUSEHOLD Q ANTITIES (25 GALLONS)? YES NO. _ � r 4. FULL NAME OF APPLICANT: - : 5. NAME OF ESTABLISHMENT: i? 6. ADDRESS OF ESTABLISHMENT: ^ 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: q q 8. TELEPHONE NUMBER OF ESTABLISHMENT: tt, 9. EMAIL ADDRESS: L0^�v�d� CCU Sort f i� O y-) 10. SOLEOWNER: /YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADD�ESS,AND TELEPHONE#OF: CORPORATION NAME Cc' , C- PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS / EMAIL: • SIGNATURE OF APPLICANT DATE Q: Application FormsViAZMAT APP 2017 REVISED.docx i Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $150.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., Marstons Mills, MA Is Hereby Granted a License For: Storing or Handling 500 gallons or more of Hazardous Materials. -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2018 unless sooner suspended or revoked. ---------------- --------------------- PAUL J.CANNIFF,D.M.D,CHAIRMAN DONALD A.GUADAGNOLI,M.D. 07/01/2017 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health TRow of Unstable eg atory ervlces . Richard V. Scah, Director THE rp,, o� Public Health Division BARNSTABLE • • uxns,wtF•;xru iut•conrt•xr—js LUNWABLE, + wuerms vns•os9'-201 nsren:n;lae;t mess Thomas McKean, Director 639.2oi4 QED 39. �`� 200 Main Street,Hyannis,MA 02601 575 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 l st—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 J9 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. 2. IS THIS A PERMIT RENEWAL? 1/ 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: 5. NAME OF ESTABLISHMENTnr�I�c(,�,,�" 6. ADDRESS OF ESTABLISHMENT:(�, - 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:P-Ar�C 170 z 8. TELEPHONE NUMBER OF ESTABLISHMENT:5©0 7 7/• 9,39Q 9. EMAIL ADDRESS: bONQ1041 C01)6k"140(� yes rQO/) 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME Fct"46(e�` Cam( ltoa, 07 �G PRESIDENT (?Q.1N � l P - ^ Ir7" TREASURER VX%)6 p( -Z CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLIC DATEneSx �Q/ Q\Application Forms\HAZMAT APP 2017 REVISED.docx Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., MarstonsMills,MA 02648 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 1� l IHE RegulatorY Sep"ViCes ' nommg F, Genet,Dinac'ol- Pabhc Health DI ion 2D01�ia Sz�-i, E ; , 02601 F� 50a-7�0-b304 O c�: 50B4 2 644 $1 MAIO DATE CA IMIN FOR T'OR PER TO STORE T7M,T7,T,NIGRE � 111 G_ALLADIS OF HA ARD'Otis ATERLIkLs -q-u—r_ NI o1 N of ESTA_BL'9 � 0 ADDRESS of EST NUM34_ SOLE OFT - YES NO TH r�PP?�IC _NT I5 A PRZ'�15 � Alal�LOiY��DDSS OF??J IFAPPIJC_2N'I�5 A CflRPORRz?TION; = IDE�ITZICA=ON NO,6 V' STA= Off'IliCORPOR,�MO T W�� ------------ ,�� U ri171L -EOS71L' r1LD1S..L'�il "V l •r rIJJ W w Rai too CLI= E(34ATURZ OF-0YIIC LN :i PIS771ICTIONS: EONS j0DR��S U i EOPII TT=, EON! 9 ' i i I Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $loo.00 Town of Barnstable Boars! of Health This is to Certify that Bortolotti Construction 45 Industry Rd., Marston sMills,MA 02648 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 thereto, and and expires 6/30/2011 unless sooner suspended or revoked. WAYNE MILLER, M.D.,CHAIRMAN _PAUL J.CANNIFF, D.M.D. 6/30/2010 JUNICHI SAWAYANAGI THOMAS A. MCKEAN,R.S.,CHO .Y�_ y.... Director of Public~Health Town of Barnstable 1HETp Regulatory Services Thomas F. Geiler, Director BA MASS. ' public Health Division .t, MASS. A 1639. `gym pfFoM A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 ` Office: 508-862-4644 Fax: 508-790-6 304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE tt/)e APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT nc� ('��� �•-Q(� �j �C j i�+C • TELEPHONE NUMBER, -93 SOLE OWNER: 66S NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. OY • CgJ 6Gj j f STATE OF INCORPORATION " A FULL NAME AND HOME ADDRESS OF:. / PRESIDENT Z� J ',3( ' �� �O Y1s TREASURER CLERK X • SIGNATURE OF APPLICANT. RESTRICTIONS: HOME ADDRESS pO c Sl /a s 1,,m d "ff HOME TELEPHONE # j e 4 Fiaz.doc%"U`y Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd.,.MarstonsMills,MA 02648 - -- ..... .. 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 Town of Barnstable Barnstable ~�� T 0 Regulatory Services Department • Public Health Division 9 i6� b� 200 Main Street, Hyannis MA 02601 2007 j 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 III GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT U)C . 4S o ECc "YDA • ADDRESS OF ESTABLISHIVIENT VN-Nea � �) , In^p ,p TELEPHONE NUMBER 508 -1'1\ -o1 S95 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL,NAME AND HOME ADDRESS O ALL 9 c� PARTNERS: un = 9� IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. OV4 a . X Sca 1 STATE OF INCORPORATION I FULL NAN F D HOIrIE ADDRESS OF: PRESIDENT p J. TREASURER CLERK J. • 4A—T- URE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE QAHaziriaP,Haz Mw Application2003.DOC I 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 Pape QAHazrna*Iaz_Nlat Application2QUS.DOC BORTOLOTT[ CONSTRUCTION:` INC. ; DRAINAGE 'LAND DEVELOPMENT SEPTIC SYSTEMS - JANUARY'l; 2009 TO ALL EMPLOYEES OF BORTOLOTTI =CONSTRUCTION r RE:. SHOP,HAZARD WASTE CONTINGENCY PLAN IN THE EVENT OF AN OIL SPILL OR ANY OTHER HAZARD CHECMICAL MATERIAL SPILL, YOU ARE REQUIRED TO CONTAIN AREA WITH SPEEDY DRY AND DISPOSE-OF SPEEDY DRY IN A SAFE AND.PROPER MANNER - SPEEDY DRY IS LOCATED IN AREA OF PARTS WASHER. 'ANY MAJOR SPILL SHOULD BE REPORTED TO VAN It. . JOHNSON. THANK Y LJ! P.O. BOX 704 •MARSTONS MILLS,MASSACHUSETTS 02648 (508)771-9399 • FAX(508)428-9399 7 Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS $15o.00 s Town of Barnstable Board of Health s This is to Certify that Bortolotti Construction 45 Industry Rd., Marstons Mills, 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. Town of Barnstable • �t t°�ti Regulatory Services Richard V. Scah,Director ` $" MASEL " Public Health Division BAMSTABLE s639 39-20 ms " mvsn'ea"ax"sos Thomas McKean,Director 165754 ; 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 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 charze of$10.00 will be assessed if payment is not received by July Ist. ASSESSORS MAP AND PARCEL NO. DATE Sty ZL. 1a%6 FULL NAME OF APPLICANT: i NAME OF ESTABLISHMENT: ADDRESS OF ESTABLISHMENT: U g 8 MAILING ADDRESS (IF DIFFERENT) % wSMAS TELEPHONE NUMBER OF ESTABLISHMENT: `1- EMAIL ADDRESS: .oh SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADD SS,AND TELEPHONE#OF: CORPORATIO PRESIDENT TREASURER CLERK • �. . - IF PREPARED BY OUTSIDE PARTY: SI�.hTATURE O'F APPLICANT Name: Company Address obi 31r4ot _ Telephone#: Email: Q:\Application Forms\HAZZAPP Revl6.docx Page 1 of 2 ` \ Number Fee 42 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that Bortolotti Construction 45 Industry Rd., Marstons Mills, 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 Regulatory Services • Richard V. Scan,Director • a ` ELARNVLA3314Public Health Division " Thomas McKean,Director � a 200 Main Street, Hyannis,MA 02601 rr; Office: 508-862-4644 Fax: 508-790-6304 Application Fee:$100.00 LIS) ASSESSORS MAP AND PARCEL NOO 61()Qq DAT�Z he !L4 �-M APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS j FULL NAME OF APPLICANT-�D 1p- T'"TI NAME OF ESTABLISHMENT I n b0; ADDRESS OF ESTABLISHMENT 4-3 ad c TELEPHONE NUMBE O Q' 7 7I `925 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL so PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION -SaC (VFULL PRESIDENTNAW HOME DRESS wtioKi-I)f TREASURER CLERK SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS , HOME TELEPHONE# f-50 R" —77,(0 Mcwhe\Temporary Intemet Files\0LKD3111AZAPP Rev2015.DOC !s °p THE Tpk� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. 200 Main Street• Hyannis, MA 02601 039. �`rECMP TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: Y 27 1-7 Location/Mailing Address: 14 = vsMod A441 1 -O% PDT "70 Contact Name/Phone: ab }olo44 p8-'111 - 3 �tvx JnhN1so►•�, q�! 4 . Inventory Total Amount'!-1�QD- IL 001a1 SDS: Ye,1, License#: q 2 (!rL 3 Tier II : a Labelino: Spill Plan: Oil/WaterSeparator: r4A Floor Drains: b Emer enc Numbers: e-5 Storage Areas/Tanks: Old 1- &�e 0'1 -o,l 2 a,l i-),o, 2l t Emergency/Containment Equipment: ,11 V% 0 S GI`lm+cJ Waste Generator ID: AW 5b%L 2I TSOI S Waste PrArfiuct: o %!�rc2A . o-1 Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Y'cS Other Waste Disposal Methods: o 1 01., vim- OV-16-1 k-0-I d-A%J 6c4 6JIX- a 4A I S 4,f-� 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. IbS Antifreeze SSA \too``'Ai- Dry cleaning fluids ✓ Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes tuxS Bug and tar removers '0 Hydraulic fluid (including brake fluid) Windshield wash 1 -0o Motor oils '5vo*3oo 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 yS Refrigerants c v Degreasers for engines&garages%o 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" 5� �s (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: �, oil 2'1 v l A-5� %S 2,M �� — 12 V . H.� Inspector:� L ,�.c ,,h VUC-4)kt_Co11ZC�(,.� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS oats t0y� Town of Barnstable Office:508-862-4644 ~ Public Health Division Fax:508-790-6304 • BAMA2% E • 200 Main Street• Hyannis, MA 02601 39. Fo a�O� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: S2`t l6 Location/Mailing Addres : Meo - Contact Name/Phone: Holo Snrfn o+ , S --'1 r- 5 Inventory Total Amount: SDD 0LI MSDS: License##: L�Z Tier II : No Labelina: \A 2z\ Spill Plan: S Oil/Water Separator: Floor Drains: Emergency Numbers: Storage Area -�ifl0 �� 2-0 r 1 I,yJ ,� h �Qravel L®,1 2�7 a, +&A A 5-1 i d,o, Emergency/Containment Equipment: o C a� S ►J���' Waste Generator ID: My08 y2�g3 Waste Product: O� , Date&Amount of Last Shi ment/Fre ue 10� I (I<-,w 6A,e, 0 1�aV'%3r, k<-2e Z-p:�► )C Licensed Waste Hauler&Destination: DSO Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS �i�av (,'� a-o Iv1J Get IV CAV04- v�� GCS.!�5 NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazVdous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. At. Z WasJ-e- a l S �S� wvz-� m V4A Antifreeze 5 Dry cleaning fluids d�P.q�X c.��`'� - 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 6VL7 t�I,� p19+. ?�j* b V Miscellaneous Corrosives Gasoline,jet fuel, ation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil 4D a\ Refrigerants Degreasers for engines&garages w 1 Pesticides: Caulk/Grout �c''�� insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries dL 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 PCBs 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) VIOLA I NS: ORDERS: INFORMATION/RECOMMENDATIONS: &1 R51 r ( Inspector: 0. 1 CAQ oak �Ovk� 0�.P,A."r, Facility Representative: [rF7-7- WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS INEro Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • RaRMASS. 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Bo-c4o t o-W, Date: I �� Location/Mailing Address: yS us a• : O a �70 Contact Name/Phone: -111- q3q o� olo-l--l-,, IYw Qv- ToHAls a K-- Inventory Total Am unt: �0.1 MSDS: ¢-5 License#: Tier II Mo Labeling: \ Spill Plan: Oil/WaterSeparator: NIA Floor Drains: o Emergency Numbers: 25 Storage Areas/Tanks: - 00 i4l 2- wpi o•l- i iAq 4"if o, 2-S5 t Emergency/Containment Equipment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: US O���Cv� wtlg 4 I Z I13 , C.e�ot�e otil. �aS�'+,ns Q vtvvt. Licensed Waste Hauler&Destination: Other Waste Disposal Methods: A<oyor LIST OF TOXIC AND HAZARDOUS MATERIALS N o MA \v,K CAA ivt,� 5 v�- \w-AcA;; r&dn S+vice fast,.tiAi2d-,O", NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous aterial use, 1 storage and disposal of 111 gallons or more requires a license from the Public Health Division. I(p Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers 00 Hydraulic fluid (including brake fluid) Windshield wash q o Motor oils Soo Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants I�, 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 to 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:SQ,c_ ®�3-S• ICoc��[ i1}-S-Foc�d�acg 4r2 ORDERS: 11= 12, IMy5--�aUg _ eti Cover .Jer . INFORMATION/RECOMMENDATIONS: U-CAvL s 0zm2yA tajk6e, I'v vim,. x��� C ocdZs o+,-�� d5a1 Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS HAZARDOUS WASTE CONTINGENCY PLAN TELEPHONE IN AREA OF STORAGE EMERGENCY COORDINATOR # 508-737-7066 FIRE DEPARTMENT CALL 911 SOUTHEAST REGIONAL EPA # 508-946-2700 (OIL SPILLS IN EXCESS OF 10 GALLONS) MATERIALS TO HANDLE SPILLS: FIRE EXTINGUISHERS SPILL RESPONSE KITS WATER HOSE SPEEDI-DRY SAND ALL CONTAINERS ARE TO BE PROPERLY MARKED OF CONTENTS EACH EMPLOYEE HAS BEEN INSTRUCTED IN EMERGENCY PROCEDURES, PREVENTION AND RESPONSE Date: al-�Zol l TOWN OF BARNSTABLE �n ct,ort, TOXIC AND HAZARDOUS MATERIALS REGW4bkff0N FORM NAME OF BUSINESS: 90r✓�o 10++' Cov,si<-�a4 i o BUSINESS LOCATION: y!�,D� Js+r ,M, Ilf, INVENTORY MAILING ADDRESS: fc) o TOTAL AMOUNT: TELEPHONE NUMBER: 70 qal/oKS T CONTACT PERSON: 'jab EMERGENCY CONTACT TELEPHONE NUMB R: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: Fire District: �Pe.e,• ,Ct&II V all a -oOf$ C00,-I-a,11.iti,,,-e., wAs+�e- . N)IIQs , ? I'�{2p C-0- ✓I'1 m o d T K c o Q Jta+2� - vn4, ( C�wi eel �r a2ra,rt ► tv o'k'sfe- 60n 4►ners s) ClearL 1"/oars 4�ounXIl ks °►�- s- Aa 9 Waste T afeV6ert fie Last shipment of hazardous waste: S /z .3 /r Name of Hauler: f-b..Aq 5dyek4 &x�ove �\Destination: Mur d Sys "4L 0,1 Waste Product: my tvrF��'cce-&e Llcensed!!� No /Hyl�'ab(o oDS' 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 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 I b Antii eze (for2USEDilo ine or coolant systems) Miscellaneous Corrosive ® NEW S� Cesspool cleaners s Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts(Halite) Sao Hydraulic fluid (including brake fluid)3 Refrigerants Motor Oils Pesticides 2-3°°A, SooA5T (insecticides, herbicides, rodenticides) l I oa aNEW tS 0'USED ss e Photochemlcals (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 /D Degreasers for engine and meta Printing ink e-P- a 5 C Deane Degreasers for driveways&Parages cIi= Wood preservatives (creosote) Caulk/Grout wluv%Avf- n use Swimming pool chlorine 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) ❑ NEW ❑ USED Any other products with "poison" labels (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 Writ ,� n e o► d 300 9� �}ST>✓ b4s,-G I tA- Laundry soil &stain removers (including bleach) �ea,�e_�, a,lso �11 Spot removers&cleaning fluids (dry cleaners) J- (guts of �D iev, tJar✓►u r✓ylovt To Other cleaning solvents � Bug and tar removers 4o J -- /4.e('s Qfe �f'q)rLtJ 1 P40 Windshield wash ����' WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signat re Staff's Initial �/ S M E A D KEEPING YOU ORGANIZED 10334 2m1d WDE NUM GET ORGANIZED AT SMEAD.COM I 04 REF L. C. ��8,24�'- - LOT �96 GRAP ]K�C SCALEo �rrLLPL� �T -� PO D Z 0 NING. �r� n c�° ss o� » 30 0 15 30 60 120 O� M / � � ��- ASSESSORS MAP 58 / LOCUS PA 1�CL�L.. �� ( IN FEET ) � 970 / 97.0 o, � �� � PRINCE 1 inch = 30 ft. AREA = 4 � ��4 �S. F f � ��o i /� o o LO VELL S `�ggp CO VE POND o � 98, p0 W 96 SETBA CKS FRONT SIDE' REAR �� / '' � � 3 .5 LOT 95 � 0000� ASS. LOT 2360 25 40 NO � / oon� � ROBER'T G. KESTEN SR. 0 VERLA Y DISTRICT "AP " �6 2 �"� RESE� g5 � C"TF,� 91453 LOCUS MAP ' � AOO 5 915? v, H, pT• Cb' RAIN AGE 6 w �J 96'vE� � ARK � \ SITESITE �� ��� � ��� � �� L A ND g PA/ loo °p � 1 �% 5 �' ��AIN� � AL Iz n�__-=� LOCATED IN Of 9.0 4.3 PREPARED FOR. 99. 00 9� 9800 co L & R REALTY TRUST p14A 4\ y p AS FA 96. 00 �.. � P �� BOX70`Y- TAG BOLT 97. 00 �A��LTO 96 g,cPOINT MARSTONS MILLS, AIA , 020"400 LOT 3 96� ,SLAB �LV �A��' � (508) 428- 8926 ASS. LOT 1 aTro � � ; � � � � � � � � � � � � JOHN T. PECK 96. 0 g5• �� � � — 97. p �, � � � � � � � � � � � � „ � � � � � � � � � , � ; � � / ssoo — NOVEMBER 12 1�996 CTF# 119920 5. 0 / � _- -; � � , � , � � � � � � � � � , � � � � � 0 9 LEGEND i C) DasxEv rrroe w/lvo eox = EXISTING CONTOURS � i szo � 491 'GRAVEL GRAVEL 95 — Qo '' w 95 Q� ` � 4 �p � 30 � 154 94 SOLID LINE wrrN aox = PROPOSED CONTOURS �� s ! � o o � ASS.o LOT 22 N. o � ROBERT G. KESTEN SIB \ � �o o 0 , 00 CTF# 91453 9 0 SCALE: PA c�• C a 5 � YAzVKEE SURVEY CONSULTANTS�= �?•6� � �`� .ems 94. 5 LOT 93 � UNIT 1, 40 INDUSTRY ROAD ASS. LOT 21 � P O. SOX 265 � 030110 LA TfRENCE J BENNETT MAz?STONS MILLS, MASS, 0264 8 — � CTFF 130396 TEL: 428- 0055 FAX 420- 5553 NOTE.' DRAINAGE ONLY. J# 50915C