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0375 BARNSTABLE ROAD - HAZMAT
\ f - - - - - - \� I IKE rotiti i Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B"R �`E' M � 200 Main Street• Hyannis, MA 02601 039• TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT 1E0 MPS Business Name: 1 Fc Date: Location/Mailing Address: C� 0 Contact Name/Phone: 'Z Q me e-- Inventory Total Amount: L SDS: VY=5 License#: I a� Tier II : 4142 Labeling: Spill Plan: Oil/WaterSeparator: 091A Floor Drains: d►/b Emergency Numbers: F,5J Storage Areas/Tanks:2 X 16;c, V's ac li w Emergency/Containment Equipment: Waste Generator ID: )Z 403 060 79'5- '� Waste Product: Date&Amount of Last Shipment/Frequency: J1,1reJeal �6�Sc/v, 4f- �al(2bT- 'rs Licensed Waste Hauler&Destination:g r r^, r?'cc-mo J-71,c.J pie Other Waste Disposal Methods: JV An LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids f/ Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes f/Bug and tar removers f/ Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous-Corrosives ✓Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides ---Battery acid ( Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) iQNS: V�YV L C� moo,, S�-10 ORDERS: �--� INFORMATION/ EC MMENDATIONS: bide A Inspector: Facility Represent ive: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS �� � �� �-6 E i i .°F ►�roy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B^MAC�e.$ 200 Main Street• Hyannis, MA 02601 "rEOM9.+ TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Cjo1Y1� "' S Date: 7/3I )9 Location/Mailing Address: 5 S -b Contact Name/Phone: �0 A =7 V -711 S9 Inventory Total Amount: < q SDS: License#: 1a Tier II : Labeling: f�° �( Spill Plan: e S Oil/WaterSeparator: N 0 Floor rains: No Emergency Numbers: Storage Areas/Tanks: Emergency/Containment E ui ment: �-� Mi ab5orhmb Waste Generator ID: d01% q Waste Product: �1 k 2� Date&Amount of Last Shipment/Frequency: —c�4S--n _ Licensed Waste Hauler&Destination: &I�rJ�� � ahe Pn I`l)P�rnJZAn �0 , e vNorl Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage grid disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze '�1-0 Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers gine and radiator flushes Bug and tar removers ydraulic fluid (including brake fluid) V Windshield wash ')0 �e(otor oils Miscellaneous Corrosives EE]] Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants / Degreasers for engines&garages V 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 I� (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: n0 r& wnr cal Inspector: Facility Representati WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS °p IHE roe.. Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • 6AMASS`E�' 200 Main Street• Hyannis, MA 02601 039.�'D'FDMN+,`e TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Cvv-"Aa�`1-(d-n g 'O2073 as S ao d&VLVeAC . Date: S 1 16 Location/Mailing Address: 3 TS eLmt Contact Name/Phone: z —Bears OP> - '790-J71 l g '"ASP: V14"el Inventory Total Amount: �� MSDS: G-c to %v&&-e VA!s% License#: l(2 Ck-k-2- Tier II : 00 Labeling: .1\ Spill Plan: Ye-5 Oil/WaterSeparator: Floor Drains: o Emergency Numbers: C S Storage Areas/Tanks: 3 I DK4 AL Aqfo o W- Sc tvu..\ DA.Ckm COAAnIVW Emergency/Containment Equipment: 5 k Q S < Pe 5 P,llS 'oo( Waste Generator ID: D Ont O O Waste Product: fiatik w w -eC V,4\X Date&Amount of Last Shipment/Frequency-11 .; q l (0 1 S' a� I a I o,,� s Licensed Waste Hauler&Destination: �N w� •rr� �k IP � JVI� Other Waste Disposal Methods: A\ `- "� LIST OF TOXIC AND HAZARDOUS MATERIALS N 0 VVVk m< CV�A rvl I v4ev4c,�y 4>cG;e.PT � 5 FASa ham-\ NOTE: Under the provisions of Ch. 111 Section 31 of the G�neral Law9 of MA hazardous material use p , storage and disposal of 111 gallons or more requires a license from the Public Health Division. r VL Q,%4tk,e-A 04411. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash 3< Motor oils 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 Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil&stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RE OMME DATIO S: \ \\k V a)<4'5 -506e— OJ-2 \ w C,-5 OLCCe' S S Q DVU�-� `� Ot C' 01�. ►Ja a .�� Inspector:"1 e� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS °p IKE*og� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • HARAr MSS. 200 Main Street• Hyannis, MA 02601 f639 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT reo rae+ Business Name: 12 -e -A,*-7 Date: Location/Mailing Address: rvcw1 StQ Y:R avivt► S Contact Name/Phone: Inventory Total Amount. �r— MSDS: Co a C-& iv, License#: Tier ll : o Labelii K kcl.l \ 1��"`� Spill Plan: Oil/WaterSeparator: Floor Drains: o Emergency Numbers: Ye Storage Areas/Tanks: - 10 v o c) q a1 v - Aa5 M,v-� Emergency/Containment Equipment: Ir 5 -ir ?5 ova. Waste Generator ID: MtPc C.3c70© 1"I L} 0 Waste roduct: Jw,,'re..! ,M\,x Date&Amount of Last Shipment/Frequency: 13 i 5- o,I 0.5 Licensed Waste Hauler&Destination: . - �v�v�Co w GIa10 �i e5 a 1�� Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. o Antifreeze 1 0 Dry cleaning fluids Automatic transmission fluid I- I- Other cleaning solvents&spot removers 7— Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) 1-75 Windshield wash -f-'{S +! 4 yy A- �L Motor oils 1-� Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil I Disinfectants I Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes ti Miscellaneous Flammables L Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) a Any other products with "poison labels" (including chloroform,formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECO M NDATIONS: \J<C'k k5 S o o 155;u ee-S 0.c-0 AKtl0AS 4 144A\g Inspector: i Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: 3 / 1 TOWN OF BARNSTABLE tar � �L* TOXIC AND HAZARDOUS MATERIALS FORM NAME OF BUSINESS: BUSINESS LOCATION: 315� Pac�S- b��'��. , ,,����s INVENTORY MAILING ADDRESS: ja TOTAL AMOUNT: TELEPHONE NUMBER: ��S -��i o -1 it t CONTACT PERSON: L-t, 6.2a,<6 e--, EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: a') 61W� \av\ CodNe, ve�nc.C, 0<e,, YZ5 INFORMATION / RnEC MENDA�TPIO S: N �.u�.,k tie,.,��¢�. Fire District: p C�C,ohn�anex,A'� trn.� � `Ch�S ��ukp� ahh�5 Waste Transportation: /AAC.30 DD r) I. Q6l'�-q Last shipment of hazardous waste: All�' I Name of Hauler: '��L Destination: doc,, u`1'es, \(o e-w , Waste Product: Licensed Yes No Ny�Dg31`i c b�� 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 An ' reeze (for gasoline or coolant systems) Miscellaneous Corrosive NEW" ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants 3 c'� Mo)�°°r Oils Pesticides O'NEW3a ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine 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 I Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes �� ���' a�o5D,�t4S Dr. 5 e— Laundry soil &stain removers (including bleach) & � Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents y Bug and tar removers �j Windshield wash �,00 WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signature Staff's Initials I Ix Number Fee 1129 THE COMMONWEALTH OF MASSACHUSETTS 1oo.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS#2073 375 BARNSTABLE ROAD, HYANNIS, MA Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 07/01/2015 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable Regulatory Services Thomas F. Geiler,Director KASK10311 Public Health Division e Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. _3/0 --// DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT -404 ADDRESS OF ESTABLISHMENT_ j/ TELEPHONE NUMBER_ �b 0�- 7ZO SOLE OWNER:_VY/ES NO IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. PJ jLlyy� STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT -06 TREASURER T7- CLERK SI RE PLICANT r?::;...,. ...; RESTRICTIONS: HOME ADDRESS Cu b i land Farms �C1C` HOME TELEPHONE# - Crossing STOTteVard Framingham, MA 01702 , 3 THE T° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMS�LE. ` 200 Main Street• Hyannis, MA 02601 p 2639.p�0 'FOMA� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: LV" &rm= Date: Location/Mailing Address: Contact Name/Phone: - 71 47,53 Inventory Total Amount: <Soa MSDS: License#: Tier II JVIAI Labelina: Spill Plan: QP Oil/WaterSeparator: AIA FI or D a' Emer enc Numbers: `J Storage AreaslTanks: Ual Emergency/Containment E ui m' t: Waste Generator ID: 1A 5 Waste.Product: MIVLPIIrr Date&Amount of Last Shipment/Frequency: lb VAS 0y / 3 IN Licensed Waste Hauler&Destination: S14 Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS nO 6 NOTE: Under the provisions of Ch. 111, Section 31, of the Gerteral�Laws of A, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives (creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORM ION/R CO MENDATIONS: %`A mil /1 ` v Inspector: _� Facility Representative: l � WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number umb THE COMMONWEALTH OF MASSACHUSETTS Fee $1Fee 25.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS#2295 ................................................................................................................................. 375 Barnstable Road, HYANNIS, MA ........................................................................................................................................................................ Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. .................................................................................................................................................................... Restrictions: .................................................................................................................................................................... This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town Of Barnstable Inspectional Services BARNS TABLE Public Health Division ; • LMQWA=X £ Thomas McKean,DirectorKAM tl g 200 Main Street,Hyannis,MA 02601 •; p.w Office: 508-862-4G44 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 I st—JUNE 30th). APPLICATION FEES CATEGORY I PERMIT .26 110 Gallons: $ 50.00 O CATEGORY 2 PERMIT Ill _499 Gallons: $125.00 yr GI CATEGORY 3 PERMIT 500 or more Gallons: $150.00 *A late charge of$10.00 will be assessed if payment is not received by July 1st. . 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? YES NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONINGBUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF GREATER THAN HOUSEHOLD QUANTITIES(25 GALLONS)? YES NO. A. FULL NAME OF APPLICANT: _rc. S. NAME OF ESTABLISHMENT uM e.1 Z G[ Yci/ni s 6. ADDRESS OF ESTABLISHMENT: ,� S /1 . O O .7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: ll 6w ws lid, // e6. ary S. TELEPHONE NUMBER OF ESTABLISHMENT: O 9. EMAIL ADDRESS: S IA"Ala, 10. SOLEOWNER: 1/YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TE�PHONE# F: CORPORATION NAME PRESIDENT TREASURER ce Cz>L)-ca CLERK, ._. 12. IF PREPARED BY OUTSIDE PARTY: NAME: _ - TELEPHONE#: COMPANY ADDRESS EMAIL: 4 Matthew T.Durand. :SIGNATURE OF APPLICANT s .�, ,:.<.a°^enq DATE �' O - d QMpplics ion FormMaz Mat Appli Draft 1an2019.docx k# CumbWand • Date of Incorporation: September 14, 1984 State of Incorporation: Delaware Principal Address: 165 Flanders Road,Westborough, MA.01581 Office Telephone: 508-270-1400 Federal ID No: 04-2843586 PRINCIPAL OFFICERS George Fournier President 165 Flanders Road Westborough, Ma.01581 • Caroline Taitelbaum Vice President 165 Flanders Road Westborough, Ma.01581 Nick Unkovic Secretary 165 Flanders Road Westborough, Ma.01581 John T. Daly Assistant Treasurer 165 Flanders Road Westborough, Ma.01581 • Number Fee 1129 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS#2073 375 BARNSTABLE ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons 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 �y Town of Barnstable oF�HE Inspectional Services BARNSTABLE • ,� '�„ Public Health Division �N BARIMABLE, ' Thomas McKean, Director tk; �r fo A 200 Main Street, Hyannis,MA 02601 .�z 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 MY 1st—NNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 Vv I et f itsSCULf CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. .3/d —l/ 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: $- 5. NAME OF ESTABLISHMENT: CUMBERLAND FARMS#2073 375 BARNSTABLE ROAD 6. ADDRESS OF ESTABLISHMENT: HYANNIS, MA 02601 - 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: ��S IGIa.,�P.rs R� WGs rbero a�lS�� 8. TELEPHONE NUMBER OF ESTABLISHMENT: a_J90 - 9. EMAIL ADDRESS: LSalvuaci@wmberlandfarms.com 10. SOLEOWNER:/YES_NO IF NO,NAME OF PARTNER: Y 11. FULL NAME,HOME ADDRESS,AND TELEPIJONP#OF: CORPORATION NAME PRESIDENT TREASURER. ? ��4. CLERK 12. IF PREPARED BY OUTSIDE PARTY: . NAME: LEPHONE#: COMPANY.ADDRESS E ; • SIGNATURE OF APPLIC �y Q:Wpplication FormsTaz Mat App Revised 09-10-18.docx Richard Fournier Tax Manager Number Fee 1129 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS #2073 375 BARNSTABLE ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 -499 gallons 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 Cf } I ' iA. ' own of B4nslable egulatory Services Richard V. Scali, Director CF'THE T Public Health Division BTU �mry BAB'NSSrABLE, = Thomas McKean;Director ' ,4 059• `e� �Tr N haJ pTFGMAVA 20011.1ain Street,Hyannis,NIA 02601 Office: 508-862-4644 Fat: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS t ;t 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 j CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 oQ h CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ P � O :�— *A late charge of$10.00 will be assessed if payment is not received by July 1st. Li 1. ASSESSOR'S MAP AND PARCEL NO. 610 '//9 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: 5. NAME OF ESTABLISHMENT: ��mbe-f-Lijol 6. ADDRESS OF ESTABLISHMENT: 3?,r ar,—nsT 6`,� 4/& h.In s 04, 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:/GS'IC/arer 8. TELEPHONE NUMBER OF ESTABLISHMENT: /71FP 9. EMAIL ADDRESS: LSVAVUGci G�crr+�G7Gt rn�t . GOs� 10. SOLEOWNER: 1/YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION_ NAME PRESIDENTTREASURER CLERK CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: • SIGNATURE OF APPLIC C:\UsersTecollik\AppData\Local\Microsoft\Windows\Tem ra met Files\Content.Outlook\BMQD49H2\HAZMAT APP 2017 REVISED.docx ichard Fournier Tax Manager y �O F A �R til S Date of Incorporation: September 14, 1984 State'of Incorporation: Delaware Principal Address: 165 Flanders Road, Westborough, MA 01581 Off ce' Telephone.- 508-210-1400 Federal ID No` 04-2843586 PRINCIPAL OFFfCERS: Ari N. Haseotes President and d CEO 165 Flanders Road Westborough, MA 01581 Howard S. Rosenstein Treasurer 165 Flanders Road Westborough, MA 01581 Brian E. Glennon, II Secretary 165 Flanders Road Westborough, MA 01581 John T. Daly Assistant Treasurer 165 Flanders Road Westborough, MA 01581 Cumberland Farms, Inc. 165 Flanders R=270-1 Westborough, MA 01581 490 www.cumb6rlandfarms.com Number Fee 1129 THE COMMONWEALTH OF MASSACHUSETTS $125.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS #2073 — 375 BARNSTABLE ROAD, HYANNIS, MA Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------------_--------------------------------------------------- This license is ranted in conformity with the Statutes and ordinances relating there to, and g tY and expires 06/30/2018 unless sooner suspended or revoked. ----------------------------- ---------- 1 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 1f �w of Unstable egUorvices �t►+e rqi, Richard V. Scali, Director o Public Health Division BARNSTAB11 � BP0.YST4tlLF•iFx.E"•JILE•COTUIT•"Y4nt:15 BARNSrABLE. Thomas McKean, Director 39 2.014(Srep?nSrteE - 1639. e`er 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 --102101 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 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 3/O -//q 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 QUANTI/TIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: 6zmberlarjol FarmS # ao-;o 6. ADDRESS OF ESTABLISHMENT:3 7S Bo ins ta bl e i'oa Qhnjs A 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE:/G3 or �d �C Gyesdr 8. TELEPHONE NUMBER OF ESTABLISHMENT: 211f- 9. EMAIL ADDRESS: G S�9L f�LIGGi�G'l.�irl d�-lc�r�d 7cz/'�s, �o 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT ,j��o O r,-- TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT 4ATE QAApplication Forms\HAZMAT APP 2017 REVISED.docx Number Fee 1129 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that CUMBERLAND FARMS #2295 375 BARNSTABLE ROAD, HYANNIS,MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 6/30/2014 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 3/18/2014 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health I i Town of Barnstable Regulatory Services _ Thomas F.Geiler,Director 1 Public Health Division t� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862A644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. _�f©� l/� DATE` APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE THAN 111 GALLONS OF HAZARDOUS MATERIALS - T. c FULL NAME OF APPLICANT -/ NAME F - - O ESTABLIS HMENT ADDRESS OF ESTABLISHMEN le— &01 rl TELEPHONE NUMBER Cc SOLE OWNER: ✓ YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME D HOME•ADDRESS OF ALL` ` PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION'NO: -.; STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT TREASURER — CLERK -R haV F-ou-mier___ lax Manager SIG'AT O PLICANT FA-rMsInc, RESTRICTIONS: HOWEADDRESS Tax r)Pnarf rnPnt HOME TELEPHONE # logCrossing- Beekeva rd Framingham, MA 01702 Massachusetts b �),q Fire Incident Report Hyannis Fire Department FDID incident No. Exposure Date of Day of week Time Of Arrival Time In Incident Call Time Service 01922 A980792 0 of 0 8/15/981 Saturday Type of Situation Found Type of Action Ta n Mutual Aid 41 Spill/leak W/o 4 Remove Hazar Fixed Property Use Ignition Factor "paved Public Street." 96 00 No Fire Found g; S W ............. Method Of Alarm Shift No Of Alarms # of Personnel Responded M r 1 Telep . ... Engines Tankers Aerial Other Vehicles knit OU 11J I Fire Service Other Injuries Injuries Fatalities Injuries Fatalities Rescues gal Insurance A iv,Wmj NVI Complex Area Of Origin Equipment Involved In Ignition Form Of Heat Of Ignition ............... 2UOE quipme ntjW s'Inv6Ive&ln'IgnJJon MtM V A EWqp I p ,p n mqe OW -WO 61ft Method of Extinguishment Level Of Fire Origin Number Of Stories 7 111 Construction Type Detector Performance Sprinkler Performance F— Extent Of Damage Flame Smoke F— Material Generating Most Smoke Type Of Material Generating Most Smoke Avenue Of Smoke Travel Weather Conditions Commanding Officer F U Melanson Comment Page for Incident No. A989792 Address 1375 1BARNSTABLE ROAD 4-431 Date of Report 1 8/15/98 Commanding Officer JU Melanson FIRE ALARM REC'D A CALL REPORTING SOME TYPE OF OIL IN THE ROADWAY NEAR THE INTERSECTION OF LEWIS ST AND BARNSTABLE ROAD.I RESPONDED IN E-826 WITH FF'S COSMO AND KLEMANAKIS.UPON OUR ARRIVAL WE FOUND A SPILL OF A MATERIAL SIMILAR TO LIQUID TAR IN THIS INTERSECTION, SOME OF WHICH,A VERY SMALL AMOUNT, HAD ENTERED THE STORM DRAIN.WE CONTAINED THE SPILL USING SPEEDY DRY AND I REQUESTED THE BPD FOR TRAFFIC AND THE BOARD OF HEALTH AS THE DRAIN FLOW INTO THE HARBOR.BPD REQUESTED A RESPONSE FROM THE BARNSTABLE DPW.BRIAN FROM AUBUCHON HARDWARE CAME OUT AND TOLD ME THAT THE SPILL OCCURRED BEFORE NOONTIME YESTERDAY BECAUSE ONE OF HIS EMPLOYEES WENT OUT AT LUNCH AND REMOVED A 5 GALLON PAL FROM THE ROADWAY.THE PAL HAD BEEN PLACED IN THIS STORES DUMPSTER.I WENT AND CHECKED THE DUMPSTER AND FOUND THE PRODUCT TO BE:SUPER SEAL FOUNDATION COATING WHICH IS MADE USING PETROLEUM DISTILLATES.MR DUNNING FROM B OF H ARRIVED AND ASSESS THE SCENE.WE WAITED A REASONABLE TIME FOR THE HIGHWAY REP TO SHOW.BPD UPON CALL BACK WAS UNABLE TO GET AN ETA ONLY THAT HE WAS ON HIS WAY.AND WHEN NO ONE ARRIVED AFTER A REASONABLE PERIOD OF TIME(40 MINUTES)WE UTILIZED PETROLEUM PICK UP PADS TO GET AS MUCH PRODUCT AS POSSIBLE FROM THE TOP OF THE SURFACE OF THE WATER IN THE STORM DRAIN.MR DUNNING STATED HE WOULD FOLLOW UP WITH THE DPW TO HAVE THEM PUMP OUT THE DRAIN ON MONDAY.WE REMOVED THE SPEEDY DRY AND RETURNED TO QUARTERS.UPON OUR ARRIVAL AT QUARTERS A MR SANTOS FROM THE DPW DROVE IN.I EXPLAINED THE ABOVE TO HIM AND HE STATED HE WOULD SCHEDULE THAT DRAIN TO BE CLEANED FIRST THING MONDAY MORNING. MATERIAL USED:TWO 25 LB BAGS OF SPEEDY DRY,ONE PAD,ONE TRASH BAG. LT. DEAN L. MELANSON 15-AUG-98 4/13/2016 Town of Barnstable Page 1 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 021008 140 OLD OYSTER ROAD BARNSTABLE.,TOWN OF (SCH) 2 00652 7/25/1988 27 SPLIT SPLIT Cotuit P.O. BOX 955 HYANNIS, MA 02601 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C & TASHA, M J TRS 1 00870 9/15/1987 28 WP IN Cotuit P O BOX 692 SAGAMORE, MA 02561 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C & TASHA, M J TRS 2 00871 9/15/1987 28 WP IN Cotuit P O BOX 692 SAGAMORE, MA 02561 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C & TASHA,M J TRS 3 00872 9/15/1987 28 WP IN Cotuit P O BOX 692 SAGAMORE, MA 02561 024021 4418 FALMOUTH ROAD/RTE 28 JASON, REGAN C& TASHA,M J TRS 4 00873 9/15/1987 28 WP IN Cotuit P O BOX 692 SAGAMORE, MA 02561 104002T00 1000 RACE LANE BARNSTABLE, TOWN OF (LB) 2 00931 7/6/1989 26 GP OUT Marstons Mills 367 MAIN STREET HYANNIS, MA 02601 104003T00 1460 ROUTE 149 BARNSTABLE, TOWN OF (MUN) 1 01052 1/1/1990 26 SPLIT OUT Marstons Mills 367 MAIN STREET HYANNIS, MA 02601 - 104003T00 1460 ROUTE 149 BARNSTABLE, TOWN OF (MUN) 2 01053 1/1/1990 26 SPLIT OUT Marstons Mills 367 MAIN STREET HYANNIS,MA 02601 117026 981 MAIN STREET(OST.) CALLAHAN,RICHARD P'TR 7 00205 11/9/1992 23 WP IN Osterville C/O HOSTETTER, DANIEL 770 A MAIN ST OSTERVILLE, MA 02655 117026 981 MAIN STREET(OST.) CALLAHAN, RICHARD P TR 8 00206 9/1/1986 29 WP IN Osterville C/O HOSTETTER,DANIEL 770 A MAIN ST OSTERVILLE, MA 02655 L _ 4/13/2016 Town of Barnstable Page 2 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 117026 981 MAIN STREET(OST.) CALLAHAN, RICHARD P TR 9 00205 11/18/1992 23 WP IN Osterville C/O HOSTETTER, DANIEL 770 A MAIN ST OSTERVILLE, MA 02655 215027002 2155 IYANNOUGH ROAD/RTE132 MASSACHUSETTS, 9 01027 1/5/1990 26 SPLIT SPLIT W ct_T�� N�kh 17I S COMMONWEALTH OF(HIGHWAY) 2155 IYANNOUGH RD/RT 132 WEST BARNSTABLE, MA 02668 215027002 2155 IYANNOUGH ROAD/RTE132 MASSACHUSETTS, 10 01028 1/5/1990 26 SPLIT SPLIT ��y��n�S 2 COMMONWEALTH (HIGHWAY) 55 IYANNOUGH RD/RT 132 WEST BARNSTABLE, MA 02668 254015 10 ATTUCKS LANE MACGREGOR,J BRUCE TR 1 00966 1/4/1986 30 WP IN Barnstable DRAWER W HYANNIS, MA 02601 254015 10 ATTUCKS LANE MACGREGOR,J BRUCE TR 2 00965 1/4/1986 30 WP IN Barnstable DRAWER W HYANNIS, MA 02601 269159 326 WEST MAIN STREET V W M ASSOCIATES LLC 4 01107 5/1/1993 22 WP IN Hyannis 22 CAMPION RD YARMOUTH PORT, MA 02675 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 6 00000 9/1/1989 26 WP IN Hyannis ATTN: TAX DEPARTMENT 15 NORTHEAST INDUSTRIAL ROAD BRANFORD,CT 06405 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 7 00000 9/1/1989 26 WP IN Hyannis ATTN: TAX DEPARTMENT 15 NORTHEAST INDUSTRIAL ROAD BRANFORD,CT 06405 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 8 00000 9/1/1989 26 WP IN Hyannis ATTN: TAX DEPARTMENT 15 NORTHEAST INDUSTRIAL ROAD BRANFORD,CT 06405 4/13/2016 Town of Barnstable Page 3 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 9 00000 9/1/1989 26 WP IN Hyannis ATTN: TAX DEPARTMENT 15 NORTHEAST INDUSTRIAL ROAD BRANFORD, CT 06405 274020 1449 IYANNOUGH ROAD/RTE132 GLOBAL COMPANIES LLC 10 00000 9/1/1989 26 WP IN Hyannis ATTN: TAX DEPARTMENT 15 NORTHEAST INDUSTRIAL ROAD BRANFORD, CT 06405 289140 88 GREENWOOD AVENUE WHITCOMB, LINDA MARIE CARA 1 0 1/1/1968 48 SPLIT OUT Hyannis DONNA 88 GREENWOOD AVENUE HYANNIS, MA 02601 293001 382 FALMOUTH ROAD/RTE 28 BARNSTABLE,TOWN OF(MUN) 7 00754 9/26/1988 27 SPLIT SPLIT Hyannis 367 MAIN STREET HYANNIS, MA 02601 293001 382 FALMOUTH ROAD/RTE 28 BARNSTABLE, TOWN OF(MUN) 8 00755 9/26/1988 27 SPLIT SPLIT Hyannis 367 MAIN STREET HYANNIS, MA 02601 293001 382 FALMOUTH ROAD/RTE 28 BARNSTABLE, TOWN OF (MUN) 9 00756 9/26/1988 27 SPLIT SPLIT Hyannis 367 MAIN STREET HYANNIS, MA 02601 295004001 0 WILKENS LANE CAPE COD HOSPITAL 2 00040 10/1/1985 30 SPLIT IN Barnstable GLEASON HOUSE 27 PARK ST HYANNIS, MA 02601 310119 375 BARNSTABLE ROAD CUMBERLAND FARMS, INC 4 00000 3/27/1996 20 SPLIT IN Hyannis — 100 CROSSING BLVD FRAMINGHAM, MA 01702 310119 375 BARNSTABLE ROAD CUMBERLAND FARMS, INC 5 00000 3/27/1996 20 SPLIT IN Hyannis 100 CROSSING BLVD FRAMINGHAM, MA 01702 4/13/2016 Town of Barnstable Page 4 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 310119 375 BARNSTABLE ROAD CUMBERLAND FARMS, INC 6 00000 3/27/1996 20 SPLIT IN Hyannis 100 CROSSING BLVD FRAMINGHAM, MA 01702 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD 1 00890 1/1/1987 29 GP IN Hyannis LLC 326 WEST MAIN ST HYANNIS, MA 02601 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD 2 00891 1/1/1987 29 GP IN Hyannis LLC 326 WEST MAIN ST HYANNIS,MA 02601 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD 3 00892 5/1/1987 28 GP IN Hyannis LLC 326 WEST MAIN ST HYANNIS, MA 02601 311017 590 IYANNOUGH ROAD/RTE132 JAY IMAD ENTR IYANNOUGH RD 6 00000 1/1/1986 30 GP IN Hyannis LLC 326 WEST MAIN ST HYANNIS, MA 02601 311022003 513 BARNSTABLE ROAD BARNSTABLE,TOWN OF (ARP) 2 00000 8/1/1981 34 GP IN Hyannis 6 SYLVAN WAY PARSIPPANY,NJ 07054 311079 199 FALMOUTH ROAD/RTE 28 BASSIL, ELIE&RABIH TRS 7 00000 4/24/1995 20 SPLIT SPLIT Hyannis 8A HEADWATER DRIVE WEST YARMOUTH,MA 02673 311079 199 FALMOUTH ROAD/RTE 28 BASSIL, ELIE&RABIH TRS 8 00000 4/24/1995 20 SPLIT SPLIT Hyannis 8A HEADWATER DRIVE WEST YARMOUTH,MA 02673 327055 112 BARNSTABLE ROAD SAVON HATEM LLC 9 00000 1/24/1995 21 SPLIT OUT Hyannis 94 EAST FALMOUTH HWY EAST FALMOUTH, MA 02536 4/13/2016 Town of Barnstable Page 5 of 5 Fuel Tanks 20 Years Old and In Zone of Contribution Tank Owner Tank Age in Town State Map Parcel Property Location Owner Address No Tag No Install Date Years ZOc ZOc 327055 112 BARNSTABLE ROAD SAVON'HATEM LLC 10 00000 1/24/1995 21 SPLIT OUT Hyannis 94 EAST FALMOUTH HWY EAST FALMOUTH, MA 02536 329003 480 BARNSTABLE ROAD BARNSTABLE, TOWN OF(ARP) 6 01266 12/19/1985 30 SPLIT IN Hyannis 480 BARNSTABLE RD 2ND FL HYANNIS, MA 02601 329003 480 BARNSTABLE ROAD BARNSTABLE, TOWN OF (ARP) 15 01118 1/1/1990 26 SPLIT IN Hyannis 480 BARNSTABLE RD 2ND FL HYANNIS,MA 02601 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM j�44ME OF FIRM: �� /AUTO dawd l _MI61 MAILING ADDRESS:�G; �' /[of, TELEPHONE NUMBER: -1,363 1 CONTACT PERSON: J 4 Aark m� Does your -firm—store any of the toxic or hazardous 3nateri-al=s- -ldsted' below-,. either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a YES or NO answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasline or coolant systems) Refrigerants Automatic transmission fluid Pesticides (insecticides, Engine and Radiator flushes herbicides,rodenticides ) Hydraulic fluid (including brake fluid) Photochemicals Motor oils/waste oils Printing Ink Gasoline, Jet fuel Wood preservatives Diesel fuel, Kerosene, #2 heating oil (creosote) Other petroleum products: grease, Swimming Pool chlorine lubricants Lye or caustic soda Degreasers for engines and metal Jewelry cleaners Degreasers for driveways & garages Leather dyes Battery acid (electrolyte) Fertilizers (if stored Rustproofers outdoors) Car wash detergents PCB' s Car waxes and polishes Other .chlorinated hydro- Asphalt & roofing tar carbons, (inc.carbon Paints, varnishes, stains, dyes tetrachloride) j/ Paint and lacquer thinners Any other products with Paint & Varnish removers, deglossers "Poison" labels (including Paint brush cleaners chloroform, formaldehyde, Floor & Furniture strippers hydrochloric acid, other Metal polishes acids) Laundry soil& stain removers Other products not listed (including bleach) which you feel may be Spot removers & cleaning fluids toxic or hazardous (please (dry cleaners) Other cleaning solvents RECEIVED Tist.� Bug and tar removers HEALTH DEPT. Household cleansers, oven cleanN OF BARNSTABLE Drain cleaners Toilet cleaners Cesspool cleaners Disinfectants 3 �98� Road Salt (Halite) �� MAY q. ' TOWN OF BARNSTABLE -� BOAR® OF HEALTH f' CONTROL CF TOXIC AND HAZARDOUS MATERIALS - INSPECTION SHEET F. FIRM ADDRESS Major types of materials: 1 >� �.'ir /.•t ) 3} 2 l.r. I. Description of material(s) use: '���, II. Storage (denote product by number listed above) A. Containers metal glass paper plastic cans,bottles,jars drums,barrels Y k" aboveground tanks underground tanks bags,boxes open,loose,un--overed , lUt � 6�,. inadequate labelling B. Storage Facility ✓or # Remar.ks/RecommeTi i ions A. . Indoor 7/ a) separate, contained room b) stored in general work area r f i) inadequate ventilation ii) floor drains iii) inadequate fire protection 2. Outdoor a) uncovered, exposed to weather b) pervious surface/catch basins III. Disposal A. Reclamation/Recycling unit B. On-site disposal 1. Town sewer 2. Regular septic system 3. Separate holding tank C. Off-site disposal 1. hauled by own firm 2, hired hauler l / a) name of hauler b) address or disposal site Perso.n(s) Intervieured _, —- - — — — — InspectoF R °" �? � _ — _ — — — — — — — — Date - - - - 6 30 81 J i�1 OF BARN L� f 2. Printers :.. � ;i Q satisfactory a �3• Auto Body Shops � ARD OF HEALT'f lunsatisfactory- 4.' Manufacturers r (see"Orders") S. Retail Stores COMPANY o►vetlr i ^ 6. Fuel Suppliers ADDRESS E� `w±` Class: 7. Miscellaneous � �1 ' � � V 'c � ' Z QUATIES AND STORAGE (IN=indb s; OUT=outdoor MAJOR MATERIALS Case lots Drums AbgveTanks � Undetg ouad Tanks IN UT R e e r Fuels: L Gasoline, Jet Fuel (A) G , ' 1 Diesel, Kerosene, A2 (B) J Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic J Synthetic Organics: . NAA j 1 �,l > Miscellaneous: k d, 95�. v .a 1 y` DISPOSAL RECLAMd1TION REW%RKS: 1. Sanitary Sewage 2. Water Supply 4 Jsc4 O Town Sewer Public AA -On-site Private i 3. Indoor Floor Drains: YES NO �____ F ` O Holding tank: MDC O Catch basin/Dry well _ On-site system 4. Outdoor Surface drains:YES NC Holding- tank: MUC .ti �- f. tAk , • i 1 0 Catch basin/Dry well - - OOn-site system S. Waste Trans .e•rter n 3� icet n e i na io }�,Zc Prod •t er -- 0 12 23 81 Pe on(s) .Int.erviewe Inspector Date OF BARNSTA.�L t'2. •,Printers ,B�JA D OF HEALTH 1 Osatisractory , 3...'nuto Body shops ' R unsatisfactory- 4. Manufacturers (see"Orders") S. Retail Stores COMPANY w a 6. Fuel Suppliers ADDRESS Class: t L 7. Miscellaneous --- QUANTITIES AND STORAGE (IN=indoors; OUT=outdoor 2 � Case lots Drums AbdveTanks Undetground Tanks MAJOR MATERIALS IN 1 A 8 e C i Fuels: Gasoline, Jet Fuel (A) Diesel, Kerosene, 12 (B) Heavy Oils: waste motor oil (C) , new motor oil (C) transmission/hydraulic Synthetic Organics: - degreasers ` Miscellaneous: DISPOSAL RECLAMJITION REW%RKS: 1. Sanitary Sewage 2. Water Supply a Town Sewer public 5 ,A_-71 Zcf F IAA:. •� On-site • Q Priva - t °" +I ^ •3. Indoor Floor Drains: YES N0 S � O Holding tank: MDC f O Catch basin/Dry well �.� - 0 On-site system 4. Outdoor Surface drains:YES NO h �. Holdink tank: MUC ~ ,- O Catch basin/Dry well O ,On-site system .' �., F L ce fl nsed? S. Waste Transporter ;. Name of Hauler_ D a inatinn }�(,1ste Produces ' y _ u ei son s) Int.erviewe Inspector Date Or M � �' o COMMONWEALTH OF MASSACHUSETTS PARTM:EhtT�OF,=ENVIRONMENTAL:QUALITY ENGINEERINGY r �x DIVISION OF SOLID AND HAZARDOUS WASTEr A fi 4 fA c `' �" `One Winter Street c , r U�S`• r u Boston,`Massachusetts 02108 -;_ :Please print or type.(Form designed for use on elite(12 pitch)typewriter i� � '�'�JNIFORMHAZARDOUS ,r 1 G'ene�atorUSEPAIDNo Manifest !'.y 2 Page1 InformaUonmtheshadedareas r 'A Dou ent o- of Is not regwied by Federal law WASTE MANIFEST 0 f t� 2 1 3'Generators Name and Mailing Address,: r ti e, , x State Manfes�t Document Number ;s.. fi a a ye » - Rota Auto Body a I , 016 4 07 y rrpp � i $ anriis "MA 02601 BGen y y s.:= �+ 'ate g •�4�. �` ' ' +,"�t ,`. a ' Generator.S Phone i'' .1-„st r _`7 r z •.,.•-r A i� ° at z tr t+� � �7 ,r f fYort�east: bOlveliits'�io . 4f rt "'� M p � r 1: f -bb, ,_ - 57 Transporters 2 Company Name r - r 8 US EPA ID Numberz:y Transporter Phone;(g 17x�) �83. r1002 RA fate Trans=.D 9".Desig_�ated Facility:Nam 'a d Site Address 3 '+ 10; ` <�- US EPA ID Number` -r `'rI ',I�II' I ,I lTr�'1- '� ) I'".�•'c`•` -�yr}a . Northeast' S�o�vents Corp i; i j w F>zTfens orter s Phone l ) 'f" sfs., c >�- a t r r .t f P a s �S'♦pa*a �.k , •w., i µ 300 Canal Street s` G State Facilit s iD,� Not Re wired ' i.ararence; MA 01840� �� 4 _ y ,et. r r s '." „ ;: a M A D 0 0 .:05+6 0 4 4: 4' 7 FI gFacility s,PFione 1 1 68:3 10.0ZVV N . _ 12 Containers 'er ] Q:F. ytT.U$DOTDescriptionhnc/udingPiopShipping,karOa HaiardC1ass;andlDNu-ppela,;,t w� Total„r Unit' _ Waste No '''1 No. ' T e' Quanttt . '"WtNol ; Yp Y r w 'CO G. t tUy �O✓ YY 1 E itOs �C Ca m 4.c:. .. C ti ,. Li • z nn E ram. '�. •,t ,, ia 4"k," R Ys: }'A rt,n tt1!3 '$1•s' 'r ��r..'Miy Q ✓r✓crr-r7 - 'y£ ... t ..> t ,•, m Y.. fx "'v kr Z. .� -�,�x'� � `'' `ft S G• x �, 3 a �� r� r y , . M t��,���< 4,!'s'>•r d:' � �`_�m, � r e,v� s r: � r- I"�. 2`i t--� ? � _F r•: ..,C i �'�+. ` '�a.. '�:. - .i " Y KHandlin"Codes forWastes t_i`s'ted Above`$"` i _ J:,.dditionalDescriptions for Materials Listed Above pnc/ude physical state and hazard code 1 u 4 s g M�„ I ai,€}nr n k ",, c:t .s a tam = l 1, ��, �•�x tt1tf g� " a 't 3 l: (j U.,; �` m'" .C�`-`� �'1£\"ts"s„A'°�'. �'C it 'ir'�" �`k. ..'5 8• a f� y Cx �+a '^k t .' 1; C �:N'- ,�a' ,:i"�.�...p/� !�/T��G �f uf"..4ra."r$�.ys��u��"tr f� �+�' ``i ctJ`." y{tt .E kt{,�� R3 5 't't,..€,`'.• y> "�'`�,-+fir,-,t a+,s*-�.",'a �C.3_,,,. ' ?+.f-.: K,Gt 'sf�' t /Li�. � I' ' k'"$:rt� �. ,r#y 4 t � � �a +:�nTs*a .,,a t.:� +r .a 1 4' z � 3, r uaT " '`,�::✓ #f� t0 "',k.t ♦. � >•�SS as fq z'c.: �,% .ag pat,-,t', 4 ��.r"r.;L � ....t ' ,s s,� -�'�`#+ . yu." ; �� Tp:' a r•r � ..�..Jc... �.�°.;,_:�, d ;,,a�, :>a � ... X,� x i. 1 b d �s 15 Special.Handlmg Irisiructions and Additional Information m ? 3 p,., " 16vGENERATOR..S.CERT ATION I hereb declare tnat;t a contents of this consinment are full' and accuratet described above b ro er shi in name_and v), y Y 9,. Y_ Y YP p PP., 9 >` f are classrfied packed!marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and national O A govV6_k.. rgovernmen egiilationai apd"all applicable,State-laws/regulations.Unless Gam a;small quantlty.generatoh.who bas been exempted by statute oraegulabort from <ti °•V' " the dut tolmake.a waste minimization certification under Section 30021b1'of RCRA,I also certif that 16a e a ro "ram in lace to reduce the volume and toxin a C u �. Y Y P 9 p of.'waste generated to ttje degree i have determined io be economically p7acticable and I haveselected the method of treatment store a or dispo"I currently awlable.fo me which minimizes the present and future threat to human health and the environment 4v a �. SFr .� .� c.. .f.. .a q. r Date' a e Pn ed d N ature `Day Month `. . Year Iv .��Z HAI+� 01=1 , �- : , f f.�. T 17;:Transporter_ 1-:,'tAcknowledgement of Receipt of Materials '�- '..,„ - �� ' :: ate to R lnted Typed Name K " t re ,.� 3 Month 'Da x� R 18:-Transporter 2,Acknowle ement f Receipt of Ma er als Date T Pnnted/TypedName �;_ Signature- Month Dey Year'. ,rq�5 E 3 0 �, y. a - . _ n n- a -3- Discrepancy Indication Space c c ° FAs y at 1 ys v FaW ility.Owner or bperator Certification of receipt of hazardous materials covered by Phis manifest except as noted in -f A- - :t1 � .. 9 ,< aS t F "' dZ.`- x t-. ` Date" .T Y Pr;ted//TypedNeme S(gnatur 3 ; ;t /r l NJogt� Op Ye `' wL J"Form Approved OMB No 2000 0404.Expires 7.31-86 r 6f,EPA Form 8700-22(Rev;4-8 5.Previous;additlon is obsolete)f' , ti GENERATOR.=MAILED BY T'SDF ' . K a r TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION } MAP NO. 310 PARCEL NO. 119 ADDRESS OF TANK: 375 Barnstable Road VILLAGE: Rvatania Numbmr atrw4wt MAILING ADDRESS ( IF DIFFERENT FROM ABOVE,) 777 Dedham St.. Canton. 0202,x OWNER NAME: Cumberland Farms, Inc. PHONE: 617-828-4900 INSTALLATION DATE: 1976 BY: Cumberland Farms, Inc. INSTALLER ADDRESS: 348 Allens Ave., Providence, R.I. 'CERT.1JO. *TANK LOCATION: Tank. C;is furthest from building DCiiQfi I aG TANK LOQAT I ON WITH RQCPQOT TO mU 2"m 2 NO) CAPACITY 10,000 TYPE/OF TANK steel AGE '1:3 YRS. FUEL/CHEMICAL gasoline TESTING. CERTIFICATION [ 3 PASS C 3 FAIL DATE LEAK DETECTION J 3 CHECK IF N/A TYPE/BRAND Red Jacket ZONE. OF CONTRIBUTION [�] YCCE�S�'' [ NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED"++ [ X3 YES [ 3 NO DATE April 15, 1986 CONSERVATION [X3 CHECK IF N/A DATE ff BOARD OF HEALTH TAG N0. [ 3 DATE /m ik PLEASE PROVIDE A SKETCH. SHOW,ING THE TANK LOCATION ON ,THE BACK OF THIS CARD �_ ' '�, .�---� �� �1 ��1 1.� � �- �� ��� r - - � gnu RTMENT'OF PUBLIC SAFETY DIVISION OF FIRE PREVENTION a -D ' I t Da 19 PERM te • EW UNDERGROUND STORAGE FACILITY Form F.P. 290 TO MAINTAIN AN EXISTINGIN permit to maintain an Part , s. with rovisions of 527CMR5.2re is er In accordnew underground storage facility g existing ' erty 3�5 Barnstable Rd. Location. of prop street address '• Farms , Inc. ,,.; A, and or corporation �� °Cumberl � Owner- z f..°property: Full name of person, firm eta#: +?• f`i Restrictions. F. (M.G.L.A. Chapt. 148 Sec. 10A Fee Paid'$ re !Z `as d Dept• or a pointed d gnee Ths it will i exP of Fire i `Date — gnatu of Hea Part 11 sted at the storage facility wi (Owner's Copy to be p o th F.P.290 TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. 310 PARCEL NO. 119 ADDRESS OF TANK: 375 Barnstable Road VILLAGE: Hyannis Number atrwwt MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : 777 Dedham Street. Canton. M. 02021 OWNER NAME: Cumberland Fury►, Inc. PHONE: 61.7•-828-4900 INSTALLATION DATE: 1976 BY: Cumberland Farms. Tnc. INSTALLER ADDRESS: 348 .Alma Ave.. Providence. R.T. 'CERT.140. *TANK LOCATION: Tank B is second closest to building; (oCaon I aG TANK LooAT Z oN W 2 TH mummooT Yo aU I LLD I NO) CAPACITY 10,000 TYPE OF TANK. Steel AGE 13 YRS. FUEL/CHEMICAL gasoline TESTING CERTIFICATION C ] PASS C ] FAIL DATE LEAK DETECTION C ] CHECK I N/A TYPE/BRAND Red Jacket ZONE OF CONTRIBUTION [ ]AYES NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C x] YES C ] NO DATE April 15, 1986 CONSERVATION [X] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. C ] DATE PLEASE PROVIDE A SKETCH SHOWING .THE TANK LOCATION ON THE BACK OF THIS CARD TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION • ..MAP NO. 310 PARCEL NO. 119 ADDRESS OF TANK: 375 Barnstable Road VILLAGE: Hyannis Nuanb�r otr��t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : 777 Dedham Street, Canton, Ma. 0202I OWNER NAME: Cumberland Farms, Inc. PHONE: 617-2 828-4900 INSTALLATION DATE: 1976 BY: Cumberland Farms, Inc. INSTALLER ADDRESS: 348 Al.lens Ave., Providence , R.I. 'CERT.1-40. *TANK LOCATION: Tank A closest to building (ommonzom TANK LOOATION WITH ACoPCCT TO =uXL_oXNO) CAPACITY 10,000 TYPE OF TANK Steel AGE 13 YRS. FUEL/CHEMICAL gasoline TESTING CERTIFICATION C ] PASS [ ] FAIL DATE LEAK DETECTION C 7 CHECK IF N/A TYPE/BRAND Red Jacket ZONE OF CONTRIBUTION 11 YES NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C X] YES C ] NO DATE April 15, 1986 CONSERVATION [K] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. C ] DATE INK PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE HACK OF THIS CARD ��`' \ �l� �� `}�- r TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME Cumberland Farms Dis—Gas Station 852073 ADDRESS 375 Barnstable Road and VILLAGE Hyannis , MA Lewis Street LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL same as above 10 ,000 Regular 4 yrs . steel 10 ,000 Regular 4 yrs . steel 100000 No Lead 4 yrs. steel (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 2/19/7 6 2 2/19/7 6 3. 2/19./7 6 4 DATE OF FIRE DEPARTMENT PERMIT: 6/9/7 5 TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS OCATION NAME C 7> garnst,able Road ' �t Hyannis, ML (N/c Lewis Street) •AMOUNT STORED BOOK & PAGE.--D9rE GATED Aboveground: 500 gallons of 109/24 June a' anti-freeze and motor oil Underground: 50,000 gallons in 3 tanks--gasoline I. DATE PAID June 9� 975 �,�� �4`�. -( , ��J_ � ��,t,�L.<,Z 1 ►p MAR 151976 MAY z 2, 1977. MAR J 191p I