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Home My WebLink About0707 IYANNOUGH ROAD/RTE132 - HAZMAT �� !�nYl ov��P f� ��Z� i o i t UPC 12543 No. 53LOR HA RTJ�+ns Vld f IKE*okti Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 en MASS.LE.$` 200 Main Street• Hyannis, MA 02601 1639. �prFDMA'�a`0 TOXIC AND H RDOUS MATERIALS INSPECTION REPORT Business Name: Aufltok Date: U111 Location/Mailing Address: -701 Contact Name/Phone: 77S- Inventory Total Amount: ~ MSDS: e `"' License#: I�b� Tier II : 0 Labelina: f- Spill Plan: Oil/WaterSeparator: Floor rains: Emergency Numbers: Storage Areasjanks: 61W r0D M. I f i Emergency/Containment E ui ent: i' ai 14-, Waste Generator ID: Waste Product: �A Date&Amount of Last Shipment/Frequency:!1 [,Other Licensed Waste Hauler&Destination: 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. Antifreeze ,Dry cleaning fluids Automatic transmission fluid +7"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 :=VSwimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: ;00 Inspector: J*%�� Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS `°piRE TOyy� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 Y BARMASS. 200 Main Street• Hyannis, MA 02601 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: CvU� A Date: 7/9/I q 1 Location/Mailing Address: 76 Z f► W ' W 4 2 Op Contact Name/Phone: ! S- Inventory Total Amount: SDS: 4 eb V(� License#: 0 Tier II : No Labeling: Jigs _ Spill Plan: �cS Oil/WaterSeparator: Floor Drains: me ency Numbers: Storage AreaslTanks: KWM ;o Emergency/Containment Equip ent: C. i S rro. A Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: `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. 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 esspool 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 V 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 J RECO MENDATIONS: y Inspector: 171� / �� Facility Representative: I! T �s y� c ° WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS I IKE T° Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS . . • 200 Main Street• Hyannis, MA 02601 1639. � TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: Location/Mailing Address: `70-7 J- aN�•o.� 1ti, ar�,A 5 Contact Name/Phone: J< b2< 'o -"T - 00 n, p a ��-o o Ib o Inventory Total Amount. 5 SDS: ZS x �a��`�o�5 License#: Tier II : 0 Labeling: 0 K Spill Plan: 6K — Oil/Water Separator: ilk Floor Drains: �� -�icwa-1 Emergency Numbers: OK StorageAreas[Tanks: -atkN,nn k4u.,kL." -.� 1,A,S Emergency/ContainmentEquipm nt: ZWwS�nS ov&t. .�� C�Ck. ��sG,k<, C>d Waste Generator ID: Waste Pro uct: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: AA ll LIST OF TOXIC AND HAZARDOUS MATERIALS 0! 4,\k,%VN -S iv�_ {� NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous mateorial 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 I(�} c�caw�•rs 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 VA p g � Swimming pool chlorine I oc� 1b 4 Paints, varnishes, stains, dyes Lye or caustic soda ` Lacquer thinners Miscellaneous Combustibleb Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes �,� Other chlorinated hydrocarbons Laundry soil &stain removers (�'� c,,►'�S� (including carbon tetrachloride) (including bleach) I Ca= ��" Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: Inspector:1-< 6oi�k�101 Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS j r `OF THE F,- Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 RARNMA LE. ` 200 Main Street.• Hyannis, MA 02601 �"rFDMP+p TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Coop a-rA 6q M4�rle- o+4- Date: Location/Mailing Address: -707 ¢ o� �- 4nvl,s Contact Name/Phone: oo mount: _ Yes-1a�Ke� ,, , Qicoemn s11e1�#:��Invento Total S �I+?n b MSDS Tier II : V Labelino: C04- - oo Spill Plan: S Oil/WaterSeparator: Floor Drains: C -- 2� Emergency Numbers: Storage Areas/Tanks: I 6i a 65 C&A O,IAX f7 - e,. ti Emergency/Containment ui ment: +Dvs,4S Waste Generator ID: it Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS - NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid 16 Other cleaning solvents&spot removers 2h y Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives 2 t fi Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil t-I Disinfectants SoT q A-1, Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages 2 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 'l0 Swimming pool chlorine'lo tto Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes —�� Miscellaneous Flammables �-Jr Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons b Laundry soil &stain removers (OK (including carbon tetrachloride) (including bleach) <d�` �<S Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: INFORMATION/RECOMMENDATIONS: 1JAVAAa- cq ow e1 b 1 A 6t( 0�6 e-t S S �a -a- v2�y,��lvcyavt,'t- acl -�'/ � LaN�e.,l �� Inspector: Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Number Fee 1203 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Courtyard By Marriott ........------------------------------------------------------------------------------------------------------------------------- 7071yannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 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 r .yVL G. Town of Barnstable e Inspectional Services BARNSTABLE pF1F1E P N.THREE-RNlEtVLE•COU •FYAkA15 Public Health Division ' 54` °�"1639-7 014 eA 9r M - Thomas McKean, Director 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 I st—JUKE 30th). APPLICATION FEES 2(vir PA CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 CATEGORY 2 ERINIIT 111 —499 Gallons: $125,00 ❑ CATEGO RMIT 500 or more Gallons: $150.00 *A late charge of$ 0.00 ill be assessed if payment is not received L b Jul 1st. 1. ASSESSOR'S MAP AND PA NO. 2. IS THIS A PERMIT RENEWAL?YYES_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: 76-1-114 Aa G e/ 1, L e' dIA14, 5. NAME OF ESTABLISHMENT: Ina 6. ADDRESS OF ESTABLISHMENT: 707 ;1 2d V 13;)" 14 an/i 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: y9� Nxs�q Gd3W 8. TELEPHONE NUMBER OF ESTABLISHMENT: 4',Q pG 9. EMAIL ADDRESS: k,,ZAc%/ aeidL rlcl M pr//GACC K 10. SOLEOWNER: YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 7vLi� Nclel L PRESIDENT /Vgyqn G . RGi,y TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICA DATE Q:1Application Forms\Haz Mat Appli Draft JafIocx I Number Fee 1203 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Courtyard By Marriott 7077yannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 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 r Town of Barnstable Inspectional Services BARNSTABLE 3. FSHE Tn.. ."v"sic':suiis�'us*�vii°v'rraraar"rwe `"'r • 'Y"�, Public Health Division 575 BARN.—MBLE, Thomas McKean, Director 9�i0r1 659. 200 Main Street, Hyannis,MA 02601 X: Office: 508-862-4644 Fax: 508-790-6304 �ry 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 DULY I st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 .9 VS � CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ B g CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charize of$10.00 will be assessed if payment is not received by Jules 1. ASSESSOR'S MAP AND PARCEL NO. 311 - m O 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: 7U L/ /a SIG 1�G/ G L G dA& _ 5. NAME OF ESTABLISHMENT: e!iCy lW(J/f/of 6. ADDRESS OF ESTABLISHMENT: U 7T'ynnwg� I&•C11 10"- 3.1 JJyann1a 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: y95. �W�'9u�C Drl �y �U'l, 8. TELEPHONE NUMBER OF ESTABLISHMENT: S-(J8• 77S GOD Gd3GJ 9. EMAIL ADDRESS: . tt.Amd%. C nd--Gr/Gi 10. SOLEOWNER:-YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME M A� 141-.4e/ L.L G, PRESIDENT AAAC- TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: tGNATURE OF APPLICANT DATE pp.ication Forms\Haz Mat App Revised 09-10-1 cx Number Fee 1203 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Courtyard By Marriott 7071yannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 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 r' i I ow of UnslIble aTRegulatoervces Richard V. Scah, Director ' OF ZNE Tn. Public Health Division BAMSTABLE KUST R MILLS HfFRYILtF.fDfUR.NYAMNLS BARNSTABLE, = Thomas McKean, Director "' '°'�"`Lsi�a o 4-��Sy` - - Ma+°�� -- -- - _. ..200 Main Street,-Hyannis,lV1A 02601---- -- - - ---- - -��1�- --- --- - - 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 3Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 x V.S CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 2. IS THIS A PERMIT RENEWAL? X 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 iGREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT: �� G/� & Inay1a 6. ADDRESS OF ESTABLISHMENT: 70 yC�hh a��1� 1& IP / 3 a l r a�nl� 11 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 105- Ga eJ 4 i 1J41 GIG 9,(,rdNi a U 8. TELEPHONE NUMBER OF ESTABLISHMENT: �� 8 - -77T 9. EMAAIL ADDRESS: bt/Gndy.."e-,-&/ /Y1a,�`/� 10. SOLEOWNER: X YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME oq-%/of-1- e&/ Ll.C- PRESIDENT �yp�eur C• �,�G / TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: I GNATURF, OF APPLIC DATE f y2 LApplication : Forms\HAZMAT APP 2017 9SEe Numbcr Fee 1203 THE COMMONWEALTH OF MASSACHUSETTS $50.o0 7:p Town of Barnstable Board of Health This is to Certify that Courtyard By Marriott --Y 7071yannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons 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 I J che* I 0(PS(v f wn. of B stable r Regulatory Services Richard V. Scali, Director � w THE • "o Public Health Division BARNSTABLE a. • + wcwsr4ue•:txrcuvi�•cmuir•nvu;r:rs BARN rABLE. Thomas McKean, Director MRRS1 :SMLLS 3r9 203yYlcSi P4?n5R6E ! 0 39. s`0� 200 Main Street, Hyannis,MA 02601 1NDo/�-a 0/g WQ Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1st—JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 Pd V•S CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ *A late charge of$10.00 will be assessed if payment is not received by 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 . ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGEIUSE OF GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: '7 UJJ fit- jL& �e/ L L L 5. NAME OF ESTABLISHMENT: CGt/2 C/ra ht, 114aaln# P 6. ADDRESS OF ESTABLISHMENT: ij 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: y q s� wej4q,2h DVLe gfaILfG�1, !� Ga3Gf 8. TELEPHONE NUMBER OF ESTABLISHMENT: `SUF- 7 7f 66 9. EMAIL ADDRESS: GU.ef' I0 , afl d-erlc� al�arri 10. SOLEOWNER:— YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 1_-)--6 PRESIDENT IV-O h , f A kJ TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: . NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT « " DATE :\Application Forms\HAZMAT APP 2017 REVISED. x 1 � r Number Fee 1203 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Courtyard By Marriott 7071yannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons of Hazardous Materials. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2017 unless sooner suspended or revoked. . ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF, D.M.D. 07/01/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health Town of Barnstable 0, F1NE toys Regulatory Services °^ Richard V. Scali,Director t .& . ( e°"MS`"BLE, Public Health Division BARNSTABLE MASS.y eaaasuo¢•cn+¢vnuc•cmumn::xs oA 1679. �0 aiasro!:s rws•°seiNu[•rr e.:xsie 1fDpM�A Thomas McKean, Director 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 DULY 1 st—NNE 30th). APPLICATION FEES CATEGORY I PERMIT 26— 110 Gallons: $ 50.00 CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. DATE lY FULL NAME OF APPLICANT: Jl-I1LL- 14e ie-/ L L C NAME OF ESTABLISHMENT: cct/✓4 G✓� 1'1�Q�i'1G7� ADDRESS OF ESTABLISHMENT: 767 MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: ZD 1,60' , ft EMAIL ADDRESS: ��d� C>✓Y �rI f-y�G�rr�iG1}'a �Cr� SOLE OWNER: "AYES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME �C.%/(�.. •-1 C L L C PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: . S GNAR ICANT Name: Company Address : Telephone#: Email: I QAApplication ForniskHAZZAPP Rev t 6.docx Pagel of 2 I f � ;ar Town of Barnstable Office: sog-862-4644 Fax: 508-790-6304 Regulatory Services Department y. y Public Health Division ` Thomas A.McKean,CHO zbq. d` 200 Main Street, Hyannis, MA 02601 F Payment Receipt ;Hazardous Materials Payment received:_ 50.00 (Check) on 6/14/2016 Permit number: 1203 Check number: 15545 Check amount: $50.00 Name on check: Courtyard by Marriott I j !Business: Courtyard By Marriott } ;Address: 707 IYANNOUGH ROAD/RTE132, Hyannis I � .._----- ........._..._.... _-____ .............. ____._......_.__._.___.. ________-___..____ ..................... __ ................-_-] • Number Fee 1203 THE COMMONWEALTH OF MASSACHUSETTS $so.00 Town of Barnstable Board of Health This is to Certify that Courtyard By Marriott 7071yannough Road, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 100 gallons of Hazardous Materials. -----------------------------------------------------------_--------------------------------------------------------------------------------------------------- ---------------------- ------------------------------------------------------------------------------------------------------------------------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires 06/30/2016 unless sooner suspended or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN PAUL J.CANNIFF,D.M.D. 02/16/2016 JUNICHI SAWAYANAGI THOMAS A.MCKEAN,R.S.,CHO Director of Public Health �Ut-f19 STown of Barnstable °F1K�E►� Regulatory Services y Richard V. Scali,Director .2A p BARNS LE BA MASS' : Public Health Division 1-' 7b3s1. `00 Na50*:5&I'Ltt3�KTH LLE�a'T!'.";x`sr�e Q'J '°'fuN,cre, Thomas McKean,Director 16✓-2 1 4 r 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 I st-JUKE 30th). APPLICATION FEES 11 CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ • A late charge of$10.00 will be assessed if payment is not received by July 1st. ASSESSORS MAP AND PARCEL NO. 31 — 0 DATE �lI LP /10 FULL NAME OF APPLICANT: 7L"J/a- �G � L- Z- C Cl NAME OF ESTABLISHMENT: CGS G1�" ��G ADDRESS OF ESTABLISHMENT: 701 good 1 MAILING ADDRESS(IF DIFFERENT): � -eJ2` TELEPHONE NUMBER OF ESTABLISHMENT: 6-OF--7 7 9- _ 06 EMAIL ADDRESS: Leh a�y " � ��G 11/-n o r-r/G11, SOLE OWNER: YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME 9141 A--14C IC) L. /---e . PRESIDENT st/G�,c i C'• Pi/ TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: SIGNATI= OF PLICANT Name: • Company Address : Telephone#: Email: QA Application Forms\HAZZAPP Rev I6.docx Page 1 of 2 't! Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department - Public Health Division +� anlu+ia�t.� ass:. Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt ,Hazardous Materials Payment received: $50.00 (Check).on 2/16/2016 Check number: 15221 Check amount: $50.00 Name on check: Courtyard by Marriott jBusiness: Courtyard By Marriott Owner: 7ULIA HOTEL LLC Address: 707 IYANNOUGH ROAD/RTE132, Hyannis • II