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Home My WebLink About0085 KIDD'S HILL ROAD - Health ss k4�P� /�ir�r✓� ��,,, ,�_ i -- �a� , /�'C lY Number Fee 1237 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that ACKSpray Foam Insulation 85 Kidds Hill Road, Barnstable, 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 Town -of Barnstable Inspectional Services THE BAsT�LE pF wRne.e•mw:;L•cwrt•.,wr o Public Health Division °3�0w'°'=° ��i4" �° ` Thomas McKean, Director 1639.9�ArEa``� 200 Main Street, Hyannis,MA 02601 �a Office: 508-862-4644 Fax: 508-790-6304 r APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE •' �E 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—JUNE 3 Oth). .APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 RVS� CATEGORY 2 PERMIT 111 499 Gallons: $125.00 ❑ 1 d r, 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. 6201'�- 003 2. IS.THIS A PERMIT RENEWAL?0<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: D(l (8(�C—� 5. NAME OF ESTABLISHMENT: IBC �( . � ��y ��/� �ySc,,Lc�•� 6. ADDRESS OF ESTABLISHMENT: �,(G�/\ r�� ! C 1 0�1� H rAk JM5 7. MAILING ADDRESS DIFFERENT FROM ABOVE: A aC C0 C 2 8. TELEPHONE NUMBER OF ESTABLISHMENT: 9. ,EMAIL ADDRESS: f/�,��C.:�J�/.G?� �C��/I Lam•�� 10. SOLEOWNER:_KYES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT W DATE Se 201 Q:Wpplication Forms\Haz Mat App Revised 09-10-18 x Number Fee 1237 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that ACK Spray Foam Insulation - 85 Kidds Hill Road, Barnstable, MA Is Hereby Granted a License For: Storing or Handling 26- 110 gallons of Hazardous Materials. eiJ ------- ----- ------------------------------------------------------------------------------------------------------- ------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------------ C-6 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 S DONALD A.GUADAGNOLI,M.D. 07/01/2018 JUNICHI SAWAYANAGI THOMAS A.MCKEAN, R.S.,CHO Director of Public Health t�� '� ' fOn of B ,�rnstable egu atory ervices oFj KKE Richard V. Scali, Director �a � A�u Public Health Division BARNSTABLE +: &DRYS'AEIE.[EM MILI.-=U-WVi`i S . BARNSTABLE, ' Thomas McKean, Director MASS. v Mp, 6.1 200 Main Street, Hyannis,MA 02601 ��Ig 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 �+ U 1 CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00j P,4 ve D ca'h CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 ❑ 00$ 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 STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: 5. NAME OF ESTABLISHMENT:�! 7,01X,4 6. ADDRESS OF ESTABLISHMENT: 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: /19eAl. DA 8. TELEPHONE NUMBER OF ESTABLISHMENT: Y?"1)1 Z 9. EMAIL ADDRESS: A� 5�,,�e��U,�e!.•¢�� C� ..tf,® e/1/1,4 (' 0 --L� 10. SOLEOWNER: _�__YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q:\Application Forms\HAZMAT APP 2017 REVISEI5.Socx Town of Barnstable Office: 508-862-4644 Fax: 508-790-6304 Regulatory Services Department HAJAN &OL& y Public Health Division Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt "Hazardous Materials Payment received:$60.00 (Cash) on 8/28/2018 _ Permit number: 2018-2019 i !Business: ACK Spray Foam Insulation Owner: Waldeci Rodrigues ,Address: 85 KIDD"S HILL ROAD, Barnstable ;Note: Category I (+$10 Late Fee) 2018-2019 i I • N. Number Fee 1237 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of:Health This is to Certify that ACKSpray Foam Insulation 85 Kidds Hill Road, Barntable, MA g' J 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 Number Fee 1237 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to.Certify that ACKSpray Foam Insulation 85 Kidds Hill Road, Barntable, 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 06/30/2018 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 ,r art.. . . T�wn, of Banstable eg atory ervices THE Richard V. Scah, Director � �� o� Public Health Division B enausnx •i.[nreuviu.t•cmurt•nrnrasARNSTABLE BARNSrABLE. s Thomas McKean, 16 Director M q5 P5 MW5-51:RV/ILLE•r 5lN?YSf48f i6 �� r 4 '°ren 3 a 200 Main Street, Hyannis,MA 02601 5 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-JUNE 30th). APPLICATION FEES CATEGORY 1 PERMIT 26- 110`Gallons: $ 50.00' vlS . 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?�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: AC k- S'fgj9t FOAM . J1JfVL J97j(DAj 6: ADDRESS OF ESTABLISHMENT: QS 'k)VjQs ->J 1l 1? 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: R�S� r�e �✓i'�C/lI�V�S' N1�E�Z�6� 8. TELEPHONE NUMBER OF ESTABLISHMENT: ' S21 � 9. EMAIL ADDRESS: - 19G KSzE jA--1r 1z FlV®/N& ( 0,11-11 L . C:2/-1 10. SOLEOWNER: �Y YES_NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE#OF: CORPORATION NAME AC k I PPPOr F-oAl i ),Aj f o-Pz o� PRESIDENT_ VJ p L 06c i ✓l• x�d� �• TREASURER - CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT V DATE 0(- � - Q:\Application Fom]s\HAZMAT APP 2017 REVISE . o f • Number Fee 1237 THE COMMONWEALTH OF MASSACHUSETTS $50.o0 { Town of Barnstable Board of Health This is to Certify that ACK Spray Foam Insulation 85 Kidds Hill Road, Barntable, 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 p • Town of Barnstable , Regulatory Services • , Richard V. Scali, Director ��AB _ BARNSTABLE �. r Public Health Division 1639• S�0 wMna r-A U u COw euxn �fD jiAO� Thomas McKean,Director - 1639-2019 4 fag co 200 Main Street, Hyannis,MA 02601 ' Office: 508-862-4644 Fax: 508-700-6304 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 PERMIT 26- 110 Gallons: $ 50.00 CATEGORY 2 PERMIT= 111 -499 Gallons: $125.00 El .- CATEGORY 3 PERMIT 500 or more Gallons: $150.00 El A late charge of$10.00 will be assessed if payment is not received by July 1st. • ASSESSORS MAP AND PARCEL NO. DATE a' t FULL NAME OF APPLICANT: \,.�LO C G 1 M • (Z�0 O Q ) 6 (/CS NAME OF ESTABLISHMENT: Xc k : S PRPI f'-->6M /N S✓49 T/2AJ ADDRESS OF ESTABLISHMENT: 9') i ADS' Ia I L L (t 6,9(RNTr/9eLc' MAILING ADDRESS (IF DIFFERENT): 3t Ic OSC I L-R&C& • S-o✓ I H 0c-A1A//S o2�b10 TELEPHONE NUMBER OF ESTABLISHMENT: ? -S 2 I T 29 EMAIL ADDRESS: 'C r� S I� �N SuL/�TIaN (�jN1 Ali - CO/.,I SOLE OWNER: -) Y S NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME PRESIDENT TREASURER CLERK IF PREPARED BY OUTSIDE PARTY: �ATUe�APPLICANT . Name: /V Company Address : Telephone#: Email: Q:\Application Fonns\IAZZAPP Rev16.docx Page I of 2 y ' Town Of Barnstable Office: 508-862-4644 Fax: 508-790-6304 s Regulatory Services Department a --nRNSPaBLE; Public Health Division . Thomas A.McKean,CHO ` 200 Main Street, Hyannis, MA 02601 Payment Receipt !Hazardous Materials Payment received: $50.00 (Cash) on 7/12/2016 Permit number: 1237 i l ;Business: ACK Spray Foam Insulation Owner: Waldeci Rodrigues ;Address: 85 Kidds Hill Road, Barnstable i f.Note: Category I Permit 2016-2017 I ,