Loading...
HomeMy WebLinkAbout0093 THORNTON DRIVE - Health 93 Thornt ' Sarn Sb�e 191-013 r v ° N 0 4 ° 9 ti � I rq Town of Barnstable Hazardous Materials On-Site Inventory and Inspection FACILITY INFORMATION: Business Name: J G,q L.4 AtI n &-,v 7z-1Y Business Location: 7W OI�Al TdAJ tflV No%S Mailing Address: As 46avc Telephone Number: .510k ^ 36 G ' D 6 6 :7 Contact Person: el-A y rDAJ S" Emergency Contact Telephone Number: ,f5_0,f 360 6 G Type of Business: 41j41JA1CA17_ kW_b !3,+L-A"JC-/A6(1 HAZARDOUS MATERIALS (CHAPTER 108) Virgin Product Total Quantity Container Size(s) Storage Location Major Materials Gallons or Pounds Quarts,gallons, Shed,retail store, drums,tank,etc... cabinet,closet,etc UNtiiW0Wi1 ?>AR TS (- AdCA-61 45- S6L✓Fiver" (�/�zLv�� d-LE-itNcp,- ? 61L � (�I�-leL6�S ��/-t - 1 - Misc.Combustibles Misc.Corrosives Misc.Reactive Misc.Toxics Inventory Total Amount: A PPROVMA Cz/d I-DA S Hazardous Materials License Posted?Yes No -411A Contingency Plan Posted? Yes No Fire District: 11VA AJAJIS Fire Extinguisher Service Date: / +9 Zo// Metal Covered Rag Bin:� No Absorbent Material Available?ee No Type of Absorbent: peedy D Pads Pigs Other: MSDS on site? Yes 0 Hard Copy Computer Access Hazardous Waste Handling Hazardous Waste Generator Identification Number: ky sw -3w -06 6 Type(s) of hazardous waste product(s): k14-5 7L OIL Date of last hazardous waste shipment,type of waste and quantity: /a-;Z- A:Q4 doNi9U5n ec-" 1—i c u rd . 30 G/4t!-OAJ5 T Hazardous Waste Transporter(s): Wei a-)U) 6/L Designated Hazardous Waste Facility: WeS 719e-AJ 0/4,„ L iN"L" 4-- Hazardous Waste Storage Area Description: -W f.srr �A-94W 5rv1*f-c--D IA Is hazardous waste storage area labeled: Yes No Are tanks/drums/containers labeled with the words zardous Waste' 'the type of waste and the associated hazard (i.e. ignitable,corrosive,re oxic es No If hazardous waste is stored out of doors is it covered from the elements? Yes No N�i7 Is it in 110% containment? Yes No If hazardous waste is stored indoors is it on an impervious floorC es No - 2 - FLOOR DRAINS (Chapter 381) Town Sewer Account Number: Indoor floor drains: Yes 9 If yes,circle one,does it discharge to a: holding tank dry well on site septic. Outdoor surface drains: Yes No If yes,circle one,does it discharge to a: holding tank dry well on site septic. FUEL AND CHEMICAL STORAGE TANKS (Chapter 326) Underground Storage Tank(s) on site? Yes o Age: Is removal required? Yes No If yes,when? Is testing required? Yes No If yes,when? Out of doors above ground storage tank on site? Yes 100 If yes,is it protected from the elements? Yes No If yes,how? Is it on a foundation larger in size than the tank? Yes No COMMENTS/RECOMMENDATIONS/CORRECTIVE ACTIONS A-4"WIAIC A e-C.-65S 72) 1-7fLr C0HP1/?EP, r, /-- AJ /-0 LOA)40(' LL.St' ��E 77V-C SPtA)7- 5LLV'&-WT /AJ 77te- h-7-5 (iLCWaJ&r 5MU-1-b 6E J/S/aoS&t atf A A 1, `+A-Z-*9b,0 u_S LJ M rE N'f}tC-Lt7Q /S A16T 5u6JZ-Zr Td 1-#e Ii4 a.yrbeaj 41S67J tire' /f&-Zeylleeweyr DF &ov-q-f'7E72 /aS wyjAj or- 8,+4,y57;*81L q-s /S /-&'3S 77f.4N 0NE-#UAA1' L---6 Date: .Z:7 ?d// Public Health Inspector: Facility Representative: - 3 - Parker, Alisha From: Childs, Barbara on behalf of wpcd wpcd Sent: Tuesday, January 02, 2007 9:43 AM To: Parker, Alisha Subject: RE: Sewer Connections Both are connected -----Original Message----- From: Parker,Alisha Sent: Tuesday,January 02, 2007 9:32 AM To: wpcd wpcd; Mastroianni,Ann Cc: Giangregorio, Robin Subject: Sewer Connections Good Morning, Would you please be able to tell me if 93 Thornton Drive(m/p 296-oig) and 31 Thornton Drive(m/p 296- 007) are connected to Town sewer? Thank you,Alisha Alisha Parker 0 Hazardous Materials Specialist Town of Barnstable Health Department 200 Main St. Hyannis, MA 02601 Phone: 508- 862-4645 Fax: 508-790-6304 alisha.parker@town.barnstable.ma.us i YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office,1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE:-3/1 0 Fill in please: I APPLICANT'S YOUR NAME: a 'i- N ^nwA`' BUST SS YOUR HOME AbDRESS:'Z�i S iC��1 llJ '� ��N �P 134 AA Z4 x 4� �.1 PM TELEPHONE # Home Telephone Number;S F.. �, •tx:; ,A,sa�.,d •,,'-�' #� , t TYP; ,�• 7 x-+r 9 m - ���.�� .� .. � �,.. � �� p�tay}y � �,e :1, n� , 9. 't ct: ,yam. ry �T.. ,.. .,, .• fir: � _ 2` :� '3'T� 'k"" a;. si, 13• + 'i Y �a .�. `�' '� $ - �,-, 7� ..-;���i`C .Ka '�� � -.I �• r zR y p r•'r,�',; a t•' z a�.-....�-Ul�•� � _ .. z� x .-. �v'.: .,,, ..,.4e s : � .`M�, �:. ,r d pV;}p�YW�n' . ., ¢�.��' g�F''�' .:i ram,.. � �'. £w. ., ...� •.•..N .- -.r'� .� .. '....i}}. 1 u n 4 .I '„ - .;.,. ,..A.- -, a ^§, �,>:'a .�_ .; x.,,r' . T '. ,�;.' " r B c:'s.• ,.:���Lid` ,.si.yd.'�n:. Y+ �.- .1': When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM NER'S OFFICE This individu 1 ha e n i�tfo a any permit requirements that pertain to this type of business. Au hori Ted i nature** ,n COMMENTS: i �a�► C=d 06+-(Ow 10L kh 2. BOARD OF HEALTH This individual has bep infor d oft a permit requirements that pertain to this type of business. A thoriz d Signature** COMMENTS:d 1D �(_o � d y r��S J 4Q&ir.S 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha glen inf ed•of th e i g e uirements that pertain to this type of business. Authorized Signa tub* COMMENTS: CU .^` �� "10 ha4,.-e. dape YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for years). A business certificate ONLY REGISTERS YOUR NAME in town wh you must do by M.G.L.-it does not give you permission'to operate.) Business Certificates are available at the Town Clerk's Office, 1' FL.[367h Main Street, Hyannis, MA..02601 [Town Hall) ?,tl.:at K41LL`CkNA 8 + fV_/ -7—v—7 . T p Fill in please ED4,TIE: : APPLICANTS YOUR NAME:C4-r%S ►Y7�GLrZ/ BUCINECS Y yrrF�4 7 YOUR HOME ADDRESS; 2 71WX S. S,4,rrJ 7GL1 TELEPHONE # Home Telephone Number 77 S/ v2 ? /!/2 NAME OF NEW BUSINESS lVer�T IS THIS A HOME OCCUPATION?. TYPE OF BUSINESS: A ,e i ye co NOy�os-tir.�i'.v�e YES . Have you been given app°roval'from the buildn'g':dNlsori? YES NO r / ADDRESS'OF BUSINESS -3 Ttio.� >`ani /; U/ -i�/ �. N ` AF/PARCEL NUMBE When starting a new business there are several things you must do in order.to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information.you Inay need. You MUST GO TO 200 Main St. - [corner of Yarmouth Rd. &Main Street)_ to make sure you have the appropriate permits.a' licenses required to legally operate your business in this town. 1., BUILDING CO SSI NER'S OFFICE This individ al ha en i d �Q ny permit requirem s that pertain to,this type of business. Au hprize Si ture** COMMENTS: 2. BOARD OF HEALTH This individual h e n info ed f th p rmit requirements that pertain to this type of business. Authorized gnature* COMMENTS: . MUSTOWYMMIL HM 3: CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature.** COMMENTS: r Hazardous Materials Inventory Sheet Checklist Date Physical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts-(le.gas being used to fuel machines,thinner to clean brushes all count as hazardous materials) torage Information-location of storage,how long is storage for? .V If none,note that. ' isposal Information-where and who?If none,note that. plicant Signature-understand what is listed and noted taff Initial-any questions,know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and e exI ain it-note that it was given Attach the Business Certificate with your sign off and comments a "The inventory form should explain what the business consists of and the procedures I, they are doing. Notes need to be left to explain what You discussed with Them Date: S 1 13 lc-7 TOWN OF BARNSTABLE I TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY , NAME OF BUSINESS: Ne)r t Ge ve- L i �e I BUSINESS LOCATION: 9_7 T4o r v/oni ale. UN i r A 4 /-1 _,41"s / 4 ozd O / INVENTORY MAILING ADDRESS: <Afe TOTAL AMOUNT- TELEPHONE NUMBER: 77 V a 7 rS- 111Jy CONTACT PERSON: CZ I-%s EMERGENCY CONTACT TELEPHONE NUMBER: 7 7y ? F )Vl f/ MSDS ON SITE? TYPE OF BUSINESS: A)l® b-►a k V C tA(kP-I'a r /lc 7C,1,Vi'.r4 iW:� INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: 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) 0 , Misc. Corrosive NEW USED 6 Cesspool cleaners O Automatic transmission fluid 0 Disinfectants ® Engine and radiator flushes O Road Salts (Halite) Hydraulic fluid (including brake fluid) O Refrigerants Motor Oils 0 Pesticides NEW USED (insecticides, herbicides, rodenticides) 0 Gasoline, Jet fuel, Aviation gas 0 Photochemicals (Fixers) 0 Diesel Fuel, kerosene, #2 heating oil NEW USED ® Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED d Degreasers for engines and metal 0 Printing ink 0 Degreasers for driveways &garages d Wood preservatives (creosote) Caulk/Grout 0 Swimming pool chlorine O Battery acid (electrolyte)/Batteries ® Lye or caustic soda 0 Rustproofers Misc. Combustible d Car wash detergents I Leather dyes o Car waxes and polishes 0 Fertilizers 0 Asphalt & roofing tar Q PCB's r Paints, varnishes, stains, dyes 0 Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED O Any other products with "poison" labels d Paint &varnish removers, deglossers (including chloroform, formaldehyde, 0 Misc. Flammables hydrochloric acid, other acids) 0 Floor &furniture strippers 6 Other products not listed which you feel Q Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers CaN 1 c //l, ���et (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents 0 Bug and tar removers 0 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: BUSINESS LOCATION: -__(TAUJ��0012M= INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: -3102 MSDS ON SITE? TYPE OF BUSINESS: [IJ� C�, d )► INFORMATION/RECOMMENDATIONS: Fir istric t7YYl� ���L 1<, -FE QA .Q_Wa 2= T g> -�-]2 �r_t/L, S'4bpia _YX VA Waste Transportation: 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 NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants V Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants ✓�✓ Motor Oils 4D Pesticides NEW USED 'insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED 1p 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 0 Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's 0 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, O Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, O 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) Cr6N Spot removers &cleaning fl I s — I (dry cleaners) Other cleaning solvents Bug and tar removers - OL t -c" o Windshield wash WHITE COtHEAEIPARTMENT[CANARY COPY-BUSINESS * f f S c 1 � G Date: /j / g / TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: f-A r BUSINESS LOCATION: q3 A 4 IN MAILING ADDRESS: 100 ,6vX /35� H7,10_,jUU s - A-f+ D lot TOTAL AMOUNT: TELEPHONE NUMBER: 5M — 7!Z0 " CONTACT PERSON: kD be-r h 0. o-4-A-rn "t i EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: h Fire District: l 7 Waste Transportation: NO Last shipment of hazardous.waste: Name of Hauler: Destination: III • Waste Product: Licensed? Yes No 6r 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 NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) 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 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 0 (including bleach) rx-tb a Spot removers &cleaning fluids AiU (dry cleaners) I ° Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: ti 0q TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: 63 3e-NICa BUSINESS LOCATION: GO) MAILINGADDRESS: Q Mail To: TELEPHONE NUMBER: Board of Health Town of Barnstable CONTACTPERSON: (��u,� d�;U\x� P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: C-ok-Up-4611i Hyannis, MA 02601 TYPEOFBUSINESS: 4,,ky Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES * NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: Sew c TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(forgasoline orcoolant systems) Drain cleaners NEW USED Cesspool cleaners .��. Automatic transmission fluid Disinfectants Engine and radiator flushes = � Road Salt (Halite) - - Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) u 6&lton Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda ]_ Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids II+ a�oi.c. Q r-e.. c>a-cr e 4,r,.. " zS�' 1AIV61 (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS v� Number Fee y1264 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Scala Auto Center 93 Thornton Drive, Hyannis, HA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials. --------------------------------------------------------------------------------------------------------- --------------- ----------------------------------. This license is.grauted 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 T THOMAS A. MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable. Inspectional Services BARNSTABLE pFt��� nnawsme_e•ce+ ;:a;L•caum.wkr - ,� Public Health Division :5]9-301a d Thomas McKean, Director BARNSTABLE, f • ' MASS. i639 `0� 200 Main Street, Hyannis,MA 02601 y `r+rl Office: 508-862-4644 Fax: 508-790-6304 W APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE c 1 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 3 Oth). APPLICATION FEES e_ y CATEGORY 1 PERMIT_ 26— 110 Gallons:. $ 50.00_ X VST p,(COA CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 ❑ CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ -t-Vvy *A late charge of$10.00 will be assessed if payment is not received by July 1st. ::H,3 p; 1. ASSESSOR'S MAP AND PARCEL NO o °' 2. IS THIS A PERMIT RENEWAL? 7YES 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: Cr lQ f D v\l S 6p 4 A 5. NAME OF ESTABLISHMENT: S G A L A -14 y T Q L G- I'll 7-G`1 6. ADDRESS OF ESTABLISHMENT: 2 3 - y0 ft IV T©1V &R Ve, AV M/V'IV IS 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: 509-,5(0 0&&1 9. EMAIL ADDRESS: C 1-6 X 7-0 iN SGa4-,4 a A/o i MA L.607M 10. SOLEOWNER: YE' 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 L Q:\Application Formsgiaz Mat App Revised 09-I0-1 .docx Number Fee 1264 THE COMMONWEALTH OF MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Scala'Auto Center 93 Thornton Drive, Hyannis, MA SD 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 S 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 if a4 4 � Vwofons Barnstable egu atory ervices Richard V. Scali, Director ' opti R FTHE i o� Public Health Division BARSTABLE sAxNSTAHLE. • Thomas McKean, Director MAR5TDi5""�iGgEn 4W%515AFNsl4 y MASS. �'iDreu Mn+p`� 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 1 st-JUNE 30th). APPLICATION FEES ` CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 �� +A o l 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? 4ES_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. 4. FULL NAME OF APPLICANT: G �4 r f Q Uy 5. NAME OF ESTABLISHMENT: SG A L / A U L D G&1k1 T G R, 6. ADDRESS OF ESTABLISHMENT: 23 ��2M y ro ru H YA IV Al iS 0 2�01 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: Soo - 360060 9. EMAIL ADDRESS: C L E Y 0 N S(C 4 L R Q Y0 [M41'L G o t1/1. 10. SOLEOWNER: __,gLNO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME ADDRESS,AND TELEPHONE #OF: CORPORATION NAME �I PRESIDENT TREASURER CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: — TELEPHONE#: COMPANY ADDRESS EMAIL: SIGNATURE OF APPLICANT DATE Q8 10 /110 ,9 Q:\Applicarion Forms\HAZMAT APP 2017 REVISE .docx Number Fee 1264 THE COMMONWEALTH OF MASSACHUSETTS $50.00 Town of Barnstable Board of Health This is to Certify that Scala Auto Center 93 Thornton Drive, 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 zjz� and expires 06/30/2047 unless sooner suspended or revoked. L --------------------------------------- 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 ro,,ti Regulatory Services II Richard V. Scali,Director 4 { j B"i"MAM'F"AB`E ` Public Health Division V BA STABLE BAIU15*ABtL•@l1DtVfuL•CDNR•FnAMN15 1639 �0 /�(\' wxroxsus•os�nwue•wa euxsme '(a ��h.J 1639-2014 ~ Thomas McKean, Director ( 573 200 Main Street,Hyannis,MA 02601. Office: 508-862-4644 r Fax: 508-790-6304 W co 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 CATEGORY 2 PERMIT 111 —499 Gallons: $125.00 El CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ A late char a of$10.00 will be assessed if paMent is not received by July Ist. ASSESSORS MAP AND PARCEL NO. DATE FULL NAME OF APPLICANT: 44)�' o 4 NAME OF ESTABLISHMENT: SG A A PA V"T,0 ' C N T 61, ADDRESS OF ESTABLISHMENT: W R 1 V f-, pj�oj I Vn A MAILING ADDRESS(IF DIFFERENT): TELEPHONE NUMBER OF ESTABLISHMENT: 5o f 3 6o 06 6-4 EMAIL ADDRESS: Clie_ iMnAi aYCJO\'i A •_Q 'V\©T V+n A� J C ®ram► SOLE OWNER: _YES NO IF NO,NAME OF PARTNER: FULL NAME,HOME ADDRESS,AND TELEPHONE# OF: CORPORATION NAME PRESIDENT TREASURER CLERK e . IF PREPARED BY OUTSIDE PARTY: SIGN , OF PLICANT Name: Company Address Telephone#: Email: Q.'Application Forms\HAZZAPP Rev16.docx Page 1 of 2 Number Fee 1264 THE COMMONWEALTH OF 'MASSACHUSETTS $5o.00 Town of Barnstable Board of Health This is to Certify that Scala Auto Center 93 Thornton Drive, Hyannis, MA Is Hereby Granted a License For: Storing or Handling 26 - 110 gallons of Hazardous Materials.y - ----------------------------------------------------------------------------------------- --------------------------------------------------- ------------ 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 TRowr of B fable eg atory ervlces Richard V. Scah, Director of t KME Public Health Division BARNSTABLE + BnuVsinutk•i.H+rEuvL1•cOTurt nrncris +fir + BARNSTABI.E, ' !ua5iusHies 9 eisr ee?nsrne:t .new �. Thomas McKean, Director 163 16,9-201Zo1, h� 039. s`0� 200 Main Street, Hyannis, MA 02601 aol8Office: 508-862-4644 / Fax: 508-790-6304 "ri �r APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE HAZARDOUS MATERIALS ; IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE, CHAPTER 108, E 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 ❑ 4 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. 1. ASSESSOR'S MAP AND PARCEL NO. t!' � '2. IS THIS A PERMIT RENEWAL? YES NO: IF YES,SKIP QUESTION 3. ' <, 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS y ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT: -C / L-fr 4-✓rl7 C Cn/_rFe—: Ic Y7va/.�'t�4 . 5. NAME OF ESTABLISHMENT: ScC q- p 6. ADDRESS OF ESTABLISHMENT: f 3 P-10,CA 7 d A/ j) 2(•v 7. MAILING ADDRESS (IF DIFFERENT FROM ABOVE: . y- a --- Y--- 8. TELEPHONE NUMBER OF ESTABLISHMENT: -508 �34o 0661 9. EMAIL ADDRESS: 10. SOLEOWNER: J( 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'APPLIC DATE_�- .JZJ III: Q:�Apphcation Forms\HAZMAT APP 2017 REVISED! x C F' 1 wok rokti Town of Barnstable Office:508-862-4644 o r � Public Health Division Fax:508-790-6304 vB"RMASS. 200 Main Street• Hyannis, MA 02601 1639. �AlEDMP+p`0 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: L i fe, I fe S Date: Z� Location/Mailin Address: F- Contact Name/Phone: Q v 1 o L ,ram Inventory Total Amount: SDS: License#: Tier II : Labeling: Spill Plan: Oil/WaterSeparator: Floor Drains: Emergency Numbers: Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: 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 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, Wta wI1�, 6"J o hydrochloric acid, other acids) `- VIOLATIONS: ID'L'-Oe — 106 -} 2V1%&- ,>+ kvrk — VJrAeS v o Q 0 V — v a$4 ORDERS: 06 a'V kcL-,/ y r a l,J INFORMATION/R COMMENDATIONS: Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS s ~*�°tT!+E►ow Town of Barnstable A Office:508-862-4644 Public Health Division Fax:508-790-6304 t BA MATSSBLE� 200 Main Street• Hyannis, MA 02601 i639 M TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT ' rFOP�a Business Name: L-'�� < <<�S �/L� �� s Date: {fZ //cr3 Location/Mailing Address: Z 3 `' -rm.:' o '/ v,y Contact Name/Phone: t/�A r r� L��.. �D - `aet1�-"14 l �, ' \6\)1 V,_ V\A V Ut GZ t dl 1 WA-0 L! —Z p Inventory Total Amount: SDS: License#: Tier II : Labeling: Spill Plan: O'il/WaterSeparator: Floor Drains: Emergency Numbers- Storage Areas/Tanks: Emergency/Containment Equipment: Waste Generator ID: 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 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 >= f Paints, varnishes, stains, dyesfl. l-' Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers a Leather dyes Miscellaneous Flammables �_ Fertilizers Floor&furniture strippers I� �` '� f` PCB's Metal polishes „r�` ' Other chlorinated hydrocarbons Laundry soil &stain removers .,Lt - t , (including carbon tetrachloride) " (including bleach) ,r �. ' Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: L- t` (� 10'f c — 1✓���-� -�.� `��V,XA_ I �,o ?4-� �y r - _7 v`j C,-,4 A a (- r 'Re-1 J,_4 &-p r 1v a VI)K a 1 ORDERS: ,ce_15�, ;JX! 15 n 11 rt 1,C- �,Ac_fv-e /Q ,",0 ��p 4/—, J,-4� �ir_�i V 1llP_r1 f tC?l ',aR U_' f 1-t INFORMATION RECOMMENDATIONS: { Inspector: t Facility Representative:, WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS *IRE/per. Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 ane As�LE.B! 200 Main Street• Hyannis, MA 02601 059. i°�FOna+'tee TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: �'c a�2 g W 115 Date: Z I to Location/Mailing Address: oc,nkow <.v� tN�,n.S Contact Name/Phone: •• '' Inventory Total Amo nt: �� MSDS: N D- 0%11 vb�a'w License#: Tier II : 0 Labeling: Jle-W C6A'0-\vuf6 Spill Plan: tv Oil/WaterSeparator: Floor Drains: J Emergency Numbers: DK Storage Areas/Tanks: --e-4 15 � xz- Emergency/Containment Equipme t: T'�c, C,s "t a, ce,&c Waste Generator ID: MIA 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 �— Other cleaning solvents&spot removers N 3 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: l Caulk/Grout/bpndo -�ttlL1 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 4 Lye or caustic soda Lacquer thinners V Miscellaneous Combustible n.7 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: M01A a Q�, S W\A�A. Cotti-kt-\Ak5 INFORMATION/RECOMMENDATIONS: E Inspector:--' Facility Representative: 41 A �— y�v�rt�s WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS °FINE Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARMASS. * 200 Main Street• Hyannis, MA 02601 1639. MP� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: !"�M/J«rezb �I�S Date: I I Location/Mailing Address: of ,v�2� An Contact Name/Phone: c o L i v- OM -`7 H I Inventory Total Amount: LEI` al MSDS: /" License#: Y A Tier II 00 Labeling: Spill Plan: Oil/Water Separator: N Floor Drains:_ o Emergency Numbers: g / Storage Areas/Tanks: oflk Emergency/Containment E ui ment: Amb Waste Generator ID: A I Waste Product: Date&Amount of Last Shi ment/Fre uenc : 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 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: In�p►SkQ a�e�C \\^.�o o �.ivl. ORDERS: Q 0/ 6610, AD vti. I Lea �•(� �o�S . INFORMATION/RECOMMENDATIONS: a 5 ko a '5LO y- ,k,WMAM -e VA, to `0 0. �jo26 < \,�-5ka��� +ov,-t-Sow.V' ,4 Inspector: G� Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY BUSINESS - 1 Date: 7 / 2 / TOWN OF BARNSTABLE �s�,��,o,ti TOXIC AND HAZARDOUS nnMATERIALS N FORM NAME OF BUSINESS: i ; oo�111-t BUSINESS LOCATION: erj m a� INVENTORY MAILING ADDRESS: S,.w%4— TOTAL AMOUNT: TELEPHONE NUMBER: -5'oS I<,D qR l CONTACT PERSON: l ze— /►/Ioljyu.r; EMERGENCY CONTACT TELEPHONE NUMBER: MSDS SITE? TYPE OF BUSINESS: I&P r gaAr �t �INFORMATION / R E COMMENDATIONS: 9010 -Zio, Abb6 64Le.-Vs a Fire District: 1e��2s0 ov-. e.. 2 Cam' '.-re vct-,V%4VI IL,.�s skrJ►C4612 J& sfabl e— Waste Transportation: .A)lA 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 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 Antifreeze (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 Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerose #2 he tinQ6il Asr ❑ NEW ❑ USED ►"�y Nx- Photochemicals(Developer) Miscellaneous petroleum products: grease, 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 (KO-4 c.'t,T) Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes 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 Applicant's Signature Staff's Initials Date:7 / 2 / 1 -3 TOWN OF BARNSTABLE f,o� TOXIC AND HAZARDOUS MATERIALS R FORM NAME OF BUSINESS: (r'1 `i'k��t,�► BUSINESS LOCATION: ve- 4,rrt6- t* e—. INVENTORY MAILING ADDRESS: Af liqAc" l?ooc.i , TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: Lee, MPI,AA r; EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: 10►►ti4, OC;P (INFORMATION / RECOMMENDATIONS: a0fTX-x+,rt Ir Fire District: 15 &-�Qlea �w� ,MDs�' •��'�u- INV2vnntfor,/ r.�J� �2e►-loy W,`��►vc a Wre��y�Arx5izLble . old. 0.0 �t�ex4e_ ►S C�C.9���(2_d� �`�''l'It�S {'�v>.-a— — Sob;er-+ {-o tellotAl3� �� a�a. I a� �►-��..®/U Q fo 0644,, 1ksD5 isl�fs fk lea aK erfer re:. Uj9kd7S -<erJ l�cXs Waste Transportation: 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 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 Antifreeze (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 Motor Oils Pesticides ❑ NEW ❑ 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 �p 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 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 Applicant's Signature Staff's Initials (� 0p*THE okfl Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 BARNSTABLE. MAS.4. 200 Main Street• Hyannis, MA 02601 Fs639. TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Date: 6 2 1 t., Location/Mailing Address: -J olv��ow L aMn� Contact Name/Phone: e-z l l b Inventory Total A ount. tiboqxI MSDS: es License Tier II : Mb - Labeling: gyo Spill Plan: orb Oil/WaterSeparator: 1A Floor Drains: Emergency Numbers: ot', Storage Areas/Tanks: Emergency/Containment Equipment: --Xkl V <Z1-41nke Waste Generator ID: A YD Waste Product: _ Di/ Date&Amount of Last Shipment/Frequency: 1 1 / eve r &R4 ►Mo Licensed Waste Hauler&Destination: Idos•-;<%4_ �� ( i K co I vt,I 2Z 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. 3 Antifreeze Dry cleaning fluids Z Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers ' Hydraulic fluid (including brake fluid) 3 Windshield wash 3 t Motor oils 1+3o w"ve, Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants i Miscellaneous petroleum products: Road salts grease, lubricants, gear oil t ��DNve Refrigerants 10 Degreasers for engines&garages Q�t�,x�— Pesticides: 1 Caulk/Grout� � ,Il1.r r insecticides, herbicides, rodenticides 10 Battery acid (electeolyte)/batteriestik ,.v6. Photochemicals(Fixers) Rustproofers Photochemicals(Developer) . Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine 1 Paints, varnishes, stains, dyes 1 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: INFORMATI N/RECOMMENDATIONS: •2 CCI-eS *tu- ax-C.5, coctc of Inspector•. -a W4 Facility Representative: WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 • BARMASS. 200 Main Street• Hyannis, MA 02601 �'OtFOMn+p,O TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: Sc��a- v tn�2 Date: 11 S 1 ef- Location/Mailing Address: IS kC `*'t *<,,4-V,'DC%VP .S Contact Name/Phone: 3ab2�,t- 4 7 D-i 4o C-6k SOPS-3/60-04,67 Inventory Total Amount: 411-1 MSDS: A4� License#: M Tier II :_ o Labeling: OTC Spill Plan: tQ � Oil/Water Separator: Floor Drains: No Emergency Numbers: Storage Areas/Tanks: 3D --I was}-0- o, ov, c, Q\t-e-k Emergency/Containment Equipment: 5 Waste Generator ID: _tAJ 7-1 Ll 4-r 0�40o Waste Product: o Date&Amount of Last Shipment/Frequency: i o 1`i 309,L r Licensed Waste Hauler&Destination: oLs�.l �1.►ewlr�tc�y�rtil 7 A'1'icA"r, g4e_ J4xo-,OHA 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. VJ 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 V Motor oils X 301 A,I wMxe-, Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants VMiscellaneous 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: o o-e CJIco INFORMATION/RECOMMENDATIONS: w 5W0,01 Oftodl VI(VVILZGet— oil Inspector: Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY- BUSINESS Date: -7 TOWN OF BARNSTABLE ��5 tlovl- TOXIC AND HAZARDOUS MATERIALS ORM NAME OF BUSINESS: 5e-aka. BUSINESS LOCATION: 93 6-rC `"�torrl,�'ov���r J2-. 5 � Le, INVENTORY MAILING ADDRESS: 5,,ote_ TOTAL AMOUNT: TELEPHONE NUMBER: -77c+- y?D- 1400 "' qq a j CONTACT PERSON: a Sc4 a— EMERGENCY CONTACT f ELEPHONE NUMBER: �o8-3rab-ob(.7 MSDS j2N SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: '�0 alw S.D sly 5 4w& Fire District: OVIs/-I�'e_2)V2r,�./ �Ar�r'� ,Kass J�`1" 3) .L�q(s'�-a]01-c— 4� 4-15010 D USe� gS Q oJ$ 1jaC g yJ g�c� a�l Dcv�dLt c o rt-�-a 1�� �C.e. c yV�cc� �_� r\� r,ti.�s.e_. . l-�av��'.re �►�v rS{irrc3- se�vi� Waste Trans portation:'E)MV77q'4 7011/00 Last shipment of hazardous waste: 7 r 113 Name of Hauler: o bool?./ ,(✓e, �ecov�ry CD Destination: Ajr065 llts&�� /�lab��.�,j(4A Waste Product: I„ �e.-*, l Licensed Z� No ,M �f SB�aoS 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 Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive- ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) I Hydraulic fluid (including brake fluid) Refrigerants 33 Moott'r Oils / Pesticides NEW 3 USED 30 (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 De re g a ers qqor en i es and "�'� Printing ink g�a,�s clearu.� dCrs�o}e6�o{' Degreasers for driveways&gar ges 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 Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes a 1 G2 u I LeS Laundry soil &stain removers - (including bleach) In 464.� I� ���-�-l�d�- , �,�2,e�,o'�f•) On 514e.. Spot removers&cleaning fluids / (dry cleaners) .I �Q✓ Other cleaning solvents .� Bug and tar removers 0yt, j� aYl/,� 5���-asslgh 1 M7 L ---r Windshield wash ( Otta,f—C Pco%4.1 +o 6cA- (n� WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials �. NAME OF OFFENDER . Dn—, T D A 7 9 4 4 f u. MO�i TOWN OF ADDRESSOFOEN� v A, e L BARNSTABLE CITY,STATE,ZIP ODE �t11E t MV/MB REGISTRATIOW NUMBER , g OFFEN ,,IAS:. , d aQu.ye4 -41,1 G Z 4l kIfLU fED MKks ��'S`t ;C (-,dk!17..�� 1 l% ���1 V-1 k 000 e%,� TIME AND DATE OF VIOLAT)gft LOCATION 0 VIOLATION LU e NOTICE OF .'G Z) (A.NI)/ P.M.)ON ,: e 20 , ��I nc ,.J+o SIGNATURE 0 �' .E S ENFOR e,4 BADGE NO. LU N F VIOLATION - •; �p v O OF TOWN I REBY ACKNOW ED E RECEI OF CITATION XUj ORDINANCE JO Unable to obtain ig ature f offe er. / 2r THE NCRIMINAL FINE FOR THIS OFFENSE IS S-',, e>1.> Date mailed w OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH RD TO DI ITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL CL - DISPOSITION WITH NO RESULTING CRIMINAL RECORD. Lu REGULATION You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monda�through Friday,legal holidays excepted, W before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money order or posta note to Barnstable Clerk,P.O.Box 2430, J Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. a V)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST If DIVISION,COURT COMPOUND,MAIN STREET,BARNS'ABLE,MA 02630,Attn:21 D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or H you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature .y TOWN OF BARNSTABLE Ordinance or Regulation BAR -W G023 WARNING NOTICE -Name of Offender/Manager cle"14ovk P Address of Offender- MV/MB Reg. # Village/State/Zip _ Business Name C�� yv o � 'ci am/pm; on 20 J� Business Address Signatuce,ot Enforcing Officer Village/State/Zip �V s M A C>Z.'L,o / r Location of Offense Sc le, Au Ce - ( Enforcing Dept/Division Offense ' ' �2 �1�t �tY' t1)5 s/�t ����i 1 t 2 ylE Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances,.Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations-will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE Ordinance or Regulation . BAR -W 6023 WARNING NOTICE Name of Offender/Manager. - ti -l - € L Address of Offender MV/MB.Reg._# Village/State/Zip j Business Name am/pm; on ?f 20_ Business Address . Signature of Enforcing Officer -Village/State/Zip _- f Location of Offense —se-4J I` AvA - Enforcing Dept/Division Offense ` t ` { 17 afitt"v ti' rt ��+ i f r cqt�! ; �1i ' + �s„t� .1 �t;.w� � * Facts . _ Its-r , � j � ; f This will serve only as a warning. At this time no legal action has been taken. It is the goal:of Town agencies to achieve voluntary compliance:of Town-Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance Subsequent violations will result in-appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFER GOLD- ENFORCING DEPT. .. . . ..,-,_,.. .�..-.:,...•� a-,..y„•„y.i...,.,,.�n,,..,w,Sri.,,.,,...,.:s+.,,,.,.,.,,.,,`.1. ;-•r--,...r,.-`-. ..,,..,.•..y?-•,�..^.�,.,---•+.-+.--.�.wy,•,.y�",-,�r---.. .:y TOWN `OF ,BARNSTABLE , BAR'=W 4 7 Ordinance-for; Regulation. ' WARNING ,NOTICE: Name of Offender/,Manager. ' Address of .Offender �� hoer\. fr C�.vt?,;.'. MV/MB.,Reg # Village/Stat-a/.Z:ip r". Business Name "tf� aY �a .r_ 1,1� ce,, ::: �'.h> •am/;p on ' '. r ��n . 20 Business Address q17 ; %� c,v`, ajCt�, •! ,vt! _ 4 . Signature .of Enforcing_ Officer, LA u,z 4 f -- Viliage%S.tate/Zig {�<-%t��r�.\i�F Location of Offense Enforcing Dept/Division Offense \�" n�' ,� �M F, ! `,e >>a L�r> 'h'� �f�, 10 ,- Facts l').r+.G s; lhJ .`) t' 4 �a:�Y�. � `yi."Ce,? ._TCC?c t rSr �}Vl XtiriityL This will serve..only as ,a warning.,. At this time no 'legal .action has' been:•taj e It ''is the•,. goal of ..Town agencies to' •achieve ' voluntary compliance'. of Town'' Ordinances,. Rules and- Regulations Education efforts and :warning...notices . are attempts to gain .voluntary' compliance Subsequent `violations will .result in appropriate legal action :by: the,'Town WHITE.,OFFENDER CANARY-ORD./REG-PROG PINK,fENFORCING OFFICER GOLD-ENFORCING DEP.T. A TOWN OF BARNSTABLE BAR-w 47P, Ordinance 'or Regulation WARNING NOTICE Name of Offender/Manager % Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on 1 2 0 Business Address J: Signature of Enfg;qinLg Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense Facts J. This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the. Town. WHITE-OFFENDER CANARY-ORD./REG.-P ROG. PINK",'ENFORCING OFFICER .GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE . BAR -W Ordinance or Regulation 6054 WARNING NOTICE Name of Offender/Manager C1Q`1;VA $Ca�Q Address of Offender MV/MB Reg. # Village/State/Zi.p _ t - Business Name 5C0,10, AuTo (eDleir am/pm; on, 051�5 20 i Business Address 93 T6C'loo Dr- �y Signature of Enforcing Officer Village/State/Zip �Lkann►�i( fTl oi�*601 Location of Offense Si� A��Vt�'{ C1�� tY1�tG1 tt 11 Enforcing Dept/Division Offense �IC)laI IQn � �wrN cc) lag- I'anse. om( C0*(keoN Plaf) Facts buc)'Inbs owrkr IS S�orM cA <l6 em> �110 0ullonS 0 W xAcu.S matelr;cAl w;f w- pfoPe 1.cer�5�nAv SubmO aapi;��; ►v�, e + 4 a* fee Vi6ofe- iSune 3A This will serve only as a warning. At this time no legal-action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and.warning notices are attempts.to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK- ENFORCING OFFER GOLD ENFORCING DEPT. f� TOWN OF BARNSTABLE Ordinance or Regulation BAR -W 6054 WARNING NOTICE Name of Offender/Manager. CIQ-"rCA S aCkl - _ -Address of Offender MV/MB Reg. # - Village/State/Zip J�, t} �1� . Business Name SCalt Auto Cei tle( W 0 am/pm; on 5/�5 20,1 Business Address or ofi Dr 4 g3 h , '' * Signature of Enforcing Officer Village/State/Zip R(AaC3tli�/Ao,i/Q�t7 l - Location of Offense. walla, Auto Ceoe( �"VKO() Enforcing Dept/Division ii 1 Offense V�{,06NfUf) 6 4Wf\ C04 1a�-G it 'C C1 2 01) � C0f*r 1)(q t�'t1} xf) x ' ;ne% CAW S S�V ► cj,6 a Facts l '(� t f ht1C G �U W ��!'ape censt S(AxV aoph(d4l l fee I(A tea* .fee fore j0W 3A YY4-� �i 1.�r lll��� t� 4 � � o 1 f This will-serve only as a warning.. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rulesand Regulations. Education efforts and warning notices are attempts to gain voluntary.compliance. Subsequent violations will result in appropriate legal action-by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK- ENFORCING OFFER GOLD- ENFORCING DEPT. ./-T.s,.,.eti...,.- '..-,-�4^.ti.-„t,,....�.;..:.,c..-,.,..2..-.M -'^•.�r--.erw„r`-.rx--•,1rfY'`,r,....,....A:�� .ri,,e...—Y--en....o„M�---!✓"---w-\,..-.f•--.. 1+!` ,:..—: TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager ( ��- ,,,�_ c4 e%" .. r t Address of Offender MV/MB Reg.# Village/State/Zip Business Name � Ga. I„ Au L 0, 4xJ-ts, Q: /pm, on ` )"I 20 116 Business Address Signature o��f�� Enforcing Officer Village/State/Zip H of o ,i,,, MO 07— Ln i Location of Offense S G A ek A �„ (-.0 Enforcing Dept/Division Offense V1 ()1 "M 1f,5,4. �)� ��TA Imo, ` ,1t4 /yr /i) 'V C Facts tT 4l\ j- G yr t, ) n tn.1 A 4-1 ,.-)t` t-i- a I �'+ \�f� [ This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING .NOTICE Name of Offender/Manager f Ck Address of Offender MV/MB Reg.# Village/State/Zip Business Name 4' /pm, on f 20 4 Business Addre ss Signature of Enforcing Officer Village/State/Zip V, ml Location of Offense I-) Enforcing Dept/Division Offense (1 41 Facts T v This will serve only as a warning. At this time no legal .action has been taken. It is the goal "of Town agencies to achieve voluntary compliance of Town Ordinances, Rdles and Regulations.. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town.- WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. } U.S.POSTAGE>>PITNEYBOVVES ((�^ 2M Town of Barnstable �' � �..e Health Division ~ = ZIP 02601 006.465 `h a 200 Main Street 02 � Hyannis, 02601 �. 00003.336455 AUG. 29. 2016 , 7012 1010 0000 '2847 . 8780 1 i Scala Auto Center Attn: Clayton Scala 93 Thornton Road Hyannis, MA 02601 N UP 11 .A B{ c TO F '5,. R D. 9327@89921811997 UTP BC; `02601400200 g a�1669--027398'3-03-30 0 2 S@ 1 Y 4 0 0 Z /� �. 1 r� i �� 6 �� 1 i r I I UNITED STATES POSTAL SERVICE First-Class,Mail I Postage&Fees Paid USPS I Permit No.G-10 M I • Sender' Please print your name, address, and ZIP+4®in this box* I I I I ' Town of Barnstable Health Division i •� 200 Main Street I j I Hyannis;MA 02601 V, i I I I I I I I ' I I COMPLETE • ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee I so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery I ■ Attach this card to the back of the mailpiece, I or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No G'la fog csca/a I ;;{{ 3. Service Type ?3 O 'v J$[Certified Mail® ❑Priority Mail Express- / S� �� ❑Registered Return Receipt for Merchandise ❑Insured Mail ❑Collect on Delivery U 4. Restricted Delivery?(Extra Fee) ❑Yes 2.I Ar� 7012 1010 0000 2847 8780 S. PS Form 3811,July 2013 Domestic Return Receipt ,� NAME OF OFFEND R �V � � � I' Z tJ ,. � , Mra�t. a .1 I BAR TOWN OF ADDRESS OF OFFENDER t �;, t w�'" } � I = m = 3. ' AL t i.. < i " .,. wJv� 'c I S v I' CITY,STATE,ZIP CODE. -) BARNSTABLE �>tAt►qw ul MV/MB REGISTRATION NUMBER / I z W HAH\ti7'AHI,F. 1 OFF E fr1 E e ! L f)S e rs Ca.' ,T t,'iv'�- y Y' t,C.✓ _` §^... w.J'F w�'S� .[,.,E.. "I..)g''L. Q',- '�" G7.. ,a„V"" cb' V�. �'A"`� t P° �„' a-1 r 639• �e ,�.,m 1 C LILI TIME AI� DATE OF VIOLA.ION 1 LOC�JJON OF VIOLATION lrl. W I O y ,4 NOTICE OF F A.O P.M ON 6 ��� 20 � �a,'�� L� 1 � �„��•�.��~ a I Om � OOOm VIOLATION SIGNATUREOyf FRB RSON ff ti r ENFO CI GDEPT.l BADGE NO. W I y C' OF TOWN , m m 14EREBY ACKNOWLEDGE RECEIPT OF CITATION X CL ORDINANCE -9 Unable to obtain sig ture Qf offender. �*��"" � I D � Date mailed �'4-�` F d THE NONCRIMINAL FINE FOR THIS OFFENSE IS S r; W OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL a ? DISPOSITION WITH NO RESULTING CRIMINAL RECORD. W C "REGULATION a' I m m You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, W D T� m s before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money.order or postal note to Barnstable Clerk,P.O.Box 2430, � p `(: [ Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. a m S �2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST :F < RNSTABLE DIVISION,COURT COMPOUND,MAIN STREET BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this ( W W citation for a hearing. 2 T (3)If you fail to pay the above offense or to request a hearing within 21.days,or if you fail to appear for the hearing or to pay any fine determined at the < W hearing to be due,criminal complaint may be issued against you. j ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ ' Signature- ;I. ;,,, TO OFFENDER: Failure to obey this notice within 21 days Place after the date of violation may result in a stamp criminal complaint being issued. DO NOT Here ' MAIL CASH. Post office will not deliveY without stamp I I I I I MAIL TO: I I j BARNSTABLE CLERK I! P.O. BOX 2430 I HYANNIS, MA" 02601-2430 I i I � I I prifpzx.h s i SME:Ad KEEPING YOU ORGANIZED No.10334 2.153L MME M USA GET ORGANIZED AT SiViEAD.COMi