HomeMy WebLinkAbout0102 CAP'N CROSBY ROAD - HAZMAT 102 Cap'n Crosby
Centerville
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UPC 10259
No. H1630R
HASTINGS.MN
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 the iTown
(WHICH YOU MUST DO BY M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form
at 2'00 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 151 FI., 367 Main St., Hyannis, MA 02601(fown Hall) and get
the Business Certificate that is required by law.
DATE:
Fill in please:
APPLICANT'S YOUR NAME: —bC,6O 2 CQZO, S
`" BUSINESS YOUR HOME ADDRESS: jc�Z (°ctP+ oS �7i C�vl a2lr
r k 77�-15y-0-r5s)
TELEPHONE # Home Telephone Number:
NAME OF NEW BUSINESS ' �C'�cS;CQ2 ln-V-r-1 - TYPE OF.BUSINESS
IS THIS A HOME OCCUPATION? YES \. - 10
Have you been given approval from the building division? YES NO
ADDRESS OF BUSINESS .Io, ckca + Cj\ VnY4 MAP/PARCEL NUMBER
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.
T. BUILDING COMMISSIONER'S OFFICE
This individual has been informed of any permit requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
2. BOARD OF HEALTH
This individual �hs b i rme�ofV��errm�i u ments that pertain to this type of business. MUSTCOMPLYWITHALL"AIARDOUS MATERIALS REGULATIOr`tqAuthorized S
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has
been informed of the Incensing requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
• � Date:�Z /�I / 0�
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: StC4 S1 14
BUSINESS LOCATION: 1 "a C'ca�� �01>Li ate-vWe— ►'np, - INVENTORY
MAILING ADDRESS: 1 u2- 0WR CiIIUS63 I'_69 ��:v►I�e lrn14 TOTAL AMOUNT:
TELEPHONE NUMBER:
CONTACT PERSON: )k\Do LRl,
EMERGENCY CONTACT TELEPHONE NUMBER: So�-7� _S� S 1D. MSDS ON SITE?
TYPE OF BUSINESS: Bat n- %A4
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) 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)
` do/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)
ANEW USED Any other products with "poison" labels
Paint & varnish removers, deglossers (including chloroform, formaldehyde,
Misc. Flammables hydrochloric acid, other acids)
Floor &furniture strippers Other products not listed which you feel
Metal polishes may be toxic or hazardous (please list):
Laundry soil & stain removers
(including bleach)
Spot removers & cleaning fluids d—
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS