HomeMy WebLinkAbout0971 SHOOTFLYING HILL RD - Health (2) 971 Shootflying Hill Road
Centerville.
A= 191 - 033
UPC 12534
0.2.153LO
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BUSINESS OWNERS
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APPLICANT'S YOUR NAME• S/j 1� .
BUSINESS
YOUR HOME ADDRESS:
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TELEPHONE Tele hone Number Home
NAME OF NEW BUSINES 'f i TYPE OF BUSINESS
IS THIS A HOME OCCUPATION? ES N
Have you been given approval from the building`division? Y, S�NO
ADDRESS OF BUSINESS )((// (( MAP/PARCEL NUMBER �vJ
When starting a new business there are s v things you must do in order to be incompliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures,
listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall)or if you get the business certificate first
you MUST go to the following office to make sure you have all the required permits and licenses..
GO TO 200 Main St.—(corner of Yarmouth Rd. & Main Street) and you will find the following offices:
1. BUILDI MMISSIONER'S OFFICE
This indiv' ual- been r WIT
of any permit reqt irements that pertain to this type of business.
Authorized nature**
C M ENTS: Mpl° Lo -ecJ
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2. BOARD OF HEALTH
This individual has beeainfo f th it requirements that pertain to this type of business.
A on Si ature**
COMMENTS: .S
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature**
COMMENTS: -
Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must
do by M.G.L. -it does not give you permission to operate -you must get that through completion of the processes from the various
departments involved.
**SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY.
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r� TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: I j &-
BUSINESS LOCATION: S o -L AW0; %VENTORY
MAILING ADDRESS: D TOTAL AMOUNT:
TELEPHONE NUMBER n
CONTACT PERSON: f 6 i �J( D�
EMERGENCY CONTACT TELEPHONE NUMBER: — 7doa MSDS ON SITE?
TYPE OF BUSINESS, 5"(-tl �P.�D�^E- �L
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)
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 s7 C 0 i 11*1
(including bleach)
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS