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Home My WebLink About0028 BARNSTABLE ROAD - Health 28 Barnstable road Sewer Acct # 0433 Hyannis A = 327 -077 ti o r � t ' I YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 yearn). 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 Cleric's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) 7r) r� ""rTw , FwrR DATE: fly: 63f /� Fill in please: ,��i�'�lw��;•�;;t;�fr,1u",". ; APPLICANT'S YOUR NAME/S: au, iY�?Ir"W's'II�fi>hY' �R;;t°It BUSINESS YOUR HOME ADDRESS: 7Z '%'yvP_. ✓% /7;Ga-7`712 All, O yZ 6' / dp�� rro��7r :. L TELEPHONE # Home Telephone Number �z/`- Z%e OZ z. NAME OF CORPORATION: e NAME OF NEW BUSINESS L�r/! �lyv/i'�,il+'e. TYPE OF BUSINESS .SQ�dn IS THIS A HOME OCCUPATION? YES NO_fG_ / �7 O-T ADDRESS OF BUSINESS !�4/r1�u�/C .QU! ��' /fif/ MAP PARCEL NUMBER / b Assessin 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 malce sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ISSIO ER'S OFF E This individu I he a in ed of y p rmi requirements that pertain to this type of business. Au orized mature . COMMENTS: 2. BOARD OF HEALTH This individual has been f rmed of the pe 6i requir r�i nts that pertain to this type of business. uthorized Signature** f COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) nun' S �tFr tw, 4 DATE:- Fill in please: F� "NTR J APPLICANT'S YOUR NAME S: W i [I P",\ D=r-002'e BUSINESS YOUR HOME ADDRESS. g$tmA TELEPHONE # Home Telephone Number 79-1-775= NAME OF CORPORATION: NAME OF NEW.BUSINESS " >>� l TYPE OF BUSINESS . �cR/v2 _CC0 .CIRt RIA � IS THIS A HOME OCCUPATION? YES NO � A ADDRESS OF BUSINESS ,Zf MAP/PARCEL NUMBER a17-,0 '1 J (Assessing) 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 COMMISSIONER'S OFFICE This individual has been informe f any permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 2. BOARD OF HEALTH This individual ha een inf med f the p �rnitquirems that pertain to this type of business. Authorize ignatu ent re** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain.to this type of business. Authorized Signature* COMMENTS: s DateC TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: 1-2-$' BUSINESS LOCATION: la.A/e JP0_1/ 4 hri i MAILINGADDRESS: S a ±21-P Mail To: Board of Health TELEPHONE NUMBER � A: . � i— `�' a Town of Barnstable CONTACTPERSON:� Y / - � /c c P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: Wa Z - 51 1C�� Does your firm store,,any of the toxic 9r hazardous materials listed below, either for sale or for you own use? YES NO V 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 other than your mailing address: ADDRESS: 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(for gasoline or coolant 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) 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 Paint brush cleaners Any other products with "poison" labels (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 (dry cleaners) 4ZA e o /o Other cleaning solvents Bug and tar removers 4 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Je TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY ��l'1 �-�' (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS _-�A 1n j Class: 7.Miscellaneous 1 44AAU' QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Mmm1 IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers . Miscellaneous: P4� v� r DISPOSAI✓RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply Lf.xs .Town Sewer �&ublic O On-site OPrivate 3. Indoor Floor Drains YES NO X O Holding tank:MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES <NO ORDERS: O Holding tank:MDC Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler 1 YES NO M 1. 2. Pers (s) Interviewed Inspector Date L TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Sg,/o ,0,4 Mail To: BUSINESS LOCATION: _ Sri, d Board of Health Town of Barnstable MAILING ADDRESS: S �. -' � '� `� P.O. Box 534 TELEPHONE NUMBER: -C '?0' - 7 7 C 2- Hyannis, MA 02601 CONTACT PERSON: c S g- l C � We JG k. EMERGENCY CONTACT TELEPHONE NUMBER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalli g, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? 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 other than your mailing address: ADDRESS: 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: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous 1pas ist): (dry cleaners) rnCj d 0 yt/ 0h 5 Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business