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Home My WebLink About0339 BARNSTABLE ROAD - Health 6 ;339 Barnstable Road = Hyann s, - -- --- -- - _ _ _ --, --- --- r ---- ----- _ - - - 'A 310 -:1 41 z ° r r I I i r� ° YOU WISH TO OPEN.A BUSINESS? C 1 For Your Information: Business certificates (cost$40.00 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.) You mustfirst obtain the necessary signatures on this form at 200 Main St.,'Hyannis. Take th.e completed form-to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis; MA 02601. (Town Hall) and getthe Business Certificate that is required by law. DATE: 1 Fill in please: :,ti'r. ti '•.'I ^;:4N�TiYi ''�'=' � ' :l APPLICANT'S YOUR NAME/S: 14 SC_0 BUSINESS YOUR HOME ADDRESS: �;,:. .r�I ..1 tt F,i fS.; s?YJ��G '� • l g v� i G Home Telephone Number � 6d 0' TELEPHONE # Y ,..•vnt;i � 1i1; iC;�I�jyl E-MAIL $C.:�t NAME OF CORPORATION: t. Li' TYpE OF BUSINESS S NAME OF-NEW BUSINESS tLa 1 - iV 15 THIS A HOME OCCUPATION? . YES_- NO ,. _(Assessing) ADDRESS OF BUSINESS. 2 ,( MAP/PARCEL NUMBER 3 1 h 1 'A ( g) 133` When starting a new business these are several things you must do in order to be in compliance with the rules and regul'ations of the Town of Barnstable. This form is intended to,assistyou in obtaining tho 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 COMM R'S OFFICE This individual ha bpq info , Q� an L mit re uiremeri '.that pertain to this type of business. u prize Sig rtuf ** � COMMENT : 2. BOARD OF HEALTH This individual has been info t e r �requirents that pertain to this type of business. Authorized ignature** 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$40.00 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 opera e.-1ro0 must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. I a 91r 'as DATE: �'�y \ \/� Fill in please: pmW. ��a� �''' APPLICANT'S YOUR NAME/S: I_r e �wi M� \1\6)\(A\o BUSINESS YOUR HOME ADDRESS: \ct9 l�inNk (cQ $ .. lCr tf3 PSI TELEPHONE # Home T lephone Number 'iC Wit: '1 Q�ti NAME OF CORPORATION: NAME OF NEW BUSINESS N 6,\ v c t- r = TYPE OF BUSINESS Y nSk IS THIS A HOME OCCUPATION? YES NOS ADDRESS OF BUSINESS O MAP/PARCEL NUMBER /f� C � (Assassirig) 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 R.00 _ain St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operaf6 your business in this town. 1. 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 ha$ beery. fprp�ed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS ( CENSING AUTHORITY) This individu as n inf rmed of th lice reqkentshat pertain to this type of business. 2. Auth,6rizpd Sign tur _ COMMENTS: �=^ Date: L / (I TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: S Ce moo BUSINESS LOCATION: A J 4 B MAILING ADDRESS: 2 Mail To: Board of Health TELEPHONE NUMBER: Town of Barnstable CONTACT PERSON: I P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: zz&iLl _Sa-C® ki Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES k 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. 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 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 So% (dry cleaners) V �Q Other cleaning solvents Idelue Bug and tar removers 4 rx-44( v WHITE COPY-HEALTH DEPARTMENT/CANARY CO Y-B SINESS Date: .TOXIC AND HAZARDOUS MATERIALS REGISTRATION FOR,MZ, } NAMEOFBUSINESS: S � SOU BUSINESS LOCATION: 3 0 �5�� MAILING ADDRESS: � � Mail To: Board of Health TELEPHONE NUMBER: 7 - n Town of Barnstable CONTACT PERSON:. 2_ P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: t10 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES Ji 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 i address: r ADDRESS: I TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS i 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 ' l you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. f � t 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 l Lacquer thinners Other chlorinated hydrocarbons, E NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel j (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids CcJ(or(u-i So r (dry cleaners) SQ Other cleaning solvents a � Bug and tar removers qce rY 0 �b v WHITE COPY-HEALTH DEPARTMENT/CANARY CO -B SINESS ;. . 7 2/ D0-57�` 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 (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 1 Class: 2 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS Case lots Drunis Above Tanks Underground Tanks 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: !SU s'o4,4tzop Sa (gyp DISPOSALIRECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 1 Town Sewerublic �Q.,1 ,- 6-14 f 0 On-site OPrivate 3. Indoor Floor Drains YES NO 0 Holding tank: MDC 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES /�NO ORDERS-, 0 Holding tank: MDC Catch basin/Dry well 0 On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. r — 6 —9 2 Person(s) Interviewed Inspector Date