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Home My WebLink About0064 CHASE STREET - Health 64 Chase Street Sewer Acct # 2681 Hyannis A = 308 230 PF I I, .... ..... ..............w. :.:,1 ...,. ..... 1 . 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 operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st Ff., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE:6 se,12,01. Fill in please: APPLICANT'S YOUR NAME/S: . Y—aiL.w anemk1h1'f- RIsER.'X E� BUSINESS YOUR HOME ADDRESS.-AG&l e_-1-AjLS S44ViY f j &�7"'' TELEPHONE # Home Te Telephone Number 'Z €-MAILS Prox a•' ^ NAME OF CORPORATION: NAME OPNEW BUSINESS_4>�X%OS Dnnnr TYPE OF BUSINESS ' IS THIS A HOME OCCUPATION? YES NO ✓ nn ADDRESS OF BUSINESS- O 0% MAP/PARCEL NUMBER I/ (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. S.Main Street) to make sure you have the appropriate permits and licenses required to legally operate yatrr business in this tovm. 1. BUILDING CO ISSI NER's of E MUST COMPLY WITH HOME OCCUPATION This individ I e i o d f r rpquir erns that into this type of business.RULES AND PrGULAT'IONS. FAILURE TO qut or d igna re** COMPLY MAY RESULT IN FINES. OMMENT ali n, - - I 2. BOARD of LTH1 MUST COMPLY WITH ALL This individual has been inf a.�.of the permit requirements that pertain to this type of business. HAZARDOUS MATERIALS REGULATIONS Auth ied�Signature**/� 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: Date r / / L�� il WIWI TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Ae 2(w0r BUSINESS LOCATION: bLk 1,WL5�, S�. wq annicy- MA K OO/ INVENTORY � MAILING ADDRESS: (C'��I ( �( � `' �G�.rtYi I �l�/ 01Z16-2 1 TOTAL AMOUNT: TELEPHONE NUMBER: ` 2 1 J CONTACT PERSON: V,,Lk3�(k (,(h1 oka rw 2)atM or e Y EMERGENCY CONTACT TELEPHONE NUMBER: 'l"t�{ GjIl - qSh Z MSDS ON SITE? TYPE OF BUSINESS: 2 V\U t �My � INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: wki-m f ,hl['L1l`Di't Pr�K 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 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 r i WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS PP Icant's Si nat a Staff's Initials 1 N, YOU WISH TO OPEN A BUSINESS? P I For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: ' 15- 15- r Fill in please: d 10 CC iJ APPLICANT'S YOUR NAME: �'�V�. � � Fi f' BUSINESS YOUR HOME ADDRESS: 04 C-H A -5 IJ - N . o ..0 TELEPHONE # Home Telephone Number S� NAME OF NEW BUSINESS D tJ (-> q,,)n CA ►L), TYPE OF BUSINESS ftwf>S C ft F ,) IS THIS A HOME OCCUPATION? YES NO Have you been given approval from the building division? YES NO ,r� ADDRESS OF BUSINESS fry'v 5- ,jA ' / (J MAP/PARCEL NUMBER�SA When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S FICE This individual has bee ed ny permit requirements that pertain to this type of business. MUST COMPLY VVITH RULES HOME Authori d Signature COMPLY AND Y�GULATIONS. FAILURE To COMMENTS: �co�� r�r-v C.Q Q 4 i/� cQ �-e Q�- Cb S �SU( f IN OWES S T® 2. BOARD OF HEALTH Al M CWKY W JITH ALL This individual ha en inform d t e per a ui e s that pertain to this type of business. ,H42'ARDOU$MATERIgS.REGUL/kTION$ Au ized Signature** 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: TOWN OF BARNSTABLE Date:06l1•� I 16 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 6o iocA) G4�s L V(A cjnj11( Avo rojjSj"Cj,a✓ BUSINESS LOCATION: Gi`(gs,r f1 . 0��/ INVENTORY MAILING ADDRESS: (462, 51 14Y4v r;,e. - lrm Qi6,Qj TOTAL OUNT- TELEPHONE NUMBER: ,906 CONTACT PERSON EMERGENCY CONTACT TELEPHONE NUMBER: - MSDS ON SITE? TYPE OF BUSINESS: '&AJ a INFORMATION / RECOMMENDA IONS: 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 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 O served / 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 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 I CANARY COPY-BUSINESS App' a,nt's¢Sig ature - Staff's Initials _ _.f -- - _ -_ - ----- - - � �� ,,,� �� emwimF ilkd'Sd asnchusetls Asinirrs Hotllicatlon Fow=- ANF-001 Asbestos Abatement 005001011 r Mi 1. racilky location: !V�}►v�t Swevwel smuctron mom.. At sedsan of lets ......._._......... - adae�Moaept<M 13/fSP/�tP�l ....... 9gVtMwd d ......__.:__._.� ..«...__w____ ne�eAmsntd IlatbpeorbarbabNMralgaarr,/•� L It the ladtity occupied? as ONO aarl.,Nets d>fa Csa IlIt"aatiddpe 3 Asbestos Contractor. '�'d Ne (and SvrFAC _. ► 2.L9!? .tl!�L � � h;n }1�Street genmaidleaw "°" �- "� adeddes - �sarrpuirnets _��L-- �...._.................. .............�?.�_7._ e 4M Ctrt e.12 (� aps?a.. row* rNip7orr brr prb rb6[atbe b ,rreirr - _- .QfJ(1�q.b..: ........................'..............................................................._..................._....... w_..«._.._. eae.tr .vAidva+►. aneye.i catad lot(wftM*+9 e �4 4. On-SAsPro)edSupervisoUrorenun: Abntogidterarfic:� i3v1 fi5 !`�.. Q `(.w«._ - t ►M DLIC tore :.oeMdtt d 6waehteth S. .Prooct Monitor.. idedu he1� eNTf r-n - v a�.t soon Irk G Ml� w�_.....w._........................... Ieete�aUattat- - . w. ouras�ni 6. Asbestos Am"cat lab: inb ronemga TC� 11'IoO �t-)Z7 � «...... la rd"ft w S.tfthevn id aos alanswroa/ 9^ M40" —d 9 endlaltD22 epecHkworkhours(Mon.-rd.)_'-`�(Sal Sun.) raseissanropiant 7. ProNddarldals_J� , wC.dor sprtbrs ,,�� 0dWsi le 0. Whaltype of p ar ro)ad is this? (drele one): d0di 9. Descdbe the asbestos abatement procedures to be used (dreb): OW M . nra�rr ooNfmrd deM'tr -3�a' ' RtpOiyp�/ aprprp+td alca"n '� 10. Is the job being twndud JY ed r doors O outdoors 7 11. Total amoud of each type of Asbestos Containing Malerkis(ACM)to be handled on pipes or ducts(0near ft.) _or olhir surfaea(square IL).= lo be removAd,enclosed or encepaulated: r '. linearlsauan/ut; laid,br.dr�t oast sHt aum oa�trps.i._J nsm+(500deas0a rudaft ...._.J corn+prrdsrrrt.adpwoatmutrtn ..13J ► t a, ri; '' ... :. J 4 f� aaa0ard:. .........._/ roetAt d _� :.taetby bard bltra.eren itrb ... , ................... .: _J IL Describe the decontamination system(:)to be used:AS41 13. Describe the containsdtatbn/dlspoesi methods`Ito.coompb with 310 CMR 7.16 and 453 CMR 6.14(2)(g): ....._.«wll..... S�.._..._ 14."Far Er iergency Asbestos Abatement Operations the DEP and Dll officials who evaluated the emergency:" f oe►rarnaasar __ ._ .il>r�►i «_. w«...w«...ww.«_«_w»_ . taaermaem`r . ........� wrwrasm WINK f /S ,2ta 27A•r to this protect? O Yes �No �Do pnvw%g saga rat a appb as per M.O.I.a 149.i 26 a tar , r FOCII/ty Dosc[IPIIOfl 1. Current of PEW use of ISCIRty. L Is Um ladlity owner-occupied. residential with 4 units or kle? tj Yes 0 No 3. Facirty Owner ....................... Ad&m low 4. FadMy,s Owners On-SlIs Manager. ............. ........................................... ......... L General Contractor A)IA—. CWm ----------- IL What Is on she of on l*CIRI72mv—(B4 it) V of flom) ; Asbestos Tiansporla(lon and Disposal 1. Transporter of"bisloo-contaInIfill waste 0106431 110m cite 10 lemPorety&lorsg#she(K nice"my)to final disposal 541:+ L-Lp -Faa Q ...................* 118 -7 . ...I *k ;......................... storage site I*final disposal site: L•- TransWor of nbuloo-contalning waste material ljorn lgmov&V temporary '341-Cit-f-3 .......Qk-4.8Q......... ........................ Rb rld................. 410:rfarder' lwf pAhm transfer station and ownff(I applicable): Comply Milt au watt -4;0 A&W VMLW ripple.-, j law Im 310 CAIR Imv 4. nW Dis Fill e, h&_n i ens, 14eld i 159,35 0 ISO .Iva*`" ....... .............. &I he/she has read The Commahwagith or msstachusolis Aegulallons The Undwalred hereby states,under the penaftles of PerlurY.III for the Rgmqnk containment or Enespe talnod In ulatlon of Asbestos.463 cmA 0.00 and 310 CMR 7.15 ton.and that the Information bad of Nolher knowledge and belief No notification Is Is"and Corlett to the Doy Primmer '537-XiT , 1-1-P ....6 - &M for OU radapwm, 0 "ran ice) UiNmouti-N zw W� bin 71:y AMM *,'F"gxwppi(W.Town,dlsljki munkIp&lhousInq authodty.owner-mcupled issidonilmll of four units or less) Xy0s 0 no 151111cul I(ham hoid of form): 7 26 76 3 New England Surface Maintenance, LLP I r'�A M4 o850 Washington Streetc, 1 Weymouth, MA 02189 P t• t Town of Hyannis Health Department Hyannis, MA 02061 ' .� '-Oil IIIit XI N11�t..I'l;J:1t.I1t1�1�.��t,��titil III gill 111�1141 ' i i ?j i i i i:i s•.,i i ;! �^"=!f=,.` Y�,;, i 1 i f i —i;i i i i i 't �. i t i —