HomeMy WebLinkAbout0060 LEXINGTON DRIVE - Health 60 LEXINGTON DRIVE
Hyannis
A = 270 - 101
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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
You must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at
-town (which
the Town Clerk's Office, 1" FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
DATE:
APPLICANT'S Fill in please:
BUSINESS YOUR NAME/S:
� b S.: a YOUR HOME ADDRESS:
t .2 ,r-
d F�'`I TELEPHONE # Home Telephone Number
,:P
NAME"OF CORPORATION:
NAME OF.NEW.BUSINESS_
1S THIS A HOME OCCUPATIONS . YES Np TYPE OF BUSINESS
AQDRESS.OF BUSINESS r
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:rn O MAP PARCEL X NliIMB R � 11 �]
When starting a new business there are severall�ssessi );
things you must do in order to be in compliance with the ru and regulations
Barnstd'ble. This form is.-intended to assist you in obtaining the information o
Rd. & Mai u g s own of
n Street) ma e ne et ed� J to rrjake sure you have Y Y You MUST GO TO 20
Y the a 0 ain ppropriate permits and licenses required to legally operate your business (n this town Yarmouth
1. BUILDING COMMISSIONER'S OFFICE
This individual has been informed of any permit requirements that pertain to this type N Ti9QMPLY WITH HOME OCCUPATION
RULES AND REGULATIONS. FAILURE TO
COMPLY MAY RESULT IN FINES.
COMMENTS: Authorized Signature**
2. BOARD OF HEALTH
This individual has bee ormed of the permit requirements that pertain to this type of business.
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Authorized Signature** MIST COMPLY MTNALL
COMMENTS: 4A7ARDOUS MATERIALS REGU.:: q
� QTI/'14,I
3, CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has n in m f the licensing requirements that pertain to this type of business.
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COMMENTS: Authorized Signature**
TOWN OF BARNSTABLE Date:03/ /Z® I
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
C
NAME OF BUSINESS: ►� 1 ZZ �' 1 V1-�-��`/�(`-�
BUSINESS LOCATION: INVENTORY
MAILING ADDRESSO oX 5 \,V- .Isj"_ 26 TOTAL AMOUNT:
TELEPHONE NUMBER:
CONTACT PERSON: A �.
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: 7)� .�, v\_�7 /\
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 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) p Miscellaneous Corrosive
❑ NEW ❑ USED 0 Cesspool cleaners
(0 Automatic transmission fluid o Disinfectants
10 Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
(o 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)
C� lubricants, gear oil ❑ NEW ❑ USED
Degreasers for engines and metal Printing ink
Degreasers for driveways&garages Wood preservatives (creosote)
�( ko Caulk/Grout Swimming pool chlorine
Battery acid (electrolyte)/Batteries (0 Lye or caustic soda
0 Rustproofers (b Miscellaneous Combustible
Car wash detergents C) Leather dyes
Car waxes and polishes Fertilizers
Asphalt& roofing tar PPCB's
(b Paints, varnishes, stains, dyes Other chlorinated'hydrocarbons,
ro 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
!a Bug and tar removers
Windshield wash jq
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials