HomeMy WebLinkAbout0099 LINDEN STREET - Health 9.9 LINDEN STREET
Hyannis
A= 310 -277
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YOU WISH TO OPEN A BUSINESS? s
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: 08— O 3 — Z 0/5
Fill in please:
} APPLICANT'S YOUR NAME: cS-O SC. �' I-- )i Gu C��Cl
BUSIlNESS YOUR HOME ADDRESS: G 9 I V1 i 5 f'i W o2 G c�
50?) Z92 —g530 b-T 3
TELEPHONE # Home Telephone Number 08� zit 2 --i53 d
NAME OF NEW BUSINESS: 7-CcA 5on TYPE OF BUSINESS L0 n k
IS THIS A HOME OCCUPATION? YES NO
Have you been given approval from the building- di ion? YES NO
ADDRESS OF BUSINESS I i h d / n 01 MAP/PARCEL NUMBER.
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 CO ISSION R'S OFF "MUST COMPLY WITH '��C `�'i�UPAfION
This individu I hat b inft3>"m d f n er it re uirements that pertain to this type of businessR.ULES AND REGULAT I A►LURE TO
Aut on Si afar -* cowi-;Y MAY RESULT iiti FINES.
COMMEN / ....
✓" 1 _ `
2. BOA1 O EALTH
+
This individual has been in o �f h permit requirements that pertain to this type of business. AIIUS CAMPY 1TH`ALtJ
HAZARDOUS MATERIALS t ECilLkTIOM
Authorized 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:
Dater / 3 / Z �l.�
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: J ��San M a��i renan c�
BUSINESS LOCATION: qq \vn�, pn �
P ' }-,401Al S �M 02 6ol INVENTORY
MAILING ADDRESS: Po 624, I (3+3 Amannrs N& ey G n t TOTAL AMOUNT:
TELEPHONE NUMBER: S'o$ ) 2 92,- q 5 30
CONTACT PERSON: --ye-ck sp
EMERGENCY CONTACT TELEPHONE NUMBER: 0 360 -S a-t MSDS ON SITE?
TYPE OF BUSINESS:
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) 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
naI`� Rustproofers Miscellaneous Combustible
c'K J 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 , iL.l USED Any other products with "poison" labels
(including chloroform, formaldehyde,
\Y^ 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
f Laundry soil'&stain removers
(including bleach)
j Spot removers&cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
v� •/ Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applic Staff's Initials