The URL can be used to link to this page

Home My WebLink About0039 LOUIS STREET - Health 39 1Y'ous S Hyannis. , "'Ot SEW ER , i i 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 to - 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, V, 367 _ Main Street, Hyannis, MA 02601 (Town Hall) DATE: �.� J•� J Fill in please: J PUN t f lA ffill I 1��' `N ,{ APPLICANT'S YOUR NAME/S- bra I N h r, c. ; 2A--s r, i .,Lily J<2 � ixfr G fi)'r 9ht BUSINESS, YOUR HOME ADDRESS: 3't c T TELEP ONE # Home Telephone Number L �t _ IM1NfniR D(u�4' M1�'.$1I,+L1Fj} NAME OF CORPORATION: ',/� U \//aS 1 7 ' NAME OF NEW BUSINESSLOA/ hiv 17 S r4 ) )! 6 TYPE OF BUSINESS I cr ��`��/�. IY`)Ll IS THIS A HOME OCCUPATION? YES NO w� MAP PARCEL NUMBER c7 (Assessing) ADDRESS OF BUSINESS / 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 COM%se R'S OFFICE This individu d f ny p rmit requirements that pertain to this type of businessMUSTCOMPLY WITH HOME OC UPATION RULES AND REGULATIONS. FAILURE TO ze re** �On/lpl.y MAY RESULT IN FINES. COMMEN : 1 _ 2. BO ARD O HEALTH This individual h t d ermit requirements that pertain to this type of business. MUST COMPLY WITH ALL Authorized Signature'* HAZARDOUS MATERIALS REGULATIONS COMMENTS: . 3. CONSUMER AFFAIRS (LI NSING AUT ITY)` tha t' ertain to this e of business. informed f licen m r uirements type This individual has n of 9 9 P A orized Si ature COMMENTS: , Date: 1 / 5 / I TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF'BUSINESS: ��,, �; ��g, p r BUSINESS LOCATION: 3cj INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: �7 ZGT Z4 4, 314� j MSDS ON SITE? TYPE OF BUSINESS: > �✓1�,sf31��d✓c 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 re uires 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 V (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 scant ignature Staff's Initials l: `f Tzardou Materials Inventory Sheet Checklist -Date fi -Physical SO dt Address-Check.database to ensure it exists ti Working Phone Number r Actual Amounts -( ie gas being usedto fuel"machines, thinner to „. clean brushes all count as hazardous'materials-no blanks) ✓✓✓ Storage Information -location of storage;.how long.is storage for? If none, note that. ti. Disposal Information -where and who? If none, note that. F Ij Applicant Signature -understand what is listed and noted tall Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it Attach,the Business.Certificate with your sign.off.and comments "*The inventory form should explain what the business consists of and:the procedures they are doing. Notes need to be left to explain what y ou discussed with them. . . 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, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall).and get the Business Certificate that is required by law. DATE: Fill in please: - atZ APPLICANT'S YOUR NAME/S: C AM\LLR L-AC)S i }R BUSINESS YOUR HOME ADDRESS: --L� Wu t S S'C €� TELEPHONE # Home Telephone Number 3oL Gl . NAME OF CORPORATION: NAME OF NEW BUSINESS TYPE'OF`BUSINESS ''GI�Ef'rtv1 NCg IS THIS A HOME OCCUPATIONS = YES NO ADDRESS OF BUS INES8.4 }., ( MAP/PARCEL NUMBER &0 D (Ass„e_ ng] 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 usiness in this town. 1. BUILDING COMMISSIO R'8 oFFlc MUST COMPLY WITH HOME OCCUPATION This individual had b inferm o�a per "requirements that pertain to this type of business. RULIES AND REGULATIONS. r AILURE TO �J Au_t-o ' ig afore. COMPLY MAY RESULT IN PINES, MMENT - i, 2. BOARD OF ALTH This individual has be , f r e.d of the permit requirements that pertain to this type of business. MUST ,OMPLY WITH ALL Authorized Signature** HAZARDOUS MATERIALS REGL1 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 F � Date: O ARNSTA�LE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 1.CMo S IN G BUSINESS LOCATION: INVENTORY MAILING ADDRESS: 3G) CI i5 5'C TOTAL AMOUNT: TELEPHONE NUMBER: rj %3Q_ ci8 J2 CONTACT PERSON: C.•AM ILLA EMERGENCY CONTACT TELEPHONE NUMBER: E�OR a,Q/ °�9 MSDS ON SITE? TYPE OF BUSINESS: C/..C1 �1NG 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 I Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW Zd USED Cesspool cleaners Automatic transmission fluid L Disinfectants r 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 removes, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): C 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/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials