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Home My WebLink About0046 LOUIS STREET - Health 46 Louis Street - Your Health'M'fttters-".,. Hyannis A = 309 — 100 YOU WISH TO OPEN A BUSINESS? For Your information: Business certificates (cost$40.00 for 4 Vears). 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 siKnaturc:S on this form at 200 Main St., Hyannis. Take the completed form to flee Town Clerk's Office, 1 st. FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by lavv- y . DATE: r!g�!� �� Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: a # ,. TELEPHONE # Home Telephone Number y36 D�'6'�i NAME OF CORPORATION: 4=-:r' h cS S NAME OF NEW BUSINESS 'TR 0-7-10/t1 TYPE OF BUSINESS G�D/vrT�;��i/�/✓ IS THIS A HOME OCCUPATION? YE NO 2 ADDRESS OF BUSINESS Ve Gwif �i' w i e/.f� O O MAP/PARCEL NUMBER J 0 9 — 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, & 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 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 has been ir#amied of the permit requirements that pertain to this type of business. MUST XIVIPLY WITr'ALL HAZARDOUS MATERIALS RF(r-!!' Authorized Signature* COMMENTS: // x/vE Z-OtmS Sr 1VO VI '?/// c'�JCE -2E /—A!t{ 51D 446 Q J A;N y N A Z A1�4'1 a C7hAv Si7�c77o /&A-7 t-e iA--r- &K) 77�" PRO P00 i� �9,C7 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** ` COMMENTS: _ G� Date: ` TOWN OF BARNSTABLE Fa rem (IA TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS: Tl/�f/E�/C'ON.Pi,wcr/pit/ BUSINESS LOCATION: INVENTORY MAILING ADDRESS: W L.oair TOTAL AMOUNT- i TELEPHONE NUMBER: y36�p ed9 CONTACT PERSON: 1�lelr&Rdw- Xa ll o In EMERGENCY CONTACT TELEPHONE NUMBER: 3`01a2902 y'43o2 MSDS ON SITE? TYPE OF BUSINESS: P00,04#9 , -rio- w f 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 j 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 polishesf/1L- 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 Appl icanyCXs4ture Staff's Initials J TOXIC AND HAZARDOUS MATERIAL REGISTRATION FORM NAME OF BUSINESS: Mail To: BUSINESS LOCATION: f Board of Health MAILING ADDRESS: Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: Hyannis, MA 02601 CONTACT PERSON: EMERGENCY CONTACT TELEPHONE N BER: Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES 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: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners t, Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may _ Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business