HomeMy WebLinkAbout0029 MURPHY ROAD - Health 29,MURPHY ROAD
HYANNIS
8
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H_a;parcjous Materials Inventory Sheet Checklist
Date
Physical Street Address-Check database to ensure it exists
Working Phone Number
--77'—Actual Amounts - ( ie. gas being used tcTOAWWqyi,-es�,7. MSjEr to
clean brushes all count as hazardous materials-no blanks)
Storage Information -location of storaq, th(T, lqn is o�qC�,or?.
If none, note that. �'' a
-- Disposal Information •where and who? If none, note that.
Applicant Signature - understand what is listed and noted
Staff Initial -any'questions, know who tp- ash y t _' -
Vehicle Washing/Rinsing? -give a vehicle w"hing 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 you discussed with them.
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which
you must do by M.G.L. it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1'FL., 367
Main Street, Hyannis, MA 02601 (Town-Hall)
u DATE: Fill in please:
APPLICANT'S YOUR NAME/S: (E C I:�;/SV!
BUSINE /S7 9{ YOUR HOME ADDRESS: G2 1-4V
9 7
r s S
.'$. TELEPHONE # Home Telephone Number �
NAME OF CORPORATION:
NAME OF NEW BUSINESS—(—::, t TYPE OF BUSINESS
IS THIS A HOME OCCUPATION?, R YES NO 0 � �
ADDRESS OF BUSINESS•`2 +-Ue h lzo H PIJ N4 GZ6MAP/PARCEL NUMBER (Assessing)
When starting anew 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 h been inf tr �jf t ermi requirements that pertain to this type of business.
Authorized ignature*
COMMENTS:
:3. CONSUMER AFFAIRS (LICENSING AUTHOR IT
This individual ha-A n infor e dthe lic in6re ements that pertain to this type of business.
Authorized Signature**
COMMENTS:
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: �� _ vl
BUSINESS LOCATION: c2q t] INVENTORY
MAILING ADDRESS: S4NE JS AA ove TOTAL AMOUNT:
TELEPHONE NUMBER:
CONTACT PERSON: C-
EMERGENCY CONTACT TELEPHONE NUMBER: °y ' �' � MSDS ON SITE?
TYPE OF BUSINESS: P41 n T 1�&) j
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 materials 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) Misc. Corrosive
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
I Motor Oils Pesticides
NEW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil NEW USED
Misc. 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 Misc. 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__ s-- _. - (inc. carbon tetrachloride)
NEW USED Any other products with "poison" labels
Paint &varnish removers, deglossers ,�/ (including chloroform, formaldehyde,
Misc. Flammables hydrochloric acid, other acids)
)
Floor&furniture strippers Other products not listed which you feel
Metal polishes may be toxic or h and us (please list):
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