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Home My WebLink About0045 MURPHY ROAD - Health 45 MURPHY ROAD Hyannis ® A= 309-170 1 aiscussea wim triem. C` 131azardous Materials Inventory Sheet Checklist ate Physical Street Address-Check database to ensure it exists Working Phone Number Actual Amounts -( ie. gas being used to 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, .mote that. (Disposal Information -where and who? If none, note that. Applicant Signature -understand what is listed and noted Staff 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 --- +ice nro rininn Nintoc ncarl to hp laff to arnlain WhAt tniI r{icriMCZAH With Thom 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 m6st first obtain,the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office,.lst Ff., 367 Main St:,'Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Fill in please: ..., yF APPLICANT'S YOUR NAME/S t BUSINESS YOUR HOME ADDRESS: 'f, All . _ TELCPHONE # ` Home Telephone Number ICIAME pF CDRPOI"A710N NAME OE NEW BUsIPIESS � .(;rr7 (cL�I S( , S i7(s F�o S., .. TYPE OE.' LISWESS �`•�D a i ,��1 L.t.��s� TL1r✓1^ IS TW15,A HOMEIQCCIJPAIpN? YES pVO QdDRESS OE BUSIIySS� MAP/PARCEL fVUIV10ER Wisassing) 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 ha been i med.of the permitr puWaments that pertain to this type of business. c Authorize Signature** MUS7 S,OM.3L't 'Vv COMMENTS: i42AFiUUtJS MA,T[=.RIALS l S. CONSUMER AFFAIRS(LICENSING AUTHORITY] This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: ' J a_ TOWN OF BARNSTABLE Date: ql(fd. l (y TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: _ ! � . c ;c )S �� LS � . BUSINESS LOCATION: INVENTORY MAILING ADDRESS: � S A,\, v\-A TOTAL AMOUNT: TELEPHONE NUMBER: ,k, CONTACT PERSON: knqr4j, , EMERGENCY CONTACT TE PH E NUMBER: , -rtd6'd. 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 14C )LA-. 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 0 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 C) Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels ,r� (including chloroform, formaldehyde, Paint&varnish removers, deglossersr LJ hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may a toxic or hazardous (please list): 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 Sta4's Initials