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Home My WebLink About0008 NORTH STREET - Health 8 NORTH STREET, HYANNI D I' I i 1. 'z TOWN OF BARNSTABLE Date: VI TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: AkA 1'ehyoqdSC,4 ilk BUSINESS LOCATION: K Not th 3 4, vAINVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: �cl W EMERGENCY CONTACT TELE HONE NUMBER: - MSDS ON SITE? TYPE OF BUSINESS: fSC.w�j�j(� INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: 44 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) g,,/ 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 poj,� 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 (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 Applican Signature Staff's Initials YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by`M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St.,, Hyannis. Take the completed form to the Town Clerk's Office,.lst FL, 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 7h 6 1a0/H Fill in please: ' {.utt w iwf Yam' • � Y APPLICANT'S YOUR NAME/S: old SUS h`� BUSINESS YOUR HOME ADDRESS: 6 l 12 4V i-I C 0 TELEPHONE # Home Telephone Number f�lAIV1E;pF'COR Pgf4AT ION Y NAME OF NEW BUSINESSF TYPE OF`BUSINESS C / ISTHIS ANOM 4CCUPA . Y .. : No .ADDRESS OF BUSLIVSS f" /I% lS MAp PARCEL NUMBER ` V:! t " / [gssessing);. When starting a new business there.are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has ee.r"n rr.y�d_of the permit requirements that pertain to this type of business. MUST COMPLY WITH ALL • CAr�IV 1 HAZARDOUS MATERIALS REGULATION$: 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: ` i ' 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 s`FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: V, Fill in please: fr r, aK .�' b irk � APPLICANT'S YOUR NAME/S: d Suo Z 0 `rrt MET ;!'' BUSINESS YOUR HOME ADDRESS y E Sob-a 8v-o 0� ;r4 tr7 4 TELEPHONE # Home Telephone Number SD -1 0 7;;1 NAME OF CORPORATION- .. NAME OF NEW BUSINESS ee L TYPE OF BUSINESS yi !1� IS THIS A HOME OCCUPATION? " YE NO ADDRESS OF BUSINESS ?' nnI S MAP/PARCEL NUMBER 3� /,;4 (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 T0.200 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 is own. 1. BUILDING COMMISSIONER'S OFFICE MUST COMPLY WITH HOME OCCUPATION This individual,_hab bee informed;of/any permit requirements that pertain to this type of businessRULES AND REGULATIONS. FAILURE TO '� `• �il�,t �� % '1��_... COMPLY MAY RESULT IN FINES. Authoriz d Signature COMMENTS: c. �c _ _ flA 2. BOARD OF HEALTH This individual has een i o (F � e permit requirements that pertain to this type of business. "'' ``` V // p q P YP MUST COMPLY WITH ALL HAZARDOUS MATERIALS REGULATIONS 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: r � Date: {gyp / 1 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: ��/lam �re�iR 1 �Q �SC�eril<'/ BUSINESS LOCATION: ��rn � �n/ INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: O' 05'02 CONTACT PERSON: D EMERGENCY CONTACT T.�EEL y TELEPHONE 77y- ,�08 ^ 7 w MSDS ON SITE? TYPE OF BUSINESS: A,7segPl-I4 INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: 40 17�A Last shipment of hazardous waste: 17 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 O served/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 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 (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 ay be toxic or hazardous (please list): Laundry soil & stain removers 6 (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers ® Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Make application to local Fire Department. Fire Department retains original application and issues duplicate as Permit. ° '=lJe`ZC(/1�C/J92P/l7.Ca��r�xe ��rc� — ✓c�aa��Lc�C�rr�re �i��/!1(%/'LCGC'iiL APPLICATION and PERMIT for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: Tank Owner Name(please print) Caps Realty Trust X _._ Signature i apllying or penn1 I i Address 8 North St. , Hyannis, MA - ------ Street city oo i Company Name Advans-e-d Fnvironmemtal _ 7Coordividual Print Print i AddressP n Rr-x 472 r197-Great Western Rd Address Print _.—_-- Signature /(if,.applying f perm Signature (if applying for permit) = IFCI Certified Other IFCI Certified _ L.SP # Other Tank Location t8 North.St. Hyannis MA �7 Staet-Address----^^'-f c q Tank Capacity (gallons) 1275 Substance Last Stored Tank Dimensions(diameter x length) 9 jRemarks: �= zoo �o 00 Firm transporting wasteAdvanced Environmental State Lic. N MV508385 Hazardous waste manifest# E.P.A. # Approved tank disposal yard James G.Grant Co . , Inc Tank yard 9 008 _--__.___..---_-._-_ Type of inert gas Tank yard address wn 7 rr o t t St R o a d v i 11 e , MA ---- - - City or Town yQrt'1n1.s __—_FDID#01CI 1-:" Permits Date of issue �3 -q = moo Date of expiration 3- o Dig safe approval number: 20000803772 — Dig Safe Toll Free Tel. Number- 800-322-48414 Signature/Title of Officer granting permit ------ - -- eaNVV IRIB120 , BON After removal(s) send Form FP-29OR signed b r�I YAH Compliance Unit, One Ashburton Place, Room 1310, Boston, MA 02108 1618. 4MA95 HIGH SCHOOL RD. EXT HYANNIS, MA 02E01 �" 0 �I 292(revised 9/96)