HomeMy WebLinkAbout0020 PEARL STREET - Health F
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YOU-WISH TO OPEN A BUSINESS?
For Your Information! Business certificates (cast$30.001or 4 yl2rs . 'A business certificate ONLY REGISTERS YOUR NAME in town (which
you must do by M.Q.L. it does not give you permission a e.j Business Certificates.are.available at the Town.Clerk's,Off ice, 1"FL.; 367
Main Street, Hyannis;'MA 02601 (Town Hall)
DATE: '1-�ZL `2,L Fill in please:
=APPLICANT'S o 2
YOUR.NAME/S:
BUSINESS YOUR'HOMEADDRESS: � r. i�.sA �"�? rd� Y�i'ilyui
8 � r?x TELEPHONE #. Home Telephone Number 3. 2 C 2 8 7
NAME OF CORPORATION: "
NAME OF NEW BUSINESS F' ' V7 1ry 6 TYPE OF BUSINESS P'A V l 2 i n/
IS THIS A HOME OCCUPATION? . ES -.-NO : w
ADDRESS OF BUSINESS zr PL ! o —MAP/PARCEL NUMBER l - [Assessing)
When starting a new business there are several thingIs.you must do in order to be in 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 20 ain St. - (corner of Yarmouth
Rd. &Main Street) tol 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.permitrequirements that pertain.to this'type of business;.
Authorized Signature*
COMMENTS:
2. BOARD OF HEALTH
This individual has�been:.ir�form o ern-it requirements that pertain to thisl;ype of business.
MUST COMPLY WITH ALL
Authorized Signature** HAZARDOUS MATERIALS REGULATIONS
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been infor,�ned of the licensing requirements that pertain to this type of business. .
Authorized Signature*
COMMENTS: C�Y� u-`ti l�t� .Y�hati
Date:
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: CON
BUSINESS LOCATION:',S> R RIAR.I S'l iA sa �-1t�r"% (Y A 0�U y � INVENTORY
MAILING ADDRESS: `Z`-> PQ=AILL s"7 i i �6 A ly Iyt S iM A e > TOTAL AMOUNT:
TELEPHONE NUMBER: 'S 6 �- �02-v`-S-47+ ?
CONTACT PERSON: _KE.QLSY��
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS:_2 4\ 9 'T� N) t::,
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
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 may be toxic or hazardous (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