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HomeMy WebLinkAbout0185 STEVENS STREET UNIT UNIT 1G - Health 185 STEVENS STREET Hyannis A= 308-025 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, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. 1 N DATE:Dl �' 6 Fill in please: APPLICANT'S YOUR NAME/S:Z BUSINESS YOUR HOME ADDRESS: I�'ti S T r%� TEL # Home Telephone Number hO3' 2 1 JtY i NAME OF CORPORATION: ZO �ftc 'l - -6 NAME OF NEW BUSINESS A^I;- %9 �G h �-, �6 TYPE OF BUSINESS IS THIS A HOME OCCUPATION? V YES NO ADDRESS OF BUSINESS I S , +rE S 'l _MAP/PARCEL NUMBER off- �\ ( ss sing) 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 Yarrpouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. BUILDING COMMISSIONER'S OFFIC HOME OCCUPATION 1. WITH H to this type of business. MUST COMPLY WI This individual has b en,i rme any permit requirements that pertain yp RULES AND REGULATIONS, FAILURE TO. 9. thor¢ed Signat ** COMPLY MAY FIE-SULT IN F NE COMMENTS: 2. BOARD OF HE LTH (Ix This individual has been informed the perrjn�t eq ' ements at pertain to this type of business. 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: TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF-BUSINESS:,�e�,�,« /•© Gl BUSINESS LOCATION: INVENTORY MAILING ADDRESS: 'M 9 a (;e 1.•� I'irl f'/ ,� Jr�of �/G , �� �, TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: ,vo y f® <<,.^�6l� A DV nit Fire District: Waste Transportation: Last shipment of hazardous waste: nr o Name of Hauler: r9 Destination: Waste Product: 0 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) 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 polishes Laundry soil &stain removers (including bleach) /1/a ll v 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 Staff's Initials --Hazardous Materials Inventory Sheet Checklist ( Date �- 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? !f nano, note 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 **T e 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. l TOWN OF BARNSTABLE } YOU WISH TO OPEN A BUSINESS? For Your Information.'- usiness 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, 1 st FI., 367 Main St., Hyani A 02601 (Town Hall) and get the Business Certificate that is required by law. ON T� DATE-7 Fill in please; APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: TELEPHONE # Home Telephone Number �NAME AME OF CORPORATION: OF NEW.BU51NE55`Ai �S , til►r TYPE OF BUSINESS THIS A HOME OCCUPATION? YES NO1��' '—'I 1�k r1Cr rdk ADDRESS OF BUSINESS !S j r � ozwd MAP/PARCEL NUMBER [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 Str6et) .to male 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 Thi s indivi dual al has Men inf me,_qi of bhp permit requirements that pertain to this type of business. Authorized Gignature** MUST COMPLY WITH ALL COMMENTS: H"WWMATE RIALS (�E�IJtATiON� 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. ~ Authorized Signature** COMMENTS: TOWN OF BARNSTABLE Date: + 09 / Iq TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTOR NAME OF BUSINESS: s ��S�T� OAJ BUSINESS LOCATION: � S- a 91�1 Uhl 2if) INVENTORY MAILING ADDRESS: 1%5, , uQ rr4) Sr4Q Ljr.� 2b TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON:, EMERGENCY CONTACT TELEPHONE NUMBER: 31,-+- 5-40, 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 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 polishes L V»�<k sale, 145 0/% 6,9w v1, �s-- (mc+e�irr9'�M Spot removers &.cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash �J.s,U✓d� ICI WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials