HomeMy WebLinkAbout0273 SUDBURY LANE - Health 273 Sudbury Lane
Hyannis
A=270—278
YOU WISH TO OPEN A BUSINESS? v"
FFo.ri Your Information: Business certificates cost$30.00 for 4years),
ears : A business certificate ONLY REGISTERS YOUR NAME "townhich
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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
n Street, Hyannis, MA 02601 [Town Hall)
DATE:ob-oZ6--0-6
M MMVO , Fill in please: /�
APPLICANT'S YOUR NAME: /x AVM O {Mir I � �
BUSINESS YOUR HOME ADDRESS: DZ 3 R Z_ f �
TELEPHONE # Home Telephone Number
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NAME OF NEW BUSINESS G,R 16✓0 TYPE OF BUSINESS
IS THIS A HOME OCCUPATION? YES J NO :._. ..,.
Have you been given approval r.o►n the buildingdivision? YES. : NO
ADDRESS OF BUSINESS_ �� �V D�3V �Y LAMAP/PARCEL NUMrER
When starting a new business there are several things you must do in order to be in compliance with the letio the Town of
Barnstable. This form is intended to assist you in obtaining the information.you may need. You MUST GO T s and regulat. - (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 COIVlMtSSt ER'S OF IC
This individual ha e i y permit requirements that pertain to this type of business.
Auth z d ure* r ,
OMMENT i - j Ile I i. O • 1F�'
2. BOARD OF HE H
This individual has_I�.ee 0 0rmed�f the it requirements that pertain to this type of business.
thorized 31,9nat re**
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COMMENTS: z
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
Date: l2lQ /orP
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: .(5 10 KG M O� b 6 41 A)
BUSINESS LOCATION: ` 500 8 0 A V Q HM AI S INVENTORY
MAILINGADDRESS: TA6, IsA /V1 C- . TOTAL AMOUNT-
TELEPHONE NUMBER:
CONTACT PERSON:
EMERGENCY CONTACT TELEPHONE NUMBER: S 0 9 2 3� 7 n 5 MSDS ON SITE?
TYPE OF BUSINESS: C LA 106 N 7/Z
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):
iLaundry soil & stain removers
I (including bleach)
Spot removers &cleaning fluids
i.
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS