HomeMy WebLinkAbout0415 BARNSTABLE ROAD - Health 415 BARNSTABLE RD'..,:HYANNIS
THRIFTY;CAR RENTAL:
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TO ALL NEW BUSINESS OWNERS
Fill in please* a r YOUR NAME:
'' ' BadK� ���
APPLICANT'S
YOUR HOME ADDRESS:
BUSINESS J,9rH
Tele hone Nu ber Home D 2
TELEPHONE arc TYPE O
BUSINESS �c�d r `i 7 0,0x-
!ADDRESS
ME OF. NEW /,9 T��
USINESS ark �� �� ��� A 1�s
o3S- c�0z
THIS A HOME OCCUPATION? L� ,�= MAP/PARCEL NUMBER elf `
OF BUSINESS you must in order to e in c mpliance with the rules and regulations of the Town
When starting a new business there are several things y t floor - Town Hall).or if.you get the business
of Barnstable. This form is int
ended .to assist you in obtaining the information you may needlsOnce you have obtained the required
signatures, listed below, you may apply for a business certificate at the Town Clerk's office
ired permits
certi
ficate first you MUST go to the following office to make sure yond ave 11-will ndahe ollowing offices:
licenses..
GO TO 200 Main St. — (cCE
f Yarmouth Rd. & Main Street) Y
1. BUILDING I TOR'S OFF
This individu as be informed f a y per i equirements that pertain to this type of business.
u orized Signature
COMMENTS:
2. BOARD OF HEALTH
This in
dividual has een ' rermit requirements that pertain to this type of business.
Au horized �S&iqnLature COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
Th
is individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature
COMMENTS: (whichyou must
s cost$20.00 for 4 years). A business certificate ONLY REGISTERSo mpOlet on o�the processessE in the town from the various
Business certificate ( you must get that through
do by M.G.L. - it does not give you permission to operate -
departments involved.
7 / ,Ox X4(4 _.6�5Lf
r.
� 34:
• Date:
TOXIC AND HAZARDOUS MATERIALS REGIST , TION FORM
NAMEOFBUSINESS: R1OALff�eiea id /�/ �ov&, ,f°(Q�C�rt/,��
BUSINESS LOCATION:
MAILING ADDRESS: 01 IcIf'? rVX ZL/ A Mail To:
7/- S� . J 25�1� Board of Health
TELEPHONE NUMBER:
� �S' f Town of Barnstable
CONTACT PERSON: F
P.O. Box 534
EMERGENCY CONTACT TELEPHO E NUMBER: Hyannis, MA 02601
TYPE OF BUSINESS:— .e fly
Does your firm store any of the toxic r hazardous materials listed below, either for sale or for you own
use? YES NO
This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed
envelope for your convenience.
If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing
address:
ADDRESS:
TELEPHONE:
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health has determined that the following products exhibit toxic or hazardous character-
istics and must be registered regardless of volume. Please estimate the quantity beside the product that
you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS.
Quantity Quantity
Antifreeze(for gasoline or coolant systems) Drain cleaners
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salt (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor oils Pesticides
NEW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet uel Photochemicals (Fixers)
Diesel fuel, ker ene, #2 ting oil NEW USED
Other petroleum roducts: g ase, Photochemicals (Developer)
lubricants, gear o NEW USED
Degre ers for en 'nes an me al Printing ink
Degrea ers for driv ways garages Wood preservatives (creosote)
Battery cid (electrol e) Swimming pool chlorine
Rustpro fers Lye or caustic soda
Car as detergents Jewelry cleaners
Car a e and polishe Leather dyes
Aspha roofing tar Fertilizers
Paints, arnishes, stains, dyes PCB's
Lacquer thinners-�� __� � - Other chlorinated hydrocarbons,
NEW USED -tom,-:.� ,
inc carbon tetrachloride)-,,.. .
Paint & varnish removers, eglossers
Any other products with "poison" labels
Paint brush cleaners
Floor& furniture strippers (including chloroform, formaldehyde,
hydrochloric acid, other acids)
Metal polishes
Laundry soil & stain removers Other products not listed which you feel
(including bleach) may be toxic or hazardous (please list):
Spot removers & cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
COX,'
1vao
OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE
ANITFREEZE
GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF
.. II.
HYDRAULIC/ MISC. MISC. MISC. MISC. `"
BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM
(GEAR OIL/GREASE/
LUBRICANTS)
FREON ACETYLENE CAR WASH CAR WASH PAINTS/
WAX DETERGENTS THINNERS �(
SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT
SOLVENTS BATTERY
ACID
FERTALIZERS WASTE SOLVENT MSDS
MANIFESTS
In d /�/�dte: 4b
TOWN OF BARNSTABLE —jos
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: Wi,t"may e-we LL (/l"
BUSINESS LOCATION: I,r if OAVAk7,bif, &9A, aAKA_ .S INVENTORY
MAILING ADDRESS: '� TOTAL AMOUNT:TELEPHONE NUMBER: MAX/ I /`
CONTACT PERSON: � -i`''
EMERGENCY CONTACT TELEPHONE NUM ER:
Q? - g - MSDS ON SITE?
TYPE OF BUSINESS:
INFORMATION/RECOMMENQ TIONS: vJiA Fire District:
if , ub nA - QJAM � .
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 AA.,l Is
(including bleach)
Spot removers & cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
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"`.FL., 367
Main Street, Hyannis, MA 02601 (Town Hall)
DATE: ��2-O4
!'amomm- Moo
=MR ffz M M;� ' Fill in please: '
APPLICANT'S YOUR NAME 1�z
BUSINESS YOUR HOME ADDRESS: whqy (
-= TELEPHONE # Home Telephone Numbdr.
NAME OF NEW BUSINESS TYPE OF BUSINESS. [JSGD C41t 0E/QZiS
IS THIS A HOME OCCUPATION?' YES NO
Have.' been given approval from th building:divisio ? °YES: : NO /
ADDRESS OF BUSINESS C MAP/PARCEL NUMBER 51` fA,+P
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 bbeenjDformed o e ppqrut requirements that pertain to this type of business.
A orized Sig e** ,
COMMENTS: . D 'Z Zc
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that,pertain to this type of business.
Authorized Signature**
COMMENTS:
Licensee 508 771 0450 Thomas J.Levesque Bresnahan Auto Sales Bourne 7594484 Edward J.Bresnahan,Jr.
415 Barnstable Road Licensee Falmouth 5409942
Airport Rotary i z — 250 Cranberry Hwy.Rt.6A Hyannis 7710450
Hyannis,MA 02601 P.O.Box 2811 Plymouth 7465240
Orleans,MA 02663 Provincetown 4879418
Out of Town Reservations: 508 255 2234 Sandwich 8888333
1-800-FOR-CARS®
www.thrifty.com Out of Town Reservations:
1-800-FOR-CARS®
�tiri« �ti�►i�jii
��AH9CarRental 'F ff"' TCarRantal �
Y
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
BOARD OF HEALTH
satisfactory 2.3.Auto Brody Shops
unsatisfactory- 4.Manufacturers
COMPANY Caw (see"Orders") 5.Retail Stores
yy77, /� p 6.Fuel Suppliers
ADDRESS 7/S N0- 11.5" � I�G' Class: 7•Miscellaneous �'o„i
/l
6a—" QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Prurns Above Tanks Underground
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline Jet Fuel(A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil(C)
r eo D�
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers
Misce laneous:
Lj �s� V
DISPOSALIRECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply In
O Town Sewer *ublic Y49 &1 4 J
kon-site OPrivate amJtp- -s o t-I o G,� rcn-i
3. Indoor Floor Drains YES NO
O Holding tank: MDC `f �` �QC�v
O Catch basin/Dry well
O On-site system
_- 4.:Outdoor Surface drains:YES NO V ORDE_RS:
O Holding tank:MDC 4.6 1 /�a-�f-uc� -� OtiD�S7 21.E '--
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
1.
2.
Pe (s) Interviewed Inspe ctor Date so
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair
BOARD OF HEALTH satisfactory g.Printers to Body Shops
01 unsatisfactory- 4.Manufacturers e
COMPANY' / (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS ass: 7.Miscellaneous
QUANTI IES AND STORAGE (IN= indoors;OUT=outdoors)
MAJOR MA RIALS r Tinks
I JOUT I IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
4
�s
i
DISPOSAUREC:LAMATION REMARKS:
1. Sanitary Sewage 2. ater Supply � i Gov
Town Sewer ublic
On-site Private
oe" r rl r � .
3. Indoor Floor Drains YES NO_V
0 Holding tank:MDC
0 Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
0 Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Nanic of Hauler Destination Wastc- Product Lice r
YES NO
1.
2.
Person(s) Interviewed Inspector Date
TOWN OF BARNSTABLE OMRUANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
unsatisfactory- 4.Manufacturers
.COMPANY 6 e 2is n 1n ifs O (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS C183S: 7•Miscellaneous
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATtr~IALS~IALSove , Tanks
IN OUT IN OUTI IN OUT #&gallons Age Test J�
Fuels:
Gasoline Jet Fuel(A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil(C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
DISPOSAL/RECI.AMATION REMARKS:
1.Lanitary Sewage 2. Y ater Supply n
Town Sewer ZPublic
O On-site OPrivate
3. Indoor Floor Drains YES NO _
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
1. r YES NO
2
Person (s) Interviewed Inspector Date
5
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair
2. Printers
BOARD OF HEALTH �O satisfactory 3.Auto Body Shops
„oC unsatisfactory- 4.Manufacturers
COMPANY I V)QW� C Q �� (see"Orders") 5. Retail Stores
6. Fuel Suppliers
ADDRESS L+I!9 C e� Lin_ - Class: 7• Miscellaneous
QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors)
MAJOR MATERIALS Case lots Drunis Above Tanks Underground Tanks
IN OUT IN IOUT IN I OUT #&gallons Age Test
Fuels:
Gasoline,Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous:
DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply -U� ► i
Town Sewer Public
0 On-site OPrivate
YI
3. Indoor Floor Drains YES NO
0 Holding tank:MDC
0 Catch basin/Dry well
O On-site system
4. Outdoor Surface drains:YES NO ORDERS: _
0 Holding tank:MDC
O Catch basin/Dry well � j�
O On-site system Ll
5.Waste Transporter
Nanie ofliatile-t- Destination Waste Product Licensed?
YES NO
1.
2.
Person(s) Interviewed Inspector Date
Date: RZ/A q
TOWN OF BARN STABLE =EINVENTORY
TOXICAND HAZARDOUS MATERIALS ON-SI
NAME C BUSINESS: Y146 Y
BUSINESS LOCATION: qi,5 cUk VENTOR
MAILING ADDRESS:
k' TO AL AMOUN
TELEPHONE NUMBER: —
CONTACT PERSON: J)ayiA M • 11 mrX
EMERGENCY CONTACT TELEPHONE NUMBER: -' MSDS ON SITE?
TYPE OF BUSINESS:
INFORMATION/RECO, ENDATIONS: ire District:
e
5( t✓
V, ' DLAVIIA i d. 6
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 -P
(including bleach)
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE
ANITFREEZE qll�
GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF
a
HYDRAULIC/ MISC. MISC. MISC. MISC. �
BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM
(GEAR QM/GREASE/
LUBRICANTS)
FREON ACETYLENE CAR WASH CAR WASH PAINTS/
:. WAX DETERGENTS THINNERS
SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT
SOLVENTS BATTERY
I
ACID
FERTALIZERS WASTE SOLVENT MSDS
MANIFESTS
�)o a4ufl fro -a act t o►ti on
JOHNSON MOTORS
I
BILL FITZGERAL'D
'YOU WONT FIND BETTER PRICES ANYWHERE'
415 BARNSTABLE RD. s
NYMNIS,MA.02601
1-50&790-9300
a
l
TOWN OF-BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory 2.Printers
BOARD OF HEALTH 3.Auto Body Shops
` ' unsatisfactory- 4.Manufacturers
COMPANY)0".yCgA / �'r�`�'�'f O (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS 1/r x0W 1,j l Class: 7.Miscellaneous.
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots Drums Above Tanks Underground
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
- Gasoline Jet Fuel (A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
new motor oil (C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous: L-3 9t
zo
DISPOSAURECLAMATION REMARKS:
1. Sanitary Sewage 2.Water Supply 3 c_6 ` `�d t M fi d—, li✓
O Town Sewer Public v ��w� L ,�.
S:Qn-site OPrivate add.
3. Indoor Floor Drains YES NO
O Holding tank-MDC VCR
O Catch basin/Dry well
O On-site system J
4. Outdoor Surface drains:YES NO ORDERS:
O Holding tank:MDC
O Catch basin/Dry well
O On-site system
5.Waste Transporter
Name of Hauler Destination Waste Product
YES NO
1.
2.
13`eA.c#is) Interviewed I Spector Dat