The URL can be used to link to this page

Home My WebLink About0112 WEST MAIN STREET - Health 112 NEST MAIN ST.,HYA nn GRENIER ST V r P i 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.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) x. ,h DATE.- I`� Fill in please: f'ku§ie'•'?Ie.fi a 5�`# ;n, ;,; ,I, ' APPLICANT'S YOUR NAME/S: (.1 Y1 e SC e oe TN F Jil'� �i U BUSINESS _ YOUR HOME ADOREyS�S: �L rVl PPP v� rf r�4i`°�� ,, nFrnA�ris l'" [ 1LJ U7 P/i !✓.�(f �j2 �J� TELEPHONE # Home Telephone Number `T-74/- 1_ 7 NAME OF CORPORATION: e TZ NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO i ADDRESS OF BUSINESS 1� n)n �Q2 �� MAP/PARCEL NUMBER v�� 1/ (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 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 ha,,b n info ed f the rmit r uirements that pertain to this type of business. Authorized ignature** MUST COMPLY WITH ALL COMMENTS: { 7AlinMIS- ATEMAj,S j EGI II ATIONS 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: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FOR NAMEOFBUSINESS: 6r-AeN1ep S ►0 BUSINESS LOCATION: //,31, WaAJ M LW St. "IJ I.`S MAILINGADDRESS: Mail To: TELEPHONE NUMBER: -77 / �O�,6 Board of Health Town of Barnstable CONTACT PERSON: M ljo__q &Pe.N i e,e, P.O. Box 534 EMERGENCY CONTACT TELEPHONE.NUMBER: -7 9,0 -qD e 3 Hyannis, MA 02601 TYPEOFBUSINESS: A J Does your firm store any of the toxic or 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 other than 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 Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers 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 Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FOR NAMEOFBUSINESS: GAe-N 1 P_yc� 0 BUSINESS LOCATION: /I,;I. ( aAj MAW St. k ►j"M l.5 MAILINGADDRESS: (S► :nQ� Mail To: TELEPHONE NUMBER:_,DA-77 /f16 M Board of Health CONTACT,PERSON: 1Pi 4P_< Town of Barnstable P.O. Box 534 . . EMERGENCY CONTACT TELEPHONE NUMBER: "7 90— ?a $ 3 Hyannis, MA 02601 TYPEOFBUSINESS: W* - A__ ,�hJ Does your firm store any of the toxic,or 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 other than 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 Fes`% Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants - Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil-,, NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes, PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW -- - USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers 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 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 0 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANYC-3w wy— S�udloO (see"Orders") 5.Retail Stores _ 6.Fuel Suppliers ADDRESS ,-) Al "0 1 Sfi• Class: 7.Miscellaneous 1� i�fS QUANTITIES AND ST RAGE (IN=indoors;OUT=outdoors) MAJOR MATERIALS - IN OUT IN OUT IN OUT #&gallons IAge 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: DISPOSALIRECLAMATION REMARKS: 1. anitary Sewage 2.)Water Supply Town Sewer MPublic 0 On-site OPrivate 3. Indoor Floor Drains YES NO Z / \ Y� 0 Holding tank:MDC 0 Catch basin/Dry well 0 On-site system Ij 4. Outdoor Surface drains:YES NOX11— ORDERS: 0 Holding tank:MDC ' O Catch basin/Dry well 0 On-site system 5. Waste Transporter es ination YES NO 2. l iC,o1,e,� 2 Person(s) Interviewed 1 -Inspector ctor Dat