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HomeMy WebLinkAbout0689 YARMOUTH ROAD - Health 689 Yarmouth Road Hyannis A= 345-005 0 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 the Town (WHICH YOU MUST DO according to 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, 1st Fl., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required,by law. DATE O Fill in please: APPLICANT'S YOUR NAME/CORPORATE NAME �� A�a1w, ccn� u�g NESS TYPE: C �QSS vSf:9 CI �S . BUSINESS YOUR HOME ADDRESS: a z5a b TELEPHONE # Home Telephone Number f—5r9 $ / NAME OF;NEW BUSINESS'` 3,t nS�(o�a (M ''7 1 � S6L g Have you,;been•grven approval fr m;the b lldm di:ylsion. .Y.E5 NO . . ob.6 0�' MAP/PARCEL NUMBER iI S�-C3 a ADDRESS OF BUSINESS q`:` cu w�tiZ -T- r. ', 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 bee ' form d of the permit requirements that pertain to this type of business. MUST-COMPLYWITH ALL -_HAZARDOUS MATERIALS REGULATIONS. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS LICE �WUTHOR'TY) This individual h n r the licensing requirements that pertain to this type of business. u horize a e I COMMENTS: Date: rZIA / I TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: �J cS 6�- BUSINESS LOCATION: aq, YL r 6a6IINVENTORY MAILING ADDRESS: J V-A TOTAL AMOUNT: TELEPHONE NUMBER: 1- 5©5-- 77' CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: !- 0'3-- -I 7�_ IISDS ON SITE? TYPE OF BUSINESS: CC&-t, -,!) --ZT— 1)3eAA-) V&.6 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 Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) -- i Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS A p a t' Signature Staff's Initials