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HomeMy WebLinkAbout2861 FALMOUTH ROAD/RTE 28 - Health (2) 2861 FALMOUTH RD., OSTERVILLE A= /S^'DU XFOR-GOT-ME-NOT • 0 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 the -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, 151 FI.; 367 Main St., Hyannis,.MA 02601(Town Hall) and get �. the Business Certificate that is required by law. n =a DATE : E er Fill in please -L S APPLICANT'S YOUR.'NAME: if t 3t BUSINESS= YOUR HOME-ADDRESS: y �e zcU TELEPHONE # Home Telephone Number: 5--0 - NAME OF,N'EW BUSINESS .�?l T 77,e -j— y a. ���• T�r,� �/�' TYPE OF BUSINESS IS THIS AHOME-.00CUPATION? YES NO_Have you been given approval from the building division? YES: NO.. ADDRESS OF.-BUSINESS /.,-�o . 72 y MAP/PARCEL NUMBER`j Zi oi:.j Ale— 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. . T 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. r , BUILDING CO ISSIO ER'S O IC d' This indiwid al h n,+nf rrr of ny ermit requirement 'that pertain to`this type of.business. _ Au horized-Signa e** MENTS: OF iflA 2. B AR OF HEALTH This individual h s been inf r�ned of "erper it requir ments that pertain to this type of business. / o Authorize ignature**COMMENTS: MUST COMPLY WITHALL 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. i Authorized Signature** COMMENTS: Hazardous Materials Inventory Sheet Checklist �/ G�.ate v Physical Street Address-Check database to ensure it exists orking Phone Number . Actual Amounts -( ie.'gas being used to fuel machines,thinner to clean brushes all count as hazardous materials-no blanks) C�Storage Information -location of storage, how long is storage for? ' If none, note that. If Information -where and who? If none, note that. �/ pplicant 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 "The 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. Date: s / V / o TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF B_ USINESS: �rwr✓l.o sa T 7- r;P� s�s �*+l BUSINESS LOCATION: Z8'GL �:��.�a�T/, �i„_,e/Z,r /Ozl Ar INVENTORY MAI LING ADDRESS: 5's �e��A<. � L�.C-✓ ��Zes ,,.,Ile ©2,6.3- TOTAL AMOUNT: TELEPHONE NUMBE04�8"S s'z6-. ZyV CONTACT PERSON: /''��►���� EMERGENCY CONTACT TELEPHONE NUMBER: %L98 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 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 Z God Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) �t 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 MAny 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 (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers —G' Windshield wash WHITE COPY-HEALTH DEPARTMENT!CANARY COPY-BUSINESS Number Fee THECOMMONWEALTH OF MASSACHUSETTS 1-1-05 - - - - -THE- $125.00 - - Town of Barnstable Board of Health This is to Certify that Paramount Landscaping 2861 FALMOUTH ROAD, OSTERVILLE, MA ..........................................................................:------...------............------................--....--------....------......--------...... Is Hereby Granted a License For: Storing or Handling 111 - 499 gallons of Hazardous Materials.. Restrictions: ................................................. .................................................................................................................. This license is granted in conformity with the Statutes and ordinances relating there to, and expires 06/30/2021 unless sooner suspended or revoked. ---------------------------------------- JOHN NORMAN DONALD A.GUADAGNOLI,M.D. 07/01/2020 PAUL J.CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO . Director of Public Health � . Town of Barnstable Inspectional Services BARNSTABLE OFt�� tuaxsraatE•ccarEitntaE.cerurt•rrnuas PL:YSTNIc M'L3.0�[M1'llt=.'d".St B}tltl$@B!E Public Health Divisions 639_2014 r 1 BAJWsrasL : Thomas McKean, Director � , R 1 3ys� 200 Main Street, Hyannis,MA 02601 Office: 508--862-4644 Fax: 508-790a6304 err. APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE '{a HAZARDOUS MATERIALS L0 IN ACCORDANCE WITH THE TOWN OF BARNSTABLE GENERAL ORDINANCE,CHAPTER 108, HAZARDOUS MATERIALS,ALL BUSINESSES THAT HANDLE OR STORE HAZARDOUS MATERIALS GREATER THAN HOUSEHOLD QUANTITIES ARE REQUIRED TO OBTAIN AN ANNUAL PERMIT(RUNS JULY 1 st—DUNE 3Oth). APPLICATION FEES CATEGORY 1 PERMIT 26— 110 Gallons: $ 50.00 ❑ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑ 010 *A late charge of$10.00 will be assessed if pay jm �ent is not received by July 1st. 1. ASSESSOR'S MAP AND PARCEL NO. 1�I b ay V L `'� O 2. IS THIS A PERMIT RENEWAL? " YES_NO. IF YES,SKIP QUESTION 3. 3. FOR ALL NEW PERMIT APPLICATIONS,INDICATE WHETHER BUSINESS HAS ZONING/BUILDING APPROVAL FOR HAZARDOUS MATERIALS STORAGE/USE OF • GREATER THAN HOUSEHOLD QUANTITIES (25 GALLONS)? YES NO. 4. FULL NAME OF APPLICANT:. 01 vtf 5. NAME OF ESTABLISHMENT: . ESTABLISHMENT: 6. ADDRESS OF 7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE: 8. TELEPHONE NUMBER OF ESTABLISHMENT: SD& 9. EMAIL ADDRESS: a -al l 10. SOLEOWNER: •`YES NO IF NO,NAME OF PARTNER: 11. FULL NAME,HOME AD SS,AND TELEPJJONE#OF: CORPORATION NAME PRESIDENT TREASURER Yh CLERK 12. IF PREPARED BY OUTSIDE PARTY: NAME: TELEPHONE#: • COMPANY ADDRESS EMAIL: I i SIGNATURE OF APPLICA DATE lY 0 �Application Forms\Haz Mat Appli aft Q: Jan201 d cx TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations, ep BOARD OF HEALTH satisfactory 2.Printers 3.Auto Body Shops �� -O unsatisfactory- 4.Manufacturers J COMPANY (see"Orders") 5.Retail Storesy/ ,o n 6.Fuel Suppliers ADDRESS I3 f, �' �K Class; 7.Miscellaneous 0,5�AW, 4 QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS ,• , IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Heavy Oils: 7 waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Orgdnics: degreasers r Miscellaneous: - i � VIZ DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply �4 :.� t1 O Town Sewer Public ,G `I- OOn-site OPrivate 3. Indoor Floor Drains YES NO 0 Holding tank:MDC ��` `� W 0 Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES NO ORDERS: 0 Holding tank:MDC 6a 1. "� �� �1.19 0 Catch basin/Dry well 0 On-site system 5.Waste Transporter Name of Hauler D Sti e nation � YES NO 2. Person(s) In ewed Inspector Date