HomeMy WebLinkAbout0832 BEARSE'S WAY - HAZMAT LAJ6L
Number Fee
1212 THE COMMONWEALTH OF MASSACHUSETTS $50.00
Town of Barnstable
Board of Health
This is to Certify that Big Bad One Inc. DBA Ziggys Auto Specialties
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832 Bearses Way, Hyannis, MA
Is Hereby Granted a License
For: Storing or Handling 26 - 110 gallons of Hazardous Materials.
Restrictions:
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This license is granted in conformity with the Statutes and ordinances relating there to,
and expires 06/30/2021 unless sooner suspended or revoked.
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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
1
Town of Barnstable
Inspectional Services BARNSTABL;E
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Public Health Division fi�D�<
BAMsTner.E. = Thomas McKean, Director
rs
et 6 200 Main Street, Hyannis,MA 02601
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Office: 508-862-4644 Fax: 508-790'6304
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE
HAZARDOUS MATERIALS
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-JUNE 30th).
APPLICATION FEES ,�/
CATEGORY 1 PERMIT 26- 110 Gallons: $ 50.00 lJ v
_ CATEGORY 2 PERMIT 111 -499 Gallons: $125.00 Elt. CATEGORY 3 PERMIT 500 or more Gallons: $150.00 ❑
*A late chWrize of$10 00 will be assessed if payment is not received by July 1st.
1. ASSESSOR'S MAP AND PARCEL NO. 2gq/(51
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:. i n
5. NAME OF ESTABLISHMENT: ► "J tg U
6. ADDRESS OF ESTABLISHMENT: AQQ-re Q.S W(W
7. MAILING ADDRESS(IF DIFFERENT FROM ABOVE:
* 8. TELEPHONE NUMBER OF ESTABLISHMENT: O(%S� -7 2 3 I--7 I
9. EMAIL ADDRESS: Z)CQV 5 0 11i—n J
10. SOLEOWNER: J YES NO IF NO,NAME OF PARTNER:
11. FULL NAME,HOME AD RESS, TELEPHONE#OF: --
CORPORATION NAME
PRESIDENT
TREASURER -
CLERK -
12. IF PREPARED BY OUTSIDE PARTY:
NAME: TELEPHONE#:
COMPANY ADDRESS EMAIL:
SIGNATURE OF APPL E CT���
Q\Application Forms\Haz Mat Appli Draft Jan20l9.docx