HomeMy WebLinkAbout0024 CLIFTON ROAD - HAZMAT 30
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YOU WISH TO OPEN A BUSINESS? a46-yt-
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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, 1s' FL., 367 Main Street, Hyannis, MA 02601 (To n all) and 200 Main Street Offices at the Licensing counter.
DATE:S/19106
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Rr Fill in please:
APPLICANT'S YOUR NAME: i I l
' BUSINES YOUR HOME ADDRESS: Crr cuj
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TELEPHONE # Home Telephone Number: CV_R- - ` Q r 1 G
NAME OF NEW BUSINES TYPE OF BUSINESS_ J cu�:y
IS THIS A HOME OCCUPATION YE �C N
Have you been given approval from the building div,son? YES NO
ADDRESS OFi BUSINESS MAP/PARCEL NUMBER;
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 Ven informe5#the p it requirements that pertain to this type of business.
utho ized Sign re*"
COMMENTS: /r
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:
TOWN OF_BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS. f �" A�� rl S4
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BUSINESS LOCATION: O 1 5 0 - 04MS INVENTORY
MAILING ADDRESS. i ann;s A O 601 TOTAL AMOUNT:ta"`ti
TELEPHONE NUMBER: 4 tq- 92,61 vhow-
CONTACT PERSON: a j ' Q.✓�1 4 r 1%v41e�)i
'qlEMERGENCY CONTAC TELE HONE NUMBER: '' $3 �o �'d� MSDS ON SITE
TYPE OF BUSINESS: ri `,n
INFORMATION/RE OMMEND IONS: Fire District:
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MIL S
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
VNEW 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)
�bOx 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
dints, varnishes, stains, dyes Other chlorinated hydrocarbons,
3 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 LZ Qqg�wr (;�,rr,&Wo pv�
(including bleach)
Spot removers &cleaning fluids ✓ vo / Q'l� -K,y7
(dry cleaners) ✓ 5If
Other cleaning solvents AtIVO `- I- 3
Bug and tar removers
Windshield wash Q� `
WHITE COPY-HEALTH DEPARTMENT/CANARY Y-BUSINESS