HomeMy WebLinkAbout0357 MAIN STREET (HYANNIS) - HAZMAT ��—1 - 115 .�ztn'�v�--�
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YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLREGISE S.YOUR this s foNm at AME in town Main hic Hyannis.
you
must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures
Tale 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.,,.
Fill in ease: 7:
_:,� , i,•:i+'6:,r��] ' ''R: :� APPLICANT'S YOUR NAME/S: '
ME ADDRESS: 0
YO R H9
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BUSINESS N
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NAME OF CORPORATION: 1 ypE BU5INESScat
NAME OF-NEW BUSINESS O `r
IS THIS A HOME OCCUPATION?--, ES ND MAp/PARCEL NUMBER 3 a-2 DU l (Assessing)
ADDRESS OF BUSINESS. 0O
When starting.a ne usiM'is b/'e t 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 COM IS 10 R'S OFFI
This individu een nfor-n d a pe mit equiremerits that pertain to this type of business.
th rized Signature**
CO EN S:
GCfMPLY WkfiH ALL
2. BOARD OF HEALTH `
This individual has been infor he permit requirements that pertain to this type of business. HAZARDOUS'fNATERIALS REGU�.Y S�
Authorized Signa ure** SI
COMMENTS:
3. CONSUMER AFFAIRS [LICENSING AUTHORITY) that pertain to this type of business.
This Individual has been informed of the licensing requirements P er.
Authorized Signature**
COMMENTS:
.:. . . a Date,-? / 5 / ��7
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: I:L� n(60
BUSINESS LOCATION: N NTORY
MAILING ADDRESS: 0 TAIL AMOUNT:
TELEPHONE NUMBER:
CONTACT PERSON:
EMERGENCY CONTACT T L E P�H 0 N EN UM�R: MSDS ON SITE?
TYPE OF BUSINESS: t n
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 ( ease list):
_
Metal polishes b
Laundry soil & stain removers
(including bleach) ,
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applican s Si na ure Staff's Initials
-^ ,04/12/2006 10:23 5087786448 HYANNIS FIRE PAGE 02
HYANNIS :FIRE APPLICATION..FOR%:PRRMIT %?;,i
ALTER
D15TRICT -TO INSTALL—• `FUEL 'OIL'BURNING'EQUIPMENT`;;`'
To the Head of the Fire Debartment:
Application is hereby made Yn accordance'with".;the,provisions of:Chap:''148;'
and Regulations made under•auLhority thereof'by,the undersignea,:for pe'rmit to'4nstall•a
alter, for the person or Dersons and at the location'nam@d herein, certain egiiiy'ai'eiii,Ur•;;;;: .'
the keeling, storage or use of fuel or other.infiammab7e;^liquid Droducts, ueid for:'duel
as described 'bAow. - �.� ' , ?•I::
I. SAME)
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Location '����^:._.r:._...._.,._......_•_.:r..._. ..M
Seora a Tank: Ty(9Z
'�e'�'�. C a it' ...;'� _ :gals.''(or) Sized1.
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mount of fuel.'rlion
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A This aDplic'atirni.1 de' with full knowledge�oP the.'` r�quirenients'o .p e ;`.>':
" regulations governing such1y=A.:b a Sri"eonipliance'-tlterewitfi" r';• ?, `f`
Note: If this application involves'alteratloiae to `ezi�tiRg:;eQui......
dekcri'be full ;on reVe#se
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A4/12/2006 10:23 5087786448 HYANNIS FIRE PAGE 03
CERTIFICATION O COMPLETION
Aat ?____
To: Head of Fire Department
Subject: Certificate of completion—Installation r Alteration of Fue 1 Burning
. Equipment
The undersigned hereby certifies that the installation (or alteration) of fuel oil
burning equiDi�uent made under authority of permit No. date _
issued yqu and DIying t e installation fore•—••
at •_� _ ..i has been made in accord ce with
provisions of Chapter 148, '. ., and regulations made under authority th reof now
currently in effect and pertaining thereto.
Furthermore, this installation has been testcd in accordance with such
require-ments, is now in proper operating condition and complete instructions as to its use and
maintenance have been furnished to the person (or persona) for whom the installation
Was made.
The fallowing data applying to such installation is submitted for record:
BURNER
�C�®Name fg. by
ef�a.�=�
Type Mo de or Size _...To use not or than — fuel oil
STORAGE TANK
Type ..� _. _.......�..._ `p ityCO gals. ( ) Size
Lotion _ —��...� _ ....�._...__.....:...�... __.._�........._........ __ _.._..... __.__o
CONT
Ty (automatic or manual)
Aut atic shut-off valves at burner ank Install w
Manua t-off valve at tank._...
(additional atic. BY