HomeMy WebLinkAbout0038 WAREHOUSE ROAD - HAZMAT 3 k)Qre nu se. R6 �293103o
Number Fee
702 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00
Town of Barnstable
Board of Health
This is to Certify that Morrison Motor Works
32 Warehouse Road (or 38), Hyannis,MA 02601
Is Hereby Granted a License
FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS.
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This license is granted in conformity with the Statutes and ordinances relating there to, and
and expires 6/30/2010 unless sooner suspended or revoked.
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WAYNE MILLER,M.D.,CHAIRMAN
PAUL J. CANNIFF, D.M.D.
6/30/2009 JUNICHI SAWAYANAGI
THOMAS A.MCKEAN,R.S.,CHO
Director of Public Health
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� Town ®f Barnstable
Barnstable
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R.egulatory Services Department
T
• AB Public Health DivisionBARNST '
9A 200 Main Street,Hyannis MA 02601
TFD lw1A`{A
2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. DATE
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE
MORE THAN III GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT
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NAME OF ESTABLISHMENT
• ADDRESS OF ESTABLISHMENT S
TELEPHONE NUMBER
SOLE OWNER: KYES NO
IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS F AL Ir,' -
PARTNERS: .r
E+J
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. z
STATE OF INCORPORATION /OW
FULL NAME AND HOME ADDRESS OF:
PRESIDENT
TREASURER
CLERK
6:
• SIGN O � „PPI,ICAt .
RESTRICTIONS: HOME ADDRES
HOME TELEPHONE#
QAHazmatlHaz Mat Application2008.DOC
Town of Barnstable
of1HEr Regulatory Services
ti
• �``P ° Thomas F. Geiler, Director
BARNSTABLE, "
MASS. a Public Health Division
9�0 039. `gym
ArEDMA�A Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Application Fee: $100.00
ASSESSORS MAP AND PARCEL NO. DATE
APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN
I I I GALLONS OF HAZARDOUS MATERIALS
FULL NAME OF APPLICANT d n py
NAME OF ESTABLISHMENT /jirdit�- t'1 / /TTXLS
• ADDRESS OF ESTABLISHMENT
TELEPHONE NUMBER
SOLE OWNER:
,A_YES NO
IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL
PARTNERS:
IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Q—yY?9735 j
STATE OF INCORPORATION
FULL NAME AND HO E ADDRES OF:
PRESIDENT
TREASURER
CLERK
• GNATUR OF APPLICANT
RESTRICTIONS: HOME ADDRESS
HOME TELEPHONE # ;Z
Haz.doc;\P!y