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HomeMy WebLinkAbout0973 IYANNOUGH ROAD/RTE132 - HAZMAT i t_t r Number Fee 203 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 973 Iyanough Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. - - ---------------- --------------------- --------------------------------------------- -------------- --------------------- -------------------------- This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2008 unless sooner suspended or revoked. WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN, M.S.P.H. 7/20/2007 PAUL J. CANNIFF,D.M.D. THOMAS A. MCKEAN, R.S.,CHO Director of Public Health Town of Barnstable Regulatory Services Thomas F. Geiler,Director snxNSUBLE, . . Public Health Division x63q, �0� %639 Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 L Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. 9At4-c)>t-oD11- DATE � 4, /c, 7 g-5K_aX _0o 13 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT NAME OF ESTABLISHMENT ADDRESS OF ESTABLISHMENT T kJAk,-)VC)061q TELEPHONE NUMBER SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: c-+ as " .a'. IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND(HOME ADDRESS OF: _ PRESIDENT jp�t e_r I(�V'r1 ,f _ Stia (�l/ �i' q ITV W'AS"v /< ( � . 9 J-a G z_ C( CfREAStMER SDo Wei r, e �. W sokv, Yr, CR- 9Ja4 Z CLERK ! SIGNATURE OF APPLICANT RESTRICTIONS: HOME ADDRESS HOME TELEPHONE i# d1� _ Number Fee 203 THE COMMONWEALTH OF MASSACHUSETTS $100.00 Town of Barnstable Board of Health This is to Certify that West Marine Products 973 Iyanough Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. -------------------- ------------------------------------------------------------------------ ------ ------------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2008 unless sooner suspended or revoked. --------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. 7/1/2007 PAULJ. CANNIFF,D.M.D. THOMAS A.MCKEAN,R.S.,CHO Director of Public Health ' Town of Barnstable , r, Regulatory Services °,. Thomas F.Geiler,Director i ���MASS. . ' Public Health Division A,O� �6CMA� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 o ASSESSORS MAP AND PARCEL NO. .2- q -00C-Pao_y)ATE � 7- JU!�I ? 0 2007 c�' APPLICATION FOR PERMIT TO STORE AND/OR UTILIZ)" O_ THAN 111 GALLONS OF HAZARDOUS MATERIALS w m FULL NAME OF APPLICANT W -s NO r r v-<- Fr')cL� t T('oLc - NAME OF ESTABLISHMENT iti tfof rr'V-,C ADDRESS OF ESTABLISHMENT !((o P-0 Ltl e 13 a- �NX4 4 k(4 1-4 , HIT TELEPHONE NUMBER 2 10 SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. -a3 7- STATE OF INCORPORATION 0-04 f2 r r FULL NAME AND HOME ADDRESS OF: PRESIDENT PL4v- 14-&v rr'J —BEd �r��r'cl��c�� - svo vj.,s4v c Dr. V)%1�6k c \/a ��tnc� - cl4 o V P F-rkt.4,,L'. — ru I,uR.r{�t� pr riot-.Stc,- SIGNATURE OF APPLICANY RESTRICTIONS: HOME ADDRESS HOME TELEPHONE# Ya5'7 L Number Fee 203 THE COMMONWEALTH OF MASSACHUSETTS $1oo.00 Town of Barnstable Board of Health This is to Certify that - West Marine Products 973 Iyanough Rd., MA 02601 Is Hereby Granted a License FOR: STORING OR HANDLING 111 GALLONS OR MORE OF HAZARDOUS MATERIALS. --------------------------------------------------------------------------------------=------------------------------------------------------------------------- --------------------------------------------------------------------------------------------=------------------------------------------------------------------ This license is granted in conformity with the Statutes and ordinances relating there to, and and expires June 30, 2007 unless sooner suspended.or revoked. ---------------------------------------- WAYNE MILLER,M.D.,CHAIRMAN SUMNER KAUFMAN,M.S.P.H. July 11, 2006 PAUL J. CANNIFF,D.M.D. -•-THOMAS-A.-MCKEAN,R.S.,CHO Director of Public Health IF Town Of Barnstable �4 +E Regulatory Services R P;a.. ° Thomas F. Geiler, Director �QE� . a Public Health ]Division ON231D46 dD Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax:.508-790-6304 . Application Fee: $100.00 Xa> ,02-(v-0OA I ASSESSORS MAP AND PARCEL NO. 2�1�-.©2�'DD DATE 127 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN _111 GALLONS OF HAZARDOUS MATERIALS FULL NAME Lhi OF APPLICANT Pan Re FyLt S 1 no, ' } NAME OF ESTABLISHMUNT y cof J°`Akrk n'(�) ADDRESS OF ESTABLISHMENT �� J- �1 Q d�(n��j � rQ`-&q T r TELEPHONE NUMBER (56) -SOLE OWNER: YES Y NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. STATE OF INCORPORATION FULL NAME AND HOME ADDRESS OF: PRESIDENT 44twi (�I�re:�> 5roo �1(�5tnc�� 1(� on\1��1eta ��`1b- 1 71 TREASURER. CLERK Vs . " SIGNATURE OF APPLICANT. , /��1-1 RESTRICTIONS: HOME ADDRESS Sao V yQ A-Y-1A 6Dv Wat-Son\de,CA HOME TELEPHONE # qij 0Ib 4 171 Haz.doc'wplr, MAIL-IN REQUESTS Please .mail the completed application form to the address below. Also include copies of your employees food sanitation training certificates. in addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Allow five to seven (7).working days for in-house processing. Our mailing address is: Town of Barnstable Public Health Division 200-Main Street Hyannis, MA 02601 FOR FAXED REQLTESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please.fax copies of your employees food sanitation training certificates. In addition, you must mail the required fee amount (see fees at bottom of this page). Please make the check payable to:.Town of Barnstable. The check must be mailed to the address listed above. Allow up to four days for in- house processing. For further assistance on any item above, call (508) 862-4644 Back to Main Public Health Division Page