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HomeMy WebLinkAbout0455 YARMOUTH ROAD - HAZMAT 45!D `ppIKE ip Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 9 BARNA�BLE.D` 200 Main Street• Hyannis, MA 02601 OMP+"`00 TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: A C 1�1L�` C�v� ovt5 Date: y Location/Mailing Addres : 4 a+n+� 5 Contact Name/Phone: -7-1`1-4 70- CAA, Cbv"'^'� ow n 1 n InventoryTotal Amount: 2 w'It SDS: 4o J)4Zoy, &w11vu,access License#: J v f Tier II : ,o Labelina: s0k A-A1 1�� Spill Plan: Oil/WaterSeparator: Floor Drains: v Emergency Numbers: Storage Areas/Tanks: v o nfj Aeg4pe Emergency/Containmentt: Waste Generator ID: 4. Waste Product: Date&Amount of Last Shipment/Frequeoo: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains,dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: Oq INFORMATION/RECOM MENDATI NS:� IA0 o JJ-A+e> O 2 V� yl —- Inspect Facility RepresentatiJe�l( ti WHITE COPY-HEALTH DEPARTMENT/CANARY COPY- BUSINESS �j IB*ok� Town of Barnstable Office:508-862-4644 Public Health Division Fax:508-790-6304 B,RMA.R • 200 Main Street• Hyannis, MA 02601 �pfEt639.A,O� TOXIC AND HAZARDOUS MATERIALS INSPECTION REPORT Business Name: C Date: y ZJ 6 Location/Mailing Address• qS5- aOV71 S Contact Name/Phone: a ,i re- -7 l - `71 -7 Inventory Total Amount: MSDS: N1, License#: Tier II : Labelina: OK Saill Plan: Oil/Water Separator. Floor Drains: Emergency Numbers: JtI l Storage Areas/Tanks: kv1A-W\AAG O� /1--AAk nj 504? 0\\y Emergency/Containment E ui ment: Waste Generator ID: Waste Product: Date&Amount of Last Shipment/Frequency: Licensed Waste Hauler&Destination: Other Waste Disposal Methods: LIST OF TOXIC AND HAZARDOUS MATERIALS 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 requires a license from the Public Health Division. Antifreeze Dry cleaning fluids Automatic transmission fluid Other cleaning solvents&spot removers Engine and radiator flushes Bug and tar removers Hydraulic fluid (including brake fluid) Windshield wash Motor oils Miscellaneous Corrosives Gasoline,jet fuel, aviation gas Cesspool cleaners Diesel fuel, kerosene, #2 heating oil Disinfectants Miscellaneous petroleum products: Road salts grease, lubricants, gear oil Refrigerants Degreasers for engines&garages Pesticides: Caulk/Grout insecticides, herbicides, rodenticides Battery acid (electrolyte)/batteries Photochemicals(Fixers) Rustproofers Photochemicals(Developer) Car wash detergents Printing ink Car waxes and polishes Wood preservatives(creosote) Asphalt&roofing tar Swimming pool chlorine Paints, varnishes, stains, dyes Lye or caustic soda Lacquer thinners Miscellaneous Combustible Paint&varnish removers, deglossers Leather dyes Miscellaneous Flammables Fertilizers Floor&furniture strippers PCB's Metal polishes Other chlorinated hydrocarbons Laundry soil &stain removers (including carbon tetrachloride) (including bleach) Any other products with "poison labels" (including chloroform, formaldehyde, hydrochloric acid, other acids) VIOLATIONS: ORDERS: 0 . 01 C, w CA INFORMATION/REC MMENDATIONS: D l Inspector: \ Facility Representative: WHITE COPY- HEALTH DEPARTMENT/CANARY COPY-BUSINESS YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 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.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. A% DATE: y r�// i /r Fill in please: APPLICANT'S YOUR NAME/S: hl l� �✓ BUSINESS YOUR HOME ADDRESS: 42 a TELEPHONE # Home Telephone Number NAME OF CORPORATION. 1.: NAME OF NEW BUSINESS L C J : TYPE OF BUSINESS u E IS THIS A HOME.OCCUPATION? YES NO ADDRESS OF BUSINESS ,rt.�of MAP/PARCEL NUMBER OTC When starting a new business there are s eral 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 SID ER'S OF ICE This individuha a ntfor d f a r it regiremen�s that pertain to this type of business. Aut orize&Signa ure* COMMENTS 2. BOARD OF HEALTH This individual has een in or ed of the permit requirements that pertain to this type of business. MUST COMPLY WITH ALL r at MATERIALS REGULATIONS Authorized Signature** MAIAR S� _ COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: f TOWN OF BARNSTABLE Date:3 / TOXIC AND HAZARDOUS MATERIALS NAME OF BUSINESS: -LVC © BUSINESS LOCATION: ��,! r y c�,i�v, -L, /� LK ,,(4�;T INVENTORY MAILING ADDRESS: , ,4,M TOTAL AMOUNT- TELEPHONE NUMBER: CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: Y :2 7/Z MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: jA 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 Obsery d / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid fR infectants Engine and radiator flushes ad salts (Halite) Hydraulic fluid (including brake fluid) frigerants Motor Oils sticides ❑ NEW ❑ USED secticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gasotochemicals (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 CB'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 (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) i Other cleaning solvents Bug and tar removers Windshield wash WHIT COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applica is Signature Staff's Initials Date: ' TOWN OF BARNSTABLE .< TOXIC AND HAZARDOUS MATERIALS RE 3fSTMRON FORM NAME OF BUSINESS: MOOktt'0/5 A.4-0 �jg Lis BUSINESS LOCATION: '{SS ptvvnl s INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: 95-17 67 -3 7,11 I 1 l CONTACT PERSON: r-ab e-v�, EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: AQko .5C.A--5 04 N INFORMATION / RECOMMENDATIONS: Fire District: u aK 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 M`,Ao( rh%5(, IUD, F jqV), qqar b — gal Pa" The Board of Health and the Public Health Division have determined that the fdilovong roduc7texhibit 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 (please list): Metal polishes 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 Applicant's Signature Staff's Initial n 9 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 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.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: Fill in please: Ril } �-/ t APPLICANT'S YOUR NAME/S: O ' BUSI ESS YOUR HOME ADDRESS: drlti Ali r ._ x' m� �/70- 1�L�L� l'C e 0 MA TELEPHONE # Home Telephone Number pal MOM NAME,OF CORPORATION: In ✓i S r C. NAME OF NEW BUSINESS TYPE OF BUSINESS AMID bdAleA SS. I&THIS A HOME OCCUPATION? YES. NO ADDRESS OF BUSINESS ��`"�fi I�II�P/PARCEL NUMBER -� (Assessing) 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 OFFICE This individual has been i' or f any pe quirements that pertain to this type of business. �1 Autho ized n ur ** r /} COM ENTS: //rC • 2. BOARD OF HEALTH This individual has be o the per equire is that pertain to this type of business. Authorized Signature** MUST WITH ALL COMMENTS: t ERIALS RI`GULABONS. AZAi D(�IIIP 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type-of business. Authorized Signature* COMMENTS: TOWN OF BARNSTABLE Date: ? /,2-7/ TOXIC AND HAZA OUS MATERIALS REGISTRATION FORM • L � NAME OF BUSINESS. I C S 6470e. Cod C� BUSINESS LOCATION: S1414QMO t 44 iirj0{�5 &V 076W INVENTORY MAILING ADDRESS: o &M►Al 94 fluftee4WA, TOTAL AMOUNT: TELEPHONE NUMBEtl `774— 70— el r CONTACT PERSON: C-h Goo,Nqja EMERGENCY CONTACT TELEPHONE NUMBE o4f MSDS ON SITE? TYPE OF BUSINESS: --L 0 C-� (22tftr INFORMATION / RECOMMENDATIONS: Fire District: =d:3t _ 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,,deg lossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers l GW Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature V staffs Initials f J i Type of License: Auto Dealers - Class I V check with Zoning to see if Site Plan Review Class II needed Yes No Filing Fee to the Town: $ 100.00 Hearing Required: Yes X No Fees: State $ Advertise 10 days before: Yes X No Town$ 150.00 Notify Abutters: Yes No X State Forms Town of Barnstable Forms Form 53 TOB Auto Dealer Form Workers Compensation Form*. Business Certificate v, Plan- showing building &display area } Lease Agreement or P&S Contract with manufacturer of new vehicles Resume of Manager Articles of Organization/LLC papers Site Plan Review Sign-Off- required There are NO transfers of auto dealer licen es. If there is a different owner it is handled as a new application. If a license already exists at the location, a letter is required from the existing owner relinquishing his/her license. If the entity was not licensed the prior year, on of the Form 53's needs to be taken to the RMV. Amended 5111 Notes: Issued by: Licensing Authority Q/Consumer/wpfiles/licensing/forms/P34form lid g;g g 130 P. 34 License Period: New Application � �. Tow I] stab le ?y 0 Renewal Date: AUTO DES`, ' PLICATION , ' ❑ Transfer �. i.Ssa, �' ❑Amend NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON T PREMIS t� Name of appl' ant/corporation: D/B/A Name C{) utl;N ,� S L° 1C►C� 440 j(C fj/%/c- Address of applicant/corporation: /YI dJ �N S, IY4 Q 6 Home phone#: , ,,� Business phone#: ; -- q70 Ll Business location: [�j� 41aa vq1 CL 0, AOJI A-. 0 Z&0/ Business mailing address if different from above:1 Q,5 ' i Ah Q. W%kTe t4, 0,7 6 LICENSE TYPE: Class I (New and used vehicles ) Class II (Used Vehicles HOURS OF OPERATION:I 9;;30 /{ -F" e'.�v..s-Sq FID #: last digits UN Name of Manager/Owner: tc I— It�v,N , email: i ��,,V , ��/� G, Manager/Owner's home address: 4A 4 P P oA 62-64 home phone Name of property owner: -,5-w&5 o Idsm ASSESSOR'S MAP/PARCEL#: MAP I LI PARCEL Do you have a sign (free standing/window) listing your business name and hours of operation? Yes No ❑ Do you have a repair facility associated with your business? Yes No If yes, name & address of facility: &-At 14, *4U15. Do you have an approved parking plan available for inspection? YesE No ❑ Do you use a compu nerated version of Used ehicle Inventory Book? Yes zNo Signature of applic nt Date: For Town use only Health Department #Display/Unregistered Vehicles HazMat Approval 130 #Customer Vehicles # Employee Vehicles Inspector Signature Date Total#of Vehicles on Site Approved Site Plan Attached YES F-1NO❑ Building Department Site Plan Not NeededE] Approved E] YES ONO Building Signature DateC� R.E.Tax Paid = YES E]NO C Tocuments and Settings\hartsgre\Local Settings\Temp\8fa93a5dfc5c4b8583a8168981fefb47.Town Auto Dealer Form_BFECC34.doc eti THE COMMONWEALTH OF MASSACHUSETTS Town Barnstable ---------------=-------OF--------------------- APPLICATION FOR A LICENSE TO BUY,SELL,EXCHANGE OR ASSEMBLE SECOND HAND MOTOR VEHILES OR PARTS THEREOF I,the undersigned,duly authorized by the concern herein mentioned,hereby apply for a class license,to Buy,Sell, Exchange or Assemble second hand motor vehicles or parts thereof,in accordance with the provisions of Chapter 140 of the General Laws. 1.What is the name of the concern? ' vi N /,S U& Q44 Business address of conern.No. S� Vrn O 0 St., I in 34 City—Town. 2.Is the above concern an individual,co-partnership,an association or a corporation? tJ ....................................................................................................................................... 3.If an individual state fu name a d residential ad ess. E!'Ch Arc] k,(dth' , fk,\J c2s ge;w ............................................................................................................4.If a co-partnership,state full names and residential addresses of the persons composing it. ......C........r�....j........ '—. ...... .......�z�............................... ...... .........� ..�.........� ............... . ..� ...... ................................ 5'........................ ................................................................................................................................................................. ................................................................................................................................................................. 5.If an association or a corporation,state full names and residential addresses of the principal officers. Presiders Secretary Treasurer 6.Are you engaged principally in the business of buying,selling or exchanging motor vehicles? If so,is your principal business the sale of new motor vehicles? Is your principal business the buying and selling of second hand motor vehicles Is your principal business that of a motor vehicle junk dealer APPLICANT WILL NOT FILL THE FOLLOWING BLANKS Application after investigation.................................................. (Approved or Disapproved) LicenseNo. ....................granted.....................................20.......... Fee$............................................................... Signed........................................................................................ ......................................................................I................. ......................................................................................... ....................................................................................... .........................................................:.............................. ........................................................................................ r; CHAPTER 140 OF THE GENERAL LAWS; TER. ED., WITH AMENDMENTS THERETO (EXTRACT) Section 57. No person, except one whose principal business is the manufacture and sale of new motor vehicles but who incidentally acquires and sells second hand vehicles,or a person whose principal business is financing the purchase of or insuring motor vehicles but who incidentally acquires and sells second hand vehicles, shall engage in the business of buying, selling, exchanging or assembling second hand motor vehicles or parts thereof without securing a license as providing in section fifty-nine.This section shall apply to any person engaged in the business of conducting auctions for the sale of motor vehicles, Section 58. Licenses granted under the following sections shall be classified as follows: Class 1.Any person who is a recognized agent of a motor vehicle manufacturer or a seller of motor vehicles made by such manufacturer whose authority to sell the same is created by a written contract with such manufacturer or with some person authorized in writing by such manufacturer to enter into such contract,and whose principal business is the sale of new motor vehicles,the purchase and sale of second hand motor vehicles being incidental or secondary thereto,may be granted an agent's or a seller's license;provided,that with respect to second hand motor vehicles purchased for the purpose of sale or exchange and not taken in trade for new motor vehicles,such dealer shall be subject to all provisions of this chapter and of rules and regulations made in accordance therewith applicable to holders of licenses of Class 2 Class 2.A person whose principal business is the buying or selling of second hand motor vehicles may be granted a used dealer's license. Class 3.A person whose principal business is the buying of second hand motor vehicles for the purpose of remodeling,taking apart or rebuilding and selling the same,or the buying or selling of parts of second hand motor vehicles or tires,or the assembling of second hand motor vehicle parts may be granted a motor vehicle junk license. Section 59. The police commissioner in Boston and the licensing authorities in other cities and towns may grant licenses under this section which shall expire on January first following the date of issue unless sooner revoked.The fees for the licenses shall be fixed by the licensing board or officer,but in no event shall any such fee be greater than$200.Application for license shall be made in such form as shall be approved by the registrar of motor vehicles,in sections fifty-nine to sixty-six,inclusive,called the registrar,and if the applicant has not held a license in the year prior to such application,such application shall be made in duplicate,which duplicate shall be filed with the registrar.No such license shall be granted unless the licensing board or officer is satisfied from an investigation of the facts stated in the application and any other information which they may require of the applicant,that he is a proper person to engage in the business specified in section fifty-eight in the classifications for which he has applied,that said business is or will be his principal business,and that he has available a place of business suitable for the purpose.The license shall specify all the premises to be occupied by the licensee for the purpose of carrying on the licensed business.Permits for a change of situation of the licensed premises or for additions thereto may be granted at any time by the licensing board or officer in writing,a copy of which shall be attached to the license.Cities and towns by ordinance or by-law may regulate the situation of the premises of licensees within class 3 as defined in section fifty-eight,and all licenses and permits issued hereunder to persons within said class 3 shall be subject to the provisions of ordinances and by-laws which are hereby authorized to be made.No original license or permit shall be issued hereunder to a person within said class 3 until after a hearing,of which seven days'notice shall have been given to the owners of the property abutting on the premises where such license or permit is proposed to be exercised.All licenses granted under this section shall be revoked by the licensing board or officer if it appears,after hearing,that the licensee is not complying with sections fifty-seven to sixty-nine, inclusive,or the rules and regulations made thereunder;and no new license shall be granted to such person thereafter,nor to any person for use on the same premises,without the approval of the registrar.The hearing may be dispensed with if the registrar notifies the Licensing board or officer that a licensee is not so complying.Any person aggrieved by any action of the licensing board or officer refusing to grant,or revoking a license for any cause may,within ten days after such action,appeal therefrom to any justice of the superior court in the county in which the premises sought to be occupied under the license or permit applied for are located.The justice shall,after such notice to the parties as he deems reasonable,give a summary hearing on such appeal,and shall have jurisdiction in equity to review all questions of fact or law and may affirm or reverse the decision of the board or officer and may make any appropriate decree.The decision of the justice shall be final. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However, the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply your insurance company's name, address and phone number along with a certificate of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit.should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary). A copy of the affidavit that has been officially stamped or marked by the city.or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite. 100 Boston, MA 02114-2017 Tel. ## 617-727-4900 ext 7406 or 1-877-MASSAFE Fax # 617-727-7749 www.niass.gov/dia Form Revised 7/2013 oOHE ra Town of Barnstable Regulatory Services Department snxxsras[,E, .� Richard V. Scali, Interim Director �pIFD'"p`p� Consumer Affairs Division 200 Main Street Hyannis, MA 02601 Office: 508-862-4672 Fax: 508-778-2412 REGULATIONS FOR TOWN OF BARNSTABLE CLASS I AND CLASS II AUTO DEALERSHIPS ADOPTED BY THE LICENSING AUTHORITY ON DECEMBER 30, 2013 1) Total vehicle count shall include the numbers of displayed/unregistered vehicles, customer vehicles and employee vehicles. The plan shall be approved by the Building Commissioner and Fire Department. This shall apply to all new, transferred or amend license applications. 2) A sign is required on the property, whether it is a free standing sign or displayed in the door or window, listing the name of the business and hours of operation. 3) All dealerships shall have a repair facility or provide repairs themselves, available and listed on the application and renewal of the license. This information shall be provided yearly. 4) An approved parking plan shall be available on site for any inspections. This shall apply to all new, transferred or amended license applications 5) All spaces delineated on the approved parking plan, shall be marked out with lines, on the surface of the property, except for lots that are storage or non-asphalt surfaces. 6) All Class II dealers who do not display vehicles on the licensed property or who only conduct business via the internet, shall submit to the Licensing Authority a quarterly report of all vehicle transactions, as delineated in the Used Vehicle Inventory Book. 7) All licensees may use a computer-generated version of the Used Vehicle Inventory Book, so long as it is approved by the Mass. DOR. 8) A physical vehicle count may be conducted quarterly by the police/inspectors of all Class I and Class II dealerships. 9) An inspection of the Used Vehicle Inventory Book for each dealership, may be conducted by the police/inspector, at least once a year. O:\Licensing\PacketsNon-Alcohol\cardealersregs 12-30-13.doc TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM _ Mail To: NAME OF BUSINESS:t.�- �dC ' Board of Health MAILING-ADDRESS: 11455 Town of Barnstable TELEPHONE NUMBER: -775',( � P.O. Box 534 CONTACT PERSON: (� Hyannis, MA 02601 Does your firm store any 9f the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: \ TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered when stored in quantities totalling more than 50 gallons liquid volume or 25 pounds dry weight. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) ► re�l?v112�u�ry� Other cleaning solvents > �V • z'hjYP�I i n <<2. Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business h' ioc _ TOWN OF BARNSTABLE A COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD OF HEALTH o satisfact°ry 3. Body Shops Ounsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores COMPANY. S�'� 4 6.Fuel Suppliers ADDRESS'' ','S �.r'WAI a cP Class: 7.Miscellaneous `#'J"_11"'XQUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MATERIALS Case lots Drums Above Tanks Underground IN OUT IN ' OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: ax degreasers Miscellaneous ep AAV All DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2. Water Supply � �, O Town Sewer ,OPublic 0'0n-site 0Private 3. Indoor Floor Drains YES NO ,3 O Holding tank:MDC O Catch basin/Dry well O On-site system s. . 4.Outdoor Surface drains:YES NO ORDERS: Q Holding tank:MDC O Catch basin/Dry well O On=site system 5::Waste Transporter Name of Hauler Destination Waste ProductLicensed? YES NO 2. � t Person(s) Interviewed Inspector "/ Date s -,� r-A r� (O�dPLIXNCE: 'CLASS: 1. Marine,Gas Stations, Repai.r � OF Br- RNS ! t ,aLC 2. Printers BoA,RD OF HEALTH � satisiactory 3. Auto Body Shops Q unsatisfactory- 4. Manufacturers COMPANY 6ekPIZ Co� tA44(' ' (o (see"Orders") S. Retail Stores ►'� ` 6. Fuel Suppliers ADDRESS � ttu -� I /rt dt;ti, Class: -� A Miscellaneous ' QUANTITIES AND STORAGE (IN=indoors; CUT=cutaoors P•tA,IOR hL4TERIALS Case lots Drums AboveTanks Underground Tanks IN QL7 IN OUT IN BOUT # zllon !A e t e_ ? Fuels: Gasoline, Jet Fuel (A) Djesel; Kerosene; #2 (B) ! Heavy Oils: AI' waste motor oil (C) new motor or (o,r..t►- /70 transmission/hydraulic \, Synthetic Organics: degreasers)OV) t,41,-1 � opo� < too i ,, -A r I I i i ziscellaneous. C )e"y•1 . ltf r Lk o AN i F i IF 1) r �+.t1 ` tJtp,\\tiA pit`' , 0, ?>PA it I>CAl t �. a O� ' ` ` ,U.' � 4 ! J s 4 t ( ! 3 ! DISPOSAL RECLkNATION RLM.",RKS: -- - 1. Sa�nktary Sewagep" Ky 2. Water Supply O Town Sewers P' 0 Public 1'~k .,ca�o f • ' OOn-site ® Private 3. Indoor Floor Drains: YES Holding tank: ,,DC --_ — _— ® Catch basin/Dry wellr 17 _ On-site system � ,.. . � ° --- ------------- •,---- ---- - -------- 4, QXtdoor Surface drains:YES NO j 1P Holdint tank- ','BC Catch basin/Dry well .` --— - -- ►=1 �i Lt 'L/ __._,. On-sites stem 5. Waste Transport Pr t, r. �„=y* ..—_.__—___. �� . --- (�t� c�3 ►ty/2� ��,,.� i - LicensreC ti Nam2of Hauler _Ci��rin _tion ,^ste Proc'�r""�`�� t Person(s) Interviewed Inspector Date �.IOVVN l^/FL \/. • VI Y��� /�.'II�IL L.� l:UP1YW AiruCs ,i satisif ctory3, putotPod Shops EAL'i'H ' ' Manufacturers �DAR� �� � �Qusaatisfactory- 4'S. Retail Stores COMPANY (see Orders ) 6. Fuel Suppl ers ` 7 Miscellaneous ADDRESS r ;� �.� �., � -� ? � Class: (f QUANTITIES AND STORAGE (I indoors; OUT=outdoor Case lots Drums AboveTanks Undetground Tanks MAJOR MATERIALS IN rJHJVIII 8 g lions 9ge r e s f Fuels: - Gasoline, Jet Fuel (A) • V Diesel. Kerosene, 12 (B) Heavy Oils: waste motor oil (C) new motor oil (C) _ I transmission/hydraulic Synthetic Organics. ; ti degreasers Miscellaneous: UIS PU.,AL7{�qG MX HIUN REME.RKS: 1. Sanitary Sewage 2. Water Supply Town SewerPublic _ On-site Private •3. Indoor Floor Drains: YES," NO O Holding tank: MUC �� Catch basin/Dry ell ---._»..--.--...- ---- _ 0 On-site system ' 4. Outdoor Surface drains:YE_ NO ' 11olding• tank: MUC OCatch basin/Dry well •----- - - On-site system _ .._.. • _ . .•S. Waste Transporter Licensed?J , Namg of Hauler_ 1]Pst;natlnn_ "te Product 1 • � — Zw > ers ° .lfit.ft ewe s .r x; ._. .. Inspector Date n It