Loading...
HomeMy WebLinkAbout0270 COMMUNICATION WAY - Health (2) 270 Communications Way Sewer Acct # 759 Barnstable A =314-041 -00Z Bld'g#4 r l ` i I Uji II �e Usi c1mr), VW him III 00, ►���rdless Hazardous Materials Inventory Set Checklist ),-11•MDate x Physical.Street Address-Check database to ensure it exists Working Phone Nu'rber Actual Amounts -( ie. gas being used to fuel machines,thinner to . clean brushes all count as hazardous materials) Storage Information -location of storage, how long is storage for? —�If none, note that. Disposal Information -where and who? If none, note that. Applicant Signature - understand what is listed and noted I/ Staff Initial -any questions, know who to ask 0 Si Vehicle Washing/Rinsing? -provide a vehicle washing policy and explain it-note that it was given Attach the Business Certificate with your sign off and comments. **T e inventory form should explain what the business consists of and the procedures they are doing. Notes need to-be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? 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:) 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, 1st FI., 367 Main St.; Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is req a i,red by law. DATE: Fill in please:. M APPLI4ANT'S YOUR NAME/S > BUSINESS YOUR HOME ADDRESS: 7777 TELEPHONE #. Home Telephone Number $ O y NAME OF CORPORATION: NAME OF NEW BUSINESS- e�' TYPE OF BUSINESS " IS.THIS:A HOME OCCUPATION?___L YES NO ADDRESS OF BUSINESS 70 MAP/PARCEL NUMBER — --D (Assessing)', w, When starting anew business.there are several things you must do in order to.be.in catS�pliance w h the rules and regulations ofthe Town of Barnstable:. This,form.is intended to assist you in obtaining the information you may eed. You MUST GO TO 900 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operateyour 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 hEks b inform loft p hitrequirements that pertain to�this type of business. MUSTCOMPLYWITHALL Authorized Signn�ature** HAZARDOUS MATERIALS REGULATIONS COMMENTS: 3. CONSU MER AFFAIRS (LICENSING AUTHO�IITY. ] This individual has been informed of the licensing requirements that pertain to this type of business: Authorized Signature* COMMENTS: Date: z, /a7 / o� TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY _7ej JA,,-&,_ NAME OF BUSINESS: BUSINESS LOCATION: INVENTORY MAILING ADDRESS: DLL,/ � TOTAL AMOUNT: TELEPHONE NUMBER: O — _'2 CONTACT PERSON: ILv EMERGENCY CONTACT TELEPHONE NUMBER: 0 --6® SS-1 MSDS ON SITE? TYPE OF BUSINESS: icy! 0a iaL / ' 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 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 NEW 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) 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 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other-prodticts 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 1/'� ac*4A A& (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS r ..`�''b°'��'2u`F•.?w� 'N'�.`N�a�' .s�s,Aa,r��',•sty'A.a. , f Date: z /97 / oq TOWN OF BARNSTABLE TOXIC AND: HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: BUSINESS LOCATION: INVENTORY MAILING"ADDRESS: fY D yu� !/�-_3 TOTAL AMOUNT: TELEPHONE NUMBER: S D - y CONTACT PERSON: tT U EMERGENCY CONTACT TELEPHONE NUMBER: �/o'�O -(�D k 1 MSDS ON SITE? TYPE OF BUSINESS: Gt1/ ir7 04 k) kAAAr4 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 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 INEW USED = Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes �l Road Salts (Halite) Hydraulic fluid (including brake fluid) r--, Refrigerants Motor Oils h.. Pesticides i NEW USED - � j (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) IDiesel Fuel, kerosene, #2 heating oil : NEW USED I Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ,, �' / �" " NEW USED fl Degreasers for.engines and metal Printing ink Degreasers for driveways& garages Wood prese.rvatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda I Rustproofers Misc. Combustible Car wash detergents Leather dyes i Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's i Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (Inc. carbon tetrachloride) NEW= - - ..`US:ED.- Wit_ ��..,._._ -o t ee p - s wit poison a el _ _Any t rodtJct : h " i `' lab l 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 (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE IN�ENTO Y NAME OF BUSINESS: Airv6' 5 - BUSINESS LOCATION: mm INVENTORY MAILING ADDRESS: 1' (Z�l�SC �� / TOTAL AMOUNT: TELEPHONE NUMBER:" CONTACT PERSON: EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: - n INFORMATION/RECOMMENDATIONS: ' Fire Distr'ct: n D 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) 1112 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 NEW 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) 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 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, 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 (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS OIL WASTE OIL OIL FILTERS ANTIFREEZE WASTE ANITFREEZE t GASOLINE WASTE GAS DIESEL'FUEL W/W FLUID ATF HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM (GEAR OIL/GREASE/ / I© LUBRICANTS) FREON ACETYLENE CAR WASH CAR WASH PAINTS/ WAX DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID FERTALIZERS WASTE SOLVENT '� MSDS MANIFESTS d I�� (Xi Date:L TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 2�&- X S S-� BUSINESS LOCATION: _ INVENTORY MAILING ADDRESS: ' . TO TELEPHONE NUMBER: 0 "' 7— ` TiBD CONTACT PERSON: LJ 6 AU-7 Bid J22 17-1 17 y kel EMERGENCY CONTACT TELEPHONE NUMBER: 1 S TYPE OF BUSINESS: INFORMATION/RECOMMEN ATIONS. 1 �� A Fire 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) 0 Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid nDisinfectants 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 go Misc. petroleum products: grease, Photochemicals (Developer) O lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink 62 Degreasers for driveways & garages Wood preservatives (creosote) 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 2_0 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, 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 1 Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents D . Bug and tar removers O Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i YOU WISH TO OPEN A BUSINESS? 1 i 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, 1 FL., 367 Main Street, Hyannis, MA..02601 [Town Hall) DATE: J ,TN _",OA K > � Fill in please: I i APPLICANT'S YOUR NAME: D rI7 V. j A� BUSINESS YOUR HOME DRESS: ` A � TELEPHONE # Home Telephone Number B17-0 0 / NAME OF NEW BUSINESS ci r t' TYPE OF BUSINESS 1S THIS A HOME OCCUPATION? YE NO i Ll Q t e . .: 5... . II ADDRESS OF BUSINESS R 7b s 6= MAP/PARCEL NUMBER �T 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 of Rd. & Main Street). to make sure you have the appropriate permits and licenses required to leg`at"pe this town. 1. BUILDING COMMI ER'S OFFICE This individual ai b infor d. y permit requimnra s that pertain to this type of business. Authorized Si ure** WM MQN S:JU Jo Cj/.to Ym-Gc) fLA l,PZ-)' - 2. BOARD OF HEALTH This individual haOthorizQd infor ed oft r t requirements that pertain to this type of business. Signature* COMMENTS: �Y 3. C SUMER A AIRS (LICENSING AUTHORITY) ` This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature.* COMMENTS: V 'i Ta z ►- C Jl lr' L.A- q k -' �-_____` �� v l�,(�-fir• ------------ O� w s� _Tiq P lks -C76 ----------- w c IN CASE OF EMERGENCY; _--- Proceed carefully downstairs. Exit out the front door. ----------- Walk with staff across the road. Wait on the grass. r TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date '' p - ___Ie 6 0 Owner x,C � Tenant59M Address Address I Compl!once Rem rks or Regulation# Yes No Rep mmendo ons Mtj N%WG 61VV r/WVS,25. 2. Kitchen Facilities ( ? VES 3. Bathroom Facilities S)G 4. Water Supply or 5. Hot Water Facilities R14C 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal ffifilhkqlr�� 6Y, au)A�k 16. Sewage Disposal DAf 17. Temporary Housing )I PART II419 37. Placardi derail+g egg emovai-af lition D Person(s)Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMMAAN' HA'B�ITATTI'ON !' �/ Date // °UO3 ✓'?` ' �,K V.r!Gr 1 00( Owner Tenant � J� �t�i a ,� J� G Address � Address A 1 Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 10in W, /1Y 4Z) 3. Bathroom Facilities 'V V Lim (1 4. Water Supply 0 a 5. Hot Water Facilities Vim' 6. Heating Facilities f do7. Lighting and Electrical Facilities �� f V �l}ni go 8. Ventilation r V U�l/�/ 9. Installation and:Maintenance of Facilities / 0 lroj 10. Curtailment of Service a 11. Space and Use a S'In 6 �I V 12. Exits J�J 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents ✓ s 15. Garbage and Rubbish Storage and Disposal �15-�P(—, 0# V 16. Sewage Disposal 17. Temporary Housing VV PART 11 C✓1 V r'� 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition c Person(s) Interviewed Inspector MM . �! v. If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date O S" , A I �G fl i e J� S coo t Owner Tenant u <'7N� M M Address f Address !V A Complionce Remarks or Regulation# Yes No Recommendations 2. Kitchen FacilitiesLIN 3. Bathroom Facilities r�,� /�� 'y - �1 1 � 4. Water Supply 5. Hot Water Facilities41 6. Heating Facilities 1EI)IV (,r 7. Lighting and Electrical Facilities ' do '� �/ �}nn f ✓,�n�� 8. Ventilation V ��I/l.' 9. Installation and Maintenance of Facilities A(M/ 0)r) S LO& ( 10. Curtailment of Service A An 11. Space and Use /�VfS 1 `A V t 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents5 15. Garbage and Rubbish Storage and Disposal Mom s��" Off S 16. Sewage Disposal U - 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; C,/l Removal of Occupants; Demolition Person(s)Interviewed Inspector �� If Public Building such as Store or Hotel/Motel specify here TOWN O BAR S F BARN STABLE C/ BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date d 3oVfP6�i,5� Owner OkOgr `� Tenant H IGP y ®Address ►'V Address �17® CIP' 'J V" om lionce Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities - 3. Bathroom Facilities �� s 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15: Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION �� Date O JS .F ► b G Owner Tenant a v� �Q�� ►" �`� Address DO CO ffj M 09�reln S A Address Ca O `I w 14 h I LS III LIN 1-7 "!7`G '14 VAFrN,,A l::�) tomp liance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3N/A P 3. Bathroom Facilities � � '� 1 4. Water Supply I V 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities .8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service I I. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents N11p% 15. Garbage and Rubbish Storage and Disposalu �� fed �P�1 16. Sewage Disposal 17. Temporary Housing PART 11 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Person(s) Interviewed �� Inspector if r If Public Building such as Store or Hotel/Motel specify here e HoBBs&WARREN.INC. TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date 5� 97 O� ' f Tenant Address Address i Compliance Remarks or Regulation# Yes No Recommendations I 2. Kitchen Facilities S s 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities i 6. Heating Facilities i 7. Lighting and Electrical Facilities 8. Ventilation 1011 9. Installation and Maintenance of Facilities 10. - Curtailment of Service .i 11. Space and Use 12. , Exits s. ✓ 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents r 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Person(s) Interviewed ! i4v P, Inspector If Public Building such as Store or Hotel/Motel specify here Hoses&WARREN.INC. -