HomeMy WebLinkAbout3217 MAIN ST./RTE 6A(BARN.) - Health 3217 MV !a St. Barnstable`
A=299-023
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TO ALL EW BUSINESS OWNERS
DATE: LP Z.- MMUMIMEl 1
Fill in please: aW W tIowa 1
APPLICANT'S Vnimm .. YOUR NAME:
BUSINESS YOUR HOME ADDRESS: An !'✓
TELEPHONE Telephone Number Home
NAME OF NEW BUSINESS TYPE OF BUSINESS warrC
IS THIS A HOME OCCUPATION? YES 1 .1 NO
Have you been given approval from t e building division? YES NO
ADDRESS OF BUSINESS �' S� ee-- cz I MAP/PARCEL NUMBER
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. Once you have obtained the required signatures,
listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall) or if you get the business certificate first
you MUST go to the following office to make sure you have all the required permits and licenses..
GO TO 200 Main St. — (corm of Yarmouth Rd. & Main Street) and you will find the following offices:
1. BUILDING C MISSIONER' FICE
This individual s beppr informed of ariv per quirements that pertain to this type of business.
uth rized Signature**
COMMENTS:
2. BOARD OF HEALTH
This individual hasten informed of the ermit requirements that pertain to this type of business.
Authorized Signature**
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:
Business certificates(cost $20.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must
do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various
departments involved.
"SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY.
MAR-27-2002 12 : 17 AM P. 01
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UVS AMOMUTION r 035J,035K,W5L, OM,035N,drip,0350,=A,0968,03M V'AC'j j
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UNITED STATES POSTAL SERVICE REGULATED MEDICAL WASTE
MAILING MANIFEST GENERATOR(MAILER) CERTIFICATION
"I certify that this carton has been approved for the mailing of used medical sharps, has been
prepared for mailing in accordance with the directions for that purpose. and does not contain
excess liquid or nonmallable material in violation of the applicable postal regulation. I am aware
that full responsibility roals with the generator(mailer)for any violation of 19 U.S.C. 171le which
may result from placing Improperly packaged home In the mall. i also certify that the contents of
this consignment are fully and accurately described above by proper shipping name and are
classified, packed, marked. and labeled. and In proper condition for carriage by air according to
the applicable national governnlantal regulations.'
All Items below must ba filled out completely.
1. Generator's name(If applicable, add patient Identifier number.)
(Le1G, A,* W-CL446j tre _ L-A c.-_
Name(p&A.d) (Nano, ) . - ,
S-A i-I S.+. 2. Description of Contents
Address(swat) (obeeel6n)
t�cy><nni A rNl A- 02(03 OCRY 14D � k:etl Sharps •
� 0$]342-3358 a°) nP�ceNgo P • 00,
(arse eede) Pnene (Tomfeno) 8v;w ( al Dais (Feeha)/
TRACKING FORM(MANIFEST)DIRECTIONS FOR GENERATOR
*Check above, everything must be filled out completely.
•Keep"Generator'(bottom)copy for your rawrds.
•Make sure Item number 3 Is signed and dated.
•Put thle Tracking Form In 21ploek bag on aide of box and seal
COMMD N O V 8 2001
TO 9E COMPLETED BY DISPOSAL SITE ONLY
Printed certification of receipt and Incineration-"I certify that the Contents of this package
have been received and Incinerated in accordance witflabi4Cdnd Federal
re9ulstion8.0 I �Nfi��f{
Sharps Envilron~tal SetMOes
DISPOSAL FACILITY 10BURMIliftbM84EPRESENTATIVE
City of Carthago Perrrlft Na 170-A
Panda Co. Resouroes Recovery Site 01 Print name
900 LaSalle Pkwy.. Carthage, TX?WW N
TOM 1741/rACB R-9620 810 a re Date
IN CASE OF EMERGENCY,OR DISCOVERY OF D Gfs OR I FA9AGe CALL 14XW772-GW
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BILL SHORES
FILE
Weight: 4.65
Burn pate: 11/13/01
MAR-27-2002 12 : 17 AM P. 02
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Sharps Compliance, Inc. Pick List
9050 Kirby Drive•Houston,Texas 77054scl Date 1/10102
OrderM S121610
Customer 0:F100425
Sold to: Ship to:
Acutherapy
NIFTUS,LLC33 3217 Main St.
225 North 11th Street Barnstable MA 02830
PO Box 1508
Wytheville VA 24382
_....._. ._.. --..._.. .— -...._-,..—_.._. Tex ID:
�Ship Date: 00100t00
381es R Csublett i Act s• --�-- ,--..--.-_. •_.
NET 30
wt:g 10:23
Order Ship BO'd UI Item No Description ex BIN
i pT 2 0 2 EA FMPY102 2 Galion Protec Mail Back
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Sharps Compliance, Inc. I Sharps Compliance, Inc.
9050 Kirby Drive•Houston,Texas 77054` 9050 Kirby Drive• Houston,Taxes 77054
8404 I 8404
Ship to: Ship to:
Acutherapy Acutherapy
3217 Main St. 3217 Main St.
Barnstable MA 02630 Barnstable MA 02630
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