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Home My WebLink About0076 THORNTON DRIVE - Health Thornton Dr:, his - ;)�THE SIGN MAN - ' YOU WISH TO OPEN A BUSINESS? d 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: r - ' _ APPLICANT'S YOUR NAME/S: �! BU�!SS YOUR HOME ADDRESS: G ) - TELEPHONE # Home Telephone Number _ - NAME OF CORPORATION: NAME OF NEW BUSINESS Gt TYPE OF BUSINESS �^ IS THIS A HOME OCCUPATION? _ ` YES NO - ADDRESS OF BUSINESS � �n� �/ nn c ?� MAP/PARCEL NUMBER::2 K `O� V b (� (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 COM SION R'S OFFICE This individu I h b i an pe mit requirements that pertain to this type of business. Aut orized Signal COMMENTS: 2. BOARD OF HEALTH E This individual has been inf d e it uirements that pertain to this-type of business. MUST'COMPLY WITH ALL'. HAZARDOUS MATERIALS REGUI=ATI AI Authorize ignature* 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: Date: TOWN OF BARNSTABLE [ ( TOXIC AND HAZARDOUS MATERIALS ON-SIT INVE TORY NAME OF BUSINESS: --nQ S o- r a " BUSINESS LOCATION: off- y hvf N, "A juds INVENTORY MAILING ADDRESS: l� TOTAL AMOUNT. TELEPHONE NUMBER: l�29 171 1 ® CONTACT PERSON: Shta11- EMERGENCY CONTACT TELEPHONE NUMBER:15-yk t040 MSDS ON SITE? TYPE OF BUSINESS: 4 INFORMATION/RECO MEN DATIO S: ' ' Fire District: .� f K P 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) 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 5 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 D-6 Vt qlaql 0 IV 9 1-KOWDA Wsr OIL WASTE OIL OIL PILTERS ANTIFREEZE WASTE ANITFREEZE GASOLINE WASTE GAS DIESEL FUEL W/W FLUID ATF HYDRAULIC/ MISC. MISC. MISC. MISC. BRAKE FLUID COMMBUSTIBLE FLAMMABLE CORROSIVE PETROLEUM (GEAR OIL/GREASE/ LUBRICANTS) FREON ACETYLENE CAR WASH CAR WASH PAINTS/ WAX DETERGENTS THINNERS SEALANT CLEANING BATTERIES/ POISION/TOXIC CAULK/GROUT SOLVENTS BATTERY ACID FERTALIZERS WASTE SOLVENT Vua e 'o MSDS ND to A M �,,,�i. i MANIFESTS Town of Barnstable CFTHE A Regulatory Services Thomas F. Geiler,Director Public Health Division * BARNSTABLE, * Thomas McKean,Director y MASS. g 200 Main Street, Hyannis,MA 02601 qj 1639• ♦� ArFD MA'i A Phone: 508-862-4644 Email: health(a,town.bamstable.ma.us Fax: 508-790-6304 Office Hours: M-F 8:00—5:00 November 7,2006 Derek Miller The Sign Man 76 D Thornton Drive , Hyannis,MA 02601 Dear Mr.Miller: Thank you for your time and cooperation during the hazardous materials inventory and site visit at The Sign Man on September 26, 2006. This letter contains information from that visit that will help you become compliant with Chapter 108 of the Town of Barnstable Ordinance: Hazardous Materials. Enclosed is a copy of the Toxic and Hazardous Materials On-Site Inventory form from the visit to your place of business. Please note the observations listed below: OBSERVATIONS: • Two flammable cabinets on site and in use. • Very Small Quantities Generator(VSQ) and will not need to obtain a Hazardous Materials Permit for the fiscal year 2006-2007. • All waste paint can be brought to the transfer station in Marstons Mills for disposal in small quantities. On Site Inventory Total The Toxic and Hazardous Materials On-Site Inventory from September 26, 2006 shows that you have approximately 25 gallons of toxic and hazardous materials being used, stored, generated and disposed of at The Sign Man, 76 D Thornton Drive,Hyannis(Please see enclosed Toxic and Hazardous Materials On Site Inventory sheet). The Board of Health has determined that the using, storing, generating and disposing of over 111 gallons of hazardous materials per month requires businesses in the Town of Barnstable to obtain an annual Hazardous Materials License. This license is not required to be obtained for the fiscal year 2006-2007. If you have any questions about these observations, or you need further information,guidance or assistance,please do not hesitate to contact the Public Health Division. Sincerely, Alisha L.Parker Hazardous Materials Specialist Enc. On-Site Inventory(copy) TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: ��c.rr fcrt Mail To: (7 BUSINESS LOCATION: 7Cv �'�d�;� iE-�� T= Board of Health Town of Barnstable MAILING ADDRESS: P.O. Box 534 ° TELEPHONE NUMBER: (S o � - �"11 !�I® Hyannis, MA 02601 CONTACT PERSON: r C 1� ►�� V®� � Jj EMERGENCY CONTACT TELEPHONE NUMBER: !2Cf, - - Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, i , 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 character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case 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 �44 ers 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): S (dry cleaners) / Other cleaning solvents wax Rsn►ott9e Bug and tar removers Household cleansers, oven cleaners S.. White Copy- Health Department/ Canary Copy-Business _ 4y TOWN OF BARNSTABLE gOMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOAR OF HEAL H 3.Auto Body Shops COMP Si9W O unsatisfactory- 4.Manufacturers (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous vv JD QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) A MAJOR M &NS Ca se lots Drunls Above Tanks Underground Ta'ks- 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: degreasers Miscellaneous: o wrs D&k, a- kSiOCLttI� - X U jCYt�tJ�, DISPOSAL/RECLAMATION RFMARKS. ® s 1. Sanitary Sewage 2. ater Supply ® r✓ LiX'sBE a O Town Sewer NjkPublic On-site Oprivate 3. Indoor Floor Drains YES NOk A, t (7)A/,�� /- O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES NO 1. 2. -Al 'Vt 1p �jq Person (s) I terview •d Inspector MR e TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS �c Class' 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoo MAJOR �ERIALS Case lots Drurn�, Above Tanks Underground Tan,ks IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel(A) a% Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic f ----- ' Synthetic Organics: degreasers is�ella ou DI5 SAUREC O RE S: 1. Sanitary Sewage 2. Water Supply % O Town Sewer Ajublic you-site O Private 3. Indoor Floor Drains YES N0_L/ O Holding tank:MDC ` O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product 1. 2. w � i Person (s) Interviewed Inspector Date TOWN OF BARNSTABLE MPLlANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops Q unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS gg. 7.Miscellaneous � �•t QUA NTITI S AND STORAGE (IN= indoors;OUT=outdoors) MAJOR ER.IALS ,• - IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: v dal Lm DISPOSAU✓RECI AMATION REMARRS: �J 1. Sanitary Sewage 2. ater Supply O Town Sewer Public Pn-site Private AVA r t 3. Indoor Floor Drains YES�NO O Holding tank:MDC O Catch basin/Dry well O On-site system 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 YES NO 2. ot Perso (s) Interviewed Inspector Date