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APPLICATION FOR PERMIT
City or Town: Yarmouth
Date:12 / 01 /20].5
permit Number: 101836
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
bY: Pax Rana
Address: 170 Seaview Av /Dunes Motor lnn/South Yarmouth, MA 02684
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For permission to: lnstall Oil Burning Equipmenutanks
Name of Competent Operator:JEFF ESHBAUGH PH.: 508-477-1115 Cert. No
Date lssued-Rejected L2/O7 /2OLS By
Date of Expiration: 03/07 /2OL5 Fee:$s0.00 $ paid
(StEnature of applicantf
Due
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