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APPLICATION FOR PERMIT
City or Town:
Date:
Yarmouth
o4/09/20L2
permit Number: 101027
ln accordance with the provisions of M.G.L. Chapter '148, as provided in Section 10 A application is hereby made
by:
Address. 476 Route 6A /Getty Petroleum/YarmouthPort, MA 02675
For permission tor Storage of LPG 527cMR 6:08 (28)
Name of Competent Operator:Blue Rhino
Date lssued-ReJecled 04 /09 /2OL2 By
Date of Expiration. o4/Og/2ol4 Fee: $s0'00 SPaid
Cert. No
(S-r g na re-fa p,licant)
Due
115
GETT04
The Commonwealth of Massachusetts
Department of Fire Services - Office of the State Fire Marshal
P.O. Box 1025, State Road, Stow, [tIA 01775
APPLICATION FOR PERMIT
A
Citl or lorrn \ armouth
l)utc 03/26/20t2
ln accordance $ ith lhe provisions of M.G.L. Chapter 148. as provided in Section
-lOI-
application is hereby made
br Blue Rhino of New Ensland - South
(Eull ne. of F!o{ Fim d Coeo.aion)
1709 Page Blvd.. Springfield, MA 01104,\ddress
ISn ff Forortrcliy tr ltq)
For permission to (state clearly purpose for which permit is requested)
or cxcharge in a lockcd cage. Cylinders rlill be filled offsite at a location operated by Blue Rhino and
Slore (21) Pronane (lvlinders for resale
will comply with NFPA58 and 527 CMR 6.00
Name of competent operator (lf Applicable)
Date Issued-rejected
I)atc ol e\piration
N/A cn. No N/A
Duc
By Wayne A. LaFlcche
Paid
The Commonwealth of Massachusetts
Department of Fire Services - Office of the State Fire Uarsnalfr
P.O. Box 1025, State Road, Stow, MA 01775 v
PERMIT
Cit\' or To*n Yamouth
ln accordance with the provisions of M.C.L. Chapter 148, as provided in
to Yarmouth Pon Celty
DIC SAFE \T \IBER
Smn Date
l0A this permit is graoted
Customer # 53310
l)alc l/26/10 t2
(full une 6f p€rsn, F'm or Coeor.tion)
Rcslricli(nrs Nl-l,A 58 and 52? ( MR 6 00
(Oit l@tion by std rnd m . n dsnb. in uch mnnq s lo povide ad.qu{c idenlifiolion of l@rion)
476 Main St Ya rmouth Port Ma.02675
Fee Paid $ 50.00 Ck #This Permit willexpire on
Signaturc of Olllcial (;rantinB PcnDil Title
DIG SAI [ \T \IB[]R
I
Stan Date:
tr Fec S 50.00
Permit Number (ifapplicable.l- L
lbr sr^pgp ^l'(,) I \ ,ol R ('ylin.l.r( f^r r..alp ^r Fr.hrngf in a l^.tp,.l .igF
,)rU
This permit must be conspicuously posted upon the premises