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APPL!GATION FOR PERMIT
City or Town: Yarmouth
Date:oL/02/202s
permit Number: 103426
ln accordance with the provisions ol M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by: LovELETTE rNsuRANcE
Address: 396 Route 28 /West Yarmoulh, MA 02673
For permission to: Above Ground Tank Removal 527CMR 1.12,8,2
Name of Competent Operator: LOVELETTE INSURANCE/TANK REMOVAL SRVS Cert. No.
Date lssued-Rejecled 0L/ 02 /2025 By
Fee: $50.00 $ paid
(Signature oI applicant)
Due
184
LOVEOl
Date ol Expiration: