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APPLICATION FOR PERMIT
City or Town: Yarmouth
Date lr / or /2023
Permit Number: 103242
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address: 9 ALMIRA ROAD /South Yarmouth, MA 02664
For permassion to: lnstallation of LPG tanks 527CMRl .12.8.50 NFPA 58
Name of Competent Operator:
Date lssued-Rejecled LL / 0L / 2023
Cert. No
Date of Expiration Fee: Sso.00 S paid
rcEnature ofappllcanif
Due
142
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PERMIT
City or Town: Yarmouth
Date:7r/03/2023
Permit Number (if applicable) 743242
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to: EASTERN PROPANE 120 Gal above
For permission to: lnstallation of LPG tanks 527CMR1.12.8.50 NFPA 58
At 9 ALMIRA ROAD /South Yarmouth, MA 02664
DIG SAFE NUMBER
Start Date:
$50.00Fee Paid $
Signature of Official Granting Permit
This permit will expire on
Tifle
ermit must be cons icuousl osted u n the rem rses
EASTERN PROPANE '120 Gal above
By
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Restrictions: Strict and complete compliance with all federal, state and local laws, rules, regulations and codes.
Notify YFD before and after work is complete.
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