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APPLIGATION FOR PERMIT
01115
City or Town: Yarmouth
Date:ot /22/ 20L5
permit Number: 101619
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address: 6 Albion Rd /South Yarmouth, MA 02664
For permission to: Above Ground Tank Removal 527CMR 9.02
Name of Competent Operator tank removal ph.: 508-778-8265
Date lssued-Rejected 0l/ 22/ 2Of5 By
Cert. No.
Fee: Sso.00 $paid
(Si gnaturaof ap-licanif
DueDate of Expirataon 04/22/20Ls
THEUOl
ALBIOl
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PERMIT
City or Town:
Date:
Yarmouth
oL/22/2075
ln accordance with the provisions of M.G.L. Chapter 148, as provlded in Section 10 A this permlt is granted
to: tank removal ph.: 508-778-8265
At 6 Albion Rd /South Yarmouth, MA 02664
DIG SAFE NUMBER
Start Date:
Fee Paid $This permit will expire on 0412212015
Signature of Official Granting Permit Title
This ermit must be cons cuousl ted u on the rem rses
For permission to: Above Ground Tank Removal 527CMR 9.02
Restrictions: Strict and complete compliance with all federal, state and local laws, rules, regulations and codes.
Notify YFD before and after work is complete.