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APPLICATION FOR PERMTT
City or Town: Yarmouth
Oate:o6/L2 /2O!s
permit Number: 101757
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
bY: Mike Bueaell
For permission to: Dispensing motor fuel from a tank vehicle (on land
Name of Competent Operatorl Diesel Direct Alexandra 781 856 0203 Cert. No.
Date lssued-ReJected 0 6 / f2 / 2OL5
Date of Expiration o6/0f / 2oL'l
By
Fee: S5o. oo $ paid
n ure app
Due
Address: 131 Ansel Hallett RD /YarmouthPort, MA 02675
142
UNITO2
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APPLIGATION FOR PERMIT
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E*,
City or Town: Yarmouth
Date:06/1,2/2Ot5
permit Number: 101757
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
bY: ieff mello
Name of Competent Operator:Diesel Direct Alexandra 781 855 0203 Cert. No
Date lssued-Rejected 06/12/20L5 By
Date of Expiration. 06/o]-/20L7 Fee:SsO.00 $ paid
Gionature of appilcantf
Due
142
UNITO2
Address: 131 Ansel Hallett RD /YarmouthPort, MA 02675
For permission to: Dispensing motor fuel from a tank vehicle (on land
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FP.O06
(Rev.'1.1.2015)
V,ty /&oo*%r.'*r*lkr QY+
Application for Standard Permit
t Return completed application to t
Permit Number
City or Town
Date: 6lfrt t-
ln accordance Wth the provisions of l\4.G.1. Chapter 148, as provided in Seclion application is hereby made
DIG SAFE NUMBER
Start Date
by
of
(FullName of Person. Firm or Corporalion)
Ag-
(Phone Number)t3\ zAns.\ tl,r\tel 2*..'\Vor.n,^*h Qrr+ Nn+
(Address: Str.jet or P.O Box City or Town. Zip Code)
for permission to (state clearly purpose for lvhich permit is requested)
Name of Competent Operator (if applicable)
Date lssued-rejected By
Date of expiration
(Signature of Applicant)
Amount Paid $Fee
A-
?Vr* -r r, r, no/tl. r/ er/. /r*r"lrrat"&IEl?tr,c/L,,./ _
PERMIT
City or Town
Date
Permit Number (if applicable)
ln accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
to
DIG SAFE NUMBER
(FullName of Pe6on. Firm or Corporalion)
Restrictions
at (Slreel and * or Oescribe LocaUon lor Adequate ldentilicalion)
Title
t This permit must be conspicuously posted upon the premises ts
Cert. No.
FP{06
(Rev. 1.1.2015)
for
Start Date:
Eaa p?id S This Dermit will exDire on
-
Signature of Otllcial Granting Permit: