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APPLICATION FOR PERMIT
City or Town: Yarmouth
Date:06/r6/20a5
permit Number: 10176'l
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address €rrrth-Yarmouth, MA 02664 1
For permission to: Storage of LPG 527 CMR 1.12.8.50 NFPA 58
Name of Competent Operatorl Eastern Propane for cooki ng
Date lssued-Rejecled O6 / L6 / 2OL5 By
Cert. No.
rg re a lcan
Date of Expiration
142
GREA2l
Fee: Sso.00 S paid Due
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PERM!T
City or Town:
Date:
Yarmouth
o6/L6/2Ot5
Permit Number (if applicable) ' - '' -.,'
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to: Eastern Propane for cooking
For permission to: Storage of LPG 527 CMR 1.12.8.50 NFPA 58
Restrictions: Strict and complete compliance with all federal, state and local laws, rules, regulations and codes.
Notify YFD before and after work is complete.
South Yarmouth, MA 02664
DIG SAFE NUMBER
Start Date:
Fee Paid $ss0.00
Signature of Offlcial Granting Permit
This ll expire on
Title
This permit must be conspicuously posted upon the premises
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Application for Standard permit
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