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APPLICATION FOR PERM!T
City or Town: Yarmouth
Date:04/03/2024
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
bY: PHYLLTS ruoHY
Address: l7 AVON ROAD /YarmouthPort, MA 02675
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L.rl
Cil Burning Equipmenutanks
Ltor TUOHY/REMOVAL PRO Cert. No
/ 03 / 20?4 By
Fee: 100.00 $ paid
l9 app tcan
Due
permit Number: 103316
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APPLIGATION FOR PERMIT
City or Town: Yarmouth
Date:
Permit Number: 1033'16
ln accordance with the provisions of M.G.L. Chapte||48, as provided in Section 10 A application is hereby made
bv: pHyLLls ruoHy
Addressr 17 AVON ROAD /YarmouthPort, MA 02575
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For permission to lnstall Oil Burning Equipmenutanks
Name of Competent Operator: TUOHY/REMOVAL PRO Cert. No.
Date lssued-Rejecled O 4 / 03 / 2024
fsg 100.00 $paid
(Signature of applicant)
Due
By
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AVON04
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PERMIT
DIG SAFE NUMBER
City or Town: Yarmouth
Date:oa/03/2024
Start Date:
Permit Number (if applicable) 1 0 3 11 6
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 1O A this permit is granted
to; TUOHY/REMOVAL PRO
For permission to: lnstall Oil Buining Equipmenutanks
Restrictions strict and complete compliance with all federal, state and local laws, rules, regulations and codesNotify YFD before and after work is complete.
17 AVON ROAD /Yarmouthport, MA 02675At:
Fee Paid g 100.00
This permit will expire on
Signature of Official Granting Permit Tatle
This oermit must be consDicuouslv Dosted uoon the Dremises
o4/03/202A
Date of Expiration:
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FP{56
(Rev.6/23)
527 CMR 1.00
Section 1.12.8.2.1
Form 1
Application for Permit, Permit, and Certificate of Completion for the
Installation or Alteration of Fuel Oil Buming Equipment and the Storage of Fuel Oil
Yarmouth
(City or Town)
March 28,2024
FDID#:
(Date) _/
tue Paid:g 50 y'Permit #s: FD Elec.
Owner/Occupant Name Phyllis Tuohy
lnslallation Address: l7 Avon Rd
E Heating Unit El Domestic Water Heater
Burner: ENew E Existing E Location
Tet.#: 508-362-6194
E Power Vent
Serviced Floor or Unit #
Other
Mlg:
Type Model # or Size
E Fuel oil E Kercsene E waste oit
Storage Tank: E New E Exbting E Removal Location:
Type steel Capacity: 275 gallom No. of Tanks
Special requirernenls (or additional salety devices)Remove old AST
Nozzle size:
Basement
E OSV vatve D Oit Line Protected
1dn 617-504-2455Co. Name
Address:City:Raynham zip1680 Broadwav
fumplelbn Date:March 27 ,2024
Combustion Test: Gross Stack Temp
CCP Test:
Net Stack Temp
Breech Dratt:
Smoke:Overf ire Dratt:
that the installationersigned cenily offuel buming equipment h6 been made in accordance with M.G.L. Chapter 148 and 527 CMR 1.00in elfect. Funhemore, this installation has been tested in accordance with such requiremeits, is now in proper operaling coMition ardimtructrons as lo its use and maintenance ha\€ been lumished to the person or whom the ins{allation (or aneratbn) $as
Etf iciency Raling %
l, the und
q.rnefltly
corndele
lnstaller:
e
Eric J. Haikola BU3 t9l96
Cen ol C#
Address
tuint Nane
232 Darington Dr
(no Stamp)
City:Ravnham
Once signed by the tire department, this is a PEnMIT for the storqge of fuel oiland use o, the oil buming equipment.PLEASE TIOTE THAT ONLY APPLICATIONS WIH ORIGINAL WET SIGT'IATURES WILL BE ACCEPIEO. PHoTocoPtEs oF APPLICATIoT{s WILL I{oT BE PRocEssED.
Keep original as application. tssue dupticate as permit. This form may be photocopied
I
Removal Pro L. L. C.
02767
Approved by: Date:
--
,4.:b'_\The Commonwedlh of I'ltaxnlJrtusells
Department of Fire Seruices
527 CMR 1.00
Section 1.12.8.2.1
Application for perrn, n"-rllTt.lnin""r" orco.ptetion for the
Installation or Alteration of Fuel oil Buming Equipment and the storage of Fu€l oil
Yarmouth Port 3 s)L
FP{56
(Rev.6/23)
Permit #'s: FD _ El6c. _FDID#:
Owner/Occupant Name:vllis Tuoh Tel.#:
(City or Town)(Date)
Fee Paid: $
62-6194
lnstallation Address: 17 Avon Rd Serviced Floor or Unit #:
E Heating Unit E Domestic Water Heater E power Vent Other
Burner: ENew E Existing E Location:
k Fuet oit
Storage Tank: El""
E Kerosene
E Existing
E Waste Oit
El Removal Location:Ba ment
(o!\-*": -D.\H\
Special requirements (or additional safety devices)
E OSV vatve El Oil Lin€ protected
Co. Name
Address:
ln
PO Box 1
Completion Date:
Combustion Test:
Capacity: 2 7 5 gallons No. of Tanks: 1
Tel# 508-945-1100
City: W Chatham Zip:02
Gross Stack Temp.:_
CO, Test:
Net Stack Temp.: _
Breech Draff:
Smoke: _ Overfire Draft:
l, the undersigned certify that the installation offuel buming equipment has been made in accordancs with M G.L. Chapter'148 and 527 Ct\4R 1.00cunently in efiect Furthermore, this installation has been tested in accordance with such requirsmenb, is now in proper condition andcomplete inslructions to its use andk.lr""""jffi hav6 b€en fumishsd to the psrson or whom lhe installation (or ) was
lnstal
Ptint l,lane
Address:L() v rls lu,'Lt
Onco sa9n6d by the fire
PLEASE }IOTE THAT OI{LY
L ") los6
Cen ot U 1 a
City (', , , Signatuo lno S&,r']/pj
hAf Ltt'1
d€partmsnt, this is a PERMIT tor th6 storagE of fuel oil and use ofthe oil buming squipmont.aPPucaro{s wlr' oRlclNAL wET stc}taruREs wrLL BE accEprEo.
"r,oroc-oals o, *pucAnor{s wLL tror BE pRocEssED.
Date:
Approved by:
Keep original as application. lssue duplicate as permit. This brm may be photocopied.
,,/
Type:Model # or Size: _ Nozzle size:
Vernon
Mfg:
Ef{lclency Rating %:
mada-
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All applications must be on Form 1
Over 1O,OOO gallons on site requires License &
Permit from local community
Certificale of Competency required, no other
ticense acceptabld, plumbing, eleclrical, etc'
Verify emergency shut-off is outside bumer room
Veriiy separate circuit for oil burner
Verify presence of overhead thermal switch
Verify presence of service switch within 3' ol bumer
Verify presence of high limit controller
Primary contml has safety shutoff within 15 secs'
Stack type primary may be easily removed
Clear access to clean out and services panels
No oil leaks Present at bumer
lnstallation instruclions present on site
Combustion test results on Form 1
Three metal screws al each ioint in chimney
lF POWER VENTER lS USED: Check air prossure
switch, post purge control and semndary control'
lnstallation instructions present.
Oraft regulator is present unless exempted
Adequate air is present for combustion
Adequate cloarances per manufacturers listing
Thermal valves at bumer and tanks
Listed flexible hose may be used (at burner only)
No Teflon tape on oil line or on oil line fittings
No compression fittings are permitted
Solderioints made with 500 degree F solder or
greator
All oil suDDlv and retum lines must be protected
rrom iniurv. All new lines must be contnuously
"ri"r"6-viiiti non ,etallic tubing. Oil safety valves
ii-.i'0" r.i!& on eristing lines not exposed to .
frerizing. Overhead lines require no sleeve ano are
permitted
Oil suoDlv lines and retum lines to tanks exposed to
freeziir! [emperatures must come olf the top oI
tanks[in"i fo, t eto"en", and range oil (#1) are ex€mpt -
No oil leaks Present at tank
Listed oil filter is Present
Tank is UL8O or (DlB+) PV-VI 321 (under 660 gal)
or UL 142 (over 600 gal)
Thermal shutoff valve located at bottom of tank
Vent as Per NFPA 31
Oiltank gauge must be present to determine oil
level
lnside tanks hav€ audible llll device (vent alarm)
Outlet cross connection at bottom oitanks must be
'I /2' pipe or tubing .
Non-combustible tank supports, tank secure
UIIENCLOSED TAI{l(s
Single tanks shall not be larger than 660 gallons
Maximum aqqreqate capacity of unenclosed
multiple tan[a is1320 gallons
Unenclosed tanks shall be at least five leet from an
internal or external flame
t.,nenclosed tanks shall not obslruct service meters,
service panels and shutofi valves
Bottom outlet tanks pitched to the opening
Tanks exposed to vehicles willbe prolected by
baniers
ENCLOSEO TANKS
Over 660 gallon tanks enclosed by two hourfire
resistive assembly
Tank enclosures provided with 6. high tight sills or
ramps
Tank is 4. above floor supported by 12'thick
*lJiil* "iiotL! ipiced' not morathan-eighl feet
ijii&ili6ri-ant tsoirom top and walls of enclosure
Alt oil must b€ Uansferred by pump, and
con]ieCiionJmust oe at the iop of the tank
ALL TANKS
Two tanks maY be cross-connected as shown in
Fig. 8.9.1 NFPA 3'l 2011 edition
Return lines must enter the top of tanks
Vent pipes must be two feet from building openings
Vent pipes must terminale 3 ft. above grade min'
Vent pipes must have weatherproof cap6
Fill pipes must be two feet rrom building openings
Fill pipes must hav€ tamper proof identifying caps
OUTSIDE TANKS
All UST'S and tanks over 660 gallons must be
installed as per NFPA 31 2011 edrton
Tank protected ftom physicaldamage
Tanks exlerior coated with organic alkyd resin or
asphalt Paint
Damaged protective coatings must be recovered
Tank does not block means of egress
Tank mounted on continuous 4'thick slab that
extends 8' beyond tank Perimeter
Tank is supported by tigid non-combustible
supPorts
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