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APPLIGATION FOR PERMIT
City or Town: Yarmouth
Date:03/o6/2020
permit Number: '102602
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address: 104 BAKER ROAD /South Yarmouth, MA 02664
For permission to: Above Ground Tank Removal 527CMR 1.12.8.2
Name of Competent Operator JEFFREY ESHBAUGH Cert. No.
Date lssued-Rejected 03 / 0 6 / 2020
Date of Expiration Fee: S50. 00 $ paid
lsionature of applicant)
Due
6080
l O4BAKERRD
By
527 CMR 1.00
Secfron 1.12.82.1
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