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APPL!CATION FOR PERMIT
City or Town: Yarmouth
Date:o1/23/2O24
permit Number: 103276
ln accordance with the provisions of M.G.L. Chapte|I48, as provided in Section 10 A application is hereby made
by: TEo FRTEND
Address: 36 BANISTER LANE /South Yarmouth, MA 02664
For permission to: lnstall Oil Burning Equipmenutanks
Name of Competent Operato r: HALL OIL/FRIEND
Date lssued-Rejecled 0L / 23 / 2024 By
Date of Expiration Fee: Sso. 00 $ paid
(SE naiurtof apFficant)
Due
142
lBANISTERLN
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PERMIT
DIG SAFE NUMBER
City or Town: Yarmouth
Date:0L / 23 /2O2a Start Date:
Permit Number (if applicable) 1t121€
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to HALL OIL/FRIEND
COPY
For permission to: lnstall Oil Burning Equipmenutanks
Restrictions. Strict and complete compliance with all federal, state and local laws, rules, regulations and codes
Notify YFD before and after work is complete.
At
s50.00Fee Paid $
Signature of Official Granting Permit
This permit will expire on
Title
This oermit must be consDicuouslv Dosted uDon the Drem rses
cert. No.-
35 BANISTER LANE /South Yarmouth, MA 02664
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FP{56
(Rev. '1.26.2015)
527 CMR 1.00
ection 1J2.8.2.1
Application for Permit, Permit, and Certificate of Completion for the
Installation or Alteratipn ofFuel Oit Buming Equipment and the Storage ofFuel Oil
w.'Yc.c -rJlL rlrrlg
Permit #'s: FD x Elec
Owner/Occupant Name r?J) Qo-pr.t
lnstallation Address: 3U BAup rsaAB hj
(City or Town) (Date)
Fee Paid: $
Ter.#: 5ob -M-1o83
5ct@
V(eating Unit Domestic Water Heater
Bumer: u/tt"* :Existing r Location:
C{:(@Ltr..J
Power Vent
Serviced Floor or Unit #
Other
Mfg
Type:Oal*)Model # or Size: E2- t ?Lo
.lFuel Oil ' iKerosene
Storage Tank: I I New y'Existing Location:
Nozzle size ;?sr-lo'ts
RemovalWaste Oil
t|*seMEF4-
Type:
Special requirements (or additional safety devices)
i OSV valve {O,,t tir. Protected
co. Name: hAtl-Ol\- k)tet* 316-3s31
Address: Ll3t ?C. txq City $, QgpptS Zip
Completion Date:
Combustion Test:Gross Stack Temp
CO2 Test:
qzs Net Stack Temp.:3-?S
Breech Drafr: -o3tLi.
Smoke: O Overfire Draft -dL Efficiency Rating %:o.t7
I, the undersigned c€ttify that the installation of tu61 buming equipnent has been made in accordance with M.c.L. Chapter 148 and 527 CMR 1.00
cuar€nw in effct Furthermore, this irctallation has been t6ted in accordance with such requirements, is norv in prop€r operating condition andcdrplste
ln6taller
inrtrudions as to its use and mainlenance have been fumished to the person or whom tlre (or
L5?1
fiade
Pint Neme
aaaregs: lG I AAIJ ff'
Cen ol C*
City S ocl!\l
Approved by
Keep original as application. lssue duplicate as permit. This form may be photocopied
(no
Onc6 sign€d by the fire departrnent, lhis is a PERMIT for the storage of tuel oil and uee ol the oil buming equipment
FDID#:
A..rnA Capacity: Zl S gallons No. of Tanks:
)z:t
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