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APPLICATION FOR PERMIT
City or Town:
Date:
Yarmouth
03/21 /2OL4
permit Number: 101430
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by
Address: 8 Bass River Rd /South Yarmouth, MA 02654
For permission to: lnstall Oil Burning EquipmenUtanks
Name of Competent Operator:oal express : 800-822-6400 Cert, No
Date lssued-Re.iected 03 /21 / 20]-4
Date of Expiration 04 / 28 /2oLA Fee: S50.00 $ Paid
(Signature of applicant)
Due
THEUOl
8ASS200014
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PERMITt\^,
,il
'4ln I
City or Town: Yarmouth
Date 03/27 /2OL4
Permit Numbet (if applicable) 1014 30
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to oil express p: 800{22-6400
OIG SAFE NUMBER
Start Date:
For permission to: lnstall Oil Burning Equipmenutanks
Restrictions: Strict and complete compliance with all federal, state and local laws, rules, regulatlons and codes.
Notify YFD before and after work i8 complete.
At 8 Bass River Rd /South Yarmouth, MA 02664
Fee Paid $s50.00 This permit will expire on 0412812014
Signature of Official Granting Permit L-/,1,r-2--Q //,/z:*
This rmit must be cons icuousl ted u n the remlses
By
rr,liiir,irlilr
Title
Primary Contact:
YFD
96 Old Main Street
South Yarmouth, ma 02664
508-398-2212
Receipt for cash or check
Ocsq)attcY:
Bass River Rd 8
8 Bass River Rd
South Yarmouth, MA 02664
oi1 express p: 800-822-6400
I sgued Effective ExPilQs FeePeroit l+rype
1014 3 0 Install Oi1 Burning
Equipment,/tanks
a3/2'7 / 2074 8 n'7 /2014 04/28/2074 ss0.00
Check NunJcer:Tota1 F€e 9s0.00
Cash Received by:
Special conditions of, issue:
A3/21 /2074 71,:55 Page 1