HomeMy WebLinkAboutinstall oil tank 2019C"r,,r*r*rr//l r/ f/tu/r.,l"/b
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Date:
permit Number: 102649
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
bY: ted Galkowski
Address: 41 BAXTER AVENUE /West Yarmouth, MA 02673
Name of Competent Operator:Galkowski/Scudder & Taylor
Date lssued-Rejected L2 / L2 / 20t9 By
Date of Expiration Fee: $50.00 $ paid
Cert. No
(Signature of applicant)
Due
BAXTO5
City or Town: Yarmouth
Date:o7 /07 / 2O2O
Permit Number (if applicable) 14264e
ln accordance with the provislons of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to: Galkowski/Scudder & Taylor
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 41 BAXTER AVENUE /West Yarmouth, MA 02673
DIG SAFE NUMBER
Start Date:
ss0.00Fee Paid S This permit will expire on
C:"-Signature of Official Granting Permit Title
This permit must be conspicuously posted upon the premises
APPLICATION FOR PERM!T
Gity or Town: Yarmouth
L2 /L2 / 2OL9
\
For oermission to: lnstall Oil Burninq Eouionenutanks '
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PERM!T
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S27 CMR 4.00 Form 1
- Applioatioo fq. p.,,nit, perEit, aad Ccrtif cate of Ccmplctioo fur &aIastallatioa or Altaation of Fuel Oil Bruins tO*.*i_iiti
"*e of Fuei OiJ
IP-056
. (Rov.04,/10)
O\,rner/Occupant Name:
or To,vn)
Elec Fee Paid: g -futet.*.,{N ,,?/l-b7bz
lnstallation Mdr€ss:ff*runo E Domeslic Water He€ter El power vent
Bumer. E New. 6rang E Locaflon:
lt Sorvicad Floor or Unit #:
Otler ,
Mfg
D Kerosene
@d*t E existns
Modd # or Size:
E Weste Oil
Locauoh:
Capacl!:gallons No. ofTanks:
oit
Storage Tank:
Type:
spedai requirements (or addttbftal safety devices)
El osv vatv" 6ru ine Protec{ed tr Strcct noct E Sprinkler AFUE; Eyes E no EF: EyesD no(unaca and bolle6) $/Edr heder)
H* V{?J6-:{t<q:i
Co. Name:
Addrose:
Combuslion Test Gro5s Stack Tarnp.;
Cg Test
Smoke: -- OyerfrE Drsft
lndaller.
P?tn
Addre3s:
ffiHffi#"#ffiffiH
Clty Zp:
Net SEck Temp.j
Breech.Draft
Efficiency Ra6ng %:
burrirp equiD[Ent hss beer, made in aocord€E wih M.G.L Chaptr 1,{8 anO S27 4.00bee'] tgsted ln rccodance tr4th suctt llql'rllsn6nf6, ls no*/ lh rjropor opsrdnOhave been ft.fnilhed to tfE peEon orwhom the iq*a&tbn (or
bdord
Citr
on's c,rEd by th' fire depqtrE rL fis b a
'ERMIT
br ttE sb.a'! oftuer on a., ule ofrhc oil blrniro cquipmcnr
AppE\,€d by
Keep orlg{naj as appllcadon. lssue duplrcate as pennlt Thls brm may be photocopied.
Permit #s: FD FDID#:
NozzJe slze:
Completion Date: / ) -t Z- tq
D.ls: