HomeMy WebLinkAbouttank removal 2021APPLICATION FOR PERMIT
City or Town: Yarmouth
Date:o9/02/2O2L
permit Number: 102865
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section '10 A application is hereby made
bv: JoE DEsousA
Address: 105 BAYVIEW STREET /South Yarmouth, MA 02664
For permission to: Above Ground Tank Removal 527CMR'1.12.8.2
Name of Competent Operator: DESOUSI'/ALL CAPE HVAC AND PLUMBING INC Cert. No._
Date lssued-Rejecled O9 / 02 / 2O2r By
$ Paid
tsEnalure of applianif
Duefgs; S50.00
171
105801
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PERMIT
Date:o9/02/2021
Permit Number (if applicable) t . - '
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to: DESOUSA/ALL CAPE HVAC AND PLUMBTNG tNC
For permission to: Above Ground Tank Removal 527CMR 1.12.8.2
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 105 BAYVIEW STREET /South Yarmouth, MA 02664
Start Date:
Fee Paid $
Signature of Official Granting Permit
This permit will expire on
Title
This permit must be conspicuously posted upon the premises
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Date of Expiration:
City or Town: Yarmouth
DIG SAFE NUMBER
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FP-056
(Rev. 1.26.2015)
527 CMR 1.00
Section 1.12.8.2.1
Form 1
Application for Permlt, Permit. and Certificate of Completlon for the
Installation or Alteration of Fuel Oil Buming Equipment and the Storage of Fuel Oil
o r.13
FDID#:Permit #'s: FD Elec
Owner/Occupant Name:Sse \\e -\..,,i
lnstaltation Address (>S )
Tel.#:eog A?-z q 445
E Power vent
Serviced Floor or Unit #
OtherE Heating unit E Domesic water Heater
Burner: E ttcw E rxisting E Location:
Mfg
Type,
E Fuel Oil
Storage Tank: E New dristng
Type:
Model # or Size: _ Nozzle size:
waste oil
Location:
Capacity gallons No. of Tanks:
EfRemouat
I
Special requirements (or additional safety devices)
euress' '/4 (Ui
Completion Date 0- 2/
Combustion Test: Gross Stack Temp.:
CO, Test
City:t(/-%,r*t4
E oSV valve E oit Line FTotected
Co. Name Al CA?E HuAc.8 P/ua9//uG Tel #s1s -'%Lls// z5
zip 0267j
Sgndure (.p St np)
Net Stack Temp.:
Breech Draft:
l, the undersigned cenify that lhe installatifi of fuel burnirE equipment has been made in accordance vrith M.G.L. Chapter 148 and S27 CMR 1.mcunently in eflec1. Furtherrnore, his instalhtion has been tested in accordance with such requiremeots, is norv in Proper operating condition andcomplete instructaons as to its use and maimenance have b6ren furnished to the pe6on or wtlom the install&h (; aheration) was nrde.
o.n\C o\tr <.U-
Efiiciency RaUng %:
5lnstaller:
Adfess:
(+int NafiP-Ce,l of Cl
3'7()\City:er
once signed by rhe llre depaffilert, ttris is a pERl,lr tq rhe stqage ol tud oil and use oa the dl burdng eqJipment.
ApFoved by:
Keep original as application. lssue duplicate as permit. This form may be photocopied
o.]-
(City or Tovun) (Date)
Fee Paid: $ _
E Kerosene
Smoke: _ Overlire Draft:
Rre 3r
Date:
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