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HomeMy WebLinkAboutnew oil burner 2007,TfiE Dcparhw$ of a 527 CMR 4.00 - Form I Applicelion for Pcnnit, Pcrmit, tnd Ccrtilietc of comphtion for thc Installalion orAltcrrtion of Fucl Oil Burning Equipmcnl and tht Storage otFud Oil c/7'/ ty or Town) Pcmit fs: FD . Elcc. _ FDIDf: pant Namc:Ktc l/z o -7ao <- Irst rllation Address: ate) Fcc Paid: // &4-o-QarZ Zenz Serviccd Floor or Unit # I fficedng lrnit E Domcstic Warcr Hcercr Burncc E tVw tr Exisring Locadon: E Powcr Vcnt E Othcr E€c<E> T}fle-i G-P Model # or Sizc; lvlfg:<' Lo. Ozcta o>a- (:o1' Nozzlc Si:c: E Fucl Oil Sronge Ta.nk: E Kcrosene E Wastc oil B New flg*;oino Locetion: Typc:-=7-g*/-Capeciry: ;ry ga.ls. No. ofTurks: lt EOSV Vatve (Oit tln" prorccred DShcet Rock Osprin&lcr AFUE: Oycs Eno EF: EJyes Eno (Furnace ud boilers) (Watcr heater) Co. Neme:Pefuzso^t otL .S R.VtcE Tel #tr >el- too i.;larlgls. 2.1 4 R Esce,,o*-67 .' -citr LJoRe^rSta,e Zip: 4t6OC €.) - eomplction Datc: Combustion Tcst:Gross Stack Temp.l / C)Ove16rc Draft: {3 Nct Stack Tcmp.:/,23 Brecch Drafl:o3 Ellicicncy rating %:{3 G (Lo^ /d.d Smokc --o/ l. !t. l,d..riFrcd G.nifr ltt.l dt. lurll.rir of fEl bn*q cgipmr [g ten mdc ir rodm *i6 M.O.L G. l.l ..d t2, CMn ..Oo ...rG.tjt iir.rT.c( Fcnkrhorc. thir iuunrdql i., l€! l.{./ h...o.drg *i$ r.t ngncaaru. L,rr.il 9roF. oFrdn8 Gddidd.rJ.ooy'.a iinruclirn ., ro iu ure rad ruhus*r [.n LGr f{rirh./ to rr!. F r.i ao, *toll A. f-rt ^)o 4lnsrallcr: C.fl o/Ct Signoturc (ao Stoap) Addrcss:Lut City:{lu*t nn(( tn(. Oncc signed by thc firc dcpanmcnt, this is a PERMIT for thc stoogc.nd trsc ofoil burning cquipmcnt. li.ccp Originrlrr rpplicrtion. lrruc duoLcrtc rt pcrmit. This form mry [r phorocoprcd Tafl:@.-@57 Tnde Ngmc: Specia.l rcquirements (or additionallafery devices) CO! Tcst: .lkE&n) vr. n.i<. Approvcd by: Datc:- - - - - - -!-?-?s-1 -- -- --- - g7 / L? /?sg? l4:5e3 25 L OIL FT ozc0 EFFc0e DRFTex/A NTcoaf 483, 't€.9zza3' 61e,6-9.e34?.983'Z32 tP' inHe0il PPI siK+: ll t g1 15 fr. _a__ l3o U- 0outllL LUE Yianornt. 7Zt 45 PEIERSON OIL CO License: OIL BURNER TECHNICIAN CERTIFICATE Number: BU 030688 Expires: 04/06/2009 RICHARD T FITTON JR 6 VIRCINIA DR ROCHDALE, MA 01542 oPs4Ar a 5or,r-o5,ttPo0,.t0 5AA 354 7Z2A P.A2 Birthdate: 04/06n960 Restricted To: 1517 7 /tp 6'umrmaarue,am' o/'lttlatytnzu'r't* Deoartment of Prfblic Saf^4Y-d[Jnlnuurton Place, Rm 1301 Boston, Ma 02108-1618 17. nq; 4425.0 K€ee roP lor tlseipt rnd ch.nge of addtess nolific'uga' t7L 6:",*,,,,.,,,,*/A "/"/{.&".L'*bOEPARTf,E f OF PUBUC SAFETY OIL BURNER TECHNICIAN Numbec BU 030688 Blimere: 0ar06/1950 ErpilEs: 0{10612009 Tr' no: 4425 0 R6trlcted:1517 00 . llon6 l0.GmvnytEed 15-1I2Oir RICHARO T FITTON JR 5 VIRGINIA OR ROCHoALE. illA 01542 OIG SAFE CALL CE TER: (E88) 3/'/t-7233 TOTAL P. A2 %z24.-comnltgionar / PETERSON DIL CO 5Ze 364 7Z2Z F.Z1 I 1ate 75 Crcscent Screet, Worcester, llA 01505 Tcl: 508J6E.1000 i Fer: 50E.36t'1020 Fuet Oils ' ComPlare Hc lng tittallstions ' Senice Fromi ^)r%sas /FA)( G? 760 *4a61a*,Q{ Dat.3 7 4,hona: t/ &4,o -L/,u<cCifu: lu6rnl O--O. lt?- cc l?loer cornmrnt ;?l"" "flY tat 45 E -3 ]For Rcvlcwr/