HomeMy WebLinkAboutremoval and install of oil tank 2015Crr,rr*r*rr//l / fl"a4rrt rrrl,
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APPLICAT!ON FOR PERMIT
City or Town: Yarmouth
Oate:72/30 /2ots
permit Number: 101851
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address: 13 Brewster Rd Mlest Yarmouth, MA 02673
For permission to: Above Ground Tank Removal 527Cl6R 1.12.8.2
Name of Competent Operator:Hall Plumbing 508-398-3831
Date lssued-Rejected L2 / 30 / 20L5 By
Date of Expiration: 03 / 29 / 20L6
Cert. No.
-(Sr-0nalrrreo-f apdf canif
Due
THEUOl
BREW02
Fee:$ Paid
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APPLICATION FOR PERMIT
Cityr or Town: Yarmouth
Date:L2/3O/20Ls
Permit Number: 10'1850
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address: 13 Brewster Rd /South Yarmouth, MA 02664
For permission to: lnstall Oil Burning Equipmenutanks
Name of Competent Operator Hall Plumbinq oh.:508-398-3831
Date lssued-Rejected t2/ 30 /2OL5
Date of Expiration: 03/29/20L6 Fee: s50'00 $Paid
(Signaiure oft Flcanif
Due
By
Cert. No.
THEUOl
BREW02
FP-056
(Rev. 1.26.2015)
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06\slPermil #'s: ro FFffi Etec
Owner/Occupant Name:Mrrev DorArtrl6
lnstallation Address
Heating Unit
Burner: New
t3 Ee{l.ttqefe zi
527 CMR 1.00
Section 1.12.8.2.1
Form 1
Application for Permit. Pcrmit, and Ccrtificate of Completion for the
Installation or Alteration of Fucl Oil Buming Equipment and the Storage of Fuel Oil
\tc\s (City or Town)
FDID#
(Oate)
Fee Paid: $ S(,q"
Iet.#: 5d -11 s-1o51
Power VentDomestic Water Heater
-. Existing Location
Mfg:
Type
4uetoit
Storage Tank: 4"*
l\,,1odel # or Size
Kerosene
Existing Location:6nservr eli1.
Nozzle size
Waste Oil Removal
Type fllfr€ utkt-L
Special requirements (or additional safety devices)
Capacity: @- gatlons No. of Tanks: I
OSV valve vd tin. Protected
Co. Name:
Address:
tlAuu otL u rer* 97s8-31s-3831
q3 (2+ t3Lt City s .trS Zip o'zLG0
Completion Date L
Combustion Test: Gross Stack Temp.:.....-- Net Stack Temp
CO' Test Breech Draft:
Smoke: _ Overfire Draft:Efficiency Rating %:
Cetl of C#
I' the undersigned certify that the installation of fuel burning equipment has been made in accordance with M.G.L. chapter 148 and 527 cMR 1.00currently in effecl Funhemore. this installation has been Gsted in accordance r,vith such reqrir"-"nL, i" "or-in piop-J iperaring conoition anocomplete instructjons as lo its use and maintenance have been fumished to the person or whom the installation (of alte.ation) was made.
lnstaller:
Signature (no Stamp)
City
once signed by the lire department, this is a pERMrr for the storage of fuel oir and use of the oir buming equrpmenlEvl()-lrq r IL Date: l.li-lbApproved
Keep original as application. lssue duplicate as permit. This form may be photocopied
Serviced Floor or Unit #:
Other
Addressl
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