HomeMy WebLinkAboutnew oil burner 2008Lo+nnnnarea/lr|,/ //kdlo1/urrrllt
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APPLICATIOil FOR PERMTT
.iity or Town:
Date:
Yarmouth
o6/ LO / 2008
permit Number: 001956
ln accordance with the provisions of M.G.L. Chapter 14g as provided in Section 1O A application is hereby made
by:
Address , MA 02673
For permission to: lnstall Oil Burning EquipmenUtanks
Name of Competent Operator D.C. Cook Plum bin & Heati Cert. No
Date lssued-Rejected O6/LO /2OOa
Date of Expiration: O? /LO/2OOB
1\
&rp*,j.- l tl
P,A E*
25 B.ookhilt Ln /VVest yarmouth
Fee: $20.00 $ paid
FAO RUELL
BROO07
nature o app rcan
Due
By
I
'lfu Comnonuteottfr. of fr{ass aitrsets
Depattrnmt ,f 9"6fu sof"ty
Application for Permit, Permit, and Certificate of completion for the Installarion or
Alteration of Fuet Oil Burning Eqrieq7:r1d I.he Storage of Fuet Oil(C lt$l!r
Pernrir #'s: F'D , q j6 Bec.
Owner/Occupant
Installadon
CHearing Unit trD
B,rrncr: dNc* E edsring locadon:
(Dalc)
FDID#: Fcc Paid: .
Sewiced Floor or Unit i:
-
Locacion:
(Gty or Town)
7r.,- 11Trade Name:Mfg:
Tlpe:Modci # or Size
Ef Fuet ou E Kcroscnc E Wasrc oil
Stonge Tank E New Efe*isrirrg Location:
Special requiremens (or addidonal safety devices)
I
Hearcr
(
Po
EI. osv vaivc
Combusrion Tcsr
Ncw Suck Ternp.:
Smokc:
Co. Name
Nozzle Sizc
COlTcsr
EI'OA Un" protecrcd E Sheu Rock EI Sprintict .lFuE B-yes E no
4
,(a
I, the undcrsigned cenifo that the installation of fuel bumiq cquipment has been made in accordance with M.G.L. c. 148 and 527 CMR 4.00
currently in effect. Furthermore, this installation has been tested in accordance with such requirements, is now in pIop€r operating condition ,nd
complete instructions as to its use and nreinteflance have been fumished to the person for whom *re installarion (or alteration) was made.
/Tel 70'q) /z
Address City:,har{, tVt )/,zip:OlZ (,1 t
Installer:
PrinrNare Si8na0r. (no S.dnp)
Once signed by thf fire departmeqt, this is a PERMIT for the storage and use of oil buming equipment.
lnspected by:Date
WHITE CoPY| Property owner's copy; CAiIABY COPYj Y.F.D. Copy - Relum when job is completed; PINX CoPY -This copy must be posted at installalion,
527 CMR 4.00
Form I
Tcl it:
E o,h.r
-
e /L-
nh-/., /
2,n ?/1/t
Type: ,., 7 az, Capacity: 7'7 ff t gals. No. of Tanks:
./-/r,
04
/<
/,/
/t
Do". tn ? (r-,k
Gross Suck Tcnrp.:
o Overfire Drafc Efficic1lcy rzdng 9o:
a
LICENSURTPFOFESSlo!{Alotusol{ oi
COMMONWEA LTH OF MASSACH USETTS
A
ISSUES THIS LICENSE TO
DARREN C COOK
70 KERRY DR
I''ARSTONS
?317 5 05/01/to
IrtILLs fiA o?6q8 _ 7729
MBEF
493(37
SEBIAL iIO
LICEI{SE r{o
OATE
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