HomeMy WebLinkAboutinstall oil tank 2022A C"",r,rrr*r"fl / f'Xra4rl,,rrr1,
W,t,*,t "l Jr* &^i.' - W "l il* Mh" Ji* Tll"^l^l
P.A. 8"" 1025, N"l, nod, Nr*, mA 01115
APPLICATION FOR PERMIT
City or Town: Yarmouth
Date:09/22/2022
/^
fi A,(Y4.,
Lc 1 Jo)<
Permit Number: 103056
ln accordance with the provisions of M.G.L. Chapter 148, as provided in on 10 A application is hereby made
by NES
Wtr
PAUL L
Address: 14 BUTTERCUP LANE /South Yarmouth, MA 02664
For permission to lnstall Oil Burning Equipmenutanks
Name of Competent OPerator LLANES/HALL OIL COMPANY INC.
Date lssued-Rejecled 09 / 22 / 2022 By
Cert. No.
na re of applicant)
Fee: S50.00 $PaidDate of Expiration
150
14BU01
(sis
Due
Vr* *"*,".m {e%anl-,t"m.
FP-056
(Rev. 1 .26.2015)
Heating Unit
Burner: New
Mfg
Type
rG
527 CMR 1.00
Section 1.12.8.2.1
Form 1
Application for Permit, Permit, and Cenificare of Completion for the
Ilstallation or Alteration of Fuel Oil Buming Equipment and the Storage of Fuel Oil
S uv,"*-th qls l*'-
FDID#
Power Vent
(City or Town)
Serviced Floor or Unit #:
Permit #'s: FD Elec.
Owner/Occupant Name l_t_t+ne
lnstallatio'n Address: I a Cr-)L
Domestic Water Heater
Fexisting - Location 7-,/\\-, ttttr t -.q-i
Model # or Size Nozzle size
uel Oil Kerosene Waste Oil Removal
isting Location
Type AI Capacity Ll2 gattons No. of Tanks
Specialrequirements(oradditionalSafetydeVices)
OSV valve
Co. Name:A IiJL,
City:9,DU:t),.:t,
Completion Date:
Combustion Test: Gross Stack TemP Net Stack TemP.:
CO'? Test:
Smoke:
-
Overfire Draft Efficiency Rating %
l, the undersigned c€rtify that the installation of tuel buming equipment has been made in accordance with GL
cunently in effect. Furthermore. this installation has been tested in accordance with such requireme
fu,, a,n" Protected
Tel #31 B-3ts31
ULuGo
comple*e lnstructions as to its use and mainlenance have been fumished to the Person or whom th
lnstallen
_31 Z
Pdnt Name Ced of C4
?€ kft3 Bo o oL)
Adoress-
Once signed bY the fire department,thrs is a PERMIT for the storage of tuel oil and use of the oil bumlng equipmeot
a!e.
14E and 527 CMR 1 00
tn operating condition and
alteration) was made
4
Approved bY
(no Stamq)
(4.
(Date)
Fee Paid: s SO -
s7 8.-36t ol ?o
Other
Storage Tank:
Address: WS f<f l7+
Breech Draft:
Zip:
City:
Keep originai as application' lssue duPlicate as permit This ferm may be photocopred'