HomeMy WebLinkAboutnew oil tank 2008&rp*t,,^1 $ J* br*ir^
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APPL!CATION FOR PERMIT
City or Town:
Date:
Yarmouth
Permit Number: 001773
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address: 20 Camelot Rd /YarmouthPort, MA 02675
For permission to: lnstall Oil Burning Equipment
Name of Competent Operator The Oil Express 508-548-0131
Date lssued-Rejecled OL / 23/ 2OOg By
Cert. No
Fee: $20. 00 $ paid
fsEnnure oft Flicant)
DueDate of Expiration . 02/ 22 / 2OOB
FAOLENAHAN
CAME02
oL /22/2008
-#rlli!
-^
(Gry or To
Permir *'s: PO 6O nlrl
EI Hearing Unit
Bumer EI Ncw
Trade Name:
E Domestic Warcr Hearcr
Mfs:
Modci # or Size:
tr Fucl Oil E Kcroscnc E] Wasc oil
Storage Tank New
Type:
Special requiremcns (or additional safery dcvices)
tfiz Comnonanoltfi of lr{assacfuuets
Deporanatt of 9"5ti, Safrtg
527 CMR 4.00
Form i
Application for Permit, Permit, and Certilicate of completion for the Insrallarion or
Alteration of Fuet Oil Burning Equipment and the Sto
t / .-/or -
FDIO+:1t35 I
owncr/occupant uan:rl: iha/rcoF{ /}itlrrf < ra*.6o/6-76 )-?
[n5trll41|6p Addrcss:Scrviced Fioor or Unit #:
-
(Datc)
Fee Paid:
EI Power Vcnr E oth.r _
. .Belrrt'lz,-?7--ua,[.ocarion
Type:Locarion:
E Existing Location:,Zeitzerz*-
Capaciry:&79 gais. No. of Tanls:
E osv valve
Combusrion Tcsr
Ncw Stack Tanp.:
Smokc:
Oil line protccted E Sheer Rock E Sprinttcr AFUE: E
Nozzle Sizc
COrTcst Breech Dnfc
Ovcrrire Drafr
ves tr no
Efficicncy ratiag 7o:
I, the undcnigned ccnifo that the installation of fuel buming equipment has been made in accordance wirh M.G.L. c. 148 and 52? CMR 4.00
currently in effcct. Furthermore, this iostallation has been tested in accordance with such requircments, is now in proper operating condition and
complete instructions as to it5 use and fiuintcnance have becn fumished to the perrcn for u,hom thc installation (or alterarion) uras made.
Co. Name Z-Tel. +
Address,/3 zll,Aqr*V4y'o rcz arn.zip:
lnstaller:
Pnn! Name dse (no S@nD)
Once signed by the re department,is is a PERMIT for the storage and use of oil buming equipment
Inspected by:Date:l-zo - o
WHITE CoPYi Property r's copy; caNARY CoPY: Y F. D copy - Return when iob is compreted; prNx copy . This copy must be posred 8t insta lation.
of Fuel Oil
Ecc.
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