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APPLICATION FOR PERMIT
City or Town: Yarmouth
Date:oL/o8/2O].6
permit Number: 101857
by:
Address South Yarmouth,A 02564
For permission to: lnstall Propane Tank
Name of Competent Operator:Yarmouth Fire Department
Date lssued-Rejecled OL / Og / 2OL6 By
Cert. No
Date of Expiration Fee: Sso.00 $ paid
139
61C401
(Signature of applicant)
Due
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
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