HomeMy WebLinkAboutnew oil tank 2007L"anunamronltL o/ l/hauoziaulld,
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APPLIGATION FOR PERMIT
City or Town:
Date:7L/O9/2001
permit Number: 001647
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address 84 Camp St /West Yarmouth, MA 02673
For permission to:n I Buming Equipmenutanks
s:.
Winslow Plumbin &B
Date lssued-ReJecled LL / 09 / 2OO7
Date of Expiration: L2/09 / 2oo7 Fee:
ert.
n
FAOLENAHAN
cA[rP18
0 $ Paid
a nt
Due
Yarmouth
Name of Competent Operator:
By
A,.
$:w\
tt))'or Town)
Permit #'s: FD /ootsb Bec.
Owner/Occupant Name:,&ete/ 4'/ba*
lnsralladon Ad&css: I
Burncr: E Ncw
Trade Name:
Locarion:
Mfg:
Type:6",,t Model # or Size:
K Fucl OiI tr Kqosene E Wasrc oil
tfiz Comrunut ea[tfr. of 9v{ass otfius ett
Depornwnt ,f e,thfu Srfrtg
527 CMR 4.00
Form I
Application for Permit, Permit' and certilicate of completion for rhe Insrallarion or
Alteration of Fuel Oil Burn Equipment and lhe Storage of Fuet Oil))q
((Datc)
FD6,. O t|{ / o"p^,a. )L cu
,t/. lr
X **t
4t"*e //
r
Locarion:
Ent*retfLocuion:
a7.s'gals. No. of Tanks:
Speciai requirernens (or additional safery dcviccs)
E osv valre X Ou rin" prorecred E Shea Rock EI Sprinllcr effi,-ffyes tr
Combusrion Tcsc Nozz]c Sizc Gross Stack Tcrnp.:
oo
New Stack Tcmp.:
Smoke:
CO lTcst Breech Dnfr
Efficicncy rating 9o:
I, rhe undersigned cenify rhat the installadon of fuel buming equipment has been made in accordance with M.G-L. c. 148 and 527 CMR 4.00
currenrly in effect. Furthermore, rhis installation has been rested in accordance with such requiremenrs, is now in proper operating condirion and
compleie insEuctions as to its use and maintenance have been fumished to the person for whom the insrallarion (or alreration) was made.
Co. Name Tsrue' 41eqA
Ovcrfire Drafc
L-/
Address Bax J?{City:,6zada/n
G&s., t l/._*zip:o26
Installer:
*o 2A7 Pri*Nr"" {J SigranJre (
Once signed by fire department, this is a PERMIT for the storage and use of oil burning equipment.
lnspected by:Date:-7 o ()
WHm CoPY: Property owne/s copy; CAIIARY COPY: YF.D, Copy - Retum wh€n lob E completed; PINX COPY"Thi! copy must be posted at installation.
r"tf5g-7/75- O!!i
IScsiced Floor or Unir t /
( Hcaring Unir E Domestic Warcr Hearer E Power Venr E Other
Sorage Tank,X n.* E exisdng
qp", JT€e L capacity:
rd." 5d-47///f