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APPLICATION FOR PERMIT
City or Town: Yarmouth
Date:tt/Lo /202!
permit Number: 102894
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
For permission to: Unvented Gas Heater lnstallation 527CMR 1.12.8.6
Name of Competent Operator Marlowe / Scioletti
Date lssued-Rejected Ll / LO / 2O2L
Date of Expiration
Cert. No.
Fee: S50.00 $ paid
(Signature of applicant)
Due
139
11CA01
Address: 11 CAPTAIN WEILER ROAD /South Yarmouth, MA 02664
By