HomeMy WebLinkAboutnew oil tank 2009City or Town:
Date:
Yarmouth
06/77 /2OO9
Permit Number: 100397
ln accordance with the provisions of M.G.L. Chapter 148, as provided ln Sectlon 10 A application is hereby made
by
Address: 24 Captain Wright Rd /South Yarmouth, MA 02664
For permission to: lnstall Oil Burning Equipmenutanks
SDeed wav Fuel 508-394-7240
Date lssued-Re.iected 06/!7 /2009 By
Date of Expiration: 07/L7/2009 Fee: S25'00 $ Paid
Cert.
(srgnature ot applicant)
Due
FAOLENAHAN
cAPT400038
Name of Competent Operator:
6..
Owner/Occupant
EI Heeoag Unir
Bumcr: Ei Ncw E} -gxisung
Trade Name:
(DaIc) ( .\ it'
-r.''l*0,FDID*:
afiz Cormonarca{tfi of ll{araiuset*
Deparanant ,f en1fu Sofety
s27 CMR 4.00
Form i
Application for Permit, Permit, and Certilicate of completion for the Installarion or
Alteration of Fuel Oil Burning Equipment and the Storage of Fuet Oil
L
(Ciry or Town)
"t
Floor or Unir fr
-
[,ocation:
Mfg:
Type:Modcl # or Sizc:
E Fuei OiI E Kemscn"tr $Iastc oil
Storage Tank E
Type:
Locarion:
d"'"E Exisring Location:
Capaciry: ga.is. No. of Tanls:
Special requircmens (or additional safery dcvices)
E osv valve
Combusrion Tcsc
Ncw Suck Tcrnp.:
Smoke:
E oit tinc prorccted E Shcet Rock E Sprir*lcr AFLIE: E ycs E
Nozzlc Sizc Gross Stack Tcmp.:
Ovcrfire Drafc
oo
CO lTcst Brcech Drafc
I, the undersigned certif! rhat the installation of fuel buming equipment has tcen made in accordance with M.G.L. c. 148 and 527 CMR 4.00
cunenrly in effect. Furthermorc, this installation has been tesred in accordance with such requirements, is now in proper operaling condition and
complete instructions as to irs use and rnaintenance have been fumishpd to the person for whom the installation (or ahcration) was made.
Address
?< L: 1.,0/.t\Tel.:r
Ciry:
)\0t c )B<
ol zrp:
LAIA a l t/I
Prina Ndme
Once signed by thefire departme t, this is a PERMIT for the storage and use of oil buming equipment.
Date:
WHITE Copyr property o*ne/! copyi CANARY COPY: YF.o. Copy- Return when iob b compleled; PINKCOPY-Thi3 copy must be Po3ted 8t inst lletion.
Permit *'s: FD Elec.
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Powcr Vcnr E Other
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Efficicncy wimg 7o:
?€(Co. Name
Oral tzfi -fY1
Installer:
Signoture (no Sranp)
lnspected by:)
It I .l
tnAddress:<lJ