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APPLICATION FOR PERMIT
City or Town:
Date:
permit Number: 100629
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by:
Address: 3 Captain York Rd rsouth Yarmouth, MA 0265,4
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Yarmouth
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o8 / 03/2O1O
For permission to: Underground Tank Removal Chapte. 148 sec 38A
Name of Competent Operator: Tank Removal Service 508-778-82
Date lssued-Rejected 09 / 03 / ?OLO By
Cert. No.
Date of Expiration . 08 / 03 / 2oLL Fee: $25.00 $ paid
FAOLENAHAN
CAPT4OO04l
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Due
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