HomeMy WebLinkAboutnew oil tank 20076.
Permit #'s: FD
Owner/Occupanr Name 'ANE
ln5rrll4(6n
(Gry or Town)
Bec.
-
FDID#: lr
tfiz Comnorwtealtft of *{ass ocfrusetx
Dqoranatt of e"bfu S"frtg
527 CMR 4.00
Form I
Application for Permit Permif and Certificate of completion for the Installation or
Arteration or Fuer oir Burning ti:rr#?,rT\J+fl" srorage of Fuer oil
rx\Tcl th
(Darc)
^aFee Paid: LO -,8.2G
EJ Hcaring Unir
Bumer: E New
Trade Name:
E Domestic
E gxlsting l.ocarion:
Mfg:
Type:Model # or Size:
{t,ret on E Kcroscnc E wasc oil
Storage Tank lil-Ncw E existing Location: _
Location:
Type:PofH Capaciry:S gais. No. of Tanks:
Speciai requircmcns (or additional safcry dcvices)
ca<\az 3Ddrcss25
d osv varr"
Combusrion Tcsc
New Sack Tanp.:
Smoke:
El'-Oit tine protected E Sheet Rock E Sprinklcr AFUE: E yes E
Nozde Sizc Gross Suck Tcnrp.:
COzTcst Brcech Drafc
Ovcrfire Draft:
no
E$icienry radng 9o:
I, the undersigned cenify that the installation of fu€l buming equipment has been made in accordance with M.G.L. c. 148 and 52i CMR 4.00
currcndy in effect. Furthermorc, this installation has been tested in accordance with such requiremenG, is now in propet operating condition and
complete instructions as to its use and rnaintenance have been fumished to the peron for whom the installation (or alteration) was made.
Co. Name t\" \\c Tel. *
Address City:zip:
lnstaller,
P?iru Ndm. Sigia.lre (rlo St rP)
Once signed by the fire department, thip is a PERMIT for the storage and use of oil buming equipment.tit
th
lnspected by:Date
WHITE COpy: Property owne/s copy; CAIIARY CoPY: Y.F.o. Copy. Feturn vrhen ,ob b comPleled; Pltlx COPY -This copy must be Posted at instellaiion.
17l1t
Scrviced Floor or Unit *
-vcnr E Orhcr
I
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