HomeMy WebLinkAboutnew oil burner 2014Llwuzmuuonlli, a/ )fhlraill.adle
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APPLICATION FOR PERMIT
City or Town:
Date:
Yarmouth
oL/24/2Oa4
permit Number: 101383
ln accordance with the provisions of M.G.L. Chapte|!48, as provided in Section 10 A application is hereby made
by:
Address: 30 Center St /YarmouthPort, MA 02675
For permission to: lnstall Oil Burning Equipmenutanks
scudder &lor : 774-836-5363
Date lssued-Rejecled OL / 24 / 2OL4 By
Cert. No.
Fee: $s0.00 $ paid
(Signature of applicant)
DueDate of Expiration: 02 / 24 / 20!4
THEUOl
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P.0. B'* 1025, l)1"1" R*1", l)l*u, mA U115
PERMIT
City or Town: Yarmouth
Date:07/24/2Or4
Permit Number (if applicablel I 0r 383
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A this permit is granted
to: scudder & taylor p: 774-836-5363
For permission to: lnstall Oil Burning Equipmentftanks
Restrictions: Strict and complete compliance with all federal, state and local laws, rules, regulations and codes.
Notify YFD before and after work is complete.
30 Center St /YarmouthPort, MA 02675
DIG SAFE NUMBER
Start Date:
$s0.00 This permit will expire on 0212412014
Signature of Official Granting Permit Title
This permit must be conspicuously posted upon the premises
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Name of Competent Operator:
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Fee Paid $
A
Permit #'s: ro \C[?rc{rt Elcc.
afie Cotraaonutea[tft of 1v{ass odrus et*
Depor*wnt of errhfu Sofrty
s27 CMR 4.00
Form I
Application for Permit, Permit, and Certificate of clmpletion for the Insullarion or
Alteration of Fuei Oit Burning Equipment and the Storage of Fuet Oi!/-zr./
(Gty or Town)5\
d@O' Fce Paid:
I (Dare)
EDID#:
Owner/Occupant Namc:
[n5EIl4!s1 Ad&css:
t ut./z/)I Tcl tt
c&11 Serviced Floor or Unir *
-EJ Heating Unit
Bumer: E Ncw
Trade Name:
EI Domcstic Warcr Heatcr tr Powcr Vcnt
tr Existing Locadon:
Mfg:
E ottrer
111
Ty?e: _ Modcl # or Size: _ Locarion:
EI Fuci Oil E Kcmscne EI rl/astc oil
Storage Tank EI New E existing Location:
Type:Capaciry:
Spccial requiremcns (or additional safcry devices)
gals. No. of Tanks:
E osv vaivc
Combustion Tcsc
New Stack Tcmp.:
Smoke:
EI Oit tine protccred EI Shcct Rock E Sprinllcr AFUE: D ycs E
Nozzle Sizc Gross Stack Ternp.:
no
CO lTcst Brcech Drafr
Ovcrfirc Drafc Efficiency raaag 9o:
I, the undersign€d cenify that the installation of fuel buming equipment has |een made in accordance with M.G.L. c. 148 and 527 CMR 4.00
cunently in effect. Furthermore, this imtallation has been rested in accordance with such rcquirements, is now in prope. operating condition and
complete instrucrions as to its use and rnaintcnance have heen fumished to the person for whom the installation (or alteration) was made.
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&inr Nanre I SiSruore (no Sarnp)
Once signed by the fire department, this is a PERMIT for the storage and use of oil buming equippent.
Inspected by Da I(
WHITE CoPY| Property owner's copy; CANABY COPY: YF.D. Copy - Relurn wfien iob is completed; PINK COPY. This copy musl be posted at installalion.
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