HomeMy WebLinkAboutTank and Tank Truck Permits - Permits - 3 MASSACHUSETTS AVENUE 6/14/1995 qfzz Conmwnweadh of Massachusetts
ry, � 527 CMR 4.00
Form 1
Application for Permit, Permit, and Certificate of completion for the Installation or
Alteration of Fuel Oil. Burning Equipment and the Storage of Fuel Oil
North 1kndover
(City or Town) ( ate)
Perrrdt ''s: FD Elec. FDID##: 0 9 210 Fee Paid:
Owner/Occupant Name: k �� h �' s f c Tel V- ?>, "_3 131
Installation Address: e2 ,A —serviced Floor or Unit n:
EJ Heating Unit El Dotrlestic Water Heater 0 Power Vent Other I a K
Burner: 0 View` El Existing Location:
Trade Narne: Mfg:
"hype: Model ## or Size: Location:
® Fuel Oil ® Kerosene Waste oil
Storage Tank: Er New El Existing Location:
Type: Capacity: C,&W CO,C60gals. No. of Tanks:
. �
Special requirements (or additional safety devices)
--e
D USV Valve ® Oil line protected El Sliect Rock ® Sprinkler AFUE: ® yes CJ no
Combustion Test: Nozzle Size Gross Stack Temp.:
New Stack Temp.: COjTest Breech Draft
Stricke: Ove:rfzre Draft: Efficiency rating 176:
L the undcmgned eenify thu the insullat4on of fuel burning equipment has been made in accordance with.M.G.L-c, 148 and 527 C%IR 4.00
crmcndy in efrem Furthermore-this installation huts beat tested in accordance with such requirements, is now in proper opalung condition
and complete instructions as to its use and maintenance have been furnished to the person for whom the installation for alterarion) was rt=dr-
Co. Name:
t
Address: _ C City: 4'r C V\ i Zip:
Installer: �
Pant Name Signature (rw Stamp)
Croce signed by the fire departmc t. this is a PERMIT for the storage and use of oil burning equipment.
Inspected b%.
Keep Original as application. issue duplicate as PctML This form may to photocopied..
FORM F.P. 44 (rev. 8/92)
SN\.
The Commonwealth of Massachusetts
Department of Public Safety - Division of Fire Prevention
6-14-95
(City or Town) (Date)
APPLICATION FOR APPROVAL OF TANK TRUCK
In accordance with the provisions of 527 CMR 8.00: Board of Fire Prevention Regulations,application
is hereby made for approval of the transport vehicle described herein.
Name of owner
Address-L4 i 'zz6 6
(Address of etnin d r icensed Land Where Vehicle is Principally,Garaged)
Year Vehicle A,e
Registration State /,W) VIN#-LL
Tank capacity
ZZ x,,?
(Signature of)"i I icant)
A..... roved ve................ ..............-,2Disappro d t7 2 Permit
02040
(.Signature Head of the Fire Department Or Designee)
Lt. Kenneth E. Long
(Print name) FIRE DEPARTMENT FILE
---------------CUT HERE _._--------------
FORM F.P. 44 (rev. 8/92�
The Commonwealth of Massachusetts
Department of Public Safety - Division of Fire Prevention
Jr 6-14-95
(City or Town) (Date)
APPLICATION FOR APPROVAL OF TANK TRUCK
In accordance with the provisions of 527 CMR 8.00: Board or Fire Prevention Regulations,application
is hereby made for approval of the transport vehicle described herein.
Name of owner /( bl, Ae, r",
Addressc ?
Ar dress of emitted tied or Licensed I-And where V e Vehicle is Pringtipally Garaged)
Vehicle type'IA,,i 1, rt5 5 —Make Year
Registration �75-40_ Stale45 A/ VIN#
Tank capacity L2 �=,
(Signature of Ali cant)
Appro
02043
Permit#
ve- bisapproved
7,T
(Signature Head of the Fire Department or Designee)
Lt. Kenneth E. Long
(Print nanic) FIRE DEPARTMENT FILE
CUT'HERE -----------------------------
FORM F.P. 44 (rev. 8/92)
The Commonwealth of Massachusetts
Department of Public Safety - Division of Fire Prevention
6—14-95
(City or Town) (Date)
APPLICATION FOR APPROVAL OF TANK TRUCK
In accordance with the provisions of 527 CMR 8.00: Board of Fire Prevention Regulations,application
is hereby made for approval of the transport vehicle described herein.
Name of owner
Address 04Z,7e, s,S /)rel", 'zl
(Address of Pernililited'oF Licensed Land Where vehicle is P ' ally Garaged)
Vehicle type Mrtl:e Year .. ........
Registration Stale "I VlN#
Tank capacity .,�Z�
(Signature of ApRficant)
1111-..........
f,,ApproveO,-'Disapproved Pen-nit# 0204`2
(Signature Head of the Fire Depariment or Designee)
Lt. Kenneth E. Long
(Print narne) FIRE DEPARTMENT FILE
------------------------------CUT--HER-E---------------------------------------------------------
FORM F.P. 44 (rev. 8/92)
The Commonwealth of Massachusetts
Department of Public Safety - Division of Fire Prevention
6-14-95
(City or Town) (Date)
APPLICATION FOR APPROVAL OF TANK TRUCK
In accordance with the provisions of 527 CMR 8.00: Board of Fire Prevention Regulations, application
is hereby made for approval of the transport vehicle described herein.
Name of owner 4 fi,"t,/' I/T 4, �All
Address
(Address of Pert tied or Licensed Land.Where Velticle is Princially Garaged)
Vehicle type,��.jjj, 6�k6� Make 4" Year
Registration 11,V,9J,/ State 11;',/f` ��VIN#' 7- r,4 i'�)
Tank capacit A,
4
(Signature of Appli59t)
.................
ATp ,,,4)roved- isapproved Permit# 02041
(Date)
(Signature Head ol"ibe- Fire Department or Designee)
Lt. Kenneth E. Long
FIRE DEPARTMENT FILE
