HomeMy WebLinkAboutFuel Island Systems Inspection Report - Inspection - 79 CHICKERING ROAD 1/21/2021 Mefro U S a Fire Protech"on, Inc.
203 Concord Street, Suite 405 Pawtucket, Rt 02860
(401) 365ml 094 Fax: (401) 365=1 096
DUEL ISLAND SYSTEMS INSPECTION REPORT
Customer.. U �( ��r��L�'� Date V <AV�
Address Inspector _ d c�
City/State e ).�Ti, An Lic. No..6,4�4"
Manufact rer Mfg. Date (QO
Mo. No. �� 01a"rSize- �"�%A �� 3
�No. of Cylinders
No. of Islands r � € f
No. of Pull Stations � Carl. Location Ov\
System installed per Manufacturers Specifications N
System In Operational condition i//
(�
Fuel Dispenser Shutdown N
System Connected to Local Municipal Fire Alarm
CCTV System 1(/N
Last Hydro Static Test Date � Last b Year Maintenance
Thermal Detectors: Quantity-,........ Temp. a 5.a�
Do all Thermal Detectors comply with manufacturers specifications p�
and Authority having jurisdiction? /N
If no, please indicate reason(s) in comment section below. v
Comments:
rc on
Fire De t. Representative Customer/Authorized Signature
Commonwealth of Massachusetts
f Executive office of Public Safetyalnd Security
7P
Department of Fire Services
www.mass.gov/dfs
lei
4/16
Self Service Motor Fuel Facility
To: forth Andover Fire Department SS I D-00 599
From: Matthew A Murray Full Self-Service
Designee of the State Fire Marshal
Date: 12/04/2020 Facility: Super Petroleum
79 Chickering Road
North Andover MA 01 45
The Department of Fire Services, Division of Fire Safety has reviewed and approved the enclosed plan for
the facility referenced above in accordance with the requirements of 527 CMR 1.09 Section 42.7.5.
Upon completion of the installation, you are requested to make anon-site inspection to determine that the
facility has been constructed in accordance with the approved plans. You are requested to return this
completed fora to the Department with your approval or reason for denial.
You may return the completed fora by email to vicky.giguere@mass.gov by fax to 97 567-3819 or by
mail to Department of Fire Services, PO Box 51025, Springfield, MA 0115
Name of Suppression System Installer:
r+
Certificate of Competency No:
4(D
proved []Disapproved
lig-nature Dead Fire re ire