HomeMy WebLinkAboutPermit - Propane Fill Station 2018 - - 800 WAVERLY ROAD 9/17/2018 North Andover
Applicationfor Standard Permit
FP-006 r f
(Rev.1.1.2015) Return completed application to: WF-
Permit Number: EDIGSAFEUMBER
City or Town: North Andover
Date: 9/17/2018
In accordance with the provisions of M.G.L. Chapter 148,as provided in Section 10 A application is hereby made
by Blue Rhino of New England 413.781.3694 Ex 3
(Full Name of Person,Firm or Corporation) (Phone Number)
of 1709 Page Blvd. Springfield, Ma. 01104
(Address:Street or P.O.Box,City or Town,Zip Code)
for permission to(state clearly purpose for which permit is requested) To store ( 21 ) propane cylinders for resale or
exchange, in a locked, vented, impact protected cage. Cylinders will be filled off site at a location operated
by Blue Rhino, and will comply with NFPA 58/ NFPA 1/527 CMR 1/527 Chapter 69
Name of Competent Operator(if applicable) N/A Cert. No. N/A
Date Issued-rejected By Wayne A. LaFleche
(Signature ofApplica
Date of expiration 6/06/2019 Fee $ 50.00 Amount Paid$ $ 50.00
Q (154543-Walgreen's# 10209 -800 Waverly Rd.)
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'pr /00 North Andover
FP-006
(Rev. 1.1.2015) PERMIT
City or Town: North Andover =SAFENUMBERDate: 9/17/2018
Permit Number(if applicable):
In accordance with the provisions of M.G.L. Chapter 148,as provided in 10A this permit is granted
to Walgreen's 10209 Customer# 154543
(Full Name of Person,Firm or Corporation)
for Storage of( 21 ) 20 lb. Propane Cylinders for retail or exchange
Restrictions: NFPA 58/NFPA 1/527 CMR/527 chapter 69
at 800 Waverly Rd.; North Andover, Ma. 01845
(Street and#or Describe Location for Adequate Identification)
Fee Paid$ $ 50.00 This permit w i expire on 6/06/2019
Signature of Official Granting Permit: itie
no This permitispremises