HomeMy WebLinkAboutPermit - Propane Fill Station 2017 - LP Gas Tank - 1725 TURNPIKE STREET 5/12/2017 wity North Andover
Application for Standard Permit
FP-006
Return completed application to:
(Rev. 1.1.2015)
Permit Number: DIG SAFE NUMBER
City or Town: North Andover
Start Date:
Date* 5/12/2017
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10A 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,C4 or Town,Zip Code)
for permission to(state clearly purpose for which permit is requested) To store ( 14 ) 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 CIVIR 1/527 Chapter 69
Name of Competent Operator(if applicable) N/A Cert. No. N/A
Date Issued-rejected By Wayne A. LaFleche
(Signature of Applica
Date of expiration L/, — —Fee 50.00 Amount Paid$
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C7_7 C 2 9
North Andover
FP-006
(Rev,1.1.2015) PERMIT
City or Town: North Andover DIG SAFE NUMBER
Date: 5/12/2017
Start Date:
Permit Number(if applicable):
In accordance with the provisions of M.G.L. Chapter 148,as provided in 10A this permit is granted
to Al Prime Gas Station# 1'08 Customer# 161402
(Full Name of Person,Firm or Corporation)
for Storage of( 14 ) 20 lb. Propane Cylinders for retail or exchange
Restrictions: NFPA 58/ NFPA 1/527 CIVIR/527 chapter 69
at 1725 Turnpike Rd.; North Andover, Ma. 01845
(Street and#or Describe Location for Adequate Identification)
Fee Paid$ 50.00 This pegit wA expire on /z, —1:� 16PIl-,
Signature of Official Granting Permit: Title Z--,;e c
This permit must be conspicuously posted upon the premises #M