HomeMy WebLinkAboutPermit - Propane Fill Station - LP Gas Tank - 4 MAIN STREET 9/17/2018 W. /��
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Application for Standard Permit
FP-oos return com leted a lication to: 1 'Y
(Rev. 1.1.2015) p PP N 1 t
Permit Number: EDIGSAFENUMBER
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 ( 18 ) 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
—____—_—_ (10614 - Richdale Store# 52 -4 Main St)
c-
p' /moo North Andover
FP-006
(Rev,1.1.2015) PERMIT
City or Town: North Andover DIG SAFE NUMBER
Date: 9/17/2018
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 Richdale Store#52 Customer# 10614
(Full Name of Person,Firm or Corporation)
for Storage of( 18 ) 20 lb. Propane Cylinders for retail or exchange
Restrictions: NFPA 58/NFPA 1/527 CMR/527 chapter 69
at 4 Main St.; North Andover, Ma. 01845
(Street and#or Describe Location for Adequate Identification)
Fee Paid$ $ 50.00 This ermit will expire on 6/06/2019
Signature of Official Granting Permit: Title
permitThis i the i