HomeMy WebLinkAboutOil Burner Installation permit - Inspection - 56 BEAR HILL ROAD 1/6/2026 67-7
04r'4wol WWW
VWY
Application for Standard Permit
FP-006 Return completed application to:
(Rev.6/23)
Permit Number: DIG SAFE NUMBER
City or Town: V'-""�i rA 0
6, -Al / Start Date:
Date: L;
In accordance with the provisions of M.G.L.Chapter 148,as provided in Section application is hereby made
by f --s c- L, -2
(Full Name of Person,Finn or Corporation) (Phone Number)
t
L
7
Of
(Address:Street or P.O.Box,City or Town,Zip Code)
for permission to(state clearly purpose for which permit is requested)
Name of Competent Operator(if applicable)
Date Issued-rejected BY
(Signature of Applicant)
-V Date of expiration Fee p
Amount Paid$
- ----------------------------------------------------------------
(:;7—
VIP 0/'VtW?VJM ZW'aa 0
FP-006
(Rev.6/23) PERMIT
Ni
City or Town: DIG SAFE NUMBER
Date: 7-o 2-
Start Date:
Permit Number(if applicable):
In accordance with the provisions of M.G.L.Chapter 148,as provided in this permit is granted
to 0 A 1 e-
z 14 T---) C
(Full Name of Person,Firm or Corporation)
for
Restrictions:
at be a,--
(Street and#or Describe Location for Adequate identification)
Fee Paid$ This permit will expire on
Signature of Official Granting Permit: ti Title
PLEASE NOTE THAT ONLY APPLICATIONS WITH ORIGINAL WET SIGNATURES WILL BE ACCEPTED.PHOTOCOPIES OF APPLICATIONS WILL HOT BE PROCESSED.
00 This permit Must be conspicuously Posted Upon the premises 4111111
s i
Commonwealth of Massachusetts .
Department of Fire Services
BU-017 93
Oil Burner Technician Certificate
JOHN W SCULLIN �
12 BRADFORD LOOP t �
GEORGETOWN MA 01833.:
Expiration Date
State Fire Marshal 11/0512027
r
F
® ail Burner Technician Certificate
I
Failure to comply with Massachusetts General taws
relative to the iss
uance
ante of
this license may he c
re � � Y ease for
rev
ocation,
- I
Refer to: www.mass.gov/dffs 978-567-3780
If found,please return to Massachusetts Department of Fire Services
State Road,P.O.Box 1025,Stow MA 01775
C .
i
i 9 '7 I
Marblehead 631-0134 ® Beverly.927-2422
Lynn 592-5700 �
I
Imo] ®Ilhe®t
em
Name
i
Street G` � � ttd
�p /`k tAcct No J
1
•• cQ 'COMBUSTION TEST HEATING SYSTEM
y n Cl)
0 V
_ to Date: idb T ( sc)
_ 00 � r„F Boiler/Furnace :
e 00 Manuf. 7rvP �r
h 6 M n j
y °0 1 Gross Stk, Temp. `; Model
® CD 0 t ��V � ❑ F. Warm Air ❑G. Warm Air
N Cc '"Hot Water ❑G. Hot Water
�I n CO Net Stk. Temp. ❑Steam ❑Coal Converted
^1
i
�_ No. of Zones 4
❑CO2% ❑02% 6017
Aquastat Setting �
ill � i
N Smoke 01' Burner/�c,�"�
tgt
r
Manuf. ,�"
Breech Draft �r v
_Model Info. a�n
I i
Overfire Draft !
Nozzle
IL SIzelLbAngie &0 Spray K—; 1
® Winter K-Factor
EFFICIENCY _;
� Combustion Chamber
d IE Excellent r` ❑Replace ❑Repair E2 10K I
❑ Good Domestic Hot Water
❑ Fair ❑Oil ❑Gas ❑Electric
❑ Poor ❑Separate ❑Tankless
❑ Tankless with Booster Tank
i
Tankless Size pm
Q
q Temperature Setting
n l
Technicia &ik!0 (A)
Oil Tank {
J�
Certificate No. (/ / �/ Size � �'" Gals.
i
DEALER
Y .
�_
INN
i to SeriaFNumberTOT,
� "I U.S Dollars and Cents n "' '
5562229
r <
��d l
SFGflEYFPY6@pGNING•qF6 �GI mty1N1N .gRNibSSE i
/ Amotln( ✓r �! /
Pe �
®26Y5 United States Postal'—l-All Rights ReserJed. 1 11 :
55023 , '