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HomeMy WebLinkAboutLP storage tank permit - LP Gas Tank - 92 SANDRA LANE 11/5/2015 f CJiZv �C�O�.:?LO��,�'/�'2C✓.f�Z GL O��Ir,,ri,'�.r�G(b6�il �»'•�.`."---r;`a,- s �<2:2:U.L(iL!E �:,j:�LLG2 C�:1 f,Gl1GGG -��•-1�;.�� -� w i � e`icrm�n�O�C���rxe �� ce--( c e a t%e %G fi Ctxe r? �ua�zcr� 5, ^JC ��ao t=iLGa; ✓� 07775' DIG SAFE NUMBER. Date: PPLICATIO FOR.-LPERMHT START DATE: Y: C.82 S.40 M.G.L. ,+- To: Mead of]Fine Department: A 0 [City i Town In accordance with the provisions of Chapter 148, M.G.L. as provided in SectiOn application is hereby made by: Name: ���� !t l� -:3 (Full name ofperson,fum or corporation) Address: '<1f G, cr✓1'. �E, :7 f L (Street or P.O.Box) (City o n) (State) (Zip Code) For Permission to: 5"��/ / Fj C � /► �o uy $a CA e �'(�- a, l! rnq�:7' n l State clearly the purpose for which the permit is r uested: _ .Location: Name of competent operator if applicable: �7 7 y!y ��r Certificate of Competency#: - Date Issued{ } Date Rejected { }: By: Date of Expiration: Fee Paid { } Fee Due { } Amount: Applicant Signature: y_� ��„ Fire Department Number: . (If Applicable) 77❑G G O Q r3 0 013 n 0 G n n M 0®9 0 n a la 0 0 0 n O G 0 G G n n a G 0 G a n 0 G a n O G n 0 r7 a a 13 n 0 a G n G.a a n 0 n n 0 n Q,G n 0 n a©m n n'0 G O n G m g 9 a a 0 0 0 � ulslcc v� w° �efia��Gyn.�nG`a�C-�`l�xe C��vv�,d-�ti�,cce a��ie iJJ/,rzzGe -�ixe�•l�Ca��icr,C _ � ' i DiG SAFE NUMBER Date. PE �T C.02 S.40M.G.L. START DATE: In accordance with the provisions of Chapter 148,M.G.L. as provided in Section this permit is granted to: game: 1i ers �-� ��z �-ev c:� M"'+ i ail - "(Full name of Person,firm or corporation) J For Permission to: /J5�/��i�� �'-�� �;�� ) t� �>t^�ci ��rs1r� s- � e'' l—� State clearly the pu pose for which the perrris granted: Rentz ctions: Location: `9� S'ti nGl��a Zr). Fee Paid: is P �t;� 11 Expire O Signature and Title of Official Granting Permit: =>(THis PERMIT MUST BE CONSPICTIOINT.V Pnc-rv-TT-- -- Sitewalk Checklist for Sketch Sketch Checklist: o Cank to house o Leech Bed o All Windows that apply o Second Stage Regulator o Driveway oAll Doors that apply to Windows o Temporary Tank Location o All Sources of Ignition o Second Stage Regulator o Only I temporary tank • Second Stage Regulator to Doors Ineedediallowed o Ali Measurements o Second Stage Regulator o Z temporary tanks o Tank to Windows to Sources of Ignition needed o Tank to Doors o Second Stage Regulator o Tank to all Property Lines to Tank(including o Tank to Sources of temporary tanks where Ignition applicable) Comments notes from technician to ogee): 9` �° � f d'i iC_ < 7` t;a.�:' f r1 � �. f v' � efigr"0 5.� >. I� + 1� d�',:5' d# A, rl & J it Y�i�' �/ !Y',f J� (7 yv�� I,� fd �,.�ir�:,A" :�'8a a� r�ilrCc,.. f jy�i ~°'�.Q ril�,:J/� ""• j�,r! _ b-t!Ul Jae C "'r C 0 w -{- 1 �i Ct / •r2 ttit /�' Office Notes/Correspondence(customers/technicians/other customers): Sitewalk Drawing: Q � I I