HomeMy WebLinkAboutLP aboveground storage tank permit - LP Gas Tank - 25 WOODBERRY LANE 1/12/2016 zero
TheCommonwealthof scs
Department Fire Services
-- a} Office of the State Fire Marshal
C74, P.O.Box 1025 State Road,Stops;MA 01775
APPLICATION IT
Date:
Permit No
(City or Town) (If Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter as
provided in Section application is hereby made Start Date
by .4 C(2-z -yl C-
(Full name of person,Firm or Corporation)
State clearly Address t I�C7�� L, "W ygl/\C..e
purpose for (Street or P.O.Box City or Town)
which permit For permission to O ZZ
is requested f
Comments:
k�
at o`�J WCC b u yr 4 1.,.1Q Pig F�
(Give location by strut and no.,or describe in such manner as to provied adequate identi cation ot location)
Name of competent operator � � �(l�e Cert.No.
(If Applicable) T
Date Issued-*"e e4 By
Signature of Applicant)
c
Date of expirations �� Fee '�2 P Due
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The Commonwealth of Massachusetts
it
a Department of Fire Services
{ a Office of the State Fire Marshal
-~ P.O.Box 1025 State Road,Stow,MA 01775
Permit No PERMIT Date:
(City of Town) (If Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter as provided in section
�+ Start Date
This Permit is granted to: / /-1-1-�1 ' 'U e_L_s
Full name of person,Firm or Corporation
Permission to ?9 S14+¢ '� IQ U 16
Comments:
Restrictions: NO PRODUCT PLACED
J ON SITE UNTIL PERMIT ISSUED BY FIRE DEPT.
at 95 (.. co d b U r`� �i�y.
(Give location b street and no.,or descri such manner as to provied adequate identification of location)
Fee Paid$ S`a.U C) r
This Permit will expird i19, (Signature ofbffical granting permit) granting penmt (Title)
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