HomeMy WebLinkAboutLP aboveground storage permit - LP Gas Tank - 37 STONECLEAVE ROAD 8/4/2015 FP6(rev.3/00) P- 6. 93� -10,95, e&4 R� C%,,, QA-2-001775
APPLICATION FOR PERMIT
City or Town A d/ (--I M DIG SAFE NUMBER
Date
Start Date:Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10A application.is hereby made
by
(Full name of person,Firm or Corporation)
Q.Address r- IeI7(,e
(Street or P.O.Sox)(City or Town)
For permission to (state clearly purpose for which permit is req sted) /41 C,2
a
U
Name of competent operator(if Applicable),71WV7!�-,j EQQ q C 6d/-5 Cert. No.
Date Issued4ejected By
(Signature of Applicant)
&
Date of expiration Fee $ Paid Due
C� � . -- -c��--"- - - �,�,�'�fog�� __- "--
--- ——————————————————————
VIP
FP6(rev.3100)
PERMIT.
City or Town DIG SAFE NUMBER
Date
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
(Full name otpersoh,Finn or Corporation)
for 11 Soy lt
Restrictions:
at +6-tn,2. 6
(Give location by street and no.,or describe in such manner as to provide adequate identification of location)
Fee Paid$ This Permit will expire on
Signature of Official Granting Permit
This permit must be conspicuously posted upon the premise's