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HomeMy WebLinkAboutLP aboveground storage tank permit - LP Gas Tank - 245 BOXFORD STREET 4/27/2015 �fi� y'd�1TZ9?z�<��s�a•�1;z�9'1L'n�tiza`raae� �^�}�y r /'i.2-2Ci'�'G!%✓%� �l�`✓���:f i.:(1L'LC, r:�^?�l�� 1��'`jF7��_� > �T DIG SAFE NUMBER Date: r�� .�9 APPLICATION Lip 1�`�. ;!�>�1t�1V HT } e START DATE: C.82 S,40 M.G.L. ,I To: Head of Fire Department: " 1gnd a-,P-,r L City/Town In accordance with the provisions of Chapter 148,M.G.L. as provided in Section application is hereby made by: A NTame: (Full name of person,fum or corporation) Address: �' e r npk S t,Cs.(-,j re2 N (Street or O.Box) (City/Town) (State) (Zip Code) For Permission to:--4-17 6 ,rl I"'/(� CrG`/�f�'� CyA(ts 7;CL State clearly the purpose for which the permit is requested: •Location: r l rame of competent operator if applicable: GLt�d Certificate of Competency#: 1a � Date Issued { } Date Rejected { }: By: Date of Expiration: _ Fee Paid { } Fee Due { } Amount: ApplicantSignature: � 'a �j------- Fire 17.Department Number: (If Applicable) OG u E!O QH0 00 q Qcr®a®00[(0000 mn Q a 00°rJ 0 0 a 13G4.0 a 0 0 Q 0 n❑aR'Maa tan 000,M E1 U.©a 0000.00 a a a a 0 000130000[7600000 Q ,ie l(omr�a7�uecr on �aeaczc/zcLZa. ' ti 9a..t;10,-5, ` l C—%,,, Q:�` OYM' DIG SAFE NUMBER Date q'�7'1 �' PERMIT C. C82 SAO M.G.L. START DATE: in accordance with the provisions of Chapter 148,M.G.L. as provided in Section this permit is granted to: ff '(Full name of person,firm or corporation) For Permission to::'~' ` ! State clearly the purpose for which the permit• granted: Restrictions: Location: ?ee Paid: s ermit WillExpir n: Signature and Title of Official Granting Permit: ""`' Sitewalk Checklist for Sketch Sketch Checklist o dank to House o Leech Bed o All Windows that apply o Second Stage Regulator o Driveway o All Doors that apply to Windows o Temporary Tank Location o All Sources of Ignition o Second Stage Regulator o Only 1 temporary tank o Second Stage Regulator to Doors needed/allowed o All Measurements o Second Stage Regulator o 2 temporary tanks o Tank to Windows to Sources of Ignition needed o Tank to Doors o Second Stage Regulator o Tank to all Property Linea to Tank(including o Tank to Sources of temporary tanks when Ignition applicable) Comments(notes fkom techniciaq to office): �— �� lace. f` ) l jr) ► t° to.4 ttw S G ,,dff Office Notes/Correspondence(customers/technicians/other customers): Sitewalk Drawing: 1 � . ao Sw8 6 10UU , rj T