HomeMy WebLinkAboutLP aboveground storage tank permit - LP Gas Tank - 68 BEAR HILL ROAD 6/1/2015 FP6(re .3/00) r� Ax -10,95, eT� Raa , �t�QGf�� 9"Q'775
S APPLICATION FOR PERMIT
r DIG SAFE NUMBER
City or Town
Date "� 5
—.___.... Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10A application.is hereby made
by U,4 4,4Y S
(Full name of person,Firm or Corporation)
Address `� ���% z� W � c,r 3,6,e' P1,1 A 6 0
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit it
requ/ested) > D a5 r�/< ���
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Name of competent operator(If Applicable) ! )16-M �,-�,Pie; c.,e-,0r5� Cert. No.
Date Issued-rejected By
(Signature of Applicant)
Date of expiration Fee $ Paid Due
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FP6(rev.3/00) ✓ .(V. %CIQ '��Jr� ��C1P �%� 0 , �s�G(1, ����2 �'/ /Jr
PERMIT
City or TownYd`Yl /1t)(l�r� =Date:
UMBER
Date j—15`
Permit Number(if applicable)
In accordance with the provisions of M.G.L. Chapter 148, as provided in 10A this permit is granted
c ~
to 1-� ' r�y -� � �f ( ,�: •� (' � ter.} /dam //
�— (Full name of person,Firm of Corporation)
for � '4ll I lU"?) L6 C' _'�b1,0C,6"'-x3rl-CIC f` 06 - S( %,
Restrictions:
at /V
(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 �G '
Signature of Official Granting Permit, Title f
This permit must be conspicuous y posted upon the premises