HomeMy WebLinkAboutLP aboveground storage tank permit - LP Gas Tank - 846 CHESTNUT STREET 1/9/2015 'lam
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APPLICATION FOR PERMIT
Cit or Town NQ DIG SAFE NUMBER
Datel _
Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10A application.is hereby made
by _G7� A0
(Full name of person,Finn or Corporation)
Address r f�� r?C�YI. a4y �W�Pr1C� ?'1/l 4 0 t
(Street or P.O.Box)(City or Town)
For permission to(state clearly purpose for which permit is requested)
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Name of competent operator(If Applicable) / i7G�Ylil.�'5 (2D �6Gdr� Cert. No.4!'" /Q
Date Issued.-rejected By
(Signature of Applicant)
-Date of expiration —` ——` —_ Fee Due
—r—— _ $ Paid ——^—— —————^`—
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FP6(rev.3/00) t%• -0,'5, lJ&& Roa"e, eL.0, Q&C9107775
PERMIT
City or Town 09W A)6 fini4 o' M�- DIG SAFE NUMBER
Date
Permit Number(if applicable) Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in 10A this permit is granted
to �� f .2�J �'t� �I C-U g
(Full name f person,Firm or Corporation)
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for ZC� 7�r�� ' /C`� �/G�1 '7L f��� f� I OIA6CI rllnc( LP6- 7 4y, .
Restrictions: 1 /
(Give location by street and no.,or describe in such manner as to provide adequate identification of location)
Fee Paid$ ��U This Permit will expire on
Signature of Official Granting Permit,, N ���__ ,�O � , '%�.__ ,'�) Title
This permit must be conspicuously posted upon the premises