HomeMy WebLinkAbout0061 BARNSTABLE ROAD - Health 61 Barnstable Road Sewer Acct # 1184
Hyannis +
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Make application to local Fire Department.
Fire Department retains original application and issues duplicate as Permit.Wammamvealg �J.—�
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APPLICATION and PERMIT Fee: hl'
for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions
of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by:
Tank Owner Name(please print) Louis J Panesis X
Signature(it aplyrng forpermrt
Address 61 Barnstable Road Hyannis Ma 02�n�
Street .. Crry Sfate Zrp
• • • •
Company Name Advannp-8 Rnyirnnmental _ Co. or Individual
Print Prim
Address g Pddress
rat Print
Signature (1Pa�pplyi fo er Signature (if applying for permit)
;7 IFCI Certified Other :1 IFCI Certified O LSP # Other
Tank.Location Barnstable Road Hyannis Ma 02601
Steet Address City
Tank Capacity(gallons) 5-- --500 Gallon -'Substance Last Stored
Tank Dimensions(diameter x length)
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Remarks: �s °
Firm transportingwasteAdyanced Environmental State Lic. # MV508 - 610(3D ?00
Hazardous waste manifest# E.P.A. #
Approved tank disposal yard James G.Grant Co. r Inc Tank yard# OOR
Type of inert gas Dry Ice Tank yard address Woi r-ot t St • Readyiile, MA I
City or Town FDID# Q/�—Permit# n n _
Date of issue ' / � �,[ .. 1 Date of expiration
Dig safe safe approval number: 20000103473 �® Dig Safe Toll Free Tel. Nu r-800-322 48 4
Signature/Title of Officer granting permit
After removal(s) send Form FP-29OR signed by Local Firerfl�S4tr�t pliance Unit, One Ash urton Place,
Room 1310, Boston, MA 02108-1618. `r �,�� J /'�
292(revised 9/96) f