HomeMy WebLinkAbout0038 LIGHTHOUSE LANE - Health 38 Lighthouse Roacl,,,N7:"
Hyannis
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Make application to local Fire Department.
Fire Department retains original application and issues duplicate as Permit. —
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APPLICATION and PERMIT Fee: 10 01)
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) Faith Peak X
Signature(ifapp"g--permit
Address _38 Lighthouse Lane , Hyannis, MA 02601
Street _ City State Zip
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Company Name Enviro-Safe Corporation Co.or Individual Bennett & O 'Reilly
Print Print
Address 14B jan Sebastian Drive Address1573 Main Street , Brewster, MA
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Signature (if r pe ) 2
Signature(if applying for permit)
❑ IFCI'Certified Other ❑ IFCI'Certified ❑ LSP# Other
Tank Information
Tank Location r38 Lighthouse Lane; Hyannis`, MA
L — Sleet Address
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Tank Cap pacity(gallons) \1000 Substance Last Stored #2 o i 1
Tank Dimensions(diameter x length)
Remarks:
Firm transporting waste Enviro-Safe Corp. State Lic. # 329
Hazardous waste manifest# MAM8378111 E.P.A.# MAD985269323
Approved tank disposal yard Turner Inc . Tank yard# 002
Type of inert gas Tank yard address 235 Commercial Street , Lynn , MA
• • Conservatio Dept.. : ' Date:
City or Town G2iUL N� J 211 / Permit#
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Date of issue � 1' p
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Dig safe approval number: "'''kh,�1� FD ig Safe Toll Free Tel. Number-800 322-4844
Signature/Title of Officer granting permit
After removal(s) ("Consumptive Use"fuel oil tanks exempted)send Form FP-29OR signed by1ocal Fire Department to Office of the
State Fire Marshal, UST Reoulatory Comoliance Unit. P.O. Box 1025. Slow. MA 01775
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