HomeMy WebLinkAbout0652 POPONESSETT ROAD - Health (2) �5a /�aPanssv� /Zoe
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TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
OWNER AND INSTALLER INFORMATION
ADDRESS: � j'�� MAP NO. 46 PARCEL NO.6
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OWNER NAME: jLeV-1 4r- 094 VILLAGE: G' fyrr'
INSTALLATION DATE: lowa / BY: '�"'*�"���'' � {�r> _ lQ w
ADDRESS: _ LIV ► �t CERT. NO. ��
A/ TANK INFORMATION
LOCATION OF TANK:
CAPACITY loot) ,
TYPE f 4 AGE �Z2 FUEL/CHEMICAL
TESTING CERTIFICATION,� E': ] PASS C ] FAIL DATE
LEAK DETECTION- CV] CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION, C ] YES V3 NO DATE TO BE REMOVED !g
FIRE DEPT. PERMIT ISSUED C V 3 YES C ] NO DATE
CUNSERVAiION CV] CHECK IF N/A DATE
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BOARD OF HEALTH TAG NO. [ C ]C ]C' ]C ] DATE `7
PLEASE PROVIDE A �SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
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3 y COTUIT. FIRE DEPARTMENT f :
PERMIT FOR' STORAGE OF FUEL OIL
<< In accordance with v provisions of Chapter 148, G.L„ and Regulations•� .•
made under authority thereof. ' {
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Name ..Hi�o�.�,..A�..S atki:..:............:. Name �I �..�...Caruxom................,_.
(owner or occupant) (Installer)
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Po onesset Rd Address Centerville Rd Hyannis„Address .......P.P.q ..ss........... ..R ....
Burner. Storage
Arcoflame
Make ...................................................... Type of Tank
Manufacturer American Standard 1000
...........a .......an............. Capacity .............. gals. (or) Size,._........
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Model No. or Size _•-DH 5 Location Underground -
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Type....GM.............. Mass. Approval No. 13566.........
Permit issued ...
fl.. ..................... ............. ............ r�.:..... ........ .. ....
(Head of Fire Departme
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(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES)
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MRS. HAROLD A. SPATHE
POPPONESSET ROAD
COTUIT, MASSACHUSETTS- 02635 t >
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