HomeMy WebLinkAbout0655 MAIN STREET (HYANNIS) - Health 655 MAIN STREET
Hyannis
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TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
MAP NO. _ PARCEL NO.
ADDRESS OF TANK: IY��=th VILLAGE: 1�� IoE b1 1 J
N u m bM r Y t r we*!
MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : Ya cS `�k4a Gt A fl S)
OWNER NAME: og y e- PHONE: -77 23QA'�
INSTALLATION DATE: BY:
INSTALLER ADDRESS: � -CERT.NO.
*TANK LOCATION: I',-e4 o4 too/SLY/ bi®
(DC�Of4 Z aG ANK 1�OQAT ON W Z TH ACOPQCT TO m1J Z LD 2 NO)
CAPACITY c TYPE OF TANK ��� AGE _YRS. FUEL/CHEMICAL
TESTING CERTIFICATION C ] PASS C ] FAIL DATE
LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION [ A YES C ] NO DATE TO BE REMOVEDQ,
FIRE DEPT. PERMIT ISSUED C ] YES [ t�l NO DATE
CONSERVATION [ ] CHECK IF N/A DATE
BOARD OF HEALTH TAG NO. C ] DATE
PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
TOWN OF BARNSTABLE 1 UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
-----MAP NO. _ D PARCEL NO'.fJ`JJ`
ADDRESS OF TANK: L1lJJ ( �} . N �Q m 0 S V,[ILLAGE. '
. Number Yt tel
•.,� fiy'... y
MAILING ADDRESS ( IF DIFFERENT FROM; ABOVE)`, `" ,��tl-��[ urp 41 n
OWNER NAME: 02 v � t.��t'�IMI/�.� f"� PHONE:
INSTALLATION DATE: BY:
INSTALLER ADDRESS: °_ '.CERT.N,0. �MoJr�
f rr,�,, t
*TANK LOCATION: r�� r d holliJi Ra I (A` �J�I G A
(D Q O O R I n C TANK L O O A TyON W S T H R G 0 P Q 0 T T O m u S L D 2 N O)
CAPACITY TYPE OF TANK D (l AGE f6 YRS. FUEL/CHEMICAL
TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE ~'
LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED
FIRE DEPT. PERMIT ISSUED [ ] YES [ L]N 0 DATE
CONSERVATION [ ] CHECK IF N/A DATE
BOARD OF HEALTH TAG NO. [ ] DATE
* PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
'Y
TOWN OF BARNSTABLE. .� UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
f-----.—MAP NO. PARCEL NO. t -5 V
ADDRESS OF TANK: N 1VI LLAGE: [�.�- 0 i
Number mtr��t i t
MAILING ADDRESS ( IF DIFFERENT FROM,` AHOVE) : � C 't � k/(0 A h C C
OWNER NAME: V Lp plow //)o PHONE: 77 � =
INSTALLATION DATE: BY:
INSTALLER ADDRESS: I Y�'CERT.N0.� z"."~y
*TANK LOCATION: r'-eeq r 04 t> pg / y
c ommaw z aC TANK 1-00A-rJoN W S TH RGmPW0 r TO mU X 0-I NO)
CAPACITY "� TYPE OF TANK <_
AGE `� YRS. FUEL CHEMICAL"
TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE
'.
.LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND ---
ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO HE REMOVED
FIRE DEPT. PERMIT ISSUED [ ] YES C �]JNO DATE
CONSERVATION [ ] CHECK IF N/A DATE
HOARD OF HEALTH TAG NO. [ ] DATE
*' PLEASE PROVIDE A SKETCH SHOWING THE .TANK LOCATION ON THE HACK OF THIS CARD