HomeMy WebLinkAbout0159 MAIN STREET (OST.) - Health (2) C
C1/,D. A:/ ^0 TOWN OF BARNSTABLE VA�ve IrA G
UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
ASSESSORS MAP NO. PARCEL NO.
ADDRESS! j S ej --7A 1 $4 151, VILLAGE
AME
CONTACT PERSON J-�t''�87�2t.j (i�(-F dp�/ PHONE NUMBER `7`7+SS- 4-5 4
LOCATION OF TANKS: . CAPACITY: .TYPE OF- FUEL. AGE: TYPE:, LEAK
t-5r_>.._.....-___OR-CHEMICAL% I' '- SIN. --: DETECTION
�A341KA ( S�/t-it-1Ii�sG1 �L�� SYSTEM'!
DATE OF PURCHASE OF EACH: 1. �!/�L�' 2. IR;J �— 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED: PASSED >< DID NOT PASS
I
PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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COTLIIT FIRE DEPARTMENT
,CENMV1UE—OSTERV1LLE FIRE DEPARTMENT
PiQIlAIT TO INS T ALL ALTER:--4U EL OIL BURNING EQUIPMENT ,
Name Mt-, ��,�,-Gl,�. " ` Name
er or 2"pa=t ' _ J instailer
• : 'Address f /27',,i7 ��4 Address , rJ
Date:— / ���� Certificate of Competency #
This is to certify that the above license installer has permission to instal! alter fue) oil
��w burning equipment at above location inaccordance with an app lication#on file with
office and subject to theprovisions of Chapter 148 General Laws and regulations made
under authority thereof
Permit expires 60 days after issued date.
Locking device will be adheared to oil fill if unit is found installed and perhas expired.
A violation will be issued unless reapplication is made or release on the job to
the fire department in writing before expiration date.
Head of Fire Department J.-M. Farrington -Issued By: �
_ ,x 77.
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