HomeMy WebLinkAbout2025 FALMOUTH ROAD/RTE 28 - HAZMAT �10� 5 Falniou+h `PoaaP
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PERMIT VO--INSTALL -ALTER
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-FUEL--(?IL,: B,UPtNING EQUIPMENT . . �.
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C This is to certify that -f r J C�cO�t� has
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P o i stall/alter fuel oil burner eq
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J plication'`on file in this office,, and subject to the .provisions 'f Chapter 148,- ,
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Gen. Laws; and _Regulations made under=authn 'thereof.w
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TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
j OWNER AND INSTALLER INFORMATION '
ADDRESS: 2 61 S MAP NO. �` PARCEL NO. 0 .S�- ac,
OWNER NAME: '!C fig- ?r� % `E '�� Yf ; e0)pWV I LLAGE:
INSTALLATION DATE: BY:
ADDRESS: w 1 CERT. .:_NO,_
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-�,-- --—TANFC' I NFORMAT I.ON. ...w
LOCATION OF TANK: /J— en— F;o p L>zl� / Cy
CAPACITY 7 /n t,.TYFE AGE A/ FUEL/CHEMICAL
TESTING CERTIFICATION E I PASS C I FAIL DATE i
LEAK DETECTIONJ C� 'I CHECK IF N/A TYPE/BRAND 3
ZONE OF CONTRIBUTION C ] YES C NO DATE TO BE REMOVED 1?q
FIRE DEPT. PERMIT ISSUED C I YES C l NO DATE
UUNSERVAIION C CHECK IF N/A ( DATE
BOARD OF HEALTH TA NO. f� ]C ]C ]C ] DATE / (�
PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
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