HomeMy WebLinkAbout0160 HILLSIDE DRIVE - HAZMAT Z- YVI Yq
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TOWN OF BARNSTABLE ' � l
UNDERGROUND FU L D CHEMICAL STORAGE SYSTEMS V��
ASSESSORS MAP NO - � PARCEL NO. �
ADDRESS: a h—S VILLAGE- C`evre"rv���E'.
CONTACT PERSON PHONE NUMBER �6C� (l/
LOCATION OF TANKS: CAPACITY: .TYPE OF FUEL. AGE: TYPE: LEAK
OR CHEMICAL: DETEGTION
76'_ a,,s SYSTEM!
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DATE OF PURCHASE OF EACH: 1. j 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS
.PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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CENTERVILLE • CISTERVILLE FIRE DEPARTMENT ,l
PERMIT FOR STORAGE OF FUEL OIL r
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In accordance with previsions of Chapter 148, G. L., and Regulations
made under authority thereof.
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Name hcma.s...;v.-- ................ Name ....James...D.eF-orest............
(owner or occupant) (Installer)
Address ..••1.611•. i.i.l.l,sic e...D.r.....CeA 4ress ......5..7..Wh-ite-?-s...P-a-th..sYar. i
Burner Storage i
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Make ..........MUc' aAe....._..................... Type of Tank ......exl.stixlg.............
Manufacturer ..........Dueane ....... Capacity gals. (or) Size............
Model No. or Size .........DMR.-1Q1.-a.. Location ..................................................
Type................gurt Mass. Approval No. .1.6-05......
Permit issued : �..�.j�. ..� ..... . T1i�
/ :'Fi ffj of Fire�epartment
.............................................................. By ......
(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES) j
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