HomeMy WebLinkAbout0139 OLD STAGE ROAD - HAZMAT f� '-I�9-0$�-Uu�
TOWN OF BARNSTABLE
�= UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS Ykv,�
ASSESSORS MAP NO. _--� PARCEL NO.
M-DRESS: / � c� � ./� VILLAGE'
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IS,
CUT ACT PERSON _ ,(26 fc�+" td Z PHONE NUMBER 7 Vr e
WCATION OF TANKS: CAPACITY: TYPE OF FUEL. AGE: TYPE: LEAK
OR CHEMICAL: DETECTION
���fiL. � �i,✓ �6� SYSTEM! �
DATE OF PURCHASE OF EACH: 1. 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 OSTERVILLE FIRE DEPARTMENT .
PERMIT FOR STORAGE OF FUEL OIL
� . ,
In accordance with provisions of Chapter 148, G.L., and Regulations
-. made under authority thereof.
o ^Li].V2I' Name :.
Name ...j`:.� ,. Ri
....:........... (Installer)
(owner or occupant) °7
Old Stare Ted '•
Address �.�.9...............
:...r.:z..r....... Address .
Burner Storage
fir]::? t Type of Tank ...... ;�. :G.lZ1 ............
Make e'P 'Be
kett Corp Capacity ........... gals. (or) Size............
Manufacturer . •••
........
Under.ground
R1 . . ? ... location ...............................
Model No. or Size ...........•..•...00•...
Type....�F?aZl............ Ma s. Approval No. ..... .....
Permit issued ....
Z��.o: ..................Jal.7a..�`�......E'a.rr.j
Head of F' part e
..............
By .:.. ..
(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON+ #IE PREMISES)
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