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TOWN OF BARNSTABLE
N UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS
ASSESSORS MAP NO.- PARCEL NO. R
ADDRESS: �,6-7 9Ly>u-!. H i U- R VILLAGEi C67-07'c7t V-1 LL
14AME;.-.
zTCONTACT PERSON �/�(zL �rL ~�j zrys �d � � PHONE NUMBER 77 W
LOCATION OF TANK:_ CAPACITY: TYPE OF FUEL AGE: TYPE: LEAK
G�O N p to o® 6h L . OR CHEMICAL: S��r I- DETECTION
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DATE OF PURCHASE OF. EACH: 1. 2. 3. 4. 5. _
~ DATE OF FIRE DEPARTMENT PERMIT: 6/�1151.70
TESTING CERTIFICATION SUBMITTED: j q a . PASSED DID NOT PASS
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PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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~ CENTERVILLE - CISTERVILLE FIRE DEPARTMENT ^� '
PERMIT FOR STORAGE OF FUEL OIL
In accordance with provisions of.Chapter 148, G. L., and Regulations '� TJ
mode undo or
thereof.
r+`��, 0 llGrg®• LQYen) �•• . {Name ��Ill@T.... A .`�3r. ....R1............ ..t...Nome ............. .....................................
,(owner or-occupant) (Installer
� '' S t F1 Hill 1 Howard Ct: E. Brocton.
g. Addres��7 t7,Q.4 Address �t
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Burner Storrs e ,'
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4 x Make .......RBd....Nli.tlg.............................................Type of Tank ....,Si .A1.... QS�1�d....
•';'=,M anufacturer .GO.IA1d..... @,.,......QQ..........Capacity..AQPQ..:'9als.(or)Size......'t..........
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No. or Size . .-.2...Gal............................Location . U d@rg,I'01121........................................
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-Type ......G4 n.......:..... M s. Approval No.743...............
Permit issued k r},
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(head of Fire De r m' ent)
- +(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PR
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