HomeMy WebLinkAbout0131 YACHT CLUB ROAD - HAZMAT /31 qa6h Club 'Eaa� rl�
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINALS)
I M ^C&L
DATA
TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
OWNER AND INSTALLER INFORMATION
ADDRESS: MAP NO. PARCEL NO.
OWNER NAME: VILLAGE: l�/�/✓ 1�V�I�1��(�
INSTALLATION DATE: BY:
ADDRESS: CERT. NO.
TANK INFORMATION
LOCATION OF TANK:
CAPACITY TYPE AGE FUEL/CHEMICAL
TESTING CERTIFICATION C I PASS C I FAIL DATE
LEAK DETECTION C I CHECK IF N/A TYPE/BRAND
ZONE OF CONTRIBUTION C I YES C ' I NO DATE TO BE REMOVED
FIRE DEPT. PERMIT ISSUED C I YES C I NO DATE
CONSERVATION C I CHECK IF N/A DATE
"'Z-71,-
BOARD OF HEALTH TAG NO. q or ]C ] C ]C 1 DATE ��6 4 1
PLEASE PROVID4, A ,SKETCH SHOWING THE TANK LO ATIqV ON THE BACK OF THIS CARD
AV.
fi CENTERVILLE•.= OSTERVILLE FIRE DEPARTMENT 1
ERMIT FOR STORAGE OF FUEL OIL y
In a ance with provisions of Chapter 148, 0.L., and Regulations
s made under authority thereof.,.
Name'.Thomas Realty Trust Name Alton F" ,And•ersrn ,
.. ..............
(owner or occupant) (Intaller).
Address I,ot,, �,
�{ Yacht C l
.. ubIdress ... 3 le ;stint
St,
enterville Hyannis�rner Stor ge `.• f�
Make"Arcoflame Type of Tank2^..RQunc� S e l {
........: ..... ..
... {
,American Radiator 0 Manufacture ................................:.. Capacity ..r?..��......:. gals (or)'Size...........:
-Model No. or Size .......DH.... F5..................... .Location .:1AAO.�?:.g�:Q�S�a.,;
Typ . Gu n
e... ............ ... Mass.
�Appr-o-v7al No :�.3.r?.�?�..
Permit issued ./. ...�^':.?...../... "
TO It f ad ire Department
................................................. ....... By. . .. .. ....
(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES) i
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