HomeMy WebLinkAbout0063 CHESTNUT STREET - HAZMAT ��► PSG u� ��-r�efi
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TOWN OF BARNSTABLE _ UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
s OWNER AND INSTALLER INFORMATION
ADDRESS: C '�'}� - t� n 4" � ' MAP NO. l_?q PARCEL NO.
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OWNER NAME: , J:> '�` ° `e'2`" at-s iF in#4 VILLAGE: l_VAX# �
INSTALLATION DATE: "" BY:
ADDRESS: CERT. NO. §/ old- � t1`^�t
TANK I NFbRMAT I ON ",
LOCATION OF TANK C&.."
"""` APAC ITY 7'' Tlf !E rt-tr ir� AGE t on FLiL%CHEM T f1AL !"� : L
TESTING CERTIFICATION C ] PASS C ] FAIL DATE
LEAK DETECTION C . ]. CHECK IF N/A' TYPE/BRAND
ZONE OF CONTRIBUTION C ] YES ] NO DATE TO BE REMOVED ` ,
FIRE DEPT. PERMIT ISSUED 4C}t] YES C ] NO DATE
CUNSERVATION C ] CHECK" IF N/A DATE o
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BOARD OF HEALTH TAG NO. ]C ]C ]C ] DATE q1141)
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PLEASE PROVIDE A SKETCH SHOWING THE .T4AK LOCATION ON THE BACK OF THIS CARD-- - .
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THE COMMONWEALTH OF MASSACHUSETTS
FIRE DISTRICT OF HYANNIS, MASS.
FIRE DEPARTMENT s'
FIRE PREVENTION DIVISION
PERMIT FOR STORAGE OF FUEL OIL
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In accordance with provisions of Chapter 148, General Laws, and amendments thereto and
Regulations made under authority thereof. i
Lame __Gnx_d.an_P..ex.1:.y........................................Name ...D.aniel_...L.u.beke......QlA.4.5.6._..__
(owner or occuliant) (Installer)
j Address .__ _ __ .Xlh] ......SIX.e.e.t...........Address. ..............................................................._............_..............
.
BURNER STORAGE
I Name .....Carlin..........._._................._.................__.._....._..Type of_Tank EXlStlri A
. g........_..........._........_..
Manufacturer —SaMe..............................................._.............—Capacity _......_...._.............gals. (or) Size.......................___
Model No. or Size _....1.00,0.Yd..._.............................Location ...._...... .. . .._........_......... .....
Type _.-G_LIn...._..._Mass. Approval No. .......]
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p Permit issued2_..-.1l..__. pires............................ (Head of artm>en�t)
IL Fee::^ Paid_-_—-.—.---./................_..... By .... tV
..;�5 "^r,�•••— -••-•••__...
• This Permit Must Be Consp uouosted on Premises