HomeMy WebLinkAbout0038 SCHOOL STREET - HAZMAT 3g &kool �r¢rk, 1�� ��n� s
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TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
MAP NO. �7PARCEL NO. 4- 1 —
ADDRESS OF TANK: 39 5 0-1v a!_ s / • VILLAGE: !L' ✓/
Num bar
f!Q �✓
MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : '
6
OWNER NAME: PHONE: S` !
INSTALLATION DATE: 31t/4S BY: �• E S w`
I"!STALLER ADDRESS: ij ' fI✓Y/Y1S CERT.NO.
*TANK LOCATION: Af1',l E X + FA 41 H U y
(OKSCRINK TANK LOCATION WITH MKnpK.CT TO BUILOINm)
CAPACITY 00 TYPE OF TANK AGE 'YRS: FUEL/CHEMI-CAL 0/4-
TESTING CERTIFICATION [ I PASS [ ] FA"IL . DATE
e'
LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ' l
ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO HE REMOVED
FIRE DEPT. PERMIT ISSUED [ V] YES [ ] NO DATE
CONSERVATION [ ] CHECK IF N/A DATE
HOARD OF HEALTH TAG NO. [ 10 ] DATE / iL
e r
Y
PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
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*k �h PE' ?FOR+ STTpRAGE OFMh iSC ��v,s 'k ' x °�' d
IIEL S p j a c
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in accordance witlr�pt p�isions oChapter 148„G L and x Regul�ttons}madet under authorit t
thereof
Namerr�r_t� - Name t V ki x r'
;a(owner or occupant) y (Installer) fi wr ite aJIF •
(� 1`,ki�itizzi '
! Addreas'��rtc mot? cdc !�c ?'� Address
i�
BURNER MegTORAGE k, i" + k <<•.
.Name's � . � xe"of Tank _{ 44A t,GrY".. YP ��' .t��
ti
9 1 S {s
Manufacturers"�,l +�l,�.--,u,,
' Iocation ............
'Model No. of SlA. .� - P•
( Type t r p: p(rovapti..
t/;f �sI ^tF
r t - l i 0. h�9d .}F ♦ 1 ire h P t S 4. (,,iq.
, � 4 '' / � �^' ��Eft 4�¢�,�''3 *4y` + b�l i ✓���tlLr�.�.� Y't ,� t r,�,yy�o
,hermit;issued
1enartment)�
tt �;
�� _,r,,. ,+� �gs•ea�. ,,..r.,.......... ,—�n,.<•,.s;, �,<^.e... ..r,rrr•.;r:'r.'.oe�+Rr'.p^. na,-vp�-�.r+•or^r-s+.:� r r. ��.�.,1••��
+ �^ THE COMMONWEALTH OF MASSACHUSETTS
y AIS'X'...........of......Y.ANAITS....... >.
FIRE DEPARTMENT
FIRE PREVENTION ;DIVISION
PERMIT FOR STOIfAQE OF FUEL OIL
In.accordance with provisions.of Chapter 148, G neral.Laws, and amendments ther. Eo and
Regulations made under authority thereof, sy
b Name `........�I�tIE?d.QZsI.BEAM ........... ....... ..Name ........1ESLII;.Y.:..A?U= .....
(owner or occupant) (Installer)
Address Wig.. 'I Q( ,..S�....HZ'Ar 1�S...........Address ....0S.TE$V=.. S. .......
BURNER STORAGE
Name .......:3ECI :T�..�Q 1�AQ�..................Type of Tank ........:..��'�i i t................. .:r:.....
Manufacturer ..1L W .BECCET'T MR.F.••••Capacity...275..:..gals. (or) Size........
Model Na. )r Size........Q#Rt....... .......................Location. . ...... 9AQU.ND............ .........
Type......C.i. ..... ...Mass.Approval No....�69...:
Permit issued....6/2/55.. expires + ....... (Head of Fire Department)
Fee....... ..... Paid. .... Bq;:.n�✓ :. a` ... ......
,tau�k k+�+�^�� t��i�,n�`.R
r'� ' 'Thls�Permit must ber+C omp►'cuDus'ly Poste mtses`�
p4r �24S•Fwaees M! o "; eongi;�,•.
MASS. S.P.C.A.
GAPE CO® BRANCH
1577 FALMOl9TH RD.
CENTERVILLE, MA 02632