HomeMy WebLinkAbout0636 SCUDDER AVENUE - HAZMAT �O3�a &.udr1¢r Aven��e , ll+�a,n�i;
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OWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION
h0l ERER AN�IN_STALLER INFORMATION
ADDRESS: nr m mDref AUE. OP-/ MAP NO. _ 11,/ PARCEL NO.
OWNER NAME: G L VILLAGE: T7 VAA1AJI -r 0
er
INSTALLATION DATE: BY:
ADDRESS: CERT. NO.
PN014 C-O TANK INFORMATION
LOCATION OF TANK:
CAPACITY TYPE AGE FUEL/CHEMICAL FV I-Q1L�
TESTING CERTIFICATION E I PASS E I FAIL DATE
LEAK DETECTION E ] . CHECK IF N/A � TYPE/BRAND
ZONE OF CONTRIBUTION E I YES EA NO DATE TO BE REMOVED
FIRE DEPT. PERMIT ISSUED E I YES E I NO DATE
UUNSERVATION E ] CHECK IF N/A DATE r BOARD 'OF HEALTH TAG NO. E/O E 31 ]E 31 ] DATE 'J �.1
PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD
�...s SUBDIVISION PLAP1 0? 'LAND.IN.. BARNSTABLE.
�•, (HyannisPort)
Nelson Hearse-Richard Law Surveyors
Centerville, Mass
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prone. c Since_nircel#3 is to bP held in common
Chu►" h,G' ownership Frith n3rcel#1 annroval is not
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r1 law
' Subdivision of lot 2 .shown on L.C. elan APPROVAL NOT REQUIRED UNDER
No.17,anR B
THE SU9DFVI510N CONTROL LAW.
Ran ddy pl Pa son,,ow er Cert.# 19244 TOWN OF BARNSTABLE
ho�th/s lon was mode in occora�once
With L and Court 1nslruC ton S of 1959 PLANNING BOARD
Dole..Oct / /965 - hc��,, Ros.a,��. Surveyor- DATE.__.
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1 21•00 l-- 36 22 7 ��� E�E��s !q40_.-�i
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'...:.� $938
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