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0250 HIGHLAND AVENUE - LP Storage
(itu of ate , '' ussadiu ett FIRE DEPARTMENT - FIRE PREVENTION BUREAU 29 Fort Avenue Salem, Massachusetts 01970-5232 To: HEAD OF FIRE DEPARTMENT Fee Due $-3'8"0O f-1 Ck. ## 7 r Rec'd by: -2 Y-ca5 (Date) Application is hereby made ill accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location named herein: Name of .Owner. 64- Gk. p . in,$-/` Li Number of Tanks: Company: i /l i e.V5 .4 ) Issued by: - Form %901 (Rev 9/97) Address: 2 5`D /-- t 4.(J �-</-e Capacity of Each Tank- / O ©v 4 3 r7 Total Storage: �.✓e-lhiv'/ .'24 Address: /3- C tea` Installer. Date: t _ote7—a 7 DO NOT WRITE BELOW THIS LINE SALEM FIRE DEPARTMENT FIRE PREVENTION BUREAU PERMIT (Written Signature) Date: FOR STORAGE OF LIQUIFIED PETROLEUM GAS In accordance with provisions of Chapter-148, G.L., and Regulations made under authority thereof. Name: 0 - k %' 'd t9 Act i Name: j'eCl y' (Qwrrer or occupant) / (Installs Address: ` 5-7-) 1'6347'- 77i 4-6,4 . Address: 1 i3 '/G/C-Y 41/77 PERMIT is hereby granted to store /030 gallons of Liquified Petroleum Gas Subject to approval of Salem Gas Inspector, for piping and equipment. Date Permit Issued: Inspector: Form Y9o1 (Rev. 9/97) 0‘,1e-/ c,og Fee Paid o r use in an approved appliance. L(Chi f Fire Department) THIS PERMIT MUST RE CONSPICUOUSLY POSTED UPON THE PREMISES This permit will expire on a change of ownership, burner or storage. SALEM FIRE DEPARTMENT FIRE PREVENTION BUREAU PERMTI' TO INSTALL LIQUIFIED PETROLEUM GAS STORAGE TANKS n accordance with provisions of Chapter 148, G.L., and Regulations made under authority thereof. name: R ��- I �9-; I Ole Name: ` e%'re-Ll .fit (Owneq or cupant) / {tn taller) /ti / �,sort- -/ - �,ddress: r 7i % .,,i �. Address:l3-3 /14°.y�y.77 A /fir' 0. a2�� oiJ PERMIT is hereby grant 3d to above listed installer, to install L.P.G. tanks on the premises of the above listed owner or occupant. foes- Number of Tanks: Capacity of Each Tank- 421Total Storage: Fee Paid $38-110 'tl,(e_ 02y Date: �� v ("0� )ate Permit Issued: