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0000 WINTER ISLAND ROAD - Street Files I WINTER ISLAND RD W .,r,. ter.. .... .. as Fire Department retairas;oraginal�appllcation and Issues duplrcate.as.Permi (2 � bi`I56I 1 �3C� 41 APPLICATION and PERMi1 Fee: S"0 for storage-tank rernoval and transp`orfiation to approved tank disposal yard In ai�ordance. provisions of M.G.L.Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made:by: �/ Tank Owner Naive(Please print) G S J� X ,p /�10 Address f'r. 'A s CkY Srate Z42 . Company Name r �� r:�""��y Co.or Individual Address 01-: 1V k7s J 1'Q,"V/�J (� Q I V/� Address Stgnatun�(if pl g for pe, ft) Signature(If applying.for permit) O IFCI' rtlfied . Other O IFCI*Certified . O LSP,# Other TankLocation `� &MAditn Cry tank CapaC ty.(gallons) _ K L Substance Last Stored aiL Tank Dimensions(diameterx length) �/Y`"( 17 t� Remaft: _. / / — . Firm transporting waste �. ... �i �• State Lic.# Hazardous waste manifest# ' 4 -L. G Q SI 0 E.P.A.#Ajq Approved,tank disposal yard , �' Tank yard# Type of inert gas Tank yard address 0 �, Q r1 CttY or l ownJ� �t�/1%l . _ FDID# Date of issue Date of expiration lQ� IS/ Dtg safe approval.number•. Dig Safe Toll Free Tel.Number-800-322-4844 re./Title of Officer granting permit Alter removat(s)('Consumptive Ilse ,fuel oil tanks exempted)send Forrn.FP-290R signed Local Fire Dept.to UST Regulatory Compliance Unit,Department of Fire Services,P.O.Box t025,State Road,Stow,MA.:01775. •litemationai Fire Code Institute 'P 292.trevisat 4/97) .: . City of (Salem, "' `h FCC Due Inspecti n dat FIRE DEPARTMENT - FIRE PREVENTION DIVISION � 29 Fort Avenue Time c) Salem. Massachusetts 01970-5232 APPLICATION FOR CERTIFICATE OF COMPLIANCE Closing Date: To: HEAD OF FIRE DEPARTMENT 90ne Family Dwelling ❑ Two Famlily Dwelling. ❑ Condominium Unit # Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by Massachusetts General Law'. Chapter 1,48-Sections 26F. 261171/2 and 527 CMR 31. et seq. Type of Smoke Detector . Battery Hardwire Hardwire w/Bat. back-up_Heat Combination Tvpe of Carbon Monoxide Detectors Battery Pluu-in W/ Bat. Back-up Combination Location of Property 1.S Z41'j iQ o'l cj Owner of Property ((�P t . g.� P ',U 'z I r f Date of titication: /NJ Owncr or A^_ent By 2�o i2�a 'none Note Anv certificate issued in accordance wvith provisions of M.G.L. Chapter 148 Sections 26F. 26F 1/2 expires sixty (60) days after issuance by head of the Fire Department. as I NDIP CHEC # C1t of(Salem, Ma&saChusetts .K �.aC3 ak Fee Due n a FIRE DEPARTMENT- FIRE PREVENTION DIVISION Inspect' n Dale: 29 Fort Avenue ? Salem, Massachusetts 01970-5232 Time A:2�? APPLICATION FOR CERTIFICATE OF COMPLIANCE Closing Date: SOne Family Dwelling To: HEAD OF FIRE DEPARTMENT ❑ Two Family Dwelling ❑ Condominium Unit# Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by Massachusetts General Law,Chapter 148 Sections 26F,26F1/2 and 527 CMR 31.et seq. Type of Smoke Detector Battery Hardwire Hardwire w/Bat. back-up Heat Combination Type of Carbon Monoxide Detectors Battery Plug-in w/Bat. Back-up Combination Location of Property Owner of Property �/c�r i K d 1 C'r P Date of Certification��l O WNER OR AGENT Bye�:L'o�.� _ � ��;--Y . PHONE Note:Any certificate issued in accordance with provisions of M.G.L. Chapter 148 Sections 26F, 26F1/2 expires sixy(60)days after issuance by head of the Fire Department. 527 CMR 1.00 g 360 Section 1.12.8.2.1 FP-056 Form 1 (Rev. 1.26.2015) Application for Permit,Permit,and Certificate of Completion for the Installation or Alteration of Fuel Oil Burning Equipment and the Storage of Fuel Oil r � . a (City or town) (Date) Permit#'s: FD Elea, FDID#: (019.2 Fee Paid:$ Owner/Occupant Name: �" ) ' "t - f w i 7"I 1 ;,:,a Z1 f< Tel.#: 4# T( � �' �? / Installation Address: ( : R 3 ,�- _)��;„ Serviced Floor or Unit#: 1"- .Heating Unit,. 0 Domestic.Water Heater ❑Power Vent Other Burner: New ❑ Existing ❑ Location: Type: _ 1� a' '�-�� Model#or Size e e Nozzle size: Q ' f - 'Fuel Oil ❑ Kerosene t]Waste Oil ❑ Removal Storage Tank: ❑ New xisting- Location: Type: ,> �• ,, Capacity: ,��,:- gallons No. of Tanks: _ Special requirements(or additional safety devices) ❑OSV valve ® Oil Line Protected Co. Name: STOCKER OIL COMPANY INC Tel# 978-535-5180 Address: 236 BOSTON STREET City: TOPSFIELD Zip: 01983 Completion Date: Combustion Test: Gross Stack Temp,: Net Stack Temp.: COI Test: %i , ;: A Breech Draft: - - - T Smoke: . ' Overtire Draft: Efficiency Rating%: I,the undersigned certify that the installation of fuel burning equipment has been made In accordance with M.G.L.Chapter 148 and 527 CMR 1.0o currently in effect.Furthermore,this installation has been tested in accordance with such requirements,is now in proper operating condition an ; complete Instructions as to its use and maintenance have been furnished to the person or whom the Installation(or aft ration).was in e. ,t Installer: {r�t�%'� � � 'r`� �' , ..�- J;.}: \ � � sj i ,t,� ....�`� 01 Print Name Cart of CO SYgna ure(no Stamp)' Address: 23_ 6 BOSTO STREET city: TQP FIELD Once signed by the a department,this is a PERMIT for the storage of fuel oil and use of the oil burning equipment. Approved by: Date: 211 Keep original as application. Issue duplicate as permit.This form may be photocopied. ALL INSTALLATIONS Note To Installer:Inspections will be conducted using this checklist as a guideline.Current regulations will apply. ❑ All applications must be on Form 1 UNENCLOSED TANKS ❑ Over 10,000 gallons on site requires License fk Permit from local community ❑ Single tanks shall not be larger than 660 gallons ❑ Certificate of Competency required,no other ❑ Maximum aggregate capacity of unenclosed license acceptable,plumbing,electrical,etc. multiple tanks is 1320 gallons ❑ Verify emergency shut-off is outside burner room ❑ Unenclosed tanks shall be at least five feet from an ❑ Verify separate circuit for oil burner internal or external flame ❑ Verify presence of overhead thermal switch ❑ Unenclosed tanks shall not obstruct service meters, service panels and shutoff valves ❑ Verify presence of service switch within T of burner ❑ Bottom outlet tanks pitched to the opening O Verify presence of high limit controller Q Tanks exposed to vehicles will be protected by Cl Primary control has safety shutoff within 15 secs. barriers ❑ Stack type primary may be easily removed ❑ Steam boiler equipped with low-water cut-off ENCLOSED TANKS ❑ Clear access to clean out and services panels ❑ No oil leaks present at burner Q. Over 660 gallon tanks enclosed by two hour fire ❑ Installation instructions present on site resistive assembly ❑ Combustion test results on Form 1 ❑ Tank enclosures provided with 6"high tight sills or ❑ Three metal screws at each joint in chimney ramps ❑ Tank is 4"above floor supported by 12"thick ❑ Thimble present at chimney connection masonry saddles spaced not more than eight feet ❑ IF POWER VENTER IS USED:Check air pressure on centers and 15"from top and walls of enclosure switch,post purge control and secondary control. ❑ All oil must be transferred by pump,and Installation instructions present. connections must be at the top of the tank D Draft regulator is present unless exempted ❑ Adequate air is present for combustion ALL TANKS ❑ Adequate clearances per manufacturers listing ❑ Thermal valves at burner and tanks Q Two tanks may be cross-connected as shown in ❑ Listed flexible hose'may be used. Fig.4.03 1. ❑ No Teflon tape on"oil line or on oil line fittings ❑ Return lines must enter the top of tanks ❑ No compression fittings are permitted Cl Vent pipes must be two feet from building openings ❑ Solder joints made with 500 degree F solder or ❑ Vent pipes must terminate 3 ft.above grade min. greater'. ❑ Vent pipes must have weatherproof caps ❑ All oil supply and return lines must be protected Q Fill pipes must be two feet from building openings from injury.All new lines must be continuously ❑ .Fill es must have tamper roof identifying caps sleeved with non metallic tubing.Oil safety valves P P P R fY 9 p may be used on existing lines not exposed to ❑ -IF POWER VENTER IS USED: freezing.Overhead lines require no sleeve and are All outside connections sealed Vent terminal must be three permitted feet above all air inlets within 10ft.Burner air intake is ❑ Oil supply lines and return lines to tanks exposed to exempted Vent terminal must be four feet from doors and freezing temperatures must come off the top of windows.Vent must be one foot above finished grade.Three tanks foot clearence.from inside comers. Not above or within three Lines for kerosene, and range oil #1 are exempt- feet of an oil tank.Seven feet above a public walkway. 9 ( ) P pub c _ ❑ No oil leaks present at tank ❑ Listed oil filter is present ❑ Tank is UL80 or(DIB+)PV-VI 321 (under 660 gal) OUTSIDE TANKS or UL 142(over 600 gal) ❑ Shutoff valve located at bottom of tank ❑ All USTs and tanks over 660 gallons must be ❑ Size of vent as per manufacturer installed as per NFPA 31 ❑ Oil tank gauge must be present to determine oil ❑ Tank protected from physical damage level Q Tanks exterior coated with organic alkyd resin or ❑ Inside tanks have audible fill device(vent alarm) asphalt paint P ❑ Outlet cross connection at bottom of tanks must be ❑ Damaged protective coatings must be recovered 318"pipe or tubing, ❑ Tank does not block means of egress ❑ Non-combustible tank supports,tank secure. ❑ Tank mounted on continuous 4"thick slab that extends 8"beyond tank perimeter ❑ Tank is supported by rigid non-combustible supports 111T^, Commonwealth of Massachusetts Department of Fire Services - Office of State Fire Marshal City of Salem - Fire Prevention Bureau '"+' '"°,�� 29 Fort Ave. Salem, MA 01970(978) 745-7777 APPLICATION FOR CERTIFICATE OF COMPLIANCE FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS M.G.L. CHAPTER 148, Sections: 26F, 26F1/2 -Res. Smoke& CO Detectors City of Salem Permit: FA-19-411 Application Date: 6/27/2019 Application is hereby made for inspections of smoke detectors and carbon monoxide alarms as required by Massachusetts General Law, Chapter 148, Section 26F, 26F1/2 and 527 CMR 31,et seq. NOTE: SUBMIT APPLICATION TO SALEM FIRE RESCUE HEADQUARTERS Property Location 15 WINTER ISLAND ROAD Salem, Ma. by OSHEA FAMILY gHOLDING cTRUST OSHEA PAUL C/OSHEA ANNE L TRS DBA f 3e, / 7,,-- /,;?,7— Phone: Email: Inspection/Testing completed on: 6/27/2019 By0-0-r Inspector Fee(MGL C 148, Sec 10A): $50.00 Fire Chief Chief,Salem Fire Department Note:Any certificate issued in accordance with provision of M.G.L.Chapter 148,Sections 26F,26F1/2 expires sixty(60)days after issuance by head of Fire Department. Fire Department's Copy Commonwealth of Massachusetts Department of Fire Services - Office of State Fire Marshal City of Salem - Fire Prevention Bureau 29 Fort Ave. Salem, MA 01970(978) 745-7777 APPLICATION FOR CERTIFICATE OF COMPLIANCE FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS M.G.L. CHAPTER 148, Sections: 26F, 261F1/2 - Res. Smoke& CO Detectors City of Salem Permit: FA-20-353 Application Date: 7/20/2020 Application is hereby made for inspections of smoke detectors and carbon monoxide alarms as required by Massachusetts General Law, Chapter 148, Section 26F,26F1/2 and 527 CMR 31,et seq. NOTE: SUBMIT APPLICATION TO SALEM FIRE RESCUE HEADQUARTERS Property Location 19 WINTER ISLAND ROAD Salem, Ma. by MUNROE WILLIAM H DBA CC Phone: Email: \ Inspectionrresting completed on: 7/20/2020 By: ( z 0-r.— Inspector Fee(MGL C 148, Sec 10A): $50.00 Fire Chief Chief,Salem Fire Department Note:Any certificate issued in accordance with provision of M.G.L.Chapter 148,Sections 26F,26F1/2 expires sixty(60)days after issuance by head of Fire Department. Fire Department's Copy