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LP Gast Storage a I sue VFW Michael Gray Blue Rhino of New England 401-831-2227 Fax 2 Central St, Suite 204 401-258-9800 Cellular Middleton, MA 01949 Retail Store Name: 05Aris 6 7-dww— we4s Date: (9— 1 0� Contact Name: Wc c k Phone: 9 7,6— 79)- 63d� Address: fy,f 4l0,/d �911-e , JAI&EW P1 (219'76 Propane Cylinder Exchange Cabinet 44" w x 66"h x 30"d #Cages—L #20 Ib.Cylinders ILA a c2 fc-s c h$� I have reviewed this site plan and have given approval to set up propane exchange at this location as indicated above. THIS IS NOT A PERMIT. A permit will be issued upon verification of proper placement of display. Print Name Date Sign Name SALEM FIRE DEPARTMENT Fee Paid$30.00 FIRE PREVENTION BUREAU_ PERMIT Date: '0-1-'7 FOR STORAGE OF LIQUIFIED PETROLEUM GAS In accordance with provisions of Chapter 148,G.L.,and Regulations made under authority thereof. .,�e &h Name: �moo' Name: (Owner or Occupant) I (Installeh Address: ��i D i�����,� �?/ Address: PERMIT is hereby granted to store gallons of Liquified Petroleum Gas,for use in an approved appliance. Subject to approval of Salem Gas Inspector, for piping and equipment. Date Permit Iss Q 7 Inspector. (Chief it rtment) THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES Form#90L(Rev"9/97) This permit will expire on a change or ownership,burner or storage. . SALEM FIRE DEPARTMENT Fee Paid$30.00 i y FIRE PREVENTION BUREAU 9 " PERMIT Date: TO INSTALL LIQUIFIED PETROLEUM GAS STORAGE TANKS In accordance with provisions of Chapter 148, G.L.,.and Regulations made under authority thereof.- Name: Name: (Owner or Occupant) (Installer) Address: Address: PERMIT is hereby granted to above listed installer,to install LP.G.tanks on the premises of the above listed owner or occupant. Number of Tanks: Capacity of Each Tank: Total Storage: Date Permit Issued: Inspector: (Chief of Fire(impartment) Forth k90L(Rev.9/97) (OVER) Titg Of 6altM, AaS0aC4USCttB Fee Due$30.00 Q FIRE DEPARTMENT • FIRE PREVENTION BUREAU 'b 9 29 Fort Avenue Rec'd by: - Salem, Massachusetts 01970-5232 0_ 7 To: HEAD OF FIRE DEPARTMENT (Date) Application is hereby made in 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�npamed herein: Name of Owner. 1D11.G 0),r® Address: 02 Ce*rT. Number of Tanks: )G� Capacity of Each Tank:II ` 7 65 ' �/ /Total Storage: Company: Q ��d_S (51a,&,5;-N Address: oZ�O /`?I��/'-yd *�/ Installer n e ure Issued by: 02JOI..r.— �A 4,.(fi,.SL� Date: �" /...d Form#901.(Rev.9/97) DO NOT WRITE BELOW THIS LINE SALEM FIRE DEPARTMENT Fee Paid$30.00 i t FIRE PREVENTION BUREAU PERMIT Date: '0-1-(�7 FOR STORAGE OF LIQUIFIED PETROLEUM GAS In accordance with provisionst of Chapter 148,G.L.,and Regulations made under authority thereof. Name: U Zyz° 7t7'yd Name: A (Owner or Occupant) pnstalleo Address: D Uit24la, 2 4V Address: iG��a ��9y t2L PERMIT is hereby granted to store gallons of Liquified Petroleum Gas,for use in an approved appliance. Subject to approval of Salem Gas Inspector, for piping and equipment. Date Permit Iss �~ �—© 7 Inspector. ;O—rk _ (Chief it rtment) THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES Form#901-(Rev.9/9n This permit will expire on a change of ownership,burner or storage. SALEM FIRE DEPARTMENT Fee Paid$30.00 d ' FIRE PREVENTION BUREAU PERMIT Date: TO INSTALL LIOUIFIED PETROLEUM GAS STORAGE TANKS In accordance with provisions of Chapter 148, G.L., and Regulations made under authority thereof. Name: Name: (Owner or Occupant) (Installer) Address: Address: PERMIT is hereby granted to above listed installer,to install L.P.G.tanks on the premises of the above listed owner or occupant. Number of Tanks: Capacity of Each Tank: Total Storage: Date Permit Issued: Inspector: (Chief of Fire Department) Form#9oL(Rev.9/97) (OVER) - ti � t jar..,• t t � -� ., _�; ti jr NOTICE TO INSTALLER: RESTRICTIONS: 1.Installer certifies that the installation shall be made in accordance with all provisions of 527 CMR 6.00. 2.An installation of an underground tank,shall re,�4ire the submittal of a plan for stamped approval,with an application.(Form #81 G)Separate fee of$30.00 for each underground tank,with application. 3.Application shall be made to the Salem Gas Inspector for approval of piping and appliances. 4.All tanks installed in an area where damage may occur due to motor vehicle traffic conditions,shall require such additional protection as the Head of the Fire Dept may require.Any tank or tanks,with a total of 1,000 gallons capacity or more,or which may be subject to vandalism,shall require a chain link fence to be provided. 5.NO L.P:G. SHALL BE PUMPED INTO ANY TANK OVER 499 GALLONS CAPACITY, UNTIL THE SUPPLIER HAS KNOWLEDGE OF A PERMIT BEING ISSUED, AND SAID PERMIT SHALL BE POSTED ON THE PREMISES. 6.DISPENSING OF L.P.G. FOR RESALE, REQUIRES ISSUANCE OF A SERVICE STATION PERMIT.