Burner Issue� .
. `
3 _
Owner ~
' --------------------------------------------
TECHNICIANS COPY
This copy to.be properly filled out by a
licensed oil burner technician and return-
ed to the Salem Fire Prevention Bureau,
for reinspection,when necessary service
has been completed.
ggam�,,,, �Q
^ Owne,.Y:.. ...................
Address............................................ .................
Name of Burner . ........ ...............................
Cause of trouble ....................
.......� 41.....................-...........................
The undersigned hereby certifies that
the above fuel oil equipment has been
serviced in accordance with provisions
of Chapter 148 of the General Law` ''
Signature.. .. ................................... ...................
9 f
Date..®..:/t.�/..... Cert. #.06?4")