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PLUMBING INSPECTOR
TOWN OF RYE
APPLICATION FOR INSTALLATION OF OIL BURNER AND TANK
No
APPLICATION IS HEREBY MADE to the Plumbing Inspector of the Town of Rye for the
approval of the detailed statement herewith submitted for the installation of the
oil burning equipment herein described, and for a permit to install such oil burning
equipment as provided for in the Town of Rye ordinance for construction and insta-
llation of oil burning equipment, etc.
It is agreed that if such permission be granted that said equipment will be
installed in conformity with this application and the plan and specifications thereof.
as approved, and that all State Laws, by-laws and ordinances of the Town of Rye, and
rules, regulations and orders of any board, body or department so far as the same
may be pertinent, including the National Board of Fire Underwriters, will, be complied
with..
The applicant further agrees to furnish such additional information, plans or
statements as may be required by the Plumbing Inspector.
1. What is the owner's name and address? ,E"",d
2. What is the contractor's name and address? / (�`j 0�/y'C1 y� )ye R4 Tel
3. Location where installation is to be made
4. What is the number of the lot? 1 Block?
5. Location of Tanks (Exterior or Interior)
6. Capacity of each tank- - /GT-a f C�� - �. S
r.. ��
7. Gauge of metal in each tank .� f K
8. Name._af_Burnes .
9. Has Burner been approved by Underwriter's Laboratory?
10. Distance of Tank from Foundation Wall -7)
11. Distance of Tank from Adjoining Property �G�G �✓
Signature of Applicant.(��,
'
rt, Address_
Dated, LAC
wort Chester,N.Y.�
Fee o4 S^t 4LC0N.PA1JY this application.
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