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21.188 REVISED Application for License to Store Flammables and Combustibles at 138 North King StreetejXe 1"powvmo� VdT 0 eye Application For License GqM 5`e' FP-002A Massachusetts General Law, Chapter 148 § 13 (Rev. 1.1.2015) New License ❑ Amended License GIS Coordinates LAT. License Number Application is hereby made in accordance with the provisions of Chapter 1.48 of the General Laws of Massachusetts for a license to store flammables, combustibles or explosives on land in buildings or structures herein described. Location of Land: /V / /V � .S}/ - eA Number, Street and Assessor's Map and Parcel ID Attach a plot plan of the property indicating the location of property lines and all buildings or structures. Owner of Land: H/G Y /�/ z,; S / Address of Land Owner: R0015A VZ�4�7— 0 06 ; �15' t% /�� _ d9 Use and Occupancy of Buildings and Structures: If this is an application for amendment of an existing license, indicate date of original license and any subsequent amendments a copy of the current Flammable and Combustible Liquids, Flammable Gases and Solids Complete this section for the storage of flammable and combustible liquids, solids, and gases; see 527 CMR 1.00 Table 1.12.8.50; Attach additional pages if needed. All tanks and containers are considered full for the purposes of licensing and permitting. PRODUCT NAME CLASS MAXIMUM UNITS CONTAINER QUANTITY gal., lbs, UST, AST, IBC, �o �E� h �' © c feet drums _ s� Total quantity of all flammable liquids to be stored: Total quantity of all combustible liquids to be stored: Total quantity of all flammable gases to be stored: Total quantity of all flammable solids to be stored: L% L (Caniplere this sactionfar the storage aj't P-gas or propane) Indicate the maximum quantity of LP -gas to be stared atnd a sizes and capacities of all storage containers. (See 527 CUR 1.00 Table 1.12.8.50) 44 Maximum quantity (in gallons) of t.P-gas to be stored in aboveground containers: 4 List sizes and capacities of all aboveground containers used for storage: � q. + Maximum quantity (in gallrrnr) of LP -gas to be stored in underground containers. List sizes and capacities of all underground containers used for storage: Total aggregate quantity of all LP -gas to be stored: Eis's�(complew Mix .sec Tian for the swr age rtf firenwrks) All - indicate classes of fireworks to be stored and maximum gtzanttty of each class. (See 52 € UR i.11it tilde 1.12.8.50) 44 Maximum aaatiount (re pmoids) of Class 1.3G: Typelclass of magazine used for storage: 4• Maximum amount (in pounds) of Class I AG: -- Type/class of magazine used for storage: 0*4 Maximum amount (in pounds) of Class 1,4; _ � Type/class of magazine used for storage Total aggregate quantity of all classes of Greworks to be stored: ES.p1gsiyes (Complete tit#x,sec;tion for1hesto►age gj'r_Tp1a3rLVfi) e� indicate classes of explosive to be shred and maximum �ly of eacli class. (sae 32,17 C'ttrlR 1.00 Table 1.12.8 50) "+ Maximum amount (In pounds) tif Class 1.1: •�* Maximum amount (inpounds) of Class L1: s;' Mlyimunt amount (lit pounds) of Class 1.3. 8 Maximum amount (in pounds) of Class 1.4: �sg M ixiintun amount (fat putinds) of Class 1.5. _ g:8 Maximum amount fin Pounds) of Class 1.5: Number of magazines used for stomgc� Number of magazines used for storage: Number ofnvga€zincs used for storage: Number of magazines used for storage. Nu€atbar of magazines used for storage. Number of magazines used for storage. hereby attest that I am authorized to make this application. I aeknow4edge thAt the infolrration contained herein is accurate and complete to the best of my knowledge and belief 1 acknowledge that all materials stored pursuant to any license granted hereunder must be stored or kept in accordance with all applivabii.- laws, codes, rules and regulations, including but not limited to Massachusetts Chapter 148, and the Massachusetts Fire Code (527 CMR 1.00).1 further acknowledge that the storage of any material specified in any license granted heretmder may not exceed the maiximuin quantity specified by the license. mate 01.19.2021 Name Matt Q'Amaaur igritur� � - 'ire Department Use Only " '. le 5 , Heat; of t-he �� ��� /'A � Fire Departiant endorse this application with m; pprova: Dim vn Page 2 FP-0,A (Rev, 1.1.201S) u tlW'NO1dWtlH1210N 133il15 9NIN H1ilON U c BHA s r AlllI�d� c. R gag 13n:i/3DN3IN3AN0� a f o g ,i f 43SOdObd $ns a F�m W Z '=3= LLJ � m _ o Lij_ LL LLaia LLI { 0 Z W 0 J �m om�ma�m non i c gN Hm g m VW 'NoiAWVH1110N 133N1S 9NIN HIVON 8 y 4j maom a AjllDVJ c 13n:i/3:)N3lN3AN0:) C G7 a3SOdONd Z sg hzi R W 88m s Z o6 CL F rr�C r: ,i KINGiFd��i ° oz I r. 7 W a License O,M SVOY FP-002 Massachusetts General Law, Chapter 148 § 13 (Rev. 1.1.2015) ) New License ❑ Amended License After notice and hearing, and in accordance with Chapter 148 of the Mass. General Laws, a license is hereby granted to use the land herein described for the purposes described. GIS Coordinates LAT. LONG. License Number Location of Land: 1, -,S / / ,i`�//t1 6 T/ a Number, Street and Assessor's Map and Parcel ID Owner of Land: Address of Land Owner: I?6 <�. Vkr ,q V&, SP 177519 Flammable and Combustible Liquids, Flammable Gases and Solids Complete this section for the storage of flammable and combustible liquids, solids, and gases. All tanks and containers are considered full for the purposes of'licensing and permitting. (Attach additional pages if necessary) PRODUCT NAME CLASS MAXIMUM UNITS CONTAINER QUANTITY gal., lbs, UST, AST, IBC, cubic feet ums CA 0 �,5p k: /X/E / �� 6l A)41WA! dr a137, D//y LP -gas (Complete this section for the storage of LP -gas or propane) X-11719- ❖ Maximum quantity (in gallons) of LP -gas to be stored in aboveground containers: List sizes and capacities of all aboveground containers used for storage Maximum quantity (in gallons) of LP -gas to be stored in underground containers: List sizes and capacities of all underground containers used for storage Total aggregate quantity of all LP -gas to be stored: Fireworks (Complete this section for the storage of fireworks) Maximum amount (in pounds) of Class 1.3G: +A Maximum amount (in pounds) of Class 1AG: +.+ Maximum amount (in pounds) of Class IA: Total aggregate quantity of all classes of fireworks to be stored: THIS LICENSE OR A CERTIFIED COPY THEREOF MUST BE CONSPICIOUSLY POSTED ON THE LAND FOR WHICH IT IS GRANTED. Ex piosives (Complete this section for the storage of explosives) IVII Maximum amount (in pounds) of Class 1.1: ❖ Maximum amount (in pounds) of Class 1.2: Maximum amount (in pounds) of Class 1.3: Maximum amount (in pounds) of Class 1.4: Maximum amount (in pounds) of Class 1.5: ❖ Maximum amount (in pounds) of Class 1.6: Licensing Authority Use: Number of magazines used for storage: Number of magazines used for storage: Number of magazines used for storage: Number of magazines used for storage: Number of magazines used for storage: Number of magazines used for storage: This license is granted upon the condition that the licensed activity will comply with all applicable laws, codes, rules and regulations, including but not limited to Massachusetts General Law, Chapter 148, and the Massachusetts Fire Code (527 CMR 1.00) as amended. The license holder may not store materials in an amount exceeding the capacities herein specified unless and until any amended license has been granted. ADDITIONAL RESTRICTIONS: Signature of Licensing Authority Title Date THIS LICENSE OR A CERTIFIED COPY THEREOF MUST BE CONSPICIOUSLY POSTED ON THE LAND FOR WHICH IT IS GRANTED. FP-002 (Rev. 1.1.2015) Page 2