2021 Town of Amherst Temporary Propane Installation Application

Company Information
Business Name:*
Phone Number*

Area CodePhone Number
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email:*
example@example.com
Installation Information
Installation Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Size of tank(s)/cylinder(s) being installed:*
# of tank(s)/cylinder(s):*
Installation Requirements

Requirements*

	Yes	No
Site Plan Provided
Barriers Provided
Installed on Stable, Non-Combustible, Level Base:
Area clear of dry grass, weeds, and other combustible material within 10 ft of the container:

1) Shall comply with NFPA 58, 2017 Edition*

2) Shall comply with 2020 Fire Code of NYS: Chapter 61 Liquified petroleum gases*

3) No smoking signs shall be posted

Failure to comply with #1, #2 and/or #3 above can result in fines and/or court appearance tickets. Failure to comply will result in revocation of permit and temporary propane shall be removed from site immediately.

*If you have any specific questions regarding the Fire Code or the NFPA standard please contact the Fire Safety Division at (716) 631-7140 or e-mail firesafety@amherst.ny.us
Submitter Information
LPG Installations
(Temporary Under 1000 gal)

1. Compliance with NFPA 58, 2017 Edition

2. 2020 Fire Code of New York State (FCNYS) Chapter 61 - Liquified petroleum gases

3. Area of Heavy Snowfall: In areas where heavy snowfall can be expected, piping, regulators, meters, and other equipment installed in the piping system shall be protected from the forces anticipated as a result of accumulated snow. (NFPA 58 2017)

4. Where physical damage to LP gas containers, or systems of which they are a part, from vehicles is a possibility, precautions shall be taken against such damage. (NFPA 58, 2017) 2020 FCNYS 6107.4 & 312

5. Containers shall rest on non-combustible supports. (NFPA 58)

6. Loose or piled combustible material and weeds and long dry grass shall not be permitted within 10 feet of any liquid petroleum gas containers. Per section 6107.3 2020 FCNYS

7. All outside tanks shall be suitably painted with a light reflecting color, and shall be clearly identified. (NFPA 58)

8. Minimum of 3 foot to window/door openings

9. Minimum of 10 foot from sources of ignition

10. Containers located outside of buildings shall not be located within 20 feet of any exit access doors, exits, stairwells or in areas normally used, or intended to be used, as a means of egress.

Failure to comply with these regulations may result in Legal Proceedings
at the Amherst Town Court
Date*

MonthDayYear
Date
Submitted By (Print Name)*
Submitted By (Sign with mouse)*

Clear
Should be Empty:

Company Information

Installation Information

Installation Requirements

Submitter Information