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BOARD OF HEALTH
120 MAIN STREET TEL: 682-6483
NORTH ANDOVER, MASS. 01845 Ext. 32 or 33
APPLICATION FOR DUMPSTER PERMIT
PURSUANT TO SECTION 31A AND 31B OF CHAPTER 111
OF THE GENERAL LAWS, AND RULES AND
REGULATIONS OF THE
NORTH ANDOVER BOARD OF HEALTH
DATE
TO THE BOARD OF HEALTH:
Application is hereby made for a permit to maintain a dumpster on
property located at �0/ 1,L2q 0� / LAnc%y6/ IWA
in accordance with the Rules and Regulations of the Board of
Health
Check use:
( ) Residential use
( ) 30 day temporary
Name of applicant:
(1') Commercial use
( ✓) Annual
Owner of property: J)iZ Z(1_
Telephone number:
On the bottom half of this form, please sketch an outline of
property, showing the proposed location of the dumpster. Give
distance from dumpster to other buildings and lot lines or
boundaries. Use back side if additional space is needed. ,
On the *bottom half If
property, showing thpr
distance from dumps rl
boundaries. Use back
thisform, please sketch am out ine 0
o ation of the dumpster(s). Give
e buildings and lot lines or;
x ad itional space is needed.
35;r room LOT 44,V6 s 1 N
Please return this application with a fee of $10.00 per dumpster
($5.00 for temporary permit) to: Board of Health, 120 Main St.',
No. Andover, MA 01845. -
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�9SSACHUS
BOARD OF HEALTH
120 MAIN STREET TEL: 682-6483
NORTH ANDOVER, MASS. 01845 Ext. 32 or 33
APPLICATION FOR DUMPSTER PERMIT
PURSUANT TO SECTION 31A AND 31B OF CHAPTER 111
OF THE GENERAL LAWS, AND RULES AND
REGULATIONS OF THE
NORTH ANDOVER BOARD OF HEALTH
DATE
TO THE BOARD OF HEALTH:
Application is hereby made for a permit to mg�tain a dumpster(s)
on property located at
in accordance with the Rules and Regulations of the Board of
Health. Number of Dumpsters I
Check use:
( ) Residential use
( ) 30 day temporary
Name of applicant:
Owner of property:
Telephone number:�..�, _.
( 0TOOOCommercial use
( nnual
On the bottom half �f this
property, showing the pro o
distance from dumpsler o
boundaries. Use back
V7 i
3' AWM "T
So' RwAl #3"06.00? a l
J'
form, please sketch an outline of
ation of the dumpster(s). Give
e buildings and lot lines or
ad it
ionall space is needed.
iN
Fgw.K
LOlr-`
Please return this application with a fee of $10.00 per dumpster
($5.00 for temporary permit) to: Board of Health, 120 Main St.,
No. Andover, MA 01845.
NUMBER
FEE
THE COMMONWEALTH OF MASSACHUSETTS
$-lA-_ 0 0
TOWNof ......... NORTH ANDOVER
----
This is to Certify that ........... Sy-nergy ... Engineering ... &... TQQl... Co -,-,.-.-IG........
NAI%IE
201 Sutton Street, North Andover, MA 01845
.-------------------------------------------------------------------------------------------------------------------------------------------- ................. .........
ADDRESS
IS HEREBY GRANTED A PERMIT
For ......... Maintain one (1) dumpster
.--------------------------------------------------------------------------------.........--------...----------------------------...............----...-------•-......-•----
This permit is granted in conformity with the Statutes and ordinances relating thereto, and
expires ...... December ... 31-,_...1.9.91 ............. unless sooner suspended or revoked.
:...
....... February .... 8 .................... 19-_91:_..:Y`�c�,c.,,�:l.A.c�� �� 1
-------------------------- /....
FORM 451 HOBBS @ WARREN, INC.
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