HomeMy WebLinkAboutFlammable Storage Permit - Flammable Storage Permit - 49 ORCHARD HILL ROAD 1/10/2006 The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
P.O.Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
/jam p Date:
C/O G!i%„fi.r _ Permit No
(City or Town) (If Applicable) Dig Safe Number
In accordance with the provisions of M G.L. Chapter as
provided in Section /!'!/� application is hereby made Start Date
by G^ (3 6�
(Full name of person,Firth r Corporation)
State clearly Address � �l �
�! _7 50 --Z. w��G
Lo
purpose for 1 (Street or P.O.Box City or Town)
which permit For permission to e n D e w �J �] q L, �� 1
is requested
Comments:
at 1-� Q C->-14)�� 1Z� �� Y1 L b is
( Y r.... _ s'=
Give location b street and no.,or describe in such manner as to p ovied adequate identification of location)
Name of competent operator Cert.No.
(If Applicable)
Date Issued-Fejeeted f(� _ 0 " B '
'� y
(Signature of Applicant)
Date of expiration Fee$ '.5� --Paid Due
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The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
P.O.Box 1025 State Road,Stow,MA 01775
Permit NO PERMIT Date: z
(City of Town) (If Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. _ Chapter as provided in section
Slant Date
This Permit is granted to:. C C.;i P 71 r/7
Full name ofperson,Firm or Corporation
Permission to f/ 6ca t 7�.�— li2 �n v .L D
Comments: �fJ f� /�eCv.z �f7�C C1= lt-�`
/Y �/L(J �U�/ r//-t'- /� ���51�—[L�r V�
Restrictions: — -.—r
at
Give location b street and no.,or describe m such manner a to rovied adequate identification_.
y 9 of location)
Fee Paid$ .�
This Permit will expire (Signature of offtcai granting permit) Offical granting it (Title)
TI-1IC PPPUIT U1 ICT pu= (_t' w mr_I I(11 ICI Y PnCTP:r) I IP(1Rl TNF PRt=MIC;=C ��