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HomeMy WebLinkAboutDumpster Application & Permit - Permits - 61 ESSEX STREET 8/20/2016 The Commonwealth of Massachusetts 1,4-1. Department of Fire Services Office of the State Fire Marsha# P,O.Box 1025 State Road,Sto-w.,MA 01775 APPLICATION FOR PERMIT Date: Permit No I City or Town) --- (IKA�pplicable) Dig Safe Number In accordance with the provisions of M.G.L. Chapter . 1_0 as provided in section 527 CMR 34 application is hereby made Start Date byC— (Full name ofperson,Firm or Corporation) State clearly Address 7- purpose for (Street or P.O.13ox City or Town) whiclipennit Forpermissionto Locate- dumpster for construction/renovation/demolition is requested Of st—r:—u—cture Comments: dumpster must be 25 ' from structure or covered when�not in use at Give location by street and no.,or describe in such manner as to provied adequate identification of location) Name of competent operator t'0, Cert.No. (If Applicable) Date,Issued-rejected J 13Y Signature of Applicant) Date of expiration -3e) Fee Paid Due —----—----— The Commonwealth of Massachusefts ink Z Department of Fire Services Office the State Fire Marshal P.0.Box 1025 State Road,Stow,MA 01775 Permit No PERIVI.IT Date: City of Town—) Dig Safe Number In Ila accordance with the provisions of MG.L. Chapter- 10as provided in section 5 2 7 CMR 34 This Permit is granted to: --Q7-1r f"&­7 C, ®�4 Start Date Full name of person,Firm or Corporation Permission to locate dumpster for construction/renovation/demolition of structure Comments: dumpster be 25 ' from structure or covered with tarp or plywood Restrictions: a t end o f workday at e--z rSE'-5'— E"7— Crave location by street I and no.,or describe in such manner as to provied adequate identification of location) Fee Paid$ This Permit will expire ............... Signature of oilical granEFP—ermit) M—fic—al—granting�permit Tide—) T14[-Q PRRUIT MI IRT AP MM-RIDIrl Inj I_qi V Pf)-QTr=n I lPnM T141= PR1=U1-QP-Q 4==