HomeMy WebLinkAboutDumpster Application & Permit - Permits - 50 PETERS STREET 9/1/2016 The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
Date:
Permit No
City or Town)
(If�Applicable) Dig Safe Number
In accordance with the sions of M.G.L. Chapter , 10 as
provided in Section p5r02'ii7 CMR 34 application is hereby made Start Date
by �0.4 C4
(Full name of person,Firm or Corporation)
State clearly Address ?c-) V-tA--, k �� �A�
purpose for (Street or P.O.33ox City orTown)
whichpormit For permission to L o c a t e dumpster for construction/renovation/demolition
is requested Of st—FUcture
Comments: dumpster must be 251 from structure or covered when not in use
at
------�-0
(Give location by street and no.,or describe in such manner as to provied adequate identification of location)
Name of competent operator Cert.N
(If Applicable)
Date Issued-rejected B
t Signature of Appolliant)
Date of expiration —/V Fee S Paid Due
The Commonwealth of Massachusetts
Department of Fire Services
Off'ICG Of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775
PERMIT A4 Date;
0 101, Permit No
(city offown) Applicable) Dig Safe xUbWer
In accordance with the provisions of maL. ChaPteK---1 Pas provided in section 5 2 7 CMR 34
This Permit is granted to; Lf Start EDate
Full name of person,Firm or Corporation
Permission to locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 25T from structure or covered with tarp or plywood
Restrictions: —a—t--end of workdaY
at
(Give location by street and no.,or describe in such anner as toprovied adequate identification of location)
Fee Paid$ _,L _ 4�?
This Permit will expire gr gpermit) ' Of;*gran—tEs—permit
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