HomeMy WebLinkAboutDumpster Application & Permit - Permits - 27 MARBLEHEAD STREET 9/16/2016 The Commonwealth of Massachusetts
7,4�4
Department of Fire services
Off!CG of the State Fire Marsha#
P.O.Box 1025 State Road,Sto-%r,MA 01775
APPLICATION FOR PERMIT
No Date:
Permit
(Ci LTOM) ----(If�Applicable) 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
by
(Full-name of person,Finn or Corporation)
State clearly Address
purpose for
(Street or P.O.Box City or Town)
which permit For permissioato 'Locate-- dumpster for construction/renovation/demolition
is requested Of st—iucture
Comments: dumpster must be 25 ' from structure or covered when not in use
at ZC- 4 z I t " f /�, ---
v�." �A 6
(Give location by street and no.,or describe in such manner as to provied adequate identification of location)
Name of competent operator 21,41
NO.",
(If Applicable)
-rejected
Date Issued
Signature ofApplioant)
Date of expiration Oro 670
Fee Paid' Due
The Commonwealth of Massachusetts
Department of Fire Services
Office of the State it Marsha[
P.O.Box 1025 State Road,Stow,MA 01775
Permit No PERMIT Date:
--(—City of Tom) ---7 If—Applicable Dig She Number
In accordance with the provisions of MG.L. Chapterl Oas provided in section 5 2 7 CMR 34
This Permit is granted to: StStartDate
Pull name of person,Firm or Corporation
Permission to locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 251 from structure or covered with tarp or plywood
Restrictions: at end of workday
at ® .
(Give location by street and no.,or describe;mi such anniejr.-,as-ttoproviie(diadequateiid tfficatdion�cof location)
cjl --—.'��describe
Fee Paid S
grantulgpermit) (-Title)—
This Permit expire ipature of officea Mora mantiru�""it
gpe ffical granting permit
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