HomeMy WebLinkAboutDumpster Application & Permit - Permits - 241 MASSACHUSETTS AVENUE 9/15/2016 2 ,:
The OMMOn ealth o Massachusetts
,�C w ®OPartm nt of E re Servicea
Offh t
r ° ice of the Site Fire Marshal
P.0.Box 1025 State Road,Stm,,MA.01775
APPLICATION
� Date:
474r T own ermit No (If Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter 10 as
provided in Section 5 2 7 C MR 3 4 application is hereby made Start Date
by - -- �
(FIE name ofperson,Firm.or Corporation)
State clearly Address �� n
01,7�—1t
purpose for (Street or P.O.Box City or Town)
which petmit For eimissiorttoLocate, dumpster for construction/renovation/demolition
is requested p of structure
Comments: dumpster must be 25 ' from structure or covered when not in use
at 2 ( s cx.>-Q_r- Cat
(Clive location by street and no.,or describe in such manner as to provied adequate identification of location) .
Name of competent operator Celt.Na.
(If Applicable)
Date Issued-rejected By
`G (Signature of Applioant)
Date of expiration Fee$ Paid Due
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DepartmentThe Commonwealth of Massachusetts
ire Services
Offl'CG of the State FireMarshal
P.0.Box 1025 State Road,Stow,MA 01775
PERMIT
Permit No Date:
(City of Town) (If Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter 10 as provided in section 5 2 7 C M R 34
This Permit is granted to: 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: at end of workday
at
(Give location by street and no.,or describe in such manner as o provied ade ate identification of location) !�
Fee Paid S
This Permit will expire /®- algauture,of offiaai grantin rmit C offical /r� °
gPe ) granting permit (Tide)
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