HomeMy WebLinkAboutDumpster Application & Permit - Permits - 225 HAY MEADOW ROAD 7/26/2016 The COMMOnweafth of Massachusetts
Department of Fire Services
Office of the State Fire Marshag
ti P.O.Box 1025 State Road,Stmil.,MU 01775
APPLICATION FOR PERMIT
Date:
Permit No
k City or Town) ---(If�Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter . 10 as
provided S application is hereby made Start Date
rovided' Section
527 CMR 34
by q"V I j`I f I e- J
(Full name of person,Firm or Corporation)
State clearly Address _j !!; - /j'I I—C' I. - C,
purpose.for (St,-et or P.O.B., City or T.",)
whichpermit Forpermis I sionto Locate dumpster for construction/renovation/demolition
is requested of structure
Comments: dump.ster must be from structure or covered when not in use
at 2� C y AA
(Give Iocati by street and no.,or describe in such manner as to provied adequate identification of location)
Name of competent operator Cert.No.
(If Applicable)
Date,Issued-rejected BY
D (Signature of AppApplicantate of expiration
Fee Paid Due
--—----—----— ---------------------—---------
The Commonwealth of Massachusetts
Department of Fire Services
OffiCe of the to Fire Marshal
P.O.Box 1025 State Road,Stow,MA 01775 Ar
Permit No PERMIT Date: 7-) ,6 -/-4- _
City of—Town --- If�Applicable) Dig Safe Number
In accordance with the provisions of MG.L. Chapter� 10as provided in section 527 CMR 34 Start EDate
This Permit is granted to. Keev-) <��'5-�V-'-�C-I �'C"-\ C11—
Full name of person,Finn 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
(Piye locatiort by street and no.,or describe in such manner as to provied adequate identification of location)
Fee Paid
This Permit will expire 0 granting
Offlcn, Ling Lpermit (Title)
TWIR PRQUIT U1 I-QT.14P r-MI-Roirl Inj 1gj V Pn-qTl=n 1 lPnM T14;= PP1=Mj-Qj=-q 4MMM