HomeMy WebLinkAboutDumpster Application & Permit - Permits - 350 WINTHROP AVENUE 10/18/2016 The Commonweafth of Massachusefts
Department of Fire Services
Office of the State Fire MarshaP
P.0-Box 1025 State Road,Sto'91,MA 01775
APPLICATION FOR PERMIT
Date:
Permit No
i7iY7 or Town) (if Dig Safe Number
In accordance with the pro-visions of M.G.L. Chapter 1_0 as
provided in section 527 C M R 3 4_application is hereby made Start Date
by M671U,e7-1 4 a,,/ -
(Full name ofperson,Firm or Corporation)
State clearly Address 3 ro &"A/rAte&,4 4.0 C�
purpose for (Street or P.O.Box City or Town)
whiclipermit For permissi to "Locate, dumpster for construction/renovation/demolition
is requested on Of structure —
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 Cert.No,
(If Applicable)
Date Issued-rejected By
(Signature of Applicant)
Date of expiration -ozi-z 7 Fee$ Paid Due
————---—---------—-—---------
Z The Commonwealth of Massachusetts
Department of Fire Services
Office Oft e State Fire Marshal
P.U.Box 1025 State Road,Stow,MA,01775
PERMIT Date:
Permit No
City of TO—YM) -----(ff—Applicable) Dig Safe Nu—mber
In accordance with the provisions of A/W.L. Chapter�—1 Oas provided in section 5 2 7 C M R 34
This Permit is granted to: Start Date
F1`11 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 1,9 7'L010
Fee Paid$ Give location by street and no.,or describe in such manner as to provied adequate identification of location)
c2c
This Permit will expire, (Sigria of4ganon mof6 granting mn13�Zp permit (Title)
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