HomeMy WebLinkAboutDumpster Application & permit - Permits - 38 MABLIN AVENUE 11/9/2016 The Commonwealth of Massachuseus
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Department cif Filre Sag-VOC98
El: OffirG of the State Fire Marshaa
P.0.Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT Date:
TNFO_rT�om) Permit No -(If A—pp—limble) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter_ 10 as
p id"section 527 CMR 34 rovi a-PpHicationishermeby ad Start Date
(21
by V"
CoIE name fr
State clearly Address 7—ff 7�7
purpose for - Z/--
which permit 'iocate- dumpster (Street or P.O.Box City or Town)
is requested For pertnission.to - for construction/renovation/demolition
Of Structure
Comments: dump s ter must be 25 ' from structure or covered when w en not in use
at
(Give location by street LtJno.,or describe in such manner as to provied adequate identification of location)
Name of competent operator Cert.No.
(If Applicable)
Date Issued-rejected
By
Date of exTiration '(Sigloatureof
Fee Paid Due
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The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 017.75
Permit No PERMIT Date:
(City of Town) (TApplicable) Mg Safe Number
In accordance with the,provisions of M.G.L. Chapter__10as provided in section 5 2 7 C M R 34
Start Date
This Permit is granted to:
�UHllF
name Of Person,Firm or Corpora
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 101111-11
(Give location by street and no.,or describe in such manner as to provied adequate,identification of location)
Fee Paid
This Permit will explre�
�kb�grantjmgg 2p'� �CVf�Rcal�grg�pvrmit permit (Title
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