HomeMy WebLinkAboutDumpster Application & Permmit - Permits - 2 BANNAN DRIVE 11/28/2016 The COMM oonweafth C' Massachusafts
tA Department of Fka Sem ces
Office of the State F1rG Marshal
P.0.Box 1025 State Road,Stogy;MA 01775
APPLICATION FOR PERMIT
Date:
Permit No
City or Tom ---TIf�Applicable- Dig Safe Number
In accordance with the provisions of M,G.L. Chapter._ 1_0 as
provided in Section 527 CMR 34
-z-�—application is hereby made Start Date
by
I- A 7nO
(Full name of person,Firm or torporation)
State clearly Address a -11--�
purpose for (Street -I P.O_Bo/xyCiiy or Town)
whiclipermit Forpermissionto Locate dumpster for construction/renovation/demolition
is requested of st—r—UFYu—re
Comment : dumpster must be 25 ' from structure or covered when not in use
at CL-h K
(Give location by street and no.,or describe in such manneras to provied adequate identification of location)
Name of competent operator Cert.NO,
(If ApplicablL)
Date Issued-rejected By
(Signature of Applicant) '
Date of expiration Fee ?aid Due
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T COM
he monwealth of Massachusefts
Department of Fire Services
Office of the State Fire Marshal
P.0.Box 1025 State,Road,Stow,MA 01775
PERM,IT Permit No Date:
(City of Town) --- (If A�pphcable) Dig Safe=Number
In accordance with the provisions of M.G.L. Cbapter—.1(0as provided in section 5 2 7 CMR 34
Rte
This Permit is granted to: 4f Start Dg
Full name of person,Firm or Corporation
Permissionto locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 25 ' from structure or covered i,vith tarp or plywood
Restrictions: a t end of workday
at
(Give location by street and no.,or describe in such�manner as�topro�yieladequate identification of location)
Fee Paid S JD — .
This Permit will expire (Signature gnpe ling z
(Title)
THIR P;=P?U1T MI I-qT"RF: rr)K1-q131r1 Ini ICI V Pn-qTPr) 1 19)(W TW;; PP1=UJ-r,,r:-q 40mm