HomeMy WebLinkAboutDumpster Application & Permit - Permits - 35-37 SAUNDERS STREET 11/28/2016 ` The OM Jdlvvea th Of as
' - apartment of FireSServuces �� �
!CG Of the State Fire MarshagP.®.Box 1025 State Road,Stow,MA 01775 _
APPLICATION FOR PERMIT
Date:
--(—City or Town) Permit No
(If Applicable) I9eg Safe Number
In accordance with the provisions of M.G.L, Chapter . 1 p as
provided in Section 527 C MR 34
b application is hereby made Start Date
y
(ul**rim efperson,111milor Corporation)
State clearly Address
purpose for ----�=
which permit (Street or P.O.Boa City or Town)
is requested For permission to Locate dumpster for construction/renovation/demolition Of structure
Comments: dumpster must be 25 ' from structure or covered when not in use
at ,
(Give Iocation by sicer and no.,or describe in such manner as to provied adequate identification of location)
Name of competent operator
(If Applicable) � �V Y+n�` T`� Cert.No,
Date Issued-rejected B y
--—Date of expiration � �'
(Signature of Applicant)
Fee$
------------ - -_ -___-------- -------------------------------cut------------------- _-----Paid Due
-----o- - _-----
_----------___
0
Department of Fire Services
Office of the State Firs Marshai
P.0.Box 1025 State Road,Stow,MA 01775
A PERM.IT
Permit No Date:
(City of Town) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter 1 Oas provided m se lion 52 7 CMR 34
This Permit is granted to: , �o �T Start Date
Full name of person,Firm or Corporation
Pemiissionta locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 25 ' from structure or covered with tarp or plywood
Restrictions: a t e n d o f workday
S
(Give location by street and no.,or dese ' e in such manner as to provied adequate identification of location)
Fee Paid$ o, C�
This Permit will expire / "_-
(Signatoeof'offical9'r9p�ermit)
�Offical gr g permit
(Title)
TWI_C P1=PUIT III I.gT'RP ('_nKljq l('`_I in,l_q1 b PP)QTI=n 11P)IaI TWF= PP1=u1C1=_q