HomeMy WebLinkAboutDumpster Application & Permit - Permits - 66 LONGWOOD AVENUE 12/1/2016 The Commonweafth of Massachusaft
DepaFtment of nre senaces
YN.
Office of the State Fire Marshag
P.0.Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
Date:
Permit No
City or Town) -(I
— --- -fApplicable) Dig Safe Number
In.accordance with the provisions of M.GI, Chapter_ , 10 as
provided in,section 527 C M R 34 application is hereby made Start Date
by__,e!2 7-);1 ,'vim
'
(F1.111 name ofperson,Firm or Corporation)
State clearly Address 2L,046/,f 0/j-C-/S-
purpose for (Sh-eetorP.O.Box City ar Town) /
which pam2it Forpermissionto "Locate dumpster for constiuction/renovation/demolition ,��
is requested
of st—ructure
Comments, dumpster must be 25 ' from structure or covered when not in use
at
Give location street and no,,or�describe in such manner as to provied adequate identification of location)
Name,Of competent operator Cert.No.
(YApplicable)
Date Issued-rejacted, By
Date of expiration Fee ?aid (Signature of Applicant)
Due
------—-------—-—-----———--------—----- -------- ---------—--------------
The Commonwealth of Massachusefts
Department of Fire Services
Office of the State Fire Marshal
P.0,Box 1025 State Road,Stow,MA 01775 it
Permit No PERM.IT Date:
City ----TIf�Applicable Dig Safe Number
In accordance with the provisions of M.G.Z. Chapter 10as provided in section 5 2 7 CMR 34
This Permit is granted to: Start Dig
70 7 rz ll f-,�2 7,z
Full 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 /I Z, Z-1 it
(Give locatidAy street and no.,or describe in such manner as to provied adequate identification of location)
Fee Paid
This Permit will expire djE' (Signs 0gc "t4lg permit)—e sitingpormit
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