HomeMy WebLinkAboutDumpster Application & permit - Permits - 11 PEMBROOK ROAD 11/4/2016 9
The Commonwealth of Massachusetts
Department Fire Services
Office of the Sta4te Fire Marshal
'4 P.0.Box 1025 Stair Road,Stow,MA,01775
PERMIT Date:
Iql, o V f A- JPer ift No Dig Safe Number
(City of Town) If Applicable)
In accordance with the provisions of MG.L. Chapter 10as provided in section 5 2 7 CMR 34
�j� __.,�,�/ Start Date
This Permit is granted to: ///�✓✓`1f4,) �/�f� ///57
Full name of person,Firm.or Corporation
Permission to locate dumpsi er for construction/renovation/demolition of structure
Comments: dum+pster be 25 ' from structure or covered with tarp or plywood
Restrictions: a t-end of workday
at
(Give location by street andno.,or describe in such manner as to provied adequate identification of location)
Fee Paid. 4� A,-rr f
This Permit will expire //�/�� (Signature o ofroal granting permit) Offic granting permit (Title)
TWIA PFP1t IT MI I-QT ;kF: r'_r' MRPIr'_I Inn IRI V Pr'1QTPn 1113r)M TWI= PRP1ltI1MPA