HomeMy WebLinkAboutDumpster Application & Permit - Permits - 92 BRIDGES LANE 1/2/2017 4 The COMMOnweafth of
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Mazaach
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Office of the State Fire marqW
P.0.Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
Date:
(city Permit No
or To —CH—Applicable)——— Dig Safe Number
In accordance with the provisions of M.G.L, Chapter l D as
provided in section
527K CMR 34
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Star Datey I )LC.Fu:ll Of'per L on I fi7M Or Corporation)
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hate clearly Address
urpose for
&ichpemlit Forertnissionto ''tocate dumpster (Street orP.D.Box CityorTovm)
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requested of st for Construction/renovation/demolition -,;��,
Comments: dumpster must be 25- from structure or covered whennot in use
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(Give location by street and no,,or describe in such manner as to Provied adequate i
Name Of competent operator ev 01�Y ,�';A�'. A location)
.
(If Applicable) —w� Cert.No.
Date Issued-rejected By
Date of expiration 311117 C afore of Applicant)
Fee$
61
Paid
The colmmonwealth Of Massachusefts
Department Of Fire Services
Office of the State Fire Marshal
R 0,Box 1025 State Road,Stow,MA 01775
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PERM.IT
Date:
(City of Town) Permit No A—p—plic—abla�) Dig Safe Number
In accordance with the provisions of M.G.L. ChaPtex�--1 Das provided in section 5 2 7 CMR 34
This Permit is granted to: Start Date
Full name of Person,Firm or Corporation
Permission to locate dumpster for construction/renovation/demolition of structure
Comments: dum ster be ?,; ? from :ure or covered with tarp or Plywood
Restrictions: at end 0 f workday
It Al 40 0 �-
Give location by street and no,,or escribeins h m7ner as to proviod adequate i
Fee Paid 3 :7!!!aflan of location)
'his Permit will expire atme Of offical granting 't) cal
granting Title
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