HomeMy WebLinkAboutDumpster Application & Permit - Permits - 336 CANDLESTICK ROAD 1/18/2017 x� The COMMOnWeafth
_ Partment of Hire Ssrvkes
OffIC8 Of the SfalLq F'pq MfirahaU
P.0,BOX 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
lllll
Date:
Permit No
City or Town)
(IfApplicable) Dig Safe INIU=mber
In accordance with the provisions of M.G.L. Chapter l p as
provided in Section. 527 CMR 34 application is hereby made Start Date
(FaR name ofperson,Firm or Corporation)
,ate clearly Address [�
upose for
uahpemnit (StreetorP.D Box CityorTowa)
requested l+orpermissionto T�ocate dumpster
of s for construction/renovation/demolition `,�truct re
Comments; du.mgster, must be 25 ' from structure or covered when not in use
at 'S 7 t ' /%7E 1 .
(Give location by street and no.,or describe m such manner as to provied adequate identificstiott of location)
Name of competent operator
(If Applicable) Cert.No.
Date Issued rejected B -
(Signature of Appliaant)
Date o£ex�piration
.—_....y._ Fee$ ,Paid Due
_-_.......__.__...,—-----..._._...._.__
The Commonwealth Of Massachusetts
aDePartment Of Fire Services
Offl'CG of the Stat Fire Marshal
P,0,Box 1025 State Road,Stow,MA 01775
PERMIT
� �x.>nit.l�'o Date:
�
{City of Town) {If Applicable} Dig Safe Number
In accordance with the provisions of mm. Chapter l Oas provided in section 5 2 7 CMR 34
Ibis Pan nit is granted to; 1+(l /"' '1/ Start Date
Full name of person,Firm or Corporation
?ermissionto locate dumpster for construction/renovation/demolition of structure
'01m' dum ster be 251 from structure or covered with tarp or plywood
:estriotions; at end o f w o r k d a y
(Give location by street and no,,or describe in such manner as to provied adequate identification of location)
ee Paid S .6q9-11,
his Permitwiu expire Sign Si a cal granting
( ofopermit) Offs grEn
g Pest (Title0000 )
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