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HomeMy WebLinkAboutDumpster Application & Permit - Permits - 202 MARBLERIDGE ROAD 2/1/2017 r The Commonwealth of Mazzachusette 111 210 ©epaFtmsnt of Rre Semites Office of the State (pare MarehW p sw P.0,Box 1025 State Road,Stow,MA 0.1775 �APPLICATIONFOR PERMIT Date: Permit No (CRY or Town) (If Applicable) Dig safe Plumber In accordance with the provisions of M.G.L. Chapter 10 as provided in Section 527 CMR 34 application is hereby made Start Date Fiiff nam'ofperson,Firm or Corporation) :ate clearly Address C� �� ��L r n A/ irpose for (5treetorP.o.Box City or Town.) Ltichparmit For m7nissionto Locate dumpster for construction/renovation/demolition requested p of s t r u c t r e Comments; dump'ster must be 25 ' from structure or covered when not in use at a p -- , (Give location by street and no,,or describe in such manner as to provied adequate identificatioa of location) Name of competent operator Cert.No. (If Applicable) Date Issued rejected By ( i Lure of Applioant) Date of expiration Fee$ Paid D ue ---------_---- Thecam- 4 DePartmGnt of Fire Services tCG of the State Fire Marshal l P-01 Box 1025 State Road,Stow,MA 01775 it PERVIT Date: Permit No //� (City of Town) (If Applicable) ZStartDatt; Safe Plumber 7 In accordance with the provisions of M.G.L. Ch'gpter 10 provided in-sectioa 5 2 7 CMR 34 (�This Permit is granted to: �' -) G� 57/L�C ''dr, Full name of person,Firm or Corporation Permission to locate dumpster for construction/renovation/demolition --of--structure Comments: dumpstler be 25 ' from structure or covered with tarp or plywood Resiriations: a t end o f w o/r k day at ' C (Give location by street and no,,or describe in such manner as o r 'end adequate" entification of location) Fee Paid$ �a &)"' This Permitvrill expire /- (Signature of offieal antic permit) Of6.cal antic i/ �`/� � g� ) gr g permit (Title) Z°l-did P;:PPllll S' 14P11 t `1" RI= C ("1M P1r°d in11g1 V P QTPr) 111 r)M TWX P PP1ti11_Qt=_q