HomeMy WebLinkAboutDumpster Application & Permit - Permits - 125 FLAGSHIP DRIVE 3/7/2017 E
The COMManweafth of Massachusetts
,
Depailment of Five Servkea
A
Office of the State Fire Marshag
P.0.JBOX 1025 Statc,,Road,Stow,MA 01775
APPLICATION FOR PERMIT
Date: 7—
Permit No If�Applicable) Dig Safe Number
city or Town
In accordance with the provisions of M.G.L. Chapter_ 1_0 as
provided in Section 527 CMR 34 application is hereby made Start Date
by__C MIMI
(Full name ofperson,Firm or Corporation)
State clearly Address Z
purpose for
which permit (Street or P_a Box City or Town)
is requested Forpermissionto Locate dumpster- for construction/renovation/demolition
Of structure
Comments I: dumpster must be 25 , from structure or covered
at
(Give l=a' by street and nO.,orde�cr�tein suC ma�merasto�prmvipd adequate
Name Of competent operator CeTt.No,
(If Applicable)
Date Issued feet 2-1� By
Date of expiration Signature of Applicant)
Fee Paid Due
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The Commonwealth of Massachusetts__________'.
2Qk
Department of it Services
Office of the State Fire Marshal
P.0,Box 1025 State Road,Stow,MA 01775
k
Permit No PERMIT Date:4c2ioty-00�f Town) :Di g:Safe N:,um b e_r
(If Applicable)
In accordance with the provisions of M.G.L. Chapter� 10as provided insection527 CMR 34
Start DateDate
This Permit is granted to:
Full name of person,Firm or Corporation
Permission to locate dumpster for construction/renovation/demolition of structure
Comments:
dumpster be 29 ' from structure or covered with tarp or plywood
Restrictions: at end ofrr workday
at
CTivive location by 141fleet and no.,or describe in such manner as to provied adequate identification of location)
Fee Paid
This Permit will expire (_Sip_a_ETe_of ranting�p4��
Offical grafftmg permit Title
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