HomeMy WebLinkAboutDumpster Application & Permit - Permits - 147 MASSACHUSETTS AVENUE 3/9/2017 The COMMORNWeafth as Vftzaachusaftszi
of Fire Services
Depanment
Office of the SIMIL9 Fire MarsW
P.0.Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
0 V Permit No Date:
City or Town)
(If Applicable) Dig S,,',e Number
In accordance with the provisions of M.G.L, Chapterl , 1_0 as
provided i.Section 527 CMR 34 b application is hereby made Start Date
y �0's'" -
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(Full'a amie ofperson,Firm or Corporation
hate clearly Address /5-7� nV14-5 A-6-010 (el Y141
purpose for (Street orP-O.Box City or Town)
s re
,kirbparruit For permission to ''L o c-a t e dumpster for construction/
quested of s t Tu_d_�7u r e construction/renovation/demolition
Comments: dumpster must be 25 ' from structure or covered when not in use
at
(Give location by street and no.,or describe in such manner as to provied adequate identification of location)
Nwnc Of competent operator
(If Applicable) Cert.No,
Date Issued--rejeeted
By
Date of expiration Signature of Applicant)
Fee Paid Due
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Commonwealth Of Massachusefts
Department of Fire Services
Office of the Staile Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775
PERM.IT Date: _.CT
Permit NO _Z2�_
City of Town) Safe Number
71TA—pplicable�) Dig Safe Number
In accordance with the provisions ofmaL. ChaPter-1 Oas provided in section 5 2 7 CMR 34
This Permit is granted to: Start Dig
Full name of person,Firm or Corporation
Pennission to locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 25 ' from structure or covered wi,-,-
Restrictions: at end of workaay tarp or- Plywood
at Z%77 g-6- ��c
.' (Give location by street and no.,or describe in such manner as to provied adequate identification of location)
Fee Paid$ 9 Z) — f
This Permit will o%Tire ,0
Unical grchfwgpermit Title)
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