HomeMy WebLinkAboutDumpster Application & Permit - Permits - 61 WOODCREST DRIVE 3/23/2017 The Cammonjvsaflth an pjazsachuaaftn
Department of Fire Services
0
fflcs ®f the SIMILG Fire Marshal
P.().-Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
Date:
Permit No
(CETorTown�) (_1fA_pp_1ic_—Able,) Dig Safe Number
In accordance with the provisions of M.G.L. Chapterl 1_0 as
provided in section 527 CMR 34
application is hereby made Start Date
by I_ " —,
s Full name of person,Firm or Corporation)
Address State clearly L ()�T;Ce J� Ajov)(r /*
purpose for (Street or I P.O.Box City or Town)
whichpormit Forpermissionto "Locate dumpster for construction/renovation/demolition
is requested of struc-ture
Comments-, dumpster must be 2 ' from Structure or covered when not in use
at __—(' I -
(Give location by street and no.,or describe in-such manner as to provied adequate identification of location)
Nome Of competent operator
If Applicable) Cert.No,
Date lssued_T`Ieeted By
Date of expiration Signature of Applicant)
S Fee s Paid Due
---------------—-------—--—--------—----- —----- cut-----------------------------------------
The Commonwealth of Massachusefts
12k
Department of Fire Services
Office Of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775 it
PERM.IT Permit No Date:
(City of Town) --- (—If Applicable) Dig:Safe N:,,m,
M.G.L.
Iu accordance with the provisions ofM.G.L. Ch ter 1 0as provided in section 5 2 7 CMR 34
This Permit is granted to: Z EStart Date
Full name of person,Firm or Corporation
Permissionto locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 251 from structure or covered with tarp or plywood
Restrictions; at end 0 f workday
at a a /I __ _4�,
(Give location by street and no.,or describe in such manner a o provied ado---ate identification of location)
Fee Paid 71
01 granting This Permit V'Uo`%T're Oig�UdLUZC 01 OMCaj granting F=�t Tacal gr g permit Title
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