HomeMy WebLinkAboutDumpster Application & Permit - Permits - 96 WOODCREST DRIVE 3/28/2017 The Cammanjnvea�th ag VAazaachusaft
Depaftment of Res Services
tics Of the State Fire Marshal
P.0.Box 1025 State Road Stow,MA 01775
APPUCATION FOR PERMIT
Date: -7
City Or Town) (ITApplicable) Dig Safe Number
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
Ruff namie ofp6scp,Finn or Corporation
State clearly Address
purpose for
whichpennit (Street orRO.Box City orTown)
is requested For permission to Locate dumpster for construction/renovation/demolition ,-,,
of structure
Comments: dumpster must be 25 ' from structure or covered when�not j n use
at
Give location by street and no.,or describe m* such manner as to provied adequate identification of location
Name Of competent operator
(If Applicable) Cert.Na,
Date Issued4ejeete& -------
By
7
Date of expiration Signature of Applicant)
Fee s C--Z> Paid Due
---------------—-----—-—-—---—----—----- cut-------------------------------------- ------—-
The Commonwealth of Massachusetts
Department of Fire Services
Office Of the Stal te Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775
PERMU
Permit No Date: I?_"�L�42
(City of_
Town)—
---FIf—Applicable) 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 D:ate.
Full name of person,Firm or Corporation
Permission to locate dumpster for construction/renovation/demolition of structure
Comments: dumpster be 25 ' from structure or covered with tarp or
Restrictions: at end of workday Plywood
at a
(Give location by street and no.,or describe in such manner as to provied adequate identitieation of location)
Fee Paid S
This Permit will expire
—�V—1 (Signal anting permit Title)
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