HomeMy WebLinkAboutDumpster Application & Permit - Permits - 345 MAIN STREET 3/29/2017 DePanment of Five Se�vices
Offics Of thG 3MG Fare MaraW ...�
P.0.BOX 1025 State Road,Stow,MA 01775
Q.f � JO�•�4
APPUCAMN FOR PERT
Date:
City
Permit:No
( or Town) (If Applicable)
Dig safe Number
In accordance with the provisions of M.G.L. Chapter 1 p
provided in Section� 527 C MR 3 4 application is hereby made Start Date
by 1��e
(Full name ofperson,F- or orp n)
State clearly AddressS1
Purpose for —_7:.q 1 36 -c, /
Which permit (Street or P.O.Box City or Town)
srequested Forpermissionto Locate dumpster for construction/renovation/demolition _`
of structure
Comments: dumpster must be 25 ° from structure or covered when not in use
at ve° P' �7 3
(Give location by street and no.,or describe in such manner as to provied adequate identification of ocation)� �
Name of competent operator (
(If Applicable) Cert.Na.��
Date Issued-rejected By
(Signature of Applicant)
Date of e��riration � Fee .Paid
Due
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Commonwealth of Massachusetts
Department of Fire Services "
Office ®f the State Fire MarsW
P.0,Box 1025 State Road,Stow,MA 01775
o ®v G Permit No Date:
(City of Town) (If Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter l 0as provided in section 5 2 7 CMR 34
This Permit is granted to: Start Date
- - -
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 plywood
Restrictions: at end o f workday
at
(Give location by street and no.,or describe in such ma er as to provied adequate identification of location)
Fee Paid S
This Permit will expire dot (Signature of offical granting permit) fficaigrautingpermit
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