HomeMy WebLinkAboutDumpster Application & Permit - Permits - 25-27 MAIN STREET 3/3/2017 - The Commanwe
d afth Oa Mass.Depanm
Gnt of Firre Serv5ces
Offics Of thG State Fire Mqnshag
P.0.13 ox 1025 State Road,Sto-W,MA 01775
JJ
APPLICATION FOR PERMIT
Date:
Permit No
City or Town) ---FIf—Applicable)
In accordance with the provisions of M.G.L, Chapter.. I�0 as Dig Safe Number
provided in Section 527 C M R 34
by �application is hereby made StartDate
---------- --------
Rill name person, 0" anon on- � 5
State clearly Address T
purpose for '�- Yz)C) - D C7
which permit (Street P.D.Box cityorTowa)
Forpermissionto Locate dumpster for construction/renovation/demolition
is requested Of struction/renovation/demolition
Comments: dumpster must b e 25P from structure or covered when not---in u s e
at
ruo vt
(Give location by street and no,,oz
describe in such marmer as to provied adequate identification o
Name Of competent operator f location)
(If Applicable) It C. Celt.NO.
Date Issued-rejected
By
Date of expiration Signature of Applicant
—---------------------- Fee PaidDue
-cut-----
The Commonwealth Of Massachusefts
Department Of Fire Services
Office of the State Fire Marshal
P.0.Box 1025 State Road,S1017,MA 01775
ermit N® PERMIT Date:
In accordance with the provisions of M.G.L. (If Applicable) Dig Safe Number
This Permit is granted to: Chapter Pas Provided in section 5 2 7 CMR 34 Start Date
Pennission to locate Full name of person,.Firru or Corporation
construction/renovation/demolitionter for of structure
Comments: dumpster be 251 from structure or covered with tarp or Plywood
Restrictions: --
at end Of workday
at
Ic' '-t
:10
(3ive location by street and no.,or
Fee Paid$ 00 escribef such anner as to provied adequ te identification of location)
This Permi will expire Signature of offical granong Offical granting permit
Title�)
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