HomeMy WebLinkAboutDumpster Application & Permit - Permits - 33 PILGRIM STREET 4/20/2017 The CammoonvveaQth of Ma938ChU8gtj_3
Department of Hrre Services
Office Of the State Fire Marsha�
P.0.Box 10295 State R04 Stow,MA 01775
APPLICATION FOR PERMIT
Date:
dPermit No
I (�Citylor Town) (If Applicable) Dig Safe Nlumnber_j
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
(Full name of-person,Firm or Corporation)
State clearly Address
purpose for
which permit (Street orp.a Box City or Town)
is requested Forpennissionto Locate dumpster for construction/renovation/demolition ,-,,
of StTufture
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)
Name Of competent operator C C Cert.No.
(If Applicable)
Date Issued-rej*Ted , Z-_,,) c) -/ 7 By
Signature of Applicant)
Date of expiration 2 y ;7 Fee Paid Due
----------------------------- —------—----------------
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The Commonwealth of Massachusefts
Department of Fire Services
_0 Off'[CG of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775
PERM.IT Date: 62-//-7
14 Permit NO
(City Or Town) ----(If Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Chapter -I 0asprovidedin section 5 2 7 C M R 34
This Permit is Branted to: _g � 'at,:
141 Start EDate'..,,
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 0 f workday
at 23 's-157--l-r " -
. (Give location by street and no.,or describe in such manner as to provied adequate identification of location
Fee Paid
This Permit Will expire
(Signature o 40c81V_antingpermit) Of6eal Ling permit (Title)
THIR P;=P.MIT M(I-qT"RR rr)KjRDjrj in, _ql V P()_qTRr) I MnM TWF: PPPUj_Qr:q