HomeMy WebLinkAboutDumpster application and permit - Application - 270 BRADFORD STREET 4/26/2017 X
The COMMOnweafth 0' Massac hula fts
2 LW;� Department
OEM, -vices
-1
of Five Se�
Office of the State Fire Marshal
P.G.Box 1025 State Road,Stow,AM 01775
APPLICATION FOR PERMIT
Date:
Permit No ----CIf�Applicable) Dig Safe Nu' mber
(City 'r—ToV,%
In accordance with the provisions of UGI, Chapter 1_0 as
provided in Section 527 C M R 34 application is hereby in a Start Date
by 1:Z7'1� I Q-0 i L- i � C-,-,
(Full name of person,Firm or Cotporation) 0)
State clearly Address --2-70 CA Lro-k- L) 9 -- s
purpose for (Street or P.O.Box City or Town)
which permit Forpormissionto Locate dumpster for
is requested I of structure construction/renovation/demolition ,--,
Comments: dumpster must be 2 ' from structure or covered when not in use
at
(GGive location by street and no.,or describe in such manner as to provied adequate identificationof location)
Name of competent operator f 7-T 1k,) Ceit.No.
(If Applicable)
Date Issued-rejected By
Date of expiration (Signature ofApplioant)
Fee Paid Due
—----------------------------cut- -------------------------------------------------—------------—----------
The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775 it
a x PERMIT Date: V-,2- -2
ali Permit No 1 6 -1
City of Town-)--- (If Applicable) Dig g Safe I
In accordance vfith the provisions of M.G.L. Chapter 10as provided in section 527 C M R 34
'at,
Start D
This Permit is granted to: Date
Full name of pers nm,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 -2-7® fry-
G ,location by street and no,,or describe in such manner as to provied adequate identification of location
Give
--7
Fee Paid$ < U
Illy
This Permit will expire (Si9na40'0f off cM-18ranpermit)' 0*a1gr—mitingpermit Tit,
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