HomeMy WebLinkAboutDumpster application and permit - Application - 102 BEAR HILL ROAD 5/2/2017 AZIN
The COMMOnweafth Of Mazaachusafts
'N
r�- a-;. , I OW DepaFtment of Fires Serrvicas
Office of the State Fire marsW
P.0.Box 1025 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
Date: J --2 7
Permit No
City or Town —
-- (If�Applicable) Dig Safe T6mber
In accordance with the provisions of M.G.L. Chapter 10 as
provid1l,in Section 527 CMR 3 4 application is hereby made Start Date
(Fuff name of'person,Finn or Corporation)
State clearly Address Z- lie cl, i� 0
purpose for V--k
(Street orP.D.Box CftyorTown)
whir,hparmit Forpermissionto Locate dumpster for cOnstYuction/renovation/demolition ,.,',
is requested of structure -
Comments:
d umpster must be 25 ? from structure or covered when— not in use
at
Give location by street and no.,or descri e in such manner as to provied adequate identification of location)
N=0 of competent operator Cert.No.
(HApplicable)
Date Issued-vejected,
7 By
Date of Qx-piraEon (Sipa reofAppioant)
Fee Due
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r.
The Commonwealth of Massachusetts
Department of Fire Services
Fire Marshal
Office Of the State
P.0,Box 1025 State Road,Stow,MA 01775
PERM.IT Permit NO Date:
Miiy of Town) ---7If—Applicable) Dig Safe Number
In accordance with the provisions of M.G.L. Ch t 10
Las provided in section 5 2 7 C M R 34
This Permit is,granted to: a/-- Start Date
Full name of person,Firm or Corporation
Permission to locate dumpster for construction/renovation/demolition of structure
Comments: Lumpster be 25 ' from structure or covered with tarp or plywood
Restrictions: a t end Of workday
at -IE
Xz
Give location by street and no,or describe in such manner as t9 provied adequate identification of location
Fee Paid
� (Trat)
This Permit will expire 2 (Signature- 4Afficaftj
granting��= Officalgrantmgpernut
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