HomeMy WebLinkAboutDumpster application and permit - Application - 32 FURBER AVENUE 5/18/2017 The COMManweafth Of Massachusafts
Depaulment of Fire Servkes
Offics Of the State Fire Marsha� AN-1 ftl
P-0-13Qx 10225 State Road,Stow,MA 01775
APPLICATION FOR PERMIT
Date:
Permit No
City or Town J ----(lf�Applicable) Dig Safe l�u�mber
In accordance with the provisions of M.G.L. Chapter 1_0 as
provided in Section 527 CMR 34
by 7---77—application is hereby made Start Date
et dr 7 7;
(Full name of person,Firm or Corporation)
State clearly Address
purpose for
wbiclipermit (Street or P.O.Box city or Town)
is requested Forpm7nissionto Locate dumpster for construction/renovation/demolition
of structure
Comments; dumpster must be 25 ' from structure or covered when not in use
Give location by street and no,,or describe in such manner as to provied adequate identification of location)
Nome,of competent operator cort NO,
(If Applicable)
Date Issued-rejected By
Date of expira6ou Signature of Applicant
Fee$ ?aid Due
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The Commonwealth of Massachusetts
X-1k
Department of Fire Services
Office of the State Fire Marshal
P.0.Box 1025 State Road,Stow,MA 01775
PERM.IT
92 Permit No Date: 7
City of Town) ---- Dig Safe Numb(If Applicable) ber
In accordance with the provisions of M.G.L. ChaPter�-—1Oas provided in section 5 2 7 CMR 34
This Permit is granted to: 1.17 Start Date
--------------
Full name of person,Firm or Corpofation
Permission to Locate dumqster for construction/renovation/demolition of structure
Comments: duml)ster be 25 ' from structure or covered with tarp or plywood
Restrictions: at end of workday
at
Give location by street and no.,or describe in such manner as tr proviedade ate identification of location)
& �"' "+C, ",e
Fee Paid
This Permit will expire
(—Siga;iaA'4ffif)1i'a'11�gra'ntiing
permit) Offical granting permit /-=-�(Title)
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