HomeMy WebLinkAboutFire Dept Permit - Permits - 660 GREAT POND ROAD 5/29/2012 d 5Xrea��v»zo�n-u1ea� i
=P6(rev.3/00)
APPLICATION FOR PERMIT
DIG SAFE NUMBER
City or Town �r�'! 4 AJcdr��r
Date
Start Date: s7/49/12 .
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by (" 1eJ f e% S
(Full name of person,Firm or corporation)
Address 7`�lfrsts"c�C? �r. �� C1 /-) !7L
(Stree(orP.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested) ASS r f
Name.of-competent operator(If Applicable) Cert. No. CaS'c9
Date Issued-rejeG#ed_ �_ By
(Si nature of Applicant)
)ate of expiration Fee C�? $ Paid Due
--------------------------------------------
d/ a �pa/z'z�_ 6_1�
rev.3/00)
PERMIT
ity or Town - <! n C/r�r'i �f DIG SAFE NUMBER
ate
FStarl :
3rmit Number (if applicable)
accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
n ice€ S'
(Full name of person,Firm or Corporation)
�strictions:
(Give i06211on by street and no.,or describe in such manner as to provide adequate identification of`location) .
e Paid $ This Permit will expire on 1.��
.... Ti -�
inature of�Official Grantin Permit Title
-----, •.-.• --- z ^ r,.. '� r- i- rl � o n r�n -F
o