HomeMy WebLinkAboutFire Dept Permit - Permits - 1275 TURNPIKE STREET 4/4/2012 FP6 (rev.3/00) 70�� / CiG0�775
APPLICATION FOR PERMIT
Cityor Town /�� /� l DIG SAFE NUMBER
1.a �v�v^
Date
Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by Ell r lc-
(Full name of person,-Finn or Corporation)
Address 12,5
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested) -Tl5I II 6, FA 'S
)n i�eu l 5 rzr,/ 1 P��P P�IcI���� / g ss r �� Ca re C c-; ) V
Name.of competent operator (If Applicable) T(o"CA')Ce Cert. No. 1�0
Date Issued-reiee#ed .2— By
(Signature of Applicant)
Date of expiration �Go G l��11�„�Tv� Fee o Paid �'` Due r�
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i(rev.3/00)
PERMIT
City or Town G�` '' '7�lOy��/l, DIG SAFE NUMBER
Date �l/Z
Start Date:
Permit Number (if applicable)
n accordance with the provisions of M.G.L. Chapteerr}148, as provided in this permit is granted
(Full name of person,Firm/or Corporation)
or /�11 ✓ '/� 7��`p�I ��` Sl/�Gt/ �i t'� /9/���i <' /C'ZZ-
restrictions: Y
(Give location by street and no.,or describe in such manner as to provide adequate identificatioonn�ollocation) .
-ee Paid Z7 This Permit will expire on �dn
>ignature of,Official Granting Perm Title
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