HomeMy WebLinkAboutFire Dept permit - Permits - 1120 OSGOOD STREET 6/6/2011 a��v»z�n•crri.Z cz 0-
FPS(rev.3100) Ox 'DG�� U C 2 C�CZ� U Go z,,
APPLICATION FOR PERMIT
/ J =Date:
UMBER
City or Town >�Vy�7 Gl '�t-- c��✓�`'
Date L� — �! I
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by �s�
(Full name of person,Firm or Corporation) >
Address l I `\ 1 f 12SLl— �� �G4
(Street or P.O.Box)(City or Town)
For permission to state clearly purpose for which permit is requested)
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Name.of competent operator (if Applicable) MC_44d f_d `'1 Cert. No.
Date Issued e 4/"
(Signature of Applicant)
Date of expiration 61"!5;7Gn , ��� Fee �—$ Paid �� _ Due
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'6(rev.3l00) SP &. ✓)c az
PERMIT
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City or Town DIG SAFE NUMBER
Date
• Start Date: '
Permit Number (if applicable)
In accordance with the p .visions of M.G.L. Chapter 148, as provided in this permit is granted
t
i �r6/ / / (Full name of person,Firm or C oration)
for `zi��v L �' L ��
Restrictions:
at
(Give location by street and no.,or describe in such manner as to provide adequate identification of location)
Fee Paid $ Y a^ This Perm ill expire on
•
Title
Signature of'Official Granting Permit
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COMMONWEALTH OF MASSA;CHUSETTS`.'
ELECTRICIANS
A REGISTERED SYSTEM TECHNICIAN
ISSUES THE ABOVE LICENSE TO. °
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MICHAE'L J MEADOWS
" 62 CADOGAN WAY
NASHUA NH 03062-225G'. ;
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2978 D 07/31/13 890003J+ �¢ i