HomeMy WebLinkAboutFire Dept permit - Permits - 60 WILLOW STREET 5/15/2011 _h �2cr�=fitr:Q�nG ���� .L/P%=ZLGeJ �� e a�l12e CJ
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APPLICATION FOR PERMIT
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IGUMBER
Ciry or Town �>rG✓
Date S
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by
(Full name of person,Firrn or Corporation)
Address G1�'/T N —
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested)
Name.of competent operator (If Applicable) Cert. No. c
Date Issued-te}e e-d Z Z Z// - By
(Signature of Applicant)
Date of expiration Fee Paid —t � Due
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PERMIT
City or Town DIG SAFE NUMBER
Date 3//
Start Date:
Permit Number (if applicable)
In accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
to f
i (Full naHe 1 person,Firm or Corporation) /
for J^ /� �` . L i�-2 /�avQJ
Restrictions:
(Give location by street and no.,or describe in such manner as to provide adequate identification of location) .
Fee Paid This- Permit will expire on
Signature of,Official iGranting Title /�;1,—
s