HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 9/16/2013 -. ��?,2 �4?97�?920iI2L11-�CxL�/!'GI Q���•�'�-L�'.LCZCI2.G!/.1t?z�,l
'6(rev.3/00)
APPLICATION FOR Pi_RNIFF
� =Date:
MBED
City or Town �,7° �fi��Gr"✓��"�
'Date �f
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by
(Full name of person-Firm or Corporation)
Address
(Street or F.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested)
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z V rje td,f-v f ;� ,�a�3C Fi f 5� cx`_
Name.of competent operator(If Applicable)
Cert. No. 9 lie) )Ile
i,
Date Issued-rejected BY
(Signature of Applicant)
Date of expiration Fee $ Paid Due
Ij
,9. 775
EIS'
. �, , 7v boV��, ,1✓l,� DIG SAFE NUMBER
amity or Town
)ate
• :Start Date: '
'ermit Number (if applicable)
accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
(Full name of person,Firm or Corporation)
testrIctions: ���L,
t / � . i%�11� / ��✓
(Give location by street and no.,or describe ih-such manner as to provide adequate identification o!location) .
ee Paid $
C� This Permit wilf expire on /1 0.j• h0
r .' 9 yn�' ,�P,� a Tile
signature ofiOfficial Granting Pe ~° _
J
t Commonwealth of iiMassachusetts
Department of Public Safety,
Sprin9clei-.Jrotarneeman .6
License: SJ-110419
CHRISTOPHER XOREILLY
171 NASHUA RDA
Bedford NH 03110 v
f.
r `
Expiration.
Commissioner 06/28/2015