HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 7/30/2013 ( �/�j �4��U77Z4�J'L"GL'2CZL� Q��%�ucy:J�CC/Z•G%)f?z�,l
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APPLICATION FOR PERMIT
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UMBER
City or Town A P f
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In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
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(Full name of person,Firm or Co(poration)
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Address C1 � �a S`1� .j L�L S'� a �, /�
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested) L '�
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Name.of competent operator (If Applicable) 5
Date Issued-r@}a&ed By
(Signature of Applicant)
Date of expiration V Z06�, �c���®� Fee �1 $ Paid Due
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(iev.3/00)
PERMIT
amity or Town '%��` fIC10ClE� > DIG SAFE NUMBER
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" 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)
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testrictions:
(Give location by street and no.,or describe to such mailer as to provide adequate ldentification of location) .
ee Paid $ Theis Pe�rnifwill expire on % lt` o�e����`��___—
signature of,Official Granting ermit Title
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Clarion Fire Protection 16179033189 P.1
Ccmrr.an;veaith of ,j j S s ac h u
Department of Public Safety
License. sc-o06847
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ExpilatiOn:
Commissioner 02f2212014