HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 2005 SALEM STREET 5/14/2013 0_-N214JLLIJECL Q' yJCCG 2.L(/lt , l
FP6(rev.3/00)
APPLICATION FOR PERMIT
�. DIG SAFE NUMBER
City or Town" '
Date ��f I D Start Date:
i
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by
(Full name of person,Finn or Corperatien)
t
Address \ h� 1 o � M- -y e c
(Street or P.O.Box)(City or Town) Or
For permission to (state clearly purpose for which permit is requested) �, .t- ` "
Name.of competent operator (If Applicable) � � �' Cert. No. - �'
Date Issued-fa} d �S=/�J�_ B
(Signature of Applicant)
Date of expiration U� �a � .�J®� Fee Paid :2 -----_- Due
6(rev.3/00)
PERMIT
City or Town r � v C1r1 `u ter- DIG SAFE NUMBER
Date l>l if
IStart -
Permit Number (if applicable)
In accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
to
(Full name of person,Firm or Corporation)
1
for S
l
Restrictions:
at
(Give location by street and no.,or describe in such manner as to provide adequate tIntilication of location)
Fee Paid $_�� _ This P it will xpi;e n _1/Jcin /�
Title
g
Si nature of,Official Granting Per
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