HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 2/1/2012 FPS(rev.3/00)
APPLICATION I
City or Town " 'is ., DIG SAFE r1t1M13ER
Date
Start Date:
.In accordance with the previsions of M.G.L. Chapter 148, as Provided in Section
by
application is hereby made
(Full name of person,�rrrt or Corporation)
Address
(Stn:ef ori?O.@may)(City orTovvn)For permiss}on to (state clearly purpose for which permit is requested) �<.�C:�;� �i � -
Name of competent operator if Applicable)
Cert. No. � a) Ct
Date Issued-rejected By
Date of expiration (6lgnature olApplicant)
-- ------- Fee ___-- -Paid ------ Due --
�. r
FPS(rev.3fao) : oz 90�5,.�� , 775
PERMIT
City or Town j ��G� �
DIG SAFE {NUMBER
Date___
Permit Number(if applicable) Start®ate;
In accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
to
/ (Full name of person,Finn or Corporation)
for 1 ��`i �G/ '�-- e��r
Restrictions: )) / /
at
(Give location by street and no.,or descnbe in such manner as to provide adequate identification of location)
Fee Paid$
-This.-Permit
will expire on
Signature of Official Granti Permit
Title
espermitk m s e conspicuouslyt the premises
_::'�t-:r;•a;ts>aers:�r;r� c�� =�c.•3:c:r..rrs�-��v OFPUSUCSAFETY
'
Spinider Contractor License
_- Number. SC - 004508
Expares:0412112012 Tr.n 29.0
R : LYNCO FIRE PR ON
PAUL T SWANFELDT
RI
BURLINGTON, MA 01303
commissioner