HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 58 PETERS STREET 1/29/2013 FP6(rev.3/00) Y. 6. �ox ,1025, G9&& Roald, CNo�1 , (DI"0-1775
APPLICATION FOR PERMIT
DIG SAFE NUMBER
Cityor t/,
Date
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by 1 1 -
(Full name of person,Firm or Corporation)
Address *Ls 0
(Street or P.O.Box)(city or Town)
For permission to (state clearly purpose for which permit is requested) r-, Cc, It
A
i t, i'I 141c-'ei,
Name of competent operator(If Applicable) f I i't C t" 1%- Cert. No.
Date Issued-rejected By
(Signature of Applicant)
Date of expiration Fee $ Paid — Due
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FP6(rev.3/00) 00'x -102,5-, c;%& R.11' 6r"' Q4 pwo�775
PERMIT
City orTown DIG SAFE NUMBER
Date 1—,L.Ir-r,2 cz
Permit Number (if applicable) Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
to 4z"'�
(Full name ofperson,Firm or Corporation)
for
Restrictions:
at
(Give location by street and no.,or describe in such manner as to provide adequate identification of location)
Fee Paid $ This Per%will on expire 1�lze0l? 72,�
re o�
Signature of Official Granting Permia. Title C /,7- -
N* This per it must be conspicuously posted upon the premises *M