HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 1250 OSGOOD STREET 11/8/2012 -'-- � 4�9'IiJ92O�J2•GIlECl O•' ,y.1�Cf2Gl/,1e��
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APPLICATION FOR PERMIT
DIG SAFE NUMBER
City or Town
Date
Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
(Full name of person, tmn or Corporation)
Address
(street or F.o.Box)(City or Town) ,p
For permission to (state clearly purpose for which permit is requested) Cl
Name.of competent operator(If Applicable) Cert. No. 1
Date Issued-r ' ® ® X. B
(Signature a/Applicant)
Date of expiration /Jp®� ��d Fee $ Paid Due
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PERMIT
DIG SAFE NUMBER
,ity or Town
)ate f r
2z:
Start Date:
'ermit Number (if applicable)
I accordance with the provisions of M.G.L. Chapter 146, as provided in
this permit is granted
i (ruli name of person,Firm or Corporation)
Iestrictions: <
t � 5 vV v d no o dr ncse be in`such manner as to provide adequate identification of location)
(Give location by street an
ee Paid $ 0 U 'This Permit will,expire on J/0b17 ®1 1 T'
{ Title
ignature of,Official Granting Per
/'1
Commonwealth of Massachusetts
Department of Public Safety
SJujnkler Cnntrnctur
License: SC-210029
JOHN J LAWTON-
266 SUGAR RD
BOLTON MA 01740 -
Commissioner Expiration:
07/02/2014