HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 129 TURNPIKE STREET 10/30/2012 FP6(rev.3/00)
APPLICATION FOR PERMIT
City or Town a"tG � '
DIG SAFE NUMBER
Date j I
LStarte:
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In accordance with the provisions of M.G.L. Chapter 148, as provided in Section l G A application is hereby made
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by sus r�i 9`i e'er Vic' a
(Full name of person,Firm or Corporation)
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Address 6° �rC
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested)_ kccl - I
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Name of competent operator(If Applicable) 11(11r)r I Cert. No. (_.
Date Issued-rejected By
(Signature of Applicant)
Date of expiration Fee $ Paid Due
L/G-�'LE �Q/1'/?//?20�12L11�CliLG12 G�C��G L�C7Ci12G(/.iPG� '
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PERMIT
City or Town /- A n:(cv_'f DIG SAFE NUMBER
Date 6; `. I
Permit Number(if applicable)
Start Date:
In accordance with the provisions of M.G.L. Chapteer148, as provided in rl , this permit is granted
to �lGtrTfj�S�tf'G �t(-(� ' '( -be C'1(C,I � (tKI
(Full name of person,Firm or Corporation)
for 1�-�' �ClGCn !iG'7 C I Sn( n L-Ce/" l-Le}Czt�s
Restrictions:
at 1 z-q
(dive location by street and no.,or describe in such manner as to provide adequate identification of location)
Fee Paid $ This Pefmit will expire on ' tA-,14 All,7_1 LJ
Signature of Official Granting Per Title �s2
NO This it s be cons icuously posted upon the premises
? Commonwealth of N3ass chu-,otts,
Department of Pubfic Safety
License:sC-003841
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LAWRF,Nc ;F DEAU i is
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LUNI�tDND,��'iR'4� ^>
Commissioner Expiration,,.
02J98/2094
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QEPARTMENT OF P&BUC SAFEW
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,a^ Wmber. SJ. 006635
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7 GLEN# - 03104LLS
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MANCHESTER, tf
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