HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 10/2/2012 /Cle (; al/.YJ�CL�fQ%/2G(/.lQ�
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APPLICATION FOR PERMIT
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G SAFE NUMBER
City or Town ) �,�„--i ^�
Date ,���'~ =� ,�� ..un..
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section i0jq , application is hereby made
(Full name of person,Firm or Corporation)
Address V':�'3� ��ao � i �a & . _
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested) "y L4' t
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Name of competent operator (If Applicable) Cert. No. CIC
Date Issued-rejected-_ By
(Sigi.jature ofApplicant)
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Date of expiration w- Fee �° $ Paid Due
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FP6(rev.3/00) �. 9c ol-v 70�5, � te Raaal, &d((,, � 0/775
PERMIT
City or Town AJ, Padc'JC'_° DIG SAFE NUMBER
Date J - 4 —l am
Permit Number(if applicable) Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in (G �q this permit is granted
to
(Full name of person,Firm or Corp ation)
for /}'IG�snG �G'G�li� �: ehoca Gtd
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Restrictions:
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(Give location b irbet and no.,or describe in such manner as to pro ide a uate identification of location)
Fee PaidThis Permit will expire on 'n
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Si nature of Official Granting
Permit p
00 This pert ust b cons Icuously posted upon the premises 4111111111