HomeMy WebLinkAboutFire Sprinkler permit - Sprinkler Permit - 1160 GREAT POND ROAD 7/18/2012 FP6(rev.3/00) 93ox m25,
APPLICATION FOR PERMIT
City or Town _A1C,'_r14- Avor-"p DIG SAFE NUMBER
Date- /I ohz_
-et(3 7 Z_ Start DIG
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section- application is hereby made
by -LC'C4'-Je_Y
(Full name of person,Firm or Corporation)
Address ;n-4- 7
(Street or P.O.Box)(city or Town)
For permission to (state clearly purpose for which permit is requested).
Name of competent operator (if Applicable) e_r' Cert. No 5, C q 7/
Date Issued-rejected By ktiz
V (Signature ol'Applicant)
Date of expiration Fee $ Paid- Due
---------------------------------------------
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FP6(rev.3/00) 025, J C%w, 94K?Q/61-1775
City orTown JVC-,A!-rH- AIJA'�-�eA'—" PERMIT - DIG SAFE NUMBER
Date— V1 7__
I .
Permit Number(if applicable) [Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
J
to
(Full name of person,Firm or Corporation)
for 0 C-rf-77 C-Aff
Restrictions:
ate Scj)cv
(Give location by street and no.,or describe in such manner as to provide adequate identification of location)
Fee Paid $ This Permit will expire on
Signature of Official Granting Permit Title
N* This permit must be conspicuously posted upon the premises *E
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---- DEPARTMENT OF PUBLIC SAFETY
Sprinkler Contractor License
oM M Number: SC 148712
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- 0 Expires: 04/21/2013 Tr. no: 359.0
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0 2 h 7 Restricted: LEGACY FIRE PROTECTION
o 0 n o N c PETER E MICCOLI
o m 0 160 PINEWOOD RD
0) -I r , !:� � 7I LUDLOW, MA 01056CZ
Commissioner /
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W cn s FIRE PROTECTION UT��, TFD JOURNEYPERSON
PETE
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LTFDLOWWJ" a;01056
LIC./REG NQ, EFFE TIC VE — EXPIRES
FRP.0020850-Fz1/OI f 201�t /31/2012
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SIGNED
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3 DEPARTMENT OF UBLIC SAFETY
rD 0 .m Sprinkler Contractor License
j n Number: SC 148712
M '0 Expiresr04/21/2013 Tr. no: 1429.0 '
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-i @ a Restricted: ENV.FIRE PROTECTION
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N O PETER E MICCOLI
� z 160 PINEWOOD RD /
m o LUDLOW, MA 01056 1 ��
wCn �,� _ Commissioner
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