HomeMy WebLinkAboutFire Alarm permit - Permits - 1160 GREAT POND ROAD 7/18/2012 ;_> L/C� �477'1i7720�72•G(12C2'L�i/'L d./��CCC;�.1•CZCf2•GU.l�'r�.l i�
< � �2ai7rirravr�l`d�� CJ�=v�ceJ- i�� e a�l2e CJCcze ���e C���Gcz'xticz� ;
FP6 (rev.3/00)
APPLICATION FOR PERMIT
City or Town
NOR t /4 AA_,T)pL) Z DIG SAFE NUMBER
Date 7/1 RI/I Z-
4
Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by �il� E L E %/Z IC A-1
(Full name of persan,-Firm or Corporation)
Address ?Si F)RJ-bC,e ?CZ f-1 02 a
(Street orF.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested) RerndL/ ((� Ex1SD 1� 6 H6sn��srl Ll
Iqti-Q /VEW HofZN_S7-7t.3 0 )
sTRo3E �4 }✓ ✓� � �av�2c'ti,c�' �carr�
Name.of competent operator(If Applicable) l�fZ f 14A/ Wr'L$H&1Z/Q Cent. No. 2®L/'J
Date Issued-rejected By
gnature of Applicant)
Date of expiration Fee $ Paid Due
6(rev.3/00) (
PERMIT
City or Town `G✓ =Date,
UMBER .
Date
:Start
Permit Number (if applicable)
In accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
to `S
i (Full name of person,Firm or/Corporation)
for 4 �r at✓F 1 / / X�`�� . (6 c/f/4,7
Restrictions: An Jtf rL /d /Id T d O
at Coo. G o < - �o ✓ — ,� ' '
(Give tec_alion by street and no.,or describe in such manner as to provide adequate identilication of location) .
Fee Paid $ 50 O This Permit will expire on UP y 0 /1210 f 2_�11`dam
t � r
Signature of,Official Granting Permit Title �/o:,rnc e!
+k t] rl r fl YT'1 i C C1 C r'Lt=:l
Fold,Then Daiach Nong Ali PeOomdons
—Ib�A
0 A RD, C TR I C JA N S
TV1'1,6�s 7 E IR E LE c TIR 3 c A-y�'j
F�E
!SSL,'ES THE ABOVE UCENISE
Y P E BRIAN M ',Y,,1ASHBURN
'A 330 BOLIVAR ST
C A N T 0 N MA U2021-3223
zmw -A MUM UWE,:
Fold,Then De�ach Aiong,