HomeMy WebLinkAboutSprinkler permit - Sprinkler Permit - 15 RIDGE WAY 3/8/2012 r -
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APPLICATION FOR PERMIT
DtG SAFE NUMBER
City or Town
Date
Star# Date:
1n accordance with the provisions of M.G.L. Chapter 148, aa provided in Section application is hereby made
by
( c��r7arx�e o p rson,-Fan or orpora��or�J
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Address -
' - (Street orPO.Box)pi� or Tosvry '
d .� ,
For permission (stateCep[ prpo for h� � pent E raq�et
as
Name.of competent operator If Applicable) Cert. No. {
Date Issued-rejected S
(Signature of ApplIc-gnt)
Date of expiration Fee Paid Due
lip
3(rev.3100) e,�6r,& Roa,5�1, Q&CO'N775
PERMIT .
City or Town IF "(J DIG SAFE NUMBER
Date
Permit Number if applicable) . . i
in accordance with the pr6vi ien f M.G.L. Chapter 148, as provided in this permit i (anted
# (Full narne of person,Ran or orporatr'on)
for �-
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Restrictions:
t Z-1- "120
dive localion4sheet and no.,or desc be in s arch rrlannor as to provide adequate r'denalrcai*or?of loca��or�� r
:�ae Paid - This Permit will expire on _--a—to V/1 ��D 1 �t
3i nare l- ffijl Granting Parrnit �0� T'ii rn
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Department of Public SafetY
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Expiration*
commissioner 01115120U
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DEPARTMENT OF P "AFF
Sprinkler CoMroctor License
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Number. SC0038
f ' 40 r :0 /0 / 013 Tr.no: 1123.0
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erl #e :'X -FIRE PROTECTION IC
CHRISTOPHER T M0bADDtN
3 GRANITE HILL.RD
U INDHA #, NH 03087
KCommissioner
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