HomeMy WebLinkAboutSprinker permit - Sprinkler Permit - 126-128 MAIN STREET 1/11/2011 -. ���-re �a��v»zo�nu�e�x��• a�G��zysczc��e�.�
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APPLICATION FOR PERMIT
DIG SAFE NUMBER
City or Town All �//��v'F�
Date /-
:StartDate:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by R/�'r�CC� /C
(pull name of person,•Finn or Corporation)
Address_ f U �'jC� X �3 J� Z_6 11,/A
rStreet or P.O.Bob)(City or Town)
For permission to (state clearly purpose for which permit is requested) REL Exls-ri 6 Sor-i NKEX5.
i
Name.of competent operator (If Applicable) 5a N Cert/No.
Date Issued-rejected' By A
/
(Signakire ofAppki.nt)
Date of expiration Fee $ Paid Due
07— _02P/Ir!11GCP.�J• — .� GCP G/ZP V�2 L J"UI�Pi C.��G•LLU/41�Z�G 1 .
3(rev.3/00)
PERMIT
City or Town DIG SAFE NUMBER
Date
EStarte:
Permit Number (if applicable)
In accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
to
i (Full name of person,Firm or corporation)
`or C��L�>G 1,T� c` X/Si lt(� ��/2!n(fCC.0 12 S TI./i0 AA Gy CE
restrictions:
(Give Location by street and no.,or describe in such manner as to provide adequate identification allocation) .
=ee Paid $_ �-� -- his Permit wlii re,. _t�nIWJ 77`o17
Signature of-Official Granting Perrrjit Title
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