HomeMy WebLinkAboutSprinkler permit - Sprinkler Permit - 1701 OSGOOD STREET 5/16/2011 L/C12e 2479'L79Z>yl2•Lll�CZ•�� 4���/�LCLB•.1•CZCf2•G(/,!G'r�.J•
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APPLICATION FOR PERMIT
\ =Date:
UMBER
City or Town y��y\ u y v 2r
Date �� � � / �� � � �
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section _ application is hereby made
by
(Full name of person,•Firm or Corporation)
Address �'� �/�J<•���v\r ` � \mac?s �z�� V y 01 U
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested)
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Name of competent operator(If Applicable) F�� :�tic�; �' ° t ��� ���0 Cert. No. -S C, (j�G� 0
• �7 dr. ._.----
Date Issued-rej S= // By
(Signature of Applicant)
Date of expiration 7-"0, Fee :,�� $ Paid _1_1/x Due
dui-jue W amJt.Q�- aG eat
o��'�ri��e _09e7�r�•
(rev.3/00) 1• gar 614
PERMIT
amity or Town O"f�!� <1 vC/F� DIG SAFE NUMBER
Date
Start Date:
'ermit Number (if applicable)
n accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
i V (Full name of person,Firm or Corporation)
Iestrictions:
t
(Give location by street and no.,or describe'in such manner as to provide adequate identification ollocaiion) .
ee Paid $ :��' This Permit will expireon
ignature of'Official Granting Permif Title