HomeMy WebLinkAboutSprinkler permit - Sprinkler Permit - 80 MAPLE AVENUE 5/25/2011 4
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FP6(rev.3/00) ( OZ 70��, U tlOLIf� �%iGIO'l
APPLICATION FOR PERMIT
=Date:
UMBER
City or Town 6YO�y��KdD�P�' _
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 490 �e $2d6s le w o Z y 7
(Street or P.O.aox)(City or Town)
For permission to (state clearly purpose for which permit is requested)
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80 L4_&ale .owe
Name.of competent operator(If Applicable) J• G �� Xi eP Cert. No.
Date Issued-rejected By
(Signature of Applicant)
Date of expiration Fee $ Paid Due
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16(rev.3/00)
PERMIT
City or Town /V ,I�7 n �n�d✓P.n' DIG SAFE NUMBER
Date —_/ZS A�
Start Date:
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)
for �/✓ _4 —Ll�%✓ �i���r�l�T— _✓_�[���, 60�,/
Restrictions:
(Give location by street and no.,or describe'in such manner as to provide adequate identiticatioq of location)
Fee Paid $ �� r t This Perm it.wi expire on '/�on C' o/n��E���
Signature of-Official Granting Permit Title y/ /, 1-tg'
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