HomeMy WebLinkAboutRadio Box installation Permit - Permits - 5/26/2017 G7 ,
Permit Number: DG SAFE UNBER
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City or Town: z1Z'12_'.rH
Start Date:
Date: ,, ,12,(" I 1
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by �, 'i ,i .. .� ye' r vm , . �., � �, 0,1C W✓
m or Corporation)
( po ) (Phone Number)
(Full Name o arson Fir
of /Vr
(Address:Street or P.O.Box,City or Town,Zip Code)
for permission to(state clearly purpose for which permit is requested) / , `f`X-7/✓19-"7 :"°' :J'
Name of Competent Operator(if applicable) 19---e V , rt. No. 1/41 C �c' J"7"W�Ce _
Date Issued-rejected By ��-
^' (Signature of Applicant)
Date of expiration Fee Amount Paid$
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ti..=..1��
FP-006 f
(Rev. 1.1.2015) PERMIT
City or Town: !/� /`�/IC�G/� DG SAFE KABER
Date: ���—�-�— "�
Start Date:
Permit Number(if applicable):
In accordance with the provisions
/o'f M.G.L. Chapter 148,as provided in �* this permit is granted
to sc j?is J r` t'r" "_4 0r G2i
r— (Full Name of Person,Firm or corporation)
for x sue`/�.5 /G,� e5' f tiS U L
Restrictions: A
at Z- /&4/,-
(Street and#or Describe Location for Adequate Identification)
/
Fee Paid$ s' � _ This perm` w' x {efgn
Signature of Official Granting Permit: Title i-✓ Gi �-
r , "'! e`1-lic p I mlf muss: ba ccnsri�cucrus6y doted upon U"I.C4 premlses