HomeMy WebLinkAboutRadio Box installation permit - Permits - 80 FLAGSHIP DRIVE 3/15/2016 V r
01775
DIG SAFE NUMBER
Date: APPLICATION FOR PERMIT START DATE
C. 82 S.40 M.G.L�
To: Head of Fire Department: oVel-,
City/Town
In accordance with the provisions of Chapter 148,M.G.L. as provided in Section application is hereby,made by:
Name: VV
(Full namf of person.',ffm or corporation)
Address. 7-q Paf L— 01
(Street or P.O.8 IcItyrrkwh) (State) IZip Code)
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For Permission to: "LA;�"Ka 0 66
State clearly C,D=OSe for W}Z' permit' r t d the s eqi4es e
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Location:
Name of competent operator if applic�Ale: 0al, ID";n 7- Certificate of Competency
Date Issued I I Date Rejected f 'I: By:
Date of Expirations_ Fee Paid I I Fee Due Amount:
Applicant Signature:�-, Fire Department Number: (If Applicable)
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PP :DBox'025 Rd, (--5&,, Q&�0-1775
DIG SAFE NUMBER
Date: PERMIT
C. 82 S.40 M.G.L. START DATE:
In accordance with t1ae provisions of Chapter 148, M.G.L. as provided in Section this permit is granted to:
Name: L V5 C-0/M/;,an-/
/ .(FuIrnarne of person,firm or corporation)
For Permission to: 'rA 5-iz-t ff 9—a cl"o ee K-
State clearly the purpose for the pemait is granted:
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Restrictions:
Location: o Ax, It 4jove,,--,
Fee Paid: This Permit Will Expire On:
Signature and Title of Official Granting Permit:
=>(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES.) <=