HomeMy WebLinkAboutRadio Box installation permit - Permits - 1070 OSGOOD STREET 12/4/2015 e Commonwealth of Massachusefts
17 Department of Fire Services
Office of the State Fire Marshal
P.O.Box 1025 State Road,Stow,MA 01775
APPLICATIONPERMIT
Date:
Permit No
(City or Town) (If Applicable) Dag Safe Number
In accordance with the provisions of M.G.L. Chapter as
provid in Section application is hereby made � Start Date
by ��"j`CO�v1 ,r'rn �► � ,��,me%ter ��,� �ns �li/�1e� ���
(Fid1 name of person,Firm or Corporation)
State clearly
purpose for (Street or P.O.Box City or Town)
which permit For permission to
is requested ,
Comments:
at
(Give location by street and no.,or describe in such manner as to pZed—ade—quateidcnti cation of location)
Name of competent operator \\J�j, � y, Cert.No.
(If Applicable)
Date Issued-rejurted- ( ` _ / S By
(Signature of Applicant)
Date of expiration ` i i Fee Paid Due
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x
The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
R O.Box 1025 State Road,Stow,MA 01775
PERMIT Date: %
Permit No Dig Safe Number
(City of Town) (If Applicable)
In accordance with the provisions of M-G.L. Chapter as provided in section
/ Start Date
This Permit is granted to:
Full name of person,Firm or Corporation
Permissionto ��� vd f!7/ s�"T.� /b D �C /lr✓ r�G // �trL` !�/-���d
Comments:
Restrictions: ' /� /
at _ iL J��/7/i/� ��s Z0 7 d
(Give location by street and no.,or desc such manner as to provied adequate identification of location)
Fee Paid
This Permit will expire Signature of offical granting permit) Of fical granting permit (Title)
TWIA PPRMIT MI IAT R1= r-r)lal-qPlr'-1 lr'I ICI V PCICTi=n I IWIM TI-IP PRFMICRQ