HomeMy WebLinkAboutRadio Box installation permit - Permits - 2370 TURNPIKE STREET 10/16/2015 - ��
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Application for Standard Permit ✓
FP-006(Rev. 1.1.2015) 0 Return completed application to:
Permit Number: DIG SAFE NUMBER
City or Town:
Date: Start Date:
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In accordance with the provisions of M.G.L. Chapter 148,as provided in Sectiony� application is hereby made
(Fu I Name of Person,Firm or Corporation) (Phone Number)
of q
(Address:Street or P.O.Box,tity or Town,Zip Code)
for permission to(state clearly purpose
- for which permit is requested) � C� �� �- (�"
Tut P_ L �) )S c -Fv, C2 hl,o? P
C)
Name of Competent Operator(if applicable) `ash' 2 Cert. No. A51
Date Issued-rejected By
(Signature of Applicant)
Date of expiration Fee Amount Paid$
FP-006
(Rev. 1.1.2015) i( PERMIT
City or Town: k"t�c?� 4s1 . DIG SAFE NUMBER
Date: 0 C-1— L 6 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
(Full Name of Person,Firm or Corporation) .a
for A k
Restrictions:
at 6 a
(Street and#or Describe Location for Adequate Identification)
Fee Paid$ `7 U 6 r This permit will ex pi on
/ P/ , 0z
Signature of Official Granting Permit: Title
This permit must be conspicuou ly posted upon the premises