HomeMy WebLinkAboutRadio Box installation permit - Permits - 815 CHESTNUT STREET 9/17/2014 /� - ;i
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DiG SAFE NUMBER
Date: APPLICATION FOR PERMIT ST4RTDATE
Ca 82 S.40 M.G.L.
To: Bead of Fire Department:
City/Town
In accordance with the provisions of Chapter
er,
148, M.G.L- as provided in Section application is hereby made by
Name: L . LIB )B i �, 5
(Full name of person.firm or corporation)
Pa P
Address. �� �R < ! L t� ��
(Street or P.O.Box) (CityTrown) (State) (Zip Code)
For Permission to: ) K)s rp u J'2�a o M— -c7e $�
State clearly the purpose for which the permit is requested:
Location: > ). ®�3 JT 37
Name of competent operator if applicable: IDsNtJ9ai 1 is 1 11`bi L. Certificate of Competency # 1
Date Issued ( ; Date Rejected ; ;: By'.
Date of Expiration: _ Fee Paid { } Fee Due f ) .Amount:
Applicant Signature: Fire Department Number.
(If Applicable)
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Date: 01 ~�'� _``� PET,� ,rrT
�vll 1 DIG SAFE NUMBER
C.82 S.40 M.G.L. START DATE:
In accordance with the provisions of Chapter 148, M.G.L. as provided in Section this permit is granted to:
Name: u') 1 Co
(Full name of person,firm or corporation)
For Permission to: ) N STAu— RAC )1 o mLime= BZ"< GV N
State clearly the purpose for which the permit is granted:
Restrictions.
Location:
Fee Paid: v d ire
Signature and Title of Official Granting Permit:
=-(Tms PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES.) <