HomeMy WebLinkAboutRadio Box instalalation permit - Permits - 12 MASSACHUSETTS AVENUE 6/11/2014 I: -� � L/��L2 �0-��ZiJ7ZO�J2•GG�CLd�il21 O•' C�//l�L:�•:LCZCl2•G(/J�z�.l �
--- _
C_ La,�,e (�6 �G' 91&171J1-ZCC<
:16(rev.3/00)
APPLICATION FOR PERMIT
=Date:
NUMBER
City or Town Yr 1`0 : L/� C'�"t e 2
bate , U A_)E
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
(Full name of person,Firm or Corporation)
Address Q `7 L S LC vT _S% 44,0 f S
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which per requested) 11-15 Tr-)L- C Itli 0
Name.of competent operator(if Applicable) 0�_ (A 1 � - �/�GA IC/TCert. No.
r
Date Issued-rejected By
(Signature of Applicant)
d !
Date of expiration r _v Fee $ Paid Due
rev.3/00) l O� , � v XX 0- 775
5
PERMIT
ity or Town =SAFEMBER •
ate 1 —��
StaLDate-
ermit Number (if applicable)
accordance with the.provisions of M.G.L. Chapter 148, as provided in this permit is granted
01e Az,, ,C (_ 64 S' v
i (Full name of person,Firm or Corporation)
r �s✓ // �7 €iy�c .cab �C �,Z �1���S' /�//�
strictions:
(Give location by street and no.,or describe in such manner as to provide adequate identification ollocaiion) .
;e Paid $ S� This Permit will expire on via e� r�o�
gnature of,Official Granting Permit A Title :1r,
-•--"--� ^•�'•• .t __—._�--.1 {....�. r.r.ri r..-ti��, ,r^, ,C t,i ri n CST!'Z� i 7 1"1 n 3'l '{'�f.1 i^.+,Y C.•1 m i C'�C