HomeMy WebLinkAboutRadio Box installation permit - Permits - 586 MASSACHUSETTS AVENUE 5/22/2014 ���e �Ga��v��2o�2•�2cz�� a�C%l/�czyiczcl c���.� �
�6(rev.3/00) � •l%. �O!Z ���7, U C� �/f�aCGGz, U GO�Iy, ����7�5
APPLICATION'FOR PERMIT'
City or Town '�"�� � � DIG SAFE NUMBER
.,bate
Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section application is hereby made
by N rn C yd -f &iYy1j 'Lrv1-ef -e
(Full name of person,-Firm or Corporation)
Address 7�, L e r
(Street or F.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested) ""S �� iC1
Name.of competent operator(If Applicable) C Cert. No. 1 )
Date Issued-;&jee�qd. BY
(Signature of Applicant)
Date of expiration _(Z,20 1 (10 -� i - Fee Paid Due
ev.3/00) V . ✓Claz �a��, � , �Gla�7��
PERMIT
ty or Town DIG SAFE NUMBER
ate
Start Date:
)rmit Number (if applicable)
accordance with the provisions of M.G.L. Chapter 148, as provided in this permit is granted
/ (Full name of person,Firm or Corpcotion)
strictions:
(Give location by street and no.,or describe In such manner as to provide adequate identification of loca(ion) .
e Paid $ This Permit will expire on Q T`a�
nature of,Official Granting Permit Title /
,r
�._,1 ., ---•-—-` t-... ,•,�-.r, ..-.... ... ..
.,, ,.., ,<-I i 1«.'"�i