HomeMy WebLinkAboutRadio Box installation permit - Permits - 101 MORKESKI MEADOWS 7/13/2012 P el I-eoae'e •-Tllw66l C =Z1
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Li 1775
DIG SAFE N UMBER
Date: 3 APPLICATION FOR PERMIT
ST ART DATE
C. 82 S.40 M.
To; Head of Fire Department: clo-y C r
City /Town
In accordance with the provisions of Chapter 148, M.G.L. as provided in Section application is hereby made by:
Name: L
firm or lorat�W
Address: 7 61
(Street or P.O.Box) (Cityrl own) (State) IZip Code)
For Permission to: ,) K L54-c 8 e) X
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State clearly the purpose fpir which the pe t reluested:
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Location:
Name of competent operator if applicable: Certificate of Competency 26a C
Date Issued { } Date Rejected f I By:
Date of Expiration: Fee Paid Fee Due f ) Amount:
Applicant Signature;�-' Fire Department Number:
(If Applicable)
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Date: PERMIT Dic;SAFE NUMBER
C.82 S.40 M.G.L. STARTIDAM.
In accordance with the provisions of Chapter 148, M.G.L. as provided in Section this permit is granted to:
Name: 6, " 1(5 Cc'V�p exr)z
(Full name of a, Or CDrPD 08)
For Permission to: "t- k�L d: o
State clearly the purpose for whicli the permit granted:
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Restrictions:
Location: rVI r,r k-e &I O L(/
Fee Paid: This Permit Will E7xpire On:
Signature and Title of Official Granting Permit:
=>(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES.)