HomeMy WebLinkAboutRadio Box installation permit - Permits - 1 MCCABE COURT 7/13/2012 011-11141,1�i61'c 7162/eZl/
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DIG SAFE NUMBERDate: 7 / l APPLICATION FOR PERMIT
START DATE
C. 82 S.40 M.G.L.
To: Read of Fire Department: IV10r 1ALI(40
City/Town
In accordance with the provisions of Chapter 148, M.G.L. as provided in Section application is hereby made by.
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Name: C.-.,. P- VQ I "I t
,Full naF,,ot person.firm r corporation)
Address:
(Street or P.Q.Box) ((-Iry/I Own) (State) (Zip codes
For Permission to: C-i A o
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Li I,i " th 70'e Iti s requested:clearly the purposefor which &
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Location:
Name of competent operator if applicable: Certificate of Competency #:
Date Issued I ; Date Rejected f By:
Date of Expiration: Fee Paid Fee Due Amount:
Applicant Signature ~ Fire Department Number.
(If Applicable)
a a a m ff a REENMEN Beam mmma"N"s Newmann*
0-1,775 Date: PERNUT DIG SAFE NUMBER
C. 82 S.40 M. START DATE:
In accordance with the PTOViSiOUS of Chapter 148, M.G.L. as provided in Section this permit is granted to:
Name: .
(Full name oflierson,'UM dr4orw muntir
For Pennission to:
State clearly the purpose for which the permit is granted:
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1�1 1VOCIA Lk i�C
Restrictions:
Location: L
Fee Paid: This Permit WW Expire On:
Signature and Title of Official Granting Permit:
=>(THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES.)