The URL can be used to link to this page

81 E a. w CITY OF SALEM Fee Due$25.00 Rec'd by: FIRE DEPARTMENT-FIRE PREVENTION BUREAU 48 Lafayette St., ck.# �Z2� Cash Salem, Massachusetts 01970 •2 -z S 19?? 508-745-7777 (Cate) APPLICATION FOR APPROVAL OF PLANS: To: HEAD OF FIRE DEPARTMENT Form#81E. Sprinkler and/or Standpipe System In accordance with the provisions of the Massachusetts State Building Code and the Salem Fire Code, application is hereby made for approval of plans for the installation of Fire Protection devices. LOCATION: 7 5 N C,-T i� ST'. OWNER OR OCCUPANT: D y 1 p �Fl L T�E� Tel. # INSTALLER: E7�'4G41- z � License# INSTALLERS ADDRESS: Llo Po R--wA ou-T I� (Z� Tel. # �� 9 Plans are approved solely for identification of type and location of devices. Installation subject to final inspection and filing of Certificate of Completion. Date approved: �' Z� p ©• -- (Signature of applicant) Date of expiration: Z MA-Q ,ST• Ams MA , (Address) city • State Zip Do not write below this line Fee Due$25.00 CITY OF SALEM Rec'd by: FIRE DEPARTMENT-FIRE PREVENTION BUREAU 48 Lafayette St., Ck.# �ZZ� Cash Salem, Massachusetts 01970 508-745-7777 a) APPLICATION FOR APPROVAL OF PLANS: To: HEAD OF FIRE DEPARTMENT Form#81E. Sprinkler and/or Standpipe System In accordance with the provisions of the Massachusetts State Building Code and the Salem Fire Code,application is hereby made for approval of plans for the installation of Fire Protection devices. LOCATION: -7 5 N C 12-I 11 SE OWNER OR OCCUPANT: �' p �Fl �- 3 ER Tel. # INSTALLER: �� G Ja�� O License# Lio RD (� 1^5M0U�i R� INSTALLER'S ADDRESS: Tel. # 9�� Plans are approved solely for identification of type and location of devices. Installation subject to final inspection and filing of Certificate of Completion. Date approved: ys I�cw"� O L+-�-'�—° _ (Signature of applicant) Date of expiration: Z rZ 3 A 4� . M l� ST AN1C5 M (Address) City Slate Zip Do not write below this line CITY OF SALEM /Y ck Z� FIRE DEPARTMENT-FIRE PREVENTION BUREAU 48 Lafayette St., 3 f " Salem, Massachusetts 01970 508-745-7777 PERMIT TO INSTALL: Date Zs' g� Sprinkler and/or Standpipe System Owner's Name: Installer's Name: Permit is hereby granted based on approved plans,to install the system designated above. All plans are approved solely for identification of type and location of fire protection devices. All plans are subject to approval of any other authority having jurisdiction and issuance of a permit by said authority. Upon completion,the Installer shall request a test and file a Certificate of Completion or Inspection. Location: (Give location by street and no.,or describe in such manner as to provide adequate Identification of location) NOTICE: CONTRACTOR TO REQUEST FINAL INSPECTION. (Signature of official granting pe ')// This Permit will expire (ritie) HIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES.) Form#81E-(8/81)