4 Technology Way Form 32 FEE E: 50.00
Rec'd by: ec r
callotrq ..
Check: //.7 9 Y
y� riG fs CITY OF SALEM
FIRE PREVENTION BUREAU
48 Lafayette Street
4 Salem,Massachusetts 01970
-
�Q!M!Ng!?°'` APPLICATION FOR PERMIT
(D te)
To: THE HEAD OF THE FIRE DEPARTMENT
In accordance with the provisions of Chapter 158,G.L. as provided in Section I OA, and Regulations established under the
Salem Fire Prevention Code,application is hereby made for permission to cut and/or weld in the City of Salem.
A SEPARATE PERMIT IS REQUIRED FOR EACH TYPE OF OPERATION.
Type of Permit: t�"5 •
( ) Shop in the City of Salem,approved per regulations .!.. .....
(Give location by street and number)
Mobile Shop: Current Mass. Reg.#.....................................................................................
Portable Unit(list type) ..............................................................................
Restrictions: Notify the Salem Fire Prevention Bureau in advance,on all jobs outside an approved shop location. At
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least one approved extinguisher and an approved flame retardant blanket on each job location.
Name. ARt�?ES.... -� ?l!-S.... 4n?1'...... CST.�.....V`.ZG?e%\�.t.°:�?C>
(Full name of person,firm or corporation)
Signature of Applicanteox.....`......................
Date Issued .. .�!.`��....... Address r?.7..7...... S�
Expiration AF0 w"��,c N t t� UZ���
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(DOTNOT WRITE BELOW THIS LINE)
r ter; >�: SU.UO
Rec'd by: e,
��� ca01!'��a Check: Z/,9 Y
CITY OF SALEM
5 _ FIRE PREVENTION BUREAU
48 Lafayette Street
Salem, Massachusetts 01970
APPLICATION FOR PERMIT
To: THE HEAD OF THE FIRE DEPARTMENT (D te)
In accordance with the provisions of Chapter 158,G.L. as provided in Section 10A,and Regulations established under the
Salem Fire Prevention Code,application is hereby made for permission to cut and/or weld in the City of Salem.
A SEPARATE PERMIT IS REQUIRED FOR EACH TYPE OF OPERATION.
Type of Permit:
( ) Shop in the City of Salem,approved per regulations
(Give location by street and number)
( ) Mobile Shop: Current Mass. Reg.#.....................................................................................
( � ) Portable Unit(list type) ..............................................................................
Restrictions: Notify the Salem Fire Prevention Bureau in advance,on all jobs outside an approved shop location. At
least one approved extinguisher and an approved flame retardant blanket on each job location.
V(,:5....i !`?1�......!L�C-AA-r.......................
(Full name of person,firm or corporation)
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Signature of Applicant . ...........� .....................
Date Issued ..4,1.�!. ��.......
Address Expiration Ap �1.'7 7.... �Zcx�!\7.,,.. �
�O ....................................
(DO NOT WRITE BELOW THIS LINE)
yw,�cor>flrr�9� CITY OF SALEM
FIRE PREVENTION BUREAU FEE PAID : $50.00
Fie G1�,Ji�4e 48 Lafayette Street Check#�����
Salem,Massachusetts 01970
PERMIT
In accordance with Chapter 148,G.L. as provided in Section 10A, and of the Salem Fire Prevention Code,this permit if
granted to cut and/or weld in the City of Salem,per regulations.
Name .... r<z�S....��y,4`.�cQyh. .....................
I.........................
(Full name of person, firm or corporation granted permit)
Type of Permit: /
( ) Shop in the City of Salem, approved per regulations .....y.��C `?clj �!.(.a
(Give location by street and number)
( ) Mobile Shop: Current Mass. Reg.#.....................................................................................
( V ) Portable Unit(list type) .......................... ........
Restrictions: Notify the Salem Fire Prevention Bureau in advance, on all jobs outside an approved shop location. At
least one approved extinguisher and an approved flame retardant bjg<61 on each job location.
This Permit will expire:A 0
.......�„^.
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Permit issued by..
............ ...... .. ...............
Chief of Fire Department