Fire Alarm Install,- . . � . �.�"�� (�itg of �ttlem, �Eitts�ttci�usE#�tt
f. � FIRE DEPARTMENT -FIRE PREVENTION BUREAU Fee Duq��00
j�" s 48 Lafayette Street Ck. # Cash
�� Salem, Massachusetts 01970 Rec'd by: C . L .
April 6, 1989
(Date)
APPLICATION FOR PERMIT
To: HEAD OF FIRE DEPARTMENT
In accordance with the provisions of the Mass. General Laws and/or the Salem Fire Code, application is hereby made for a permit to
install approved fire alarm devices.
Location: l3 HAWTHORNE BLVD. Owner: SALEM BOYS CLUB
Installer:
Installer's Address:
a
EAST COAST ELECTRICAL CONTRACTORS INC. Tel# (617)899-4065
Type of Occupancy:
37 LEXINGTON ST. WALTHAM MA.
SOCIAL CLUB
License # A 12 0 8 0
- LIST TYPE AND LOCATIONS OF DEVICES ON REVERSE SIDE, OR PROVIDE PLANS. -
Installation subject to final inspection and filing of Certificate of Completion, �y installer. Installer mus�,be present.
Date of approval:
(Signature off Ap�nt)
Date of expiration: � ��� s/ E��%��i%r�-- yy1 �
(Address)
Form #81F (Rev. 12/88) DO NOT WRITE BELOW THIS LINE