Welding Permit wl A/\-4 0" lz le a `c� �,�'� ��4 rc G�
Form 32
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>=iR- PRE`(/ELATION 8'qEA' C.�
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48 Lafayette Street
Salem, Massachusetts 01970
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APPLICATION FOR PERMIT k
To: THE HEAD OF THE FIRE DEPARTMENT (Date)
In accordance with the provisions of Chapter 148, G.L. as provided in Sectfon 10A, and Regulations
established under the Salern Fire Prevention Code, application is hereby made for permission to cut
and/or weld in the City of Salem.
A SEPARATE PERM;- IS REQUIRED FOR EACH TYPE OF OPERATe I0M.
Type of. Permit:
Shop in the City of Safer,,, approved per regulations . • • . (Give location by street and number)
�3cbiie SF.,op: Cui rent Mass. Reg. # . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . .
CK) (Por-�able Unit"fisttype) . . .Ltil1!(�✓ .�91 . . . . . . . . . I . . . . . . . . . . . . . . . ... . . . . . . . . . . . .
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
---- ket on each job
�Jos er locatio
Cc' O
7/0 Name. . . o . .. . . .. . . . . ` . . . . . �!?. .. ..
o oerana f)r r corpIOnj
Date Issued . A ( C�`� . . . . .-:-t . . . . . . . . . . . . . . .
(Signacu of 'Wicant)
Date of Expiration: April l 30, J. . l0l !� . . 5. . . . "l S� . . . . . . . .
P — 20� . . . .
(Address)
iDo Not `Write Below This Line.)