31B-114 (6) 2013-10-07 11 :18 DPW Central 14135871576 >> 14135871272 P 2/2
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a,, REDEppre,, Northampton Fire Department
., 26 Carlon Drive, Northampton, Massachusetts 01060-2373
r7 ' �.• y 4 . Telephone: (413) 587-1032 Fax (413) 587-1034
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Fire Prevention/Operations Officer: Duane A.Nichols
,- - Deputy Chiefs:Dana Cheveretto,David Gagne,
William Hurley and Timothy McQueston
Brian P. Duggan We[ site lttpl/•i3�wuwv.Nartliamptgnfirrr':org
Fire Chief
FIRE SUPPRESSION WORK PERMIT
Facility Name &Address: 1 D-Ce K;In SA—• LL-C.
Owner's Name &Address: - , (.. h.. _iwi'- ..cu 4
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Contact Person m iCAi.P.ILI% gu vi . . Phone# 413 . 2_...18. 3Sv6
Versi2:344e2snu-e
Company/Technician performing work: Ma.Lic.# SC- 22.5
Dates of work is to be done:
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Description of suppression work to be performed:
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Contractors performing work must notify Central Dispatch(413-587-1030)at the stark of ouch work
session,and whon work is finished,or when work Is finished for the day.An•electrical work permit
must be obtained from the Electrical inspector(413-587-1244)
Fire Suppression Work Permit Fee $ 0.00 Paid: Rocoipt Number: ,,,,�„•,
Approved By �� Date k).74///-4
"Professionalism through Courage and Dedication"
7
2013-10-07 11 :18 DPW Central 14135871576 >> 14135871272 P 1/2
�TaT CITY OF NORTHAMPTON, MASSACHUSETTS ,
e °ti DEPARTMENT OF PUBLIC WORKS
I125 Locust Street j fib ../
Northampton, MA 01060-2066
413-587-1570
Fax 413-587.1576
Edward S. Huntley, P.E
Director
DATE: /CJ ~ 7-L3
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FAX: /a
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TO: . d i. , f # '
FROM: J
NUMBER OF PAGES including this sheet: 4:2—
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