HomeMy WebLinkAboutCopy of License - BLDT-23-2122 25699c\{R 7
Porr\ riar\4n
N8m! of Colttpet trt Pcrrou (as dcffncd by
A Dstcr 5 zf
BY -qc]!qlg TIIIS TORM, TIM APPIJCANT, OWNE& AND EXCAVATOR AIJ ACXNOWLEDGE AND CERTIT"TTEAT TEEY ARE FAMIIJAR WT[E, O& BETORE COMMENCEMENT Of TIIE WORIq WU,L BECOME TAMILIARWITE, ALL LAWS AND REGITLATIONS APPLICABLB TO WORX PROPOSED, WCl,uonrC OSrl nrCurrOxS,G'L. C. 8?"I, 520 CMR 7.()O ST r€q, AND ANY APruCABLE MTJNICIPIL ORDtr{ANCES, SY.LAWS A}{IiREGITLATIONS AND TEEY CoYENANT AND AGREE TXAT A.LL wORr DONE LNDER TEE pEriMrT TSSUED rORSUCE VgORI( WILL COMPLY TEER&WITH IN AI,L RF.SPFCTS AND WTTS TEE CO!{DTTTONS SEf, FORTIIBELOW
TBE I'NDERSIGNED OWNER AUTIIORIZES TgE APPLICANT TO APPLY TOR TEE PERMTT AND TEEExcAvAToR To IINDERTAIG sucE YsoRx oN TEE PROPERTY or TEE owNEn, AND AISO, roR TmDI,RATION OF CONSTRUCIION, AUIEORIZES PERSONS DI,LY APPOINTED BY TiIB MUMSIPAIITy ToENIER I'PON TEE PROPERTY TO MOMI1OR AND INSPECT TEE WORX FOR CONI.ORMITT WTTfl TEECONDIIIONS ATTAClrf,'D EERETO AND lEE IAWS AND REGTJLATIONS GOVERING SUCI{ WORT.
TBE TJNDERSICNED A}PLICAIVT, OWNER AND EXCAVATOR AGRTE JOBTTLY AND SEYERALLY TOREIMSURSE TEE MI'MCIPAIJTY TOR ANY AND ALL COSTS AND EXPENSES INCI'RRED BY TEEMUMCEAITTY IN CONNECTION WITE TEIS PER}qT AND TIIE VTORK COMUCTED IEEREUNDER,INCI,UDING BIIT NOT LIMIIED TO ENIORCING TSE REQI'InE&TENTS OT STATE I,AW AND CONDITIONS OTTEIS PERMIT, INSPECTIONS MADB TO ASSURE COMPLIANCE TEEREWITE, AND MEASITRES TAEEN By TEEMUMC[PAIITT Ilf, PRoTECT Tm PIIDLIC WEERE TgE APPUCANT OwNEi oR ExCavAToR EAs FNLED roCOMPLY TEEREWIIB INCLUDINC BOIICE DETAIIS AII{D OTEER REMEDIAL MEASI'N,ES DEEMED
NECESSARY BY TEE MT'T{CIPALTTY.
THE UMERSIGNED APPLICANT, OWNER AND EXCAVATOR ACBXE JOINTLY A}ID SEVERALLY TO DE[,END,INDEMNITY, AND EOLD HARMLESS TEE MII!,ICPALITY AND ALL OI'ITS AGENTS em etfplOyefs rnOrr,i4{c {ID 4M44IILITY' CAUSES oR aCIIoN, coSTS, AND HPENSES REsITLTTNc rnorrl oilmrcmrC OUr9I 1II-ryJBY' DEATH, LOSS, OR DAMAGE TO iNY PEtrSON OR PROPERTY PURN,IG TITE WORXCONDUCIM UNDER TEIS PERMIT.
APPLICAM SIGNATT]RE
OWNER'S SIGNATTJRE GT DIITEREI\TD
DATE
EXCAVATOR SIGNATURE (tr' DIFFtsREND
Mrsse&u$ns Eotsdng Ltc.rsc # HE $%aq 57
/ry'*z
DAlE