HomeMy WebLinkAboutTrench Permit _BLDT-23-2127 - BLDT-23-2127 27298Description, Location and Purpose of Proposed Trench
Install of a septic system
Dig Safe # (1-888-DIG-SAFE)
20234704283
Name
Robert Gilfoy
Street Address
374 Route 130
City, State, & Zip
Sandwich, MA 02563
Phone Number
508-477-0653
Massachusetts Hoisting License #
HE-048170
License Expiration Date
02/17/2024
Are you an employer? Select from the options below.
I am an employer with full and/or part time employees.
Insurance Company Name
Selective Insurance
Policy # or Self-Ins License #
S2398787
Expiration Date
05/01/2024
Type of Insurance Coverage
Liability Policy
Trench Permit
BLDT-23-2127
Applicant
Tyler Ancahas 508-477-0653 matt@bandbexcavation.net
Location
11 GROVE ST
WEST YARMOUTH, MA 02673
Trench Information
Excavator Information
Workers' Compensation Insurance Affidavit
Policy and Job Site Information