HomeMy WebLinkAboutTrench Permit _BLDT-24-3 - BLDT-24-3 32178Description, Location and Purpose of Proposed Trench
Install a new septic system
Dig Safe # (1-888-DIG-SAFE)
20235103608
Name
Edward Tallent
Street Address
588 Bourne Road
City, State, & Zip
Plymouth, MA 02360
Phone Number
781-831-3454
Massachusetts Hoisting License #
HE-159974
License Expiration Date
12/05/2025
Are you an employer? Select from the options below.
I am an employer with full and/or part time employees.
Insurance Company Name
Main Street American Assurance co
Policy # or Self-Ins License #
MPJ3478T
Expiration Date
11/19/2024
Type of Insurance Coverage
Liability Policy
Trench Permit
BLDT-24-3
Applicant
Edward Tallent 17818313454 ace_excavation3@yahoo.com
Location
9 PUMP HOUSE LN
WEST YARMOUTH, MA 02673
Trench Information
Excavator Information
Workers' Compensation Insurance Affidavit
Policy and Job Site Information