HomeMy WebLinkAboutTrench Permit _BLDT-23-2138 - BLDT-23-2138 31938Description, Location and Purpose of Proposed Trench
Install a septic tank and leaching tank in front yard
Dig Safe # (1-888-DIG-SAFE)
20235200573
Name
Douglas Brown
Street Address
PO Box 145
City, State, & Zip
Centerville, MA 02632
Phone Number
508-400-7159
Massachusetts Hoisting License #
HE-103432
License Expiration Date
11/07/2025
Are you an employer? Select from the options below.
I am an employer with full and/or part time employees.
Insurance Company Name
Safety Insurance
Policy # or Self-Ins License #
J2316735072
Expiration Date
10/25/2024
Type of Insurance Coverage
Liability Policy
Trench Permit
BLDT-23-2138
Applicant
Douglas Brown 5084007159 dabrown5@comcast.net
Location
23 WOOD DUCK RD
WEST YARMOUTH, MA 02673
Trench Information
Excavator Information
Workers' Compensation Insurance Affidavit
Policy and Job Site Information