HomeMy WebLinkAboutTrench Permit _BLDT-24-19 - BLDT-24-19 35739Description, Location and Purpose of Proposed Trench
Install a new septic system (tank and field)
Dig Safe # (1-888-DIG-SAFE)
20240404544
Name
Chad Hathaway
Street Address
15 Victory Lane
City, State, & Zip
South Yarmouth, MA 02664
Phone Number
7742742581
Massachusetts Hoisting License #
HE-201182
License Expiration Date
10/19/2024
Are you an employer? Select from the options below.
I am an employer with full and/or part time employees.
Insurance Company Name
Next First Insurance
Policy # or Self-Ins License #
874602382
Expiration Date
01/01/2025
Type of Insurance Coverage
Liability Policy
Trench Permit
BLDT-24-19
Applicant
Chad Hathaway 774-274-2581 hathawayseptic@gmail.com
Location
12 BRADDOCK ST
SOUTH YARMOUTH, MA 02664
Trench Information
Excavator Information
Workers' Compensation Insurance Affidavit
Policy and Job Site Information