TOWN OF DOUGLAS
NEW APPLICATION CHECKLIST
CANNABIS RETAIL SALES LICENSE
395 CMR 500.000
CCC License:
Proof of license through the Cannabis Control Commission.
Town of Douglas Application:
Download, type information, and print off, the License Application for Cannabis Retail Sales.
Workers Compensation Insurance:
Contact your insurance company and have them list "The Town of Douglas" as the "Certificate Holder", and
email skane@douglas-ma.gov or fax to 508-476-4012.
State W/C Affidavit:
Sign and return the "State Workers' Compensation Insurance Affidavit" form. Even if your business does not
require Workers' Compensation, this must be filled out and returned.
Lease Agreement:
Provide a copy of your signed lease agreement showing proof of your legal right to occupy the premises.
Floor Plan:
Copy of the blue prints or a hand drawn to scale, floor plan of the proposed business.
Business Certificate:
Copy of your "Town of Douglas Business Certificate" issued by the Town Clerk's office. Per MGL c110
(5,6), a business certificate is required for any person conducting business in the commonwealth under any
title other than the real name of the person conducting the business, whether individually or as a
partnership, or under the true corporate name.
Fire Inspection:
Copy of your Fire Inspection Report. Per the Town of Douglas Fire Code Compliance Policy for
Businesses and All License Holders. Please call the Fire Department at 508-476-2267 for an appointment.
Emergency Contact Information:
Fill out and return the "Emergency Contact Information" sheet found on the Town Website.
Application Fee:
Check made out to "The Town of Douglas" for $1,000.
Please Note: The Board of Selectmen meet the 1st and 3rd Tuesday of each month. All applications must be
reviewed by other Boards, Committees, and Departments. The review process can take up to two weeks.
Once reviewed, the application will be placed on the next agenda.
All forms can be found at www.douglas-ma.gov
douglas-3/19/19
