Fillable TOWN OF SHREWSBURY APPLICATION FOR DRAINLAYER LICENSE & (SELCO)

Fill Online, Printable, Fillable, Blank TOWN OF SHREWSBURY APPLICATION FOR DRAINLAYER LICENSE & (SELCO) Form

Use Fill to complete blank online SELCO (MA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

TOWN OF SHREWSBURY APPLICATION FOR DRAINLAYER LICENSE & (SELCO)

On average this form takes 11 minutes to complete

The TOWN OF SHREWSBURY APPLICATION FOR DRAINLAYER LICENSE & (SELCO) form is 2 pages long and contains:

  • 1 signature
  • 8 check-boxes
  • 35 other fields

Country of origin: US
File type: PDF

U.S.A. forms for SELCO

BROWSE SELCO (MA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Office of the TELEPHONE: (508) 841-8502
Dept. of Public Works watersewer@shrewsburyma.gov
Water & Sewer Div.
TOWN OF SHREWSBURY
Richard D. Carney Municipal Office Building
100 Maple Avenue
Shrewsbury, Massachusetts 01545-5338
APPLICATION FOR DRAINLAYER LICENSE & WATER SERVICE INSTALLER
I ____________________________________do hereby make application for a license to engage
in the business of Drain-Laying in Shrewsbury.
Residence: ________________________________Telephone:__________________________
Present Occupation:___________________________Email:___________________________
How many years experience have you had in the Drain-laying business?:________________
In what capacity?: _____________________________________________________________
Where did you learn the drain-laying business? Give names and addresses of former
employers.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
State in detail how you would lay a drain to a sewer main:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Date:_____________________ _____________________________
Signature of Applicant
TOWN OF SHREWSBURY
Richard D. Carney Municipal Office Building
100 Maple Avenue
Shrewsbury, Massachusetts 01545-5338
APPLICATION FOR TOWN APPROVED DRAIN LAYER
Name: _____________________________________________________________________
Company Name: _____________________________________________________________
Business Address:____________________________________________________________
Telephone No.:_______________________________________________________________
Telephone No. Emergency:_____________________________________________________
Emergency Address:__________________________________________________________
Email: ______________________________________________________________________
INSURED AND BONDED FOR:
Renewal for Water Service: YES NO
Sewer Service: YES NO
Drainage: YES NO
_____________________________________ ______________________
Signature of Applicant Date
NOTE: TO BE APPROVED THE FOLLOWING MUST BE SUBMITTED
1. Bond stating Water, Sewer or Drainage Work $5,000.00
2. Certificate of Insurance:
a. No less than $1,000,000 Public Liability, and
b. No less than $1,000,000Property Damage
3. License Fee: $50.00 for the calendar year.
4. Three letters of recommendation (required for New Drain Layer’s only).
-----------------------------------FOR TOWN USE BELOW-------------------------------------------
Approved: YES NO
________________________________________ ______________________
Water/Sewer Superintendent Date
Page | 2
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

TOWN OF SHREWSBURY APPLICATION FOR DRAINLAYER LICENSE & (SELCO)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 5 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document