23A-132 IMG_20170725_0001Town of Williamsburg 141 Main St Haydenville
Solid Waste Disposal Affidavit
ln accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
,\rrAfi, ot06ZAddress of the work:
The debris will be transported by: Do-r- V -cbbn ]t"o4
The debris will be received bv: Da"'< W -r l'fu' 1c""Vw5
Building permit number:
Name of Permit Applica.t 5h^ Re; L^?
Ftor*r^co
re of Permit Applicant