Construction Debris AffidavitCity of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In 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.
Address of the work: _______________________________
The debris will be transported by: ______________________________
The debris will be received by: ______________________________
Building permit number: ______________________________
Name of Permit Applicant ______________________________
__________________________________________
Date Signature of Permit Applicant
40 SPRING ST. NORTHAMPTON, MA, 01062
SUNRUN BOXTRUCK
STEPHEN KELLY
WASTE MANAGEMENT TRANSFER STATION
856 BOSTON POST RD. EAST MARLBORO, MA, 01752
4/9/2021