HomeMy Public PortalAboutSeptage Handler PermitTOWN OF BREWSTER
2198 MAIN STREET
BREWSTER, MA 02631
PHONE: (508) 896-3701 EXT 1120
FAX: (508) 896-4538
BRHEALTH@BREWSTER-MA.GOV
WWW.BREWSTER-MA.GOV
OFFICE OF
HEALTH DEPARTMENT
SEPTAGE HANDLERS PERMIT APPLICATION
Application for permit to pump and transport the contents of any part of an individual sewage disposal system. If all
information is correct and the blanks filled in, please sign and return to the Health Department with the fee and the state
required Workers Compensation Insurance Affidavit form. No permit will be issued if form is not returned. Should
corrections be needed, please make them.
FEE: $110.00/PER VEHICLE
1. Full name of applicant:
2. Business name:
3. Mailing Address (if different from above):
4. Business address location:
5. Telephone number:
6. Type of business:
7. All sites of disposal:
This permit will expire on December 31, 20
Signature: Date: