Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Solid Waste Hauler Application

  1. Application for Solid Waste Hauler Permit

  2. Fee: $150

  3. No permit will be issued until payment is received in full and processed by the staff of the City of Gardner Health Department.

    In accordance with M.G.L c. 111, Section 31B, and Board of Health Regulations for "Removal, Transportation, and Disposal of Refuse in the City of Gardner," the undersigned makes application to the Board of Health for permission to remove and transport solid waste as set below:

  4. Please describe below the solid waste services you offer:

  5. Yours

  6. One Time Events

  7. Is recycling offered to your clients?*

  8. Certification, Acknowledgement, and Electronic Signature

    I certify that the information I have provided is true and accurate. I recognize that it is a violation of this permit to dispose of solid waste anywhere other than the identified disposal locations or other approved by the Board in writing. I agree to comply with M.G.L. Chapter 111, Sections 31A, 31B, and any rules, regulations, or policy of the Gardner Board of Health.

  9. Important Note:*

    A social security number or federal identification number is required for the completion of this application. Someone from the Health Department will contact you via phone to get this information. Please do not send this information via email.

  10. Under the Laws of the Commonwealth of Massachusetts, Chapter 233, Section 35, Acts of 1983, you are required to complete the following:

    Pursuant to M.G.L. Ch 62C, Sec 49A, I certify under the penalties of perjury, that I, to my best knowledge and belief, have filed all State tax returns and paid all State Taxes required by law.

  11. Required if applicable

  12. Leave This Blank:

  13. This field is not part of the form submission.