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2. The Board of Selectmen, acting as both the Selectmen and Board of Health, voted to establish a rubbish fee of $89.25 quarterly, per household/unit, effective January 1, 2023.

4. PLEASE CHECK OFF OPTION BELOW AND RETURN TO D. P. W. TO BE PLACED ON FILE.
6. Phone Number*
7. Account Number
9. Name*
11. I am the OWNER of property located at*
13. If this is an apartment house, how many units
14. EFFECTIVE DATE*
17. Option #1

    1. To be billed quarterly, $89.25 (limit to 1, 64 gallon barrel & 1, 96 gal. recycle cart)
    2. To be billed additional 64 gal. barrel (@ $51.00 per quarter)
20. Option #2

    1. To purchase Town Bags. ($13.00 - 5, 15 gal. bag. / $26.00 - 5, 30 gal. bag.)
23. Option #3

    1. Not to receive trash services from the Town.

    Reason:____________________________________________________________
26. Option #4

    1. Request additional 96 gal. Recycle Cart ($50.00 one time fee)
28. Date*
29. Signature of Owner
33. Attach Identification
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field