Wappinger, NY · Dutchess County
Blasting License Hold Harmless Statement
Blasters or applicants complete this statement for a Town of Wappinger blasting permit, agreeing to hold the town harmless for claims related to blasting activity.
What this form is
The statement records the blaster or applicant, blasting permit number, and location, and sets out the applicant’s agreement to indemnify and hold the Town of Wappinger harmless for claims related to explosive materials or blasting activity. The form cites Section 80-9(e) of the town code and includes spaces for the applicant’s printed name and signature.
Who needs it
A blaster or applicant associated with a Town of Wappinger blasting permit uses this statement to record the required hold-harmless agreement.
How to submit it
Submit it to the Town of Wappinger Office of the Fire Inspector; check the town website for current submission instructions and contact details.
About notarization
This document is signed without a notary; the blaster or applicant prints their name and signs the hold-harmless statement.
How to submit this form
- 1
Download The Statement
Download the Blasting License Hold Harmless Statement PDF.
- 2
Complete The Statement
Fill in the blaster or applicant, blasting permit number, and location, then print your name and sign.
- 3
Review The Details
Check that the applicant and blasting permit information are entered on the statement.
- 4
Submit To The Town
Submit the statement to the Town of Wappinger Office of the Fire Inspector.
Frequently asked questions
- Who uses the Blasting License Hold Harmless Statement?
- A blaster or applicant associated with a Town of Wappinger blasting permit uses this statement to document the hold-harmless agreement.
- What information does the statement request?
- It asks for the blaster or applicant, blasting permit number, and location, and provides spaces for the applicant’s printed name and signature.
- Do I need a notary for the Blasting License Hold Harmless Statement?
- No. This document is signed without a notary; the blaster or applicant prints their name and signs the hold-harmless statement.
- How do I submit the Blasting License Hold Harmless Statement?
- Submit it to the Town of Wappinger Office of the Fire Inspector; check the town website for current submission instructions and contact details.
Need something notarized?
This Blasting License Hold Harmless Statement doesn’t need a notary — but if you have another Wappinger form that does, a commissioned online notary can help.