Duck, NC · Dare County
Gas Contractor Release Form
Gas contractors use this form to identify the project and affirm their qualifications and responsibilities to the Town of Duck.
What this form is
The form identifies the permit, project address, general contractor, and gas contractor, including the contractor’s contact and license information. The gas contractor signs and dates an affirmation of qualifications and responsibility for the project, and agrees to notify the Town of Duck Building Inspector if they leave or are no longer affiliated with it.
Who needs it
A gas contractor or company taking responsibility for gas contracting on a project in the Town of Duck completes and signs this form.
How to submit it
The form lists fax number 252.255.1236. It does not give a mailing address or other submission instructions.
About notarization
The licensee signs and dates this form without a notary; its affirmation says “affirm or swear,” but it lists no notarized attachment or step.
How to submit this form
- 1
Download The Form
Download the Gas Contractor Release Form PDF.
- 2
Complete The Project Details
Enter the permit number, job cost, project address, contractor details, and gas contractor company and license information.
- 3
Sign And Date
The licensee signs and dates the form to affirm qualifications and responsibility for the project.
- 4
Fax The Form
Fax the completed form to 252.255.1236, the number listed on the form.
Frequently asked questions
- What information does the Gas Contractor Release Form request?
- It requests permit and project details, general contractor information, the gas contractor’s company, address, contact numbers, email, license number, and classification.
- Who signs the Gas Contractor Release Form?
- The form includes a signature and date line for the licensee, who affirms being licensed and qualified to take responsibility for gas contracting on the project.
- How do I submit the Gas Contractor Release Form?
- The form lists fax number 252.255.1236. It does not provide a mailing address or further submission instructions.
- Do I need a notary for the Gas Contractor Release Form?
- No. The licensee signs and dates the form without a notary. Although the affirmation says “affirm or swear,” no notarized attachment or step is listed.
Need something notarized?
This Gas Contractor Release Form doesn’t need a notary — but if you have another Duck form that does, a commissioned online notary can help.