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2. First Name*
3. Last Name*
5. Email Address*

6. You will be added to the notifications e-mail list within the next 48 normal business hours.  If you are interested in the notifications in the meanwhile, please see the state notifications site: https://www.mass.gov/dep

8. Phone Number

   Optional - For DPW contact only - All Notifications will be sent out via the email you provided. 

9. Alternative Phone Number

   Optional - For DPW contact only - All Notifications will be sent out via the email you provided. 

   
   

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11. 1. Receive an email copy of this form.
12. Email address

    This field is not part of the form submission.

13. Submit

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