Town of Hamilton, MA



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GATEHOUSE MEDIA NEW ENGLAND

COMMUNITY NEWSPAPER COMPANY

PATRIOT LEDGER/THE ENTERPRISE

HERALD NEWS FALL RIVER/TAUNTON GAZETTE

WALPOLE TIMES/PROVINCETOWN BANNER

NANTUCKET INDEPENDENT/

254 Second Ave., Needham, MA 02492-2811

Remittance Address: P.O. Box 845908 Boston, MA 02284-5908

Date: ______________

I hereby acknowledge that the application I am submitting to the:

TOWN OF (FILL IN NAME HERE), MASSACHUSETTS

__ Zoning Board of Appeals __ Planning Board

__ Conservation __ Historic Districts Commission

__ Other: _____________ __ Board of Selectmen

REQUIRES a legal notice of public hearing. Said hearing is to be held on: ______________. Legal notices are submitted to the (FILL PAPER NAME HERE), for publication on the following date(s): _____________ : ______________.

I hereby AGREE and AUTHORIZE that the required legal notice be billed directly to me by Gatehouse Media New England, d/b/a, Community Newspaper Company Inc

Printed Name: _______________________________________

Signature: __________________________________________

Address: ____________________________________________

City: _____________________ State: _______ Zip: ________

Phone: ( ) -

Original copy to Town, copy to customer and copy to Legal Publication Dept. of Wicked Local with ad copy.

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