Skip to content
Skip to navigation
Site map
Town of Danvers
Toggle mobile menu
Primary menu links
Residents
Businesses
Visitors
Events
Departments
Contact
News
Home
Action toolbar
Answers
Payments
Search
Town of Danvers
For the most up-to-date information on the Coronavirus please click here.
Documents and forms
Water Use Mitigation Program Rebate Form
Water Rebates
Town of Danvers Appliance Rebate Application Form
Rebates are for
Danvers' residents only
with
active accounts
in
good standing
.
Type of Rebate
*
Required
Toilet
Clothes Washer
Showerhead
Faucet
Lawn Irrigation Rain Sensor
Rain Barrel
Water Account Number
*
Required
Name on Account
*
Required
First
Last
Mailing Address
*
Required
Street Address
Address Line 2
City
•If the rebate is for an apartment tenant or condo owner, the “Mailing Address” should be for the apartment owner or condo association. Unit information should be filled under “Installation Address”. These applications require both applicant and account holder cooperation, as the rebate check can only be made out to the account holder. If the appliance/fixture was purchased by the applicant, the account holder will need to reimburse the applicant directly.
Phone
*
Required
Email
*
Required
Resident Name (If different than account holder)
First
Last
Installation Address (If different than account holder) - Must be a Danvers Residential Address
Street Address
Address Line 2
City
•Rebates are available to Danvers Residents only. Applicants listed must be Account holders with all active accounts in good standing.
Resident Phone (if different than account holder)
Resident Email (if different than account holder)
Approximate Age of Existing Item, Fixture or Appliance
New Product Information
*
Required
Manufacturer
Model Number
Date of Purchase
Date of Installation
Toilet: How many gallons per flush?
*
Required
Please upload the following with your submission: (1) proof of purchase/receipt dated within 2 years of submission- must include model number; (2) product specifications with gallons per flush and (3) signed plumbers permit.
Clothes Washer: Most recent Consortium for Energy Efficiency (CEE) Tier #
*
Required
Please upload the following with your submission: (1) proof of purchase/receipt dated within 2 years of submission- must include model number and (2) product specifications with CEE Tier. Only one clothes washer rebate per household.
Showerhead: Gallons per minute
*
Required
Please upload the following with your submission: (1) proof of purchase/receipt dated within 2 years of submission- must include model number and (2) product specifications with gallons per minute.
Faucet: Gallons per minute
*
Required
Please upload the following with your submission: (1) proof of purchase/receipt dated within 2 years of submission- must include model number and (2) product specifications with gallons per minute.
Lawn Irrigation Rain Sensor: Is it wireless?
*
Required
Please upload the following with your submission: (1) proof of purchase/receipt dated within 2 years of submission- must include model number and (2) wireless product specifications.
Rain Barrel: # of gallons
*
Required
Please upload the following with your submission: (1) proof of purchase/receipt dated within 1 year of submission- must include model number and (2) product specifications showing number of gallons.
Signature
I have read, understand and agree to the Terms & Conditions below and have attached all required backup documentation requested above.
Required documentation
*
Required
Drop files here or
Residential Rebate Application Terms & Conditions:
Rebates are available to
Danvers Residents
only. Applicants listed must be Account holders with all active accounts in good standing. If account is not active or in good standing, rebate will not be processed. Rebate application will not be processed until application with required documentation is received. Incomplete applications will be returned. Please call 978-777-0001 x3011 for guidance.
If the rebate is for an
apartment tenant or condo owner,
the “Account Information” should be for the apartment owner or condo association. Unit information should be filled under “Installation Address”. These applications require both applicant and account holder cooperation, as the rebate check can only be made out to the account holder. If the appliance/fixture was purchased by the applicant, the account holder will need to reimburse the applicant directly.
Application requires: the proof of purchase with a clear line item displaying the product purchased with a model # in the form of the sales receipt, all required backup documentation for the specific appliance/fixture and a
completed and signed
Rebate Application.
The rebate program is on a first-come, first-served basis and is effective until the funding is exhausted or the program is discontinued.
New construction projects (any construction after January 2008) or home additions do not qualify
for rebates since all usage in new construction or additions is considered an additional draw on Danvers’ water reserves.
Rebates are for remodeling only.
Appliance/fixture must be replacing an existing appliance/fixture. Old appliances/fixtures cannot be reused by applicant or other Danvers residents. Appliances/fixtures must be installed at the account location. Danvers reserves the right to inspect the installation on premises.
Applicant agrees and understands that Danvers does not guarantee that the installation of a high efficiency appliance will result in water savings, as site-specific water consumption varies.
Danvers does not warrant, endorse or assume liability for the quality, performance or safety of the contractor and/or retailer or wholesaler or performance of any appliance/fixture. Responsibility for product chosen is solely the applicant’s.
Individual rebates more than $600 may require the issuance of a 1099 Tax Form.
Helpful
Share
Facebook
Twitter
Email
Size
+
Reset
a
−
Translate
Translate language select
This content is for decoration only
skip decoration
.
Close window
Search Site
Search
Close window