HomeMy WebLinkAboutTrench Permit _BLDT-24-5 - BLDT-24-5 32691Description, Location and Purpose of Proposed Trench
Excavate for pool cabana
Dig Safe # (1-888-DIG-SAFE)
20240103717
Name
Patrick McDowell
Street Address
313 Hokum Rock Road
City, State, & Zip
East Dennis, MA 02641
Phone Number
508-385-5993
Massachusetts Hoisting License #
HE039080
License Expiration Date
04/19/2024
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I am an employer with full and/or part time employees.
Insurance Company Name
Berkley Assurance Co.
Policy # or Self-Ins License #
VUMA0308030
Expiration Date
03/29/2024
Type of Insurance Coverage
Liability Policy
Trench Permit
BLDT-24-5
Applicant
P.K.M Contractors, Inc. 508-385-5993 pkm@pkminc.net
Location
6 FAIRWIND CIR
SOUTH YARMOUTH, MA 02664
Trench Information
Excavator Information
Workers' Compensation Insurance Affidavit
Policy and Job Site Information