HomeMy WebLinkAboutTrench Permit _BLDT-24-13 - BLDT-24-13 35137Description, Location and Purpose of Proposed Trench
Install a new septic system
Dig Safe # (1-888-DIG-SAFE)
20240305462
Name
Michael J Leone
Street Address
7 East Road
City, State, & Zip
Mashpee, MA 02649
Phone Number
508-428-8926
Massachusetts Hoisting License #
HE-077443
License Expiration Date
02/19/2024
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I am an employer with full and/or part time employees.
Insurance Company Name
Federated Mutual Insurance
Policy # or Self-Ins License #
6086236
Expiration Date
03/07/2024
Type of Insurance Coverage
Liability Policy
Trench Permit
BLDT-24-13
Applicant
ROBERT BORTOLOTTI 508-771-9399 bortolotticonstruction@verizon.net
Location
7 LOON LN
WEST YARMOUTH, MA 02673
Trench Information
Excavator Information
Workers' Compensation Insurance Affidavit
Policy and Job Site Information