3371-3375 Washington Street

3371-3375 Washington Street, Boston, MA 02130

3371 Washington Street will consist of 39 new residential units in a 5-story building. All will be rented to low and extremely low-income senior households. Amenities will include indoor and outdoor common areas, a communal kitchen and dining room, common laundry, and an 800-square-foot restaurant space dedicated to the El Embajador Restaurant, a current tenant on the site. Peabody Properties will manage the building and provide a broad range of supportive programs and services to both frail and independent residents, including, but not limited to, regular programmed activities, 24-hour emergency response, service coordination, and an on-site meal program.

Application for Employment

Personal Information

First Name*:

Last Name*:

Street Address*:

City*:

State*:

Zip*:

Phone*:

Email*:

Referred by*:

Employment Information

Education Experience

HIGH SCHOOL

High School (Name & Location):

Years Attended High School:

Did You Graduate High School?
YesNo

Subjects Studied in High School:

COLLEGE

College (Name & Location):

Years Attended College:

Did You Graduate College?
YesNo

Subjects Studied in College:

Additional Relevant Experience:

Please provide all experience, including projects you assisted on but were not paid:

Employment Experience

Former Employer 1:

Employer 1 Phone:

Position:

Start Date:

End Date:

Reason for Leaving:

Former Employer 2:

Employer 2 Phone:

Position:

Start Date:

End Date:

Reason for Leaving:

Former Employer 3:

Employer 3 Phone:

Position:

Start Date:

End Date:

Reason for Leaving:

References

Reference 1 Name*:

Years Known*:

Reference 1 Phone*:

Street Address:

City:

State:

Zip:

Reference 2 Name:

Years Known:

Reference 2 Phone:

Street Address:

City:

State:

Zip:

Reference 3 Name:

Years Known:

Reference 3 Phone:

Street Address:

City:

State:

Zip:

Section 3*

I have lived in Public Housing or had a Section 8 voucher within the past five years:
YesNo

I have lived in a Masshousing development within the past five years:
YesNo

Within the past five years:
My annual household income for the number of people in my household IS MORE THAN the income in the chart belowMy annual household income for the number of people in my household IS LESS THAN the income in the chart below

I understand that the information above relating to the size and annual income of my family may require verification.

I agree to provide upon request documents verifying this information and I authorize my employer to release information required for the United States Department of Housing and Urban Development and or/ Department of Housing and Community Development to verify my status as a "Section 3 Worker" under Section 3 of the Housing and Urban Development Act of 1968 (and the related regulations).

Why we require this information:

Section 3 is a Federal (HUD) and State (DHCD) program to ensure employment and other economic opportunities to public housing, section 8 and those designated as low-income individuals.

Section 3 is a starting point to obtain job training, employment and contracting opportunities for low-income individuals.

Low income is defined as someone earning less than 80% of the median income for the area. Currently the Attleboro Area is defined as $48,450 annual income for a single person. This amount increases for families of 2 or more (see the chart on the attached form.)

This form informs us of the individuals qualifying for this preference.

All construction workers on this job are required to complete this form.

Click Here or more information on Section 3 or email [email protected]

Section 3 & Application Agreement*

I agree to provide upon request documents verifying this information and I authorize my employer to release information required for the United States Department of Housing and Urban Development and or/ Department of Housing and Community Development to verify my status as a “Section 3 Worker” under Section 3 of the Housing and Urban Development Act of 1968 (and the related regulations).

I hereby certify that the facts set forth in the completed employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application may result in dismissal. I release and hold harmless any person, firm, or entity that discloses matters in accordance with this authorization, as well as from liability that might otherwise result from the request for use of and/or disclosure of any or all of the foregoing information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. You are hereby authorized to make any investigation of my personal history academic/professional credentials, military service records, criminal, driving, financial and credit record through any investigative or credit bureaus of your choice.

* This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

Thank you for your cooperation on this important program.

Message/Cover Letter:

Upload Your Resume Here:

Accepted file types: .PDF, .doc, and .docx . Max file size: 10MB

Boston Resident Verification

This form must be submitted to verify the address of all Boston resident employees and to report the change of address for any Boston resident employee while working on this project.

Check if reporting an address change:
My address has changed

Date Moved:

Project Name:

Contractor Name:

Employee Name:

Social Security Number (last 4 digits):

Street Address:

City:

State:

Zip Code:

Email:
Phone:

Gender: MaleFemale

Race: AsianBlackCaucasianHispanic/LatinoOther

Date Arrived on Job Site:

Trade:

Union Status: UnionNon-Union

I hereby state under penalties of perjury that the foregoing information is true: This information is true

Please attach Proof of Residency:

- Driver's License (Current address must be listed on face of license)
- Massachusetts ID Card (current with expiration date)
- Utility Bill (Bill must be less than 6 months old and state employee's name, address, and date. Accept only: gas, electric, cable or landline phone bills)

Accepted file types: .PDF, .doc, and .docx . Max file size: 10MB

Application for Employment

Personal Information

Employment Information

Education Experience

HIGH SCHOOL

COLLEGE

TRADE SCHOOL

Employment Experience

References

Section 3*

Why we require this information:

Section 3 & Application Agreement*

Message/Cover Letter:

Upload Your Resume Here:

Boston Resident Verification

Please attach Proof of Residency:

LET’S GET STARTED!