Simon C. Fireman Expansion

640R North Main Street, Randolph, MA 02368

Establishing a benchmark for quality, sustainability and resiliency, the Simon C. Fireman Expansion will create 45 affordable senior housing units and program space in a new construction Passive House building that serves as a connective spine to an existing 160-unit senior campus. Leveraging the strength and vibrancy of the existing community and its service-rich programming, this building provides a variety of additional spaces for flexible programming and choices while creating a stronger network of paths and nodes to enhance mobility. The three-story building, surrounded by ample woods, creates new courtyards and accessible paths to both active and passive open spaces.

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Section 3*

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

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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:

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