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Home My WebLink AboutBuilding Permit #168 - 127 WAVERLY ROAD 8/30/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit MAW � Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �" L v 'L- ant PROPERTY OWNER L' fi N'1 'Print MAP NO: &PARCEL ZONING DISTRICT. 'Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteratio No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodpla-in Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: &EO Phone: Address: / 2,7 GV)�ve,#- c.Y CONTRACTOR Name: re Phone: �` T= l�? Address: 1+2,, f ''' � �✓�n Supervisor's Construction License: 65 6 :, Exp. Date:: Z 7-0/ Z Home Improvement License: 72y Exp. Date. 2 ,7- ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: , �� FEE: �- J $ Check No.: , Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the gu tyA Signature of Agenti/Ovvner Signature of contractor Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ : Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for,Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ . Building_Permit"Application ❑ Certified Proposed Plot Plan ❑ Photo of H.J.-C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of'Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the-decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT =Temp Durnpster on site yes no Located at 124 Main Street Fire Department signature/slate COMMENTS II Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use) ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. f Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ °Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for,Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ _ Building._Permit Application - ❑ Certified Proposed Plot Plan ❑ Photo of H:I:C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of^Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic_Calculations (If Applicable) -- ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp thedecisionfrom the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:I. W � Date Received Date Issued: X-2 d 7 IMPORTANT:Applicant must complete all items on this page LOCATION / 2- 7 Vc L /?-px Nle * . /h PROPERTY OWNER 460 L ,w 43' P Print MAP NO: ! PARCEL: �^ � fJNING D15TRICT=Historic District yesno Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteratio No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 2 e t, to j',ovevoT o16w1Az �x4,i t7 Identification Please Type or Print Clearly) 3_ OWNER: Name: LEO Phone: Address: Z 7 Gl�ftk LY CONTRACTOR Name: �G YHA'-moi i Phone: ,704 Address:- Supervisor's ddress: IL Supervisor's Construction.License: 6�21 Exp. Date: Home Improvement License: l t 7 Exp. Date:—&U/z-10/2 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ , FEE: $ — Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the gu atyfiu Signature of Agent/Owner 1- Signature of contractor Y --1 Location,/ 2 No. Date Date t E'. TOWN OF NORTH ANDOVER o L 0 p � q Certificate of Occupancy $ ,ssACMUSE�� Building/Frame Permit Fee $ i Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # '— 245'i O building Inspector Tile,6mm onwealth of Massachusetts rn Department.of Industrial Accidents Office of rnvesligadons . 600 Washington Street- Boston, treetBoston, MA 02111 www.pnassgov/dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/EleEtridans/Piti�ibers:. Appbc`ant Information Please Print`Lei,IV . 000001 Name(B,isn,ess(Ocganization/lnd�vidual).' M.' '� L% i 7'. City/State/Zip: N' `'%/V i /fig 6r/1fYJ�Phone#: ��" 4 y—, 71�`' ArIama an employer?Check the appropriate boa: Type of project(required): . 1. employer with _ 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors: 6. E]New construction ,�.,,� 2.❑ I am a sole proprietor or partner- listed on the attached sheet x 7. LKneodehug ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.mi surance. [No workers'comp.insurance 5. F-1Weare a corporation and its 9 Building addition required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption.::per.MGL .,I-E]Plumbing repairs or additions myself[No workers'comp, c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp.mft1ra,cereguir-..d.] 13.[4' Other 2 R^'Dc�.✓S . applicant that chi box rl must alsO t'il'e ULt fne St-CEM°eeiUVV shOWL-g tczir worj!=�a' t Homeownerswho submit this affidavit indicating they are doing all work and then'hire outside cororactora must submit a new affidavit indicating such. +Contractors that chi this box must attached an additional sheet showing the name of the sub-contractors and their workers' comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company I`lame: Policy#or Self-ins.Lie.# U6_ oz-90 M ?9 y-- y Expiration Date: Job Site Address: 12 7 A0 , City/State/Zip: i,�wt /-P Attach a copy of the workers'compensation policy declaration.gage(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1300.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby cerci r pains enalt._s of perjury that the information provided ab a is true correct Simature: Date- Phone#: -1 �0 1 ��3' 7 y y Official use only. Do not write in this area, to be completed &cit�r or town offrciaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: NORTH omm Of Andover .. 0 T - adodVr over, Mass.,AS� Y 0LAKE COC HIC HEW ICK �. C RATE D BOARD OF HEALTH Food/Kitchen Septic System PEI�i.M IT T D BUILDING INSPECTOR THIS CERTIFIES THAT............ ......... ........!.�..� .................................................................................... Foundation 1 _ ♦ has permission to erect......................... buildings on ....e. ........ �L4`-' ....... Rough i............ to be occupied as..........19...........ih.'?.t.r�,. .��!!�........................................................................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final Z PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR 3 ARTS - UNLESS CONSTRUC Rough .............. .. ................................... Service BUILDING INSPECTOR ` Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. .RightFax N1-1 10/8/2010 8:54 : 54 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 101OW2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES;NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the 120110y(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: DOHERTY INS AGENCY INC PHONE FAX (A/C,No,Ext): FAX PO BOX 1985 (AIC,No): EMAIL ADDRESS: ANDOVER,MA 01810 PRODUCER CUSTOMER ID#: 22YMX INSURER(S)AFFORDING COVERAGE NAIC# � INSURED INSURER A: TRAVELERS 1NDEMNTTY COMPANY TWOMEY&LEGARE CONTRACTING INC INSURER B: INSURER C: PO BOX 366 INSURER D:INSURER E: NORTH ANDOVER,MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wrTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS ANDCONDRIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 1 ADDLSUBR POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE f POLICY NUMBER (MMlDD%YYYY) (M WMYYYY) I INSR WVD LIMITS GENERAL LIABILITY i EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. DAMAGE TO RENTED $ PREMISES(Ea occurrence) MED EXP(Any one person) $ GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&&ADV INJURY S POLICY PROJECT LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG S AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE $ ALL OWNED AUTOS LIMIT(Ea accident) SCHEDULE AUTOS i BODILY INJURY $ HIRED AUTOS (Per person) BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE DEDUCTIBLE AGGREGATE $ RETENTION $ $ $ WORKER'S COMPENSATION AND WC STATUTORY LIMITS OTHER EMPLOYER'S LIABILRy, Y(N US-029OM994-10 09!18/2010 09/18/2011 E.L EACH ACCIDENT $ 500,000 ANY PROPERITORMARTNEWEXECUTIVE Y OFFICERlMEMBER EXCLUDED? E.L.DISEAfSE•EA EMPLOYEE $ 500,000 (Mandatory In NH) It yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLEVRESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUI•D TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE CERTIFICATE HOLDER ' j CANCELLATION TOWN OF NORTH ANDOVER i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 1600 OSGOOD STREET WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE NORTH ANDOVER,MA 01845 Charles J Clark ACORD 25(2009/09) 1988-2009 ACORD CORPORATION. All rights reserved. l 7 , AUG-24-2011 WED 04;09 PM FAX N0, 9784750303 P. 05 clie :13298 4C-ORD,- CERTIFICATE OF LIASILIT INSURANC OOUCER N�E DATE(MM/DD/YYYy) E lo herty Insurance Agency,Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INF RMAT/ION 11 0.Box 1985 ONL AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2 Elm Street HO L ER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR dover,MA 01810 ALT R THE COVERAGE AFFORDED BY THE POLICIES BELOW, IN UREO INSUR RS AFFORDING COVERAGE Twomey 8,Legere Contracting,Inc. INSURER : Arbella protection Ins Com an MAIC# PO Box 366 INSURER North Andover,MA 01845 INSURER ; INSURER C( £RAGES INSURER S. E POLICIES OF INSURANCE LISTED BELOW HAVE 81:EN7SSUED TO TH6 INSURFD NAMED ROVE FOR HER PERIOD INDICATED,NOTWITM Y REQUIREMENT.TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCUMENT WITH SSPE F R WNjtrH,THIS CERTIFICATE MAY BE ISSUED OR Y PERTAIN.THE 1NSURgNC[AFFOROED�Y THE POLICIES DESCRIBED HEREIN IS SUBJE T TO -DIGS•AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. STANDING ALL THE TERMS EXCWSIONS AND CONDITIONS OF SUCH A N4 TYPEOFINSURANCE A GENERAL LIABILITY POLICY NUIDBEfl OU EP EC POA EXPIRATION X COMMERCIAL GENERAL LIABILITY, 8500043255 06122/11 LIMITS 06/22112 EACH OCCURRENCE CLAIMS MADE DAMAGE TO RENTED $1 000 0 nAA X OCCUR � - s100 Opo MED EXP(any one parson) $5000 PERSONAL A ADV INJURY $1000000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY GENEAAL AGGREGATE $2 000 000 PFT LOC PRODUCTS-CAMPIOPAGG $2000000 AUTOMOBILE LIASILRY ANY AUTO COMBINED SINGLE LIMIT Ee ALL OWNED AUTOS ) $ SCHEOULEDAUTOy BODILY INJURY HIRED AUTOS (Per person) $ NON-OWNED AUT08 BODILY INJURY (Per accident) S GARAGE LtA81Lfy &r,E�NOAMAGEtPt) $ ANY AUTO AUTO ONLY-EA ACCIDENT S EXCESS/IIMBRELLA LlgglyTY OTHER THAN EA ACC S AUTO ONLY: OCCUR AGG $ ❑CLAIMS MADE EACH OCCURRtZNCE S OEDUCTIBLtAGGREGATE S ' ; RETENTION $ 8 W RKERS COMPENSATION AND S III IOYHRS-LIABILITY $ A PHOPitIETORJPANTNEWEXECUrivE WC STATU. 0TH. OF ICERIMEMSER EXCLUDED? IIuexc%6a uncle, E.L.EACH ACCIDENT $ OT ER S CIA) PROvISlO 5 bel w E.L.DISEASE-EA EMPLOYEE S F-.L OISEApE-POLICY LIMIT $ ORSCRIP1 ON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS Coverii g operations usual to Twomey 8 Legere Contracting,Inc... CERTIFII ATE HOLDER CANCELLATI IN Town of North Andover SHOULD ANY OF Til E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1600 Osgood Street DATE THEREOF,71 F ISSUING.RNBURER WILL ENDEAVOR TO MAIL North Andover,MA 0'1845 NOTICE TO THE CE TIFWATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 80 SMALL IMPOSE N0 OBPGA rjou OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPR NTATIYE ACORO z (2001/08)1 of 2 #S27512/1427509 r DML 0 ACO CORPORATION 1988 : Massachusetts- Dcpartment of Public Safety ;Board of Building Regulations anti Standards Construction Supervisor License License: CS 67560 Restricted to: 00 SHAUN M TWOMEY 61 PATROIT ST :- N ANDOVER, MA 01845 Expiration: 10/25/2011 ('ummissiuner Tr#: 4949 ' Massachusetts- Department of Pultlic Cafet� Board of Building Regulations and St n(lards -- Construction Supervisor License License: CS 55108 DOUGLAS J LEGARE 79 GARY AVE HAVERHILL, MA 01830 '` :a Expiration: 9/2/2012 ('ummi �ioner. Tr#: 2766 tDumet zVtazi fi "`/s'�'zaclufi en , Office o onsumer fags smess egu a on HOME IMPROVEMENT CONTRACTOR Registration:" 136779 . Type: Expiration: ,8/2612012 Partnership TMEY t LEGARE"CONTRACTING INC. SHAWN TWOMEY, 87 BELMONT ST. <_ N.ANDOVER,MA 01845 Undersecretary N Proposal TW 0 A CONTRACTING Ws Professional Buddham f Remodeling 87 Belmont St: Office. No.Andover, NM 01845 Fax: 978-685-7447 a 978-556-1547 9Y8-685-7446 NAME OF OWNER t:. � 'J/ `�f . / v�' ADDRESS OF JOB__ TEL. /G . ../� DATE: We hereby submit estimates for: ' lL� -�i✓"�J /' /xL y� � 2-,/ C1/a Lit%fs a A,%( I _ r3 �•� ��'%'f'f�'°`-+'- i(J'. t'�i �� . :iir.•''ldt��i.�.% �' �r.�t ��'�r �G�`C�-f� C.,j We Propose hereby to furnish material and labor—complete in accordance with above specifications,'or the sum of: dollars(S 1. Payment to be made as follows �t G ��''' (14t i. f./ :l ts�3 ' y'j L:E� i �.� Authorized Signature NOTE:This proposal may be withdrawn by us if not accepted with in days. ACCepUnce ®f FrOPOMl ..-The above prices, specifications and conditions :are satisfactory—.:and are .hereby. accepted.You are authorized to do the work as specified.Payment will be made as outlined above. -----�-M Signa -` Date of Acceptance: Si nature