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Home My WebLink AboutBuilding Permit #820-13 - 157 WAVERLY ROAD 5/30/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: s? ,/ Date Received Date Issued:---�] *'1 IMPORTANT: Applicant must complete all items on this page LOCATION' i y J ! �P✓/� L,` A /9,t - - - Print PROPERTY,OWNER. �?tf f�- Print 100 Year Old Structure yes ; nno MAP NO:,�_ PARCEL. /'/ ZONING DISTRICT: _ .,Historic District yes: Machine Shop:Village yes, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One ff 'ly ❑Addition ��ivo or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic D Welli ❑ Floodplaim ❑Wetlands ❑ Watershed-IDistrict: ❑Water/Sewer DESCRIPTIO OF'WORK TT BE PE�RCFOBMED: MZ— tification Please Type or Print Clearly) OWNER: Name: C/�lV1GL Phone: ?7P,�� /ala Address: CONTRACTOR Name.: V 's6wS Phone: 7f--�� Address: � . � N,i � / )U /YOL Supervisor'sConstruction,License: d� � Exp: Date: 6/gf Home Improve-ment;License-:, � �� _ Exp. Date; 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: $ /e�l-> FEE: $ Check No.: 071 C, Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ovvner Signature of contractor ,.` Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 I I DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ i COMMENTS i I CONSERVATION Reviewed on Siqnature 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 L.®PW 7Covdd ]Engineer: signature: Located ood Street r IRE'DEPARTMFi. N'T - Temp Dumpster on site yes no Located at'124 Mairl'Street Fire Doartiii649ignat%treffleo ` COMMENTS I � i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Deter location, mast or service drop requires approval of Electrical Inspector Yes No DARKER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use D Notified for pickup - Date Doc.Building Permit Revised 2010 i 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.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 the decision from the Board of Appeals that the apWal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm;tted with the building application Doc: Doc.Bui?ding permit Revised 2012 Location No. IJaO -13 Date 3 - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee '� .. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 26454 BU, ding Inspector .r 7 NORTH w: : S E ic . . ve". . g2a- h ver, Mass, /- COCNICNIwKx Z1,9 A°RATED S U BOARD OF HEALTH Food/Kitchen PER. -IT T L D Septic System w/ /l THIS CERTIFIES THAT ...... ... ..... .1..... �h l ! BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on�.��. ..?..l. ��.�,f.... ... ... .�l t.�................... / Rough to be occupied as ......................&41!q..e r..: :... E.,t2 .... :. a.�7. ............................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS ' Rough Service ............... ....... .[,.�/. . . .. _....................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE AC40RH CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ODIYYYY) 0111112013 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 policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain Policies may require an endorsement. A statement On this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 00775.001 &QgJACT DUr50&Jankowski Insurance �iUC."Ido EIIt): (978)682-6176 V.N_o.: (978)794-0313 198 Mass Ave Suite 1018t� s; _ _ — North Andover,MA 01846 - .�NSllREgi61AFFOs,DIN9 -- __ A.I.M.(AR)Mutual Insurance Company 33758 INSURED — Arthur Walsh A J Walsh 8 Sons 56 Pleasant Street ELD.a-• - -•-• -- - North Andover,MA 01845 s�CiRR 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 WITH 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 AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Ify6 _ TYPEOFINSURANCE TM W. POLICY NUMBER n GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMS t''Mi)RE.unsno CLAIMS-MADE OCCUR MED EXP(Arlt'one Person) 5 -_ PERSONAL ADV INJURY S GGNERALAGGREGATE EN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OP AGO E OUCY l Mol I 0C AUTOMOBILE LIABILITY (OCen11 L�'LIMIT s ANY AUTO BODILY INJURY(Per person) 3 _ _- _ AU70SJNED SCHEDULED BODILY INJURY(Per accident) S — T HIRED AUTOS AUT03�ED (BSER --E S UMBRELLA LIAO OCCUR EACH OCCURRENCE M $ - ExCESS LIAR CLAIMS MADE AGGREGATE 8 _ DED ( RETENTION$ _ S _ y�p�Ep.SI�..�- gT,q�U TN AND EMPLpYER9 LIABILITY x 11Y LIMIT& OEIi - /_N E.L.EACH ACCIDENT S _ 100,000 A cECUTNE�„ NIA AWC7014648012012 11/14/2012 11114/2013 E L DISEASE-EA EMPLOYEE s 100,000 (uManddateoscrynlbn NwH,dl _ p �RIPTIOI�DF�PERATIONSbalow .__ — — E.L DISEASE-POLICYLIMrr S 600,000 DESCRIPTION OF OPERATIoN8I LLOCATIONS I VEHICLES(Attach ACORD 101,Addttlonal Remarks schedule,M more space Is required) CERTIFICATE HOLDER CANCELLATION N Town of North Andover 1600 Osgood Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE North Andover,MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI?ED REPRES]INTATIVE ®1968.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD �l 'd ILZL 'ON 3MMNI 031dIDOSSd Wdll :� �lOZ 'l l 'NVQ M._ C �/�� /�'�Tl j . Office of Cffi onsumer Affairs&-Busihess Regulation e l, ,kIOME IMPROVEMENT CONTRACTOR ma egistration: -103358 Type: VlvxPiration:, 7/7/2014_- Private Corporati( A.J. &SONS INC. Arthur Walsh,Jr, 55 Pleasant St N Andover, MA 01845 Undersecretary 1 Massachusetts -Department of Public Safety �✓ Board of Building Regulations and Standards Construction Supervisor _ License: CS-022680 - ; ARTHUR J WAI.�O JR 159A WAVERLY�RD' pr-) N ANDOVER MA 5 NA Expiration Commissioner 06/09/2014 Department of Industrial Accidents Office of Investigations I x t 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers 1!121icant Information Please Print Legibly [Me (Business/Organization/Individual): 1191;� [dress: Ff *_S/7-'y 7 's .y/State/Zip: , �� ?�� Phone #: � "�G-7 7 yo n employer?Check the appropriate box: Type of project(required): kf I am a employer with_ 4. [] I am a general contractor and I employees(fill[ and/or part-time).* have hired the sub-contractors 6. ❑New construction I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. E] Demolition _ working for me in any capacity. employees and have workers' � 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12 oof repairs insurance required.] I c. 152, §1(4),and we have no q ] employees. [No workers' 13.0 Other comp. insurance required.] )plicant that checks box 41 must also fill out the section below showing their-workers'compensation policy information. owners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, ctors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have :es. If the sub-contractors have employees,they must provide their workers'comp.policy number. in employer that is providing workers'compensation insurance for my employees. Below is the policy and job site latlon. nce Company Name:. #or Self-ins.Lic.4: C'/��`/�7� l�yp./,3 Expiration Date: /1z``/, e Address: 1,K7City/State/Zip: /Y�/}�00GC�� A10 a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a i to$1,500.00 and/or one-year imprisonment, as well ascivil penalties in the form of a STOP WORK ORDER and a fine o$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of gations of the DIA for insurance coverage verification. weby certify under the pains and pena�ltiies/of perjury that the information provided above is true and correct. ,ire: !tet r.G� C��/�G�� Date: 57 scial use only. Don t y o write in this area,to be completed by city or town official ✓or Town: Permit/License# iing Authority(circle one): ;oard of Health 2.wilding Department 3.City/own Clerk 4.Electrical Inspector 5.Plumbing Inspector tther t ort Percmr Phone#• i MASSACHUSETTS HOME IMPROVEMENT CONTRACT This form satisfies-:all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowaers. Seek.legal advice if necessary. An " Y Pin"ph�ng home�inprovements should fust obtain a copy of"a Massachusettssconsumer.guide to home4mprovement"before agreeing to any work oa yourresidence.You may obtaima free copy by'calling the Office of Consumer.Affairs and Business•Regulatioes Consumer Information Hotline at617-9738787 or 1.A 283-375.9. . Homeowner Information 'Contractor Information Name Street Address'(do not use a Post Office Be dress) tra tor/Salesperson/.Owner Name City?owpny� State f^'de usiness A un include a street address) . or l.kkt— Daytime Phone Eve nin one. ity?owu State Zip Code Mailing Address(It different from above) usineas Phone ederal Employer ID or S.S.Number lav tvq.r tutmwtho®eim.I Acme tC®"�geraee?hmher .Haiivatim-0ne poranml aoa"atrgt 6rvee The Contractor agrees to do the following work forthe Homeo nerdoa®w RequiretiTerotits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured:by the contractor as the homeowner's agent; be adhered to`urdess circumstances beyond the contractor's'control arise (Owners who;sectrre their own permits will be excluded:from:theGnarantyFund'provisionsof Date when contractor will boon contracted work. MGt chapter 142A.) 2 J` _ 7 Datt when contracuid .work will besubstantially:-nipleted.. Total Contract Price and Payment Schedule , / A The Contractor.agrees to perform the work,furnish-the material and labor specified above for the total sum of. J ®�/ (•) Payments will be grade according to the following schedule: $ uponaigning contract(notto exceed l/3 of the total.* contract price g the cost*of apccial order items,whichever is.greater) $ by or/_ or upon completion of $ by Y=7_or upon completion of ------------------ $ ' upon completion of the contract (Law forbids demanding full payment until.contract is completed to.both parry's satisfaction) . . The following material/equipment must be special S e paid for ordered before the contracted work begins in order S to bed for tomeetiic.coinjil6tionschedule.(••) ,Pm r NOTES:(•)Including all finance charges(")Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greeter of(a)one-third of the total contract price or(b)the actual con of any spedal.equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty Is an express warranty Deia¢.nrovlded by fbeeontnmw•• No Yes (aR terms of the werreet. d to the eontraNl Subcontractors The contractor agrees to be solely responsible for completion of the work described regardless of the actions of nay diiid party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under iii aereement Contract Acceptance Upon signin&this document becomes a binding.contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security intcrest)tas been placed on the residence. Review the following cautions and notices carefully before signing this contract • Don't be pressured into signing the contract Take time to read and fully'understand it. Ask'questions if sord-athing is unclear. • Make sure the contractor has a valid Hom ImmovThe loiv requires most home improvement contractors and. subcontractors to be registered with.the Director ofHonmregimprovement Contract6h Registration You May inquire about contractor. . -800. 23- 3 writing to the Director atUne Ashburton Place,Room 13M.,Boston,MA 02108 orby.calling 617-727-3200 or 1-800.223-0933. .,. • Does the contractor have insurance? Check to see that your'coutractor is properly insured • Know your rights and responsibilities. Reed the Important Information on the tevem side of this form and get a copy of the Consumer Guide to the Home hhprovemerht Contractor Law. You may cancel this agreement if it has been signed at a place other than thecontractrit s normal place of business,provided yo=_ti=;t contractor in writing at his/her main offide or branch office by ordinary mail posted,by telegram sett or delivbusiness day following the signin of this a by cry,not later tg greement.See theattached notice ofcancellation form foranexplanation of.th T SIGN S ONTRACT IF THERE ARE ANY BLANK SPACESM ?yy��oo•end i rhe rid i copy.shoula go to the .The other L / ewy,hoala be kept by the c�osa.aor. H/omen er's Si ture Contractor's Signature Date Date Contractor Arbitration The Home Improvement Contractor I:aw:provides homeowners with thenghtu4nitiate•an arbitration action(as an alterria6-11.._1.-_.1_,....b,; ve to courtacu,00 if.th Have a,dispute.with.a contractor. The.same rightis not automatically afforded to'a. contractor,how.ever.-..'I'he,contractor would have;rp resolve any,dispute he/she.has.with a homeowner in court unless .... both parties agree to.the optional elause provided below..This clause would.give the.contractor rthe.same.right to arbitration as is afforded to the homeowner:by the Home Improvement Contractor Law. 7be contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a.private arbitration firm which has been.approved by the Secie' of the Executiv a of Consumer Affairs and Business Regulation an&the consumer shall be required to sub itra' i sachusetts General Laws,chap 142A. ces Signdture Contractor's Signature NOTICE:The signatures of the parties abL apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor.The.:homeoymer,may initiate altemative.dispute resolution even where this section:is not s arately signedby'..the parties.: Homeowner's.Rights A homeowner's rights under heHome'Iraprovement Contractor Law(MGL chapter 142A)and other consumer "protection laws(i.e.MGL chapter 93X)may not be waived in any way,even by agreement: However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeown�who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home provement Contractor Law. The contractor is responsible-for completing the work as described,in a timely andworkmanlike:marine r. Homeowners.may be entitled to.other specific legal rights if the contractor guarantees. or provides an.express warranty for:workmanship or materials. In addition to.guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability:and fitness fora particular purpose. An enumeration of other matters on whichthe homeowner and contractor lawfully agree smay be added to the. terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in du lice a and should not be signed until a copy of all•exhibits and referenced documents have been attached Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contractwith attachments is to be given to the owner and the other kept by.the contractor. Any modification.to the griginal.contract must be in writing and agreed to by both parties.Contracted►vork may not begin until both parties have received a fully executed copy of the contract,and the three day recission period has expired. Accelerated Payments A contractor may not demand payments in advance.of the dates specified on the payment schedule incases where the homeowner deems him/herself to be financially insecure. However,in instances where a.connactor deems him/herself to be financially insecure,the contractor may require that the.balance of funds not yet due be placed in a joint escrow account as a prerequisite to.continuing the contracted work. Withdrawal of funds from said account would require,the signatures of both parties. Additional Information If you have general questions or..need additional information about the Home Improvement Contractor Law or other ,or if you wish to.obtainafree:copy.of"A Consumer Guide to the Home.Improverrient Contractor consumer rights Law,"•contact Cgnsumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787 or 1-(888)2833757 If you want to verify the-registration of a contractor or if you have.questions or need.additional information speci5aally about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Bureau of Building Regulations and Standards One Ashburton Place,Room 1301,Boston,MA 02108 . (617)727-3200 ort-800-223-0933 For assistance with informal mocliation of di§pates or to register formal complaints against a business;call Coi�sicaner Coihplaint'section Office of the Attorney General (617)727-8400 AND/OR Better Business Bureau (508)652-4800 (508)755-2548 (413)734-3114 roool Page# of pages + CS # 022880 978-688-6737 HIC# 103358 A. J. Walsh & Sons or 55 Pleasant Street 1-866-AJWALSH .North Andover,MA 01845 Proposal Submitted To: Job Name 14 Job# Address Job location p 4 40,4 Q el Date r•� Date of Plans Phone# `-Orl/Q Fax# v Architect rIWeereby submit specifications and estimates for: 92, �. - 61or i 7 4 V v rVWVe propose hereby to furnish material and labor—complete in accordance with the above specifications for jhe sum of: Dollli. ars with payments to be made as follows: Aw- `�!/a.3 ek# 3 s6 Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only*upon written order, and will become an extra charge over and submitted - (' above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our cohtrol. Note—this proposal may be withdrawn by us if not accepted within days. i The above prices,specifications and conditions are satisfactory and are nature hereby accepted.You are authorized to do the work as specified. V t if Payments will be made as outlined above. Date of Acceptance Signature r i Propool Page# of pages CS # 022680 978-688-6737 HIC# 103358 A. J. Walsh & Sons or 55 Pleasant Street 1-866-AJWALSH .North Andover, MA 01845 Proposal Submitted To: Job Name �/� Job# Address Job location Date �`��/f3 Date of Plans Phone# q �{ �f r} Fax# f Architect FWe hereby submit specifications and estimates for: 9 V -- — v 7�proposehereby to furnish material and labor—complete in accordance with the above specifications for jhe sum of: Dollars with payments to be made as follows: fie, e4., e A4 . 'f jai ck# Any alteration or deviation from above specifications involving extra costs will be Respectfully ��1�/ executed only upon written order, and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our control. Note—this proposal may be withdrawn by us if not accepted within days. The above prices,specifications and conditions are satisfactory and are nature hereby accepted.You are authorized to do the work as specified. V t k../ Payments wi11 be made as outlined above. f Date0 f Acceptance Signature y ''