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HomeMy WebLinkAboutBuilding Permit #666-2016 - 275 ABBOTT STREET 12/22/2016A�7 TYPE OF IMPROVEMENT PROPOSED USE _ Residential Non- Residential New Building 0 One family 0 Addition 0 Two or more family ' Industrial El Alteration No. of units: L Commercial ,'Repair, replacement 0 Assessory Bldg 0 Others: 0 Demolition 0 Other Vice, ids �i�i #e sn d C l # c# Identification Please Type or Print Clearly_ ) 1�� -Oyy� OWNER: Name: Gt~ lyxewn� Phone: /7 f Address: 120,4 0/ff'y5 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: $ .Check No.; � 11 Receipt No.: NOTE: Persons contracting with, unregistered contractors do not have access to the guaranty fund BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION permit No#: M_+� 1--1- - Date Received -..—a . ^a TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0 One family [I Addition 0 Two or more family 0 Industrial [I Alteration No. of units: 0 Commercial D Repair, replacement El Assessory Bldg 0 Others: 0 Demolition 0 Other - Septic 01Nell E! Floodplain � Weir Ed Watershed Distract -W E atdr/-S I DESCRIPTION OF VVUKK I L) est FtKt"L)K1V1t=L); Identification - Please Type or Print Clearly' OWNER: Name: AAA Phone: J C -_&9500r. Na­fne,::*_. Rhone:': S Gpbbestfdc f ff PMP6­ht:L tefi _. Asa I ARCHITECT/ENGINEER Address: Phone: Reg. No. FEE SCHEDULE. BULDING PERMIT: $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125-00 PER S.F. f- _,Total Project Cost: $ EE: $ Check No.: Receipt No.: -access to th&7guarrintyfund NOTE: PeFsoms contracting with unregistered contractors do not have. _;if h P"r-a e �ibn tUr' of contractor 4 Locationrl 6'V1f4, No. (DW (P — 2G lDate iZ TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ r Other Permit Fee $ ` TOTAL $ r Check #� '�672 Building Inspector +� i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TypB-OF SEWERAGE DISPOSAL Public Sewer ❑ Tanaing/Massage/Body Art ❑ Sv imm'ng Pools ❑ Well ❑ Tobacco Sales ❑ FoodPackaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature. COMMENTS CONSERVATION Reviewed on Signafiure COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Y 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 Dumpster on site yes Located at 124 Main Street Fire Departrn�nt signature/date COMMENTS no -)imension 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 Doc.Buflding Permit Revised 2014 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 Li 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 ci Photo Copy of H.1. C. And C. S. L. Licenses • Copy Of Contract ❑ Floor/Cross Section/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) o Building Permit Application o 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 o Engineering Affidavits for Engineered products JOIE: 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: Building Permit Revised 2014 v C 0 M O CD 0 ZCL r V1 �o D to cin � o � 0 CD cD Q o r�� c 0) =r CD CD O ou CD W CD O' CA O ID (Q. CDD � � v z CD 00 O �CD CD `3 C W 0 O ° v D m 1 r m LA z H 9 O T V1 O N i] O .OQ S m ;u O m S C Z 0 T (") 3 3 3 m 7J O = S T O 3 O_ m 0 3 C C) O 0 N f0 n N N T O Q r n S 3 m ° O T m 2 OM z cnn o— c� z ic z 0 o"c -i t°n - C tar � =:5. O c (D n � n " ? � o -S cn V! �. rt CD• TI O•��CL 0 • N W C G �D CD 2 0, 6 "1 >C N O C) =r CDrr C LD YC CD � 0 O 00� Z �� -0.4 -I. �US v"� C 0QQ�0�� r ) �. C.) O G cc 00 '� rCD CD ; CD N C9 �- v_ CD la:r o � rt N 3 O (p � M rt N N Z 0 W 0 O ° v D m 1 T lu m O 000 S LA z H 9 O T V1 O N i] O .OQ S m m n r 0 -nm 3 O m S C Z 0 T (") 3 3 3 m 7J O = S T O 3 O_ m 0 3 C C) O 0 N f0 n N N T O Q r n S 3 m ° O T m 2 MA CSL: 0106967 ' MA HIC: # 125338 P.O. Box 287 Swampscott, MA 01907 617.469.4528 or 800.248.4900 781.595.1140 fax Sweet Contracting Corp. dba 1211he C.unnt Phiennaw Cuuaan P r op� ���,1 1SPPIFICATIONS AND ESTIMATE PROPOSAL SUBMITTED TO: DATE: ^ Wayne Niemi 12/12/16 STREET PHONE 275 Abbott St. r 617-680-9494 CITY, STATE, ZIP CODE PHONE North Andover, MA 01845 Safety Commission, the U.S. Environmental Protection Association and the American Lung Association EMAIL wayneniemi@rubywines.com s Pull a building permit with the town of North Andover. s Seal the gaps between the stainless steel liner, the fireplace flue and the smoke chamber. s TOTAL (includes labor, materials, waste removal and cleanup): $2,500.00 Cost for Permlt, time to acquire Permit and final inspection of work with the building insaector added to the final Payment. See natmtent schedule below. 3 Billy Sweet Chimney Sweep guarantees all labor and installations for one year. If we come back each year to do a sweep an, d inspection of the chimney, the material warranty and the company guarantee stays intact. Take advantage of our annual 20% Spring Discount for inspecting and sweeping your chimneys during the months of February and ;March. The first annual sweep and inspection Is free, if done during the months of February and March 2017. The National Fire Protection Association, the Chimney Safety Institute of America, the U.S. Consumer Product Safety Commission, the U.S. Environmental Protection Association and the American Lung Association recommend annual inspections of your heating system chimneys, flues and fireplaces. WE PROPOSE hereby to furnish materials and labor — complete in accordance with above Specifications, for the sum of: ******************Two thousand five hundred and 00/100*************** Dollars ($) 2,500.00 PAYMENT TO BE MADE AS FOLLOWS 1/3 deposit in advance ($830.00), 1/3 payment at the start of work ($830.00), balance due when the work is complete plus permit cost ($840.00+ $200.00= $1,040.00). Advance de its are non-refundable in case of cancellation by customer. A9 material is guaranteed to be as specified. All work is to be completed in a substantial workman- like manner according to specifications submitted, per standard practices. Any afteration or deviation from above specifications involving extra costs will be executed only upon written orders, Authorized nature and well became extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control, Owner to carry fire, tornado and other necessary Note: This proposal may be insurance. withdrawn by us if notcepted within 30 S. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as Signature: _ specified. Payment will be made as outlined above. f Date of Acceptance:. oZ ;o Signature: i C:\Docs\Customer Reports 2016\n-p\Niemi 275 Abbott St Chimney Proposal 161212.docx i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 I U1. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Narne (Business/Organiration;lndividual): 6.11 Address: r. tJ City/State/Zip: C_ Phone #:--?F'1' 5q`( ' ;z 3 3 Are you an employer! Check the appropriate box: I a R I am a employer with, /0 _ 4. ❑ I ant a general contractor and I employees (full and!or part-time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp, insurance. (No workers' comp. insurance 5. ❑ We are a corporation and its required] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGI. myself. [No workers' comp, C. 152, § 1(4), and we have no insurance required.] t employees. INo workers' comp. insurance required.] *A a licant hat h' k' b to Type of project (required); 6. []New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.F] Roof repairs 13 . Other___ �� r r IV pp t a. c cc s ox . must also 1111 out the section below shoWing their workers compensation policy information. t I lomeownets who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name ol'the sub -contractors and their workers' comp. policy information. I ant an employer that is providing workers' compensation Insurance for my employees. Below is the policy and fob site information. i Insurance Company Name: Policy # or Self -ins. Lie. #: Job Site Address: © Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). 6/1 S� Failure to secure coverage as required under Section 25A of vIGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 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. Re 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 certify under the pains and penalties of perjury that lite information provided above is true and correct. . 3�3 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone #: ©® CERTIFICATE OF LIABILITY INSURANCE P-rE(MMIDD/YYYY)A TYPE OF INSURANCE 12/27/2016 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(les) must have ADDITIONAL INSURED provisions or 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 I CONNECT HeatherATenney Thomas St Jean Insurance 484 Lowell St AIC N EX • PHONE978 531-8053 (AIC, No): (978) 531-5653 Suite 1-C E-MAIL ADDRESS: L% heather�1� s eaninstrmance.co Peabody. MA 01960 INSURERS AFFORDING COVERAGE NAIC k INSURER A: ATLANTIC CASUALTY INS CO 42846 PERSONAL & ADV WURY $ 1,000,0W INSURED Sweet Contracting Corp dba Billy Sweet ChimneySwe INSURER 8: CHARTER OAK FIRE INSURANCE CO 25615 P 0 Box 287 INSURER C NAUTILUS INSURANCE COMPANY 17370 Swampscott, MA 01907 AUTOMOBILE LIABILITY ANY AUTO OWNED / SCHEDULED �/ AUTOS ONLY AUTOS / HIRED / NON -OWNED V AUTOS ONLY V AUTOS ONLY INSURER D: INSURER E: 11/30/2016 INSURER F: COMBINED SINGLE LIMIT $ 1000000 Ea accident COVERAGES CERTIFICATE NUMBER: RFVISIAN NIIMRFR: 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDOIYYYY POLICY EXP MM/DDNYYY LIMITS A COMMERCIAL GENERAL LIABILITY CLAUS -MADE � OCCUR MP0020000500177 04/12/2016 04/12/2017 EACH OCCURRENCE $ 1,0W,O DAMAGE (RENTED 550 000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV WURY $ 1,000,0W GENL AGGREGATE LIMIT APPLIES PER: POLICY E JECT F7LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGO $ 2,OW,MO $ B AUTOMOBILE LIABILITY ANY AUTO OWNED / SCHEDULED �/ AUTOS ONLY AUTOS / HIRED / NON -OWNED V AUTOS ONLY V AUTOS ONLY BA7167M153 11/30/2016 11/30/2017 COMBINED SINGLE LIMIT $ 1000000 Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLALIAB OCCUR EXCESS LIAB CLAVAS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRETOR/PARTNER/EXECUTME❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) IF yes, describe under DESCRIPTION OF OPERATIONS below N / A I PER OTF4 STATUTE FR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ C C PLO 40000906- POLLUTION 04/12/2016 04/12/2017 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) NGICI lr-FLINT C r7VLYCR VWVIiCLLA11U14 Town of Andover 120 Main Street North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ACORO®DATE CERTIFICATE OF LIABILITY INSURANCE (MM/DDrrNY) 12/22/2016 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 CONTACT NAME: Thomas St .lean PNONE. Exile 978 531-8053 c Na THOMAS ST JEAN INSURANCE E-MAIL � st'leaninsurance.com ADDRESS: tstjean@stjeaninsurance.com INSURER(S) AFFORDING COVERAGE NAIC # 484 Lowell St. Ste 1-C INSURER A: LIBERTY MUTUAL FIRE INS CO 23035 PEABODY MA 01960 INSURED INSURER B SWEET CONTRACTING CORP INSURER C; DBA BILLY SWEET CHIMNEY SWEEP INSURER D: INSURER E: PO BOX 287 INSURER F SWAMPSCOTT MA 01907 COVERAGES CERTIFICATE NUMIRFR! 11.q171 RFVISIt'1N NIIIMRFR- 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDPOLIDY EFF rrfM MM(POIDD CY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) i $ PERSONAL & ADV INJURY $ N/A GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT F7LOC PRODUCTS -COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NIA BODILY INJURY ( Per acc) ident $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE NIA DED RETENTION $ $ WORKERS COMPENSATIONX A AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETORIPARTNER/EXECUTIVE I OFFICER/MEMBEREXCLUDED? I NIA NIA NIA WC231S351551036 05/07/2016 05/07/2017 STATUTE ETH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE -EA EMPLOYEE s 500,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 1 NIA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers' Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B, no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires, or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued (unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage -Coverage Verification Search tool at www.mass.gov/lwdtworkers-compensation/investigations/. 1,:tKIIr1L:A1C KULUtK UAN(itLLAI IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main St AUTHORIZED REPRESENTATIVE North Andover MA 01845 Daniel M. Cr ~y, CPCU, Vice President—Residual Market— WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD C01IStrUction Supervisor Postricted to: Untestricted - Buildings of any use roup which contain lesS than 35,000 cubic fit (991 rise mskes) of anclosed since. Failurt to pmess a cuftnt edition of the Apasqh0usetto StrAe Building Code is causo for revocati-tift of thir. ficanso, M Liconsing Intomiatiatj vigit, WMM-MASSAOMPS !Z' M.Aosuhumetts Department of Publib 30c4y Po rd of SuOdi" Regivittidms and $tAmd0rds Uea,"e: CS -438W363 C"-,i.ttructjoj. Supervisor MLLIAM F SWEET 46 NEW OCEAN STi'. SWAM P30 OTT MA 4j; Expiration: 04=2018 Office of Cons mor Affairs and Business Regulation '10 Park Plaza- Suite 5170 Boston, Massachlusefts 02116 Home Improvement Cqq r Rogistration ReglaVOon: 126338 TYPS: DaA SILLY SWEET CHIMNEY SWEEP QLLIAM SWEET PO 13OX,287 SWAMPSCOYT, MA 01907 Vpdft Addrem and raturn ard. Mek remo for abolp. !Address 0 [3 Employmout elm. %Omommt&A MR 0Mct d Coummer Aft1n; & RuOntm U101411on assert or rtoftOgn vol[d for ladividul uta only NO)AS IMPRWOW *)NTFA1 b4or6*69%�h*11 ditto. Iff6und return to' II� Tyc "iat OrCoftudlerAftt% and StWiften RoplatiOn 7 08A 10 Park ?I= -gultb 3170 DOW, NA 41116 VVILUAM SWEV 45 NEW OCW MAMPSCOTT, Wk OV36ixcratarj+NetvAlld'vithout signaWit