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HomeMy WebLinkAboutBuilding Permit #458 - 459 WAVERLY ROAD 12/11/2009TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: P -40-1, Date Issued: IMPORTANT: LOCATION ,K) PROPERTY OWNER ---I uvuv MAP NO.: tZ– PARCEL: TYPE AND USE OF BUILDING TYPE OF IMPROVEMENT ❑ New Building ❑ Addition Alteration ❑ Repair, replacement ❑ Demolition ❑ Moving (relocation) ❑ Foundation only DESCRIPTION OF Y OWNER: Name: Address: s a APPROVEece ved must complete all items on this P nt rPrint — ZONING DISTRICT: I HISTORIC DISTRICT YES ❑ PROPOSED USE Residential Non- Residential ❑ One family ❑ Two or more family ❑ Industrial No. of units: 11Assessory Bldg ❑Commercial ❑ Other I ❑ Others: TO BE Identification Please Type or Print Clearly) kLl 1 t e - CONTRACTOR Name: /p` �t�ao �aa•ry�\ F3? — [2 74; Address: i x n 4PJA -v ° Supervisor's Construction License:`l 76 Exp. Date: 3 — Home Improvement License: Exp. Date: ARCHITECT/ENGINEER 4 dtL42�Name: Phone: Address: "ZZC 11 I -e'k —517Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.0.0--W- $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ ISD v FEE:$ 7,s Check No.: b I Receipt No.: Page 1 of 4 0 TYPE OF SEWERAGE D[SPOS L Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site ❑ ` Private (septic tank, etc. Electric Meter location to project NOTE: Persons contracting_ with unregistered contractors do not have access to thFg Signature of Agent/O `r Signature of contra_ cto4��' Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS XCONSERVATIO COMMENTS HEALTH COMMENTS ATE REJECTED DATE APPROVED �C2rt-'." DATE REJECTED 11 E DATE APPROVED FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS V oning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Drivewav Permit 13V Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Require Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 000 NOTES and DATA — For department use Page 3 of 4 Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC. Jan.2006 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 A J- ❑ 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 PC 0 .4 Sx U Addition Or Decks ❑ Building Permit Application wLatvsn wt- ❑ 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) 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 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORN105 Page 4 of 4 Location—J 7 �tJGfy• No. ,T �!J Y Date Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit fee $ TOTAL $ 19868 Building Inspector + HTN F TOWN OF NORTH ANDOVER OFFICE OF Aft BUILDING DEPARTMENT Ilk1600 Osgood Street Building 20, Suite 2-64 AcNu5North .\-ndover, Massachusetts 01 845 Gerald A. Brown Inspector of Buildings Please mint DATEJ ,� - 7 -_0 6 Telephone (97F) 688-9545 Fax (978) 6S8-9542 HO:�IEOw'�ER L[CE:VSE EXE;�IPTIOiv JOB LOCATION:_ 1 U ic Number Street Address :\1ap/Lot EIO,NTEOWNER Pt',, A QV, • a / n.- Name Home Phone PRESENT MAILING ADDRESS City Town State Work Phone Zi C d X�R3-\ p o e The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less an to allow such homeowners to engage an individual for hire who does nod acts as supervisor). State Building (Code Section 108.3.5.1) t possess a Incense, provided that the owner DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is or ' be, a one or two F imily structures. A person who constructs more that one home in a two-year {' Intended to Considered a homeowner. y period shall not he 'The. undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeo+.kner" certifies that lie, she understands the Town of North,\ndovcr BuildingDepartment minimum inspection procedures and requirements and that he'she will comply with said procedures and HOMEOWNERS SIGNATURE_ \PPROV,M. OF R11LDING OFFICL\L I:•...nt Honic"', 'rs F rq'iir.rt r_.\I m If.. :x-, i. ,.- r f"I O 1Z w O 0 a 0 z g 0 � CCD0 G3 y C.- -0 C40 O O m m �3 O CD o 0 O O d ZL cmQ Ca 0 CL S� c cc W W 0 W N w� x w w° a U w a w a°' w x w w°' w p°G w ° U) V) r f"I O 1Z w O 0 a 0 z g 0 � CCD0 G3 y C.- -0 C40 O O m m �3 O CD o 0 O O d ZL cmQ Ca 0 CL S� c cc W W 0 W N A REScheck Software Version 3.7.3 NOCompliance Certificate Project Title: Addition & Renovations to the Petrie Residence Report Date: 03/31/06 Data filename: C:\Program Files\Check\REScheck\Petrie Residence.rck Energy Code: Massachusetts Energy Code Location: North Andover, Massachusetts Construction Type: 1 or 2 Family, Detached Heating Type: Other (Non -Electric Resistance) Glazing Area Percentage: 9% Heating Degree Days: 6322 Construction Site: 459 Waverly Road North Andover, MA 01845 Owner/Agent: Paul Petrie 459 Waverly Road North Andover, MA 01845 978.685.1293 Ceiling 1: Flat Ceiling or Scissor Truss: Ceiling 2: Cathedral Ceiling (no attic): Ceiling 3: Cathedral Ceiling (no attic): Skylight 1: Metal Frame with Thermal Break:Double Pane with Low -E: Ceiling 4: Flat Ceiling or Scissor Truss: Floor 1: All -Wood Joist/Truss:Over Outside Air: Wall 1: Wood Frame, 16" o.c.: Window 1: Wood Frame:Double Pane with Low -E: Door 1: Solid: Wall 2: Wood Frame, 16" o.c.: Window 2: Wood Frame: Double Pane with Low -E: Window 3: Wood Frame: Double Pane with Low -E: Window 4: Wood Frame: Double Pane with Low -E: Window 5: Wood Frame: Double Pane with Low -E: Window 6: Wood Frame: Double Pane with Low -E: Window 8: Wood Frame:Double Pane with Low -E: Wall 3: Wood Frame, 16" o.c.: Window 7: Wood Frame:Double Pane with Low -E: Wall 4: Wood Frame, 16" o.c.: Wall 5: Wood Frame, 16" o.c.: Boiler 1: Other (Except Gas -Fired Steam): 80 AFUE Permit # Permit Date Designer/Contractor: Robert Atwood Architectural Energies, P.L.L.C. 200 Sutton Street, Suite 235 North Andover, MA 01845 978.681.0055 AEArchitect@verizon.net 99 38.0 0.0 3 68 38.0 0.0 2 264 38.0 0.0 6 24 0.270 6 688 38.0 0.0 21 153 30.0 0.0 5 416 19.0 0.0 23 8 0.270 2 18 0.190 3 988 19.0 0.0 51 50 0.270 14 25 0.270 7 24 0.270 6 13 0.270 4 9 0.270 2 9 0.270 2 16 19.0 0.0 0 8 0.270 2 99 19.0 0.0 6 60 19.0 0.0 4 Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 3.7.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Addition & Renovations to the Petrie Residence Page 1 of 6 Design Condi ' in th a HV C uipment selected to heat or cool the building shall be no greater than 125% of the desi as ec ifi s78 1310 and J4.4. Buffder/Designer Company Name D ale Project Notes: Addition of second story living quarters to a single story ranch, primarily encompassing Bedroom & Bathroom spaces. Per 780 CMR - the Commonwealth of Massachusetts State Building Code, this calculation is for the Second Floor Addition & Breezeway Addition only. These calculations have been perforated using R-19 FGL Batts, it is recommended that R-21 FGL Batts or Spray -in Cellulose be utilized for higher/better performance. The Existing Areas of the Dwelling may, at the option of the Owner, be re -insulated with Blown -in Cellulose. Addition & Renovations to the Petrie Residence Page 2 of 6 REScheck Software Version 3.7.3 Inspection Checklist Date: 03/31/06 Ceilings: ❑ Ceiling 1: Flat Ceiling or Scissor Truss, R-38.0 cavity insulation Comments: Breakfast Nook Clg ❑ Ceiling 2: Cathedral Ceiling (no attic), R-38.0 cavity insulation Comments: Staircase Clg ❑ Ceiling 3: Cathedral Ceiling (no attic), R-38.0 cavity insulation Comments: Master BR Cath ❑ Ceiling 4: Flat Ceiling or Scissor Truss, R-38.0 cavity insulation Comments: Above -Grade Walls: ❑ Wall 1: Wood Frame, 16" o.c., R-19.0 cavity insulation Comments: Breezeway Walls ❑ Wall 2: Wood Frame, 16" o.c., R-19.0 cavity insulation Comments: Second Floor Walls ❑ Wall 3: Wood Frame, 16" o.c., R-19.0 cavity insulation Comments: 2nd fir Staircase Ext Wall ❑ Wall 4: Wood Frame, 16" o.c., R-19.0 cavity insulation Comments: 2nd fir Staircasse Int Wall @ Storage ❑ Wall 5: Wood Frame, 16" o.c., R-19.0 cavity insulation Comments: Wall bet Garage & 2nd Flr Staircase Windows: ❑ Window 1: Wood Frame: Double Pane with Low -E, U -factor: 0.270 For windows without labeled U factors, describe features: Vanes Frame Type Thermal Break? Yes No Comments: Front window @ Breezeway ❑ Window 2: Wood Frame: Double Pane with Low -E, U factor: 0.270 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Master BR - 4 units ❑ Window 3: Wood Frame: Double Pane with Low -E, U -factor: 0.270 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Walk-in Closet - 2 Units ❑ Window 4: Wood Frame: Double Pane with Low -E, U -factor: 0.270 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: BR 3 - 2 units ❑ Window 5: Wood Frame: Double Pane with Low -E, U -factor: 0.270 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: BR 2 -1 unit ❑ Window 6: Wood Frame:Double Pane with Low -E, U factor: 0.270 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Addition & Renovations to the Petrie Residence Page 3 of 6 Comments: Master Bath - t Unit ❑ Window 8: Wood Frame:Double Pane with Low -E, U -factor: 0.270 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? _ Yes No Comments: Common Bath Window ❑ Window 7: Wood Frame:Double Pane with Low -E, U -factor: 0.270 For windows without labeled U -factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: Windows @ top of Staircase Skylights: ❑ Skylight 1: Metal Frame with Thermal Break:Double Pane with Low -E, U -factor. 0.270 #Panes Frame Type Thermal Break? Yes No Comments: Optional MBR Skylights Doors: ❑ Door 1: Solid, U -factor: 0.190 Comments: Breezeway Entry Dr Floors: ❑ Floor 1: All -Wood Joist/Truss:Over Outside Air, R-30.0 cavity insulation Comments: Breezeway Overframed Floor Heating and Cooling Equipment: ❑ Boiler 1: Other (Except Gas -Fired Steam): 80 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. ❑ When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1 • Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2• Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 Ibs/ft2 pressure difference and shall be labeled. Vapor Retarder: ❑ Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. Materials Identification: ❑ Materials and equipment must be identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. ❑ Insulation R -values and glazing U -factors must be clearly marked on the building plans or specifications. Duct Insulation: ❑ Ducts shall be insulated per Table J4.4.7.1. Duct Construction: ❑ All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturers installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. ❑ The HVAC system must provide a means for balancing air and water systems. Temperature Controls: ❑ Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Addition & Renovations to the Petrie Residence Page 4 of 6 Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: ' ❑ Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: ❑ All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non{iepletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table 2. Addition & Renovations to the Petrie Residence Page 5 of 6 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 133187 Expiration: 5/16/2007 Type:. individual JAMES P. DELANEY JAMES DELANEY 18 KENNEY RD. MIDDLETON, MA 01949 Administrator K 6✓T, BOARD OF BUILDING License: CONSTRUCTION SUPERVISOR Number: CS 046760 Birthdate - 03/17/1965 03117/20 Expires.07 Tr. no: 12224 Restricted: 00 JAMES P DELANEY 18 KENNEY RD MIDDLETON, MA 01949 Commissioner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 133187 Expiration: 5/16/2007 Type:. individual JAMES P. DELANEY JAMES DELANEY 18 KENNEY RD. MIDDLETON, MA 01949 Administrator The Commonwealth of ,tilassaehuselts c Department of Industrial: lccidents t 1 Office of Investigations 1 600 Washington Street Boston, ,VU 02111 www.mass.gov/din Workers' Compensation Insurance ,affidavit: Builders/Contractors/Electricians/Plumbers Name tllusincss Urzaniialiunilndividual): (� V 1 Address: City. State, Zip: MJAM�n ft ®(�? y I Phone #: q 7e— 2 7 2 266, Z Ire ou an employer? Check the appropriate box: I . I am a employer with 2, 4. ❑ I am 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. 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 MGL myself. [No workers' comp. c. 152, 31(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 3. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I I.[] Plumbing repairs or additions 12.❑ Roof repairs 13.0 Other 'Any applicant that checks box J I must also fill out the section below showing their workers' compensation policy information. y homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am tin employer that is providing workers' cumpenshiion insuranceJor my employees. BeG►w is the policy and job site information. 77 (� Insurance Com a i Name:_p Policy 'tor Self ins. Lic. 'f:iC)Ti CU — Expiration Date:3�� sy 2,U ry p � Job Site Address:. ✓We 6 - Ci �State,�Zi :_ ,attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of %-IGL c. 152 can lead to the imposition of criminal penalties of a tine up to $1,500.00 and/or one-year imprisonment, as well its civil penalties in the form of a STOP \k ORK ORDER and a line of up to 5250.00 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 certify it, it r the pains and p Analties pe Jury that the inform ition provided above is true and correct. `i nahlre: nate: — ZLS— r1/fc•ial ,ise/tily. !?o :teJ tri ite »this rrn�a, to hey . r„»I►Med n� r,ri} r►r town ,��ficial. C:ty or Town: P!:rtnit/License 4 !ssuing •Authority (circle one): I. Hoard of Health 2. Building Department „Z. City/Town Clerk 4. I !ectrical g ispector 3. Plumbing Inspector 6. Other rimfict !'r.r:„iia: Phone #: ACORDM CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YY) 11/06/2006 PRODUCER Ambrose Insurance A Inc. gy ' ' 56 Central Ave. Lynn, MA 01901 781-592-8200 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED Delaney, James JD Builders 18 Kenney Rd. Middleton,, MA 01.949 _ .. _ INSURERA: Providence Mutual Fire Ins. Co. INSURERB: AIM Mutual Insurance Co. INSURER C: 'INSURER D:- ,. ,> INSURER E. COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE MWD DATE MWDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $1, 000, 000 FIRE DAMAGE (Any one fire) s50, 000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE F—I OCCUR MED EXP (Any one person) s5, 000 A CPP005145700 3/17/06 3/17/07 &ADV INJURY $1,000,000 -PERSONAL GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY1-1 PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 5 0 0, 0 0 0 B VWC6009435012006 9/16/06 9/16/07 E.L. DISEASE - EA EMPLOYEE $500, 000 E.L. DISEASE - POLICY LIMIT $ 5 0 0, 0 0 0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry — 1. .. .-- .-, I V V 1 I I AUDI I IUNAL MbUKCU; MbUKLK LC I I M Yizhong Yim 388 Lowell St. Andover, MA 01810 Fax: 978-623-8104 L.NIYL.CLLA 1 1 V IY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. s+� AUTHORIZED REBRESENTAI IVE / 1� w1,.UKU Z5 -s (nyi) © ACORD CORPORATION 1988 r'ropubd1 Page No. I1 J.D. BUILDERS of_Page+�'s! General Contracting II 18 Kenney Road . Middleton, MA 01949 w lam' — ��� (978) 777-7662 PROPOSAL SUBMITTED TO: DATE: O/Q' 77 NAME: ( , I JOB NAME: STREET: —., STREET: CITY: CITY: STATE: STATE: Irrt'_IECT `tL�i LCIP' T� F P�j We hereby submit specifications and estimates for:Odd t V r 1 ? 10 � .�5 O I v - (l 0 (e- /16 L) GTi C A J j l � -►-- I 06 �`r ok QILCa. ' - l>,�.. 7-L-1CL/ atmIt Ole-� �� ��< bo,r � 11 s° vo s k le ,4 7 rzkscA- � tuC?-.. ,-- I ; �- sly 1 AC. 1 0 d �ry (e -s crpe-x; s --" .'.C�t✓��,�iC { d � ��J / Y\'t.� �� l:"r'_.1 ^'�.C' 1f �"' � � �1 \ �-'-.... � /`�• ri S l r � (�� �1--� j UC-fC� - � s7c)' V ' f L rive ` � r �-� mac% t � �n l �: c�4 � -� �.: Olt �� we herby propose to furnish labor and materials complete in accordance with these specifications, for the sum of /(-J�V e.cj-'dollari (s �J'� „�) with payment to be made as follows: �' ovo aC ., I C� S ✓vC 10.00'D -r4v1lec1 n 494i !� =Y1 All material a guaranteed to be as specified. All work to be completed in a workmanlike manner according i' standard practices. Any alteration or deviation from above apecificolions involving extra costs, will be executed only upon wr' orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyon our antral. Owner to curry fire, for o and other necessary insurance. Authorized Signatur XrrPr2>tnrp ofrutn3�1 The above prices, specifications and conditions are Satisfactory and ore ereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. s�ttP�i2Pi1: Signature Date Signature iC+ NOTE: This Proposal may be withdrawn by us if not c ept d within days.