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Home My WebLink AboutBuilding Permit #467 - 55 LINDEN AVENUE 3/4/2009Permit N0: Y Date Issued: % d LOCATION BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received RTANT: Applicant must complete all items on this i- j)�� n PROPERTY OWNER t <'t,-Ct Print MAP NO: PARCELS ZONING DISTRICT: Historic District yes Machine Shop Village yes fsP TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Othe : Demolition Other Septic Well Floodplain Wetlands a rshe District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: 2 V I I I Erma r9=1 � 71 �Q' Address: Supervisor's Construction. License: Exp. Date: 2 Home' Improvement' License: l (1� -� Exp.. Date; ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDIN(G MIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: 7" �� FEE: �� $ c3 Check No.: (If,— Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce s to nature �'r 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 o 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 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 Application Revised 2.2008 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 V 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: FIRE DEPARTMENT Temp Dumpster on site Located at 124 Main Street Fire Department signature/date Located 384 Osgood Street yes no 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 0 Notified for pickup - Date Doc.Building Permit Revised 2008 Location No. Date 01 TOWN OF NORTH ANDOVER 9 1 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # v 21852 Building Inspector m X m m m C) y C � d CO) C) CD n Z cop) a.O �. r O CL:q. y CD a� O cr �C d CD CCD O Cp 00 00 3 C CDCD vi O y 1■1■■i CD I S v CA O CD CD Z O � • CD O CCD 11 W c O •tA O Q IS r a COD y ® m C! m�ao rn Z !.P ?� N• m Ct _ y N O �O O O=' m > oC2 cc0 O OZ N !N9 a y a o cc o s � O O N ' co c CL o d m�: � O 0 0) N N d d C ?� .� a wo ? f N N NO m � N MCD o �a ,0 *** O IA moo: O C� ■mow � G1 Do � CDa 1 .11 o�v m o-IZD a Ax O 0 x °� n"JC1 pig O " r7 O d Cn ^ cp y ai Q. CD: N ;w d C) o'o 0 . 5.7o: o IA moo: O C� ■mow � G1 Do � 1 .11 o�v m o-IZD a Ax oda 0 x °� n"JC1 pig O " r7 O d Cn ^ cp y ai Q. tvx X- A w o�v w oda tz x °� n"JC1 oGa r7 O d Cn ^ cp y ai Q. tvx C) 0 o . ✓, f',f �d7)7/1)2CYlZU+Gfll�3t. n�l`/�l I,GC�f.��_Lla_f:f , Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 108424 -'W Cd. ;°8.1812009. Tr# 132909 Type: DBA ARCO ROOFING & CONSTRUCTION Joseph Gys I'C�MEGHANN LANE #; LOWELL, MA 01852 Administrator - _ L/lle iJd77�/IId(YI2!(/2G.�L1Z• fJ�a,��JLt (.i2fldS�6 BOARD OF BUiLDiNG-REGULAci IONS License,:,_ CONSTRUCTIOWSUPERVISOR Number: CS 092469 Birthdate: 09/27/1954 r . Expires: 09/27/2009 Tr. o: 92469 Restricted: 00 JOSEPHJ GYS 10 MEGHANN LANE c, LOWELL, MA01852 Commissioner €. _. .. a '.�.,. .. v.�✓: w RightFax N1-2 4/25/2008 4:21:51 PM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MM\DD\YY) 04-25-08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FRED C CHURCH INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO BOX 1865 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE LOWELL, NLA 01S53 COMPANY 29H5J A HARTFORD GROUP INSURED COMPANY B GYS JOSEPH DBA ABCO CONSTRUCTION COMPANY 10 MEGHANN LANE C LOWELL, NIA 01S52 COMPANY D COVERAGE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM\DD\YY) DATE (MM\DD\YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. S CLAIMS MADE OCCUR- PERSONAL && ADV. INJURY $ OWNER'S && CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED. EXPENSE 'Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY (Per Person) $ SCHEDULE AUTOS BODILY INJURY (Per Accident) S HIRED AUTOS PROPERTY DAMAGE S NON -OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT S AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB -746X6841-08 05-01.08 05-01-09 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 100,000 PARTNERS/EXECUTIVE INCL DISEASE POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE - EACH EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORKERS' COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR GYS JOSEPH. CERTIFICATE HOLDER CANCELLATION SHOULD.4NY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF LOWELL EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 375 MERRIMACK ST FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. LOWELL, MA 01852 AUTHORIZED REPRESENTATIVE ACORD 25-5 (3/93) Ramani Ayer I 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 IYt LTR I= rYPE OF INSURANCE POLICYNUMBER DA EYFECMM DDmE POLICYEXPIRATTION LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 500,000 D MAGE RENTED PREMISES Ea occurence $ 50,000 A CLAIMS MADE OCCUR CCP8251803 4/26/2008 4/26/2009 MED EXP (Any one person) $ 5,000 PERSONAL BADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO POLICY ElLOC PRODUCTS-COMP/OPAGG $ 1,000,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULEOAUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UM BRELLA LIA& LITY OCCUR CLAIMSMADE EACH OCCURRENCE $ _ AGGREGATE $ —`--"— DEDUCTIBLE "'---'----- RETENTION $ WORKERS COMPENSATION ANDWC EMPLOYERS' LIABILITY STATU- OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L. EACH ACCIDENT _ $ If yes, describe under SPECIAL PROVISIONS betow E.L. DISEASE- EA EMPLOYEE S OTHER E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS evidence of workers compensation to be sent directly by company fax#978-446-7103 r1=PTI1:ICATc UAl noo - -_ Ity of Lowell 75 Merrhiiack St. ,ONVell, MA 01852 ACORD 25 1'2nn1/DRI . Ao 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. AUTHORIZED REPRESENTATIVE r A1181?i -- cert P V ACORD CORPORATION 1988 f i IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/ORI www_ mass.gov/dia Workers' Compensation Insurance.Afc}ay.It: Builders/ContractorsTlectricians/piumbers 1)iicant Information Name (Business/Organization/Individual): Address: (0 City/State/Zip: `•� � ��C� r �� / .� Phone #: F2. e yo enepioyer? Chec111t a appropriate box: I am a employer with 4. I a ap TT oject (required): ❑ m a t ,.neral contractor and I.J ( 4 d)' employees (full and/or part-time).* have hired the sub -contractors 6• construction I am a sole proprietor or partner- listed On the attached sheet 1 7• ❑Remodeling . ship and have no employees These sttb-contractors have working forme in any capacity. workers' comp. insurance. 8. ❑Demolition [No workers' comp. insurance �. ❑ We are .a corporation and its 9. ❑ Building addition 3. ❑required.] officers have exercised.their 10:❑ 'Electrical repairs or additions i am a homeowner doing all work right of exemption Myself p Per MGL 11.❑ Plumbing repairs or additions y [No workers' comp, c. 152,1(4), and we have no insurance required.] t employees, [No .workers' 12, oof repairs COMP. insurance required.]: 13.7Other `Any appii an .thatWho checks box # I .must siso fill out the section below showing their workers' compensation policy information, + iiomeawners who sub:nii •tris asda.t�ii indicating they ate duitt� a : rv;:.=;; ;�t den rsi� aidb contractors mutt submit a new atnciav IC onnactom that check this box must attached an additional sheet showing the na*ne.of t . ii indicating -::ch. } - s •b-connaetors and their workers' comp. poi icy information. I am an employer that is providing workers' co information insurance f r my employees• B the oft P 'and jab site Insurance Company Name: Policy # or Self -.ins. Lic. #: Expitati on Date • �-c0 01 Job Site Address: Attach a copy of the workers' compensation Policy declaration Pau City/State/Zip: e (showing the policy number and expiration Failure to secure coverage as required under Section 25A of p ration date). fine up to 11,500.00 and/or one-year imprisonment as well as civil penalties in the formad to e of a STOP WORK ORimposition of DER penalties of a in es to .5250.00 a day against the violator. Be advised that a copy of this statement may RDER and a fine Investigations ofIA for insurance coverage verification. } be forwarded to the Office of I do herebj� Official use City or Town: oJPerfury that the informafion provided above is 7 Do not write in this area, to be completed by city or town offxiaL Issuing Authority (circle one): Permit/License 4 �Ue and correct 09 1. Board of Health 2. Building Department 3. City/Town 6. Other Clerk 4. Electrical Inspector S. Plumbing Inspector Contact Person: Phone The Commonwealth of Massachusetts Departmentfo Industrial Accidents "tG: . � Office of Investigations 600 W a.shington Street Bostoaz , MA 02111 www_ mass.gov/dia Workers' Compensation Insurance.Afc}ay.It: Builders/ContractorsTlectricians/piumbers 1)iicant Information Name (Business/Organization/Individual): Address: (0 City/State/Zip: `•� � ��C� r �� / .� Phone #: F2. e yo enepioyer? Chec111t a appropriate box: I am a employer with 4. I a ap TT oject (required): ❑ m a t ,.neral contractor and I.J ( 4 d)' employees (full and/or part-time).* have hired the sub -contractors 6• construction I am a sole proprietor or partner- listed On the attached sheet 1 7• ❑Remodeling . ship and have no employees These sttb-contractors have working forme in any capacity. workers' comp. insurance. 8. ❑Demolition [No workers' comp. insurance �. ❑ We are .a corporation and its 9. ❑ Building addition 3. ❑required.] officers have exercised.their 10:❑ 'Electrical repairs or additions i am a homeowner doing all work right of exemption Myself p Per MGL 11.❑ Plumbing repairs or additions y [No workers' comp, c. 152,1(4), and we have no insurance required.] t employees, [No .workers' 12, oof repairs COMP. insurance required.]: 13.7Other `Any appii an .thatWho checks box # I .must siso fill out the section below showing their workers' compensation policy information, + iiomeawners who sub:nii •tris asda.t�ii indicating they ate duitt� a : rv;:.=;; ;�t den rsi� aidb contractors mutt submit a new atnciav IC onnactom that check this box must attached an additional sheet showing the na*ne.of t . ii indicating -::ch. } - s •b-connaetors and their workers' comp. poi icy information. I am an employer that is providing workers' co information insurance f r my employees• B the oft P 'and jab site Insurance Company Name: Policy # or Self -.ins. Lic. #: Expitati on Date • �-c0 01 Job Site Address: Attach a copy of the workers' compensation Policy declaration Pau City/State/Zip: e (showing the policy number and expiration Failure to secure coverage as required under Section 25A of p ration date). fine up to 11,500.00 and/or one-year imprisonment as well as civil penalties in the formad to e of a STOP WORK ORimposition of DER penalties of a in es to .5250.00 a day against the violator. Be advised that a copy of this statement may RDER and a fine Investigations ofIA for insurance coverage verification. } be forwarded to the Office of I do herebj� Official use City or Town: oJPerfury that the informafion provided above is 7 Do not write in this area, to be completed by city or town offxiaL Issuing Authority (circle one): Permit/License 4 �Ue and correct 09 1. Board of Health 2. Building Department 3. City/Town 6. Other Clerk 4. Electrical Inspector S. Plumbing Inspector Contact Person: Phone Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute; an employee is defined. as "...every person in the service of another under any contract of h ire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state o►r local licensing agency shall withhold the issuance or renewal of a iieense or permit to operates business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence o►f compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." . Applicants Please fill out the workers' compensation affidavit compl-etely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or. partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have _ employees, a policy is required. Be advised that this afficiavit maybe submitted to .the Department of Industrial Accidents for confirmation of insurance coverage. -Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions res�rdirg the lava, or if you are required to obtain a workers' compensation policy, please call the Department at the nmrrber:listed below. Selr insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed ie�rbiy. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant: Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple pennit/license applications in any given year, need only submit one affidavit indicating current poiicy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where, a home owner or citizen is obtaining a Iicense or permit not related to any business or commercial venture (i.e. a dog license or permit to burnleaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you. in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of 1rudusirial Accidents. Office of Lnvmtigations 600 WashEington Street Boston; MA G21 I I Tel. 4 617-727-4900 e= 406 or 1-877-MASSAFE Revised 5-26=05 Fax 4 61 7-727-7749 vAml.mass.gov/dia 3 Pape. No. of Paps ARCO: ROOFING & CONSTRUCTION CO. CONTRACT LOWELL, MA 01852 HIC # 108424 a Super Contractor License # 092469 .978-937-5840 or 978-475-7544' PROPOSACL SUBMITTED TO PHONE DATE STREET - l •- / j JOB .NAME / CITY, STATE AND-ZIP'tODE JOB LOCATION ARCHITECT DATE OF PLANS JQB PHONE We hereby submit specifications and estimates for: r 13 � L 6 'r '� ,,� '. I! F' ,p� ' � .. •r�^` � . ! .°j- ( `, � C �i`;`y i f ,��L.� �- �k 1.17 � �•- �;� V! i r [ /yew r t / f;, u c L J u i 0; �rr� G +vel 1 �'~! � �f•t1 t E. � C. l,.' •/ . 4 , �- , i s +..,.�. •- """� r^ We Propose hereby to furnish material and labor — complete in accordance with .abov-e. specificotions, for the surraof: ' k --.-Y 'r dolQV lOrs �• i / 1S Payment 'to be mode as .follows: rAllmoterial guaranteed to be os specified. All work to be completed in a workman -according to standard . practices. Any alteration or deviation .from above Authorized specifkaftans involving extra costs will be .,executed only upon written orders, and Signature _ wiIl became an extra .charge over and. above the estimate. All agreements contingent � upon strikes, accidents .or:delay; beyond_ our. control. Owner to carry fire, tornado Note: This may be and other necessary insurance. Our workers are fully covered by, Workmen's Com• withdrawn by us ii not .accepted within days. pensation insurance./� . Ameptance of Proposal -The above prices, specifications and conditions ore satisfactory and are: hereby accepted.: You are authorized to do the work. as specified. Payment will be made. as ootlined above. Date of