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HomeMy WebLinkAboutBuilding Permit #630-14 - 800 TURNPIKE STREET 3/17/20140ORTM q BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATI Permit N0: ���� y ^o �" Date Received � Date Issued: �9CHUS t� IMPORTANT: Applicant must complete all items on this page LOCATION ��o- ��L�� 1K �{erSc S-Rce v Print PROPERTY OWNER S GlV ce Print MAP NO: PARCEL6DPL ZONING DISTRICT: Historic District yes Machine Shoo Villaae ves /t'io'`) TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Others: ❑ Repair, replacement ❑ Assessory Bldg ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer Bc h r iceite`ori 5 4P2�r- �f. OWNER: Name: Address: Identification Please Type or Print C-1 I ) n VS) �16ewn GL( L I U C��' (!SC T a u� Phone: oa�v CONTRACTOR Name: lFcocOn &-,rvkCEj, �C. Phone: Address: t\ -b mo"Ple GiC-�,CQ��C12'�, w� olggb Supervisor's Construction License: _ 1 t Q t , Exp. Date: -7�' (3 Home Improvement License: Exp. Date: r ARCHITECT/ENGINEER flebq �Qd neeri f1 Phone: R- % -aS U Address: c Reg. No. qCI?, 11 FEE SCHEDULE. BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ T� �o Cr1 FEE: $ 11 C 6 `-f. Do Check No.: 1 Receipt No.:_� NOTE: Persons contractin u e istere ntractors do not have access t e Signature of Agent/Owner Signature of contract r TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this LOCATION - _ _Print_ PROPERTY OWNER Print 100 Year Old Structure yes no 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 ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer DESCRIPTION OF MAIM I V tat 1-trc1-uK1Y1tU: Identification Please Type or Print Clearly) OWNER: Name: Phone: AAAr^e t lll1U1GJJ. CONTRACTOR Name:._ m Phone; Address: _. Supervisor's Construction License: Exp. Date: Home Improvement 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with -unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Sogafure of contractor Plans Submitted FL Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El J t Plans Submitted ❑ PlansWaived-❑ Certified Plot Plan ❑ Stamped Plans F1 TYPE -OF -S) WERAGEDISPOSAL - Public Sewer ❑ Tanning/MassageBodyArt ❑_ . Swimming Pools ❑ Well ❑ Tobacco -Sales ❑ Food Packaging/ Sales ❑ Private<(septic tank, etc_' ❑ =Permanent Dumpster on-site ❑ - -. " THE. FOLLOWING WING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: DATE APPROVE _ PLANNING & DEVELOPMENT ❑ jIJ 7/4 - COMMENTS_ I �e / /vtVl �GeU►e� p� l� u I �� CONSERVATION Reviewed o COMMENTS © etc ,./� I p p ` HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: Comme Zoning Decision/receipt submitted yes Conservation Decision: Comments Water & Sewer Connection/ Signature Date Driveway Permit DPW T'ow0 Engineer: Signature: - Located 384 Osgood Street FIRE D'EPARTtW ENE �=:.Temp Dumpster on site Yes no Located at'124,Mair Street _- Fire"Departure►itsignature/date 'Y COMMENTS f.. -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 DANGERZONE LITERATURE: Yes No MGL -.Chapter -166 Section. 21A,—.F and G min.$100=$1000:fine NOTES and DATA - (For department use El Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The following is'=a-1i'st of -the required -forms to be filled out'for the appropriate. permit to .be obtained. Roofivg, Siding, Interior Rehabilitation Permits ❑' Building Permit Application ❑ Workers Comp Affidavit o Photo Copy Of H.I.C. AndlOr'C.S.L Licenses o Copy of Contract o 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 api)oal 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.Building permit Revised 2012 Location,, A/x No. ;,0 Date Check 9 27-551 TOWN OF NORTH ANDOVER Certificate of Occupancy $- Building/Frame Permit Fee $64 "-p Foundation Permit Fee $ Other Permit Fee $- TOTAL $ "�'HdAg Inspector F=- Q W � O co C:E Y O Ll In u Q In ° W d IA Z (7 Zco m Q -a 7 CLL t D' c E U LL W Z Z J t : cc LL O W a Z Q V W J W t CSA W us i N m LL a O H a Z C7 3 K LL z W °C W 0 uj LL a`) m O z Y CU N V) *' Q v Y O N V Cl)� �a Cz G Z cc —0 z~ cn M Lu cn x Lu U cn �w M Z O w :a Cl) CD 0 •m w ;v a w L.: d N o :a 0 mm The Commonwealth of Massachusetts - Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 UT www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/OrganizatiorAndividual): t_n '1cyk Address: C( n) S City/State/Zip:C, 1 i 1 �T' Phone #: �� �" l� 30 ^ `1 � a a CA Are ou an employer? Check the appropriate box: 1. I am a employer with 4. ❑ I am a general contractor and I _3,7 employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I 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, §1(4), and we have no insurance required.] employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition '1 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check 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 Name:. CV m V tl nn 1(f („o, �(� `�� NaS a Policy # or Self -ins. Lic. M SSgo ( J Expiration Date:_ Job Site Address: r? `I ' 1 �V�Ci 1� I City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL 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. 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 certi der the pains and penalties of perjury that the information provided above is true and correct. 11 r�, -I _ I .. 1 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone ACO CERTIFICATE OF LIABILITY IN_SURAN_CEDATE(€ ,DdYYYY, BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. , 2/11/i41 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS z 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), AUTL•10R12ED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(es) 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 endorsemen#s). PRODUCER CONTACT NAME: Earl B McK.izuley----_._--- ..._. Exchange Insurance Agency PMON, X617) 523-7360 aX N {617, 523-6313 E-MAIL ss earl.mckinney@exchangeins.com 225 Friend Street, Suite 800 INSURERS)AFFORDING COVERAGE NAZCA Boston, MA 02114 ` iNSURERA ;lain Street America—Ins CO INSURED INSURER s: Commerce ..b In4ustry._Ins Co Falcon Services Inc INSURERc•Plymouth_Rock Assurance_.___ 113 Maple Street INSURER D; Gardner, MA 01440 INSURER E: INJURY (Pel S INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELMN HAVE EILEN 1 5UMU I U I Fie IIVJUKCU IVAIVICU ^t7.JV= rv_ , nc __ , , —., . ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTVMTHSTANDNG CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONOTIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I - -. - .... _.. INSRj :ADDLISUBR LTR TYPE OFINSURANCE N i POLICY NU€SER ..POLICY EFF . POLICY EXP.._ €d h1(DOKYYY € OAIUDD+YYI Y LIMITS A t GENERAL LIABILITY MPS02823_ 4/1/13: 4/1/14 EACH OCCURRENCE $ 1 000 _000 ' _ $ _._ 00 — }( CG%IMERCIAL.GENEPALUAB?€.I`�Y OarWcE TO—RE NTCO RcPAI� Sa 500100 —0 IF CLAIMSMADE X 1 OCCUR ? MED LEP ;Arywm eISoa) S 5 000 1 i PERSONAL 8 ADV INJURYOOO, OOO _•. _ , PoT IOQfl,iO�X 'GLNERALAGGREGATEPer _ fGENT AGGREGATE LM!TAPPLIcSPEP . PRODUCTS-COMP:OP_GG 1 S 2,00.0 OOS� y t •• I ` POLICY'!X FRO LOC I AUTOMOBILE LIABILITY ! " ; PRC00001003078 C I 9/24/13. 8/14/141 (003 tN[D $€NG1.11-IMI % ' iEa�wCer � s 1,000,000 1 1 BODILY INJURY (Per persan)) S ANYAUTO ALLOVlrEDXSCS@DOLED INJURY (Pel S ! AUTOS AUTOS ! NON -OWNED X 1BODILY �nt)ue _-.— i'(tOPEFiTY DAt.JiG g ( HIRED AUTOS AUTOS L A AX ;` UNBREUJiLIAB X OCCUR j ;CUS02823 4/1/13; 4/1/14" FACHOCCURRF.NCE 5 5 000,000 i E EXCESSLIAB CL,y;MS-F.,.ADE' � e AC-G RE GATE-----�---1 S -- I DED RE7EN`ION B ; WORK ERS COMPE NSATION ; !WCOO5590133 4/1/13; 4/1/14 167CS�ATU- . OTH-; TQRY_IMAI7S . i FR AND EMPLOYERS' LIABILITY Y / N ! I ANYPROPRIMO.%PARTNERrtXECUT?Vk ,i I ; f ___ > F.L 4 ACF3 ACCIDENT ! c 500,000 , I OFFICERUEMBE.REXCLLOED-, NIA" Vandalory in NH) " ; E.L. DISEASE -EA %-PLOYEEi S 500 , 000 3 i`yes. ddCribe urcer _ ! DESCRIPTiON Or OPERATIONS n1ow - % E.L. DISEASE -POLICY LIM(i S 500,000 j DESCRIPTION OFOPERA71ONSILOCATIONS lVEHICLES (Attach ACORO1M,ArkfitlonalRenaftSchedu€e,lfmore space isrequired) general liability coverage applies to all KS Partners,LLC Properties subject to the terms and conditions of the policy ; ; j TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KS Partners, LLC I ACCORDANCE WITH THE POLICY PROVISIONS. 130 New Boston Street ! Woburn, ma 01801 AUTHORIZED REPRESENTATIVE lEarl B McKinney @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD Phone: (617) 523-7360 Fax: E -Mail: earl.mckinney@exchangeins.com Page I of I Falcon Pr EN INEERING, LC STRUCTURAL AND CIVIL ENGINEERING Lt. 13330.01 October 28, 2013 Falcon Services 113 Maple Street Gardner, MA 01440 Attn: Jim Sitroski Job No. 13330 Re: EXTERIOR STAIR INITIAL FEASIBILITY REVIEW AT THE ADDRESS KNOWN AS 790 TURNPIKE STREET, NORTH ANDOVER Mr. Sitroski, As requested, we visited the above referenced address on October 15, 2013 to evaluate your request regarding the feasibility of installing a proposed exterior stairway. The purpose of this letter was to provide your organization a basic overall concept, to aid you in making decisions in the design of the proposed stairway. The intent of the stairway is to provide access to a parking lot with a grade roughly estimated to be 20' to 26' above the grade of the existing buildings and lower parking lot. Attached is a sketch (SK -13330-1) which shows a conceptual section of the proposed exterior stairway. The concept is to provide two flights of stairs with a landing at mid -height of the overall stair assembly. The conceptual elevation view utilizes the code compliant 7" riser and 11" tread and assumes the existing slope is steeper, but will not be known until field information is obtained. Please note, a second landing may be required, by code, if it is determined that the overall height differential of the parking lots is greater than 24 feet. We propose the stair treads are constructed of metal grating with a slip resistant surface supported on steel channel stringers. While on site we discussed the possibility of high heel shoes getting stuck in the grating however, a close mesh grating can be selected to prevent such issues. The stair stringers would be supported by braced steel platform assemblies supported on sono -tubes or poured foundations. Prior to any detailed design, we recommend a survey of the slope, in the proposed location of the stair, showing the elevation contours be performed. This survey would provide a basis for the overall layout of the stair, number of platforms and required support, where the base of the stair is located and if any cut or fill of the slope is required to achieve the desired profile. We also recommend two borings or test pits are made on the slope. One should be taken at the top and one at the bottom of the slope to determine the depth to undisturbed soil. Please let us know if Phelan Engineering is to obtain the surveying and boring information or if it will be done by others. Please note that the information contained within this report and sketch is conceptual and not intended to serve as design directives. Additional designs and documents will need to be developed, please let us know if you want us to proceed with detailed design services. �S w of a% Regards, As�c /A WILLIAM M. tiG V v PHEL-M U STRUCTURAL cp William M. elan, P.E. No. 49311 12 SLEIGH ROAD A CHELMSFORD, MA 01824 q�FGISTER�� �4 (978) 256-4014 A FAX (978) 250-3764 A www. Phelan Engineering. c0 NA, ENG EXISTING GRADE CUT & FILL OF - SLOPE T.B.D ONCE CONTOUR IS DETERMINED CHANNEL STRINGER GALV. GRTG. TREADS FOOTING (TYP.) EXISTING SLOPE & ELEVATIONS T.B.D 20 PROPOS�E:..��TAIR APP . SCAL. I%" STD PIPE HANDRAIL PLATFORM SUPPORT POST EXISTING GRADE PRELIMINARY ONLY NOT FOR CONSTRUCTION SEE PHELAN ENGINEERING LETTER Lt. 13330.1 FOR MORE INFORMATION STAMP PROJECT SCALE: AS NOTED E ]NEER G �5, VMLUAM M. �cy�s PHELAN U STRUCTUR �° 4 JEFFERSON OFFICE PARK PROPOSED STAIRWAY DATE: 10/28/2013 12 SLEIGH ROAD CHELMSFORD, MA 790 TURNPIKE STREET DRAWING N NMER TEL. (978) 256-4014 FAX. (978) 250-3764 �o�: �1 �SJ0 AI ENG�a13 NORTH ANDOVER,MA 3 30 - SK -1 Massachusetts - Department of Public Safety Board of 3uijding Regulations and Standards License: CS -071911 L JAMES SHETIPNWSIG 12 CBApmAN PK GARPTNER MA 01440 =xpirafion 0711012015 c57w Office of Consumer Affairs and Business. Regulation ">1 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 163030 Type: Private Corporation EXDiration: 5/4/2015 Tr# 239F,R1 SCA 1 e: 20M-05/11 Update Address and return card. Mark reason for change. I Address ❑ Renewal n Employment n Lost Card ..� r-�✓!IL'Gr'c9T17724711aCU�f1EGhC-�-/7/CGJS[CC�F(3ctl' -�---_._..r-_�_..-�----- Office of Consumer Affairs & Business Regulation License or registration valid for individul use only � Rr�OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - egistration 163030 Type: Office of Consumer Affairs and Business Regulation "� �10 Park Plaza - Suite 5170 fiExpiration: 5/4/2015 Private Corporation - ' Boston, MA 02116 FALCON SERVICES INC.,. ' JAMES SHETRAWSKI 113 MAPLE ST. 4 �r GARDNER, MA 01440 Undersecretary Not valid without signature 130 New Boston Street Suite 303 Woburn, MA. 01801 Telephone: 978-560-0560 Fax: 978-560-0561 [rfi 0 Fam 7�� t 9 ;, (v / l ` Re: Cc O UWnt ❑ For Review O PWSO CammOnt O Please Reply O Plesse Recycle f ti 1) caiiii M•EFTCIAL Ir40 LSTRIAL l�-GON�U'IC INC �ACIL1TlG.S MAINITF—NANCE� & I Proposal November 6. 2013 page 1 of 1 Mr. Tbm Beauregard, KS .Partners LLC 130 Oeiv.Boston Street Woburn, MA 01801 RE- Exterior Steel Stair Fabrication &.installation - 790-800 Turnpike Street We hereby submit specification and estimates to: Provide labor, materials and equipment to carry out fabrOtion and installation of. steel stair set and related work as follows: 1. Provide plans and specifications for stair design and construction from Phelan Engineering LLC a Massachusetts registered engineer. 2. At subject exterior location designated by others, excavate for eight (8) separate concrete piers as noted in the plans. Set the concrete forms and fill with specified concrete as required. Provide and set appropriate attachment hardware as designed. 3. Shop and field fabricate 96" wide steel framed, steel tread stair set ascending from the lower to upper parking lots as shown on the plans. Provide open steel grate treads and landings with appropriate spaci15g for pedestrian traffic use. a, Assemble'handrails, rails, treads and stringers with appropriate welded or mechanical connections as specified. Coat all new metal with zinc rich coating and apply high quality, satin enamel paint as finish. All workmanship will conform to standards and practices of the trades. All debris caused from work in progress .shall.be removed by Falcon Services Inc. Any existing damage or other unacceptable conditions, Bidden or otherwise not readily visible. shall be repaired and or replaced upon written change order; above and beyorrd this contract. We will furnish materials, equipment and labor to carry out the above for the total sum of: Fifty Fine Thousand Three Hundred Twenty Sic Dollars and 001100 $56,326-00. Qpe and payable as follows: due when complete Authohzed $Ignature: AM walk lo LWOMWA00 MA pWMin annul Tenger Waconnrq go wKRvnN Un ��M I Any emkGrAfAt ily wWM awinkin m�Q rA boo" *P*rlfkn1 IMM the lMW* kxalvtn7 win be? on bdrd COMA mror ave WWelkm e lla� AIIAWOOMWO C n ammel We110"I .Pon sl;dM *bNEeMe nr Ilalnye bmm*C nIr eprWntl 0*w1h perry ". IBM& aftd biker _ W*ceasvy Inoennne. puy wmkeT nr* IUAynw*}na M Wnrkera COMM PAIllon mae*nc*. L. James Shetrawski, President TMS t'ROPOSAL AAAY'BE WtTMpRAVVN HV US IF NQT ACC2P'TE0 WITHIN 34 OAYS aGCE TAiVCE'DF PROPOSAL: The above Prices, sp®clfic,Ations entl conditions are satlmFaclory and are hereby aGe®pted. YOU Are Quthorizad to do the work s specified. Payment will be made as outilned above. OV1Fh1 _ OR OVtINERS RE RES TATIVE DA� 113 MmI 5MV e 6AWM, MA 01440 "( rYAN WAY, Ay", MA 04M rHorll:; 978�6250.4922 ef`Ax; 976--632-6511 a FALG0N%VlG0lNG,r.GM