Loading...
HomeMy WebLinkAboutMiscellaneous - 45 GLENWOOD STREET 4/30/2018 (2) 45 GLENWOOD STREET / 210/007.0-0005-0000.0 1 ' I i i P/A V-� C6!i Tff,;sE I IDEN THE PROVIDENCE MUTUAL, FIRE INSURANCE COMPANY FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GENERAL LAWS, CH. 139 SEC. 3B To: BUILDING COMMISSIONER OR BOARD OF HEALTH OR INSPECTOR OF BUILDINGS BOARD OF SELECTMEN TOWN CLERK'S OFFICE 120 MAIN STREET NORTH ANDOVER, MA 01845 RE: INSURED : EMMANUELLE DORSAINVIL PROPERTY ADDRESS : 45 GLENWOOD ST, NORTH ANDOVER, MA 01845 CLAIM NUMBER : 15-3584 POLICY NUMBER : HP 019212403 DATE OF LOSS : 03/02/2015 CLAIM HAS BEEN MADE INVOLVING LOSS, DAMAGE OR DESTRUCTION OF THE ABOVE CAPTIONED PROPERTY, WHICH MAY EITHER EXCEED $1,000.00 OR CAUSE MASSACHUSETTS GENERAL LAWS CHAPTER 143 SECTION 6, TO BE APPLICABLE. IF ANY NOTICE UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139 SECTION 3B IS APPROPRIATE, PLEASE DIRECT IT TO THE ATTENTION OF THE WRITER. INCLUDE A REFERENCE TO THE CAPTIONED INSURED, LOCATION, DATE OF LOSS AND CLAIM OR FILE NUMBER. 6/41/0/9�5f SIGNATURE DAf E PROVIDENCE MUTUAL FIRE INSURANCE COMPANY P. O. BOX 6066—PROVIDENCE, RHODE ISLAND 02940 TEL. (401)827-1800 FAX(401) 822-1921 EMAIL: CLAIMS a@PROVIDENCEMUTUAL.COM ON THIS DATE, I CAUSED COPIES OF THIS NOTICE TO BE SENT TO THE PERSONS NAMED AT THE ADDRESSES INDICATED ABOVE BY FIRST CLASS MAIL. SIGNATURE DATE CC: FILE 4/0 ;AS'.1'A�'"ENUF,, WA- /J(-1%K, RI02886 a I•EL: (401.) 27--1800 MAJ..la1..N(; DI)RESS. RO. BOX 066, PROVIDENCE,E, FSI 02.304 "I"0.....>i., FR,F1E: 1-8-7-763-1800 • FAX... (40 I) 822-1921 Date 1. .f d�. . "O°':��o TOWN OF NORTH ANDOVER 0 11.1 PERMIT FOR PLUMBING ,SSACNUSE� This certifies that v. . .%?. .` has permission to perform . .. . .. .. .. . 1 4 4 . plumbing in the buildings of . o. . . P,:„S y/trL . . . . . . . . . . . . . . at . .. . . ... ... . . . . . . . . . , North Andover, Mass. Fee..76"O .Lic. No.. ,I) . . . . . . . . . . . . . . . . . . . . . . . . . .A . PLUMBING INSPECTOR Check # 1k19 7341 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS / Date Building Location Y.� )G4 wcy0 5-7—' Owners Name Pe5CNI e12 Permit# Amount Type of Occupancy Re 5; d e n C2 New ri Renovation Replacement [] Plans Submitted Yes E] No FIXTURES H F a y, E sLRERW R4Sff" 1 >�)FIDlz2 z a FLOCK 3M>LOCR a>a�>Etaat 5MiO 7M FLOCFL gm rLOM (Print or type) Check one: Certificate Installing Company Name Q- S Cm/i 5TruC7-,'�� ❑ Corp. Address P 30X q-r Partner.' Business Telephone q-2 g - 9 q C./ - 5)6 Ll � Firm/Co. Name of Licensed Plumber- Insurance lumberInsurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Q Other type of indemnity E] Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner El Agent E] I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the M e P tubing Codes and C pt 42 of Seneral Laws. C �� V By: igna o t ns um er Title Type of Plumbing License � City/Town cense_tea - f i um �a Master � Journeyman APPROVED(OFFICE USE ONLY The Commonwealth of Massachusetts ^I Department of Industrial Accidents GLer1`jQA S7' q5 . Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Avylicant Information Please Print Le ibl Name(Business/Organizatiowlndividual):�� • "r�/• �'on�i�vcT� o itJ Address: , oZ- City/State/Zip: -pt;Acv I m A . Phone#: 9 7 c/ Are you an employer?Check the appropriate box: 1;Q I am a employer with 3 4. ❑ I am a general contractor and I Type of project(required):_ A employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.t 9• ❑Building addition 3.❑ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions I am a homeowner doing all work officers have exercised their myself � 11.❑Plumbing repairs or additions y [No workers comp. right of exemption per MGL insurance required.]t c. 152,§1(4),and we have no 1211 Roof repairs employees.[No workers' 13.❑Other comp,insurance required] •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 subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. r am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Li c.#: Expiration Date: Job Site Address:_4 ,/2,vwoo W' 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 required under 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 insuran a covers a verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si tures Date• Phone#: — [Ity fjletal use only. Do not write in this area,to be co lete . inp d y cl or town tY of,JlclaL City or Town: Permit/License# uing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Ins ector OtherPntact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employdrs 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 hire, express or implied,oral or written." An employer is defined as"an individual,partnership,artnershi 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,pp,artnershi 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 or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of 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 completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)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 affidavit may be 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 regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the approptiwte line. City or Towu Officials Please be sure that the affidavit is complete and printed legibly. 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 permitilicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy 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 license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves 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 Industrial Accidents Office of Itnvestigadons 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext.406 or 1-877-MASSAFE Fax#617427-7749--_ Revised 11-22-06 www.rnass.gov/dia L(o0q)BayS�tateGas A NiSource Company May 22,2006 Peschier, Kenneth Account Number: 5256140059 45 Glenwood St North Andover MA 01845 Dear Peschier Kenneth: This follow-up letter is to inform you that your gas H/H/W/H located at 45 Glenwood St has been tagged due to a violation of state safety regulations. It is unsafe to use until the following condition has been corrected. Flooded Water The Masachusetts code pertaining to the installation of gas appliances and gas piping, established under Chapter 737 Acts of 1960,requires that the condition be remedied. If you have questions or would like to discuss this issue, please call 978-687-1105 and ask for the Service supervisor. Please disregard this notice if the condition has been corrected. Sincerely, Service or Meter Department Bay State Gas Company CRR: CRR# CAdsu atedletters�236 � 05/22/06 55 Marston Street P.O.Box 869 Lawrence, MA 01841-2312 978-687-1105 Fax: 978-688-1875 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GRSFITTING (Print or Type) < \ NORTH ANDOVER Mass. Date , L-7 -T. kuilding Location i4Sc r5 f,�:U ( noD 9 Permit # 1L5 /� aU Owners Name4 • Y _ New 77 Renovation Replacement Plans Submitted 0 FIXTUPEls W � W tJf Z CC C1 W G: 0 W .O : 0 = � W a vs Q O V m tu Z Cl N N ¢ O 0 = O Z t W d w W 1• W a rt �, 4 W W W Z U W Os W 4 0: t, a h x W W t77 J d Z W tt: O Q W W O C7 tL C7 1. Z ,� h Z H N Lu W O W h W _ h W Z d W G W W O Z O W = Q to > C W O Z Q G 4 < O O W Cr O W 1— c= O cs Z u. to U -1 Q cr y to a 1— O 511Q—BS..1T. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR aTH FLOOR (Print or Type) Check one: Certificate Installing Company `Name St LTi H4-- 0 Corp. Address]� F + QT 4 (/QF_ = Partner. DR /��* (n ��,t� Firm/Co. Business Telephone:�j R' 1� Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I , the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner U Agent I hereby certify that aU of the devils and information 1 have submitted (or entered)in above application are true and accurate to the best of my knowledge and that aU plumbinx Work and WEAUvions petformcd under Permit issued fo: this application will be in compl7i with all neat provisions of the htaisachusetis Slate Cas Cude and Qapter 142 of the General Laws. r By TYPE LICENSE: Plumber Title asfitter nature of icensed Master Alumber or�^Gasfitter City/Town: urneyman APPROVED (OFFICE USE ONLY) License Number Date.... •,�ORTM TOWN OF NORTH ANDOVER rOy PERMIT FOR GAS INSTALLATION SSACMUSEt °y This certifies that . . . . . . . . . . r. :. . . . . . . . . . . . . has permission for gas installation . . . in the buildings of . . . . . . . . . .�., j at . .`. f. ? . . .,�.�f.�. . . . .... . . .J� ., North Andover, Mass. Fee. . /.'!X :17. Lic. No.. .t��std. . . . . . . . . . . . . . . . . . . . . . . . . . . . Off "; i 1 + � � GAS INSPECTOR WHITE:Applicant t CANARY:Building Dept. PINK:Treasurer GOLD:File f Location NORTH TOWN , ORVI� QOVE Of� •�o ,�1h r Certificate of Occup ° Building/Frame Permit Fee �rC Foundation Permit Fee $ JACHUSE Other Permit Fee $ h Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector Div. Public Works PEWMIT NO. 2,b I APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. L PAGE 1 4' MAP 440. I LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. -I LOCATION16 - e, / Dv woo 10 PURPOSE OF BUILDING / OWNER'S NAME G R AC,Q _C 0/.o tl- NO. OF STORIES SIZE OWNER'S ADDRESS CO llz� BASEMENT OR SLAB ARCHITECT'S NAME 7C-7yv SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME 00 ' _CaA-sr, SPAN DISTANCE TO NEAREST BUILDING (r DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST ?, 0 aZ r. PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. ` PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY 1 ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT OWNER TEL# F E E © • �7 CONTR.LIC.# PLANNING BOARD PERMIT G ANTE I L 19 BOARD OF SELECTMEN ol UILDIN INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D —_ PIERS PLASTER _ DRY WALL _ _ (TNFIN. 3 BASEMENT AREA FULL FIN. B'M'T AREA _ V. 1/2 '/. FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDY✓'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE —{I_ STUCCO ON MASONRY �— STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY - WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 8 COLS. STEAM STEEL BMS. 8 COLS. _ HOT W'T-R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING C O N S E R V A 11 U rA,_....-.__._._._./ 1lir%&0 z1CVVrn1FV _1 ...ff ."a PLANNING FINAL NORTIy Town of Andover No. 26111 DRIVEWAY ENTRY PERMIT � - 1 a = A Y E r er, Mass. go-A +, SiC of? pP � S BOARD OF HEALTH PERMIT T LDy THIS CERTIFIES THAT.. .. 60416r.?T- #1............................. BUILDING INSPECTOR JcAw has permission to erect/f*4.&..y. .. buildings on T.. ... �.......... Rough ' jr1i06 be occupied as......lM/. 6�rOF.....4.4 SII. ........................................... Chimney Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough s' Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids th' it. PERMIT EXPIRES00. 6 ONTHS ELECTRICAL INSPECTOR Rough UNLESS CON RU IABT Service Final f ILDING INSPECTO GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smokemoet Building Inspector N2 t ,iu J J Date..F..... -..1 '...... Y ¢H NOR7F, 4 °�<�``°:•�"° TOWN OF NORTH ANDOVER o , PERMIT FOR WIRING p TAcmUSEt This certifies that . .,> ...j,L.!.......:'r`= ` `.........•. �..... .Y•t, � has permission to perform --�� �'< - ! g� wiring in the building of........... ............................ /..................................� at.4/J".. �� North An/dlover,Mass. Fee'3`? . ..... Lic.No................ .d ate, .�, l. ..,....................................... / ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer tl ' Office Ute n , a4e QI111t anwtall of MUSUC411atts Permit No. 11tpartmtttt of Public $ofttg Occupancy d Fee Checked(30 BOARD OF FiRIk PREVENTION REGULATIONS 527 CMR 12.-.M' peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 8126199 City or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 45 GLENWOOD STREET Owner or Tenant ILDA AMILCAR Owner's Address (617) 331-3598 is 91 pe". .It In conjunction with al building permit: Yes ❑ No ® (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service _Amps_/ Volts Overhead ❑ Undgmd ❑ No. of Meters New Service Amps_! volts Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers TbW KVA No.of Lighting Fixtures Swimming Pool Above M' grad. ❑ gnuL ❑ Generators • KVA No.of Emergency Lighting No. of Receptacle Outlets No.of ON Burners battery Units ? . No.of Switch Outlets No.of Gas Burners FIRE ALARMS No.of Zones No.of Ranges No.of Air Cond. Tbtal No.of Detection and t tons Initiating Devices No.of Disposals No.ol Heat Total Total ` Pumps Tons KW No.of Sounding Devices No.of Sell Contained No. of Dishwashers SpacelAree Heailty MN DetsctionlSounding Devices No.of Dryers Heating Devices Kitt Locai © MC� ❑ether No.of Water Heaters KW Sign Nsalute WWrtgg BURGLAR ALARM No. Hydro Massage Tube No.of Motors Tbtal HP ' OTHER: _INSURANCE COVERAGE:Pursuant to the requirements of Massachusetts general Laws I have a current Liability insurance Porky Including Completed Operations Coverage or Its substantial equivalent. YES G NO O 1 have submitted vaild proof of same to the Office.YES O NO O If you have checked YES.please Indicate the type of coverage by checking the appropriate box. INSURANCE O BONO, O OTHER Q (Please Specify) Estimated Value of Electrical Work$ 1039.00 (Expiration Oate) Work to Start 9/1/99 Inspection pats Requested: Rough Final 9/4/99 Signed under the Penalties of penury: FIRM NAME LIC. NO. 19314: Licensee nnnal rt A_ Rrnnks Signature LIC.NO. , 1231C .— Address 111 Morse Street.-Lorwood. MA Bus.Tel.No. ) 741.4008 An.Tel.No. 1,131---- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not haw do Insurance coverage or Its substantial equivalent as to, qulred by Massachusetts General Laws. and th rd my signature on this permit application waives this requirement. Owner Ao"I (Please chock one) .,.Telephone No. PERMIT FEE S. 35.00 1!Slpnsture of 0"or or Agont)