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35-178 (6)
BP-2022-0653 8 PINE VALLEY RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 35-178-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0653 PERMISSIONIS HEREBY GRANTED TO: Project# SIDING Contractor: License: ALL STAR INSULATION & SIDING Est. Cost: 18532 CO INC 099739 Const.Class: Exp.Date:02/14/2024 MIMITZROBERT E SR &THOMAS MIMITZ Use Group: Owner: TRUSTEES Lot Size (sq.ft.) Zoning: WSP Applicant: ALL STAR INSULATION & SIDING CO INC Applicant Address Phone: Insurance: 56 Franklin Street (413)527-0044 6HUB-5N069 1 1-1-2 1 EASTHAMPTON, MA 01027 ISSUED ON:06/07/2022 TO PERFORM THE FOLLOWING WORK: VINYL SIDING ON MAIN HOUSE AND SUN PORCH POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 1 .2 CP 1 • ' I Fees Paid: $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of Massachusetts wt Board of Building Regulations and Standards FOR Massachusetts State Building Code,780 CMR MUNICIPALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building� Permit Number: eoa- ��--' G53 Date Applied: _ 411t.>/Jar ,'//2 6-7-ZOZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers I 1.1a Is this an accepted st t?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 wner'of Record: IAp—a Min 1-z HOre Ilea. , Mil- of Dld. Name(Print) City,State,ZIP $ PIN, kd 4tw5g9-B'�51 Cad- No. an Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 1:11 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ® Addition ❑ Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: 1,92 W' II r-rYlo uf.._ -R-�l V�� 1 jUr U � I'Y1di n hflA D -r ,su.n dreh d- / n1 Uf - Sfd,� x . 1.8' Sp ' SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ ,8'/53 4'D 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Total All. iF9s94 0 `{/Suppression) 062� Check NHV Check Amount Cash Amount: 6.Total Project Cost: $ Jg,5�.7dt. 0 Paid in Full ElOutstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-099739 2-14-22 Ed Losacano License Number Expiration Date Name of CSL Holder List CSL Type(see below) R 128 Glendale Road No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Southampton, MA 01073 R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-527-0044 _ allstar5270044@gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 101858 6-28-22 All Star Insulation & Siding Co., Inc. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 56 Franklin Street allstar5270044@gmail.com No.and Street Email address Easthampton, MA 01027 413-527-0044 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ® No . ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Ed Losacano to act on my behalf,in all matters relative work aut orized by this building permit application. c � Robert Mimitz, Homeowner .5/? Print Owner's Name(Electronic Signature) ate SECTION 7b:OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Ed Losacano, Owner ` (.� 5071a-a--- Print Owner's or Authorized Agent's Name Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(IBC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at oca Information on the Construction Supervisor License can be found at www.niass.eo\ its 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) (including garage,finished basemenUattics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: Pine_ l )0_QQ.c,cs. tma, The debris will be transported by: �3n — 00,W i 11 4 1'q ��111 ;vet „Vca The debris will be received by: Wt3'kv+fl_Pe{'c ��►-tf1 lUilh}alYar�� r� otc1,5 Building permit number: �1 J Name of Permit Applicant no- 1;11 540r iY>`5ao-�ioni 8i( i►)Cc. Inc. Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents A►=r Office of Investigations i Lafayette City Center t' 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: ALL STAR INSULATION & SIDING CO., INC. Address: 56 FRANKLIN STREET City/State/Zip: EASTHAMPTON, MA 01027 Phone #: 413-527-0044 Are you an employer? Check the appropriate box: Business Type(required): 1.❑■ I am a employer with 10 employees (full and/ 5. ❑ Retail or part-time).* 6. ❑ RestaurantBar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. ❑ Office and/or Sales(incl. real estate,auto,etc.) employees working for me in any capacity. [No workers' comp. insurance required] 8. ❑Non-profit 3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment their right of exemption per c. 152, §1(4),and we have 10.0 Manufacturing no employees. [No workers' comp. insurance required]** 11.❑ Health Care 4.❑ We are a non-profit organization, staffed by volunteers, CONSTRUCT/HOME IMPROV with no employees. [No workers' comp. insurance req.] 12.❑■ Other *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy information. Insurance Company Name: THE TRAVELERS INSURANCE COMPANIES Insurer's Address: 97 CENTER STREET City/State/Zip: CHICOPEE, MA 01013 Policy#or Self-ins. Lic. # 6HUB-5N06911-1-21 Expiration Date: 8/13/22 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under§ 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 certify, under the pains and penalties of perjury that the information provided above is true and correct. Signature: t dJ Date: (j PI Phone#: 413-527-0044 Official use only. Do not write in this area,to he completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 1 f Board of Health 2.0 Building Department 3.0 City/Town Clerk 4.❑Licensing Board 50 Selectmen's Office 6.❑Other Contact Person: Phone#: www.mass.gov/dia �..m,„N ALLSTAR-05 ACORO DATE(MM/DDIYYYY) `---- CERTIFICATE OF LIABILITY INSURANCE 8/20/2021 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 1 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 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 NAME CT Laura Misseri _ Phillips Insurance Agency,Inc. PHONE 41 (AJC,No):(413)592-8499 97 Center Street ac,No,Ert):( 3)594-5984 Chicopee,MA 01013 itioNiEss:laura@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:State Automobile Mutual Ins Co INSURED INSURER B:State Auto Property&Casualty All Star Insulation&Siding Co.,Inc. INSURER c:Travelers Insurance Company 36161 56 Franklin St INSURERD: Easthampton, MA 01027 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP UNITS LTR INSD WVDIMMIDD/YYYY1 (MMIDOIYYYYt A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PBP2903632 8/13/2021 8/13/2022 DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMpIT.APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X JEI:T X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO BAP2482222 8/13/2021 8/13/2022 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUUTNOSyyryEp PBOODILY INJURYp (Per accident) $ AUTOS ONLY _ AUTO ONLY (Derr accident)AMAGE $ $ A X UMBRELLA LIAB X ,OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS UAB I CLAIMS-MADE PBP2903632 8/13/2021 8/13/2022 AGGREGATE $ 1,000,000 DED X RETENTION S 0 $ C WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N 6H U B5N 06911121 8/13/2021 8/13/2022- - - 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N N/A andatory In NE) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below , E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED y L ' EDREEPRESSENTATIVE � ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Feb 12 2022 5:45pm Florida Office 13524833575 p.1 - � Commonwealth of Massachusetts • Division of Occupational Llcensure Board of Building Regulations and Standards Constructiie P y Specialty CSSL-099739 :• ••- •-- EDWIN W. >3 expires:02/14/2024 128 GLENDAE RDN� f SOUTHAMpicN MA 01073• Commissioner &pica >i. ErCmt • J CJIJI/72/n{wipea / .//�(�11�1r3C1'�/I.CC,3P/f1 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 101858 ALL STAR INSULATION&SIDING CO. Expiration: 06/28/2022 56 FRANKLIN STREET EASTHAMPTON, MA 01027 Update Address and Return Card. SCA 1 15 20M-O5/17 .72, //, Office of Consumer Affalfs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 101858 06/28/2022 1000 Washington Street -Suite 710 ALL STAR INSULATION&SIDING CO. Boston,MA 02118 EDWIN W.LOSACANO %?qr 56 FRANKLIN STREET EASTHAMPTON,MA 01027 Not valid without signature Undersecretary a3 • r. . „v .t)) I• 71;,. C INSULATION MAY 2 3 2022 Easthampton Office SIDING CO., INC. est 413-527-0044 56 Franklin Street • Easthampton, MA 0102 • 13-568-6411 CSSL License # CSSL-099739/MA HIC# ,101858/CT HIC# 0630805 fax 413-527-1222 • email:allstar5270044@gmail.com • www.aIlstarinsulationsiding.com. Proposal Submitted to Phone Date Robert Mimitz "Purchaser"413-584-8759 Cell May 13, 2022 Street Job Name 8 Pine Valley Road City,State and Zip Code Job Location Job Phone Florence, MA 01062 Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW VINYL SIDING ON MAIN HOUSE AND SIDE SUN PORCH OPTION 1• INSTAI I ATION OF NFW VINYI SIDING ON MAIN HOUSF AND SIDF SUN PORCH 1. We will remove all existing Vinyl Siding from exterior walls and dispose of in a dumpster suppliectby us. 2. We will install a 3/8"insulated Styrofoam backerbehind the siding and tape seams where and if needed. 3. We will install new Vinyl Siding oniall exteriox walls. Homeowner wi I have choice of brand name. style. anti �f" color iN(:r(t tICI ''.i< L_ro\\5 b8L.. L-1 t' 6 4. We will nail all siding approximately 16-24" on center using aluminum nails so they will not rust underneath the siding 5 Wood trim around (18)windows will be covered with White aluminum coil stock material. 6. Wood trim around (3) doors will be covered with White aluminum coil stock material. 7. Wood trim soffit and fascia will be covered with White aluminum coil stock and perforated White vinyl soffit material. We will drill out wood soffit areas to increase attic ventilation. 8.Wood rake fascia will be covered with White aluminum coil stock material 9. Any existing wood that is loose will be renailed 10. Any existing wood that is deteriorated which needs to be replaced so that we can perform our work pill be replaced. This does not include any structural or dimensional lumber or sub sheathing. If any sub sheathing is needed there will be an additional charge of$88.00 per sheet to install new 7/16 Q$B sub sheathing. If any structural work is needed, an estimate will be given prior to doing_any work and will approved by homeowner. - = 11 We will install (2)White 12"X 18"gable end louvers with screens-in designated areas 12. We will install (6)Whiteyinyl lite block behind light fixtures. 13 We will install (2)White dryer vents_3nd (2)feline hlooks in designated areas 14. We will install White Decorative Traditional corner posts on all corners 15 We will remoye and reinstall existing gutters and. ownspouts 16 We will remove and reinstall existing shutters. 17. Right side of sun porch will be covered as follows: Exterior of sun porch will be covered where possible and interior will not be covered/touched in any way by us. 18. Job site will be cleaned upon completion of job. 19. vinyl Siding has a"Manufacturer's Lifetime Warranty". PRICF• S1Ri,532 Of) CONTINUFD ON THE NFXT PAGF PAGF 1 OF 2 WE PROPOSE to furnish material and labor, complete in accordance with above specifications,for the sum of: fir I �' dollars($ 1/3 DOWN, 1/3 AT START OF JOB, ), payment due upon receipt of invoice. If payment late, interest at 1 1/2%may be added. BALANCE DUE COMPLETION OF JOBS` NOTE:_Ih s proposal may withdrawn by us if not accepted within FIFTEEN / days. ED LOSACANO4-OWNER /, I �`° .' .( � Contractor Salesman Hobert Nfimitz � Acceptance by Purchaser,and Title "You may cancel this agreement if it has been consummated by a party thereto at a place+other than an address of the seller,which may be his main office or a branch thereof, provided you notify the seller in writing at his main office or branch by ordinary mall posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right." SUBJECT TO TERMS AND CONDITIONS PRINTED ON REVERSE SIDE • INSULATION •; SIDING CO., INC. Easthampton Office 'Westfield Office,` 413-527-0044 56 Franklin Street • Easthampton, MA 01027 413-568-6411 �-... CSSL License # CSSL-099739/MA HIC# 101858/CT HIC# 0630805 fax 413-527-1222 • email:allstar5270044@gmail.com • www.allstarinsulationsiding.com Proposal Submitted to Phone Date Robert Mimitz "Purchaser"413-584-8759 Cell May 13, 2022 Street Job Name 8 Pine Valley Road City,State and Zip Code Job Location Job Phone Florence, MA 01062 Contractor hereby submits to Purchaser specifications and estimates for: INSTALLATION OF NEW VINYL SIDING ON MAIN HOUSE AND SIDE SUN PORCH t%,%DPTION 2• INSTAL L ATION OF NFW C_UTTFRS AND DOWNSPOUTS (.% 1. We will remove and dispose of existing gutters and downspouts and install new heavy duty .032 gauge C55" Residential Seamless aluminum • tters and-,downspoms._We will use the Canadian hanger or Vampire hanger method of installation. Application will be based on the existing design of fascia hoard. If Vampire hanger method is used hanger may be placed on top of the shingle if shingle will not lift or is too brittle. There will be approximately(43)'of gutter and (12)'of downspouts with (1) drop. Downspouts will be installed 6"-12"from ground. 2. Locations will be as follows: Front of main house where now existing (1)downspout to ground PRICE $321 00 **APPROXIMATF START DATF WII I R JUNF/.IIJI Y/Al1GlJS PONCF WE RECFIVF DFPOSIT AND SIGNED CONTRACT I FSS ANY INCI FMFNT WF,ATHFR I AROR IS GUARANTFFD FOR "1-YFAR" **Al I STAR WILT SFCURF BUIL DING PFRMIT IF NFFDFD HOMFOWNFR WILT BF RFSPONSIBL F FOR ANY &Al L FFF.S RFOUIRFD ** PRODUCT & LABOR WARRANTIES WII L NOT RF ISSUFn UNTIL WF RFCFIVF FINAL PAYMFNT. ** HOMFOWNFR WII L RE RFSPONSIRI F FOR ANY &Al I Fl FCTRICAI OR PI 1➢MRING WORK THAT MAY RF NFFDFD **SEAM FSS Al UMINl1M GUTTFRS AND DOWNSPOUTS HAVF A"20-YFAR MANI IFACTURFR'S LIMITFD WARRANTY" I AROR IS GUARANTFFD FOR "1-YEAR" ICE DAMAGF IaNOT COVFRFD UNDFR MATFRIAL OR I AROR WARRANTY **ALl STAR SFAMI FSS GUTTFRS IS NOT RFSPONSIRI F FOR WATFR I FAKING RFTWFFN FASCIA BOARD AND GUTTFR nUF TO IMPROPFRI Y INSTAI I Fn DRIP FDGE ** ALB STAR SFAMI FSS GUTTFRS IS NOT RFSPONSIRI F FOR BIRDS GFTTING INTO GUTTFRS AND MAKING NFSTS **ALI STAR SFAMI FSS GUTTFRS WII I NOT RF RFSPONSIRI F FOR RFMOVING OR RFINSTAI I ING HEATING CAR FS IF FXISTING OR ANY FLFCTRICAI WORK **A CFRTIFICATF OF INSIJRANCF FOR WORKMAN'S CQMPFNSATION AND LHARlI ITY WII I RF FORWARDFD UPON RFO(➢FST ** PHII I IPS INSI IRANCF AGFNCY INC OF CHICOPFF MA IS OUR AGFNT PAGF 2 OF *V Fig fi.7. E 1 , A,kd d °e WE PROPOSE to fulnish material and labor, complete in acc r nce with above specs ios,f r the sum of: f .o'3 opf1 + , dollars($. 113.DOWN._1/3 AT START OF JOB, ), payment due upon receipt of invoice. If paymentlate, interest at 1 1/2%may be added. BALANCE DUE COMPLETION OF JOB - - - - - NOTE:TtiLs pro osai ma withdrawn by us if not accepted within FIFTEEN days. � ,�% ED LOSACA OWNER s� Contractor Salesman kobert 1uCmItz � �Ac �9 ptanc e by Purchaser,and Title ,\ "You may cancel this agreement if it has been consummated by a party thereto at a place ther than an address of the seller,which may be his main office or a branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mall posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right." SUBJECT TO TERMS AND CONDITIONS PRINTED ON REVERSE SIDE