17D-058 (8) %pj,
THE COIIIIONWEALTH OF MASSACHUSETTS
ON THIS DAY or 19
BEFORE ME, / , A NOTARY PUBLIC DULY
COUHISSIONED A D QUALIFIED FOR THE CO! IONWEALTH OF MASSACHUSETTS, PERSONALLY
APPEARED ROBERT W. WINFIELD, P. E., WHO BEING DULY SWORN, DEPOSES AND
SAYS THAT HE HAS SUPERVISED THE CONSTRUCTION OF Menard Bldg.
(STREET ADDRESS)
L5 Garfield at, F1 orPnce, MINDER PERMIT # AND THAT THIS
(CITY OR TOWN)
STRUCTURE CONFORMS TO THE SUBMITTED PLANS AND TO THE CODES OF THE Florence
(CITY OR TOWN)
AND THE COMMONWEALTH. i
FURTHER, THAT ALL REQUIRED APPROVALS AND MATERIAL AFFIDAVITS HAVE BEEN SUBMITTED,
AND THAT THERE ARE NO VIOLATIONS OF LAW OF ORDERS OF THE DEPARTMENT OF PUBLIC SAFETY
PENDING.
1, AS THE AFFIDAVITED ENGINEER AND/OR ARCHITECT HEREBY CERTIFY THAT I HAVE ON
June 9, 1992
THIS DATE INSPECTED THE PROPERTY LOCATED AT
AND FIND THAT THE LOCUS AND ITS STRUCTURES
(STREET ADDRESS)
COMPLY WITH MY PLANS AND SPECIFICATIONS AND ALL RULES AND REGULATIONS OF THE CODES
OF THE COMMONWEALTH.
THEREFORE, I REQUEST A CERTIFICATE OF OCCUPANCY 'FO5,,_. .,ABOVE ADDRESS.
HOWEVER, ALI, MECHANICAL SYSTEMS MUST BE INSP THE R AUTHORITY,
FROO U,AT
w. i
OR L & SEAL I DATE
4
SUBSCRIBED AND SWORN TO BEFORE ME THIS _1_, `rS� T 19
. � NOTARY UBLI�C t�
i
MY COMMISSION EXPIRES ""s' �6iTlSSiRiIEx?r ��• 21,1997