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24C-174 (3) BP-2023-0906 111 FRANKLIN ST COMMONWEALTH OF M:• SSACHUSETTS Map:Block:Lot: 24C-174-001 CITY OF NORTHA PTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGI'.TERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING P RMIT Permit# BP-2023-0906 PERMISSIO IS HEREBY GRANTED TO: Project# STRUCTURAL REPAIRS 2023 Contractor: License: Est. Cost: 125000 STEVENSVILLE CO' 'ORATION 033055 Const.Class: Exp.Date: 02/22/202 Use Group: Owner: 109-117 FRANKLIN STREET LLC Lot Size (sq.ft.) Zoning: URB Applicant: STEVE SVILLE CORPORATION Applicant Address Phone: Insurance: PO BOX 121 4132961100 4849256 WEST CHESTERFIELD, MA 01084 ISSUED ON: 07/12/2023 TO PERFORM THE FOLLOWING WORK: STRUCTURAL REPAIRS 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 NOR I HAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 0 � r • >Q • Ti • Fees Paid: $875.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 11--.)---------' . &CIF , Jo O • The Commonwealth of , asg ,chusettsi 1 ,-,'V ey Office of Public Safety an• ,:. - -. a Massachusetts State Building ode :: C 5 Uizoi Building Permit Application for any Building oth than a One- '"" 4,to k-,i ' D elli (This Section For Official Use O ) 444 o7080ON3 Building Permit Number:.23 - Q Date Applied: Bu.ding Official: SECTION 1:LOCATION is Of --- I/'7 J4=0L M14.90 b/pie No.axed Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2 PROPOSED WORK Edition of MA State Code used ` ea-If New Construction check here❑or check all that apply in the two rows below Existing Building. Repair Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes MK No 0 Is an Independent Structural Engineerin Peer eview epuued? / /� Yes ti- No 0 �_J Brief Description of Proposed W k: r .12QiQJ Il,tiri2��.4b-N - ) �1* 7 h .x 11 ell" A wa�w, SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING '1,'C61° ;:::::t-ts-r c.,-,i-ta..,:,,...2.A.47,, ND1 RGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34)Ica Existing Use Group(s): Proposed Use Group(s): SECTION 4: BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) :5 21 � 25ep Total Area(sq.ft.)and Total Height(ft.) --,r✓-TJG "3-_ 1_,r , sc, SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub ❑ A-3 0 A-4 0 A-5❑ B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0 I: Institutional I-1 0 I-2❑ I-3❑ I-4 0 M: Mercantile 0 R: Residential R-112 R-2 0 R-3 0 R-4❑. S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA CI IB ❑ HA CI IIB ❑ IIIA ❑ IIIB ❑ IV 0 VA CI VB 0 SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information Sewage Disposal: Trench Permit Debris Removal: A trench will not be Licensed Disposal Site O( Public I5[ Check if outside Flood Zone Xl Indicate municipal requiredT 'or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable . Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 1 Yes 0 No 0 PI/D` SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: I. -1'ra c kt, a iM0 City of Northampton ixf r fr �<?"� k v i° i ,, , Massachusetts r ' DEPARTMENT OF BUILDING INSPECTIONS t d.$;h,:,,, 212 Main Street • Municipal Building M"'"*' Northampton, MA 01060 .-)‘'< PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR COMMERCIAL & MULTI-FAMILY NEW CONSTRUCTION/ADDITIONS/ALTERATIONS 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specifications of proposed work (Digital & Hard copy). 3. Site Plan with location of proposed structure(s) and setbacks. 4. Construction Debris Affidavit filled out and signed by applicant. 5. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy of CSL and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate (if applicable). 8. Note any Conservation and/or Special Permit requirements (if applicable). 9. Driveway Permit (if applicable). 10. Proof of Water and Sewer entry fees paid (if applicable). 11. Trench Permit (if applicable). 12. Initial Construction Control Documents filled out and signed by the Registered Design Professional in responsible charge. 13. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton A SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner levc-R hnc& F Shaft,v -t-P44v- 5YL v, / tE4O.JA oDLE t-tI LL,Ro ot'a Y Name(Print) No.and Street City/Town n/ Zip Property Owner Contact Information: l//3'39Y - j(o// - - g�k-e. cZGasVA....Q�,•�� , Title Telephone No.(business) Telephone No. (ce ) e-mail address If applicable,the property owner hereby authorizes: Name Street Address 'ty/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work au orized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) t, dkA/WIC1140A/ Li(�-42e-Tih7 v G4(,.a.A.s,..,....rs.,o,1to. C.esb-. 5 ,8 Nape(RnegistrQnt), sp Telephone No. e-mail address Registration Num erJj` e r 4of Gti,�.t-� ‘ k t.". . O i o 1 2• Q"' "` c i.n«r Street Add esY s �1/ City/Town State Zip Discipline Expiration Date 10.2 General Contractor Ro ,ter l3 1 o�� "ur`" G,.�, z- . . ;,� 5 -- r-12 Company Name f" e t- e's G iv'z" C S 0 3 3 a5 E XF 2--2 Z--W/ Name of Person Responsible for Construction License No. and Type if Applicable 1/i R4 ev -al lift 41 68 `` Street Address City/ wn State Zip 11/3- age. -pod Y/3.-04 7-y 7 Ail 19 s 2 3,....,,,`L.. v-x., Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVI"(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes 0 No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Estimated Costs:(Labor Item and Materials) Total Construction Cost(from Item 6)=$ 12.S. — a 1.Building $ • 'ls.a 4'Q Building Permit Fee=Total Construction Cost x Insert here 2.Electrical $ b appropriate municipal factor)=$ 3.Plumbing $ Q 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ O Enclose check payable, to 6.Total Cost $ 1 '2.E,(.Co (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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. 12......0 5e:r . &V r^'~ Isla.- a.-W.'.- 41'✓`' ?.gL 11 adtit 112O zS Please print and sign name Title Telephone No. Date P - I l8 Lows,•-. wy.-P. ( V--/ cis4•w-P.o l'ev't t oe3 4-- v-1.�,ar,I..° t._9AS ,5'^r 8*-a Street Address City/Town State 'p Email Address Municipal Inspector to fill out this section upon application approval: 7'/!-26Z Name Date CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE The ConIntonwealth of Massachusetts rizuww, Department of Industrial Accidents was. 17, I Congress Street Suite 100 Boston. M-I 02114-2017 PSIVISInsass.govidia 11orkers'Compensation Insurance Affidat it:Builders/Contr tors/ElectrieiansPlumhers. 10 III FILED 11 LIII THE PLRMITIIING HORITV. Annlicant Information Pkase Print Lei!ibla Name lt3uuw>,4 Orga niza tion I ridividual); SA—le Ne.=-4-13 V _ Address: t da:)%inapt City/State:Zip: '1/4.?-1- C. - — rot kok l'eVcSk- Phone p: "a/ i=ez. Art yule-an employer?t'beck the apporprhdr boa: pe of project(required): I, Iarn a employer wth 3 , employees(fall At141,43C 7. D Nev COnstrUctitill 20 1 am a sole proprietor ur pdsinerstim and lia‘c nu employees%Working tor me in 8_ El Remodeling aria capacity..[Nu workas'comp,insurance mutured.) 9. 0 Demolition 30 I ant a lionaOLMT4.1 nutria all work mloself.(No workers'comp.insunmor requinsii' l 0 CI Building addition to I am a hormownez and will be hiring contractors ti9 L.oriditet all work on my property. 1 will ensure that all contra:tura either lure workers.'ctiorpcinahon mauramx Ur are styli 11 0 Electrical repairs or additions proprietors with no ininnloyei,N, 12. Plumbing repairs or additions .st:jI 3171 a ilt:71Cral contractor and I have hired the sub-contractors Listed on the athieheil sheet I 3.EIRoof repairs These sob-contractors haw.employees and base workia-s'comp,instrance. •. b.0 I 41:10ther We are a poration and its Officers have exercised their right of exemption per holCil. 1 I i :mil we ll:ElpliJ)1.3:S.[NO workers'comp.insurance required! An applicant that cheeks box al MOM alsotill uut the section ban*showing their workers conversation potiLy inferrnation_ Hornet,*nets who minim this affidavit indicating they are doing all work and then hire outside coritinctors mini...about a new affidan it nalicuang such. *,Contractors din check this box most attached an aiddltronal shut; hnw inF the name of thsc Salb-etnarict•ss atm!siXs: holiter not tho,c entitle, croplo)ccs, lt the sob-contractors 1.3.1‘,c anplos et:s. ni=ant rm.> e kcis .ainark.poli‘.2,number 1 am an employer that&providing workers•compensation insurance for my employees. Below is the policy and job site information. insurance t.'onipany Name: (../1-tc .. *—t , . Policy#or Sels.Lie.g. 4°}4a 2 (0 xpiration Date: r..1\••••-•7 '4, • c:)2- , Job Site Address: t •'V agt-.. city State Zip; irlf v-1 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiraAna date). Failure to secure coverage as required oniter MCiL c. 152.1125A is a criminal violation punishable by a tine up to SI.500.00 andior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 a day against ihe violato.7.A copy of this statement may be forwarded to the Offii.c of investigations of the DIA for insurance coverage verification , . 1 do hereby c inder the pains and penalties of perjury thin e lnforination provided above is true and corre&r. 1 sigma Date: 2_4_12_3 Phone=. 4 bl 2-9L• Official use wili. Do not vrite in this area,to be completed by city or fawn of/ic lot 11 (its or Town: PermiteLicense Issuing Authority (circle one): Nr-r I.Board of Health 2.Building Department 3.Cityrf own Clerk 4.ElecttkaI Inspector 5.Plumbing Inspector 6.Other IContact Person: Phone# • City of Northampton Massachusetts td�. DEPARTMENT OF BUILDING INSPECTIONS1Q„.0. ,. 212 Main Street • Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: A4 e--a="' �°``�"`¢'� 5V tvAte- Location of Facility: —� $o.�•S - Svc w� ' 1r S �� � The debris will be transported by: Name of Hauler: VNI\ar—C--- �� -v,r 1 a, ru Signature of Applicant: j Date: 1! a"25 Initial Construction Con o1 Document „ l To be submitted with the building pe mit application by a 'R Registered Design Professional f I for work per the ninth edition of the -*„.1-" V Massachusetts State Building Code, 180 CMR, Section 101 Project Title: 111 Franklin St Foundation Repair Date:07-01- 23 Property Address: 111 Franklin St, Northampton,MA Project: Check (x) one or both as applicable: New construction X Existing Construction Project description: Repair collapsing stone foundation with reinforced concrete,and repair rear brick wall in rear. I John A Wallen of The Engineer Group LLC MA Registration Number:46578 Expiration date:6-28-2023, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerningl: Architectural Structural X Mechanical Fire Protection Electrical they: for the above named project and that to the best of my knowl dge, information, and belief such plans, computations and specifications meet the applicable provisions of 'e Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed proje t. I understand and agree that I (or my designee) shall perform the necessary professional services and be p esent on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 MR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construc on to become generally familiar with the progress and quality of the work and to determine if th work is being performed in a manner consistent with the approved construction documents and th s code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I shall submit field/pro ess reports (see item 3.) together with pertinent comments,in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a'Final Construction Control Document'. Enter in the space to the right a "wet" or t" `44 electronic signature and seal: I JOHN A "' WALLEN + NO 41511 Phone number:413 626 8167 Email: johnw@theengineergroup.com '.. 'Fos , , '4 Building Official Use Only v 7/1/2023 Building Official Name: Permit No.: Date: Note 1.Indicate with an'x'project design plans,computations and specifications the t you prepared or directly supervised.If'other'is chosen,provide a description. �....,41 STEVCOR-01 KTOMLIN Ali coRo CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) �'-�� 7/11/211/2023 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 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 CONTACT NAME: AXiA Insurance Services PHONE FAX E4 Myron Street (A/C,No,Ext):(413)788-9000 I (aC,No):(413)886-0190 Suite A ADDRESS:ktomlin@axiagroup.net West Springfield, MA 01089 INSURER(S)AFFORDING COVERAGE NAIC# , INSURER A:Utica National Insurance Company 25976 INSURED INSURER B: Stevensville Corp INSURERC: 768 Berkshire Trail INSURERD: Cummington, MA 01026 - 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 LIMITS LTR INSD WVQ IMM/DD/YYYY1 (MMIDDIYYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 1 • PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY LOC PRODUCTS-COMP/OP AGO $ OTHER: — $ AUTOMOBILE LIABILITY (Ea SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSO ONLY _ AUTOSN Ep BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONNLY (Per PROPERTY (DAMAGE $. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ • • EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 4849256 514/2023 5/4/2024 E.L.EACH ACCIDENT $ 100,000 MFFICERIMEMBER EXCLUDED? N/A andatory in NH) 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/LOCATIONS/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 City of Northampton Building Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St Northampton, MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �r o�o�tt i Page No. of Pages\ STEVENSVILLE CORPORATION CARPENTERS & ENGINEERS GUMMING ONHMAS TRAIL1026 LA C �' © 33 o' PHONE (413) 207-4790 "a-2. -ay PROPOSAL SUBMITTED TO .- _ PHONE �(�-} / DATE �-y G� :letiti-���-j 7/1y �'Lim .. t\� r i tl (�34:..5�✓ l "e' I tG I i' A.t., t o L � 2.,. STREf j/ _ JOBBNAME i adr " 1:41 CITY,STATE and ZIP CODE JOB LOCATION pi< W—_,,, ARCHITEë4rwQkT I DATE OF PLANS JOB PHONE / Tom. Lla . ' We hereit specificatidrlS and estimates for: hact/ 4, aei-e..1r a?1.e-e44) eopeleA,:tda:ke.xyL.,----/---cele, an:;:A‘uaciakA„,*s4A.Q.....,cfx)z.t.,vtooa*vvn. _ , ilta.,::,...44.AR.,ax..,Li 4. a)Cov,019 low_ -, p-tv(4) ,:.,h-t,' ' ' Jece&tww) Pi,-;, , •aira+(4i' - ' f ox-�6 e _ �C .Grrl- /111414144&)—i Afazzik)' ' el• Rata.gat-7e-- V-a i 1 d t e-4 0-e ii,-C14, ce,-&-e- 1 v. JL j : ." d .� t • .. ta-ak Cfi,,,e-4 aljtcon-ed... 40"4 rade 7415-.44-J1g' /7/)." R.er , , '77:5 --- ,Arr-titt. pd24,4ake. , o,. ..,,t - K,3 - Sr.4.4ziazzLeatit fra-c.42/./4rk ,, gi2„Qcji4az_ ezeg ce,,2Pcvz2_,C111--'d.riz•- ...ziii, /,zostiateijii194,cr",0 Aeqz:&2_ &:0"4 is "r0(62,,:- Ala K ' , . { - cJ lite.:464: � r _,6,49 -4-z..1,pit # NIB p propose hereby to furnish material and labor — complete in accordance with\above specificat'ons, for the sum of: PayWMt to be made as follows: ,'''�` p,r f lint ,e- �`//, 441....ae 3 A CriAg4�d rr' IL.- LEA eisaze- t 'Ll'5. All material is gfaaranteed to be as specAll work to be complMed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders, and will become an extra SignatureCR31 '..› charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance.Our Note:This proposal may be \workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days. -, cii:a.,,- cy....,,, ;,/,, < Acceptance of Proposal —The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized Signature . 7 ,' I _ to do the work as specified. Payment will be made as outlined above. o Date of Acceptance: Signature O `-1i , f