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HomeMy WebLinkAbout0537 LUMBERT MILL ROAD � :. . . � _ �'z3 �` per` Y a o� r, .: , . k ;; 8 P Nn FSHe r Town of Barnstable *Permi , Z (v . ° T Expires 6 mont o e e Regulatory Services Fee �'' ' snaxsrns[e 1 Richard V.Scali,Director ArEp3,tp PRESS Building Division fi�ee ` Tom Perry,CBO,Building Comm' ij er 200 Main Street,Hyannis,MA 0 0"1OF Office: 508-862-4038 ©^ 15 www.town.barnstable.ma.us O� ��`SF• a> .��8-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 7Residential Address C, ►Wt,6, �� . ;`�-ILL/l ke�Value of Work$ Cep / d�/(/ Minimum fee of$35.00 for work under$6000.00 ��,.�e a Owner's Name&Address I s &,-ee 9-sl 2"� Lai( hal Cenkoyi' /Ic Contractor's Name Ta4ACL Telephone Number � 22_ Home Improvement Contractor License#(if applicable) FT3 l6tZ Email: Construction Supervisor's License#(if applicable) 1 V✓`1 �/ ❑Workman's Compensation Insurance Check one: 211 am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance 1 Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Req st(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to _.__Q(f0jg0 ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) C111 ❑ Re-side -?jZ ❑ Replacement Windows/doors/sliders.U-Value (maximum -34+#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required— SIGNATURE: i QAWPFILESTORMS ilding permit fonns\EXPRESS.doc Revised 061313 W-- %J The Commorrivealth oflllassachusetts Deportment of Industrial Accidents 4 y Office of In1Wfigadons 600 Ff ashijiglon Strceet Boston,M4 02111 n ovay.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/ContaractorslE-I ricaans/Phmbers Applicant Information Please Print Legibly Name,(Bussinea;i70rganizationadividua1): 9 Address: (� &L��l ad, , CitylStatf_IZip: Dw/S _02063 Phone# `t Q Are you an employer?Check the appropriate boa: T}pe of project(required): 1.❑ I am a employer urith ontractor and I 4• [ 1 am a general c * have hired the sub-contractors 6_ ❑New construction employees(full and or part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7_ ❑Remodeling ship and have no employees These scrub-contractors Imve g--❑Demolition working for me in any capacity_ employees and have workers' c insurance 1 9- El wilding addition. [No workers' comp_insurance comp- 5• ❑ We.are a corporation and its 10_❑Electrical repairs.or additions I❑ I am a homeouuer doing all work officers have exercised their 11.�A2of g repairs or additions self o workers'c. right of exemption per MGL �' � �P- 12_ airs insurance required.] c. 152, §1(4),and we have no employees.[No workers' 13.0 Other comp_insurance required_] 'piny appfitiant that checks box#1 apt also fill out the section below,showing their workers'compensation policy informatim I F_omemwners who submit this.affidavit intlicatin:g they are doing all wcA and then hire outside contractors nmst submait a new affidavit indicating sack TG'ontacmrs that chew this box must attached an additional sheet showing the mane of the sub-comm-cwrs sad state whether or not those entities have enu IM%es. If the mbzuntractors have employees,they mast pmtdde their workers'cmgp.policy number_ I am an employer that is providing workers}compensation insurance for►+raw entployees. Below 2s fhe putic-y and job site information. Insurance Company Name: f Policy 9 or Self-ins.Lie._,4: Expiration Date: Job Site Address: 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 hIGL c, 152 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 anti or one-year imps somnent,as well as citril 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 maybe forwarded to the Office of Im-est gations of the DIA for insurance coverage verification. I do hereby cerfi rartder t1a iris car name. as rt'tha to in orrraatiora rotRded abmw is true and correct 3 t p? Pe I .f P Si tore: Date: Phone i?: 0 iai.Erse only. Do rant twrite fn this area,to be completed by city or toiwn of cfaL City or T'omm: PermitUcense 9 Issuing Authority(circle One): L Board of Health -1,Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: V 2015 MON 11: 39 FAX 5089923538 southeastern 1A WJVV.L/ UV.L DATE(MMIDDNYYY) o CERTIFICATE OF LIABILITY INSURANCE 4/20/2015 ERTIFICATE 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((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 lights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT Joanne Bretton NAME: Southeastern Insurance Agency, Inc. PHONE . (508)997-6061 AAIC No: (508)990-2731 439 State Rd. -MAIL DDRFSS.jbretton@southeasternins.com P.O. BOX 79398 INSURER(S)AFFORDING COVERAGE _NA IC* North Dartmouth Ili 02747 INSURER AArbella Protection Insurance 41360 INSURED INSURERB AEIC All Cape Exterior Remodeling LLC INSURER C: 12 Baldwin Road INSURER D INSURER E: Dennis MIL 02638 INSURER F: COVERAGES CERTIFICATE NUMBER:2015 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 POLICY NUMBER IPOLICY EFF POLIO EXP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RFENTE5 x COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE FXI OCCUR 8500041933 /14/2015 /14/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO--JECTLOC $ AUTOMOBILE LIABILITY ( MIN NGL LIMI Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMSMADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TOP LIMITS ER ANY PROPRIETOR/PARTNER/F�CUTIVE� NIA E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? C50078962014A /9/2015 /9/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under er included DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) n CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The Crowell Family Irrevocable Trust Dana Goober, Trustee 76 Chesterton Road AUTHORIZED REPRESENTATIVE Wellesley Hills,. Mk 02481 Joanne Bretton/SWL ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD CURL Y' & C 0 R Eii` & CONSTRUCTION RY: An Rotted.or Otherwise Deteriorated Trim Boar t d POSSIBLE EXTRA CARPENT y or Any Other Carpentry Needing Replacemen Sheathing,Missing Metal Flashing'Side Walling will be done and charged for as an Extra Materials Plus Labor at the Rate of$80.00 per Hour. e wi NT SCHEDULE: A Deposit of One Half is due at the Signing of this Roof Proposal and PAYMENT on Completion. Final Payment for the Balance is Due Immediately Up WORK SCHEDULE: All Roof Work is Scheduled for Completion Within 60 Days of Acceptance ed are andNon- Receipt a After of Deposit providing the Materials are Available.Therefore Deposits a Three Day Cooling Off Period from the Date of signing. This Pro osal Ma Be Withdrawn B Us If Not Accented&De osited Received Within Da s Or Before The Next Price Increase In Materials Please Make Checks Payable to: PATRICK CLIFFORD CONY & COREY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Years and the Shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warrants the Shingles up to a CATEGORY III HURRICANE-130 MPH WIND WARRANTY. CERTAINTEED Warrants the Shingles to be Algae Resistant for a Full 10 Years. COREY & COREY carries Workman's Compensation and Public Liability Insurance on the above work I ® DATE OF ACCEPTANCE: ACCEPTED BY: SUBMITTED BY: ATRICIA A6SER CHARLESTOPYT, CqNSULTANT HOMEOWNER COREY & CO NSTRUCTION RI t�tteFtt'if r s, `S[rrt 'n}iuiat7ctss"atad .j 'torast�twai Superior Siveral17 tr '� =w L►cense ESfit 1D59 Corrpt�issb�Ser ; F ;,�JIP l!-G///II!(•iU^'!/�✓�r/ ('I(1..,;!(!'1[Ilic'��i License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: o 130ME IMPROVEMENT CONTRACTOR Type' Office of Consumer Affairs and Business Regulation p Oegistration: 173192 10 Park Plaza-Suite 5170 xpiration: 9/11/2016 DBA Boston,MA 02116 COREY AND COREY CONSTRUCTION PATRICK CLIFFORD 12 BALDWIN RD - DENNIS,MA 02638 Undersecretary Not valid without gnature r o'�y�••: TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING � rua g i639 �� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department ? , DATE: q �S j f An Occupancy Permit has been issued for the building authorized by Building Permit�`$k... ..........................,................... ». issuedto 1 - ..»....................................................................................»»....... »».»......»..»»..».»»» Please release the performance bond. `I TOWN OF BARNSTABLE 28806 Permit No. �..., Building. Inspector ��--- Cash OCCUPANCY PERMIT Bond X Issued to Richard Roser Address Lot #53, 537 Lumberts Mill Road, Centerville Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Jl-eGrS uilding Inspector { t ' CONTINUATION OF ROAD BOND The undersigned owner/contractor hereby agree to maintain their road bond in force until the following work items are completed to the satisfaction of the Engineering Section of the Department of Public Works. �1 (p loam and seedshoulders as soon as weather permits. other (explain) SIGNE Owner ntractor ENGINEERING AUTHORIZATION i 1 . BUILDING mrqhERMIT TOWN OF BARNSTABLE, MASSACHUSETTS JOB WEATHER CARD DATE 19 PERMIT NO. ' t16 �? APPLICANT ADDRESS (NO.) (STREET) (CONTR'S LICENSE) 1 PERMIT TO NUMBER OF (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) - N0. (PROPOSED USE) F ZONING AT (LOCATION) DISTRICT IN0.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) i LOT SUBDIVISION LOT BLOCK SIZE i BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTP t TO TYPE USE GROUP - BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR PERMIT VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) i f OWNER BUILDING DEPT. ADDRESS BY �. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY c ® PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE-BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAIN! FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIO OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK: INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE, 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET ( BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 Jl 2 2 2 3 HEATING !NSPECTI G A ROVALS REFRIGERATiONJ VALS 1 1 � .- � OTHER — -_ - - z 2 BOARD OF HEALTH i" A , ! ''WCRK SnAL_ NCT PROCEED UNT;L THE PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTION IN CATED ON THIS CA INSPECTOR HAS APPROVED 'HE 'iAR'CUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE.THE CAN BE ARRANGED FOR BY TELEPHO STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABbVE. OR WRITTEIG,fOTIF.ICATION. a 0 '\ J . 2 l �k c , o 1 LoT S Z. LoT- 5 3 1 o Lo7- S4 �rICHARD `J •4r �� E3AXTER � _ \ ; No.24043 .6 O CERTIFIED PLOT PLAN I CERTIFY THAT THE 1=oor,3 TED LOCATION C e ti 7-�-R�/i C.LC 1 1 SHOWN HEREON COMPLYS WITH SCALE DATE II 'Z5-,1u . THE SIDELINE AND SETBACK REQUIREMENTS OF THE TOWN. OF PLAN REFERENCE 13A2k)S`r-AF3LC AND 1S !Jett' LG. 374 2 Z. c- r LOCATED WITHIN THE FLOODPLAIN. � t.� Lo-r 53 DATE : L MS- �.. e�, BAXTER a NYE INC . THIS PLAN IS NOT BASED ON AN REGISTERED LAND SURVEYORS INSTRUMENT SURVEY AND THE OSTERVILLE^tMASS. OFFSETS SHOWN SHOULD NOT BE USED TO DETERMINE LOT LINES APPLICANT P-I (--i-fAR_�, i �. sseesor's map and .lot number ..f.. �.-.. f.../.:............ u%THE?� 4"Sewage Permit: number ............. Wig. :: ... `'. SEPTIC SYSTEM MUST SE d�P� �♦� ������ INSTALLED IN COMPLIANCE ' � ' �• Z BAR39TADLE, i 3 Fes' WITH TITLE 5 �Housenumber ................................................�..............:.. ...:. r ro MAB6 039. ENVIRONMENTAL CODE AND o,�oyAY��O APPROVE D I W Bar table Conservation C io N OF B A R 1 � N ,/, * j Signed / Date. ILDING INSPECTOR APPLICATION FOR. PERMIT TO u v . . ....� .:............ ...... . .................................................................................... TYPE OF CONSTRUCTION ....�!.�./.... ........ . ,..........��.................................................................... .0.............. 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin �fo ation: Location ....v".d-........� .......1.............. ... .........L........ ...... ....... ProposedUse .......................................................................................................I......................... Zoning District .. .. .... . ... . 0 At .. .... . .. .... ....Fire District .t ..:................................. Name of Owner .. .... ....... ..... ....... ..Address ...t. .... .. ........ .. Name of Builder P....... ........ ...... ..........Address ....... ................ Nameof Architect ... .... .... ......... ...... dress .................................................................................... Number of Rooms ...... J ........................................... Foundation .l.ti.J........1. ..................................... Exterior .... ...... ...... .................Roofing .... .. ..... ..... .... ........................................... .....................Interior .... ..........Floors �!k` ..... Heating'^ ... ....4...............:...........................................Plumbing ..... ..................................................................... Fireplace ......Approximate Cost -.. r Definitive Plan Approved by Planning Board 19 Area . .............................. Diagram of Lot and Building with Dimensions �� — Feed 2'-s -�� SUBJECT TO APPRO-VAL OF BOARD OF HEALTH Z Zl Z OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of wn f r s abl re arding the above construction. Name .. .............................. ®a? � i Construction Supervisor's License .........................�..... ROSER, RICHARD f CI St c� 28806 n 1 Story o ................. Permit))for .. ............................. Single Family Dwelling ........................... ...:..........:.......... t Gr 4 I Lot 53, -" 5371 I,umberts Mill Road Location ............. ...r......... ...............................:. a Cenl�erz sille . ............................... ....I......... ................................. Owner Richa d'oRose= Type of Constructio '&z ame sa `r............................................. ................................. Plot ............................ Lot ................................ Permit 'Granted ..........laxwaxy...2...........19 86 Date of Inspection ....................................19 ate Completed ....19 r �cc m t ' rj = ' { 7, 4k Ass `�klSewage Permit. 039. 0 MAR TOWN OF BARNSTABLE BUILDING INSPECTOR ...C�ID.....-. .............142� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according the �|-�' �/ / / | Location -'���LJ'L--.��=��,�--l~�^ .=�� .l �.J��L�..- ----. ` Proposed Use 'r----�--~�' 1 Zoning District ...Fire District -._.~-- ----` ~ ` Name of \ -1j ---.-. ' Y.�� \ Ma- ..A Nome of 8oi|6er ' --� ..L�`��.� ----- - - Nome of Architect ' ...... nass ----_----. -----. -._------__' , '( Number ufl ----------'.------. Foun6o� / ��! ..................................... / ExIeriu, c-,-4 - -----'Roo�ng ' ---___............. - - ` � (�� Floors -'°= --r-�� ----.',- r—|nte�or ��. -__ ................................... ~ ' ` ` ` /\ ° ,� f�mHeating -��-��[-/�\...........................................................Plumbing .....:�~°��z�-------________________ Fireplace -����=----------------'�--.---.Approximate Cos --_/./��� .. _.. .. ��.'���zn�- - Definitive Plan Approved by Planning Bnon6 19 9�n , Auyz �K (��/�� +_�� ' c~ � ,Diagram of Lot and Building' with Dimensions, Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ' ^ . . v / | � � ' ' ' ' ' | | ' ^ ' / | ~- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS / � ' � | hereby agree to conform to all the Rules and � / . construction. � ' Nome \�-~-'-`--'`^'~ �] /�� � � Construction Supervisor's License ������.-'-��.!_!,- _~ . , � J f t ROSER, RICHARD A=146-097 No ...28806... Permit for ....1 StorY.............. Single Family...Dwelling. . . ........................... ...... . . ...... Lot 53, 537 Lumberts Mill Road Location .................... ............................................ Centerville ............................................................................... Owner ...Rich.ard. . ..Roser. . .. . . .. .. . . ...................................... Type of Construction ,....Frame ................................................................................ Plot ............................ Lot .............:.................. Permit Granted .....January 2, 19 86 Date of Inspection ....................................19 Date Completed 19 ' �p OF OF c ► RICHARDe`* � PETEA. R �� 1 o BAXTER N� ; StiLLiVAN H No.24046O No.29133 i- t�t/ELL 4 � I cam/. qo'c� .:-� = `�� �-r t��•��.�, TIa.�Sf1Cr> V. 3C Z f�V. 36,-Q Gcs,,cool ,' 3p,U � M cL i �I- .. �' �uc�=[-c.,u��E�-2GC� s✓.�/GL C F=t-�b/L��- —�-'� 3EZ:��cx�s�-t ._� -.---.,-'"�� �l� i,c%l-��=�2 � o GEC �2i�✓�c-� I - i sow ice *..^.-�- 1.+-.-.:-`"s" �` I - _ •�-s, ,x. \_ . . .,...r. _ _ - _ � .. _ w.Y .i .-`—a;' .r .� c:!- '..":'x- — , j'-�,""'-°"� r!/��•.�—w»�" ".r' TC�L- �(`dry �•95Ate. UPwea;� E vID-31 y gS APPROVED s L 6/S / B8T stable � ^rvation Commissiotl OS;- `//�4L AM s a . Y Signed Date 4 A'