15 PUTNAM ST - BUILDING INSPECTION I'he Commonwealth of Massachusetts
Board of Building Regulations and Standards Ci l'1'OF
Massaeusetts State Building Cudu, 750 C'MR /?,.% •d.(6n 'n//
I)uilJing Permit Application To Construct. Repair, Renovate Or Demolish a
One-or Tuvo-P2on 1. Utre/finq
This Section For Otliciai Use Only
building Permit Number. Date, lied:
s(t II
,,ding 011icial(Print Munel Si Dahc
SECTION I: SITE INFORMATION
1.1 Prope/r�ty�A}d-Yd�ress: 1.2 Assessors.Hap S Parcel Numbers
/.S A lJ / I[ a rwo. S' t
JI.la Is this an acce ted street?ves no flap Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed U:w Lot Area(sy 11) Frontage(11)
1.5 Building Setbacks(it)
From Yard Side Yams Rear Yard
Required I'mvidcd Reyuircd Provided Reyuind Provided
1.61Vater Supply:(M.G.L e. 40,§!a) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Ihtblle❑ Private❑ Zone: _ Outside Flood"Lone? Municipal❑ On site disposal s)skm ❑
Checkif cs❑
SECTION I. PROPERTY OWNERSHIP'
2.1 Owner'of Record:
N;unu(Print) C'ity.State,ZIP
14 y f?3Z
No.and Stmet / . V+n a k,% relephone Email Address
SECTION J: DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ I Alteration(s) ❑ 1 Addition ❑
Denmlition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Spucily:
Brief Description of Proposed Work":
? X e2 /20, b *+, o f Y P iPa
SECTION 4: ESTIMATED CONSTRUCTION COSTS
hens Estimated Costs:
I tabor and .Materials) OOlclal Use Only
I. Building S 1 I. Building Permit Fee: S Indicate how fee is determined:
2. Llcarical S ❑Standard City:Tussn Application Fee
❑Tutni Project C LIA'(Item 6)x multiplier
1. 1'lumhing S 2. Other Fecs: S
4. MQ01.11lical ill\ %C) i Lisl:._ ..—__
tiu +ressuml rotal ,\II Fe": S_..___—___
// ' / b g ChecA Vu. ( hak :lnnnurt: _ (',uh \imiunc
n Tuwl I'rtjcct Coo: ❑P,dd in Full Cl Uolstanding I1.I1mce Duey
(70- -
��,o-t r-7,ti
SEC CONS: CONSI-RUCTIONSERVIC'ES
5.1 C'unslrucIion Supcnisur License((SI.) p A5- �a ?_� 2 0 3
-- .. _..-- -- - - - ---
+ �� I icenae Number P,pir;niou I);ne
Nance of-C.I. IIUI'ler I lst('tit. l\pe l�ec l+elawl.---
` 0
1 T C Q 1'f PC Desmiiiion
No. .inJ Street (i l4vcclricrcJlUuilJin+s ti m1y1)tmcu. it
f � 'M r/ 7 . . .__ R IlalricteJ NIL! Parma Dttellin
Cil�illn,n,.Stale,/III ,\I Mason
µC RIM,IIn Onerin
N'ti Window and tiiJin
SF Sul iJ fuel Ihsming Appliances
AT -7 B- �� S ��L� I Insuluti..n
Pale bona Ifmail address D Denuditiun
5.2 Rrglstcred Ilume Improvement Contractor(IIIC)
IIIC ICcgisumiun Number liq,inition Rule
I IIC Conlpan) Name Air /
'2 31 6 45 Sr b N S'r' EO j�S e/P(
No. aid Street 9;7B. Y B ?e 5Y7 6 Email address
City/Town. Slate ZIP rile hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L At. 152. 1 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this atlldavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .......... O No...........O
SECTION 7a: OWNER AUTHORIZATION TO 8E COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERN11T
I, as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner Is Nwne(Electronic Signature) Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
n name below, I hereby attest under the pains and penalties of perjury that all of the infurmation
By entering i y Y
contained in this application is true and accurate to the best of my knowledge and understanding.
Zrv� 'C)O ( 1 P i A-e / — / 2
Prim ner'i ur:\uthurircJ,\gant's Name tltlectronic Signature) Date
Nous:
I. .\n Owner who ubtains a building permit to do his her uwn work,or an owner who hires an unregistered cunir.wor
(nut registered in the Hume Improvement Con«actur(HIC) Program),will no have access to the arbitration
Program or guaranty fund under M.G.L. c. IJ?A.Other impunant information on the HIC Progrmn can be round m
I-.t" �, ," i Information an the Construction Supervisor License can be found at,s w+, w-,- �;o\ ,IP,
lien substantial work is planned, provide the information below".
row floor area(sy. 11.) _ __—_.._I including garage, linished basement attics,decks or porch)
Gross livingarealsy. 11.) ___. - Habil.lbleroum.uunt .-
\untberroftireplaees .. -... . \unlherofhcdroanu
♦unthert,l'hulv.+mns \unlberul'halfhalhs
I1 pe of he.uing ;)stein - Number ol'dvai, porches
I' I+e of eoolmlg i\itoll
I'nela,ed (lean
i. "I,ael I'rojcet Square Poot.ige"m;n he,uh,titu ted Ili"rotel I'rojacl Cost"
C1.1-Y UE S,kLE.N[a NL1SSACHUSEITS
s BuILOING ❑EP.kwF%IE.NT
1,`.�) 120 1V,"HLNGTON SMET, 3'a FLOOK
J\ • ' ILL (978 745.9505
F.,x(973) 7.104846
K1%,13E,RL.EY DRISCOLL MOSUSST.PIFAM
AiLYOA
DIRECTOR OF PCOLIC PROPERTY/OhR.D(\C,l'0361155(ONER
Workers' Compensation Insurance AtTidavit: Bui)dens/Contractors/Electricians/Plumbers
%milleant Information � Please Print Legibly
y
NmndlDmitu+tUrWtpnlnliutilnJivilnlual): 1 V YVt V'1 G C
Address:
CitylstoteyZip: I 5-eS E,e I d /tOR - Phone to: 9 7 5F S S d
%re you in employer!Cheek the appropriate bon Type of project(required):
1.❑ 1 am a employer with _ 4. 69:1 am a general contractor and 1 6. ❑Now construction
employees(full andlor part-time).• have hired the sub-contractor
2.❑ I am a sole proprietor or partner- listed on the attached sheet I �• ❑Remodeling
,,hip and have no employees These sub-contractors have 8. ❑ Demolition
working fist ma in any capacity. worker'comp. insurance. 9. Building addition
(No workers'.comp,insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemplion per MGL 11.0 Plumbing repuin or udditions
myself. (No workers'sump. c. 152,41(4),and we have no 12, clot repairs
insurance required.) t employees.(No workers' l3. Other
comp, insurance required.)
•.very applkwe ttsr dnvka bat rt must also fill uut Ihv suclioo below ahawins(hair"ken'compeneolon policy Imbrmmion,
'I hvnauwnon wha.ultmif Ihie atrlMvit indleaaing ihey am doing ail nwrk and then tiro outride cantneratrs mtar auhenit a raw allldavit indicsaine tuck
:('anrr%fYn that chwk this has meet anwhed an aadniuwd.hart showing that nurse of the rrub,untrac"and their workere'comp,pulley Inferttsaan,
l urn ere nnployer that Is providing worker'comperttatlon insurance for my employees. Below Is the policy and job site
iuforrrrutam Q /
Innumuce Company .Name: C'L(6se ✓�__-NvtJ L L `
Policy V or Selr-ins. Lie N: II C S 06 7 c 6 g�_ Expiration Dltte: I d —
a
lob Sile Address: /s RJ {W(Jk+ S City/Stutr/2ip: S 4 ( .. rLJ
.meets a copy of the worker' componsalloo policy doclarm lan page(showing the policy number and ssplradon data).
Failure to wcura coverage as required under Section 2JA of%IGL c. 152 can load to the imposition of criminal penalties of a
rice up to 11,500.0 ondlor one-year imprirnnment,as well as civil penalties in the form of a STOP WORK ORDER and a tiro
ar up to 5350.(10 a Jay against dtt violamr. Ile advised that a copy of this..um riunt may be furwardcd to ilia 011ico of
IJ VCIIIgJIlnnt ul IIIC DIA li)f lilt Uranee tJvemgC Vefl lleallun.
[,to hereby certify undep d paint an aenaltier if pvrjury that the infunnudaa prmvidaJ above it true vnJ currrct
D.Ito:
PI•,1;a 1 97 K 2F S'7- s1Q4 0 ? ;7
Oiliciul see only. Oo mnf wtire fir this area, fa be completed by city of town rrffleiut
Cay or I"ovn:.----
Muia- Atilhurily (circle one): -- -
I. tloard of Ilcallh !. IluilJlnc Dcp.lrmreml 1. ('ily,1-own Clerk 1. Electrical 1-ilc0ur i. Plooihin4 Inspector
ti. Other
Cnotnal I':rw n: Vhnnc 1:
1
V_j
ACORD. CERTIFICATE OF LIABILITY INSURANCE 01/09/2012
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:H the certificate holder is an ADDITIONAL INSURED,Uo polay0es)must be endorsed. H SUBROGATION IS WAIVED,subleclto the
terms and conditions of the policy,certain policies may require and erdorsemerd. A statement an this certificate does not confer rights to the
certificate folder in lieu of such eMorsemenl(s).
PRODUCER CONTACT
NAME:
PHONE FAX
CHASE&LUNT LLC (A/C,No,EId): FAX
(A/C,No):
POB 590 EMAIL
ADDRESS:
PRODUCER
NEWBURYPORT,MA 01950 CUSTOMERIDM
77BPK INSURER(S)AFFORDING COVERAGE NAICR
INSURED INSURER A: TRAVELERS DDMECr ASRGMKW
INSURER D:
TURNPIKE GENERAL CONTRACTING INC INSURER C:
INSURER D:
239 BOSTON STREET INSURER E:
TGPSFIELD,MA 01983 INSURERF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THEINSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICHTHIS CERTIRCATE MAY BE ISSUED
OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 0 SUBJECTTO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
UNITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS.
INSR ADOLSUBR POUCYEFFOATE POLICYEXPOATE
TYPEOFINSURANCE POUCYNUMBER (MARDOIVYYY) (MMEDD\YYY'D UMRS
LTR INSR WOGENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED $
CLAIMS MADE OCCUR. PREMISES(Ea..Ne once)
MED EXP IAny one persaN $
PERSONAL&&ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY PROJECT Lee PRODUCTS-COMP/OP AGO $
AUTOMOBILE LIABILITY COMBINED SINGLE $
ANY AUTO LIMIT(Ea accident)
ALL OWNED AUTOS BODILY INJURY $
SCHEDULE AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
(Per accident)
NON-OWNED AUTOS PROPERTY DAMAGE $
(Per accident)
UMBRELLA LMB OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WCSTATIRORYLIMITS OTHER
WORKER'S COMPENSATION AND
EMPLOYER'S LIABILITY YIN UB-4939PI55.11 1W222011 10/2212012 E.L.EACH ACCIDENT $ 1,000,000
ANY PRWERITORIPARTNERIEXECUTIVE N E.L.DISEASE-EA EMPLOYEE $ 1.000,000
DFFIGEIOMEMBER EXCWOEOI
(FmnancgIr NH) E.L.DISEASE-POLICY LIMIT $ 1,000,000
II yes,describe under
DESCRIPTION OF OPERATIONS helm
DESCRIPTION OF OPERATIONSILOCAMONSIVEHIC LESIRESTRICTIONSISPECIAL ITEMS
THIS REKACES ANY PRIOR CERTIFICATE ISSUED TO THE CPRTIPICATE HOLDER AFFECTING WORKERS COMP COVERAGE
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATETHEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Charles J Clark
ACORD 25(2009109) 18aa-ms ACORD CORPORATION. All rights reserved.
1
TURNP-3 OP ID: CA
,d►`ofzo CERTIFICATE OF LIABILITY INSURANCE DA 02127n 112
o21z
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 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 endorsements .
PRODUCER 978 4624434 CONTACT
NAME,
Chase&Lunt LLC 978-465-6204 PHONE WC A.
:
P O BOX 590 A/c No
47 State Street E-MAIL
ADDRESS:
Newburyport,MA 01950
Marcos W.Shaner INSURER(S)AFFORDING COVERAGE NAIC p
INSURER A:Scottsdale Insurance Co.
INSURED Turnpike General Contracting INSURERB:Commerce Insurance Company
239 Boston Street INSURER C:Peerless Insurance Co.
Topsfield,MA 01983 -
wsuRERo:Hanover Insurance Company
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, TERf-' 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 rODL 5USRJ POLICY EFF POLICY EXP LIMITS
LTfy TYPE OF INSURANCE POLICYNUMBER MM/DD/YYYY MMIDDIYYYY
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
A XI COMMERCIAL GENERALUABILITY BCS0026080 10121111 10/21/12 PREMISES Ea oovnence E $0,00
CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,00
PERSONAL B ADV INJURY S 1,000,00( -
GENERALAGGREGATE $ 2,000,00
GEN'L AGGREGATE U MIT APPLIES PER: - PRODUCTS-COMP/OPAGG $ 2,000,00
POLICY X PRa LOC $
COMBINED SINGLE LIMIT 1,000,00
AUTOMOBILE LIABILITY � Ee ecatlenl b
B ANY AUTO BDBRJM 10120111 10120/12 BODILY INJURY(Per Penwn) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
MON-OWNED PROPERTY DAMAGE $
X HIRED AUTOS X AUTOS Perautldent
S
UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000,00
A X EXCESSLIAB CWMS-MADE XLS0077698 10121/1l 10121/12 AGGREGATE $ 5,000,00
DED X RETENTION$ 0 Is
WORKERS COMPENSATION TWRST TdU HOE -
WORKERS EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNEWEXECUTIVE Yr N/A TO BE i5SUED FROM CO E.L.EACH ACCIDENT $
OFFICERIMEMSER EXCLUDEDi
(Mandatory In NH) E.L.DISEASE-EA EMPLOYE E
If yes,desanbe under
DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $
C. Inland Marine IM8883151 12/01/11 12/01/12 Materials 250,00
D Commercial Crime 3200939 01/17112 01117113 Limit 100,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remark;Schedule,if more space is required)
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.
AUTHORIZED REPRESENTATIVE
V
C 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD _
r
Unrestricted-Buildings of any use group which Massachusetts -Department of Public Safety
contain less than 35,000 cubic feet(991m)Of i Board of Building Regulations and Standards
enclosed space. Con'truoum supeniw,r
License: CS480145
Y` ,,, I I♦ pA i. t
GEORGE VAS1 AI1ES rY
5 PTfCAMN WAY. ,
u,sMCH MA 69125 -
Failure to possess a anent edition of the Massachusetts
State Building Code is cause for revocation of this license. '
Expiration
For DPS Ucensing information visit Commissioner i0/26/2013 I,
I
A o�e��ai�and�es egul n
10 Park Plaza - Suite 5170 -
Boston, sachusetts 02116
Home '--- ontractor Registration
Registration: 167567
r, s Type: Supplement Card
TURNPIKE GENERAL CONTRA z P�filration: .10/4/2012
GEORGE VASILIADES m o
239 BOSTON STREET BOX 366 w
TOPSFIELD, MA 01983
C
��,tr svt•y� Update Address and return card.Mark reason for change.
JPS-Ml o last-0emw10121e Address Renewal ❑ Employment Lost Card
' ��oosumam+u�.Os a�./uaaeac/umelA
Ofnee of Consumer Affairs&Business Reguadon License or registration valid for Individal use only
OME IMPROV MENT CONTRACTOR before the expiration date. If found return to:
Re0latrauor l—Su .Type: Office of Consumer Affairs and Business Regulation
10 Park Plaza-Sufte 5170
Expire 1 Supplement Card Boston,MA 02116
TURNPIKE GE ING INC.
GEORGE VASIL
239 BOSTON �---
TOPSFIELD,MA Al Undersecretary Not valid without signature
` MC
#154326
BIN#56-2618812
Alpine Property Services Inc.
Painting,Roofing&Siding office 978-535-0943
515 Lowell Street—Peabody MA 01960 facsimile 978 535 2008
Jim Collette
Essex Management Group
50 Washington St.
Haverhill,MA 0183.0
(978)469-I232
Job Location:
15 Putnam St
Salem,MA
Dear Jim,
June 17,2009
The following estimate is for the roof replacement for the property located at the above address. The following paragraphs
describe the work that will be performed. I know that you don't need a roof now but since we did the take off you can have
the estimate and the measurements for future reference.
Rubber Roof:
• Roof size is 37 feet by 27 feet with a drain near the center
• The roof is pitched to the drain
• There is one non functional chimney that should be removed when the roof is done
• Strip existing ribber roof on the house
• Install %,"fiber board with screws&plates
• Install all new flashing around the perimeter of the roof
• Install .060 fully adhered EPDM rubber roofing
• Install 3"seam tape on all seams
• Install L-Stock drip edge on entire flat roof perimeter
• Install 6"cover tape on all aluminum L-Stock
• Remove all debris from property
• In addition we will provide you with a 1 year warranty on workmanship
• The manufacturer recommends that you inspect your roof every year to make sure that all the seams are intact
• Failure to inspect your roof each year could void your warranty
• We also provide a service where we can come out and inspect the roof for a fee
Initial ootions you are choosine below:
Cost for Labor&Material for Rubber Roof: $4,500.00
Payment Terms: 133 deposit upon signing contract S L3 work in progress S and 113 upon completion S
Remit to:Alpine Property Services Company,Ina,515 Lowell St.,Peabody,MA 01960
Total Amount Agreed To Be Paid: $ LI So o' v o
The following schedule will be adhered to unless circumstances beyond Olympic's control arise: -
Work Scheduled to Begin: TBD Expected Date of Completion: TBD
Warranty: Alpine Property Services Inc.guarantees all worklp
od of one year. If any problems occur we
will cove a cost r and material to correct the prostomer's satisfaction.eorge Vas Lade , EO Alpine Property Services Company Inc., roup
d/b/a Olympic by(Name)
I
I
CITY OF S',L &Nrj JNE1Ss.kcFiUSETI'S
JLLWLYG CEP.i)tT1LE`1
120 1�kSmOiGTON Srim", jW FLOOlt
I1rL �971� 141-959!
UJ�EALBY DRLSCOCI, FAX(978) 1-1&9&W
,bUY01< 7 NOAU Sr.Ptax"
DtltFGTOt{OP PL t1LIC PROP1ATY/81•MDNG CO.%L%11531
OV Eft
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition otthe State Buildin
Debris, and the provisions B Code, 780 C P m of MCL a 40, S J4; MR section 111.5
Building Permit At
is issued with
his work shalt be dis the condition that
disposed of in a property licensed waste disposal facili the dcbris resulting from
11 I, S I JOA. ryas deBncd by hIGL c
The debris will be transported
Po by;
21 � llea w9S + -2
' (n.une ut'hauleq
The debris will be disposed of in :
(nameme a-ly) �--
i,ddn�, or•r"i„y)
� 9n.mraulpyrmit�pphunt __..
,!pro �'--