23 WALTER ST - BUILDING INSPECTION (4) The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
Massachusetts State Building Code, 780 C'MR. 7'edition OF SALF.M
`) Rrrisra/Jarnarrr
1d,,1 Building Permit Application To Construct, Repair, Renovate or Demolish a
()nr-or Two-F mile Dwelling
This Sectimini For Official Use Only
Building Permit Number: Date Applied:
Signature:
fluildiniiftommissi d 1 of Buildings Date T
SECTION I: SITE INFORMATION
1.1 0 rry Addrt :: 1.2 Assesses Map& Parcel Members
I.1a Is this an accepted street?yes no Map Number Parcel Number
I Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq 11) Frontage(Il)
1.3 Building Setbacks(R)
From Yard Side Yards Rev Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.I.c.Jo,§SI) 1.7 Flood Zone Informed oa: 1.8 Sewage Disposal System:
Public O Private a Zone: — OOutsideeck f laecdd Zone? Municipal O On siCh te disposal system O
SECTION 2., PROPERTYOWNERSHIPt
2.1 Owners of R rd:
Name(Print) Address for Service:
Signature Telephone
SECTION 3: DESCRIPTION Of PROPOSED WORK'(chock all tbat apply)
New Construction O I Existing Building O Owner-Occupied 13 1 Repairs(s) O I Alteration(s) ❑ Addition O
Demolition O Accessory Bldg.O Number of Units_ Other O Specify:
Brief Description of Proposed Work':
C7l2I allel /_.*- iftL <
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Ofllclal Use Only
Labor and Materials
1. Building S 6� by I. Building Permit Fee:f Indicate how fee is determined:
2. Electrical Is O Standard Cityfrown Application Fee
O Total Project Cost'(Item 6)x multiplier x
). Plumbing S 2. Other Fees.- S /
d. Mechanical (HVAC) is List:_
a
f. Mechanical (Fire
Suppression) S Total AIf Fees:f
Check No. Check Amount: Cash Amount:
6. Torah Project Cost: S —
��06• 0 Paid in Full 0 Outstanding Balance Due:
/
SECTIONS: CONSTRUCTION SERVICES
11-1 Licensed Construction Supervisor(CSL) e,6 S i32
/1�� n �� _ I.iccnse Number 111pinlion Irite
N;urtt of l'SI - Iu1Jer = 12P I.is CSL fype IsK below)_r�
Uefcri ion f
:\ddK U Unrestricted to35,000 Cu. FI.
R Restricted l A2 Farm Uwellin
Si Ko M M 0111
al
RC Residential Raclin Coverin
W. Residential Window and Sidin
I'cicpMxe SF Residential Solid Fuel Burning A liamve Insallalwn
D nidential Uemolilion
5.2 Re littered Henna improvement Contractor(HIC) /D) 3.3
7—Registration Number
IIIC om f' swFIIC Re t{ t awe -/
Address „ ` �� J'�3.J —/ la t4 E.spintioa Daw
Signal Telephune
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.a Ill.S 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 ..........O No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1 as Owner of the subject property hereby
to act on my behalf,in all matters
authorize
relative to work authorized by this building permit application.
7�Na�me
- Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
f� 0 j /7f ty _,as Owner or Authorized Agent hereby declare
d information on the forego plicauon ore true and accurate,to the best of my knowledge and
Signature of by tar Authorizd Age Data
(Siancel under the alns and Ities of
MOTES:
1. An Owner who obtains a Is permit to Jo his/her own work,or en owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will gg have access to the arbitration
program or guaranty fund under M.G.L.c. IJ2A.Other imponam information on the HIC Program and Hurl
Construction Supervisor Licensing(CSL)can be found in 790 CMR Re ulations I I O.R6 and I IO.R5.respectively.
y.
When substantial work is planned,provide the information below:
Total lloors areaISq. Ft.) (including garage, finished basement/anics,decks at 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
T)pe of cooling system Enclosed Open
), -Total Project Square Footage"may be substituted lor'Tulal I'mject Coil"
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston. Massachusetts 02116
Home Improvement Contractor Registration
Registration. 100733
Tvpe: Private Corporation
xpiration: 6/23/2012 Trk 298405
A. B. CARNES, INC.
Barry Carnes
30 Arrowhead Farm Rd.
Boxford, MA 01921
Update Address and return card.Mark reason for change.
Address Renewal Employment Lost Card
Dupartlnent cat puhiic �.dcis
1 Itn:ud nl 13 uiidin_ Rc_ui;n .m1d �L�ndard�
l
Lw; nse CS 68139
Restnebetl 10: 00
If
KENNETH R CARNES t-•
8 DORIS ST -
GROVEIAND, MA 01834
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MWDN "Y)
03/31/2010
'RODUCER 791.439 f SOOO FAX 781.438.SO28 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
New Engl And Heritage Insurance Agency Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
335 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Stoneham, MA 02180
INSURERS AFFORDING COVERAGE NAIC#
4mmED A. B. Carnes, Inc. iwwRERA Essex Insurance Co.
30 Arrowhead Farm Rd. em)RERs, TRAVELERS INSURANCE 0038
Boxford, MA 01921 kmsuRERc: Granite State 000111
INSURER P.
I INSURER E
'OVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
7R TYPE OF 1N91RNA110E POUCYNWmEt D/1 GAVE OAMMONYM
LIMITS
GENERAL LIABILITY 3DD3690 03/19/2010 03/19/2011 EACH OCCURRENCE $ 1,000 00,
X COAM7ERC AL GENERAL DABILDY PREMISES Ea amarerxP $ 50,00
a ueM MADE QX OCCUR MED EXP(Any one Pesm) S EXCLUDE
A PERSONAL SADVINJURY $ 1 900,001
-----__-_-__-- _ _-- GENERAL AGGREGATE S -- 2,000,001
GENL AGGREGATE LIMB APPLIES PER: - PRODUCTS-COMPIOP AGG $ 1,000,001
POIJCY jPL LOC
AVIONKMILE LABIL" BA 69I MS06 09/29/2009 09/29/2010
ANY AUTO (Ea
a ac ev=Udw ED SINGLE LIMIT S 1,000,001
(Ea d )
ALL OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (FlBr 0e ) s
B X HIREDAUTOS
Hx)OLY INJURY S
X NON-OWNED AUTOS (Pe acadeal)
PROPERTY DAMAGE S
(Per aaodeN)
GARAGE WIBILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EAACC S AUTO ONLY: AGG S
EXCESS I IRIBRFUA UAINUTY EACH OCCURRENCE $
OCCUR 17 CLAIMS MADE AGGREGATE $
S _
DEDUCTIBLE S
RETENTION S $
WORKERSCOMPENMATION WC 742 62 18 01/31/2010 03/31/2011 ToaYUMITs ER
AND EMPLOYERS'LNRJT BY
ANY PROPRIETOMPARTNE YIN E.L.EACH ACCIDENT $ 1,000,00
C OFFlW CEMEMBER EXCLUDED?
"MrAftmin NN) E.L.DISEASE-EA EMftOYE N 1,000,00(
SPEcuL vRrnn ONO bd. F-L.DISEASE-POLIcv uWT $ 1,000.00
OTHER
ESCRNMR--OF OPERATKINSILOCATTOM IVeNELES/EXCLUSKkS ADBEOBY ENDORSO19Rf SPECIAL PROVISIONS
Nltractor
abject to terms, conditions, endorsements and exclusions on the policy.
Tis will serve as evidence of insurance only.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRAM
DATE TIEREOF,THE M WNG NSUIER WILL ENDEAVOR TO MALL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDEN NAMED TO THE LEFT.BUT FAILURE TO DO SO SMALL
BEOSE NO OBLIGATION OR LUIBNRY OF ANY KIND UPON THE INSURER.ITS AGENTS OR
REPRESENTATIVES.
"PROOF OF INSURANCE COVERAGE ONLY" AUTHORIZED REPRESMATHVE y
CITY OF INLkSSACHUSETI'S
• BUILDL1IG D EPA RTMIENT
120 WASHINGTON STREET, 3' FLOOR
\ TEL (978) 745-9595
FAX(978) 740-9846
KI.,,tBERr RY DRISCOLL
MAYOR THOMtAS ST.PIERRs
DIRECTOR OF PUBLIC PROPERTY/BUHMM;COMMISSIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit# is issued with the condition that the 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 transported by:
9
(name of hauler)
The debris will be disposed of in
Q (_2c �
(name of facility)
�e410 �u
(Vddress of facility)
signature of permit applican
date
and��rd.x
CITY OF S. —&M, , LXSSACHLSETTS
r J BUUMCZG DEPART>IENT
��� • 120 WASHINGTON STREET, 3m FLOOR
TEL (978) 745-9595
F.tx(978) 740-9846
KI.\fBFRf FY DRISC01-L THONL%SST.PIFxRB
MAYOR DIRECTOR OF PUBLIC PROPERTY/BUMDt\G CO\WISSIONER
Workers' Compensation insurance Affidavit: Builders/Cont ractors/Elect ricians/PIumbers
Alifilicant Information Pfcase Print Le¢ib1Y
711 �0101
miorelndividuaq: _
PhoneCheck the appropriate box: 'Type of project(required);
4, ❑ I am a general contractor and 1 6. New construction
I am a employer with ❑
employees(full and/or part-time).* have hired the sub-contractors
e p listed on the attached sheet. 7. ❑ Remodeling
2.❑ lain a sole proprietor or partner- t
These sub-contractors have S. ❑ Demolition
,hip and have no employees Capacity-
workers'comp. inswance. q, ❑ pudding addition
working for me in any
[No workers'camp.camp. insurance 5. we area corporation and its IO ❑ Electrical repairs or additions
required.) officers have exercised their
right of exemption r MGL 1 i.❑ Plumbing repairs or additions
3.❑ 1 myself
a homeowner doing all work c b152, '1(4). nd we have no
myself. [\o workers'comp. 412.❑ Roof n:pairs
¢mploye . [No workers'
insurance required.)t 13.0 Other
comp. insurance required.]
-Any upplic:aa tint duck"box al must also fill out the sectien below showing their worked cumpenstaion polity inhumation.
t I r,"a,wnen who submit this affldssit indicating They ate doing all work art!then hire uutsido eonuaetaes must suhmil a new afrdavit indicating such
=Comrxwn that check this box meats anahod an additional host showing The name of the iubicontndors and their woken'romp.policy information.
I am an employer that is providing warkers'compensatlon hisurance jar—my employees. Below/s the policy and job site
inran C ei
insurance Company Name: �/�.
�°° 11 l` �j Expiration Date: 3 _ 31 —du I I
Policy tl or Self--ins. Lic. H:�1______�<��
Job Sim Address: 23 L.L/tILT2-z 5�. City/State/Zip:_,;)
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration data).
Failure to secure coverage as required under Section 25A of YtGL c. 152 can lead to the imposition of criminal penalties of a
tine up to SI,500.00 and/or one yea!imprisonmen ell as civil penalties in(he form of a STOP WORK ORDER and a line
of up to S250.00 a day against the violator. I vised that a copy of this statement may be forwarded ro the Oflice of
Investigations of the DIA for insurance crags verol wiun.
I do hereby certify the al and penalties of perjury that the information provided above is true and correct
s. Data: _- 3-1"Z2
Pho c rl.
Ojjicial we only. no tot write in tiro area,as be completed by city ur town ajjh•laL
City or Town: - . Pcrmitif.lccnse N_-__._—.
Issuing Audiorily(circle one):
I. Board of licallh 2. nuilding Department J.Cilyfrown Clerk 4. Electrical Inspector 5. Plumbing Inspector
ConUcl Person: _. ._.. ... Phone M:
J
Information and Instructions
Massachusetts General Laws Chapter I j2 requ ties a I I employers to provide workers' compensation for (heir ctilployees.
Pursuant to this suture, an empleree is defined as"...every pet-ion in the service of another under;my contract of hire,
e\press or implied,oral or written."
An employer a dclined as"an individual,partnership,association.corporation or other legal entity,or any two or snore
,,I the tore¢omg engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
r ecerver or trustee of.m individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance, cumtruction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152. §25C(6)also states that "every state or local licensing agency shall withhold the Issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant vvlro has not produced acceptable evidence of cumpliance with the insurance coverage required."
Additionally. NIGL chapter 151, 4. 25C(7)sates"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance w ith the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please till out the workers' compensation affidavit completely, by checking ilia boxes that apply to your situation and, if
necessary, supply sub-contractors) name(s), address(es)and phone nurnber(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP) with no employees other than the
members or partners, ure not required to carry workers' compensation insurance. if an LLC or LLP does have
employees.a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
he returned to die city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Departrnent at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete tad printed legibly. The Department has provided a space.at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permiUlicense number which will be used ass reference number. In addition,an applicant
that must submit multiple penniUlicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and tinder"Job Site Address"the applicant should write "all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by ilia city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a clog license or permit to burn leaves etc.)said person is NOT required to complete thisaffidavit.
the Office of Investigations would like to thank you in advance fur your cooperation and should you have;my questions,
please du nut hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
office of Investiratlons
600 Washington Street
Boston, MA 02111
Tel. N 617-727-4900 ext 406 or 1-877-MASSAFE
Fax N 617-727-7749
www.mass.gov/dia
Proposal
A.B. CARNES, INC.
30 Arrowhead farm Rd
Boxford, Ma. 01921 Page 1 of 1
978-887-1431 or781-599-9197
Barry Carnes,Pres.
Mass, Builders License No.000230 Contractors Registration.No 100733
Proposal Submitted Ta.
NADIA PRESCOTT,TRUSTEE Date October 7, 2010
23 WALTER ST Job Name NADIA PRESCOTT LVING TRUST
SALEM, MA 01970 Job Location SAME
978-594-8593 Work Phone
We Pa"hereby to furnish material and labor-complete in accordance with specifications below,for thre su
Fifty Nine Hundred dollars($5,900.00)
Payment to be made as follows: $300.00 Deposit, Balance Upon Completion
Notice:All home improvement contractors and subcontractors engaged in home
improvement contracting,unless specifically exempt from registration by provisions Authorized
of Chapter 142A of the General Laws,must be registered with the Commonwealth Signatur
of Massachusetts. Inquiries about registration and status should be made to the Agent)
Director,Home Improvement Contract Registration 1-50H21-9375 ext 502 Note: 's proposal may be withdrawn by us if not accepted within 30
days.
We hereby submit specifications and estimates for:
ROOF WORK
® STRIP ROOF OF TWO LAYERS OF ASPHALT SHINGLES,COVER DECK WITH UNDERLAYMENT PAPER,AND COVER EXTERIOR WALLS AND
FOLIAGE WITH TARPS TO HELP P E.
® INSTALL ICE&WATER SHIE SIX FEET WI AT LEADING EDGE.ALSO INSTALL ICE 8 WATER SHIELD IN ALL VALLEYS AND AROUND ALL
ROOF PENETRATIONS
ID COVER ALL PERIMETERS WITH 8 INCH ALUMINUM DRIP EDGE.
® INSTALL RIDGE VENT AND/OR®AS NEEDED ROOF LOUVERS FOR ADDED ATTIC VENTILATION.
® COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS.
E REPLACE WALL FLASHING AS NEEDED WITH ALUMINUM OR LEAD,AT THE ADDITIONAL COST OF$25.00PLFT .
® CHIMNEY FLASHING. CUT ALL EXISTING TAR AND LEAD FROM ONE STUCCO CHIMNEY(S).CUT NEW REGLET WITH CARBIDE SAW AND
SECURE NEW LEAD FLASHING IN PLACE W/LEAD ANCHORS. PROPERLY SEAL REGLET JOINT. PLEASE ADD$500.00 TO ABOVE PRICE.
❑ REBUILD CHIMNEY FROM ROOF DECK UP WITISED BRICK. ADD TO ABOVE PRICE.
® COVER ROOF SURFACE WITH CERTAINTE ALGAE STANT WOODSCAPE 30'S.
® REPLACE DEFECTIVE ROOF DECKING WITH t RUCE BOARDS AT AN ADDITIONAL COST OF$4.50PLFT.
® COVER ROOF DECK WITH CDX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADDITIONAL COST OF
$4.00PSOFT.
—� 0 SHINGLES ARE TO BE STORM NAILED.(USE SIX NAILS PER SHINGLE)
❑ INSTALL SKYLIGHTS PROVIDED BY CUSTOMER,FRAME ROOF DECK AS NEEDED,PROPERLY FLASH UNITS WITH FLASHING KIT(S)PROVIDED,
CUSTOMER TO PERFORM ALL INTERIOR WORK. ADD TO ABOVE PRICE.
❑ REMOVE EXISTING GUTTERS ❑INSTALL NEW SEAMLESS.032 ALUMINUM GUTTERS USING THE POSITIVE LOCKING BAR HANGER SYSTEM.
® REPLACE FASCIA BOARDS, RAKE BOARDS AND SOFFITS AS NEEDED WITH#2 PINE PRIMED,ADD$15.00 PER FOOT TO ABOVE PRICE.
❑ INSTALL NEW ALUMINUM DOWNSPOUTS, POP RIVET ALL CONNECTIONS.
CLEAN ALL DEBRIS FROM OUTSIDE WORK AREA. OBTAIN ALL PERMITS AND CARRY ALL NECESSARY INSURANCE AS REQUIRED BY LAW, WE CANNOT ACCEPT
RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS. CUSTOMER SHOULD COVER VALUABLES. GREAT CARE WILL BE USED TO PROTECT THE STRUCTURE
AND FOLIAGE.HOWEVER,SOME MARRING AND OR MINOR DAMAGE COULD OCCUR.
HAND NAIL ONLY,NO NAIL GUNS TO BE USED.
SPECIAL INSTRUCTIONS:
1. THE ABOVE PROPOSAL INCLUDES ALL ROOF SECTIONS EXCLUDING THE LEFT SIDE SUNROOM ROOF SECTION,
2. TODAY I MADE A SITE VISIT AND VISUAL INSPECTION OF THE ROOF.IT IS OBVIOUS THAT THIS ROOF WAS NOT INSTALLED ACCORDING TO
THE MANUFACTURERS SPECIFICATIONS AND SIMPLE ROOFING PRACTICES FOR A ROOF INSTALLATION.THE CHIMNEY FLASHING AND THE
TWO SOIL HAVE BLACK TAR TO SECURE THE EXISTING FLASHING&THESE SHOULD HEVE BEEN REPLACED WITH NEW FLASHING.
3. THE DRIP EDGES ARE NOT PROPERLY ALIGNED AND HAVE OPENEINGS.THE SHINGLES BEHIND THE CHIMNEY ARE NOT LYING FLAT.WIND
DRIVEN RAIN AND A BUILD UP OF ICE AROUND THE CHIMNEY COULD RESULT IN LEAKS.
4, THE SHINGLES ARE SUPPOSE TO BE SECURED BY SIX NAILS(CODE IN ESSEX COUNTY)THE INSTALLED SHINGLES HAVE FOUR OR LESS
NAILS SECURING THE SHINGLES.
OUR RECOMMENDATION IS TO REPLACE THE ROOF AS PROPOSED ABOVE TO MEET OR EXCEED CODE AND THE MANUFACTURERS
INSTALLATION INSTRUCTIONS.
WARRANTY-All work warranted to be free of installation defects for 5 years,this is limited to the installed item and its repair only. Material warranted by mfg.to be free of defects for
30 years,see mfg.warranty for exact warranty performance.
Customer has legal right under federal law to cancel this contract wnhout penalty or obligation within three business days from acceptance date by mail or tele3ram sent:c A.P.
Carnes,Inc.at the above address. See reverse side for cancellation procedures.
Once all items in this contract are completed as agreed,customer has 3 days to fulfill payment schedule or pay statutory interest on the unpaid balance. All parties agree that
disputes over$2000.00 will be settled through binding arbitration as provided by the American Arbitration Association. Please see reverse side,Arbitration of Disputes.
Acafu4,a 4 P Signing this proposal means you have accepted all the terms as stated on the front and back of this agreement. Please see
reverse side.
Date of Acceptan [/
Signature Signature
PLEASE SEE REVERSE SIDE