128 ESSEX ST - BUILDING PERMIT APP The Commonwealth of Massachusetts INSPECTIONAL SERVICES
Department of Public Safety L
Massachusetts State Building Code(780 CMR) , !OI[ 8AY _b A U: [2
Building Permit Application for any Building other than a One-or Two-Famt y welling J
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
128 Essex Street Salem 01970
1 n No.and Street City/Town Zip Code Name of Building(if applicable)
J 1 SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Building IR Repair E Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No q
Is an Independent Structural Engineering Peer Review required? Yes ❑ No
Brief Description of,Proposed Work: -
componensts Cleaning repair and restoration of all sandstone stairs treads risers stingers with
—.lahn Rastoration mortar mix
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
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.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
P.-Factory F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H4❑ H-5❑
I: Institutional 1-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 1110 IIA ❑ IIB ❑ IIIA ❑ HIB ❑ I IV 1 VAO VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
=hl
: Debris Removal:
Public❑ Check if outside Flood Zone❑ Indicate municipal❑ be Licensed Disposal Site❑
nch or specify:
Private❑ or indenti[y Zone: or on site system❑ d❑
Railroad right-of-way: Hazards to Au Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
mr�tL..EO S113
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Peabody Essex Museum 161 Essex Street _Salem MA 01970
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Same
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application,
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
[f building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑and slap Section 10.1
10.1 Registered Professional Responsible for Construction Control
Jay Norman 617 669 6943 jay(@abbotbuilding.co CS107145
Name(Registrant) Telephone No. e-mail address Registration Number
Besten A4A— o:21 1,9 1 Inrestricted 419 919 01 7
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
nl,l,e�BuildinQ k�esteratien Ce , Ins
Company Name
StPyPn Nodati CS 079194
Name of Person Responsible for Construction License No. and Type if Applicable
399 Chadwick Road Havehill MA 01835
Street Address City/Town State Zip
» 44.5-0274 617 59D ���� steven@abbotbuilding com
Telephone No.(business) Tele hone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT 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❑ No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ 50,500.00
Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact mu��ality�\
5.Mechanical Other $ J\I
Enclose check payable to
6.Total Cost $ (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 y knowledge and understanding.
AY Norman Director 617- 669 6943 5/5/15
Please print and sign name Title Telephone No. Date
Bmkline Boston MA 02118
Street Address City/Town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Da e
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Peabody
P E I M Essex
Museum
Exhibit A
Scope of Work
for
Stone Repair and Restoration
Cotting-Smith Assembly House & Gardner-Pingree House
Cotting-Smith Assembly House
• Re I repair and restoration of the existing sandstone curbing supporting cast
iron fence a ates at the Cotting-Smith Assembly House. All work completed
as described in the ect Manual: Cast Iron Fencing dated 2 , art 2 Repair
Specifications Pages 9- 1 , s prepared by Groundroo eservation LLC.
• After removal and cleaning of the san curbing, color matching samples will be
created by Abbot for approval by P . Sam roduction will be coordinated with
Cathedral Stone using Jah storation mortar mi . amples will be installed adjacent
to the existing stone aces for review and approval.
• Scope incl es the removal, cleaning, restoration and the reinstall ' n of all sandstone
curbi and granite newel posts. Restored and repaired curbing will be et in new
ch with appropriate gravel footings.
• Abbot will coordinate the stone repair and restoration work with the cast iron fence
restoration contractor(DeAngelis) who has been separately contracted by PEM.
Gardner-Pingree House
• Repair and restoration in-place of the existing stone stair and podium components
supporting the wood columns and portico roof of the Gardner-Pingree House. All work
to be completed as described in the Project Manual: Gardner-Pingree House Portico
dated 2014 as prepared by Groundroot Preservation LLC. .
February 2,2015
Peabody
Essex
PEM Museum
• Scope includes the cleaning, repair and restoration of all sandstone stair components
(treads, risers and stringers)as well as the top and sides of the existing podium
structure.
• After complete cleaning of the sandstone stair and podium, color matching samples will
be created by Abbot for approval by PEM. Sample production will be coordinated with
Cathedral Stone using Jahn Restoration mortar mix. Samples will be installed on-site
adjacent to the existing stone surfaces for review and approval.
• Temporary protection will be provided by Abbot for the work area. Work area protection
to be coordinated with the temporary shoring for the portico roof as provided by the
preservation carpenter.
• Abbot will coordinate the stone repair and restoration work with the cast iron fence
restoration contractor, and the preservation carpentry work which have been separately
contracted by PEM.
February 2,2015
r
AGREEMENT
Peabody Essex Museum
161 Essex Street
Salem, MA 01970
^^ �
Agreement made this day of h, 2015 by and between:
"Owner":
Peabody Essex Museum ("PEM")
161 Essex Street
Salem, MA 01970 (the"Site"or the"Museum")
Phone: 978-745-9500
Email:robert_monk@pem.org
Contact: Bob Monk, Project Manager
"Contractor":
Abbot Building Restoration Company, Inc.
Twenty Eight Allerton St.
Boston, MA 02119
Contact: Steven Diodati, Vice President
Scope of Work:
A. Cotting-Smith Assembly House:
The removal, repair, restoration and reinstallation of the existing sandstone curbing supporting the cast iron fence
and gates at the Cotting-Smith Assembly House.All work to be completed as described in the Project Manual:
Cast Iron Fencing dated 2014 as prepared by Groundroot Preservation LLC.
B. Gardner-Pingree House:
The repair and restoration, in-place, of the existing stone stair and podium components of the Gardner-Pingree
House portico. All work to be completed as described in the Project Manual: Gardner-Pingree House Portico
dated 2014 as prepared by Groundroot Preservation LLC.
Abbot will coordinate the stone repair and restoration work with the cast iron fence contractor at Cotting-Smith Assembly
House and with the preservation carpenter at Gardner-Pingree House both of which will be contracted directly by PEM.
Total Fee: $80,400(Eighty Thousand Four Hundred Dollars)
A. Cotting-Smith Assembly House: $29,900(Twenty Nine Thousand Nine Hundred Dollars)
B. Gardner-Pingree House: $50,500(Fifty Thousand Five Hundred Dollars)
WHEREAS, the Contractor, has visited and familiarized itself with the Site(s) and has reviewed the Scope of Work
attached as Exhibit A and having familiarized itself with the Museum, the Scope of Work and the requirements of the
Owner, is desirous of entering into an Agreement with the Owner for the performance of the Work in the terms and
conditions hereinafter set forth.
WITNESSETH that the Owner and the Contractor for the consideration hereinafter named agree asfollows:
-1 Owner. Peabody Essex Museum
Contractor.Abbott Building Restoration Company,Inc.
Dated: March 3,2015 Contractor's Signature
i I
_ 1. Services to be Provided. 1.10 The Contractor agrees to physically attend all meetings
required by the Owner.
1.1 The Contractor represents that it is licensed,
experienced and skilled in the performance of work of a
magnitude and complexity comparable to the work and that it
will furnish and complete the work in accordance with the
provisions of this Agreement. 2. Insurance.
1.2 All work shall be performed using the Contractor's own 2.1 The Contractor shall purchase and maintain the
forces, which in all cases shall be appropriately qualified, insurance with coverage of or exceeding the amounts in
trained and licensed individuals. All individuals employed by Exhibit B,Insurance Requirements.
the Contractor for the performance of the work shall be
employees of the Contractor and shall not be considered or 2.2 All insurance coverage will list the Owner as a
hold themselves out to be employees of the Owner. certificate holder and shall name the Owner as an additional
insured.
1.3 The work must comply with all applicable federal and
local laws, codes, permits and authorizations and with the 2.3 The Contractor waives all rights against the Owner and
requirements of this Agreement. its agents, trustees, officers, directors, employees and
volunteers for recovery of damages to the extent these
1.4 Upon acceptance of an individual by the Museum, such damages are covered by commercial general liability,
individual shall complete training administered by the Museum commercial umbrella liability, business auto liability or workers
prior to performance of any Services. compensation and employers liability insurance maintained per
requirements as stated in the Insurance Requirements set out
1.5 The Contractor shall be solely responsible for the in Exhibit B.
performance of the work and for the conduct of all of its
employees. 2.4 As a condition precedent to the commencement of the
Services, the Contractor shall deliver executed Certificates of
1.6 The Owner reserves the right,at any fime,to notaccept Insurance with the minimum amount of coverage set out in
any individual presented by the Contractor as a potential Exhibit B,to the Owner prior to the commencement of the work
tradesman or to request the removal of a tradesman, with or and on endorsement that coverage will not be cancelled or
without cause. In such instances, the Contractor shall either altered except on thirty (30) days prior written notice to the
not present such individual for the Owner's consideration at Owner.
any future occasion or, where appropriate, shall promptly
remove such individual from the Museum and such individual 3. Indemnification.
shall not longer perform any of the work.
3.1.To the fullest extent permitted by law,the Contractor at its
own expense shall indemnify and hold harmless the Owner, its
affiliates, and their respective trustees, directors, officers,
agents, representatives, employees, volunteers, successors
and assigns, and each of them (the"Indemnified Parties")from
1.7 The Contractor shall perform the work and its and against any claims, actions, proceedings, liabilities, losses,
obligations under this Agreement with its most diligent efforts damages, costs and expenses, including reasonable legal
and consistent with the best practices and professional skill fees, which the Indemnified Parties may sustain by reason of
and care ordinarily provided by first class companies working any misconduct or any wrongful or negligent act or omission of
on world class museum projects(the"Standard of Care"). the Contractor, its consultants, officers, agents, employees, or
subcontractors arising out of the work hereunder or arising out
of or resulting from the Contractor's failure to comply with the
1.8 The Contractor shall provide any information required terms of this Agreement. This indemnity, and hold harmless
from it in a timely manner. obligation shall survive the expiration or termination of this
Agreement.
1.9 The intent of this Agreement is to include all items
necessary for the proper execution of the work. Items omitted 4. Owner's Rights and Responsibilities.
from the Agreement shall be included within the scope of the
Agreement if they are required by applicable law, regulation,or 4.1. The Owner is relying on the Contractor to exercise the
code, if they are reasonably inferable from the intent of the Standard of Care in connection with the performance of the
Agreement, or if they are necessary to produce the intended work. Notwithstanding anything else set forth herein, any
results. approval" or"consent" of the Owner to individuals presented
by the Contractor for consideration as tradesmen, the
_2
Owner: Peabody Essex Museum
Contractor:Abbot Building Restoration Company,Inc.
Dated: March 3,2015
Contractor's Signature
i I
Contractor shall remain solely liable for the conduct of such 5.6. The contractor shall include as part of each monthly pay
individuals. application, a retainage amount equal to 10% of the value of
the Completed Work. This 10% retainage amount will be
4.2. The Owner's Representative for the project shall be Mr. released to the contractor as part of the Final Pay Application.
Robert Monk. Mr. Monk is authorized to act on the Owner's
behalf with respect to the Project. In addition, the Owner,
hereby designates Mr. Phillip Johns as the Project Manager. 6. Claims of the Contractor.
Mr. Monk is authorized to approve Optional Services, changes
and Reimbursable Expenses,which do not exceed$25,000. 6.1. The Contractor shall have no claim for extra or additional
compensation or for any damage allegedly sustained or for any
changes or modifications to the work unless it shall have first
S. Fee. complied with all the applicable terms and provisions in this
Agreement pertaining to submission of claims, changes,
5.1. Owner agrees to pay the Contractor as full payment for modifications, and damages where such additional work has
the complete performance of all work performed, furnished, been pre-approved by the Owner in writing as described above
and provided by the Contractor, as more fully described in in Article 5.3.
Exhibit A,$50,500(the"Fee") for Gardner-Pingree House and
$29,900 (the"Fee") for Cotting-Smith Assembly House. Such 6.2. Notwithstanding the foregoing, the acceptance by the
payments are to be made in the manner and at the time Contractor of any payment hereunder shall operate as a waiver
hereinafter provided below. Refer to Exhibit C. proposals from and release of its rights to receive or make claim for additional
Abbot Building dated January 21, 2015 for Gardner-Pingree compensation for any work, labor or materials, performed or
House, January 26, 2015 for Cotting-Smith Assembly House furnished by it prior to the date of acceptance of said payment.
and February 26,2015 Unit Pricing for both projects.
5.2. The Fee is the total amount which the Owner will pay the 7. Assignment.
Contractor for the performance of the work.
7.1. Neither this Agreement nor any of the funds due or
5.3. Prior to performing any work not identified in the Scope of becoming due hereunder may be assigned or sublet by the
Work, the Contractor shall notify the Owner in writing of the Contractor without the prior written consent of the Owner.
fact that the Contractor considers that it is being requested to
perform additional work. The Contractor shall not be entitled to 7.2.The Owner may assign this Agreement at its sole
payment for any work not identified in the Scope of Work discretion. The Contractor hereby consents to such
unless it shall first have notified the Owner in writing as assignment and agrees to be bound to the assignee, by the
described above and the Owner has approved such additional terms of this Agreement.
work in writing.
8. Remedies of the Owner.
5.4. No partial payment, or certificate thereof, shall constitute
the acceptance or approval by the Owner of the work for which 8.1. The Contractor stipulates and agrees that each of the
the partial payment is made. No partial payment shall agreements and covenants herein contained, and by it made,
constitute a waiver by the Owner of any right to require constitutes a material condition of this Agreement. In the event
fulfillment of the entire scope of this Agreement. Neither the of any breach by the Contractor of any condition of this
final payment nor any partial payment, nor any certificate for Agreement herein incorporated by reference, then, and in that
either, shall constitute acceptance by the Owner of improperly event,the Owner may:
performed work nor of any element of the Contractor's
performance determined to be at variance Wth this Agreement. 8.2. Deduct from any payment otherwise due or becoming due
all sums chargeable to Contractor and damages due from said
5.5.The Contractor shall submit an invoice to the Owner by breach;and
the last day of each calendar month. The Contractor's invoice
shall show the work in place from the preceding month and 8.3. Terminate the Agreement for default in the following
shall be accompanied by such additional information as may manner: the Owner shall give to the Contractor written notice
be required by the Owner. Payments are due and payable no of the breach or breaches, and, unless said breach or
later than thirty(30) days from the date of the Owners receipt breaches are cured within forty-eight(48) hours from the date
of the Contractor's invoice. of the notice, the Agreement shall be deemed terminated for
default
8.4. If the termination for default is determined to be unjustified
then such termination shall be deemed a termination for
convenience pursuant to Article 9.
_3_Owner: Peabody Essex Museum
Contractor:Abbot Building Restoration Company,Inc.
Dated: March 3,2015
Contractor's Signature
11. Arbitration
S.S. In the event the Owner is a party to any legal proceeding
on account of any acts or conduct of the Contractor, the 11.1. A demand for arbitration shall not be made after the
Contractor agrees to pay Owner all reasonable expenses date when the institution of legal or equitable proceedings
including attorneys' fees and expenses incurred in connection based on the claim, dispute or other matter in question would
with the legal proceeding and any damages assessed against be barred by the applicable statute of limitations. For statute of
the Owner as a result of the Contractor's acts or failures to act. limitations purposes, receipt of a written demand for arbitration
by the person or entity administering the arbitration shall
constitute the institution of legal or equitable proceedings
9. Termination for Convenience. based on the claim,dispute or other matter in question.
9.1.The Owner may notify the Contractor to discontinue or 11.2. The foregoing agreement to arbitrate and other
terminate all work or any part of the work for the convenience agreements to arbitrate with an additional person or entity duly
of the Owner. Such notice shall be given to the Contractor in consented to by parties to this Agreement shall be specifically
writing, and, thereupon, the Contractor shall discontinue such enforceable in accordance with applicable law in any court
work or such part thereof as the Owner so designates. having jurisdiction thereof.
9.2. If the Owner notifies the Contractor to discontinue all, or 11.3. Any arbitration which takes place in accordance with
any part hereof, the Owner shall pay, and the Contractor shall this Article 11 shall be held in Boston, Massachusetts unless
accept as full payment for all work performed by the another location is mutually agreed upon.
Contractor, payment for the work performed together with any
actual reasonable expenses incurred by the Contractor as a 11.4. The award rendered by the arbitrator(s) shall be final,
result of the termination of this Agreement. and judgment may be entered upon it in accordance with
applicable law in any court having jurisdiction thereof.
9.3. The Contractor shall not be paid, and neither the
Contractor nor any entity claiming through the Contractor, shall 11.5. The Owner, at its sole discretion, may consolidate an
have any claim for loss of anticipated profits, for loss of arbitration conducted under this Agreement with any other
expected reimbursement, or for any increased expenses arbitration to which it is a party provided that (i)the arbitration
resulting directly or indirectly from the discontinuance of any or agreement governing the other arbitration permits
all work. consolidation, (ii) the arbitrations to be consolidated
substantially involve common questions of law or fact and(it)
the arbitrations employ materially similar procedural rules and
10. Dispute Resolution. methods for selecting arbitrator(s).
10.1. The Owner and the Contractor agree that for all 11.6. The Owner, at its sole discretion,may include by joinder
disputes under this Agreement, responsible persons selected persons or entities substantially involved in a common question
by each party will meet together and use good faith efforts of law or fact whose presence is required if complete relief is to
(including exchange of all necessary documentation)to resolve be accorded in arbitration, provided that the party sought to be
the issue between them within fifteen (15) days of the written joined consents in writing to such joinder. Consent to
request of either party. The parties further agree that, as a arbitration involving an additional person or entity shall not
condition precedent to instituting arbitration proceedings constitute consent to arbitration of any claim, dispute or other
against each other, they shall participate in non-binding matter in question not described in the written consent.
mediation in Boston, Massachusetts pursuant to the Mediation
Rules of the American Arbitration Association. 11.7. The Owner and Contractor grant to any person or entity
made a party to an arbitration conducted under this Article 11,
10.2. Any claim, dispute or other matter arising out of or whether by joinder or consolidation,the same rights of joinder
related to this.Agreement, subject to but not resolved by and consolidation as the Owner and Contractor under this
Mediation, shall be subject to arbitration, which, unless the Agreement. -
parties mutually agree otherwise, shall be administered by the
American Arbitration Association in accordance with its
Construction Industry Arbitration Rules in effect on the date of 12. Miscellaneous.
this Agreement. A demand for arbitration shall be made in
writing, delivered to all parties of this Agreement and filed with 12.1. This Agreement is intended to incorporate by reference
the person or entity administering the arbitration. all applicable provisions of law which by law are required to be
incorporated in this Agreement.
12.2. This Agreement and all attached Exhibits shall
constitute the entire contract between the parties and shall
supercede any proposal, agreements and representations
_4
Owner. Peabody Essex Museum _,r/!/ Ck%s"�'►'�"°'r/
Contractor:Abbot Building Restoration Company,Inc.
Dated: March 3,2015
Contractor's Signature
made by the Owner and by the Contractor and may not be
altered or amended in any respect except by writing duly
executed by the parties hereto.
12.3. Any article or provision of this Agreement which maybe
deemed in violation of law shall not affect in any manner the
remaining provisions of this Agreement.
12.4. No action or failure to act by the Owner shall constitute
a waiver of any right or duty afforded to it under this
Agreement, nor shall any such action or failure to act constitute
an approval of or acquiescence to any breach under this
Agreement, except as may be specifically agreed to in writing
by the Owner.
12.5. This Agreement shall be governed by and interpreted in
accordance with the laws of the Commonwealth of
Massachusetts.
12.6. The Contractor shall promptly re-issue, at no cost to the
Owner, portions of or all of the design provided by the
Contractor if(i)necessary to correct design errors or omissions
found prior to or during the course of construction, (ii)
necessary due to failure to follow written instructions of the
Owner during any phase of design services or the construction
of the Project, or (iii) necessary due to Contractor's failure to
comply with the terms of this Agreement. The Contractor shall
also be responsible for and shall indemnify the Owner for all
additional costs incurred by the Owner, including additional
construction and consultant costs, as a result of such errors
and/or omissions and the additional time and/or work made
necessary as a result of such errors and omissions and the
Contractor's subsequent correction of the design.
12.7. The parties have negotiated this Agreement in good
faith. Any ambiguities in the language of this Agreement are
not to be construed or resolved against either party based on
the fact that such party was principally responsible for the
drafting of this Agreement.
12.8. Nothing in this Agreement shall create a contractual
relationship with or a cause of action in favor of a third party
against the Owner or the Contractor.
12.9. The Owner and the Contractor each represents and
warrants that the execution and delivery of this Agreement has
been duly authorized, that it has full power and authority to
perform its obligations under this Agreement and that the
person executing this Agreement on its behalf has full authority
to do so.
12.10. This Agreement is not intended to create, nor should it
be construed as creating an agency,joint venture, partnership
or similar relationship between the parties. The Contractor will
act solely as an independent contractor of the Owner and
neither the Owner nor the Contractor will have the right to act
for or bind the other party in any way as to represent that the
other party is in any way responsible for any acts or omissions
of such party.
_5
Owner: Peabody Essex Museum
Contractor:Abbot Building Restoration Company,Inc. ✓✓✓►►►
Dated: March 3,2015
Contractor's Signature
I�