Loading...
HomeMy WebLinkAboutBLD-23-04709 „.t .v`: , `k y� I=, .",,n4 s j•e^."x5'. iL„f,rrr!'/, '” "'A xj °. r ,-' 'a ' ate:, -r,4 p 4,,, "t.,sk ' ,„'','.4,a r, < 7 " ;, „s` _ :: x ';r,h'`�`�y',i�x y`���;°!y.•� ,/'">'` "c» SeF>'"�a�`l�?�? "1�.''�'RO„aNa;",.' �"' �,' ,' '%1' .. ' , %gip. E`Awg r /� 'ai%',' iri '` •E: ,. �',,,i ,,,.�{, „. it,,,,"' ""e ,. ''B it i 'nPER * ucAT T; F4,;';,,•,., �X; ;;' z"� ,;; „ • .�K "R,p�� ,nay �N `Yt` ,u Fr��, . . " .� may' " i4P �i ;; r ',,, ,.., : 0-.• r� ' ', .. R,' ,V v 0 ,,-:FUSE. ...�. 4 :, EIJI' , 1 ,,, E,OR „, . • , IL 1:), . N ,,,‘.,,- . , ke,,,-...„.•• •,' „ \ r�`� ::. z`:';iw- �"""�Il�'p y "', , • i�n"iv 3 1 �t E' ,E#�; ,.,.�\a 3 , , ,,,,,If"•`ttp,- -`,:,-,,,^ _ f .§'n ''f/-%l ..1% S' ,,, ii,FF;" 'y-7%. .;"d�/r`r'. • ems,,:.- /y • �yy�, : ; .. ' . rir at PRI. �,," :„,'f" Y/" : r,,,E,�_ ,,,, . f ., V y`, wig.r . Y`� < 9 6�qv. „ , y y/,;r,; 4 , ram ".:,:.' <Q,ast ,. S . - /� i' , e ' /wlal\,aS+ ' /i/ �� .. am§r/i '^2. e, � ft/ ^ '..- /'Cx�.��N� "��vc� F ' ,. / : 24, atu s> _ .' ;3x'i ' � ' x '',' 4ti o.. -�▪ �:�5a^:f ' €',P „" "✓}G7 -[..� , < ,/47, ;'/, iFa , �„. ^ /„ �l e *- , v \. v ,, `y G;,, �,-,,,,Is not, j' n,v , ` -s ;*'Siff , • ,4. , ;M,,:, 0✓�., _ , �', ° ; ,v 'W 1 .iv•- •.,,, ,,,r,,//n„--%a• ��..'` • ',"r�aai ma- .:.,.s ` i z' „E..,: , ;°`,,, t';` `3ya`\, , "�«:a,;y6„ x' "'� #w3'O yItkd-" y/ , i . !AA Ail , < ���s<<R,`Gir.'; T�+�,rw� 'rIR',u',t: "i s _ E. a�g,,,� `t..„N,' _ �s" .. ;�.��.;E ," rr,�i%5r NJ ,V' ; .. w .v �. : : '>wny'b " ' ` 'G.,, , ,' - ��'N, i v . y��;� .,, ,ICY ; . ' � "`>s;".zrtg3 � / . ` "„ - s/, 9s;y;"%' a�`' r + ^:\��a`a<f !ice * '51,(m'/`� ' �' ; x '.%4_ E,: '4. \: r, 3i; ` ',AA , ' ' f/.i',' ' »ii ,_< °Y,�`'S%., �'� 'F/'/ / ' ; „ / ^ • , F cv20•i ' , : " J_ ''-' i...AAA., �6 i ;%':,",a .,., � i, 'r r'',7 ,,4 ` ,"/ � ,"�A vf -ar;,<i , '' E02Ai, _ %a p: i .,.ar^ r 4,44 if F , I2 ,LI - /;?iiii, . ''K' «, ::" ` a y , 3. �i,E^;;;fi a ' »• j ,/a > / �,,, , *A,A, maao.,,r„,..v , ,,, , e „�:\ ao • S • r .-� „ "/, om �, n� , A is'f` -+.� , II % ,t t; :.� � ' CEP,.�'i:`' .,./( -, rrt"/:., ^. , aa< 2', " .Y�.'t,'., `, :;ate ,e ,r, „-:, `, .,.':N,r ' „ emu, :,SVa, c: tea' P ik y:;.; " ,,ling ry �u ,;\\.: .�: `>sa' ' % " ,` :' i i, T' a ,,'.;, ate„' ,/ %!' tea, ' V T \ "8�.,.,,.\. / '� /�y,, ' �O`:a,, ^` /r,� a, =�i{��}'{t; ,,,„,;.,44:+&\�::� <,�,r •" ice �/'/j/r.yi;',;v, Y3'5"= ";y,. , s �;,r 72 S ; ` .„ ;; 'a - `,.�,▪y▪ a IA'N. 'afrk ,; 1• j�Wo - e e. , ,,h , .'j '•• ';%,« 4 , , , ... ,., ,....,...... , , , _. .,. .,..,,, . .„,.. .„., ..,. .. ,/- /''"'''':', '' " "kr I.1.'Z'Ccr• -• ''''' '..;. ei,,Oe ..,.-„,''. , .,,,, \ � ;';; • 3 -rev-mil'',irk AI' sr i;; lo. a'�,.. �' ' !yir%Y"` .'s a ski ,,,� ,.� t `- y i �,,.: /� s• 1*'i"'; ;-n�'',//"\�;r,,` � ,ems i �'''.6yY,,, / ,,' >'',�` `, "vet, r„• tt, � ' ,� d „fie • 3 a. frz• ..,,.'5.�...., c»,'�1"3 �.•vv,,y��� .s :"„ ,//s ,,,,,,„` ;-. /„ ,� `` y '• - o' ' „`'•a „ `ram. ` eLs 'F/i'�, r, 1L% .�./ "F ,com yy e[[ <."�`a" '" ,, rH ;' - . „'and"/'„^` n. .,. , ���5��M��t ,yam�, `�C v .,, , re(E'r. •,),A,`, ---- 9,'x9X=?4.-",--.„a "r • „, /"f— , ��=»_ ,K,` {?»� " '�/ a ,. r. .t' "f< *n ' ;�",,,r, „, ,swan ,zi,:>,',�7�' 'u'6',.,,� ,\,^ , , . , ,„yx4„F==, rr, • E, 4.f C„ }}��y�� 4< (4!4(��44 Todd lsv,= i R > OV TE, GE,'`E E,USE;,OGt=Pe- .• '- YO ;- , :-, W, , ., A/ .•.4 ,.ayNL7 i d a< ", 6 7; ': ", {'1 , �_` „,, ,.bn 4 q ' er'i... - S�„!'xf( <�. fa f 210 ' " = `_°�y'may,_ %./t :'C,' ;` it� �} �C x ,, '5 ii;, , ' „ W ,` ,' � zw% } * "G """ '' Y - d7 [Y C IO ., ; n v" *.' / ,�/ a " ftii '' <„ ,,.=r , < ;,,,'=,= Thi ` � ., �„ 44 Btsildr Pent IEI ' ' : ,r.,i "; _ -ah= r .' „ie. , r'a<„ " a. `,,::iJ. `:Sgt. ' -�>�r``— -moo, /'",' „r r N ;.'\" .i , ", 334;;„.".�0;'5,i3,3 - ' `hex`` \\`�' d l ft � \.' �„ ,Eo.; •• ," 0 a� , � ?%_ 4 A77. ,< " "`Lil'..'-`^;, , a :G -Datif", ,tt ;t * , aa•\, `\k,\ szel\,a... fi ;%." R %J 6 \r, ., =Y. \>` ' ;,\'` , W „ < w \.:, 1.. .,, ,"/" <,<„ „ :. E;„ii' �r EF,, ,,:,ao,,,s, *:{}yry ` Se - Ri,x f ' >i,ynrl„"' �11/ � •... „ �c2�i',anK ='»_ice'-er r.,- �� ,,;,,'' - e, h t<.• �w f S'�z"s'l' „ ---.','..<". 4', ✓,-4"%' ,r ...: ksgida;,"r,'3s''� a,4,r '; : -xis ,\-`;� < ,.ew ' �.� ,c,�zi <,r,,��, l/,,,„, fir„ , e,'„"a�„<,`f"` „ ^-,. a, ,5 ;, 'PlOtittedgMtershrPf ,- "; ,, ,v1,,'7 W-."1¢; ,s ,, .:� '`>s,, ' i% ,, -'"v � .,.mom ,$ "x Y,,'/E „E >'�gy,, i"" • •. ;.ak ,,`�✓: �A�f � ' . °, '. „ '"4„ „ < x :�•: , '� 1/Rt „> :/;'' , ,/, r - ;\ // L/i o { '" '} , .r y \\ - � � y, , / . / 4\ La � ,\:" cam,;:" , % tick %i ':3, _ s ia,,," a'x/r„ F j{��ef ?`ti ✓r'd-'' y, ..z.�-" »»,„,,, :,,,tfi °=„ ;'e.` -s/ " �j j� jyj{�3 ({( - ', Vie„ ^ra?. t �„". ' i i *-,4 k `\� „ fir, 7^"- ..7"., v""7„.,.,„. .<^ °. 77, ' . „'„, -, '"7,,c ,/.. ',�/JIF' zti: .:tea' 'Y'V.4: r < „,,.'ja; "'ice .�' "�<, 3 N: �C ,."�x. ,IIMMt 41,41 jf " " �..;" r, \ _:€ .» � „,\„ ,,,;gin °',, ""�' 'd,, `% !:' .,' " 441 F "°�M" �S .`1 ✓ ..,, '„.cif' a� ''K FaX �/ '",`,;^"/`\ •",,, ;,- ,,r✓r✓,,,r < ,,::i„,, n\ a = ^` 1 n �i z„.``�`:'"s \, ' r zt7" ,'i_mar " •/`<,', •' t� g'D,�Ey'....; ZZA _ _ ^;'ss, �� i^ ��k <.<.Y rt/ �, - F>'' ir`' ',+�i y 6y�!,j j j77! y�l7 .,'<',.i<o, ,�E " a `;�,_ •._ `- ` ` 1 <, 1C. Syr ' `M ,\ N '- .,•,.;5";r °is _ate'°' ,,s,,. „ ,,, ., :,�'',„ ", ``f :••,=f,"; .`‘, ^'fi '^is, °\..-a a'-,%: ; .';' e' f4 _ i 4 - yr i. „" L' „tea, gym^ s.<. ..:::"d<,' Yam"c iii , .i ter.9 , '� ; a� tiii,l dG ��» if �.., is J/<„ •',s,,' . ,� r''✓', : • _ "; 6 l,y,ay//,�E"' .: �0` ,,s,�; �f.'t", - -'H,r/x/ ,':4• ..,a ,+ � 3,`%l �„-',�..,.fier,.;,::4, ,,,�<'�"rc�.. ",nr��;.i_. -.ya¢,<. �,- .+ �� e : 'i a ', ,h„�z/, 4yyie # ,` „: „�';,a",� fi ; , ;�iyy a h _ a�` .,' < /a.,„.- " /, ,ce . ' ., �„ ,%/ n/m + a--,, C nFt 491 -'a3k- 0'" ; +<g} ": d ' ,io" ,r//,, ..<. 3=. i'ems a ' t�` / ' ";• y' nn . �" ' % ;r.�;�: / N," ,,i •,,,o :„ ' tip s¢ S»�/ -",• ,*,�,s-:�yi< ///" i �"`, -/r�, s „"c>° ,dryy,n_,-v4 " r,' �F,i':S.„ , �'/�"e ,, 't��f t 0-_ i , " f .- {�, � ,,=vv< ,n „Y� '` 1" `, -, a4` ' K , ,, ;,,.u% •:Fk 245" . �, � '\ A%' ' v " ' ''r, " � �wce v,,ii:,,'i, ,%�:",444" w„,% %/�,/ xi.i',. „' / > _ ` �� <``. „ y . ^C' - i .� 3 ir .4,"">. „ 3, ,;- '„/ `„ ' ` a lE=L1k1+41e f ,� i;` :. a �` /,r�,/I� ''" %' °1.3', 0'4.!�.^ te a %^„ :aa/ �a ,a; . � ,,%� r- �, „/ " /" '� €y " •, , - .. ;'m,`h x• /Adi� _ y , .it. V eg4 n ffi: ' lf%j %/E,�E , � � ,/ ,J •„%s'o,. '-^ , � g„ ,,pa, 1 4' �>:n-y�r , .r.,°.• f c�?'n ' !""-- 4,...t � „-J. . `"^' ,"ts>.; ,?%' »:,r/. sr';'y»✓ '/1.-y 't,n� , r_,-,7a -%%`% y---p- : _;2,0' �✓: z, . � �°;/�� : or °%�w . - a - ".' - '" -"t6 "; <.0 a+ p .y ^ � �`i,. ;' / ;: ' <�,";jWi,„ *', /j % , ././ .e, gi � � 3 g ° ;;` ,�a ;�F ,- :,•_., ' L:.'r1 //6r /�'r Hr/;y • - �' � y,�„ ;'J'` , '�y � %rr"/ .':'F G„ r;y , ,1 /f' ,x ' » tys 7347, / v. •, ' ' �<" l '.,� 's / /:' s, r : /'R-ter,- '„,/^.%<.E �us ` AN` , • • '� rih .,,ila,'1`c a „%i„' = s'E�", r ; ''€ •,ae..a. „7• . =\ « ✓,G, � 44 ��" „v "; ` [' y,.��, % % / ' "�,%,„2a: - d ' , '/'��/ , �!/.,„- ,t,;/f°' ,q l+ ,� ^,„� ,„ ,-:4_',w��ako, '� ^ ,r / ah E? ,,„ , ,a , z • s s"4 " 44 "/,� ` t „' A/A � ' % ,, �/L. � .r.<.„ - „."s iv � ''y/, , �" „: r 's "�° ` "" , ' s;a., gym., E,/, j 'sy'•,J _, y ,.,?/,.t. �;,;.. . ` 'a/��Z, i //ini�(E .•./s / :i'' / .,,,,ri{ � ' V,,., "• ✓/ . .. e -,K ,✓""' ' „E :£c' y ° 4/ `•.,Ai ,""% � m�.5E,,F �y , /./;//„ '',-'S �" ,.r/4_ ? . `�:? d �,�.,'.,/�, , � '; r✓ � : � A 4- v �/ nx" , ^;'< ,'aria ? /„ "%; ,. N `x . • <„ . s�� E. :�/;' . fG E - � , _ _ •<�`�,' [ l-/'i/j yid, _ � 4 c'�'€ ' - ,/ai '';i s 7,.. �/% , , � , %'/", %„ '% -i' L' "a r\ 'a / , ., y//,u fit„ ?1.4�i ,a r;• ,'« c' - ��10 ,,'-, � .e °4'-'3'1 >''/,' ;/ s'::,-,•r -1:> • _ t sP%F"y .�', :,„ -,,,,, /,,t i?a. ,,,iyj,r '� .��;:,•z;,i,,,,,/' 6, %r•:r<- � l -"_:a''. /, ,/ -,"( V ,A,, '',,.- k w; W ,,''�,.% ;!-'.° a. ,i#'�'"h%/,<6 ; '"'y_1'6"",a' ,,'•;k r;�V ,s;` <- •3 "`.'„�! %,_`'-'� "-4 ,L'd �,'<,�`-"4.. G// zip 4.• -///„; d .<•_, < ;: j •a- "G„�-' r" A'�/s',•„f.,•'; ,' '"'� ,,-•p,, , - _"/":° ice,., _fir ///,d _ / 'r ss .�,✓ta, ,.:lr/'F`^- .=iF,^S„„','� F,`!G? ® ut7.=lam"'. �v{.' a_t /„'°' �,,".,,V'�,,,✓ �''' --, �;',,. '' :s.��,,� „//-',;:` /, a',y/' x,�� Mll, .4 „, . C -_` 7/+'s '.*,„/ " ;.v>a/v7�• Me?�` -, u�t ?.r..��g� E a;"/,'y '�Y,,'y-;,';',.. */. '"z , , W,, i „40,--,"/'%';F n /,,,%d" ,/ ^�.,,,,w3. _ ;.a i t ,i/ . <% i ,n~ .�i� E " "' '4;• .4 - oar 'y . ��� F ,- r��' .'' , ,%W - % :v ,,./. „'• /ie ✓s� , ; s �6.1 � ' �' y a / / a > "` ' ' „ �° • ,; . ,': " / '' v " ` ',p. % � ', � � ••Y : -' •;i,rJ:�: a:ri,„ D ,,Q ";i . . ,, ,,y " `y�� ,, p' %k` s •.,//' ,, ,, , ,.,,,,, - Si , i 44 , _r „, ✓ �t / :< ^ a4-, ,./, ,;2 .,"' •r ` � '4 4- x— „ , '4.„ :_ ,r "'` %> ',"/,�,a" � ;; : os' ,,, -:x // „, � r.� ;ice• xr r �<y ' � �a,"l: <,/",,,= m / ' 'v: � u" '/� G . , ,/ „fin _� � � � :'`ry�" 0,�'„ ` j1 s° .- = '.�:"- •� , � ,, �„ auex ' :.� „ , _aft.. ";5:: % /%j, N '9;, :,\ ry � / � II u a �. ' " „ .t� ® d v G �, 2 , ; � na�' ? / it ,✓/ , „ os/ a /: ar 20 W'=:v;% i , ,;.` _ ' :'�, " � ig,n'•, a ,_ .s".`as .,'<,gy'i r"...,,.. e � 'i, � ' � \ �."a9�; �. .,t^ ��4�"< ��0�ems; �' ., �� , ';"F ' "g"fir: AT'''' '' fir„„ _ j ."„f,,, ` � r: a Aa.. i c „ � �„ �*+• ,j .'Gamy�/%;,,,s ? , / %? 1rc �,. j , / , n4*° � e ; , - . , :axe s„ 'f� / ';: , ',;-/ ' a �: „i �,; � < '� s 'C ;• �' ;t g:g \ lr E- x1..`";7 � '71 c,_ a a `` : � ' a- ' - : r ; . ,.4I - 1 /, ' ,, _ . ,,,, 4. a; „vet, . �-„ ' ,r 'i y �Y i <. 1`^, f—' : , 1* �' '„ ,,/ �".fe N•, � " ' n% a � .; ,- � "" > =- ;w% e •n itetli. Y fir qN a�rk , : `> / ./ /' '.„„" , 21m; ��T ' . "„ ' x fir / ` c j37 =--0/' . \ z rtrart'; - ` z'% _; j/ 4wN ? ,\ r°" ;y/ ' �:-, 'fl%r iHG� .l ',r j ; dd�li;n "j .my --a "'A, , ` „,, ,:! ' / ., / . '114 /4;4"1 yi ',/imr,' z,e e y/ ,c ;.rw.,;s%tin:?,, '%F w�, _,� ',� �� r :\,s44/t v^,,,,„ „.„-- ,,", ,... �_,,,:,�`�.. ,. aim „« % u,'-% p �a�r ; --,9 ;"ia �,`r`i:'"- ''°i:y; ,,�, � may,,- G„ , 'y/ " „� • ,. 5" a = � • ' �cr`g 4 Y'y ,.ems`• '• n:w�"'/, ,,y ,,w , ,. -- r P €--A � " $ I Wk p 9 ' L pp ,s, /'', ' ,.� y , r " i £ 4 ` ,' s,, •„ \ , , ,a" ` AI- '3 0€ o " * I ° 31i� a , , • ,�7, . - .Y• i ,ss-- ` C � g..,j i - } ', t aM ; i.a'2 %fniy E E/•r. f'k � ^6, ' `��•'r. k'j ,'AV"' - h F i� { , n p ' fr pro �. ^ / a s F,' < ,,,rry~ 'n i a 33 � d y ^ E,_ r „ Y%� 'a . ! �rn e \ a '"' ' °j` , _" , ti' ' "` % _"., i ,e, G1y,. `` s ' ;;, : o : ,z,,,4 , c ";/ si ,€'N Y.. . W ' f 1 ._ 'G; €: ,- <,`*"F '.'1,, y `'"- "1'4,- < f r / r °; .4 y a .,, , <i. ?` 't; /ry` ,'" , " q f^ .n.o<- , '5> y';, ,:4 a E, .ate - '/ .a e <- 2 s / g y,„„,? ,;' ::,`a 'S/„." �, ,; „ r,ree.w:,,,,am.,;,,A* %`--r , ✓ r1,',,, 'i� i,/ l",f ` t:/F?„i ,. I,,,; ,<,- ,./ �` ` , ` y 3 � „, ,, o5„ i/r , u . l" al� v ` s ,s"t. r�` ;:, � , -- r -.' o.. H, �. -• w 3� ' , �' %Y ; ' kw� „ a�l, , `�� � N`s %/'.' ,,.„*, �'//,`'E,'�z' ,I,„ 4'.:x.. 9%.2-,%iurr„ -n� ,//..£° ,,,-,,','`.,a;,,,, :imp y, ^< .:._., i/''_- a....,<' //,y _ �`,�.?'7"� "rd` // /': �j ns u /,%"ice., i� i'=% �,,;;rsc . „ '�,;r„ ` t �iirr�(r„ /yfi „", "p" FN r»,- '1 �_,,,, ,fd✓' 'ca< >r 1`,- is /i r %'`" "/ „i,/E ..`E „-i,' ,/, d ,,' 7'„f.,��.� „„; y "� r �<,, ,ter � ��/ �j` ,ir� r/�r'�",..;t„=„':;;�`�i;,'; ,E ' N%Y. ,y /f:, /)', 0, 7.',""`i,"j// "i,' �My,,,'A'`z •", �i �,�� • ''''' AA r,%;,; ,''''' ; .,»_�'. / ""fir „ "r,a<,""S:.i'` " ,'S- '`'•',�'rr'�r'r ^r. `�',r ,V --„J .« ', ir," 4'."`�:„- .»1l",,; ,,,�U,:A„",,,\„„,,}, ,ri'., "� ,",ram%,, s a<a✓?: � � „/F: `..�r� ti��'��r �<�,�"� ���k��"�r'�.11�E��yy,'r, r ,a�r �< / %' /y,, Air%% ,�;�. 9" �y �'�'��_ ///, :�'_.»�. b/ V�`�:�,J��' 'r" �-u ,",: a%,» 'L�e,{.+-" / Vy y 5 ll(r/t "+-4 ' ' ,`: gnSi '� ,_ s r /4 ,!/i ✓t �" „/��'�"^ ....» �s� �,t�� �� rr ���\Y ,our,Ya//✓,/' "�'lA r'„ �Y� G.��„r. ,. r/� ✓� /%� f'ry, ,i' , --' .fir „r,' "'°/i,. ";-;,r*, � ,n ..� '� y � << „ '' < ' ';z h'�' -s,� ,ter, � »<�,� P. w°„,j;ria3'` a /�,=,",r„ ��������"%. ,,,x�., �,,, ,` =,£r, �� �'�,r , aa yi, //" �{�� Yr ..,>Y ,x, Ayr ;' ,.S � a'r, �"'» �,'/; fa, r u<s'"r_,. r/ , \< � 42'h., x /�; � Aawi � `� *,� r�; -'�T N Poz / �„/9" -'�' -.�'. ,�"./r/^`�1'_�-„`i ,r_ ,li, tLfIC�` {� ' ram AFz, �y"'$' „rli,',r?r.F h tx,-,- .iir",0. -• "< �r�,r51t spy �, y/,€ < 74,A,21 i' `,4r 3,'/ `. '%, ,,,,,,',`r r.R /rY)!'}^ Aor F.�",-ri., '� ,� � - ,lY.v 4, rrC�*t"�;h, " r/ � 5 J y %' a`�/„ „„ " ,< 7 t�� ' i N,^y#`'i ?; `,,Wo '` -.'' ^`mod,,'// ''� ; ,s ,a',.,T ;. =sv '/'r„"r ",/ri/' ,/N,',�'''',./,"',i! ✓'/r ;' ;'f4,-,, r 4- - / s H . ,i.A ;A': „a,,, , , .%5 - `E. .�,,, x` ✓/ y',---,,- ,'fr`';-:.d '9% ;� 4/„z !E � y'��" i:%�" /e " , /'`",.a r4A"i"//' '% € -ir �<..,_ A G'.a�& ','- '-'' ,-`/"" .ri a"'rR'K .t,�„ ",���„>,,, ,/C'P�''' �Y:�.i,, ��:<�% ,,,ti"S,:1;i r "x✓%2"_ �wl����„ ..,� '''�; �"� ,,,,5s°�' p n'R �%;:'r!` sy, .. ,,• f�'�'t r�H€r,a,,s/>,�%��''v'r�''�f�;;�J�i.% '�fi��:y,";�"„!., • _:�_ ��, a'��'' yS Ai % zA�/' ` am <-�_/ �• Fz ,/", fa,y a x,. "" r,5'� 'E €€r,„�,t,� � �.„:5�?N< ..,/ �� it ;.;dh;.'.a _ :r aN / iti,E� it /, :. „4„i,,, „ ,-„,.. ' ,`„/," „�.$" x„,; ,. ,,.',r'sl .�,\ j�'s "<,3%/aH.'"` �r ;� F�"�', rr y_ �; ,yr',✓�,:a wry "%s' ,>v� ,r, ',;/�%+v".<,a;.a-, rr;,r� r" �w O`°` >'>� ,,7i k ; <<€ ' ' ��,t V, . ,,.di :! ,,,,- #, `,-..4 a,x, Vi:1' ,„ 4,- r r, (.b'R'' 1, ' M� F/2,7',€ A'r/ 1 :;,rA r _, 1-' / ,"9 ; i v,�'/ r `„".z -'' 4: 47'.<c tea' :s // �. `� ����� j"'=�" „' Y .,,�` „4.� /, „ ,a� .Q\ 'S'2'" ��,,�,:94��%� �.ujj �`\ ��' y Ste, "�. • • <, •j; .ate /,- %: Y-;, ,,''i%,.Y'� s �c\ '`"-,4pAcZa> ,�`; E <„; *(�„ ,.4 `�A„. v' `.. ^ r '- ':..9. '_ 'fw/4 �i"`, '--•'mil'`,` ';%"�j< , A ,> °" ?,< i .< .v rr,'" %" f^ 'ems,sz,.,, ,ram - .,, .,&�71n..4rr �i� %,'r " ✓jA„ 'y Y�E� i � . • J �r/ , . � /f ` : iG,_ ." rl y' „ y;,y.`�• --- , ,/r, ;1 d, T , . �A .� - am -'m i% A�, a• :;\"; /,�„ � oa '� '.i ' .s m:�a ' � 6 r% , < • " %i /-- �>" ,/, � m,=r`, i,-rr %;„ 4 „; •, . ._ - i ,A77 "77 • itk °..n�� / *'ot % * ,/3 ';/":.%- , _ "i • � 4✓,` s%,"�.ii//r<a�/",%"�`<�,x. "s,=�` �� „e /'raw"''-",yr 'i„ _ � , ��„""� ,�,s,•ny$/� ,� �, � `+ '.\'t:" =,-,z���',zx"r v, ;< • y�., >+P' n;f • , /� '''' `b '� ,r•`, '% e�p` `.< "`%!%%4 •'',l%x>"'% ; `z`� •,,ti;; 'e%= /"=e':°•/f- Z� `,,c`. „ - '';'y''„" �",, '' ` ;%% m`=- '4,."`'\ � <.5.s,s'z;:,-'`r„~ ", `- y fi ,'//%' r%'3,' X-"'' F- `°g.v`�.�-tl ':/"r�,,,'- �__<, "ur , Yah "!"'r' j;,' Et,, -" =A"'.., ',' ` aar^ „NA r/, s � ,.a °«y's on, ''�`,,, , ,.w ,/-,- ,,p -s�' ,,yy>•-;n'�. . - ",/'r liyr„., ,,/zzr=sv' i s ''0` ,r« �-`,'/� zw== ,'''%% - "r. , ' z,a x�i-< /B k4, y,, `'' .'r/'' <u ;-,, tZr{,t. " `,' e `%AV/.3✓r'." ,p'' / '✓ ,,'",0 -�-% , -, / ?E !! �,, r4;;•%ry r4' Y r,i ,;,y T v�'"i,,,-�..e,•,',-\''r , ' W rte.G i w.r`! '"f" ",;"/' fr t, , ,✓/ ��r ,> -4y. ,,.`wow - ,+umsA„, ra,.z?"-- �yqq//��,,Er,,;.,,,- i' ,>*s3`u>,�`''/ i'y 3 '/�;;:"Ds/� ,,,�';,:);, "/s%';`` „,/, 4 ��. ,.� ;�'�z " =.i! a',;2� %%vi` '" ,=ems u '`� //y����,,,< 3� "�, r;,��. s» ` ,4","' ^ `yAr��- ".a. ,� - 44, x. - �j, IFS, ',� >-%?, :j?• " '"`�/ �, �, ,rIF r.,,J "h„< �',r»:en v/ gyp ,=\= r� `�`` rsy ;..'?'�-" , y- - y'{ z',���s fir- 'r yp 3 xx"4"= `r ;,t�;y,�`a w„a" � ,,/,A'�„ / .,r,��s *7E %'�x / v 1;kU fi 'F -' " . " • ,sn�' " ; , i `'3u /' ✓,, � Sa a_„y" , ;i\a== _-',,r1 ` m ,, • -/- .>:" _ �. , , cra --' ,;,< > xc.,„ ter-_„ , "_ , � x' `%„ sy am i - '' , y„ % `` ' ,E,F::u y�,,r 3V/lf / "y,a; N ?41_" ,.$4-= _,_� s4 - /f;'rs, » a %% ,, ,., ,r,.`, , ' i ., ' ,r _Tr /iyj" A ,, 'i ' %A ' , " , ''/e % „ .� ; $' r x: r;,, r, / ai " /r y, \ /u er ..%y/ y • ,W � , = -fi' / '7. Vjft , :,•7. 77, ,i._ ,/o f /i `� 3 I ;,,r, z' 4 �3 /„ / {"-mac>;'r„ :;% rry - ,u°i'l n ;'//i' ,F as,/�. ./✓ ;^/,i 's; ,%', _ "s". v :,, \-" " e �� ' � �j, E# i,��,�%�� � ` 'M 'E „ .- /, ',,'„n�;1,_ / <<>am- �° ly3 ' : '.ce'`!Ar' i,f oEs n ' ,�, EY' ,,,', �aF" e.lJ � , A3 /, )', - ,, z ' „` / A '„ „r , , „„ ,- ',,' - a . AY" ;`ti y 3'/ , „ _€i�y�� �� ‹ � '! Es% �_ s�;4,„ ram , a -„/ . ;��k �� Yh=� ,,� r ^ , ` ` Ar ,, " A�y,a , �� - �" ' -a � � 7r"r , s/ v r�/ � • ri" ' =Y �� ;4 ' � "`j/ . W '-a�_ra�xr+ ', ,I ,CS,,,„ ,'✓, .«..'%ly�::. , ; `:,11 ,4, `d 0,' , , :� , I si u m tJ 0 0 c v 0 6m 83 {V m m 0 p a,ao e 4. Ct i Cl). as on tiu �, a i f- c va o d a C W CO 0 A ® 'wo 'P"' .� 0,.... 0. t0 i'fl.mr 0 _ ter. a .. 0m0 0 N t a To 44 CC. r > r C r > I trow„,,, ii 4F4 0.00.11 ,„ � ono O = c .,, ......< _ c 0 2 ii 1 4. I/ li 111/011111118“11111 r.rei 0 ..g Q Uc) i {perIIIHIM ( Q` m O r to (I) 00E .fir © p0 CO _.. c 1 y ULI O N m m II o b = u C c"D S . 0? 0 N C I-E ',k-'""",..�."`.'14+, z tit L-7= ,'4'1, <' i� -II <., 0 F-is J� gi > /� E a ap=¢ z y Pr. p 0,112 u zai 2.c - >2 o� p 5 aQtu o <o0 o 1- LI2c4 1>f aE = 0 Ili -Z i C 0 c' Ci Division o;Professional Licensure i Board of Building Regulations and Standards Constru,ai'or1'S ip�,rvisor CS-113356 _ .. TI EA.pires:05/06/2022 CHRISTIAN FOAVENPORT -i _r,f4: i. 20 NORTH MAIN ST t ~"% _';- ' - SOUTH YARMOUTH M,4.:0Z664 - 0 -- '" i s �� I t� I Commissioner �iii. ` JJ// `V _ [ .1 i 1 %'" ''"�""'/'/''�"'// /' ��//w-i///�i//%F��;. Registration valid for individual use only Office of ConsumeraiYs&Busmess Regulation HOME IMPROVEMENT CONTRACTOR i before the expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation $ Registration Expiration 1000 Washington Street -Suite 710 106024 07/20/2022 Boston,MA 02118 s • DAVENPORT BUILDING CO.TRUST I i i 1 CHRISTIAN DAVENPORT / 1 Not valid without signature 20 NORTH MAIN STREET ga,/,..s(a jam' P SOUTH YARMOUTH,MA 02664 Undersecretary f V i i . `1 Y • F 3 1 R 33Y$Y$ 1 . i. 1 S 1 e 1i 1 ' 3 i 1 • A $ I kgg I Z 1 X 1 ti ,__.•-1 DAVEREA-01 OKAY ACC: O" CERTIFICATE OF LIABILITY INSURANCE DATE(MMI o22) 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 ppEA endorsement(s).eNTT NAM PRODUCER ' 7 Valley Forge Captive Advisors (a/CC,,No,Ext):(610)458-3659 I itic,No):(484)965-9627 I 630 Freedom Business Center Drive Suite 203i ss: King Of Prussia,PA 19406 INSURER(S)AFFORDING COVERAGE NAIC S �1 INSURER A:Zurich American Insurance Company 16535 INSURED INSURER B: �I Davenport Building Co INSURER C: s c/o Davenport Realty Trust a 20 North Main Street INSURER D: South Yarmouth,MA 02664 INSURER E: _INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WWI POUCY NUMBER IMM/DD/YYYYI IMMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ a GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY jE 0. LOC PRODUCTS-COMP/OP AGG $ OTHER: I CA AUTOMOBILE LIABILITY (Fa FOMaBINEDen SINGLE LIMIT t) $ 1,000,000 X ANY AUTO — BAP8196256 3/1/2022 3/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED } _ AUTOS ONLY _AUTOS yy� p BODILY INJURY(Per accident) $ A��EOS ONLY _AI�OS O Y I er acci tDAMAOE $ $ _ UMBRELLA LIAB —OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X STATUTE ER OTH AND EMPLOYERS'LIABILITY Y/N 1WC8196035 3/1/2022 3/1/2023 1,000,000 I ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ li OFFICER/MEMBER EXCLUDED? I I N/A 1,000,000 (Mandatory in NH) E.LDISEASE-EAEMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ I ri DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) i ri s r 4 CERTIFICATE HOLDER CANCELLATION i l SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE t THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. i AUTHORIZED REPRESENTATIVEki 47/40. ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ) i i t I ti I 1 ��� DAVEREA-01 OKAY ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYIY) 1/41.......---' 2/16/2022 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 ir 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 NQNTACT Valley Forge Captive Advisors PHONE Fax 630 Freedom Business Center Drive (A/C,No,Extl:(610)458-3659 I(A/c,No):(484)965-9627 E-MAIL Suite 203 ADDRESS: 3 King Of Prussia,PA 19406 INSURERISI AFFORDING COVERAGE NAIC# INSURER A:Zurich American Insurance Company 16535 INSURED INSURER B: Davenport Building Co t c/ Davenport Realty Trust INSURER Co 20 North Main Street INSURER D: South Yarmouth,MA 02664 INSURER E: r INSURER F: i COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER _(MMIDgryYYYl IMM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 o CLAIMS-MADE X OCCUR GL08196255 3/1/2022 3/1/2023 DAMAGE TO RENTED 1,000,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 4 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ' X POLICY T& LOC PRODUCTS-COMP/OP AGO, $ 2,000,000 j a OTHER: $ I COMBINED SINGLE LIMIT 1,000,000 ' A AUTOMOBILE LIABILITY (Ea accident) $ X ANY AUTO BAP8196256 3/1/2022 3/1/2023 BODILY INJURY(Per person) $ OWNED —SCHEDULED _ AUTOS ONLY _AUTOS BODILY INJURY(Per accident) $ H RED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY _AUTOS ONLY ,(Per accident) _ $ ) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ r A WORKERS X STATUTE ERH z AND EMPLOYERS'LIABILITY Y/N WC8196035 3/1/2022 3/1/2023 1,000,000 ( ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ it OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 1If yes,describe under 1,000 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 t k I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ) P 1 1 ( t 8 CERTIFICATE HOLDER CANCELLATION a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BuildingDepartment THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ( P ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. IIThe ACORD name and logo are registered marks of ACORD 1 ( i ) 11 7 ® DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE ki,----- 6/1/2022 2/3/2022 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(les)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 1 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies NAME CT 1185 Avenue of the Americas,Suite 2010 PHONE FAX New York NY 10036 E-MAILo.Ed): (A/C,No): 646-572-7300 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:James River Insurance Company 12203 INSURED Davenport Building Company Trust INSURER B:Aspen American Insurance Company 43460 1494749 20 North Main Street INSURER C: South Yarmouth MA 02664 INSURER D: k INSURER E: f INSURER F: I COVERAGES CERTIFICATE NUMBER: 18237148 REVISION NUMBER: XXXXXXX t 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 b CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 1 EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR W TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSD, VD POLICY NUMBER IMM/DDIYYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A DAMAGE TA X N N 00092008-2 6/1/2021 6/1/2022 RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 3 X Ded:$5k MED EXP(Any one person) $ Excluded PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JE 0 I I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ ( A AUTOMOBILE LIABILITY N N 00092008-2 6/1/2021 6/1/2022 COMBINED SINGLE LIMIT $ E` (Ea accident) 1,000,000 ANY AUTO BODILY INJURY(Per person) $ XXXXXXX 6 @ — OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS XXXXXXX X HIRED XPROPERTY $AUTOS ONLY AUTOS ONLY (Pr accident) $ XXX3 � B X UMBRELLA LIAB X OCCUR N N CX00CQR21 6/1/2021 6/1/2022 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER I ANY PROPRIETOR/PARTNER/EXECUTIVE [I E.L.EACH ACCIDENT $ XXXXXXX j OFFICER/MEMBER EXCLUDED? I I N IA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX r 1 1 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) I i 1 f 1 CERTIFICATE HOLDER CANCELLATION 18237148 P 5 Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE L THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. t _ AUTHORIZED REPRI$l5Eir I AI VE t(, ///J I ©1988-2015 ACORD CORPORATION. I rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD I i • The Commonwealth of Massachusetts ax��� t D epartment of Industrial Accidents =il l' 1 Congress Street,Suite 100 �„ . . Boston,MA 02114-2017 ` www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Flumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): J)&vepor1' 6u,(16.4s ( 41, 2 an y Address: go A . ,'ka,„ SI. . City/State/Zip: S, a,rh*evitt Phone#: (5-6V c) `a-Q6/ Are you an employer?Check the appropriate box: Type of project(required): in I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in ca ci8. Remodeling an y pa city.[No workers'comp.insurance required.) 3.0 I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on myroe I will 10 [� Building addition ensure that all contractors either have workers'compensation insurance or are sole p 11.0 Electrical repairs or additions proprietors with no employees. 5. am a general contractor and I have hired the sub-contractors listed an the attached sheet I k17' Plumbing repairs or additions hese sub-contractors have employees and have workers'comp.insurance.: 13.E]Roof repairs 6.0 We art a corporation and its officers have exercised their right of exemption per MGL c. 1'4.❑Other • 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 41 must also 511 out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company2.��1 G � Name: A €' 1h ""/ IV V"I"c e (6vn. PQVy Policy#or Self-ins.Lic.#: (A,C a 14 6 b "3 r Expiration Date: 3/,/ o, 3 Job Site Address: g Fr Z 1' City/State/Zip: _.Xv-na ,A4A- dab 6 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u r to pains and • of perjury that the information provided above ' true nd correct. Signature: For �'� L Date: D �..1, 6 � Phone#: f - .-a b • Official use only. Do not write in this area, to be completed by city or town official. , City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-223E1 ext.-•1261 Fax 508-398-0836 • Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at (6 81 t2t a r Work Address Is to be disposed of oat the following location: S I- J .EX C d Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, 150A. d- �-�4�Signature of Application Date • Permit No.