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BP-47525 'ermit No. BP-47525 B U I L :'PERMIT GI 42©$ 1 l�oinmoncve.. o g adaaGzuaetta 4079, TOWN OP DARTMOUTH Lod QQ0 4 400 Slocum Road,`Dartmouth,MVIA i02747g Sub�1ot 0000 Phone - ,, ,10 1$?0 • Fax (508)910 1438 Cafegor TOPLA Project f ` ' S Zp0 7 OQ174S : PERMISSION IS IIERE,BY:G,R4N ED TO: It+3 E44j 4 398 0 Fee 4 . $ 0 Oil ? ' ' Contractor: License Phone Coist Class Use Gr-4up `- R4 ' ��s , 3 Engineer: "' - License Phone# Lot,S)ies"ti It). .' 12500- r Zoning SR$ �� Applicant: Phone# New Const N/$ '; JOHN A JENNINGS (SQ8)99 -7347 a A t 0onst N/A ', -: ,. CHET BROWN ' , Oate Typed 01.24 2007�- OWNER: JENNINGS JOHN A DATE ISSUED: TO PERFORM THE FOLLOWING WORK: Replace eight windows in SAME OPENINGS Proj t Lo tion: 85 PINE ISLAND RD V Approved/Issued By: r DAVID BRUNETTE,LOCAL UILDING INSPECTOR All work shall comply with 780 CMR 6TH Ed.(MGL Chap.143)and any other applicable Mass.Laws or Codes and plans on file. SCHEDULE APPROPRIATE INSPECTIONS AS REQUIRED. UPON COMPLETION OF WORK,FINAL INSPECTION IS REQUIRED. THIS PERMIT WILL EXPIRE PER 780 CMR 111.8(NOT MORE THAN 3 EXTENSIONS WILL BE GRANTED)OR ON ISSUANCE OF A REGULAR OCCUPANCY PERMIT. I hereby certify that the proposed work is authorized by the owner of record and I have been authorized by the owner to make this application as his agent and to receive this permit, I further understand other agencies may have reason to STOP WORK if items under their jurisdiction are not met; not withstanding the issuance of this Building/Zoniryg Permit. Signature of Owner/Agent:_4 O /c r' E - - ' NFEEg ST� A )-IFYNI 'U $ !INGINSPECfiION RS IRl41T'MBER IS REQURD l w(AT EQ t D© QAComments PEII Ns S TIONREI ,AC MENT FEDWI LB L' ORETe*IWNg,A IOTA RIN _E- R"Persons contractin with unregistered contractors do not have access to the guaranty fund(as set forth in MGL c.142A)" Inspector of Inspector of l D.P.W.Inspector Building Inspector Inspector of Gas Fire Department Plumbing Wiring Water Service#: Footings: Underground: Oil: Underground: Service: Foundation: Rough: Smoke: Rough: Rough: Sewer Service#: Rough Frame: Insulation: Final: Final: Final: Cross Connection Final: Final: _ j Treasury: j Board of Health E-911 jAdditional Comments: j Planning Board 1 Prior to issuance of Certificate of Occupancy/Completion,this card must be returned to the Building Department with all necessary inspections signed off. Department phone numbers are listed on the white"Required Inspections"document provided with the issuance of the building permit. POST CARD SO IT IS VISIBLE FROM THE STREET TOWNOF DARTMOUTH 47,52c_k., BUILDING RECEIPTS . COLLECTOR'S OFFICE Name ; ,. - ,L,, //-f ,.._,i;,,„.„,k1 v....-7,,,4, 1 ._,,,7 Property il.,...11,1 1 , ----4,.......... Date: i / - '''' ifirl —7 / r ./(......, / .----p --- ' ' ' ' -.) i 4Owner: . ... / ! /,, „......, j i / _,,: ., i „...:, , ,/,- I Job Location: i.." / ./.- - he,/4.: :,, / --2,. 4.-4 e,,'N'..../ '—''''' / / `''') / 7/ -1()VVI .Y.c.9-..,7,7141- 1cTEP e.,-- .. ,` White Copy-Collector's Office 1,---1 , A i i Plot //I (-1 Lot: cOt i 1-f ' ' Yellow Copy-Customer's Receipt ,, .-, . Pink Copy-File Copy I I / 't= ' ' - ,:, . ,.,...Green Copy-Building Department Phone: ,1 A_ ', •--- --1 to T1 taw , , •-[ 4- _,. Description General Ledger#'s Ref.# - Amount Building /./ ) /..,, .- s--' ----, zi-----7 License&Permits- "--.7 01000-44105 /, 1 iili,:' -,,, i L.....! , _-----:,/ 1 - r 1,1 License&Permits-Building Misc. 01000-44105 License&Permits-Electrical 01000-44106 License&Permits-Plumbing&Gas 01000-44107 Other Department Revenue 01000-42420 ---,,-.......) This is not a Permit or License for Building.Plumbing or Gas Received Br', 0 SPECIAL PERMIT(Per 780 CMR 111.13) $2 5.00 APPLICATION FEE IS NON BE-FUNDABLE &NON-TUISANSFERABLE _ DATE RECEIVED :'E "N: DARTMOUTH BUILDING DEPARTMENT _`. 400 Slocum Road, P.O. Box 79399 / ' Dartmouth, MA 02747 ' Phone: 508-910-1820 Fax: 508-910-1838 �.a �,fi�4 www.town.dartmouth.ma.us "'2 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING n THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: BUILDING PERMIT NUMBE /715 7 DATE SENT FOR REVIEW: / /y O." DATE ISSUED: ,�� �I fl O.K.TO ISSUE-SIGNATURE:4 ,,,,, . :„, '�" DATE: /-- .. `3 Zoning District:. Proposed Use: Zone: ❑ C ❑ B A ❑V Aquifer Zone: THE FOLLOWING AGENCIES SHOULD BE NOTIFIED: ❑Board of 0 Board of 0 Cons. 0 Demo ❑DPW ❑Elec. 0 Energy Report Appeals Health Commission Affidavit Card Sent: Cut Off "Follow-up* ❑Fire 0 Gas 0 Planning ❑Sewer Card 0 Water Card 0 Zoning 0 Other Chief Cut Off Board Cut Off Cut Off *REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL Zoning Review: Signature: Om)?cit.-?_0,644-7,.7,,g Date: /— , 3` 7 Energy Report: Signature: Date: Fire Chief: Signature: `� Date: QBoard of Health: Signature: // Date: Conservation Commission: Signature: Date: Other: Signature: / Date:� n Brief description of work being performed: / / e f °" S SECTION 1 -SITE INFORMATION 1.1 Property Address: 5JS /- i ie , / a f"3. 1.2 Assessors Map&Lot Number: Nearest Cross Street: Map sf7r Lot, - Subdivision Name: 1.3 Historical District ❑Yes 0 No Total Land Area Sq. Feet: Has application been submitted to the Historic Commission? 0 Yes 0 No Date: 1.4 Water Supply(MGL 0 s54): 1.5 Sewage Disposal System: ❑ Municipal Private Well 0 Municipal 0 On Site Disposal System ❑ CONSTRUCTION PLANS 0 SITE PLAN 0 ENERGY REPORT RESIDENTIAL SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Ow er Record: , �1 v J O�"� J'`' C / N 0- •Pw� Ai PI o qq5 (7 Name(print) J Contact Address Phone Number 2.2 Authoriz Agent: B i" 1 cbG '&13(,,,I 4 (\iv f;,\142.- -5D g-17 4576 V Name(print) ontact Address Phone Number SECTION 3=CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction Supervisor: License Number: .-. co Address: Expiration Date: W Signature: Telephone: Z 3.2 Registered Home Improvement Contractor: Not Applicable 0 W O Are you a Home Improvement Contractor subject to(780 CMR-6)? 0 Yes 0 No .J If No,go to the next section! LPL Are you claming exemption from the requirements? 0 Yes 0 No 0 If Yes, submit the required affidavit! aCompany Name: Registration Number(if none, state"none"): 0 Address: V Signature: Telephone: Expiration Date: 3.3 For Residential Remodel Work Only PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND: QUESTIONS OR COMPLAINTS call or write: Home Improvement Contractors Registration, One Ashburton Place-Room 1301, Boston, MA 02108, 617-727-8598 ciI am a Homeowner performing all the work myself. Owners Name(print): 41 (.--,./t/ J� Signature: / 41 si nin t e e-h above,tllom1 edges that there will be no eligibility to the Guaranty Fund Date: 1 ' 17-U? 3.4 Homeowner Exemption-One&Two Family Only FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT 109.1.1 Licensing of Construction Supervisors: Except for those structures governed by Construction Control in Section 116.0,effective July 1,1982,no individual shall be engaged in directly supervising persons engaged in construction,reconstruction,alteration,repair,removal or demolition involving the structural elements of buildings or structures,unless he or she is licensed in accordance with the rules and regulations promulgated by the BBRS entitled Rules and Regulations for Licensing Construction Supervisors. Exception: Any Homeowner performing work for which a Building Permit is required shall be exempt from the provisions of this section;provides that if a Homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor. For the purposes of this section only,a"Homeowner'is defined as follows: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a Homeowner. ( If you are applying under this ction sig below: 0 V Signature: v 4 Your signat e c Ties m responsibilities,including but not necessarily limited to,general liability NOTICE TO LICENSED CONTRACTORS:The Building Code provides in the Rules and Regulations section that any licensed Construction Supervisor,whether or not they have taken the permit are responsible for code compliance. (see Appendix of 780 CMR R5.2.15) SECTION 4 WORKER'S COMPENSATION INSURANCE AFFIDAVIT(MGL c 152§25) Worker's 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 0 No SECTION 5 -DESCRIPTION OF PROPOSED WORK(Check all applicable) ❑Deck ❑Pool ❑Repairs 0 Alteration 0 Chimney/Fireplace 0 Woodstove/Pellet Stove ❑New Construction* 0 Accessory Bldg. 0 Roofing/Siding 0 Other (Energy report required) (Shed/Garage) (Specify below) ❑Addition tiReplacement window/door 0 Demolition (Energy report required) No.of windows Doors (Specify below) *If new construction, please complete the following: Single Family: No.of Bedrooms No.of Baths Two Family: No of Bedrooms Unit 1 No. of Baths Unit 1 No of Bedrooms Unit 2 No. of Baths Unit 2 ❑Furnace(hot air)-fuel gas(natural or propane),fuel oil,electricity,other(specify): ❑Boiler(heating)-fuel gas(natural or propane),fuel oil,electricity,other(specify): ❑HVAC(combined unit)-primary fuel,natural gas,propane,electricity,other ❑Air conditioning-(separate unit) ❑None of the above to be provided ❑Hot Water: Gas Electric Fuel Oil Other Description of proposed work: cb p \(.c j c) \ e_ (2-0k-t91/) O e�� P � SECTION 6-ESTIMATED CONSTRUCTION COST Item Estimated Colt($)to be completed by permit applicant 1. Building1-) C:1 50 2. Electrical 3. Plumbing 4. Mechanical(HVAC) 5. Total=(1 +2+3+4) SECTION 7A-OWNER AUTHORIZATION (to be completed when owner's agent or contractor applies for building permit) (Pleas �P int) 1, 66 A) ,W,v /q�( , as Owner of the subject property hereby authorize iC 1b/ '\L71 v to�ct on m be If, in all matters relati work authorized bythis buildingpermit application. Y PP Si atu a of caner Date SECTION 7B-OWNER/AUTHORIZED AGENT DECLARATION I, e1A-e-r- C51�' ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sign and r the pains and penalties of perjury. S a ure of Owner/Authorized gen R t� Date SECTION 8-=INSPECTOR'S REVIEW/COMMENTS 1. Date plan reviewed: 2. DENIED(see project review worksheet): Date: 3. HOLD Reason: Date: 4. HOLD subject to Zoning Board of Appeals action: Date: Comments: Inspector's Signature: ALOrd-r�-) -C.t/y'� Date: 3 S CTIO -APPLICANT NOTIFICATION�'l� 2 /Applicant informed of ab ve: Date: / 2 Time:i,,-3IO / Clerk: Comments: / , 1 ,ii ._. (ifeiriij SECTION 10 OFFICE/INSPECTOR'S NOTES Total Permit Fee:$ 3 0 Less Application Fee:$25.00 Remaining Balance: $ --0 Other$Amount$ TOTAL FEE: Gross Area- New Construction total sq.ft. Gross Area-Alteration total sq.ft. , Permit Issued to: SECTION 11 -ADDITIONAL COMMENTS/SKETCHES ��/Z,6(// 0 SPECIAL PERMIT(Per 780 CMR 111.13) $25.00 APPLICATION FEE IS NON BE-FUNDABLE &NON-TUANSFERABLE DATE RECEIVED irrrs,_71:4-S9,1,;:\ DARTMOUTH BUILDING DEPARTMENT 400 Slocum Road, P.O. Box 79399 - — ---\- '.1 ‘14/ .....,// .town.dartmouth.ma.us Dartmouth, MA 02747 •,...0,,-.MG s.,,,,, Phone: 508-910-1820 Fax 508-910-1838 1 N....../66 :....--- APPLICATION TO CONSTRUCT, REPAIR, RENOVATEOFFICIAL ORDEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR USE ONLY .BUILDING PERMIT NUMBER: RECEIVED BY: . co DATE SENT FOR REVIEW: 7 . DATE ISSUED: O.K.TO ISSUE-SIGNATURE: DATE: Zoning District: Proposed Use: Zone: 0 C 0 B CI A 0 V Aquifer Zone: THE FOLLOWING AGENCIES SHOULD BE NOTIFIED: ID Board of 0 Board of 0 Cons. 0 Demo 0 DPW 0 Elec. 0 Energy Report Appeals Health Commission Affidavit Card Sent: Cut Off Follow-up* 0 Fire 0 Gas El Planning 0 Sewer Card 0 Water Card 0 Zoning 0 Other Chief Cut Off Board Cut Off Cut Off *REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL Zoning Review: Signature: Date: Energy Report: Signature: Date: Fire Chief: Signature: Date: ...-- Board of Health: Signatur . i4 Date: /_ Conservation Commission: Signature: Date: Other: Signature: , Date: Brief description of work being performed: ,p-y )//1 i '1.11:11 3 SECTION 1 -SITE INFORMATION 1.1 Property Address: 6 F, s- ) 94e .,r-citkio a • 1.2 Assessors Map&Lot Number: Nearest Cross Street: Map 7/ Lot AY___- Subdivision Name: 1.3 Historical District 0 Yes 1:1 No ______ _____ __ Total Land Area Sq. Feet: -- _ .7, ,.., ,: Has application been submitted to the Historic Commission? i r ' 0 Yes El No Date: 1.4 Water Supply(MGL 0 s54). 1.5 Sewage Disposal System: 0 Municipal VPrivate Well 0 Municipal 0 On Site Disposal System 0 CONSTRUCTION PLANS 0 SITE PLAN El ENERGY REPORT ��- ,- Dartmouth BuildingDepartment 4 l�'_ �I► `ll _: 400 Slocum Road o 4 $1 P.O. Box 79399 508-910-1820 sy` Dartmouth, MA 02747 FAX 508-910-1838 REQUIRED INSPECTIONS FORM #115 README. The applicant is responsible for calling this office when scheduling inspections. Please refer to the list below for required inspections. I J .$ 6.c..�.. ♦....�_.c_ a..�-.. _ L ...� .n.,..:�.�.......y.� .��.—� rota Address 6 _& ��_.._. Date l- 7 *FOUNDATION(as-built needed): Notice *BEFORE INSPECTION,FOUNDATION BRACING MUST BE INSTALLED. *SONO-TUBE INSPECTION: *INSPECTION IS NEEDED BEFORE THE CONCRETE IS POURED. *ROUGH/FRAME(with approved plans- ` *AFTER ALL ELECTRICAL&PLUMBING HAS BEEN INSTALLED&INSPECTED FIREPLACE: ❑ Footing(If separate) ❑ Throat 0 Before cap is installed INSULATION(with approved energy report): NOTE: N.F.R.C.LABELS MUST BE ON ALL WINDOWS AND DOORS OR USE DEFAULT CHART VALUES. rS -1;P?A FINAL (with approved plans and energy report): ...,, r-t The Commonwealth of Massachusetts Department of Industrial Accidents 1*=`=r1 „� t�tr' Office of Investigations � _::�= 600 Washington Street ,�i�= s, Boston, MA 02111 y v. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): l 0 A( Fi(iV ( Address: ��� P/A/E ._T�r'/i,/-41 1I) City/State/Zip: 09/17/ttati4 /)'/,,1, V 94 Phone#:(3-00P py,2` 734 Are you an employer?Check the appropriate box: Type of project(required): 1.n I am a employer with 4. ( I I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.n I am a sole proprietor or partner- listed on the attached sheet. + �• (� Remodeling ship and have no employees These sub-contractors have 8. n Demolition working for me in any capacity. workers'comp. insurance. 9. n Building addition o workers'comp. insurance 5. n We are a corporation and its required.) officers have exercised their 10.n Electrical repairs or additions 3. I am a homeowner doing all work right of exemption per MGL 11.n Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.1 I Roof repairs insurance required.]t employees. [No workers' comp. insurance required.] 13.n Other *Any applicant that checks box#I must also fill 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ' Insurance Company Name: r P!Lnig, A A , 1' Policy#or Self-ins. Lic.#: f �d f Expiration Date: Job Site Address: `- " City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 10 hereby certify nder e pains and penalties of ' ry that the information provide above is true and correct. '-Signature: /� O? i <<� _ Date: Phone#: -ZA — ery- rirril 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an 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,construction 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 who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"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 with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(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,are 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 be returned to the city or town that the application for the permit or license is being requested,not the Depai fluent 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 Department 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 and 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"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 the 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 dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-05 www.mass.gov/dia *)errnit No. BP-47525 Project Location: 85 PINE ISLAND RD Commonwealth of.Massachusetts GIS# 4208.00 TOWN OF DARTMOUTH Map,, 0079 400 Slocum Road,Dartmouth,MA 02747 Lot 0024 Phone: (508)910-1820 • Fax:(508)910-1838 Sublot: 0000 BUILDING PFRIVIIT Category: TO REPLACE Project# JS 2007 001745.,,. Est.Cost $1980.00 FIF,T ,D INSPECTION Fee: $30.00 const.Class; Contractor: License: Phone#: Use Group: R4 Lot Size(sq. ft.) 12500 Engineer: License: Phone#: Zoning: SRB New Coast ..,.. NIA.; Alt.Const.: N/A Applicant: Phone#: Ceiling: JOHN A JENNINGS, (508) 995-7347 Walls OWNER: JENNINGS JOHN A Floor Glazing: DATE ISSUED: I P.,k TO PERFORM THE FOLLOWING WORK: Replace eight windows in SAME OPENINGS DATE TIME TYPE OF INSPECTION&REMARKS INITIAL A7- T�f � x%- s ‘.67 4d ,��i i C /g/i<3// 7 '/�� 4/6, / S 0,9//e I f �-' c/o hA, ."0 AN C Tt----A-4-C/ /1/ OA/ / ELAit / —4 doLc 6 UT( /1/ k (21-/ .1;.s /1/11P Fll L P;Ip x():j 4it 67/3 6 '7