53 NE 102 St (4)HEAD, BECKHAM & SWARTZ INSURANCE AGENCY, INC.
128 SHORELAND ARCADE
P. O. BOX 3820 MIAMI 24, FLORIDA
April 1, 1949
REGISTERED
Building Dept.
Village of Miami Shores
Miami Shores, Fla.
Gentlemen:
Certificate of Insurance - October 25, 1948
Clyde DiPrima & Ethel DiPrima - Policies
UC 7 -4935 & LP 48285 - Fireman's Fund
Indemnity Company
Please accept this letter as notice of cancellation of
DiPrima's above numbered policies, in accordance with
terms of certificate of insurance, on file in your
office.
blh
Very truly yours
HEAD, BECKHAM & SWARTZ INS. AGENCY, INC.
D� ta,e4,
Philip ead
,REGISTM:LO HAIL CANCELLATION ADVICE Certificate Holder
Date April 13th l 19 49
City of Miami Shores
Miami Shores, Florida
Assured. Di. Prima & Ethel DiPrima
Address 629 N. E. 92nd St... Shores & g/w in State of Fla.
Our Policy No. M
effective
October 2th.,
••••••■••■•■••••■•■••■•••■••••
19 48
covering the above risk has been cancelled as of 4
Desc: Carpentry & Masonry
o orr ie
Accts. 411 ED-3M-1-48-HB
BY
(date)
FIREMAN'S FUND INDEMNITY COMPANY
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FIREMAN'S FUND INDEMNITY COMPANY
4 , 6 40
A EASTERN DEPARTMENT
NEW YORK
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CERTIFICATE OF INSURANCE
Date OCTOBER 25 1948
This is to certify to • MIAMI SHORES
Address MIAMI.... SHORES., FLA,.
that the following described policies are in force at this date :
Name of Insured
CLYDE &.. HFT. DiPRIMA,
..- .Dj.PRIMA.... .ET
li
Address 62. N. E....... 92nd... ST....,... ..MIAMI.... SHORES. .•AND- ..E -LSE RE . • .r STATE OF
POLICY NUMBER KIND OF INSURANCE LIMITS
EFFECTIVE
EXPIRATION
DATE
DATE
IIC 7- 4935.. ......_ WORKMAN'S COMPENSATION STATUTORY
1Q 2.5 -48
10- 2.5-49
LP 4828.5 PUBLIC LIABILITY
•10•25•48
10••2- 5a49.
Each Person $... .3,0 0 .0 0
BODILY INJURY
{ Each Accident $ 20,000
Each Accident $ 1,000
PROPERTY DAMAGE
{
Aggregate ... $ 10,000
... OWNER'S OR CONTRACTOR'S
PROTECTIVE LIABILITY
BODILY INJURY
Each Person $
{ Each. Accident $
PROPERTY DAMAGE {Each Accident $
Aggregate ... $
_ „^_. „ „_ AUTOMOBILE LIABILITY
BODILY INJURY
Each Person $
{ Each Accident $
PROPERTY DAMAGE— Each Accident $
(MISCELLANEOUS LINES)
Description of Coverage: CARPENTRY & MASONRY
PRIOR TO ANY CHANGE IN OR CANCELLATION OF THE POLICY THE COMPANY WILL
NOTIFY THE CITY OF MIAMI SHORES, MIAMI SHORES, FLORIDA BY REGISTERED MAI:
HEAD, BEC : ' , J & SWARTZ INS. AGENCY, INC.
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LW= Aut °rued Representative
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MISC. 4423p 5014-5.46
STATE OF FLORIDA) SS
COUNTY OF DADE )
19
A F F I D A V I T
_ _ _ of the Village of Miami Shores,
ty of Dade = • State of Florida, being duly sworn, doth depose and say,
t under the provisions of. Ordinance He. 185, dated June 15, 1L &, ,, - end -
ing paragraph (d) of Section B - -368 of Ordinance '1o. 97 • f the Lui ' r_ ; ode
of Miami Shores Village, he desires to build a
on Lot
that he i s` j�fi6 owner of said property, and 1 • . he owner
__ _ �, that he will do the woi .c pe n;,cn��.11y,
and that he ?'ill, at such times as are re ; uired by the Zoning ancl
Director:-
1. File plans and specifications and obtain approval of the
Plaining Board and the Building Inspector.
2. Apply for and secure a Permit.
3. Pay the required fees.
4. Execute the work in accordance with the provisions of this
Code.
5. Apply for inspections.
6. File with the Building Inspector certificates that provision
has been made to carry the necessary Workmen's Co^ipens tion,
Public Liability and Property Damage Insurance.
7. File with the Building Inspector as the job progresses certi-
ficates showing the payment required by the Federal Social
Security Act to the State of Florida or the United States of
America.
8. Assume the responsibility of not employing other than properly
licensed contrcctors by Miami Shores Village for any part or
portion of the work.
9. Not set himself up as a "contractor ".
10. Sign an affidavit before commencing work to the effect that
he has read this Article and will do the work personally and
observe all of the requirements of the Building, Electrical,
Plumbing and Zoning Codes of Miami Shores Village. Such
affidavit to be properly notarized upon blanks to be supplied
by the Building Inspector.
11. In order to prevent abuses and subterfuge the right of such
owner- builder as herein provided, is limited to but one
owner - builder permit each 2 years, and where an owner-builder
has once exercised the privilege herein conferred no second
application for owner - builder permit shall be granted in less
than 2 years, unless the applicant is qualified as a licensed
General Contractor under the applicable Ordinances of said
Village.
And Further this Deponent says not:
SUBS BD AND SWORN TO BEFORE -, ME this
-!__
OWNER
day of A. D.,
AR PUB
1761`.' ■ ', "f:i 1, 'i:': "• .`;i'4.; %? t