Document jyyNYVmZvE9JyOG4MdG80nv6Z

FILE NAME: Insulators Workers' Comp Claims (IWC) DATE: 1965 DOC#: IWC026 DOCUMENT DESCRIPTION: Claimant - Chester, Charles I * k|(,TM OK PENNSYLVANIA 1-(1. llENT^OK LAHOR ANO INDUSTRY CLAIM PETITION FOR COMPENSATION FOR SILICOSIS, ANTHRACO-SILICOSIS AND ASBESTOSIS HAKKISBUKO. PA. .^hoN Rm M 12-00-65 022,170 charlea Cheater -tnt or T n nun of Claim ant fV16 B e r t w o o d Ave. ' ' Olouceater, N.J. Claim Petition No. JUSUXBL 19 u-mstrong Contracting & Supply Co. Lin ployof . J 2 5 N. B r o a d St. Phila. Pa. Ailrtre. In.ur.nc C u rtir AdrtrtM O c c u p a tio n a l DIm u m F u n d TO THE WORKMEN'S COMPENSATION BOARD, COMMONWEALTH OF PENNSYLVANIA: The claimant respectfully represent: 1. My name is __________ C h a r lea C h e a t e r _____________ 2. I became totally disabled as the result of ( Asbestosis 0f ___ S e p t e m b e r __________ 1Q 65 3. My total disability is result of employment in a hazardous occupation having a j j hazard, and I have been so employed in the Commonwealth of Pennsylvania at least two years in the aggregate during the ten years next preceding the date of disability as follows: Dut of Em ploym ent N ame of Em ployer In P en n ay lran ta Address From To L'el aw are I n s u la t io n Co. 5 th & Colem an S t . , W ilm in g to n MancTGt '''Coi`K'"'C';';'"" t'"'f" B'Tn'esa ---------------------------------- 1956 th ru Nov. 1957 T3 'c 'r " r 9 5 7 ""EH ru"T a h ' r 196 3 r m s t r o n g ''C o n t r r '2 9 2 5 ~''N.~T3r o acT" t . 7 ' W n a : 7 ~Pa7 ~----------- * t i e c h a n i c a r ' I n i B u i a t i o n C o . ""3T T W. Mt'7 P T e a s n t " 7 iv V lf ir * K e c h a h i c a T ~ r h a l a t i n ~ C 7 7 '" ^ I I W. H t 7 `T I 'e a o a h T 'A ^ ,''B H Ila r r i d y " S u p y ~ C 67~,~"7 7 3 7 " l^ TM C m b r id g TM S `" ~ P l I T T 7'"P T "* Ar m s t r o h g _ ''C h t7 ", 2 9 2 5 ~N7-'BroTnir" 5 1 . ;" '" F h ia '.T " P A l------------- y 1963 A u g u s t , 1 9 6 3 ................ "Nov"."""T 96T ' 't h r u Wa 1904 ~Sopi~. I 9 6 T ' t h r "'6 ct". 1 9 C " J U n T l9 5' i t l r 'N6'v 7 1964 O v e n s ' C o r n in g ~ 0T a i i s T T T ^ a c l c s h t '"Sw lm oon"^S'tT# P K T I a . B a r r T c a H e C o a t T h g C . , T O T N7 " K i n g s ~S t . , ' C r u c e s ' t f 7 r . ' J . "N ov. i'9 6 4 t h r u .. F e b . 196 5 "'Felo. 965 t h r u M a rc h 1965 P h i l'a rA s T i'i s " ''e o 7 r ^ ' 0"i r r n [ 0^ F r i d ^ 5 p ]n y ~ C 7 7 ` ' T n 7 7 tf7 " C ^ ^ S t : 7 r' P h T I a 7 7 "P a': " H h ic H '1 9 6 5 "" t h t u ' J u n e 1965 ^ I 7"7 L9 6 r u n t I T ' h o 8- ..................................................................~ , __________ ____________ " p i t a l l zed 8ep t . 1965 4. The above named defendant was my employer when I was last exposed to a SUtK Asbestos hazard and I was in the defendant's employ from -- to --- --A * 5. Since the date of leaving the defendant's employment, I have been employed as follows: ---- ----- does not apply. ________________ .... ....... --.......... - -- ...... - ........................ ............... .....................--.----."yx^r ...... - 6. I served notice of my disability on the above named defendant on ------------------- -- ------- day of -..N ovem ber,.____________ 19_AA_ in the following way: A t t a r _ j M u ^ ...v x ....t e ------------------------------------ -- 7. Before my disability began I earned | 175 09_____- a week as Fj^S'A . ? c --^ ....?. efes * t.Q j._vgxK RS_____________________________________ ______________________________________ ( h .r . tU U n tu n of w ort don> 1 1 > (See Reverse 81de) 8. I | js p itax? 1 receive medical, surgical, dental or hospital services as follows: Hilhn.eX0.6XU3----- Ax e l K. O ls e n , M.D. ; J a c k J . P e r i l , M.D.y We s t J e r s ey H o s p ita l (B u t nm of doctor or OoapttaU) 9, I | cHnot j request the defendant to furnish such services; and they j j furnished by the defendant. 10. If medical, surgical, dental or hospital services were procured at your own expense state what sum was spent by you for each Dr. O l s e n $ 8 2 5 . 0 0 ; ...V,;est_Jer^ ------------- 11. My social security number is: . 1 7 9 - 0 7 - 6 2 4 5 12. I believe the following additional facta to be important: Wherefore I ask that your Honorable Board shall make an award foi such compensation as may be due My Commission Expires on (T bit ffldarit m*7 b* worn to bfor ComponaaUon Rt/tr* or any other penton authorised to administer an oath). day of 19. NOTICE: This petition may be signed and sworn to by any dependent for himself and all other dependents. I '! i .t? 'V \ v> . 1. V , . Please enter my appearance for petitioner .L. A ttorn * r - 735 P.S.F.S. Bldg., 12 S. 12th St., JifaAulAl A... Addrwi ........................... . .. .' . Bank & Minehart, Eaqa. NOTICE: This petition should be filed In original and five exact copies either typed or printed. The parly taking oath Is requested to type or print fuD name and complete address of Petitioner signing this petition. It is necessary to make affidavit to only the original copy of the petition. m !' . V ii v' / K 1, 1 A rs fo . . c% *4 . O,. " no:'! hir.IZiJZ---- <->V" j..*. o vo _i f *8.r`$o ~... no ovcrf 1 J r u 1-rr-' 1 o-.1 lr> ,,| XR - /:y>*.o -*- . . 1 3 .1 (3 0 1 ^ P.TM tin i :* i on -t M \ r: ` i ' 4 !) r 'Ji ''Itr : i -, m 1 i 1li i C l 1 .... . .. . ' . ' f . . . I W V l '' i " - 'f ' .. i . v ' . i . II ) 1 ru .'i <1 1 Q-jtiVyi<uwf- A % C uj.cIclj G-f C A ^ o / ^ s J 'j TV>i4a( C !<*i c *tcj d o , '- / c c\J . s C o A" >7 s?4>y,< / U/Ci* , W c ~~ /2-Z <? / 6 S~ i< July 22, 1966 ( The Aetna Casualty and Surety Company Suburban Statical Building 1617 John F. Kennedy Boulevard Philadelphia, Pennsylvania 19X03 Gentlemen! Subject) Fatal Occupational Disease Marie Chester, Widow versus Armstrong Cork Petition 191|555 Armstrong Contracting aai Supply Corporation should be named In this claim petition rather than Armstrong Cork. It is our wholly owned subsidiary engaged in the insulation contracting business. An answer is required within 20 days of the date of the petition. We request that you answer as required and taka whatever other steps are necessary to protect our interest. We will be happy to cooperate in any way we can. The periods of employment listed In the petition are essentially correct. Vary truly yours, DHB Enclosures Wallace B. Hofferth Insurance Manager ! NTF O FFICE COMMUNICATION To From Subject F. L .Gardner, juancaster J. T, Boyd, Philadelphia Workmen's Compensation Board Notice of Patal Occupation Claim Charles Chester - Deceased 816 Bartwod Are. Gloucester, New Jersey Petitlote July 20, 1966 We are attaching subject notlie received from the Department of Labor and Industry* Workman's Compensation Board* I suppose you will turn it over to our insurance carrier for attention me att* FORM 1501 P r i n t s In U.S.A. 5 rONM U l C I - l l O - l l M - l l ' M Ml Comm sBwttUh of PaaniylT tiiU DEPARTMENT OF LABOR AND INDUSTRY WORKMEN'S COMPENSATION BOARD NOTICE OF Fan~oo"CIi5" PETITION The enclosed copy of petition has been presented to the Workmen's Compensation Board. aria Cheater, Wide Charles Cheete*r~C***4-------------cuto" * 816 pertwood ........ Olauceater*.Haw...Jorjay. Addmo PETITION NO. _..291*555.__ Dolaoduit Addrau Armstrong Cork 2925 !! broad sto -Philjtr., -**nri9n2~ AGREEMENT NO. 122",W Harrisburg, Pa...... .... 7 -1 The above petition has been assigned to COMPENSATION R E F E R E E ------------------D IS T R IC T _____________________________ A D D R E SS_____________________________ Leonid! b - I o n ----- -r .. T ills., Fa. for investigation and determination in accordance with the provisions of the Pennsylvania Workmen's Compensation Act. We hereby notify you that unless an answer shall be filed with the said Referee at his office within twenty days from the date of this notice, the facts alleged in the petition will be deemed to be admitted and no testimony will be required from the claimant to prove, nor heard in your behalf to deny, such facts. A ttj 0. Hughes, Jr., K-q. See1 138,309 W ORKM EN'S COM PENSATION BOARD Aetna C<m, & S u re ty Suburban ` t a t io n UT 1617 P. nivd. P h ila ., Pa. 19103 MOT; Y.ur t u t . , muti b. md I I t l .l l .t l t nd "ltd wllb lb R ,, 'M- ro iJ - \ . * 7. Did the dcV-Mscd empl oyee : " ' ;w I:.v>!,v... i, ' ic.i!. i >i i ^ ~ 'll' su. [I i ... .1 . , I I , .. 8. W li.it sseie t!sc c s p . n s e s ot l U I.. ( , , ; u ,* mid 's i n .i .' H a s lhe e m p l o y e r paid any p a il ol i .u a, so, hose m ..m i 9. Ilia sseekly w,i;\ a ot ilia UwAuiaii m me snip!.., ni the o 10 Was cunipan .atiun paid decedent m m ami the t m u mod ad . a v... , S . _ Jaaps !k am and the slate ol Ills cLatlu I I. T h e deccslenl's Mimal sesinits n. aabei _ _ 12. T h e claimant set h a t h the fol !<. .s in.: add. asm J l.mts ss .mi'. a:e o . h e s s d to l-e impoitanl a. ; l>f: ' 1 .. a , , - _ Wlierefsirc the clai mant ask t!.s. W sa .-.men's (' sm. pm'.v.'.mn I k u i d to n u k e an .m.aid that the 1)s lend.uit shall [lay sm.h conipensaton as due unUei tiu Os upational h a . . . M' Co mp e n sa t i o n Aet. P ,' S a h sc n he d and sssoin tyi liytoie pie, ' hi. at ' l O C - d 2w M y C om m ission l spues on /V Ma y s . w f'in t r a u o n MotafJI Psjlilic i'luuii1rl|,r*n< t `biliii|f||;hi tto ' ........... My Comimss.o.) u ,s ,i. s a, lOon.t.cr 12 i% G si is s>l 11> N O I I d . : This petition may lie sipned and swum i i h\ any dependent im liunsrll and all other dependents. I ' k . i e elite; ms ,i p| >sai alls e loi pe tilioiiei 1`) c, NO I Id s : T h is p itilio n should he tiled in o n p in al and live es.isl copies sillie r Ispssl or p rin lsd . Ills' pally lakinp oath is reiiuested lo l \ p e or print lu ll n am e and com p le te ad dress ot Pe titio n er sipump this petition. It is necessary to m a k e at ta in s it to only the o r i g i n a l copy ot 1tie pe tition. FORM L i a C - 3 6 4 - 2 0 M - n - 6 5 Commonwealth of Pennsylvania D ep artm en t of Labor ifiid Industry DEFENDANT'S ANSWER TO CLAIM PETITION Bureau of W orkm en's Compensation Harrisburg, Pa. Claim Petition No............. 19.. C ity S ta te Employer S treet Number Insurance Carrier City and S tate J Addreae TO THE WORKMEN'S COMPENSATION BOARD, COMMONWEALTH OF PENNSYLVANIA: The answer of the defendant to the above entitled claim petition respectfully represents: 1. 2. 3. 4. 5. G (b). 6 (a). 6 (c). 8... 9. 10. As a further matter of defense the defendant states the following: MeMMao*****1****'*4 Wherefore the defendant prays that the claim petition be dismissed. Enter my appearance for defendant Defendant Attorney Addreaa A dd. CM Subscribed and sworn to before me, this ...... day of 19.. at [T h is a rtu U v it m ay be aw o ra to b efo re a C o m p e n s a tio n He or any other peraon authorized to adm inister an oath ) M.MVy Cl OomIIimiiMsshilOonIl teix.\p|HiIrCe3s Monil tmhee .-.-.-.-.- ------------ --------- diiy of .......-...... ........... ------------------ ----- 19 T h is an sw er should be filed direct, w ith th e office of th e R e fere e to w hom th e case Is assigned A nswer must. be filed w ith in 20 d u >.3 E veiy a lle g atio n m a claim p e titio n n o t sp ecifically d en ied will be deem ed U> be a d m itte d . B la n k e t d en ials or '`proof dem anded*' will n o t be a com p lian ce w ith th is re q u ire m e n t. / March 8 1966 / Mr. David 7 . la lin a r A tto rn ey Suit 1600 2 Penn Cantor Plata* Philadelphia P*. 19102 Door Mr. Salinort Subjact1 H4 CC 113079 , . Charles Choator SS #179 07 6243 816 Bertwood Avenue G loucester, lav Jersey Armstrong Contracting and Supply Corporation Wo have boon requested by Mr. Q. H. Aikans, Clain Representative of tho Philadelphia O ffice o f The Aetna Casualty and Surety Company to send you vagea to Charlaa Chatta r, aa f o il owe Weak 2 -1 2 -S ? 2-17-63 2-18-63 2-24-63 2 -25 3 - 3 3 -4 3-10 3-11 3-17 3-18 3-24 3- 25 >31 4- 1 4- 7 4-8 4--14 4-15 4-21 4-22 4-28 4- 29 5- 5 5- 6 >12 >13 >19 5-20 5-24 Ho work Qrogg $140.80 176.00 176.00 176.00 176.00 176.00 176.00 176.00 158.40 176.00 176.00 176.00 140.80 176.00 176.00 6-10-63 6-17 6-24 7- 1 7-8 7-15 5-28-64 6- 1 6- 8 6-15 6-16-63 6-23 6-30 7- 7 7-14 7-16 He >31-64 6- 7 6-14 6-21 work 448.80 140.80 246.40 176.00 246.40 73.60 73.60 184.00 184.00 184.00 Week 6-22-64 6-28-64 6-29 7 - 5 7-6 7-12 Cross 8165.60 147.20 184.00 7-13 7-14 73.60 Labor dispute 3-14-64 8--16-64 36.80 8-17 8-23 299.20 3-24 8-30 316.80 8-31 9- 6 170.88 9- 7 9-14 9-21 9-28 10- 5 9-13 9-20 9-27 10- 4 10-11 154.56 191.04 115.20 192.00 192.00 10-12 10-18 192.00 10-19 10-26 10-25 10-28 192.00 115.20 Bo work I 7,247.68 Tory tru ly your, Mabel B. Barnet Inaurenoe Department Copies to i Mr. 0 . H. Aikaas, Claim Representative The Aetna Casualty and Surety Company 1617 Job 7 . Kennedy Boulsrard P hiladelp h ia , Pa* 19103 Armstrong Contracting and Supply Corporation Arohitaota Building 17th and Sanson Streets Philadelphia, Pa. 19103 CHARLES CHESTER SS #179 07 624-5 G81l6ouBceersttveoro,dfiA, vJen. ue ------- Armstrong Contracting St Supply Corp. employee MEBarnet 3/8/66 "T"- - t The insurance company needs wages f cr these periods Feb. 9, 1963 to May 23, 1963 i } ; i- s i June 9, 1963 to Ju ly 16, 1963 I .. i i- ! !. May ;28, 1964 to Oct. 28, 1964 However, another record I have s ta te s he was employed by ACSS as follow s: rFeb.: 1963 th r'u J!u ly , 1963I t i Junej, 1964 tjiru Nov. 1964 j | i j j j j So perhaps you had b e tte r give me h is e a r n ir g s , by week, fo r the d ates he was! employed in 1963 and 1964, then I ' l l have i t when the a tto rn ey s fo r the oth er side w rite f o r inform ation. Thanks. Mabel  41? The /Etna Casualty and S urety Company Th e S ta n d a r d Fir e In s u r a n c e Co m p a n y H a r t f o r d . C o n n e c t ic u t PH ILA D ELPH IA O FFIC E Armstrong Contracting & Supply Corporation A rchitects Building 17th & Sansom S tre ets Philadelphia, Pa. 19103 A ttention: Mr. John Boyd S U B U R B A N ST A T IO N fclUILOING 1617 JOHN F KENNfrOY UOULLVARO PHILADELPHIA. PA 19103 LOCUST 8 1 3 0 0 March 2, 1966 Charles Chester 816 Burtwooc Avenue Gloucester, New Jersey Dear Mr. Boyd: We th a n k you l o r y o u r com m unication o f F eb ru ary 22 w here you gave u s th e d a te s of employment o f tn e above C n a rle s C h e s te r, we need ad d itio n al inform ation fo r our attorney before th is case goes to t r i a l . W ill you p le a s e fo rw ard u s , on y o u r Company s t a t i o n e r y , the wages paid th e above C harles C hester fo r th e follow ing periods: February 9, 19o3 to May 23, 19o3 June 9, 1963 to July 16, 1963 hay 28, 1964 to October 28, 19o4 We would a p p r e c ia te i f you would fo rw ard t h i s in fo rm a tio n d i r e c t l y to David F. K a lin e r, A ttorney, S u ite 1600, 2 Penn C enter P laza, rh ila d e lp n ia , Pa. 19102 and forw ard copy of tn is communication to t h i s o f f i c e t o th e w r i t e r 's p e rs o n a l a t t e n t i o n . We th an k you f o r your cooperation. Very tr u l y yours, gha/dra G. li. a ik e n s , Claim R e p re s e n ta tiv e Claim Department A K K II.IA T r.M O F .K T N A I .IKK I N H I I U N K C O M P A N Y J a n u a r y 2 0 , 1 966 Hoe Aetna Casualty and Surety Company Suburban Station Building l6l7 John 7 . Kennedy Boulevard Philadelphia, Pennsylvania Gentlemen: Subject! * Claim Petition for Compensation Charles Chester versus*" -- Armstrong Contracting and Supply Claim Petition 188,309 Corp This claim petition alleging total disability as a result of asbestosis has been filed against Armstrong Contracting and Supply Corp. and others. An answer must be filed with the designated referee at his office within 20 days of the data of the petition. Since this claim is Insured by you, we assuas you will work with the Philadelphia office of Armstrong Contracting and Supply Corp. In completing and submitting defendant's answer. If our understanding is incorrect, please let us know insedlately. Very truly yours, Wallace B. Hofferth Insurance Harm grp* BHB Saclosurea Mr. J . 7. Boyd, Branch Manager Armstrong Contracting and Supply Corp. A rchitects Building 17th and Sanscm S treets Philadelphia, Pennsylvania 19103 inter/ OFFICE COMMUNICATION // 3 hr To f -,--fcr G ard n er, L a n c a ste r From J . F . Boyd, Phi la * Subject Charles Chester 816 Bertwood Ave. G lo u c e s te r, N. J . Compensation Claim P e titio n ( A r m s t r o n g contracting January 17, 1966 We a re forw arding to you the attach e d o ccu p a tio n al c la im p e t it io n re c e iv e d In t h i s o f f i c e on Mr. C h e ste r. me FORM 1501 Prlnt.d In U.S.A. rOHM L I C B - J I O - - ! - Cm u m b w m IUi of PontuylTnU DEPARTMENT OP LABOR AND INDUSTRY WORKMEN'S COMPENSATION BOARD NOTICE OF 0 0 clfciM________ PETITION The enclosed copy of petition has been presented to the Workmen's Compensation Board. Claimant AddreM Cha pie Cheter 816 Bertvood Ve Gloucester #N oJ# 138,309 PETITION NO____________ Philadelphia Defendant A ddrtM Armstrong Contracting A Supply Co 2925 H. Broad St. Fhila,,. Pat___19132________ AGREEMENT NO. Harrisburg, Pa. !UL2^ The above petition has been assigned to COMPENSATION REFEREE ----------------- Lnid&a._A^...A llan ---------------------------- DISTRICT ADDRESS ---------------------------------------- ~~------------------------------------------------- - DtQQ --li** for investigation and determination in accordance with the provisions of the Pennsylvania Workmen's Compensation Act. We hereby notify you that unless an answer shall be hied with the said Referee at his office within twenty days from the date of this notice, the facts alleged in the petition will be deemed to be admitted and no testimony will be required from the claimant to prove, nor heard in your behalf to deny, such facts. Aatna Casualty & Surwty Co* Suburban Station Bldg* P h ila ., Pa. 19103 Atti C. K* Hugh Jr.* Eq. MOTE Yur w mm* to m m * to tH*Mw* I M Mft II WORKMEN'S COMPENSATION BOARD j ' 'U- Socrrtary y bs I82-I5M -2-J "<9 i >U M o M l K A l.TH OK P E N N S Y L V A N IA IMI.-I MKNT OK l.AROK AND IN D U STRY CLAIM PETITION FOR COMPENSATION FOR SILICOSIS, ANTHRACO-SIIICOSIS ION HAHItlSBURG. PA. AND ASBESTOSIS RaqM 12-10-65 122,17a t..h a r l e a C h a s t e r Print or Typ nam* of Claimant ,16 Bertwood A v e . , Gloucester, H.J. Claim Petition No. 19____ mnstrong Contracting & S upply Co. l.inployof . 325 N - Bro*d St., P h l l a . , Pa. Adilrto, Inaurane# Cantar Addreaa O ccupational Dtaaaa# r u n d TO THE WORKMEN'S COMPENSATION BOARD, COMMONWEALTH OF PENNSYLVANIA: The claimant respectfully represents: 1. My name is . . ....... C h a r l e s C h e s t e r [SftcSS* ) 2. I became totally disabled as the result of [ Asbestosis on ) of S eptem ber, 19. 65 3. My total disability is result of employment in a hazardous occupation having a j .day j hazard, and I have been so employed in the Commonwealth of Pennsylvania at least two years in the aggregate during the ten years next preceding the date of disability as follows: Date* of Employment Name of Employer In Pemuylmnln Addreaa From To Delaware Insulation Co., 5th & Coleman St., Wilmington .. 1956 thru Nov. 9 5 7 M a n cTt''Cox`K'"C".''r"ir"'r^i'a:8l'RS- "Dc. "1957 thru Tan. 196 3 r n i s t r o n ^ ' ContT", 2925'"H 'r ^ r a d ' 'B t . 7 'T h T Ia 7 7 ~ F a T ~ X ' Y S . T 9 S T "t h r u J u i 1963 M e ch a n ica l i n s u l a t i o n C o ., T i l W. Hfc. P le a s a n t" ^Sve, h ills A u g u st, 9 6 J M.. e c.h--anT. c a I--"Yurri- "s_u---T.Ta- xt-I-or -n- -- Co'-.-"-#---T31iXr ~- rW,. M>bj'r . TIeasant""A,"BiXa "~TNW^oTv,'._TI99"ll""t'th'hrr 1964 r r i da'7'"SupoTv_Co".T'T7T7"l ^ C ^ ' r i d g e "'T tT r" PhiTaT",~P'a. `S e p t . 1963 thru 6c t. 19t A r m 3 trohT"Coht., 2925 H 'BEdSiT'St. 7~~Ffti.T&'77~"Fft' ... t TuniSrI9CT thru N ov. 1964 Owens C ornFng G la s s C o. V Taclcson 6 Swanson S t . , P f i l l a . jNov.__i96'ji t h r u F e b . 1965 B arfTca3e'"C oatTng'~Co".~''~T0r~N~~Klngs'~T,t 7 ,''g I^ ' c e a 'te f".iri'3. Feb.. ..1965 t h r u . M arch 1965 P h il'a . `A sB eo to s'"'Co71 2010 W.""lO th S t . , P h l l a . , P a . F r i d a y ^ u B ^ y ^ T 7 ~T7T 7^W TlSm iSridge"'St".'"7"Phn:a. , P a . J u l y , TL965 u n t i l h o s - ------ = ______________ ~______ "pitaiized Sapt.j_._j.965 ( SiXiCK ,, , 4. The above named defendant was my employer when I was last exposed to a j Asbestos \ hazard and I was in the defendant's employ from to l * P * ? b * g * 5. Since the date of leaving the defendant's employment, I have been employed as follow s:----------- does not apply. 6. I served notice of my disability on the above named defendant o n ---- - --"--4-U--T-------- N o v e m b e r * _______________1 0 65 ln th e follow ing w a y : I t t ^ r ^ e n O . Y ^ Y _ ^ ^ day. of 7. Before my disability began I earned $-- >AJ3.0_ a pb e a t p i . wgrKftg___________________________ ih m i u u aatur# of a week as "chnnic i n s u l a t i o n and (See Reverse Side) 8. I | ibm it 1 recelv* medical, surgical, dental or hospital services as ffoolllows: HaimemaxLCLH o sp i t a l y A x e l K, O l a e n , M.D.; J a c k J . P e r i l , M.D.? W est Jersey Hospital (BUI nam of doctor* or bovpIUU) 9. I | | request the defendant to furnish such services; and they j were not | furnished by the defendant. 10. If medical, surgical, dental or hospital services were procured at your own expense state what sum was, spent by you for each D r . Olaen $825.,,00,1,, W e W e r a ^ r ~ ^ 1 *1(1_A 1 __L A K 11. My social security number is: ------ ------------- 12. I believe the following additional facts to be important: Wherefore I ask that your Honorable Board shall make an award for such compensation as may be due me under the Occupational Disease Compensation Act. - * ....... ^ ( Hum l c f .jtLo_____________ Subscribed and sworn to before me, this at ........ P h i l a d e l p h i a F n n , . _ My Commission Expiree on B16 Bartwood Ava.. fllQUcastar^-- JUUn L th . ..day of m ay s . WC1NTRAUB .A > 19.6.5__ ,, ; , , y |'ui k i'l,:!3(!',,Ph"' ' ru.l..4eli'n-.a C . .Ml r.<,..r,'5 Vll'M ' ' U- VJVj (Thl* ffldTlt m*7 b* worn to b<ort O om ponutlon Refera or ony other person utboriaed to dmmister en oth). day of 19- NOTICE: This petition may be signed and sworn to by any dependent for himself and all other dependents. ..CM1, u Please enter my appearance for petitioner i ' . i, . Attorney . * , 735 P .S .F .S . B ld g ., 12 S . 1 2 th S t . . . , . . -E tlU fl..-- Addraee i 19107 ....................................... ......................... . .. ' . Bank U M inah& rt. E sq s. NOTICE: This petition should be filed In original and five exact copies either typed or printed. The party taking oath is requested to type or print fuD name and complete address of Petitioner signing this petition. It is necessary to make affidavit to only the original copy of the petition. . , 'j * 3 j,, II vokjic r * `""ito no''.I ovcff I rs. Cfr\>" " o >- y> tij </> V . v-- -- .* 5P; 'CO --*-- ------- *-- ............. n o J r n ii'fr - A'! f*><0^ ___ ._ - - M M 1" ! an , Hi I :ic `f V :'. * ' 'll . r Nf. i n I m v I f i otm U H L' J64 -V U m -i-64 ( omntou^i'alth of I'i n m y l t i n i i |) |iartmrnl of Labor *nd Industry DEFENDANT S ANSWER TO CLAIM PETITION Bureau of Workmen's Cnniiicnsatinn Harrisburg, Ps C lntm ftut stn i'f Number Claim Petition No. 3.8 8 ,3 0 9 19. City and S late Km ployrr Street Number Insuraoce Carrier City and S tate A ddreaa TO THE WORKMEN'S COMPENSATION BOARD, COMMONWEALTH OF PENNSYLVANIA: The answer of the defendant to the above entitled claim petition respectfully represents. 1_____ ______________________________________________________ 2. -------------------------------------------------------------------------------- 5. ................................................................... ........... 6 ( a ) . -----------------------------------------T. ( b ) . ............................................................. ............. 6 ( c ) - -------------------------------------------7.......... .................................................................................................................................... ......... Q ......... L I I ----MIM--------*--* As a further matter of defense the defendant states the following: MHI*** Wherefore the defendant prays that the claim petition be dismissed. Enter my appearance for defendant D sfandtnt A tto rn ey Address Addr*e* Subscribed and sworn to before me, this ,,day of 19.. at (T hii em devit m .y lx worn to before Compensation Referee or any other person authorised to administer en oath.) Mv Commission expires on the day of ..._ 19.. ^m ^w w w ithin 20 rriih days. r n E ll re V ry t a 'm r t 'dlV allegaUon KInrwaIUclaimth e office peUtlon of n o th t e sp R ec eferee incally to whom denied wlU c." * ^ be deemed ^ 'E i^ u ^ B I w to be adm itted. k e t^ rn B lan k et TT den K 1 or "proof dem anded" will n o t be a com pliance w ith th is req u irem en t. Noveafcer 12, 19 6 $ Bae Aorta Casualty ad Surety Ccevooy 3hburt*ui Station Building lfilT Joba F. Kennedy Boulevard, ih ilad alp h ia, Pesmsylvwxia I 9 10 3 G eatleneni S u b je c t! Cb&rlM Chaster Sbeatoels d o la The otiQirxiad lo tta r fren tbo la v o ffieoa o f Soak ad Mimfaort 1 notle to our subsidiary, Armstrong Contracting &&& Bupply Corporation, o f n osbeetoeis claim fila d on behalf o f Chari00 Chester. E vldintly, paper to th i e ffe c t v i l i comi through In due course. We have not referred to our records concerning Mr. Chester's employment. U v i l i do so i f ad then the information i s required. Very tru ly yours, W allses B. Sofferti Insmaos Manager USB Mr. J . F. Bqyd, Broach Manager Armstrong Contracting and Supply Corp. 2925 North Broad Street Philadelphia, Pennsylvania 19132 Mr. Fred L. Qudner, AC8 , Lancaster IN TE OFFICE COMMUNICATION To From Subject Fred G ardiner, Lancaster J . F. Bcyd, P h ila d elp h ia Charles C hester Bank & M in eh art November 8 , 1965 I am e n c lo s in g l e t t e r o f November Uth re g a rd in g C h a rle s C h e s te r. We have n o t acknow ledged t h i s l e t t e r t o th e above law f ir m . JFB/dmd e n d . (1) r ' FORM 1501 P rin t.d In U .S .A . I '/>/,, s ' f f i ) Thomas Z Mincmart MCkViN Alan Sana MauaiCCA. Bank LAW O F F I C ES BANK AND MINEHART 738 PHILADELPHIA SAVING FUNO BUILDING TWELVE SOUTH TWELFTH STREET PHILADELPHIA. PA 19107 November 4, 1965 I ! I MAawkt 7 Armstrong Cork Contracting & Supply Co. 2925 North Broad Street Philadelphia, Penna. 19132 ' r e : Mr. Charles1 Chester Gentlemen: J * . . Please be advised that this office has filed a claim petition for asbeatosis for the above named individual whom we represent. Please be advised that you have been named as defendant and noticfe is Jjyareby given that our client was totally disabled .beginning September, 1965 and cbntinuing to date. ^ / Sincerely yours,' BANK & NEHART VBC:pak By. Vincent B. Corsetti * C