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184 1-2 NORTH ST - BUILDING INSPECTION �+µ The Commonwealth of Massachusetts Department of Public Safety Massachusetts State Building Code(780 C NIR)Seventh Edition City of Salem BuildingPermit Application for an Buildin er than a 1-o - amil Dwelling (This Section For Official Use nlv) I� Building Permit Numb r. Date Applied: Buildin• c _1 SECTION 1: LOCATION (Please indicate Block N and Lot M for locations or whi stye dress is not available) No. and Street City /Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair C3 1 Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ 1 Change of Occupancy Cl Other ❑ Specify: _• Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineerin•Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work: ea�"L-c' 5't-i :2 5 5�I A L lcc-d6t-1 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Evaluation is enclosed(See 780 CMR 3402.0) ❑ Existing UseGroup(s): Proposed UseGroup(s): C Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: 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-2r ❑ A-2nc ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4 ❑ H-5❑ 1: Institutional I-1 ❑ 12 ❑ 1-3❑ 1-4 ❑ N?: Mercantile❑ R: Residential R-113 R-2 ❑ R-3❑ R-4❑ S: Storage S-1 ❑ S-2 ❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE (Check as applicable) IA ❑ Ill ❑ IIA ❑ JIB ❑ IIIA ❑ IIIB ❑ IV ❑ 1 VA ❑ VB ❑ SEC TON 7:SITE INFORMATION (refer to 780 CMR 111.0 for details on each item) Water Supply: Floor:Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check it uutmde Flood Zone ❑ Indicate municipal ❑ A trench will not be Licensed Disposal Site ❑ Private ❑ or mdenlifv Zone: or on rile system ❑ required ❑or trench or,pecifv: - permit is enclosed ❑ Railroad right-of-way: Hazards to Air.Navigation: VA I (,nnmi„Lm Rrciv,m Nnl \pphcable ❑ 1, StruCtury (heir ree c%, Completed.' "t ('nn,cnl to Build cndo,ed ❑ Yes❑ nr No❑ Yes ❑ No ❑ SECTION 8: CONTENT OF CERTIFICATE OF OCCUPANCY I jition ,I C."de. U,r r%pe of Cun,truction: (kalpanl Load per IluoC I)-W' the buildlOg C011loina11 Sprinkler S\,em': SprClal Stipulations SECTION 9: PROPERTY OWNER AUTHORIZATION Nye a ad Address of Properly Owner n . l -C � Name(Print) No.and Street Cite/Town Zip I'nape?tv 0%%ner Contact Information: '1"ey E)10r0� 105 _ _ : oOv 309 (v37b 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 pna perty owner's behalf, in all matters relative to work authorized by this building permit a p plication. SECTION 10:CONSTRUCTION CONTROL (Please fill out Appendix 2) (IL building a is less than 35,M)cu. ft.of enclos d s pace and/or nut under Construction Control then check here O and.kip Section I0.1) 10.1 Re istere``d Professional Responsible for Construction Control JYq- W/13 7 Pe.1.,?I Name istrant) Tele phon Nu. e-mail addre5s '�� Registration Numbr Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Cum anrName: Name of Peru espurisible for Construction License No. and Type of Applicable Street Address City/Town State Zip n -�- R/4.3 sbE� - 77� - 1031 T 1� C i (n L22'1!<-S F ry c Telephone No. (business) Telephone 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 O No O SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE. Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1. Building $ Building Permit Fee=Total Construction Cost x_(Insert here 2. Electrical $ appropriate municipal factor)_$ 3. Plumbing $ 4. Mechanical (HVAC) s Note:_Minimum fee=$ (contact municipali /, 1 5. Mechanical (Other) $ Enclose check payable to _ 'w 6. Total Cost -- $ pp, ©O (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 iJhis application is true and accurate to the best of my knowledge and understanding. I'Icasv prynt anyi sign names rifle Telephone.Vo.titreet \ddress CityiTown titate Zip.Municipal Inspector to fill out this section upon application approval: �Name I),a 1 , NSCAP 98 Main Street x Peabody, MA 01960 _ *S ; �f raJA �v:t' .r+ ­ __, d Clien Ilcatlon> 'z tApp # ° d i f i M Kt ry Agency NSCAP F ro* r id- PROGRAM r'tG a lKe s an/2011._ td&n,._ g W y WOrk Orde7# rr Z t ^� i *V t, 4qWork Order Date , , N + 08/04/1Y It 1 � ,JobSLrmrt t -a u` ,rr i, Prunary Conttactor� n ` I Atlantic Weat henzrICati n" t>Eer L7,ntt $a�500400rS c Other Contactors aManchester E_lecttc LL C t � _ 'lWlp_,�ri .s C r" �w Clen`.a NA. of s � c t 1'9'11 treet 4 1172 North St eet Apt IAlf1bbTi ,y7,tp T'l 0 ,i'd'�a#.°'S, qrF o8 74`5 2539/978 979 7514 Staud AloneerINo,r t- r, 2 , .� ,` i fi ,A"? , f' k- k s s.: -) t4r,t�4.� 5k �,iCr� s,' ,t'wFeC COde i �¢Z �4'ar ;C " ' 2 irff -a-.Blower Door Test',= "�', c , a5 , f ',a, N,, ,yza,a�, ck<':"' r is ;[y g.�x7 e•ts rrj n:W y 5�' Kt'al '�4�ew_� n �k.. l �.r .. Ir,'d _y�.a r•4 a.�Y:. a -:t t ..,ram ..., a, , Y, Iris ectKniip &,Tube„��rNo i �t.E'1'ec Contraetor !„�y, ,la'".,'�rt�,!1, ° �"'.E41".,"'""� .:'w_a et`f �.x, 4, ` ,.,�. �AtTIC.II1SnlatlOn € �� ,y+,t '.e yA �t :ny" Irc€ rSdx rr M „^� u� t,n:v5 -EstAct, ss,,, C��yyoet„���„ c.�fEstlOosta ,�;_,AoACosts�}€r�. au d. S,fU 'Swn � sri.'€+'..�NT;g,°W>"S il'1J ill, 'L.rs' ,a..{i r!4+,- 1 0r$ �40 .: `Qgtc�Fla[�Ra30o ' �`. 1 `'F '„h% .x; ; RR, -vii_K ;@ga, 'z9''' tJwN '_�Aise" r3�s.:u ..1"-t-n�rrl- n �F Y`v' :r Attto Flat R20 o en �;' ,z �.�=;,r�a� '� :t:� ` ; ,� '� .}? it,. ?+;n , t„c3ka��n•. _.:-ram.L . 41 r�..a .� AtttcFlafRr103�oPe4„ s.: '�y. . vC!"ss WIM- �11.5,.�"�-am'JI is rY " !21Ji.,t. �AtttgF,lat% to e�R30restncted r:r3t L,: -'a ,..^-,; ,� ,. � '' -`4 k''"'$1 415�5:r..�.n F,,l ;r:,n J .. ^Y+n. S�."pen _i ",Tm, AtttcFlat/SlopeR20res[rlcted ,:,;:; ,,r ., s - 'r ,�.. .-. _!�?:T.'� $ "35a,�,5,'q,,, , ka.,'...ta�,�., r, .''y .>r ,..,,w2aw:..„4 ,.,,. ,' .r'�"�.���' .'�$124'li r''�, "�:F;:�.d akvt5�'�sTi,i ':.' 'k`+sN,,41 ?- ,; 'Attic Flat/Slo e R10„restpcted ,_.., t: , ,T , _ ,.�„ �,, 12S r. n i '^CrC rn ,rr �Tri ii ...�.._ -F .., .:. �`s,:,,F > -. !`, ICneewall�FlooriR30restricted . .s .: : r :):w n��' ;;,,1 'a"$1,1r41`-='I„ t" ";,1,'' 1 -'g'� i' s'fi 3x hA. .( 3E Lt + d n :� fimts$edAtttc'Access 'ra aa. l_f .,�u_ Iry, , -n t3�' ,.,,s �!100'!90m, ;6fi� &i .t*T,rW .w. r,,..:�,Ia�kf':r� FTemporary.tAtttcAccessa. v° ;;`Miiwi�4`p�„�:' ,` �, lW ifflp0:r$i75r00r i'x o%m"', } 'fib ��,(#s, '"„�; cb :th,.D 'k i ,� v ,,ig ;;�s? k .��'fl�.�'g Gauge Ceilid look 30 wittia °royal`> xw #- i Q .110 ,.,,I iS. .S +{' _!9C^{ 4� ,�£,H }Mf.is+.'s ,2.- k § >>t, s p' �RoofUi;nt)large �rcr :.:is3,.a,ll��;,rP�,r;f�'��'..nU--. r :.`f-•+, , - .��95�OOa:i�:l8 �£.,�r�5a'>;,�:7,;1+��,°y�'.�'f-�:utr Roof, ®rfvsmal] a yk{~,".�a' t�cdt .�' , s`j.l 6 `y n-�,..:�Y$76€O,Or'P,kl>~ r .., "' '�Q4h Il_ ..L.:t..�-L*., ?�.�.K, Y�i+.-S= FY . , ;a .u�M axa ..,,:'k _+�'r.',rd:. .: n 3 . dt'.sf+'a"° 1'<k ' , a , Turtiine,Uent''+.;* - ;�« $160 00�G ,[ t' - ,12 'PiOrka Uerit'f -W'W"n.?z-'I,>•`xt ..:'�L. � A AA�,�s-iy,.a� �°��i 22 +•' nc Gable Ve $88 001 -5j nt.(all sizes) ;:z,r-,._�.z.r..:>, `.N:: =r s, �..a .�„ wk'`a M, Pik+.� k.if �, r... t h., ` e" 'i :,ra,, r k' nro `n %`s >s m , .rt�. :.!$22 00,E GIl 8 a' '>�-0�,?.fr':,-:na-v '. �ecr c '.- :. ! _Attic Au.Sea_Img2 partFoam�(2 ho�u[rs m_ )} _ a;#.;='i:' < < a'v m7S!00' ' ',�„* F'. i.4sa t�s�.'s` Ir�'?`v ' t ..N 1i1 ll r Y :Pent Dryer//Qpath Exhaost a = ." ''AIrIf �`.�. 1 ua ;SC J 017NII,C" (�,,'I ]tH t -�}t'tJJyy,, §r R irr s> r.., y m I`�L, rY `[�'�.± u�dh�x a21.R_q-i'!3'',�niSb ., ,rN�F. ee�du�-'-;Sl'L ! ,...�„`�3-.' Knob&Tube Wmn -Ihs ectton t't * 'l Ow is .::Mnr- ,irda.: iu 1 PH e'Z-t. Ilv"nt.r Fd" x`y, `>t _ d u '�'.r�1,v nY$ad ski"$,[..:-o�� k�3964 $L�y ' .F' ' <vfbRs A �wae _ hcemazre,Lesch x „€ ,; d a. „xla �a :e1 quad ._1 ,- + _. u� . „ S � kl­ sr � Et "'s' , .� " ­111 s lost T0L'ActaCosf r=m . yw Q1Vr'1k, �' Wall',IusulBtlon It�€"�`� a'§4�,�'� ., ,Li!{_ ' s j� i. ��.� h.-.:�6e f +��>�,�*1'>r,t;�_s_ fi.�t 8rli ��'' SmgleNarledAsbesYosrAsphaltRl=S„DP; s '€ ' _, , .. ,w'1A';NMI, 2 )!0ut ,"r�., ?, ,'=;ruA PIN N `�' ;" E3W MEW ff��aa $J.� , '< F[r fw"I a'� a,w 4!pF rr3i{ ;xe7�`. in-tenorWall$low 9Pl�'aster 81; Clapboard L,W,00d Sh ngle/V tiyl=RLS,D$ rY?`, 4,64 K $1 70; _g $7,88 80 y,i I "14RdP' nFaMRN00w;Il"Iff It e;yr`r"'d3a ,�'� i �' Wl Sx u'r,;,sw*' {.'fFa . 1 �. .�i .s.z3ji F. % 1 .N= `a"SSAa*r�J' :Y ', 1 7 4 `-s.�Atr:Sealine Ltmtt ,r�' Sin 'All';Others_ $200"r_'=,.,rl qr 373..nz'il"�". ,' ,I `-«' ' n:�tea- r' ' 1*,y, �> .i''"r {:: 7 r. Door Re ular Door :,i aem r g ' rt't„x'�r _'� e:i i�pF vl ' „ '"3a k i ti:r'S" AutomattcipoQr,$weep� ..�__ : _ _.._ , ., 1._€ x fir..' ^�,, , . , $2200a ; ,:,s - awr�,.... .�.., _._:-.:.rl:; ,, ., $;IS%OOi t r#i1an ra`a6Y.t€rr 7T .y'f aY ;,s ';^.Str Sealing 2 art Foam-(3 hoursittax wr-; .'rKs s .,k_ ,,.,,�,., Sash Lock,`cr y , ' w tis ;In "4ORK V 'Glass RepCzceJnent_, -,a, v ten. :, .N�+ .t� z� wL-au{I$4200;>-y 52M > ,x-t n r ' L�*ny . # rot a> his N �Y" I:,y� '1-ua 1. a.:, t i`s' r`arkdt{,._ti.. .E ... ��1 ININ, r-&Wi6.4,':.c ', .:`�'m. Y _. '; Y ik -tliA} Fgg4,v gi il'�"a,'t,tF si-- i ice'. G�!p81ii't iFu�l.m is�✓1�\��# �y .� 'rE tyyvYy4a '?'F_-e n:.1:Y7 V1F A ,RR �yii-,�,..W.F�yi�J,sS7}.:�..TeTiA"b 7Pv Iu� g�, a '.A'c��,•.lh. A 5..:' 4..*r], �i ly rt""Ik#i tell tir:lY 1sN ,(fi4 . '9Q � .` '„"J � ,l i 3 1 f\'Il1a' d�F . ..,"a � ' i�t�-J(.y, otal A�Seapn ost t �_ _ rc..., .>� I..J+!'.dkwe`?� .,�:k.U. _sK i-.- G�,�.Ia'�...:�"� �F..'., ,� �.r_.-ll:-,a"a II �',�hxsYn� aA :,, y >• ?� un bin lE ql 4rY f 1t rr rp , t,; m4 4»— 4 ' ,ry Iliz ,�'�. .:t._ .,{,I V��i��:�&w,brd,�,'In.11 �5 Hydromc Pipe Insulation,to l =',£°. 3 a`' ,.$3 25 :.. .'j„,r :�k1*�e��" s'',�'N tst n- H drom P.i a Insulation Ik25 +RS Il' #t.s t,;a; n*�a.-'n �i, p $It-, 'A" " ,I`q,;yl,,.b = w Y P . _. .,�_ _.,._ a --)4. r n , 3 .•.�}r P1 �". t d Steam Ptpe InsPlanon[0�1 25,RS t. ,,,,w ;1., '� Oi p=�_ $,5 25 l "AI �z +.;,,„I,sF=#a = +,}�! rc ,lkA ,v 'a r m-n + 5'i Y "!, rr w r ,. r 5� v; 4 "+ r" S1" �i ' 11�KIr w n,o-t �SteamP,tpe�Insulahon 1z5, 2„RS' r : r� = :! i' '„$c6 05 ,_!� {, .-�r.��`.a' ,.a' ;�tiw�„4r��itw `a, r~T, ,0.� l B_ oiler/Fum_ace Re lace_ment x�w {r, ' 3 Progry r b ft�� tr :ux s A I t'se a r }'' r„r�'" :$.�t00"5 .,,F„J*� R;J,( amiRe atr, ,- „ ..i. ui,�.:.,�.,,U::ur a 't t..,u� ....,._a at FEW r�,�.,� 4 f K.---Actton approval needed Rax$500N o-. Actual Totaladoeslnot mclud'e`,$175t00kKw&'T,chg , S ; M�, �u,�yb G kt""Mzrr y y,. t >, S.F r r �5• ps".1'rtx� �- n i ;fir. M .b~� d,t ek�a 'v;J 5 ^7 `-Mill° t,"1 rMN r u 'r sew' a +stY-� 6r1'; r14-e. x Ir ��X h yY-� '$O,OOj,{ t` ctNTotal.,,,., ._ ... �� t>r'fj.� '.0 „g5.ava @a ,..�n..,r... . .. rd'tt�.._ _ : ,; ��= 1as., �ti+:.'+g�+-�y'i.rk..�'_�iiir. .wA�+r.a6>.m,}�Ch7,"„�-�{F:� Sr°se rr4k•"�„w�,.r`�x"k >w-'� ,'Ik/;, ..�'�a•Ra tzs y3`��C' 7��� �,"�� F ,� ACTION, INC 47 Washington Street !` TM „ Gloucester, MA 01930 � �r b y�1 i4�y 1 y�rvrJ r a I� r�"k�/��•'r 1�f '�k t '' k���.F t � .+� "F�^& ervr5°�, - � I�x, �, �� �ra1 t�'kaddu � :� ''t' t E r°3 t�' �,� �� � a kruANSCAP n r s "" NGRID Apphcahon# "�� 't ,?'ntiOB NUMBER0 r'`Y^ �`x a s r! �,y' �.t'a I �i b tY•'`rnsw # It ti ! A S �, Ll kn i3 ale@x ° 'r�„ „ :DOE Work O"rder#r a,` n 5 ' '°-f-0' .� r s "' ' ' ErS Clpe`rformed?' ', �No ° - r-x ➢ v>€ r,r ,s Y i"y+c° WZau_ fy* ziZ,r°r x -x -S- L E -a C� i7 F- 1 ,rt w sga f Work Oriler Date s " 08/04/11 a � r PnmaryContractoi rr'P`o-` AtlanticJWeathenzatton- ',, r . a •+ x .{ 4'�'`k• 5 I .1 luj "�,: •-,Fi' ±u.. OtheraContractor � Manchester�ElecVtc LLCa ,'� ,,,,r,,,•q; i�t#,Bulbs nstalled! �3�, r$�00",I: s�-. z a- ;s{_" x b '3 En x�.,+ a°'Cost ot'IBlllbs'' >* " �4 r r :+ �. rwn rg °il s' s. „t4 lit < tr-aU �' r a�,�,w'�, _:,Chen[ A'I cemane Lesch " : y " nt �a Yns t$175 0b Maxim ,�'$0 00 P -ga - .,.PT ^' '' l !t� t�ar f�➢Lr , .ft {n�"� rl' to r A Stt�ee� 184 I/2eNor[ti�7re�t Apt sl�F�oor1 •„ r,��r�{� �rOt�Gfe�IryKtnd� L�?4t�$Oy01)�;,'�i-.+ IState� Ztp Salem019r70Elecmcal�WorkJ'�uti-�`$0 3 ity><4 Au tr, y ,p lephone 97�8 745 2 39/978 979 751a's mot' �- ,m�i "' 1,{5�A aunt KepySpart�I.w tg°'$0 OOj„} + k+r' P + "� .GA 1'+A � rsi i � AmellntNat104a1tGnd z 'i 107000 �'P h'It v 'x a„ �� � < >:• -. r- 7`$ n r�r it rZ $ +�; 'rM'rr",rmt,�,.BlowerD4orTest "R! 9No"r"°'f �e�' n "t� Y �' "r'" 'fpsr0� YYr ''� 1r q H n flier UYtlt J,«, �$( 00 ,rli-< r q @. aaM I- � Jr:�Yr9, sr .: w e..�, s •.�� �n. h�� +�A I ' S€ a .� M 'ate ,.>.� �4.k w�.- .:'��,�4.. J� ;�r.r a�q»-:rrr.,r ;�a+.. '• .�y,•,,,ri�«'�Actual Repar�Tjotal a�f4�'�r �'�J$0;00 Cost jprjart°k''_,hrEst_fCos$!+�,d,',' '', + 'ActlCost ," � 1 —r ,i' •+s nr �n DoorJKrt x.:ix,�•,-�, �. + .,��-:axs•,•-� s:���i.,;�7A '�,yl ',N �.. s'*$$43 OQs �C„'$17�2.O.Oa.a .�, ':Regular,Doo�FSwee izp•r',�r,ti.x..�'-,-r�* `; '" -"w. 4�r. ,�I. y,� 'r. �$15 OQ "1rMr + r S ^>•I you Automanc`Door Swee ��`-i'�`- 'sue, t+..� 9.';; vti„tR�:;. ;h.... -�!$22.,O,��i;•� aCa2"ln� � .t,'• ?l IF iSn Sealing 2part Foam''fP-er hour)�'�'' ,` 41!`_ ,� • D! " }.z$75 Q1 I+w. .,zl,$300,00 ,a16,l r° ;' W "'i"s;F P x •k,s 1 ri." .a Y't "" '� 'lf AttoA rSealmed pert Poam.(PCrtiour) xrl'-' ,a:m;�s �'1- ,,.{$75 "IR �Weatherstnp'E,Wrndow(per°s de), kC+�x :v'rs•` tr.,, ±:�� `+: ' -' sI.,$5.00 ��Sif.�.h`'n,,�ds�t ,5' s��l:l , _ "Mastic•,�a r r'{ ,i�', r rd �: 'h rvtty"�j.�+r+•4n�pai ' .t .IiN r! $d2 0' i x i. B e a t t J G '(g @ o-•IMr 'Seal Ducts,;;._. . ,.P 0 1. h�.-�._:�:_.+._.���.4k'Qt. Y✓/S&Insulate Atttd+Hatch,R'30'r,?> t.+r`a-'r1'91�i* 11i _r ``_.au$OO�OO Gt i1�� ,i' .I�s.� 'rR'ar"��Y,r.' ��' .' ,'gtq .,.,I�ya J!d'L�,'�a { i _t"£ i%ix n , ,7 S .r s iir 'r: v e X�,�q H ,.✓ha v .J li.. ,x°i�Q00 �3;,,.1i �c 12S1,1°. '6.rWJ � ' 'E�.Sz' .lih-Y:S 'wal " r^s,' s yr`�, a-0'r•,33° '�"'"`^" iq"r"v �I< �j Jsa s$53200r 1 .. 9�,,I�r Y,...$�li,:,�'� .bAr3N!�IF x"��..,�ilt9r 'dot=Fr ...>;�`�u�b ,x,rl4c� ",�GgC',.�r >'I,..,alr„�?��,`t��i1�.~F.•�4��:�ir'�Y,�ikf',,.'�"�r.����R,Ir.�E;�h Insulatton� ryru,�", `hr, Q,j%j3jMftW L�t"Act.C,ost ` ; Dp_ackOv'e`fian'�Fill`Ca tylta ku�°# I A ,¢wx y• !M, �� 3 I IAtttc F,lat/Slo"s}R30crestiicte`d3ar� ,t, P41wt •'j2a. e � , G't "Attrc F.lat%Sl es IR20fiesttrctedlFi1, ta' ''.<ahr<-,$1'"'3-5.')J JF •cw '.:-,.w". ' .ali . !Attic Krieewall l�SSCelll)v/Membrane°a%s: :,�.•�,,f;.,� .',' . t=f.1,$1'y65. t 5.`+tt pg$ va w✓- ^'rA 'ac>• x, -�! 4v s Ra..: Y r-'i ! niFr{A. Attw Kneewall FloorjR30 iesmctedY `y 4 „ ,..,g a.{1 , , '(. t„+ $14�j,',k,,, ,Aw—M N ';,,,f,. ,;; ;�,�a tR2s :Insulate Attc,Stazrs&;A✓alls„rKi� ,�':::�,Yl ,tP, ,^'r- ri $1300,0 MI o- ;J;y`pa_'.a U" i, .�I:; a�,r y ri ,.` °e" ..:"/a`�"SOO,?a�.'t'." t =i_,z� 'Y$1..70' If,.'��ler$1;�•3fi000!,:�� ,t',.,'trt°,M $dewalls 'm IRISDP i, t. l,J"t;;�r{i,.>R,f � r Interior,Walls-Plaster`RgS;'DPI,'� .. ,r•.� rt3'�..t. 5i;1�1'1 ` r $flry8Il§3r,���•a�+C.• '. `s€�4„�n,�:lm'�n. s��',.; � sM 95:..mt@ a`,la� ? '•[ ' •I M'�!MF`, 31 �DUct Insulation RS&Seal_S.eamsV. El dromcei'e'lnsul to 1i:R5 I��iek�r �"a11 ,�1 d"'J1il.Y ' - .,it}" `rr j$3•JL_Sd;ryi... 4_' xpl 7 N rA "Nr Ak 5 A +` S a'3 'Steam P! e hsul to d 25,' Sir rn '' ' '`xa 1 e ..' '1" G- 4:°�Iw=,fa.x✓N��e ter'.-P� -. .,. ,1 Y J -✓��-r k D)-IW,Pt e'I suauon°'A5.•!`:: ""t '.r'!.a' 6:IYr.'4:!iJ x ..� :"•{; Insulate Doorew/"FB4 min) v,y3.-:i Rsir',,> 1„ 'i M - - ii`'- $44A x M�$44 OO twnm��.'?°.;.t ^s C ,�M00. ,67A 9 a Cxl£$3,�.6 I'M E ( CAlicemane;lesch„ i.. !�PEI�*- sue rrsPage2f" rrfr," DOE 1'-�.r 44! :0`�,ki „ 'F , 1. T ""'tw ' Ij IT.Esf Costx y r'rZ Act,Cps;;2 Ront Vent Slttal' IFFan I sS' k +3A '1t' '' _,,. ._ i' .' ,4rair.HK;, hr...$,7600.a+ ,,, _ y Recess�dliCan Cover z; «�a� .�_.� e . r ,� Cut/Fmrsh;Atnc/ICn e wall,Access Mom, rN�hx�s1=�,- i` & : ��N,�r.k,$100Y00,4 Test D'nll Sidewalk 4's"iiles5. 4. ""t? ?y"!�t' , .' ;iq J,_$60t00'.ff trfi- ,_�gP , Iru"Ti f` 13ik� 3i, d, wt< 2 Blower DooE,Tes[vrh" '- �i�e.,s a�-xi` al.?' ,-r� ia�: AM ,� a'vlrw�`�y} _,fs Yix &7 Faucet Aera or '� ;� {i*, MEMO O IVW t`7`}FL L'ow`FIhowerhe aw:S �ad P' 'z�, . ,',`� nri 5� '*=tx$25r00eu�'i i = -: ." » 7;? 1 x_. yi . ^ ,M4. ,.+ z l'ig ^>§ ..: �4,_� 2` 4�$0 O .Fr :" k+iK `: � 3.9 ?) i�ik"""- nr'VIII AwkS ' 'Y s $1Q ` 0 0 , c� r ,>s¢ �.�' a 0 Other Total �w -r., , 4.,� y,� �� �.=xi.yR r r >;; �. i ,... � }....�S ,. . mt, ,_, l :€�' ...� ,s> �.�"1.:�s...i n, �f.,1fd-i z'i.0 : ..v r ol R- 'i$bTOo��i'-riY n'"�",Tr�r�$0?00,'. w6 ]'ti°ti.F,?�,A'Kl y__&i% ,�''a.�,r'.L 'r'aterr �irkSX�putri "-�ti li w-IP�1 iN..ue'i 4r�i h en ','c , it 4i i mklhe Energy!Cbnservahort . '� ! t 'r,� {R *"+a-3 vt�,7 7-1 7MMI,3i, s 1 I MI M Cost`,,, m$m Pict C,os"?'. Totals $I0,000100)! a "�; WISw'-.��i�zh-11W;O- a �tEst3Cost- ''I N E`RIC-A roAMI:112.. *1 #-._ n--i , �a '- .� z. w "1��.$5,0,00 ,�.. ,+,1-a'�-�°�_ �;� J'r'1`ds`. a ,ep_ 'WJ d'= rt., 4 _ �p ;9� �"�I Mv,. vzf':u '�Ad ustDoor�SnrkerPlate�ar r �`r?° ,,,f'��,aap.,s.Y'�' �+3! .!?4 $20PO�Ob..,-I 414�`i� ; °t ;1.s�., h.A lul',t,t of 4'1d9.n ,.r,& $"'trt H .,,4,�.. m t-wY{ T j{.t k.p,g�y f Door Thie_shold:;: s.lt,.!ai a�� ,sa ," 1�;Ei3r„<.r�.k41r vM1,sF ;�: 'au r$,40�00�� ��e-;; �t ;Steel P,H Door w/Ltte.a, r';,*,, :.„e m. ... ,de+ ?S ,CIE,ENE, Eric Sash S ie bulalt'�s i�n`ean o,; ,�a $�. T $4�-0D �s} .!-.��.�7h��t�ra'if4 GlassHZe lacement to 6 t��"� bs M MI a ro,. ,1 {„-r " C ,,( Ir�u ^' t .H,J tNay , ._ $4�G9.OQ s , _use 9. .u. �� t» „ nil $uildmg PermtY 4A"i+ry,�," ,��"a I.. s+,+< as l2 t7?;`A _ -tee' ei nt i"t N .. :k� az ,�� a,:.d s. : s �+: '.Health `,d' #i�'.i,.0 }4F -�p:�4.-3'.Mfriino�:"�:i, f �. .� i -'rc' n t' ! . ar""a a s ke _-a1 If T ."' �., __ _ CNN a_;Vent Clothes�D er to''iExnor „�,,,.;5,i LL�.,yk',,�;,� ^r,t,5 rt,< ,_ , l,$85 00'.�i � IM �„ ,s '1 �ti^, Uen[Bath Exhaust Far"ii to;Eztenorrr,;,'` i�!„, slf`tFrF'"'Yi �,JI ` .t`L^i�.4$85,Q.0_;�;t$!'; }i, .� s !t;' �.' ,t�C'° - __ - w„�.. ke tacelD e_i Hosed :.al t.Y to l �,'1'�,�� 't,� Ck ',I ,' : � t>''.l"$3_N'.0_2-'P."I�' '�":^pr_� {„I' r ¢ . C FI K 9 ..v_:�.<�' taw:i n wr s'f' - :."s.. $SOO.00pt t j. 8 Bathroom ExhaustFan cat,h ilt � � , ... Ia4A.,-9Te.vi ,'d�'9a W" a"4 i +µ�q lo-�r ]r^„w{y , «g�c��. .r t e m' i�l'.9' "3�ae :T;} f $Q�l).��GL�,k�� YYi�?5:k��u�l�.Pq'+ I SIr=fpp4 ° rfIJ yIX-_A 5 .J I III Rbl,Su Ie f "j1 !m' {c!.'Ch'IStiif '�r•Y+rt '�'a�`�-_�' 4W"��' ,w`-' t.�p N^- -i�i�.Gr tru' .. r }rai iu r v '�i Y p g u Ss�t = ,tn1 iTTr-J,,,-�fiy .w 4 !, ` 'LK'3_hJ,eY:4"E�a.a�'4GP_''Yr,}�.`a'�..,�: 11 rvT�._�.`_ti��,,:.2..!TTS�k, vG,�h.*.J}�i�.3.cw,z.�: �4.+.,ntrn♦ st. _,t�_t•,.< .3.: �.�': U? -r f.^t:;.Other W,s ' �r"!' �:t,..!m�+t`. .,,,Y, #:'� 4 0,00_' WS y ,.a�#.`p .. � �:.:51!' JA L I *,a ,Other : $ 0 "g 3i s*_'lleat rig System,Repali"„�.r.'m�` iu ljgffxia'aa. , s 4$0 00 'ge rci# ;&1 � . rry >~..'.$0 00,"i'l w*Actwn approval only* ' `fi{�;+-+-,#' 56; `�' *'� r' Lrc*1'y , ' N� v `>u F kr '`!"� e,I� ` - ar r ryv r "�''.4; '{k +r ^[„ t w ! e�k Y+vw it J 5 8✓�-`" ,>"k_pA 'a I6 s .PI t siC 1 k I` e x5� cx� �i`" €v s ,� 1 itta.* 3''{ii�, ,c ' _r4 ! +�+G'ymtLy11. 4'. r {�C �., v r'� k° [axr 7" 37'3`'�# #� af., =.'�1 i'irt �3", uar i5 {§ 7rd4 s f ki it h G 1 Iw ,� i m e ,y -r j DIY t rh' r s. jk>, � ( 1 , r F"Estrinated,JobTotal ,'r' >y: $21a3i100+u � 'f� t"1 4,ro '� sP ` trt �- ,Job cauuot exceed'$10 000 00 �, , r d +J'rc„�.;4� v �', >kt,ziniffium-35 ,l� �! FJ�obymrmmum�y$500 I�*s}s�1�d s9Ji,Ri's-�'i' �F {J �!'t`.A 4 �''��'A n i tta.i '�AtUD�rTOR `bouCiatifoid ' "'�'„� ` � r I' i �'ra 't '9mro° Ilia 'ft xi..d off"', ..n" 't.�+c $ r !Iq 'iexS �s �TPf- n�{' 8 f ACTION, INC i ! I� 47 Washington Street I �� ' i= I� �G mr a if w Gloucester, MA 01930 v � ' � !Tax IRS d I,{+r'tJ F "I�fil..n u[ikm. it+F' r.., r i' y, kTy"liA�fCnCl i` r NSCAP " ur �'t rs a�-c-'� m r fa `{! c, .� NGRID Apphca{ton , 9 r , G'h f rt vy ryri1 Ia,� r r sr i •f.91 'x tryN.' F 2 rd z� ` {. r I PROGRAM =(AA�LAWAPo`^ O„ i,UiSIW'� 'i�'M `J >-e av .di .! a iNJOB7NUMBnER' % t7fg i�" J,fn a v(Fs;r[`r tl raiw.✓it 46 '��!` �.�� «t• � !e .s-,C�,.� - )"t#7 S'��✓s � r ere ' !1 4 GF€ t�I�`�: h fi$`� u �t a -i R 4;r m5 M�v r n' sr, �, a t'cr .� :.,BH.. K ✓ f ¢ t h "„� ,« (�.. aN�s Ys % h DOES ork Order# a r4 �� 5a 1 w 4 Aijiwomfurd,�er Date r � r[ 08104I1 a i I41 i o �rPr miry Ci n�tractor s l rf, .�tltlanh Weathe�tfil; n(- y s,a4�{ ,! + -a' OOthe Contractit oor C "midr '� ManchesterElectytc liLC ,,, �$ .;{ n {#Bulbsemstalledr s�3.$000't. i,l FM�Li4a` Itr^ �'"�+� ,t� h '+ 3 c' Ih a v m 6 5 lye... F+s' a l�'Yc �im-39j11`.. { � ,'tu �r>.,i ? '6 .k �u '� �^ xr ur ma's.-.�fitilJ.x ' 4 syy l`�+Gost ofB l6sAf0yH, ,ilYic$ O�4 9 Streel 1J%f 1 2 NorthrSreet AOtt l tr 3%F oolr 3 tr'5, SP't �c F00 Max ,ig000 'lY, n p f j p. �, rOtherYn Kmd. M r $0 00 a ; if dp s rvr'S^I,p3 .. a e. r+ki3 -1re i4 a �} Ctty State rZlp SaI J'Ma pd a " ' 01970 ; .' ".d Electrical+Work , r" $0+00 l' i ., _ , a fa! t a + Y Te7e hone 978 885 2875/978 394 803,2' 3` r 1 " I P s t �'• a r „kkkpG,�O rlw $Amount eySpan , ,{ z$00�,.: fillr *€ Y,Sf* k srz af. !dza '.i „ira =faf3!+txz r5ae f�1'i`'� "$41noNationaL Grtd x!" �3$000 pGl+ Y, lf4l �� r p1 tSNi"�, ' t i tii �ly u; 4tykvM1�4.t �$Iower Door. - {�nfNti � ' h {r tl`, f`II�tOtl eraPlrttitty Inspect Knob&Tube i ,f s -m tut ! rr-f r{L.+ rDate Job Completed y$' �s s+i!'a- III f• shmatedrReparr 7tq[alr + a, r$457it00t sV it .r.-..?Sf 2 .., 31th. .r3"rtn�i�,',;t ':.c.Actual'Rpatr,Total �ifx.iat4d'bJ.$000 1', -a + rnpr, �,wfrt squ, E'stl "� w":Actr�- .. a.r.. .r ><��.. bul - [�oor (t;ri;jF,..>.`�19ry.� .,siLr7'�!',Pt. y r .. �-}3�.d �.A i M,�`�.�$6.0€OO.N'�i��� +�J�1_�""�;�'� . vllr{{ .j w z ryie r. „ ati r,a Automattc"DoorSge_e +!:r;'i, �'W,J: �yE •�'- ,�.". �r�.. �$,�9�SM� 'Anmimgvi2!parCFoarnr',(p_e'_r' r,OL`'S_`.YxL?'7y�''r� 'i"M aj3 :pc ,itP�Yr� ,py hu f -.!Iiie ". f`� $c'.. ,:;. $,75_00', ..t '.'-��.$22"Sr00, M'a' islrg: t- xa Arz,9ee1 B:g Pena Cvx )tom '��:.: 3 s�.� v_.... .1' I3 Weatherstnp Wtn'dow,1P_ '9 de)„,r. ; yRW't,,f sk.:., s ;� . $5568 k'"r'-���€I''M���».�4�rc�n�i'tIla��-'s��-^.!:'.: er �y,�!MM�!.4a.,�1tJI�f�1t�r��T',:U�*:.�:',.'i�.l! W/S&Insulate Attfcli-Iafch R3 ', w'LM'11�i&l t 1 4j;`.'�` s : ^S!} ,� $30s"00 Ad ri x 3$3Rd,,0 �'''O is"", Pn,,i „ ;!'r'�,�"',°- 4.nr�i.,��a-r: ...a : .,: : ,. ; 1, , � t . s, �- �r?�! ` ` ;; ?. _ fill "fi�" 1 :. ,if.4,, ;I,tl!fl id rfhw � 11'11 1'"q!i s *i'-$Oc0.0. a:. ^ r`—"`;.'' F .vtu��Yx^,; liFU'�F3s �a' { zlv +- s.. rmssi^.•f: Ls'i� '}i ': yl' T$0" O'`:' ti s '4`'+ �" �}.�.;f + c'�err ' r `": 01 .'iy.nchJ. .; .. �` 1` $�FQQ' fx it ko' tlt8 1 r'i 'rr A{5i,8'I3.4"�tli ,t,��iaf•7,},!ris 'f. ;"�i�u�$'S62z00i�'i+�.. 'a$93Ps"ice! ! 'r�, 'r."- + ri '�+ ;{f eW�>,z a: j�,a �a x{� f�;.,tit I :igi=i f.TS `f � �2: ,A]..lk'�, 1,xP ^'1r !1. ., y Insulation-°=m'S �a w „ ° :;:Act Cogf 'Est;Cost,{?!`}li '1k11, Vl f` st: . Do iCOE0olf 111R1!71RT",'`„ _' �,180,y li' 's',Y,�t$1 3.3; m'lst)„,$'143`'00 " 'Gambrel Sl.'Bigim fromSoffitl .uE ga. .,,.w,s352,„�`, , 'c- '±t': R'$2 Attic Flat/Slo ,q' '�t�t ,q�"�,'tn'!i�is •i'-! (Attic FlaUSlo'"es R20 iesVtcted't �!+, `" ! �.I",�xyw,;.rur•,m, ,u' Sr f $145^, -4,,,ri,"��.'. �IY �!'I'"iay'�t '"w"t1?. -Attr v ay t cm, i ,l i .h r, tii *J S te,JCneewalRl3,F,�GfaR! w •rlt' �d5 ^.€,7:kr-..T ,n, :"��;S'."t.m;.3i.: :.i=c�. =_�:._� elttte ICKne wall R15aCell�w fembrane lir+'.% `, . „'i'!R3` s�i�'� ! !r.'"IM, a >01A1- r!N � = - Mesr r rr u�ar.'irt r r " ,' 7J- uy, Attic 1C{leewall Floor„R30yresmcted "„!; �„i..,�.,+,�_ 1� MINI Insulate P.'t[i�S't'atrs&Walls`{"t'S I,rrc- .ta r 1+$130�0 „20i AM y,! '. ='. StdeWalls; ?iti;l R+I P�'fc'!a�l n. )�i+.�v '650q ?.,,z J',!.ire S,.$1�70 V.-e, i" $"1105a06? ha +,',vide 9) yy s _al "+PlasteiRrl3iDP q f_,1 J„�fi"' • '.: .,. TMia 81`<iFa`.F�y: :l raRl d-,Foam,Boazd x:4�'_-"t:{{3).,s`I rN,a,;l'!I _% f.._llwr$185a: ',..11.',1.: '1�.: _a'.0 ktl.' ' f n , '�!, _:",! ;': "'vVC$ 4$_5 IM �" J� 11 e i NM,. -- Ducflnsulatton RS&Seal Seams s„,, ,,w•�4Ji9 I!f ,fi-tl i' ;..;_!. I-I dronic'P.i e7nsulto 1.-FRS 1 ;'. i w ,Ya;. .."1 r�$3:: 5 1"" ,!�F Y � 4t". a _7i�. ILL A6'AES,A.>r. 7.9 r+i r<.};, 4Yss ;,,: 1 . F'.. e f° {«°F,dx 2 u1F !Steam Pi erInsul to 1 25 RS_, „ �:,t„ ,�. .t tp.-,,, '' - $._,.5$ �rs$I8�00,1''s+ tIu. 's !Insulate Door w/FB(zl;. mm).,lr!t .rrt 45; ..�., ila. ' ;:. ;;.'� ,,�_$4,4'0.0,E 'a�$a vf.]"s%E'' j<k"'i> if1;,c' 'w4 :t1!y Sd1,2 part F a n w/FG Batt�Rt9+!iO.•,:�.u'z!S .«..... ..3 „'i «irl .�9.W �$?��, "n.�'!�ti�N'� ��RAW�+-,i'iguzo 1".�Mil 21 430 i r 0,««I�M.�r'P��>:r7! 007 $0 .1«!`.w',," wxY r'°a`'� T"'" a'uen 1 [x ran,, Y'o'uR. rr. &G '# •ate- J '`Gma'Gazza4-. ".,z'.r.< rr age M�- PrR igg ' D_OE1 .r� ,,,:;.r. g� t s'. OtherMeasure"s ,h"•k'ss.1' .F'r 'g;r& 'an,>,iEst=c Ll „MINA-o N-1,3,;,Cosfa S,;�EstCost! g, j xActCost.}: e ,7.6TW,,k" ;` '*`::.r' - �C, '?'.. Gablet�/ent�.G�reetan ,It!,�2u . .. , _k. 42ecessed;Cui GM/Fmtsh Alf M Access_; 1„ Na1"yy`:d'ud;; :1; ,?'$100go Xv, fi t g g j„, Test �Blowac Uitl",-TE _ 5 P_ i�zax,_�+ Umyl Replacemen[WundoJv 101ut "' xks -•i.,gy`,= �; '$.$35000�.j,.�'��:I_;.� 3`f;��'.,�',..;'„�k�s+''I>' ,.=: 1 0.0.a .v 49 ww „ "t"'Ilk NON sty �: a$25.90 a W ;g�5 :_ �a . �f�! rx'�--b'" �itul.'s�izw, ,�3�. „y"!txtt ; i!**`" � kau'"�if•`.�,..a:1RR4.�r �� �p 'uR-iici',�ti!i 'rL rF r' 'tt7> l �+I�`�7k Y'^3�yr�� ,:- $000 t`3' '�',' �i " �Ili d..:..�..c� .1 :u „ .5,.«3..er L ,. >; ..........5s �c ..� y Other Totals fi,. -i `A ,'::�-a,'� 'k1- .;Tf 7 R°};5'11t"i' ii n f `'� " 't$ 76 k.._ i,..-r, .,w„r:�{!.d' L.#`. [F 1,3n=iwy.t +1§''` 1!.@t.; . ^'pti "y's9A{' 4 ,G:i'1 -�r .w-...t: ��, ,lijr�},�,{""rN "E�! iF_ 'W ..J!i,n:,:. Y,SIG 3_ +!elkAYt&r, - ,HN ""Yead�ud.le..x, rwY =)!;,v: i1k'"F.,: kaltyuEsfjbosf'� Iaotals_ ..ly�Ma . .d'' d':'..r '.t gi.a,q � ItwltOOg��,� ;2;C; jlj�l �i Ana.- .�.iM�.. ';Clean IO0?11:QA MIT for o��11A' 14 ',Solid Core,!I)oor�w/Hardware°? �a .''i' 3 ? `�.F, ,..,T[ Sash.L�ock f.atit6 _�' uaj tt:' .tII.,. k i � 1 $9_231 " � .3�t '�t i.J 'a3' �9iafa -r _v:x. .0 .i �c : ! Glass,Re lacement to„6,4sm ,�* „A a�M 6.a�%�w-, }r<..;,I p !$252y00�s r 'axelp i x-.:y r -r'a',,,* 5 to bu ltl tiaulkh adD r,wn,Mb} ' :.'" n .�4M,::n. irq$4, 5"OQ„i;.,, d d mldm Permrt Fee„�,�n, < 5 ��is 1_ICnob.and Tube+Irisection'�:.,, r e t� .avrG.w " 1 aWl ,tt v r" t Y' 1 i rl r 1 awl 4 r :Dent Clo(hesiD er'to Ez`[�tois"`itx,:01 ; :`! ` .VentBa[h Eztiausi F,an[9r_Ex[�erro� �"'zl agfq 'r ''+; � .2�:tr$85a001��e1 $SS�i0,0'N +Sii . 33gsg}Fa '�i'v�� Re laceHose_, U1, a ' .. Aka' ;f "- vx .. _.n . .::: .. i r:�I>$38 O.b� _., e�&�6u f .,."t z:=V�?§ ' I-.- 1 r.^ar �m.3. r� W-r �' C4 i ,Y'ar. �Bathroom.ExhaustFan >, `r�t!a :.:.: .° { li, fod +n qi r n ,1, - .., >.y: ate] , rr rfi:!,rv: ir...rf , s ''� 6tl..w,*J '' z>`•_ Is�h$Ol€00; ;7i`' .:�"MAW t 3_+:�.,9>4�t 1!G+:'A 4 ." L. ;�.a�$.... ;�h�h'd�QQ W u1N ' C�'*aY' J �t..LLinly t t • P w.,al-,*+Is,+n s,& kr t 'Ibl '' 11tl(itt!!!ggql J a x '�'YY+' 1v`^'f - ' K "*i.;'3� [VIIN -MOT Order Sub'Total' 4 ?1'">tl�`"��,2."r l a F4''�kyt�} -Tuie �y'ti de s EH >�z -!ywt ^ mt{M �Gir hl4rati as e iff "` 5'ri n` t me P't it r t }u1ti t 'tJ t 1>1 �' d'l?>•t�✓� ��l t 1r 1 f : i<', t+' ' rY, FO(n!�� u j � qt r 1 F' rn ,vi WY' XiiW"4Sr. LI-�� s..i!'�.,F`+ !a.1 vaiA �. ��w,$ �,i�r.rr� w Measures,:. al �1 i , , ,n$0O ,7x � 'M !'� r ' + 000.E�?e- Rav r, ;=b � x eh1 ..r ar 4 rAcuonaPpro alionlY�' ?'�rc .i 3*M^a �f1 stG'A ril,�, iF"'lrink-Ef''li"'1 df '� ! '1"n*p� M�!9 S�r":td `f ' 'Fy4!i , r 1hg.l e Job'.Ica not exceed+$10 hey{otal - ', 1 ' JoD mmtmum �tPN�',"4tt�` H fll s NQK.,- � .,�'� :.�' ,�.,a?G�..�� 1.,�>�4W'��wE��.''u�`. i��� NSCAP �tIr s' 98 Main Street { Peabody, MA 01960 Tax Fxpmnt it 042-lR5-2Rn s c-n eFf':z +r Re 3 *µ- a:1 t � t a ,sa r t 'hs`�)Nsl >€..e- i 'a* '�r.�'�`,�r` �s d� s, -t"*a,.�F?.�n'� .` 'H,�,�r ,:}, C rtR� 'tom d S �'hF 1' 3 F'T Agency , ri t �iNSCAP � pp �: ChentA hc'at�on #may a a �.,��:-�a ' F �dp £ � rCa. 3-'-R.. ^•v�� � nak� Yv ✓ 3 � art�,rvtd•Fx'�f�«���`.!'` ;�a+h{ ,a, :,r. �r -�a� nn Y,p +.�� a�M T�.�c..,a ,Y ff '��, � � � � d {�:� �a rJOB NUMBER �t F O a r} , �i �s �a,�"k wl. ai `� +-4m�a.Igp'-f h$,WiOLIC Ordex# a ,>E a�-R ,d"f r 0..-,,a >°' '�-�• .h , `.� Iv€' 7'�' ......,a Order Date ,° z' s '�" 08/04'/1I �"" - 4 ' , '+ '� a hl` " 'd't --� m " - ,¢ JOb JJIIRIt I,yz '` tw Pnmary Contractor : 1, Atlantic WeatheTiz ha on, " t ' { Per,Umts,$4500 00 ti` w ^"�3 IT ''' t++Other,Contractor ,' MarichesterE]ectrictLLC � rh$ lip e r s'i'"' t n YI kxV " A b s,lv"K L` at i( rh F IT 3 7{"(Ghent GmaGazza t"` ") �� KkT¢Yes 1!M o`0 stir ' .x[. _7_*r i` a a ' k� � ` S Street 484 1/2 North Sreet Apt 3/Floor 3� K&T t fir, Ctty State Ztp Salem Ma t 01970 dfs u' � 1 �fi; , ,u t y •�' f- , {� , _� r.�•, )rt `"' �'� "� I� ,Telephone ;978 885 281,5/°978 394 8032 tr Stand;Alone-pg -,er=,INo, .,yr •,�. , ,, »1 1 4 a`+ �c x s.. r r If a. 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'' r f'. : „� s' 1, 0,0E 'u'..i�'6..'.J.`•li 'f 5'Ya'�u-�,� '�k ,o. R . Pro aVent 'r�'hJ -•?�,�s �: I.`C'r" 'r jr 1 '.':I ynE a-A,•,� $3°"75 'i MUM ",- �'iM� 5,r+ gg v'm +L k. h d'%.e ,'e ,�J�3:NI,�''v,�,Ab IM Ni n m ,a, y2y?<'-. " ` -�'' '`'. `"$88 00,?-. zf -. {-sjnra {�' hoj,, rd-;''C. r� `Gable Vea'(all sizes). f._ 1, ;�' 4„ x. , :Y d-:.fi, �_' ,, _ _. i.u;I ;'Fi. .. w I-_� . 41,�a.�. :F;�:a, Sofft Vept'x"a,�d 'aar TM'.f ,�':..v ,i fw__rd,.,. �� „s,,-..: "' Y, .. a$,26+_0,0 �Rad'a Vent: er']n(ft ":i'; e"''u t ro ,n g �,`^ ., 0 u '. g -;( )�,_ ,aW; '$:,w...s.- 3Idv :44 .. 'ICY ..$2200.�!p�t h.r' ". `,'v', v". ,i�i-„3 �1,+ a',+.."',,-.tll! N �`• , ,� ram- ni ,:-, }- -ai �»t:' s: `i " ""-."•w. }r ' >lix k`.`.$a75 00,�t�.:vu � 3, ^��d`'m�ia+ �fpr,aa.iG..'W�14Y�,�.,�F ii �Qttic AuSealsng+2 partF�oam,(2 hours,inax) ,. +x b' '". .a $85+00 Uent Dry_er%Bath E?chaust,Fan;�,. ,. }• tr�', ,t ? y !.?. 3!` ... .. .- i I, TI-I . m1 ' rt�.+''� O-n^6P+. 1 3u.e"n ';;m '.'"�'' t wr�.__._ A5Y N�.k I �.m>r�..k41 7.416'«'r.�•".-�.:ti Knob& beWmn Ins"ectwn� 5' �y t ;" ;' 1''s �L' ' $17500 € snrvtgi8 if .,(L'+I�"i n }, "s e u8'-, kc t • .,m.x:,_� : ? +:. Ie``-Y.ePa e�2,'t I .Gtk,.::i.. x_... , ,}, i4 > 4 .fi.'tiF k..J.,(nrh r_.Iyilp xi. _ y '� , •,.,+i:-:: ,t Ns,.alr�gl�.;sf + �C7,lIla VaZZa is 4. U.'.. ��_t.4�»`.� ?• ,,:,.+.H3"IIF L?' ,6Giltt.w�a �f.�.: i�o-,n SL t�,f�'I������,Fs d,.��.P4.�iiR e.±�r[�.3d j y } rt. SESt:':s._ .tarns CVsl.__, :r'�.acsEs1'Gost.,..:s 3. :st..Act_C'OstS33 Wa11.IlisUlahou ' o-if > 3 rt i } ,¢ 31 I" Lr I' ,a+ ].y , c,[-. I!^n :I_a .fit 4R' iSmgle Na led�Asbestos.�1,ASphaR RI5 DP,._ ,� ' a fi : ,".,,-' ni $2' 1;�Oit is h - ` 1;Urm Double Nailed Asbestos/;Aluminum R,IS bP:, ',n $ 3 - R+'v �n�t-;� ;,,_�$2 20;r ;,z,it r'# •.e?:k g,°;*, , '34"�'! t} af3*"'" 'nW BnCk/Stu000R15DP= ,r ,a ,.� $2',75,,, 5 �Ihtenoi,Wa1�I�Blow Ela'sterR`15DL?r�=,ai "fir,;' �i`3t',"S':y ,.4 ;Iui $,1�,"_�8`l�7+hta.w',.0a,".!V2,q"�';y`i�A Clapboazd:/Woodshmgle/VtnylRlSiDPt,. ` "„ti a.ua FEN-- 70_�: k�a ` >a�; z.: r a 47 ,9r %Y T '..L i s • Y"'i� "' 'ryQvl n '.�' .5.1 J ? V'+ e `.e �p ,rt_"' Test Drlll ldes _ ', c— - r 4' " 'lezL d; '"'q' ',i �. °fF F It x ;: ,.x:N:, ��.ai;7'�'arl:I,,�t� .:1,.,, .t,- ,:`S'm ,iE '�. '51' .luf, , F t S C� S�rHilu41 e "' ♦, (� 'e-,. 7� T 15r1rn, ,:e�sg�a� = b_..o?A'ry2Y i 's p`�1"ry' aa�+r x »4 � s �._.r t, a fz 1� �J��IL 4e #r.1L�;�e. ,p4__ ,,�y=, 1n �;� •�,u _ ' t �ila3 Cs r� axa its, ,fi +I '=ytiT =AIr SeslinQ Llmd• wa ,;_„ r,_�_ ¢ .„ •�.,..c Single F,aiiiily wBto,Wer�DOor,,_.$4 00 3 'a � ., .. =A11Others` $,2 Lt.!i`, `t yw u b zfi LI a en._ _ _. .. ,. .a a.,,�.,4. .,re6 _.f..__- ., .._.,_ s.. _ ,'' .. i_r _a-.z�_.__.: . i� 2. r s -,.:.c,..- , ?:9 ,r�. _-- I>OOr,]tlt I'.iL n t',i'a ., .i. i f x r,a:x l? 1t .- F $,43 00„-.. , ..y!„slv ,t,L 1....1 :�aal•�,a6,-emu.,u+c :mot `� 'dr _: u:F+fft ;, ar -_- .d- s�'.'tz iFrn 4 a iy 7 j RegalazDogrJSwegP ,�rr.! ., *��xrac ,n u�7k$iJ<u.500r.=�,, t�'dR25 'Vic a- p'C'I.' —p`1.1 t Alr SeaLng:2,part FAoa ri(3yhours---4M,rrr„r ;: 15 a F 5 tar ' iti w 9 i Sash L,OCki ' ''.aC= d.4`rr :. „M .e kt.+x+.�.+,s,m,.L M p.` t r� try rn� "i tlL e Bwer Door Setu y s t I ::: , lo I yr � r a r �r[2� x a 7 �It i + dR�y,r�J wa�^"5 +'6° r .r:n7ui I 'n. lu rr rill r,I ,wd�,. z•,.m. ;l'. 4'.=I.4uI' +.'.. u;d _':.m".''i;"i,a+�':�t'FE.ae rriti.e-,'i:.ui3c.u5'# I k ' i !' :+•.7s S tk ,' i''z r,, r � i :�t„3:'.F?xi"a ,+i'.„n c ur l fir i'.,4.�„ 'v, Lv Fls (�-=. :S teal [^r' F. 1 e I s,r' as vit 't s!'I I. r".:_�ti,� ,t �e'�i:r.,al *r_=i:-d t vc3�. s �»� 1 t .,�a l!7%.� + �A IFLOtaI A1Il$ea1106zCOSt 5 iNrtuS�i>q�l: ii'', a If 'ri I" "HiA'$I c,'N 7r' ,'�✓.. .�✓R£'3"e Heatins:$ystemclVIeasures � '' Dut u ,Sm ( y ,� g� CI, ��� Hydromc PC a Insulation{"'01�,RS' p"'t�' �,$3;�25r?ra;,�,l . a"`-'+ ,, I y4 Hytlromc Pipe Ins'ula4ion�1 ir S fft r f �$3, Q �it*':c.. w- ,� , r-r;- ,Ii,'��'_$5 25��r�t•�"u4ea�li$��i„=€''�€ a:,aw. .n, '�« S[eamPie;Insulahonl!5 r2' R5,`:,_TE,se �'rp -t$"EL r�` '��.. .; :' `.�1`�" ? :.ety;N,aki,r;7v, . ,wy . Boiler!F.umace,Re lace_ment ,L1tyd1_ t '"" " 'r :r 1 r-S`' 9'3; m� 4r'�..^ $0+00 ',t �,rrilc:. �-0lif ^. ^ a "" �,M K{i Pro ram'Re ag... w.�..,,..�>•!, .:,, mi.'_e2':�* r -, ,€-n: .'.�:lxl«�i $OOOI n,a,� ©ctua[T,ptal doeg oat anc�ude$175 OO I�& Trc�ig t ,w�, ) q 4i-�e �F, 'y" �t,�� 639 60 �st�Total �.� .. �• k� � Ytr ,tyl tt ,ry I�s j�,p n ! ��S ') �",.t y I��1 my9s _ �j `� as .� ra � �'i R' � -.,,— .s-v�.,w`��`"ii�,a�,.�:,� '��„{'�'+t�r�,��fi�f J�,i�; ��, . �r c• `�t ai s r.y,5� ='���!1{Mtn�``$O�OO n' Act Total'',:*��� ACORiZ CERTIFICATE OF LIABILITY INSURANCE 03/16/2011 03/16/2011 PRODUCER 508.651.T700 FAX 508.655.8653 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC — Main ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 233 West Central Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Natick, NA 01760 INSURERS AFFORDING COVERAGE NAIC If INSURED Atlantic Weatherization LLC INSURER A: Arbella Protection Ins. Co. 41360 61 Rear Jefferson Avenue INSURER B: Arbella Indemnity Ins Co. 10017 Salem, MA 01970 INSURER C: Chartis INSURER D: Nautilus Insurance Company INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Il1q ry q TYPE OF IN POLICY NU48Eq DATE MM/DD�Y O TE MIDDATION LIMITS GENERAL UAmUTY 8500042816 03/20/2011 03/20/2012 EACH OCCURRENCE $ 1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 50,000 CLAIMS MADE O OCCUR MED EXP(Arty one xIrwr) $ 5,00 AIf-- PERSONAL S ADV INJURY $ 1,000,00C GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000 000 POLICY X PRO. LOC AUrOMOWLE LIABIurY 93827400003 03/20/2011 03/20/2012 COMBINED SINGLE LIMIT ANY AUTO (Eaaccident) E 1,000,000 ALL OWNED AUTOS X SCHEDULED AUTOS (Per pe INJURY $ B pe wn) X HIREDAUTOS BODILYaccident) INJURY $ X NON-OWNED AUTOS (Peraccdent) PROPERTY DAMAGE $ (Per accident) GARAGE UABILRY _ AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY: AGG It EXCESS/UMBRELU LIABILITY 4600047820 03/20/2011 03/20/2012 EACH-OCCURRENCE $ 1,000,00C OCCUR CLAIMS MADE AGGREGATE $ 1,000,00 X O A $ DEDUCTIBLE E RETENTION E $ AND KERSEMPLOYERS' COMPENSATION NC1616071 03/20/2011 03/20/2012 X AND EMPLOYTOWPARTNE YtN TORV LIMITS ER ANYCER/MEETOR/PARTNDED? CUiIVE❑ E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBEP EXCLUDED? (Mandatory In MR E.L.DISEASE-EA EMPLOYEE $ 500 000 R dewribe antler SPECIAL PROVISIONS Celow E.LDISEASE-POUCYLIMIT $ 500 OOO OTHER CPLO152189210 10/01/2010 10/01/2011 General OLLUTION LAIBILITY Aggregate -Condition 000 D Each Pollution Condition - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS $1,000,000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR CITY OF SALEM REPRESENTATIVEI 93 WASBINGTON STREET Aun1oRGTDREPflE3ENrarnE SAIfEM, MA 01970 - Rosenary Fulham/PMA ACORD 25(2009101) ®1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department oflndustrial Accidents (� Offee of investigations 600 Washington Street, Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): AtliiiiUc wC4ffi7A011,LLC Jeff Jorson Avenue Address: 0-1e„ 1970 City/State/Zip: Phone#: 9 2 s " - ? IV -- 8 / y 3 Are yo employer?Check the appropriate boa: Type of project(required): 1. I am a employer with a 5� 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time). have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees 'These sub-contractors have g, ❑ Demolition working for meinany:capacity. e-Aplo ees andhave workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.: required.) 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I L❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t, c. 152,§1(4),and we have no employees.[No workers' 13.❑ Other comp.insurance required.] 'fwy applicant that checks box#1 must also fill out tbe.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. tCuutractors that check this box most attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they most 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 informadom `` Insurance Company Name: C.Vv�`h t f2 — Policy#or Self ins.Lic.#: t„9 �� _7 Expiration Date: '>-Ac Job Site Address: "• �,f ✓r� `j� City/State/Zip: S� e�. Attach a copy of the workers' compensation policy declarat;on page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL o. 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. I do hereby eerlify under the pains and penaties ofperjaryytthhat/the information provided is true and correct Signature: ` _ ' " ! Date• 7ove � Phon #• Tw 7 Y y - ,�i y 3, 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.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person Phone# Restricted to: 00 Nlu.SNaChUW111- Dcpartmcnt of Public Sarctc 00- Unrestricted Board of Buildinl- Regulations and Standards 1G-1 2 Family Homes Construction Supervisor License License: CS 87977 Restricted to: 00 Failure to possess a current edition of the ERIC W-PALM -vk{o^- Massachusetts State Building Code is cause for revocation of this license. 3 HILTON ST SALEM, MA 01970 Refer to: WWW.Mass.Gov/DPS ,.. --G- -sue Expiration: 4/23/2012 <'o..... ionrr Tr#: 22214 � '(�omvmoonoeald o�✓fuaelG License or registration valid for individul use only before the expiration date. If found return to: _ office of Consumer Affairs&Business Regulation Office of Consumer Affairs and Business Regulation i HOME IMPROVEMENT CONTRACTOR 10 Park Plaza-Suite 5170 Registration:.t.142089 Boston,MA 02116 Expiration: 3/122012 Trig 292174 i Type: Ltd Liability Corpor ATLANTIC WEATHERIZATIOtJ L.L.C. ERIC PALM s 61R JEFFERSON AVE Not valid without signature SALEM,MA 01970 Undersecretary