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104 PROCTOR ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts Department of Public Safety Massachusetts State Building Code(780 CMR) 0 Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number: Date Applied: Building Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) ID M OQ Z- SA��j H4 No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here❑ or check all that apply in the two rows below Existing Building❑ TRepair❑ FAIteration ❑ Addition❑ 1, Demolition q (Please fill out and submit Appendix 1) Change of Use ❑ I Change of Occupancy ❑ Other GYS�pecify: tAl V'-5 '( Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineering Pe r Review required? j � -' D Yes ❑ No El Brief Description of ProposedWork��j��Wc✓ C,�lrVIO 14AP.4AA1"�7 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed (See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): 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-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ I B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5 ❑ I: Institutional I-1 ❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3 13' 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 IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ 1 IV 1 VA VB ❑ SECTION 7:SITE INFORMATION (refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site Private❑ or indentify Zone: or on site system❑ required ❑ or trench or specify: permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed ❑ Yes❑ or No❑ Yes ❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: � ,z SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner M O!4a se i s�stosP 402 Ee&Ar ir l_oo, A Name(Print) No.and Street City/Town Zip Property Owner Contact Information: �/ 1L - 3. 7-�A2 _ - Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes am� Street Address Cty Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control A4 VC27rtg (-8g4nV20 rb4s�y Vme Je istrant) Telephone No. e-mail address Registration Number o �j— A9q „fir �.�•. Street Address C /Town State Zip Discipline Expiration Date 10.,2/1Geenferal Contractor ►7 {/ s�'�6N� cj oe, 44e Company Name J& Faey �� �� 103 g74 iiW N eN e of Person or Construction License No. and Type if Applicable tin Epp s 2)1 f,Y� W �05( Street/Acldrje(sss �� �� City/Town State Zip �i�1W O 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❑ No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ 4300 Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)_$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ 14 36D (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 in this application is true and accurate to Q'e best of my knowledge and understanding./ aease rint and sign names f V_ P Title Telephone No. to Ke xi R2Z'_1 �. .�C�r/tiA Streetss City/Town State p Municipal Inspector to fill out this section upon application approval: It44-.4 ) Name Date Appendix 1 For the demolition of structures the building permit applicant shall attest that utility and other service connections are properly addressed to ensure for public safety. Please fill in the information below and submit this appendix with the building permit application. The building permit applicant attests under the pains and penalties of perjury that the following is true and accurate. Property Location (Please indicate Block # and Lot # for locations for which a street address is not available) No. and Street City /Town Zip Name of Building(if applicable) For the above described property the following action was taken: Water Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Gas Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Electricity Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) i CITY OF S.UEN1, .!L-ksSACHLSETTS • BUMDING DEPkRT%m\-r • N 120 W.♦sHLNGTON STREET, 3w FLOOR TEL (978) 745-9595 Fix(978) 740-9846 KIMBERLEY DRSSCOLL MAYOR THo&L►s ST.PIERRB DIRECTOR OF PUBLIC PROPERTY/BUtmtNr.COMMSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit Al is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: "TlLM(n, A4-A6-r"f �wC (name of hauler) The debris will be disposed of in —C e vtM - (name of facil ty) �- 2 (address o facility)' s n re f ermit appl nt date 3ehrisaitaa: CITY OF SMXA1, 2ANSSACHUSEM • BUILDING DEPART,%tENiT 1• 120 WASHINGTON STREET, )a°FLOOR TEE- (978) 745-9595 FAX(978) 740-9846 KjNfBFRt EY DRISCOLf MAYORT�tOMAS ST.PtERRfi DIRECTOR OF PUBLIC PROPERTY/BUUMING CONMSSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anplicant Information J�]) Please Print Leeibly NaI'ne (Busimss;Orpoization/lndividurt):....H'L/ ✓A5 4 Gil rN �w$�rL4ZiCr✓ `L� Address: To '60V R Z Z9 City/State/Zip: L oy6y 'MA 01404Phone Are you an employer?Check the appropriate box: Type of project(required): L� 1 am a trmpioyer with `­) _ 4. 0 1 am a general contractor and 1 6. Q New construction employees(full and/or part-time)." have hired the sub-contractors 2.0 1 am a sole proprietor or partner- listed on the attached sheet.' 7• El Remodeling ship and have no employees These sub-contractors have S. []Demolition working for me in any capacity, workers'comp. insurance. 9. D Building addition [No workers comp, insurance S. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised thew 3.© 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers'comp. C. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.)t employees. [No workers' 13.[C�Pjt)ter �ii6 d comp. insurance rcquired.J 'Any applicant that ceucks box#1 must also fill out the suction below stowing their workers'compensation policy information. t l lomcowoors who submit this affidavit indicating they am doing all work and then hire outside contmcom must submit a now affidavit indicating such. :Contmetors that check this box most auachot nn a Witional shoes showing the name of the s,b• n1m,10 g and their workers'comp,policy inronnotson. I am an emplayer(hat is proiddling ivorkers'rorapensadon Insurance for my employees, Below Is the policy aad Job site informarrion. Insurance Company Name:. y1�t?-&LJUL'r0S Policy#or Self-ins.Lie.#: `f 73 2 61 5- "1 tr Expiration Date: 2 — 7—J rr��`7 Z Job Site Address: ID y t/LDC77f/L City/State/Zip: 2 4414 Attach a copy of the workers'compensation policy declaration Page(showing the policy number and expiration bate). 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 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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. 1 elo hereby eert6&u der the pains aad penalties of perjury that the information provided above is true and correct . i>nat rce' _ Date: Z- Phone#: Ojric ial use only. Do not write in ribs area,to be completed by city or town afftc•iuL City or'fown: Permit/License Issuing Authority(circle one): I. Board of Hewlth 2.Building Department 3.Cityffown Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other _ Contact Person: _ Phone#: 03/15/2012 22: 51 17815955820 AMBRO.SE INSURANCE PAGE 01/07 AC-CaD. CERTIFICATE OF LIABILITY INSURANCE DATEn�M) E: ROOUCFR zi THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION , Inc. ONLY AND CONFERS NO R UPON THE CERTIFICATE Ambrose Insurance Agency DOES HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 56 C®astral Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Lynn, MA 01901 781-592-820C INSURERS AFFORDING COVERAGE NAICII i NSUREO All Seasons windows 6 Insulation INSUR!RA $ ottsdale - - P .O. Sox 8229 INSURSRW Arbel14 Protection Lynn, MA 01909 INsuR-R G Travelers ._ —{I----I IRSURCA 0' INSURER E: I :OVERA ES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PSI INDICATED.N0Tw THS7ANDING ANY RECUIR-M'ENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENT WTH RESPECT TO 'NHICH THIS CERTIFICATE MAY BE ISSUED OR rMY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONCI TIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY t CTIVE POLN;V tgg PI N —� ,rrt n vU PF pF INAUFAN' POLICYNILVhER OAT,CV, T NV DAT'° , 0IDDm) LlMlib _I GF.NF.RAL LLhBILITV EACH OCCURRENCE $ l GOG nO tO� yC i 'S; IAMERCIAL GENERAL.LIAWLITY PRGMIS IEa xavnnLC) 9 50_4 v�.QI �� 'LA'.IAdvMAOE }S OOG'JR 4`AEO EXP(PnYero parcan7 A 5 , p; , ! _____ CPPOG58607 3/19/12 3/19/13 IrPCP30NNALSADVW.IURY f 1 000 . 0.00 I GENERhL AGGREJAT4 3?.000 GGO FIIN'.AGGN.GGA'-T1E LdYMT APPLIES PER'.( PRODUCTS-COMPIOPAGG 13 2 C O ACTpSnOGIL=UAEILITY L'OIABINEDFWGLFLIMIT 'IS 1 ,000 ,000 r-- (Ea ecc2eru 4I:w Al'l'C —1— ALLOAINEOAUTOS BODILYINJVRY i3 g SCHEOULEDAI.ITOS .I lPall 0 1 B HIRED AUroS . 37797400001 - 5/15/11 y nomLYinIJURY� I' $/15/_3 IPP_ocadeP•d�, 6-NGN.O'J."LED<.U-05 I .. ' PROPERT"DAIAAGE 3 y GIRACELIA 9pJTY AVTOON'LY.EAALLIpEN? f _— ANY 41jTO OTHER THAN EA_ACO I f — I AUTCONLY, ACO 9 EncH OCCIJRRENGE f I EXGE S31'JPI8REtLA LIASgiN OCCUR �I!CLAIh.3 MAOC �ACICLRF,GATE !3 ---�3 1 t—i DEOUCTIBLF � I0.ETEn TION ] ' I3 WJRKC SCOtJPEN ATCNANp YVV LIIA IS % ERT f1] DYERS LIABIIITY F.LEAOHACCAGNT _ $ 500 , 000 nN� ^F. P PT.ARrI.-crxrc�nwx _50_0 000 ' L. orravn.c1,.'dEae eAa,w c -' 4973P69-5-11 12/1.5/11 12/15/12 E.L.N$CAE 6�EMPLGYE 3 a 'Eo oecer I e.L.DISEASe-roucY LUAI' s 500 . 000 SI'EOIAL PgOVISIDN<nu:aw pt HFR I I I I I C'e5'FI:TION pE OPCR4T IOnS l LOCniIGNS/VEHIC LES I ETCLVSIONS n0UE0 BV ENDORS F.MEh'T i SPECIAL PROMS IDN6 ' iCarpentry/Insulation/Electrical i I CERTIFICATE HOLDER _ - CANCELLATION city GY .5 nJ.6i[r SHOL"_0lJLV CF THE A90VE OESCR;BED PCLICIEE BE CANCELLED 9EFORETHEEXPIRATION y DATE THEREOF, l'HF,189UING INSURER WILL ENDEAVOR TO MAIL20 DAYS WRr77'EN Attn. : Building Dept. NOTICE TO THE CERTIFICATE HOLDER NAMED TOTNE LEFT,eUT fkLUP.e TO DO 60 SHALL City Hall IMPOSE NO OBLIGATION OR LIAP,II,IT' OF ANY KIND UPON THE INSURER. ?S A:,F,NT$OR Salem, ilA 01970 RC_PRESENT471VES AUTHOR¢FO REP TAA�E--- -- ACORU25(20(111DS! .. ---`.G.+'ACOROC PORATION 19F8 P ' I Massachusetts - Department of Public Safetx Y" Board of Building Regulations and Standards, ,Constructioj,Suwvisc,r License Restricted to 00 JEFFREYeMAYOTTEi,) { ,:,.i ri, ,;i, t 29ANDREWS'I-N.d' ,!)', i< EAST KINGS TON NH 03827 a r•jr Expiration: 1/23t2013 CummisiunerC 4J Tr#: 103474 Ottice o(�L`oneu.F At al fincse tCegulei-- r HOME IMPROVEMENT CONTRACTOR Registration l64564 Type: h Expiration 10/2]]/2013 Individual I J EV MAYOTTE 7, JEFFREY MAYOTTE 29 ANDREWS LN. t:..� .ai--' EAST KINGSTON NH 03827 I, ` Undersecretary I I � i NSCAP 98 Main Street Peabody, MA 01960 Tax Exempt#: 042-385-280 Agency: NSCAP PROGRAM: National Grid/2012 Job Number: 0 - NGRID Application#: 0 Work Order# 0 Work Order Date: 06/04/12 Job Limit: Primary Contractor: All Season Windows&In Per Unit $4500.00 Other Contractor: Manchester Electric Client: Sara Gomez K+T Yes=1 No=O Street: 104 Proctor Street, 1st FI K&T: 0 City; State;Zip: Salem,MA Telephone: (978)335-3677 Stand Alone: No Fee Code: 0 Blower Door Test:FNI-0--i Stand Alone Yes-1 No=O Inspect Knob&Tube: No Elec.Contractor: Attic Insulation Estimated Actual Cost Est Cost Act Cost Attic flat R49 open(elec heat only) $1.61 Attic flat R38 open $1.47 Attic flat R30 open $1.37 Attic flat R20 open $1.29 Attic flat RIO open $1.21 Attic flat/slope R30 restricted $1.48 Attic flat/slope R20 restricted $1.42 Attic flat/slope RIO restricted $1.30 Attic kneewall R 13 $1.31 Attic kneewall floor R30 restricted $1.48 Attic/kneewall floor transition DP $2.52 Finished attic access $105.00 Temporary attic access $78.75 Crawls ace RI9 w/ oly vapor barrier $2.53 Garage ceiling/floor R30 $2.10 Thermadome $180.00 Roof vent-small $80.00 Roof vent- large $95.00 Pro pa vent $4.00 Gable vent-all sizes $92.00 Soffit vent $27.00 Attic sloe R30 cellulose w/membrane $1.95 Attic sloe R20 cellulose w/membrane $1.75 Anic kneewall R15 cellulose w/membrane $1.73 Attic air sealin 2-part foam $75.00 Vent dryer/bath exhaust fan l $89.00 $89.00 Page 2 National Grid/2012 iMasbesto.s/alummum Estimated Actual Cost Est Cost Act Cost s/as halt R15 DP $2.21 aluminum RIS DP $2.31 Brick/stucco P $2 89 Interiorwall blow-plaster R15 DP $1.90 Clapboard/wood shingle/vinyl R15 DP $1.79 Test drill 4 sides $60.00 Sill 2-part foam w/FG batt R19 150 $2.20 $330.00 Sill insulation R19 faced $1.58 Perimeter wrap R5 $1.91 .Air Sealin Door kit 3 $45.50 $136,50 Regular door sweep 3 $15.75 $47.25 Automatic door sweep $23.00 Air sealing 2-part foam 4 $75.00 $300.00 Sash lock $9.50 Glass replacement $44.00 Blower Door Setup $45.00 Total Air Sealing Cost: Heating System Measures Duct insulation&seal seams(sq. fl.) 348 $3.10 $1,078,80 Hvdronic 2iPe insulation to I" R5 — $3.41 H ydronic pipe insulation 1.25"+ RS $3.68 Steam pipe insulation t0 1.25" R5 $5.51 Steam pipe insulation 1.5l' -2" R5 $6.35 Boiler/furnace replacement $0.00 Program repair $0.00 $423.00 Aa"m tom does not ino ee$ns.00 n a T charge. 52,404.55 Est Total 50.00 ActTotal AUDITOR: Doug Cranford - NSCAP 98 Main Street Peabody, MA 01960 Agency: NSCAP _ Client Application#: PROGRAM: Keyspan/2012 28460 Job Number: 0 Work Order# 0 Work Order Date: 05/04/12•-- Job Limit: Primary Contractor: All Season Windows&.Insulation Per Unit $4500.00 Other Contractor: z NA Client: Arelis Melo K+T Yes=1 No=O Street: 104 Proctor Street, 2nd Floor K&T:. 0 City; State; Zip: Salem,MA 01970 Telephone: (978) 744-48.90 Stand Alone: Yes Fee Code: 1 Blower Door Test: No Yes=1,No=2 Inspect Knob & Tube: No Elec. Contractor: Attic Insulation Estimated Actual Cost Est Cost Act Cost Attic flat R38 open $1.47 Attic flat R30 open $137 Attic flat R20 open $1.29 Attic flat R10 o en $1.21 Attic flat/slope R30 restricted $1.48 Attic flat/slope R20 restricted $1.42 Attic flat/slope R10 restricted $1.30 Attic kneewall R13 $1.31 Attic kneewall floor R30 restricted $1.48 Attic/kneewall floor transition DP $2.52 Finished attic access $105.00 ,Temporary attic access $78.75 Crawls ace R19 w/ oly vapor barrier $2.53 Garage ceiling/floor R30 $2.10 Thermadome $180.00 Roof vent-lar e $95.00 Roof vent- small $80.00 Turbine vent $168.00 12" stack vent $152.00 Pro pa vent $4.00 Gable vent(all sizes) $92.00 Soffit vent $27.00 Ridge vent(lin. ft.) $23.00 Attic air sealing 2-part foam $75.00 f Vent dryeribath exhaust fan 1 $89.00. $89.00 i f /MSinglensauilled Ke s an/2012 Estimated Actual Cost . Est Con sbestos/as halt R15 DP Double nailed asbestos/aluminum R15 DP $2.31 Brick/stucco R15 DP $2.89 Interior wall blow-plaster R15 DP $1.90 Clapboard/wood shingle/vinyl R15 DP $1.79 Test drill 4 sides $60.00 Perimter wrap R5 $1.91 Air Sealing Door kit 3 $45.50 $136.50 Regular door swee 3 $15.75 $47.25 Automatic door sweep $23.00 Air sealing 2-part foam 2 $75.00 $150.00 Sash lock $9.50 Glass replacement $44.00 Blower door setup $45.00 Total Air Sealing Cost: $333.75 Heating Svstem Measures Duct insulation& seal seams (sq. ft.) 320 $3.10 $992.00 Hydronic pipe insulation to 1" R5 $3.41 Hydronic pipeinsulation1.25" +R5 $3.68 Steam pipe insulation to 1.25" R5 $5.51 Steam pipe insulation 1.5" -2" R5 $6.35 Boiler/ furnace replacement $0.00 Program repair ($500 max.) $0.00 Actual Total does not include$175.00 K&T charge. $1,414.75 1 lEst Total AUDITOR: Doug Cranford 50.00 I lAetTotal w ,. �0 ACTION, INC " 47 Washington Street a ' Gloucester, MA 01930 Agency: NSCAP - -NGRID Application#: - PROGRAM: DOE/12 0 , JOB NUMBER: 0 a' DOE Work Order# 0 .' E.S.C.performed? No Work Order Date: 05/04/12 Primary Contractor. :All son Windows&InsulationOther Contractor: Manchester Electric #Bulbs installed` 0 Cost of Bulbs $0.00 - - Client: Luz Billipi 'Insp,t$175.00 Max, $0.00 Street: 104 Proctor Street,3rd Floor - 'Other In Kind $0.00 City; State;Zip: Salem,MA 01970 Electrical Work $0.00 Telephone: (978)335-5757 $Amount KeySpan $0.00 $Amount National Grid S0.00 Blower Door Test: No Other Utility $0.00 • Inspect Knob&Tube: - - Date Job Completed: Estimated Repair Total $540.50 Actual Repair Total $0.00 Weatherization Estimated Actual Cost Est Cost Act Cost Door kit $45.50 Regular door sweep $15.75 Automatic door sweep $23,00 Air sealing 2-part foam(per hour) $75.00 Attic air sealing 2-pan Foam(per hour) $75.00 Weatherstrip window(per side) $6.00 Seal ducts-mastic $65.00 ' Seal duct returns-mastic $65.00 W/S&insulate attic hatch R30 $33.50 $0.00 $0.00 $0.00 $0.00 $0.00 Weatherization Total: -: $0.00 $0.00 Insulation Estimated Actual Cost Est Cost Act Cost Attic flat R38 open $1.47 Attic flat R30 open $1.37 Attic flat/slope R30 restricted $1.48 Thermodome - $180.00 Attic kneewal RI l FG $1.31 Anlc kaeewall Rl z cellulose w/membrane $1.73 Attic kneewall floor R30 restricted $1.48 Insulate attic stairs&walls fl$135.00Sidewalls-vinyl RI5 DP Interior wall- faster R15 DP 1"rigid foam board Duct insulation R5&seal seams H dronic i e insul to I"R5 Steam i e insul to 1.25" R5 DH W pipe insuation R5 $2.63 Insulate door- I" rigid board R7 $51.00 Sill 2-part foam w/FG batt R19 $2.20 - Insulation Total: $0.00 $0.00 DOE :Measures Estimated Actual Cost Est Cost Act Cost ' ' vent-small $80.00 s e le vent-rectan lar $92.00 ecessed can cover $30.00 Cut/finish attic/kneewall access $105.00 Test drill sidewalls-4 sides $60.00 Blower door test $45.00 Vinyl replacement wiindow- l0lui $350.00 Faucet aerator $15,00 Low flow showerhead $25.00 $0.00 $0.00 $0.00 $0.00 $0.00 Other Total: 1 1 $0.00 $0.00 Eisergy Conservation Est Cost Act Cost Total: (Max$10,000,00) $0.00 $0.00 Repairs Estimated Actual Cost Est Cost Act Cost Repair/refit door $52.00 .Adjust door striker plate $20.00 Door entry lockset 1 $73.00 P$73.010 Repair door hinge $25.00 Slide bolt $20.00 Sash lock $9.50 Steel re-hun door w/lite $640.50 Solid core door w/hardware 1 $367.50 $367.50 Glass replacement-to 64 ui $44.00 sire-lain inrerior Mkhead door wiiamt: $435.75 Clean gutters(per hour) $60.00 Building perrinitfee I $100.00 $100.00 Health & Safety Vent clothes dryer to exterior $89.00 Vent bath exhaust fan to exterior $89.00 Replacemem window lead-safe practices $20.00 Repair/H&S Total:(Max$2500,00) $540.50 $0.00 Work Order Sub Total: 1 $540.50 1 1 $0.00 Measures Estimated Actual Cost Est Cost Act Cost Other $0.00 Other $0.00 "Heating System Repair $0.00 "Action approval only Estimated Job Total: $540.50 Job cannot exceed $10,000.00 Job minimum =S500.00 Job Grand Total: $0.00 AUDITOR: Doug Cranford