1 TURNER ST - BUILDING INSPECTION , �
���I� -.'� -- I'hr Commonne;�hh af hl:u,;ichu�eus
y; �� Du,irJ �N'13uilJing Nrgulaiions ;mJ ScmJarJs ���� l' l)F
'r ,;, � ��1;is.a;irhwctts S�atc DuilJing CuJ¢, 7Y0 C�IR �'���'�I
'�..,.� lr.'rierJ IGir:lll!
13uilJing P¢nnil ,\ppliratiun '!'o Cunstrurt, Rep;iir, Ncituv;rt¢Or Dcmulish a
Uuv ur Tu u•P�mruh' D�r.•llin,��
This Srction Fur Ol)icial Us¢Onl
DuilJing Permit Number: Date; pli¢J:
� _ —--
IIuilJiny 0111ci�1�Prim N+une) Siyn�turc Ualc
SECTIOIV I:SITE IIVFORDIJITION
I.I Property.1dJre�r. i.1 Ae�eewn��I�p P «I Numbm
t
I.la I�thi�an;icce �ad street? ef no �lap NumAcr I'urcul Numtxr
I.! lanlnO Infonnntlon; I.� Properly Dimen�lon�:
Luuiny Diytrie� I'mpn+eJ U w Lut�mu Isy Itl PmNuy�111)
1.1 BuIIJin`Setbulu(R)
Frum Y;vd Si�c Y�rJi
H.ar Y:vJ
Reyuired I'ruviJud Reyuircd provided Heyuind I'ruvideJ
I.6 1Vxter Supply:�M.G.I.c.JU,§J�) 1.7 Flood Zont Informrtlont I.a S�w�p Di�poul Sy��em:
I�iblic O Pri��iu O ZO^°� — UubiJe Flood"Lune1 Municipd p On sita Jispurul y�v�em ❑
CM1rck il' �ca0
SBCTION2: PROPERTYOWNERSHIP�
7.1 Own�r�of Record: � � //� p
�P�JfA �rnG SG•E..Q �/ , !21 A O / / �Q
N;unc 1 Prmq ('uy,5wtc.l.IP �----
/ T�o-n�r S-f 97,� 7�/S�'i�.33 ,�/q
Nu.:mJ Sirce� . f.lepAuna Einuil AJdrcsf
SECTION�: D65CRIPTION OF PROPOS£D ldORN'(ch¢ck all thri npply)
Naw Construction ❑ E.ristiny Buildiny O O�vner•Occupied ❑ Repairs(s) � ,�Iterotlon��) O Additiun ❑
Demuliiion ❑ .�ecr�sory 81dy, O Nwnberof Unib Oihe� �3peciry: ,.�S��a o i.,
Orief Deecription of Proposed 1Vork^ 16� h
� r � � w f-1
VL�'1.4 - e
SECTION �; HSTI��IAiED CONSTRl�CT10N COSTS
I����� Esiimatrd Cosu:
il..ihur and.\I;nr�ial�l Ofllclul Ufe Only
L OuilJing S I. Bui�ding Pertni�Fee: S hidicaie huw lae is deiemiincJ:
� '. h:l��ariral S �Standard Ciry?w�n Applicaiion Fee
❑7u�il Project Cusl��Itent 6)� multip�ier _ _ �
i 1. I'lumhin�j S � — ' _._ ._
� _. U�her Fca: S
� J. \Iccli.mi:.d ill\ 1('1 S Lisl: .
' � llrih.inic.d il`ir�� '- -'--- --"'--- -�- -.. ..._ . .
� 5 fo�al \II Fca: S -- --- -- _ . ._ ._ .
�u� �n•�sianl
(�hrrA V��. (�hccA :\nrtninC l',ieh \iwwnL �
n Tui�l Prnjcci CuH ) - -- �. ._ . .
���0' �� ❑P.iiJ in Full ❑Ou�sr,mJinq O.il,utc¢ Du.:
�
7�j- %.�'= �ey'S /�r,�/�-,�
�� � C���-�-r��v�,
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sec ru�� s: c ��Ns rRi�< n�i�v seH�u r'.s ' '
SJ ('ons�ruciiunSupenisurl.ir.nselCtil.l o�lfdZ l/_ / ',_7
__..._. _ _. . ... -. —
"-- ' ����vduanl)dl¢
/ Q e I icemc,\'wnhcr I
--,��h�..!_+,✓ . . /.5_F��..S - _._. . .__----
� .V.uneol'C51 ILdJcr li.+ll'\I. I'��wl•.�balu��l__"_" _—' ._
Zq��_ ' h�/?__. _. - d Ikscrip�ion
�!_n1��-- --' - - - --� —�--- 1)pu .
Nu md�irccl �i l�nn.�ridcJU)wlJin�r ii ia 15,UU�I.u, ILI
� 6G _[iLi� �/�G` U � -- I1e�IricleJ L'l•] I�,unil Ducllin
Cii�ifa��n.�i,n LII' \I ,\L�.;wi
HC H�M�lin C���crin
q'ti � K'indU�r,md SiJin
...—. _n/ $p 5olidl'u.l0uminy,\ppliuncey -
7��' y7f?D� C cd "[�H C%�*/P.�Ow/ I Insulutiun
f.l� hunc
I'n:iil:dJrr.� U Drniuliiiun
�.2 Rr I�IcreJllumelmprurrn�rnlCu/ntrnctor�HlC) ��c��� //.36�/�
���r�.�.� �%,.�,�� �`f�o�.t. �-�-G IIIC' R.yi�uaiiun Numhcr If�piruliun Ua�e
I IIC Cainpan� Nainn or I IIC'1l.y SlNll{Nd11fY �,�S�,O��.�tN ��e. C'O«-+
2 x�fF�•y, l7`a �
�:111Y1�J��R:I!
N��,�sv�c;r�� or4rav ?2/-Z/7,f2�ir
ci rroW ,s�o�e ZIP f.l� hune
SECTIOIV 6t WORKfRS'COM1iPENSaT10N INSURANCE AFFIDAVIT(M.C.L e. Il3.� 2SC(6))
Worken Compensallan Insurance of(idevit muat be completed and�ubmitted with thi�applice�ion. failure to provida
thfa a111d4vit will result in the denfal of Ihe Is�uance of�he bui�ding permit.
Signed Affldavit Attached7 Ye� .......... No...........O
SECTION 7�e OWNER AUTHORIZATIOIV TO BE C0111PLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDINC PEN�IIT
I,as Owner of the subject praperty,hereAy outhorixe C�G�s���
to act on my beholf,in,pll mu�ten relutive�o work ewhorized by thie buildiny permit oppNcaUon•
/� � /0.27•/?
/�-�� � 7-.�= -•
Duta
I'nnt O�wcr'a Nwne(Elcclnnuc Srynuluro)
SECTIOIV 7E:01VIVER� OR AUTt10RIZED.ICENT DECLAFWTION
8y entering my naine below, I hereby a�te�t under the pain�ond penaltie�of perjury that all uY the infurmn�iun
containad in thie ap ' uio�e and ccurole ta the best of my knowledge and undentandiny.
� Cy `��' �Z
1'rinll)��i •iear:\whorveJ,\�aneN�uN II�.IeUnnu�.�igndtur�l
Dalo
VO'f ES:
I, .\n O��ner ��hu ob��ins a builJing pannil la do hif her o�vn �wrk,or an o�vner��ha hira an unregisicrcd.onlricWr
1 nut registdred in�he Hunte ImDrovrnttnl CunlncWr 1 HICI ProgronU. ��������� have accass io ihe arbiiriiiun
program ur guaranty I'unJ under�I,G.L. c. I�_'A. Uihcr impun�n� inl'urmation on ihe HIC Program ran be tl�wid a�
,,,,,� n�.n. ��� �, i Inforin:uiun un ihe Cunslruclion Supervisor License.in be found at������ ����•"'�'� �!I��
? ��hen subxt:uuial �wrk is pl;mncJ, pru�iJe ihe inl'unne�iun below:
I'otal tluor arca I;y. �l.i . ----..-iincluJing�uragt. linished baxm.ntauics. daks or p��rciu
flabi�abla ruam caunl . . ... .
� liruisii�inq .irralsy. 11.l .... _... . - �
' \wnF.r��l lirc�+la:cs
-... \umh¢rul'hrJruunu . . . . �
� \�nnhrro(hadviviut .. ._ _ . _ -- \�wubcrol'hall'hailis , . I
I i�pd��l'ho.�ling s).lam \unth¢f ol'J¢Cl.i �torches �
I'ndo.cJ .���,•n
' �\�•���� COU�IIIL N(121p � .
� � ..��q.l� ��(���C�I ti��11:IfC �'�hq.1�C Itlll\ ��l' Nlh�lllllli�) ��q "���1,1� ��f��fii� �J��••
, .
� ,�" '�:� C('C`I UF S.1LE.�,I, 1�L1�5.\CHI,"5ETT5
' � lJ UCILDIVG DtP.1tt�C�l��T
�'���'���<`�� I�O1Y/.\iHNGTO 1O OZ
\�\�;, � ST�tEET, 1 F2u
�;�:,, .,y �t �975) 7�5-9594
F.CC(9iY) 11U-98-36
;�I�IpERI�Y DRISCOII.
�L�YO:Z � � T�iO�Li3$T.P1E.iA8
DIAECTUR UF Pl'9LIC ?f10PEATY/OCR�NG CO\L\II55[U\ER
Wurk�rs' Cumpeneation fnsur�nce,�ITTdavit: [3uildcn/Cuntr�cturv/Elcctrlctan.Uplumben
4ii�ilic;�nt Infiirm�tlnn PlcaYe Prhit L���hfv
.V(Itl1d�Ilueiiw�sUr�,tmvaii��rolndividu.J): /7G�4asstl' �t12tis.,7 ���jvh J L.LC
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:\�Jress: 2�/��,�.%{�a /L/-�
City�St�tc/Zip: /'Qak�o,l j t�.r arOl y� o Phuna N� 7d'/ y7,r=zG�'j-'r--
,\re ynu �n cmploya!ChecM fh��apprapriau boas
1'yp�uf prnJee!(ra�ufreJ):
I�m a amp�oy�r with �_ 1. Q I;un a gen�r�l eunlractor anJ I
i°P�^Y��(nil�myor part�ime).• hava hircd iha wdcontnclno 6• ❑Nuw eunywction
1.Q I,nn a aole propricior ur p;utncr- livnd on�ha aeached ah�ct � 7. ❑Remadeling .
.hip unJ hava nu cmpluyeey Thes�sub�onlra¢ton hava 8. �nemolition
wurkiny ILt ma in;my capuity. �varken'camp.ineurnnca ,
�No wurkcn'.comp.inaurance 1. Q Wa ua a cnrpamNan and iV �• ❑ Ouildiug udJitiun
rcquircJ.i oiticm have exnrcieed thdt 10•�E��ctrical rcpain ot additiona
J.0 I am a homcuwncr Juing ali wurk dyht of exampli�n pe�MGL �I.Q Plumbing rcpuin ar uddiNons
myxif.(\a wo�kea'cump. c. I J2, �I(4),anJ we have no I7.0 ftoof n:pain
ineur�nw«yuireJ.� � vmpluyeea(No warlten' �
cump, inxumncercyuinJ.J I).QOihcr
•.��ry uppll.:un Jw eh�aY�boa il mu�1�Ir.,NI nm ih�v.uw buH.v,haWiny in.ir.wYm'eomMnudun pull�y m�Lm�oiion.
'1 h,nvuwno u�u.uhmit i�i�u}41nvi�indlealn�ihq�n dainy ull�wrt md�Aen hin uuqiJ�vammewn m�ul rohmh�new aillJaril indiain�,ueh
�ll�mrxwnilwlcha�kihi�6uemwUnachwl.+n.WJ�tluwl.hud,huwinyih�nwnvafiA�iuO..unincux��nJihalrwnhm'mmp.pullryin(wmatlas. � .
/u�n an rurp/uy�i ehuNt pruvlJ/nX ivorkiri'cumprntadun lutqrane�Joi my emp/uyrrx, Bduw!i diipoN�y undJub iUa
inlolqrul/nlb q
Ifi�ql:llill'�)UitlrOflYVp111G: �v /��/y����A�
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Pnlicy J ar Self�ina. Lia. ntf��/�U���/O �7 �iJ ' ,r'�( 7
Eapirucion Oota: J ' y' � > �
lub Sita,l�lJn.vy: � �////7/�!/ .S'� �p� �2 CiryiSt�te/Zip: JGYp,�t.� �� �/9 �Q
�����h+���py u(�hr�rorker�'companudoo palley declar��lan p�X�(�hawing ih�pollty numbor and �ipin�lae data).
�'iiluru w ucury euva�,a�r rcquireJ undar Sce�ion ?1.l of'�fGL e. 172 eon IraJ ia�he impoai�ion oFerimin�l pen�ltia�oi a
ricc np ro i I,SCO.UO unJ/ar unayar impri.rnnmcnt,���vcl��y cfvl p¢����iai in�ha tortn oj u STOP WURK UROEA�nJ a li,ia
,:i�.�p to S'SO.QO i Jay iy�inst�he viola:nr. Ile�Jvir���hat�cupy ul ihi�.uieinenl�n�y ba turwarJ�•J tu dia nl'tica ol'
I.irr�lig�uunx,il'iho nL\ rl�r inaar�nce cov�•r.iye veritir��iun.
/:luirrrrbyi•�r�i/'ynnJ�i�hip�ii m�JpenvlNrr,i�p.yjuryihu!!/�ii��urnrudanpru�iJrJuGuvri�i�w�urJrorrrra
,. � �, .
.,.., ,� I)dt t ....__—,1 �
�'�.�c,i• ��5'/� S�JS= 7/>�S
� /.�/�iciv!rne�ndy. O,i,n�f n�ri��in d�ir:uro� !d�t run�plt/.�J�Sy rity u�Im.n�i��lri�L -
City ��� I'��wd: _..._. . .. ._ i'crmi��l.kenie �
I.�uiiiy.\ulharily (circlunnc): _—"' . . ._ .__
I. ;LiaN nl Il:�lih !. Iluildfn�� Uvp.irluicnl 1. l-ily�'fnun C(p�� 1. IiI.•ctri:.il fn� n� �
,i. l)ilirr ___ __ _. __....._._ I cf��r i. 11�i�ul�in4ln�pacf�i�
l'�idl.lit i'rn���c
. :' �_'_ --____'.__-_:- - -� 1'hqn¢ !i
� OA7E{NmAIDdYYri)
,acaRo� CERTIFICATE OF LIABILITY INSURANCE 5i2s �z
TI-03 CER7IFICATE IS ISSUED AS A NIATTER OF INFORMATION OI�Y AND CONFERS NO RtGHTS UPON THE CERfIPCATE HOLDER TMS
CERIIFICATE DOES NOT AFFlRMATIVELY OR NEGATNELY AMEI�, EXTE� OR AL7ER TF� COVERAGE AFFORDED BY 7HE POLICIES
BELOW. TFUS CERTIFlCATE OF INSURANCE DOES NOT CONSTrtUTE A CONiRACT BETWEEN THE ISSUING INSURER�S), AUTHOPoZEU
REPRESENfA71VE OR PRODUCER,AND 7HE CERfIFlCATE HOLDER.
IMPORTANT: tM certifieate hdder ia an ADDI710NAL IIJSURED,1he polie�es) rtwst be endorsed. If SUBROGATION IS WfUVED,subject to
the femis and con�Ho�ofthe policy,ceRain policies rrey require an endorsement A sta�meM on this ceRiNate dces not confer righffi to ihe
certificate holder in lieu of such endorseneny�•
rrtoacER wnr E: Paul T M h
� Paul T. Murphy Insurance Agenc P�NE . 'J$1 321-9700 �x N : <�81) 32<-a253
628 Broadway qooaness: ul@ tminaurance.com
Malden, MA 02148 ir+sur� SAFFOROINOCOVFRI��E NAICq
uauariea:First Financial Ins Com
��Ep ir+s�aee e:3afet
Advanced Energy Solutions LLC i�R�rsc:Chartis
28 Hamilton St u�sur+mo:
Peabody, MA 01960 ��RERE:
INSIIRER F:
COVERAGES CERTIFICATE NUMBER: , . REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLIC�S OF INSURANCE LISTED BELOW HAVE BEEN�SSUEO TO THE INSUtED NAMID A60VE FOR THE POUCY P6tIOD
IND�ATm. NOTMTHSTANDWG NJY REQUIREMFM,TERM OR CANDITION OF ANY CANTRACT OR OTHER DOCUMENT WfTH RESPECT TO WH@CH THIS
EXCLU50NS ANDCONDITIONS OFS^UGH POIJGES LIMITS HOWN MHY HAV�E BEEN REDUCED BY p pCLAI�AS HEREBJ IS SUBJECT TO ALL THE TERMS,
wTp IYPEOFINSURIWCE �L VOUClNUN�ER PtdND �F W1udYYYY 1IM75
A QEpFRpLIJq&LIIY 807F000697 5/7�12 5/7/13 D�HGETOREENTCEU S 1 000 000
X COM4�IERCIAIGEt�RALLIABILITV � $ 50 000
CtA@1SidA0E �OCCUft AIEDE76' More ersan) 8 $.0��
rEnsow,�aaoviwunr s 1 000 000
ceNEwanGcaEcn� $ Z OOO OOO
PRODUCCS-ODf�lOPAGG E �L OOO OOO
GEN'LAGGREG111E�P9TMP�ES PER
5
POLICY P� LOC
puranom�uaeiuir 6217181 3/i5/12 3/is/13 �°�,� s 1 000 000
$ 80DILV INJURV(Pa person) $
ANY AU70
PLLOW�'ED X SCHEDULEO BODILYINJURY(Peracident) E
AUTOS NON-0NMED PROP KTY DMN�GE g
X HIREDAUTOS X AUTOS ge
$
Ut�NEl1A1JAB OOCUR � EACMOCCUARENCE E
E%CE89UAB CLAIMS-M40E AGGF7EWTE S
S
Dm REfFM10N 5/14/12 5/16/13 �{ �'�'C5TATU- OTM-
L. NqRK66COI�ENSATION WC005690446
/WDEM%.OYERS'lN&L1TY y�ry EL.EACHACGDEI�T S 1 .00O OOO
AN'(PFtOPRIEfORIPARfNEF/E%ECU7NE NIA
OFFMEWMEMBEREXfXWED7 N E.L.DISEASE-FAf7rfl�0VE S 1 OOO OOO
(YaMabry In NH)
Hyes,CmaDewtlef EL.DISEA�-POLICVLIMR S S OOO OOO
DESCN�PT�ON OF OPERATqNSOebw
�ESCRI]TON OF OFERATONS I LOG770N3!VEI9CLES (�AW�707,Ad6tlana�Re�reAm Sdretl�de�if more e(nca Is re9Jrea)
Insulation-Coverage is aubject to policy terms conditions and exclusions.
CERTIFICATE HOLDER CANCELLATION
SNOULDANV OF 1HE A60VE DESCRIBED POLC�S BE CANCELLED BEFOFtE
TFff E%PIRATION DA�E TF�f�OF, NOT�CE �N�LI- BE DEUVERED M
TOwn O£ BilSerica ACCORDANCE WITH T1E POLICY PROVIS�ONS•
AUINORIZED REPRESENTAINE
, � ��
O 968-2010 CORD CORPORATION. All rights reservec
ACORD 25(2010/05) The ACatD �me and logo are regiatered ma�lcs of ACORD
P��: Fax: (978) 794-1251 E-Mall:
Cin of S.kL&Nf, AUSACHUSETTS
JLMDLNG OEP.1RTtE`7r
120 WASHLNGTON STXW, 1iO FLOOR
• � f2L X978) 74S.9S9!
KIJc3FR1 RY DRLSCOLL F.Vt(918) 1449846
MAYOI! MO.+W ST.PMUS
DIRBCrano auc PROPERTY/9t:mnLNG COILAIIS!(ONE1t
Construction Debris Disp0831 Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 180 CMR section 111.1
Debris, and the provisions of MGL o 44, S 34;
Building Permit 4 is issued with the condition that the debris resulting from
(his work shall be disposed of in a properly licensed waste disposal facility as dofincd by NIGL e
I 11, S I JOA.
The debris will) be transported by:
/So 7`yv c �G
(Mama of hauler)
The debris will be disposed of in :
(name of facdily)
L.3 10�H lel/11, s�
/. ,/H jJdrefr aYAcihiy)L
�n�tutauf;crmll IPPI ;Oant
,I�fO
• Ma.ssachuselts - Department of Public-S rvi
Board of Building Re ulations,md StandatdN
Construction Supervisor Lic--nsev
License: CS 90902
r
RICHARD B GORGES -�
28 HAMILTON ROADf* •y '
PEABODY, MA 01960 t
��•� -�� Y "' Expiration: 11/1/2012
('ummisxianer' 1`+ Tr#: 5481
•\
Orr.
ce of ""mee�e gfaf`� CBdsiness Reg
r{ -= HOME I .. I.
I ReglstratlonOYEMENT CONTRACTOR
Explratlon -164893 d
r 11/30/2013. Type:
ADVANCED ENERGY SOLl7TIONSiLLC. �% f�
RIC
HARD
28 HAMILTON RD -
PEABODY, MA 0198
r Undersecretary ,i
NSCAP
98 Main Street
Peabody, MA 01960
Agency: NSCAP Client Application#:
PROGRAM: Keyspan/2012 23509-
Job Number: 0
Work Order# 0
Work Order Date: 06/19/12 Job Limit:,,.-.
Primary Contractor: Advanced Energy Solutions Per Unit $4500.00
- Other Contractor NA
Client: Debra French K+T Yes=1 No=O
Street: I Turner Street Apt: 2 K&T: 0
City; State; Zip: Salem, Ma OI970
Telephone: 978-745-9633 Stand Alone: No
Fee Code: 2
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 $1.37
Attic flat R20 open $1.29
Attic flat RIO open. $1.21
Attic flat/slope R30 restricted $1.48
Attic flat/slo a R20 restricted $1.42
Attic flat/slo a RIO 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
Tem orary attic access -$78.75
Crawls ace R19 w/poly vapor barrier $2.53
Garage ceiling/floor R30 $2.10
Thermadome $180.00
Roof vent- large $95.00
Roof vent-small $80.00
Turbine vent $168.00
12"stack vent $152.00. '
Propa 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
Vent dryer/bath exhaust fan 1 $89.00.- $89.00
"Keys an/2012
Estimated Actual Cost „''Est Cost Act Cost
Wall Insulation
Single nailed asbestos/asphalt R15 DP- $2.21 i:•.
Double nailed asbestos/aluminum Rl5DP_ $231
Brick/stucco R15 DP $2.89
Interior wall blow-plaster R 15 DP $1.90
Clapboard/wood shingle/vinyl R15 DP it $1.79 0,3 3,y
Test drill 4 sides 1 $60.00' $60.00 "
Perimter wrap R5 - .$1.91."
Air Sealing
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 2 $75.00 $150.00 .Sash lock - - - $9.50
Glass replacement $44.00.
Blower door setup $45.00
Building Permit 1 $100.00 $100.00
Total Air Sealing Cost: $433.75
Heating,S stem Measures
Duct insulation&seal seams(sq. ft.) $3.10
H dronic pipe insulation to 1" R5 $3.41
H dronic pipe insulation 1.25"+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. $582.75 Est Total
AUDITOR: Brandon Dorrington $0.00 1 jAct Total
L