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3 WATSON ST - BUILDING INSPECTION (2) �P $ S-r z (050 -- GK � 35 The Commonwealth of Massachusetts r(,�� II,��jD� Department of Public Safety IYu�^ Massachusetts State Building Code(780 C%IR) � Building Permit Application for any Building other than a One-or Two-Family Dw ling (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 s address is not availab e WP:Tsom ST :E�LIE:m O19-1O No.and Street .City/Town Zip Code None of Building(if applicable) SECTION 2:PROPOSED WORK Edition of NIA State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair WTUteration ❑ Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No - / Is an Independent Structural Engineering Peer Review required? Yes ❑p No fsY nef Description of Proposed Work: LAd, 6*.i ""r� 1WPV 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 17-A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-t ❑ F2❑ H: Hi h Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5 O L• Institutional 1-1 ❑ 1-2❑ 1-3❑ 14❑ M: Mercantile❑ 'I R: Residential R-1❑ R-2❑ R-3❑ R4❑ 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 Cl IIB ❑ HIA 0 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❑ required❑or trench or specify: Private❑ or indentify Zone: or on site system❑ Permit is enclosed❑ t` Railroad right-of-way: Hazards to Air Navigation: MA I,ti to i C�>{nnp,yu n Re,11" 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: Dues the building contain an Sprinkler System?: Special Stipulations: SECTION 9: PROPERTY OWNER AUTHORIZATION _ Name and r d Tress of Proper Owner C ' Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Title Telephone No.(business) Telephone No. (Ceti) a-mail address If applicable, the property owner hereby authorizes Name Street Address City/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) - [f building is less than 35,000 cu.ft.of enclosed space and/or not under Commiction Control then check here O and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control _ N:mne(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor - • - - - SE�,A��c�,�.o5 Con,paMy Nam -�r —� Name of Person Responsible for Construction ` � License No. and Type if Applicable q �n N a n, A.4�, LyNu AP- OR - Street Address ity/Town State Zip Telephone No.(business) Telephone No. cell e-mail address SECTION 11:IYORI:ERS'C ONII'tiN5At1ON INSURANCE AFF11AVI4 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 uance of the building permit. Is a signed Affidavit submitted with this application? Yes=o 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$e�d•� 1.Building $ u Building Permit Fee=Total Construction Cost x (Insert here 2. Electrical S appropriate municipal factor)=S 3. Plumbing $ 1. Mechanical (HVAC) $ Note. Nlinimum fee=$ (contact municipality) 5. Mechanical Other $ Enclose check able to 6.Total Cost S payable a (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 an accurate to the best of my knowledge and rmderstanding. se 0601'Cii�, 741 A9-3.077 3 Please print and sign name Title Telephone No. Date Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date CITY OF SM.EM, A[ sSACHUSETTS BUILDING DEPARTMENT '. Q Ir i 120 WASHINGTON STREET, 3-FLOOR TEL (978) 745-9595 F.A-x(978) 740-9W KI\iBERLEY DRISCOLL THOAIAS ST.FIFRRF MAYOR DIAECI'DR OF PUBLIC PROPERTY/BCILDI?1G CONL\IISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractorv/Electricians/Plumbers Applicant Information Please Print Legibly Name(nusinessorgan i zatiorvindividual): Se 4AO\R Address: CA —TILkN X City/State/Zip: L-NhL `� ANN • 011 Phone #: 7`�I —91 ��i ' OUP7 I A,-rc,j)Xu un employer?Check the appropriate box: 'type of protect(required):.L I am a er with era to 4. ❑ 1 am a geneml contractor and I \ P Y 6. ❑ w constructionemployees(full and/or part-time).' have hired the sub-contractors 2.❑ ] ,am a sole proprietor or partner- listed on the attached sheet.) �• emodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity, workers' comp. insurance. 9• ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their l0.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. ('No workers'cutup. c. 152, §1(4),and we have no 12.0 Roof repairs, insurance required.)t employees. (No workers' 13.❑ Other comp.insurance required.) •Any upplicem dui checks box BI mean also rill out the section below showing their worker'cumpenaation policy airarnatiun: 'I61mc0wncra who submit this affidavit indicating they am doing ail work and then hire outside contractors mtut suhmit a new affidavit indicating such. $;amncmn thus check this box must auachul an additiowl shut showing the name of the sub<anlractoss and their workers'comp.pulicy information. I tun un entpluyer thus fs providing workers'rontpeusatlun insurance jar my eurp/uyers, Below Is the po/%y turd fob site Inj4rlr141f44. (��/ Insurance Company Name: Policy #or Self-ins. Lic. #: Expiration Date: Job Sile Addruss: I W CN-VSoul JT = City/State/Zip: ,\ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of kfGL c. 152 can lead to the imposition of criminal penalties of a tine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine orup to S250.00 a day against The violator. Be advised that a copy of this.statement may be forwarded to the Office of Investigutiuns ofthe DIA for insurance coverage verification. I do hdreby e7xr=aada die pan ss ul mltier ojperfary shut the lnjannation provided above is true /and eorrecL Date: ,/ Phone d: Of ficiul use only. Do nor write in rhis area,to be completed by city or town official Citynr'1'usvn: ___. . luuing Aulhurity(circle one): 1. Board of 1lcalth 2. Building Deparlinvnt .i.City(ruwn Clerk J. Electrical Impcctor 5. Plumbing Inspector 6.Other Contact Person:_ _ _.. ....— Phone #: 1 n CITY OF S�1I.E�,[, ti�.1SS.ICHUSE ITS BuLmr,DEPAR'M&NT 120 WASHNGTON STREET 3'D r FLOOR 4 T EL (978) 745-9595 F.kx(978) 7-W-984d K1\tBE1tLEY D2ISCOLL NLAYO:t T1 tO ALAS ST.PIEUE DIRECTOR OF PUBLIC PltOPHRTY/8UILDLNG CON L%(ISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 730 CMR section l t 1.5 Debris, and the provisions of VIOL c 40, S 54; Building Permit fa 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 rV1GL c 11 I, S 150A. The debris will be transported by: y ' (name ofhauler) The debris will be disposed or in (narne o 'facility) signature of permit applicant late na„I Ir ,, -7 o L Df,* 341, 1 y 6-s" W/i & flaw-ihor/1e /rt6de4 � y The Commonwealth of Massachusetts Department of Public Safety Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (Thus Section For Official Use Only) CA Building Permit Number. Date Applied: Building Official: m SECTION L-LOCATION(Please indicate Block#and Lot#for locations for which a street address is t av ) L04 3 t{ dslObcne '11 �`i'lve_ i5ii70 7, . No.and Street City/Town Zip Code -Name of Building(ifflplicapej� SECTION 2•PROPOSED WORK , Edition of MA State Code used_ If New Construction check here Vor check all that apply in theZwo roy��s below Existing Building❑ Repav❑ Alteration ❑ Addition , Demolition ❑ (Please fill out and sub Appvdix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes No O SON Ft1 Is an Independent Structural Engineering�Peer Review required , Y ❑ No Brief Description of Proposed Work / naicud— Aew JI�P [IDJP60 of SECTION 3:COMPLETE THIS SECTION IF.EMSTING BUILDIN6:UNDERGOING RENOVATION,ADDITION,OR III 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❑ 1 B: Business ❑ E: Educational ❑ R Facto F-1 ❑ F2❑ _LR ffigh Hazard H-1 ❑ H-2❑ H-3 H-4❑ H-5❑ I: Institutional I-1 ❑ 1-2❑ I-3❑ I 1❑ M: Mercantile❑ R: Residential R-1 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 ❑ 111 ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ 1 VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to.780 CMR 111.0 for details on each item) Trench Permit. Debris Removal: Water Suppl Flood Zone Information: Sewage Disposal: A trench{`('not be Licensed Disposal Site Public Check if outside Flood Zone❑ Indicate municipal required H or trench or p Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Pnxess: Not Applicable❑ Is Structure within airport approach area? Is their review comple d? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code:_� Use Group(s): Ke3, Type of Construction: JES, Occupant Load per Floor: Does the building contain an Sprinkler System?: KC Special Stipulations: SECTION 4 PROPERTY OWNER AUTHOR17ATION Na_mepndAddress PropertYOwner . ( E4J jLZ�T P®fax �8o LJ� I� M-A o Name(Print) No.and Street C /Town j Zip Proper Owner Contact Information: Title Telephone No.(business) 'Telephone No. (cell) a-mail addre If ap ilicabl--- owner hereby autho, rizes P o. Pbx `] 80 MA olq4b Name Street Address ty/Town State Zip to act on the ro owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) building is less than 35,000 ca.R of enclosed:s ace and/or not under Construction Control then check here 17 andskip Section 10.1 10.1 Registered Professional Responsible for Construction Control ap ! I /Q �C-st81 Tele hone No mail ass Registration Number Street Address O City:{i own State Zip Discipline Expiration Date 10.2 General Contractor Company Name Ba .�i '�Sf CS 27I �1�7 on��pt on. sV SoC ame of Pe n Responsible for Construction ^Lic ns No. and Type if Applicable O oX # 780 tT, Lt�jti lJll(YIt-,LS�J Street Address ity/Town State Zip ,81 - aq [V I -3 44-70210 fin_ i S 5, (�M Telephone No.(business) Telephone No. ce6 e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCEAFFIDAyrr 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 si ed Affidavit submitted with this application? Yes❑ No ❑ SECTION 12.CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor C Total Construction Cost from Item 6 =$ and Materials) ( ) 1.Building $ i .0' 1J0 U Building Permit Fee=Total Construction Cost x_(Insert here 2. Electrical $ 1 S OO O appropriate municipal factor)=$ 3.Plumbing $ O Note:Minimum fee=$ (contact municipality) 4.Mechanical (HV AC) $ 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ r) (contact municipality)and write check number here SECTI N 13:SIGNATURE O BUILDING PERMIT APPLICANT By entering my name below,I h e attest and the and penalties of perjury that all of the information contained in this application is true and accura to e f o and understanding. Q �q q � s 781� - I011 Please print andsi t e Q•H•R.` t Ti y_ „y„tTelephoneNo. Date Street Address City, own 1Y State- — (�lZip' UI-!�1 Municipal inspector to fill out this section upon application approval: Name Date UC:l�l5OZ3'til bnQd �1.7+5 DO� ��Gl �L1(:� O0D Professional Land.Surveyors Er Civil Engineers ESSEX SURVEY SERVICE. 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD 8 WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN SALF✓1 MASS. On SIP/CC B LGr 39 Dq t5� kz- `�V N �2�ZoS I hereby certify to the Building Inspector that -the- pro- posed�i LOT AREA: 1�0/UL LOT FRONTAGE: /�a�L posed construction shown conforms to the dimensional zoning of FRONT YARD: SIDE YARD: IaF REAR YARD: �Dr Mass. SCALE: l E, �(i OF a F A.es41 DATE: R cNr }t REFERENCE: BK PG 7y' . Christopher R. Mdl l'q\\P�F�,31a 104 LOWELL STREET PEABODY, MASS. 01960 yV evWwua (978)531.8121 FAX: (978) 531-5920 ., = 7 1Z95 Professional Land,Surveyors 8 Civil Engineers ESSEX SURVEY SERVICE. 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN S/DLF�J MASS. ' Lit 39 19a9 �J7�7LC ZZ �S(�oRti� N��L- • I hereby certify: to the S/fY�NL ZONE: LOT AREA: hwAIL LOT FRONTAGE: kgA, :_ Building Inspector that the pro- posed construction shown conforms to the dimensional zoning of FRONT YARD: �cilaf SIDE YARD: 10 REAR YARD: �iDff Si1Lt71 Mass.;. - aAA SCAM: " ��/ µ 0 scy DATE: llL Z ZUI /O� HER GM� REFERENCE: EK 'lUZ PG 7y AS ti! Christopher R. Mello 'PLS'o313117a///�ffjf 104 LOWELL STREET p PEABODY, MASS.01960 (978)531-8121 FAX: (978) 531-5920 _ ACORO® DATE(MM/DOIYYYY) IaI.� CERTIFICATE OF LIABILITY INSURANCE 12/2/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not comer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Bus= Donnell NAME: Eastern Insurance Group LLC PHONE . (508)651-7700 IW An, FAX 233 West Central Street E-ooa .sdonnell@easterninsurance.coast INSURERS AFFORDING COVERAGE NAIC N Natick MA 01760 INSURERAAcadia Znsurance CoMany 31325 INSURED INSURER B: _ DIBIASE CORPORATION INSURER C: Osborne Hills Realty Trust INSURER D: _ P.O. BOX 780 INSURER E: LYNNFIELD MA 01940 1 INSURER F: COVERAGES CERTIFICATE NUMBERCL1312224290 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL SUBR POLICY EFF POLICY EXP LTR TYPEOFINSURANCE POLICY NUMBER DD MM/ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL UABILIT'/ DAMGE TO RFKTEU— PR RISE Ea occurrence $ 250,000 A CLAIMS-MADE 7x OCCUR 0191229-17 /23/2013 /23/2014 MEDEXP(Anyeneperson) $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 1,000,000 X POLICY PRO LOC 8 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident $ AUTOS AUTOS - 1 HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per amid ent UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LUIB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ A WORKERS COMPENSATION X I WCSTATU- OT H- AND EMPLOYERS'LWBILITY YIN 11 ANY PROPRIETOWARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICERMEMBER EXCLUDED? NIA (Mandatory In NHI G0286788-14 /23/2013 /23/2014 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,deacdDa under DESCRIPTION OF OPERATIONS balm E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Rernarlm Schedule,N more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Salem ACCORDANCE WITH THE POLICY PROVISIONS. Salem, MA 01970 AUTHORIZED REPRESENTATIVE Sue= Donnell/PRG ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 on1M51 nt Th.Ar:nten name and Inn.am wniadarod man4e.F ACnpn Additional Named Insureds Other Named Insureds DUC RESIDENTIAL LLC Insured Multiple Names OSBOURNE HILLS REALTY TRUST Insured Multiple Names OFAPPINF(02/2007) COPYRIGHT 2007,AMS SERVICES INC Registry 10 Home Energy Rating Certificate Rating Number Certified Energy Rater Nicholas Abreu Hawthorne Model Rating Date 2/24/14 Salem,MA Rating Ordered For Estimated Annual MmBtu erg Cost Cost- �f� Use MMBtu Cost Percent 5 Stars Plus Projected Rating Heating 71.6 $588 26% HERS Index:70 Cooling 3.2 $155 7% Hot Water 23.2 $166 7% Projected Rating: Based on Plans - Field Confirmation Required. Lights/Appliances 27.7 $1197 53% General Information Photovoltaics -0.0 $-o -0% Conditioned Area 2498 sq.ft. House Type Single-family detached Service Charges $157 7% Conditioned Volume 21726 cubic R. Foundation Unconditioned basement Total 125.7 $2262 100% Bedrooms 4 %.,- Criteria Mechanical Systems Features This home meets or exceeds the minimum criteria for the following: Heating: Fuel-fired air distribution,Natural gas,95.0 AFUE. EPA ENERGY STAR Version 2 Home Cooling: Air conditioner,Electric,13.0 SEER. Water Heating: Conventional,Natural gas,0.62 EF,40.0 Gal. Duct Leakage to Outside 120.00 CFM25. Ventilation System None Programmable Thermostat Heat-Yes;Cool=Yes Building Shell Features Ceiling Flat R-40.7 Slab None Sealed Attic NA Exposed Floor R-30.0 Vautted Ceiling R-32.5 Window Type U-Value:0.300,SHGC:0.300 Nicholas Abreu Above Grade Watts R-21.0 Infiltration Rate Htg:4.50 Clg:4.50 ACH50 Conservation Services Group Foundation Walls R-0.0 Method Blower door test 50 Washington Street lights and Appliance Features Westborough,MA 01591 Percent Interior Lighting 50.00 Range/Oven Fuel Natural gas 508-326-7506 Percent Garage Lighting 0.00 Clothes Dryer Fuel Electric Refrigerator(kWh/yr) 691.00 Clothes Dryer EF 3.01 Dishwasher Energy Factor 0.46 Ceiling Fan(cfm/Watt) 0.00 The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REM/Rate-Residential Energy Analysis and Rating Software v14.4.1 This information does not constitute any warranty of energy cost or savings. 01985-2014 Architectural Energy Corporation,Boulder,Colorado. �/Qurt`fno��e lrlecQ�� CITY OF SALEM ROUTING SLIP' Neil Construction V Certificate of•Occupancy LOCATION /N OSha-n,—, •R,(I DATE ��A V ASSESSORS DATE 93 Washington St. ^ � �<i A l .N ( i l�Y i `i� 3�"�*t 7i•�.``^D��?Ys:3Jt > r < _x^ mP sods. PUBLIC SERVICES DATE 31SH � 120 Washington St. L `VATER I/d11Imo- DATE 3 120 Washington St. "�-- c (CROSS CONNECTION rM— DATE S ( rn► M S 5 Jefferson Ave PLANNING > — DATE 3f S �9 120 Washington St. UXONSERVAT ON 120 Washington St, IRE PREVENTION(T.A/^ DATES 29 Fort Avenue I rSNR�T °3+ M1m�'scrz •^eiF sN:dk� .of 1"*0 VVasliington St`."�''' V/BUILDING INSPECTOR DATE 120 Washington St. _ mil- D/A3 CITY OF SALEM ROUTING SLIP New Construction V Certificate of Occupancy / L� LOCATION 1� 05b�xpe.- DATE L//ASSESSORS DATE .L S / 93 Washington St. , V f� c d4�R4�•r ik¢ Y('+ ty13 aaigton St. a s A; t ' a ✓PUBLIC SERVICES DATE �120 Washington St. t/ `VATER DATE 120 Washington St. CROSS CONNECTION DATE 5 Jefferson Ave PLANNING DATE 120 Washington St. VtONSERVATION DATE 120 Washington St. S aS'lafayeYtF'St.�''�/ �—"�'��" V'F IRE PREVENTIONC%.b DATE 3 S /y 29 Fort Avenue r a : . esoca ... ��'L"Y � d�"C—'S .• v.td lze t*O�Wvshi'hgton �`. V/B�UILDING INSPECTOR DATE 120 Washington St.