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B-19-1292 - 0062 APPLETON STREET - Building Permit The Commonwealth of Massachusetts f _tr , Board of Building Regulations and Standards t +l ' .l If ;CITY OF Massachusetts State Building Code, 780 CMR4LEM 10/# eviset"ilgI�2011 Building Permit Application To Construct, Repair, Renovate Or Dem One-or Two-Family Dwelling -4 . 01 This Section For Official Use Only Building Permit Number: Date Applied: ¢ � Bui ding Official(Print Name) ow Signature Date 1 SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 62 Appleton St, Salem, MA 01970 Lla Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Moutafis, Theresa Salem MA 01970 Name(Print) City,State,ZIP 62 Appleton St, Salem, MA 01970 781-309-7540 No.and Street Telephone Email Address .SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ Alteration(s) N Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work2: insulation work as part of the Mass save program SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building $ 7000 1. Building Permit Fee:.$ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2. Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ / 4. Mechanical (HVAC) $ List: a 1 5. Mechanical (Fire $ Su ression Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 7000 ❑Paid in Full ❑Outstanding Balance Due: I $7 per $1000; minimum $25 t i SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-096385 10/8/2018 Romain Strecker License Number Expiration Date Name of CSL Holder w t List CSL Type(see below) U 10 Churchill Place No.and Street Type Description Lynn, MA 01902 j U Unrestricted Buildings up to 35,000 cu.ft. R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances • 781-309-7540 x 3 ops@neeeco.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 185222 5/11/2020 Neeeco, LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 10 Churchill Place ops@neeeco.com No.and Street Email address Lynn, MA 01902 781-309-7540 x 3 City/Town,State,ZIP Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit 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. Signed Affidavit Attached? Yes .......... 12 No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Neeeco, LLC to act on my behalf,in all matters relative to work authorized by this building permit application. (signed contract attached) Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION 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 the best of my knowledge and understanding. Print Owner's or Authorized Agent's Name(Electronic Signature) Romairl Strecker Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass. og v/oca Information on the Construction Supervisor License can be found arwww.mass. oy/dps 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY 4F SOU E\I, �SS.�CHLrSETTS BUMI)IING DEPARTMENT 120 W.-kSHNGTON STREET, 3'FYAOR �f TEL. (978) 745-9595 F&X(978) 740-9846 iu.NiBFRi_EY DRISCOLL MAYOR. THomAs ST.PIER tE DIRECTOR OF PUBLIC PROPERTY/BUU-DLNG CONMSSIONER 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 ofMGL c 40, S 54; Building Permit# 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: Neeeco truck (name of hauler) The debris will be disposed of in : Republic dumpster at Neeeco warehouse (name of facility) 113 Fayette St, Lynn MA 01902 (address of facility) signature of permit applicant date ilcbriwti'dix ��///�f�P� 'IL%��"L�'�e�.1��Z��I�C-�'�i�� t?,i���-i �'`�f�:1J C�Q.�f���j��✓e�:`,` l Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 185222 10 CHUR LLC Registration: PL. Expiration: 05/1'1/2020 HUR _ _ _ LYNN,MA 01902 Update Address and Return Card, SCA 1 201,4•0_1i7 �'��r`(<Y+ir6n�!'rnt'ffr�rf/t r/^,�/r>•I1tfr�nAr.I/3 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:,Su001ement Card before the expiration date. If found return to:. Registration Expiration Office of Consumer Affairs and.Business Regulation 185222` 05111/2020 1000 Washington Street-Suite 710 NEEECO,LLC Boston,MA 02118 ROMAIN STRECKER 10 CHURCHILL PL. U LYNN,MA 01902 Undersecretary Not valid vhthout signature t Commonwealth of Massachusetts fa' Division of Professional Licensure Board of Building Regulations and Standards Const§§rtorifSiSpervisor CS-096385 � �� �� E-koires: 10/08Y2020 9 w ROMAIN D.SIFRECKER 1,0 CHURCHIL ,PLAGE LYNN MA 01902r ` s a i, Commissioner CL "q, K ,nbN ter c � c I DATE(MM/DD/YYYY) ACo CERTIFICATE OF LIABILITY INSURANCE 04/02/2019 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 have ADDITIONAL INSURED provisions or 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 confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Commercial Lines NAME: Ambrose Insurance Agency,Inc. PHONE FAX A/C No Ext: AC' C No): 963 Eastern Ave E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE - NAIC# Malden MA 02148 INSURERA: Lloyds INSURED INSURER B: Merchants Mutual Insurance Company 23329 Neeecw,LLC INSURER C: Falls Lake National Ins Co 10 Churchill Place INSURER D: INSURER E: Lynn MA 01902 INSURERF: COVERAGES CERTIFICATE NUMBER: 2018 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 TYPE OF INSURANCEADDL POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGET€ 100,000 CLAIMS-MAOE a OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 10.000 A Y Y ENC000227602 04/04/2019 04/04/2020 PERSONAL&ADV INJURY $ 1.000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY E C LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO - BODILY INJURY(Per person) $ B OWNED X SCHEDULED Y Y MCA0000239 04/06/2019 04/06/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED I NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A 7 EXCESS LIAR CLAIMS-MADE Y Y ENX000012902 04/04/2019 04/04/2020 AGGREGATE $ 1,000,000 DIED I X RETENTION$ 10,000 $ WORKERS COMPENSATION X STATUTE ERH ER T AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? N/A Y WC500-0072762-2018A 05/03/2018 05/03/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Each Occurence $1,000,000 " A Professional Liability ENC000227602 04/04/2019 04/04/2020 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Abode Energy Management,LLC and National Grid USA is included as Additional Insured on a primary and non contributory basis. No reduction, cancellation or expiration of the policy shall be effective until thirty(30)days from the date written notice thereof is actually received by the insured named hereunder.Upon receipf of any notice of reduction,cancellation or expiration,HPC shall immediately notify Abode and Utility.HPC and its insurers shall waive all rights of recovery again Abode,the Utility,and any of their affiliates for any loss or damage coveraged by the policies-PLEASE olicies.PLEASE SEE THE WORKERS COMP ON THE FOLLOWING PAGE !, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Abode Energy Management LLC National Grid USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Rd. AUTHORIZED REPRESENTATIVE Waltham MA 02351 t; ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACo CERTIFICATE OF LIABILITY INSURANCE 75/16/2019 TE(MMIDDIYYYY) `., 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(les) must have ADDITIONAL INSURED provisions or 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 confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER AMBROSE INSURANCE AGENCY INC NCONTACT AME: 963 EASTERN AVE PHONE FAX MALDEN, MA 02148 AMAILL Ext: A/C No ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual Fire Insurance 23035 INSURED INSURER B: NEEECO LLC 10 CHURCHILL PLACE INSURERC: LYNN MA 01902 INSURER0: INSURER E: INSURER F: COVERAGES CERTIFICATE'NUMBER: 48698650 i t 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 TYPE OF INSURANCE ADDL SUBRPOLICY EXP LTR POLICY NUMBER MM/DY EFF MM/D//YYYY LIMITS j COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR REMIDAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO ❑ LOC PRODUCTS-COMP/OP AGG $ FAO OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ A WORKERS COMPENSATION WC2-31 S-621639-019 5/3/2019 5/3/2020 ,/ STER ATUTE I ERH AND EMPLOYERS'LIABILITY y/N OFFICER/MEMBER EXCLUDED?ECUTIVE Y N/A E.L.EACH ACCIDENT $1 OOOOOO (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION ADOBE ENERGY MANAGEMENT LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NATIONAL GRID USA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 40 SYLVAN RI ACCORDANCE WITH THE POLICY PROVISIONS. WALTHAM MA 02351 AUTHORIZED REPRESENTATIVE Jon Smith ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 48698650 1 1-621639 1 19-20 WC 1 n0254981 1 5/16/2019 6:35:36 AM (EDT) I Page 1 of 1 The Commonwealth of Massachusetts Property Address Department of Industrial Accidents d 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Neeeco LLC Address: 10 Churchill PI City/State/Zip: Lynn MA 01902 Phone #:781-309-7540 x3 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ i am a employer with'35 employees(full and/or part-time).* 7. New construction 2.M I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.[D I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 10[] Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I I.[]Electrical repairs or additions Proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.,insurance. 14.[2]Other Insulation Work 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the 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. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must 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 information. Insurance Company Name: Liberty Mutual Fire Insurance Policy#or Self-ins.Lic.#: WC2-31 S-621639 Expiration Date: 05/03/2020 Job Site Address: 62 Appleton St, Salem, MA 01970 City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ains andpenalties ofperjury that the information provided above is true and correct. Sijznature: 1__ --" Date: Phone#:781-303-7540 x 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.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: CLEAResult CONTRACT 0 CLEAResult 50 Washington Street, Customer Name:THERESA MOUTAFIS Westborough,MA,01581 Email:tmmoutafis@gmail.com Phone:978-609-0056 Premise Address:62 Appleton St,Salem,MA 01970 Mailing Address:62 Appleton St,Salem,MA 01970 Project ID:3731296 Date:April 29,2019 Applicable Customer Required Actions: Notes: • Storage Removal remove the flooring and the storage from the attic • Flooring Removal Job Description Contractor will perform or cause to be performed the following work on these"Premises"in a professional manner and in accordance with the terms of this Contract, including the attached recommendations/work order describing the work in detail(the"Work")which are incorporated herein by reference. SUr �8 Ct©i1 �OCdtiOri ° QllaRtl � UnitT '1 TOtaI�COStCustomecCOst P :, w�- wtYk�s Air Sealing at Estimated 62.5 CFM50 Per Hour 8 hr $740.64 $0.00 Damming 26 each $62.14 $15.53 Attic Floor-7"Open Blow Cellulose 704 SF $1,182.72 $295.68 Attic Slope-6"Dense Pack Cellulose 128 SF $360.96 $90.24 Walls-Vinyl-3"Dense Pack Cellulose 1378 SF $3,403.66 $850.92 Hatch-2"Thermal Barrier Polyiso 1 each $46.28 $11.57 Exterior Door Weather Stripping(with AS hrs) 5 each $150.35 $0.00 Door Sweep(with AS hrs) 5 each $126.55 $0.00 Blower Door Test 1 each $72.75 $18.19 Total: $6,146.05 Program Incentive: -$4,863.92 Customer Total: $1,282.13 Payment Customer agrees to pay Contractor for the Work,the Customer Share of the Contract Price as follows: Payment#1:$42100 as a Deposit payable to CLEAResult upon signing the Contract(not to exceed 1/3 of the total retail costs). Mail check&contract to CLEAResult,50 Washington Street, ,Westborough,MA,01581. Final Payment:$861:13 as the final payment for the Work shall be payable to the Home Performance Contractor(HPC)or Independent Installation Contractor(IIC)upon satisfactory completion of the Page 1 of 4 Work.Customer understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of $4863.92.Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. Dispute Resolution The IIC and Customer hereby mutually agree in advance that in the event that the IIC has a dispute concerning this Contract,the IIC may submit such P dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to submit to such arbitration as provided in M.G.L.c 142A. j You may cancel this agreement if it has been signed by a party at a place other than an address of the seller,provided you notify the seller in writin by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this reement. D NOT SIGN,THIS CONTRACT IF THERE ARE ANY BLANK SPACES. I� NEEECO t Customer Signature Date Indicate your selected IIC here,if applicable Initial here if you want the Program to assign a Participating Contractor 9-18-19 Garrett Hodgson CLEAResult Signature Date Name of CLEAResult Representative s g 7 { 3 Page 2 of 4 1 i i TERMS AND CONDITIONS ASSIGNMENT OF CONTRACT BY CLEAResult Customer acknowledges that CLEAResult will,and Customer hereby requests CLEAResult to,assign this Contract to the IIC to undertake the Work on the terms set forth in the Contract.After such assignment:(a)CLEAResult shall no longer be a party to this Contract;and(b)Customer shall have no recourse against CLEAResult for any of the performance,non-performance or deficient performance of the Work or any obligations under this Contract performed by,or on behalf of,the IIC.Notwithstanding the foregoing,Customer shall provide CLEAResult with(i)such information regarding the IIC's performance as CLEAResult may reasonably request;and(ii)reasonable access to the Premises as CLEAResult may request to permit CLEAResult to inspect IIC's work;and(c)Furthermore,Customer agrees that he/she/they(i)shall notify CLEAResult of any dispute between Customer and the IIC concerning the Contract;(ii)shall provide CLEAResult with such information regarding the dispute as CLEAResult may reasonably request;and(iii) consent to CLEAResult's participation,at its sole election,in any arbitration or other dispute resolution proceeding between Customer and the IIC. LIMITED TIME OFFER The terms,prices,and any incentive offered in this Contract are valid for only thirty(30)days from the date of CLEAResult's presentation of this Contract to the Customer.In the event that Customer does not execute thjs Contract and return it to CLEAResult within such thirty(30)day period,the terms,prices and any incentive offered by CLEAResult is NULL and VOID. COMMENCEMENT AND COMPLETION The IIC will not begin the Work or order the materials before the sixth(6th)day after the execution of this Contract by CLEAResult and Customer, whichever signs later(the"Contract Execution Date").Subject to the availability of subcontractors/materials and to delays attributable to the weather or "acts of God",the IIC shall begin performing the Work as soon as practical after the Contract Execution Date,and the IIC shall substantially complete the Work no later than sixty(60)days after that Contract Execution Date,barring delay caused by circumstances beyond the IIC's control,including but not limited to any delay resulting from Customer's decision to wait for a particular IIC.Each of CLEAResult and the IIC reserve the right to advise the Customer of changes in the projected start and completion dates,based upon availability of materials and subcontractors.Upon completion of the Work,the IIC will leave the Premises in a neat and orderly condition but shall not be responsible to correct conditions outside the scope of its Work. MODIFICATION Prior to CLEAResult's assignment of this Contract to the IIC set forth in Section IV(above),this.Contract cannot be changed except by a writing signed by CLEAResult and the Customer.After CLEAResult's assignment of this Contract to the IIC set forth in Section IV(above),this Contract cannot be changed except by a writing signed by the IIC and the Customer that has been approved in writing by CLEAResult. PERMITS In connection with the Work to be performed at the Premises by the IIC Under Contract,the following permits may be required for this project depending upon the judgment of local inspectors:Electrical,Plumbing/Gas,Mechanical,Building.The IIC shall be responsible to,and shall,obtain any and all permits required for performance of the Work.The IIC shall inform the Customer of the permits required and any Customer co-pay or cost of the required permit acquisitions.If Customer chooses to secure her/his own work-related permits,and/or deal with an unregistered contractor, Customer will be excluded from the Guaranty Fund provisions of M.G.L.c. 142A. CUSTOMER'S DUTY Customer must prepare the Premises for the Work.Objects which obstruct areas of Work must be moved before the Work is to commence.Customer affirms that they have received no incentives(from the above-named Utility)during the last calendar year. DISCLAIMER OF LIABILITY OF CLEAResult AND UTILITY Customer understands and acknowledges that the IIC is not an agent,vendor or sub-vendor of the Utility or CLEAResult with respect to the installation of any energy efficiency measures.In the event of the failure of any energy conservation device to perform as expected,Customer agrees that Customer's sole recourse is to the IIC and not to CLEAResult or the Utility.The Utility and its operating companies shall not maintain,remove or perform any work whatsoever on the energy conservation measures installed.Customer understands and acknowledges that its participation in the Mass Save Home Energy Services Program is voluntary and that it has consented for the IIC to install the proposed energy conservation measures. Customer agrees that it shall not hold CLEAResult,the Utility,their affiliates or operating companies liable for the IIC's failure to perform its obligations under this Contract,for failure of the energy conservation measures to function,for any damage to Customer's Premises caused by the IIC or for any and all damages to property or injury to persons caused by the energy conservation measures. ENERGY BENEFITS The local sponsoring Utility is entitled to 100%of the energy benefits associated with all energy conservation measures,excluding the value of energy cost savings by the Customer,but including all rights to all associated ISO-NE Energy,Capacity and Reserves Products(as defined by ISO New England),and the IIC agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and Products. IIC REGISTRATION The IIC and any subcontractors must be registered by the director and any inquiries about the IIC or any subcontractor relating to a registration should be directed to:Office of Consumer Affairs and Business Regulation,Home Improvement Contractor Registration,10 Park Plaza,Room 5170,Boston, Massachusetts 02116,617-973-8700. Page 3 of 4 IIC WARRANTIES The IIC warrants as follows: A. Materials and workmanship will meet or exceed the specifications in CLEAResult's Materials and Installation Standards. B. The Work and the materials furnished by the IIC will conform to the requirements of this Contract.If there be a defect in workmanship or materials,or any damage caused by its subcontractors or employees is discovered within one year after completion of the Work(including cleanup),the IIC will,at its own expense,at its option,remedy,repair,correct,replace,or cause to be remedied,repaired,corrected or replaced such defect or damage. CUSTOMER RIGHTS UNDER M.G.L.C 142A Customer has the following rights under M.G.L.c.142A: A. At the time of signing this Contract,the Customer shall be furnished with a copy of it.No Work shall begin prior to the signing of this Contract by the Customer and CLEAResult. B. Any party may bring an action to enforce any provisions of Mass.G.L.c. 142A or to seek damages or the Customer may request that a dispute be decided under the terms of a private arbitration program approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations. C. Customer may have the right to be compensated from the Residential Contractor's Guaranty Fund for actual losses incurred as a result of a registered contractor's or subcontractor's conduct found by a court to be work performed in a poor or unworkmanlike manner or which violates certain laws for the protection of consumers within 6 months after the Customer has obtained a judgment or arbitration award and has exhausted customary reasonable efforts to collect the judgment or award. Page 4 of 4 Permit Authorization mass save Form s4n thrQuo en � COWency Site ID: 3609617 Customer: THERESA MOUTAFIS I, (4EX/--.Lr d��`"t (S ,owner of the property located at: (Owner's Name,printed) 62 Appleton St Salem, MA 01970 (Property street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obta' a building permit to perform insulation and/or weatherization work on my property. Ownerts Signature: Date: 1 I aa�aaaaaaaaaaaaaaaaaa�aaa+raaaaaaawaa#aa�raaaa+�aaaaaam+�aasaaaaaaaaaa�a�aaa I FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: S Participating Contractor Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 For Office Use Only