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B-19-1260 - 0005 BRENTWOOD AVENUE - Building Permit
The Commonwealth of MassachusettsF Board of Building Regulations and Standards) El �_ ;._ CITY OF r < L, ,,,r'A i -z r,.:. .-u SALEM Massachusetts State Building Code, 780 CMR Revised Mar 2011 Building Permit Application To Construct, Repair, RenoNy lis a : 3 ; One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: -�� Buildmg Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 11 Assessors Map&Parcel Numbers 5 Brentwood Ave Salem, MA 01970 l.la Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4'Property Dim;nsioos: 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: David Machado Salem MA 01970 Name(Print) City,State,ZIP 5 Brentwood Ave No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORKZ'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) IN Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Workz: 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 $ 6000 1. Building Permit Fee: $. Indicate how fee is determined: 11 Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: l -Y c;� 6,6 5.Mechanical (Fire $ Su ression Total All Fees: $ 6000 Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due: $7 per$1000; minimum $25 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 1 � •• List CSL Type(see below) U 10 Churchill Place No.and Street Type Description U Unrestricted Buildings up to 35,000 cu.ft. Lynn, MA 01902 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 .......... ® No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,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) Romain Strecker Date NOTES: 1. 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 at www.mass.gov/dpss 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" f CITY OF S��I.&$ 1�I��SS.�CHLTSETTS • KILDIING DEP ARTM&NT j 120 W.asHLNGTON STREET,3"D FLOOR T EL (978) 745-9595 FA.r(978) 740-9846 KI.\iBERLEY DRISCOLL MAYOR T HomAs ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BUI DIING 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 of MGL 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 dcbrisff doc / o r 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 C HUR LLC Registration: PL. Expiration: 05/11/2020 HUR '- LYNN,,MA 01902 Update Address and Return Card. SCA 7 C 20&1-0=177 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:.SUDDlement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 185222 05i1112020 1000 Washington Street-Suite 710 NEEECO,LLC Boston,MA 02118 r t• I 1 ROMAIN STRECKER `,2 C � �-- 10 CHURCHILL PL C: U LYNN,MA 01902 Undersecretary Not valid vhthout signature t® Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards i ConstrlEtl 1Si�pervisor a CS-096385 y •i E'�pires: 10/08/,2020 'ROMAIN D ST-REPiKER 10 CHUL.CHIL`� LAC } � LYNN-MA 01902% t //tea! Commissioner Q. �3 c.. ti tt£ �' 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: A/C,No): 963 Eastern Ave E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Malden MA 02148 INSURER A: Lloyds INSURED INSURER B: Merchants Mutual Insurance Company 23329 Neeeco,LLC INSURER c: Falls Lake National Ins Cc 10 Churchill Place INSURER D: INSURER E: Lynn MA 01902 INSURER F: 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 INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDD MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 Fz�o DAMAGE To RENTED CLAIMS-MADE OCCUR PRE'SES Ea occu ante $ 100,000 MED EXP(Any one person) $ 10,000 A Y Y ENC000227602 04/04/2019 04/04/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED I B X Y Y MCA0000239 04/O6/2019 04/06/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ i H AUTOS ONLY X AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB Ll CLAIMS-MADE Y Y ENX000012902 04/04/2019 04/04/2020 AGGREGATE $ 1,000,000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? ❑ NIA 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 EProfessional 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 cover aged by the policies. PLEASE SEE T H E WORKERS COMP ON THE FOLLOWING PAGE ! CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE . t 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD J • ACORO® 75/16/2019 E(MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 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 AMBROSE INSURANCE AGENCY INC CONTACT NAME: 963 EASTERN AVE PHONE FAX MALDEN, MA 02148 A/C Ext: A/c No): E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual Fire Insurance 23035 INSURED INSURER B: NEEECO LLC 10 CHURCHILL PLACE INSURERC: LYNN MA 01902 INSURERD: INSURER E: INSURER F: COVERAGES r CERTIFICATE NUMBER: 48698650 - 6 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 SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY O ❑ LOC PRFACT PRODUCTS-COMP/OP AGG $ JE 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 $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC2-31 S-621639-019 5/3/2019 5/3/2020 �/ STATUTE ER H AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1000000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS/LOCATIONS/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 LeiJbi 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): I.�✓ I am a employer with 3=5 => *employees(full and/orpart-time).* _ .- 7..:❑New construction In I am a sole proprietor or partnership and have no employees working for me in $, ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 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 LEJ 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.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other Insulation Work 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. tContractors 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 5 Brentwood Ave Salem, MA 01970 Job Site Address: 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 and penalties of perjury that the information provided above is true and correct. Signature: C 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#: r ........_... . Page 1 of 2 nezeco mass save° This agreement is made by and among PARTNER 1. DESCRIPTION OF WORK TO BE PERFORMED NEEECO,LLC tvillperform or cause to be performed the following woik on the customer's address above,in a professional manner and in accordance with the terms of this Contract,including Hie attached recommendations/work order describing the work in detail(the'Worr)which are incorporaled herein by reference. Customer Name:David Machado Email:Not provided Phone:978-590-9932 Premise Address:5 Brentwood Ave,Salem,MA 01970 Mailing Address:5 Brentwood Ave,Salem,MA 01970 Project ID:3875110 Date:Aug.17,2019 Job Description Nleasu eDescnptior �� sLOca`tion� QuantityU ItTotalCost , ��,�usfomerCo t{ Rim Joist-6" Fiberglass Batting 30 SF $81.00 $20.25 -z+ Air Sealing at Estimated 62.5 CFM50 Per Hour 8 hr $740.64 $0.00 Door Sweep (with AS hrs) 2 each $50.62 $0.00 Exterior Door Weather Stripping (with AS hrs) 2 each $60.14 $0.00 +� Bath Fan Hose 1 each $26.20 $6.55 'Oh Attic Stair Cover w/Carpentry(with AS'hrs) 1 each $289.31 $0.00 Attic.Floor- 11"Open Blow Cellulose 989 SF $1,958.22 $489.57 Open Wall 3" Fiberglass Batting 75 SF $143.25 $35.81 Open Wall -2"Thermal Barrier Polyiso 75 SF $358.50 $89.62 �. Propavent 70 each $291.20 $72.80 2 YMENT:Customer agrees to pay NEEECO for the work as follows: P ng reBecled below maybe subjeecctt toad Lsimenis.in program prcing and offerings and µiss guaranteed for 60 days from the d e the onlracI is Orin led. Paymentiil(Deposit):$ 2°k , �L ?CA 1 d L� CA # I011 d l� � �7 �9 a 2a'0 deposit bycheck is due upon contract signature.Deposit is not to Led 1/�of the total contractcosl. Rd " aert3f is a�lr Final Invoice:$ 04. 27 Additional payments for Work shall be due upon corrpletion of the Work.Please write a check to'NEEECC'and hand it to the crew chief. ,C D C7 stomer Sign Date C ted ame C r 1 NE a Date resentative PrInted f#ZFe NEEECO,LLC 10 Churchill Place Lynn,MA 011902 a 781-309-7540 o info@ne.eeco.com•neeeco.com Page 2 of 2 ne :ECO mass save This agreement is made by and among - PARTNER 1. DESCRIPTION OF WORT(TO BE PERFORMED NEEECO,LLC will perform or cause to be performed the following vrorts on the customers address above,in a professional manner and in accordance with the terms of Ihi; Contract,including the attached recommendalionstwork order describing the cork in detail(1he'Work')which are.incorporaletl herein by reference Customer Name:David Machado Email:Not provided Phone:978-590-9932 Premise Address:5 Brentwood Ave,Salem,MA 01970 Mailing Address:5 Brentwood Ave,Salem,MA 01970 Project ID:3875110' Date:Aug. 17,2019 Duct Insulation Removal 100 SF $115.00 $28.75 Duct Insulation 100 SF $400.00 $100.00 Duct Sealing-4 Hours (not insulated, up to 200') 1 each $337.28 $0.00 . Damming 98 each $234.22 $58.55 Project Total $5,085.58 4 Duct insulation incentive ($386.25) Weatherization incentive .-($2,319.44) Duct sealing incentive ($337.28) Pre-Weatherization barrier incentive ($0.01) Air sealing incentive ($1,140.71) Total Program Incentive -$4,183.69 Customer Total $901.89 PAYMENT:Customer agrees to pay NEEECO for the work as follows: P mg reflected below may be subiecl to adiuslmenis gram pricing and offerings and is guaranteed for-60 days from the to the. ntract is printed- Paymerrtg1(Deposit): z� - �; b - 77 P rL F� 1 k33°�oepo us upon contraa signature.Deposit is not to e..eed 1 of the total contract cos;. \ �Z ditional Payments andfinal Invoice:$ Additional payments for the Work shall be.due upon corrpletion of the Work.Please virile a check lo'NEEECO'and hand if o the crewchief. i gwtn _ Date doted Name NEEEC gnature Date REEEeO Representative PrInlistlKame NEEECO,LLC a 10 Churchill Place Lynn,MA 01902 0 781-309-7540 info@neeeco.com neeeco.com Permit Authorization mass sage Form Site ID: 3872350 Customer: David Machado I' V?Ck O o , owner of the property located at: (Ow is Name,printed) 5 Brentwood Ave 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 o Ji ding permit.to perform insulation and/or weatherization work on my property. Owner' Signature: ate: (6 fi 1:k Q Ls.4 ,4�a.G,+�'ii .�F a.:-:°�u' :t?t t2,� 3,` ,n' wl fir.Y?;-z�s '' :5'`s'$i', z "S` #r zs S_:t>. .:*b Est FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date Name: Neeeco Phone: 781-309-7540 Email: info@neeeco.com Page 1 of 1 For Office Use Only Rev. 102015 J