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Building Permit #266-11 - 41 BRUIN HILL ROAD 9/28/2010
i BUILDING PERMITof No oT b TOWN OF NORTH ANDOVER �2.h�''- `-A' APPLICATION FOR PLAN EXAMINATION h Permit NO: Date Received �9SSACH►1`-+' Date Issued: / IMPORTANT: -_ Applicant must complete all items on this page LOCATIONn. �_' GLV1 IN I tt_ L�,b -- ipnnt PROPERTY"OW%R�Le,L I ,u�v t� t L `MAP NQ PARCEL: ,..,ZONING,DISTRICT :Historic Dist."nct yes + �.x - y Q. r Macfi_jne Shop Tillage Yes, _._ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial q Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other d`Septl.c MW- 6711 ❑ Floodplain D Wetlands ❑' Vl/atershed District; n-W4ter/Sewer __; __ DESCRIPTION OF WORK TO BE PREFORMED: n eZ V 116 KOt,e /-JN O �C��u�c�: IM"u c.>4NINZ a -t- S t�-te'tp-oclt— c,A-c e Ui t N z) o W S EE ,4T1i4 cd Ei ?C- Identification Please Type or Print Clearly) OWNER: Name: 3,06f ,/C , -Ce &)i lkt� Se,-K Phone Address: ,4t 9xu-A',t hW1 4 c� WA de vcx CONTRACTOR Nano: lli � [=,NTv _ Phonei _ Address Supervisor's€ConstructiontLicense:_7-5. 20,A . E--x !Date _ - .m . P Moine#Improvemerit.,License: „j S_S.__9UExp. Date:_, ^/7�1I_ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.,BULDING PERMIT.$12.00 PER/$1`000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ I FEE: $ j�`—� Check No.: f, 7� Receipt No.: ���� 6 NOTE: Persons contracting h unregistered contractors do not have access to the guaranty fund Y _. 9T =g u � . � F Si9nature�of A ent/OwnSi naturekofconfractor I r I BUILDING PERMIT pF "°oT" q TOWN OF NORTH ANDOVER 0� APPLICATION FOR PLAN EXAMINATION h Permit NO: Date Received ~' ED Date Issued: v ��SSACHUS���� IMPORTANT:Applicant must complete all items on this page LOCATION.. � 1_' _B CiLtA.i eJM CC- Pri PROPERTY OWNER,L -F _I AJ AV tC 1 L_k, AJS.0 Al M 'MAP NO: (� PARCEL.77.,ZONING"DISTRIC- ,Historic Distract yes Q - _. Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial q Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0 Septic El Well O Floodplain ❑Wetlands 0 1Natershe6District ❑Water/Sewer_ DESCRIPTION OF WORK TO BE PREFORMED: f � � I�C` Nl0(� E �NQ ��1�C.ArCL fNSU► lf� y 4' � 11,tET1OCI( VU lejo ows , SEE /` 7" IAc#fit) CCS ?E— Identification Please Ty e or rint Clearly) q OWNER: Name:-Son i C -4- dee ,(J� ��cv�satl Phone: Address: #1 , xkivt h911 4aw ecleA GONTRACTOR Name: rgAgV- r6r17V.✓ Phone. Address: 1 S" 0 AJ0,A- 0))AU6 ��0 0 &01 r N f.t Supervisor's'Construction"License: 73 2 OA _ . . . Exp-. Oate:. Home Irnprovement.License: IS-S190 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.,BULDING PERMIT.,$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. on Total Project Cost: $ , '7a FEE: $�(r� � Check No.: Ion Receipt No.: �0 NOTE: Persons contracting h unregistered contractors do not have access to the guaranty fund -7 Signature of Agent/Own_: ignature ofcontractor �_ Locatiot—/z h Or No. Date i ,.oRT►+ TOWN OF NORTH ANDOVER 3'�' •.. - • O � w a i Certificate of Occupancy $ f i � Nus t� Building/Frame Permit Fee $ ,. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #1d 2 23501 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swmunmg Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY {I INTERDEPARTMENTAL SIGN OFF - U FORM I DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ I COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Sianature COMMENTS I P i I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comment I� Water & Sewer Connection/Signature& Date Driveway Permit 1 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp�Dumpster on site yes v _ Located�at`124 Main'Stre.et FireiDepartmentasignature/date -.--- -_-. COMMENTS Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ ! Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS r Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Loeated.at 124•Ma n;Stteet Fi.ielDepartmentrsignature/date COMMENTS . t Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 J Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses O Copy of Contract o � Proposed Interior Work -a�.a.i.nserin Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) a Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 x.10RTH 0 0 6Andover __ lit a '� dover, Mass.,��l=o�� LAKE COC H IC HE WICK ADRATED P+PF`�,�GJ S V ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT Y/ ............. ..... /. .............. ..,........................................................................ Foundation has permission to erect.................:........ ............. buildings on ....... . ........[ .l�.. .,�1.. J ....................... Rough to be occupied as � OLtIJ �+iv / v NJ �d h Chimney L ....v.a t..... .. W.I.h .......................,5..........7 ....... .......... ......�1............. provided that the person acce tin is ermit s1� n eve res ect conform to the terms of thea lication on file in P P P rY P PP Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations-Voids this Permit. Rough Final 0 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC S ARTS Rough ... ........................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. BEL FOR �16� WORK AUTHORIZATION/SERVICE AGREEMENT Customer Information Contractor Information ("Property Owner or Authorized representative") ("Contractor") Wilkinson, Bonnie&Lee BELFOR USA GROUP,INC., a Colorado Corporation Name 41 Bruin Hill Rd 4-6 Avenue E Street Address Street Address(Not Post Office Box) North Andover Hopkinton MA 01748 CWTown State Zip Code CiWTown MA 01845 508-544-4325 Business Phone State Zip Code (978)886-0867 (978)258-4141 84-1309171 Federal Employer ID Cell Phone Home Phone Location of Property to be Repaired 41 Bruin Hill Rd Street Address North Andover MA 01845 City State Zip Salesperson(s): Jason Camerano Contractor Registration#: 73702 Exp. Date: 1-4-2011 WORK TO BE PERFORMED AND MATERIALS TO BE USED Contractor Agrees To Do The Following Work For Owner(describe in detail the work to be completed): See the attached scope of services Materials Expected To Be Used(describe in detail the materials to be used,specifying type,brand and grade of materials): See the attached scope of services THREE-DAY CANCELLATION RIGHTS You [Wilkinson,Bonnie&Lee] may cancel this agreement if it has been signed by a party hereto at a place other than an address of BELFOR, which may be his main office or a branch thereof,provided you [Wilkinson, Bonnie& Lee] notify BELFOR in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. WORK SCHEDULE The following schedule will be adhered to unless circumstances beyond the Contractor's control arise. The schedule is contingent on timely issuance of permits, timely inspections and approvals,and other events outside the Contractor's control: Work Schedule Estimated To Begin:_10-1-10_ Scheduled Date Of Substantial Completion:_11-8-10_ TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE The Contractor agrees to perform the work and furnish the material and labor specified above for the SUM of ($_35,065.65_). This amount includes all finance charges. Payment Schedule: Payments will be made according to the following SCHEDULE: $ 11.688.55 upon signing contract. (Not to exceed 1/3 of the total contract price OR the cost of special order or custom made materials or equipment,whichever is greater.) $ 11.688.55 upon completion of the mold remediation. $ 11.688.55 upon completion of the contract. (No final payment shall be demanded until the contract is completed to both parties'satisfaction.) REQUIRED PERMITS The following building permits are required. It is the obligation of the contractor to secure such permits as the homeowner's agent: General Permit NOTE.Owners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of M.G.L. c. 142A. NOTICE: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 617-727-8598 The Owner permits Contractor to obtain a personal credit report to ensure that the insurance proceeds for this project are not in jeopardy. Contractor is in good standing with the Better Business Bureau. Contractor and Owner reserve their rights to terminate this contract should the other materially breach its terms. Should the Contractor deem itself to be insecure as to the Owner's ability to perform, it may require as a prerequisite to continuing the work that the balance of funds due under the Contract, if in the possession of the Owner and not the Insurance Company, shall be placed in a joint escrow account requiring the signature of the Contractor and the Owner for withdrawal. MISSING OR DAMAGED ITEMS The Homeowner and Contractor agree that the Contractor shall have no liability for damaged or missing items of personal property, unless the Contractor agrees in writing to prepare a written inventory of all items of personal property touched or removed from the Property by the Contractor in the performance of the Contractor's work, in which event the Contractor shall be liable only for items included on the written inventory. THREE-DAY CANCELLATION RIGHTS As stated on page 1 of this contract, Owner may cancel this Work Authorization if it has been signed by a party hereto at a place other than an address of the Contractor,which may be its main office or a branch thereof, provided Owner notifies the Contractor in writing at its main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this Work Authorization. See the attached notice of cancellation for an explanation of this right. WAIVER OF THREE-DAY CANCELLATION RIGHTS Notwithstanding the Owner's right to cancel this Work Authorization within three business days,where Contractor's services are needed to meet a bona fide immediate personal emergency of the Owner and Owner has initiated the transaction, Owner may expressly waive its three-day cancellation rights by providing Contractor with a statement in Owner's handwriting describing the situation requiring immediate remedy and expressly acknowledging and waiving the right to cancel this Work Authorization. See the attached waiver form IDENTICAL COPIES OF THE CONTRACT SIGNED BY BOTH THE OWNER AND THE CONTRACTOR SHOULD GO TO BOTH THE OWNER AND THE CONTRACTOR NO WORK SHALL BEGIN PRIOR TO THE SIGNING THIS CONTRACT AND TRANSMITTAL TO THE OWNER OF A SIGNED COPY OF SUCH CONTRACT DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Contractor: Owne g BELFO S�? A GROUP, INC. Date: C �//� B 1. /Ti h Date: �� LIENS Pursuant to M.G.L.c.254,Contractor has various rights including the right to a lien upon the property that is the subject of this contract to secure the payment of all labor, material,and equipment furnished under this contract. WARRANTY Contractor will perform all repair work in a good and workmanlike manner in accordance with the General Conditions,will have a policy of insurance in full force,will comply with local safety standards and will perform all work according to local building codes. A one-year workmanship warranty in the form attached hereto will be presented upon full payment for the work performed. ASSIGNMENT OF INSURED'S RIGHTS The Owner hereby transfers,assigns and conveys to Contractor his/her/their right,title and interest in and to the insurance policy proceeds and all drafts for work performed or to be performed by Contractor to the extent of the Contract Sum.Accordingly,the Owner authorizes and directs their Insurance Company(named below)to make Belfor USA Group, Inc.a payee on all insurance drafts for all insurance work performed by Contractor on the above damaged property to the extent of the Contract Sum. The Owner also agrees to immediately endorse and tender all drafts as produced to the Contractor to the extent of the Contract Sum. All insurance work performed by the Contractor is subject to the terms of the Owner's policy of insurance which sets the scope and price of the work based upon industry standards: All uninsured work performed, including uninsured code-upgrade work,depreciation and insurance deductibles are the responsibility of the Owner. Contractor agrees to perform the insured work as approved by the Insurance Company and to accept insurance proceeds as the exclusive source of payment for the insured work. Any uninsured work,which includes but is not limited to code- upgrade work,asbestos removal or any other form of work not covered under Owner's insurance policy shall be paid by Owner. In the event insurance proceeds are not issued Contractor has the right to stop work until such time the insurance proceeds are released. Liberty Mutual Incurance 15579904 Name of Insurance Company Claim Number GENERAL CONDITIONS Owner agrees to allow timely inspections by municipal inspectors and/or mortgage company agents and to assist with obtaining any third party payee signatures on all insurance drafts so that Contractor can be timely paid. If for any reason the Owner's claim is denied by the Insurance Company or they refuse to pay the costs of any and/or all insurance work performed by Contractor, or the Owner otherwise delays or prevents the payment of said insurance draft, or use it for other purposes, then the Owner of the above mentioned property will be personally liable for all costs of services performed. The Contractor and Owner acknowledge and agree that the Contractor shall have no liability for, and shall be indemnified and held harmless from and against, all claims, damages, liabilities and costs arising out of or relating to the presence, discovery, or failure to discover, remove address, remediate or cleanup environmental or biological hazards including, but not limited to, mold, fungus, hazardous waste, substances or materials, or asbestos unless covered by the insured's policy of insurance, remediation is part of the scope of work and such work is directed by an Industrial Hygienists protocol and clearance testing. If for any reason the amount due under this Work Authorization is not paid when due, the Contractor shall be entitled to its expenses and attorneys fees incurred in the collection of this agreement with interest on the unpaid balance at the rate of 1.5%per month or the rate prescribed by law. t BELFOR s*O Belfor Property Restoration PROPERTY srsl ock I I Summary Line Item Total 24,031.28 Total AdjErstments for Base Service Charges 1.087.47 Material Sales Tax @ 6.250% x 7,507.34 469.21 Subtotal 25,587.96 Overhead @ 10.0% x 25,587.96 2,558.80 Profit @ 10.0% x 25,587.96 2,558.80 Replacement Cost Value $30,705.56 Net Claim $30,705.56 Jason Camerano WILKINSON(ACTREP3) 9/24/2010 Page: 10 BELFOR QOD Belfor Property Restoration PitopcPTYa r s t o e4 n ua Grand Total Areas: 3,978.83 SF Walls 1.776.85 SF Ceiling 5,755.68 SF Walls and Ceiling 1,776.85 SF Floor 197.43 SY Flooring 525.83 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 525.83 LF Ceil. Perimeter 1,776.85 Floor Area 1,927.74 Total Area 3,978.83 Interior Wall Area 2,831.88 Exterior Wall Area 373.50 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length WILKINSON(ACTREP3) 9/24/2010 Page: 9 BELFOR QOD Belfor Property Restoration PROPERTY REs To 94T 10M CONTINUED-GENERAL DESCRIPTION QNTY UNIT COST TOTAL Permit 1.00 EA @ 350.00= 350.00 Based.on$10 per thousand Residential supervision-pec hour 6.00 HR @ 61.31 = 367.86 Single axle dump truck-per load- including dump fees 1.00 EA @ 333.43= 333.43 all debris from the roof Single axle dump truck-per load including dump fees 1.00 EA @ 333.43= 333.43 all debris from the siding,trim and windows Cleaning Technician-incl. cleaning agent-per hour 10.00 HR @ 31.82= 318.20 post construction cleaning of the interior 10.00 EA @ 5.50= 55.00 Caulking caulking for all joints for azek material General Laborer-per hour 3.00 HR @ 35.56= lOG.6$ labor to deliver the packing supplies Bubble Wrap-Add-on cost for fragile items 2.00 EA @ 35.00= 70.00 packing supplies for the client to pack up small items in the DR,LR,rear bedroom and office before the demohnold remediation begins Provide box,packing paper&tape-small size 25.00 EA @ 2.31 57.75 = packing supplies for the client to pack up small items in the DR,LR,rear bedroom and office before the demo/mold remediation begins Provide box,packing paper&tape- medium size 25.00 EA @ 4.89 122.25 = packing supplies for the client to pack up small items in the DR,LR,rear bedroom and office before the demolmold remediation begins Adjustments for Base Service Charges Adjustment 125.92 Carpenter-General Framer 252.32 Drywall Installer/Finisher 242.80 Plasterer 112.72 Painter 221.73 Roofer 131.98 Siding Installer Total Adjustments for Base Service Charges: 1'087.47 Line Item Totals:WILKINSON(ACTREP3) 25,118.75 WILKINSON(ACTREP3) 9124/2010 Page: 8 BELFOR�0� Belfor Property Restoration PROPERTY R r S t oil At in DESCRIPTION QNTY UNIT COST TOTAL Tarp-all purpose poly-per sq ft (labor and material) 100.00 SF @ 0.45= 45.00 used to collect roofing debris R&R Additional charge for high roof(2 stories or greater) 7.00 SQ @ 14.32= 100.24 Remove Tear off composition shingles (no haul off) 6.35 SQ @ 32.61 = 207.07 R&R Sheathing-plywood-5/8"CDX 64.00 SF @ 1.96= 125.44 Ice&water shield 216.00 SF @ 1.14= 246.24 entire slope Roofing felt- 15 lb. 4.30 SQ @ 25.01 = 107.54 R&R Drip edge 72.00 LF @ 1.67= 120.24 R&R Flashing-pipe jack 1.00 EA @ 28.65= 28.65 Architectural-30 yr.shingle 7.00 SQ @ 295.50= 2,068.50 GAF-ELK Timberline Prestique High Definition Shingles Williamsburg Slate Ridge cap-30 yr Architectural shingles 36.00 LF @ 6.53= 235.08 Roofing-General Laborer-per hour 4.00 HR @ 35.56= 142.24 labor to cleanup site of roofing debris FRONT SLOPE DESCRIPTION QNTY UNIT COST TOTAL Tarp-all purpose poly-per sq ft(labor and material) 100.00 SF @ 0.45= 45.00 used to collect roofing debris Remove Tear off composition shingles (no haul off) 6.35 SQ @ 32.61 = 207.07 R&R Additional charge for high roof(2 stories or greater) 7.00 SQ @ 14.32= 100.24 Architectural-30 yr.shingle 7.00 SQ @ 295.50= 2,068.50 GAF-ELK Timberline Prestique High Definition Shingles Williamsburg Slate R&R Drip edge 72.00 LF @ 1.67= 120.24 Ice&water shield 216.00 SF @ 1.14= 246.24 entire slope Roofing felt- 15 Ib. 4.30 SQ @ 25.01 = 107.54 R&R Rubber roofing-Fully adhered system-60 mil 0.25 SQ @ 443.96= 110.99 remove and replace roofing on top of the chimney and use the left over Azek trim on the top perimeter of the chimney Roofing-General Laborer-per hour 4.00 HR @ 35.56= 142.24 labor to cleanup site of roofing debris GENERAL DESCRIPTION QNTY UNIT COST TOTAL WILKINSON(ACTREN) 9/24/2010 Page: 7 BELFOR�*� Belfor Property Restoration PROPE MTV[if$I 7E 4 t ION CONTINUED-LEFT ELEV DESCRIPTION QNTY UNIT COST TOTAL (Material Only) Flashing, 14"wide 8.00 LF @ 1.18= 9.44 materials for the flashing on the two 2nd level windows (Material Only)Siding trim-5/4" x 4" Azek sill board 18.00 LF @ 3.01 = 54.18 material for Azek window sill (Material Only)Siding trim-5/4" x 4" Azek trim board 72.00 LF @ 3.01 = 216.72 material for Azek window trim Carpenter-Finish,Trim/Cabinet-per hour 4.00 HR @ 6i.05= 244.20 2 hours for each window remove exterior trim.prep exterior of opening, install ice and water shield around opening,cut and joint the Azek trim, install Azek trim and caulk all joints 2 second floor windows Carpenter-Finish.Trim/Cabinet-per hour 2.00 HR @ 61.05 122.10 = I hour each window to remove the interior casing,spray expanding foam insolation and install the casing back on 2 second floor windows Detach& Reset Vinyl window-double hung 2.00 EA @ 85.69= 171.38 2 2nd floor windows Paint window opening-2 coats (per side) 2.00 EA @ 22.03= 44.06 interior of 2 second floor windows RIGHT ELEV DESCRIPTION QNTY UNIT COST TOTAL (Material only) Siding trim- 1" x 4"PVC trim board 36.00 LF @ 2.27= 81.72 material for rake boards (Material Only)Siding trim- 1"x 10" Azek trim board 36.00 LF @ 5.90= 212.40 material for rake boards Carpenter-Finish,Trim/Cabinet-per hour 3.00 HR @ 61.05= 183.15 labor to remove the wood rake boards,prep area and install new Azek trim and caulk General Laborer-per hour 3.00 HR @ 35.56= 106.68 labor to work with carpenter to remove the wood rake boards,prep area and install new Azek trim and caulk Scrape the surface area&prep for paint 858.00 SF @ 0.44= 377.52 Paint wood siding- 1 coat 858.00 SF @ 0.61 = 523.38 REAR SLOPE WILKINSON(ACTREP3) 9!24!2010 Page:6 BELFOR COD Belfor Property Restoration PROPF}i1'Rf s 101?At 13N CONTINUED-LEFT ELEV DESCRIPTION QNTY UNIT COST TOTAL 4 sections for 1 week Paint wood siding- 1 coat 858.00 SF @ 0.61 = 523.38 Seal &paint wood siding 858.00 SF @ 0.96= 823.68 R&R Sheathing-plywood-5/8" CDX 96.00 SF @ 1.96= 188.16 R&R House wrap (air/moisture barrier) 858.00 SF @ 0.29= 248.82 R&R Siding-shiplap-cedar 858.00 SF @ 4.29= 3,680.82 (Material Only) Siding trim- 1"x 5" Azek trim board 54.00 LF @ 3.50= 189.00 material for garage door trim (Material Only) Siding trim- I"x G' Azek trim board 54.00 LF @ 3.50= 189.00 material for garage door trim (Material Only) Flashing, 14" wide 24.00 LF @ 1.18= 28.32 flashing for around garage doors Carpenter-Finish,Trim/Cabinet-per hour 10.00 HR @ 61.05= 610.50 labor to remove old trim from around garage door openings,prep the openings,install flashing,cut and joint the Azek trim,install the Azek trim and caulk joints (Material Only) Siding trim- 1"x 4" Azek trim board 54.00 LF @ 2.27= 122.58 material for the corners (Material Only)Siding trim- 1"x 5"Azek trim board 54.00 LF @ 3.50= 189.00 material for the corners Carpenter-Finish,Trim/Cabinet-per hour 3.00 HR @ 61.05= 183.15 labor to remove old corner trim,prep corners,and install new Azek trim General Laborer-per hour 3.00 HR @ 35.56= 106.68 labor to work with carpenter to remove old corner trim,prep corners,and install new Azek trim (Material Only) Siding trim- I"x 10"Azek trim board 36.00 LF @ 5.90= 212.40 material for rake boards (Material Only) Siding trim- 1"x 4"Azek trim board 36.00 LF @ 2.27= 81.72 material for rake boards Carpenter-Finish,Trim/Cabinet-per hour 3.00 HR @ 61.05= 183.15 labor to remove the wood rake boards,prep area and install new Azek trim and caulk General Laborer-per hour 3.00 HR @ 35.56= 106.68 labor to work with carpenter to remove the wood rake boards,prep area and install new Azek trim and caulk (Material Only)Siding trim- 1"x 5" Azek trim board 18.00 LF @ 3.50= 63.00 materials for the water table (Material Only) Siding trim- 1"x 8" Azek trim board 18.00 LF @ 4.79= 86.22 materials for the water table Carpenter-Finish,Trim/Cabinet-per hour 1.50 HR @ 61.05= P 91.58 labor to remove the trim on the water table,prep area, install new Azek trim and caulk WILKINSON(ACTREP3) 9/24/2010 Page: 5 BBLFOR QOD Belfor Property Restoration PROPf RTYaf>;6e q T io it Ceiling Height: 7'6" LR DESCRIPTION QNTY UNIT COST TOTAL 1/2"drywall-hung,taped, ready for texture 20.00 SF @ 1.31 = 26.20 Texture drywall-heavy hand texture 50.00 SF @ 0.65= 32.50 Seal then paint the ceiling twice (3 coats) 253.50 SF @ 0.93= 235.76 Ceiling Height:8' Bath DESCRIPTION QNTY UNIT COST TOTAL Content Manipulation charge 1.00 HR @ 35.56= 35.56-per hour 13.82 Floor protection-self-adhesive plastic film 30.71 SF @ 0.45= Remove 1/2"drywall-hung,taped.ready for texture 32.00 SF @ 0.37= 11.84 1/2"drywall -hung,taped, ready for texture 32.00 SF @ 1.31 = 41.92 Texture dq,,wall-heavy hand texture 32.00 SF @ 0.65= 20.80 Seal then paint the ceiling twice(3 coats) 30.71 SF @ 0.93= 28.56 Base Level Ceiling Height: 7' 9" Garage QNTY UNIT COST TOTAL DESCRIPTION 52.00 SF @ 1.01 = 52.52 Batt insulation-6" -R19 Thin coat plaster over 1/2"gypsum core blueboard 52.00 SF @ 3.34= 173.68 100.00 SF @ 0.65= 65.00 Texture drywall-heavy hand texture Seal then paint the ceiling twice(3 coats) 576A0 SF @ 0.93= 535.68 374.00 SF @ 0.93= 347.82 Seal then paint the surface area twice (3 coats) walls LEFT ELEV DESCRIPTION QNTY UNIT COST TOTAL Detach&Reset Exterior light fixture 1.00 EA @ 59.61 = 59.61 customer to supply a new fixture Labor to set up and take down scaffold-per section 4.00 EA @ 19.99= 79.96 4 sections for 1 week Scaffold-per section (per week) 4.flfl WK 44.80= 179.20 WILKINSON(ACTREP3) 9/24/2010 Page: 4 i BELFOR eOD Belfor Property Restoration ►RG►E R TV p[9 l OR It.o4 CONTINUED-DR DESCRIPTION QNTY UNIT COST TOTAL Paint baseboard-one coat 45.00 LF @ 0.66= 29.70 Seal then paint the ceiling twice (3 coats) 162.00 SF @ 0.93= 150.66 Seal then paint part of the walls twice(3 coats) 316.50 SF @ 0.93= 294.35 Den Ceiling Height: 7' 6" DESCRIPTION QNTY UNIT COST TOTAL Batt insulation -4" -R13 80.00 SF @ 0.64= 51.20 1/2"drywall-hung, taped,with smooth wall finish 80.00 SF @ 1.99= 159.20 1/2"drywall-hung,taped, ready for texture 20.00 SF @ 1.31 = 26.20 Texture drywall -heavy hand texture 50.00 SF @ 0.65= 32.50 Baseboard -3 1/4" 13.00 LF @ 2.39= 31.07 Seal &paint baseboard-two coats 13.00 LF @ 0.98= 12.74 Paint baseboard -one coat 47.00 LF @ 0.66-- 31.02 Seal then paint part of the walls twice (3 coats) 331.50 SF @ 0.93= 308.30 Seal then paint the ceiling twice (3 coats) 175.50 SF @ 0.93= 163.22 Kitchen Ceiling Height: 7' 6" DESCRIPTION QNTY UNIT COST TOTAL Protect contents-Cover with plastic 100.00 SF @ 0.14= 14.00 Content Manipulation charge-per hour 1.00 HR @ 35.56= 35.56 Seal then paint the ceiling twice (3 coats) 156.00 SF @ 0.93= 145.08 Main Entry Ceiling Height:TV DESCRIPTION QNTY UNIT COST TOTAL Seal then paint the ceiling twice(3 coats) 81.25 SF @ 0.93= 75.56 VVILKINSON(ACTREP3) 9/24/2010 Page: 3 BELFOR q*� Belfor Property Restoration PROPERTY RF ST*NATION WILKINSON(ACTREP3) 2nd Level Rear Bed Ceiling Height: 7' 6" Subromn 1: Rear Closet Ceiling Height:7'6" DESCRIPTION QNTY UNIT COST TOTAL Batt insulation-4"-R13 32.00 SF @ 0.64= 20.48 1/2"drywall-hung,taped,with smooth wall finish 32.00 SF @ 1.99= 63.68 Seal then paint part of the walls twice(3 coats) 487.50 SF @ 0.93= 453.38 Baseboard-3 1/4" 13.00 LF @ 2.39= 31.07 Seal&paint baseboard-two coats 13.00 LF @ 0.98= 12.74 Paint baseboard-one coat 45.00 LF @ 0.66= 29.70 Paint door opening- I coat(per side) 1.00 EA @ 14.57= 14.57 Paint door opening-Large-I coat (per side) 2.00 EA @ 17.16= 34.32 Office Ceiling Height: 7' 6" Subroom 1: Front Closet Ceiling Height:7' 6" DESCRIPTION QNTY UNIT COST TOTAL Batt insulation-4" -R13 32.00 SF @ 0.64= 20.48 1/2"drywall -hung,taped,with smooth wall finish 32.00 SF @ 1.99= 63.68 Baseboard-3 1/4" 10.00 LF @ 2.39= 23.90 Seal&paint baseboard-two coats 13.00 LF @ 0.98= 12.74 Paint baseboard-one coat 45.00 LF @ 0.66= 29.70 Seal then paint part of the walls twice (3 coats) 432.50 SF @ 0.93= 402.23 Paint door opening-Large- I coat (per side) 2.00 EA @ 17.16= 34.32 Paint door opening- 1 coat(per side) 1.00 EA @ 14.57= 14.57 Main Level DR Ceiling Height:7' 6" DESCRIPTION QNTY UNIT COST TOTAL Batt insulation-4" -R13 80.00 SF @ 0.64 = 51.20 1/2" drywall -hung,taped,with smooth wall finish 80.00 SF @ 1.99= 159.20 1/2" drywall-hung, taped.ready for texture 32.00 SF @ 1.31 = 41.92 Texture drywall -heavy hand texture 50.00 SF @ 0.65= 32.50 Baseboard-3 1/4" 12.00 LF @ 2.39= 28.68 Seal &paint baseboard-two coats 12.00 LF @ 0.98= 11.76 VVILKINSON(ACTREP3) 9/24/2010 Page: 2 BELFOR COD Belfor Property Restoration PROPS*TT Of 579E4 I ion Client: Wilkinson,Lee& Bonnie Home: (978) 258-4141 Property: 41 Bruin Hill Rd North Andover, MA 01845 Operator Info: Operator: JCAMERAN Estimator: Jason Carnerano Business: (508) 544-4325 Business: 4-6 Avenue E Hopkinton,MA 01748 Type of Estimate: Water Damage Date Entered: 8/9/2010 Date Assigned: Price List: MAB05B AUG10 Restoration/Service/Remodel Estimate: WILKINSON(ACTREP3) File Number: 15579904 lily t�cti��la�iutt vutj�tatttt� Page 1 Of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Mass.Gov Consumer Affairs and Business Regulation Home> Consumer> Housing Information> Home Improvement Contractor Program> ..........................................................................................._.............................._..............................._........................................................_...................................................................... HIC Registration Complaints Registration# 155902 Registrant BELFOR USA GROUP, INC. Name GERARD MCGONAGLE Address 185 OAKLAND AVE STE 300 City,State,Zip BIRMINGHAM,MI,48009 Expiration Date 5/17/2011 Status Current No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search ©2010 Commonwealth of Massachusetts _,A6k MaNsachosetts-Delmilment of Pulaiic S.tfctj Board of Buildingl2e�ttl ttit►ns ant!Standards Construction Supervisor License License: Cs 73702 Restricted to: 00 MARK J FENTON 185 OAKLAND AVE#300 BIRMINGHAM, MI 48009 , c-- Expiration: 1/4/2011 t 41ntmisi s°er Tr,": 12330 Restricted to: 00 00-. Unrestricted 1G-1 2 Family Homes Failare,to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS ......... CERTIFICATE OF LIABILITY INSURANCE r7ATE(MM/DD/YYYY) 04/05/2010 PRODUCER Aon Risk Services Central , Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Sou-rhfi al cl MI Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 000 l uwn Center CkR11rICAfE LUES NOI ANIL+'ND,EXI END OR ALrLR'1HE Suite 3000 COVERAGE AFFORDED BY THE POLICIES BELOW. Southfield MI 48075 USA PHoNE-(866) 283-7122 FAX-(847) 953-5390 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Insurance Company of the State of PA 19429 Belfor USA Group ` 4-6 Avenue E INSURER B: National Union Fire Ins Co of Pittsburgh 19445 ca^. Hopkinton MA 01748 USA INSURER C: Chartis Specialty Insurance Company 26883 2 INSURER D: � a INSURER E: c COVERAGES SIR applies per terms and conditions of the policy 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED INSR ADD' LTR INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YYYY DATE(MM/DD/YYYY) B GENERAL LIABILITY GL4376513 04/01/2010 04/01/2011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 PREMISES(Ea occurrence) CLAIMS MADE X❑ OCCUR MED EXP Any one person) $10,000 r PERSONAL&ADV INJURY $1,000,000 r GENERAL AGGREGATE $2,000,000 k GEN'L AGGREGATE LIMIT APPLIES PER: t ❑ POLICY X❑ PRO- ❑ PRODUCTS-COMP/OP AGG $2,000,000 JECT X LOC r t A AUTOMOBILE LIABILITY CA8263538 04/01/2010 04/01/2011 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 X ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY NON OWNED AUTOS (Per accident) HX Comp Ded $1,000 PROPERTY DAMAGE X toll Ded $1,000 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGO A EXCESS/UMBRELLA LIABILITY BE9613260 04/01/2010 04/01/2011 EACH OCCURRENCE MS, 0 OCCUR ❑ CLAIMS MADE AGGREGATE $5,000,000 ®DEDUCTIBLE RETENTION $10,000 B WCO20634974 04/01/2010 X JWe STATu- oTx- WORKERS COMPENSATION AND TORY LIMITS OT EMPLOYERS'LIABILITY Y/N a E.L.EACH ACCIDENT $1,000,000 ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 (Mandatory in NIT) E.L.DISEASE-POLICY LIMIT $1,000,000 If yes,describe under SPECIAL PROVISIONS below C CP016851546 04/01/2010 04/01/2011 Aggregate Limit $5,000,000 OTHER Pollutn/Env imp Per occurrence Limit $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Evidence of Insurance CERTIFICATE HOLDER CANCELLATION Be 1 fo r USA Group SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 4-6 Avenue E DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Hopkinton MA 01748 USA 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE wiz• ` Gua (�zGi!mG J ACORD 25(2009/01) 01988-2009 ACORD CORPORATION.All rights reserved— The ACORD name and logo are registered marks of ACORD FE The Commonwealth of Massachusetts Department o f Industrial_.Accidents Office ofinvestigations 600 Washington Street Boston, MA 02111 Workers' Compensation insurance Affda-4t: B,uilde s/Contras An ficant Information tors/Electricians/Plumbers PIease Print Legibly Name (Business/Orgamzation/Individual): . 0 2 'J,� 20� Address: 'y -& le City/State/Zip: l-'/C-I4/T-D,t) 0 o t � Phone Are u an employer?Check the appropriate box: I•L►� 1 am a employer with (/0 a 4. ❑ I am a o. Type of project(required): employees(full and/or part-time).* have hirecle contractor and I the sub-contractors 6 ❑New consiraction 2.❑ I am a sole proprietor or partner_ listed an the attached sheet 7• ❑Remodeling ship and have no employees These_b-contractors have working for me in any capacity. workers COMP. ' 8- ❑Demolition [No workers'comp. insttrance 5, • P insurance. 9. ❑ We are a corporation and its ❑Builaing addition regtured] officers have exercised their 10.0Electrical 3.❑.I am a homeowner doing all work right of repairs °r additions emption per MGL 11. Plumbing myself c[N a workers'comp. c. 152,§I(4),and we have no 1 ❑ repairs or additions insuran ❑Roof � ] employees. [No workers' �� 'AM,applicant that Pomp,insurance required.] 13•7 Other k krJx.. m:lst asC,ju,cut the ,— i Iiomeownees who s �`ce she," ="_ wor�azs'cetn•���.:c. + submit affidavit indicating th-,a•_do W-aL'cacti and_ ,. Contractors that chill,thir box,•n•=attached an additional sheet showing the am hire a sub_ccent�c±e . s anbmit a new atmdavit indicating such. name of the sub canuactan and their workersI I am an employer that is providing workers'coin cash on r.-p-pommy information. inform don P uisurance for my employees Below is the policy and job site Insurance Company Name: :::�Jri64,-,f _ R,/u f s ��. ,,� pr Policy#or Self-ins.Lic. Expiration Date: Sob Site Address: b Attach a copy of the workers' compensation policy declaration paDe(sho City/State/Zip:/�yaTQe Wp�v�a r� b L YYJ' Failure to se„ wing the policy number.and expiration date). ^ire coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment as well as civil Of up to $250.00 a day against the violator. Be advised that a co penalties to the form of a STOP WORK ORDER and a fine Investigations of the DIA for insurance coverage verification. PY of stat-m-at may be forwarded to the Office of I do hereby certi,fy under the pains and pdn�cs o er , fP J�J that the inforinau%n provided above is true and correct Siunatur Phone#. Official use only. Do not write in this area, to be completed by citj,or town official City or Town: permitUcense# Issuing Authority(circle one): L Board of Health 2.Builriing-Department 3. Citv/Town p 6. Other Clerk 4.Electrical Inspector 5.Plumbinb Inspector Contact Persun• Information an- d Instructions Massachusetts General Laws chapter 152 requires all employs to provide workers'compensation for their employees. Pursuant to this statute an employee is defined as ...every peon in the service of another under any contract of hire, express or implied oral or written." An employer is defined as an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including t3ae legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association ox-other legal entity,employing employees. However the owner of a dwelling house having not more than three apartroLents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintemanee,construction or repair work on such'dwelling house or on the grounds or building appurtenant thereto shall not be cause of such.employment be.deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or 10ocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to c--onstruct buildings in the commonwealth for any applicant who has not produced acceptable evidence of colimpliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the.performance of public work un-til acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.,, Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your'situation and,if necessary,supply sub-contractor(s)name(s), address(es) and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(l L,C) or Limited Liability partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' comp=sation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. .Also be si u'e to sign and date the affidavit The affidavit should be ivt uu`vd to the city or town that the auulica ion for the p"sI is t'or License L4 being requested,not th. .—r'ep8rtment.of Industrial Accidents. Should you have my T-lestiom regarding the lau: ;f you ai a.,.k;;ired to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the pmmit(license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under`.`Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license 07 pmt not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would halm to than you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Departramt'.s address,telephone and-fax_numbcr_ The Commonwmltlz Of Massachusetts. Department of fndustiial Accidents Office of Inrestigations 600 Washm tan Street Banton,M-A 0.2111 Tel 617-72.7-4900 ea.-t 440.6 or 1-9 7/7-NL4SSAFE Revised 5-26-05 Fax 4' 617-72-7-7749 VrVirVi'.MM..aov/dia. Base Level 24'8' Base Levef WILMSON(ACTREP3) 9/24/201.0 Page: 11 Main Level 33'4" 13'6" — —13' 6'6" wq rrtcnen �' 13' S'I1" n LR m IP am ih Mein FMw Y3, M 33'—1 to 24.6.. 1' Main Level WILKWSON(ACTREP3) 9/24/2010 Page: 12 2nd Level 18' ie' r m z in S. 37. 9'6. Front Ck—t III iv 1 8.A.. dike T 12'2' I; 2nd Level WILKINSON(ACTREP3) 9/24/2010 Page: 13 EELFOR Belfor Property Restoration PROPERTYRESTORAtIOR Client: Wilkinson,Lee&Bonnie Home: (978) 258-4141 Property: 41 Bruin Hill Rd North Andover,MA 01845 Operator Info: Operator: JCAMERAN Estimator: Jason Camerano Business: (508) 544-4325 Business: 4-6 Avenue E Hopkinton,MA 01748 Type of Estimate: Water Damage Date Entered: 8/9/2010 Date Assigned: Price List: MAB05B_AUG10 Restoration/Servi ce/Rem odel Estimate: WILKINSON(MOLD) File Number: 15579904 BELFOR Qin} Belfor Property Restoration P RO PER TYRE$TO R#IT IO R WILKINSON(MOLD) 2nd Level Rear Bed Ceiling Height: 7' 6 Subroom 1: Rear Closet Ceiling Height:7'6" DESCRIPTION QNTY UNIT COST TOTAL 109. Clean and deodorize carpet 203.50 SF @ 0.35= 71.23 120. Negative air fan/Air scrubber(24 hr period) -No monit. 3.00 DA @ 71.08= 213.24 110. Content Manipulation charge-per hour 2.00 HR @ 35.56= 71.12 111. Floor protection-self-adhesive plastic film 101.75 SF @ 0.45= 45.79 112. Tear out trim/base and bag for disposal 12.00 LF @ 0.68= 8.16 113. Tear out wet drywall,cleanup,bag for disposal 32.00 SF @ 0.73= 23.36 114. Tear out and bag wet insulation 32.00 SF @ 0.49= 15.68 115. Apply anti-microbial agent 32.00 SF @ 0.21= 6.72 116. Sand exposed framing-Walls 32.00 SF @ 0.73= 23.36 117. HEPA Vacuuming-hourly charge 1.00 HR @ 46.73= 46.73 118. Cleaning-Remediation Technician-per hour 2.00 HR @ 43.60= 87.20 119. Seal/coat the surface area-one coat(anti-microbial coating) 32.00 SF @ 0.94= 30.08 Office Ceiling Height:7'6" Subroom 1: Front Closet Ceiling Height: 7' 6" DESCRIPTION QNTY UNIT COST TOTAL 108. Clean and deodorize carpet 138.39 SF @ 0.35= 48.44 155. Negative air fan/Air scrubber(24 hr period) -No monit. 3.00 DA @ 71.08= 213.24 154. Content Manipulation charge-per hour 2.00 HR @ 35.56= 71.12 153. Floor protection-self-adhesive plastic film 69.19 SF @ 0.45= 31.14 152. Tear out trim/base and bag for disposal 10.00 LF @ 0.68= 6.80 151. Tear out wet drywall,cleanup,bag for disposal 32.00 SF @ 0.73= 23.36 150. Tear out and bag wet insulation 32.00 SF @ 0.49= 15.68 149. Apply anti-microbial agent 32.00 SF @ 0.21 = 6.72 148. Sand exposed framing-Walls 32.00 SF @ 0.73= 23.36 147. HEPA Vacuuming-hourly charge 1.00 HR @ 46.73= 46.73 146. Cleaning-Remediation Technician-per hour 2.00 HR @ 43.60= 87.20 145. Seal/coat the surface area-one coat(anti-microbial coating) 32.00 SF @ 0.94= 30.08 Main Level DR Ceiling Height: 7'6° WILKINSON(MOLD) 8/30/2010 Page: 2 BELFOR a*� Belfor Property Restoration PROPESTYPESTORATION DESCRIPTION QNTY UNIT COST TOTAL 28. Content Manipulation charge-per hour 2.00 HR @ 35.56= 71.12 labor to move and reset contents as needed 164. Containment Barrier/Airlock/Decon.Chamber 21.00 SF @ 0.80= 16.80 165. Peel&sea]zipper 1.00 EA @ 11.71 = 11.71 29. Floor protection-self-adhesive plastic film 162.00 SF @ 0.45= 72.90 30. Protect contents-Cover with plastic 100.00 SF @ 0.14= 14.00 169. Negative air fan/Air scrubber(24 hr period) -No monit. 3.00 DA @ 71.08= 213.24 31. Tear out trim/base and bag for disposal 12.00 LF @ 0.68= 8.16 32. Tear out wet drywall,cleanup,bag for disposal 112.00 SF @ 0.73= 81.76 80sf from wall and 32sf from ceiling 33. Tear out and bag wet insulation 80.00 SF @ 0.49= 39.20 34. Apply anti-microbial agent 112.00 SF @ 0.21 = 23.52 35. Sand exposed framing-Ceiling 32.00 SF @ 1.36= 43.52 36. Sand exposed framing-Walls 80.00 SF @ 0.73= 58.40 37. HEPA Vacuuming-hourly charge 1.00 HR @ 46.73= 46.73 38. Cleaning-Remediation Technician-per hour 2.00 HR @ 43.60= 87.20 77. Seal/coat the surface area-one coat (anti-microbial coating) 112.00 SF @ 0.94= 105.28 Den Ceiling Height:7'6" DESCRIPTION QNTY UNIT COST TOTAL 101. Content Manipulation charge-per hour 2.00 HR @ 35.56= 71.12 labor to move and reset contents as needed 167. Containment Barrier/Airlock/Decon.Chamber 21.00 SF @ 0.80= 16.80 166. Peel&sea]zipper 1.00 EA @ 11.71= 11.71 100. Floor protection-self-adhesive plastic film 175.50 SF @ 0.45= 78.98 99. Protect contents-Cover with plastic 100.00 SF @ 0.14= 14.00 168. Negative air fan/Air scrubber(24 hr period)-No monit. 3.00 DA @ 71.08= 213.24 98. Tear out trim/base and bag for disposal 13.00 LF @ 0.68= 8.84 97. Tear out wet drywall,cleanup,bag for disposal 100.00 SF @ 0.73= 73.00 80sf from wall and 20sf from ceiling 96. Tear out and bag wet insulation 80.00 SF @ 0.49= 39.20 95. Apply anti-microbial agent 100.00 SF @ 0.21= 21.00 80sf from wall and 20sf from ceiling 94. Sand exposed framing-Ceiling 20.00 SF @ 1.36= 27.20 93. Sand exposed framing-Walls 80.00 SF @ 0.73= 58.40 92. HEPA Vacuuming-hourly charge 1.00 HR @ 46.73= 46.73 91. Cleaning-Remediation Technician-per hour 2.00 HR @ 43.60= 87.20 90. Seal/coat the surface area-one coat (anti-microbial coating) 100.00 SF @ 0.94= 94.00 WILKINSON(MOLD) 8/30/2010 Page: 3 BELFOR 4•D Belfor Property Restoration PROPERTYRESTORATIOR LR Ceiling Height:7' 6" DESCRIPTION QNTY UNIT COST TOTAL 65. Content Manipulation charge-per hour 1.00 HR @ 35.56= 35.56 66. Protect contents-Cover with plastic 100.00 SF @ 0.14= 14.00 69. Floor protection-self-adhesive plastic film 63.38 SF @ 0.45= 28.52 170. Negative air fan/Air scrubber(24 hr period)-No Tmonit. 3.00 DA @ 71.08= 213.24 70. Tear out wet drywall,cleanup,bag for disposal 20.00 SF @ 0.73= 14.60 71. Sand exposed framing-Ceiling 20.00 SF @ 1.36= 27.20 72. Apply anti-microbial agent 20.00 SF @ 0.21- 4.20 76. HEPA Vacuuming-hourly charge 1.00 HR @ 46.73= 46.73 75. Cleaning-Remediation Technician-per hour 2.00 HR @ 43.60= 87.20 78. Seal/coat the surface area-one coat (anti-microbial coating) 20.00 SF @ 0.94= 18.80 Base Level Garage Ceiling Height:7' 9" DESCRIPTION QNTY UNIT COST TOTAL 173. Negative air fan/Air scrubber(24 hr period) -No monit. 3.00 DA @ 71.08= 213.24 10. Tear out wet drywall,cleanup,bag for disposal 52.00 SF @ 0.73= 37.96 32sf from ceiling and 20 sf from walls 13. Tear out and bag wet insulation 52.00 SF @ 0.49= 25.48 11. Apply anti-microbial agent 52.00 SF @ 0.21= 10.92 14. Sand exposed framing-Ceiling 32.00 SF @ 1.36= 43.52 15. Sand exposed framing-Walls 20.00 SF @ 0.73= 14.60 12. HEPA Vacuuming-hourly charge 1.00 HR @ 67.14= 67.14 16. Cleaning-Remediation Technician-per hour 2.00 HR @ 43.60= 87.20 clean area 17. Seal/coat the surface area-one coat (anti-microbial coating) 52.00 SF @ 0.94= 48.88 GENERAL DESCRIPTION QNTY UNIT COST TOTAL 163. Haul debris-per pickup truck load-including dump fees 1.00 EA @ 154.07= 154.07 all debris generated by the interior demolition 121. Add for personal protective equipment(hazardous cleanup) 12.00 EA @ 10.90= 130.80 WILKINSON(MOLD) 8/30/2010 Page: 4 BELFOR 0*� Belfor Property Restoration PROPERTMSTORATION Grand Total Areas: 3,081.50 SF Walls 1,508.89 SF Ceiling 4,590.39 SF Walls and Ceiling 1,508.89 SF Floor 167.65 SY Flooring 407.67 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 407.67 LF Ceil.Perimeter 1,508.89 Floor Area 1,633.00 Total Area 3,081.50 Interior Wall Area 2,532.17 Exterior Wall Area 334.33 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length WILKINSON(MOLD) 8/30/2010 Page: 5 BELFOR a*� Belfor Property Restoration PROPERTY RESTO RATION Summary Line Item Total 4,325.36 Material Sales Tax @ 6.250% x 555.64 34.73 Replacement Cost Value $4,360.09 Net Claim $4,360.09 Jason Camerano WILKINSON(MOLD) 8/30/2010 Page: 6 Base Level I 2d'8' 21' f 7L90C Base Level WILKINSON(MOLD) 8/30/2010 Page: 7 Main Level 13'T 13'8" W 13' lR o Qffi EI I Main Leval WILKINSON(MOLD) 8/30/2010 Page:8 2nd Level 18' in m in Fent t 0,,t U I a".- ofte 1 1161- 172' 2nd Level WILKINSON(MOLD) 8/30/2010 Page: 9