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HomeMy WebLinkAboutBuilding Permit #133-12 - 95 PENNI LANE 8/16/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO.-.L �L' Date Received Date Issued: ��A, IMPORTANT:Applicant must complete all items on this page LOCATION �.Spte ��I P t PROPERTY OWNER 7 / � oAt Print MAP N0:/0/7' PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resi ential Non- Residential ❑ New Building One family ❑ ddition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other via '^ - '�a. -F l ®,Septic� 1®IFWell��� ®�Floodplaihn � Wetlands).• ® Water shed�Di_strict x - DESCRIPTION OF W RK T BE D: 2 entification Please Type or Print Clearly) OWNER: Name: _T� -&- Phone: Address: 9.�' 1�/r ,aA CONTRACTOR Name: T-1F �L'�. J® Phone: �-ZE17 7 7 Address: Tlf'7� Supervisor's Construction License: g 1 -� !� Exp. Date: Z Home Improvement License: 02 Exp. Date: ARCHITECT/ENGINEER Phone: S t Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 1 . 10 FEE: $ 7.0°d Check No.: �' ®� �l' Receipt No.: o��lY7 7 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty and S: n :. ::... S�gnature:of_°Agent/Owner, =.!9..afure:ofcontraetor;: .,: _,; 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ 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 Neter Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording . Lust be submitted with the building application Doe: Doc.Building Permit Revised 2008mi f 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 ❑ 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 Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments t 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 Located at 124 Main Street Fire Department signature/date COMMENTS i 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 Location �� rNNi f�Gi�E No. z Date NOR7M TOWN OF NORTH. ANDOVER O s • Certificate of Occupancy $ Building/Frame Permit Fee $ �s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # I 24477 Wilding Inspector Y %ORT#q Town of V" No. _1&4 - ro o , dover, Mass., !C LAKE COCHICHEW ICK 7� ORATED CO BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR C THIS CERTIFIES THAT............. ........ ...................................................................................... ........................................... Foundation has permission to erect......... .............................. buildings on ..:/. ....................... /V ee;................................. Rough d CF//N/©s� -" i � i a 1 !��/ — �c f 3f G Chimney to be occupied as.........................................., ..........,." ...........................................................................................`.......... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in 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- PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO 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 (Mall To Be Done FIRE,DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 1 . I '� -/4YlL)Y2(yYLll/P.fLLc1L- Cy. ,- ([lXOJl4f./L[I�co _�. Office of Consumer Affairs&Business Regulation k"HOME IMPROVEMENT CONTRACTOR Registration: 141124 Expiration: 1/1212012 x Type: Supplement Card t A+M GENERAL CONTRACTING INC. MICHAEL FITZGERALD 5 SOUTH RIDGE CIRCLE LYNN,MA 01904 Undersecretary �la..arhu.rtt• Department of I'uhlic "atct� Huard i)f Buildin,: Rc�,ulatiuu, anti NtantlarilN onstructicn Supt&rrisor Speciaity License License: CS SL 99933 Rest;acted to: RF,WS,DM,IC MICHAEL FITZGERALD 9 WINCHEST COURT GLOUCESTER, MA 01930 expiration: 6/19/2012 „nuni>•Ian r Tr 99933 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 j Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �9r' �Q/. �D/✓r. Address: ZZ y City/State/Zip: d' Phone #: 9Z2 Z2Z 7Z?7 AVI u an employer?Check the appropriate box: Type of project(required): 1. arra a employer with Z Q 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its officers have exercised their 10.El Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ the oof repairs 13. O insurance required.]t employees. [No workers' �/ comp.insurance required.] L� *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. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: -� Policy#or Self,-ins.Lic.#: L- ��?� Expiration Date: Z 6 L � Job Site Address:�NA� A/1/4 City/State/ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL 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 penalties in the form of a STOP WORK ORDER and a.fine of up to$250.00 a day against the violator. Be advised that 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 Ae pains a ties of perjury that the information provided above is true a d correct. Si ature: Date: Phone#: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person 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 the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance 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 until 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(LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation 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 sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required 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 permit/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 or permit not related to any business or commercial venture (i.e. a dog license or permit to bur leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia From:Susan Petro FaxID: Page 2 of 2 Date:3/24/2011 09:36 AM Page:2 of 2 .•� OP ID:SM ,acoRr�° CERTIFICATE OF LIABILITY INSURANCE DATE03124DIYYYY) 03/24111 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ACT PRODUCER 781-224-5700 CNAME: Mazonson LLC www.mazonson.com 781-224-5777 PHOS Fax No Ead): AIC,No): _.- 701 Edgewater Drive E-MAIL Suite 230 PRODUCER Wakefield, MA 01880-6236 CUSTOMERIDx:ABMGE-1 John Scanlon INSURER(S)AFFORDING COVERAGE NAIC# INSURED ABM General Contracting,Inc. INSURER A:Peerless Insurance Co Norman Dube INSURER B:ACE-USA 119R Foster Street INSURER C Peabody,MA 01960 INSURER D INSURER E: _ INSURER F COVERAGES CERTIFICATE NUMBER: 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 REOUIREMENT,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. IN - UB POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDNYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X C UMMERCIAL GENERAL LIABILITY CBP8762001 03!20111 03/20112 PREMISESEa occurrence $ _ 100'000 CLAIMS-MADE FKOCCUR MED EXP(Any one person) $ 5.000 PERSONAL&ADV INJURY $ 1,000.000 GENERALAGGREGATE $ 2,000,000 GEN'LA.GGREGATELIMIT APPLIES PER I PRODUCTS-COMP/OPAGG $ 2,000.000 POLICY 17 T (^I LOC $ AUTOMOBILELIABILITY? . COMBINED SINGLE LIMIT $ 1,000,000 A BODILY ANY AUTO BA8762301 03/20111 03/20112 dent} BODILY IN,AJRY(Per person) $ ALL OWNED AUTOS BODILY IN JJRY(per accident) $ X SCHEDULEDAUTOS PRO PERT Y DAMAGE HIRED AUTOS (Per accident) $ X NON-OWNEDAUTOS $ $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 Q CU8762501 03/20/11 03!20112 DEDUCTIBLE $ X RETENTION $ 10,0_00 $ WORKERS COMPENSATION WC STAT U- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER B ANY PROPRIETORIPARTNER/EXECUTIVE Y 1 N C46275251 03/20/11 03/20/12 E L EACH ACCIDENT $ 500,000 OFFICERIMEMSER EXCLUDED? 1 111 A (Mandatory In NH) E1 DISEASE-EA EMPLOYEE $ 500,000 If yes,descnbe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) ed CERTIFICATE HOLDER CANCELLATION (� TOWNAN1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD If Job Number 3956 DATE JULY 29,2011 Client YEN MAC 978-687-7992 address 95 PENNI LANE city/town NORTH ANDOVER MA contractor A& M 1.WEATHERSTRIPPINGICAULKING QUANTITY TOTAL AUDITOR NOTES Door Kits Q-Lon or Equiv. 4 172.00 BROWN KITS Door Sweeps(Regular) 0 0.00 Door Sweeps(Automatic) 3 66.00 Reglaze Windows M.inch 0 0.00 Wlndow.Weathstr Schiegal per side 0 0.00 Attic/Basement bypass sealing man/hr 4.5 270.00 SEE GARAGE AIS NOTES Attic sealing with 2-part foam man/hr 2.5 187.50 GAIN ACCESS FROM GABLES IF POSSIBLE SUBTOTALS 695.50 2A.INFILTRATION I INSULATION AUDITOR .NOTES.: Domestic pipe Hot Water Tank 1st 6' 0 0.00 Sill Insulation R-19 CF 0 0.00 Sill Two Part Foam wl Fiberglass Batt 66 132.00 Drape Perimeter R-5 Anch.Sq.ft. 0 0.00 Drape DOOR R-5 Arch. 1 44.00 Tape Joints(Aluma Grip only)per hr. 0 0.00 Duct Insulation&Tape In.ft. 0 0.00 Rigid Foam Board Anch. 1" 0 0.00 Hydronic pipe insulation to 1"R-5 0 0.00 Hydronic pipe ins.1.25"-1.5"R-5 0 0.00 Steampipe Ins.tol.25"iron pipe R-5 0 0.00 Steampipe Ins.1.5"-2"Iron pipe R-5 0 0.00 Steampipe Ins.3"iron pipe R-5 0 0.00 Air Conditioner Meeting Rail 0 0.00 i Air Conditioner Cover 0 0.00 Air Conditioner Cover Special Order 0 0.00 SUBTOTALS 176.00 2B.INSULATION XcUDITORNOT�S G Open Unrestricted R 49 0 0.00 Open Unrestricted R 38 960 1344.00 SOME PLYWOOD BUT NOT NAILED Open Unrestricted R 30 0 0.00 I Open Unrestricted R 20 0 0.00 Open Unrestricted R 10 0 0.00 Restrict FL/Sloped R 30 0 0.00 Restrict FUSloped R 20 0 0.00 Restrict FL/Sloped R 10 0 0.00 R-19 FGB open rafters/walisikneewalls 0 0.00 j R-11 FGB open rafterslwallsfkneswalls 0 0.00 Attic Stairs(stairwell&common wall) 0 0.00 Cover Pull Down Stairs Thermadome 1 175.00 Site built pull down stairs 2"foam box 0 0.00 Page 2 -',:',.AUDITOR;_NOTES Attic/Kneewai Floor Transition.Dense pack cellulose 0 0.00 W.S.&bat Hatch R-19/Q-Lan or= 0 0.00 W.S.&bat Hatch R•30/Q-Lon or= 0 0.00 Kneewall R-12 cell behind Per.Memb 0 0.00 Open Rafter R-20 Cell.1w poly 0 0.00 Open Rafter R-30 Celt./w poly 0 0.00 Basement Overhead R-19 fiberglass 0 0.00 Basement Overhead R-30 fiberglass 0 0.00 Crawlpace Overhead<4'high R19 0 0.00 Crawlpace Overhead<4'high R30 0 0.00 Garage Ceiling cavity filled w/cellulose 600 1200.00 SEAL AREA NEXT TO BEAM IN GARAGE Wood,Shake,Clapboard,Shingles Vinyl 1168 1985.60 Asbestos(single nail)/Asphalt 0 0.00 Asbestos(doub.Nail)/Aluminum 0 0.00 Brick/Stucco 0 0.00 Vinyl over Asbestos 0 0.00 Multi-layered 3 or more layers 0 0.00 Drill rough plaster or finish wood plug 0 0.00 Drill finish plaster 200 362.00 Test Drift Walls(all 4) 0 0.00 SUBTOTALS 6066.60 2.INSULATION TOTAL 2A.+2B. 6242.60 3.STORM WINDOWS/DEADLITES -:;AUDITQRNOTES Plexiglass up to 88 u.i. 0 0.00 Additional per UI over 88" 0 0.00 Other(Negotiated Price) 0 0.00 SUBTOTALS 0.00 6.OTHER MATERIAL .... .: AUDITOR'NOTES:;; Ridge vent In ft. 0 0.00 Vents Gable rectangular 0 0.00 Varipitch Vent 0 0.00 Vent Roof 135(1 sq ft NFV)Large 0 0.00 Vent Roof 865(A sq ft NF1/)Small 0 0.00 Vent Soffit Round 0 0.00 Vent Soffit Rectangular 0 0.00 Turbine Vents All 0 0.00 Stack Vent 0 0.00 Propa Vent 0 0.00 Permable House Wrap 0 0.00 Vapor barrier 0 0.00 Energy Star R-4 Rigid Vlnyl Repl to 73"U.I. 0 0.00 Energy Star R-4 Rigid Vinyl Repl 74-84"U.I. 0 0.00 Energy Star R-4R1gid Vinyl Repl 84-93"U.I. 0 0.00 Energy Star R-4 Rigid Vinyl Repi 94-101 U.I. 0 0.00 SUBTOTALS 0.00 6./7.E.C.MATERIAL/LABOR 5938.10 Page 3 8a. HEALTH&SAFETY .AUDlTOkkOTES Vent Bath/KAchen Fan 0 0.00 Dryer vent w/exhaust duct Heartland 0 0.00 Dryer Transition Duct only 1 38.00 Blower Door Test Pre Post 0 0.00 SUBTOTALS 38.00 _ 8b.REPAIR MATERIAULABOR AUDITbR NOTES' Basement outside door only 0 0.00 Basement outside door w/jambs 0 0.00 Door Repl pre hung 32-36"Steel" 0 0.00 Door Rep)Interior solid core 28-32" 0 0.00 Door Repl pre hung 32-36"wood" 0 0.00 Window Replacement w/SIR less than i 0 0100 Basement Window Repl.Awning/Hopper 0 0.00 Basement Window Repl.With a frame 0 0.00 Lockset(door)Schlage or equal 0 0.00 Repair/Refit Door 0 0.00 Replace Side Stop 0 0.00 Replace Casing 0 0.00 Glass Replacement to 64 0. 0 0.00 Glass Replacement per u.i.over 64 0 0.00 Sash Sidelock/Top Replacement 0 0.00 Threshold(Wood) 0 0.00 Threshold(Aluminum) 0 0.00 Slide Botts 0 0.00 Plug Plate Cover 0 0.00 Cut/finish attic-kneewall access 0 0.00 Cut/close atfic-kneewall access 0 0.00 Labor Rate Hours 4 240.00 SOFFIT RIP-GARAGE OVERHEAD REPAIR Permits/Fees(Wap only) 0 0.00 SUBTOTALS 240.00 TOTAL REPAIR+HEALTH&SAFETY 278.00 GRAND TOTAL WORK ORDER# (A) 3956 6216.10 Any alterations or deviations from the above specifications involving extra costs must be cleared in writing before installation. The Work Order must be complete within 15 working days from acceptance date below: CONTRACTORICOMPANY: A& M ACCE PTANCE:Com pany/Contractor AUTHORIZED SIGNATURE: Date AGENCY APPROVALS: CTI Authorized Signature: Date GLCAC Authorized Signature: Date