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11A-031 (5)
I I LEONARD ST BP-2021-0978 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 11A-031 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2021-0978 Project# JS-2021-001679 Est.Cost: $3000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOMEWORKS ENERGY INC106148 Lot Size(sq. ft.): 10367.28 Owner: ROSEN JEFFREY Zoning: URA(100)/ Applicant: HOMEWORKS ENERGY INC AT: 11 LEONARD ST Applicant Address: Phone: Insurance: 357 COTTAGE ST (781) 205-2595 () WC SPRI NGFI ELDMA01104 ISSUED ON:3/8/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATION/WEATHERIZATION POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF II RT,1=• MPTTNU4i r VIOLATION OF ANY OF ITS RULES AND REGULATIONS. , . , 'a . I � Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 3/8/2021 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner FEE: $65.00 o sHRMpro City of Northampton, DepFOR `; . ":. Building Department R�'`-�, 212 Main Street r.---_,-, /,...--;;--iNsuLATIoN` r ^,, ,l.,�c„1- Room 100 / L. Northampton, MA 01060 /I4p \ rs'" phone 413-587-1240 Fax 413-587-1272 I ONL Y APPLICATION FOR INSULATION FOR A ONE OR'TWai4iI Y7DWELL.ING ONLY SECTION 1 -SITE INFORMATION INSULA TION PERMIT 1.1 Property Address: This section to be completed by office Map ( ( 4 Lot O 31 Unit 11 Leonard Street Northampton Massachusetts 01053 Zone Overlay District Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Jeff Rosen 11 Leonard Street Northampton Massachusetts 01053 Name(Print) Current Mailing Address: See Attached (413)336-4890 Telephone Signature 2.2 Authorized Agent: Adam Glenn 357 Cottage Street, Springfield, MA 01104 „tyes_. Name(Print) caL as ; - " Current Mailing Address: 781-205-4484 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 3000.00 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) Cc 5. Fire Protection 1. 6. Total = (1 + 2 + 3 +4 + 5) 3000.00 Check Number 5` �7 This Section For Official Use Only Building Permit Number: ✓ 9 .6 Date / Issued: Signature: 1//72 '3- 8 ZO1 Building Commissioner/Inspector of Buildings Date wxpermitting @ homeworksenergy.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 4-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder:Adam Glenn 106148 License Number 357 Cottage Street, Springfield, MA 01104 07/30/2022 Addres � Expiration Date 781-205-4484 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 HomeWorks Energy 181138 Company Name Registration Number 357 Cottage Street, Springfiel MA 01104 03/02/ zc?Y Address caL sii-)01av Expiration Date Telephone 781-205-4484 SECTION 5-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 n No 0 Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 504791 Adam Glenn , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Adam Glenn Print Name GA44 c000t.i.v. cet,‘...._ 03/02/2021 Signature of Owner/Agent Date I Jeff Rosen , as Owner of the subject property hereby authorize HomeWorks Energy to act on my behalf, in all matters relative to work authorized by this building permit application. See Attached 03/02/2021 Signature of Owner Date City of Northampton OYMAM/'TO.. Massachusetts �2S.S...i sic!` ( DEPARTMENT OF BUILDING INSPECTIONS \ .r " 'w ,°.. 212 Main Street • Municipal Building yv`._ \,!o Northampton, MA 01060 sdh `moo AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC, that entity must be registered Type of Work:Weatherization Est. Cost:3000.00 Address of Work: 11 Leonard Street Northampton Massachusetts 01053 Date of Permit Application: 03/02/2021 I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 03/02/2021 Adam Glenn 181138 Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature �sr' City of Northampton E‘ ),r Massachusetts �? ' !<< DEPARTMENT OF BUILDING INSPECTIONS ; ` C :* ,, 4iF jt > 212 Main Street •Municipal Building `. -C� Northampton, MA 01060 ASV `1/40 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 11 Leonard Street Northampton Massachusetts 01053 (Please print house number and street name) Is to be disposed of at: McNamara Waste Services LLC, 24 E Longmeadow Rd, Hampden, MA 01036 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) 644A �.6 03/02/2021 Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. Y� 7To City of Northampton SN5 Massachusetts c�� *- :z � DEPARTMENT OF BUILDING INSPECTIONS ti 212 Main Street • Municipal Building Jtif `NC$ Northampton, MA 01060 sNY 3' ' MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: Contractor Name: HomeWorks Energy Address: 357 Cottage Street City, State: Springfield, MA 01104 Phone: 781-205-4484 Property Owner Name: Jeff Rosen Address: City, State: Adam Glenn (contractor) attest and affirm that the building I intend to insulate does not have any open air (knob and tube)wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. Contractor signature Date 03/02/2021 The Commonwealth of Massachusetts i _ _„ 1, Department of Industrial Accidents ,•t�ATM I Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.gov/dia UP Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information r r Please Print Legibly Name (Business/Organization/Individual): Address: 357 COTTAGE STREET City/State/Zip: SPRINGFIELD, MA 01104 Phone#: 781-205-4484 Are you an employer?Check the appropriate box: Type of project(required): 1 am a employer with 500 employees(full and/or part-time).* 7. ❑New construction 2. 'am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself [No workers'comp.insurance required.] 10 ❑Building addition 4.n 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 11.[1] Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.ri I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp. insurance.: 13. Roof repairs 14 ther WEATHERIZATION 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors 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: NH Employers Insurance Company Policy#or Self-ins. Lic. #: #4001017 Expiration Date: 1/1/2022 Job Site Address 11 Leonard Street Northampton Massachusetts 01053 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 and the pain and enaltie 9ury that the information provided above is true and correct. �' Signature_ """`0, " -- - Date: 03/02/202 1 Phone#_781-205-4484_// wxpermitting@homeworksenergy.com 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#: /......,N HOMEENE-01 LLARIVIERE AC'ORO CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) km.-- CERTIFICATE 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 Lisa Lariviere NAME: Foster Sullivan Insurance Group,LLC PHONE FAX 163 Main Street (A/c,No,Eat): (978) 686-2266 3011 (A/c,No):(978)686-6410 North Andover,MA 01845 E-MAIL ADDRESS: g p certificates fostersullivan rou com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Markel Insurance Company 38970 INSURED INSURER B:Safety Insurance Company 39454 Homeworks Energy,Inc INSURER C:McGowan Excess&Casualty 551155 Homeworks IIC LLC 101 Station Landing Suite 100 INSURER D:NH Employers Insurance Company 13083 Medford,MA 02155 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 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 NUMBER POLICY EFF POLICY EXP LJMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR MKLVIPBC001429 1/1/2021 1/1/2022 DAMAGETORoccur 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident) $ ANY AUTO COM5915393 1/1/2021 1/1/2022 BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $_ X AUTOS ONLY X NON-OWNEDUUT PROPERTY accidentDAMAGE $ $ C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESSLIAB CLAIMS-MADE MQSX00007091-01 1/1/2021 1/1/2022 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ D WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ECC-600-4001017-2021A 1/1/2021 1/1/2022 E.L.EACH ACCIDENT $ 1,000,000 FFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,UOU If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Pollution Liability CPLMOL105056 1/1/2021 1/1/2022 $10,000 Deductible 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Homeworks EnergyInc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 101Station Landing Ste 100 Medford,MA 02155 AUTHORIZED REPRESENTATIVE • I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD . 7,' Yr„ i,eti � �i r,,,//Af/ , . //e/4.,•ir,%i,f//i Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Nome Improvement Contractor Registration Type Corporation Registration 181138 HOME WORKS ENERGY.INC. Expiration 03i0212021 101 STATiON LANDING STE 110 MEDFORD,MA 02155 Update Address and Return Card. Wise et Can sums**Wail A B„iirees ReOula'b^ R .Mrebon valid lOf I d Wuat use only r �C 0/Putmerallair &Businese,Jellt HOME IMPROVEMENT CONTRACTOR Office m Consumer Affairs&Business Regulation TYPE.Cratioai,m` Wore the expiration Ogee. H found return to HOME IMPROVEMENT CONTRACTOR HIMEEIMKI r Office of Consumer ANans and Guiltless Regulation TYPE:Supplement Card # 151 136 03,CCr202' 1009 Was Sirs&/-Suite 710 ilataktration Exylriujgj ti nit)mE wectitS ENERGY.INC tloston.M 0271 181138 03/02/2021 HOME WORKS ENERGY,INC. I 101xSTATG O(.AkDING STE 110 �— valid without signature ADAM GLENN NR,OFORp MA 22155 Underserfelfiry tot SIATION LANDING STE 110 y ..e,,i, .,•G;`d" MEDFORD,MA 02155 Undersecretary Commonwealth of Massachusetts Construction Supervisor Specialty Illi Division of Professional Licensure Restricted to: Board of Building Regulations and Standards CSSL-C-Insulation Contractor Constr uctiq ttiptMV r Specialty CS S L-1061 s8 ftpires;07/30/202 2 it 17 ADAM GLENN 19 CHARGE POUND RD ''. WAREHAM MA 02571 `1 ♦oics-4 4.5 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license, CommissionerCAL For information about this license Cali(617)727-3200 or visit www.mass.govidpl Insulation/Air Sealing Permit Authorization rO \� � Specialist: Kevin Pomerleau Company: HomeWorks Energy rI Ill J Email: kevin.pomerleau@homeworksen' Address: 101 Station Landing HomeWorks Cell: 774-991-2643 Medford, Ma 02155 'Y Phone: 781-305-3319 Customer: Jeff Rosen Address: 11 Leonard St Email: jfrosen@aol.com Northampton Site ID: 504791 Phone: 413-336-4890 I, the owner of the property identified above hereby authorize HomeWorks Energy Inc., or their Partner to act on my behalf in obtaining any building permit that maybe required to perform insulation and/or Weatherization work on my property and all matters related to the work authorized by said permit if one is obtained. Any related permit application cost will come at no additional charge provided that the agreed Weatherization work is completed. In the event that a permit is pulled on your home for insulation and/or weatherizotion work, you may be required to have a final inspection scheduled and performed on the work by the building inspector in your town. If this case relates to your job, you will be notified by Home Works Energy that an inspection is necessary and you will be given the proper steps on how to complete this process to close out your permit. Email Customer Signature: Date: 7/7/2020 Jeff Rosen PLAN VIEW 3 Name: Jeff Rosen Site ID: 504791 Finished Sq. Ft: 1512 S Phone: 413-336-4890 Year of House: 1976 Electric Acct#: 7, Address: 11 Leonard St # of Floors: 2 Gas Acct#: Northampton Unit#: # Occupants: Housing Type?cape DUCTWORK INSPECTION Ducts Insulated?❑ Duct Linear Ft. 50' Duct Square Ft. Duct Air Sealing Hours Duct Insulation 15' Duct Insulation Removal BASEMENT INSPECTION 24, finished Existing Spec'ing Ln/Sq. Ft. 12' Bsmt Wall AG 9, Crawl Ceiling 9" FGB 2"poly 180 Crawl Rim Joist Bsmt RJ w/Sill Bsmt RJ NO Sill 38 Vapor Barrier sqft. Bsmt Door Y/N Blower Door? WALLS&GARAGE Drill Location? Siding Ceil. Height Existing Spec'ing Sq. Ft. Framing Exterior Wall 1 3" FGB x x Balloon/Platform Exterior Wall 2 x x Balloon/Platform Overhang x x Garage Wall x x Balloon/Platform Garage Ceiling x x 0 z s uJ I- Insulation Removal Sgft. Sweeps: WX Stripping: WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawlspace Other: K &T Y/N Moisture Y/N Combustion Sfty Y/N Kneewall Overhang/Garage Asbestos Y/N Mold>100 sq. ft Y/N CO Detector Missing Y/N Ductwork Exterior Walls Vermiculite Y/N Structl Concerns Y/N Other: Notes for Lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? ❑ OR KW SLOPE AND GABLE END Blind Spec? H J Why? Why? existing FRAMING EXISTING SPEC'ING SO.FT. FRAMING EXISTING SPEC'ING SQ.FT. WALL X X SLOPE 2 X 6 x16., 6" poly .38U FLOOR x x GABLE 2 x 4 x16 4" poly ,49 ,O ACCESS X TRANS 2 x6 x16 0 AS 38 z .- TRANS X X ATTIC of D J ATTIC SLOPE X X SLOPE X x EXISTING VENTING? 5 EXISTING VENTING? EXISTING PIPES? Y/N rrnn 7 ' flip + slash FGB 429sqft KW Venting Vent BF BF Hose Damming Sheathing Access Temp Access 7' KW Venting Vent BF Temp Access R R KNEEWALL MANDATORY l7 2 Q tr 0 o6 U a 10' 38' Insulated Wall X X Rec'd Light 0 Ins.Hose I BF I Vent BF IBFV I Chlm.ICH l Damming 12"Roof V t(2RV) BAS Air Handler IAH I Temp Access I T I Pull Down 'DSI Hatch El Wall Hatch H/ Door o/ 8"Roof Vent RV - Vol: x .0058 X x ATTIC 1 Blind Spec? ❑ x x ATTIC 2 Blind Spec? ❑ x r story) 119s.a(1(2 smryl l - z Existing Spec'ing Sq ft Existing Spec'ing Sq ft 13.6(3story) o Multipliers E Unfloored Unfloored Trusses Cross Batting a Floored Floored i d Insulation Duct Work - oose No Cath Slope Cath Slope U Air Sealing Hours Walls Walls Access Access 1 t Venting Propavents Vent BF BF Hose Damming ^ Venting Propavents Vent BF BF Hose Damming 110 v, WHF Box: ;_ Temp Access: C L a Sheathing Access: vs to R.L.Covers: Sq.Ft/300= - (Exist.NFA Vent-mg). (Needed Sq.Ft/300= - (Exist.NFA Venting)= (Needed Existing Venting? NFA Venting) Existing Venting? NFA Ven ngl Roof Type: HomeWorks Energy Err l I l 101 Station Landing,Medford,MA 02155 CONTRACT - WZ works 781-305-3319 FAX 0 Energy,Inc Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT# WORK ORDER Jeff Rosen (413)336-4890 01/11/2021 504791 60003 SERVICE STREET BILLING STREET PROPOSED BY: 11 Leonard Street 11 Leonard Street HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Leeds, MA 01053 Leeds, MA 01053 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 100%2020 For a limited time, Columbia Gas is offering an incentive of 100%on qualifying weatherization measures. This contract must be signed and returned within 30 days and the weatherization must be installed by June 30, 2021. FLIP/SLASH/FIX EXISTING INSULATION 429 $107.25 $0.00 $107.25 Slash the vapor barrier,flip, or re-position insulation in the attic area. KNEEWALL- RIGID BOARD 380 $1,504.80 $1,504.80 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to a kneewall area. KNEEWALL- RIGID BOARD 49 $194.04 $194.04 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to a kneewall area. HomeWorks Energy Ir4 t l 101 Station Landing,Medford,MA 02155 CONTRACT - WZ H« ,Al_J__ 781-305-3319 FAX 0 Energy,Inc Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT S WORK ORDER Jeff Rosen (413)336-4890 01/11/2021 504791 60003 SERVICE STREET BILLING STREET PROPOSED BY: 11 Leonard Street 11 Leonard Street HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Leeds, MA 01053 Leeds, MA 01053 DESCRIPTION QTY COST INCENTIVE TOTAL TRANSITIONS-OPEN 38 $259.92 $259.92 Provide labor and materials to air seal the open kneewall transitions of your home against wasteful, excess air leakage. Total: $2,066.01 Program Incentive: $1,958.76 Customer Total: $107.25 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Hundred Seven &25/100 Dollars $107.25 COMPANY REPRESENTATIVE CUSTOMER SIGNATURE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE 01/13/2021 SIGN DATE DAYS. 3 C a tsK oca state ma.usitliC to .stefiRegttst �} * • ..: 4,:�t • .,.,.-�,' + is truce.I;e.ym:r , Ma:•Adam ut..•el- Q Rne frq:7een*`rj- M 'Rao-tit -edam{it ® Itivisr Dar.*,mt- a Sepik-it•Hnmr'N j Th,s n a,Om aov<n,0•u! •a i.v.s'rw.e•rt.N K•ssatrv.sertr •lane 11•O ^I11111111400. Woo al Ca a rn YTa,.•s s,...•,ea nwo,.v+m 1• Certrac•C weprn. My Registrations • YGur company Rer/siratlGnS 41•16.0f Appk;ations with trier statuses ale displayed to the 1st bete e • To manage or view any Registration.c&wck on the ayppropnale Task button • To regialet a new company as a Manx Improvement Contractor,rack the Start New Appaoabon button. Contractor Name NIC Number Registration Status Effective Date Expiration Date Applicat on Type Application Status Create Date Task NOW WORKS ENERGY,INC.181t3e Active 0343r2019 03.022021 Renewal Registatton Issued 0210.2019 HOME WORKS ENERGY.INC 16t138 Eepaed 03a03120t7 03102r2019 Renewal Regtstrabon tssuea 03102,2017 MOW WORKS ENERGY,INC 181138 Expred 0343,2015 03102,2017 InilialAppbcatton Regtseatwn ttsued 03422015 '. , 2021 Commonwealth of Massachusetts