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43-167 (5) BP-2022-0577 428 WESTHAMPTON RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 43-167-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0577 PERMISSIONIS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 1000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date:07/30/2022 Use Group: Owner: HARVILL-CORREA, JANA & CORREA,IVAN E Lot Size (sq.ft.) Zoning: WSP Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 7812054484 ECC-600-400 1 0 1 7-202 1 A STOUGHTON, MA 02072 ISSUED ON:05/23/2022 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: • Fees Paid: S65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $65.00 ,<CP' City of Northampton , \ ' DePFOR y l Building Department c� �y A g• 212 Main Streeto4 o INSULATION ' . . 4 Room 100 y*7 �%� `-C c' Northampton, MA 01016u phone 413-587-1240 Fax 413-58742 -2 L Y ,07.,_,..\ so 0, , APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT This section to be completed by office 1.1 Property Address: Map 4/.3 Lot / 0 2 Unit 428 Westhampton Road Northampton Massachusetts 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Jana Harvill-Correa 428 Westhampton Road Northampton Massachusetts 01062 Name(Print) Current Mailing Address: See Attached 775-360-9857 Telephone Signature 2.2 Authorized Ascent: Adam Glenn 59 Tosca Drive Stoughton, MA 02072 Name(Print) czy;raV Current Mailing Address: ca44781-205-4484 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 1 ,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee . ti4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) 1,000 Check Number 634 This Section For Official Use Only tjp_ aa- 5- 7 7 Date Building Permit Number: Issued: Signature: �2 5- Z. 2022 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 59 Tosca Drive Stoughton, MA 02072 07/30/2022 AccalnaL o Expiration Date C)soei/� 781-205-4484 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 HomeWorks Energy 181138 Company Name Registration Number 59 Tosca Drive Stoughton, MA 02072 03/02/2023 Address Expiration Date Ca S3eid 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 I I No 0 Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 4462873 I, 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 cdian 5/16/2022 Signature of Owner/Agent Date l Jana Harvill-Correa 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 5/16/2022 Signature of Owner Date City of Northampton -0. HAMc�,0 Y 55,... s.Cl r• Massachusetts �4t.` 1.- << ' ., s - 4 177 r ', t DEPARTMENT OF BUILDING INSPECTIONS e. 212 Main Street • Municipal Building svh cD, 'n° '" Northampton, Mk 01060 'PS'bJy � 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: 1 ,000 Address of Work:428 Westhampton Road Northampton Massachusetts 01062 Date of Permit Application: 5/16/2022 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: 5/16/2022 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 City of Northampton Massachusetts r,. M DEPARTMENT OF BUILDING INSPECTIONS 7 ,4 212 Main Street •Municipal Building ., Northampton, MA 01060 rsbyy ar)��`�� 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: 428 Westhampton Road Northampton Massachusetts 01062 (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) 5/16/2022 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. City of Northampton I ; Massachusetts • Tf DEPARTMENT OF BUILDING INSPECTIONS yJ '3►r •.s 212 Main Street • Municipal Building _✓�0P Northampton, MA 01060 9I7‘ MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 428 Westhampton Road Northampton Massachusetts 01062 Contractor Name: HomeWorks Energy Address: 59 Tosca Drive City, State: Stoughton, MA 02072 Phone: 781-205-4484 Property Owner Name: Jana Harvill-Correa Address: 428 Westhampton Road Northampton Massachusetts 01062 City, State: I 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 5/16/2022 The Commonwealth of Massachusetts Department of Industrial Accidents .= IE = 1 Congress Street,Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): HorneWorks Fnergy Address: 59 Tosca Drive City/State/Zip: Stoughton, MA 0207.2 Phone#: 781-205-4484 Are you an employer?Check the appropriate box: Type of project(required): 111 am a employer with 500 employees(full and/or pare-tune).' 7. New construction 2.11 II 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.]t 10[]Building addition 4.❑1 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 1 LE] Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.0 lam a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 14 ther WEATHERIZATION 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§I(4),and we have no employees.[No workers'comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: NH Employers Insurance Company Policy#o r Self-ins.Lic. #:#400 1 0 1 7 Expiration Date: 0 1/0 1/2023 Job Site Address. 428 Westhampton Road Northampton Massachusetts 01062 City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation-punishable by a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and pe s of perjury that the information provided above is true and correct CaL Signature: _Date: 5/16/2022 Phone#:781-205-4484 // wxpermittingahomeworksenergy.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 A`CO'RO CERTIFICATE OF LIABILITY INSURANCE DAT1(3/202IYY) 1/3/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CIAMEACT Lisa Lariviere Foster Sullivan Insurance Group,LLC PHONE FAX 163 Main Street (A/C,No,Ext):(978)686-2266 301 1(A/c,No):(978)686.6410 North Andover,MA 01845 E-MAIL ADDRESS:certificates©fostersullivangroup.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Central Mutual Insurance Company 20230 INSURED INSURER B:NH Employers Insurance Company 13083 Homeworks Energy,Inc INSURER C:Markel Insurance Company 38970 Homeworks IIC LLC 101 Station Landing Suite 100 INSURER D: 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 LIMITS LTR INSD WVD (MMIDDIYYYYI (MMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 PRDAMAGISEES(E TO RENTEDaoccurrence) $ 300,000 EM MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY Tef LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000 _ ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ OWNED X SCHEDULEDO BODILY INJURY(Per accident) $ AUTOSRE ONLY AUTOS BODILY D X AUTOS ONLY X AUU ONLY (Perra dent) MAGE $ . $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE CXS 8698471 1/1/2022 1/1/2023 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ECC-600-4IIU1017-2022A 1/1/2022 1/1/202$ E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ "I AMMO If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ ' C Pollution Liability CPLMOL109278 1/1/2022 1/1/2023 $10,000 Deductible 1,000,000 DESCRPTION 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. 101 Station Landing Ste 100 Medford,MA 02155 AUTHORIZED REPRESENTATIVE -him ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD e.//G� /�n/� an/�tC ( /!1 /Yac4ie4 11/14 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Ra HOME WORKS ENERGY,INC Expiration: 13 23 • 101 STATION LANDING STE 110 �iration:: 03;'02 02/2 20 MEDFORD,MA 02155 • • Update Address end Return Card. SCA 1 0 2QM.O511? Wiles of Consumer Affairs&Business Reputation .HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration EERit3UQII Office of Consumer Affairs and Business Regulation 181138 0310212023 4000 Washington Street -Suite 710 HOME WORKS ENERGY,1NC. Boston,MA 021110 !,'} ADAM GLENN � CJ-'t""' 101 STATION LANDING STE 110 g i✓ •. r/fir MEDFORD,MA 02155 Not valid without signature Undersecretary Commonwealth of Massachusetts Construction Supervisor Specialty Division of Professional Licensure Restricted to: Board of Building Regulations and Standards CSSL4C .Insulation Contractor Cons tructicut.SupitiVsur Specialty CSSL•10e1s8 fpires•0760/2022 ADAM GLENN 19 CHARGE POUND RO WAREHAM MA 02571 at"'�1► i)1�►r 1it4° Facture to possess a current edition of the Massachusetts n /1 State Building Code is cause for revocation of this hcense �•r For information about this license Commissioner Call(617)727-3200 or visit www mass.govidpl Insulation/Air Sealing Permit Authorization Specialist: Michael Hathaway Company: HomeWorks Energy Email: michael.hathaway@homeworksenergy. Address: 101 Station Landing Cell: 4135882467 Medford,Ma 02155 Phone: 781.305.3319 Customer: Jana Harvill-Correa Address: 428 Westhampton Rd Email: Icorrea.md@gmail.com Northampton, MA,01062 Site ID: 4462873 Phone: 7754328437 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 weatherization work, you may be required to have a final inspection of the work scheduled and performed by the building inspector in your town. If required by the town, you will be notified by HomeWorks Energy that an inspection is necessary with instructions on how to complete this process to close out your permit. Email: lcorrea.md@gmail.com Customer l Signature: ( DaV �� Date: 4/2/2022 J a arvill-Correa "'���JJJ ���' For Condo Owners: If you have property oversight by a condo associationt, please have the association's authorized person(s) complete and sign the section below. Please email this document to wxpermitting@homeworksenergy.com once completed. We, being the duly authorized representatives of the association Name of association or management companyt or management company have reveiwed the plans and specifications for improvements to the address specified above. We further acknowledge that the above listed owner has given notice that they intend to seek permits and to carry out the proposed work. Signature of representative Date Print Name t Other unit owners may sign when there is no association. • PLAN VIEW g Name: j...vv,L4v:((--ect(ruk Site ID: ct it (2 Iik.3 1 Finished Sq.Ft 1.4 sio Phone: '11 s"-tit -'ktket'l Year of House: Electric Acct II: Address:°in 1,41(441,=.14..A.,1(..k #of Floors: . 5 Gas Acct#: !.:. ..-. Ndrst.-...p.L."1,ousblkot#: #Occupants: Housing Type7-7Armec404"1....vwif7' , - -, f- I , it . . , DUCTWORK INSPECTION Ducts insuistedt0 i i i :. . ! i i : , i - HI I. • . Aa • i ; •-•;-1•--1--- -:--!---•-• I-7--i77-7*-"-r-.-T-'-"8".1116...4- . , I : IS uct Linear Ft. 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FLOOR x x us,. 1 jo GABLE x x m . t-•'; x ••••....----' TRANS x X .•NS X x V.N i 4%.-4'•4•,,:•. f 4.54.41 HomeWork.s ATTIC ';,:,:;•1',...,.. .,,,.4.xiii. .--, fi‘i .-,-. A ' Eve x x iTrgy. .. 4...4.-_,Q:44E,4.7:;4 .... SUDPE ,- ,...!• i-..;•47-...,r4.1.f.,;..•:.- ..:1" ,...::•.•:,...-'•.', :, :-..• -..., -. •PE X X )••.•''.'i.:;1.7.;.t;•-. ..: : EXISTING VENTING? NG VENTING? I\Ihi, EXISTING PIPES?Y/N , _ . 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Ingideted Will X X Mod LW*0 ten.lloan%Vent Di '7;3 01101.1Xlimatoiri;- 1r NW ge A i'Kan li dla:El mp Amon CO Pull Crown Notch a Wan Hatch",/ Door iv r RoolMtnt 1111 Vol: x..00511 x C:'ftre4 x x ATTIC 1 - Iliad Spec? 1:3 x x • 2 alind Sp -ec? 0 15.4 12 gam) 000 fisting Spec'Ing Sq ft Existing S. ing Sq ft pony) Unfloored -i.:.'.:::..:,..<. , Unflo• - . nesellIEMILIIIIIIIIII Floored Floored - Mind Insuintion . • ..:‘ . . •6` •...-- Cath Slope ...4:i...1.-:.':::!:-..........4Y., ,.... _. Cath Slope Ait Sealilig HOW Accss ....•...47..•!•,:t.-:•e,-.;t* V'enting.:' • •.: '•• '...,- ',';,1 F Hose Damming ep 44 Vent 1.•.4:...:.••••41,i!,.... irin I - -• 7:77,i . . . '' •- ',.':••.,; - •i••.'•.;' . '...-.:: tart/300• - IttliL NRI1V00110do ed . . Sq.Ft/300. - (Ildst.NM Vended._Melded ...... 1113*raft) tink Wallas) Roof Type: Existing Ventini? Existing Venting? fl'hiC( .41, Page 1 of I (47- 410k - HomeWorks mass save ri] Energy, Inc PARTNER 101 Station Landing Ste 110,Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Jana Harvill-Correa Email: Not provided Phone:775-432-8437 Premise Address:428 Westhampton Rd, Northampton, MA 01062 Mailing Address:428 Westhampton Rd,Northampton, MA 01062 Project ID:4470669 Date:April 2,2022 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour Living Space 2 hr $185.16 $0.00 Door Sweep (with AS hrs) Living Space 9 each $227.79 $0.00 Exterior Door Weather Stripping (with AS hrs) Living Space 8 each $240.56 $0.00 Project Total $653.51 Air sealing incentive ($653.51) Total Program Incentive -$653.51 Customer Total $0.00 9 4.0„.illito, _c_a _277.te„) /g/dJ Total Contractor Price and Payment Schedule HomeWorks Energy, Inc. agrees to perform the above described work,furnishing the material and labor specified for the listed total price. Payment of the balance of the customer contribution is expected upon completion of the work. Customer Signature: Date: Customer Phone: Specialist Signature: _Date: _ LIMITED TIME OFFER: The prices and incentives in this contract are subject to change it accordance with the sponsoring utility MassSave Home Services Program offers. Proposals can be sent to:lnbox@HomeWorksEnergy.com