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32A-016 BP-2023-0111 9B WALNUT ST UNIT 9B COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-016-002 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-2023-0111 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 1000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date: 07/30/2024 Use Group: Owner: S SHIELDS, ALEXANDER M &MICHAEL Lot Size (sq.ft.) Zoning: URC Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 781-205-4484 ECC-600-4001017-2022A STOUGHTON, MA 02072 ISSUED ON: 01/31/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/W EATH ERI ZATI ON 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: I qrtA, Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner City of Northampton DepFOR qN= L Building Department 3 212 Main Street T ° INSULATION .a t Room 100 Northampton, MA 01060 Q" '�,„No/A,,, f" phone 413-587-1240 Fax 413-587-1272" ONLY 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 Lot Unit 9 Walnut Street Northampton MA 01060(Unit1) Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Blaire Shields 9 Walnut Street Northampton MA'01060(Unit1) Name(Pent) Current Mailing Address: See Attached (603)325-3251 Telephone Signature 2.2 Authorized Agent: Adam Glenn 235 Essex Street, Whitman, MA 02382 Name(Print) 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 1 ,000 (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 +2+3+4+5) 1,000 Check Number This Section For Official Use Only Building Permit Number: 1V--- 3 ��� Date Issued: Signature: /7/2 /- J' /-Z6Z-5 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 D Name of License Holder:Adam Glenn 106148 License Number 235 Essex Street, Whitman, MA 02382 07/30/2024 Addre S Expiration Date 781-205-4484 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ HomeWorks Energy 181138 Company Name Registration Number 235 Essex Street, Whitman, MA 02382 03/02/2023 Address Expiration Date C,-141"(4 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 [ j No 0 Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 522780 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 r_4(A. 1/27/2023 Signature of Owner/Agent Date Blaire Shields , 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 1/27/2023 Signature of Owner Date City of Northampton H M 0- O tf t oy �.N5 si, Massachusetts ��, ,, fl � � DEPARTMENT OF BUILDING INSPECTIONS atJx '" ,w �` 212 Main Street • Municipal Building D` f. M y Northampton, MA 01060 ss'Ily -1'‘���� 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:9 Walnut Street Northampton MA 01060(Unit1) Date of Permit Application: 1/27/2023 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.C.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: 1/27/2023 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 Af,? *� 'l�� «t • t• 1 DEPARTMENT OF BUILDING INSPECTIONS ) 212 Main Street •Municipal Building Northampton, MA 01060 SNjti �� 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: 9 Walnut Street Northampton MA 01060(Unit1 ) (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) ca4A ,g;fil " 1/27/2023 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;,,.,i City of Northampton r. ti 'x Massachusetts '')Pr r : 4 �,, v'jl ^ ., DEPARTMENT OF BUILDING INSPECTIONS [ 212 Main Street fibMunicipal Building , 1i, . Northampton, MA 01060 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 9 Walnut Street Northampton MA 01060(Unit1 ) Contractor Name: HomeWorks Energy Address: 235 Essex Street City, State: Whitman, MA 02382 Phone: 781-205-4484 Name:Property Owner Blaire Shields Address: 9 Walnut Street Northampton MA 01060(Unit1 ) 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 Cdia4 c5_441:4?) ce,Se— , Date 1/27/2023 The Commonwealth of Massachusetts Department of Industrial Accidents 9: .'---2-1M0 Office of Investigations Lafayette City Center 2 Avenue de Lafayette,Boston,MA 02111-1750 "" 4-7w ww mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Homeworks Energy — Address: 235 Essex Street City/State/Zip:Whitman,MA 02382 Phone#: 781-205-4484 Are you an employer? Check the appropriate box: Type of project(required): 1.IN I am a employer with 500+ 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' insurance. 9. ❑ Building addition [No workers' comp.comp. insurance required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3 Q officers I am a homeowner doing all work have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.M Other Weatherization 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: Federated Mutual Insurance Company Policy#or Self-ins. Lic.#:#1847910 Expiration Date: 1/1/2024 Job Site Address:9 Walnut Street Northampton MA 01060(Unit' 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 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 and r the pains and pe s of perjury that the information provided above is true and correct. Signature: j;,(4 Date:1/27/2023 Phone#: 781-205-4484 Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department laity/Town Clerk 4. 0 Electrical Inspector 5.Qlumbing Inspector 6.0Other Contact Person: Phone#: 15 '4CoRo E(MNI/DEVYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/302022 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 POUCIES 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 NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE X HOME OFFICE: P.O.BOX 328 (A/C,No.Est):888-333-4949 (AA/C,NW:507-446-4664 OWATONNA,MN 55060 E-MAIL DD LESS:CLIENTCONTACTCENTER@FEDINS.COM INSURERISI AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 419-899-0 INSURER B: HOMEWORKS ENERGY,INC. INSURER C: 101 STATION LNDG MEDFORD,MA 02155-5134 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:0 REVISION NUMBER:1 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 LTR INSR WVDIMM!DDIYYYY) UAMIDO/YYYYI LIMITS X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $1,000,000 CLAIMS-MADE I X OCCUR DAMAGE TO RENTED —.._.- _.._ $100.000 PREMISES(Ea occurrence) MED EXP(Any one person) EXCLUDED A N N 1847909 01/01/2023 01/01/2024 PERSONALS ADV INJURY $1,000,000 Ain AGGREGATE UNIT APPUES PER: GENERAL AGGREGATE $2,000,000 X POLICY JECT I LOC PRODUCTS-COMP/OP AGO $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 IEe sodden') X ANY AUTO BODILY INJURY(Per person) A OWNED AUTOS ONLY AUTOSULED N N 1847908 01/01/2023 01/01/2024 BODILY INJURY(Per accident HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIAB CLAIMS-MADE N N 1847911 01/01/2023 01/01/2024 AGGREGATE $1,000,000 DED j RETENTION WORKERS COMPENSATION X 'PER STATUTE' I ER AND EMPLOYERS'LIABILITY y/N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $500,000 A OFFICER/MEMBER EXCLUDED? NIA N 1847910 01/01/2023 01/01/2024 ---- ----- - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $S00A00 If yes,describe under ' DESCRIPTION OF OPERATIONS below EL DISEASE-POUCY LIMIT 55�,0(p DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space rs required) THIS COPY IS NOT TO BE REPRODUCED FOR ISSUANCE OF CERTIFICATES. CERTIFICATE HOLDER CANCELLATION 01 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN A CERTIFICATE HAS BEEN FILED WITH EACH OF YOUR CERTIFICATE ACCORDANCE WITH THE POUCY PROVISIONS. HOLDERS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2018/03) The ACORD name and logo are registered marks of ACORD / fi //1 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 181138 HOME WORKS ENERGY,INC. Expiration: 03102/2023 101 STATION LANDING STE 110 MEDFORD,MA 02155 Update Address and Return Card. SCA 1 0 20M-05117 .. ..... .... .. / Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Ripiatratioo Eicoira(ian Office of Consumer Affairs and Business Regulation 181138 03102.2073 1000 Washington Street •Suite 710 HOME WORKS ENERGY,1NC. Boston,MA 0211E ADAM GLENN 101 STATION LANDING STE 110 MEDFORD,MA 02155 Undersecretary Not valid without signature Commonwealth of Massachusetts Construction Supervisor Specialty Division of Occupational Licensure Restricted to Board of Budding Regulations and Standards CSSL4C •Ins ulation Contractor Conti tructic t'IIi�u r Specialty •$`` , ». 4 CSSL•1061 d8 eipires: 07130/2024 ADAM GLENN r 19 CHARGE ' e WAREHAM MA I :% Failure topossess a current edition of the Massachusetts rjt,tvd'zi) State Building Code is cause for revocation of this license. For information about this license Commissioner add �' d ` Cati(61T)T2T4200 or vise wwN.rnass.gov+dp Insulation/Air Sealing Permit Authorization Specialist: Abel Silva Company: HomeWorks Energy Email: abel.silva@homeworksenergy.com Address: 101 Station Landing Cell: 4138246686 Medford, Ma 02155 Phone: 781.305.3319 Customer: Alex Shields Address: 9 Walnut Street B Email: lara_shields@MAC.com Northampton, MA,01060 Site ID: 522780 Phone: 7734944243 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: lara shields@MAC.com Customer Signature: Date: 11/30/2022 Alex Shields 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. ,",_.,u. 'j. v;` .r • , y! i i . 4 , a F to F � MULTI-FAMILY PLAN VIEW w Name: 69144z '-, Site ID (Unit 1): 5 7 7 Q Finished Sq. Ft: 715`r 4 Floors: I z Phone: Site ID (Unit 2): Year Built:!7cc Occupants: I g Address: 111.-,tvju r` Site ID (Unit 3): Housing Type? Oe- (f z l ,. 7, Site ID (Unit 4): '' Electric Acct# (unit 1): Electric (2): Electric (3): Electric (4): Gas Acct# (unit 1): Gas (2): Gas (3): Gas (4): BASEMENT INSPECTION / • Unit EXISTING SPEC'ING LN/SQ. FT. 3/6 ` X 6 rawl Ceiling 'i rawl Rim Joist Bsmt R1 [1( /{ 1, /j tl S /if apor Barrier sqft. Bsmt Door t t w H a m fY f 7 A/s I1 0 PC)11 PIG SSII 5/i S r "Y/N Blower Door? WALLS&GARAGE Drill Location? Unit SIDING CEIL. HEIGHT EXISTING SPEC'ING SQ. FT. Exterior Wall 1 ( V,, -d I F6 r2 _�. Framing Exterior Wall 2 q t ( (Svj x x Ba loon/Platform Exterior Wall 3 f x x Ba loon/Platform Exterior Wall 4 x x Overhang x x Balloon/Platform Garage Wall x x Garage Ceiling w. 0 H -114 f z c CC 0 IC. � Z WORK SPEC'D BUT NOT CONTRACTED Insulation Removal Unit: 1 2 3 4 Attic Basement/Crawlspace Other: Unit: SQ.FT. Sweeps: Z. Kneewall Overhang/Garage Ductwork Exterior Walls WX Stripping: Li' ROAD BLOCKS PRESENT?(MANDATORY) Unit 1 2 3 4 Unit 1 2 3 4 Unit 1 2 3 4 K&T Y/ Y/N Y/N Y/N Moisture Y/ Y/N Y/N Y/N CombustionSfty Y/ Y/N Y/N Y/N Asbestos Y/ Y/N Y/N Y/N Mold>100 sq.ft Y/ YIN Y/N Y/N CO Detector Missing Y/ Y/N Y/N Y/N Vermiculite Y/ Y/N_Y/N_Y/N Structt Concern ,Y/ Y/N Y/N YIN Other(indicate unit) Notes: KW WALL AND KW FLOOR Blind Spec? OR si.. KW SLOPE AND GABLE END Blind Spec? — Why? Unit: Why? Unit:t FRAMING EXISTING SPEC INC SQ.FT FRAMING EXISTING SPEC'ING SQ.FT. WALL x x SLOPE X X FLOOR X X GABLE X X fic vs (O ACCESS_ X 'TRANS x x m u- TRANS X X ATTIC p ATTIC SLOPE x X P SLOPE x x EXISTING VENTING? Z EXISTING VENTING? EXISTING PIPES? Y/N m ..,.,; .,,.,.•L. 'emp Access xv4 or r BF Hove Damming SUealh,ng Access Te 't C i IS n v KNEEWALL MANDATORY fi- ,• r, ;,,, -"" cc(' (A .1 it 1.-- I on v_ a DUCTWORK INSPECTION Ducts Insulated? Duct Linear Ft. Duct Insulation Duct Square Ft. Duct Insulation Removal Duct Air Sealing Hours Unit: x x ATTIC 1 Blind Spec? x x ATTIC 2 Blind Spec? Air Sealing Multipliers Unit: EXISTING SPEC'ING SQ. FT Unit: EXISTING SPEC'ING SQ. FT. Hours Unfloored Unfloored Unit iI I Trusses o Floored Floored Mixed Insulation wE Cath Slope Cath Slope >6"Loose Unit Walls Walls Cross Batting 2 WHF Box Access u Access Unit: / Sheathing Access Unit: a Venting PropaventS Vent BF BF Hose Damming Venting opavents Vent!iF BF Hose Damming R.L.Covers Unit: c c / Temp Access Unit: ya a.; Roof TYpej� ,•- j., N sr: 1 t HomeWorks Energy °r� r� r t I lam' 101 Station Landing,Medford,MA 02155 55 CONTRACT - AUDIT wow 781-305.3319 fNIG'^hra+,;w- Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT! WORK ORDER Alexander Shields (603) 325-3251 11/30/2022 522780 00001 SERVICE STREET BILLING STREET PROPOSED BY: 9 Walnut Street 9 Walnut St HomeWorks Energy SERVICE CITY.STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL HOME AIR SEALING 1 $94.33 $94.33 Seal areas of your home against wasteful, excessive air leakage. Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics, basements,attached garages and other unheated areas (windows are not generally addressed.) WEATHERSTRIP AND ADD DOOR SWEEP 2 $115.84 $115.84 Provide labor and materials to install Q-lon weatherstripping and a doorsweep to door(s)to restrict air leakage. BASEMENT SILLS-RIGID BOARD INSULATION 118 $512.12 $512.12 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. HomeWorks Energy r fl l 101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT HomeWorks 781-305-3319 Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT N WORK ORDER Alexander Shields (603)325-3251 11/30/2022 522780 00001 SERVICE STREET BILLING STREET PROPOSED BY: 9 Walnut Street 9 Walnut St HomeWorks Energy SERVICE CITY,STATE.ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATE BULKHEAD DOOR 1 $68.83 $68.83 Provide labor and materials to insulate the back of the door to the basement's bulkhead with rigid board. Total: $791.12 Program Incentive: $791.12 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/ Dollars $0.00 lhh durrL 3"/z:add, COMPANY REPRESENTATIVE CUSTOMER SIGNATURE 01/16/2023 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE DAYS.