24C-115 (7) BP-2023-0365
144 FRANKLIN ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24C-115-001 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-2023-0365 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 5000 HOMEWORKS ENERGY INC 106148
Const.Class: Exp.Date: 07/30/2024
HAYHURST CHRISTOPHER W&JENNIFER KEFER
Use Group: Owner: HAYHURST
Lot Size (sq.ft.)
Zoning: URB Applicant: HOMEWORKS ENERGY INC
Applicant Address Phone: Insurance:
59 TOSCA DR 781-205-4484 1847910
STOUGHTON, MA 02072
ISSUED ON: 03/24/2023
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:
0 • Jf• . ' 'I •
,
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
FEE: $65.0 .13oicT 16106
,;fn rir City of NorthamptorY K7,„ ---,. ' DepFOR
!-- ''' ' Building Departme�it - ' h� ,
4' 212 Main Street q9 INS ULA TI ON
l Room 100 �,_)
k ?0,,70 ,r,
R I-I Northampton, MA 0 ,�960
'- phone 413-587-1240 Fax 41 -587 2 01.11.. Y
.„,,,,,,, . .
,,,
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
144 Franklin Street Northampton MA 01060 Zone Overlay District
Elm St. District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Christopher Hayhurst 144 Franklin Street Northampton MA 01060
Name(Print) Current Mailing Address:
See Attached (413)588 1720
Telephone
Signature
2.2 Authorized Agent:
Adam Glenn 235 Essex Street, Whitman, MA 02382
Name(Print) i
.- 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 5,000 (a)Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee ii,0/5
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 +2+3+4+5) 5,000 Check Number i i`7 g f
This Section For Official Use Only
®— Date
Building Permit Number: 3 - cis Issued:
Signature: / --- J- 23 -2OZ-j
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 ❑
Name of License Holder:Adam Glenn 106148
License Number
235 Essex Street, Whitman, MA 02382 07/30/2024
Addre 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 03/02/2025
Address Expiration Date
Srvirotie) 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 ❑
Brief Description of Proposed Work
Residential weatherization/ Air sealing. No structural changes. SITE ID 803193
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 •
si;:ad 3/10/2023
Signature of Owner/Agent Date
Christopher Hayhurst 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 3/10/2023
Signature of Owner Date
City of Northampton
atMAM
k Massachusetts w k_ f .
t •
.: ( °.it DEPARTMENT OF BUILDING INSPECTIONS y `
•�� 212 Main Street • Municipal Building
Northampton, MA 01060 3'fry, VD`A"
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:5,000
Address of Work: 144 Franklin Street Northampton MA 01060
Date of Permit Application: 3/10/2023
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.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:
1 hereby apply for a building permit as the agent of the owner:
3/10/2023 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 ,=,:
'�.yy��� DEPARTMENT OF BUILDING INSPECTIONS
4 ! y 212 Main Street •Municipal Building
Northampton, MA 01060
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:
144 Franklin Street Northampton MA 01060
(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)
Cdta A 3/10/2023
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,.,,,,irt. City of Northampton ..
aS s... s'c
, s , Massachusetts ,�� ` -
1 ' DEPARTMENT OF BUILDING INSPECTIONS it
''•=jY F, 212 Main Street •• Municipal Building J��% 4 OCa
.%, Northampton, MA 01060 '�y�
MANDATORY FOR HOUSES BUILT BEFORE 1945
Property Address: 144 Franklin Street Northampton MA 01060
Contractor
Name: HomeWorks Energy
Address: 235 Essex Street
City, State: Whitman, MA 02382
Phone: 781-205-4484
Property Owner
Name: Christopher Hayhurst
Address: 144 Franklin Street Northampton MA 01060
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 affcicoavidavit.
Contractor signature 6a4i,
Date 3/10/2023
The Commonwealth of Massachusetts
tea_
Department of Industrial Accidents
z ' x
f,", Sri= Office of Investigations
"' Lafayette City Center
_''4- 2 Avenue de Lafayette, Boston, MA 02111-1750
A '- www.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.❑� 500+ 4.I am a employer with ❑ I am a general contractor and I 6. 0 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. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
9. ❑ Building addition
[No workers' comp. insurance comp. insurance.+
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.10 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 Weatherization
employees. [No workers' i3.■❑ Other
comp. insurance required.]
*My 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.
tContractors 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: 144 Franklin Street Northampton MA 01060 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 under the
eppains
�and pules ofperjury that the information provided above is true and correct
Signature: �'"" `� Date: 3/10/2023
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):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing
Inspector 6. Other
Contact Person: Phone#:
/ "N
ACCORD CERTIFICATE OF LIABILITY INSURANCE �' 12/30/2022
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 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
FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER
HOME OFFICE:P.O.BOX 328 (A c,No,Eel):888-333-4949 ONE FAX No):507-446-4664
OWATONNA,MN 55060 ADDRESS:CLIENTCONTACTCENTER(L 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 INSURER D:
MEDFORD,MA 02155-5134
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
INSLTR ADDL TYPE OF INSURANCE INNSSR SWVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS
I MMIDDIYYYY) lMM/DDiYYVVI
X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $1,000,000
ICLAIMS-MADE X•'OCCUR DAMAGE TO RENTED $100,000
PREMISES fEa occurranael_
MED EXP(Any one person) EXCLUDED
A N N 1847909 01/01/2023 01/01/2024 PERSONALS ADVINJURY $1,000,000
•
GEN'L AGGREGATE LIMIT APPUES PER. GENERAL AGGREGATE 52,000,000
�POLICV jE I LOG PRODUCTS-COMP/OP AGG $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000000
(Ea accident)
X ANY AUTO BODILY INJURY(Per person)
A —OWNED AUTOS ONLY S AUTOSDULED N N 1847908 01/01/2023 01/01/2024 BODILY INJURY(Per accident)
—
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
—
_AUTOS ONLY !Per accieenU
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000
A —
EXCESS LIAR CLAIMS-MADE N N 1847911 01/01/2023 01/01/2024 AGGREGATE $1,000,000
OLD RETENTION
WORKERS COMPENSATION OTH-
AND EMPLOYERS'LIABILITY Y/N X PER STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $$500000
A OFTICERIMEMBEREXCLUDED? NIA N 1847910 01/01/2023 01/01/2024
(Mendelory in NH) E.L.DISEASE-EA EMPLOYEE S500 �O
It yes,describe under E.L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS below $SOO,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is 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 POLICY PROVISIONS.
HOLDERS. AUTHORIZED REPRESENTATIVE
6 1
O 1988-2015 ACORD CORPORATION.AN rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
Commonwealth or Massachusetts
Division of Occupational Licensure ConsiruCtwn Supervisor Specialty
Board of Building Re �atron Rest td ed tc� and Standards CSSL-IC - nsutatt,n Cant-actor
t'.Orttair c tl ' fi Specs iit`i
y
CSSL-106148 eit�pires: 07/30/2024
ADAM GLENIti
19 CHARGE FUND RD
WAREHAM M . 0261 . :►
t
e g Failure to possess a current edition of the Massachusetts
�+'�U ,' ' may, State Build ng Code is cause for revocation of this license.
�' � For information about this license
Call{617) 7 27-3200 or visit ww mass govrdpl
Commissionerf . VOr....A,
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
04,
-s'
f•r • = •"� .: Type: Corporation
HOME WORKS ENERGY, INC. it, '�"`"�""' Registration: 181138
'••.-'— Expiration: 03/02/2025
101 STATION LANDING STE 110 ...
OP OOMPOPOOPOP
ilk
MEDFORD, MA 02155 �r4 � '
AO �>� ...k ..
/ ��ei! soi0'. = ..
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Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE: Corporation Office of Consumer Affairs and Business Regulation
Registration Expiration 1000 Washington Street -Suite 710
181138 03/02/2025 Boston, MA 02118
HOME WORKS ENERGY,INC
_ C
ci,e4s___
ADAM GLENN tt sr'IV"-=*---------'
- T r
101 STATION LANDING STE 110 `` //„ 4.7 /���� � ��y ;�"
MEDFORD, MA 02155 , •���.,�-;'��
`"'- Undersecretary Not valid without signature
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: Christopher Hayhurst Address: 144 Franklin St
Email: hayhurst33@gmail.com Northampton, MA, 01060
Site ID: 803193 Phone: 4135881720
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 Home Works Energy that an inspection is necessary with instructions on how to complete
this process to close out your permit.
Email: hayhurst33@gmail.com
Customer
Signature: Date: 3/8/2023
C ist y r
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
Name:1 L.cc fite ID: Is 63 ( (.7\_ Finished Sq. Ft: (61 2'
° Phone: ( Year of House: I ck,G V. Electric Acct #:
N Address: d. #of Floors: Gas Acct #: /---
Curt ta-wtffl41 Old Celt a; #Occupants: (A Housing Type? C Grwtn.t f e Kt-
DUCTWORK INSPECTION Ducts Insulated?L
Duct Linear Ft.
Duct Square Ft. k. 64-4)Ci`'LLA�Duct Air Sealing Hoursf „„
.:.,
Duct Insulation
>�U C CU{LL`'I
rud Insulation Removal L51"
000����
' \l BASEMENT INSPECTION V1 2
W Existing Spec'ing Ln/Sq. Ft. A
Bsmt Wall AG
r Crawl Ceiling
Crawl Rim Joist
Bsmt RI w/Sill
Bsmt RI NO Sill
V.'or Barrier sgft. Bsmt Door
Blower Door? WALLS&GARAGE Drill Location?
Siding Ceil.Height Existing Spec'in sq.Ft. Framin
Exterior Wall 1 Vn t.t( N.0itc. it44('C act x IA x Ba •o. _• atform
Exterior Wall 2 cfb.,k 5�,( (, - -( fv,n,c t ,AD K. , x vl x r:allo•. • :tform
Overhang
Wall 4-^�t v / C(,4-( P MC till) G t I x \ x ` .w7`�
Garagex x Ba oon/Platform
Garage Ceiling x x
w
--,,,- _ _ .. \ii( s,,,,o (), ,,, i,-0 (
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...
- • t�
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T.).-1 1,,,kt t 0.k sin-. (c X ioq) ,
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(s` ` Insulatfoi►Removal
\i/ ♦ 14' Step p
s: ; �
Strippin
-- , .-i 3 WX gt
WORK SPEC'D BUT NOT CONTRACTED AD BLOCKS PRESENT? ANDATORY)
Attic Basement/Crawlspace Other: ' K&T Y/ Moisture Y/ ombustion Sfty Y/
Kneewall Overhang/Garage Asbestos Y N Mold>100 sq. ft YtN 0 Detector Missing Y N
Ductwork Exterior Walls Vermiculite Y N V Structl Concerns Y 1 N ther:
Notes for Lead Vendor/Work Not Contracted:
KW WALL AND KW FLOOR Blind Spec? E -. OR • KW SLOPE AND GABLE END Blind Spec?
hy?
Why?
FRAMING EXISTING! `,Pi.-"Irli, I so.F7,
WALL X X , / FRAMING lFXJ57JJ1JG SPEC'MG Sq.Fr
FLOOR s X X ! SLOPE X X f
cc
q GABLE X X
O CCESS X % ` TRANS x x
ce
TRANS X x V ; mATTIC '7
} 2NGVE:IN:
..le EXISTING PIPES? Y f N m
f...._. "con Acctn
I
L
KNEEWALL MANDATORY
—,)
4 *—
edwa1X....,
_,
4,
cr
a. „".k" cA
X Rec'et ght D Ins.Hose i Yent BF iV Clam.l Darnmvy 12"Root
CO
��JJ
er.Handier Elrt Ta Access Ei Pun Downn Hatch b Waa Hatch "/' Door / B-Root Vent gA5 VOI: x .0058
•
X x ATTIC 1 Blind Spec? 0X X ATTIC 2 Blind Spec? r X(195.141172,2c:,)
'
Existing Spec'ing Sq ft Existing Sped-ing Sq ft
o 1,.6°A m
i
Unfloored Unfloored ,t:es rant tit.
a Floored Floored
Ln
__ 7xe6`n6uiatian `,
Cath Slope I f Cath Slope Air Sealing Hours
Walls Walls
Access Access .
Venting Propavetc .t t i' I c`•i h'.' Damming rnhng irntl ..r,; tic -. t
0 no WI*BO
`v / ......_____,
Temp cess.
Ca
Existing Venti ' vt°"° Existing Venting? type: n!�r�(
c; • e, Root t r 1
HomeWorks Energy
r Home Performance Contractor
irs 14 101 Station Landing,Medford,MA 02155
g CONTRACT - AUDIT
HomeWorks 781-305-3319
CUSTOMER PHONE DATE CLIENT# WORK ORDER
Chris Hayhurst (603)991-9234 03/08/2023 803193 11701
SERVICE STREET BILLING STREET PROPOSED BY:
144 Franklin Street 144 Franklin St HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CRY,STATE,ZIP
Northampton, MA 01060 Northampton, MA 01060 Page 1
DESCRIPTION QTY COST INCENTIVE TOTAL
EXTERIOR DOOR WEATHER STRIPPING (NO ASHRS) 1 $31.81 $31.81
Provide labor and materials to install Q-Ion weatherstripping to
door(s)to restrict air leakage.
DOOR SWEEP(NO ASHRS) 3 $78.33 $78.33
Provide labor and materials to install a doorsweep to restrict air
leakage.
INSULATE VINYL SIDED WALL WITH 4" DENSE PACK 604 $1,618.72 $1,214.04 $404.68
Furnish and install blown in Class I Cellulose to vinyl-sided exterior
walls. Homeowner has received a copy of the EPA's Renovate Right
Lead-Safe information guide explaining the potential risk of the lead
hazard exposure from the weatherization work to be performed. Your
signature is your acknowledgement of receipt and agreement to
proceed.
INSULATE WOOD SHINGLE SIDED WALL 4" DENSE PACK 810 $2,000.70 $1,500.53 $500.17
Furnish and install blown in Class I Cellulose to Wood shingle
exterior walls.The butt of the upper course of your wood siding is cut
to drill holes into the wall sheathing behind. The holes are then
plugged and the wood siding is reinstalled using exterior grade nails.
Touch-up painting, if needed,will be the customer's responsibility.
Homeowner has received a copy of the EPA's Renovate Right Lead-
Safe information guide explaining the potential risk of the lead hazard
exposure from the weatherization work to be performed. Your
signature is your acknowledgement of receipt and agreement to
proceed.
3) /Z3
HomeWorks Energy
Landing,•, Home Performance Contractor
r I I l 101 Station Medford,MA 02155
� g CONTRACT - AUDIT
I ItJI I�Norks 781-305-3319
Energy,Inc
CUSTOMER PHONE DATE CLIENT# WORK ORDER
Chris Hayhurst (603) 991-9234 03/08/2023 803193 11701
SERVICE STREET BILLING STREET PROPOSED BY:
144 Franklin Street 144 Franklin St HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CITY,STATE.ZIP
Northampton, MA 01060 Northampton, MA 01060 Page 2
DESCRIPTION QTY COST INCENTIVE TOTAL
INSULATE WALL FROM INTERIOR WITH 4" DENSE PACK CEL 108 $279.72 $209.79 $69.93
Provide labor and materials to install blown in Class I Cellulose to
exterior walls through an interior surface drill and plug method. Plugs
will be spackled and left with a rough finish. Finish sanding and touch-
up priming/painting will be the customer's responsibility. Homeowner
has received a copy of the EPA's Renovate Right Lead-Safe
information guide explaining the potential risk of the lead hazard
exposure from the weatherization work to be performed. Your
signature is your acknowedgement of receipt and agreement to
proceed.
Total: $4,009.28
Program Incentive: $3,034.50
Customer Total: $974.78
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***Nine Hundred Seventy-Four& 78/100 Dollars $974.78
1714-3 3) E
,A0 f _____..> r/23
3/g /--;
COMP Y REPRESENTA E CUSTOMER SIGNA -
NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE
SIGN DATE
30 DAYS.