23A-022 (10) BP-2023-0385
21 PARK ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23A-022-001 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-2023-0385 PERMISSION IS HEREBY GRANT1D TO:
Project# 2023 WEATHERIZATION Contractor: License:
Est. Cost: HOMEWORKS ENERGY INC 106148
Const.Class: Exp.Date: 07/30/2024
Use Group: Owner: PLATT CONSTANCE A
Lot Size (sq.ft.)
Zoning: URB Applicant: HOMEWORKS ENERGY INC
Applicant Address Phone: Insurance:
235 ESSEX ST 781-205-4484 1847910
WHITMAN, MA 02382
ISSUED ON: 04/03/2023
TO PERFORM THE FOLLOWING WORK:
WEATHERIZATION/AIR SEALING
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:
O .
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
FEE: $65.00 u ; )gy-7
.rn�r Cityof Northampton
DepF it
ti'r ,�. P
Building Department
212 Main Street INSULA TI ON
. .A , • Room 100
��„". � Northampton, MA 01060
' phone 413-587-1240 Fax 413-587-1272 QftJL Y
APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY
SECTION 1 -SITE INFORMATION INSULATION PERMIT
1.1 Property Address: This section to be completed by office
Map 2-3 0 Lot 02.2- Unit 00 1
21 Park Street Northampton MA 01062 Zone U R 6 Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Vera/Kris Baker Busfort 21 Park Street Northampton MA 01062
Name(Print) Current Mailing Address:
See Attached (415)218 6300
Telephone
Signature
2.2 Authorized Agent:
Adam Glenn 235 Essex Street, Whitman, MA 02382
Name(Print) .r 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 13,000 (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) 13,000 Check Number
This Section For Official Use Only
Date
Building Permit Number: a().-27)2-3 - 037. Issued:
Signature: 3-3)-2oZ 3
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
AddreL 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
9LL& c1 / � c 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 D
Brief Description of Proposed Work
Residential weatherization/ Air sealing. No structural changes. SITE ID 802548
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 64, `
3/27/2023
Signature of Owner/Agent Date
Vera/Kris Baker Busfort 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 3/27/2023
Signature of Owner Date
City of Northampton
SMAMpT
Massachusetts
> ( a '4DEPARTMENT OF BUILDING INSPECTIONS
k.. ' 212 Main Street • Municipal Building
..�, Northampton, MA 01060 srs h, `^�`
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: 13,000
Address ofWork:21 Park Street Northampton MA 01062
Date of Permit Application: 3/27/2023
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.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:
3/27/2023 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 .�<<
G
I DEPARTMENT OF BUILDING INSPECTIONS �°
' 212 Main Street •Municipal Building yV�4 ,C��
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:
21 Park Street Northampton MA 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)
caL 3/27/2023
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.
`h� ,.,irJ City of Northampton
,�,'r,k :'-'4'
j Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS212 Main Street • Municipal Building_'' Northampton, MA 01060 w '`
MANDATORY FOR HOUSES BUILT BEFORE 1945
Property Address: 21 Park Street Northampton MA 01062
Contractor
Name: HomeWorks Energy
Address: 235 Essex Street
City, State: Whitman, MA 02382
Phone: 781-205-4484
Property Owner
Name: Vera/Kris Baker Busfort
Address: 21 Park Street Northampton MA 01062
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.
R
Contractor signature C&Ila4S;a{J
c5e---
date 3/27/2023
The Commonwealth of Massachusetts
Department of Industrial Accidents
MNIIIIIIIIIz
E Office of Investigations
--:ail—
�' -- — Lafayette City Center
�t 2 Avenue de Lafayette, Boston, MA 02111-1750
`,� . . 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):
1.0 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. El New construction
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. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 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 Weatherization
employees. [No workers' 13.0 Other
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: 21 Park Street Northampton MA 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 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 pevig es of perjury that the information provided above is true and correct
Signature: c 1._vi,r a ve �'/ Date: 3/27/2023
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):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing
Inspector 6. Other
Contact Person: Phone#:
TE(MWDO/YYYY)
'4`oRlo 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
PHONE X
HOME OFFICE:P.O.BOX 328 (AUG.No,EXH):888-333-4949 (A/C,No):507-446-4664
OWATONNA,MN 55060 E-ADDRESS:CLIENTCONTACTCENTER(aJFEDINS.COM
INSURER(S)AFFORDING COVERAGE HAIL R
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 SUER POLICY NUMBER POLICY EFF POLICY ELF LIMITS
LTRINSR WVDIMM/DDIYYYY) (MM/DDIYYVYI
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTED $100,000
PREMISES IEa ocDrrenvl
MED EXP(My one person) EXCLUDED
A N N 1647909 01/01/2023 01/01/2024 PERSONALS ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
21 � PRO-
POLK:V JECT I LOC PRODUCTS-COMP/OP AGO $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
IEa acddenl
X ANY AUTO BODILY INJURY(Per person)
A OWNED AUTOS ONLY SAUUTOSULED N N 1847908 01/01/2023 01/01/2024 BODILY INJURY(Per acrid ,U
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
AUTOS ONLY IPer accident
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 $1,000,000
LIED RETENTION
WORKERS COMPENSATION OTH-
AND EMPLOYERS'LIABILITY Y/N
X PER STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S500000
A OFFICERIMEMBER EXCLUDED? _NIA N 1847910 01/01/2023 01/01/2024
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S500,000
II yes,describe under E.L DISEASE-POLICY LIMIT S500,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Addibnal Remarks Schedule,may be alleched i1 more space,s required)
THIS COPY IS NOT TO BE REPRODUCED FOR ISSUANCE OF CERTIFICATES.
CERTIFICATE HOLDER CANCELLATION
01
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN
A CERTIFICATE HAS BEEN FILED WITH EACH OF YOUR CERTIFICATE ACCORDANCE WITH THE POUCY PROVISIONS.
HOLDERS.
AUTHORIZED REPRESENTATIVE
1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
Commonwealth of Massachusetts
Division of Occupational Licei ire Construclwn Supervisor Specialty
Rest,idol
to
Beard of Building R julptiou plat! Stat�tlertls CSSL-IC • nsutatit.in Contactor
(cif
COf1$tructi t4L449r St:'` '.:3tt`s
CSSL-106148 x etpires: 07/30/2024
ADAM GLENN
19 CHARGE I OUND RD
WAREHAM MA 0267 .' :r
r' r �� Failure Iopossess a current edition of the Massachusetts
'kb r
CMS% State Lluitd,rg Code is cause tor revocation otthis 1,cense
For information about this license
Commissioner f�'�` Ca111617) 727 3208or visit www r ass.govddpt
{ tip..
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
HOME WORKS ENERGY, INC. e Registration: 181138
101 STATION LANDING STE 110 — Expiration: 03/02/2025
`.
MEDFORD, MA 02155
r lllli
wiw maw
;..r.ti•+rrrf.
7
+i 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.
ADAM GLENN h`F g1444
J101 STATION LANDING STE 110
MEDFORD, MA 02155 --
" =�'� Undersecretary Not valid without signature
Insulation/Air Sealing Permit Authorization
Specialist: Daniel Macero Company: HomeWorks Energy
Email: daniel.macero@homeworksenergy.corr Address: 1o1 Station Landing
Cell: 4132978636 Medford, Ma 02155
Phone: 781.305.3319
Customer: Kris Baker Address: 21 Park Street
Email: krisbaker17@gmail.com Northampton, MA, 01062
Site ID: 802548 Phone: 4152186300
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: krisbaker17@gmail.com
Customer
Signature: ��� � �i Date: 3/17/2023
Kris Baker
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: /<'iif f 11/6"�/ Site ID: F6 2- 7 .;-- - Finished Sq. Ft: / :S-a
Phone: Year of House: /P/ "7 Electric Acct#:
v. Addr ss: -( ell" #of Floors: 2- Gas Acct#:
�10 44,414 Unit#: #Occupants: Housing Type? ,re< `--4<'-'6
DUCTWORK INSPECTION Ducts Insulated?0 ,Ly 1 A%
Duct Linear Ft. I t3 �� tM1\S
Duct Square Ft. LIA �I � yl ' r Li ✓y�
,,,
Duct Air Sealing Hours ✓Al d��S 11 D?u\,y
I
Duct Insulation
/ �' ✓ )
Duct Insulation Removal Z '� v •
t
w BASEMENT INSPECTION c
l' Existing Spec'ing Ln/Sq. Ft. tiL\ C a
m Bsmt Wall AG — 2 dv Wy �,�.a Z,� ( v--2 Crawl Ceiling i ;
Crawl Rim Joist (l- }f;1 2 4 D'�1~
Bsmt RJ w/Sill y _ H'« ZQ� � Zr �t� l l v
Bsmt RI NO Sill .. U�pf �J.,
Vapor Barrier, ..,<,,.,sgft, Bsmt Door] i2 i, -' r}.p�_T r ,G�
Y/N Blower Door? WALLS&GARAGE Drill Location?
Siding Ceil.Height Existing Spec'ing S .Ft. Framin
brick--Exterior Wall 1 b ,- C'j $-I j\d� 'fr 1:04- • (,0 fy x Z x/(v Balloon/ atform
Exterior Wall 2 00 . q 1-I it wt- ilia, S 146 o VI x x a oon latform
Overhang x x
Garage Wall x x Balloon/Platform
Garage Ceiling 1 x x
Eo t ', 70eP
ti ` q-I-1 r yi-
0I...____j 9 - ./4/.1/1 i_ k.,.-) ( r4 G"t)
x
\ . .. ir-
V
ef>r
14 iv (_,y A
6
TA,A.„,,,z �� ,� - r tom„a
' -,{'/, {'of/_r ram"/ Y _]f'' � Y�l ', r ,::K
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>I00 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? 0 . OR • KW SLOPE AND GABLE END Blind Spec? 0
hy?
• Why?
FRAMING EXISTING! SPFC'ING SO.FT. FRAMING EXISTING SP C'ING SQ.FT.
WALL X X I \ SLOPE X Xi3t
cr- FLOOR X X {_� , ✓ _, GABLE X X rfr '
°o ACCESS \ TRQNs x x Agra.: a; z
• TRANS Tt ; v4 m
ea X x ATTIC
a ATTIC x X SLOPE X� � x• •,r „
w SLOPE ti f EXISTING VE s.
`-'1 EXISTING VENTING? EXISTING ' '
m
t''''._ 1 'f^ 1 _ .. Dammin ash--; ..,... .., KW Venting Vet-KV Temp Attest
/y
/ 1 fit ' ,..
/ & /'
t
KNFEWAI L MANDATORY I. ,,,;, <-; ,F y;. w{r y,e_::
S/J,9"
3 / r✓ Ail bkg. s'° 4--'
{ ✓6) ac ,n /c./
\ .-eql zit3 en/Jr 1-2-
o
cr
/e) ,� t y 1J'- "
0 06 ii1
v h /Lc4 c7O .43.
k) ✓61 f- °f f�'c '4
Insulated Walt X X Rec'd Light Cr Ins.Hose iiiiient BF 53 Chim® ®
. Damming 12"Roof BAS Vol' X .0058
Al Handler AH Temp Access 0 Pull Down Hatch Wall Hatch "/ Door z/ B"Root Vent
X x ATTIC 1 Blind Spec? 0 r x x ATTIC 2 Blind Spec? X ss.41(4 strory —
a Existing Spec'ing Sq ft Existing Spec'ing S Ca
o Multipliers
E Unfloored — g 1••t'• .,Trusses toss:atnng
• Floored .S r'itiuL.c_ /64 3 O C .0 i,•_41 Floored ( M;xed lnt.ulation Duct Work
- Cath Slope -- - - Cath Slope ;�____ _ "I i6"b on:
—1 Air Sealing Hours
Walls - I — — Walls _1_.._.
a Access ;,- K'r� ' '`�`'t /At,i-Lcsi( 4 7- Access , �,
denting Prup.i:entc ;sent BF H.-' D:nim n renting PI()pay _i ,' IL rTamnue
c ! WIAF ft�
2 l i t t i�il Y r t
`M1a y 1 ` l i..' f Ire r/.'.:S'>:_.,,(,/'
11
ti
9.Iti,,.1.- 1Ernt NFA Venting, I'CecdeC v IE., .+.e'4,nt;. (::ee CeC
Existing Venting? j tj) Gv" Ng Venting) Existin enting? NFAVennngl Roof T /0 7/
� 1
HomeWorks Energy
n/ 73 Home Performance Contractor
101 Station Landin Medford,MA 02155
9, CONTRACT - AUDIT
two ICJ 781-305-3319
Enemy Inc
CUSTOMER PHONE DATE CLIENT A WORK ORDER
Kris Baker (401) 633-5829 03/15/2023 802548 42001
SERVICE STREET BILLING STREET PROPOSED BY:
21 Park Street 21 Park St HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP
Florence, MA 01062 Florence,MA 01062 Page 1
DESCRIPTION QTY COST INCENTIVE TOTAL
PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 6 $565.98 $565.98
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.)
EXTERIOR DOOR WEATHER STRIPPING 4 $127.24 $127.24
Provide labor and materials to install Q-Ion weatherstripping to
door(s) to restrict air leakage.
DOOR SWEEP 4 $104.44 $104.44
Provide labor and materials to install a doorsweep to restrict air
leakage.
DAMMING 40 $98.00 $73.50 $24.50
Provide labor and materials to install a 12"layer of R-38 unfaced
fiberglass batts for damming purposes.
ATTIC FLOOR OPEN BLOW CELLULOSE 10" 510 $1,060.80 $795.60 $265.20
Provide labor and materials to install a 10"layer of R-37 Class I
Cellulose to open attic space.
HATCH:THERMAL BARRIER POLYISO 2 INCH (ATTIC) 1 $47.37 $35.53 $11.84
Provide labor and materials to insulate the back of an attic hatch with
2"rigid insulation board at R-10.
DOOR:THERMAL BARRIER POLYISO 2"(ATTIC) 3 $271.83 $203.87 $67.96
Provide labor and materials to insulate the back of the attic door with
2"rigid insulation board.
INSULATE WALL FROM INTERIOR WITH 3" DENSE PACK CEL 3,000 $7,260.00 $5,445.00 $1,815.00
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.
INSULATE RIM JOIST WITH 2"THERMAL BARRIER POLYISO 72 $350.64 $262.98 $87.66
Provide labor and materials to install rigid board insulation to the
HomeWorks Energy
(t-(1)'i Home Performance Contractor
Fr:n9
101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT
781-305-3319
HomeWorks
CUSTOMER PHONE DATE CLIENT A WORK ORDER
Kris Baker (401) 633-5829 03/15/2023 802548 42001
SERVICE STREET BILLING STREET PROPOSED BY:
21 Park Street 21 Park St HomeWorks Energy
SERVICE CRY,STATE,ZIP BILLING CITY,STATE,ZIP
Florence, MA 01062 Florence,MA 01062 Page 2
DESCRIPTION QTY COST INCENTIVE TOTAL
perimeter of the basement ceiling at the house sill.
INSTALL 6" FG BATTING IN OPEN CRAWLSPACE CEILING 252 $614,88 $4,61.16 $153.72
Provide labor and materials to install R-19 faced fiberglass batt i\ (initials)
insulation to the open crawlspace ceiling. This will be installed with
the paper backing up against the floor above. The un-papered
fiberglass side will be facing the basement,and these exposed
fiberglass fibers will be the visible side when standing in the
basement. Your initials are your agreement and understanding of
this measure
INSTALL 2"THERMAL BARRIER POLYISO OPEN CR CEILING 252 $1,232.28 $924.21 $308.07
Provide labor and materials to install 2" rigid board to the crawlspace
ceiling.
PROPAVENT 2'OR 4' 52 $214.76 $161.07 $53.69
Provide labor and materials to install ventilation chutes in the rafter
bays to maintain air flow.
VENT BATH FAN TO ROOF OR OTHER 1 $146.78 $110.09 $36.69
Install a 6" insulated exhaust hose to a flapper vent to exhaust existing
bathroom fan(s). Fan will be vented through the roof or an acceptable
alternative if contractor cannot vent through the roof.
0pHomeWorks Energy
Home Performance Contractor
101 Station Landing,Medford,MA 02155
CONTRACT - AUDIT
u e works 781-305-3319
CUSTOMER PHONE DATE CLIENT B WORK ORDER
Kris Baker (401) 633-5829 03/15/2023 802548 42001
SERVICE STREET BILLING STREET PROPOSED BY:
21 Park Street 21 Park St HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP
Florence, MA 01062 Florence, MA 01062 Page 3
DESCRIPTION QTY COST INCENTIVE TOTAL
12" MUSHROOM VENT 1 $153.57 $115.18 $38.39
Provide labor and materials to install a 12"diameter"mushroom"roof
vent(s)to increase ventilation in attic areas. The vent can be supplied
in (circle color)black, brown,gray or mill finish.
Total: $12,248.57
Program Incentive: $9,385.85
Customer Total: $2,862.72
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***Two Thousand Eight Hundred Sixty-Two &72/100 Dollars $2,862.72
P.A.__________/- \
lq-is rkell'-'
COMPANY REPRESENTATIVE CUSTOMER SIGNATURE
NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE
SIGN DATE
30 DAYS.