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Brian Baldi Rebate Recipient Of different): Site ID:SOD002198236
62 Straw Ave Project ID:P00000203226
Florence,MA 01062-1444 Mailing Address Of different): Customer ID:C00000208299
Date of Assessment 01.03.201 a
Phone: City State: Zip: Phone: Energy Specialist:CJ Hanley
Email:
EVALUATION ENERGY SPECIALIST
KNOB&TUBE WIRING
®Contractor is to evacuate the selected locations where wentherization recommendations have boon made to determine If active knob&tube wiring
exists:
❑Attic Exterior was Basement O Attic Floor ❑Knee Well Floor Attic Slopes
MECHANICAL SYSTEM,HIGH CARBON MONOXIDE EVALUATION
0 Contractor is to evaluate the selected mechanical systemts)below and provide service,If possible,to reduce high carbon monoxide levels as measured
In the undiluted flue gas to below 100 ppm:
❑Heating System ❑Hot Water System ❑Other:
DRYER VENT EVALUATION
❑Contractor is to evaluate the dryer vent and provide service to property exhaust the vent to the exterior.
CONTRACTOR
KNOB&TUBE WIRING
Upon completion of my Inspection 1 have found that there is no active knob&tube wiring in the area(S)checked off below
❑Attic 1 0 Exterior Walls Basement ❑Attic Floor fCnee Wall Floor RAttic Slopes
CONTRACTOR INFORMATION
Company Name 4 O G Q t'�Cllr
Address: I Z NA-L.�k-(^� A �W City. State:`Z � Zip:
Contractor Name:1r;4 -05p c,, License It:] �C] Federal ID It: -o O-3A
®I have read,and agree to,the Te &Conditions of the Pre-Weatherization Barber Incentive.
Contractor Signature Date: a—�
MECHANICAL SYSTE I CARGO NOXIDE EVALUATION
Q The selected mechanical system has been evaluated and serviced.Testing results of carbon monoxide In the undiluted flue gas are as follows:
❑Heating System GO pp- ❑Hot Water system CO ppm ❑Other.
ppm
DRYER VENT EVALUATION
❑The dryer vent has been exhausted to the exterior.
CONTRACTOR INFORMATION
Company Name:
Address: - City. State: Zip:
Contractor Name: License N: Federal 10♦:
❑I have read,and agree to,the Terms&Conditions of the Pre-Weatherimtion Barrier Incentive.
Contractor Signature: Date:
CUSTOMER INSTRUCTIONS
Submit signed and completed copies of this Contractor Evaluation Report and a copy of the paid Contractor Invoice to:
Pre-WX Barrier Incentive,C/O CET,320 Riverside Drive-1A,Florence,MA 01062;or email to CustamerSupport0cetonline.org
Customer Signature: Date: