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24D-283
190 CRESCENT ST BP-2020-0830 GIs#: COMMONWEALTH OF MASSACHUSETTS MV:Block:24D-283 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2020-0830 Proiect# JS-2020-001431 Est.Cost: $2600.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOMEWORKS ENERGY INC 103832 Lot Size(sa. ft.): 5270.76 Owner: MAJUMDER FLORA C Zoning_URB(100) Applicant. HOMEWORKS ENERGY INC AT. 190 CRESCENT ST Applicant Address: Phone: Insurance: 101 STATION LANDING (781)205-2595 WC MEDFORDMA02155 ISSUED ON.112212020 0:00:00 TO PERFORM THE FOLLOWING WORK.INSULATION AND 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy signature: FeeTyne: Date Paid: Amount: Building 1/22/2020 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Dep City of N�rtha pton .., ..> Buildin 'De;�treet m�f�tN ;A^ 212 Main 2 X020 SULA TION Northampton--- phone orthampton;phone 413-587-1240 Fax 4 a 77 6 'VS ONLY —� oC APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DW LLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT 1.1 Property Address: This section to be completed by office 190 Crescent Street, Northampton, MA 01060 Map 126 19 Lot ` Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Flora Majumder 190 Crescent Street, Northampton, MA 01060 Name(Print) Current Mailing Address: 413-584-8095 Telephone Signature 2.2 Authorized Accent: Gary Clement 101 Station Landing, Medford, MA 02155 Name(Print) Current Mailing Address: 781-205-2595 SignaZZ 4f Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 2600.00 (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 V 6. Total=(1 +2+3+4+5) 2600,00 Check Number This Section For Official Use Only Building Permit Num r: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 4-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Hylder:Scott Veggeberg CSSL-103832 License Number 8 Covington Street, #1 , Boston, MA 02127 10/13/2021 Address Expiration Date 781-205-2595 SEg lure Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ HomeWorks Energy Inc. 181138 Company Name Registration Number _101 Station Landing, Medford, MA 02155 03/02/2021 Address Expiration Date Telephone 781-205-2595 SECTION 5-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(S)) 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....... V No...... ❑ Brief Description of Proposed Work Insulation and weatherization work (no structural changes) 1. Gary Clement 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. Gary Clement Print Name 01/21/2020 Signatur f OwroTAgent Date l ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date City of Northampton Massachusetts j F H �O f DEPRRTMWT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building J.ti :Cam -- Northampton, MA 01060 �y1 jyj��g 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:Insulation and weatherization work(no structural changes) Est.Cost:2600.00 Address of Work: 190 Crescent Street, Northampton, MA 01060 Date of Permit Application:01/21/2020 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: 01/21/2020 Gary Clement 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 y X DEPARTMENT OF BUILDING INSPECTIONS P r 212 Main Street • Municipal Building C Northampton, MA 01060 Massachusetts Residential Building Code Section 110.R5.1.2 Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work,then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. City of Northampton ?" Massachusetts DEPARTMENT OF BUILDING INSPECTIONS V 212 Main Street •Municipal Building Northampton, MA 01060 ssrjy TD% 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: 190 Crescent 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) CAJ-)'� 01/21/2020 66 natur f 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. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia City of Northampton t., Massachusetts ( :3: k DEPARTMENT OF BUILDING INSPECTIONS 212 Ma1Northampton, MA Building 01060 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 190 Crescent Street, Northampton, MA 01060 Contractor Gary Clement Name: Address: 101 Station Landing City, state: Medford, MA 02155 Phone: 781 -205-2595 Property Owner Name: Flora Majumder Address: 190 Crescent Street City, state: Northampton, MA 01060 i, Gary Clement (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 01/21/2020 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dra NVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Avolicant Information Please Print Leeibly Name(Businessrorganiratiotvtndividuan: HomeWorks Energy Inc. Address: 101 Station Landing, Suite 110 City/State/Zip: Medford, MA 02155 Phone#: 781-305-3319 Are you an ttnployer?Check the appropriate box: Type of project(required): I-M I am a enployer with 500 employees(full and/or part-time).* 7. ❑New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in any capacity.INo workers'comp.insurance required.] 9. Demolition ❑Remodeling 3E]I am a homeowner doing all work myself[No workers'comp.insurance required.]' 4. ❑ 10E]Building addition <1 I 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 11.0 Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.F]Roof repairs These sub-contractors have employees and have workers'comp.insurance. 14.(20ther Insulation 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 152,0](4),and we have no employees.[No workers'comp.insurance requited.] Any applicant that checks box ql 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 fob site information. Insurance company Name: NH Employers Insurance Company Policy#or Self-ins.Lic.#: 4001017 Expiration Date: 01/01/2021 Job site Address: 190 Crescent Street cit /State/z] ' Northampton MA 01060 AMR.wlwawmmwwmytmmw�� ' 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 Cement may be fomarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u pains tfd p rralties ojperjury t t the Information provided above is true and correct: Signature: Da e: 01/21/2020 Phone#: 781-305-3319 Official use only. Do not w to! 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#: i i I 1 HOMEENE-01 ILLARIVIERE ACORO ( `� CERTIFICATE OF LIABILITY INSURANCE DATE MMIDD/YYYY) 12/19/2019 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 coNTACT Lisa Lariviere Foster Sullivan Insurance Group,LLC 163 Main Street 1a/Hc°,NN,Ext):(978)686-2266 301 A/c No):(978)686-6410 North Andover,MA 01845 a oRL •certificates@fostersuilivangroup.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Homeland Insurance Company NY 34452 INSURED INSURER B:Safety Indemnity Insurance Company 33618 Homeworks Energy Inc. INSURER C:NH Employers Insurance Company 13083 Homeworks IIC LLC 101 Station Landing Suite 110 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 LTRINSD D MMI (MM/DDNYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE F—X]OCCUR 7930060650002 4/1/2019 4/1/2020 DAMAGE TREMISESO RENTED $ 500,000 occurrence)MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO- I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: JECT $ B AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ 1,000,000 ANY AUTO 6244378 4/1/2019 4/1/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOSONLYIx AUTOpSWN p BODILY INJURY Per accident $ XAUTOONLY NUQrOSONLY Pe�accRdentDAMAGE $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE 7930060660002 4/1/2019 4/1/2020 AGGREGATE $ 2,000,000 DED I X IRETENTION$ 0 $ C WORKERS COMPENSATION X PTRTUTE OTH- ANDEMPLOYERTLIABILITY YECC-600-4001017-2020A 1/1/2020 111/2021 ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE � N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION 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 Ener Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9Y ACCORDANCE WITH THE POLICY PROVISIONS. 101 Station Landing Ste 110 Medford,MA 02155 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card 1138 HOME WORKS ENERGY, INC. Registration: /02/2 021 101 STATION LANDING STE 110 Expiration: 033/02/2 MEDFORD,MA 02155 Update Address and Return Card. SCA 1 u 20M-05117 Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Reaistratlon Expiration Office of Consumer Affairs and Business Regulation 181138 03/02/2021 1000 Washington Street-Suite 710 HOME WORKS ENERGY,INC. Boston,MA 02118 GARY CLEMENT 101 STATION LANDING STE 110 (� MEDFORD,MA 02155 Undersecretary of v id without signature Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructi,Qn sdo kAispr Specialty CSSL-103832 pires: 10/13/2021 SCOTT VEGGEBERG 8 COVINGTON ST #1 = BOSTON MA 02127 Commissioner Page 1 of 2 - HomeWorks mass save �nC Energy, Inc PARTNER 101 Station Landing Ste 110,Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Flora Majumder Email:Not provided Phone:413-584-8095 Premise Address:190 Crescent St,Northampton,MA 01060 Mailing Address: 190 Crescent St,Northampton,MA 01060 Project ID:3942390 Date:Nov.29,2019 Job Description 6cation Mantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour Other 8 hr $740.64 $0.00 Hatch -2"Thermal Barrier Polyiso Other 1 each $46.28 $11.57 Damming Other 40 each $95.60 $23.90 Attic Floor- 7" Open Blow Cellulose Other 784 SF $1,317.12 $329.29 Roof Vent- 12" Other 1 each $150.06 $37.51 Roof Vent-8" Other 1 each $109.30 $27.32 Exterior Door Weather Stripping (with AS hrs) Other 2 each $60.14 $0.00 Door Sweep (with AS hrs) Other 2 each $50.62 $0.00 Project Total $2,569.76 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. I. f1'11N ' 12/19/2019 — Customer Signature: Date: Customer Phone: Specialist Signature: _Date: 12/19/2019 LIMBED TIME OFFER: The prices and incentives in this contract are subject to change in accordance with the sponsoring utility MassSave Home Services Program offers. Proposals can be sent to:Inboxoa HomeWorksEnergy.corn Page 2 of 2 �Q Ir n HomeWorks mass save, Energy, Inc PARTNER 101 Station Landing Ste 110,Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Flora Majumder Email:Not provided Phone:413-584-8095 Premise Address: 190 Crescent St,Northampton,MA 01060 Mailing Address: 190 Crescent St,Northampton,MA 01060 Project ID:3942390 Date:Nov.29,2019 Weatherization incentive ($1,288.77) Pre-Weatherization barrier incentive ($250.00) Air sealing incentive ($851.40) Total Program Incentive -$2,390.17 Customer Total $179.59 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:—I� '� Date: 12/19/2019 Customer Phone: 12/19/2019 Specialist Signature: �! r _Date: LIMITED 71ME OFFER: The prices and incentives In this contract are subject to change in accordance with the sponsoring utility MassSave Home Services Program offers. Proposals can be sent to:lnbox@NomeWorksEnergy.com PLAN VIEW Name: 0- Site lD: �J�t��6 3�.7 Finished Sq. Ft: 171 Phone: 5-TL4— %0 5r Year of House: lila Electric Acct#: 5^3 U!57- 3 0v.� Address: l U Cf e3 LCA l . #of Floors: Gas Acct#: Ufa 1� m unit#: #Occupants: Housing Type? M r DUCTWORK INSPECTION Ducts Insulated?-- Duct nsulated?"Duct Linea t. Duct Square Ft. Duct Air Sealing Ho Duct Insulation } Duct Insulation Removal BASEMENT INSPECTION 1 �� Existing Spec'ing Ln/Sq. Ft. y� Bsmt Wall AG Crawl Ceiling Crawl Rim Joist Bsmt RJ w/Sill CV Bsmt R1 NO Sill Vapor Barrier Bsmt Door Y N Blower Door? WALLS&GARAGE Drill Location? Siding Ceil. Height Existing I Spec'ing Sq.Ft. Framing Exterior Wall 1 x x Balloon/Platform Exterior Wall 2 IFx x loon/Platform Overhang x x ge all x x Balloon/P1a orm Garage Ceiling x x nsulatid 'moval L; Sgft. wee i WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawls ace Other: K&T Y NI Moisture Y Combustion Sft JY/W Kneewall Overhang/Gara a Asbestos Y/ Mold>100 sq.ft Y/ CO Detector Missing Y/ Ductwork Exterior Walls Vermiculite Y/ Structl Concerns Y/ Other: Notes for Lead Vendor/Work Not Contracted: +s✓ KW WALL AND KW FLOOR Blind Spec? ❑ '-- OR ------ KW SLOPE AND GABLE END Blind Spec? F.] Why? Wh ? FRAMING -EXISTINGPWING SO,FT, FRAMING EXISTING SPEC'ING SQ.FT. WALL X SLOPE X X FLOOR X X GABLE X ACCESS X TRANS X TRANS X X ATTIC ATTIC SLOPE x X SLOPE x x EXISTING VENTING? EXISTING VENTING? EXISTING PIPES? Y/N KW Venting Vent BF BF Hose immi, Sheathing Acca Temp Access KW Venting vent BF Temp Access a a e• ,SLI �rnm�n�n 01 Cid 3 ►� Imulated Wall X X Recd Light O Ins.HoseBF Vent BF BFV Chlm.CH'Damming --..----- 12'Roof Vjrt 12RV Air Handler AH! Temp Access Pull Down DS Hatch J Wall Hatch "/ Door o/ 8"Roof Vent BRV Vol. X .0058 1911 a• X X 6 ATTIC 1 Blind Spec? Blind Spec? story) ATTIC 2 i 2 story )1 = Existing Spec'ing Sq ft Existing Spec'ing Sq ft `73.613 story), • a . Unfl ored 0i Unfloo Trusses Cross Batting Floored Floored M' d Insulation Dud Work Cath Sloe Cath Sloe "Loos None Walls Walls HoursAir Sealing Access Access Venting; Propaventj Vent B BF lPropavent ent BFI PF'Hosr I Dammine t 'v'VH F Temp Access: CL to Sheathing Acce R.L.Covers:_ w Sq.Ft/300= (Exist.NFA Ven ting)= Needed Sq.FV 300= (Exist.NFA Venting) (Needed ExistingVentin t NFA Venting) NFA Venting) Roof Type: + g t. tl- Existing Ve l x,04.4-o.iS' SM"I\ (;cyye Vcn4 Insulation/Air Sealing Permit Authorization Specialist: Benjamin Anton Company: HomeWorks Energy Email: benjamin.anton@homeworksenergy.com Address: 101 Station Landing FIOf>r11eWOfICs Cell: 802-236-5104 Medford, Ma 02155 Energy,Inc Phone: 781-305-3319 Customer: Flora Majumder Address: 190 Crescent St. Email: 0 Northampton, MA,01060 Site ID: 3938327 Phone: 413-584-8095 1,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. Customer Signature: ilbolv�' Date: 11/29/2019 Flora Majumder