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334 ACREBROOK DR BP-2021-0065 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:29-313 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Weatherization BUILDING PERMIT Permit# BP-2021-0065 Project# JS-2021-000093 Est.Cost: $5800.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOMEWORKS ENERGY INC106148 Lot Size(sa.ft.): 10018.80 Owner: SADLOWSKI DAVID Zoning.L. Applicant: HOMEWORKS ENERGY INC AT. 334 ACREBROOK DR Applicant Address: Phone: Insurance: 357 COTTAGE ST (781) 205-2595 O WC SPRINGFIELDMA01104 ISSUED ON.7/20/2020 0:00:00 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: 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: FeeType: Date Paid: Amount: Building 7/20/2020 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner LDep EN? - -- City of Northampton Building Department INSULATION 212 Main Street Room 100 Northampton, MA 01060 y �n»_ phone 413-587-1240 Fax 413-587-1272 ONLY FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INS ULA TION PERMIT 1.1 Property Address: This section to be completed by office Map � Lot 31 Unit 334 Acrebrook Dr, Northampton, MA 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: David Sadlowski 334 Acrebrook Dr, Northampton, MA 01062 Name(Print) Current Mailing Address: See Attached 413-387-9359 Telephone Signature 2.2 Authorized Anent: Adam Glenn 357 Cottage Street, Springfield, MA 01104 Name(Print) � Current Mailing Address: 781-205-2595 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 5800.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) ')^J 5. Fire Protection 6. Total=0 +2+3+4+5) 5800.00 Check Number t^llr>C> This Section For Official Use Only Building Permit Numb BP-202,1 - OCDate Issued: Signature: 7- /7 Zo Z,�-) 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 Holder:Adam Glenn 106148 License Number 357 Cottage Street, Springfield, MA 01104 07/30/2022 AddreAs Expiration Date 781-205-2595 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ HomeWorks Energy 181138 Company Name Registration Number 357 Cottage Street, Springfield, MA 01104 03/02/2021 Address Expiration Date Telephone 781-205-2595 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....... 4 No...... ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. 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 cdw 07/13/2020 Signature of Owner/Agent Date David Sad lowski 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 07/13/2020 Signature of Owner Date City of Northampton /tel S`S_ •.�. Sic Massachusetts LIEPARTIDNT OF BUILDING INSPECTIONS tiJ a� \ 212 Main Street a Municipal Building d Northampton, MA 01060 ss�w x,100 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:5800.00 Address of work:334 Acrebrook Dr, Northampton, MA 01062 Date of Permit Application: 07/13/2020 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: 07/13/2020 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 S C'`` •' Massachusetts DEPARTMENT OF BUILDING INSPECTIONS �- z \� 212 Main Street •Municipal Building yeti cD� Northampton, MA 01060 ssNy 37C�`l 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: 334 Acrebrook Dr, 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) Cxxo ��d 4L 07/13/2020 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. The Commonwealth of Massachusetts r Department of Industrial Accidents a 1 Congress Street,Suite 100 Boston, MA 02114-2017 ..•"r www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Analicant Information Please Print Legibly Name (Business/Organization/Individual)::" omeworks Energy Address: 357 Cottage Street City/State/Zip: Springfield, MA 01104 Phone#: 781-205-2595 Are you an emplover?Check the appropriate box: Type Of project(required): I E)I am a employer 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 S. ❑Remodeling arty capacity.[No workers'comp.insurance required.] 9. ❑Demolition 1❑1 am a homeowner doing all work myself.(No workers'comp.insurance required.) 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. [will ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.: l4 Ocher Weatherization 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.(No workers'comp.insurance required.I *Any applicant that checks box#11 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 checkthis box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I art an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: NH Employers Insurance Company Policy#or Self-ins.Lic.#:#4001017 Expiration Date: 1/1/2021 Job Site Address 334 Acrebrook Drive _ City/State/Zip:Northampton,MA 01062 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). 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 statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify utpder the pains and penalti f erjury that the information provided above is true and correct. Si nature: Date: 07/13/2020 Phone#:781-205-2595 // wxpermitting@homeworkseng[gy.com Official use only. Do not write in 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#: HOMEENE-01 LLARIVIERE ACRO CERTIFICATE OF LIABILITY INSURANCE DAT29/2D/YYYY) 5//29/2020 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 C ERCT Lisa Larhriere Foster Sullivan Insurance Group,LLC PHONE FAX 163 Main Street Arc,No,Fd):(978)686-2266 301 AIC,No:(978)686-6410 North Andover,MA 01845 M I cortificateWostemullivangroup.com INSURERS)AFFORDING COVERAGE NAIL i INSURER A:Markel Insurance Compapy Company38970 INSURED INSURER a:Safetv Insurance Compapy Company39454 Homeworks Energy Inc. INsumRc:INH Emplffem 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.NSR _ ILT. TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL L N6AITY EACH OCCURRENCE $ 1'000,000 CLAIMS-MADE X OCCUR MKLVIPBC000896 4/1/2020 1/1/2021 DAMAGE TO RENTED $ 1001000 MED EXP one $ PERSONAL 3 ADV INJURY $ 1'000000 GEMLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 POLICY E PEa LOC PRODUCTS-COMPIOP AGG $ 2'�'� OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 IxANY AUTO CiOMN12M 4/1/2020 4/1/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED BODILY INJURY Peraocklerd $ AUTOS ONLY X AUTOS BODILY AUTOS ONLY X ENO ONLY OPERTY AGE $ UMBRELLA UAB [j]OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADEIII AGGREGATE $ T DED RETENTION$ C WORKERS COMPENSATION X PER OTH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ ECC-600-4001017-2020A �'., 1/1/2020 1/1/2021 1,000,000 Q�FICER/M Mgr EXCLUDED? N NIA E.L.EACH ACCIDENT $ andatory In NH) E.L.DISEASE-EA EMPLOYE S 1'Mor000 H yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 1'000'000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Addltlonal Remarks Schedule,may be attached N more space is required) Evidence Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Homeworks Energy Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 101 Station Landing Ste 110 ACCORDANCE WITH THE POLICY PROVISIONS. Medford,MA 02155 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD {rri//rr�r'/I/1 Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Kome improvement Contrador Registration Type corporation RegistraWn 181138 HOME WORKS ENERGY-r4C. Expiration OY02, 21 101 STAT ON LANDW3 STE"0 MEDFORD,"A 02155 Up,jnt�Address and Rehire Card. ()Oise W Cansum w Adair 8 flus-4s ReOLAa6�0n R .s�s1+On valla far Individual use only (��' r(Orrrzxaziu rz�l�i ry!n�auarr�rzuJlt .. WW E H11 PROV EM E NT C f)N'R AC'OR e9 office of Consumer Affairs E Business Regulation TYPE. ^r bokrre Nw e:RIrotiCn 4trN. N found retum to HOME IMPROVEMENT CONTRACTOR t)mca of Consuamr Affa+ra and Buelnese TYPE:Suoolevient Card t 181 lid -3 -C2' 1000 Wast*)^fret-Suft 710 Registration Exnirl jon i -C)VE WORKSENf RGY,SNC Boatoq'M 0211 181138 03/02/2021 HOME WORKS ENERGY,INC. MAXlr130EBERG `n•-�'::+`--" 101 STATION LANIN G STE 110 valid without signature ADAM GLENN 7 101 S I-ATION LANDING STE 110 %tLOfORD MN =155 lMrttcw5®C Btflty MEDFORD,MA 02155 Undersecretary Coinmonweafth of Massachusetts Construction Supervisor Specialty Division of Professional Licensure Restridedto: Board of Building Regulahons and Standards CSSL-IC -Insulation Contractor Cons trucfi +S`upatith&5x Speciaity CSSL•106148 �yIRD � 41P1res 07/30/2L'22 ADAM GLENN - 19 CHARGE POUNr„ WAREHAM MA 02571 P` S>`'" IWA.- 1 t1� Failure to possess a current edition of the Massachusetts C'4 State Building Code is cause for revocation of this license. Commissioner lC'4 _ For information about this license Call(617)7273200 or visit www.mass.govidpi Insulation/Air Sealing Permit Authorization Specialist: Anna Kochaniec Company: HomeWorks Energy Email: anna.kochaniec@homeworksenergy.com Address: 101 Station Landing HomeWorks Cell: 413-355-9775 Medford, Ma 02155 Phone: 781-305-3319 Customer: David Sadlowski Address: 334 Acrebrook Dr Email: desadlowski@comcast.net Northampton, MA 01062 Site ID: 3948757 Phone: (413)387-9359 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. Customer Signature:_ _ Date: 12/13/2019 David Sadlowski PLAN VIEW Name: Site ID: Finished Sq. Ft: /QO6 Phone: Year of House: Electric Acct#: �219 x611 Address: 33y PjCreExonk Dr. # of Floors: / Gas Acct#: Unit#: #Occupants: Housing Type? JA, n C Ems., DUCTWORK INSPECTION Ducts Insulated?' Duct Linear Ft. Duct Square Ft. �l 5 1JAbeJVCQ C,-3 Duct Air Sealing Hours �J Duct Insulation Duct Insulation Remova BASEMENT INSPECTION / Existing Spec'ing Ln/Sq. Ft. 1� 1 JZ I S R l'j�(.al Bsmt Wall AG Crawl Ceiling Crawl Rim Joist Bsmt R1 w/Sill Bsmt RJ NO Sill Vapor Barrier sgft. Bsmt Doori Y N Blower Door? WALLS&GARAGE Drill Location?CQ)I Q,6} Siding Ceil.Height Existing Spec'ing Sq. Ft. Framing Exterior Wall 1 q"WC 1669 A4 ' x x to Ballo / latfb-rm Exterior Wall 2 x Balloon7P Overhang f x x Garage Wall X/ x Bao P a orm Garage Ceiling x -- _ _____..-.._... -..,......,. ...._... � � r ►' �,J��a V 1 111... ! �P' i 43 LO Insulation Removal Sqft. Sweeps: 2_ WX Stripping:-3 WORK SPEC'D BUT NOT CONTRACTED OAD BLOCKS PRESENT? MANDATORY) Attic Basement/Crawls pace Other: K&T AYN Moisture 1Y)(N ombustion Sft Y Kneewall Overhan /Gars e Asbestos Mold>100 sq. ft Y NCO Detector Missing Y N, Ductwork Exterior Walls VermiculitStructl Concerns 1Y N ther: Notes for Lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? '" OR ► KW SLOPE AND GABLE END Blind Spec? = Why? Why? FRAMING EXISTING .FT FRAMING EXISTING SPEC'ING SQ.FT. WALL x X SLOPE X X FLOOR x x GABLE x x ACCESS X TRANS X X RANS X X ATTIC ATTIC SLOPE I X x SLOPE x x i EXISTING VENTING? EXISTING VENTING? EXISTING PIPES? Y/ KW Venting Vq4F BF Hose I Damming sheathing Access Ternp Access KW Venting Vent BF Temp Access c - i a Insulated Wall X X, Recd Light o Ins.Hose F Vent OF® Chlm.®Damming 12"Roof V t lr 2RV"i Air Handler AH Temp Access T Pull Down D51 Hatch LH '1 i Wall Hatch Door i B"Roof Vent B � = Vol: x .00S8 _ 1 story) x x ATTIC 1 Blind Spec? x x ATTIC 2 Blind Speer rX(7(2 stow Existing Specing Sq ft Existing Spec'ing q ft (3 sto Multipliers Unfloored II {. 1•F "nB Unfloore Trusses Cross Batting Floored — Floored ation Duct Work Cath Sloe Cath Sloe 6"Loose None Walls Walls Access Adt y I Access Venting Propavents Vent BF BF Hose Dammin g Venting Pro av 5 Vent BF BF Hose Damming O0 °D WHF Box: 'u 'U Temp Access: C1 ( 5 N Sheathing Access: R.L.Covers: Sq.Ft/300= - (Exist.NFA Venting)= Needed Sq.Ft/30 (Exist.NFA Venting)_ (Needed NFA Venting) NFA Venting) Roof Type: Existing Venting?�' Existin ntin ? Proposal Terms Customer: David Sadlowski Specialist: Anna Kochaniec Site ID: 3948757 Date: 12/13/2019 HomeWorks • NOTICE CONCERNING SPONSORSHIP:Customer understands and acknowledges that HomeWorks Energy is not an agent,vendor or sub-vendor of the sponsoring Utility with respect to the installation of any energy efficiency measures.In the event of the failure of any energy conservation device to perform as expected,Customer agrees that Customer's sole recourse is to Contractor and not to Clear Result or to the Utility.The Utility and its operating companies shall not maintain,remove or perform any work whatsoever on the energy conservation measures installed.Customer understands and acknowledges that its participation in the MassSave Home Energy Services Program is voluntary and that it has consented for Contractor to install the propose energy conservation measures.Customer agrees that it shall not hold Clear Result,the Utility,their affiliates or operating companies liable fcr Contractor's failure to perform Its obligations under this agreement,for failure of the energy conservation measures to function,for any damage to Customer's Premises caused by Contractor or for any and all damages to property or injury to persons caused by the energy conservation measures • ENERGY BENEFITS:The sponsoring Utility is entitled to 100%of the energy benefits associated with all Energy Conservation Measures,excluding the value of energy cost savings by the customer,but including all rights to all associated 150-NE Energy,Capacity and Reserves Products.HomeWorks Energy agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and products. • CLEANUP OF THE WORK AREA:Weatherization projects can generate dust,some of which may contain traces of lead.The contractor agrees to follow Lead-Safe Guidelines and to make reasonable efforts to control dust and other mess through the draping of cabinets and furniture with plastic,hanging plastic sheet walls,and cleaning floors of dust and any paint spatter. However,the contractor will not leave the interior white glove clean. Outside work area will be left broom clean and all debris and trash removed.However,the homeowner should be aware that minor amounts of cellulose and wood chips--which are harmless and biodegradable—may be left on the ground. The contractor agrees to be conscientious about picking up nails and other fasteners,but homeowner should also be prepared for the occasional fastener that escapes contractor's notice. • CUSTOMER INFORMATION Storage Removal: 7 Perimeter of the Basement 7 Attic -7 Knee Wall n Crawl Space 7 Interior Walls Notes: If the storage is not removed,HomeWorks Energy will charge$0.53/square foot of storage to move it. i Wall Insulation:There is a chance your walls may crack due to the pressure that is required to achieve a dense pack.if your walls crack,we will hire a plasterer to plaster over the cracked area.You will be responsible for repainting. Please review and sign the wall form. Insulation Removal:Insulation must be removed from the following locations: *If it is not done,HomeWorks will charge$1.19/square foot for the removal. Parking Permits:If the energy specialist or operations manager determines that a parking permit is required for installation and if you do not have a pre-existing solution we will procure one and add the cost to your invoice. r Bath Fan Venting:Installing a hose and flapper to an existing bath fan may increase noise levels due to proper venting procedures. Exposed Pipes:if the energy specialist finds pipes that may be exposed to cold weather,leaving pipes outside the thermal envelope may cause them to freeze. The auditor will recommend a solution to the best of their ability,however,HomeWorks Energy will not be held responsible for any damage caused due to frozen pipes. • DEPOSIT: A$50.00 deposit may be required when signing this document.It is completely refundable until the weatherization work is scheduled. The remaining customer copay it is due in its entirety upon completion of the weatherization work. • DISPUTE RESOLUTION:The contractor and the homeowner hereby agree in advance that in the event the contractor has a dispute concerning this contract,The contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A.The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Customer Signature: — Date: 12/13/2019 David Sadl7"D Auditor Signature: Date: 12/13/2019 Anna ch le X Page 1 c Home"Works mass save Energy, Inc PARTNER 101 Stotion Landing Ste 110,Medford,MA 02155 (781)305-3319 ext. 120 Customer Name: David Sadlowski Email:desadlowski@comcast.net Phone:413-387-9359 Premise Address:334 Acrebrook Dr, Northampton,MA 01062 Mailing Address:334 Acrebrook Dr, Northampton, MA 01062 Project ID:3949915 Date: Dec. 13,2019 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour Other 10 hr $925.80 $0.00 Hatch - 2" Thermal Barrier Polyiso Other 1 each $46.28 $11.57 Attic Floor- 8" Open Blow Cellulose Other 960 SF $1,689.60 $422.40 Bath Fan Hose Other 1 each $26.20 $6.55 Damming Other 34 each $81.26 $20.32 Propavent Other 15 each $62.40 $15.60 Walls - Vinyl - 4" Dense Pack Cellulose Other 1024 SF $2,713.60 $678.40 Exterior Door Weather Stripping (with AS hrs) Other 3 each $90.21 $0.00 Door Sweep (with AS hrs) Other 3 each $75.93 $0.00 Total Contractor Price and Payment Schedule HomeWorks Energy, Inc. ag•ees to perform the above described wo-k,furnishing the materia and labor specified for the listed tota price. Payment of the balance of th customP contribution is expected upon completion of the wo,k. 9� L� 1 � Customer Signature:_ .1 �' Date: Customer Phone: q1 Specialist Signature: 11A Date: �� 3 LIMITED TIME OFFER: The prices and incentives in this contract are subject to change it accordance with the sponsoring utility MassSave Home Services Program of-ers. Proposcis con be sent to:tnbox�a)HometNorks£nergy.com Paye 2 c HomeWorks mass save Energy, Inc PARTNER 101 Station Landing Ste 110,Medford,JNA 02155 (782)305-3319 ext. 120 Customer Name: David Sadlowski Email:desadlowski@comcast.net Phone:413-387-9359 Premise Address:334 Acrebrook Dr. Northampton. MA 01062 Mailing Address:334 Acrebrook Dr, Northampton. MA 01062 Project ID:3949915 Date: Dec. 13. 2019 Project Total $5,711.28 Weatherization incentive ($3,464.50) Air sealing incentive ($1,091.94) Total Program Incentive -$4,556.44 Customer Total $1,154.84 Total Contractor Price and Payment Schedule Horne Works Energy, Inc. agrees to perform the above described wo,k,furnishing the materia and labor specified for the listed tota price. Payment of the balance of the customer contribution is expected upon completion of the wo-k. Customer Signature:2• , ",:" J -c'_ - _ - Date: Customer-Phone: — -V 7-3 4 r Specialist Signature: Date:: LIMITED 71ME OFFER: The prices and incentives in this contract are subject to change it accordance with the sponsoring utility MassSave Horne Services Program of-ers. Proposats can be sent to:tnbox`a�HomeWorksEnergy.com Project Summary Name: David Sadlowski HomeWorks Energy,Inc. Phone: (413)387-9359 101 Station Landing Email: desadlowski@comcast.net Medford,Ma 02155 Site ID: 3948757 781-305-3319 MASS SAVE Cost Incentive Air Sealing $ 1,091.94 $ 1,091.94 Weatherization $ 4,619.34 $ 3,464.51 Duct Sealing $ _ $ _ Duct Insulation $ $ Mass Save Rebates Cost Incentive Preweatherization Incentive $ - $ t BEYOND MASS SAVE QTY Cost Lights- Recessed Box w/Mass Save Damming 2 $ 41.20 Total BMS Costs $ 41.20 tAdditional listed work may be a requirement of the insulation proposal.HomeWorks will only remove those line items if completed prior to install date.All work performed beyond Mass Save carries no incentive SUMMARY Cost Incentive Mass Save $ 5,711.28 + Beyond Mass Save $ 41.20 TOTAL PROJECT $ 5,752.48 $ 4,556.45 Total Copay $ 1,196.04 Customer Deposit Applied $ 50.00 FINAL COPAY (due on completion of work) $ 11146.04 HomeWorks Energy,Inc.agrees to perform the above summarized work(Mass Save&Beyond Mass Save),furnishing the material and labor specified for the contract price(Total Project).All work is subject to change,and homeowner's approval is required for completion of any and all work. Preferred Day of Week for Insulation Install: Customer: I l Date: 12/13/2019 Davi adl ski Specialist: Date: 12/13/2019 An i anna.kochaniec@homeworksenergy.com 413-355-9775 v.13