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36-187 (4) 866 BURTS PIT RD BP-2022-0057 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:36- 187 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-2022-0057 Project# JS-2022-000098 Est.Cost: $3000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOMEWORKS ENERGY INC106148 Lot Size(sq. ft.): 31232.52 Owner: LIENERT BRIAN Zoning: Applicant: HOMEWORKS ENERGY INC AT: 866 BURTS PIT RD Applicant Address: Phone: 1nsu •ance: 357 COTTAGE ST (781) 205-2595 () WC' SPRINGFIELDMA01104 ISSUED ON:7/20/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATIONNVEATHERIZATION 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. I1 , 5r/ ' Q Certificate of Occupancy si��;n:,lure:i *� ' I FeeType: Date Paid: Amount: Building 7/20/20210:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner FEE: $65.00 M -:. City of Northam on Dep��R 0 ¢ Building Dep f`tmen 4�\' • \`� NS ULA TION i`, 212 Main Stree �Gl j/\ `� I Room 0O.<,o \' >.w ' Northampton, S • \ '~�•�� phone 413-587-1240 Fax 9 -1272�� \ y��_.„.._,. . » � 4../...„1,_ QfiJ1(_, Y Q APPLICATION FOR INSULATION FOR A ONE OR TW ' ELL G ONLY SECTION 1 -SITE INFORMATION INSUL T ON PERMIT 1.1 Property Address: This section to be completed by office Map 3(Q Lot C 8 7 Unit 866 Burts Pit Road Northampton Massachusetts 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Brian Lienert 866 Buds Pit Road Northampton Massachusetts 01062 Name(Print) Current Mailing Address: See Attached (sso) 1-0701 Telephone Signature 2.2 Authorized Agent: Adam Glenn 357 Cottage Street, Springfield, MA 01104 Name(Print) cdia4Mailing Current Address u.cis)ezz 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 3000.00 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee -tiac 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 +4+ 5) 3000.00 Check Number I(QO I This Section For Official Use Only BuildingPermit Number: 6 0" a ' 57 Date Issued: Signature: f� - 7- 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 357 Cottage Street, Springfield, MA 01104 07/30/2022 Add c.1)0 Expiration Date clet 781-205-4484 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 HomeWorks Energy 181138 Company Name Registration Number 357 Cottage Street, Springfield, MA 01104 03/02/2023 Address ';1 Expiration Date vz. 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 I r l No 0 Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 484163 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 `1 Print Name cdfda.4c� "" 07/13/2021 Signature of Owner/Agent Date Brian Lienert , 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 07/13/2021 Signature of Owner Date City of Northampton tMAM 0.' T � % " •S...•• SC? 'Massachusetts a; e; K•; DEPARTMENT OF BUILDING INSPECTIONS yt A. QS•� F'. 212 Main Street • Municipal Building J O, Northampton, MA 01060 ‘..0 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:Weathefization Est.Cost:3000.00 Address of Work:866 Burts Pit Road Northampton Massachusetts 01062 Date of Permit Applicat•ion: 07/13/2021 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: 07/13/2021 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 • ,5 s, -r"' z ; Massachusetts �` ct` t .� w i DEPARTMENT OF BUILDING INSPECTIONS �• r M 212 Main Street •Municipal Building J`. cam Northampton, MA 01060 s67N ,O 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: 866 Burts Pit Road Northampton Massachusetts 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) 64,4 07/13/2021 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 1 1t Department of Industrial Accidents - 1 Congress Street,Suite 100 "'�:i_am Boston, MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): HomeWorks F,nergy Address: 357 Cottage Street City/State/Zip: Springfield, MA 01104 Phone#: 781-205-4484 Are you an employer?Check the appropriate box: Type of project(required): 171 am a employer with 500 employees(full and/or part-time)." 7. ❑New construction 2.11 I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0 1 am a homeowner doing all work myself [No workers'comp.insurance required.]t 10 ❑Building addition 4.❑1 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.❑ Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.Ell 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. 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14 � ther WEATHERIZATION 152,3I(4),and we have no employees.[No workers'comp. insurance required.] *Any applicant that checks box f I 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. 5. Insurance Company Name: NH Employers Insurance Company Policy#or Self-ins. Lie.#:#4001017 Expiration Date: 01/01/2022 Job Site Address• 866 Buds Pit Road Northampton Massachusetts 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 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. I do hereby certify under the pains and per s of perjury that the information provided above is true and correct. Signature: % v `�e - Date: 07/13/2021 Phone#:781-205-4484 // wxpermitting@homeworkseneray.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#: ___,..........N HOMEENE-01 LLARIVIERE AFRO CERTIFICATE OF LIABILITY INSURANCE DAT1/4/2021 Yn 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(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 Lisa Lariviere Foster Sullivan Insurance Group,LLC PHON: 163 Main Street ja"c°O,"r o,EM):(978)686-2266 301 � FAX No):(978)686-6410 North Andover,MA 01845 ADDSS:certificates@fostersullivangroup.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Markel Insurance Company 38970 INSURED INSURER B:Safety Insurance Company 39454 Homeworks Energy,Inc INSURER C:McGowan Excess&Casualty 551155 Homeworks IIC LLC 101 Station Landing Suite 100 INSURER D:NH Employers Insurance Company _13083 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD /MM/DD/YYYYI (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR MKLVIPBC001429 1/1/2021 1/1/2022 DAMAGETORENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO COM5915393 1/1/2021 1/1/2022 BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOSRE ONLY AUTOS yyry BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTOS ONE (Per accident DAMAGE $ $ - C UMBRELLA IJAB X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE MQSX00007091-01 1/1/2021 1/1/2022 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ D WORKERS COMPENSATION PER H AND EMPLOYERS'LIABILITY STATUTE ER ECC-600-4001017-2021A 1/1/2021 1/1/2022 1,000,000 ANY YIPROPRIETOREXRLNER/EDED?ECUTIVE Y/" "/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Pollution Liability CPLMOL105056 1/1/2021 1/1/2022 $10,000 Deductible 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 EnergyInc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 101Station Landing Ste 100 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 re IL//�./140cif/ieq/ // e. f/t9ar, Q,{ lr. ) Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston. Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 181138 HOME WORKS ENERGY,INC. Expiration: 03/02/2023 101 STATION LANDING STE 110 MEDFORD,MA 02155 Update Address and Return Card. SCA t 0 20M-05:17 .:13:e_viiiir»Nor//ldry. r'& Mee of Consumer Affairs&Business ReguINion NOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Supplement Card before the expiration date. If round return to: liankinan Office of Consumer Affairs end Business Regulation 1811 03/02/2023 1000 Washington Street -Suite 710 HOME WORKS ENE..ROY,1NC. Boston,MA 02118 ‘t(e2A-- ADAM GLENN 644A 101 STATION LANDING STE 110 "'ie (9'4'4 AAEDFOHD,AAA 02155 Not valid without signature Undersscreirry Commonwealth of Massachusetts Construction Supervisor Specialty Division of Professional Licensure Restricted to: Board of Building Regulations and Standards CSSUC -insulation Contractor ConstructiFoSltptiviow Specialty CSSL-105148 rapires 07/30/2022 .I .a ADAM GLENN 19 CHARGE POUND RD WAREHAM MA 02571 !�'1t► Failure to possess a current edition of the Massachusetts ,j r+ Slate Building Code is cause for revocation of this license .'�^" ice:••--� For information about this license Commissioner Call(617)727-3200 or visit www mass.govrdpl Insulation/Air Sealing Permit Authorization (rO Specialist: Bill MacDonald Company: HomeWorks Energy lI('l Email: bill.macdonald@homeworksenerl Address: 101 Station Landing HomeWorks Cell: 781-366-1358 Medford, Ma 02155 Phone: 781-305-3319 Customer: Brian Lienert Address: 866 Burts Pit Road Email: bplienert@aol.com Northampton Massachusetts 01062 Site ID: 484163 Phone: (860) 881-0701 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 scheduled and performed on the work by the building inspector in your town. If this case relates to your job, you will be notified by Home Works Energy that an inspection is necessary and you will be given the proper steps on how to complete this process to close out your permit. Email Customer Signature: Date: 2/1/2021 Brian Lienert KW WALL AND KW FLOOR Blind Spec? ❑ OR -► KW SLOPE AND GABLE END Blind Spec? ❑ Why? Why? FRAMING EXISTING SPEC'ING SQ.FT. FRAMING EXISTING SPEC'ING SQ.FT. WALL X X SLOPE X X FLOOR X X GABLE X X cc a •CCESS X TRANS X X m u-• RANS x X ATTIC IV D 05 ATTIC SLOPE X X 3 X X tn SLOPE EXISTING VENTING? i EXISTING VENTING? EXISTING PIPES? Y/N m KW Venting Vent BF BF Hose Damming Sheathing Access Temp Access\ KW Venting Vent BF Temp Access a a KNEEWALL MANDATORY 0 Z Q ite in be Y 021 tJ Q a. poly hatch b. 72 p-vents c. bf hose 24 d. 50' dam e. 5"obc = 1152 sq.ft. 48 Insulated Wall X X Rec'd Light 0 Ins.Hose I BF I Vent BF IBFV I Chim.I CH I Damming 12"Roof V t CD BAS Vol: x .0058 Air Handler FAH I Temp Access I T I Pull Down PDSI Hatch 0 Wall Hatch "/ Door o/ 8"Roof Vent RV er 2x 6 x 1 ATTIC 1 Blind Spec? ❑ x x ATTIC 2 Blind Spec? ❑ x r15A(2 story)) - z Existing Spec'ing Sq ft Existing Spec'ing Sq ft 13.6(3story) o Multipliers E Unfloored 10"fbq 5"obc 1152 Unfloored Trusses Cross Batting W• Floored Floored a Mixed Insulation Duct Work z Cath Slope Cath Slope >6"Loose None v Air Sealing Hours E- Walls Walls 31 Access hatch poly Access 10 Venting Propavents Vent BF BF Hose Damming Venting Propavents Vent BF BE Hose Damming to oo W H F Box: _ C none 72 0 1 50' Temp Access: el ai a n Sheathing Access: in v R.L.Covers: Sq.Ft/300= (Exist.NFA Venting)_ (Needed Se.Ft/300- _ (Exist.NFA Venting)- (Needed Existing Venting? code NFAventing) Existing Venting? NFnvenm,g) Roof Type PLAN VIEW Z Name: Brian Lienert Site ID: 484163 Finished Sq. Ft: 2600 Phone: (860) 881-0701 Year of House: 1978 Electric Acct #: 2652255011 E Address: 866 Burls Pit Road # of Floors: 2 Gas Acct#: 549964005 Northampton Unit#: # Occupants: 4 Housing Type? raised ranch DUCTWORK INSPECTION Ducts Insulated?PI Duct Linear Ft. Duct Square Ft. Duct Air Sealing Hours Duct Insulation I- Duct Insulation Removal Finished BASEMENT INSPECTION Existing Spec'ing Ln/Sq. Ft. co Bsmt Wall AG Crawl Ceiling Crawl Rim Joist Bsmt RJ w/Sill Bsmt RJ NO Sill Vapor Barrier sgft. Bsmt Doorl Y/N Blower Door? WALLS&GARAGE Drill Location? Siding Ceil. Height Existing Spec'ing Sq. Ft. Framing Exterior Wall 1 x x Balloon/Platform Exterior Wall 2 x x Balloon/Platform Overhang x x Garage Wall x x Balloon/Platform Garage Ceiling x x 0 W z 0 it W lK Full Insulation Removal Sqft. Sweeps: WX Stripping: 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>100 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: HomeWorks Energy pn Err I 101 Station Landing, Medford,MA 02155 CONTRACT - ISM S HomeWorks 781-305-3319 FAX 0 Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT# WORK ORDER Jacqueline Lienert (413)303-9775 02/01/2021 484163 51803 SERVICE STREET BILLING STREET PROPOSED BY: 866 Burts Pit Road 866 Burts Pit Road HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION CITY COST INCENTIVE TOTAL HOME AIR SEALING 10 $850.00 $850.00 Provide labor and materials to seal areas of your home against wasteful, excess 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.) Total: $2,704.02 Program Incentive: $2,240.52 Customer Total: $463.50 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Four Hundred Sixty-Three & 50/100 Dollars $463.50 COMPANY REPRESENTATIVE CUSTOMER SIGNATURE 02/01/2021 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE DAYS. HomeWorks Energy (c-on �n? 101StationLanding,Medford, MA 02155 CONTRACT - ISM S HomeWorks 781-305-3319 FAX 0 Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT# WORK ORDER Jacqueline Lienert (413)303-9775 02/01/2021 484163 51803 SERVICE STREET BILLING STREET PROPOSED BY: 866 Burts Pit Road 866 Burts Pit Road HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 75% For eligible weatherization measures, Columbia Gas of Massachusetts is offering an incentive of 75%for insulation measures and 100%for the air sealing measures, both with no limit. You are eligible to apply for the 0% Heat Loan to finance your co-pay, applications must be submitted before the weatherization work begins. ATTIC DAMMING- R-38 FIBERGLASS 50 $102.50 $76.88 $25.62 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLAT-5"OPEN R-19 CELLULOSE 1,152 $1,451.52 $1,088.64 $362.88 Provide labor and materials to install a 5" layer of R-19 Class I Cellulose to open attic space. ATTIC HATCH-SEAL& INSULATE 1 $60.00 $45.00 $15.00 Provide labor and materials to insulate the back of an attic hatch with 2" rigid insulation board.Weatherstrip the perimeter. VENTILATION CHUTES 72 $180.00 $135.00 $45.00 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. INSULATED BATH EXHAUST HOSE 4 INCH 1 $60.00 $45.00 $15.00 Provide labor and materials to install an insulated 4"exhaust hose to existing bathroom fan(s).