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24C-126 (2) BP-2021-2046 112 FRANKLIN ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-126-001 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-2021-2046 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: - License: Est. Cost: 4000 106148 Const.Class: Exp.Date:07/30/2022 Use Group: Owner: DAVIS R EUGENE & OLIVIA S ILANO-DAVIS Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY Applicant Address Phone: Insurance: 357 COTTAGE ST 7812054484 ECC-600-4001017-2021A SPRINGFIELD, MA 01 104 ISSUED ON:10/22/2021 TO PERFORM THE FOLLO WING WORK: INSULATION 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. Signature: $ I ' V 1 • Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner F.E 00 Dep 4'►Li;. City of No am o ���„ r� --L.} (r--- �? Building D part ent t. ,4 ; 212 Maid 0 etOCT 1 5INSULATION re Room 10 2021 Northamptoln, :�; r; _fr-,- phone 413-587-124Q €axe , 0272 ;.;,, OtIL.. 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 y y c Lot J Unit 112 Franklin Street Northampton Massachusetts 01060 Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Robert Davis 112 Franklin Street Northampton Massachusetts 01060 Name(Print) Current Mailing Address: See Attached (413)219-8938 Telephone Signature 2.2 Authorized Agent: Adam Glenn 59 Tosca Drive Stoughton, MA 02072 Name(Print) ,:>, 2_;9 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 4000.00 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 41060 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 +3+4+5) 4000.00 Check Number &l �j /� ,n l�j This Section For Official Use Only 1 Building Permit Number: l '' "rv� ` I Date Issued: Signature: / '77 M - /8.ZdZ i 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 0 Name of License Holder:Adam Glenn 106148 License Number 59 Tosca Drive Stou hton, MA 02072 07/30/2022 A r a.g" V Expiration Date 781-205-4484 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ HomeWorks Energy 181138 Company Name Registration Number 59 Tosca Drive Stoughton, MA 02072 03/02/2023 Address Expiration Date Cdaik ``�Q��3'' � 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 lr l No 0 Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 467435 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 cdtaik c..got 10/11/2021 Signature of Owner/Agent Date 1 Robert Davis , as Owner of the subject property hereby authorize HoreWorks Energy to act on my behalf, in all matters relative to work authorized by this building permit application. See Attached 10/11/2021 Signature of Owner Date City of Northampton Massachusetts A. - .c�G I '� . DEPARTMENT OF BUILDING INSPECTIONS f.°\ I 1 212 Main Street • Municipal Building �J FC�� " Northampton, MA 01060 `~•-�""'�1� 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 pm-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:4000.00 Address of Work:112 Franklin Street Northampton Massachusetts 01060 Date of Permit Application: 10/1 1/2021 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: 1 0/1 1/2021 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 op�H�• ". si Massachusetts - '<<G DEPARTMENT OF BUILDING INSPECTIONS a: 4 -a. r' 212 Main Street •Municipal Building J�;.., Ca Northampton, MA 01060 �sPpy ‘'‘� 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: 112 Franklin Street Northampton Massachusetts 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) CY/AA S1)1041)- 10/11/2021 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. City of Northampton Massachusetts �' * 4 ;cG � a DEPARTMENT OF BUILDING INSPECTIONS 81 1,1)006 212 Main Street • Municipal Building ,p�..,, OC Northampton, MA 01060 sNh 3 0�^ MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 112 Franklin Street Northampton Massachusetts 01060 Contractor Name: HomeWorks Energy Address: 59 Tosca Drive City, State: Stoughton, MA 02072 Phone: 781-205-4484 Property Owner Name: Robert Davis Address: 112 Franklin Street Northampton Massachusetts 01060 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. Contractor signature Calikk Date 10/11/2021 _ The Commonwealth of Massachusetts ii-—' '— l Department of Industrial Accidents = 1= 1 Congress Street,Suite 100 201`= Boston, MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Anplicant Information Please Print Legibly Name (Business/Organization/Individual): Horne Works Energy Address: 59 Tosca Drive City/State/Zip: Stoughton, MA 02072 Phone#: 781-205-4484 Are you an employer?Check the appropriate box: Type of project(required): 1 am a employer with 500 employees(full and/or part-time).* 7. [I]New construction 2.0 II am a sole proprietor or partnership and have no employees working for me in 8. El Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑lam a homeowner doing all work myself.[No workers'comp.insurance required.]+ 10 0 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.Q Plumbing repairs or additions 5.0 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,§1(4),and we have no employees.[No workers'comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I.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 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: NH Employers Insurance Company Policy#orSelf-ins.Lic. #:#4001017 Expiration Date: 01/01/2022 Job Site Address• 112 Franklin Street Northampton Massachusetts 01060 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 pen ' s of perjury that the information provided above is true and correct. Si&nature: </ `Z�Y Date: 1 0/11/2021 Phone#:781-205-4484 II wxpermitting homeworksenergy.com Official use only. Do not write in this area, to be completed by city or town official. 1 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#: �....iN HOMEENE-01 LLARIVIERE ,a►coRo CERTIFICATE OF LIABILITY INSURANCE DAT1(4/N/DD/YYYY) �� 1/4/2021 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 NAME: Foster Sullivan Insurance Group,LLC (A//C,No,Eat):(978) 686-2266 301 I(FA 978 686-6410 163 Main Street (ac,No):( ) North Andover,MA 01845 E-MAILDESS: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 IMM/DD/YYYY) IMM/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 $ 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: $COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY - (Ea accident) $ ANY AUTO COM5915393 1/1/2021 1/1/2022 BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOS ONLY X AUTOS BODILY INJURY(Per accident) $ X HIRED ONLY X NON- O yyry ED PROPERTY DAMAGE (Per accident) $ $ C _ UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS UAB CLAIMS-MADE MQSX00007091-01 1/1/2021 1/1/2022 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ D WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N ECC-600-4001017-2021A 1/1/2021 1/1/2022 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (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/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 I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • Fo/nei/(veititead.ife�e/ga-34fl(' 1?>4e , Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card HOME WORKS ENERGY,INC. Registration: 13 1138 101 STATION LANDING STE 110 Expiration: 03/02/2023 MEDFORD,MA 02155 Update Address and Return Card. SCA 1 0 20M O5f17 Office of Consumer Maim&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Supplement Card before the expiration date. If found return to: Registratloe Lgolration Office of Consumer Affairs and Business Regulation 181138 0310272023 1000 Washington Street -Suite 710 HOME WORKS ENEROY,INC. Boston,MA 02118 ADAM GLENN 6a14A' 101 STATION LANDING STE 110 ." ' MEDFORD,MA 02155 Undersecretary Not valid without signature / Camm�n veatlh of Massachusetts Division of Professional Licensure Restrict edto:Construction Supervisor Specialty Board of Building Regulations and Standards CSSL-IC -insulation Contractor Cons tructic ►.Sltp•kftpgr Specialty CSSL-1061 48 - Spires'07/30/2022 A'. ADAM GLEAN 19 CHARGE POUND RD WAREHAM MA 02571 ilw41.16° Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner t,(/�^" For information about this license Call(617)727-3200 or visit www mass.govfdpi Insulation/Air Sealing Permit Authorization Specialist: Bryan Ruddy Company: HomeWorks Energy Email: Bryan.Ruddy@homeworksenergy.com Address: 101 Station Landing Cell: 413.204.9308 Medford,Ma 02155 Phone: 781.305.3319 Customer: Robert Davis Address: 112 Franklin Street Email: redavis911@gmail.com Northampton, MA 01060 Site ID: 467435 Phone: 413-219-8938 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 HomeWorks Energy that an inspection is necessary with instructions on how to complete this process to close out your permit. Email: redavis911@gmail.com Customer (Dyes- Signature: f �i�`s Date: 6/7/2021 Robert Davis 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 company' 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 Other unit owners may sign when there is no association. Owner Occupied❑ Condo-❑ Tenant Occupied 0 PLAN VIEW 3 Name: Robert Davis Site ID: 467435 Finished Sq. Ft: 1422 Si Phone:413-219-8938 Year of House: 1900 Electric Acct#: w Address: 112 Franklin Street Northampton #Of Floors: 2 Gas Acct#: Unit#: #Occupants: 2 Housing Type? Conventional DUCTWORK INSPECTION Ducts Insulated?❑ 3 22 Duct Linear Ft. `C912 t 5Fi 12 Duct Square Ft. 3 a)A/S R/J 1HR Duct Air Sealing Hours 22 Duct Insulation is N m Duct Insulation Removal 3 I- m w BASEMENT INSPECTION — I cl Existing Spec'ing Ln/Sq. Ft. 3g� a m 30 Bsmt Wall AG 0 Crawl Ceiling 19 Crawl Rim Joist z3 Bsmt RJ w/Sill FGB ' y ax ': B Bsmt RJ NO Sill .rl- 16 4 Vapor Barrier - ` ,. r - + Bsmt Door r, 19 Y/N Blower Door? WALLS&GARAGE Drill Location? Siding Ceil.Height Existing Spec'ing Sq.Ft. Framing Exterior Wall 1 Wood Clap 7+1 None 4" DPC 1304 2 x 4 x 16 BalloonOPlatfor Exterior Wall 2 x x BalloonDPlatforrrC Overhang x x Garage Wall x x BalloorlJ'latforrrin Garage Ceiling x x ce 0 3 22 4 Descriptor/Area z `•C912 1. 5Fr 72 A:� I a)DPC 4"13t)4'gft 3 sc or0 22 B:EFP b)2x door kits u2i 16 133 sgft X C:EFP w 27....{t D:1.5Fr 12' 264 sgft 30 r 0 15' 19 23 Insulation Removal B - Sqft. 16 4 ,weeps,: 2 19 Stripping: 2 WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawlspace n Other: K&T YUN Moisture Y N ✓ Combustion Sfty Y N 1✓I Kneewall Overhang/Garage ❑ Asbestos Y ❑N ✓ old>10osgFt Y 0 ✓CO Detector Missing ❑ ✓ Ductwork Exterior Walls ❑ VermiculiteY❑N ✓ Structl Concerns'Y❑N ✓Other: Notes for Lead Vendor/Work Not Contracted: redavis911@gmail.com Recently knocked down a wall to make sunroom heated living space,added those walls to the PV KW WALL AND KW FLOOR Blind Spec? ❑ ....- OR I. 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 x PO ACCESS X TRANS X X Z u- TRANS x X ATTIC ATTIC SLOPE x X a I- 3 x x v. SLOPE EXISTING VENTING? p L_ i W I15 Y EXISTING VENTING? EXISTING PIPES? YnN n m KW Venting Vent BF BF Hose Damming Sheathing Access Temp Access KW Venting Vent BF Temp Access ta KNEEWALL MANDATORY ,. l7 z NO HR IN CAP or KW a 0 Y o6 U Q Insulated Wall^ r-X X Rec'd Light 0-�Ins.Hose I-1 Vent BF El Chim.El Damming 12"Roof V t Air Handler l I Temp Access l I Pull Down ] Hatch HQ Wall Hatch "/ Door o/ 8"Roof Vent RV BAS Vol: x .0058 19(1 story) x x ATTIC 1 Blind Spec? n x x ATTIC 2 Blind Spec? U X/15.4(2 story)) - z Existing Spec'ing Sq ft Existing Spec'ing Sq ft `13.6(3 story)/ o E Unfloored Unfloored Trusses Cross BattingLAJ Floored Floored Mixed lnan Duct Work I I >6"Loosd= None m u— Cath Slope Cath Slope AIR SEALING HOURS E Walls Walls Access Access _ 2 Venting Propavents Vent BF BF Hose Damming Venting Propavents Vent BF BF Hose Damming m WHF Box: c U;� Temp Access: ai a) o_ o_ Sheathing Access:U Lo .�' R.L.Covers: U Sq.Ft/300= - (Exist.NFA Venting)= (Needed _ Sq.Ft/300= - (Exist.NFA Venting)= (Needed Existing Venting? NFA Venting) Existing Venting? NFA Venting) Roof Type: Asphalt HomeWorks Energy ��r in l l l l 101 Station Landing,M Medford,MA 02155 CONTRACT - WZ HomeWorks781-305-3319 FAX 0 Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT B WORK ORDER Robert Davis (413)219-8938 09/28/2021 467435 84807 SERVICE STREET BILLING STREET PROPOSED BY: 112 Franklin Street 112 Franklin Street HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL KNOB&TUBE WIRING 1 -$250.00 $0.00 -$250.00 We have identified the potential existence of Knob&Tube wiring in (initials) your home.The following contract is not valid unless accompanied by the Pre-Weatherization Barrier Incentive form,signed by your licensed electrician.Work will not proceed with this work until we receive a copy of the form. HOME AIR SEALING 1 $85.00 $85.00 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.) WEATHERSTRIP AND ADD DOOR SWEEP 2 $160.00 $160.00 Provide labor and materials to install Q-lon weatherstripping and a doorsweep to door(s)to restrict air leakage. WALLS WOOD SIDED 992 $1,993.92 $1,495.44 $498.48 Furnish and install blown in Class I Cellulose to shingle and/or clapboard exterior walls.The butt of the upper course of your wood siding is cut to drill holes into the wall sheathing behind.The holes are then plugged and the wood siding is reinstalled using exterior grade nails. Touch-up painting,if needed,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 acknowledgement of receipt and agreement to proceed. HomeWorks Energy E NC' 101 Station Landing,Medford,MA 02155 CONTRACT - WZ HomeWorks 781�05�319 FAX 0 Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CUENT WORK ORDER Robert Davis (413)219-8938 09/28/2021 467435 84807 SERVICE STREET BILLING STREET PROPOSED BY: 112 Franklin Street 112 Franklin Street HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL CRAWLSPACE R19 FIBERGLASS AND RIGID BOARD 264 $1,573.44 $1,180.08 $393.36 Provide labor and materials to install R-19 unfaced fiberglass insulation to the crawlspace ceiling to be in contact with the subfloor and completely filling the joist cavity to be flush with the joist bottoms. Then rigid board insulation will be installed and the seams all sealed with FSK tape. Total: $3,562.36 Program Incentive: $2,920.52 Customer Total: $641.84 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF """Six Hundred Forty-One&84/100 Dollars $641.84 C-'�/Gfj COMPANY REPRESENTATIVE CUSTOMER SIGNATURE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE 09/30/2021 SIGN DATE DAYS.