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03-007 (16) BP-2022-0255 468 COLES MEADOW RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 03-007-001 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-2022-0255 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: Licence: Est. Cost: 3000 HOMEWORKS ENERGY INC 10614 Const.Class: Exp.Date:07/30/2022 CH A, SEUNGHEE, TRUSTEE 01 JUST FLOW Use Group: Owner: REALTY TRUST Lot Size (sq.ft.) Zoning: WSP Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 7812054484 ECC-600-4001017-2021A STOUGHTON, MA 02072 ISSUED ON:03/17/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERIZ ATI ON 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: i +r � � )2 . (Pt, Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $65.00 f Dep 0r-�r4r, City of Northampton �, I. OR /fit. y Building Department � `�' /00 � � 1 212MainStreet '�1q �, -el t Room 100 9 /6 ' SULA TION \.,,:0- • Northampton, MA 01060 ,l„p,_ i�' "�'` phone 413-587-1240 Fax 413-587� / / 0111.. y nT Yn ,... .-,, ,,/,1,,:„N'MVP-UN' f / APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILYG ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT This section to be completed by office 1.1 Property Address: Map O Lot 0 07 Unit 468 Coles Meadow Road Unit 1 & 3 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Terna Tilley-Gyado 468 Coles Meadow Road Unit 1 & 3 Name(Print) Current Mailing Address: See Attached (413)376 5477 Telephone Signature 2.2 Authorized Agent: Adam Glenn 59 Tosca Drive Stoughton, MA 02072 Name(Print) c::, ;:i0Current Mailing Address: cdtpv781-205-4484 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 4404 4. Mechanical (HVAC) 5. Fire Protection 4VirS 6. Total = (1 +2 +3+4 +5) 3000.00 Check Number ,/ issued: Section For Official Use Only �n ca ,Un )i.J Date Building Permit Number: ssuu ed: _15�- /,� Signature: 3" 7 7Q2z 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 59 Tosca Drive Stoughton, MA 02072 07/30/2022 Addre LS'" 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 caL Expiration Date c( _ 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 n No ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 4415163/ 4415184 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 cdtp)( sijoeid 03/10/2022 Signature of Owner/Agent Date Terna Tilley-Gyado 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 03/10/2022 Signature of Owner Date City of Northampton fat NAMYT- `- Massachusetts DEPARTMENT OF BUILDING INSPECTIONS S �!vw f1 212 Main Street • Municipal Building Jys �lca _- � Northampton, MA 01060 'PP4 3�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 e of Work: eat el"IZatlOn Est. Cost:3000.00 Address of Work:468 Coles Meadow Road Unit 1 & 3 Date of Permit Application: 03/10/2022 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: 03/10/2022 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 Massachusetts �`��Ss • t. DEPARTMENT OF BUILDING INSPECTIONS m 212 Main Street •Municipal Building of i; Northampton, MA 01060 Jfrj TO° 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: 468 Coles Meadow Road Unit 1 & 3 (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) cafb., c,..6)19 .1/4_ 03/10/2022 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. .,1,0T.,,�t. r,1 City of Northampton r� ' s F Massachusetts ►. RI DEPARTMENT OF BUILDING INSPECTIONS y.. l�c.� 212 Main Street •• Municipal Building `ji.,,y OQ %r. Northampton, MA 01060 pPh ... 1 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 468 Coles Meadow Road Unit 1 & 3 Contractor Name: HomeWorks Energy Address: 59 Tosca Drive City, State: Stoughton, MA 02072 Phone: 781-205-4484 IN me rty Owner Terna Tilley-Gyado Address: 468 Coles Meadow Road Unit 1 & 3 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 Ulifil SI;1141:() c.- ---- Date 03/10/2022 The Commonwealth of Massachusetts IE_ I Department of Industrial Accidents _', 1 Congress Street,Suite 100 • A_ 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): HorneWorks Fnergy 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): l�am a employer with 500 employees(full and/or part-time).* 7. ❑New construction 2.0 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.❑lam a homeowner doing all work myself [No workers'comp.insurance required.]t 10❑Building addition 4.❑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.❑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.: 6.1-1 We are a corporation and its officers have exercised their right of exemption per MGL c. 14 ther WEATHERIZATION 152,It 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. 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 subcontractors 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#or Self-ins.Lic.#:#4001017 Expiration Date: 01/01/2023 Job Site Addrecv 468 Coles Meadow Road Unit 1 & 3 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 violationpunishable 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 Ca signature: _ _�" ") c�e� Date: 03/10/2022 Phone#:781-205-4484 // wxpermitting(a�homeworksenergy.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#: /'....RN HOMEENE-01 LLARIVIERE ACORif, CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) `---� 1 1/3/2/3/2022 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 PHONE FAX 163 Main Street (A/C,No,Ext): (978)686-2266 3011 (A/C,No):(978)686-6410 North Andover,MA 01845 E-MAILDRSS:certificates@fostersullivangroup.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Central Mutual Insurance Company 20230 INSURED INSURER B:NH Employers Insurance Company 13083 Homeworks Energy, Inc INSURER C:Markel Insurance Company 38970 Homeworks IIC LLC 101 Station Landing Suite 100 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 LTR INSD WVD (MM/DD/YYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 DAMAGEES(E TO RENTEDaoccurrence) $ 300,000 PRE MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PPOLICY JE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X NON-OWNEDUO PROPERTY accident DAMAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE CXS 8698471 1/1/2022 1/1/2023 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION 'IfX PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ECC-600-4001017-2022A 1/1/2022 1/1/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (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 $ C Pollution Liability CPLMOL109278 1/1/2022 1/1/2023 $10,000 Deductible 1,000,000 DESCRIPTION OF OPERATIONS/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. 101 Station 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 FociwAneteifeell,0-/Agideitzelfite,13€//r4 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Rogistration Type: Supplement Card 81138 HOME WORKS ENERGY,INC Registration: 3/02/2023 101 STATION LANDING STE 110 Expiration: 03l02/2 MEDFORD, MA 02155 Update Addross and Return Card. WA 1 0 2010-05r17 i iy" Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use orgy TYPE:Supplement Card before thy expiration date. If found return to: flegistratiog E1tQlretlon Office of Consumer Affairs and Business Regulation 181138 0310212023 '000 Washington Street •Suite 710 HOME WORKS ENEROY,INC. Boston,MA 02118 • - l ADAM GLENN ! .. 101 STATION LANDING STE 110 (` 04r"E` MEDFORD,MA 02155 Undersecretary Not valid without signature Commonwealth of Massachusetts Division of Professional Licensure Restr ed ed to; Construction Supervisor Specially Board of Budding Regulations and Standards CSSL.C -Insulation Contractor Cons tructed-Supeivtiegr Specialty CSSL•106148 ftptres:07/30/2022 ADAM GLENN 19 CHARGE POUND RD WAREHAM MA 02571 •{�I�tiaL�, Failure to possess a current edition of the Massachusetts n r' State Building Code is cause for revocation of this license. 1 %.. • For information about this license Commissioner Call 1617)727-3200 or visit www mass.govldpi Insulation/Air Sealing Permit Authorization Specialist: Jonathan Barnes Company: HomeWorks Energy Email: jonathan.barnes@homeworksenergy.a Address: 101 Station Landing Cell: 4134263869 Medford, Ma 02155 Phone: 781.305.3319 Customer: Terna Tilley-Gyado Address: 468 Coles Meadow Rd Email: paznut7@gmail.com Northampton, MA, 01060 Site ID: 4415163 Phone: 4133765477 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: paznut7@gmail.com Customer Signature: Date: 2/4/2022 Terna Tilley-Gyado 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 companyt 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 t Other unit owners may sign when there is no association. PLAN VIEW Name: " 'di(( G G 89 Site ID: -lit S t 63 Finished Sq. Ft: rj ° Phone: Year of House: �616 Electric Acct#: S , (j W ddress:`'l(, 'e - Ld #of Floors: l, '-�'}.�I- Gas Acct#: �. ,y1, is N1 �tc(j)nit rt: #Occupants: 'a-- Housing Type? AC:IA_ DUCTWORK INSPECTION Ductslnsutated7� auct Linear Ft. c'tVt.l3kle Duct Square Ft. A) //.l A /` uct Air Sealing Hours suet Insulation 5. t 6 ke�1j S lr Duct Ins - on Removal ,�l/ 1 X BASEMENT INSPECTION poi_y (1 Q1 W Existing Spec'ing Ln/Sq.Ft. w m li 14t" -A ) t} Bsmt 11.1 NO Sill OJ. '` Y/N Blower Door? WALLS&GARAGE Drill Location? Siding Cell.Height Existing Spec'ing Sq.Ft. Framing .___.- Exterior Wall 1 —x x Balloon/Platform Exterior Wall 2 "'� x x Balloon/Platform Overhang r._._CM x X Garage Wall �` `R"s` x x Balloon/Platform 0 US 0 Ea - bstC� Aar- Q.). s. G ri t ri r e (`1i1r t zy.1r. Ama n c.. t.tr. '..A 1. 11ifx ,s,., WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) �rn Attic Basement/Crawlspace Other: K&T Y/ Moisture Y/ 'Combustion Sfty Y}aa, Kneewall Overhang/Garage Asbestos Y/ Mold>100 sq.ft Y tCO Detector Missing Y/b) Ductwork Exterior Walls Vermiculite Y/ Structl Concerns Y/N)Other: Notes for lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? 0 OR KW SLOPE AND GABLE END Blind Spec? -13 Why? Why? FRAMING_ E2I a .,t St,a FRAMING EXISTING SPEC1 < SO.FT. PALL X X Pr LOOA X x AB G E X % - ,■ a GABLE X X � •CCESS X ff- .- .A^ijr. TRANS x X _ _ rn w X ATTIC b •Tnc a "LOPE X X SLOPE X DOSTING r: ING? H '-' XISTING VENTING? EXISTI PIPES? Y/ti R, s KW Venn .p{ Y Mole Auto KW • K TOKtP AIMS i , ( crIECWALL MANDATORY A) A.7.5) _ 1C.( \\.•PS • o (" i (")--..) cr es Y h k a I e./ t-C.t") . Inortatad WaI X X IIacd Uant 0 u,a.Moen air Be enan.(Q1JOe..Knin! Jr tool Yaot atkV Alr Handler An Temp Arm„ TO Pun Dona Ii We Match•/ Door c/ Is'AeoWVert�M� BAS Vol: x .0058 q X ATTIC 1 Blind spec? 0 x xx(159.41212 �) = ATTIC 2 Blind Spec? �'❑ stael) 4 Existing Spec in• Sq ft Existing Spec'ing 5'q ft u.titowt G Unfloored (/"tj�. — Unfloored Multipliers Peered �IW►at:` / 1..-xaE ! n;sss rocs:.tnng re Floored M.Re- ulatfon DUO Work L., Ope Namt., _.,m.._. .. Cath Slope ' -� None C ----- Walls Air Sealing Flours Access A t''A)& 11 Access Venting Propevents Hose Dam VanUng • u I-Tiri ii.ta..a�a , 14 sq..,no• • (GLtttood..t.^V)• IMed.d +e ni tee. r *Mt. . iN. . roled ._.. .a Existin Venting? HlAvenuu `""n" g g sting Venting? Mt....41 Roolrype Cp c Page 1 of 1 �O41K Fn�3 HomeWorks mass save Energy, Inc PARTNER 101 Station landing Ste 110,Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Terna Tilley-Gyado Email:Not provided Phone:413-376-5477 Premise Address:468 Coles Meadow Rd,3, Northampton, MA 01060 Mailing Address:468 Coles Meadow Rd,3,Northampton, MA 01060 Project ID:4423746 Date:Feb.4,2022 Job Description Measure Description Location Quantity 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 $0.00 Project Total $786.92 Weatherization incentive ($46.28) Air sealing incentive ($740.64) Total Program Incentive -$786.92 Customer Total $0.00 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: Date: Customer Phone: Specialist Signature: Date: _ UMITED 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 con be sent to:Inbox@HomeWorksEnergy.com KW WALL AND KW FLOOR Blind Spec? ❑ OR KW SLOPE AND GABLE END Blind Sped.--❑ Why? Why? -- :NAMING EXI5T,i ti is FT FRAMING EXISTING SPEC7NG SQ.FT. ALL X sh• X X j it LOOK x x X X pOr, •CCE55 X TRANS X X r I sDXSTI VENTING? Y I3N Vest W N.... M...A.a s KW V Want BF Tamp Av..O v KNEEWALL MANDATORY _ ) A,1s Ili11�s 5) i; 0 Y Hol---c_lit I a• x 3° ara Si A3.ex. is' is ✓h!'''`" itsWtdWas xx P..ed Litt O Ws.Has.t;1* V..t IV 1 C.ML..l5 I2AV V Otmmht. 12•mo ) Air Mader® ma Temp Ass ID Pin Damn :. find W.3 Kash"/ Door e/ B'AooTYMIt BAS Vol: x .0058 11 tto^!f x 11. ATTIC 1 Blind Spec? 0 x x ATTIC 2 Blind Spec? ,p x(19tsA(l l2 cor ll = 1 Existing Spec In Sq ft Existing Spec'Ing •it u.a t3 Mu W Unfloored, f5'�C ,. 4 y UTiflOOre(1 rises n�Ultipl s n `s Ftlov+rd• Floored Mixed Insulation Ductwork e u Nene Gatio—Slape .9 —. . Cath Slope '6* Air Sealing Hcurs Z. Walls Mini Access Access ) Li Venting Propevsnta EMI •FHose Oammi . Venting P t `, .Ir' �1'��7 "T.t31173:11111 CknuN j _+9•N333. - (CJ.t N:AV.nina)• lN.d.1 .2tl 3D0. (Lost NTA v. • •mod• (tt..d.d Existing Venting? NM Venting tine Venting? Ma"`""w Rod type-i 0 ' < V Page 1 of l tfll? HomeWorks 404ft mass save Energy, Inc PARTNER 101 Station Landing Ste 110,Medford,MA 02155 (781)305-3319 ext.120 Customer Name:Terna Tilley-Gyado Email:Not provided Phone:413-376-5477 Premise Address:468 Coles Meadow Rd, 1, Northampton,MA 01060 Mailing Address:468 Coles Meadow Rd, 1,Northampton, MA 01060 Project ID:4423831 Date:Feb.4,2022 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour Other 14 hr $1,296.12 $0.00 Basement Wall -2"Thermal Barrier Polyiso Other 81 SF $387.18 $0.00 Hatch -2"Thermal Barrier Polyiso Other 1 each $46.28 $0.00 Exterior Door Weather Stripping (with AS hrs) Other 2 each $60.14 $0.00 Project Total $1,789.72 Weatherization incentive ($433.46) Air sealing incentive ($1,356.26) Total Program Incentive -$1,789.72 Customer Total $0.00 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: 7.- ) 0(...aa......(JL.. Date: Customer Phone: Specialist Signature: Date: LIMITED 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:lnbox@HomeWorksEnergy.com PLAN VIEW Name c ct ( `� C. Site ID: `{fit Finished Sq. Ft: t?.;�. g Phone: II( 7� �{f Year of House: Electric Acct#:�LCx7�''�1�?i `7 n Adp res +a e o of Floors: Gas Acct#:— No(-Pt n. M ^et&t3'nit>a: #Occupants: Housing Type? CC.1,1: ---cd DUCTWORK INSPECTION Ducts insutated?D ` s uc Linear Ft. uct Square Ft. ��� 6 uct Air Sealing Hours `n Duct Insulatio v�� v IUCt i .on Removal 5 BASEMENT INSPECTION Existing S.-el • jn/Sq.Ft. c m Bsmt Wall AG Crawl Ceiling Crawl Rim Joist Bsmt RJ w/St---- Bsmt RJ Siil irlirr Barrier I. • Burt Door 'YIN Blower Door? WALLS&GARAGE Drill Location? Siding Cell.Hei:ht Existing S.min: •,Ft. Framin. Exterior Wall 1 — x x Balloon/Platform Exterior Wall 2 ..________.------ x x Balloon/Platform Overhang - x x Garage W x x Balloon/Platform e Ceiling x x a o a v^ VII' C)1 u r . r G r it"*gill IiI;,-; WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT? MANDATORY) Attic Basement/Craw/space Other: K&T Y/(1' Moisture Y/itY Combustion Sfty Y/OW Kneewall Overhang/Garage Asbestos Y/e Mold>100 sq.ft Y/t CO Detector Missing Y AID Ductwork Exterior Walls Vermiculite Y/Q Structi Concerns Y(1)Other: Notes for lead Vendor/Work Not Contracted: Insulation/Air Sealing Permit Authorization Specialist: Jonathan Barnes Company: HomeWorks Energy Email: jonathan.barnes@homeworksenergy.ci Address: 101 Station Landing Cell: 4134263869 Medford, Ma 02155 Phone: 781.305.3319 Customer: Terna Tilley-Gyado Address: 468 Coles Meadow Rd Email: paznut7@gmail.com Northampton, MA, 01060 Site ID: 4415184 Phone: 4133765477 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: paznut7@gmail.com Customer Signature: ,1 Date: 2/4/2022 Ter i ley-G o 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 companyt 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 t Other unit owners may sign when there is no association.