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17D-055 (13) BP-2022-0410 116 STRAW AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: I7D-055-001 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-2022-0410 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 4000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp. Date:07/30/2022 Use Group: Owner: H MARK JASON N& CHRISTINE Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 7812054484 ECC-600-400 1 0 1 7-202 I A STOUGHTON, MA 02072 ISSUED ON:04/20/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATION POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: ( , 1 3 ci0, • yd I ' Fees Paid: $65.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $65.00 City of Northampton Dep0 Building Department 212 Main Street,' APR INSULATION .l x E . Room 100 / 9 00 /47 Northampton, MA 4 U 22 phone 413-587-1240 Fax 444, 'Z 1272 OftJL4/ APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT This section to be completed by office 1.1 Property Address: �r Map 70 Lot l/SS Unit 116 Straw Avenue Northampton Massachusetts 01062 Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Jason Mark 116 Straw Avenue Northampton Massachusetts 01062 Name(Print) Current Mailing Address: See Attached (413)270 1825 Telephone Signature 2.2 Authorized Agent: Adam Glenn 59 Tosca Drive Stoughton, MA 02072 Name(Print) � 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 4,000 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2+ 3+4 +5) 4,000 Check Number This Section For Official Use Only Building Permit Number: ~do? "--cf`D Date t, Issued: Signature: /`� �/ //-10 &22- 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 AddreL 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 6%4icjoid LA__ 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 { No ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 343235 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 caL cy'�3' '""" 4/13/2022 Signature of Owner/Agent Date 1 Jason Mark , 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 4/13/2022 Signature of Owner Date City of Northampton �iHAMPr.. S,S Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 7 tiJ a�212 Main Street • Municipal Building \\'�'y" Northampton, MA 01060 ssyn �1�c 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:4,000 Address of Work: 116 Straw Avenue Northampton Massachusetts 01062 Date of Permit Application: 4/13/2022 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 4/13/2022 Adam Glenn 181138 Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton � �� .. ��� • • sic p �" Massachusetts i � c DEPARTMENT OF BUILDING INSPECTIONS y�f� 212 Main Street •Municipal Building vti ($ `- Northampton, MA 01060 sb� ar.Dx'\�� 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: 116 Straw Avenue 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) i;=;10eid 4/13/2022 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. City of Northampton \`�til9.Crir�i ,e- Massachusetts 1� 8 ` ') DEPARTMENT OF BUILDING INSPECTIONS Q-01:b'rx • 212 Main Street • Municipal Buildingi Northampton, MA 01060 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 116 Straw Avenue Northampton Massachusetts 01062 Contractor Name: HomeWorks Energy Address: 59 Tosca Drive City, State: Stoughton, MA 02072 Phone: 781-205-4484 Name:Property Owner Jason Mark Address: 116 Straw Avenue Northampton Massachusetts 01062 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. c513)0(47-e} Contractor signature Date 4/13/2022 The Commonwealth of Massachusetts /,!t , Department of Industrial Accidents MIMI ES NMI1 Congress Street,Suite 100 _�1e,= 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 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): 11 k am a employer with 500 employees(full and/or pan-tine)." 7. ❑New construction 2. JI 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.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]? 10 ❑Building addition 4.❑lam 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 5.0 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,§I(4),and we have no employees.[No workers'camp. insurance required.] *Any applicant that checks box#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. Insurance Company Name: NH Employers Insurance Company Policy#or Self-ins.Lic.#:#400 1 0 1 7 Expiration Date: 01/0 1/2023 Job Site Addrece• 116 Straw Avenue 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 pen • s of perjury that the information provided above is true and correct Signature: Gat A t/ _ Date: 4/13/2022 Phone#:781-205-4484 // wxpermitting@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#: /....IN HOMEENE-01 LLARIVIERE ,a�oRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/3/2022 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,Fxt):(978)686-2266 301 1(A/C,No):(978)686-6410 North Andover,MA 01845 E AtLSS:certificates@fostersullivangroup.com DRE 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMBS LTR INSD WVD (MM/DD/YYYY) (MMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 pREM SES(EaEoccu ence) , $ 300,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY Ter- 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 _ AUTOSRE ONLY X AUTOS yy BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTOS ONLY (Per dentrMAGE $ $ 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 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ECC-600-4001017-2022A 1/1/2022 1/1/2023 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N 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 $ C Pollution Liability CPLMOL109278 1/1/2022 1/1/2023 $10,000 Deductible 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Homeworks 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 i I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 7Z F!,1V1/(YZi( 264 tei4 -a »fitei,/� Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card 138 HOME WORKS ENERGY,INC Registration: 13 101 STATION LANDING STE 110 Expiration: 03/02/2023 MEDFORD,MA 02155 Update Address and Return Card. SCA t 0 20m-05 t 7 . ,. %...,...,.,,,.�./,/,, ./. /f.,,,..,. - Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SuColemmt Card before the expiration date. If found return to: R.oiatr tion cgrajlon Office of Consumer Affairs and Business Regulation 181138 03102.2023 1000 Washington Street -Suite 710 HOME WORKS ENERGY,INC. Boston,MA 02115 ADAM GLENN (-AtA_614-) -e f&- 101 STATION LANDING STE 110 !✓. MEDFORD,MA 02155 undersecretary Not valid without signature ,-- Or Coinmon'.veaNh of Massachusetts Division of Professional Licensure Restrict edlo:Canstrudion Supervisor Specialty Board of Building Regulations and Standards CSSL4C-Insulation Contractor Construct►c .$1ilplh j.pr Specialty CSSL-106148 3,7 sires-07/30/2022 ADAM GLENN ( 19 CHARGE POUND RD 1' WAREHAM MA 02571 t- aft1' r .r'/SS':+4...AS - Failure to possess a current edition of the Massachusetts CL.4 State Building Code is cause for revocation of this license. Commissioner t. For information about This license Call(617)727-3200 or inset www rnass.govrdpl Insulation/Air Sealing Permit Authorization Specialist: Adam Morrison Company: HomeWorks Energy Email: adam.morrison@homeworksenergy.co Address: 101 Station Landing Cell: 3395451074 Medford,Ma 02155 Phone: 781.305.3319 Customer: Jason Mark Address: 116 Straw Ave Email: jason@jasonondesign.com Northampton, MA,01062 Site ID: 343235 Phone: 4132701825 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: jason@jasonondesign.com Customer Signature: , ro/( ?qt c Date: 3/25/2022 Jason Mark 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. 1 OWNER 1030 R UNIT A R PLAN VIEW Z Name: Jason Mark Site ID: 343235 Finished Sq. Ft: 3,792 3 2 Phone:(413)270-1825 Year of House: 193° Electric Acct#: NA 1" Address: Unit(B)118 Straw Avenue Northampton #of Floors: 2 Gas Acct#: NA Unit#: #Occupants: 1 Housing Type? Colonial/Gambrel DUCTWORK INSPEC T IO ucts Insulated?❑ .1170e _ t uct Linear Ft. �. 0,1 �/ uct Square Ft. .> C) i •'. Duct Air Sealing Hours I 11` '.uct Insulation 3' 11uct Insulation Removal 1• z BASEMENT INSPECTION { C CO � ��\ Existing Sp c'i g Ln S L QW I id m - • Wall \,(16 :8 ra -ling !`+ Crawl Rim Joist E Bsmt RJ w/Sill fq')(y e. Pot I b 0 , C`G I tj Bsmt RJ NO Sill Vapor Barrierj6-D 5 sqft. Bsmt Door' I ` Y/N Blower Door? `�I �-, a WALLS&GARAGE Drill Location? Siding Cell.Height Existing Spec'ing Sq.Ft. Framing Exterior Wall 1 x x BalloonOPlatforrrn Exterior Wall 2 x x BalloonOPlatforrrfl Overhang x x Garage Wall x x Ballooralatfor Garage Ceiling x x x o cc i w I. { I iv.,,,, 13 \ J o r :1 15 a �✓ x "i W ., g E 10 u I F &[A 5 24 It 8 12 Insula Removal 1[ { Sgft. 8 Sweeps:. _._ ._..... cc Strinoine: 3 WORK SQC'D B OT CON RACTED 11 AD BLOCKS PRLSLN1? MANDATORY) Attic Base Crawlspace ID Other: K&T YJ N Moisture Y�N Combustion Sfty YIN Kneewall Over ng rage El Asbestos Y ON old>100sgFt Y 0 Detector Missing ❑ Ductwork 0 Ex rior Walls VermiculiteY❑N Structl Concern ?ON they: Notes for Leap endor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? OR KW SLOPE AND GABLE END Blind Spec? 0 hy? Why? FRAMING EXISTING SPEC'ING O.FT FRAMING EXISTING SPEC'ING fr O.FT. ALL X X SLOPE X X 0' FLOOR X X GABLE X X / o ACCESS X TRANS X X `O • '- FP TRANS x x ATTIC ATTIC \ SLOPE X X r .r LOPE X X _�. \ EXISTING VENTING? EXISTING VENTING? EXISTING PIPES? YnN n Cm KW Venting Vent BF rBF Hose Damming Sheathing Access Temp Access KW venting Vent BF Temp Access /a NIL f m KNEEWALL MANDATORY F n t.i J L . .. . ,1 __ B t+ ` I a.L L a M ^ 1v 1Vi t ~ 1. Tt \� 1 '" I It 0 1 VA itelb /4.1 1 Ce s •la F 7 p ea)1°e) 12 c L. 12 0 t 1'N. 1 I ..---7 Insulated Wan Reed Ugh o Ina.Hose i OF i Nest BF ICH I Damming -- ..__ lY Rant l[Rv. Air Handler AH_ Temp Auefs Vull DOWn ® Hatch aU Hstch"/ Door o/ g'Roof Vent�M MI Vo. x .0058 1? x x ATTIC 1 8 d Spec? LI x x ATTIC 2 Blind Spec? U x(1:(1 a tasto:mry)ry) o Existing Spec" g Sq ft Existing Spec'ing Sq ft "°"""" WUnflooed Unfloored r Trusses Oats Battings Floored Floored ,`' Nixed Ivan Duct Work I I --S•LoosCr= None= Cath Slope Cath Slope AIR SEALING HOURS Walls Wallsr Access Access 46.Venting opavents Vent BF BF Hose Damming Venting Propavent_s ` Vent BF BF Hose Damming to c e WHF Box: 'u -. Temp Access:_ a 0/a Sheathing Access: `� `� i R.L.Covers: Sq.Ft/300: (Edo NFA Venting)= (Needed Sq.it/300= j5.ist.NFA Venting)_ (Needed �— t Existing Venting? NSA Venting) NFA Venting) Roof Type: g Existing Venting? HomeWorks Energy Err r I I 101 Station Landing,Medford,MA 02155 g CONTRACT - AUDIT I- works 781-305-3319 Fr works Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT WORK ORDER Christine Mark (413) 270-1825 03/25/2022 343235 00001 SERVICE STREET BILLING STREET PROPOSED BY: 116 Straw Apt A Avenue Apt A 116 Straw Apt A Avenue HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION OTY COST INCENTIVE TOTAL HOME AIR SEALING 2 $170.00 $170.00 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 3 $240.00 $240.00 Provide labor and materials to install 0-Ion weatherstripping and a doorsweep to door(s)to restrict air leakage. BASEMENT SILLS RIGID BOARD INSULATION 92 $364.32 $364.32 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. INSULATE BULKHEAD DOOR 1 $110.00 $110.00 Provide labor and materials to insulate the back of the door to the basement's bulkhead with rigid board at R-10 or greater with the required fire rating and seal the door's edge with weatherstripping to restrict air leakage. CRAWLSPACE 10MIL GROUND COVER 625 $606.25 $606.25 Provide labor and materials to install 10 ml polyethylene over open ground in designated crawlspace/earthen basement areas. HomeWorks Energy r I n Ir 101 Station Landing,Medford MA 21 0 55 CONTRACT - AUDIT works 781-305-3319 Energy,Inc Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT It WORK ORDER Christine Mark (413) 270-1825 03/25/2022 343235 00001 SERVICE STREET BILLING STREET PROPOSED BY: 1 16 Straw Apt A Avenue Apt A 116 Straw Apt A Avenue HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL CRAWLSPACE WALL R10 RIGID BOARD 140 $582.40 $582.40 Provide labor and materials to install R-10 rigid insulation board to the crawlspace perimeter wall up to the sill and against the band joist. Total: $2,072.97 Program Incentive: $2,072.97 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF *'''00/ Dollars $0.00 gtrir,ov COMPANY REPRESENTATIVE CUSTOMER SIGNATURE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE DAYS. Insulation/Air Sealing Permit Authorization Specialist: Adam Morrison Company: HomeWorks Energy Email: adam.morrison@homeworksenergy.co Address: 101 Station Landing Cell: 3395451074 Medford, Ma 02155 Phone: 781.305.3319 Customer: Jason Mark Address: 116 Straw Ave Email: jason@jasonondesign.com Northampton, MA, 01062 Site ID: 343584 Phone: 4132701825 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 Home Works Energy that an inspection is necessary with instructions on how to complete this process to close out your permit. Email: jason@jasonondesign.corn Customer Signature: T-o/( ' i the Date: 3/25/2022 Jason Mark 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. - 7 Pr._,:iii � `!1` 1030 R UNIT B PLAN VIEW 3 Name: Jason Mark Site ID: 343584 Finished Sq. Ft: 3,792 g Phone:(413)270-1825 Year of House: 193° Electric Acct#: NA N Address: Unit(S)116 Straw Avenue Northampton #of Floors: 2 Gas Acct#: NA i Unit#: #Occupants: Housing Type? ColoniavGambrel DUCTWORK INSPECTION DuctsJnsulated?❑ r—• Duct Linear Ft. G 1 9 2: Duct Square Ft. ^`•� 1 1` uct Air Sealing Hours ) 7\7 Duct Insulation C 6uct Insulation Remov 22 to W BASEMENT INSPECTION 0 : Existing Spec'in Ln/Sq.Ft. C3 tC m Bsmt Wall AG -• 28 Crawl Ceiling i`� t: Crawl Rim Joist _ Bsmt RJ w/Sill '^ Bsmt RJ NO Sill • Vapor Barrier soft. Bsmt Door .- -_..._._,.. _..,__..��. :._..,_._.,_._ �_. =' 4. `ON Blower Door? `4 �< WALLS&GARAGE Drill Location? Siding Ceil.Height Existing Spec'ing Sq.Ft. Framing Exterior Wall 1 x x BalloonOPlatforrr(l Exterior Wall 2 x x BalloonDPlatforrtt) Overhang x x Garage Wall x x Balloor-J'latforrtr] Garage Ceiling x x o ,--77-7 W + z s �� o $ 13 H 13 _ 1 2 / )- .. .. '.7 22 34 S 1: J ' F ,8 1 $ 2� . 24 :12 Insulati moval J128 Soft. __._.._ ( Sweeps: __.__---.�___ . ._._____ _.` Stripping: WORK SPEC'D BUT NOT CONTRACTED I AD BLOCKS PRESEN ?(MANDATORY) Attic i Basement/Crawlspace ED Other: K&T Y N I Moisture Y■ III Combustion S Y IN 1 Kneewall Overhang/Garage ❑ Asbestos Y ON I1 old>100sgFt ■ ■ 0 Detector Missing ❑ Ductwork ❑ Exterior Walls CI VermiculiteY •N 111 Structl Concern• ■ III other: Notes for Lead Vendor/Work Not Contracted: KW WAIL AND KW FL OR Blind Spec? ❑ • OR _ KW SLOPE AND GABLE END Blind Spec? ,Q „ hy? ru� Why? / �� Qi`� WALL ( to X � p QlpEcl io f SLOPE FRAMING EXISTING SPEC'ING SQ.FT. jj x x FLOOR"' X X "n GABLE X X z o ACCESS X /J__ttaNi �`yep TRANS X X m� TRANS X G X (1rr�i� ,� ATTIC D .TTIC ii I i SLOPE x X ;^ 3 l EXISTING VENTING? EXISTING VENTING? S t� t c 1 EXISTING PIPES? Y n KW Venous Vert BF Temp Access KW Venting Vent BF BF Hose Damming Sheathing Access Temp Access Q c ot5 0 C) , fii 400 ,,......,,,r. ,,.....`"/ KNEEWALL MANDATORY N. ZA ,\ H24,.,,‘ iri s i Vrl n •r 12 t f/ w • A -006eN f04(1—C 112 ..,, swy 6 1� Ir (....ioi v 1 I,,-'. ,.. 24 , /4 1,i sa 4. 14 1°...ajr/04.,Li)I j 1 1 ` r � r . vi.A.)F 4,,,:.. x ., z.2 34 )c _ Insulated Wai l s Beta Light 0 ins.Hose s gFI Vent BF-FVW im.L H J Damming . . .— 1r Boot Izgv; Air Handler F^J Temp Access[T_J Pull Down ro) Hatt ' Wall Hatch a Door o/ B'Roof Vent I tv�' BAS Vol: x .0058 x x ATTIC 1 :lind Spec? x x X 9s(I story) UATTIC 2 Blind Spec? U �Is 4(2 story)/ 2 ExistingSp- Sqft It is it story) a ing Existing Spec'ing Sq ft Unfloored W _ ,Unfloored — /� russes Cross ttrng Floored Floored Mixed Is Duct Work Cath Slope Cath Slope 6'too=� v„nn o Walls Walls AIR SEALING HOURS a Access _ Access Venting Propavents Vent BF BF Hose DammingVenting c pavents Vent BF BF Hose Damming 00 / WHF Box: `.) _� f Temp Access: to to Sheathing Access: Sq.Ft/300= (Exist NFA Venting)_ (Needed ,So.Ft/300. R.L.Covers: - Must.NFA Venting)_ (Needed Existing Venting? NIA t" "" "g) Existing Venting? NFA Venting) Roof Type: I HomeWorks Energy in i i i C 101 Station Landing,Medford MA 02155 CONTRACT - AUDIT u^Me works rk 781-305-3319 � Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT; WORK ORDER Yasna Reisi (413) 270-1825 03/25/2022 343584 00001 SERVICE STREET BILLING STREET PROPOSED BY: 116 Straw Apt B Avenue Apt B 116 Straw Apt B Avenue HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION OTY COST INCENTIVE TOTAL TRANSITIONS- FLOORED 36 $492.48 $492.48 Provide labor and materials to air seal the floored kneewall transitions of your home against wasteful, excess air leakage. WEATHERSTRIP AND ADD DOOR SWEEP 1 $80.00 $80.00 Provide labor and materials to install Q-Ion weatherstripping and a doorsweep to door(s)to restrict air leakage. KNEEWALL-RIGID BOARD 144 $570.24 $570.24 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to a kneewall area. KNEEWALL HATCH- INSULATE&WS 1 $60.00 $60.00 Provide labor and materials to insulate back of the kneewall hatch with 2"rigid board, and seal the edge of the hatch with weatherstripping. HomeWorks Energy rts-c1-.) l 101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT u^M^WAS'^ 781-305-3319 f M1IC IIC� Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT• WORK ORDER Yasna Reisi (413) 270-1825 03/25/2022 343584 00001 SERVICE STREET BILLING STREET PROPOSED BY: 116 Straw Apt B Avenue Apt B 116 Straw Apt B Avenue HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL VENTILATION CHUTES 60 $150.00 $150.00 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. Total: $1,352.72 Program Incentive: $1,352.72 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/ Dollars $0.00 n,( )!ri7/ COMPANY REPRESENTATIVE CUSTOMER SIGNATURE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE DAYS.