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31A-136 (2) BP-2022-1272 76 FORBES AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 3 I A-136-001 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-2022-1272 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est.Cost: 3000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp. Date:07/30/2024 Use Group: Owner: E GUSWA ANDREW J& SUSAN Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 781-205-4484 ECC-600-4001017-2022A STOUGHTON, MA 02072 ISSUED ON:10/06/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH E R IZATI 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: 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: ppiL, Fees Paid: $65.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $6 Q0. ' v,i,.,r lq()) Cp City of Northampton De FOR .,.' Building Department �: 212 Main Street / , ' �oz2 INSULATION RoomNorthamptonr11f4 0 ,, ii . _.,,, „r OIJL. Y phone 413 587 1240 Fax 413- $7 rat.„,,60 nos l 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: Map Lot ' Unit 76 Forbes Avenue, Northampton, MA 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Andrew Guswa 76 Forbes Avenue, Northampton, MA 01060 Name(Print) Current Mailing Address: See Attached (413)522-0333 Telephone Signature 2.2 Authorized Agent: Adam Glenn , 235 Essex Street, Whitman, MA 02382 Name(Print) `1 Current Mailing Address: CJ/ uA___ 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 3,000 (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee I 1 4. Mechanical(HVAC) 5. Fire Protection 6. Total = (1 +2+3+4+5) 3,000 Check Number 6 7C/ q This Section For Official Use Only Building Permit Number: 71 ) - /.01701, Date Issued: Signature: / l0 (v 20Z Z. 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 235 Essex Street, Whitman, MA 02382 07/30/2024 Addre Expiration Date 781-205-4484 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ HomeWorks Energy 181138 Company Name Registration Number 235 Essex Street, Whitman, MA 02382 03/02/2023 Address � csi_ `� Expiration Date 4, 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 I No ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 4591856 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 a.g3i'- fe / 9/30/2022 Signature of Owner/Agent Date Andrew Guswa 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 9/30/2022 Signature of Owner Date City of Northampton �.,.' Massachusetts k? -. r 1� .� fit, - ,,I DEPARTMENT OF BUILDING INSPECTIONSen 212 Main Street • Municipal Building �� O� Northampton, MA 01060 'is' -360 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:3,000 Address of Work:76 Forbes Avenue, Northampton, MA 01060 Date of Permit Application: 9/30/2022 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: 9/30/2022 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 ,., tt DEPARTMENT OF BUILDING INSPECTIONS E r 4 ii: ":Pi 212 Main Street *Municipal Building ,. --"� Northampton, MA 01060 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: 76 Forbes Avenue, Northampton, MA 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) . ,,c4 ./.2:ej 9/30/2022 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 tt Massachusetts DEPARTMENT OF BUILDING INSPECTIONS yt 212 Main Street • Municipal Building Northampton, MA 01060 'b •J0' MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 76 Forbes Avenue, Northampton, MA 01060 Contractor Name: HomeWorks Energy Address: 235 Essex Street City, State: Whitman, MA 02382 Phone: 781-205-4484 Property Owner Name: Andrew Guswa Address: 76 Forbes Avenue, Northampton, MA 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 6d \ 3�c� Date 9/30/2022 The Commonwealth of Massachusetts Department of Industrial Accidents 9 — ' Office of Investigations il� '` =� Lafayette City Center c. ~ _ ./ 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Homeworks Energy Address: 235 Essex Street City/State/Zip:Whitman, MA 02382 Phone #: 781-205-4484 Are you an employer? Check the appropriate box: Type of project(required): 1.❑� I am a employer with 500+ 4. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction listed on the attached sheet. 7. 0 Remodeling 2.El I am a sole proprietor or partner- ship and have no employees These sub-contractors have g_ ❑ Demolition workingfor me in anycapacity. employees and have workers' p ty. 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no Weatherization employees. [No workers' 13.® Other 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 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. #:#4001017 Expiration Date: 1/1/2023 Job Site Address: 76 Forbes Avenue, Northampton, MA 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u�the pains and pe es of perjury that the information provided above is true and correct. ) Signature: �'"v Date: 9/30/2022 Phone#: 781-205-4484 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License # Issuing Authority(check one): 1❑Board of Health 20 Building Department 3.0City/Town Clerk 4.0 Electrical Inspector 5Elumbing Inspector 6.0Other Contact Person: Phone#: HOMEENE-01 LLARIVIERE ACORO CERTIFICATE OF LIABILITY INSURANCE DAT1(1/3/2023/202 YYY) �� 2 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. I 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 301 1 (A/C,Noy(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 INSURERC: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 IMM/DD/YYYY),JM /Y M/DDYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) 1 $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED accident)IN SINGLE LIMIT $ 1,000,000 ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ OWNED X SCHEDULED _ AUTOS ONLY AUTOS yy E BODILY INJURY(Per accident) $ X A ITOS ONLY X AUTOS ONLDY (Perr acEcRdentDAMAGE $ $ 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 I STATUTE PER I I ER AND EMPLOYERS'LIABILITY ECC-600-4001017-2022A 1/1/2022 1/1/2023 - 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N El.EACH ACCIDENT $ 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 I _ 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. 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 . 7 Fe-mmtv/f(fivillet /7%/I'J.%!i////-i//4 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Roston, Massachusetts 02118 Home Improvement Contractor Recistration Type: Supplement Card Registration: HOME WORKS ENERGY.INC Expiration: 181138/2 d23 101 STATION LANDING STE 110 Eiration: d3i02 MEDFORD,MA 02155 Update Address and Return Card. 5G111 0 a:m+mowf17 ..Y t,..."n,,vw.//.,/. / i.......,/......". Offla of Consumer Affairs&&tainesa Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Supplement Card before the expiration date. it found return to: f;agletratloo Litikkggn Office of Consumer Affairs and Business Regulation 181138 03X12/2023 1000 Washington Street -SJ to 713 HOME WORKS ENERGY,1NC. Boston,MA 02118 4-- ADAM GLENN i 9 `14 101 STATION LANDING STE 1t0 L .._: a/:,'/4! MEDFORD,MA 02155 Undersecretary Not valid without signature "' Commonwealth of Massachusetts Construction Supervisor Specialty t Division of Occupational Licensure Restricted to Board of Building Regulations and Standards CSSLJC -insulation Contractor Co nstruct`gorsuper%w Specialty CSSL-106148 l i- .5 pfres: 07/30/2024 ADAM GLEN N '' 19 CHARGE • WAREHAM iv' Failure to possess a current edition of the Massachusetts Nada 011YdP State Building Code is cause for revocation of this tcense. For information about this license Co--1ssioncr r1 K. c•,,/fr ,• C all(617)727-3200 or vlsA wwss mass.govrdpl Insulation/Air Sealing Permit Authorization Specialist: Abel Silva Company: HomeWorks Energy Email: abel.silva@homeworksenergy.com Address: 101 Station Landing Cell: 4138246686 Medford, Ma 02155 Phone: 781.305.3319 Customer: Andrew Guswa Address: 76 Forbes Ave Email: dguswa@gmail.com Northampton, MA,01060 Site ID: 4591856 Phone: 4135220333 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 bye 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: dguswa@gmail.com Customer Signature: I ia-'U4 ,us?4,- L Date: 9/28/2022 Andrew Guswa 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:'. ,-{,! �, ( L^ r 3 (� Site •ID: UST 1 fG 1 6 Finished Sq. Ft: 11."-r2 $ Phone: Year of House: VGc 9 Electric Acct #: W Acldress:76 ii-10 # of Floors: Gas Acct #: l ar j.01F vJ ,n Unit#: # Occupants: (-1 Housing Type?Cc61, DUCTWORK INSPECTION Ducts insulated?❑ / 7 Duct Linear Ft. /t/s (>A Duct Square Ft. Duct Air Sealing Hours 2Z Duct Insulation �� Duct Insulation ERefioval �-, '^ 3 z. Ir.i z BASEMENT INSPECTION ` W Existing Spec'ing Ln/Sq. Ft. Mt m Bsmt Wall AG ,i Crawl Ceiling I L2- Crawl Rim Joist Bsmt RJw/Sill A-/ . ,1 j _- Bsmt RJ NO Sill ? '' Vapor Barrier sqft. Bsmt Door Y/N Blower Door? WALLS &GARAGE Drill Location? Siding Ceil. Height Existing Spec'ing Sq. Ft. Framing Exterior Wall 1 rj;J z x x16,-8a o j1Dlatform Exterior Wall 2 ! x ' x /6, Balloon/P)at#erm_, Overhang x x Garage Wall x x Balloon/Platform Garage Ceiling x x ce 0 • W z O EE W ' / I-x -r I5 to D ITV 0 • insulation Remov ' • Sgft. Sweep . WX S ripping: WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT? (MANDATORY) Attic Basement/Crawlspace Other: K&T Y j,f4' Moisture Y/iff Combustion Sfty Y/4 Kneewall Overhang/Garage Asbestos Y/14 Mold>100 sq. ft Y/if CO Detector Missing Y/ • Ductwork Exterior Walls Vermiculite Y Iiti Structl Concerns Y/pe Other: Notes for Lead Vendor/Work Not Contracted: KW WALL AND ION FLOOR Blind Spec? 0 hy? OR ► Why? KW SLOPE AND GABLE END Blind Spec? 0 FRAMING EXISTING SPEC•ING SQ.FL FRAMING EXISTING SPEC'NG so.FE WALL X X SLOPE X X o."'', atFLOOR X X GABLE X X f," Q ACCESS X \ TRANS X X TRANS X X ATTIC atl / ATTIC SLOPE X SLOPE X X EXISTING VE G? v, EXISTING VENTING? EXISTING EST Y/N m X ' %re..'nr Term f.fre': n KNEEWALL MANDATORY )/5 IG1( nJ Vic...10 oil) 2if Z q0517°6C �lle � 3 �� a a � ff •Z.Z ced 6r R —7 z2 _. 17 7X <,1e)e Insulated Wail X X Recd Light O Ins.Hose BF�Vent BF BFV Chim.CH Dammme 12"Roof Al Handler AH Temp Access Pull Down Hatchh Wall Hatch '/ Door / 8'Roof Ventrya BAS Vol. 5 i-, x .0058 L xC x Lk ATTIC 1 Blind Spec? 0 x x ATTIC 2 Blind Spec? 0 X(is(41(i stid) = ' Z 3 o Existing Spec'ing Sq ft Existing Spec'ingh 13e(3IVItiItip tiers Unfloored IL'r 1�l ` Unfloored 1'iGp� Trusses Cross•a ng 0- Floored Floored Mixed Insults ion Duet Work Cath Slope Cath Slope . 7 oo NO e z Walls Walls �, Air Sealing Hours Access j4..yic. 17 Access (-,> Venting Propavents Vent BF OF Hose Dammily Venting Prop, ents Vent 13'' (IF Hose Damming t» co WHP Dox: r m /'� Z"LI7 / temp Acce • _ a / Shea ig Access: _ in en p R. .Covers _ 3 Sa,Ft/3co. J$ •5. (Exist NFA Venting a (Needed Sc.Ft/ (East.NFA Ve.ritinei a (Needed ExistingVenting? NFAVenttr'l ? NFA Venting) Roof Type: �,„/lc C-5U Existing Venting. Cirr3 HomeWorks 4 101 Station Landing Ste 110, ( R1aSS save Medford,MA 02155 Energy PARTNER (781)305-3319 Customer Name:Susan Guswa Email:Not provided Phone:413-522-0333 Premise Address:76 Forbes Ave, Northampton,MA 01060 Mailing Address:76 Forbes Ave,Northampton,MA 01060 Project ID:4601938 Date:Sept.28,2022 Job Description Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour 10 hr $943.30 $0.00 Attic Floor- 5" Open Blow Cellulose 946 SF $1,541.98 $385.50 Hatch -2"Thermal Barrier Polyiso 1 each $47.37 $11.84 Propavent 24 each $99.12 $24.78 Bath Fan Hose 1 each $28.00 $7.00 Project Total $2,659.77 Weatherization incentive ($1,287.35) Air sealing incentive ($943.30) Total Program Incentive -$2,230.65 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: 4/14' yezetw-a- 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 ut)lity MassSave Home Services Program offers. Proposals con be sent to:Inbox()HomeWorksfnergy.corn Page 2 of 2 HomeWorks • 101 Station landing Ste 110, mass iOn Medford,MA 02155 Energy PARTNER (781)305-3319 Customer Name:Susan Guswa Email:Not provided Phone:413-522-0333 Premise Address:76 Forbes Ave,Northampton,MA 01060 Mailing Address:76 Forbes Ave,Northampton,MA 01060 Project ID:4601938 Date:Sept.28,2022 Customer Total $429.12 Total Contractor Price and Payment Schedule Ho meWorks Energy, Inc.agrees to perform the above described work,furnishing the material and labor specified far the listed total price. Payment of the balance of the customer contribution is expected upon completion of the work. Att • 'UdGf)-a Customer Signature: _� 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. Proposols con be sent to:Inbox@HomeWorksEnergv.com