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12C-076 (6) BP-2022-1485 15 MARY JANE LN COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 12C-076-001 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-2022-1485 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 2000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date: 07/30/2024 Use Group: Owner: BRIAN HANION, Lot Size (sq.ft.) Zoning: RI/WSP Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 781-205-4484 ECC-600-4001017-2022A STOUGHTOt , MA 02072 ISSUED ON: 11/16/2022 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: 14 . .� Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner FEE: $65.00 u,t_ A/0 Depp R City of Northampton .�y Building Department 212 Main Street i Room 100 / No IFISULA TION Northampton, MA 01060 5 phone 413-587-1240 Fax 413-587-1272 ONLY FAO r, •' 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 /2- C. Lot o? t2 Unit 15 Mary Jane Lane Northampton MA 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Brian Hanlon 15 Mary Jane Lane Northampton MA 01062 Name(Print) Current Mailing Address: See Attached (413)250 2782 Telephone Signature 2.2 Authorized Agent: Adam Glenn 235 Essex Street, Whitman, MA 02382 Name(Print) si3a7e) Current Mailing Address: 64(4781-205-4484 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 2,000 (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) 2,000 Check Number 7D7 q l p This Section For Official Use Only Building Permit Number: 6 P--41)- ' /cf 8 S Date Issued: Signature: ' i�- 15- 262Z 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 6%61, Expiration Date 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 El Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 4612658 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 cd4{4 ay;e:ad 11/9/2022 Signature of Owner/Agent Date Brian Hanlon , 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 11/9/2022 Signature of Owner Date City of Northampton 0.Y H4MPT N. .�;�.• SAS..r SAC Massachusetts C. 44 DEPARTMENT OF BUILDING INSPECTIONS � ;°.� 212 Main Street • Municipal Building vti. bD Northampton, NA 01060 s-,, ar'30 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 mom 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:2,000 Address of Work:15 Mary Jane Lane Northampton MA 01062 Date of Permit Application: 11/9/2022 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: 1 hereby apply for a building permit as the agent of the owner: 11/9/2022 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 c5 s � °' — Massachusetts A. - F!� L y tV i3� �� F DEPARTMENT OF BUILDING INSPECTIONS y �° ,�;, 212 Main Street •Municipal Building J. -� Northampton, MA 01060 fly'........ 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: 15 Mary Jane Lane Northampton MA 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) ,,,,gie, .:4-) 11/9/2022 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�''"��r� City of Northampton `' e ta`?5 s%r Massachusetts ��f i Y WI y: •x r DEPARTMENT OF BUILDING INSPECTIONS y3 fi ,a1'., 212 Main Street • Municipal Building 4jk.,,�1M,,�00_ Northampton, MA 01060 i4 3h� MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 15 Mary Jane Lane Northampton MA 01062 Contractor Name: HomeWorks Energy Address: 235 Essex Street City, State: Whitman, MA 02382 Phone: 781-205-4484 Property Owner Name: Brian Hanlon Address: 15 Mary Jane Lane Northampton MA 01062 City, State: I 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 (.114 ,,.e )°44)— Date 11/9/2022 The Commonwealth of Massachusetts � — Department of Industrial Accidents Env t_ 1 Congress Street,Suite 100 7_4,14 Boston, MA 02114-2017 =i 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 FnP.rgy 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 LJ am a employer with 500 employees(full and/or part-tune).' 7. [1]New construction 2. 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.n I am a homeowner doing all work myself [No workers'comp.insurance required.]t 10 El Building addition 4.❑lam a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 l am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.: 13. Roof repairs 14 ther WEATHERIZATION 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 152,*I(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. 1Contractors 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: 01/01/2023 Job Site Address• 15 Mary Jane Lane Northampton MA 01062 city/StateiZip: 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 pe ' of perjury that the information provided above is true and correct �� 11/9/2022 Signature: Date: 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#: i....N HOMEENE-01 LLARIVIERE kJ.-- YYY) CERTIFICATE OF LIABILITY INSURANCE DATE 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 Foster Sullivan Insurance Group,LLC (AicNN,Ext):(978)686-2266 301 I FAX 978 686-6410 163 Main Street Miss, ( )( ) North Andover,MA 01845 ADDRESS:certificates@fostersullivangroup.com INSURER(S)AFFORDING COVERAGE NAIC it 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 fMM/DD/YYYY1 (MM(DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 PREM ISES(DAMAGE TOEa RENTEDoccurre nce) $ 300,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY 78T LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY (EOMB accident) GLE LIMIT $ 1,000,000 ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ OWNEDTOS ONLY x SCHEDULED _ AU AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ 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 MUTE EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEY/N ECC-600-4001017-2022A 1/1/2022 1/1/2023 1,000,000 OFFICER/MEMBER EXCLUDED'? N N/A E.L.EACH ACCIDENT $ (Mandatory in NH) 1,000,000 E.L.DISEASE-EA EMPLOYEE $ 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 Energy Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. 101 Station Landing Ste 100 Medford,MA 02155 AUTHORIRIZE�D REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t-,-7Z, Faeim,(veetiea.ii:/e/AaemezeAteie/4 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: 181138 101 STATION LANDING STE 110 Ex�irExpiration: 03r02 2/2023 2 MEDFORD,MA 02155 Update Address and Return Card. SCA 1 4 7061-05117 Office of Consumer Mtake 8 Business R guleMon HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registratiog Eataltalbli Office of Consumer Affairs and Business Regulation 181138 03;0212023 1000 Washington Street -Suite T10 HOME WORKS ENERGY,INC. Boston,MA 02118 ADAM GLENN ' ( -;'" - ''e4 101 STATION LANDING STE 110 — '-':. MEDFORD,MA 02155 Undersecretary Not valid without signature Commonwealth of Massachusetts tilf Division of Occupational t iCenSUre Construction Supervisor Specialty p Restr�edto: Board of Building Regulations and Standards CSSLaC Insulation Contractor Constructs r Specialty CSSL-106148 -_* eicdpires: 07(30/2024 ADAM GLE , 4 19 CHARGE ' • ,, WAREHAM MA+0. I :if, �• �O Failure to possess a current edition of the Massachusetts *-14�Y a State Building Code is cause for revocation of this"cense. For Information about this license Commissioner i K. • Call(617)7T7JT00 or visit wwv.mass.gov'dp Insulation/Air Sealing Permit Authorization Specialist: Michael Hathaway Company: HomeWorks Energy Email: michael.hathaway@homeworksenergy. Address: 101 Station Landing Cell: 4135882467 Medford, Ma 02155 Phone: 781.305.3319 Customer: Brian Hanlon Address: 15 Mary Jane Lane Email: brianhanlon58@yahoo.com Northampton, MA, 01062 Site ID: 4612658 Phone: 4132502782 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: brianhanlon58@yahoo.com Customer Signature: Date: 10/24/2022 Bri nlon 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: Le- 6 Site ID: 6 Finished Sq. Ft: � U o Phone: Year of House: Electric Acct#: r— • ddress: v A. 12#of Floors: Gas Acct#: =ArtG,0-4-tffc,,,,t owLvnit#: #Occupants: I Housing Type? le-c-A-64 DUCTWORK INSPECTION Ducts Insulated?❑ Duct Linear Ft. Duct Square Ft. 1 uct Air Sealing Hours i K C Se,c/ ..t t--'f Duct Insulation ` y /�.—J Duct Insulation Removal Y �`—S I :• i U 1. Z BASEMENT INSPECTION Existing Spec'ing Ln/Sq. Ft. 5 14 Y,...1/41 •v ZP.'',e , a m Bsmt Wall AG ��-, Crawl Ceiling ti✓f Crawl Rim Joist Bsmt RJ w/Sill Bsmt RI NO Sill •Or Barrier sqft. smt Door eit Blower Door? WALLS &GARAGE Drill Location? Siding Cell.Height 1 Existing Spec'ing i Sq. Ft. Framing Exterior Wall 1 — x x Balloon/Platform Exterior Wall 2 �— Balloon/Platform Overhang Garage Wall \?<- x x aZhoatform Garage Ceiling x x 0 R• W F- a_ac O tILJL. ( ( W W V r,sulation Removal Saft. Sweeps: S7" 1 WX Stripping; WORK SPEC'D BUT NOT CONTRACTED AD BLOCKS PRESEN ANDATORY) Attic Basement/Crawlspace Other: K&T Y N oisture Y N ombustion Sfty Y N Kneewall Overhang/Garage Asbestos Y N old>100 sq. ft Y N Detector Missing / Ductwork Exterior Walls Vermiculite Y N Eruct!Concerns Y N Cher: Notes for Lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? ❑ OR KW SLOPE AND GABLE END Blind Spec? 0 hy? Why? FRAMING EXISTING ;PF( itP• SCL FT. FRAMING EXISTING ti!'t 't'dr, 5CL FT. ALL X X, SLOPE X X FLOOR X X GABLE X X O •CCESS X TRANS X X Z RANS X X \ ATTIC te TTK SLOPE X X LOPE X EXISTING VENTING? Y X15TING VENTING? EXISTING PIPES? Y/N j;+ f 1 KNEEWALL MANDATORY /4 --(- L ( kb k ( 01,-J S (.i' ev.c covey- > ( -,-.c, c p. I� ��a- G. kj IQ (.; / ne-/6c 0 (b Di Irc"''t ogle(.f�. , �' ' 16 0„ r )-),I) 1 ` \ I\ I. tmutated Wail X X Need Ught 0 Ins-Mast F Vent 8F Chu".0 Camm,nt IT soap s8 ftan r ut temp Access®Port Down rate. Wall Hutch / Door / s-woof Vine t tiu BAS Vol: x .0058 r�.X fir, ATTIC 1 Blind Spec? n x x ATTIC 2 Blind Spec? 0 X(1Sa11 aav�v, Existing( Spec ing Sq ft Existing Spec'ing Sq ft \=a"5C3ao+v., Multipliers Unfloored 17>-! c C>d l‹ L 01#V Unfloored rinses ross 6.,- r. Floored _Floored - - }=t v., Fl- Cath Slope Cath Slope °@ L. Walls Walls Air Sealing Hours Access /ti,li,„ O5 kturt Mk( reVit lAccess /1 () ✓ennng P!upavrntV Vim III (? How Dammin, VenhnB osas nt r.r•r,t ;3! Ff tkotir= Darnm n; 1 0 )0.s. CIO .tills'ES:,x,_ ,v >Y 1, Temp Accey Q n Sheathing Ac �s:__ v, R.1. 03vers • E a � / Existing Venting? "" °�`' Existing Venting? Roof Type. (�SAP t� Page 1 of ®OIP) HomeWorks 101 Station Landing Ste 110, mass NERD Medford,MA 02155 Energy PARTNER (781)30s 3319 Customer Name:Brian Hanlon Email:Not provided Phone:413-250-2782 Premise Address: 15 Mary Jane Ln,Northampton,MA 01062 Mailing Address:15 Mary Jane Ln, Northampton,MA 01062 Project ID:4628685 Date:Oct.24,2022 Job Description Lc itiort, ,t a ty l nat . Total CostC Comer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour Other 10 hr $943.30 $0.00 Attic Stair Cover(with AS hrs) Other 1 each $277.33 $0.00 Hatch -2"Thermal Barrier Polyiso Other 1 each $47.37 $11.84 Door Sweep (with AS hrs) 2 each $52.22 $0.00 Exterior Door Weather Stripping (with AS hrs) 2 each $63.62 $0.00 Project Total $1,383.84 Weatherization incentive ($35.53) Air sealing incentive ($1,336.47) Total Program Incentive -$1,372.00 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:Spi.:,1 f 0 L! — ate: Customer Phone: Specialist Signature/ —. (0/) l+t Date: UMITE TIME OFFER The prices and incentives in this contract are subject to change in a cordance with the sponsoring utility MassSave Home Services Program offers. Proposals con be sent to:Inbox@HomeWorksfnergy.com Page 2 of: n" HorneWorks w101 Station Landing Ste I10, mass Medford,MA 02155 Energy PARTNER (781)305-3319 Customer Name:Brian Hanlon Email:Not provided Phone:413-250-2782 Premise Address: 15 Mary Jane Ln,Northampton,MA 01062 Mailing Address:15 Mary Jane Ln, Northampton,MA 01062 Project ID:4628685 Date:Oct.24,2022 Customer Total $11.84 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..6,erjitAir _ _ _ Date:_ Customer Phone: Specialist Signature: _t_67y,t/c3:7ate: UMITE a ME OFFER The prices and incentives in this contract are subject to change in a ordance with the sponsoring utility MassSave Home Services Program offers. Proposals con be sent to:InboxtHomeWorksEnergy.corn BP-2022-1487 217 PROSPECT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-018-001 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-2022-1487 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 8000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date: 07/30/2024 Use Group: Owner: WILLIAM GERRY, Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY INC Apulicant Address Phone: Insurance: 59 TOSCA DR 781-205-4484 ECC-600-400 1 0 1 7-2022A STOUGHTON, MA 02072 ISSUED ON: 11/16/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATI 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: .14 )2 . 59f% Fees Paid: 11 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner FEE: $65.00 :�, jt_i- 013 }/ ++ ,� ; pep ' ter City of Northampton t � �re .� , ILBuilding Department ° 212 Main Street/ NOV ! w.4 Room 100 Street INSULATION r Northampton, MA 01 ,E rc„� ,'�n-�- -'' phone 413-587-1240 Fax 41.. 1 = '9 c QJL %/ 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 a fP Lot 6i I Unit 217 Prospect Street Northampton MA 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: William Gerry 217 Prospect Street Northampton MA 01060 Name(Print) Current Mailing Address: See Attached (415) 9249 Telephone Signature 2.2 Authorized Agent: Adam Glenn 235 Essex Street, Whitman, MA 02382 Name(Print) <- Current Mailing Address: 664.4 781-205-4484 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 8,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) (pc 5. Fire Protection 6. Total =(1 +2+3+4+5) 8,000 Check Number 70 7 This Section For Official Use Only 2 Building Permit Number: 2 o ,;.1,. /4-I S 7 Date Issued: Signature: ��� Il- /5- 2OZ 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 0 Name of License Holder:Adam Glenn 106148 License Number 235 Essex Street, Whitman, MA 02382 07/30/2024 Addre o.Ls''"- " 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 '} Expiration Date CaL e,A._ 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 RI No 0 Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 459590 l 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 11/9/2022 Signature of Owner/Agent Date William Gerry ,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 11/9/2022 Signature of Owner Date City of Northampton /aY HAMPj .q. SAS,..r s�C, .z Massachusetts .� W' �0_,;• t a�' DEPARTMENT OF BUILDING INSPECTIONS �'• 212 Main Street • Municipal Building 5.�ti,. �4� arrSr Northampton, MA 01060 fyw 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:8,000 Address of Work:217 Prospect Street Northampton MA 01060 Date of Permit Application: 11/9/2022 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.C.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: 11/9/2022 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 YHA�� City of Northampton 'f�o��. , ati 5��..: S�CI Massachusetts � ,( - * :c ( � 41. DEPARTMENT OF BUILDING INSPECTIONS Si fr \ �. 212 Main Street •Municipal Building S0) .,.:,•• r!� 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: 217 Prospect Street 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) cack11/9/2022 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. ,.. .,came.,_, City of Northampton' Massachusetts ��} �tit c it 'Ai• .� DEPARTMENT OF BUILDING INSPECTIONS yJ,� ,: fi 212 Main Street • Municipal Building rs+,.. �,��P Northampton, MA 01060 ..ox MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 217 Prospect Street Northampton MA 01060 Contractor Name: HomeWorks Energy Address: 235 Essex Street City, State: Whitman, MA 02382 Phone: 781-205-4484 Property Owner Name: William Gerry Address: 217 Prospect Street Northampton MA 01060 City, State: I 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 Cdfikk si3-)et .eid- Date 11/9/2022 The Commonwealth of Massachusetts •A . • Department of Industrial Accidents mr...irrifi..../c 1 Congress Street,Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Aaalicant Information Please Print Legibly Name (Business/Organization/Individual): HomeWorks FnPrgy 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): l am a employer with 500 employees(full and/or part-tune).' 7, ❑New construction 2. 1 am a sole proprietor or partnership and have no employees working for me in B. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0 1 am a homeowner doing all work myself [No workers'comp.insurance required.]' 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. 12.0 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.: 14 ther WEATHERIZATION 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 152,f I(4),and we have no employees.[No workers'comp. insurance required.] j *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 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. lac, #: 001017 Expiration Date: 01/01/2023 Job Site Addrecc. 217 Prospect Street 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 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 pe of perjury that the information provided above is true and correct caL Signature: __.__ Date: 1/9/2022 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. 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#: -....4, HOMEENE-01 LLARIVIERE ACC)RO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ki•..------ 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 ACT Lisa Lariviere Foster Sullivan Insurance Group,LLC PHONE FAX 163 Main Street (NC,No,Est):(978)686-2266 301 I(A/C,No):(978)686-6410 North Andover,MA 01845 Miss,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 POUCY NUMBER POLICY EFF POLICY EXP LIMIT'S LTR INSD WVD (MMIDD/YYYYI fM Q/M/DYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 DAMAGE ES lE TO RENTED a nce) $ 300,000 PRE occurre 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 7 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY (EOMBINdeenntSINGLE LIMIT $ 1 000()00 ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(per accident) $ AURTEOpS ONLY X- AUTNOSyy Epp X AUTOS ONLY X AUOTOS ONLY (Per PROPERTYnt)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 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ECC-60 0-40 01 01 7-2 022A 1/1/2022 1/1/2023 1,000,000 FFICER/MEMBER EXCLUDED? N NIA E.L.EACH ACCIDENT $ ( andatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below 1,000,000 E.L.DISEASE-POLICY LIMIT $ C Pollution Liability CPLMOL109278 1/1/2022 1/1/2023 $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 Energy Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. 101 Station Landing Ste 100 Medford,MA 02155 AUT'H{ORIRIZE�D REPRESENTATIVE1 71 1/l�Y ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD `,7Z Wom,?-4orzetieagiefAaJeiteciei4 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: 181138 101 STATION LANDING STE 110 Exxpi piration: 03;'022023 MEDFORD,MA 02155 . Update Address and Return Card. scA 1 0 20M-05/17 .Jr/r- �IYNIIrMNW/ //./6iw/Y/54,..�f Office of Consumer Mh1Is&Business R gulNbn HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Supctlematt Card before the expiration date. tf found return to: Basistafto Exea Office of Consumer Affairs and Business Regulation 181138 0M 202023 1000 Washington Street -Sj'te 710 HOME WORKS ENERGY,INC. Boston,MA 02118 ADAM GLENN 644A `i'" i. - `� `� le 101 STATION LANDING STE Ito 4',w...�ra.j� - MEDFORD,MA 02155 Un ,�etary Not valid without signature doseCommonwealth of Massachusetts 114 Division of Occupational Licensure RestridedtoConstrudion Supervisor SpeciaNy Board o1 Building Req�iations and Standards CSSLaC •insulation Contractor Constructs* upet9r Specialty CSSL-106148 fr spires: 07/30/2024 ADAM GLENi)) i s 19CHARGE ' a WAREHAM N , 7 Failure to possess a current edition of the Massachusetts i 'Vra�.E1f►ds`il' State Building Code is cause for revocation of this license. For information about this license Commissioner n f, ,t tf..„. - Ca11(617)727-3200 or visa www.mass.gov'dpi ,1t Oa?r ;. 7- v ��• 4•- Insulation/Air Sealing Permit Authorization Specialist: Bryan Ruddy Company: HomeWorks Energy Email: wmob@homeworksenergy.com Address: 101 Station Landing Cell: 4132049308 Medford, Ma 02155 Phone: 781.305.3319 Customer: William Gerry Address: 217 Prospect St Email: Billgerry@gmail.com Northampton, MA, 01060 Site ID: 459590 Phone: 4158859249 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: Billgerry@gmail.com Customer Signature: ���� a i/2 Date: 8/5/2022 William Gerry l� 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 z Name: I1, l' {r- Pyi Site ID: t't' y Finished Sq. Ft: 1S0�? Phone: !s tI1 q4''4 Year of House: 1q S Electric Acct#: 5 Address: (-7 f•05e"`' S - #of Floors: 3 Gas Acct#: • #: # Occupants: 2 Housing Type? (.c fc in,cot DUCTWORK INSPECTION Ducts Insulated?❑ Duct Linear Ft. 2 i"� Duct Square Ft. Duct Air Sealing Hours Duct Insulation C i Duct Insulation Removal ts PCB 1i BASEMENT INSPECTION In Existing Spec'ing Ln/Sq. Ft. m Bsmt Wall A Crawl Ceiling Crawl Rim Joist Bsmt RJ w/Sil Bsmt RJ ill Vapo arrier sgft. Bsmt Door YIN_ArIower Door? WALLS&GARAGE Drill Location? Siding Ceil. Height Existing Spec'ing Sq. Ft. Framing Exterior Wall 1 w .J,. I ho► & ' Dt- C/ =- x 9 x/ :alloon7Platform Exterior Wall 2 's S; 7 1 1 k\c*-C_ {'"Ott, . x 1 x Platform Overhang x x Garage Wal — "" x x Balloon/Platform Garage Ceiling x x 0 z 0 W H Insulation Removal Sgft. at, 1 Sweeps: WX Stripping: WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawlspace Other: K&T cy.4 N Moisture Y/N Combustion Sfty Y ,N, Kneewall Overhang/Garage Asbestos Y/N-;Mold>100 sq.ft YV N CO Detector Missing YV N) Ductwork Exterior Walls Vermiculite Y kin Structl Concerns Y/N Other: Notes for Lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? • " " OR ---- KW PE AND GABLE END Blind Spec? .. Why? Why? t,, I F ING I EXISTING SPEC'ING OFT L FRAMING \EXISTING SPECING SQ.FT. WALL XX X �FL a r III Imo I �D SLOPE X X � � FLOOR ZX l t 'CA 2 /,G_ GABLE X X y'v °�'S" �`l �c ce ►� TRANS X X O ACCESS r--R—^ Cj, _' 0.4 ATRANS X x r �`� ATTIC D ATTIC {��r SLOPE x X 3 >sytn .1 SLOPE X X Fv� / / 7/ j EXISTING VENTING? $ z EXISTING VENTING? �'/ "/( / EXISTING PIPES?Y/ J KW venting ent B Temp Access KW Venn.^.g Vent BF BF Hose Damming Sheathing Access Temp Access •CS6J// 'Y `jM1��` KNEEWALL MANDATORY ;,R f� R- d x_.. ` ;.` , ' .. R-I�� ( - al61St 0 2:4- // 1\ 4 3 a 3 6 FX T05 f1 re Insulated Wall X X Rec'd light 0 Ins.Hose(� Vent OF IBFV I OHrn.(CH]Damming 12"Roof y 12RV Air Handler 11 Temp Access?Pull Down D._.,S,J Hatch RI Wall Hatch"/ Door o/ 8"Roof Vent 18R)''.-- BA:, OI: x .0058 x x ATTIC 1 Blind Spec? ❑ X 19(1 st. x x ATTIC 2 Blind Spec? B. 111 = o Existing Spec'ing Sq ft \`Existing Spec''irig Sq ft W Unfloored / Unfl�[d / Multipliers russes ross Batting Floored Floored Mixed Insulation Duct Work Cath Slope Cath Slope ' >6"Loose Walls , a Walls Air Sealing Hours Access ,`� Access 4--- e Venting PropavBrlts Vent.Q BE Hose Damming V nting Propavents Vent BF BF Hose Damming c WHF Box: r Temp Access: '" o. N Sheathing Access: to 5g Ft/300= - (Exist.NFA Venting)_ (Needed R.L.Covers: / 7-- Existing Venting? NFA Venting) Sq.Ft/300 (Exist.NM Venting)e !':ee::ed NFA ven;:nr;; Roof Type Existing nting? YP / i HomeWorks Energy g I n 1 101 Station Landing,Medford, d,MA 02155 55 CONTRACT - ISM I YYUICs 781-305-3319 Horne Energy,inc Page 1 PROGRAM C MA-H PC CUSTOMER PHONE DATE CLIENT* WORK ORDER William Gerry (415) 885-9249 08/05/2022 459590 94907 SERVICE STREET SLUNG STREET PROPOSED BY: 217 Prospect Street 217 Prospect Street HomeWorks Energy SERVICE CITY,STATE,ZIP SLUNG CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL HOME AIR SEALING 4 $377.32 $377.32 Seal areas of your home against wasteful, excessive 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.) DUCT SEALING 2 $160.00 $160.00 Provide labor and materials to seal heating and/or cooling ducts within designated unheated areas. This work will be include materials and labor. TRANSITIONS-OPEN 48 $328.32 $328.32 Provide labor and materials to air seal the open kneewall transitions of your home against wasteful,excess air leakage. WEATHERSTRIP AND ADD DOOR SWEEP 2 $115.84 $115.84 Provide labor and materials to install Q-lon weatherstripping and a doorsweep to door(s)to restrict air leakage. KNEEWALL-R-13 FG+2" RIGID BOARD 48 $291.84 $218.88 $72.96 Provide labor and materials to install R-13 faced fiberglass to the kneewalls, covered with 2"rigid board insulation.All seams will be sealed with FSK taping. KNEEWALL-2"RIGID BOARD 166 $720.44 $540.33 $180.11 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to a kneewall area. KNEEWALL FLOOR- 10"OPEN R-37 CELLULOSE 216 $397.44 $298.08 $99.36 Provide labor and materials to install a 10" layer of R-37 Class I Cellulose to an open kneewall floor. WALLS-WOOD SIDED 1,692 $3,908.52 $2,931.39 $977.13 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 tr-n (' 101 Station Landing,Medford,MA 02155 CONTRACT - ISM I HomeWorks 781-305-3319 Page 2 PROGRAM C MA-H PC CUSTOMER PHONE DATE CLIENT# WORK ORDER William Gerry (415) 885-9249 08/05/2022 459590 94907 SERVICE STREET BUJNG STREET PROPOSED BY: 217 Prospect Street 217 Prospect Street HomeWorks Energy SERVICE CITY,STATE,ZF BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION CITY COST INCENTIVE TOTAL WALLS-INTERIOR DRILL AND PLUG 336 $766.08 $574.56 $191.52 Provide labor and materials to install blown in Class I Cellulose to exterior walls through an interior surface drill and plug method. Plugs will be speckled and left with a rough finish. Finish sanding and touch- up priming/painting will be the customers 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 acknowedgement of receipt and agreement to proceed. Total: $7,065.80 Program Incentive: $5,544.72 Customer Total: $1,521.08 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Thousand Five Hundred Twenty-One&08/100 Dollars $1,521.08 COMPANY REPRESENTATIVE CUSTOMER SIGNATURE NOTE THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE OATS.