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30B-025 (4) BP-2022-1558 15 LIBERTY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30B-025-001 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-2022-1558 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 5000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date: 07/30/2024 Use Group: Owner: FOLDY MICHAEL S Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 781-205-4484 ECC-600-00 1 0 1 7-2022A STOUGHTON, MA 02072 ISSUED ON: 12/05/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERI ZATI 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: I g • • >9 . I Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner FEE: $65.00 /ii. ; /q1() � r.Tsrir. City of Northampton Ec E I Vim_`- �DePFOR ":- 1 , Building Department r� 212 oom 0Street Novi Iif's ULA TIC)fI ;Y Northampton, MA 01060I ONLY .� phone 413-587-1240 Fax 413;587e 274+_nui�ui.,�,INSPECTIONS JRTHAMI't DN,MA01060 J 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 15 Liberty Street Northampton MA 01062 Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Michael Foldy 15 Liberty Street Northampton MA 01062 Name(Print) Current Mailing Address: See Attached (413)923-8284 Telephone Signature 2.2 Authorized Agent: Adam Glenn 235 Essex Street, Whitman, MA 02382 Name(Print) c.i.jraCurrent 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 5,000 (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee /(Pr- 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(1 + 2 + 3+4+ 5) 5,000 Check Number 76-0 a This Section For Official Use Only �f-a01 - J`' Date Building Permit Number: /5 Issued: Signature: /7/7 i i 3U - 202 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 c54;) 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 edia4 Expiration Date 1:;ife/Vgam_ Telephone 781-2054484 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 517362 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 (/f�� 11/21/2022 Signature of Owner/Agent Date l Michael Foldy ,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 11/21/2022 Signature of Owner Date - City of Northampton pPYHAMp�O� `ti_ " 4, .... . • Massachusetts • 11 it A DEPARTMENT OF BUILDING INSPECTIONS ,z 5 a` a. Y �• 212 Main Street • Municipal Building c Northampton, MA 01060 ssth, AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation ("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pm-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by re2istered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered. Type of Work:Weatherization Est. Cost:5,000 Address of Work: 15 Liberty Street Northampton MA 01062 Date of Permit Application: 11/21/2022 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: 11/21/2022 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 i '� DEPARTMENT OF BUILDING INSPECTIONS F { ' el.,::-: 212 Main Street ••Municipal Building v��ti CIS, _., Northampton, MA 01060 r�jI";};j�'�� 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 Liberty Street 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) CaL i;(1:d 11/21/2022 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. ly,:,,_,ir City of Northampton rpr, s Massachusetts ''� v,�i k DEPARTMENT OF BUILDING INSPECTIONS yJ ' 4� 212 Main Street •• Municipal Building tif. Northampton, MA 01060 s�"i' �7�^Y` MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 15 Liberty Street Northampton MA 01062 Contractor Name: HomeWorks Energy Address: 235 Essex Street City, State: Whitman, MA 02382 Phone: 781-205-4484 Property Owner Name: Michael Foldy Address: 15 Liberty Street Northampton MA 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. Contractor signatureCd11A4 ,„,c—‘)°(1:() c-te--- Date 11/21/2022 The Commonwealth of Massachusetts I,!t , Department of Industrial Accidents =; 1_ 1 Congress Street,Suite 100 '._O- . Boston, MA 02114-2017 $,,''v 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_Fnergy 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): cam a employer with 500 employees(full and/or part-tine)." J. New construction II am a sole proprietor or partnership and have no employees working for me in S. ❑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 4.01 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 11.11 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14 ther WEATHERIZATION 152,11(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. +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. InsuranceCompany Name: NH Employers Insurance Company Policy#or Self-ins.Lic.#:#4001017 Expiration Date: 01/01/2023 Job Site Athirecs• 15 Liberty Street Northampton MA 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 cjau der the pains and pe 's of perjury that the information provided above is true and correct Signature: Date: 11/21/2022 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#: �'...mN 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 c,No,Ext (978)686-2266 301 FAX 978 686-6410 163 Main Street ( ? (ac,Nola( ) North Andover, MA 01845 ADDRESS: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 POUCY EFF POLICY EXP LIMITS LTR INS° WVDIMM/DD/YYYYJ (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 DAMAGETORaENTEDrrence) $ 300,000 • PREMISES fE occu MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENTAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER A AUTOMOBILE LIABILITY CMBINED Ea accidentSINGLE LIMIT 1,000,000 ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ OWNED X SCHEDULED _ AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ X HIRED ONLY X NON-OWNED ONLYY (Per accident)AMAGE $ $ A X UMBRELLA LIAR 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 Y/N STATUTE ER 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) 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 he 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 74�r 6/ii/i-ionwie€7/Ve/..yle , 4e),Yc4/.)e11,- Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Roston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 181138 HOME WORKS ENERGY,INC. Expiration: 03/02/2023 101 STATION LANDING STE 110 MEDFORD,MA 02155 Update Address and Return Card. SCA 1 0 20M-057t7 .... ..1/ram �iwrii./�✓�rivvrl���,. Oft lc*of Consumer Males&Business Rs9utslion HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration cafe. R found return to: fiegistratlop ijakagan Office of Corsurier Affairs and Business Regulation 181138 03/02/2023 '000 Washington Street -SJite 713 HOME WORKS ENERGY,INC. Boston,MA 02118 ADAM GLENN L- ` 4 101 STATION LANDING STE 110 y.j•s44.44 MEDFORD,MA 02155 Not valid without signature Undersecretary Commonwealth of Massachusetts Construction Supervisor Specialty Division of Occupational Licensure Ratredto Board of Building Regulations and Standards -insulation Contractor Constructitif;1141.StAr Specialty CSSL-106148 mires: 07/30/2024 ADAM GLENtt) 19 CHARGE ' • WAREHAM 7i, Failure topossess a current edition of the Massachusetts '.°14Vdi'Z•l State Building Code is cause for revocation of this I:cense. For information about this license Comm; n rel c.�� Call(817)727 3200 or visa viVev.mass.govrdp Insulation/Air Sealing Permit Authorization Specialist: Frank Del Valle Company: HomeWorks Energy Email: frankdel.valle@homeworksenergy.com Address: 101 Station Landing Cell: 4135356594 Medford, Ma 02155 Phone: 781.305.3319 Customer: Michael Foldy Address: 15 Liberty St Email: Bourma@me.com Northampton, MA,01062 Site ID: 517362 Phone: 4139238284 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: Bourma@me.corn Customer Signature: Date: 9/8/2022 Michael Foldy (( 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: Michael Foldy Site ID: 517362 Finished Sq. Ft: 1354 Phone: 4139238284 Year of House: 1900 Electric Acct#: H Address:15 Liberty Street Northampton #of Floors: 2 Gas Acct #:7. unit#: #Occupants: 2 Housing Type? Colonial DUCTWORK INSPECTION Ducts Insulated?iD Duct Linear Duct Square Ft. —_ 18 As Duct Air Sealing Hours ruct Insulation • Fgb 130' Duct Insulation Removal 20 BASEMENT INSPECTION 38 Poly door ii.._ Existing Spec'ing Ln/Sq. Ft. co Bsmt Wall AG Crawl Ceiling 26 Crawl Rim Joist 0 \---"-N._, Bsmt R1 w/Sill Bsmt RJ NO Sill �--,. Fgb1 0, 18 20 singles Vapor Barrier--------sgft. Bsmt Door Poly Y/,'Blower Door? WALLS&GARAGE ' Drill Location? Siding Ceil.Hei ht Existing Spec'ing Sq. Ft. II Fr; mira Clapboard 0 ____ Dpc 864 I 2 16 L Exterior Wall 2 p iatform Exterior Wall 2 Clapboard 8 0 —Dpc -_ 2 4 16 iatform Overhang Clapboard 8 0 —Dpc 42 2 6 16 Garage Wall � \ fia Plratform Garage Ceiling \�C 0 re W 28 V Dpc 4" 1728 sf Ws + ds ii 26 4J H=8 7 H=8 6 Sqft. Sweeps: 1 WX Stripping: 1 WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawlspace Other: K&T /N Moisture Y/N Combustion Sfty Y/N Kneewall Overhang/Garage Asbestos /N Mold>100 sq.ft Y/N CO Detector Missing Y/N Ductwork Exterior Walls Vermiculite Y3l Structl Concerns Y/N Other: Notes for Lead Vendor/Work Not Contracted: Customer doesn't want to do attic at the moment as there's a lot of stuff up there and wants to go threw it KW WAU.AND KW FLOOR Blind Spec? H 46 OR .. KW SLOPE AND GABLE ENO Blind Spec? . Why> Why F 1ING EXISTING SPEON9 SO 1 t RAMING EXISTING SPIT'INC SO.Fl WALL x SLOPE X FLOOR X X GABLE X x cr. ,C) ACCESS x TRANS X x r., s& FRANS x X AMC 44* > 05 --, MIK SLOPE X X P SLOPE EXISTING VENTING" ii. i I-XISTING VENIING? EXISTING PIPES" Y/N rn KNEEWALL MANDATORY 7 , 6 30 Bf Obc 10" 612 t., Pds 19 Floor removal 470 z g ea ,., Storage removal 200 Propavents 67 Build up 100 sf Damming 30 Tdome Bf hose BA5 Vol: x 0058 . _ x x ATTIC 1 Blind Spec? x x ATTIC 2 Blind Spec? 2 f • - ' 1 . :t%- o , Existing Spec'ing Sq ft ff, Unfloore• !fog Obc Mullipliers „scl. Floored :T Obc AO Floored re• z Walls Walls Air Sealing Ho ors ...Acce ,„,. Tdome . Access _ no • • • 1 r I Danirmu ,_i `.-.ntints Prop,went Vent DI - How '5- Sv gv c., 1 a 1 67N 30 1 TurnpAc - -• vl Sieathireg A a ss: — I R L.Covers: Existing Venting? Existing venting? ' . ' '''''' • late HomeWorks Energy E 1 t ef 101 Station Landing,Medford,MA 02155 g CONTRACT - AUDIT HomeWorks 781-305-3319 Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENTS WORK ORDER Michael Foldy (413) 586-8761 09/08/2022 517362 00001 SERVICE STREET BILLING STREET PROPOSED NY: 15 Liberty Street 351 Pleasant St HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Northampton, MA 01060 DESCRIPTION OTY COST INCENTIVE TOTAL KNOB&TUBE WIRING We have identified the potential existence of Knob&Tube wiring in (initials) your home.The following contract is not valid unless accompanied by the Weatherization Barrier Incentive form, signed by your licensed electrician.Work will not proceed until we receive a copy of this form. HOME AIR SEALING 1 $94.33 $94.33 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.) WEATHERSTRIP AND ADD DOOR SWEEP 1 $57.92 $57.92 Provide labor and materials to install Q-Ion weatherstripping and a doorsweep to door(s)to restrict air leakage. WALLS-WOOD SIDED 1,728 $3,991.68 $2,993.76 $997.92 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. BASEMENT SILLS- R19 FIBERGLASS BATT 130 $308.10 $231.08 $77.02 Provide labor and materials to install R-19 unlaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. HomeWorks Energy tr t I I l 101 Station Landing,Medford MA 02155 � CONTRACT - AUDIT HomeWorks 781-305-3319 Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT# WORK ORDER Michael Foldy (413) 586-8761 09/08/2022 517362 00001 SERVICE STREET RILING STREET PROPOSED BY: 15 Liberty Street 351 Pleasant St HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATE BULKHEAD DOOR 1 $68.83 $51.62 $17.21 Provide labor and materials to insulate the back of the door to the basement's bulkhead with rigid board. Total: $4,520.86 Program Incentive: $3,428.71 Customer Total: $1,092.15 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Thousand Ninety-Two & 15/100 Dollars $1,092.15 COMPANY REPRES VTATI E CUSTOMER SIGNATURE 10/03/2022 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE DAYS.