24A-188 (7) BP i2023-0228
41. JACKSON ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24A-188-001 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-2023-0228 PERMISSION IS HEREBY GRANT 2D TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 3000 HOMEWORKS ENERGY INC 106148
Const.Class: Exp.Date: 07/30/2024
Use Group: Owner: BELUR BALAJI P&PALLAVI V BAI�DALLI
Lot Size (sq.ft.)
Zoning: URB Applicant: HOMEWORKS ENERGY INC
Applicant Address Phone: Insurance:
59 TOSCA DR 781-205-4484 ECC-600-4001017-204A
STOUGHTON, MA 02072
ISSUED ON: 02/27/2023
TO PERFORM THE FOLLOWING WORK:
INSULATION/W EATH E R I Z ATI ON
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: Footings:
Rough: Rough: House # Foundation:
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
• • - c").015/
Fees Paid: S65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
FEE: $65.00 ii) ic/ j
it
,gy4. ,0 City of Northampton Dep
BLS' r,.
Building Department
"� r" ,Zip 212 Main Street FINSULATION
=sic Northampton, MA 01060 .9
`b. OftJl_., Y
phone 413-587-1240 Fax 41 r�5$7-12 1
' a,r.
, .,„_
APPLICATION FOR INSULATION FOR A ONE OR TWO1F ALLY DWELLING ONLY
SECTION 1 -SITE INFORMATION INSULATION PERMIT
This section to be completed by office
1.1 Property Address:
Map Lot Unit
41 Jackson Street Northampton MA 01060 Zone Overlay District
Elm St. District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Balaji Belur 41 Jackson Street Northampton MA 01060
Name(Print) Current Mailing Address:
See Attached (678)982-4282
Telephone
Signature
2.2 Authorized Agent:
Adam Glenn 235 Essex Street, Whitman, MA 02382
Name(Print) � ) Current Mailing Address:
C 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:17 1..6
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 +2+ 3 +4+5) 3,000 Check Number (( I I I
This Section For Official Use Only
Building Permit Number: VP 2_.3'4 1 Date
Issued:
Signature: / / 2 -27 - 2023
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
1 � � Gt(/J 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
kbk j *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 439087
I 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 04, ,...00,av-
2/7/2023
Signature of Owner/Agent Date
Balaji Belur , 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 2/7/2023
Signature of Owner Date
City of Northampton
AM:
?• Massachusetts ? �.
r.
1 a. 4, DEPARTMENT OF BUILDING INSPECTIONS
•17 212 Main Street • Municipal Building
a h ,„. Northampton, MA 01060
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:41 Jackson Street Northampton MA 01060
Date of Permit Application: 2/7/2023
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:
2/7/2023 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
'. .
DEPARTMENT OF BUILDING INSPECTIONS
=s.' .' 212 Main Street •Municipal Building•
'.
- - Northampton, MA 01060 sf�'` 4
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:
41 Jackson 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)
41,10 S[A-)0:a;) 2/7/2023
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
r.
.?\
; t • ,„
* Massachusetts
fro
DEPARTMENT OF BUILDING INSPECTIONS
212 Mai Municipal
mpton, MA 01060 y!W W,,'‘4��
MANDATORY FOR HOUSES BUILT BEFORE 1945
Property Address: 41 Jackson Street Northampton MA 01060
Contractor
Name: HomeWorks Energy
Address: 235 Essex Street
City, State: Whitman, MA 02382
Phone: 781-205-4484
N me:rty Owner Balaji Belur
Address: 41 Jackson Street 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 o..4/1()
date 2/7/2023
The Commonwealth of Massachusetts
Department of Industrial Accidents
9 ' Office of investigations
l
I
Lafayette City Center
2 Avenue de Lafayette,Boston,MA 02111-1750
' �r 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:
500+ 4. I am a general contractor and I Type of project(required):
1. I am a employer with ❑
employees(full and/or part-time).* have hired the sub-contractors 6. El New construction
2 ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.
9. 0 Building addition
t
required.] 5. El We are a corporation and its 10.0 Electrical repairs or additions
3 0 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 12.0 Roof repairs
insurance required.]t c. 152,§1(4),and we have no 13 Weatherization
.
employees. [No workers' 1. 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.
tContractors 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: Federated Mutual Insurance Company
Policy#or Self-ins. Lic. #:#1847910 Expiration Date: 1/1/2024
Job Site Address:41 Jackson 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 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 un r the
eppains and pe s of perjury that the information provided above is true and correct.
Signature: �'"t'1 Date:2/7/2023
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 3tlity/Town Clerk 4. ❑Electrical Inspector 5J:thumbing
Inspector 6.0Other
Contact Person: Phone#:
E IMPA/DO/YYYY)
AFRO CERTIFICATE OF LIABILITY INSURANCE �'1
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 POUCIES 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
NAME: CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE:P.O.BOX 328 (A/C,No,Eel):888-333-4949 NE FAX
No):507-446-4664
OWATONNA,MN 55060 ADDRESS:CLIENTCONTACTCENTER@FEDINS.COM
INSURER(SI AFFORDING COVERAGE NAIC I)
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 419-899-0 INSURER B:
HOMEWORKS ENERGY,INC. INSURER C:
101 STATION LNDG
MEDFORD,MA 02155-5134 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:0 REVISION NUMBER:1
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS
AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP
LTR INSR WVD IMNVDD/YYYY) IMM/DDIYYYY) LIMITS
X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $1,000,000
J CLAIMS-MADE X.00CUR DAMAGE TO RENTED $100 000
PREMISES(Ea occiiriencs)
MED EXP(My one person) EXCLUDED
A N N 1847909 01/01/2023 01/01/2024 PERSONAL a ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPUES PER. GENERAL AGGREGATE S2,000,000
(POLICY -.JECT PRODUCTS-COMP/OP AGO $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
IEa acddent) $1,000,000
X ANY AUTO BODILY INJURY(Per person)
A -OWNED AUTOS ONLY _AUTOSULED N N 1847908 D1/01/2023 01/01/2024 BODILY INJURY(Per acriden8
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
AUTOS ONLY
- (Per accident)
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000
A EXCESS LIAB CLAIMS-MADE N N 1847911 01/01/2023 01/01/2024 AGGREGATE $1,000,000
DED RETENTION
WORKERS COMPENSATION X PER STATUTE O7H-
AND EMPLOYERS'LIABILITY Y/N ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S500,000
A OFFICERIMEMBEREXCLUDED? -NIA N 1847910 01/01/2023 01/01/2024
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S500,000
If yes,describe under E.L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS below $SOO,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required)
THIS COPY IS NOT TO BE REPRODUCED FOR ISSUANCE OF CERTIFICATES.
CERTIFICATE HOLDER CANCELLATION
01
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN
A CERTIFICATE HAS BEEN FILED WITH EACH OF YOUR CERTIFICATE ACCORDANCE WITH THE POUCY PROVISIONS.
HOLDERS.
AUTHORIZED REPRESENTATIVE
1988-2015 ACORD CORPORATION.AN rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
•
f , . .': :'
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Supplement Card
Registration: 181138
HOME WORKS ENERGY,INC- Expiration: 03/02c2023
101 STATION LANDING STE 110
M + FORD,MA 02155
Update Address and Return Card.
SCA I 0 20h1.05117
. . .. /. �ri„-,.n'/.•:..r.:
Office of Consumer Alleles do Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
TYPE:Supplement Card before the expiration date. tf found return to:
Registration EXQ{Jation Office of Consumer Affairs and Business Regulation
181138 0302/2023 '000 Washington Street -Suite 710
HOME WORKS ENERGY,INC. Boston,MA 02118
ADAM GLENN (.176411,-94)1°41- 144-
101 STATION t ANDING STE 110
MEDFORD,MA 02155 Undersecretary Not valid without signature
Commonwealth of Massachusetts
Construction Supervisor Specially
Division of Occupational Llcensure Restr ed to
Board of Building Requiations and Standards CSSL4C •Insulation Contractor
t'IIi
Constructii .,+ y'r Specialt;
CSSL-106148 * spires: 07/30/2024
ADAM GLENN
19 CHARGE PO i.
WAREHAM Mfg r Y •
Failure topossess a current edition of the Massachusetts
rat ,3h1 State Building Code is cause for revocation of this',cense.
For information about this license
Call(617)727-3203 or visa wwv.mass.gov1dpi
Insulation/Air Sealing Permit Authorization
Specialist: Bryan Ruddy Company: HomeWorks Energy
Email: bryan.ruddy@homeworksenergy.com Address: 101 Station Landing
Cell: 4132049308 Medford, Ma 02155
Phone: 781.305.3319
Customer: BALAJI BELUR Address: 41 Jackson St
Email: bpbalu@gmail.com Northampton, MA, 01060
Site ID: 439087 Phone: 6789824282
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: bpbalu@gmail.com
Customer
Signature: BALAJI; f �� 9 Date: 11/11/2022
BALAJI � J
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: Qc,Ltr 3t° 1 Site ID: t t o 7 Finished Sq. Ft: 1LO4
° Phone: 671f q Z f L Year of House: 1411 r Electric Acct#:
oAddress: t l t �'l Sr- #of Floors: a- Gas Acct#:
,.��. unit#: #Occupants: 4- Housing Type? Cart
DUCTWORK INSPECTION Ducts Insulated?❑
Duct Linear Ft.
Duct Square Ft
Duct Air Sealing Ho
Duct Insulation
Duct Insulati emoval 4
z r'' BASEMENT INSPECTION 1
W Existing Spec'ing Ln/Sq. Ft.
co Bsmt Wall AG
Crawl Ceiling
Crawl Rim Joist
Bsmt RJ w/Sill iLWINK, F1615, f IC)
Bsmt RJ NO Sill
Vapor Barrier sqft. Bsmt Door
rYIN Blower Door? WALLS &GARAGE Drill Location?
Siding Cell.Height Existing Spec`ing Sq.Ft. Framing
Exterior Wall 1 . ,c 7 l rD -- 2!a . x f x!5 Balloon atf
Exterior Wall 2 x x Balloon/P atform
Overhang x x
Garage Wall x x Balloon/Platform
Garage Ceiling x x
0
ti
0
af
-60
r Insu ett;Rvdh" `
Sweeps:
WX Stripping: 7""'
WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY)
Attic Basement/Crawlspace Other: K&T Y eip Moisture Y hap ombustion Sfty Y N
Kneewall Overhang/Garage Asbestos V PZEI Mold>100 sq.ft Y I 0 Detector Missing Y`
Ductwork Exterior Walls Vermiculite YD Structl Concerns Y •_.ether:
Notes for Lead Vendor/Work Not Contracted:
KW WALL AND KW FLOOR Blind Spec? 0 . OR hy? " KW SLOPE AND GABLE,END Blind Spec?
FRAMIN I TWG ti{Er TR.; Why?
t4 5� T /
WALL } FRAMING (EXISTING SPE(TIC; ` yr� I:r
m FLOOR '1'X XK • '• .,,. �. SLOPE X X
8 ACCESS 1-X.-- • 1-.1 ,,�,, GABLE X X
TRANS 03 r X .0%. \ TRANS X X
ATTIC f i �I Jthiv"<"
+Q, fEXISTING VENTING? I(4w Vent*,4 Vent Br BF Ho:e r.r
H X
KNEEWALL MANDATORY d Y
f j
f
Sri✓ ,
5
V If
s /
Insulated Walt X X Reed tight 0 Ins.Hose E=I Vent BF BFVj Clum.ED Damming 12-Roof V tll) BAS V• : ,,x .0058
An Handler® Temp Access 0 Pull Down DS Hatch ® Wail Hatch ''/ Door / 8"Rao`Vent RV 19(l :y) ,
X X ATTIC 1 Blind Spec? D. X X ATTIC 2 t rind Spec? 0 X ra t2uo
ling Spe• ing Sq ft Multipliers
z Existing Spec'ing Sq ft • p
G Unfloored 11. 1tr'OiL .. Unfloored Trusses cross Batting
` Floored i� Mwedlesulaton D��crk
c, Floored y7 C7 t ,- >6"Lod .CLff,se
z Cath Slope -w ..— Cath Slope Air Sealing Hours
Walls F4- 3 ( 14 75- Walls J
Access Access
Venting Propavents Vent BF BF Hose Dammin Ventng pro te tts Vent BF BF I Damming
m W NF Box:__
oa C Temp Access: —
C
to or iSit(ra Hail jj Access: _
ar °- R.L.C
:a.Ft/300_ (bust.NM Vennngl= lNeeded {,r r}g p L
••G.Ft/3�-./_ _ ,••t .FA venting,°_ tNeedee _.rr.. NFAVenttng) 'Roof Type: ' /l�
NM Venting) Existing Venting?
Existing Venting?
HomeWorks Energy
rrgon
` 101 Station Landing,Medford,MA 02155
CONTRACT - ISM
HomeWorks 781-305-3319
Page 1
PROGRAM
CMA-HPC
CUSTOMER PHONE DATE CIJENT# WORK ORDER
Belaji Belur (678)237-3387 11/11/2022 439087 91407
SERVICE STREET SLUNG STREET PROPOSED BY:
41 Jackson Street 41 Jackson Street HomeWorks Energy
SERVICE CITY,STATE,ZIP BXIJNG CITY,STATE,ZIP
Northampton, MA 01060 Northampton, MA 01060
DESCRIPTION QTY COST INCENTIVE TOTAL
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 4 $231.68 $231.68
Provide labor and materials to install Q-Ion weatherstripping and a
doorsweep to door(s)to restrict air leakage.
KNEEWALL: RIGID BOARD 210 $911.40 $683.55 $227.85
Provide labor and materials to install rigid board at R-10 or greater
with the required fire rating to a kneewall area.
WALLS-WOOD SIDED 210 $485.10 $363.83 $121.27
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.
COMMON WALL RIGID BOARD 75 $325.50 $244.13 $81.37
Provide labor and materials to install 2"rigid board to a common wall
area.All seams will be sealed with tape.
COMMON WALL-4"CELLULOSE 300 $693.00 $519.75 $173.25
Provide labor and materials to install blown in Class I Cellulose to a
4"common wall through an interior surface drill and plug method.
Plugs will be spackled and left in a relatively smooth condition. Finish
sanding and touch-up priming/painting 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 acknowedgement of receipt and agreement to
proceed.
HomeWorks Energy
0n
r! 1� 101 Station Landing,Medford,MA 02155
I works781-305-3319
CONTRACT - ISM I
Energy,Inc Page 2
PROGRAM
C MA-H PC
CUSTOMER PHONE DATE CLIENTS WORK ORDER
Belaji Belur (678) 237-3387 11/11/2022 439087 91407
SERVICE STREET BILLING STREET PROPOSED BY:
41 Jackson Street 41 Jackson Street HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP
Northampton, MA 01060 Northampton, MA 01060
DESCRIPTION QTY COST INCENTIVE TOTAL
BASEMENT SILLS R19 FIBERGLASS BATT 25 $59.25 $44.44 $14.81
Provide labor and materials to install R-19 unfaced fiberglass
insulation to the perimeter of the basement ceiling at the house sill.
Total: $2,800.26
Program Incentive: $2,181.71
Customer Total: $618.55
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***Six Hundred Eighteen & 55/100 Dollars $618.55
w
eZ)
COMPANY REPRESENTATNE CUSTOMER SIGNATURE
NOTE THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE
SIGN DATE
DAYS.