24D-153 BP-2023-0560
20 CARPENTER AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24D-153-001 CITY OF NORTHAVIPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-0560 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 8000 HOMEWORKS ENERGY INC 106148
Const.Class: Exp.Date: 07/30/2024
STERNBACH NANCY S& RAFAEL STERNBACK-
Use Group: Owner: LE NOURY &TOBIAS
Lot Size (sq.ft.)
Zoning: URC Applicant: HOMEWORKS ENERGY INC
Applicant Address Phone: Insurance:
235 ESSEX ST 781-205-4484 1847910
WHITMAN, MA 02382
ISSUED ON: 05/02/2023
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:
I ,
I0 • I I )/C2
•
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:,(413)587-1272
Office of the Building Commissioner
FEE: $65.00 o, 1 qoo
Depp``lcI-►jrl City of Northampton
Building Departhent4,
�` ,7 , .'
'� 4.-
INSULATION
Main Street ti.
, - INSULATION
��,� Room 100
,.
-
` ' Northampton, MA 0t, `c-
phone 413-587-1240 Fax 41.3 , 7-1272 OI'JL. ",'
\-,
APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY
SECTION 1 -SITE INFORMATION INSULATION PERMIT
1.1 Property Address: This section to be completed by office
Map Lot Unit
20 Carpenter Avenue Northampton Massachusetts 01060 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Tobias Sternbach 20 Carpenter Avenue Northampton Massachusetts 01060
Name(Print) Current Mailing Address:
See Attached 8868
Telephone
Signature
2.2 Authorized Agent:
Adam Glenn ---Th 235 Essex Street, Whitman, MA 02382
Name(Print) 1;1:ad Current Mailing Address:
781-205-4484
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 8,000 (a)Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) # 05
5. Fire Protection
6. Total = (1 +2+ 3+4+5) 8,000 Check Number f ( 5 'Y
(, This Section For Official Use Only
Building Permit Number: �j0-a3 - quo o Date
Issued:
Signature: ' 'C S 2- 20 Z 3
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 03/02/2025
Address Expiration Date
(AU
y( f !{) � Telephone 781-205-4484
SECTION 5-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes No ❑
Brief Description of Proposed Work
Residential weatherization/ Air sealing. No structural changes. SITE ID 460473
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
,s4a.rd
4/24/2023
Signature of Owner/Agent Date
Tobias Sternbach as Owner of the subject
property
hereby authorize HomeWorks Energy
to act on my behalf, in all matters relative to work authorized by this building permit application.
See Attached 4/24/2023
Signature of Owner Date
City of Northampton
Massachusetts
•4 .y
DEPARTMENT OF BUILDING INSPECTIONS �P x
Qr 212 Main Street • Municipal Building
Northampton, MA 01060 sJ'bJy �`�o
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 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: 20 Carpenter Avenue Northampton Massachusetts 01060
Date of Permit Application: 4/24/2023
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:
4/24/2023 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
f '' ° ',;.,. Massachusetts �Q}'S �'i�
K
DEPARTMENT OF BUILDING INSPECTIONS x
d ice' r`.
212 Main Street •Municipal Building JC.
-- Northampton, MA 01060 f `"�•• %��
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:
20 Carpenter Avenue Northampton Massachusetts 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)
CdtaA SIJO/Ird 4/24/2023
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.
„.,,.,i City of Northampton
r s '” s
ri Massachusetts A.. ��
..
e ° DEPARTMENT OF BUILDING INSPECTIONS ,„,„
212 Main Street • Municipal Building `�tif,, �^�'
.=�,-� Northampton, MA 01060 sbjv 4i0\
MANDATORY FOR HOUSES BUILT BEFORE 1945
Property Address: 20 Carpenter Avenue Northampton Massachusetts 01060
Contractor
Name: HomeWorks Energy
Address: 235 Essex Street
City, State: Whitman, MA 02382
Phone: 781-205-4484
Property Owner
Name: Tobias Sternbach
Address: 20 Carpenter Avenue Northampton Massachusetts 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 signature6a4 A ,,,,,ijoe2e)- c.efe_.
Date 4/24/2023
The Commonwealth ofMassachusetts
Department of Industrial Accidents
Office of Investigations
Lafayette City Center
�✓ 2 Avenue de Lafayette, Boston, MA 02111-1750
; :.- www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): HomeWorks Energy
Address: 235 Essex Street
City/State/Zip:Whitman, MA 02382 Phone #: 781-205-4484
Are you an employer? Check the appropriate box: Type of project(required):
1.0 I am a employer with 500+ 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
listed on the attached sheet. 7. ❑ Remodeling
2.0 I am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9 El Building addition
[No workers' comp. insurance comp. insurance.:
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ 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 Weatherization
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Federated Mutual Insurance Company
Policy#or Self-ins. Lic. #:#1847910 Expiration Date: 1/1/2024
Job Site Address: 20 Carpenter Avenue Northampton Massachusetts 0 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 and r the pains and pe yles of perjury that the information provided above is true and correct.
Signature:
.. v°4 `� Date: 4/24/2023
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 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing
Inspector 6. Other
Contact Person: Phone#:
E(FAM/DO/TYYY)
ACCORD CERTIFICATE OF LIABILITY INSURANCE 12/30/2022
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 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
FEDERATED MUTUAL INSURANCE COMPANY NAMEPHON CLIENT CONTACT CENTER
E HOME OFFICE:P.O.BOX 328 A C,No,ExU:888- 33-4949 (A/C.No):507-440-4664
OWATONNA,MN 55060 E-ADDRESS:CLIENTCONTACTCENTER(E)FEDINS.COM
INSURER(S)AFFORDING COVERAGE NAIC#
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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTRINSR NNDIMMIOD/YYYY) IMM/DDIYYVY)
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
AMNTED
CLAIMS-MADE X j OCCUR PRE ISES lE Ea a currencol $100,000
MED EXP(My one person) EXCLUDED
A N N 1847909 01/01/2023 01/01/2024 PERSONALS ADV INJURY $1,000,000
GEN'L AGGRE A E LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY .I JPERO-
CT _LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
X i, lEa aaccident)accident)ANV AUTO
BODILY INJURY(Per person)
CH
A OWNED AUTOS ONLY s000suLED N N 1847908 01/01/2023 01/01/2024 BODILY INJURY(Per accident)
HIRED AUTOS ONLY NON'OWNED PROPERTY DAMAGE
_AUTOS ONLY (Per accident)
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000
A EXCESS LIAR CLAIMS-MADE N N 1847911 01/01/2023 01/01/2024 AGGREGATE $1,000,000
DUD RETENTION
WORKERS COMPENSATION X PER STATUTE OTH-
AND EMPLOYERS'LIABILITY Y/N ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S500,000
A OFncERIMEMBEREXCLUDED? NIA N 1847910 01/01/2023 01/01/2024 --- --
(Mandatory In NH) E.L.DISEASE•EA EMPLOYEE S500,000
If yes.describe under
DESCRIPTION OF OPERATIONS below EL DISEASE•POLICY LIMIT S500,000
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 DELIVERED IN
A CERTIFICATE HAS BEEN FILED WITH EACH OF YOUR CERTIFICATE ACCORDANCE WITH THE POLICY PROVISIONS.
HOLDERS. AUTHORIZED REPRESENTATIVE
104-41,6-1. /
O 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2018/03) The ACORD name and logo are registered marks of ACORD
Commonwealth of Massachusetts
•
Division cif Occupational Licensur+e Construction Supervisor Specialty
Boardof Building Re aiic�rts and Starrr3ard Rest,idedte CSSLaC ".nsutatisn Cant-actof
Constructi t,• pe `rr Specialty
CSSL-106148 4k7 , t spires: 07/30/2024
ADAM GL 4
19 CHARGE "s.
WAREHAM MIA t " r
et„ Failure to possess a current edition of the Massachusetts
,� t. t�tt f"t' State auitd ng Code is cause farrevocation of this ttcense
For information about this license
y , - C all i6171 727 3200or visit www rtiass.gov dp
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
�
"'"""""` Type: Corporation
HOME WORKS ENERGY, INC. ,.. .... +1.0' Registration: 181138
'�..4 Expiration: 03/02/2025
101 STATION LANDING STE 110 741,
MEDFORD, MA 02155 "'
MS Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE:Corporation Office of Consumer Affairs and Business Regulation
Registration Expiration 1000 Washington Street -Suite 710
181138 03/02/2025 Boston,MA 02118
HOME WORKS ENERGY,IN,
y ---,
ADAM GLENN t.
,rt
101 STATION LANDING STE 110 {r°,, �;�,,,:a�
MEDFORD, MA 02155 � '---, '`
'� Undersecretary Not valid without signature
Proposal Terms
Customer: Tobias Sternbach Specialist: Bryan Ruddy HomeWorks Energy, Inc
Site ID: 460473 Date: 2022-10-07 101 Station Landing, Ste 110
Medford, MA 02155
NOTICE CONCERNING SPONSORSHIP:Customer understands and acknowledges that HomeWorks Energy is not an agent,vendor or sub-vendor of the
sponsoring Utility with respect to the installation of any energy efficiency measures. In the event of the failure of any energy conservation device to
perform as expected, Customer agrees that Customer's sole recourse is to Contractor and not to Clear Result or to the Utility. The Utility and its
operating companies shall not maintain, remove or perform any work whatsoever on the energy conservation measures installed. Customer
understands and acknowledges that its participation in the MassSave Home Energy Services Program is voluntary and that it has consented for
Contractor to install the propose energy conservation measures. Customer agrees that it shall not hold Clear Result, the Utility, their affiliates or
operating companies liable for Contractor's failure to perform its obligations under this agreement,for failure of the energy conservation measures to
function,for any damage to Customer's Premises caused by Contractor or for any and all damages to property or injury to persons caused by the energy
conservation measures
ENERGY BENEFITS:The sponsoring Utility is entitled to 100%of the energy benefits associated with all Energy Conservation Measures,excluding the
value of energy cost savings by the customer, but including all rights to all associated ISO-NE Energy, Capacity and Reserves Products. HomeWorks
Energy agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and
products.
CLEAN UP OF THE WORK AREA:Weatherization projects can generate dust,some of which may contain traces of lead.The Contractor agrees to follow
Lead-Safe Guidelines and to make reasonable efforts to control dust and other mess through the draping of cabinets and furniture with plastic,hanging
plastic sheet walls, and cleaning floors of dust and any paint spatter. However,the Contractor will not leave the interior white glove clean. Outside
work areas will be left broom clean and all debris and trash removed.The Homeowner should be aware however that minor amounts of cellulose and
wood chips--which are harmless and biodegradable—may be left on the ground. The Contractor agrees to be conscientious about picking up nails and
other fasteners,but Homeowner should also be prepared for the occasional fastener that escapes contractor's notice.
CUSTOMER INFORMATION
Wall Insulation:There is a chance your walls may crack due to the pressure that is required to achieve a dense pack.If your walls crack,we will hire a
plasterer to plaster over the cracked area.You will be responsible for repainting. Please review and sign the wall disclosure form.
Insulation Removal: Insulation must be removed from the following locations:
*If it is not done,HomeWorks will charge$1.26/square foot for the removal.
Parking Permits:If the energy specialist or operations manager determines that a parking permit is required for installation and if you do not have a
pre-existing solution,we will procure one and add the cost to your invoice.
Bath Fan Venting:Installing a hose and flapper to an existing bath fan may increase noise levels due to proper venting procedures.
Exposed Pipes:If the energy specialist finds pipes that may be exposed to cold weather,leaving pipes outside the thermal envelope may cause them
to freeze. The auditor will recommend a solution to the best of their ability,however,HomeWorks Energy will not be held responsible for any
damage caused due to frozen pipes.
0 N/A
DEPOSIT: A$50.00 deposit may be required when signing this document.It is completely refundable for three days.In the event the Customer does not
schedule the weatherization work,the deposit is only refundable if the Customer calls 781-305-3319 to cancel such work.Once scheduled,the deposit
is refundable if the Customer gives 3 days notice of cancellation.If the Contractor is unable to enter the premises or complete the weatherization work
due to an absence of the Customer or related access issues,the deposit will not be refunded.All refunds will be processed in the same manner in which
the deposit was provied (e.g., credit card payments will be refunded to the same credit card). All deposits and other payments may be made in
electronic form at the discretion of the Contractor.The remaining Customer payment is due in its entirety upon completion of the weatherization work.
DISPUTE RESOLUTION:The Contractor and the Homeowner hereby agree in advance that in the event the Contractor has a dispute concerning this
contract, the Contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of
Consumer Affairs and Business Regulation and the Consumer shall be required to submit to such arbitration as provided in Massachusetts General Laws,
Chapter 142A.
CHANGE IN QUANTITY AND PRICE:The Project Summary provided separately to the Customer is subject to change.Any change in quantity of materials
will increase or decrease the overall price of the work.Any such changes will be provided in writing to the Customer,typically via a certificate of
completion,and the Customer's approval for any such change will be obtained prior to any work being completed.
Do not sign this contract if there are any blank spaces.
Customer �
Signature: i�6 3- 424.114 .C% Date: 10/7/2022
Tobias Sternbach
Auditor
Signature: &)a',P�rlc(� Date: 10/7/2022
Bryan Ruddy
PLAN VIEW
Name: 1�,t,;t- SS ' ll (20{. 1 Site ID: ` '3 /7 J I r g % Finished Sq. Ft: 10
o Phone: 4,13 310 '166 r Year of House: 0 Electric Acct#:
ui Address: 10 I # of Floors: Gas Acct#:
w firrwtn 41,,,p{-„r, Unit#: #Occupants: 1 Housing Type? 111114/j; '1 —^
DUCTWORK INSPECTION Ducts Insulated?D
Duclinear Ft.
Duct Squa t.
Duct Air Sealing
m
Duct Insulati in
Duct Ins lion Removal ) f
� z
Z BASEMENT INSPECTION �
W Existing Spec'ing Ln/Sq. Ft. xl
m Bsmt Wall AG *'
Crawl Ceiling -.. —
Crawl Rim Joist —
—
Bsmt RJ w/Sill -131aoa it 3
Bsmt RJ NO Sill --
Vapor Barrier sgft. Bsmt Door
Yfrli$lower Door? WALLS&GARAGE Drill Location? T,"z,-.., /r-,..
S ding Ceil.Height Existing Spec'ing Sq.Ft.I2'f Framing
Exterior Wall 1 1► tn-i 1 i v".",J` 24 if.V 2 x '+- x It Balloon/Platform
ExteriorWall2 Vi,1->sr> +1 g h'-4.44- d • " 111, x x Balloon/Platform
Overhang „ x x
Garage Wall r. , �` x'`-mac Balloon/Platform
Garage Ceilig ,�� .. .� _ ��,
0
et
..a - 4 �• ,,...
F-
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CC
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F-
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WX Stripp ng'
WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENMANDATORY)
W
Attic Basement/Crawlspace Other: K&T Moisture Y J`�Combustion Sfty
Kneewall Overhang/Garage Asbestos Y Mold>100 sq. ft Y/cICO Detector Missing Y
Ductwork Exterior Walls Vermiculite Y N Structl Concerns Y/ lflOther:
Notes for Lead Vendor/Work Not Contracted:
hy? KW WALL AND KW FLOOR Blind Spec? 0 - OR - - KW SLOPE AND GABLE END Blind Spec? 0
Why?
FRAMING EXISTING SPF('INC, SO,FT
WALL
FRAMING EXISTING SPEC TIC: So.FT.
X X
FLOOR
SLOPE X X
X X
co GABLE X X ACCESS X 77,
2.1 \
TRANS TRANS X X z
LI- X X
cia ATTIC
ATTIC / 1
.--:t SLOPE X X / SLOPE X X
?'
EXISTING tn
r-
EXISTING VENTING VENTING?
,,c EXISTING PIPES? N m
J i ,1
KNEEWALL MANDATOP.f °'''''''''V';IZ'i:V,_ ,
:qr
------
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.
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Insulated Wall X X Rec'd light 0 Ins.Hose riAll vent 8F Fill Chim.M Damming 12-Roof r5c) BAS 01: X 0.58
Air Handler ED Temp Access 0 Full Down ELI Hatch El Wall Hatch,-,./ Door'/ 8"Roof Vent
19(1 sto•
2 A x it ATTIC 1 Blind Spec? [it] X X ATTIC 2 Blind Spec? 0 ^ 15 4(2
storyi
z Existing Spec'ing Sq ft 1 Existing Spec'in/ Sq ft
o l Multipliers
E Unfloored — I$ rgial/C Unfloored Trusses Cross Battne
Floored rhrot•-- tketv›.."OA 1 :1 , Floored ' Mixed insulation Du Wort:
-. Cath Slope — Cath Slope
/ >6"Loose inton
u I Air Sealing Hours
Walls rvc-..."- Pet- ,S,t, ,si i 3 Walls ,
< Access %Hi- I ft,.4 .3,""Ae- I Access
Venting Propavents Vent 81 Hi (lose Damming lrenting Pr avents Ntat,ZF fif Hose Damming ,
i
4—it) to
5
•- i WHF Box: 10"
letup Access: ,,,,,,
400' ts) d'.1., 4.01..... ...... C.., Sheathing Access:—
E. 1 ft4144,,,-,,,
ti-, ,„, N.\.,,
. , RI (()vets.
1)4 Kr 300 z , 4". 1) (Exist trilA Venting).=,...(Needed Sio ftP300- • (Exist 1.FA i,enting)- ir.teact
Existing Venting? NFA VentsneExisting Venting? toaventinip Roof Type: &It., 1.„' ,
HomeWorks Energy
Egtc)nr (3)
101 Station Landing,Medford,MA 02155 CONTRACT - ISM
I- works 781-305-3319
n�7lJli,lerrgYy,Inc Page 1
PROGRAM
CMA-HPC
CUSTOMER PHONE DATE CUENT B WORK ORDER
Tobias Lenoury (413) 320-8868 10/07/2022 460473 85406
SERVICE STREET BILLING STREET PROPOSED BY:
22 Carpenter Avenue 2 22 Carpenter Avenue 2 HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CITY.STATE,ZIP
Northampton, MA 01060 Northampton, MA 01060
DESCRIPTION QTY COST INCENTIVE TOTAL
HOME AIR SEALING 8 $754.64 $754.64
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.
ATTIC FLAT-15"OPEN R-49 CELLULOSE 1,080 $2,419.20 $2,419.20
Provide labor and materials to install a 15"layer of R-49 Class
Cellulose to open attic space.
ATTIC DOOR-INSULATE 1 $68.83 $68.83
Provide labor and materials to insulate the back of the attic door with
2"rigid insulation board.
WALLS-VINYL SIDED 1,224 $2,827.44 $2,827.44
Furnish and install blown in Class I Cellulose to vinyl-sided exterior
walls. 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.
WALLS- INTERIOR DRILL AND PLUG 255 $581.40 $581.40
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 spackled and left with a rough finish. 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.
BASEMENT SILLS-R19 FIBERGLASS BATT 13 $30.81 $30.81
Provide labor and materials to install R-19 unfaced fiberglass
insulation to the perimeter of the basement ceiling at the house sill.
HomeWorks Energy
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r n7 101 Station Landing,Medford,MA 02155
CONTRACT - ISM I
I n w _ 781-305-3319
Q(�_$ Page 2
PROGRAM
CMA-HPC
CUSTOMER PHONE DATE CLIENT# WORK ORDER
Tobias Lenoury (413) 320-8868 10/07/2022 460473 85406
SERVICE STREET BILLING STREET PROPOSED BY:
22 Carpenter Avenue 2 22 Carpenter Avenue 2 HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP
Northampton, MA 01060 Northampton, MA 01060
DESCRIPTION QTY COST INCENTIVE TOTAL
VENTILATION CHUTES 48 $167.52 $167.52
Provide labor and materials to install ventilation chutes in the rafter
bays to maintain air flow.
SOFFIT VENTS 4 X 16 9 $277.65 $277.65
Provide labor and materials to install 4"X 16"rectangular aluminum
soffit vents to increase ventilation in attic areas. Specify color: White or
Gray.
RIDGE VENT 14 $378.28 $378.28
Install continuous ridge venting at the top ridge of your roof. Shingle
age and integrity will affect the aesthetics of your new ridge vent.The
new color may not be an exact match for your roof due to material
availability and UV exposure. Before installing, the contractor will
procure the shingles for your approval.
Total: $7,737.45
Program Incentive: $7,737.45
Customer Total: $0.00
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***00/ Dollars $0.00
COMPANY REPRESENTATIVE CUSTOMER SIGNATURE
11/4/2022
NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE
SIGN DATE
DAYS.