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24C-066 (3) BP-2023-0726 76 MASSASOIT ST COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 24C-066-001 CITY OF NORTHA PTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGIS ERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0726 PERMISSION S HEREBY GRANT D TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 2000 HOMEWORKS ENE GY INC 106148 Const.Class: Exp.Date: 07/30/202 Use Group: Owner: MASO THOMPSON TODD K&ELIS Lot Size (sq.ft.) Zoning: URB Applicant: HOME ORKS ENERGY INC Applicant Address Phone: Insurance: 235 ESSEX ST 781-205-4484 1847910 WHITMAN, MA 02382 ISSUED ON: 06/06/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/W E AT H 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 , • �, 1 i . I II Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fa : (413)587-1272 Office of the Building Commiss oner FEE: $65.00 . , r MO : :, City of Northampton .,-"X Budding Department „A , ••S� 212 Main Street INSULATION , ,..-s. Room 100 rthampton, MA 01060 . _,_. 10,,,,,,,:,,„ -,,,,,o,,.04,_ t`e 3-587-1240 Fax 413-587-1272 QpJ •, Y APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT This section to be completed by office 1.1 Property Address: Map Lot Unit 76 Massasoit Street Northampton MA 01060 Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Todd Thompson 76 Massasoit Street Northampton MA 01060 Name(Print) Current Mailing Address: See Attached (413)387-9594 Telephone Signature 2.2 Authorized Agent: Adam Glenn 235 Essex Street, Whitman, MA 02382 Name(Print) Current Mailing Address: ()ALA 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 2,000 (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 0� 5. Fire Protection 6. Total = (1 +2+ 3+4+5) 2,000 Check Number ii 901 This Section For Official Use Only 3/7_) ,( r ridC( Date Building Permit Number: ./ Issued: Signature: . / -7 67- c.7- 62 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 a 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 C J j c.gie 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 805074 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 c54 '" V 5/25/2023 Signature of Owner/Agent Date Todd Thompson 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 5/25/2023 Signature of Owner Date City of Northampton ? '1:. N5 ,...SI ''"� Massachusetts A. x._ ��t' * c ' 4'16 DEPARTMENT OF BUILDING INSPECTIONS '; Ur x 44.t+� +it, f 212 Main Street • Municipal Building vti. ^�M N p."`/.- Northampton, MA 01060 sst,� ,3,3C‘`� 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:2,000 Address of Work:76 Massasoit Street Northampton MA 01060 Date of Permit Application: 5/25/2023 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: 5/25/2023 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 oatHM, , "#' Massachusetts - `...,...) 1 DEPARTMENT OF BUILDING INSPECTIONS tr, ', , 212 Main Street •Municipal Building Northampton, MA 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 76 Massasoit 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) caL ,,g)- -ad 5/25/2023 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.,,.,i City of Northampton t It Massachusetts - k DEPARTMENT OF BUILDING INSPECTIONS *.. _� 212 Main Street • Municipal Building .^... Northampton, MA 01060 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 76 Massasoit Street Northampton MA 01060 Contractor Name: HomeWorks Energy Address: 235 Essex Street City, State: Whitman, MA 02382 Phone: 781-205-4484 m Property Owner Name: Todd Thompson Address: 76 Massasoit 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 signatureCA4 sr>cr)Sta'r-() cte---- date 5/25/2023 The Commonwealth of Massachusetts Department of Industrial Accidents gj�v_rn �; ►—_G Office of Investigations _r _„ ,= Lafayette City Center =��= 2 Avenue de Lafayette, Boston,MA 02111-1750 '' -A_=°� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): HomeWorks Energy Address: 235 Essex Street City/State/Zip:Whitman,MA 02382 Phone #: 781-205-4484 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 500+ 4. ❑ 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. ElRemodeling 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. ❑ 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 11.0 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 Weatherization employees. [No workers' 13.❑� Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Federated Mutual Insurance Company Policy#or Self-ins. Lic. #:#1847910 Expiration Date: 1/1/2024 Job Site Address: 76 Massasoit 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 und r the pains and pe 4 des of perjuty that the information provided above is true and correct Signature: fe Date: 5/25/2023 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#: "4�oRo 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 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 FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER ONE FAX HOME OFFICE:P.O.BOX 328 (A CC,No,Eel):888-333-4949 (A/C,No):507-446-4664 OWATONNA,MN 55060 E-ADDRESS:CLIENTCONTACTCENTERL FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 419-899-0 INSURER 8: 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 LTR TYPE OF INSURANCE 1NSR Sys POLICY NUMBER POLICY EFF POLICY EXP IMMLIC YYYV) IMM/ SlI YI LIMITS X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED $100,000 PREMISES lEa occurrence) MED EXP(Any one person) EXCLUDED A N N 1847909 01/01/2023 01/01/2024 PERSONALS ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY jj'EsTCTC LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 1Ee ecddentl X ANY AUTO BODILY INJURY(Per person) AOWNED AUTOS ONLY SCHEDULED AUTOS N N 1847908 01/01/2023 01101/2024 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON OWNED PROPERTY DAMAGE ,_, AUTOS ONLY IPer amdenl) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIMB CLAMS-MADE N N 1647911 01/01/2023 01/01/2024 AGGREGATE $1,000,000 ^-DED RETENTION WORKERS COMPENSATION X PER STATUTE OTH- AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $500000 A OFFKERIMEMBEREXCLUDED? _NIA N 1847910 01/01/2023 01/01/2024 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500000 II yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addldonel Remarks Schedule,may be&Named 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 POLICIES 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 POUCY PROVISIONS. HOLDERS. AUTHORIZED REPRESENTATIVE 6 1 1 1044)1,4,1 W 1988-2015 ACORD CORPORATION.Al rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD r Commonwealth of Massachusetts Division o1 Occupational Licensure Construction Supervisor Specialty Resit Kt ed to Board of Building ReguIatiuns and Standards CSSL4C - nsulat on Contactor Constructill.' 'uper ric r Specialty .�' 4 CSSL-106148 ti` ,. * .r Ejoires: 07/30/2024 ADAM GL j 19 CHARGE - si --." s, � � r.rilure topossess a current edition of the Massachusetts WAREHAM WA 1 '�� State Suitd=ng Code is cause for revocation of this license For information about this license C ail 1617) 727-3200 or visit www mass.govid0 Comrnfssiorser r � taa.'a i THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration J., ew ?'--- Type: Corporation Registration: 181138 HOME WORKS ENERGY, INC. oe ,,4, Expiration: 03/02/2025 101 STATION LANDING STE 110 -^ --� • MEDFORD, MA 02155 "`== mil.. S ,R OM ir,„ mo ..--:- all 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,INC. ,, 1(D6 ...._,) � ADAM GLENN 101 STATION LANDING STE 110-. �� a.�wGlo MEDFORD, MA 02155 Undersecretary Not valid without signature 4044(C mass save savings through energy efficiency PERMIT AUTHORIZATION FORM 1, Todd Thompson owner of the property located at: (Owner's Name) 76 Massasoit Street Northampton (Property Street Address) (City) hereby authorize the Mass Save® Home Energy Services Program assigned Participating Contractor to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. This form is only valid with a signed contract. The permit will be secured by the subcontractor, at no additional cost. Owner's Signature Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date PLAN VIEW Phone: Site ID: (fc()7/ Finished Sq. Ft: p.gt4 Year of House: t i.6 0 Electric Acct#: •*-- 7,3 Address: . #of Floors::L1, 424,A111149 nit td. H21 #Occupants: rd— Housing Type? 0 ii 'kyc DUCTWORK INSPECTION DD Ducts Insulated?6 u _ Duct Air Sealing Hours cYr)144iS 6 uct Insulation I° /2-0 0 . '6 uct Insulation Removal 01 • ,... /Le.resve. ...'"S'PC_ i• 6', m .s. . .?... BASEMENT INSPECTION c ri,(.., ,.- Existing Spec'in Ln/Sq. . 13 1 3 d4 ...... 1 Bsmt Wall AG 74r„, , _ -A, n 7.:;,,,,''T',-,:t:-t:i „ A fi Crawl Ceiling , ,',.."., •,' 'Nr.,M veil or a..(--, cp,,,5-cd-r._se.._ (s o(p Crawl Rim Joist ?:' . - 4- ' --",,,'.°, Bsmt RJ w/Sill kC' Bsmt RI NO Sill n fvcs et. 2—e ,- 0 et Vapor Barrier! ., ,f,, ,; ft Bsmt Door Y66lovver Door? nw..-Lc. (14.1" WALLS&GARAGE Drill Location? Siding ICeil Height Existing Spec'ing , Sq.Ft. Framing Exterior Wall 1 , ., x x Balloon/Platform . Exterior Wall 2 '' x x Balloon/Platform , Overhang :- Garage Wall i----- --"- ),...... ..... ..----13-illoon/Platform Garage Ceiling , x x ..:: ..?-' ..... v. insulator Removal ' - sqft, Sweeps; WX Stripping: WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT ANDATORY) si Attic Basement/Crawlspace Other: K&T Moisture Y/ Combustion Sfty Kneewall Overhang/Garage Asbestos Y Mold>100 sq.ft Y/ CO Detector Missing Y I Ductwork Exterior Walls Vermiculite N Structl Concerns Y N Other:it.Ais ktr- Notes for Lead Vendor/Work Not Contracted: 1 / KW WALL AND KW FLOOR Blind Spec? ' '4 OR ► KW SLOPE AND GABLE END Blind Spec? 0 hy? Why? y� FRAMING EXISTING SPECING 5CL FT. ALL F I G: l( 3~KC�J�_(Jt t IOI SLOPE x x '° ; 7'x a fi a: LOOK . L 1( ....Koy'e_ (55rf"S O 1X-- .M GABLE X X ''r CCESS �x ir` i �t 1C fv / u1f'�w TRANS X X '� ,„��es r RANS ,,..,ALI ''_tsizt,_ k/S .& ATTIC , ,` ATTIC SLOPE X X ; ""` 9.x 3k LOPE I 1 I. EXISTING VENTING? i EXISTING VENTING? EXISTING PIPES? Y/N ., ,,.... .. t ,.,. ...,,..,, r.,: ",1,'r fir:-::.: :.•,; Kph":c^:,ri Y`eN.:pjf IUr"Aaen 1 / 1 0 et) 7 { . • g- fc f rS1f.ft )c (O 1" 6 6 c'0 rc- h;t a c6 to 0 Ct cc d p "2v x 1 // tt11 Q '` 0 /01,f Poo( L✓ (A Z`LJ) !NJc la /""-'------'—. t‘1 me �sC,ccsSx e, J" b (t-t7" LX ((U C cry<h� I,(t of -Riau"( k1C3k) 0 (, -t aac)C7° by 1/4 111 6,S liF e-kt k/S tri-rt S XL'll.' "t...< b. Po(1 Pc•c n C 'roomed,.Na N. X Rec d We 0 Fos.Hose F Vent BF Chun CH Dammiea _._____ u'Root S t1Rv' Ae Haedlet AH tenvACCesi©PuRRownn Hatch ht V,at Hatch / i;ocr j S'Roo!Vent RV t m Vol: x .�5$ X a tt tza• i Lk (2 ATTIC 1 Blind Spec? ❑ X x ATTI 2 Bunn Spec? .:t un;t• Existing Spt>c'in Sq ft Existing Spec'ing Sq h �13�'�Mult i Multipliers Unfloored - _ Unfloored r.usses Cross atttnc Floored C.. ( (� Floored ..s nsu!anc^ 0 /,.. M;xec a6 LL10.- Non ` Cath Slope f.:„Cath Slope 5h1,f'? Air Sealing Hours Walls ''n Walls • Access Ar_ , )f►/atytlr Access Jr n AF Ht i 1 Venting jPropaventsf Vent BF BC Hose t)amming1, It Venting Propavents Vent BF n;e Clarnmtng, 5 6 t� ---- iiii 7 (/j. / a+rtp ;X: 7 Sheath ngAc s _ f Sa ' ,.c-__ i5.rst NSF W.nt'na;• (Needed 0.st.tifA Vcnnnj)=_______tNeecled Existing Venting? NFAVentail Exist n‘venting? WAVenr,,i !Roots� P Pe ( e HomeWorks Energy �pn ( Home Performance Contractor `I f 101 Station Landing,Medford,MA 02155 A�.,, 9 CONTRACT - WZ HomeW r 781-305-3319 CUSTOMER PHONE DATE CLIENT# WORK ORDER Todd Thompson (413) 585-5903 05/22/2023 805074 42203 SERVICE STREET BILLING STREET PROPOSED BY, 76 Massasoit Street 76 Massasoit St HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 751)/0 For eligible weatherization measures, Eversource is offering an incentive of 75D/0 for insulation measures and 100%for the air sealing measures, both with no limit. You are eligible to apply for the 0% Heat Loan to finance your co-pay, applications must be submitted before the weatherization work begins. PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 2 $188.66 $188.66 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.) EXTERIOR DOOR WEATHER STRIPPING 1 $31.81 $31.81 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 2 $52.22 $52.22 Provide labor and materials to install a doorsweep to restrict air leakage. INSULATE RIM JOIST WITH 2"THERMAL BARRIER POLYISO 162 $788.94 $591.71 $197.23 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. HomeWorks Energy ✓gyp Home Performance Contractor r n (J 101 Station Landing,Medford,MA 02155 CONTRACT - WZ works 781-305-3319 Energy,Inc CUSTOMER PHONE DATE CLIENT M WORK ORDER Todd Thompson (413) 585-5903 05/22/2023 805074 42203 SERVICE STREET BILLING STREET PROPOSED BY 76 Massasoit Street 76 Massasoit St HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL 6 MIL POLY VAPOR BARRIER 330 $336.60 $336.60 Provide labor and materials to install 10 ml polyethylene over open ground in designated crawlspace/earthen basement areas. Total: $1,398.23 Program Incentive: $1,201.00 Customer Total: $197.23 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Hundred Ninety-Seven & 23/100 Dollars $197.23 COMPANY REPRESENTATIVE CUSTOMER SIGNATURE 5/23/2023 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS.