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16C-006 BP-2023-0911 312 SPRING ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 16C-006-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair. PERSONS CONTRACTING WITH UNREGITERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARAJTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0911 PERMISSIO IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 3300 SUPERIOR INSULA ION 106237 Const.Class: Exp.Date: 06/15/202 Use Group: Owner: JUR O-RENDE MICHELE C Lot Size (sq.ft.) Zoning: WSP Applicant: JUR -RENDE MICHELE C Applicant Address Phone: Insurance: 312 SPRING ST FLORENCE, MA 01062 ISSUED ON: 07/13/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATI ON POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # I 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 NOR HAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: >9 Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 5�,.,r L!14 L -7- 13 ,--, �/fri The Commonwealth of Mass chus s 1 c2 w Board of Building Regulations SP OR II7 ICIPALITY Massachusetts State Building Code to USEBuilding Permit Application To Construct,Repair,Renovate ised Mar 2011 One- or Two-Family Dwelling °'osoo This Section For Official Use Only Buildin Permit Number:,.� ?- - 91/ Date Applied: )ik, Ilo /////�- 7-13-ZOZ3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Prope Address: 1.2 A sensors Map&Parcel Numbers 3►2 $gyp n rn Stye �o� - 1 1.la Is this an acceptetreet?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ct, na, Zoning District Proposed se Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) hfx, Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: l/1 ck Public 0 Private 0 1/� Zone: _ Outside Flood Zone? Municipal 0 On site disposal systreml1❑ Y l Check if yes❑ h SECTION 2: PROPERTY OWN LI* HIP' 2.1 Ow er'of ecor • — Ft Oir, I t U`v bZ Name(Print) City,State,ZIP 312 r� 9 Skfec-i- 413- Zl.9 - -41tL4 No.and Stre t Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other Specify: Brief esgi onn(Prop° ed Work2: RIr s' 1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 3?-Co 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost' (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All %Fees: ��/ Check No 3 Check Amount: `� 6.Total Project Cost: $ 3?�0 0 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) J DU 2 1 e S License Number Expi an � on Da e Nam 1SL Holder +, 1 ice,,.,iP,T4 s f List CSL Type(see below) o.and Street u/ 1 Type Description U Unrestricted(Buildings up to 35,000 Cu.ft.) 1 � O291fl R Restricted 1&2 Family Dwelling City/Town,State, M Masonry e( � (}C fl RC Roofing Covering C V�/` J D�1 ' M� �l'Win WS Window and Siding I4 l i s 2'{ SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition Registered Home Improvement Conntt jracctor(HIC) l -75-�1/ 5W2-S { A '�jr(O�IFS Ala a 1 On HIC Registration Number p y Name okHIi�Registrant Name gnio.and S � � � Email address City/Town, State, IP Telephone SECTION 6: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 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES OR BUILDING PERMIT I,as Owner of the subject property,hereby authorize eC a, to act on my behalf,in all matters relative to work authorized by this buil g permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information conta' e in this appli 'on is true and accurate to the best of my knowledge and understanding. ?—c ,a/(Ae/r L z3 Print s or Auth ized Agent's Name(Electronic Signature) Dat NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program) will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton ' ' .,� . - 5,�.C--- _,..0") Massachusetts ^-f A,, \ is. ( DEPARTMENT OF BUILDING INSPECTIONS212 Main Street • Municipal Building JE ' Northampton, MA 01060 5:r�� �\V -. W ,tr"- CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: Itt ei r1 Ly-) cSryi-i-likPici e_ i The debris will be transported by: Name of Hauler: e/-j 0 r ()ir) 7-i Signature of Applicant: �,� Date: 3 The Commonwealth of Massachusetts 1�_{ Department of Industrial Accidents c=. lii►_= l Office of Investigations f = to a 600 Washington Street w. , Boston,MA 02111 "•UM www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Superior Insulation,LLC Address: 140 Point Judith Rd,A7 City/State/Zip: Narragansett, RI 02882 Phone #: 401-515-4524 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 12 4. ❑ I am a general contractor d I employees(full and/or part-time).* have hired the sub-contractors 6. 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 work rs' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and i s 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised th ' 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per M L 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other Insulate comp. insurance required] *My 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: Beacon Mutual Policy#or Self-ins.Lic.#: 67872 Expiration Date: 8/2/23 Job Site Address: re City/State/Zip: 170renc2e) ',An Attach a copy of the workers' co pensati olicy declaration page(sho 'ng the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can 1 ad to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties' 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 state ent may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: / L d > Date: Q r/ 7"( Phone#: 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#: • SUPEINS-01 MLONGOLUCCO AC-OR/fir CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7125/2022 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 NAME: Mansfield Insurance Agency Inc. ja/c°,"No,Ext):(401)596-2096 I FAX 115 High StreetINC,No):(401)348-2060 Westerly,RI 02891 ADD"REss:info@mansfieldins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Employers Mutual Casualty(EMC)Company 21415 INSURED INSURER B:Beacon Mutual Insurance Co. 30325 Superior Insulation LLC INSURER C:Evanston Insurance Company Michael O'Connor 140 Point Judith Road,Unit A7 INSURER D: Narragansett,RI 02882 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD wVD IMMIDDIYYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X 6D23763 8/2/2022 8/2/2023 pREM SES Ea occu ante) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER:General Aggregate $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) X 1 ANY AUTO X X 6B23763 8/2/2022 8/2/2023 BODILY INJURY(Per person) $ -OWNED SCHEDULED AUTOS ONLY AUTOS BODILY BODILY INJURY(Per accident) $ HIRED- TO ONLY _ AUUTOS ONLY (Per PROPERTY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE X x 6N23763 8/2/2022 8/2/2023 AGGREGATE $ DED X RETENTION$ 10,000 $ 5,000,000 B WORKERS COMPENSATION PER STATUTE EORH AND EMPLOYERS'LIABILITY Y/N x 67872 8/2/2022 8/2/2023 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution Liability x x CPLMOL107207 7/6/2022 7/6/2023 Per Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101 Additional Remarks Schedule,may be attached if more space is required) Residential Insulation Contractor-14B Enterprise Lane,Smithfield,RI 02917 Pollution Liability Aggregate Limit$500,000 National Grid and all divisions are named as additional insured per written contract or agreement.Waiver of subrogation is provided in favor of National Grid and all divisions per written contract or agreement. Pollution Liability includes mold CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Rd Waltham,MA 02451 AUTHORIZED REPRESENTATIVE Nasietfit.tor4.a 1 I � ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Occupational Licensure ® Board of Building Re ulations and Standards Construch671Ct pellb99t Specialty CSSL-106237 1 Qllpires:06/15/2025 KYLE L LEDkf C p 3750 DIAMOM) HILL RD CUMBERLAND RI 02864 ll- Commissioner cia i . /&„Lict.a.. Construction Supervisor Specialty Restricted to: CSSL-IC-Insulation Contractor Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.govldpl THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affai teatid Business Regulation 1000 Washingto r t - Suite 710 BostorMassachusetts 02118 Home Im ro men -'b:ntractor Re istration err i Itr • *# , If" _ ,� \' Type: Supplement Card .,, .......,...=ki ...registration: 175445 SUPERIOR INSULATION LLC. NI ,,,��„ Expiration: 05/12/2025 140 POINT JUDITH RD UNIT A7 ___ ,....__ ,� I NARRAGANSETT, RI 02882 k : ....... .�. ` / '(\ii. ' " :, i.t"i }"- 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: TYP,E,Lai Spiement_Card Office of Consumer Affairs and Business Regulation Registratiory Expiration 1000 Washington Street -Suite 710 17 -, .r 05/12/2025 Boston, MA 02118 SUPERIOR INSULATIo IV ,` _- .�• - :.,, KYLE LEDUC ;T.y ="- ' �� ?(//t) ) 140 POINT JUDITH RD iNlt- - ,,,"` � ,,,,,.Ma.!'a.G(�r NARRAGANSETT, RI 028$-. Y�,•,,,...�r° Undersecretary Not valid without signature City of Northampton 1� Sty g Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 1\ Property Address: 312 spring Street Contractor Name: Superior Insulation Address: 14B Enterprise Ln, Smithfield, RI 02917 City, State: Phone: 401-515-4524 Property Owner Name: Michele Jurado-Rende Address: 312 Spring Street City, State: Florence, MA Kyle Leduc/Superior Insulation (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 ,4 Date 7/13/23 mass save 2022-23 Weatherization Barrier Incentives Based on your Energy Specialist's recommendations,your home can benefit from program-eligible insulation and/or air sealing improvements. Before moving forward, please follow all the instructions below to remediate your weatherization barriers. CUSTOMER INSTRUCTIONS 1.Hire a qualified, licensed contractor to evaluate and/or remediate the weatherization barrier(s). 2.Submit signed and completed copies of this form and a copy of the paid contractor invoice(s)within 60 days of your Home Energy Assessment to' RISE Engineering,765 Attucks Lane,Hyannis,MA 02601 or email to MassSave@RlSEengi-o ring.com. 3.The weatherization incentive will be deducted from the customer co-payment amount of the weatherization work.A rebate check will be issued in the event the amount exceeds the customer's co-payment amount. 4.Complete the recommended weatherization improvements. Customer Name: Michele Jurado-Rende Client#or Site ID: 53504 Site Address: 312 Spring Street City: Florence state: MA ZIP: 01062 V/here see ccr to'--performed Phone Number: 413-219-7114 Email: rnichele@spencerpeterman.com Customer/Homeowner Signature: Date: To determine if there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save° weatherization recommendations have been made: Attic Floor (0 Attic Wall (3 Attic Slope Q Exterior Wall Basement 0 Other: 0 Other: To be filled out by the Energy Specialist le I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below. Attic Floor 3 Attic Wall 0 Attic Slope 0 Exterior Wall Basement 0 Other: 0 Other To be filled out by the Licensed Electrician Contractor Name: Robert Stanton Address: 79 Hines Street City: Cumberland State: RI ZIP: 02864 Company Name: Robert Stanton Electrician License Number: 53217-B Doctibigned by: Contractor Signature. Ip,t . ,1 ( L_. �1� Daae: 6/23/2023 My signature confirms tha axge wfiwee my inspection of the electrical systems listed above and have corrected any barriers as indicated.My signature also confirms that I have read and agree to the Terms and Conditions outlined on the back of this form. MECHANICAL SYSTEM BA . e,?f, ' reeee`e;:oeecmitrectdr4 ee .` tiSMU e High Carbon Monoxide:Contractor is to service and re-evaluate the selected mechanical system(s)and reduce the carbon monoxide level, as measured in the undiluted flue gas,to below 100 parts per million(ppm). Draft Failure:Contractor is to correct the draft in the selected flue(s).Refer to table on reverse for acceptable draft ranges. i ' ' Existing CO ppm Revised CO Existing Draft Pa Revised Draft Pa Heating systean Hot Water Heater Other ' Spillage:Contractor is to correct the spillage of flue gases in the selected mechanical system(s).Must not spill after 60 seconds of operation. 0 Heating System 0 Hot Water Heater 0 Other: Contractor Name: Address: City: State: ZIP: Company Name. License Number: Contractor Signature: Date: My signature confirms that I have performed my inspection of the mechanical systems listed above and have corrected any barriers as indicated.My signature also confirms that I have read and agree to the Terms and Conditions outlined on the back of this form. WEATHERIZATION CONTRACT EVERSSURCE CUSTOMER PHONE DATE CLIENT B WORK ORDER Michele Jurado-Rende (413) 219-7114 04/26/2023 535045 10102 SERVICE STREET BILLING STREET PROPOSED BY: 312 Spring Street 312 Spring Street. Heather Lieber SERVICE CITY,STATE.ZIP BILLING CITY.STATE.aP' Program Florence, MA 01062 Florence, MA 01062 EGMA-HES Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 75% For eligible weatherization measures, Eversource is offering an incentive of 75%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. KNOB &TUBE WIRING SIGN-OFF (FSC) 1 $250.00 $250.00 The wiring in the areas weatherization work is proposed will be reviewed by a licensed electrician to determine if there is any existing live knob &tube wiring. 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 DOOR 3 $95.43 $95.43 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage.. ATTIC FLAT-9"OPEN R-33 CELLULOSE 400 $796.00 $597.00 $199.00 Provide labor and materials to install a 9" layer of R-33 Class Cellulose added to open attic space. ATTIC FLAT-5" FLOORED R-16 DENSE CELLULOSE 224 $519.68 $389.76 $129.92 Provide labor and materials to install a 5"layer of R-16 Class I Cellulose to floored attic space. PULL-DOWN STAIR-THERMADOME 1 $277.33 $277.33 Provide labor and materials to install an easily moved, insulating cover for the attic access folding stair. The cover has integral weather- stripping to restrict air leakage. CRAWLSPACE-6 MIL POLY GROUND COVER 50 $51.00 $51.00 Provide labor and materials to install 10 ml polyethylene over open ground in designated crawlspace/earthen basement areas. CRAWLSPACE WALL -2" RIGID BOARD 80 $388.00 $291.00 $97.00 Provide labor and materials to install 2" rigid insulation board to the open wall. VENTILATION CHUTES 42 $173.46 $130.10 $43.36 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow from the soffit ventilation. • WEATHERIZATION CONTRACT EVERS=URCE CUSTOMER PHONE DATE CLIENT# WORK ORDER Michele Jurado-Rende (413) 219-7114 04/26/2023 535045 10102 SERVICE STREET BILLING STREET PROPOSED BY. 312 Spring Street 312 Spring Street Heather Lieber SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Florence, MA 01062 Florence, MA 01062 EGMA-HES Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL ASBESTOS HAZARD A blower door diagnostic test will not be conducted at your home, due to the possible presense of asbestos. Total: $3,305.54 Program Incentive: $2,836.26 Client Total: $469.28 I.DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the above work at the Client's Address in a professional manner and in accordance with the terms of this Contract: II.PAYMENT Client agrees to pay the Contractor for the Work,the Client Share of the Contract Cost is payable to the Independent Installation Contractor(IIC)upon satisfactory completion of the Work.Client understands that they will not be required to pay the Program Incentive Share of the Contract cost.Changes to the individual line items and/or previous incentives ay increase or decrease the size of the Program Incentive Share. RIS Representative Client Signature Heather Lieber 06-09-2023 Printed Name Date of Acceptance mass save® Savings through energy efficiency PERMIT AUTHORIZATION FORM Michele Jurado-Rende owner of the property located at: (Owner's Name) 312 Spring St, Florence (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. Mitt ele Ara* Owner's Signature 06-09-2023 Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: nii---EnRuitaidl on z z� Participating Contractor Date