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24D-115 (5) BP-2023-1156 19 CHURCH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-115-001 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-2023-1156 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 7000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date: 07/30/2024 Use Group: Owner: BELLAVANCE-GRACE KAREN J Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 235 ESSEX ST 781-205-4484 1847910 WHITMAN, MA 02382 ISSUED ON: 08/28/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERIZATI 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 !„, ,9 . 3-4 • . . Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $65.00 Please email Permit to WXPermitting@homeworksenergy.com Y�u,�T Iclie Dep x�r -L City of North. a.22 I EU / 1� f` Building"�e tint- �� ' 212 Main reet ,,,\,,:t• Room 1 0 „,„ a ,o \INSULATION „..,tv ._, Northampt�►n, O�ID80 —..,.. phone 413-587-12� F x 413-58 -n\.,,,,-, ,,, ONL Y ,,cT DEp1 of G ,„„N.,,,, • APPLICATION FOR INSULATION FO" • • ' 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 19 Church Street Northampton MA 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Wren Bellavance-Grace 19 Church Street Northampton MA 01060 Name(Print) Current Mailing Address: See Attached (413)923 8010 Telephone Signature 2.2 Authorized Agent: Adam Glenn 235 Essex Street, Whitman, MA 02382 Name(Print) c„.cetiai Current Mailing Address: fiaA781-205-4484 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 7,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) #(--a' 5. Fire Protection 6. Total = (1 +2+3+4+5) 7,000 Check Number Il- (/ 5 This Section For Official Use Only Building Permit Number: lJ'Q,Q 3 .. if co DateIssued: Signature: //r--v 6 25 Z023 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 ,„. i 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 cafw �� �J�_ 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 RI No ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 807802 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 cac, cii3a.rd_ 8/21/2023 Signature of Owner/Agent Date Wren Bellavance-Grace 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 8/21/2023 Signature of Owner Date City of Northampton acPA .,. e; ,, o Massachusetts A. �c,. c ti �, : V t ! ( ,, +' DEPARTMENT OF BUILDING INSPECTIONS x M ++ " 212 Main Street • Municipal Building y D y"'° Northampton, MA 01060 ss't •�� ;����'' 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:7,000 Address of Work:19 Church Street Northampton MA 01060 Date of Permit Application: 8/21/2023 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.C.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: 1 hereby apply for a building permit as the agent of the owner: 8/21/2023 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 • j►-AP;- 212 Main Street •Municipal Building Northampton, MA 01060 ,t- 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: 19 Church 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 ,„gciozed 8/21/2023 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. �tiiaaxrir1i City of Northampton 4`4 , , ',.' Massachusetts r ( ,fir y111P ( DEPARTMENT OF BUILDING INSPECTIONS y ��. 212 Main Street • Municipal Building , ..� Northampton, MA 01060 �'W. ‘^ MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 19 Church Street Northampton MA 01060 Contractor Name: HomeWorks Energy Address: 235 Essex Street City, State: Whitman, MA 02382 Phone: 781-205-4484 Property Owner Name: Wren Bellavance-Grace Address: 19 Church 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 64a4 !„..r3-)goei:d- c_ ....._ Date 8/21/2023 The Commonwealth of Massachusetts 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.Q 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 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' 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' 13.1t Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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: 19 Church 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 undder`the pains and pei es of perjury that the information provided above is true and correct Signature: �'"�' `� Date: 8/21/2023 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#: '�co 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 FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER PHONE FAX HOME OFFICE:P.O.BOX 328 (A/C,No,E 888-333-4949 (A/ C,No):507-446-4664 OWATONNA,MN 55060 E-ADDRESS:CLIENTCONTACTCENTER(cdFEDINS.COM _ INSURER(SI AFFORDING COVERAGE NAIC 8 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 POOL SUBR POLICY NUMBER POUCY EFF POLICY EXP LRd1T5 LTR INSR WA) IMM!DD,YYYY) IMM/DOIVYVYI X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $1,000,000 (CLAIMS-MADE X OCCUR DAMAGE TO RENTED $100,000 PREMISES Ma occunencel MED EXP(Any one person) EXCLUDED A N N 1847909 01/01/2023 01/01/2024 PERSONAL a ADV INJURY $1,000,000 GE 'L AGGREG E UNIT AP^PLIES PER. GENERAL AGGREGATE $2,000,000X POLICY PROT- 1 LOC PRODUCTS-COMP/OP EGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa acddenI ;1,000,000 X ANY AUTO BODILY INJURY(Per person) A -OWNED AUTOS ONLY S SLICED N N 1847908 01/(11/2023 01/01/2024 BODILY INJURY(par accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY !Per accident) X UMBRELLA LIAR 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 -_ DED RETENTION WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY YIN X PER STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 A OFFICERIMEMBER EXCLUDED? NIA N 1847910 01/01/2023 01/01/2024 --------- ------- - ---(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S500,000 II yes.describe under E.L DISEASE-POUCY LIMIT S500 000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be mulched It more spare 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 POUCY PROVISIONS. HOLDERS. AUTHORIZED REPRESENTATIVE 6 )4A,.. 0 1988-2015 ACORD CORPORATION.All riylts reserved. ACORD 25(2018/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Construction Supervisor Specialty 1 Division of Occupational Licensure Resiz+dedtc. Board of Building Regulations and Standards CSSL4C -,nsutation Contactor ('1if. ot Constru CtiQW!.5upef' r Spectatty .�' 4 CSSL-106148 _w.- (itpires: 07/30/2024 ADAM GLENN 19 CHARGE ll O ; ".�""" WAREHAM MA k 7� k Failure to possess a current edition of the Massachusetts + State Buildrrxj Code is cause for revocation of this 4cense �� �4Yrril For information about this license Commissioner eftcea f` VE Cab1617) 727-3200or visit www mass_gov+dpl THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration +'" •:='a� �� ' Type: Corporation ____ -...... HOME WORKS ENERGY, INC. ...«. Registration: 181138 Expiration: 03/02/2025 101 STATION LANDING STE 110 7 MEDFORD, MA 02155 0.i, _.r... �`` 1 �. .. ....... T �tJ,,IM S,;! 1.10 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# : - 4'4 4,1 ADAM GLENN a h;' rd., 3i `�/ ,,G,_ 101 STATION LANDING STE 1107 ,A' r4,,',`e( t ‘,a(e,ssk MEDFORD, MA 02155 Ai, --lair*i` Undersecretary Not valid without signature Insulation/Air Sealing Permit Authorization Specialist: Alexander Stevenson Company: HomeWorks Energy Email: alexander.stevenson@homeworkseneri Address: 101 Station Landing Cell: 4135443321 Medford, Ma 02155 Phone: 781.305.3319 Customer: Wren Bellavance-Grace Address: 19 Church Street Email: wren.bg@gmail.com Northampton, MA, 01060 Site ID: 807802 Phone: 4139238010 I, the owner of the property identified above hereby authorize HomeWorks Energy Inc., or their Partner to act on my behalf in obtaining any building permit that maybe required to perform insulation and/or Weatherization work on my property and all matters related to the work authorized by said permit if one is obtained. Any related permit application cost will come at no additional charge provided that the agreed Weatherization work is completed. In the event that a permit is pulled on your home for insulation and/or weatherization work, you may be required to have a final inspection of the work scheduled and performed by the building inspector in your town. If required by the town, you will be notified by HomeWorks Energy that an inspection is necessary with instructions on how to complete this process to close out your permit. Email: wren.bg@gmail.com Customer Signature: Date: 7/3/2023 Wren Bellavance-Grace 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 company+ 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. MULTI-FAMILY PLAN VIEW Name: Site ID (Unit 1): ' Finished Sq. Ft:�' /# Floors: Phone: Site ID(Unit 2)•l , .. . " .; ear Built: l� Occupants: Address: Site-ID (Unit 3)•�f7. %/.i+''.J Housing Type? Site ID (Unit 4): • Electric Acct# (unit 1)• "' -Electric (2)• '' lectric (3): '✓. ectric (4): Gas Acct # (unit 1): %'' Gas (2): Gas (3) '• Gas (4): I= BASEMENT INSPECTION r�-77�y,�I r�"i Unit EXISTING SPEC'ING LN/SQ.FT., < 1 au_'' G �� ,, i ravel Ceiling s -, ,-- — g ravel Rim Joist : Iffillierr ,rx-i smt R1 a 1 ,; i P.' ��1 k r g •apo Barrier ~ BsmtDoor Q1 a/ 1 ps: ,S.141M-` - •• - .C.4V•-2' C 11 i / 0 2 ---' A, V.471111141 ilt 1 t,61 ,,1%P'+.► 01. I.1 I Y/N Blower Door? _ _ WALLS&GARAGE _ Drill Location? Uni SIDING CEIL.HEIGHT EXISTING SPEC'ING SQ.FT. Exterior Wall 1 •: J ''/\‘.,t (i+ )1 Lf -1'" Framing , Exterior Wall 2 ( "*Z47,1,cf' 61t I; x x Balloon/Platform Exterior Wall 3 ,, , ' Ball• • PI . •rm Exterior Wall 4 ! , \ Overhang :.,= _ ; \x Ballo • • •rm Garage Wall ,/ s\ Garage C fling _ '., i / Gc 2 f 'A\CIA F f co eel' z0 vt yI "A231 A \f inyl , k41 . $1/4 ah;140 IS 1 z.o WORK SPEC'D BUT NOT CONTRACTED Insulation Removal Unit: 1 2 3 4 Attic Basement/Crawlspace Other: Unit .FT. e..l Y Sweeps: ,.4 Kneewall _Overhang/Garage /. Ductwork _ Exterior Walls _ WX Stripping: ->� ROAD BLOCKS PRESENT?(MANDATORY Unit 1 3 4 _UN t WI Unit 2 4 K&T Y „ ' ' ' : Moisture Y ,t.' • Combustion Sfty Y Asbestos Y /". Moid>100 s•.It Y ell ). ') CO Detector Missing Y N Vermiculite Y br I , A i .. , r Structl Concern / I. I► 1 Other(indicate unit) i Notes: K Blond spec? WAU AND KW FLOOR ? ;?""." OR KIN SLOPE AND GABLE END Blind Spec? J Very, _ U Why? WV :.k s ' rl \rt..i t. :rti;`` SQ FT FRAMING EXISTING SPEC'tNG . S. FT WALL r X FIOQR z X SLOPE, x x `. cc GABLE x x gacat x :.. �— j TRANS66 x Y t"; '.RANS X X • °a • ATTIC y a oPE x r ',LOPE "' ®I" 'ELATING? EXISTING NG, m i Fr _ • EXIST PIPES? y/N •W Vvot,} 4r...6t_N.,,.... 2._.___j Lv.. Gce s• trn0 A \ 4 '-K. KW Nr"r�j r,.t Pt .2 \ il ', r , 02'. Zal.."\ k's 1 I r) I 0 . 3 t l '� 1 . IC 1- = Hi Afri A , A/s . J---t r24 floe r•� ' I A/61 c After,,,i-i1 xs , MI "1\ ,, cisxzib WI pit &O 4-H-(c Z.., , 1 P L,slyki P� ti). Ar F �'Io�cx26 (', ,C.,C n DUCTWORK INSPECTION Ducts Insulated?Q ' ,......71101(..\---- Duct Linear Ft. Duct Insulation Duct Square Ft. Duct Insulation Removal Duct Air Sealing Hours Unit r f. Lxbx let ATTIC 1 Blind Spec?0ifir. x 173 ATTIC2 Blind Spec?r Air Sealing Multipliers Unit: EXISTING SPEC'ING ISO.FT. Unit EXISTING SPEC'ING SQ. FT. Hours y Unfloored ' rlC``C) \ `(Se Unfloored 7"( If mil `_"'„_0 Unit Truss Z Floored � ,1 " F',r r)l(� Floored MI.bin,ul.non'I C• ath Slope_ I '' '''''''''''''' Cath Slope Unl '11,, �*LOOSe 5.• Walls \ O Walls _ , cross Batting 7 r _ � Access f.0 'j�d'( --.--- • A• ccess ^/'r r a Venting Propavents Vent BF BF Hose Damming Venting Propav nts Vent BF BF t''..• I»mming v. ► U ter .. c. :001rvprSpvt i HomeWorks Energy r (?` Home Performance Contractor t�^ i I Station Landing,Medford,MA 02155 CONTRACT - AUDIT HomeWorks 781-305-3319 CUSTOMER PHONE DATE CUENTI WORK ORDER Wren Bellavance-grace (413)587-1249 07/03/2023 807802 97601 SERVICE STREET BIWNG STREET PROPOSED BY: 19 Church Street 19 Church St HomeWorks Energy SERVICE CITY,STATE,ZIP BILUNG CITY,STATE,ZP Northampton, MA 01060 Northampton,MA 01060 Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 9 $848.97 $848.97 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.) TRANSITION AIR SEALING 20 $129.80 $129.80 Provide labor and materials to air seal the open kneewall transitions of your home against wasteful, excess air leakage. EXTERIOR DOOR WEATHER STRIPPING 3 $95.43 $95.43 Provide labor and materials to install Q-lon weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 3 $78.33 $78.33 Provide labor and materials to install a doorsweep to restrict air leakage. ATTIC FLOOR OPEN BLOW CELLULOSE 12" 286 $646.36 $484.77 $161.59 Provide labor and materials to install a 12"layer of R-42 Class I Cellulose to open attic space. ATTIC FLOOR OPEN BLOW CELLULOSE 8" 260 $494.00 $370.50 $123.50 Provide labor and materials to install an 8"layer of R-30 Class I Cellulose to open attic space. ATTIC FLOOR OPEN BLOW CELLULOSE 6" 520 $894.40 $670.80 $223.60 Provide labor and materials to install a 6"layer of R-22 Class I Cellulose to open attic space. OPEN WALL- 1"THERMAL BARRIER POLYISO 60 $192.00 $144.00 $48.00 Provide labor and materials to install 1"rigid board insulation to(60) square feet of kneewall area.All seams will be sealed with tape. INSULATE VINYL SIDED WALL WITH 4" DENSE PACK 648 $1,736.64 $1,302.48 $434.16 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. HomeWorks Energy (rgpn,,,,R) Home Performance Contractor 101 Station Landing,Medford,MA 02155 55 CONTRACT - AUDIT HomeWorks 781-305-3319 CUSTOMER PHONE DATE CLIENT WORK ORDER Wren Bellavance-grace (413) 587-1249 07/03/2023 807802 97601 SERVICE STREET BILLING STREET PROPOSED BY: 19 Church Street 19 Church St HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZP Northampton, MA 01060 Northampton, MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATE INTERIOR BUFFERED WALL WITH 4" DENSE PACK 160 $419.20 $314.40 $104.80 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. INSULATE RIM JOIST WITH 6.25" FIBERGLASS BATTING 90 $242.10 $181.58 $60.52 Provide labor and materials to install R-19 unfaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. HomeWorks Energy Home Performance Contractor eI I ( 101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT HomeWorks 781-305-3319 CUSTOMER PHONE DATE CLIENTS WORK ORDER Wren Bellavance-grace (413) 587-1249 07/03/2023 807802 97601 SERVICE STREET BILLING STREET PROPOSED BY: 19 Church Street 19 Church St HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 Page 3 DESCRIPTION QTY COST INCENTIVE TOTAL 6 MIL POLY VAPOR BARRIER 370 $377.40 $377.40 Provide labor and materials to install 10 ml polyethylene over open ground in designated crawlspace/earthen basement areas. Total: $6,154.63 Program Incentive: $4,998.46 Customer Total: $1,156.17 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Thousand One Hundred Fifty-Six& 17/100 Dollars $1,156.17 0)2,241., 3.2-&-v-a420-,2- 91-a-CA2 COMPANY REPRESENTATIVE CUSTOMER SIGNATURE 7/10/2023 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS.