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36-187 (6) BP-2022-0497 866 BURTS PIT RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 36-187-001 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-2022-0497 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 2000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date:07/30/2022 Use Group: Owner: RIGGALL, NICHOLAS S. &SMITH,TAMAR Lot Size (sq.ft.) Zoning: SR/WP Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 59 TOSCA DR 7812054484 ECC-600-400 1 0 1 7-202 1A STOUGHTON, MA 02072 ISSUED ON:05/06/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERI ZATI 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: a • Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $65.00 1`Z:`,. DepF , r ;;, City of Northampton �!� " �� .�= Building Department' ,d INSULATION �. 4; _ � 212 Main Street,;' qy , r, :, Room 100 S - , .,-., :` Northampton, MA 01,*( '.e �0,7 / phone 413-587-1240 Fax 413' -72 QF(JI.., */ 7% ..,N,. COh'"VS,':.. f APPLICATION FOR INSULATION FOR A ONE OR TWO FAMII.QfriSWELLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT This section to be completed by office 1.1 Property Address: Map Lot Unit 866 Burts Pit Road Northampton Massachusetts 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Tamar Smith 866 Burts Pit Road Northampton Massachusetts 01062 Name(Print) Current Mailing Address: See Attached (412)904-8853 Telephone Signature 2.2 Authorized Agent: Adam Glenn ,, 59 Tosca Drive Stoughton, MA 02072 Name(Print) zz:,,c_2;L:ezCurrent 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 2,000 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 41(p 4. Mechanical(HVAC) 5. Fire Protection 6. Total = (1 +2+ 3+4 +5) 2,000 Check Number 6 300 � This Section For Official Use Only Building Permit Number: Iar #1�r(`�� Date Issued: �� I Signature: '( 5 - L ZDZZ 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 59 Tosca Drive Stoughton, MA 02072 07/30/2022 Addre Expiration Date 781-205-4484 Signature Telephone j 9. Registered Home Improvement Contractor: Not Applicable 0 HomeWorks Energy 181138 Company Name Registration Number 59 Tosca Drive Stoughton, MA A 02072 03/02/2023 Address Expiration Date S3 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 344816 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 5/2/2022 Signature of Owner/Agent Date 1 Tamar Smith , 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 5/2/2022 Signature of Owner Date City of Northampton /��pTH�M rU Massachusetts f. ',r DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building /" n v 4Y Northampton, MA 01060 rs�W 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:866 Burts Pit Road Northampton Massachusetts 01062 Date of Permit Application: 5/2/2022 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: I hereby apply for a building permit as the agent of the owner: 5/2/2022 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 �‘r`�� rt. '`\ Massachusetts,l ,,'+�£ DEPARTMENT OF BUILDING INSPECTIONS eo -, J. 212 Main Street •Municipal Building '�„o --� 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: 866 Burts Pit Road Northampton Massachusetts 01062 (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) CaCCA , c1;ir(IV 5/2/2022 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. 71.1.,irCity of Northampton r�e r Massachusetts • _ `� DEPARTMENT OF BUILDING INSPECTIONS ` t S •• -+s� 212 Main Street • Municipal Building � '`� J 'ram Northampton, MA 01060 ` // MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 866 Burts Pit Road Northampton Massachusetts 01062 Contractor Name: HomeWorks Energy Address: 59 Tosca Drive City, State: Stoughton, MA 02072 Phone: 781-205-4484 Property Owner Name: Tamar Smith Address: 866 Burts Pit Road Northampton Massachusetts 01062 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 CaCkA ,,,..010a.:() c...(,e___ Date 5/2/2022 The Commonwealth of Massachusetts At,_ ` = I Department of Industrial Accidents o! = 1 1 Congress Street,Suite 100 •_r !`_ Boston, MA 02114-2017 y www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Homework$ Fnergy Address: 59 Tosca Drive City/State/Zip: Stoughton, MA 02072 Phone#: 781-205-4484 Are you an employer?Check the appropriate box: Type of project(required): 11071 am a employer with 500 employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.(No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions .5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 14 ther WEATHERIZATION 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§I(4),and we have no employees.[No workers'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: NH Employers Insurance Company — Policy#or Self-ins.Lic. #:#4001017 Expiration Date: 01/01/2023 Job Site Addrec5; 866 Burts Pit Road Northampton Massachusetts 01062 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 MGL c. 152,§25A is a criminal violation-punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. l do hereby certify under theand pe • s of perjury that the information provided above is true and correct Signature: Date: 5/2/2022 Phone#:781-205-4484 II wxpermitting@homeworksenergy.com 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#: /...,,N HOMEENE-01 LLARIVIERE A�OR>D CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYYYY) 1/3/2022 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 Lisa Lariviere Foster Sullivan Insurance Group,LLC PHONE FAX 163 Main Street (A/C,No,Ext)(978)686-2266 301 � (ac,No):(978)686-6410 North Andover,MA 01845 E-MAIL ADDRESS: 9 Prou •certificates fostersullivan com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Central Mutual Insurance Company 20230 INSURED INSURER B:NH Employers Insurance Company 13083 Homeworks Energy,Inc INSURER C:Markel Insurance Company 38970 Homeworks IIC LLC 101 Station Landing Suite 100 INSURER D: Medford,MA 02155 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 INSR WVD (MM/DD/YYYY) IMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 PR M Sa-Ea oNcu sncel $ 300,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE TO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ OWNED AUTOS ONLY X SCTHEDULED AUOS BODILY INJURY(Per accident) $ X HIRED )( NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE CXS 8698471 1/1/2022 1/1/2023 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ECC-600-4001017-2022A 1/1/2022 1/1/2023 E.L.EACH ACCIDENT $ 1'000'000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Pollution Liability CPLMOL109278 1/1/2022 1/1/2023 $10,000 Deductible 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Homeworks EnergyInc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 101 Station Landing Ste 100 Medford,MA 02155 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - /74 Femzi/iveetifee-iiie r CIJ CLc, eI/ Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Roston, Massachusetts 0?118 Home Improvement Contractor Registration Type: Supplement Card Registration: 181138 11011E WORKS ENERGY, INC Expiration: 03/0212023 101 STAT ON LAUDING STE 110 M'-i)FORD, MA 02155 _ Update Address and Return Card. SCA t 0 20M-05l1? • } Office of Consumer Affairs&Business Regulatien HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SuMlement Card before the expiration cart. If found return to: fieciistratlog n Office of Consumer Affairs and Business Regulation 181138 03,022023 '000 Washington Street -Sj.te 713 HOME WORKS ENEROY,JNC. Boston,MA 02118 ` ADAM GLENN / 101 STATION LANDING STE 170 `'t'aL�ir.d MEDFOHD.MA 02155 undersecretary Not valid without signature C amnion wean h of Massachusetts Construction Supervisor Specialty Division of Professional Licensure Restrrctedto Board of Building Regulations and Standards CSSL-1C -Insulation Contractor Construct FichS1;tptttvtsgi Specialty CSSL-1061.18 Egyires 07/30/2022 ADAM GLENN - 19 CHARGE POUND RD WAREHAM MA 02571 ./ ?� )1S -1 0� Failure to possess a current edition of the Massachusetts e' Slate Building Code is cause for revocation of this license. For information about this license C urnmrs stoner Call(617)727-3200 or visit w'ww mass.govidpl Insulation/Air Sealing Permit Authorization Specialist: Frank Del Valle Company: HomeWorks Energy Email: frankdel.valle@homeworksenergy.com Address: 101 Station Landing Cell: 4135356594 Medford, Ma 02155 Phone: 781.305.3319 Customer: Tamar Smith Address: 866 Burts Pit Rd Email: tamarsmith@gmail.com Northampton, MA, 01062 Site ID: 344816 Phone: 4129048853 I, the owner of the property identified above hereby authorize HomeWorks Energy Inc., or their Partner to act on my behalf in obtaining any building permit that maybe required to perform insulation and/or Weatherization work on my property and all matters related to the work authorized by said permit if one is obtained. Any related permit application cost will come at no additional charge provided that the agreed Weatherization work is completed. In the event that a permit is pulled on your home for insulation and/or weatherization work, you may be required to have a final inspection of the work scheduled and performed by the building inspector in your town. If required by the town, you will be notified by Home Works Energy that an inspection is necessary with instructions on how to complete this process to close out your permit. Email: tamarsmith@gmail.com Customer Signature: '� cym..z& Date: 3/29/2022 Tamar Smith For Condo Owners: If you have property oversight by a condo associationt, please have the association's authorized person(s) complete and sign the section below. Please email this document to wxpermitting@homeworksenergy.com once completed. We, being the duly authorized representatives of the association Name of association or management companyt or management company have reveiwed the plans and specifications for improvements to the address specified above. We further acknowledge that the above listed owner has given notice that they intend to seek permits and to carry out the proposed work. Signature of representative Date Print Name t Other unit owners may sign when there is no association. PLAN VIEW 3 Name:Tamar smith Site ID: 344816 Finished Sq. It: 2624 Phone: 4129048853 Year of House: 1978 Electric Acct#: Addres', 855 Burt's pit rd _ #of Floors: 1 Gas Acct#: W # Occupants: 2 Housing Type? Ranch _---9.14TWORK INSPECTION Ducts Insulated?r'. Duct Linear Ft. Duct Square Ft. Duct Air Sealing Hours suct Insulation Duct Insulation Removal BASEMENT INSPECTION Basement fully finished 'Si Existing Spec'ing Ln/Sq. Ft. ci Bsmt Wall AG \ Ns. \ Crawl Ceiling Crawl Rim Joist Bsmt RJ w/Sill A/s 0 Bsmt RJ NO Sill i Vapor Barrier sqft. Bsmt Door! N Blower Door? WALLS&GARAGE ' Drill Location? _ Siding Ceil. Height Existing S -';,-r, Sq. Ft Framing Exterior Wall 7 Vinyl 8 _ Fgb 0 2 x 4 x 1 bAlloon/Plat"kui7h Exterior Wall 2 Overhang Vinyl 10 • Fgb D c6" � x g x 16 Garage Wall Sheetrock 8 Fgb 'Dpc4" 207-60 2- x 4 x 16 Balloon/P4aM Garage Ceiling cc ,u Dpc 4" 207 sf z 23 a i 9 Walls full fgb 20 Dpc 6" 60 Ins 3 Sq t. Sweeps. Garage wall Overhang WX Stripping: 3 WORK SPEC'D BUT NOT CONTRAC ED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawlspace Other: K&T Y/N Moisture Y/N Combustion Sfty Y/N Kneewall Overhang/Garage Asbestos Y/N Mold>100 sq.ft Y/N CO Detector Missing Y/N Ductwork Exterior Walls Vermiculite Y/N Structl Concerns Y/N Other: Notes for Lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? L.L OR . SLOPE AND GABLE END Blind Spec? 4Vhy' FRAMING EXISTING `,PI('Ni SQ F I FRAMING EXISTING SPi C' G SQ.FT. WALL X SLOP( X X FLOOR x x GABLE X X O ACCESS X TRANS x x d fRANS x x ATTIC D °� ATTIC SLOPE X X cii 2 SLOPE x x EXISTING VENTING7 i iEXISTING VENTING, EXISTING PIPETS' V/N __ e a; A Y KNEEWALL MANDATORY Attic a/s and cross batt with 13" fgb 1 hr touch up r 7 3 Open wall 130 sf u H=4 7 BAS Vol: x .005' ATTIC t ID nd Spec? > Y ATTIC 2 Blind Spec? „ X r Existing Spec'ing Sq ft E Untloored Crosat"f Unfloor Multipliers Floored Floored Cath Slope Cath Slope , Wads ( O-4Acc s Air Sealing Hours Access Ac 1 „tiro a7��eSS tiPntrr1, N• �� _ ` Temp icce55:._ .7, i I Sheaf!:nre;A,cceSS'._.`. may,. R L gvnr5 Existing pntinr. tor,/ > /� ,,�.._ Existing Venting? tom•.:, ti ,; Asphalt Rv 40' sv 4x16 x7 HomeWorks Energy I 1 l 101 Station Landing,Medford, MA 02155 g CONTRACT - AUDIT I works781-305-3319 Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT# WORK ORDER Tamar Smith (412) 904-8853 03/29/2022 344816 00001 SERVICE STREET BILLING STREET PROPOSED BY: 866 Burts Pit Road 866 Burts Pit Road HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL HOME AIR SEALING 1 $85.00 $85.00 Provide labor and materials to seal areas of your home against wasteful, excess 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 $174.00 $174.00 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. COMMON WALL RIGID BOARD 130 $514.80 $386.10 $128.70 Provide labor and materials to install 2" FSK faced semi-rigid fiberglass board insulation to a common wall area. COMMON WALL DRILL AND PLUG 207 $382.95 $287.21 $95.74 Provide labor and materials to install blown in Class I Cellulose to a 4"common wall through an interior surface drill and plug method. Plugs will be speckled and left in a relatively smooth condition. Finish sanding and touch-up priming/painting will be the customers responsibility. Homeowner has received a copy of the EPA's Renovate Right Lead-Safe information guide explaining the potential risk of the lead hazard exposure from the weatherization work to be performed. Your signature is your acknowedgement of receipt and agreement to proceed. HomeWorks Energy 101 Station Landing,Medford,MA 021 55 CONTRACT - AUDIT 111J11 works 781-305-3319 Energy,Inc Page 2 PROGRAM C MA-H PC CUSTOMER PHONE DATE CLIENT# WORK ORDER Tamar Smith (412)904-8853 03/29/2022 344816 00001 SERVICE STREET BILLING STREET PROPOSED BY: 866 Burts Pit Road 866 Burts Pit Road HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL OVERHANG 6 DENSE R21 CELLULOSE 60 $230.40 $172.80 $57.60 Provide labor and materials to install 6" R-21 densely packed Class I Cellulose insulation to an exterior overhang located below a heated floor area, by drilling holes in the overhang from below. Holes drilled will be plugged. Plugs will be sealed with exterior grade spackle and left in a relatively smooth condition. Finish sanding and touch-up priming/painting will be the customer's responsibility. Total: $1,387.15 Program Incentive: $1,105.11 Customer Total: $282.04 WE AGREE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Two Hundred Eighty-Two& 04/100 Dollars $282.04 /a:Iw, 5'hu.iY COMPANY REPRESENTATIVE CUSTOMER SIGNATURE NOTE THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE DAYS.