36-118 (6) BP-2022-0786
232 BROOKSIDE CIR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
36-118-001 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-2022-0786 PERMISSION'S HEREBY GRANTE' TO:
Project# INSULATION Contractor: License:
Est. Cost: 2000 HOMEWORKS ENERGY INC 106148
Const.Class: Exp.Date:07/30/2022
Use Group: Owner: MACKIE STEVEN
Lot Size (sq.ft.)
Zoning: URA/WSP Applicant: HOMEWORKS ENERGY INC
Applicant Address Phone: Insurance:
59 TOSCA DR 7812054484 ECC-600-00 1 0 1 7-202 1
STOUGHTON, MA 02072
ISSUED ON:07/05/2022
TO PERFORM THE FOLLOWING WORK:
INSULATION/WEATHERIZATION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: Footings:
Rough: Rough: House# Foundation:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: I
. V• w2 'Pi .
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
FEE: $65.00
Dep OR
.. rr r, City of Northampton u E I 4)j .>> Building Departme -- '
212 Main Street INSUL4TION
4
r t 7 iii ' 1 Roo 100 JUL - 1 , ;z
Northampton MA 01 60 I
phone 413-587-1240 Fax 41 Au
I OFIL_ YORrTH> MP7 .Ir, TIGNs
__ nsu 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
232 Brookside Circle Northampton Massachusetts 01062 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Andrew Perry 232 Brookside Circle Northampton Massachusetts 01062
Name(Print) Current Mailing Address:
See Attached 4137273889
Telephone
Signature
2.2 Authorized Ascent:
Adam Glenn 59 Tosca Drive Stoughton, MA 02072
Name(Print) Current Mailing Address:
f;e1781-205-4484
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) y`
5. Fire Protection
6. Total =(1 +2+3+4+5) 2,000 Check Number ( O&' 7
> This Section For Official Use Only
Building Permit Number: ',�19nn'olio — 7" Date
/�J
Issued:
Signature: ,/4 7 7"6-20??
Building Commissioner/Inspector of Buildings Date
wxpermitting @ homeworksenergy.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 4-CONSTRUCTION SERVICES
9.1 Licensed Construction Supervisor: Not Applicable 0
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
9.Registered Home Improvement Contractor: Not Applicable 0
HomeWorks Energy 181138
Company Name Registration Number
59 Tosca Drive Stoughton, MA 02072 03/02/2023
Address Expiration Date
catta4i=3„avTelephone 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 WI No ❑
Brief Description of Proposed Work
Residential weatherization/ Air sealing. No structural changes. SITE ID 4503429
I, Adam Glenn , as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Adam Glenn
Print Name 6a44
6/24/2022
Signature of Owner/Agent Date
Andrew Perry ,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 6/24/2022
Signature of Owner Date
City of Northampton
'' Massachusetts I. !e
wA.
• t
� .,.. it'l 44 DEPARTMENT OF BUILDING INSPECTIONS I
« 212 Main street • Municipal Building w,y ;bAO
''V�'" Northampton, MA 01060 ssy ^oP
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of co tractors 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:232 Brookside Circle Northampton Massachusetts 01062
Date of Permit Application: 6/24/2022
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:
6/24/2022 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
tla_�r
sus stc
Massachusetts ��? '<<
I
,;4. DEPARTMENT OF BUILDING INSPECTIONS
212 !lain Street •Municipal Building ` bb
Northampton, MA 01060 �1c
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:
232 Brookside Circle 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)
„.c)e <ad
6/24/2022
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.
,uir City of Northampton
�e •. t Massachusetts �� 1��
DEPARTMENT OF BUILDING INSPECTIONS y•,
fi`rr+� t° 212 Main Street • Municipal Building `��j, P'
Northampton, MA 01060 hY 3/)�
MANDATORY FOR HOUSES BUILT BEFORE 1945
Property Address: 232 Brookside Circle Northampton Massachusetts 01062!
Contractor
Name: HomeWorks Energy
Address: 59 Tosca Drive
City, State: Stoughton, MA 02072
Phone: 781-205-4484
Property Owner Andrew Perry
Address: 232 Brookside Circle 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 signaturec%/4 csi3;-)rav- c,(4...__
Date 6/24/2022
The Commonwealth of Massachusetts
J� _ !,, Department of Industrial Accidents
_;,t1_ 1 Congress Street,Suite 100
t=l`f_ Boston, MA 02114-2017
IMP 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$ Energy
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):
2. Iilam a employer with 500 employees(full and/or part-time).* 7. New construction
l 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.❑1 am a homeowner doing all work myself (No workers'comp.insurance required.]
10 ❑Building addition
4.0 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 11.0 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.:
6.0 We are a corporation and its officers have exercised their right of exemption per MGI.c.
14 ther WEATHERIZATION
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. 1
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 Address• 232 Brookside Circle 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.
I do hereby certify under the pains and pe of perjury that the information provided above is true and correct
CaCA Signature: --- Date: 6/24/2022
Phone#:781-205-4484 // wxpermitting@homeworksenemy.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#:
-----"."1111 HOMEENE-01 LLARIVIERE
Ate.--- CERTIFICATE OF LIABILITY INSURANCE DAT1(3/202(Yl/Y)
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 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(les)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 Larivlere
163tMer a nuStreetinsurance Group,LLC PHONE �:( ) FAX
Illivan
A/c,Nc, 978 686-2266 301 (A/C,Noi:(978)686-6410
North Andover,MA 01845 itlabs:certificates@fostersullivangroup.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 SUER POLICY NUMBER POLICY EFF POLICY EXP UNITS
LTRINSD NND IMM/DD/YYYYI (MM/DD/YYYY)
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X OCCUR CLP 8698469 1/1/2022 1/1/2023 illeiPsEELciErTEDncal $ 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 JECT LOC PRODUCTS-COMP/OP AOG $ 2,000,000
OTHER:
$A COMBINED SINGLE LIMIT'
AUTOMOBILELIABILrrr (Ea accident) $ 1,000,000
ANY AUTO BAP 8698470 1/1/2022 1/1/2023 BODILY INJURY(Per person) $
OWNED SCHEDULEDO BODILY INJURY(Per accident) $
AURTEODS ONLY X AUTOS BODILY RR
X AUTOS ONLY X AUTOS ONLY (Perr aacccidentDAMAGE $
$
A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
EXCESS LIAB CLAIMS-MADE CXS 8698471 1/1/2022 1/1/2023 AGGREGATE i ; 1,000,000
DED X RETENTION$ 0 TyII $
B WORKAND EMPLOYERS LIABLIITNY Y/N X STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE ECC-600-4001017-2022A 1/1/2022 1/1/2023 1,000,000
E gE E.L.EACH ACCIDENT $
Mandatory In R EXCLUDED? N N/A
NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000 000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ '
C Pollution Liability CPLMOL109278 1/1/2022 1/1/2023 $10,000 Deductible, 1,000,000
DESCRPTION 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 POUCIES 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
I Y
ACORD 25(2016/03) ®1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Wevi4ffileweefea#i 1.r Rollin€i i4li ' 14
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Supplement Card
138
HOME WORKS ENERGY, INC Registration: 3/02/2023
Expiration: 03
101 STATION LANDING ST 1 10 � 12
E
MEDFORD, MA 02155
Update Address and Return Card.
SGA 1 0 20M-o5t1 7
Office of Consumer Melts&Buaaness Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Supplement Card before the expiration date. If found return to:
Registr.atioo cpiratlon Office of Consumer Affairs and Business Regulation
181138 03102/2023 1000 Washington Street -Suite 710
HOME WORKS ENERGY,INC. Boston,MA 02118
-illt
ADAM GLENN �'—✓ i "4"` °?-
101 STATION LANDING STE 110 f,/rwrfard'.f
MEDFORD,MA 02155 Undersecretary Not valid without signature
r _
Canmonwealth of Massachusetts T
Division of Professional Ltcensufe Restr aedto:Construction Supervisor Specialty
ad
Board of Building Regulations and Standards CSSL4C -Insubtion Contractor
Cons tructi( SU r Specialty
CS S L-106148 aLitringlp r49si res:07/30/202 2
,
ADAM GLENNND 19 CHARGE POUND RO ra
WAREHAM MA 02571 ` k
}ill i\'=1;#� �
Failure to possess a current edition of the Massachusetts
n aIj State Building Code is cause for revocation of this license.
Commissioner For information about this license
Call(617)727-3200 or vise WWW mass.govidpl
Insulation/Air Sealing Permit Authorization
Specialist: Michael Hathaway Company: HomeWorks Energy
Email: michael.hathaway@homeworksenergy. Address: 101 Station Landing
Cell: 4135882467 Medford, Ma 02155
Phone: 781.305.3319
Customer: Andrew Perry Address: 232 Brookside Cir
Email: apfast538@att.net Northampton, MA,01062
Site ID: 4503429 Phone: 4137273889
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: apfast538@att.net
Customer
Signature: Date: 6/2/2022
Andrew Perry Y
For Condo Owners:
If you have property oversight by a condo associationt, please have the association's authorized person()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 apd 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: kn.trui itc..i/''-f Site ID (Unit 1): 4 SG ��tg-5 Finished S . Ft: Co # Floors:_
a Phone: 07 a'j 3en Site ID (Unit 2): Year Built:NO Occupants: g
o Address: a3a. 6-6o13tJe Cif Site ID (Unit 3): Housing Type? a~
7' 1lov{�.t,m..pc.A._0(06.9— Site ID (Unit 4):
Lu
Electric Acct# (unit 1): 146 -Electric (2): Elec rlc ectri
Gas Acct # (unit 1): Gas (2): Gas (3): Gas (4):
----/
BASEMENT INSPECTION ,/J
Unit 'EXISTING SPEC'ING LN/SQ. FT. �f1 IS L��CI`t
rawl Ceiling d�
rawl Rim Joist0-v tvs ,,J W
r1
Bsmt RJ P;/� �/5 0,7eyr‘-le /�'10l/l zBsmt RJU
2 apor Barrier �--sgft. Bsmt Door �--- (3 Q
X xi
v) p
m 30
r
/ Blower Door? WALLS&GARAGE Drill Location?
Unit SIDING CEIL. HEIGHT EXISTING SPEC'ING SQ. FT.
Exterior Wall 1 Fra ' g
Exterior Wall 2 x x alloon/Platform
Exterior Wall 3 x x Ba n/Platform
Exterior Wall 4 >K' X' x
Overhang x x Balloon/Platform
Garage Wall x x
Garage Ceiling
0
2
z
-:---, V (,),_( (i r-,((, c-f--et‘- e)( 0A --c-k—(( t
cc
o
(-el(i KS t ic- Ar6 6 P-A <,..--
WORK SPEC'D BUT NOT CONTRACTED I lation Removal Unit: 1 2 3 4
Attic Basement/Crawlspace Other: Unit: S Sweeps:
I t>i‹.
Kneewall Overhang/Garage
Ductwork Exterior Walls WX Stripping: e.
ROAD BLOCKS PRES T?(MANDATORY)
Unit 1 2 3 4 Unit 2 3 4 Unit 2 3 4
K&T Y/N Y/N Y/N Y/N Moisture Y N /N Y/N Y/N CombustionSfty Y /N Y/N Y/ N
Asbestos Y N Y/N Y/N Y/N Mold>100 sq. ft Y N /N Y/N Y/N CO Detector Missing Y Y/N Y/N Y/N
Vermiculite Y Y/N Y/N Y/N Structl Concern Y Y/N Y/N Y/N Other(indicate unit)
Notes:
KW WALL AND KW FLOOR Blind Spec? -• O R6. KW SLOPE AND GABLE END Blind Spec? Li
Why?
Unit: Why? Unit:
f ING EXISTING SPPC'Iti SQ.FT. LAMING EXISTING SPEC'ING SQ.FT.
WALL X X SLOPE X
FLOOR X f GABLE X
LS o ACCESS x TRANS X ,N, z
rn
.- TRANS X X ATTIC
ATTIC SLOPE x x
a. SLOPE X x EXISTING VENTING?
EXISTING VENTING? EXISTING PIPES? Y/N , m
W./Venting Vent SF :F Hose Damming Sheathing Access Temp Accest KW V- tin nt SF Temp Accent
c
y ^
0
H a
KNEEWALL MANDATORY
A4 i't
6 ic7 lokic
to
z
3
ayy
K )f.
ca
3
x
o
v .1-
F [ x
a
DUCTWORK INSPECTION Ducts Insulated?
Duct Linear Ft. Duct Insulation
Duct Square Ft. Duct Insulation Removal
Duct Air Sealing Hours Unit:
x x ATTIC 1 Blind Spec? x x ATTIC 2 Blind Spec? _: Air Sealing Multipliers
Unit: EXISTING SPEC'ING SQ. FT. Unit: EXISTING SPEC'ING SQ. FT. Hours
Unfloored D.``n/c, pc75 fon Unfloored Unit t Trusses
o Floored Floored l6 Mixed In ulation
Cath Slope / Cath Slope Unit
Walls Walls Cross Batting
z
L, Access Access wHf Box Unit:
Venting avents Vent BF Besse Damming Venting Pr..avents Sheathing Access Unit:t BF BF Hose Damming R.L.Covers Unit:
co
c Temp Access Unit:
a N Roof Type: A y
Page 1 of I
HomeWorks 101 Station Landing Ste 110,
mass save
Medford,MA 02155
Energy PARTNER (70 305-3319
Customer Name:Andrew Perry
Email: Not provided
Phone:413-727-3889
Premise Address:232 Brookside Cir, Northampton, MA 01062
Mailing Address:232 Brookside Circle, Northampton, MA 01062
Project ID:4511510
Date:June 2,2022
Job Description
Measure Description Location Quantity Unit Total Cost Customer Cost
Air Sealing at Estimated 62.5 CFM50 Per Hour Other 10 hr $925.80 $0.00
Door Sweep (with AS hrs) Other 3 each $75.93 $0.00
Exterior Door Weather Stripping (with AS hrs) Other 3 each $90.21 $0.00
Project Total $1,091.94
Air sealing incentive ($1,091.94)
Total Program Incentive -$1,091.94
Customer Total $0.00
Total Contractor Price and Payment Schedule
HomeWorks Energy, Inc.agrees to perform the above described work,furnishing the material and labor specified for the listed total
price. Payment of the balance of the customer contribution s expected upon completion of the work.
Customer Signature:_____Ait_ ____ t!�_____� !�_1Date:
Customer Phone: II
Specialist Signature:_ _: : )/ 9 _Date;
LIMITED TIME OFFER:
The prices and incentives in this contract are subject to change in accordance with the sponsoring utility MassSave Home Services Program offers.
Proposols con be sent to:Inbox@HomeWorksEnergy.com