23D-134 (12) BP-2023-0233
57 HINCKLEY ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23D-134-001 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-2023-0233 PERMISSION IS HEREBY GRANT
ED ED TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 1000 HOMEWORKS ENERGY INC 106148
Const.Class: Exp.Date: 07/30/2024
Use Group: Owner: H SCHUMANN THOMAS K&PATRICIA
Lot Size (sq.ft.)
Zoning: URB Applicant: HOMEWORKS ENERGY INC
Applicant Address Phone: Insurance:
59 TOSCA DR 781-205-484 ECC-600-4001017-2022A
STOUGHTON, MA 02072
ISSUED ON: 02/27/2023
TO PERFORM THE FOLLOWING WORK:
1 NSULATION/WEATH ERIZATION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.VV. 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 0 • )9 - G"' .
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
FEE: $65.00 1 I900
Dep R,; T rjrl; City of Northampton
i`' Building Department
,fin t. 212 Main Street
Room 100 ;� FEB INSULATION
j-� Northampton, MA 01060 4'
QfjL., Y
;.gyp^"` phone 413-587-1240 Fax 413-587-1272 203
APPLICATION FOR INSULATION FOR A ONE 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
57 Hinckley Street Northampton MA 01062 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Pat Schumann 57 Hinckley Street Northampton MA 01062
Name(Print) Current Mailing Address:
See Attached (413)320 5351
Telephone
Signature
2.2 Authorized Agent:
Adam Glenn 235 Essex Street, Whitman, MA 02382
Name(Print) cY ;� Current 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 1 ,000 (a)Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
i
4. Mechanical (HVAC) 0 5
5. Fire Protection
6. Total = (1 +2+3+4+5) 1,000 Check Number ,j Id,
This Section For Official Use Only
Building Permit Number: bm_64 3—13, Date
Issued:
Signature: /1/7._ Z'27 ZOZ 3
Building Commissioner/Inspector of Buildings Date
wxpermitting @ homeworksenergy.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 4-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:Adam Glenn 106148
License Number
235 Essex Street, Whitman, MA 02382 07/30/2024
Addre Expiration Date
,gleid 114_ 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 03/02/2023
Address 64 Expiration Date
Telephone 781-205-4484
1:joei'd �
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 800061
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
ctaL csf3a<d-
2/9/2023
Signature of Owner/Agent Date
Pat Schumann ,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 2/9/2023
Signature of Owner Date
City of Northampton
Massachusetts
I.
ya • DEPARTMENT OF BUILDING INSPECTIONS
° 14, 212 Main Street • Municipal Building
>+� Northampton, MA 01060 SSt'W A,�'�`�
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 pm-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: 1 ,000
Address of Work:57 Hinckley Street Northampton MA 01062
Date of Permit Application: 2/9/2023
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law(explain):
Job under$1,000.00
Owner obtaining own permit(explain):
Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
2/9/2023 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
Y . Massachusetts ��?'
r- DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street •Municipal Building
Northampton, MA 01060 ssF Jy.
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:
57 Hinckley Street Northampton MA 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)
Cd11/4A ,„ ;0111V 2/9/2023
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.
�,,,,,.,jr City of Northampton S,5 s;
"�; ,), r` •
Massachusetts ,,..
b.
w
�rk DEPARTMENT OF BUILDING INSPECTIONS 1,
7K ''
� - ` 212 Main Street • Municipal Building Jtis •'>'
.—ice Northampton, MA 01060
MANDATORY FOR HOUSES BUILT BEFORE 1945
Property Address: 57 Hinckley Street Northampton MA 01062
Contractor
Name: HomeWorks Energy
Address: 235 Essex Street
City, State: Whitman, MA 02382
Phone: 781-205-4484
Property Owner
Name: Pat Schumann
Address: 57 Hinckley Street Northampton MA 01062
City, State:
I 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 signature641/°(4 cS4(17() coe\---
Date 2/9/2023
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):
1.0 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'
[No workers' comp. insurance comp. insurance.
$ 9. El Building addition
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.0 officers have exercised their I am a homeowner doing all work 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.]t c. 152,§1(4),and we have no 13. Weatherization
employees. [No workers' 0 Other
comp. insurance required.]
*Any applicant that checks box#l must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. if the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Federated Mutual Insurance Company
Policy#or Self-ins. Lic. #:#1847910 Expiration Date: 1/1/2024
Job Site Address:57 Hinckley Street Northampton MA 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 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 and r the pains and pe s of perjury that the information provided above is true and correct.
Signature: �'epaJ Date:2/9/2023
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):
10Board of Health 20 Building Department 3.1ity/Town Clerk 4. ❑Electrical Inspector 5.01umbing
Inspector 6.0Other
Contact Person: Phone#:
♦ 0
AE(MWDEVYYYY)
� CERTIFICATE OF LIABILITY INSURANCE EP 12/30/2022
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(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 HOME OFFICE:P.O.BOX 328 (A/c,No,Eel):888-333-4949 (A/c,No):507-446-4664
OWATONNA,MN 55060 E-ADDRESS:CLIENTCONTACTCENTER@FEDINS.COM
INSURER(S)AFFORDING COVERAGE NAIC if
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 1'i445
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.
LTR TYPE OF INSURANCE '�R SUER POLICY NUMBER POLICY YY POLICY ERR LIMITS
IMMDD/YYVY) IfAMfDDIYYYYI
X COMMERCIALGENERALUABIUTY EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTED $100,000
PREMISES lEa occurrence)
MED EXP(Any one person) EXCLUDED
A N N 1847909 01/01/2023 01/01/2024 PERSONALS ADV INJURY $1,000,000
GENT AGGREGATE OMIT APPUES PER. GENERAL AOGREGATE $2,000,000
X POLICY JECT _j LOC PRODUCTS-COMP/OP AGO $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
IEa accident) b1,000,000
X ANY AUTO BODILY INJURY(Per person)
A -OWNED AUTOS ONLY _AUTOSULED N N 1847908 01/01/2023 01/01/2024 BODILY INJURY(Per accidmq
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
AUTOS ONLY 'Per accident)
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000
A EXCESS LIAR CLAMS-MADE N N 1847911 01/01/2023 01/01/2024 AGGREGATE $1,000,000
DED RETENTION
WORKERS COMPENSATION X PER STATUTE OTH
AND EMPLOYERS'LIABILITY YIN ER
ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S500000
A OFF10ERIMEMBER EXCLUDED? _NIA N 1847910 01/01/2023 01/01/2024
(Mendalory In NH) E.L.DISEASE-EA EMPLOYEE Q$500 000
It yet,describe under E.L DISEASE-POUCY LIMIT $500 000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addibonel Remarks Schedule,may be aRached It more space is required)
THIS COPY IS NOT TO BE REPRODUCED FOR ISSUANCE OF CERTIFICATES.
CERTIFICATE HOLDER CANCELLATION
01
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
A CERTIFICATE HAS BEEN FILED WITH EACH OF YOUR CERTIFICATE ACCORDANCE WITH THE POUCY PROVISIONS.
HOLDERS. AUTHORIZED REPRESENTATIVE
6 )4AA.,
0 1988-2015 ACORD CORPORATION.AN rights reserved.
ACORD 25(2018/03) The ACORD name and logo are registered marks of ACORD
vZ Fornziiitnif!ee/7; 1 1 ✓[/e(/J.){lf Y /^% '//
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Supplement Card
HOME WORKS ENERGY,INC. Re tion: 1
101 STATION LANDING STE 110 Expira�iration: 03i022/2
/2023
MEDFORD,MA 02155
Update Address and Return Card.
SCA 1 0 2OMO5r17
}}
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Supplement Card before the expiration date. If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
181138 03/'02/2023 1000 Washington Street -Suite 710
HOME WORKS ENERGY,INIIC. Boston,MA 02118 ►�'�
ADAM GLENN tom""'"'
101 STATION LANDING STE 110 ' _'->
MEDFORD,MA 02155 Undersecretary Not valid without signature
Commonwealth of Massachusetts
g'S Division of Occupational Licensure Rest:,eedtoConstruction Supervisor Specialty
Board of Building Regulations and Standards CSSt_4C Insulation Contractor
Constructir tiger 4$r Specialty
44'
CSSL-106148 *_ ,,, spires: 07/30/2024
ADAM GLE41 � ,F
19 CHARGE ` •
WAREHAM Mj -
w ., T
? Failure to posses s a current edition of the Massachusetts
*61.LV , State Building Code is cause for revocation of this fcense.
For information about this license
Co'"^iis iOt1CT j .6 Call(617)727.3200 or visit wwv.mass.govrdpl
Insulation/Air Sealing Permit Authorization
Specialist: Adam Morrison Company: HomeWorks Energy
Email: adam.morrison@homeworksenergy.co Address: 101 Station Landing
Cell: 1111111111 Medford, Ma 02155
Phone: 781.305.3319
Customer: Pat Schumann Address: 57 Hinckley Street
Email: na@hwe.com Northampton, MA, 01062
Site ID: 800061 Phone: 4133205351
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: na@hwe.com
Customer
Signature: i"Ct- Date: 12/5/2022
Pat Schumann
For Condo Owners:
If you have property oversight by a condo associations, 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.
1O en PLAN VIEW
o Name: D I'I SGt.�a h Site ID: rrr ) ;)eP r Finished Sq. Ft: So
o Phone: Year of House: Electric Acct#:
Address: 5 1 1-1, �C l `
w1 Silt of Floors: Gas Acct#:
en
Unit#: # Occupants: Housing Type? nr'1. e► h 'I' •
DUCTWORK INSPECTION Ducts Insulated?
Duct Linear Ft.
Duct Square Ft. 6 Yv� ,
Duct Air Sealing Hours kat Y� Pdi 1W�
Duct Insulation A�{ C N
Duct Insulation Re al 4°sa )5 C.) m
z BASEMENT INSPECTION r
N Existing Spec'ing Ln/Sq. Ft. ���„�,. D
m Bsmt Wall AG y 5
Crawl Ceiling ./.9
(,9 t,n
Crawl Rim Joist
`, ..)Bsmt RJ w/Sill F-C.2 + 3tes t� �,}
BSmtRJNOSill NOWt, Rio1`t f i I Y o?y .
Vapor Barrier >< sgft,.�Bsmt Door •4 i�"
Y/N Blower Door? q WALLS&GARAGE Drill Location?
Siding Ceil.Height Existing Spec'ing Sq. Ft. Framing
Exterior Wall 1 x x Balloon/Platform
Exterior Wall 2 x x Balloon/Platform
Overhang x x
Garage Wall x x Balloon/Platform
Garage Ceiling x x
2
z
o
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0-
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il e 13 t' Sgft.
< Sweeps:
r.._" WX Stripping: L
WORK SP 'D B NOT CONTRACTED D BLOCKS PRESENT NDATORY)
Attic Basem Crawlspace Other: K&T Y' N oisture Y N mbustion Sfty YI/N
Kneewall Over g arage Asbestos old>100 sq.ft Y/N 'C Detector Missing Ys/N
Ductwork Ext for Wall Vermiculite / S uctl Concerns /N ther:
Notes for Lead endor/Work Not Contracted:
KW WALL AND KW FLOOR Blind Spec? t R - KW SLOPE AND GABLE END Blind Spec?
Why? Why?
FRAMING EXISTING SPEC'ING SQ. FRAMING EXISTING SPEC'ING SQ.FT.
WALL X X SLOPE X X
ccfL00R X X GABLE X X o _ACCESS X TRANS X X Z
TRANS x X ATTIC P
a ATTIC x x SLOPE X X
SLOPE EXISTING VENTING?
Ilzw l
iii
x EXISTING VENTING? EXISTING PIPES? Y/N
i
KV:Ve nnng Vent BF Hose Damming Sheathing Access Temp Access 'Venting Vent BF Temp Access
J� w
KNEEWALL MANDATORY
1 / .
•
4.7
.'0 4.4...
1 'NNNN:NN.I 5
fil ''''':
Y
ell
u
a
/
l Ar.
/J
l
Insulated Wall x .> Rec'dXigh: ns.Most fin J Vint BF 1W/1 Chem.;cHT Damming --- 1r Roof V,i`12RV
Air Handler(AM' Temp Access - Pull Down PDSS1 Hatch 1 Wail Hatch "Z Door p,� B"Root Vent 'VW' ''--- 141 Vol: x .0058
c:qr„
x x ATTIC 1 Blind Spec? x x ATTIC 2 Blind Spec? 15 a'..S% , -
13.6f"story)
zz Existing Spec'ing Sq ft Existing Spec'ing Sq ft
o
E _Unfloored Unflooresl Multipliers
Trusses Cross Batting
Floored Floored Mixed Insulation Duct Woik
>6"Loose None
Cath Slope Cath Slope Air Sealing Hours
P Walls Walls
* Access , Access
Venting Propavents Vent BF BF Hose Damming Venting Propavents Vent BF BF Hose Damming 4
to no WHF Box:
c_
.iu Temp Access:
a o Sheathing Access:___-
in to
R.L.Covers:
m Sq.Ft/300= .,4t 5 .,
V. . ,g' (Needed Sq.Ft/300. - (Exist.NFA Vennegl_ _ c:ee ,,: --�
Existing Venting? NFA Ventnq) Existing Venting? 1,AVPn ng; Roof Type:
Federal ID 4 05-0405629
HomeWorks Energy RI Contractor Registration No 8186
MA Contractor Registration No 120979
/ p Home Performance Contractor CT Contractor Registration No 620120
A,�',
101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT
HOf works
781-305-3319
CUSTOMER PHONE DATE CLIENT C WORK ORDER
Patricia Schumann (413) 320-5351 12/05/2022 800061 11501
SERVICE STREET BILLING STREET PROPOSED BY:
57 Hinckley Street 57 Hinckley St HomeWorks Energy
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZP
Florence, MA 01062 Florence,MA 01062
DESCRIPTION QTY COST INCENTIVE TOTAL
PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 2 $188.66 $188.66
Seal areas of your home against wasteful,excessive air leakage.
Materials to be used to seal your home can include caulks,foams
and other products. Primary areas for sealing include air leakage to
attics, basements,attached garages and other unheated areas
(windows are not generally addressed.)
EXTERIOR DOOR WEATHER STRIPPING 3 $95.43 $95.43
Provide labor and materials to install Q-lon weatherstripping to
door(s)to restrict air leakage.
INSULATE RIM JOIST WITH 2"THERMAL BARRIER POLYISO 111 $540.57 $540.57
Provide labor and materials to install rigid board insulation to the
perimeter of the basement ceiling at the house sill.
Total: $824.66
Program Incentive: $824.66
Customer Total: $0
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***Zero&0/100 Dollars $0
A e /(Azsaeactfrrtti. Pat alailtCUZ!'L
COMPANY REPRESENTATIVE CUSTOMER SIGNATURE
023
NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITH DATE OF ACCEPTANCE 2.V.2WITHIN
SIGN DATE
30 DAYS.