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38D-043 (3) BP-2024-0892 34 HARLOW AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38D-043-001 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-2024-0892 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est. Cost: 4000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date: 07/30/2024 Use Group: Owner: BEMAK, AMBER B. & RAMIREZ,ROSALIA Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY INC Applicant Address Phone: Insurance: 71 DUDLEY ROAD 781-205-4516 1847910 SUTTON, MA 01590 ISSUED ON: 07/16/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERIZATION 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. j� Signature: 1���C�—...- Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner FEE: $65.00 /TZ7 / Plea,se email Permit to WXPermitting@homeworksenergy.com 1' -rirr City of Northampton` Dep � `- ?: Building Department •!� i^�) %1 ,- 212MainStreet 4oIpJ, ULA l TION A,,,_ il. Northampton; ht} 60 `��p1 ONL Y phone 413-587-1240 Fa eke; -127 _.. • (j,A n^,��`CAS 10,C?i APPLICATION FOR INSULATION FOR A ONE OR TW Y DV1f LLING ONLY SECTION 1 -SITE INFORMATION INSULAtION PERMIT 1.1 Property Address: This section to be completed by office Map Lot 38D-043-001 unit 34 Harlow Avenue Northampton MA 01060 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Rosalia Ramirez 34 Harlow Avenue Northampton MA 01060 Name(Print) Current Mailing Address: See Attached (214)914-9729 Telephone Signature 2.2 Authorized Agent: Adam Glenn 71 Dudley Rd, Sutton, MA 01590 Name(Print) Current Mailing Address: l - 781-205-4516 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 4,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) l 6 5. Fire Protection '7 6. Total =(1 +2+3+4+5) 4,000 Check Number 1541 q f This Section For Official Use Only Building Permit Number:6a- ` P Date �� Issued: Signature: .//�./l /- /5- 2 2 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 r I Name of License Holder.Adam Glenn 106148 License Number 71 Dudley Rd, Sutton, MA 01590 07/30/2026 Addre Expiration Date �� J C 781-205-4516 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ HomeWorks Energy 181138 Company Name Registration Number 71 Dudley Rd, Sutton, MA 01590 03/02/2025 Address l Expiration Date 64LA „ / .4 A Telephone 781-2054516 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 { 1 No ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 802320 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 cd6AA ,,,� �; L 7/3/2024 Signature of Owner/Agent Date Rosalla Ramirez 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 7/3/2024 Signature of Owner Date City of Northampton s Massachusetts '� I 1 ` • `c Y y a. DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building �, •.�'Y ' Northampton, MA 01060 fsth ‘"� 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:4,000 Address of Work:34 Harlow Avenue Northampton MA 01060 Date of Permit Application: 7/3/2024 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: 7/3/2024 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 opt H�iM��- - . ' Massachusetts w DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building .=� 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: 34 Harlow Avenue 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) cdan ,.. .:;,e,;()- 7/3/2024 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. \t��{,,,.,ir�„\ City of Northampton r Massachusetts , ,K rDEPARTMENT OF BUILDING INSPECTIONS w .r.. ' 212 Main Street • Municipal Building - Northampton, MA 01060 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 34 Harlow Avenue Northampton MA 01060 Contractor Name: HomeWorks Energy Address: 71 Dudley Rd City, State: Sutton, MA 01590 Phone: 781-205-4516 Property Owner Name: Rosalia Ramirez Address: 34 Harlow Avenue Northampton MA 01060 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. cdui‘ e..oreid- ce‘*......., Contractor signature Date 7/3/2024 The Commonwealth of Massachusetts Department of Industrial Accidents l'ti Office of Investigations ii= `'J Lafayette City Center k.4_ " 2Avenue 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: 71 Dudley Rd City/State/Zip:Sutton, MA 01590 Phone #: 781-205-4516 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 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ElRemodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.12 Electrical repairs or additions officers have exercised their 11.0Plumbing repairs or additions 3.El I am a homeowner doing all work 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.®Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infonnation. 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: New Hampshire Employers Insurance Company Policy#or Self-ins. Lic. #:ECC-600-4001157-2024A Expiration Date: 1/1/2025 Job Site Address: 34 Harlow Avenue 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 and r the pains and pees of perjury that the information provided above is true and correct. Signature: ...Cat) IV Date: 7/3/2024 Phone#: 781-205-4516 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#: i..—.1,4 HOMEENE-03 LLARWIERE ACORO DATE(MM/DD/YYYY) �---- CERTIFICATE OF LIABILITY INSURANCE 1/8/2024 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 NAM FACT Lisa Lariviere Foster Sullivan Insurance Group PHO FAX 163 Main Street acNN,EXq:(978) 686-2266 301 I (A/C,NoI: North Andover,MA 01845 noliREss:certificates@fostersullivangroup.com MSURERIS)AFFORDING COVERAGE NAIC# INSURER A:Kinsale Insurance Company 38920 INSURED INSURER B:The Commerce Insurance Company 34754 Homeworks Energy,Inc INSURER C:Everspan Indemnity Insurance Company 16882 101 Station Landing Suite 110 INSURER o:New Hampshire Employers Insurance Compan 13083 Medford,MA 02155 INSURER E:StarStone Specialty Insurance Company 44776 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 LIMITS LTR INSR WYD fMM/DD/YYYYI IMMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 0100275489 1/1/2024 1/1/2025 PfEMISESi aoccurrnce) $ 300,000 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY j& LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBLE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO L15948 1/1/2024 1/1/2025 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY(Per accident) $ XRED X A PROPERTY DAMAGE AUTOS ONLY UtO ONfE Y (Per accident) $ $ C UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESSLIAB CLAIMS-MADE BRIEII-000045-00 1/1/2024 1/1/2025 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ D WORKERS COMPENSATION X PEATUTE ER AND EMPLOYERS'LIABILITY -ECC600-4001157-2024A 1/1/2024 1/1/2025 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE V/N E.L.EACH ACCIDENT $ OFFICERMEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1'000'000 E yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY OMIT $ E Pollution U82192240AEM 1/1/2024 1/1/2025 $25k Deductible 1,000,000 A Umbrella-GL Only 0100275711-0 1/1/2024 1/1/2025 Per Occurrence 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 POUCIES BE CANCELLED BEFORE Homeworks EnergyInc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 101 Station Landing Ste 110 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 Commonwealth of Massachusetts Construction Supervisor Specialty Division of Occupational Licensure Board of Building Regulations and Standards Restricted to: ConstructiQ* per�/fa2r Specialty CSSL-IC-Insulation Contractor CSSL-106148 expires: 07/30/2026 ADAM GLENN 19 CHARGE POUND RD WAREHAM NIA 02571 O kQi.tva03 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner Contact OPSI:(617)727-3200 or visit www.maea.gov/dpilopsi THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration ==- "~`% Type: Corporation HOME WORKS ENERGY, INC. firs ems"�— Registration: 181138 augorar Expiration: 03/02/2025 101 STATION LANDING STE 110 -- MEDFORD,MA 02155 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 Reaistration Expiration 1000 Washington Street -Suite 710 181138 03/02/2025 Boston,MA 02118 HOME WORKS ENERGY,INC. 6‘.4 ADAM GLENN Q� ) V etc:4_ 101 STATION LANDING STE 110 MEDFORD,MA 02155 Undersecretary Not valid without signature Insulation/Air Sealing Permit Authorization Specialist: Daniel Macero Company: HomeWorks Energy Email: daniel.macero@homeworksenergy.corr Address: 101 Station Landing Cell: 4132978636 Medford, Ma 02155 Phone: 781.305.3319 Customer: Rosalia Ramirez Address: 34 Harlow Avenue Email: rolil@mac.com Northampton, MA,01060 Site ID: 802320 Phone: 2149149729 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: rolil@mac.com Customer 7,zovilietz paunir Signature: e Z, Date: 2/9/2023 Rosalia Ramirez 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: C0S131 iG ffu,, /✓�a---Site ID: (4--z) a3.� Finished Sq. Ft: iC/ 6 6 g Phone: Year of House: /1 2-7 Electric Acct #: • Address: -Jq K/'A`J #of Floors: • Z_ Gas Acct #: r /fv 1l+swr,4% Unit#: # Occupants: 3 Housing Type? C'<" ` -r'---� DUCTWORK INSPECTION Ducts Insulated?(�i IS ; 2,J Duct Linear Ft. /� U, _ V+ 3 , ✓ �Iv /yv Duct Square Ft. ` l Ur1-(j 1 1 i6') P` 'L� Duct Air Sealing Hours LA.) Duct Insulation /,. Duct Insulation Removal o L i BASEMENT INSPECTION I .2 1 /o w Existing Spec'ing Ln/Sq. Ft. ��7 co Bsmt Wall AG • — J 1 Crawl Ceiling _ (--- Crawl Rim Joist — — Z. BsmtRJw/Sill /J,,, - jat rPAIy izu' - Bsmt RJ NO Sill .S`/, - ;.! Vapor Barrier sqft. Bsmt Door --� / YIN Blower Door? WALLS &GARAGE Drill Location? Siding Ceil. Height Existing Spec'ing Sq.Ft. Framing j Exterior Wall 1 (,2c.(� �lr,S . A; - x x Balloon/Platform (Exterior Wall 2 ,.S`tc((,;„, ' ra‘ — — x x Balloon/Platform Overhang -- - x x Garage Wall - - x x Baboon/Platform Garage Ceiling - - x x 0 W Ej � 1:6..'... z O A w Insulation Remo Stift. Sweeps: L- WX Stripping: 2 WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawlspace Other: K&T Y/ Moisture Y/61`Combustion Sfty Y/tN-% Kneewall Overhang/Garage Asbestos Y Mold>100 sq. ft Y N 0 Detector Missing Y/N Ductwork Exterior Walls Vermiculite `N Structl Concerns Y other: Notes for Lead Vendor/Work Not Contracted: IIVV�� 7� KW WALL AND KW FLOOR Blind Spec? . ❑ " OR ► KW SLOPE AND GABLE END Blind Spec? 0 4-4 hy? Why? F• IMG EXISTING SPFC'ING S ,FT 46- FRAMING EXISTING SPEC'ING SQ.FT. WALL X SLOPE X X ' FLOOR X X GABLE X X o CCESS X.11 \ TRANS X Z FR II U- TRANS x x ATTIC ATTIC SLOP x x • SLOPE X X TING VENTING? w EXISTING VENTING? (STING PIPES? Y/N m Kt..,Venrnr Ver;p dr Note .. -.,,.h,nr Acces Tern Vert SF Temp Access E. KNEEWALL MANDATOR(' o� rJ y '....": )c-1A(6--..".5- C": a \ —72 7 a) (.9 �� ,; Z�' ✓4:_j ca..,7 1. 3 a CY C11 y0)1,01/11 VA k I— )C ( ,.. V c F) eitAs lZ(O 72 Insulated Wan X X Redd tight o Ins.Hose lJ vent SF n Chan.ED Damming tr Rent v t® BAS Vol' X .0 Al Handler AH Temp Access O Pull Down '•a Hatch Watl Hatch "/ Door r/ 8"Roo'Vent RV Blind Spec? �] x 19 15.11 3 c x x ATTIC 1 Blind Spec? 0 x x ATTIC 2 '�i/ ...— .GO aoryi z �+�cis'ting Spec'ing Sq ft Existing Spec ing Sn; Multipliers g Unfloored 7 1"'`is.44 +3 J14- ac --)7''i ur Dored Trusses rossBs ng a Floored — Floorin a opt wart >6"Loose None z Cath Slope — Cath Slo Air Sealing Hours Walls — Walls _ • • Access ici ri.d.- 41e+i?- ' 1_' I Access / Venting Ptopa' its Vent Br Br Hose Damming Venting Propavents lent BF BF(lose Damming Cr, WHF Box:__, to e `,/Z, Z •� Temp Access: Z r JJ v rar Shcathing r1c,�jes9. a N R.L.CoVetsXJ„ _� NeeCed 5q.Ft/300= (Ef st.NFA Venhng{= Needed .Ft/3C9= hunt.NFA Vennng)_ (FA YenttngS IR00f Type t V NFA\enttng) tln Venting? �}' LI_ Existing Venting? ti� {Z S`1 c,S g WEATHERIZATION CONTRACT EVERS_URCE .411111111111111111111111 CUSTOMER PHONE DATE CLIENT* WORM ORDER Amber Bemak (413)272-3167 02/09/2023 802320 60002 SERVICE STREET BILLING STREET PROPOSED BY: 34 Harlow Avenue 34 Harlow Ave HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CRY,STATE,LP Program Northampton, MA 01060 Northampton, MA 01060 EGMA-HPC Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 8 $754.64 $754.64 Seal areas of your home against wasteful, excessive air leakage. Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas (windows are not generally addressed.) EXTERIOR DOOR WEATHER STRIPPING 2 $63.62 $63.62 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. DOORSWEEP 2 $52.22 $52.22 Provide labor and materials to install a doorsweep to restrict air leakage. DAMMING 32 $78.40 $58.80 $19.60 Provide labor and materials to install a 12"layer of R-38 unlaced fiberglass batts for damming purposes. ATTIC FLOOR OPEN BLOW CELLULOSE 7" 729 $1,319.49 $989.62 $329.87 Provide labor and materials to install a 7"layer of R-26 Class I Cellulose to open attic space. HATCH:THERMAL BARRIER POLYISO 2 INCH (ATTIC) 1 $47.37 $35.53 $11.84 Provide labor and materials to insulate the back of an attic hatch with 2"rigid insulation board at R-10. INSULATE RIM JOIST WITH 2"THERMAL BARRIER POLYISO 120 $584.40 $438.30 $146.10 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. WEATHERIZATION CONTRACT EVERS_URCE r.:...✓.j..•.n.w..c-.;:,.i,-._.r:r.' + Te .,l'v.::�.wid:.�aw.+1tiU+Y.+.r�1+LS>:is af_at:w::. ,..y.4�w...,,Y:rie«�a4.... 9 j Y•,'�...,.,n.o;�...�.�,n,x.,.:.� -euY.,�,6.4�.s_._ CUSTOMER PHONE DATE CLIENT/ WORK ORDER Amber Bemak (413)272-3167 02/09/2023 802320 60002 SERVICE STREET BILLING STREET PROPOSED BY: 34 Harlow Avenue 34 Harlow Ave HomeWorks Energy SERVICE CITY,STATE,ZIP BILUNG CITY,STATE,ZIP Program Northampton, MA 01060 Northampton, MA 01060 EGMA-HPC Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL VENT BATH FAN TO ROOF OR OTHER 1 $146.78 $110.09 $36.69 Install a 6"insulated exhaust hose to a flapper vent to exhaust existing bathroom fan(s). Fan will be vented through the roof or an acceptable alternative if contractor cannot vent through the roof. Total: $3,046.92 Program Incentive: $2,502.82 Client Total: $544.10 I.DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the above work at the Client's Address in a professional manner and in accordance with the terms of this Contract: II.PAYMENT Client agrees to pay the Contractor for the Work,the Client Share of the Contract Cost is payable to the Independent Installation Contractor(IIC)upon satisfactory completion of the Work.Client understands that they will not be required to pay the Program Incentive Share of the Contract cost.Changes to the individual line items and/or previous incentives may increase or decrease the size of the Program Incentive Share. ♦ Kett/ duple- et" RISE Representative Client Signature 7/2/2024 Printed Name Date of Acceptance