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25C-128 (9) BP-2024-1507 24 ELIZABETH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25C-128-001 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-2024-1507 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est. Cost: 16000 HOMEWORKS ENERGY INC 106148 Const.Class: Exp.Date:07/30/2026 Use Group: Owner: GREG SIMMONSON Lot Size (sq.ft.) Zoning: URB Applicant: HOMEWORKS ENERGY INC Anplicant Address Phone: Insurance: 71 DUDLEY ROAD 781-205-4516 1847910 SUTTON, MA 01590 ISSUED ON: 11/13/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERI 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: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS.Si;nature: 72. Fees Paid: $120.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $120.00 ease email Permit to WXPermitting@homeworksenergy.com City of Northampton 1. '�`� DepI' oR Building Departmen, SULA TION ;., 212 .in Street Ov '''S:1)V 'w .l Rv.m 100 �B � Northampton, k phone 413-587-1240 Fa 1 72 / O ONL Y ^i S CTi �ub�6�s APPLICATION FOR INSULATION FOR A ONE OR TWO F' LY DWELLING ONLY SECTION 1 -SITE INFORMATION INSULA ION PERMIT This section to be completed by office 1.1 Property Address: Map Lot 25C-120-001 Unit 25 Elizabeth Street Northampton MA 01060 Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Gregg Simmonson 25 Elizabeth Street Northampton MA 01060 Name(Print) Current Mailing Address: _See Attached 2062505145 Telephone Signature 2.2 Authorized Agent: Adam Glenn 71 Dudley Rd, Sutton, MA 01590 Name(Print) } � 1 Current Mailing Address: 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 16,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 26 4. Mechanical(HVAC) 5. Fire Protection 6. Total =(1 +2+ 3+4+5) 16,000 Check Number A00 7 J ,,--yy(� This Section For Official Use Only Building Permit Number: 6 P-•�('• ''j ' Date Issued: Signature: mo)( 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 71 Dudley Rd, Sutton, MA 01590 07/30/2026 A irre Expiration Date 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 , 'J Expiration Date 9LdA "�' �,�_ Telephone 781-205-4516 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 n No ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 826627 826891 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 10/29/2024 Signature of Owner/Agent Dare Gregg Simmonson 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 10/29/2024 Signature of Owner Date City of Northampton OPY.I.A MF O\; 1 Massachusetts tea c yr l I DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building J s Northampton, MA 01060 ss/w,., `.‘`�O 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: 16,000 Address of Work:25 Elizabeth Street Northampton MA 01060 Date of Permit Application: 10/29/2024 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: 10/29/2024 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 \\ oat„„, �. �j••'� Massachusetts ;a -j v DEPARTMENT OF BUILDING INSPECTIONS Yr S 212 Main Street •Municipal Building Svc� Northampton, MA01060 �3'1;, / 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: 25 Elizabeth Street Northampton MA 01060 (Please print house number and street name) Is to be disposed of at: McNamara Waste Services LLC, 24 E Longmeadow Rd,Hampden,MA 01036 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) CIW ,,,,c1:;(1:d 10/29/2024 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. riilCity of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS ��� 212 Main Street • Municipal Building C- it It fl - y"""' Northampton, MA 01060 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 25 Elizabeth Street Northampton MA 01060 Contractor Name: HomeWorks Energy Address: 71 Dudley Rd City, State: Sutton, MA 01590 Phone: 781-205-4516 Property Owner Name: Gregg Simmonson Address: 25 Elizabeth Street 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. Contractor signature Ca ,,, Gill()an Date 10/29/2024 The Commonwealth of Massachusetts Department of Industrial Accidents — 'o. Office of Investigations 4r_- 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: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 1 6. El New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling 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 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.®Other Weatherization 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 I Iomeowners 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: 25 Elizabeth Street Northampton MA 01060 City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify undd r the pains and p �jes of perjury that the information provided above is true and correct. Signature: `� Date: 10/29/2024 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#: ___.--.4N HOMEENE-03 LLARIVIERE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD �� 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 heu of such endorsement(s). PRODUCER CONTACT Lisa Lariviere Foster Sullivan Insurance Group PHONE 163 Main Street (NC,�N�o,Let):,978) 686-2266 301 I FAX (WC,No): North Andover,MA 01845 ADDass,certificates@fostersullivangroup.com INSURER(S)AFFORDING COVERAGE NMC S INSURER A:Kinsale Insurance Company 38920 INSURED INSURER B:The Commerce Insurance Company 34754 Homoworks Energy,Inc INSURER C:Everspan Indemnity Insurance Company 16882 101 Station Landing Suite 110 INSURER D;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. Y EXP UR TYPE OF INSURANCE ADDL1NS 8ENDR POUCY POLICY NUMBER vv) Pip ) UNITS A X COMMERCIAL GENERAL LJAe0.RY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE n OCCUR 0100275489 1/1/2024 1/1/2025 DAMAG SE31ES(Ea RENTE urteD ncel $ 300,000 PRE)YM occ MED EXP(Any one person) $ 5,000 PERSONAL A ADV INJURY $ 1,000,000 GEN'L AGGRE TE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 1I JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBLE LIABILITY (Ea COMBINED SINGLE LIMIT ccidontl $ 1,000,000 — ANY AUTO L15948 1/1/2024 1/1/2025 BODILY INJURY(Per person) $ OWNED X SCHEDULED AURTEO�S ONL' AUTOS yy�Ep BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTOS ONLY (PPR�PE yy4AMAGE $ $ 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 I RETENTIONS 0 $ D WORKERS COMPENSATION X ANO EMPLOYERS'LIABILITYSTATUTE ER OTH- Y ANY PROPRETOHR'AHTNERIEXECUTIVE � ECC-600-4001157-2024A 1/1/2024 1/1/2025 E.L.EACIIACCIDENT $ 1,000,000 Q_Fe IC��En BER EXCLUDED? NIA ---- I(�M NH) E.L.DISEASE-EA EMPLOYEE ¢ 1'000'000 Eyes describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY UMIT $ 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 I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Scheduk,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. HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN nc. ACCORDANCE WITH THE POLICY PROVISIONS. 101 Station Landing Ste 110 Medford,MA 02155 AUTHORIZED REPRESENTATIVE i 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 Re?ulations and Standards Restricted to: Constructiort-S�`uper�Fisor Specialty CSSLIC-Insulation Contractor CSSL-106148 expires: 07/30/2026 ADAM GLENN 19 CHARGE POUND WAREHAM MCA 02571 _ Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. vUl,C 10 Commissioner Qt / Contact OPSI:(617)727.3200 or visit vwvw.mass.gov/dpllopsi THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration ♦ Z �� �� Type: Corporation HOME WORKS ENERGY, INC. .; �_ Registration. 181138 M Expiration: 03/02/2025 101 STATION LANDING STE 110 MEDFORD,MA 02155 IM sN v Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for Individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 181138 03/02/2025 Boston,MA 02118 HOME WORKS ENERGY,INC. ADAM GLENN atA , 1 o,,/ 101 STATION LANDING STE 110 ` Jam`• "tt// MEDFORD,MA 02155 Undersecretary Not valid without signature Insulation/Air Sealing Permit Authorization Specialist: Carlton Wells Company: HomeWorks Energy Email: carlton.wells@homeworksenergy.com Address: 101 Station Landing Cell: 6176088273 Medford,Ma 02155 Phone: 781.305.3319 MA CSSL- 106148 MA HIC- 181138 Customer: Gregg Simmonson Address: 23 Elizabeth Street Email: gregg@crnwest.com Northampton, MA,01060 Site ID: 826627 Phone: 2062505145 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: gregg@crnwest.corri Customerl..reeirdt Signature: Date: 10/15/2024 Gregg Simmonson For Condo Owners: If you have property oversight by a condo associationt, please have the association's authorized person(s)complete and sign the section below. Please email this document to wxpermitting@homeworksenergy.com once completed. We, being the duly authorized representatives of the association Name of association or management company+ or management company have reveiwed the plans and specifications for improvements to the address specified above. We further acknowledge that the above listed owner has given notice that they intend to seek permits and to carry out the proposed work. Signature of representative Date Print Name t Other unit owners may sign when there is no association. (� PLAN VIEW z Name: \'Olc/II{il Site ID: '6 Finished Sq. Ft: gD- 3 o Phone: Year of House: MA) Electric Acct#: 7, Address: # of Floors: )-. Gas Acct#: Unit#: # Occupants: 2.. Housing Type? PL041; DUCTWORK INSPECTION Ducts Insulated?) 1-114 Duct Linear Ft. N J Duct Square Ft. Duct Air Sealing Hours C W1/ L�� � �� Q�y Duct Insulation 143 p luct Insulation Removal ��tl77 Il Z BASEMENT INSPECTION ;� W'(� Existing Spec'ing Ln/Sq. Ft. m Bsmt Wall AG Crawl Ceiling 1-el Crawl Rim Joist Bsmt RJ w/Sill 16 Bsmt RJ NO Sill Mgt Ps1Y'14S A6' Ll 1 cl Vap$r Barrier —� sqft. Bsmt Door .— Y�lower Door? WALLS&GARAGE Drill Location? �j �.c Q ����TTTT//// Siding Ceil. Height Existing Spec'ing Sq. Ft. Framing _ Exterior Wall 1 ►^'}'1 aJ As6s4 ,g4/ I tic", U4TMkvf ►ICI t l2 x�( xri :,.IlooI/Platform Exterior Wall 2 V V 19.2- x x .alloon Platform Overhang x x Garage Wall x x alloo 'Platform Garage Ceiling .x x cc 0 it z 1.1L1 ULI A) .I134(..( 9 Dr. \Gil- 0 lLi ,A ), W 9I 1 l� 1 1 I (L� 2f��( U 3 35 i1 1\ 16 16 Insulation Removal 2- vk 2- a sgft. Sweeps: WX Stripping: _ WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?(MANDATORY) Attic Basement/Crawlspace Other: K&T N Moisture Y/ Combustion Sfty N Kneewall Overhang/Garage Asbestos N Mold>100 sq. ft Y/ CO Detector Missing 1' ;CO Ductwork Exterior Walls Vermiculite Y Structl Concern N Other: Notes for Lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? OR ► KW SLOPE AND GABLE END Blind Spec? 1 Why? Why_? FRAM G EXISTING I SPEC'ING 1 SQ.FT. FR NG EXISTING SPEC'IN SQ.FT. WALL x X SLOPE X FLOOR X X GABLE X X O ACCESS X TRANS X X z W TRANS x X ATTIC 06 •TTIC SLOPE x X I- 3 X X SLOPE EXISTING VENTING? Ns Z EXISTING VENTING? — EXISTING PIPES? Y/N m Y KW Venting Ve Pr BF Hose rr• g Sh' thing Access Temp Access KW Ve mg Vent Br Temp Aco_.. g' 2_ KNEEWALL MANDATORY 12A 1 , �011.711111.11 s � IQ7lo �I H`I ,, 1I p A\A- /. " a',.,, t:g \ R-11-1-(k I I z \ \ v.01 oft el N 3 b S�t r C 36ig co \\- E i Oft.* ..4.11.t/Pvity \)-`1/111 ` a r 1,7 6 U7) �ti v•A-- ---u 1Cm //' : �„ I •1 z9 --1) C6o0Uxg651/ \ / , : sue_ 16 II - '2 Insulated Wan • , Rec'd Eight Ins.Hose l BFT Vent BF :BF V Chlm.[CHI Damming lr ROOF Vent 12RV' A,^Iandter AI+ Temp Access - pug Down PDS Hatch H Walt latch"/ Door u a-Root Vent J3F0.' MI Vol: x .0058 x x ATTIC 1 Blind Spec? x x ATTIC 2 Blind Sp . X( ory) 1S.a19(1(2st story)) = z Existing Spec'ing Sq ft ExI ling Spec'ing Sq ft 13.6(3st°ry) o Multipliers G Unfloored ----- 1 Unfloored Trusses ross Batting N Floored hsH et,bft.I C4.L& 114\ Floored mixedlnsulation Ductl Work � Cath Slope �— -- Cath Slope '6-Loose Air Sealing Hours Walls ..- '(h, LI tl 4$33 Walls Access p•Q p11 xI Access 10 Ventinr Propavents Vent BF BF Hose Damming Venting Propave s Vent BF Hose Damming c i44,6 SV lido) no WHF Box: %J., I. (XD '2 '� \ 1 \ ''a Temp Access:— ca. / Sheathing Access t^ R.L.Covers: Sq.Ft/300= (Exist.NFA Venting)= (Needed - Sq.Ft/300= (Exist.NFA Venting)_ _(Needed NFA Venting) NFA Venting) Roof Type: , p 4_ gxistipgfVg cinen ; �:, Existing Venting? A HomeWorks Energy in(� Home Performance Contractor l 101 Station Landing, Medford,MA 02155 CONTRACT - AUDIT HomeWorks 781-305-3319 CUSTOMER PHONE DATE CLIENT t WORK ORDER Gregg Simonson (413) 461-6100 10/15/2024 826627 60001 SERVICE STREET BILLING STREET PROPOSED RV 23 Elizabeth Street 23 Elizabeth St HomeWorks Energy SERVICE CITY.STATE.DP BLUNG CITY.STATE.ZIP Northampton, MA 01060 Northampton,MA 01060 Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL CARBON MONOXIDE-HEATING SYSTEM Have your heating system tuned up and retested to be sure that the (initials) undiluted flue gasses do not exceed 400 parts per million(ppm)air- free of carbon monoxide.Weatherization work cannot proceed until this is fixed. KNOB&TUBE WIRING We have identified the potential existence of knob&tube wiring in your I (initials) home.The following contract is not valid unless accompanied by the Weatherization Barrier Incentive form, signed by your licensed electrician.Work will not proceed until we receive a copy of this form. PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 2 $213.18 6213.18 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.) INSULATE WALL FROM INTERIOR WITH 4" DENSE PACK CEL 1,512 84,445.28 84,445.28 Provide labor and materials to install blown in Class I Cellulose to exterior walls through an interior surface drill and plug method. Plugs will be speckled and left with a rough finish. Finish sanding and touch- up priming/painting will be the customer's responsibility. Homeowner has received a copy of the EPA's Renovate Right Lead-Safe information guide explaining the potential risk of the lead hazard exposure from the weatherization work to be performed.Your signature is your acknowedgement of receipt and agreement to proceed. HomeWorks Energy C Home Performance Contractor EN( 101 Station Landing,Medford,MA 02155 Hone CONTRACT - AUDIT works 781-305-3319 01gy,in; CUSTOMER PHONE DATE CLIENTI WORK ORDER Gregg Simonson (413)461-6100 10/15/2024 826627 60001 SERVICE STREET BS.UNG STREET PROPOSED BY: 23 Elizabeth Street 23 Elizabeth St HomeWorks Energy SERVICE CITY,STATE,ZIP BILLING CITY,STATE,DP Northampton, MA 01060 Northampton,MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATE RIM JOIST WITH 2"THERMAL BARRIER POLYISO 168 $927.36 $927.36 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. Total: $5,585.82 Program Incentive: $5,585.82 Deposit: $0.00 Final Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/ Dollars $0.00 COMPANY REPRESENTATIVI CUSTOMER SIGNATURE 10/24/2024 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. HomeWorks Energy p ( Home Performance Contractor 101 Station Landing,Medford,MA 02155 CONTRA T - AUDIT HorneYYoil s 781-305-3319 CUSTOMER PRONE DATE • WORK ORDER Gregg Simonsen (206)250-51451 : 10/15/20241 8 6891n 15001 SERVICE STREET BILLING STREET PROPOSED BY: 25 Elizabeth Street 25 Elizabeth St HomeWorks Energy SERVICE CITY.STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060: 1 Northampton,MA 01060 Page I 1 DESCRIPTION QTY COST INCENTIVE TOTAL CARBON MONOXIDE-HEATING SYSTEM Have your heating system tuned up and retested to be sure that the (initials) undiluted flue gasses do not exceed 400 parts per million(ppm)air-: free of carbon monoxide. Weatherization work cannot proceed until this is fixed. KNOB&TUBE WIRING We have identified the potential existence of knob&tube wiring in your: I (i■ittals) home.The following contract is not valid unless accompanied by the Weatherization Barrier Incentive form,signed by your licensed electrician.Work will not proceed until we receive a copy of this form. PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO.; 101i $1,065.90U $1,065.90J 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.)1 INSTALL 6"CELLULOSE IN ENCLOSED ATTIC FLOOR 1,2911 $2,982.21 $2,982.21 Provide labor and materials to install a 6"layer of R-21 Class I Cellulose to floored attic space.: ATTIC FLOOR ENCLOSED CELLULOSE 6"DENSE PACK 36: $102.60 $102.60 ' Provide labor and materials to install a 6"layer of R-19 Class Cellulose to floored attic space.. DOOR: THERMAL BARRIER POLYISO 2"(ATTIC) i 111 $103.051: $103.05 Provide labor and materials to insulate the back of the attic door with i 2"rigid insulation board. INSULATE INTERIOR BUFFERED WALL WITH 4"DENSE PACK 1801 $536.40L $536.40 Provide labor and materials to install blown in Class I Cellulose to exterior walls through an interior surface drill and plug method. Plugs Cl will be spackled and left with a rough finish. Finish sanding and touch-E up priming/painting will be the customer's responsibility. Homeowner I has received a copy of the EPA's Renovate Right Lead-Safe information guide explaining the potential risk of the lead hazard L exposure from the weatherization work to be performed.Your 11 signature is your acknowedgement of receipt and agreement to 7 proceed. HomeWorks Energy tOT3 Home Performance Contractor 101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT ^works 781-305-3319 )eray,inC CUSTOMER PHONE DATE CLIENT I WORK ORDER Gregg Simonsen (206)250-5145'. 10/15/2024 826891 15001 SERVICE STREET BILLING STREET PROPOSED BY 25 Elizabeth Street 25 Elizabeth St HomeWorks Energy SERVICE CITY.STATE,ZIP BILLING CITY.STALE,ZIP Northampton, MA 01060i Northampton,MA 01060 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATE WALL FROM INTERIOR WITH 4" DENSE PACK CEL 1,5121 $4,445.281 $4,445.28 Provide labor and materials to install blown in Class I Cellulose to exterior walls through an interior surface drill and plug method. Plugs will be speckled and left with a rough finish.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 1 proceed. PROPAVENT 2'OR 4' 30 $140.401 $140.40 ' Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. i VENT BATH FAN TO ROOF OR OTHER] 1, $166.53` $166.53 Install a 6"insulated exhaust hose to a flapper vent to exhaust existing i bathroom fan(s). Fan will be vented through the roof or an acceptable alternative if contractor cannot vent through the roof. INSTALLTURBINE ROOF VENT 11 $198.211 $198.21 I Provide labor and materials to install a roof mounted turbine vent. ty HomeWorks Energy Home Performance Contractor 101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT HGmeWorks 781-305-3319 CUSTOMER PHONE DATE CLIENTS WORK ORDER Gregg Simonsen (206)250-5145, 1 10/15/2024 826891' 15001 SERVICE STREET BILLING STREET PROPOSED BY: 25 Elizabeth Street 25 Elizabeth St HomeWorks Energy SERVICE CITY,SI AII,!IP BILLING CITY.STATE,ZIP Northampton, MA 01060 i Northampton,MA 01060 Page i 3 i DESCRIPTION QTY COST INCENTIVE TOTAL INSTALL ALUMINUM SOFFIT VENT" 10 $399.70 $399.70 Provide labor and materials to install 4"X 16'rectangular aluminum soffit vents to increase ventilation in attic areas. Specify color:White or Gray. Total: $10,140.28 Program Incentive: $10,140.28 Deposit: $0.00 Final Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/ Dollars $0.00 CA2/....1.-- ,e3zotea.-- ,91AY, (5)alialte. H-e-on- COMPANY REPRESENTATIVE CUSTOMER SIGNATURE 10/28/24 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE Of ACCEPTANCE SIGN DATE 30 DAYS.