Buck Island Village 2025 Participant Confirmation Form

Buck Island Village residents who have signed up to participate in the Mass Save Insulation offering; please complete the following form to confirm your enrollment.

First name

Last name

Street Address in Buck Island Village

Unit #

Has this home been insulated in a previous Mass Save offering at Buck Island Village?

Yes

No

I'm not sure

Please read the following and confirm before proceeding:

Mass Save requires someone to be present at the home at the beginning of the insulation install and at completion. Will you be able to provide access to your home in Buck Island Village, either personally, or through a trusted friend/neighbor/caretaker?

I will be present at my home, or will have a family member/trusted friend/neighbor/caretaker present.

Building Permit Authorization:

Cape Save is required to pull an Express Weatherization Permit for your home to complete Mass Save insulation upgrades. Please sign to authorize Cape Save to apply for an Express Weatherization Permit with the Town of Yarmouth Building Department for the address you provided at the beginning of this form.

Signature

Signature field is empty.

Unit Specifics:

Unit Stories and Access Floor

My unit is 1 story, accessed on 1st floor

My unit is 2 stories, access on 1st floor

My unit is 1 story, accessed on 3rd floor

Other

Attic Access?

My attic is accessible through a pull-down attic stairway

My attic is accessible through a ceiling hatch

My attic is inaccessible. I authorize Cape Save to cut a temporary access to insulate my attic and install an attic hatch.

I am unsure if I have an attic

Other

Recessed Lights?

# of Recessed Lights

Please give an accurate count of the recessed lights in your home if possible

# of Bathroom Fans

No bathroom exhaust fan(s)

1 bathroom exhaust fan

2 bathroom exhaust fans

3 or more bathroom exhaust fans

Bathroom exhaust fans in your home may need to be vented to the exterior to prevent mold and moisture problems in your attic.

Remodeling / Other Construction

Do you have any other work being done on your home that might interfere with insulating the attic/basement? Any leaks in the roof or foundation? Remodeling? Mold problems? Pests or mice?

Anything else we should know?

Preferred Methods of Communication

I prefer to communicate via phone call

I prefer to communicate via text message

I prefer to communicate via email

508-398-0398

CONTACT US

Buck Island Village 2025 Mass Save Weatherization

Buck Island Village 2025 Participant Confirmation Form

Fully Licensed & Insured. Certifications: BPI BA-T, Lead-Safe, OSHA