32C-276-008 (2) BP-2023-1630
80-82 WILLIAMS ST COMMONWEALTH OF MASSACHUSETTS
UNIT3B
Map:Block:Lot: CITY OF NORTHAMPTON
32C-276-008
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-1630 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 16090 THIELSCH ENGINEERING INC 100459
Const.Class: Exp.Date: 03/28/2024
Use Group: Owner: CONNELLY HEATHER
Lot Size (sq.ft.)
Zoning: URC Applicant: THIELSCH ENGINEERING INC
Applicant Address Phone: Insurance:
195 FRANCIS AVE (401)467-6454 WC3730961
CRANSTON, RI 02910
ISSUED ON: 11/27/2023
TO PERFORM THE FOLLOWING WORK:
INSULATION TO ATTIC
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:
r ; 2 . Tit •
Fees Paid: $119.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
,gLiti..r 191 Z$
.,-T APPloet-,ir RECENE
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The Commonwealth of Massac us s
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J Office of Public Safety and Inspectio . 'AU DING iNgPEoN3
Massachusetts State Building Code(780 r ') DEPT CD TNA ON MA O
Building Permit Application for any Building other than a One or T. -_ . . , I elling
(This Section For Official Use Only)
Building Permit Number.Z3. /(/ '3O Date Applied: Building Official:
_ SECTION 1:LOCATION
t O B'� LJI/1.14.0i S7. AioacLLI4Prov:fli 01060 wa(/4, SI: e'4'4vvo5
No.and Street City/Town Zip Code Name of Building(if applicable)
r32C-27(—OO
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used 7 If New Construction check here 0 or check all that apply in the two rows below
Existing Building Ell Repair 0 Alteration E3' Addition 0 Demolition 0 (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other I3,3pecify: /ti S f/!#04/
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Gi'
Is an Independent Structural Engineering Peer Review required? I Yes 0 No EK
Brief Description of Proposed Work: d o° le^'/1 C a,((d(osi Te o P.rA., 4.T c
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft)
Total Area(sq.ft.)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0
F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile 0 R: Residential R-10 R-2 IB' R-3 0 R-4❑
S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA CI IB 0 IIA ❑ IIB 0 IIIAEi ILO El IV El VA 0 VB 0
SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit Debris Removal:
Public 0 Check if outside Flood Zone 0 Indicate municipal 0 A trench will not be Licensed Disposal Site 0
required 0 or trench or specify:
Private 0 or indentify Zone: or on site system 0 permit is enclosed 0
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes 0 or No❑ Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Namelf and Address of Property Owner
OT4 CoNMr[I 41 $d,Y
f. k✓i/f to,/5 SZ e-ric ,4/Tv,w fi l O/e26 c,
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
VA47 G‘✓VSZ 913 -3yt- 7 J,' 1 _- - HD62,.4.,,,. ,G4 eta-IL.co,/
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here E.
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
at S F (f t/e/tidd'Io '(,
Company Name
i2/K. A/ S779I/MSpL CSSL^ /00 ets`q
Name of Person Responsible for Construction License No. and Type if Applicable
13 9 I ke,14Joot) /4-1/sr C7RA,t..-sT,.t. RI a 2 /o
Street Address City/Town State Zip
410- XI 3760 xGt33 yv/-7qt f 3F7 e.veRs7/4a04-oceP use if44'0,aam.i .con
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the§suance of the building permit.
Is a signed Affidavit submitted with this application? Yes B No I]
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$/`,, o 4 O. a 6
1.Building $ ICI a QO, 0 G Building Permit Fee=Total Construction Cost z/�s0)(Insert here
2.Electrical $ appropriate municipal factor)=$ .
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ 1' ( (contact municipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ /6, a'8, 0 ( (contact municipality)and write check number here 0 2‘6 3 3
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the est o my 1 wledge and understanding. /
FRIk 4. 2,37�s/ •� lNs�M4-r �d� 2 9a -7yy F37'7 / d 3
Please print and sign name Title Telephone No. Date
/2(1I ! v'i c vj A-,// neAterlo✓ le( 0a4/O Ave2srirrseQRarEswt,do,r .:.C,-.7
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: J��G7 /l"L/'7OZ3
Name Date
City of Northampton
!dam{/ . Massachusetts ��� '�;,
DEPARTMENT OF BUILDING INSPECTIONS r
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ti
�.'�l 212 Main Street • Municipal Building vf ��
y1ar Northampton, MA 01060 Est'N "4,-)X''
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: 5 .S 'Al Pi✓'r 50 oA-5-o, ►r: I D ?/ ?
The debris will be transported by:
Name of Hauler: 2 i S 1 /A ',01"`sue
Signature of Applicant: Date: //AA 3
The Commonwealth of Massachusetts
Department of Industrial Accidents
_a (p Office of Investigations
_"; Lafayette City Center
r�—y t 2 Avenue de Lafayette, Boston, MA 02111-1750
" 0 www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):Thielsch Engineering
Address:195 Francis Ave
City/State/Zip:Cranston RI 02910 Phone#:401-467-6454
Are you an employer? Check the appropriate box:
Type of project(required):
I.❑■ T am a employer with 599 4. ❑ I am a general contractor and I 6. 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. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. 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.❑ T am a homeowner doing all work officers have exercised their 11.0 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 Insulation
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors 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:Zurich American
Policy#or Self-ins. Lic. #:WC3730961 Expiration Date:1-1-24
Job Site Address: 80-82 Williams St. City/State/Zip: Northampton MA 01060
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 tine
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 under]e pa sand penalties of perjury that the information provided above is true and correct.
Signature: 1( Date: 11/2/23
Phone#: 401-784-3700 ext 6133
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 20 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 5E'lumbing
Inspector 6.❑Other
Contact Person: Phone#:
z.
l
Commonwealth of Massachusetts
T, Division of Occupational Lic@naur@
Board of Building RelY4 ations and Standards ®�� � �`�t�t� DRIVER LICENSE
Constructtiigt uper -Specialty
CSSL-100459 ' 03/28/1974 nLI/,n 9412536
plr@s,03/2i/2014 03/28/2026 el :. 02/11/2021
ERIK J NERfHE ;wl NERSTHEIMER
97 CLARK LANE _ ERIK JON i? __
KINGSTON R;02 : t!
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Commissioner '1L tl tf, „ ,t�,d,c,�,
10706969
Construction supervisor Specialty
roullimullirotnorinall
Restricted to:
CSSL-IC Insulation- Contractor Rev01/26/2016 o1?,,t, a
03/28/197e alrtouo,
CSSL-WS Windows and Siding www.dmv.rl.gov III
CLASS:10-Operator License
•
END:M•Motorcycle
RESTS:A-Corrective Lenses
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
The law requireschange
the d be below of any change of name or address within 10 days.
For information about this license Please print change of address below in permanent ink.
Call(617)727-3200 or visit www.rnass.gov/dp1
THaF 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:Supplement Card Office of Consumer Affairs and Business Regulation
Registration tent tlOn 1000 Washington Street -Suite 710
120979 05/14/2024 Boston,MA 02118
THIELSCH ENGINEERING INC
D/8/A RISE ENGINEERING A DIV OF THIELSCH ENGINEERING INC,
ERIK NERSTHEIMER ;J
195 FRANCES AVE �i • t `
CRANSTON,RI 02910
/ �_
Undersecretary Not valid without signature
Eversource Residential Multifamily Program
Customer Contract
This AGREEMENT is made as of August 21,2023, ("Effective Date")by and between
RISE Engineering (the"Contractor"), located at 1341 Elmwood Ave., Cranston,RI
02910, and The Williams St Condos (the"Customer"), located at 80-82 Williams St.
Northampton,MA 01060. (the"Facility").
WHEREAS,Eversource Energy(Eversource")desires to encourage energy conservation
by its customers, including through the implementation of certain cost effective energy
conservation measures ("ECMs");
WHEREAS, Contractor, in conjunction with Eversource,has developed a program to
achieve energy savings entitled the Eversource Electric/Gas Residential Multifamily
Program (the"Program"); and
WHEREAS,the Contractor has performed an assessment of the Facility and has
identified opportunities to install certain ECMs;
NOW,THEREFORE, in consideration of the mutual promises and agreements contained
herein, the Contractor and the Customer hereby agree as follows:
1. Set forth on Exhibit A hereto is a list of the specific ECMs available to the
Facility and their related cost(if any)to the Customer. If the Facility is a condominium
property, each individual unit owner shall choose the ECMs to be installed, as well as
provide access to their unit. The Contractor shall provide a Program sign-up form for this
purpose.
2. The Contractor and/or its subcontractor(s)shall install the ECMs at the Facility in
a workmanlike manner and in compliance with all applicable laws,regulations and codes.
The parties acknowledge that the ECMs used in the Program will differ among individual
buildings and from household to household within the Facility, and that each household
may not require all available ECMs.
3. The Customer shall pay the Contractor for the installed ECMs at the prices set
forth in Exhibit A hereto. Payment is due 30 days after acceptance by the Customer of
the installed ECMs. In the case of a condominium property,the Customer shall pay only
for those ECMs installed in common areas and shall not be responsible for charges
related to individual units.
4. The Customer shall use all reasonable efforts to ensure that the installed ECMs
are properly operated,utilized, maintained, and repaired.
5. The Contractor shall indemnify the Customer for any property damage or bodily
injury caused by it or any of its subcontractors, employees, or agents in the performance
of, or as a result of,the work under this Agreement. Contractor shall not be liable for
incidental, indirect or consequential damages of any kind.
6. Any estimates of cost savings provided to the Customer shall be based on
Eversource's then existing rate schedules under which the Facility is provided service.
These rate schedules and customer classifications are subject to change. Estimates
represent a prediction about future events,which are subject to variation, and dependent
upon individual living habits. Neither Eversource nor the Contractor guarantees that any
specific level of savings will be achieved in any specific case.
7. Eversource shall have no responsibility for the proper installation,maintenance,
operation, or removal of the ECMs installed at the Facility. The Customer understands
and acknowledges that Eversource shall not perform any work whatsoever with respect to
the ECMs. Eversource shall not be liable to Customer, Contractor or any other person for
any damages, claims, losses, costs, liabilities or expenses, including,without limitation,
incidental, indirect or consequential damages, connected with or resulting from the
performance or nonperformance of this Agreement or anything done in connection
therewith. For purposes of this Section"Eversource"includes its officers, directors,
agents, employees, subsidiaries and affiliates,and their officers,directors, agents and
employees,but shall not include Contractor or its subcontractors or their respective
employees.
8. The Customer acknowledges that its participation in the Program is voluntary.
The Contractor and its subcontractors shall perform their work as independent contractors
and shall have direct control and supervision of their respective employees, and neither
Contractor,nor any subcontractors shall be considered employees or agents of
Eversource for any purpose.
9. For two years following implementation of the ECMs, Customer shall provide or
arrange for Eversource and the Contractor and/or its subcontractors to have reasonable
access to the Facility to monitor,verify and maintain the ECMs. The Customer also shall
comply with all reasonable requests by Eversource or the Contractor for information to
enable Eversource to verify energy savings achieved through the installation and
operation of the ECMs, and the Customer's actual cost for the implementation of the
ECMs.
10. Neither Eversource nor Contractor shall be responsible for any tax liability
imposed on the Customer as a result of the Customer's participation in the Program.
11. This Agreement is the entire arrangement between the parties hereto, and all
previous written or verbal representations and proposals are hereby annulled and
superseded. No modification shall be binding on either party unless in writing and signed
by both parties. Both parties agree that Eversource is an intended third-party beneficiary
of this Agreement. This Agreement shall be binding upon the parties hereto and their
respective successors and assigns, including any successor owner of the Facility.
12. Energy Benefits. Customer acknowledges that Eversource is entitled to 100%of
the energy benefits associated with all ECM's, excluding the value of energy cost savings
by the customer,but including all rights to all associated ISO-NE Energy, Capacity and
Reserves Products, and the vendor agrees to provide the Company with such further
documentation as the Company may request to confirm the Company's ownership of
such benefits and Products.
13. This Agreement shall be governed by and construed under the laws of the
Commonwealth of Massachusetts,without regard to conflict of law rules. The parties
agree that all actions,disputes, claims, and controversies arising out of or relating to this
Agreement or the work performed hereunder will be subject to binding arbitration
administered in the county where the Customer is located by the American Arbitration
Association under its Commercial Arbitration Rules and judgment on the award may be
entered in any court having jurisdiction.
14. If any provisions of this Agreement is invalid or unenforceable in any jurisdiction,
the other provisions in the Agreement shall remain in full force and effect in such
jurisdiction and shall be liberally construed in order to effectuate the purpose and intent
of this Agreement. The invalidity or unenforceability of any provision of this Agreement
in any jurisdiction shall not affect the validity or enforceability of any such provision in
any other jurisdiction. The failure of either party to enforce strict performance by the
other of any provision of this Agreement, or to exercise any right available to the party
under this Agreement, shall not be construed as a waiver of such party's right to enforce
strict performance in the same or any other instance.
15. All parties understand and agree that payments by Eversource hereunder are made
through the MassSave Energy Efficiency Fund and such funding may be reduced or
eliminated by the Commonwealth of Massachusetts,Department of Public Utilities
Control ("DPU"), or other legislative or regulatory action, or designated by legislative or
regulatory action for purposes other than implementation of the Energy Efficiency
programs. Accordingly, if the Energy Efficiency Fund is designated by legislative or
regulatory action for the purposes other than the implementation of Eversource's Energy
Efficiency programs or otherwise reduced, eliminated, or unavailable for use in
connection with this Agreement, and Eversource determines that amounts available from
the Energy Efficiency Fund(or other promotional funds, as applicable) are unavailable to
meet the payment obligations under this Agreement,Eversource may direct RISE
Engineering to terminate this Agreement, and neither Eversource nor RIE Engineering
shall have any obligation to pay incentives after the effective termination date. Except for
incentives installed on or before the termination date, neither Eversource nor RISE
Engineering shall be held responsible in any way and shall be held harmless from and
against any and all liabilities, costs or damages incurred by parties in the event of such a
Program reduction or eliminations, including but not limited to the insufficiency of the
r
Energy Efficiency Fund to cover incentives sold or installed after the effective
termination date.
IN WITNESS WHEREOF,the Parties have executed this Agreement as a sealed
instrument by and through their respective duly authorized representatives on the dates
indicated below.
Cost to Association: $3,165.00
Cost to Unit Owners: $50 per WiFi thermostat selected
Jc n Nit- Ittivtddy ht,DColvietty
Contractor Signature Customer Signature
Jim McGillicuddy HD Connelly
Contractor printed name Customer printed name
Date: 10.23.23 Date: 10.08.23
Notice to buyer:
(1)This Agreement and the attached proposal(Exhibit A) will expire in 90 days of the
Effective Date if the Customer does not return an executed copy of this Agreement to the
Contractor.
(2)Do not sign this agreement if any of the spaces intended for the agreed terms to the
extent of then available information are left blank.
(3)You are entitled to a copy of this agreement at the time you sign it.
(4)The seller has no right to enter unlawfully your premises or commit any breach of
the peace to repossess goods purchased under this agreement.
(5)You may cancel this agreement if it has not been signed at the main office or a branch
office of the seller,provided you notify the seller at his main office or branch office
shown in the agreement by registered or certified mail,which shall be posted not later
than midnight of the third calendar day after the day on which the buyer signs the
agreement, excluding Sunday and any holiday on which regular mail deliveries are not
made
YOU,THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME
PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY FROM THE DATE OF
THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION
FORM (EXHIBIT B)FOR AN EXPLANATION OF THIS RIGHT.
EXHIBIT A
Scope of Work
LOCATION: Interior Units, Attic
Number of Uiiits in Work Scope: Maximum of 8 Units
INTERIOR DWE LING UNIT MEASURES
WIFI Pro.rammable Thermostats: ($50 copay •er thermostat)Furnish and install:
WiFi programmable the 'ostats (Ecco Bee 3 ote: WiFi must be available in the home
to utilize the advanced fea es of this the •stat. The existing thermostat wiring must
be compatible with the new t,ermostat. C tomer will be responsible for WiFi setup.
(Estimated Total up to 2 per 't).
Programmable Thermostats: F and install: (No Cost)
Furnish and install(Approx. estim. s d up to 2 PER UNIT) digital/programmable
thermostats(HONEYWELL RT 230 :1012/E 1 5000.229 -HONEYWELL
BACKPLATE 5000.236 or Pr. 1 or Eq 'valent)with wall plates, as needed,to replace
existing thermostats in the dw lling units. This also has a limiting feature)
Domestic hot water conse ation: (No Cost)
Furnish and install water s,ving low flow shower' -ads and faucet aerators as applicable
in dwelling units.
(estimated up to 1 per uni )Kitchen sinks 1.5 gpm
(estimated up to 2 per uni )Bathroom sinks 1.0 gpm
(estimated up to 2 per uni ) Showerheads 1.75 gpm
Some units may not require all services if work has been completed previously
Air Sealing& Insulation: (75%incentive for insulation—Air Sealing No Cost)
• Air Sealing: Seal open attic space,top plates,plumbing and wiring penetrations and other
typical leakage points.(Estimated 40 hours)
• Combustion Safety Testing of gas-fired domestic hot water and heating systems to BPI
Standards. Pre-and Post Testing Included.
• Attic Insulation: Furnish and install 14"of loose blown cellulose to open attic space
(Estimated 4250 sqft)
• Attic Hatch:Furnish and Install weatherstripping and insulation on the existing attic
hatches(Estimated 1 total)
• Bath Ventilation: Furnish and install insulated exhaust hose that rises up to a roof
mounted flapper kit(Estimated 5 IF NEEDED. REMOVE IF NOT)
City of Northampton
Massachusetts
s r
212 Main Street • Municipal Building
DEPARTMENT OF BUILDING INSPECTIONS pi
Northampton, MA 01060
Property Address: 70-- e'd• t--)11044rsr.
Contractor
Name:
Address: 4/ t 'ec.),2
City, State: t (!)0/ I o
Phone: (lui) -74141 -
Property Owner
Name: (-4 0 e 4/Ad'e 107
Address: Ia - )-
City, State: /t/o77---64 0,-,44Pti AO-
44112A47'/Zritio,ts/tli'ice k5A/eZ (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
Date