32C-093 (3) BP-2023-1806
13 WILSON AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
32C-093-001 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-2023-1806 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 2000 HOMEWORKS ENERGY INC 106148
Const.Class: Exp.Date: 07/30/2024
Use Group: Owner: KEMPER AMY E
Lot Size (sq.ft.)
Zoning: URC Applicant: HOMEWORKS ENERGY INC
Applicant Address Phone: Insurance:
235 ESSEX ST 781-205-4484 1847910
WHITMAN, MA 02382
ISSUED ON: 01/03/2024
TO PERFORM THE FOLLOWING WORK:
INSULATION/WEATHERI Z ATI 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:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:g ( r 5r,
ii
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
FEE: $65.00 ;"` PI au Permit to WXPermitting@homeworksenergy.com
iii)ILr ICl/0 �.
De
t" R
City of Northampt ��
Building Department aEu 2 9
!" � � r_ 212 Main Street 0�3
'�� Room 106''�',n0,.� NSULA TION
'�n = ' Northampton, MA 01080.,t '1W;v
phone 413-587-1240 Fax 413-587-nWo770-v- %I ONLY
APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY
SECTION 1 -SITE INFORMATION INS ULA TION PERMIT
This section to be completed by office
1.1 Property Address:
Map Lot Unit
13 Wilson Avenue Northampton MA 01060 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Amy Kemper 13 Wilson Avenue Northampton MA 01060
Name(Print) Current Mailing Address:
See Attached (413)320 6743
Telephone
Signature
2.2 Authorized Agent:
Adam Glenn -^ 235 Essex Street, Whitman, MA 02382
Name(Print) -ez-d 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 2,000 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
6 4. Mechanical (HVAC) U
5. Fire Protection
6. Total = (1 +2+ 3+4+5) 2,000 Check Number I �7d1
This Section For Official Use Only
6 0- � got// Date
Building Permit Number: Issued:
Signature: /—€ /-Z- ZOZy
Building Commissioner/Inspector of Buildings Date
wxpermitting @ homeworksenergy.com
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
City of Northampton
SS . • SC
Massachusetts
'� • DEPARTMENT OF BUILDING INSPECTIONS x
212 Main Street • Municipal Building
Northampton, MA 01060
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:2,000
Address of Work: 13 Wilson Avenue Northampton MA 01060
Date of Permit Application: 12/18/2023
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:
1 hereby apply for a building permit as the agent of the owner:
12/18/2023 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
t Massachusetts e
` a (r DEPARTMENT OF BUILDING INSPECTIONS
�►� ' 212 Main Street • Municipal Building vtif.
Northampton, MA 01060 5441, 30‘^
MANDATORY FOR HOUSES BUILT BEFORE 1945
Property Address: 13 Wilson Avenue Northampton MA 01060
Contractor
Name: HomeWorks Energy
Address: 235 Essex Street
City, State: Whitman, MA 02382
Phone: 781-205-4484
Property Owner
Name: Amy Kemper
Address: 13 Wilson Avenue Northampton MA 01060
City, State:
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 signaturecayia4 c54(.4)- coes._
Date 12/18/2023
E
ACCORD CERTIFICATE OF LIABILITY INSURANCE �'1 '
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 CUENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY PHONE
HOME OFFICE:P.O.BOX 328 IA/C,No,EXI):888-333-4949 (a FAX
No):507-446-4664
OWATONNA,MN 55060 E-ADDRESS:CLIENTCONTACTCENTERQJFEDINS.COM
INSURERS)AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 419_899.0 INSURER B:
HOMEWORKS ENERGY,INC, INSURER C:
101 STATION LNDG INSURER D
MEDFORD,MA 02155-5134
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.
INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POUCY EXP
LTRINSR WVD IMMIDDIYYYYI RaMIDDtYYYYI LIMITS
X COMMERCIAL GENERAL UABIUTY 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
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X PRO-
POUCY JECT LOC PRODUCTS-COMP/OP AGO 52,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
X ANY AUTO IEa acddenl)
BODILY RIJURY(Per person)
A —OWNED AUTOS ONLY _AUTOSULED N N 1847908 01/01/2023 01/01/2024 BODILY INJURY(Per accident)
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
AUTOS ONLY 'Per accident)
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000
A EXCESS LIAR CLAIMS-MADE N N 1847911 01/01/2023 01/01/2024 AGGREGATE $1,000,000
DED RETENTION
WORKERS COMPENSATION OTH-
AND EMPLOYERS'LIABILITY Y/N X PER STATUTE ER
ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S500,000
A OFFICER/MEMBER EXCLUDED? _NIA N 1847010 01/01/2023 01/01i 2024
(Mandatory in NH) E.L.DISEASE•EA EMPLOYEE S500,000
II yes.describe under E.I. DISEASE-POUCY LIMIT
DESCRIPTION OF OPERATIONS below 5500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addlbunel Remarks seeedule,may he attached it more space :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 DEUVERED IN
A CERTIFICATE HAS BEEN FILED WITH EACH OF YOUR CERTIFICATE ACCORDANCE WITH THE POUCY PROVISIONS.
HOLDERS. AUTHORIZED REPRESENTATIVE
CO 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
Insulation/Air Sealing Permit Authorization
Specialist: Adam Morrison Company: HomeWorks Energy
Email: adam.morrison@homeworksenergy.co Address: 101 Station Landing
Cell: 8574081470 Medford, Ma 02155
Phone: 781.305.3319
Customer: Amy Kemper Address: 13 Wilson Avenue
Email: amyekemper@comcast.net Northampton, MA, 01060
Site ID: 4919254 Phone: 4133206743
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: amyekemper@co ast.net
Customer
Signature: Date: 12/13/2023
Amy Kemper
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.
KW WALL& KW FLOOR Wind Spi': 0 ` OR KW SLOPE & GABLE Blind Spec ■I
Why? Why? t
FRAMING 1 FXISTING SPEC'IN(, l SO.FT. FRAMING EXISTING) SPEC'ING Q.FT.
WALL X X SLOPE X X
FLOOR % X // GABLE X X i
ACCESS x X ff TRANS X X i Z
TRANS x x /' ATTIC n
ATTIC / SLOPE X X
SLOPE X % /// t KW`;
/ EXISTING VENTING?�
EXISTING VENTING% EXISTING PIPES? Nn
KW Venting Vent BF F Hose Damming, Sheathing Access Temp Accesf KW Venting Vent BF Temp Access
r
c 0
a KNEE WALL MANDATORY
5
8
z" ,://
íJ';, >
:,„ , ,
' I,\,,, i (--.e ,
: (,... .,,,,_.,..,_:____ . ,;. )
,,,„ ,,,, ed a
n
7,i/ _.....) '
/4 \
. .
tt LVif
1
e\-677 1)fliV\
•
1) 1
di
1-607,......_.--, , Pen oci '
F-,d-' ,,k)
,,,,
( ) , '?ct r
ioigrrl
ill.
io4f
I ( hf-rcc.:1S- i
^ , ,,,, 2
+ s MULTIPLIERS
►>{ ew/ ATTIC..I Blind Spec? x x ATTIC 2 Blind Spec? U Trusses Cross Batting
E pstin Spy ing Sq ft Existing Spec'ing Sq ft
Unfloored _fr , Unfioored i Mixed Ins: Duct Work zw? E)
Floored Floored . , t S
>6"Loose None r
Cath Slope rkot Cath Slope '
Walls {U { 1 Wal:s .,;nSEALINGHOURS : y6Access ) i(' 1 ! . � Access I �...... ' ~ 1114Venting Propavents BF BE Hose Damming Venting P pavents Vent BF I BF Hose Damming
A 'A WHF
a 0
�./ ) 3 c Temp Acre
•
I Sheathin e
t^ R.L. rs:
Sq.Ft/300: mist.NFA Venting)= INeeded o.Ft/300 (Exist.NFA Venting)= INeeded '}
Existing Venting? a e. 7 NfA Venting} Existi ; Venting? NFA Venting) Roof Type;) r ^ j/')
#�'iCI; tI --Oil? 3(0 ` �' �\v. ) 6fft 'lo
Page 2 of
° HomeWorks
fks = � 101 Station Landing Ste 110,
M n C C mass save. Medford,MA 02135
Energy PARTNER (781,)305-3319
Customer Name:Amy Kemper
Email:Not provided
Phone:413-320-6743
Premise Address: 13 Wilson Ave, Northampton,MA 01060
Mailing Address:13 Wilson Ave,Northampton,MA 01060
Project ID:5087903
Date:Dec. 13,2023
Weatherization incentive ($673.29)
Air sealing incentive ($850.86)
Total Program Incentive -$1,524.15
Customer Total $224.43
Total Contractor Price and Payment Schedule
HomeWorks Energy, Inc.agrees to perform the above described work,furnishing the material and labor specified for the listed total
price. Payment of the balance of the c omer contribution is expected upon completion of the work.
CET 'f\V 12/13/23
Customer Signature: Date:_
Customer Phone:
Specialist Signature: _M _Date:
UMITED TIME OFFER
The prices and incentives in this contract are subject to change in accordance with the sponsoring(Allay MassSave Home Services Program offers.
Proposals con be sent to:lnbox@HomeWorksfnergy.com