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23D-171 (7) BP-2024-1488 34 RIVERSIDE DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-171-001 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-2024-1488 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est. Cost: 4000 HOMEWORKS ENERGY INC 106148 .Const.Class: Exp.Date: 07/30/2026 Use Group: Owner: PUTNAM HILL SHAWN &AMY B 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: 11/06/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATION 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. Signature: Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner FEE: $65.00 /q3- Please email Permit to WXPermitting©homeworksenergy.com c''. DepF R`�ti{:7.!/.14l City of Northampton ;'� Building Department �[�� P'1 ,% 4 212 Main Stleet `i i/i ' Room 100 �o INSULATION L \ �_� Northarrnpton, MA 01060 S ; ,� phone 413-587-120, Fax -587-1 -__ ,,,, 0// Q ftJL., Y - ?‘1:1,)rjr � /I / APPLICATION FOR INSULATION FOR A ONE ORS O FA Y DWELLING ONLY SECTION 1 -SITE INFORMATION I NS U TION PERMIT 1.1 Property Address: This section to be completed by office Map Lot Unit 31. Riverside Lr Zone Overlay District Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Amy Putnam 34 Riverside Dr Name(Print) Current Mailing Address: See Attached Telephone Signature 2.2 Authorized Agent: Adam Glenn 71 Dudley Rd Sutton MA 01590 Name(Print) c„,:30:ad 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 4000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) $ 7 S 5. Fire Protection 6. Total = (1 +2 +3 +4 + 5) 4000 Check Number /6' g 3 3 This Section For Official Use Only � Building Permit Number: ° 4)-4H4 Oqc Date Issued: Signature: c2t/L A f/-(p=2 y 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 0 Name of License Holder:Adam Glenn 106148 License Number 71 Dudley Rd Sutton MA 01590 07/30/2026 Addre Expiration Date 781-205-4516 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 HomeWorks Energy 181138 Company Name Registration Number 71 Dudley Rd Sutton MA 01590 03/02/2025 Address Expiration Date 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 t' 1 No ❑ Brief Description of Proposed Work Residential weatherization/ Air sealing. No structural changes. SITE ID 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 10/9/2024 Signature of Owner/Agent Date Amy Putnam , 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 10/9/2024 Signature of Owner Date City of Northampton CHAMP ?Y - -:rah S�5 - S, C Massachusetts )4 ' . 44 ; DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building •%�"'!lr I Northampton, MA 01060 f t 1'W -Y'`�0 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:4000 Address of Work: Riverside Dr Date of Permit Application: 10/9/2024 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: 10/9/2024 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 Massachusetts ' DEPARTMENT OF BUILDING INSPECTIONS /ar 212 Main Street •Municipal Building Northampton, MA 01060 'r `\ • • -� i .,vusa1 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 Riverside Dr (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) 10/9/2024 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. City of Northampton 7-,I4i:Il!ia,,,. ,_ ... .,. .. 3, ,z; s Massachusetts 1.�`4 ''' <<G 'c_ J C'� . j, DEPARTMENT OF BUILDING INSPECTIONS y. ;-'� i it 212 MainStreet Municipal01060uilding v4:P5'h ``ti�`� .�-� Northampton, MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 34 Riverside Dr Contractor Name: HomeWorks Energy Address: 71 Dudley Road City, State: Sutton MA 1590 Phone: 781-205-4516 Property Owner AmyPutnam Name: Address: 34 Riverside Dr City, State: Northampton MA 01062 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 64,44 ,,,,, (3)0,e2e)- cte_ Date 10/9/2024 HOMEENE-03 LLARIVIERE ;a ---- CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) �� 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 CONTACT Lisa Lariviere NAME: Foster Sullivan Insurance Group PHONE FAX 163 Main Street (A/c,No.Est):(978)686-2266 301 (A/C,No): North Andover,MA 01845 Leaks:certificates@fostersullivangroup.com ' - INSURER(S)AFFORDING COVERAGE NAIC a 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 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 10100275489 1/1/2024 1/1/2025 DAMAGISE TO Ea RENTEDoccurrence] S 300,000 PREMES l MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENT_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 POLICY JPERCOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 _ OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO L15948 1/1/2024 1/1/2025 BODILY INJURY(Per person) $ OWNED X SCHEDULED AUTOSRREE ONLY AUTOS D BODILY INJURY Per accident) $ X AUTOS ONLY X AUTOS ONLY PRO(PeraccidentDAMAGE $ $ C — UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB ` CLAIMS-MADE BRIEII-000045-00 1/1/2024 1/1/2025 AGGREGATE $ 1,000,000 DED X RETENTIONS 0 $ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ECC-600-4001157-2024A 1/1/2024 1/1/2025 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N IA 1,000,000 (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 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 Schedule,may be attached if more space is required) Evidence Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 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 The Commonwealth of Massachusetts '—� Department of Industrial Accidents omm 1.11 Office of Investigations = it= Lafayette City Center =7314 / 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.❑■ I am a employer with 500+ 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 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 workingfor me in anycapacity. employees and have workers' P h' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 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 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. I.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 Riverside Dr City/State/Zip:Northampton MA 01062 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 andpees of perjury that the information provided above is true and correct. Signature: Date: 10/9/2024 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): 10Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5E1Plumbing Inspector 6.0Other Contact Person: Phone#: >v Commonwealth of Massachusetts Construction Supervisor Specialty If Division of Occupational Licensure Board of Building Regulations and Standards Restricted to: TI 1 CSSL-IC -Insulation Contractor Constructicze upetvopr Specialty r CSSL-106148 t.,45pires: 07/30/2026 ADAM GLENN 19 CHARGE POUND RD AN O WAREHAM NIA 02571 2 /• ,l ?E, O� ..diggij' ,, :..,, 'f71,1,V,1,1�- Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner tl-.2w :.ti_ Contact OPSI: (617)727-3200 or visit www.mass.gov/dpl/opsi ____c_ THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston. Massachusetts 02118 Home Improvement Contractor Registration lop •••••••••••••••••••. ••=1=.01••••10•1111/111••••(0 r. Type Corporation v Registration 181138 = 1 HOME WORKS ENERGY, INC 101 STATION LANDING STE 1 10 _ Expiration 03/02/2025 MEDFORD, MA 02155 "`== = l v Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8 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 Resustration Expiration 1000 Washington Street -Suite 710 181138 03/02/2025 Boston.MA 02118 HOME WORKS ENERGY.INC ADAM GLENN Cr `r (-1414___ 101 STATION LANDING STE 110 -;6.s.r' ' Y,:'-,./ MEDFORD.MA 02155 Undersecretary Not valid without signature c`///vvv''' HomeWorks Energy /C"` Home Parformanc•Contractor ni 101 Station Landing.Medford.MA 02155 CONTRACT -AUDIT HomeWorics 781-3054319 GUaMMI RCN OAR _.a,• k•014•011^,6• Amy Putnam (413)923-4788 08/07/2024 823568 60002 WWII Mar alma ma. nioroac Sr 34 Riverside Drive 34 Riverside Dr HomeWorks Energy er r.n an.grans aaaa STY.gran s. Northampton,MA 01060 Norlhampbn.MA 01062 Page 1 DESCRIPTION CITY COST INCENTIVE TOTAL PERFORM AIR SEALING AT ESTIMATED 62.5 CFM50 PER HO 1 $106 59 $106.59 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) TRANSITION AIR SEALING 45 $336.60 $336.60 Provide labor and materials to air seal the open kneewall transitions of your home against wasteful,excess air leakage, EXTERIOR DOOR WEATHER STRIPPING 3 $108.96 $108.96 Provide labor and materials to install 0-Ion weatherstripping to door(s)to rested air leakage. DOOR SWEEP 3 $88 98 $88.98 Provide labor and materials to install a doorsweep to restnct air leakage. INSTALL 2"THERMAL BARRIER POLYISO OPEN GABLE WALL 56 $308 56 $231.42 $77 14 Provide labor and materials to Install Y rigid insulation board to the open gable wall INSTALL 6'FIBERGLASS BATTING IN OPEN KNEEWALL 56 $138 88 $134.16 $34 72 Provide labor and materials to install 6'R-19 faced fiberglass bait insulation to kneewall area. INSTALL 2"THERMAL BARRIER POLYISO ON OPEN KNEEWAL 175 S964 25 $723 19 $241 06 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to the sloped rafter area behind a kneewall INSTALL 6"FG BATTING IN OPEN KNEEWALL SLOPES 175 $437.50 $328.13 $109 37 Provide labor and materials to install a 6.25"layer o1 R-19 fiberglass balls to the sloped rafter area behind a kneewall. TEMPORARY ACCESS 2 $218 14 $163.61 $54.53 Provide labor and materials to make a temporary access to an attic area The opening will be closed with materials similar to those existing. Finish sanding and painting is not included. INSTALL 7'THERMAL BARRIER POLYISO ON OPEN BASEMEN 23 $127 42 $95.57 $31 85 Provide labor and materials to install rigid board insulation to the penmeter of the basement ceiling at the house sill HomeWorks Energy Home Performance Contractor 101 Station Landing.Medford.MA 02155 CONTRACT -AUDIT HcmeWorks 751.105.3319 c%fl t F,FOM o.TE aa„T F RORR ORDER Amy Putnam (413)923-4786 08/07/2024 823568 60002 BMWS SM. MU,.STREET rRoloMo Or'. 34 Riverside Drive 34 Riverside Dr HomeWorks Energy WV,.OrY.RAILS a.aR1 CM.Sun.E> Northampton,MA 01060 Northampton,MA 01062 Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATE RIM JOIST WITH 8 25"FIBERGLASS BATTING 93 $283 65 $212 7a S70 91 Provide labor and matinals to install R-19 Eaffaced fiberglass insulation to the perimeter of the basement ceding at the house all. Total: $3,119.53 Program Incentive: $2,499.95 Deposit: $0.00 Final Total: $519.58 WE AGREE HEREBY TO FURNISH SERVICES.COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF "'Six Hundred Nineteen&58/100 Dollars $819.58 CO PAFrr Ra/R•asone aiEF011011or11011 ROTE.nU=MACT MAY r RTRwwI R us.NOT raanRO Yen F. pm,a AavrYw 10/08/2024 EIeN rrn 30 nen PLAN KIN Name: P \I IA ►'1'1 Site ID: <61.1 C Le. Finished Sq.Ft: / Li hone:--�I;—� u :-4 Year of House: Electric Acct# t., Address: �'1�!�;f rS,0c #of Floors: IGas Acct#: I F�,Qn(4-'�cal /141nit p: _ #Occupants: .. Housing Type. 1 UC1WORK INSPECTION t WU U, � p{ Q 1 ( . 1..„.,, d linear F(� �.--"'-- �) f iJ I`�( t, �,:Ifluct—Square... %��_., 1 t'Duc Tt g Hours tJ, G) Pp u- I j 1,IDuct Insulation 2- .--,- -:7-- Duct Insulation Removal _ i ', 0 (ZJ ��Q q� ( Ifil ?i ti, BASEMENT INSPECTION yy l , n a l'e i.A L Existing Spec'ing Rln/Sq.Ft.( Z I I� 04— II \--_ • 1 I ball AG . ' s --` �I + i I Craa�i Ce+hn y H--- q�j } C +m Joist '"`,_ 131li 5-fort( (i r2i r- ` ..• Bsmt Rl w/sill 1:-L r� / }v �� �����^ 4 Ll Bsmt RI NO Sill is ,C P 1,i g� JV 1.7-: rier _snit. Bsmt Door j (r.1', y WALLS i5 GARAGE Drill Location? i Blower Door. r.r (Siding ]Ceil.Height j existingSpec ing Sq.Ft. Framing ,. I x � ! la$orm .: r_/att? 1-- I x r naiioon,'Piatform i (( (Exterior Wall 2 _ x x t.1(—Overhang rge/ 1-- - .. ---`� x Balloon/Platrorm }�aragal! - 1 - x x - i Garage Ceiling ..r.....J_ _- i < < 01( , 3It �•� t ' j . `� Kiel t ' t m ins RemoVI -.:r. i t Tr(-)r‘ ` r ,7 sqtr- .i ,,^ n Sweeps �T 7 if 1. ' 1J 1 f �t WX Stepping:t. ��O,t�S SPEC') JUT NOT CONTRACTED . ROAD BLOCKS PRES Y N 'Attic Basement/Craw] Ce -p-+:0221eGz -on Shy 1 Te.i ll Oeerhent/Garage _ Asbesto otd>1d0 sq,ft Y/IY CO Detecio 8 .y/N wC;,rru 4' €----;,-.�alU v rmj alite Y J N Stnxd Concerns`Y/N Other: ��� 1 0�.® t Notes for teed Vendor/Work Not Contracted: } f () n('. ;klW I�A�I ),) 61y 1� ,; r ''.; . f I N r ��'F? :addµloll t>�+ava aupu auosora— (t o,+nTrt t2uquah iuus'X3� CaDo40 .! rta1--• ".aat A!'K� �ao .Paf.�t rot we&�� dWal P.t s 1 7luwnp n as" "A A fuiva� t gt j9 as ill1uaA nuasedo,d 9uµusA [W •', �.�- ssamy ss2lsy ��, +aa i°' slleM` - -- °''x =a1 9:o `ti*adolS 41e)— adolS 4ae�` r7M17nn •,:.7alna:l pwy; Z _paiool j 9uesss:r$f asnuyl t pal00lj 'f pa'ab(juQ po,00uun ,„3;vac; -13S 8u1aad5 9IiLS!(3 4bS upads :RI 1ti:s1 1 0 pads Z)111V X X 1 p pads puns TJI11V x x (1asi161 X 1� ri 8500' < :tort srn, MY. _a is w.wa®"w�1 PM NJWM sallw1 014311RX41 x®MPW �i 't5' y a .- .4,7. 14 ri- a a. 1 'C' ( R))9 ‘,01'(3' ':',. ii I: fir . s ef\ �' ��0 9 r' \\ (� 5 ` sti Cj O°)1 vo ()) ra\,\ c\i\n1 ' 1.\-. .'Q osmtic iwxws Mama vuq a ,r t7l�YCwll ta: Md\7 siszO f 17 Wivl .wrl7. �, •r ��` N/A i53dld 9Nt1SIX3 LDN11N3A DNu.SCf3 ', n. X X id01 ,? MI■IN 3d01S 91llV r X X L, _ ___________ra.4A,uagmm=siwgwra_ _7378.4____iv...777.._...73m51,.....,wir___,,,4; _ X SS3J�e!�,; I um x�-x uorni, 06112-eail , -.... ou.v, cards FILMS QN3 3 THIN UNtl 3d015 Mx - ao -•- --- 0 i»AS vw1H 11003.i NW OW 11VM Abl. vow t -, 46 J , Insulation/Air Sealing Permit Authorization Specialist: Jake Castonguay Company: HomeWorks Energy Email: jake.castonguay@homeworksenergy.cc Address: 101 Station Landing Cell: 413-531-6585 Medford,Ma 02155 Phone: 781.305.3319 MA CSSL-106148 MA HIC-181138 Customer: Amy Putnam Address: 34 Riverside Dr Email: peacefulcalm68@gmail.com Northampton,MA,01062 Site ID: 823568 Phone: 6317415066 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 on inspection is necessary with instructions on how to complete this process to close out your permit. Email: peacefulcalm68@gmail.com Customer Signature: 10/08/2024 !i Date: 8/7/2024 Amy Putnam 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 aswc4gon or management comp nyn 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.