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31A-213 BP-2024-0031 51 HARRISON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-213-001 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-2024-0031 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est.Cost: 9000 SUPERIOR INSULATION LLC 106237 Const.Class: Exp.Date: 06/15/2025 Use Group: Owner: COHEN LEWIS M&JOAN N BERZOFF TRUSTEES Lot Size (sq.ft.) Zoning: URB Applicant: SUPERIOR INSULATION LLC Applicant Address Phone: Insurance: 14B ENTERPRISE LANE (401)515-4524 67872 SMITHFIELD,RI 02917 ISSUED ON: 01/09/2024 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: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 1' i � Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner f[r- 1i + AFF t Dily t T k/QN /� )898 o . `8 CO?4 I/ 'The Commonwealth of Massachusetts o:' %1 ii Bbard of Building Regulations and Standards FOR / MUNICIPALITY ��_;�� o�,���p�c ` Massachusetts State Building Code, 780 CMR USE `` 'rt�Perniit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 r One-or Two-Family Dwelling This Section For Official Use Only Building Permit Nmber: V-.3-414' 3/ Date Applied: /(vo-)'Kpx ///7 /-9-ZOZLI Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 51 Cxr rL Wr\ � 1.1 a Is this an accepted street?yes .., no Map Nutty Parcel Number 1.3 Zoning Information: Y 1 ^ 1.4 Property Dimensions: Zoning District Proposed Use`W Lot Area(sq ft) Front g (d ft) 1.5 Building Setbacks(ft) hp.„ Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zo Public 0 Private❑ I�ici., Check if yes❑ � Municipal❑ On site disposal system• 1 SECTION 2: PROPERTY OWNERSHIP' �2. wner'of Record: t n 13erio{ ' I1 or- -haiy1pttj #- 11..An- Name(Print) City,State,ZIP SI Na-rr►sbn Ave 413 - 33(4,- 1-4 1 1 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units; Other Specify__: 1..n aA l t2* r)I 0 Brief Description of Proposed Wor 2: i r Sad a4'1 /h SU/a c7 !e 1`i V• 't V`�W(1S W 01 100 ew �r-t I `IS • , SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ q oo° 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ ^o o Check No33 D Check Amount: If(j 6.Total Project Cost: $ U 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) I b co 2-3� � ZC eLed Lc 'License Number Expiation Da J Name f SL Holder e List CSL Type(see below) l t r Pr►s-� Type Description No.and Street p SYNeRAU Unrestricted(Buildings up to 35,000 Cu.ft.) Restricted 1&2 Family Dwelling City/Town kt \e)cb\, ZIP 1,State, R M Masonry Crr1 P S1 ,D (�,1 n o rJ ia�) RC Roofing Covering ` V� WS Window and Siding c r �►� SF Solid Fuel Burning Appliances u p 1 515 LI S21-1 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) R.sgLI S 1 I Z5 Suv e ►or z►e lo�,-rt n n HIC Registration Number E cation ate HIC�_ er Name or HIC Registrant Name aS No.and Street CSL. Email address City/Town,State,ZIP Telephone SECTION 6: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? YesA. No . 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT O, I,as Owner of the subject property,hereby authorize See . }1aC,hel to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this applic . n is true and accurate to the best of my knowledge and understanding. l 2-14 Print O r utho ' e Agent's Name(Electronic Signature) I �Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths ' Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" ___ City of Northampton .SH M >. °' Massachusetts . A,._ c ,,{S DEPARTMENT OF BUILDING INSPECTIONS rr m A 212 Main Street • Municipal Building yJti Pb f�r Northampton, MA 01060 'P'J 37�,�' 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: Sr l+h ie\c IRA 1 The debris will be transported by: Name of Hauler: lop or -1-nsk,I C .\'1 on Signature of Applicant: Win ge/1(4- Date: I 3 214 • The Commonwealth of Massachusetts Department of Industrial Accidents r Office of Investigations L. - ?il600 Washington Street r Boston, MA 02111 =� / ' ` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Superior Insulation, LLC Address: 140 Point Judith Rd,A7 City/State/Zip: Narragansett, RI 02882 Phone #: 401-515-4524 Are you an employer?Check the appropriate box: Type of project(required): 1.E I am a employer with 12 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 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.❑ I 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.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.E Other Insulate comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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: Beacon Mutual Policy#or Self-ins. Lic.#: 67872 Expiration Date: 8/2/24_ Job Site Address: 51 T IQ.Y'rl son Ate City/State/Zip:Ai or- 'ham p to n i Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). k Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ► 1 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 under the pains and penalties of perjury that the information provided above is true and correct Signature: Ayt La Date: 1 / 3/ Z"'t Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: SUPEINS-01 MLONGOLUCCO ACORO" CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 7/14/214/2023 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 C NTACT N ME: Mansfield Insurance Agency Inc. (A/C,PHONEFAX A ,Eat):(401)596-2096 I(NC,No):(401)348-2060 115 High Street E-MAIL Westerly,RI 02891 ADDRESS:info@mansfieldins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Employers Mutual Casualty(EMC)Company 21415 INSURED INSURER B:Beacon Mutual Insurance Co. 30325 Superior Insulation LLC INSURER C:Evanston Insurance Company Michael O'Connor 140 Point Judith Road,Unit A7 INSURER D: Narragansett,RI 02882 INSURER E: 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/YYYYI IMMIDD1YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X x 6D23763 8/2/2023 8/2/2024 pREM SES Ea occu ence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER:General Aggregate A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) X ANY AUTO X X 6B23763 8/2/2023 8/2/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOS ONLY _ AUTOS WN BODILYO INJURY(Per accident) $ — AUTE OS ONLY AUUTOS ONLY (Perr accident)AMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE X x 6N23763 8/2/2023 8/2/2024 AGGREGATE $ DED X RETENTION$ 10,000 $ 5,000,000 B WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X 67872 8/2/2023 8/2/2024 500,000 OFFICER/MEMBER EXCLUDED? N I A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution Liability x x CPLMOL118083 7/6/2023 7/6/2024 Per Occurrence 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101 Additional Remarks Schedule,may be attached if more space Is required) Residential Insulation Contractor-14B Enterprise Lane,Smithfield,RI 02917 Pollution Liability Aggregate Limit$500,000 National Grid and all divisions are named as additional insured per written contract or agreement.Waiver of subrogation is provided in favor of National Grid and all divisions per written contract or agreement. Pollution Liability includes mold CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Rd Waltham,MA 02451 AUTHORIZED REPRESENTATIVE IlItIAVAWt Jeer Asada C ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD e Commonwealth of Messechusetts Division of Occupational Licentiate Board of Budding Regulations and Standards C onstruct,QM'Sgupcit4o9r Specialty CSSL-106237 airsts:06/15/2025 KYLE L IEDIJ 1750 DIAMO7AI HILL RD = elCUMBERLAND RI 12114 THE COMMONWEALTH OF MASSACHUSETTS ".4. �.,' Office of Consumer Affairs and Business Regulation 1"7 LY^`' 1000 Washingtok rWt-Suite 710 Commissioner emiPa R.Fif+nc.Fu.. Boston Mansachu (p118 Home Impro'. .. - c ,,.. — .istration =L _— ~ Type: Supplement Card SUPERIOR INSULATION LLC. T w �^ 175445 140 POINT JUDITH RD UNIT A7 ". • ' 05/12/2025 NARRAGANSETT,RI 028824._ i U 1 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:Su{7p5brt iont Card Office of Consumer Affairs and Business Regulation Rea atratina 1 Exotritigti 1000 Washington Street•Suite 710 17 &1 1 05/122025 Boston.MA 02t10 Construction Supervisor Specialty SUPERIOR INSULATII`'iN _ j_ - Restricted to: ,,,j3 1B r c ; 1)I )j14Ag! CSSUC-Insulation Contractor 'Sin KYLE LEDUC 140 POINT JUDITH RD ?��/•• 1,ye.Aa( . NARRAGANSETT,RI 0 • Undersecretary Not valid without signature Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For infomution about this license Call M17)7273200 or visit wwwmass.gov/dpl WEATHERIZATION CONTRACT EVERSURCE CUSTOMER PHONE DATE CLIENT# WORK ORDER Joan Berzoff (413) 336-1711 10/18/2023 518200 61604 SERVICE STREET BILLING STREET PROPOSED BY: 51 Harrison Avenue 51 Harrison Avenue Jeff Ledoux SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Northampton, MA 01060 Northampton, MA 01060 EGMA-HES Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 75% For eligible weatherization measures, Eversource is offering an incentive of 75%for insulation measures and 100%for the air sealing measures, both with no limit.You are eligible to apply for the 0% Heat Loan to finance your co-pay, applications must be submitted before the weatherization work begins. KNOB&TUBE WIRING (Northhampton) We have identified that your home might have Knob&Tube wiring G.C. (initials) present. The following contract is not valid unless accompanied by the Weatherization Barrier Incentive form, signed by your licensed electrician.Work will not proceed with this work until we receive a copy of the form. HOME AIR SEALING 7 $746.13 $746.13 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.) TRANSITIONS 25 $187.00 $187.00 Provide labor and materials to air seal the transitions of your home against wasteful, excess air leakage. WEATHERSTRIP DOOR 6 $217.92 $217.92 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 6 $177.96 $177.96 Provide labor and materials to install a doorsweep to restrict air leakage. ATTIC DAMMING 130 $361.40 $271.05 $90.35 Provide labor and materials to install an approved damming material in the attic ATTIC FLAT- 15"OPEN R-49 CELLULOSE 500 $1,435.00 $1,076.25 $358.75 Provide labor and materials to install a 15" layer of R-49 Class I Cellulose to open attic space. ATTIC FLAT- 11"FLOORED R-35 DENSE CELLULOSE 115 $435.85 $326.89 $108.96 Provide labor and materials to install a 11" layer of R-35 Class I Cellulose to floored attic space. Document Ref:SU8K9-OJBHZ-DZWQE-FGCFT Page 1 of 6 • WEATHERIZATION CONTRACT EVERSURCE • CUSTOMER PHONE DATE CLIENT# WORK ORDER Joan Berzoff (413) 336-1711 10/18/2023 518200 61604 SERVICE STREET BILLING STREET PROPOSED BY, 51 Harrison Avenue 51 Harrison Avenue Jeff Ledoux SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Northampton, MA 01060 Northampton, MA 01060 EGMA-HES Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL KNEEWALL-2"RIGID BOARD 80 $436.00 $327.00 $109.00 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to a kneewall area. KNEEWALL-3" FIBERGLASS R13 80 $178.40 $133.80 $44.60 Provide labor and materials to install 3.5"R-13 faced fiberglass batt insulation to the kneewalls. KNEEWALL FLOOR-8" DENSE R-25 CELLULOSE 110 $349.80 $262.35 $87.45 Provide labor and materials to install an 8" layer of dense packed R- 25 Class I Cellulose to a kneewall floor. KNEEWALL FLOOR-7"OPEN R-26 CELLULOSE 110 $224.40 $168.30 $56.10 Provide labor and materials to install a 7"layer of R-26 Class I Cellulose to an open kneewall floor KNEEWALL SLOPE-8" DENSE PACK CELLULOSE 584 $2,020.64 $1,515.48 $505.16 Provide labor and materials to install 8" R-26 Class I cellulose to a sloped ceiling area by drilling through the interior ceiling surface. Drilled holes would be plugged and spackled to a semi-smooth finish. Finish sanding and repainting will be the responsibility of homeowner. HATCH- INSULATE RIGID BOARD 1 $53.96 $40.47 $13.49 Provide labor and materials to insulate the back of an attic hatch with 2"rigid insulation board at R-10. DOOR- INSULATE RIGID BOARD 2 $206.10 $154.58 $51.52 Provide labor and materials to insulate the back of a door with 2" rigid insulation board. TEMPORARY ACCESS 2 $218.14 $163.61 $54.53 Provide labor and materials to make a temporary access through roof or interior sheathing to an attic area. The opening will be closed with materials similar to those existing. Finish sanding and painting is not included. COMMON WALL-DRILL AND PLUG 4" 120 $357.60 $268.20 $89.40 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 spackled 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. Document Ref:SU8K9-OJBHZ-DZWQE-FGCFT Page 2 of 6 WEATHERIZATION CONTRACT EVERSURCE CUSTOMER PHONE DATE CLIENT# WORK ORDER Joan Berzoff (413) 336-1711 10/18/2023 518200 61604 SERVICE STREET BILLING STREET PROPOSED BY: 51 Harrison Avenue 51 Harrison Avenue Jeff Ledoux SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Northampton, MA 01060 Northampton, MA 01060 EGMA-HES Page 3 DESCRIPTION QTY COST INCENTIVE TOTAL BASEMENT CEILING-2"RIGID BOARD 140 $775.60 $581.70 $193.90 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. VENTILATION CHUTES 60 $280.80 $210.60 $70.20 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow from the soffit ventilation. TURBINE ROOF VENT 1 $198.21 $148.66 $49.55 Provide labor and materials to install a roof mounted turbine vent. Total: $8,860.91 Program Incentive: $6,977.95 Client Total: $1,882.96 I.DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the above work at the Client's Address in a professional manner and in accordance with the terms of this Contract: II.PAYMENT Client agrees to pay the Contractor for the Work,the Client Share of the Contract Cost is payable to the Independent Installation Contractor(IIC upon satisfactory completion of the Work.Client understands that they will not be required to pay the Program Incentive Share of the Contract cost.Changes to the individual line items and/or previous incentives may increase or decrease the size of the Program Incentive Share. Noy Wou.r Jeak Berg RISE Representative Client Signature 10-26-2023 Printed Name Date of Acceptance Document Ref:SU8K9-OJBHZ-DZWQE-FGCFT Page 3 of 6 4#it mass save Savings through energy efficiency PERMIT AUTHORIZATION FORM I, Joan Berzoff owner of the property located at: (Owner's Name) 51 Harrison Avenue Northampton (Property Street Address) (City) hereby authorize the Mass Save® Home Energy Services Program assigned Participating Contractor to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. This form is only valid with a signed contract. The permit will be secured by the subcontractor, at no additional cost. Joa Fro f f Owner's Signature 10-26-2023 Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Sle�c'i oar- 7S�1 C� 1 Participating Contractor Dat Document Ref:SUBK9-OJBHZ-DZWQE-FGCFT Page 4 of 6 .ter -�_ ti mass save Weatherizati0 barrier incentives , Based e yalir Enr gy Suectalist`s recommendations,Your home c.an bore!t tram pronrarst f'lia,'ble in5'it!::ttor? and/or air spiting Ip, improvements.Before moving forward pleas fallow all the instructions below to retTred+�te'your wnattterl2ation barriers. CUSTOMER INSTRUCTIONS w,thors t,C3 days of_our Hom corn 1. Mire a qualified.licensed contractor to evaluate am.✓e ru rnedtatc the weatherizat"on barne=r(s7 2. Submit signed and completed copies of this form and a wear of the paid contractor irava"ze(s) neerin9• Energy Assessment to;RISE En ineerinst 1341 EUnwoo�i Ave,Cranptccn.pgt yo2gtSt or erraail to t,)yeer Uur h,e,r,1, r.t.. c. 3. The weatherization incentive will be deducted from the customer ca-payment amount,of e weatherszation work.A rebate check will be issued in the event the amount exceeds the customers co-pemment amount, 4. Complete the recommended weathenzatbon inyproverrrcnts. 5, The Mass Save'HEAT Loan otters interest-free financing opportunities that may be used to remediate eligible weatherizatton barriers, Learn mom atmasssaveeranr/enrsavinodresidenti�9-tebatpt heat ioan_pr?gram We- CUSTOMER1NPORMAIYO1I. 51820Q — ——� Client is or Site IU: _ • Customer Name: Joan Bar?± -- state: A ZIP: Q. �E1�Q City. Northam tp Qn Site are5t 1 Harrison Avenuemati.com IN Ema,,_ lewiscohen5�_ ____ te,<rrr,i Nutnn,r 413-336 1711._�. --_— _ Date: CustomsrdRQEF1eowner Signature: . RYClEtscri tii t9➢tzdta ) � ,.... Toe mine if there is any active knob and tube wiring.the contractor will t_v.a,uatr. ttre toile arng are.es where eligible Mass Save weatherization recommendations have been made: Othyr' �Atftc Floor � WallAttie all Attic Slope Exterior Wall Basement Caner. _— loe I have perfiorrrted my inspection and determined there is no active knob and tube wiring in the areas selected below V Attic Floor i Attic Wall V Attic Slope ' Exterior Wall ir,,Basement -Other__ _ Contractor Name, [ ' ZIP: �'/ � , x �/:, 'r2 C ' State fir--- C"t .� address: ^ _ G t "`,t)7e .ji-fie 7c`rfI(t -1License Number: Company game: k pate i My sna ig ctor Signature: My cated ure confirms that i have performed my and agr e1to the e*ctrical systems listed above and and Conditions outlined have on the back o th storm rs as indicated_My signature also confirms that I have read �T ic*rs ctt�ac � M t NI T #lddatt ttee ke ariae r iene'xide_t€v€41 C HighCarthan-Monoxidet 6rttra-ter is tt�'iefoie-e-ohd-re-e altlate•�kt�:-selecte6eet-sY`st^��Y�-z"�f't E as•f tecr eft'd its ttte-i dated-#iu 5 te-laek3w-{89- f-ts- iil+art f d-+a�ec-4��rraprt�3 Drd' -Fak fat G if Cfef"t5 to correet"t4lE_EE3 t"if9't "seE iaC(57-ie€e r-te-t�tkc>'©t�"i emcr,�er-3 �a33e-��tA-rar - - Yd_ ...Heating'-Sy rter z __ .m—.q._.-^- t Hot Water Heater �.m. . _,_w, { t6ter: _ _ ,_ .__.._____-___-. — rtae #+afi+c 1 y er { 3 ++ Re Spillage: entracte; e the-s#itia9e�ef-#t+ es tote seeete i-ea t R Het-Watr-Heater Other,, etrfPY f'l ContractorSS atQre W= _ . , My signature confirms that I have performed my inspection of the mechanical systems listed above and have corrected arty barriers s indicated.My signature also confirms that I have read,and agree to the Terms and Conditions outlined on the back of this form „ - *.,ram:,m ...ww:.,-'o.. ....e... _ — .. w_ ��4.0 �r� City of Northampton Massachusetts 4y' '` <<� G R '4 . : DEPARTMENT OF BUILDING INSPECTIONS ' ' \ �” 212 Main Street • Municipal Building eta \ Northampton, MA 01060 4Y11 -LAtaliThjAV C.,.. Property Address: J ` 14 ( \ Contractor / \ L- iC Name; (�• 1 Address: Al?) Enlevp r 1sr < L 4\ . City, State: &Mek , f2 -1 Phone: _ 51 5 14 5 2.-,L.-1 Property Owner (�, Name: ��_1F1 r�'te-1- (;1`''F- r Address: S t L,- r-r So v Piv ' - City, State: N C)Y" -t -1r v-m , --'�V- I, V-I,Ak e, Lzo AC:.. (contractor)attest and affirm that the building I intend to insulate I4oes 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. I` i , Contractor signaturef'7 /fr ,•ede,--G—S•16--- I Date t ! ! i