Bedford, NY · Westchester County
HERS Energy Conservation Affidavit – Residential
This affidavit is completed by a certified HERS Rater for new or substantially renovated residential dwellings covered by a Bedford building permit.
What this form is
The affidavit identifies the HERS Rater and property and states that the rater will provide home energy rating services under the standards named on the form. Bedford requests it for new and substantially renovated residential dwellings; the form also lists documents required for a building permit and for a Certificate of Occupancy. It asks for rater, property, owner, design professional, and projected energy rating information.
Who needs it
A certified HERS Rater completing energy rating services for a new or substantially renovated residential dwelling covered by a Bedford building permit needs this affidavit.
How to submit it
The form identifies the Bedford Building Department at 425 Cherry Street, Bedford Hills, NY 10507, and lists [email protected]. It does not specify a submission method.
About notarization
This affidavit is signed without a notary; it has a HERS Rater signature line and RTID field, and no sworn or notarized attachment is stated.
How to submit this form
- 1
Download The Affidavit
Download the residential HERS Energy Conservation Affidavit.
- 2
Complete The Affidavit
Enter the building permit, rater, property, owner, design professional, and projected energy rating information requested.
- 3
Gather Required Documents
Review the form's lists of documents required for the building permit and Certificate of Occupancy.
- 4
Submit To The Building Department
Use the Bedford Building Department contact information printed on the form to ask how to submit it.
Frequently asked questions
- Do I need a notary for the HERS Energy Conservation Affidavit?
- No. The affidavit has a HERS Rater signature line and RTID field; it does not state that a notary or sworn attachment is required.
- Who completes the residential HERS affidavit?
- A certified HERS Rater in good standing completes it for a new or substantially renovated residential dwelling covered by a Bedford building permit.
- How do I submit the HERS Energy Conservation Affidavit?
- The form lists the Bedford Building Department address and email but does not specify a submission method. Contact the department using the details printed on the form.
- What information and documents does the affidavit request?
- It requests rater, property, owner, design professional, and projected rating information. It also lists documents required for a building permit and a Certificate of Occupancy.
Need something notarized?
This HERS Energy Conservation Affidavit – Residential doesn’t need a notary — but if you have another Bedford form that does, a commissioned online notary can help.