Loading...
18C-080 BP-2021-2226 815 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18C-080-001 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-2021-2226 PERMISSION'S HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 10000 BRADSHAW ENTERPRISES LLC 108517 Const.Class: Exp.Date: 12/10/2022 ARNOLD HEATHER L& EDWARD W ARNOLD & Use Group: Owner: JOANNE M ARNOLD Lot Size (sq.ft.) Zoning: URB Applicant: BRADSHAW ENTERPRISES LLC Applicant Address Phone: Insurance: 246 CONNECTICUT AVE (413)250-4746 A0158300004 SPRINGFIELD, MA 01104 ISSUED ON:11/29/2021 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERI ZATI 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department 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: Icgi el if• y2 - 'I Fees Paid: $130.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Buildine Commissioner dotloop signature verification:dtlp.us/wOdg-r7Dr-ASPN r- F-'--'s-1 :-...qt/ "-7-- The Commonwealth of Massachusetts Noy tot ' Board of Building Regulations and Standards MR-- 2„ OR Massachusetts State Building Code, 780 CMIMUJCIPALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This og Official Use Only Buildin Permit Number: t € s -- l.l.:, ' 'r pate Applied: BuildingQ tial(Print Name) Signature Date SECT N 1:SITE INFORIVIATION 1.1 Prranpriv Arlrlroee• —1 1.2 Asse5so s Map&Parcel Numb Bridge 815 Bridge Road, Northampton Ma 01060 r er0 `C) l.la Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided N/A N/A N/A N/A N/A N/A 1.6 Water Supply: (M.G.L e.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood'Lone? Municipal 0 On site disposal system 0 Cheek if yes❑ SECTION 2: PROPERTY OWNERS LP1 2.1 Owner'of Record _Heather Arnold Northampton, Ma 01060 Name(Print) City,State,ZIP 815 Bridge Road No.and Street Telephone Email Address 6EerIONI,`D SCRIPT 'OFP ®' It I WORK?(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s) Cl Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify:_Insulation MassSave Brief Description of Proposed Work2:Adding blown cellulose to attic flat to achieve an aggregate R-49.Please see attached work work order. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building $ 10.000 1. Building Permit Fee:$ Indicate how fee is determined: I .0 Standard City/Town Application Fee 2.Electrical $ .:CI Total Project Cost3(Item 6)x multiplier x 3,Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ :List: 5.Mechanical (Fire $ _Suppression) -.Total All Fees;$ of 10,000 Check-No0 CheckAutount: 13 Cash Amount: 6.Total Project Cost: $ ':Cl Paid in NI-,. ,EiOutstanding Balance Due: dotloop signature verification:dtlp.us/wOdg-r7Dr-A8PN • SHUN SERVlG1S I rt _ 5.1 Construction Supervisor License(CSL) C5-108517 12/10/2022 Sean Matthew Bailey Bradhsaw License Number Expiration Date Name of CSL Holder List CSL Type(see below) _ U 246 Connecticut Ave No.and Street Type Description Springfield,MA,01104 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted l&2 Family Dwelling City/Town,State,ZIP M Masonry _ RC Roofing Covering -------- WS Window and Siding SF Solid Fuel Burning Appliances 413-250-4746 Sean@BradshawEnterpisesLLC.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(RIC) 02/07;2023 194456 Bradshaw Enterprises,LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name Sean Matthew Bailey Bradhsaw Sean@BradshawEnterpisesLLC.com - - No.and Street Email address 246 Connecticut Ave,Springfield,MA 01104 413-250-4746 City/Town,State,ZIP Telephone SECO**bC�VOR)iC R&*COMPINSAMOT145144AN CE AFI?W4tYTT("M.G.L.c.1S2 §2 (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 0 No .❑ 440 >t Albs PPlo"CQ �c t mot. R',S. E OR ON'l ill ' ' . ?PLIES FOR. IN PEI01IT I,as Owner of the subject property,hereby authorize Bradshaw Enterprises,LLC to act on my behalf,in all matters relative to work authorized by this building permit application. Please see attached customer signature authorization form provided MassSave. Print Owner's Name(Electronic Signature) Date SEC''k wf'WNER',OR,AUTHORIZED AGEN`P DECI, 4 QN 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 of my knowlerloe anti itnrlarctanrlina dotloop verified Sea-lU 'a //a,a 11/18/2110:30 AM EST Sean Bradshaw authorized Agent AGXR-KWDB-6RHZ-XCKE Print Owner's or Authorized Agent's Name(Electronic Signature) 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" dotloop signature verification:dtlp.us/wOdg-r7Dr-A8PN ,�...141 BRADENT-01 BROOKE A MR'o CERTIFICATE OF LIABILITY INSURANCE DATE)MM/DDIYYYY) 161.------ 9/1/2021 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 Brooke Barre NAME: Phillips Insurance Agency,Inc. PHONEFAX 97 Center Street (A/C,No,Ext):(413)594-5984 (NC,No):(413)592-8499 Chicopee,MA 01013 ADDREss:brooke@philiipsinsurance.com INSURERS)AFFORDING COVERAGE NAIC N 1 INSURER A:Middlesex Insurance Company INSURED INSURER B:Sentry Insurance ,24988 Bradshaw Enterprises,LLC INSURERC: _— PO Box 944 INSURER D: Chicopee,MA 01021 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 ADDL SUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD INVD POLICY NUMBER (MM/DDIYYYYI IMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LABIUTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR A0158300 8/12/2021 8/12/2022 DAMAGESO(REr urrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENII_ IGENERALAGGREGATE $ 3,000,000 L —I POLICY L X LOC I PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER' $ A AUTOMOBILE LIABILITY 'COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO A0158300003 8/12/2021 8/12/2022 BODILY INJURY(Per person) I$ OWNED l SCHEDULED AUTOSRE� ONLY AUTNOpS BODILY INJURY(Per y/� p pReOp TY DAMAGEacGdenQ $ $ �-- -1 AUTOS ONLY AUOTOS ONLY P ) '$ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LAB CLAIMS-MADE A0158300 8/12/2021 8/12/2022 AGGREGATE $ 2,000,000 DED X RETENTION$ 0 $ B AND EMPLOYWkKERS ERS'LIABILITY X __STATUTE MPENSATION y PER EERH 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE YIN A0158300004 8/12/2021 8/12/2022 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? [Y N/A -- (Mandatory in NH) E.L.DISEASE_-EA EMPLOYEE $ 1,000,000 If Yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES )ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of East Longmeadow THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. 60 Center Square East Longmeadow, MA 01028 AUTHORIZED;2244% ,/� ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD dotloop signature verification:dtlp.us/wOdg-r7Dr-A8PN The Commonwealth of Massachusetts } Department of industrial Accidents } s 1 Congress Street,Suite 100 Boston,M4 02114-2017 R' www.mass.gov/dia " � Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Name(Business/Organizational/Individual):Bradshaw Enterprises, LLC Address: 34 Front St Indian Orchard Mills Suite G60 City: Springfield State: MA Zip: 01051 Phone#: 413-250-4746 Are you an employer?Check the appropriate box: Type of project(required): • ✓ 1. I am an employer with 11 employees(full and/or part time)" 7. New construction 2. I am a sole proprietor or partnership and have no employees working for me in any I 18. Remodeling capacity.(No workers'comp.insurance required.) I 1 719. Demolition 3. I am a homeowner doing all work myself.[No workers'comp.insurance requiredit 10. Building addition I 1 4. I am a homeowner and will be hiring contractors to conduct all work on my property. 11. Electrical repairs or additions I will ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12. Plumbing repairs or additions •IJ 5. I am a general contractor and I have hired the sub-contractors listed on the attached :L13. Roof Repairs sheet. These sub-contractors have employees and have workers'comp.insurance.± t ,�' Li6. We are a corporation and its officers have exercised their right of exemption per MGL. p[ i14. Other c.152,§1(4),and we have no employees.[No workers'comp.insurance required.] I 'Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. tHomeowners 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 attach 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: Sentry Insurance (Agent - Phillips Insurance 413-594-5984) Policy#or Self ins.Lic.# A0158300004 8/12/2022: Expiration Date: Job Site Address: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL.c.152,§25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ,14 I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct,and that clicking this checkbox and typing my name in the field below will act as my signature. Name: Sean Bradshaw Date: 9/29/20 Phone#: 413-250-4746 Email: sean@bradshawenterprisesllc.com dotloop signature verification:dtip.us/wOdg-r7Dr-A8PN Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC BRADSHAW ENTERPRISES, LLC Registration: 194456 246 CONNECTICUT AVE Exxpi ration: 02/07/2023 SPRINGFIELD, MA 01104 Update Address and Return Card. Office of Consumer Affairs& Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 194456 02/07/2023 1000 Washington Street - Suite 710 BRADSHAW ENTERPRISES, LLC Boston, MA 02118 SEAN M. BRADSHAW 34 FRONT STREET SPRINGFIELD, MA 01151 Undersecretary Not valid without signature dotloop signature verification:dtlp.us/wOdg-r7Dr-A8PN • .. 47/7- / 'i7,-.)4(46/Ci(Je/1/4.e . Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement�Gontractor Registration _-._ __ � �,l Type: LLC -s -=•-r-_^.Y f Registration: 194456 ' BRADSNAW ENTERPRISES,LLC ' ...:.k.7, t= 246 CONNECTICUT AVE L' '•�" �r Expiration: 02/07/2021 SPRINGFIELD,MA 01104 ' - .:1 1 tom, �.: -TJ ,Kr it �...." Update Address and Return Card. • SCA I 8 20M•O5l17 • Tr Y1:wee',ev...N.//A it-/�..;,,.,.�r;. ,.,rl/ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR id or di TYPE:LLC before Registrat#on the expirvalationf dataindi.i Ifual founduse return to: Reaistration Expiration Office of Consumer 194456 02107/2021 1000 Washington StreetAffairs•Suiteand 710 Regulation Business BRADSHAW ENTERPRISES,LLC Boston,MA 02118 SEAM M.BRADSHAW 34 FRONT STREET �\ �~ — SPRINGFIELD.MA 01151 Undersecretary Not v.� without si• •afore 1 y E •f e �J y -' 44ry- • ac-' s • 7 E F { f F`. 1 •i • 4irK y{ y }!�tr • 18, • 4TE, . '�"`T���1%� µwrl 'r 4 t kr �JYj �••,.. •;A t�.+1°"-•'�Glr"' ?c.i.f.,I' L: '+j r a • w� • • 4 x Z :w ;;_y. a 4 ,1 } A.t W x4 + : 14 r ,.., stA �' i 4,Yt fi 1"' 1 t 1 c S� !rk }A�" �;;44.7y• x 4ir , .�+-k; :4 'iti • IS"Y f ai* v; ;�j+ n >, z NF ,., o mo t,,. x„.,. ' �c Ltr` .¢ 4..T.,( 43.1v i• i a tt K ' q,,. lL, �� tY'V7- ;ilwr^ ','A F�y a(y ro.. R to vyi ,. n i. vim t ..t'v p} 4 i� 4,lt t �" 'li rx„1•t,�l' + 1 71 rrr.�e`fF j _¢,k .`+¢. e� -.' .,eft�i`a�, --a kr tw. a,•tf .. • 6' ,C-,n fit, ' ` r.•,�„3+''�t;" r, dotloop signature verification:dtlp.us/wOdg-r7Dr-A8PN DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of MGL c. 40, s.54, is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c.111, s.150A. ANY AND ALL DEBRIS PROUCED AS A RESULT OF WORK PERMITTED UNDER THE ATTACHED APPLICATION WILL BE DISPOSED OF IN: USA Waste Recycling Name of Licensed Solid Waste Disposal Business/Facility 15 Mullen Rd, Enfield CT 06082 Address of Licensed Solid Waste Disposal Business/Facility USA Waste Recycling Name of Hauler Sean Bradshaw 9/20/2020 Print Applicant Name Date ❑ I,Sean Bradshaw do hereby certify under the pains and penalties of perjuty that the information provided above is true and correct, and that clicking this checkbox and typing my name in the field above will act as my signature. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) n Roofing n Or Doors O Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [p Siding[O] Other[O] Brief Description of Proposed Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family ✓ Two Family Other b. Number of rooms in each family unit: Number of Bathrooms arL c. Is there a garage attached? N Q d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? 1r(Ptk 1104 CUT Fireplaces or Woodstoves I Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, f 1-1-et I r►2✓ Arno) GL-- , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. A (ILA Hat_ 5110 /,- , Signature of Owner > I, `7 ►-e C Al 1'1d),(A, , 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. +-ck' hi ✓ 4+r\o (GL Naii JAW " $ muniii :' 4 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 Company Name Registration Number Address Expiration Date Telephone SECTION 10-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 0 No 0 dotloop signature verification:dtlp.us/wOdg-r7Dr-A8PN Bradshaw Enterprises, LLC PO. Box 944 Chicopee, MA 01021 Hello Building Department We are Bradshaw Enterprises, LLC located in Indian Orchard, MA. We are an Insulation / weatherization contractor for MASS SAVE. Enclosed in this packet is our Permit application and supporting documentation as follows: -Application -HIC Registration -Insurance Certificate -Signed customer Authorization form or copy of signed contract -Construction Supervisor License -Worker's Compensation Insurance Affidavit -Pre stamped return envelope We hope you find this packet intact and convenient. If you have any questions or concerns please call or email at 413-250-4746 Sean Bradshaw 413-301-8010 Office phone Email: Sean@BradshawEnterprisesLLC.com