Loading...
32A-202 (6) BP 2022-1265 59 PHILLIPS PL COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-202-001 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-2022-I265 PERMISSION IS HEREBY GRANT I TO: Project# INSULATION Contractor: License: Est. Cost: 23000 CLEAN TECH CONSTRUCTION 106229 Const.Class: Exp.Date:01/05/2026 Use Group: Owner: T. BERCUVITZ, DEBRA Lot Size (sq.ft.) Zoning: URC Applicant: CLEAN TECH CONSTRUCTION Applicant Address Phone: Insurance: 40 MESSINA DR 508-576-1026 6hub4n60130822 BRAINTREE, MA 02184 ISSUED ON:10/06/2022 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 VIO ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: • ''1 , . d''1 • Fees Paid: $150.00 • 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildinc Commissioner <.0 Department use only City of NorthamppnoY • ig• � FOR Buildinge artment t,L , 212 Main Street OCT A�� Room 100 ':?,� INSULA T ON 0, Northampton, MA-Ol oOpoF� phone 413-587-1240 Fax 413- .' ,�, , OfsJL, y , rionq • APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT 1.1 Property Address: This section to be completed by office Map 3 a 59 Phillips Place ' " Lot �� Unit Zone Overlay District Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Debra Bercuvitz 59 Phillips Place Name(Print) Current Mailing Address: See Attached (413)695-6489 Telephone Signature 2.2 Authorized Agent: Elvis Verdezoto 40 Messina Drive Braintree, MA 02184 Name(Print) Current Mailing Address: 14 �6 508-576-1026 Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 23,000.00 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee � 61 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 +2+ 3+4 +5) 23,000.00 Check Number iit2)7 ThisTh Section For Official Use Only Building Permit Number: ✓0` �� I? De ated: Signature: a ,. l,, ZDZZ Building Commissioner/Inspector of Buildings Date cleantechconstruction1211 @ gmail.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 4-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:Elvis Verdezoto 106229 License Number 40 Messina Drive Braintree, MA 02184 01/05/2026 Address Expiration Date 1ei2.edt 508-576-1026 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Clean Tech Construction 196071 Company Name Registration Number 40 Messina Drive Braintree, MA 02184 06/27/2023 Address Expiration Date j/QA �8. • Telephone 508-576-1026 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 No • ❑ Brief Description of Proposed Work Residential weatherization/Air sealing. No structural changes. Elvis Verdezoto 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. Elvis Verdezoto Print Name 9-30-2022 Signature of Owner/Agent Date Debra Bercuvitz as Owner of the subject property hereby authorize Clean Tech Construction to act on my behalf, in all matters relative to work authorized by this building permit application. See Attached 9-30-2022 Signature of Owner Date 1.11 City of Northampton /i,• Massachusetts a k c (.: 16-'4 4) � ��C DEPARTMENT OF BUILDING INSPECTIONS 1,,,_ ° .. + Jr212 Main Street • Municipal Building�" Northampton, MA 01060 ryl'� • 0 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of cont ctors 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(" C"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, con rsion, improvement, removal, demolition, or construction of an addition to any pn3-existing owner-occupied building ntaining at least one but not more than four dwelling units....or to structures which are adjacent to such residence or uilding"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:23,000.00 Address of Work:59 Phillips Place Date of Permit Application: 9-30-2022 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: 9-30-2022 Elvis Verdezoto 196071 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 (HAM oar •�5 • Sj.P.ro.. S• Massachusetts �:• G'<< tt N; '4 • 4i DEPARTMENT OF BUILDING INSPECTIONS '7' ` 212 Main Street •Municipal Building J`.•,y :�� Northampton, MA 01060 Debris Disposal 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: 59 Phillips Place (Please print house number and street name) Is to be disposed of at: Not Applicable (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) ��cu ate 9-30-2022 Signature of Permit A plicant 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 Massachusetts �� 4G '�.c; . DEPARTMENT OF BUILDING INSPECTIONS yJ t 212 Main Street • Municipal Building 6f _. �0 Northampton, MA 01060 SPW iox MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 59 Phillips Place Contractor Name: Clean Tech Construction Address: 40 Messina Drive City, State: Braintree, MA 02184 Phone: 508-576-1026 Property Owner Name: Debra Bercuvitz Address: 59 Phillips Place City, State: Northampton, MA 01060 Elvis Verdezoto (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 (7S4 1/1 �176 Date 9-30-2022 THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 100D1Nashington Street- Suite 710 Roston, Massachusetts 02118 Home Improvement Contractor Registration '-t1 tip- • ( fr ^ ; Type: Supplement Card ..: _' Registration: 196071 CLEAN TECH CONSTRUCTION LLC Expiration: 06/27/2023 1-9C I-EUtHAL AVE "Z^SIG QUINCY,MA 02169 " s z _ ./ Construction Supervisor Specialty �'-1 M Update Address end Return Card. Restricted to: CSSL-IC-Insulation Contractor THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for Individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. II found return to: TYPE:Supolement Card Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 196071 06/27/2023 Boston,MA 0211a CLEAN TECH CONSTRUCTION LLC Failure to possess a current edition of the Massachusetts ELVIS VERDEZOTO State Building Code is cause for revocation of this license. For information about this license 190 FEDERAL AVE QUINCY,MA 02169 Call (617) 727-3200 or visit www.mass.gov/dp1 Undersecretary Not valid without signature Cornmon. ealth of Massachusetts Division of Occupational Licensure Board of Building Regulations and Standard," Constructigfri'auper(ifsiar Specialty CSSL-106229 tbpires:01/05/2026 ELVIS 0 VERREZOTO :f 16 ALSOP STREET APT 2 FALL RIVER MA 02723 Commissioner CO a DATE(MM/OD/YYYY) A C CERTIFICATE OF LIABILITY INSURANCE 09/01n2 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 NAME: Tobman,Molignano&Weiner Ins Agency (A/CC.No.Ext): 617 471-1123 FAX No); 617-773-2474 21 McGrath Highway,Suite 303 E-MAIL ADDRESS: Quincy,MA 02169 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Norfolk&Dedham Mutual INSURED INSURER B: Clean Tech Construction LLC INSURER C: 40 Messina Drive INSURER D: Braintree,MA 02184 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 THETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLBUBR POLICYEFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE n OCCUR PREMISESO(Ea occurrence) I $ 300,000 MED EXP(Any one person) ! $ 5,000 A P012011894 09/18/22 09/18/23 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE , $ 2,000,000 x POLICY PRO- ri JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS 91972894A 09/16/22 09/16/23 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) $ X UMBRELLA LIAB x OCCUR EACH OCCURRENCE $ 2,000,000 A ^ EXCESS LIAB CLAIMS-MADE U2003464A 09/18/22 09/18/23 AGGREGATE $ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE�'�( N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ( I (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 6ANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Clean Tech Construction LLC ACCORDANCE WITH THE POLICY PROVISIONS. 40 Messina Drive Braintree,MA 02184 AUTHORIZED R ENTATIVE I ©1 -2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 09/19/2022 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 NAME: Cathy Bentley AP INSURANCE GROUP AGENCY INC (n/c°."to.Extl: (508)992-3130 iAJC,No): E-MAIL ADDRESS: oathY@P 9rou a ins com P� 276 ALDEN RD INSURER(S)AFFORDING COVERAGE NAIL FAIRHAVEN MA 02719 INSURERA: TRAVELERS INDEMNITY CO OF AMERICA' 25666 INSURED INSURER B: CLEAN TECH CONSTRUCTION LLC INSURERC: INSURER D: 40 MESSINA DRIVE INSURER E: BRAINTREE MA 02184 INSURERF: COVERAGES CERTIFICATE NUMBER: 815898 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 EFF POLICY EXP LIM11fS LTR INSD WVD POUCY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ DAMAGE TO RENED CLAIMS-MADE OCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE UMIT APPLIES PER GENERAL AGGREGATE $ POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - OWNED SCHEDULED AUTOS ONLY AUTOS N/A BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA UAB _ OCCUR EACH OCCURRENCE $ - EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH RTUTE AND EMPLOYERS'LIABIUTY A OFFICER/MEMBEREXCUDED,ECUTIVE E.L.EACH ACCIDENT $ 1,000,000 NIA NIA N/A 6HUB4N60130822 09/18/2022 09/18/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE' $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 4ANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rise Engineering a division of Thielsh Engineering Inc ACCORDANCE WITH THE POLICY PROVISIONS. 195 Francis Ave AUTHORIZED REPRESENTATIVE Cranston RI 02910 Daniel M. ro y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts IA p Department of Industrial Accidents Ls ► ' Office of Investigations l_ ` Lafayette City Center - _. (� 2 Avenue de Lafayette, Boston,MA 02111-1750 •,�,• ' www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plu>+nbers Applicant Information Please Print egibly Name (Business/Organization/Individual): Clean Tech Construction Address:40 Messina Drive City/State/Zip:Braintree, MA 02184 Phone#:508-576-1026 Are you an employer?Check the appropriate box: Type of project(requi d): 1.0 I am a employer with 16 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ID New constructio 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. 0 Building additio [No workers' comp. insurance comp. insurance.: 10.0 Electrical repairs or additions required.] 5. 0 We are a corporation and its 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 12.0 Roof repairs insurance required.] t c. 152,§1(4),and we have no Insulation employees. [No workers' t 3 Other 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 entitles 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: Traveler's Indemnity Co of America Policy#or Self-ins.Lic.#:6HUB4N60130820 Expiration Date:9/18/2023 Job Site Address: 59 Phillips Place City/State/Zip:Northampton, MA 0106 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 under the pains and penalties of perjury that the information provided above is true and correct. c� ` 141.4.e4.676, 9-30-2022 Signature: Date: 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 3.111City/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone#: lope ID:0FF814E9-F68D-43CE-A15E-0F0385933CA6 Federal ID#05-040 5 629 RISE L RI Contractor Registration No 8186 MA Contractor Registration No 120979: CT Contractor Registration No 620120 RISE1341 Elmwood Ave,Cranston, RI 02910_ CONTRACT - WZ 339-502-6335: FAX 339-502-6345u Page 11 PROD`RAM E THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS CMA-HES DESCRIBED BELOW CUSTOMER PHONE. DATE. CLIENT#. WORK ORDER Debra Bercuvitz❑ (413)695-6489E 08/30/20220 343014E 61903E SERVICE STREET BILLING STREET PROPOSED BY, 59 Phillips Place ❑ 59 Phillips Place: Jeff Ledoux: SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060: Northampton, MA 01060u DESCRIPTION CITY`_ COST`_ INCENTIVE- TOTAL_ INCENTIVE: WHOLE BUILDING_ The Mass Save program offers a Whole Building 100%Insulation L Incentive per unit for eligible insulation and air sealing measures. This incentive is for a non-owner occupied single-family or,all units in _ a 2-4 building where all eligible major insulation measures in all units are being completed at the same time.: KNOB&TUBE WIRING(Northhampton)1 „—Lty, We have identified that your home might have Knob&Tube wiring : J Vt (initlats)J present.The following contract is not valid unless accompanied by L. 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. L HOME AIR SEALING: 1511 $1,414.95: $1,414.9 : 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 L attics, basements,attached garages and other unheated areas L (windows are not generally addressed)! WEATHERSTRIP AND ADD DOOR SWEEP_ 4_ $231.68_ $231.68_ Provide labor and materials to install Q-ton weatherstripping and a doorsweep to door(s)to restrict air leakage..^ ATTIC DAMMING-R-38 FIBERGLASS: 162E $392.04_ $392.04_. Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes.: ATTIC FLAT- 15"OPEN R-49 CELLULOSE: 684_ $1,532.16L $1,532.16_ Provide labor and materials to install a 15"layer of R-49 Class I Cellulose to open attic space. ATTIC FLAT-14"FLOORED R-49 DENSE CELLULOSE- 936: $3,173.04: $3,173.04: Provide labor and materials to install a 14"layer of R-49 Class I _ Cellulose to floored attic space.: ATTIC DOOR-INSULATE: 1_ $68.83_ $68.83_ Provide labor and materials to insulate the back of the attic door with 2"rigid insulation board.: WALLS-VINYL SIDED 1,710! $3,950.10. $3,950.1 Furnish and install blown in Class I Cellulose to vinyl-sided exterior walls. Homeowner has received a copy of the EPA's Renovate Right : lope ID:0FF814E9-F68D-43CE-A15E-0F0385933CA6 Federal ID#06-0406629 RISE RI Contractor Registration No 8186 CMAT Contractor Registration 20120 C Fr CT Contractor Registration No 620120 RI S` 1341 Elmwood Ave,Cranston,RI 02910 CONTRACT - WZ 339-502-6335 FAX 339-502-6345 Page 2 PROGRAM❑ THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS CMA-HES DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT* WORK ORDER Debra Bercuvitz0 (413)695-64890 08/30/20220 3430140 619031] SERVICE STREET BILLING STREET PROPOSED BY: 59 Phillips Place ❑ 59 Phillips Place❑ Jeff Ledoux❑ SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060C Northampton,MA 010600 DESCRIPTION QTY COST INCENTIVE TOTAL Lead-Safe information guide explaining the potential risk of the lead ❑ hazard exposure from the weatherization work to be performed.Your 0 signature is your acknowledgement of receipt and agreement to 0 proceed.❑ WALLS-INTERIOR DRILL AND PLUG❑ 2,0590 $4,694.520 54,694.520 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-0 up priming/painting will be the customer's responsibility. Homeowner 0 has received a copy of the EPA's Renovate Right Lead-Safe 0 information guide explaining the potential risk of the lead hazard 0 exposure from the weatherization work to be performed.Your 0 signature is your acknowedgement of receipt and agreement to 0 proceed.❑ INSULATE BULKHEAD DOORO 10 $68.830 568.830 Provide labor and materials to insulate the back of the door to the 0 basement's bulkhead with rigid board.0 CRAWLSPACE- 10MIL GROUND COVERO 5060 $516.120 $516.120 Provide labor and materials to install 10 ml polyethylene over open ❑ ground in designated crawlspace/earthen basement areas.0 CRAWLSPACE WALL-2"RIGID BOARDO 2430 $1,112.940 $1,112.940 Provide labor and materials to install 2"rigid insulation board to the 0 crawlspace perimeter wall up to the sill and against the band joist.0 VENTILATION CHUTES❑ 1440 $502.560 $502.560 Provide labor and materials to install ventilation chutes in the rafter 0 bays to maintain air flow.0 VENT BATH FAN 4INCH❑ 10 $130.6311 $130.630 Install an insulated exhaust hose to a flapper vent to exhaust existing 0 bathroom fan(s). Fan will be vented through the roof or an acceptable 0 alternative if contractor cannot vent through the roof.❑ lope ID:0FF814E9-F68D-43CE-A15E-0F0385933CA6 Federal ID#05-0405629 RISE RI Contractor Registration No 8186 MA Contractor Registration No 120979 CT Contractor Registration No 620120 RISE1341 Elmwood Ave,Cranston,RI 02910 CONTRACT - WZ 339-502-6335 FAX 339-502-6345 Page 3 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS CMA-HES DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT 0 WORK ORDER Debra Bercuvitzr i (413) 695-6489H 08/30/2022[i 343014❑ 61903 SERVICE STREET BILLING STREET PROPOSED BYT 59 Phillips Place 59 Phillips Place;.1 Jeff Ledoux! i SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060:_ Northampton, MA 01060H DESCRIPTION QTY COST INCENTIVE TOTAL PREPARE YOUR HOME us [. Homeowner is responsible for the removal of any items stored in the QD (initials) areas where the weatherization measures will be installed. The r i workers will need the space cleared to safely bring their tools and Li materials into these work areas. f_1 If you have any questions or specific concerns, please bring them to the attention of your subcontractor when they call to schedule your rl work. ❑ Total: $17,788.40 Program Incentive: $17,788.40 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/ Dollars $0.00 UPON RECEIPT OF YOUR RISE ENGINEERING INVOICE,CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. ,-DocuSigned by: DocuSigned by: V13(1, 1/Wittq& ` Vt,1rautiwf� btr t il'SCRfiC F t -,cugi 41r4/06tE 9/7/2022 1 1:33 PM EDT NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30L1 DAYS. ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE lope ID:0FF814E9-F6BD-43CE-A15E-0F0385933CA6 Federal ID#05-0405629_ RISEL RI Contractor Registration No 8186 MACT ContractorractorRegistration o 1120979, CT Contractor Registration No 620120 IRIS& 1341 Elmwood Ave,Cranston, RI 02910_i CONTRACT - WZ LJ 339-502-6335: FAX 339-502-6345: Pager 1.-1 PROG RAMC THIS CONTRACT IS ENTERED INTO BETW RISE ENGINEERING AND THE CUSTOMER FOR W RN AS CMA-HES7- DESCRIBED BELOW CUSTOMER PHONE. DATE. CUENT S WORK ORDER Debra Bercuvitz❑ (413)695-6489❑ 08/30/20220 343015 61902❑ SERVICE STREET. BLUNG STREET PROPOSED BY, 59 Phillips Place ❑ 59 Phillips Place❑ Jeff Ledoux❑ SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060u Northampton, MA 01060U DESCRIPTION: QTY: COST: INCENTIVE. TOTAL: INCENTIVE: WHOLE BUILDING: The Mass Save program offers a Whole Building 100%Insulation L Incentive per unit for eligible insulation and air sealing measures. This incentive is for a non-owner occupied single-family or,all units in a 2-4 building where all eligible major insulation measures in all C. units are being completed at the same time.L INOPERABLE HEATING SYSTEM: �,j Your heating system was inoperable at the time of our inspection. We - V1) (initials): will need to perform a complete combustion safety test on your _ system before moving forward with any weatherization work.Once it is operable, please contact RISE to schedule the combustion safety test. Your signature acknowledges this required action. KNOB&TUBE WIRING(Northhampton) We have identified that your home might have Knob&Tube wiring : � (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 L of the form. 1 HOME AIR SEALING 3: $282.99: $282.9!: Seal areas of your home against wasteful,excessive air leakage. L 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 L (windows are not generally addressed.)I DUCT SEALING: 2 " $160.00- $160.0I r Provide labor and materials to seal heating and/or cooling ducts `. within designated unheated areas. This work will be include : materials and labor.: WEATHERSTRIP AND ADD DOOR SWEEP_ 1 $57.92L $57.9': Provide labor and materials to install Q-lon weatherstripping and a !_ doorsweep to door(s)to restrict air leakage.: WALLS-VINYL SIDED: 1,755 $4,054.05: $4,054.0.L Furnish and install blown In Class I Cellulose to vinyl-sided exterior walls. Homeowner has received a copy of the EPA's Renovate Right :- Lead-Safe information guide explaining the potential risk of the lead L hazard exposure from the weatherization work to be performed.Your lope ID:0FF814E9-F68D-43CE-A15E-OF0385933CA6 Federal ID#05-0405629 RISE RI Contractor Registration No 8186 MA Contractor Registration 120979 CT CT Contractor Registration Noo 6201200120 RISE1341 Elmwood Ave,Cranston,RI 02910 CONTRACT - YYZ 339-502-6335 FAX 339-502-6345 Page 2 PR OGRAM I THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS CMA-HES DESCRIBED BELOW CUSTOMER PHONE DATE CLIENTS WORK ORDER Debra Bercuvitz-I (413) 695-6489: 08/30/2022L1 343015 61902 SERVICE STREET BILLING STREET PROPOSED BY: 59 Phillips Place 59 Phillips Placei Jeff Ledouxi i SERVICE CITY.STATE,ZIP BILLING CITY,STATE.ZIP Northampton, MA 01060 - Northampton, MA 01060. . DESCRIPTION QTY COST INCENTIVE TOTAL signature is your acknowledgement of receipt and agreement to HI proceed.Fl PREPARE YOUR HOMEH aUS Homeowner is responsible for the removal of any items stored in the (initials) J areas where the weatherization measures will be installed. The I workers will need the space cleared to safely bring their tools and I I materials into these work areas. If you have any questions or specific concerns, please bring them to i the attention of your subcontractor when they call to schedule your work. Total: $4,554.96 Program Incentive: $4,554.96 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/ Dollars $0.00 UPON RECEIPT OF YOUR RISE ENGINEERING INVOICE,CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DocuSigned by: ,-DocuSigned by: Paw& b ruaµf,y \am tt 11 0447i '-coCrthieitcs56W726.5it 9/7/2022 1 1:33 PM EDT NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30�.7i DAYS. ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE lope ID:0FF814E9-F68D-43CE-A15E-0F0385933CA6 RISES ENGINEERING" OWNER AUTHORIZATION FORM I Debra Bercuvitz (Owner's Name) owner of the property located at: 59 Phillips Place (Property Address) Northampton, MA 01060 (Property Address) hereby authorize Clean Tech Construction (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform 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. c—DocuSigned by: Rt,oa bv0A f ? O►�N'fi b9'SPswrizgure 9/7/2022 I 1:33 PM EDT Date RISE Engineering, a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 I Canton, MA 02021 1339-502-6335 www.RlSEengineering.com Pr Client: Debra Bercuvitz❑ R I S E4'1 it Address: 59 Phillips Place AN EMPLOYEE-OWNED COMPANY Northampton, MA 010601. Energy Specialist: Jeff Ledoux0 Phone: (413)695-6489 Program: CMA-HES Client# 343014 Work Order# 61903 Work Scope DESCRIPTION Qty Notes 1111 KNOB & TUBE WIRING (Northhampton) 10 2❑ HOME AIR SEALING 15EPJr seal rim only 30 WEATHERSTRIP AND ADD DOOR SWEEP 40,411 exterior doors 4❑ ATTIC DAMMING -R-38 FIBERGLASS 162C 50 ATTIC FLAT - 15' OPEN R-49 CELLULOSE 6841 60 ATTIC FLAT - 14' FLOORED R-49 DENSE CELLULOSE 936C 70 ATTIC DOOR -INSULATE 10 80 WALLS -VINYL SIDED 1,710C 90 WALLS -INTERIOR DRILL AND PLUG 2,0593 10❑ INSULATE BULKHEAD DOOR 10 11❑ CRAWLSPACE - 10MIL GROUND COVER 5061 12❑ CRAWLSPACE WALL-2" RIGID BOARD 243C 130 VENTILATION CHUTES 144C 140 VENT BATH FAN 4 INCH 10 150 PREPARE YOUR HOME 10 Diagram 19 Walls back portion of house vinyl Exterior walls vinyl sided.Atypical with 6"cagy.Extra sqft given , , construction.Extra material added. 5 CI Exterior walls post and beam. 36 5 5 5 5 12 343015 Crawl / space,poly 12 and walls- 6 11,12 6 Air Seal rim only.No 26 —� attic work-Attic okay 8 Test hole 36 E----_________ 6 Test hole 6 6 27 1\ Wails on iron proton of house WSS front door 26 with brick in between.int drill