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18C-156
BP-2023-1278 32 WARBURTON WAY COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18C-156-001 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-2023-1278 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 2800 ENERGY PROTECTORS INC 101143 Const.Class: Exp.Date: 06/16/2024 Use Group: Owner: PATRICIA DEVLIN SEAN F& Lot Size (sq.ft.) Zoning: URB Applicant: ENERGY PROTECTORS INC Applicant Address one: durance: 64 PAXTON RD (774)253-0277 6S62UB0G29826021 Spencer,MA 01562 ISSUED ON: 09/18/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERIZATI 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: 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: g Cis . Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED The Commonwealth of Massachuse - SEP 3 ,'023 � OR W Board of Building Regulations and Stan�,ardsMUVi� TPA TY Massachusetts State Building Code, 780 CMREPT or gUILDING IN'.PECTIp SE NORTHq ,p ON.m' gigfte, Mai J2011 Building Permit Application To Construct,Repair,Renovate Or r J One-or Two-Family Dwelling This SSfietion For Official Use Only Building Permit Numbet0`/2I /al 7 d Date Applied: 4,,r-S 14Z, q-16 z3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers ''3ac,., yrtotx ton, Lo ty 1.1 a Is this an accepted street?yes 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 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: — Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2. Owner'of Re rd: S Q.4'\ �-Qv �, v) J O('"\-h c.w ,f"u✓1 *Al AI' G 1 c 6 c. Name(Print) *^ City,State. 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) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other dletpeci ': W t r%2 t'tw Brief Description of Proposed Work': ,r S P cQ . 0.ti k h 5% ` -- - . c+-i-c L A v ft`vt 1 SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ e V-0 0 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ T El Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (IIVAC) $ List: 5. Mechanical (Fire $ Total All Fees: $ Suppression) Check No./-1O6Check Amount: CI, Cash Amount: 6.Total Project Cost: $ a %---e) 2 0 Paid in Full 0 Outstanding Balance Due: l SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-101143 6116/24 Joshua Dada License Number Expiration Date Name of CSL Holder List CSL Type(see below)u 64 Paxton Rd No.and Street Type Description 11 Unrestricted(Buildings up to 35,000 cu.11.) Spencer,MA 01562 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 774.253-0277 jdada790notmaa.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 172960 a/19/24 Energy Protedora Inc H1C Registration Number Expiration Date H1C Company Name or H1C Registrant Name 64 Paxton Rd idada79i t otmall.com No.and Street Email address Spencer,MA 01562 774.253-0277 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? Yes ✓t/ No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,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. 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 application is true and accurate to the best of my knowledge and understanding. (It! --3 J (� 12 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(H IC)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.govidps 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" I , The Commonwealth of Massachusetts Department of Industrial Accidents .c_L-1,1W Office of Investigations Lafayette City Center 1‘ �. 2Avenue de Lafayette, Boston, MA 02111-1750 " =%` www.ntass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationitndividual):Energy Protectors Inc _ Address:64 Paxton Rd City/State/Zip:Spencer,MA 01562 Phone #:774-253-0277 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 11 4. 0 i am a general contractor and 1 employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- These on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workin for me in anycapacity. employees and have workers' g ' P h' 9. 0 Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. 0 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 12.0 Roof repairs insurance required.] ' c. 152, $1(4),and we have no weatherization employees. [No workers' 13.�] 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 ell 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. I 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:National Liability & Fire Insurance Company _ Policy#or Self-ins. Lie. #:V9WC421284 _ Expiration Date:9/1/24 Job Site Address: 3 d. w c-r V c h n \-- c`i _City!State/ZipA)Or`k--InCt_`^'‘1(O tr-POr ''t'`A Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). CI°I O c Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of zL 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: e-0- -1_ ckgDate: O (D `r t.3 Phone#: 774-253-0277 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 .3OCity/Town Clerk 4.0 Electrical Inspector 5E'lumbing Inspector 6.DOther Contact Person: Phone#: City of Northampton ppSN2Mi o.,. S f q •" Massachusetts ��+ '<<, lif 'i - t I ,� DEPARTMENT OF BUILDING INSPECTIONS y y., 212 Main Street • Municipal Building VH �D .\y Northampton, MA 01060 P3'l',Y .,,,,,� 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: C,k- Ne s 004 4 kfl 1 Location of Facility: Sp4zvl C t r' , ✓`A/- b 1 S G a— The debris will be transported by: Name of Hauler: v\ec9 (3c �e c ,s. ` .,,, Signature of Applicant: ( ) -L be-a____-- Date: e f' 6 I 2_3 ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/23/2023 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 CONTACT Coonan Insurance Agency, Inc. PHONE Nina Arroyo FAX 267 Main Street (A/C.No.Ext):508-987-7122 (A/C.No):508-987-7152 E-MAIL Oxford MA 01540 ADDRESS: nine@coonaninsurance.com INSURERS)AFFORDING COVERAGE NAIL Y License#:1782985 INSURER A:AIX Specialty Insurance Co INSURED ENERPRO-01 INSURER B:Safety Insurance Company Energy Protectors, Inc. 64 Paxton Road INSURER C:National Liability&Fire Insurance Company Spencer MA 01562 INSURER O:Philadelphia Ins Companies _— INSURER E:Century Insurance Company INSURER F: COVERAGES CERTIFICATE NUMBER:309612825 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 LIMITS LTRINSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERALLIABILnY Y L1N-1-1714840-02 8/31;2023 8/31/2024 EACH OCCURRENCE f1,000,000 DAMAGE TO RENTED CLAIMS-MADE l_X_�OCCUR .PR,)M18E8(88 pgcurrence). S 50,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE S 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGO 82,000,000 OTHER: a . S B AUTOMOBILE LIABILITY V 6236519 12/23/2022 12/23/2023 (tANB4EeDtSINGLELIMIT $1000.000 ANY AUTO BODILY INJURY(Per person) $ OWNED AUTOS ONLY X SCHEDULED BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) f E X UMBRELLA LIAB X 'OCCUR Y CCP1168257 8/31/2023 8/31/2024 EACH OCCURRENCE S 1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED X RETENTIONS won V S C WORKERS COMPENSATION V9WC421284 9/1/2023 9/1/2024 X AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETORIPARTNER/EXECUTIVE E N/A E.L.EACH ACCIDENT S 500,000 OFFICER/MEMBEREXCLUDED7 """ --'— (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under '— -- - - -- - - - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY LIMIT S 500.000 D Potubon Liability Y PPK2510236 1/6/2023 1/6/2024 Aggregate Limit 500,000 Occurence 500 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Tiffany Circle Townhouses&Phoenix Company,Inc are named as additional insureds and coverage is primary and non-contributory.The additional insured applies to ongoing and completed operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tiffany Circle Townhouses ACCORDANCE WITH THE POLICY PROVISIONS. c/o Phoenix Company Inc 650 Lincoln Street AUTHORIZED REPRESENTATIVE Worcester MA 01605 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts r Division of Occupational Licensure Board of Building Regulations and Standards Const ion'7 t S 'WO/visor •s CS-101143 s` • * !Spires:06/16/2024 JOSHUA S • A ' — 64 PAXTON `,i s.' SPENCER MA 0 % 1b f` f vu Y iooiiii$uivt�r T✓1.._,..h.. . . 7 it i THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affatrs and Business Regulation 1nnn 1N ishinntnn Strguat - Siiitc3 71f1 Boston, Massachusetts 02118 Home tmpro ver went Contractor Registration _...* :,.._; ... Type Corporal �.....,. . bon 1729ti0 ENERGY PROTECTORS INC. "°' ... I .w' li= =+= 08/19/2024 64 PAXTON RD. ,.�1, 1:. E> oort. Pfr.Mrfl ••A es.ern '% !S. Y-.�. -`dr.' , rcrY+rcn,MI" v i.nsc "'C s i-—;1 a L. .. -w 4 I ._)-- _ (lam Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS 1 Office of Consumer Affairs A Business Reoniation Registration valid for individual use only before M HOME III11PROVEMENT CONTRACTOR expiration date. if found return to: TYPE:CCOxraiOn Office of Consumer Affairs and Business Regulation i Rtgge212110/1 Q t000 Washington Sued -Stoic 710 172clea 0811 024 Boston.MA 02118 ENERGY PROTECTORS . JOSkUA DADA ±� i L j Jai 64 PAXTON RD. A ,r ckk SPFNc,FR,MA n1S[o Unde secrrtary Tfbt valid without signature CLEAResult CONTRACTOR WORK ORDER Mass Save® Home Energy Services 50 Washington SI.Suite 3000 Westborough,MA 01581 Customer Name:SEAN F DEVLIN Email:sdev49@yahoo.com Energy Protectors Inc Phone:315-657-4370 64 Paxton Rd. Premise Address:32 Warburton Way,Northampton,MA 01060 Spencer.MA,01562 Project ID:4938256 Location Measure Description Quantity Unit Unit Cost Total Cost Living Space Attic Floor- 13"Open Blow Cellulose 640 SF $2.66 $1.702.40 Living Space Propavent 40 each $4.68 $187.20 Living Space Hatch-2"Thermal Barrier Polyiso 1 each $53.96 $53.96 Living Space Damming 24 each $2.78 $66.72 Living Space Air Sealing at Estimated 62.5 CFM50 Per Hour 6 hr $106.59 $639.54 Living Space Exterior Door Weather Stripping(with AS hrs) 1 each $36.32 $36.32 Living Space Door Sweep(with AS hrs) 1 each $29.66 $29.66 Installed Measures Total $2.715.80 WorkOrder Notes Utility Incentive and Customer Share Information Utility Incentive Weatherization incentive $1.507.71 Air sealing incentive $705.52 Total Utility Incentive $2.213.23 Customer Share Total Customer Share $502.57 Less Deposit Of $0.00 Customer Share Balance $502.57 Page 1 of 1 Permit Authorization mass save Form Site ID: 4932280 Customer: SEAN F DEVLIN Sean F. Devlin , owner of the property located at: (Owner's Name,printed) 32 Warburton Way Northampton, MA 01060 (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Sean Derr'r Owner's Signature: Date: 08 / 29 /2023 FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: 0articipating Contractor Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 For Office Use Only Document Ref:JSXQJ-73N9A-QDAVW-MGHOY Page 6 of 8