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23A-232 (4)
BP-2024-0057 139 NONOTUCK ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-232-001 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-2024-0057 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est.Cost: 5082 HB SANTOS CORP 118463 Const.Class: Exp.Date:08/29/2026 Use Group: Owner: MADELEINE HUBBELL Lot Size(sq.ft.) Zoning: URB Applicant: HB SANTOS CORP Applicant Address Phone: Insurance: 30 PROSPECT ST#2 WCMA000373901 WEYMOUTH,MA 02188 ISSUED ON: 01/19/2024 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: r�u ,2 . TijoiT Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner J' `1 A f �. ` c�c - `y The Commonwealth of Massachusetts 44/ , 0 Board of Building Regulations and Sridard(s, 'FOR,' Massachusetts State Building Code, 780 CMR� 0 MUNICIPALITY Building Permit Application To Construct,Repair,Renovate Or) Rfvise d Mar 2011 / One-or Two-Family Dwelling .,'i„Fcrio �'{ This Section For Official Use Only r Buildin Permit Number: '5e' ; I- -7 Date Applied: eft 0 ) %— /- Z3 zozy Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors M*p&Parcel Numbers 139 Nonotuck Street .2 3/z )-• b)J 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: bier3 ,y� K— 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 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Madeleine Hubbell Florence,MA 01062 Name(Print) City,State,ZIP 139 Nonotuck Street (617)417-1055 cjeverhart6@gmail.com 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 ❑ Specify: -- Brief Description of Proposed Work': SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 5082.30 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees 41 (16$ Check No. IA 4 Check Amount: Cash Amount: 6. Total Project Cost: $ 5082.30 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES Construction Supervisor License(CSL) CS-118463 08/29/2026 License Number Expiration Date Name of CSL Holder List CSL Type(see below) it 100 MPriiterranean Drive I/22 No.and Street Type Description Weymouth, MA 02188 U Unrestricted(Buildings up to 35,000 cu.It.) City/Town,Weymouth, State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances (508)840-8338 ------- I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 203195 . � 09/21/2025 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address Weymouth,MA 021 RR (508)840-8338 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 0 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 Luis C Dos Santos to act on my behalf,in all matters relative to work authorized by this building permit application. 01/12/2024 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By enterir)g,my name below hereb attest under the pains and penalties of perjury that all of the information contained in this application i true d accurate to the best of my knowledge and understanding. 01/12/2024 Print Own11\1\jj) 's or Authorized Agent's Name(Electronic Signature) Date NOTES: 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 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 "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton y °' u Massachusetts ?S ',! ` DEPARTMENT OF BUILDING INSPECTIONS y z ��y{ .fy� 212 Main Street • Municipal Building yvr C�� 1� Northampton, MA 01060 �3'Nh, 3'�° • 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: Trojan Recycling Inc. 71 Forest Street Brockton, MA 02302 The debris will be transported by: Name of Hauler: HB Santos Corp Signature of Applicant: X� 1 �t/h Date: 01/12/2024 The Commonwealth of Massachusetts Department of Industrial Accidents , ►=1 Ofce of Investigations Zigni t =,4). Lafayette City Center 17:ei •- /�.``�P 2Avenue de Lafayette, Boston,MA 02111-1750 • www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): HB Santos Corp. Address: 30 Prospect Street#2 City/State/Zip: .w.. Phone#: Are you an employer?Check the appropriate box: I am a general contractor and 151,84 •� P"f Pr`�j�c`f(required): 4. 1.0 I am a employer with 3 ❑ employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. El Remodeling 2.❑ I am a sole proprietor or partner- 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. 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 employees. [No workers' 13.0 Other Incitlatinn comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f 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: --•-----�� Policy#or Self-ins. Lic. #: Expiration Date: oi/06/2025 Job Site Address: 139 Nonotuck Street City/State/Zip: Florence; MA 01062 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/he pains and pen of perjury that the information provided above is true and correct. Signature: Date: 01/12/2024 Phone#: (508)840-8338 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): l❑Board of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 5E1Plumbing Inspector 6.0Other Contact Person: Phone#: WEATHERIZATION CONTRACT EVERSeURCE CUSTOMER PHONE DATE CLIENT# WORK ORDER Madeleine Hubbell (617) 417-1055 12/28/2023 556582 11802 SERVICE STREET BILLING STREET PROPOSED BY' 139 Nonotuck Street 139 Nonotuck St Cole Payne SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Florence, MA 01062 Florence, MA 01062 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. HOME AIR SEALING 10 $1,065.90 $1,065.90 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.) ATTIC DAMMING 30 $83.40 $62.55 $20.85 Provide labor and materials to install an approved damming material in the attic ATTIC FLAT-8"OPEN R-30 CELLULOSE 1,080 $2,322.00 $1,741.50 $580.50 Provide labor and materials to install an 8"layer of R-30 Class I Cellulose to open attic space. 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. BASEMENT SILLS-6" FIBERGLASS 11 $33.55 $25.16 $8.39 Provide labor and materials to install R-19 unfaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. BASEMENT CEILING-6"FIBERGLASS 523 $1,391.18 $1,043.39 $347.79 Provide labor and materials to install R-19 faced fiberglass batt M. (nitials) insulation to the basement ceiling. This will be installed with the paper backing up against the floor above. The un-papered fiberglass side will be facing the basement, and these exposed fiberglass fibers will be the visible side when standing in the basement. Your initials are your agreement and understanding of this measure VENTILATION CHUTES- HALF 72 $100.08 $75.06 $25.02 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. WEATHERIZATION CONTRACT EVERSeURCE CUSTOMER PHONE DATE CLIENT N WORK ORDER Madeleine Hubbell (617)417-1055 12/28/2023 556582 11802 SERVICE STREET BILLING STREET PROPOSED BY: 139 Nonotuck Street 139 Nonotuck St Cole Payne SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Florence, MA 01062 Florence, MA 01062 EGMA-HES Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATED BATH EXHAUST HOSE 4 INCH 1 $32.23 $24.17 $8.06 Provide labor and materials to install an insulated 4"exhaust hose to existing bathroom fan(s). Total: $5,082.30 Program Incentive: $4,078.20 Client Total: $1,004.10 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, Co?1 Paqe.e Nadelethe'Wire/ RISE Representative Client Signature Cole Payne 12-30-2023 Printed Name Date of Acceptance 4011/4i mass save Savings through energy efficiency PERMIT AUTHORIZATION FORM I, Madeleine Hubbell owner of the property located at: (Owner's Name) 139 Nonotuck Street Florence (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. Hadeleit4e-Ittigrell Owner's Signature 12-30-2023 Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: HB Santos Corp. (Mil/2R24 Participating Contractor Date Client: Madeleine Hubbell RisE Address: 139 Nonotuck Street Florence. MA 01062 Energy Specialist: Cole Payne Phone: (617)417-1055 Program: EGMA-HES Client# 556582 Work Order# 11802 Work Scope DESCRIPTION Qty Notes 1 HOME AIR SEALING 10 ATTIC FLAT & BASEMENT SILL 2 ATTIC DAMMING 30 3 ATTIC FLAT-r OPEN R-30 CELLULOSE 080 4 HATCH-INSULATE RIGID BOARD 1 5 BASEMENT SILLS•6'FIBERGLASS 11 6 BASEMENT CEILING-6'FIBERGLASS 523 7 VENTILATION CHUTES-HALF 72 8 INSULATED BATH EXHAUST HOSE 4 INCH 1 Diagram ATTIC BASEMENT 2E 28 2 24 24 8 48 - 7- 48 — C i 4, 2 E I` ACG'RD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `.../" 01/08/2024 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 Gary Hebsch TOBMAN PARTNERS INSURANCE AGENCY INC PHONE 617 471-1123 FAX (A/C.No,Ext): ( ) (A/C,No): E-MAIL ADDRESS: ghebsch@tmwins.com 21 MCGRATH HIGHWAY SUITE 303 INSURER(S)AFFORDING COVERAGE NAIC# QUINCY MA 02169 INSURERA: PENNSYLVANIA MANUFACTURERS ASSOC INS I 12262 INSURED INSURER B: HB SANTOS CORPORATION INSURER C INSURER D: 30 PROSPECT STREET APT 2 INSURER E: WEYMOUTH MA 02188 INSURER F: COVERAGES CERTIFICATE NUMBER: 965907 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 LTR INSD WVD_ POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT 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 N/A BODILY INJURY(Peraccident $ AUTOS ONLY AUTOS ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I PER STATUTE I I ERH AND EMPLOYERS'LIABILITY Y/N A OF ICER/MEMBEREXCLUDED?ECUTIVE N/A N/A N/A WCMA000373901 01/06/2024 01/06/2025 E.L.EACH ACCIDENT $ 500,000 (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 $ N/A DESCRIPTION OF OPERATIONS/LOCATIONS I 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 CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN thielsch Engineering Inc ACCORDANCE WITH THE POLICY PROVISIONS. 195 Frances Ave AUTHORIZED REPRESENTATIVE Cranston MA 02910 Daniel M.Crowy,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