31A-082 (3) BP-2024-0733
300 ELM ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31A-082-001 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-2024-0733 PERMISSION IS HEREBY GRANTED TO:
Project# INSULLTION 2024 Contractor: License:
Est. Cost: 12168 BRYAN HOBBS CS-083982
Const.Class: Exp.Date:05/02/2026
Use Group: Owner: ARTHUR EDELSTEN
Lot Size (sq.ft.)
Zoning: URB Applicant: BRYAN HOBBS REMODELING LLC
Applicant Address Phone: Insurancez
PO BOX 1535 (413)775-9006 ECC60040011332023A
GREENFIELD, MA 01301
ISSUED ON: 06/13/2024
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:
Fees Paid: S 100.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
RECEIVED
JUN - 6 2024
The Commonwealth of MassachusettsW -- FOR
Board of Building Regulations and Standar PT.OF BUILDING INSPE
Massachusetts State Building Code, 780_CMR NORTHAMPTON.MA ot�CIPALITY
USE
Building Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building P it Number:as
SP—.)- Cf.. 233 Date Applied:
Evtn) /i 6- ID-ZO2i
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
51‘, M SI.' _
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 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2 1 Owner'of Record:
Air y FAQ\51-c+. , HP1
Name(Print) City,State,
ENnn s\— ltrI-91. - atiGir GiVedelsltAn@ mac . c,.r,
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 Deify:WLG1 tAk.Q%
Brief Description of Proposed Work':t .� 7 -
clot Si ci. Z" 1.�y1w .'iM�►0-, kJ," t;,,1t,,t p L. C�1 1-1.44- Cx.IC►1�Y (r.)Alls t
It �e +fly tj(j.}t 11" tjxf.. 1-�►=t., 1.A4x.. €.1L VA..}-4c.kw SULKQ s . laf-e.1)',u-c,►�r.cPr
Z"P,11/404 �ka► ► (a" d,l ct ck tJe,'kr- (.1411s, GU c<11
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ a 1uyo ci c I. Building Permit Fee:$ Indicate how fee is determined:
2 Electrical $ El 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 $ 0
Suppression) Total All Fees: a�.7
Check No.°Opv Check Amount: eP Cash Amount:
6.Total Project Cost: $ ,�, 1(5 9 S" 0 Paid in Full 0 Outstanding Balance Due:
3 6 ��. 6c,
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 0g34
a
License Number Expiration Date
e of CSL Holder
153c- List CSL Type(see below) V
No.and Street Type Description
C p n \ \ - �1� � Unrestricted(BuildingsF up towel 35,Dwelling
cu.ft.)
/� JC 1"\ R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413.mr inV. anh se t6a I Insulation
Telephone Email address �C ' D Demolition
.2 Registered Home Improvement Contractor(HIC) 9(.064C LekNiar-
- eLliWILLIAN, HIC Registration Number Expiration Date
I1§ pany Name or HIC Registrant Name
153 V lQ116 h s eSnrtu,�i,c.�r►,
N and Str�c Email address
�j�Qn�iQiIL )'--VNI Z. 413- r=gcx�L
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 No .O
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.
a.. 1�,t
Prin ner's o Authorized Agent's Name(Electronic Signature) Date
NOTES:
I. 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"
•
Akrt.
mass save
Savings through energy efficiency
PERMIT AUTHORIZATION FORM
1, Arthur Edelstein owner of the property located at:
(Owner's Name)
300a Elm Street 1 Northampton
(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.
Owner's Signature
ets/
04-22-21)24
Date
FOR OFFICE USE ONLY
We have assigned the following Mass Save Home Energy Services Participating Contractor
to the above referenced project:
&Cr, \---V43J.) ettMetiLL\-- 3k4
Participating Contractor Date
Document Ref:ZKOJD-6MWFR-M73JE-5K49H Page 1 of 5
mass save
Savings through energy efficiency
PERMIT AUTHORIZATION FORM
1, Arthur Edelstein owner of the property located at:
(Owner's Name)
300a Elm Street 2 Northampton
(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.
dkir
Owner's oignature
Date04-14-2024
FOR OFFICE USE ONLY
We have assigned the following Mass Save Home Energy Services Participating Contractor
to the above referenced project:
\-\AA--VJ c_Q\Q\3(4
Participating Contractor Date
Document Ref:NXKBH-PNZVF-X4EMF-AGPNK Page 1 of 5
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington street-Suite 710
Boston,Massachusetts 02118
Home Improvement Contractor Registration
Type: LLC
BRYAN HOBBS REMODELING,LLC. Registration: 19
6045
P.O.BOX 1535 Expiration: 06/25/225/2025
GREENFIELD,MA 01302 _
Update Address and Return Card,
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE:LLC Office of Consumer Affairs and Business Regulation
Registration Faplration 1000 Washington Street -Suite 710
196045 08/25/2025 Boston,MA 02118
BRYAN HOBBS REMODELING,LLC.
BRYAN HOBBS
576 LEYDEN RD
GREENFIELD,MA 01301
Undersecretary Not valid without signature
Commonwealth of Massachusetts Construction Supervisor
Division of Occupational Licensure Unrestricted-Buildings of any use group which contain less than
Board of Building Regul tions and Standards 35,000 cubic feet(991 cubic meters)of enclosed space.
CS-083982 cp ros:0510212026t
BRYAN G Ht, BS:: • ,J! w
PO BOX 15 \, a
GREENFIEL IA•44302- : '
•
Failure to possess a current edition of the Massachusetts State
.1_ _a. Building Code is cause for revocation of this license.
Commissioner �t ii. Contact OPSI:(617)727-3200 or visit www.mass.govldpllopsi
:1-_' The Commonwealth of Massachusetts
Department of Industrial Accidents
1_: t= Office of Investigations
= _= � Lafayette City Center
�=: _ ' 2 Avenue de Lafayette, Boston,MA 02111-1750
" u www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individuap:Bryan Hobbs Remodeling, LLC
Address:576 Leyden Rd PO BOX 1535
City/State/Zip:Greenfield, Ma 01302 Phone #:413-775-9006
Are you an employer? Check the appropriate box: Type of project(required):
I.UI I am a employer with 7 4. ® I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction
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. D Demolition
working for me in any capacity. employees and have workers' 9. El Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. E] 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.] •t c. 152. §1(4),and we have no 13.® OtherWeatherization
employees. [No workers'
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.
tContractors 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:AIM Mutual ____
Policy#or Self-ins. Lic.#:ECC60040011332023A Expiration Date:10/20/2024
Job Site Address: Th cSI\M S\- City/State/Zip: �'ki1A&n - PVk-
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 ceMAunder the pains and penalties of perjury that the information provided above is true and correct
,, �++
Signature: _ 1 (1-� 1l - Date: 1 y
Phone#: L \3- m S - 1� o
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):
1EBoard of Health 211 Building Department 3ElCity/Town Clerk 4.0 Electrical Inspector 50Plunibing
Inspector 6.DOther
r1
ACORO� CERTIFICATE OF LIABILITY INSURANCE DATEIMM/DO/YYYY)
�� 07;25/2023
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 CONTACTC Adina Edged,CISH
Alera Group Inc PHONE (413)588-0111 j FAX (413)586-6481
(A/C N9 EsSF 1(A'C,No)'
Webber&Grinnell DIv s oo EMAIL aeogettaiwebberandgrinnell.com
ADDRESS.
8 North King Street INSURERISI AFFORDING COVERAGE NAK:e
Northampton MA 01060 INSURER A Selective Ins Co of S Carolina 19259
INSURED INSURER B Selective Ins Co of America 12572
Bryan Hobbs Remodeling.LLC INSURER C AIM Mutual
PO Box 1535 INSURER D: Evanston/XS Brokers
INSURER E
Greenfield MA 01302-1535 _INSURER F
COVERAGES CERTIFICATE NUMBER: Exp 08/24 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
LTRR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMSA -ADDLISUBR- &AWYYYY1 (11 ) LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
1.000.000
CLAMS-MADE X uLC�.+ DAMAGE r0 RENTED 500,000 CLAMS-MADEPREMISES Its occurrence) $
- kiEo EXP(Mr one person) $ 15.000
A S2289042 08.0412023 08r04;2024 PERSONAL 1ADV INJURY S-
1.000,000
GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2•000'000
POLICY n JE T L.,R PRODUCTS-COMP/OP AGO S 2�'�
OTHER _ S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1.000,000
lEa acorient)
ANY AUTO BODILY INJURY Per person) $
B OWNED 1%( SCHEDULED A9105300 08/04/2023 08/04/2024 BODILY INJURY(Per accrdenl) $
AUTOS ONLY �` AUTOS
X HIRED X NON-OWNED PROPERTY DAMAGE
AUTOS ONL`' _ AUTOS ONLY (Per ac-KiwMi S
Undennsured motonst BI s 20.000
f
X UMBREI I A LIAR OCCUR EACH OCCURRENCE s 2•000•000
EXCESS LEAD CLAIMS-MACE S2289042 08 04/2023 08/04/2024 AGGREGATE S 2,000•000
DED I I RETENTION S S
WORKERS COMPENSATION PE r I T ERO
AND EMPLOYERS LIABILITY )1 frATUTE I
ANY PROPRIE TORPARTNERIEXECUTNE Y/N E L EACH ACCIDENT 1 1'000.000
`' OFF ICE amtMBEP E:XCLUOED' a NIA ECC800 4 00 11 33 20 2 3A 10/20/2023 10/20/2024
(*amatory In NH) E L.DISEASE•EA EMPLOYEE $ 1.000.000(*amatory
I yes.reisonbe under
DESCRIPTION Of OPERATIONS below _ _ E.L.DISEASE-POLICY LIMIT S 1•�0'�
Per Occurance S250,000
Pollution
D CPLMOL121333 01/19/2024 01/19/2025 Aggregate S500,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule.may be attached it more apace is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
0)1988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
City of Northampton
H_AMf'
ti Massachusetts 4?5:' '..Cam...
,: ._
(tJ �-J . wi N :3
d` ( F ,44 ADEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
\ l' Northampton, MA 01060 ssj .. `�4
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: UCkiiAe--Q(Al<<vli . a3y A qn ,-‘. kIA1G!1r
The debris will be transported by:
Name of Hauler: US( n2
Signature of Applicant: 421,,, Date: l.0k-1,. 'y
Mass Save® Facilitated -u-vr, ;(( r ;i i ,Prowv g heviira :acm
CUSTOMER INFORMATION
Customer Name Arthur Edelstein Client#or Site ID: 563761
Site Address: 300 elm street City: northampton State: MA ZIP: 01060
Phone Number: (917)972-2628 Email: artedelstein@mac.com
Project ID#2: 563760
ELECTRICAL BARMEVIS
(To be filled out by the licensed contractor.)
Roadblocks identified at home energy assessment:
K&T wiring Recessed lights
Knob and Tube Wiring
To determine if there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save®
weatherization recommendations have been made:
Attic Floor Attic Wall Attic Slope Exterior Wall Basement
I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below:
Attic Floor Attic Wall 0 Attic Slope Exterior Wall Basement
Contractor Notes: passed
Recessed Lighting IC Sign-Off
The contractor will evaluate the number of recessed lights in the following areas identified by the Home Energy Specialist:
Company Name: Prestige Electrical Contractors
Contractor Name: Dominic Giancaterino License Number: 23014-A
Contractor Signature: ---. Date: Wednesday,April 17,2024
My signature confirms that 1 have performed my inspection of the electrical systems listed above and have corrected any barriers as indicated.My
signature also confirms that I have read and agree to the Terms and Conditions outlined when submitting this form.
a oche
OUR PLANET.YOUR NOME.
Mass Save® Facilitated Services: Electrical Pre-Weatherization
CUSTOMER INFORMATION
Customer Name Arthur Edelstein Client#or Site ID: 563761
Site Address: 300 elm street City: northampton State: MA ZIP: 01060
Phone Number: (917)972-2628 Email: artedelstein@mac.com
Project ID#2: 563760
ELECTRICAL BARRIERS
(To be filled out by the licensed contractor.)
Roadblocks identified at home energy assessment:
K&T wiring Recessed lights
Knob and Tube Wiring
To determine if there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save®
weatherization recommendations have been made:
Attic Floor Attic Wall Attic Slope Exterior Wall Basement
I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below:
Attic Floor Attic Wall Attic Slope Exterior Wall d Basement
Contractor Notes: passed
Recessed Lighting IC Sign-Off
The contractor will evaluate the number of recessed lights in the following areas identified by the Home Energy Specialist:
Company Name: Prestige Electrical Contractors
Contractor Name: Dominic Giancaterino License Number: 23014-A
Contractor Signature: Date: Wednesday,April 17,2024
My signature confirms that I have performed my inspection of the electrical systems listed above and have corrected any barriers as indicated.My
signature also confirms that I have read and agree to the Terms and Conditions outlined when submitting this form
a ode
OUR PLANET YOU,“OM!