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43-156 (5) BP-2024-1155 30 HAWTHORNE TERR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 43-156-001 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-2024-1155 PERMISSION IS HEREBY GRANTED TO: Project# 2024 HEAT PUMPS Contractor: License: Est. Cost: 16200 RYCOR LLC Const.Class: Exp.Date: Use Group: Owner: CLAY FIERST, DANIEL L. &NAOMI G. Lot Size (sq.ft.) Zoning: WSP Applicant: RYCOR LLC Applicant Address Phone: Insurance: 135 N CHESTNUT ST (203)974-6440 WC672735707 NEW PALTZ, NY 12561 ISSUED ON: 09/06/2024 TO PERFORM THE FOLLOWING WORK: INSTALL 4 HEAT PUMPS 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: iet7P Fees Paid: $127.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 4No `eA The Commonwealth of Massachusetts FOR v : I of Building Regulations and Standards '.11 : 6? ,' sac setts State Building Code,780 CMR MUNICIPALITYUSE " ,% : ildin lPe ' App ' ation To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 T(V4,ro One-or Two-Family Dwelling oi �• io,� This Section For Official Use Only Building Permit . ,ober: %/9'dY.. I) Date Applied: /4-v id 1 ,.$ ./.12 9-6 202/ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 30 4 or re nxte �{3 ►5&-oot Li a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Pro erty Dimensions: UISP N53o2 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 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system Check if yesiA SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner'of Record: an.-i¢1 ;ecsA* AcAvi►mon, R OtOlta2 Na (Print) City,State,ZIP 30 Fltanorne terrace +I13-341-5414 erd4 a@0.mall.cem No.and S eet Telephone Email'Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) tir Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: rns emii. du�reSs 1neakr outrun CprnclQt1SQjj leered al- Will Skies a 11r1euS¢, enncclwC3 isek� a 4�zf a5%441Qcs tnt:c1L. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building S 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical S 3000 El Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ (3200 List: 5.Mechanical (Fire $ Suppression) Total All Fees: Check Noa0I V Check Amount a'/ ash Amount: 6.Total Project Cost: $ I(0200 0 Paid in Full ❑Outstanding Balance Due: Docusign Envelope ID:DEIDDE79-1806-4767-8066-1285AC93CB33 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home�I LLC Contractor(HIC) 212 390 V j l�o 12to �� y + HIC Registration Number Expiration Date HIC Comp Name or MC Registrant Name %SS ► .Cina n S+ 4 rt�ksecv‘c T.corn No.and St E it address 11r2,u) a\ t1I 0.-S61 2b3 9ati- 2446 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 RYCOR LLC to act on my behalf,in all matters relative to work authorized by this building permit application. 1-Doousiyned by: 8/5/2024 Plu�t 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. ‹ r I t lA�� ct/4I24 Print er's or Authorized ent's Name(Electroni 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. I42A. 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" City of Northampton • Massachusetts �44?' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 ''' 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: Y\O / on\k6 aac c\ QStuliwu2flc The debris will be transported by: Name of Hauler: 1� Signature of Applicant: Date: 9/4/24 - THE COMMONWEALTH OF MASSACHUSETTS I . Office of Consumer Affairs and Business Regulation • 1000 Washing,reet- Suite 710 Boston;=Massachusetts—=02118 Home Improvemenf0b`-frac or=- egistration 't z ` ' ' t f 4 '..--4-s_, __--_.Rj „ Type: LLC • RYCOR, LLC 17? egistration: 212390 ' E jijration: 06/16/2026 i 135 N CHESTNUT ST ..� "J NEW PALTZ, NY 12561 2� 4:12,-1 '' ' rr'. \ _ / '`!/ \�r�l hr,. __t_ �/ � &. _.�'� 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: ,_:PM vnz�..._- Office of Consumer Affairs and Business Regulation i Registfattl'►► station 1000 Washington Street -Suite 710 i 217 6 b26 Boston,MA 02118 1 RYCOR,LLC A'I: t,J.tT-•—',:7J SHAWN PODZIEWSKI:� ` -'1P74� i �Z 130 SOUTHBRIDGE RD;; J'� - A • NORTH OXFORD,MA 01537;_;_;_;:-t,. -� Undersecretary Not valid without signature p R YC 0 R Rycor Heating&Cooling 135 N. Chestnut Street HEATING + COOLING New Paltz,NY 12561 Municipality: CITY OF NORTHAMPTON, MA 7-29-24 Date: This letter serves as written authorization for CT Permit Services LLC agent r f &I\22(X 1V 1OOl'Q to represent me in the procurement of the permit described below. ilj Project Details: Installation of Heat Pumps Homeowner. DANIEL FIERST Street Address: 30 HAWTHORNE TERRACE City,State,Zip: NORTHAMPTON,MA 01062 Licensee Signature: �f� Licensee Name: .S11Qw,-�. / Js'etc/Szc. # Commonwealth of laaasachusetts ghr}slprl or Occupational uatmtua lti i'li.,"..,M, ` I Rer nician AE'i o[rd fi sae FPA at arrt6i*g cvTmuytk 4 nt 1 I4v3" `� i issues this=dx vaU}ceNoa tba RT 179428 ' �:04/25/2025 Shiva!M.Pat6rleYasid SHAWNV �, NOR1M1Ct!37 p�Rqp I tit,3,930jr,,p1 ' 4 ° C t � 'd1 GVji '>�4 !" NIVERSAL tex caciou a,(Natal h5 Sat EZ.Subpm E. 07112 100 � Commlasioasr . +���` «--- t' �1 ""� `tt, U 0Y1 a s I r�✓O i Daniel Fierst Proposal #49 Status:Signed by Daniel Fierst on July 23,2024 11:11 AM Customer Advisor soX Daniel Fierst Steve Salisbury danfierst@gmail.com ssalisbury@rycorhvac.com 4.(iv" (413) 341-5477 (845) 514-0700 C)( Your home details 30 HAWTHORNE TER NORTHAMPTON,MA 01062 3 levels Single Family Residence/Townhouse built in 1993 4 beds•3 baths•2805 sqft National Grid•Gas Parcel 43-156-001•Florence 0 Summary Total cost$18,200.00 4 handlers 3x MSZ-FS06NA*** AHRI Ref#:209832200 lx MSZ-FS12NA*** AHRI Ref#:209832203 4 condensers 3x MUZ-FS06NA*** AHRI Ref#:209832199 lx MUZ-FS12NA*** AHRI Ref#:209832203 Proposal notes Complexity notes:SKS 7-7 Y Rebate notes:No Any additional dwellings on site:No Does customer have any existing heat pumps:Yes-2(replacing both) Any other fossil fuels left on site:Yes Any fossil fuels left in place for heating:Yes natural gas Recommendations Indoor Units Mitsubishi Electric MSZ-FS06NA•'*•Wall mounted Tatum's Bedroom AHRI Ref#:209832200 Mitsubishi Electric MSZ-FS06NAl*"•Wall mounted Clay's bedroom AHRI Ref#:209832200 Mitsubishi Electric MSZ-FS06NA***•Wall mounted Guest Bedroom AHRI Ref#:209832200 Mitsubishi Electric MSZ-FS12NA""'•Wall mounted Primary Bedroom AHRI Ref#:209832203 -._..'° 404a' l^r+�n�R+nn�eM "!xti.�e�-'!A[ "+Nr."y►A'+w�twwwc•..gyww.lwD..s :'s«o;v,a...+�'7MRri•�<^ttc-.w'A,w,..�.. Outdoor Units 3 © Mitsubishi Electric MUZ-FS12NA***•Up to 26.1 SEER and 12.5 HSPF AHRI Ref#:209832203 © Mitsubishi Electric MUZ-FS06NA*'*•Up to 33.1 SEER and 13.49 HSPF AHRI Ref#:209832199 Mitsubishi Electric MUZ-FS06NA***•Up to 33.1 SEER and 13.49 HSPF AHRI Ref#:209832199 © Mitsubishi Electric MUZ-FS06NA* *•Up to 33.1 SEER and 13.49 HSPF AHRI Ref#:209832199 Financials Equipment installation $21,200.00 4 zones 12-year parts and compressor warranty $0.00 12-year labor warranty $0.00 100 foot line set $1,000.00 RYCOR Beat The Heat $1000 off each Mitsubishi mini split installed by 8/22/24 - $4,000.00 Due at time of installation $18,200.00 Lower your upfront cost with financing: • Check your eligibility for the Mass Save HEAT Loan program • 0% interest for 18 months • To access our 0%for 18months loan,call RYCOR's financing department at 845-742-5110 ext 117 Optional upgrades Super Dry Dehumidification System $2,350.00 • High Performance Dehumidification and air filtration • 2 stage filter system • Can remove up to 105 pints of water per day from the air • Auto on and off based on relative humidity • 30 Month warranty Aspen Air Purification system $1,950.00 • Removes 99.98% of Nano-Particles down to 0.002 microns • 3 Stage Air Purification (Allergy Filter, Carbon Filter, Hep Filter) • Ultra Efficient• 10 year warranty with regular annual maintenance Attic Insulation $0.00 Make your home more energy efficient.We offer full attic air sealing and insulation options. Keep your heating and A/C from escaping your home. (New York State Rebates available) Surge Protector- (Square D) Full Home Protection $395.00 Square D HEPD080 Full Home protection device 80kA, 120/240V, 1 phase, 3 wire SPD type 1 Electric Vehicle Charging Station (Leviton) $4,000.00 Leviton EV Charging Station- Level 1 or Level 2 Charging stations for your electric vehicle. Can be controled by your cell phone. (Pricing is contingent on site visit) Generac Generator $0.00 A permanently installed Generac home backup generator protects your home automatically. It runs on natural gas or liquid propane (LP) fuel, and sits outside just like a central air conditioning unit. A home backup generator delivers power directly to your home's electrical system, backing up your entire home or just the most essential items. Wi-Fi: KUMO cloud (Wi-Fi only) $295.00 Mitsubishi KUMO cloud mobile app puts enhanced control of your home's heating and cooling right at your fingertips, no matter where you are. (price is per indoor unit) You might be eligible Energy Efficient Home Improvement Credit If you make qualified energy-efficient improvements to your home after Jan. 1, 2023, you may qualify for a tax - $2,000.00 credit. Learn more about this rebate Estimated cost after incentives $16,200.00 Terms - Client will provide a copyof electric utilitybill and sign Trade Ally 9 Payment Authorization form so utility company rebate will go directly to RYCOR on client's behalf. -There will be a nonrefundable Permit fee required on top of your total project cost.The permit fee is $400.The Permit cost includes all administrative fees associated with obtaining the permit along with the actual cost of the permit application and the final electrical inspection.The Permit fee will be due on the day we schedule your project. New York State requires permits for every project. -This proposal is valid for 30 days from the date this proposal was sent to you by email. Due to the constant rising cost of materials and their availability we would need to requote this proposal after 30 days.Thank you for your understanding. -There will be a $1,000 charge, in addition to the above quoted price,for every condenser that is located more than 50 feet away from the indoor unit. 7/23/24,2:30 PM Mail-Brian Yustein-Outlook Heating and Cooling Loads for Project '30 HAWTHORNE TERRACE, NORTHAMPTON MA 01602 ', System 'System 1' Brian Boshko <brian.boshko@yahoo.com> Tue 7/23/2024 2:30 PM To:Manualj <manualj@rycorhvac.com> il 1 attachments(5 KB) 30 HAWTHORNE TERRACE,NORTHAMPTON MA 01602 .csv; HVAC COOLING AND HEATING LOADS(POWERED BY ACCA MANUAL J8 Building Block Loads A Room FROM CARMEL SOFTWARE) Project:30 HAWTHORNE TERRACE,NORTHAMPTON Location:Worcester, MA 01602 Massachusetts - - _ , Indoor db 70.0 Latitude 42.2667N DR Medium Heating Indoor db 75.0 99%db 5.0 HID 65.0 - C Cooling Indoor RH 1 1 Cooling 50.0% 1%db 88.0 CTD 13.0 Elevation 986.0 Grains 90.1 ACF 1.0 1 I C i Construction Number 1 Net Heating Sensible Latent Net Heating Sensib Direction&Details Area Load Cooling Cooling Area Load Coolin Load Load Load 6A Window al Glass A 7A-1 (EAST) 64.0 2,870.4 3,323.2 Doors B 7A-1 (WEST) 106.0 4,754.1 5,504.0 C C 7A-1 (NORTH) 0.0 0.0 0.0 C D 7A-1 (SOUTH) 0.0 0.0 0.0 C 6B Skylights A Default Skylight(North) 0.0 0.0 0.0I C 6.c I AED Excursion 1,788.6 II- 7 Wood&Metal Doors M 11 D(DOOR) 21.0 532.3 212.9 C 8 I Above Grade Walls A 12B-Os w(EAST) 915.0 5,769.1 2,139.0 C B 12B-0s w(WEST) 894.0 I5,636.7_2,089.9 C El_ C . 12B-Os w(NORTH) 875.0 5,516.9 1,162.8 C -, D 12B-Os w(SOUTH) 875.0 5,516.9 1 2,045.5 II- El G 128-Os w(EAST) 1,000.0 6,305.0 2,337.7 C H 12B-Os w(WEST) 1,000.0 6,305.0 2,337.7 I C 12B-0s w(NORTH) 875.0 5,516.9 1,162.8 C J 126-Os w(SOUTH) 875.0 5,516.9 2,045.5 I i_ C __-J 8 Partition Walk A C 9 Below Grade Walls A 10 Ceilings E 16A-21 (CEIUNG) 1,400.0 4,004.0 4,312.0 _-_IC 1 10 I Partition Ceilings K 16A-21 (CEILING) I 1,400.0 0.0 308.0 LTC 11A Floors F 19A-11p(FLOOR) 1,400.0 4,701.2 1,083.3 C L None(FLOOR) 1,400.0 0.0 0.0 C 12 Infiltration A Envelope Average infii Airflow 101.9 7,068.0 J( AR 0.0 jlo.o Leakage for Heating https:/louttook.offlce365.com/maiUnbox/id/AAMkAGMSNGM1 MDEyLTU3NzYtNDc20005OTQzLTk2Yjk1 MDA1 NTczZQBGAAAAAADMSevl pn9OR76... 1/2 7/23/24,2:30 PM Mail-Brian Yustein-Outlook Gross exposed wall No of Infil Airflow area for WAR:7,330.0 B Fireplaces 0 for Cooling . 0.0 0.0 0.00 Infil Airflow 11 C for Latent 0.0 0.0 it Number o 13 Internal Gains A bedroomsf 4 #Occupants 5 1,150.1 1,000.0 Occ 0 .0 1 i One occupant=230.0 Appliance! sensible load B Appliance Gains 1,200.0 0.0 Load> .0 14 Sub Totals 70,013.3 33,587.0 1,000.0 0.0 11.0 15 Duct Loss or EHLF&ESGF 0.000 0.000 0.0 0.0 Gain ELG 0.0 0.0 16 Ventilation Vent 88.8 E Cfm 6,163.1 1,232.6 1,375.4 Loss or Gain ,CfmI' Winter 17 Humidification Gal/Day 0.0 Load 18 Hot Water 0.0 Piping Loss Blower Heat 19 Gain Manufacturer's performance data has blower heat 0.0 20 Total Loss or Gain(sum lines 14 through 19) 76,176.5 34,819.6 2,375.4 0.0 0.0 Contact I Company L_1 Add1 Add2 I City,State 55555 Phone:555 555 5555,Fax 555 555 5555, Email:test@test.com Sent from my iPad https://outlook.office365.com/maiUnbox/id/AAMkAGM5NGM1 MDEyLTU3NzYtNDc20005OTQzLTk2Yjk1 MDA1 NTczZQBGAAAAAADM5ev1 pn90R76... 2/2 rYaaSS Daniel Fierst Proposal #49 Status:Signed by Daniel Fierst on July 23,2024 11:11 AM Customer Advisor Daniel Fierst Steve Salisbury danfierst@gmaiLcom ssalisbury@rycorhvac.com (413) 341-5477 (845) 514-0700 Your home details 30 HAWTHORNE TER NORTHAMPTON,MA 01062 3 levels Single Family Residence/Townhouse built in 1993 4 beds•3 baths•2805 soft 4 q --7210 National Grid•Gas Parcel 43-156-001•Florence 14 0 ettlock.-Ve..- Summary Total cost$18,200.00 4 handlers 5O6 3x MSZ-FS06NA" AHRI Ref#:209832200 116, Igo lx MSZ-FS12NA'" AHRI Ref#:209832203 i y 6 Q o 4 condensers 3x MUZ-FS06NA'*" AHRI Ref#:209832199 lx MUZ-FS12NA'" AHRI Ref#:209832203 Proposal notes E 3y1Lf (ar' 19Q& Complexity notes:SKS 7-7 Y ��(( Rebate notes:No W i10(0 S7'� 2$441 Any additional dwellings on site:No N S Does customer have any existing heat pumps:Yes-2(replacing both) P1J ? Any other fossil fuels left on site:Yes 5 #4 , Any fossil fuels left in place for heating:Yes natural gas Be /l °Zri loks F c 40)(35 . '4(°2,c'2 The Commonwealth of Massachusetts -1 *_ —' l, 1 Department of Industrial Accidents =:=�1= q 1 Congress Street, Suite 100 - _�j- "l Boston, MA 02114-2017 ..r..1909. www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): RuCnt- L.L.C. Address: I'.3 A ale4m* ee,\- City/State/Zip: N\amp (R\-\-. 1}ay k`25(9I Phone #: ' -15-4()2-L4339 Are you an employer?Check the appropriate box: Type of project(required): 1.XI am a employer with 30 employees(full and/or part-time).* 7. pNew construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. D Remodeling any capacity.[No workers'comp.insurance required.] 9. 0 Demolition 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or arc sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ROOf repairs These sub-contractors have employees and have workers'comp.insurance.: 6.0 We area corporation and its officers have exercised their right of exemption per MGL c. 14.ROther HVAC 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#t 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 entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I an:an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: \ck ,et c.-of TnSurac Q.. ` r nyany Policy#or Self-ins. Lic. #: WC (.p 4277-3570/- Expiration Date: VC) (23- J 2024 Job Site Address: Q1 tn c crkicin S •Ir\ City/State/Zip: lAorANari n,MN Attach a copy of the workers' compensation policy declaration page(showing the policy number and expt'Yation 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: ,5'1«,, j0,,4,:g ,�,•,,,,,, Date: 7-31-24 Phone#: 845-742-5110 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: M'oDM'Y1� AoRU® CERTIFICATE OF LIABILITY INSURANCE DATE(M0NOON24 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 pollcy(les) 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 o this certificate does not confer rights to the certificate holder In Ileu of such endorsement(e). PRODUCER C�11CT Aon Risk Services Central, Inc. p p St. Louis MO Office ran.Est): (866) 283-7122 rm.No,; (800) 363-0105 4220 Duncan Avenue Asa: Suite 401 St Louis MO 63110 USA INSURER(8)AFFORDING COVERAGE NAIC/ INSURED INSURER A: Transportation Insurance Co. 20494 HOP Energy, LLC dba Rycor HVAC INSURERS: Crum & Forster Specialty Insurance Co. 44520 4 International Drive Rye Brook NY 10573 USA INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570107225045 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 AU.THE TERMS INbR (UAW) (MAIM) LImMa shown Oro as requested, 14i >I I I�Y LTR TYPE OF INSURANCE I POLICY NUMBER MMIDDmYYExP LIMITS � a X COMMERCIAL GENERAL UABILITY GL0100477 10/27/2023 10/27/2024 occuRRENce S1,000,000' !OCCUR SIR applies per policy terms & condi ti ors PRENSSES(EaRENTED e) $50,000 CLAI US-MADE FTll MEDEXP(Ary one person) Excluded PERSONAL BADV INJURY $1,000,000 ,,,, G-EM-AGGREGATE UNIT APPLIES PER GENERAL AGGREGATE $2,000,00(/ A R POLICY ❑FM' EX LOC PRODUCTS-COMP/OP AGO $2,000,000 ,. OTHER: A AUTOMOBILE LIABILITY BUA 6075563044 10/27/2023 10/27/2024 comaiN®81NGLE UMR (Ea occident) $3,000,000 X- ANY AUTO BODILY INJURY(Pee person) • G —SCHEDULED BODILY INJURY(Pr saddest) Z OYWED AUTOS AUTOS ONLY —_ ONLY PROPERTY AUTN NONLY ED (psi UMBRELLA LIAR OCCUR EACH OCCURRENCE 0 _ I EXCESS UAB CLAIMS-MADE AGGREGATE DUD I (RETENTION WORKERS COMPENSATION AND PER STATUTE EMPLOYERS'LIABILITY ER YIN ANY PROPRIETOR/PARTNER I E.L.EACH ACCIDENT EXECUTIVE OFFICER/MEMBER N I A (Mend.tory In NH) -- E.L.DISEASE-EA EMPLOYEE IrYm describe under DESCRIPTION OF OPERATIONS below EL.DIBEASEPOUCY UNIT DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional R.m.nu Schedule,may be saaceed N more space Is required) Jim CERTIFICATE HOLDER CANCELLATION r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 5EJ City of Northampton AUTHORIZED REPRESENTATIVE r 212 Main Street Northampton MA 01060 USA (�� y/� es . i �l;fdk mitt d��osseta ✓> ©1988-2016 ACORD CORPORATION.All rights reserved ACORD 26(2016/03) The ACORD name and logo are registered marks of ACO YORK Workers' CERTIFICATE OF SATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board la.Legal Name&Address of Insured(use street address only) lb.Business Telephone Number of Insured Rycor, LLC 135 N CHESTNUT ST Ic.NYS Unemployment Insurance Employer Registration Number of NEW PALTZ, NY 12561-1005 Insured 48-41749 Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations In New York State,i.e.,a Wrap-Up Policy) Number 20-4437185 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Valley Forge Insurance Company City of Northampton 3b.Policy Number of Entity Listed in Box"1a" 212 Main Street WC 672735707 Northampton, MA 01060 3c.Policy effective period 10/27/2023 to 10/27/2024 3d.The Proprietor,Partners or Executive Officers are • Included.(Only check box if all partners/officers included) • all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box'3"insures the business referenced above in box"1a'for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation Insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the Insurance carrier or Its licensed agent,or until the policy expiration date listed in box"3c",whichever Is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect Please Note: Upon cancellation of the workers'compensation policy indicated on this form,If the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Rene Greene (Print name of authorized representative or licensed spent of insurance carrier) Approved by. l 7/11/2024 (Sipneture) (Date) Title: Policy Support Specialist Telephone Number of authorized representative or licensed agent of insurance carrier. 407-804-7513 Please Note: Only Insurance carriers and their licensed agents are authorized to Issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov Workers' Compensation Law Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein. however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. C-105.2(9-17)REVERSE 43-155-001 2.11 29 c..ondenser toms �/ 43-154-001 —_204L_._ 2 17 II r—if- 25 L F.,, 43.017-001 ( 2.51 43-156-001 1.04 30 Pj C• CV s I.- 0 2 20 3 04, Tighe&Bond 30 HAWTHORNE TERR Ta. WILI-IAMSBSR(15 HATFIE fD 9/3/2024 2:52:52@ ;/..-• t ___--- _ Property Information ,,� z Parcel ID 43-156-001 O 91 Address 30 HAWTHORNE TERR a Total Value undefined a NOR T H A M P T O The information depicted on this map Is for planning purposes only. )-- It is not adequate for legal boundary definition,regulatory us interpretation,or parcel-level analyses. W ,— '�" r. H0111110weiet Name: lnrtA'EL f/E1?S i" Property Stoat Aedross. 3 G j,'1):.)-7ic cis;. T`i I7I 1G city.State.Zip: N Oft 71/1/1PIt` /"t i a/&G..1-- Muntopahty it r''J�i'Mtti7ilAi__... iraryw 1 Roo Yang "1'1 o R 1 `r<ao tot:I 1 -� swr ro 8.; C-a - 1 ' '.+4�'s f��:;1 S+e.raga /Qa tt 41.1 1 f'`i-tN i �.. 3;' 1 1 i — — _ '... ,_.....__ _ _, jam, _ `a_ * n• Sent from my iPhone 2