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29-504 (6) BP-2024-1286 10 MATTHEW DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-504-001 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-2024-1286 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est.Cost: 6300 BRADSHAW ENTERPRISES LLC 108517 Const.Class: Exp.Date: 12/10/2024 Use Group: Owner: CANDICE ORNDOFF Lot Size(sq.ft.) Zoning: WSP Applicant: BRADSHAW ENTERPRISES LLC Applicant Address Phone: Insurance: 246 CONNECTICUT AVE 413-310-8010 A0158300004 SPRINGFIELD, MA 01104 ISSUED ON:10/03/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/W E AT H E R I Z AT I 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: /<://' Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner lbt �� � OCT T to Commonwealth of Massachusetts �' 2 2024 Boa d of Building Regulations and Standards FOR /Masacl.Iusetts State Building Code, 780 CMR MUNICIPALITY ` n�n n,ti,.. Pi USE ,1044t it A plication To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 o`'Q One-or Two-Family Dwelling This lion For Official Use Only Building Permit Number: Lr aLY' / (P Date Applied: 5rzI4 t e&- D /0* 2.2 Building Official(Print Name) Si tune late SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 10 Matthew Drive,Northampton Ma 01062 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 Ii) 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: Candice Orndoff Northampton Ma 01062 Name(Print) Cit.).State.ZIP 10 Matthew Drive 413-474-0207 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) ❑ Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specit.: Insulation Brief Description of Proposed Work2: AiktielglateattletniltdrlilitkalAlapftlfltilgieal top plates. Copy of contract attached. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ 6300 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ ❑Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fee : _ CC Check No. 1 /Vteck Amount: / ash Amount: 6.Total Project Cost: $6300 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-108517 12-10-2024 Sean Matthew Bradshaw License Number Expiration Date Name of CSL Holder 1981 Memorial Drive #167 List CSL Type(see below) Unrestricted No.and Street Type Description Chicopee, MA 01020 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 413-250-4746 Sean@BradshawEnterprisesllc.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(H IC) Bradshaw Enterprises, LLC 194456 02-07-2025 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 1981 Memorial Drive #167 Sean@BradshawEnterprisesllc.com No.and Street Email address Chicopee, MA 01020 413-250-4746 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 ..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 Please see attached authorization form (Mass Save). to act on my behalf,in all matters relative to work authorized by this building permit application. 06/06/2024 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 containe this application is true and accurate to the best of my knowledge and understanding. rin s is N e(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" BRADENT-01 BROOKE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDmvr) 8/13/2024 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 Brooke Barre NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (ac,No,Eel):(413)594-5984 (ac.No):(413)592-8499 Chicopee,MA 01013 nroREss:brooke@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:Middlesex Insurance Company 23434 INSURED INSURER B: Bradshaw Enterprises,LLC INSURER C: PO Box 944 INSURER D: Chicopee,MA 01021 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES CF 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMMIDDIYYYYI IMMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR A0158300 8/12/2024 8/12/2025 DARMGE OEoNccTuErrDence) S 500,000 MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY S 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 3,000,000 X POLICY jta LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER S A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) S X ANY AUTO A0158300003 8/12/2024 8/12/2025 BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY BODILY INJURY(Per accident) S AUTOS ONLY AIJT ONLY (PeOP YtrMAGE F S A X UMBRELLA LlAB X OCCUR EACH OCCURRENCE 5 2,000,000 EXCESS UAB CLAIMS•MADE A0158300 8/12/2024 8/12/2025 AGGREGATE s 2,000,000 DED X RETENTIONS 0 A WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y A0158300004 8/12/2024 8/12/2025 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N E.L.EACH ACCIDENT (MandatoryE S in NH)EXCLUDED/ 1,000,000 E L DISEASE-EA EMPLOYEE S If yes describe under 1,000 000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,AddIional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE j�'•. ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts ,_ Department of Industrial Accidents (l Office of Investigations - Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 : www.mass.gov/dia Workers'Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leal bIN Name(Business/Organization/Individual): Bradshaw Enterprises, LLC Address: 1981 Memorial Drive #167 City/State/Zip: Chicopee, MA 01021 Phone#: 413-250-4746 Are you an employer?Check the appropriate box: Type of project(required): I I am a employer%%ith 8 -I. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in ahy capacity. employees and have workers' 9. ❑ Building addition [No workers'comp. insurance comp.insurance.* required.] 5. 0 We are a corporation and its I0.0 Electrical repairs or additions q ] officers have exercised their 11.0Plumbingrepairs or additions 3.❑ 1 am a homeowner doing all work p myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152.§1(4),and we have no Insualtion employees. [No workers' 13.N Other comp.insurance required.] 'Any applicant that checks box#I 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 subcontractors 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: Phillips Insurance Agency, INC Policy#or Self-ins. Lic.#: A0158300004 Expiration Date:_ 8/12/2025 Job Site Address: City/State/Zip: 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 certif. er the pain Ities of per' , that the information provided above is true and correct. Signature: Date: 4/2/2024 Phone#: 413.250.4746 Ofcial 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): I❑Board of Health 20 Building Department 30City/Town Clerk 4.1D Electrical Inspector 5 1'luntbing Inspector 6.0Other Contact Person: Phone#: _ Commonwealth of Massachusetts ' l Division of Occupational Licensure Mailing Address: Board of Building Requlahons and Standards 'l t Bradshaw Enterprises, LLC Const ian S rvisor 1981 Memorial Drive #167 CS-108517 _ Opires: 12/10/2024 Chicopee, MA 01020 SEAN MATTHEW BAILEY BRADSHAW u 1981 MEMORIAL DRIVE STE 167 CHICOPEE,MA 01020 4..rii.1.‘"it A-))''' ii. . :.. ..'i Commissioner o61.& K. tRem ca, THE COMMONWEALTH OF MASSACHUSETTS 4. Office of Consumer Affair§ and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Kim' l:l !� Type: LLC a -_� :• ation 194456 BRADSHAW ENTERPRISES, LLC �" 1981 MEMORIAL DRIVE '' __- E ation: 02/07/2025 SUITE 167 �lik isia ! tts ei CHICOPEE, MA 01020-4322 =t= = - ---:1111:1, 1M 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 Expiration 1000 Washington Street -Suite 710 1.94456 ,02/07/2025 Boston,MA 02118 BRADSHAW ENTER ISES,LW . . SEAN M.BRADSHAW 1981 MEMORIAL DRIV �� s✓,, yGh.lc' SUITE PE �'+ UndersecretaryNot valid without signature CHICOPEE,MA 01020-432 5 DEBRI DISPOSAL 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: Off Site waste container (USA WASTE RECYCLING) Location of Facility: 555 Taylor Rd, Enfield, CT 06082 The debris will be transported by: Name of Hauler: USA Hauling & Recyclnig Signature of Applicant: Date: April 2024 WEATHERIZATION CONTRACT EVERS=URCE CUSTOMER PHONE DATE CLIENTS WORK ORDER Candice Orndoff (321) 525-5136 08/29/2024 575779 10303 SERVICE STREET BILLING STREET PROPOSED BY! 10 Matthew Drive 10 Matthew Drive Seth Main SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Northampton, MA 01062 Northampton, 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 6 $639.54 $639.54 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.) TRANSITIONS 36 $269.28 $269.28 Provide labor and materials to air seal the transitions of your home against wasteful,excess air leakage. WEATHERSTRIP DOOR 3 $108.96 $108.96 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. DOOR SWEEP 3 $88.98 $88.98 Provide labor and materials to install a doorsweep to restrict air leakage. ATTIC DAMMING 84 $233.52 $175.14 $58.38 Provide labor and materials to install an approved damming material in the attic ATTIC FLAT-6"OPEN R-22 CELLULOSE 540 $1,058.40 $793.80 $264.60 Provide labor and materials to install a 6"layer of R-22 Class I Cellulose to open attic space. KNEEWALL-2"RIGID BOARD 144 $784.80 $588.60 $196.20 Provide labor and materials to install rigid board at R-10 or greater with the required fire rating to a kneewall area. KNEEWALL FLOOR-9"FIBERGLASS BATT 198 $568.26 $426.20 $142.06 Provide labor and materials to install R-30 faced fiberglass batt insulation to the kneewall floor. HATCH-INSULATE RIGID BOARD 3 $161.88 $121.41 $40.47 Provide labor and materials to insulate the back of an attic hatch with 2"rigid insulation board at R-10. WEATHERIZATION CONTRACT EVERS=URCE CUSTOMER PHONE DATE CLIENTS WORK ORDER Candice Orndoff (321)525-5136 08/29/2024 575779 10303 SERVICE STREET BILLING STREET PROPOSED BY: 10 Matthew Drive 10 Matthew Drive Seth Main SERVICE CITY,STATE.ZIP BILLING CITY,STATE,ZIP Program Northampton, MA 01062 Northampton, MA 01062 EGMA-HES Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL DOOR-INSULATE RIGID BOARD 1 $103.05 $77.29 $25.76 Provide labor and materials to insulate the back of a door with 2"rigid insulation board. BASEMENT CEILING-6"FIBERGLASS 864 $2,298.24 $1,723.68 $574.56 Provide labor and materials to install R-19 faced fiberglass batt (initials) 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 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). CUSTOM DISCLOSURE Customer agrees to remove all plywood from kneewall walls prior to (initial.) insulation upgrades being completed. It is also strongly suggested, yet not mandatory,for you to remove all insulation from the kneewall slope and gable ends as well MOLD AND/OR MILDEW We have discovered what appears to be a mold/mildew-like (initial.) substance in your home. The weatherization work will not eliminate the existing mold and/or mildew.Any further introduction of other moisture,after the weatherization work is completed,will provide a climate for the mold and/or mildew to re-grow. Please refer to the EPA's Guide to Moisture for guidance. This is being brought to your attention to identify it as a pre-existing condition to the insulation and air sealing work planned for your home.We cannot guarantee the prevention or elimination of the mold and/or mildew in your home. By initialing you are agreeing to not hold RISE, or its Participating Contractors, responsible for any mold and/or mildew in your home. STORAGE-BASEMENT Homeowner is responsible for the removal of the stored items (initials) blocking the installation of weatherization work in the basement. Removal must occur prior to the scheduled work start. WEATHERIZATION CONTRACT EVERS=URCE CUSTOMER PHONE DATE CLIENT WORK ORDER Candice Orndoff (321)525-5136 08/29/2024 575779 10303 SERVICE STREET BILLING STREET PROPOSED BY: 10 Matthew Drive 10 Matthew Drive Seth Main SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Northampton, MA 01062 Northampton, MA 01062 EGMA-HES Page 3 DESCRIPTION QTY COST INCENTIVE TOTAL STORAGE-KNEEWALLS Homeowner is responsible for the removal of the stored items (initials) blocking the installation of weatherization work in the kneewall attic. Removal must occur prior to the scheduled work start. If you have any questions or specific concerns, please bring them to the attention of your subcontractor when they call to schedule your work. Total: $6,347.14 Program Incentive: $5,037.05 Client Total: $1,310.09 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 wit 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. RISERSet r� Main ciie 9nurFile Prima th Main Date oQ�t nc! Ile mass save PERMIT AUTHORIZATION FORM Candice Orndoff owner of the property located at: (Owner's Name) 10 Florence Road 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. Candice DIZtd0 f f Owner's Signature 08-26-2024 Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date Document Ref.KZFDK-M4HBA-MMKCW-6WCJ Page 5 of 5