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23D-026 (2) 480 ELM ST BP-2017-0844 GIS#: COMMONWEALTH OF MASSACHUSETTS Maa:Block: 23D-026 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2017-0844 Project# JS-2017-001412 Est.Cost: $2025.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: UseGrouD: VICTORY ENERGY SOLUTIONS LLC 108212 Lot Size(sa. ft): 8015.04 Owner: CARREIRO JOSHUA L&JENNIFER L JAKOWSKI Zoning: URB(l00)/ Applicant: VICTORY ENERGY SOLUTIONS LLC AT: 480 ELM ST Applicant Address: Phone: Insurance: 1 HARTFORD SQ SUITE 206 (877)306-4483 0 WC NEW BRITAINCT06052 ISSUED ON:I/IO/20170:00:00 TO PERFORM THE FOLLOWING WORK:INSULATION : ATTIC FLAT 644SQ FT R-33 VENT BF BASEMENT CEILING R-19 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 1/10/2017 0:00:00 $55.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0844 APPLICANT/CONTACT PERSON VICTORY ENERGY SOLUTIONS LLC ADDRESS/PHONE I HARTFORD SQ SUITE 206 NEW BRITAIN (877)306-4483 0 PROPERTY LOCATION 480 ELM ST MAP 23D PARCEL 026 001 ZONE URB(1001/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT (,, Fee Paid r s"-a Buildina_Pemtit Filled out Fee Paid Typeof Construction: INSULATION :ATTIC FLAT 64450 FT R-33 VENT BF BASEMENT CEILING R-19 New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 108212 3 sets of Plans/Plot Plan THE FO NG ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON I F ATION PRESENTED: Approved _Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding _ Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management - olit elay I/ ii'//GJ lyf Sim e o Burling official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of Planning&Development for more information. 5'7/ 7 b 5� } -c, �� ,�\�, City of Northampton "'tt ' '�` '� Building Department , � : ' ,: -: } �; pti 212 Main Street a k" n . k ' Room 100 Wa ar I " 4T Northampton, MA 01060TSaisufbiti� "'t'n X". i phone 413-587-1240 Fax 413-587-1272 Plo: , ' N. APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office )4 30 1Urn rn R+ Map Lot Unit 3 0 V C Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Rec d: jnShun &rre4cn x-480 Elm Name(Print) Cugllt`r flingqr1.72: w2:, �/ 3C.) Sci Cdi `-VIykQC* Q#Qceci Telephone Slgnatu e 2.2 Authorized Agent ^ _ ' I7310 rtdJo .L5 h ch t Vc. It(Print) Current Mailing Address: 1� W1 7 SO(n- U-/U/83 ignature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building N 0 a S w (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection n 6. Total=(1 +2+3+4+5) Q' oaJ. (()O Check Number 6-7/7 4.5-3 This Section For Official Use Only Building Permit Number: Date Issued: Signature:Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department - _ , ..___ -__-._-1 Lot Size I Frontage --. --- , Setbacks Front -- -. "I Side L R: . L: R'_ Rear _ ---- Building Height Bldg. Square Footage _- - % '-- - - ___ __ Open Space Footage % (Lot area minus bldg&paved parking? __...__. #of Parking Spaces ---.. - , --� Fill: -r; (volume Sr Location) -. - _ --._ -__--. --._..._...: A. Has a Special Permit/Variance/Findin ever been issued for/on the site? NO 0 DONT KNOW YES O IF YES, date issued: - IF YES: Was the permit recorded at the(21 YES of Deeds? V NO 0 DONT KNOW YES O IF YES: enter Book Page ! and/or Document N 'I B. Does the site contain a brook, body of water or wetlands? NO d DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: i C. Do any signs exist on the property? YES O NO d IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO lJ IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,0 vation,or filling)over 1 acre or is it part of a common plan othat will disturb over 1 acre? YES NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House n Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. El Demolition ❑ New Signs [0] Decks [10 Siding /__ Siding[D]/ Other q Brief Description of Proposed, A HJ L\I11 /p) c-_ -s 8-303 f Ven4 b , ClLf+4Ql�-�-IXCp, ILA P i I Work: k 115U-1(th CSA. f Tl Ti✓r / J . Alteration of existing bedroom Yes Jr No Adding new bedroom Yes /(No Attached Narrative Renovating unfinished basement Yes e( No Plans Attached Roll -Sheet es„If New house and or addition to existing housing. complete the following: a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? L Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I. Jrach)_l n On r(P I r b ,as Owner of the subject properly �n f \JtJ hereby authorize 0 ( (JlpQ l 0(gl. ittO to act on my bepalf,in all m tters relive to work authorized by this building permit application. neol 0 L_ iia � Sign/,t e,of�Ow�nneer.� I �( �� Date I. / /x u UA.2__I td(-2 -0 ,as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. ill ic_hael 'ion-jr idcifv Pr ame marl Signature of Owner/Agon\ Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: ,f rNot Applicableli ❑ Name of License Holder: 1 Ud cI I� `x-U�(I� I0 pRI License Number 5 ► 1s ^ 'Ve. wio2© I � bs Expirati n Date ,CM g7 7 30(o-411483 Sgnatum Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Vr Efarqv SnJ( d-innA Cv�Fs I Company Name Regi tra on Number 1_ 1k11 - arch Sq . 18 • NAddress R ' v� �/{I� /�/ pO �� � (-1L-18-3Expi lip Date P(i 1 )YI1nA A ( /1o0S Telepho71 3(/0 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insure e affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of th building permit. Signed Affidavit Attached Yes No ❑ 11.-Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner, Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall he responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, tads defined by MGL c 111, S 150A. Address of the work: 420 Fi�1 q Let The debris will be transported by: V I C o its btL( ORol lt.l 1Oft,P The debris will be received by: On 'Silt ckl t r G1 � e - PM Building permit number: Name of Permit Applicant nuc v O Q( �I, ct A v Date Signature of Permit Applicant www.vkloryamryyeo Woaa.com Victory Energy Solutions Home Performance Contractor I Hartford Square,New Britain,CT 06051 CONTRACT 86045/-5590 FAX 860-7484955 Papa 1 PROGRAM CM A-HPC =STOMA Beer are ellen s wale mna Josh Carreiro (413)273-3131 12/30/2016 426863 00003 aaswe Setae asaeo swear 480 Elm Street 480 Elm Street ak tS an,orwva Si? Mune are alert YIP Northampton,MA 01060 Northampton,MA 01060 JOB DESCRIPTION AIR SEALING:Provide labor and materials to sal ares of your home against wasteful,excess air leakage. This work will be perforated in concert with the use of special tools and diagnostic tests to anus that your home will be left with a halthhl level of air exchange and indoor air quality.Materials to be used to seal your bane can include caulks,foam and other products. Primary areas for sealing include air leakage to Baia.basements,attached gauges and other unheated arta(windows arc not generally addressed) This will require(6)working hoof.A reduction in cubic feet per minute Mm)of air infiltration will occur,but the actual number of efin is not guaranteed. At the completion of the weuheriaation work,and at no additional cost to the homeowner,a final blower door and/or combustion safety analysis will be conducted by the subcontractor to ensure the safety of the indoor air quality. $510.00 AIR SEALING:Provide labor and materials to install Q-lon weatherstripping and a daoaweep to(I)door(S)to restrict air leakage. $75.00 AIR SEALING:Provide labor and materials to install Q-lon weatherstripping to(I)dam(s)to restrict air leakage. $58.00 DAMMING:Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass bean to(52)squte feet for damming puNae9 $106.60 ATTIC FLAT:Provide labor and materials to install a 9"layer of R-33 Class I Cellulose added to(644)square feet of open attic space. $920.92 ATTIC ACCESS:Provide labor and materials to insulate the back of(I)attic hatch with r rigid insulation board.Weatherstrip the perimeter. $60.00 VENTILATION:Provide labor and materials to install(I)insulated exhaust hose with roof mounted flapper wait to exhaust existing bathroom fan(s). $116.]5 STORAGE BARRIER:Homeowner is responsible for the removal of the stored items blocking the installation ofwatheriadon work in the basement. Removal must occur prior to the scheduled work fan. <<initial>> SORE BARRIER:Homeowner is responsible for the removal of any ceiling tiles blocking access to the sills.«initial> $0.00 BASEMENT CEILING:Provide labor and materials to install(77)linear fiat of R-19 unfenced fiberglass insulation to the perimeter of the basement ceiling at the house sill. $134.75 REMOVAL:Remove(55)square feet of halt style insulation from the basement arta $4125 Victory Energy Solution �.wa.t.w..w.I.as Ha..Performance CwWtxta I Haiti qw N.**nab,CT 0600 CONTRACT eeea0.Y60 FAX eta742.e60 POP 2 PR(XIRAM CMA-HPC 09nMN1 nor ... YT. OaaW.a Josh Canoim (413)27.3-3131 17030/2016 420363 (XXX73 'w ire 480 Elm Street 480 Elm Street a.R WY.Rata SWIG afl,RAM y Northampton.MA 01060 Northampton,MA 01060 JOB DESCRIPTION Total: $2028.27 Program Ineenthre $1,648.77 Ct amsTan1: .1.76..93 WE AWOL.HOMY TO ataWl twMLA-COWtntx ACCORIAP CI van'moa IOCATImS FOR THE SN6 "'Three Hundred Seventy-Six&60/100 Dollars $776.80 r,. [iit/ta2: aa. /� � port.me comma NAY WTYWla.al.r ltlf[®SS VIfMW W AI0.1M.e / I a oAt 'Aassacnusetrs - Department of Public Safety Beata at Bu.!drng Regolanons and Standards + CS 108212 MICHAEL GIONVRID 15 NICHOLS AVE • Watertown MA 02472 %G— f y . ,,n-anon 06/20/2018 la- PI 144e `Ovinntolease-aid o/PQ/gz1aaeke:iea Vl't Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 .- Boston, Massachusetts 02116 Home ImprovementContractor Registration TAM LW Roft 107827 Victory Energy Solutions tic. I. el i, it. - :.: eCr:ution: 1004/2018 1 Hartford Square Suite 206 „. -,-/ k - -: • • New Britain, CT 06052 ,.- 1„--II:r- .- • 1 ," Update Address and return card. Mart mean for clone. ECM 0 20114:61ti 0 Address 0 Renews/ 0 Employment 0 that Card — &L.%.........e.acaeleir4Aucc4curtA O • 1 % ffice al Cowan •Bughtess Repdanon HOME edeROVIAIENT CONFRACTOR 1169180010n wind for Individual use wily E ' s2.,:' V, Typo LLC sesames colnalondate. II found ISOM be Office al Consumer Affebs am.Omen'sRegulation • 10 Palk Pim-Sete MAI .= • ... 167827 11/04/2018 Boston,MA C2110 Victory TaTrituchadons Us • mithael - 1 litanosi IAPffireASIs 206 NSW MASA et cedes Unciameentaw Not valid without signature • The Commonwealth of Massachusetts e'.w mu Ft Department of Industrial Accidents _Et % 1 Congress Street,Suite 100 • • f i-a Boston,AM 02114-2017 ca www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name(Business'Orgmthadoe/lndividud):Victory Energy Solutions Address:1 Hartford Square,Suite 206 City/State/Zip:New Britain, CT 06052 Phone#:877-3064403 An you an employer?Check the appropriate box: 30 Type of project(required): I.0l ameemployer with employees(full and/or pan.tine).• 7. ❑New construction 201 son a sole proprietor or pa t'nhip and have no employees working forme in 8. O Remodeling any capacity.[No workers'comp.insurance required] 3.0 l am a homeowner doing all work myself.[No waherd comp.insurance required.]' 9 Demolition 4.0 I am a homeowner and will be hiring connectors to conduct au work on my property. 1 will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑1 am a general contractor and 1 have hired the subcontractors listed on the attached sheet. 'hese sub-contractors have employee and have workers'comp.insurance? 13.❑Roofrepairs 6.0%are a corporation and its officers have exercised their right ofexemption per MGL c. 14.['Other Insulation 152,§1(4).and we have no employees.[No workers'comp.insurance required.] 'Any applicant that checks box pl must also fill out the section below showing their workers'compensation policy mfwmation r Homeowner vela submit this affidavit indicating they are doing all work and then Etre outside canton must submit a new affidavit indicating such. eContractors that check this box must attached an additional sheet shoving the name of the subcontractart and state whether or not those entities have employees. If the subcontractors have employees,they must provide their worker'comp.policy number. I am an employer thW is providing workers'compensation Saranac for nD'employees. Below is the policy and Job site Information Insurance Company Name:Mn Trust North America,Inc.,do Ion Insurance Corp. Policy#or Self-ins.Lie..#:WWC3194167 Expiration Date:411/2017 20 (SUfl Y±&JJl 6/Coe) Site Address: 11 City/State/Zip: � I %1V.� r. • , Attach a copy of the workers'compensation policy declaration page(showing the policy number and ex.iradon date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 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. Ido hereby c�enify under ytne:P •� and pe�na/lties ofperjury that the Information provided above G orae and correct Sianature: )91tl /K• %]g/LItL1. Date: Phone it:877-30&4483 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#: AiIt Col of Masssachosetts mass save rmww�r, A MASS tqr. MASS SAVE= PRE-WEATHERIZATION BARRIER INCENTIVE 2015 CONTRACTOR EVALUATION REPORT CUSTOMER INFORMATION .^� I 1n. �� ('� y�,/� fj f \I y1 Ren es : -��l�r,�ags 4L __ __('0.0,,, .,,,...„,. .n0.'p yy �y(;_�11..•�r 1 ny Spe a St k4Sv'Y.�LLL.Ga("IL.)SUr b Cogent. Name tll 1 IIlJ ITJC��a Iia .:Ipna •\Q(t� ��jj�� ... '� CWniI!/' at.I"t .. ✓ r 0r_.t'i lir __ —state. i Lp QI. flacate Frac e d;ts t.te:.:::.... .. e City . Svrte 2::) Phone ENERGY SPECIALIST EVALUATION Competed by Enmgy SptciaasU KNOB&TUSEWIRING .5(COntractor IS to evaluate the selected locations i elo'w whore v.eathenzation recommendations have been made to determine If there is any act ve knob&tube mg: ...__ t _ :- - a tc Fitt ❑Knee Wan Floor �K Stopes MEDHANICAL SYSTEM,NIGH CARBON MONOXIDE EVALUATION ^_ ',r...•i' .;.a:,�,...,__y� .:i JContractor is to evaluate the selected meciin cal sysmm(s)below and provide service.if possible.to reduce high carbon monoxide levels as measured m the undiluted floe gas to below 100 ppm'. ❑F1ea2 nnS snr7. . . p. :.... GStYER„VENT EVALUATION QContractor is to evaluate the dryer vent and provide servR@ to properly exhaust the vent to the extedot CONTRACTOR EVALUATIONS (Completed by Contractor) KNOSESea wise . Lam, pan completion of my inSrection I have found that there is no active knob&tube wiring in the area(s)checked off belC w: _ Dr—,tt_. 2 . .'aa _ I �Fioo' I ..... K we Wall FIOcr .�— tic Slopes CONTRACTOR INFORMATION N sS5IOt, c. Comdony Nacre _J Q N? /L I I 13 G. -€15 f/ Tri c 1 e Address a$ RJVr.• ,5') r(c pr-- car F2-4,7r,p' r-c _-_,,,•,,,�State:/L1/{ ZIP. 0f o6 Cunt-actor 1,.,d1/y.._ _ I t3 gsrle.5 • s 7:1.,0 0 6_6 ��', Federal ID a' / La < e'f • k” - _ ;a: < 't S of thie:r Math&4a.Wn Barnet Ifcenove_ C nLr z: S :o,•e __� _ 0. n Gale 1�Y 1 6 MECHANICAL SYSTEM.HIGH CARSON MONOXIDE EVALUATION __ '_ t • .' , g 'V.;ay, a- 0 The selected mechanical system has been evacuated and serviced_Testing results of carbon monoxide in the undiluted flue gas areas toaows: ❑s*eauny System _CO 'r ph,: ., ,.c:a.: matt CoCbn•." porn ~ IakY,Elt'YlNTEYAWMION _ _ 1` '>:: l'.';, :t.'t S _. "Y:S 0The dryer tra>I)rjf i 2.1.o1/4„4.././rCt he cter o• CONTRACTOR INFORMATION tompar:.:.`a^'F ._ :.noes; _.._ _. ".:r _..._Sete. _ZIP' �.,� Contractor r.a'r a _._ ._ ... 4. . s:u Federal ID St —` ❑;ta:'e[i-ei-and a."yee to tn.:ut s 3 Ctr.dnuac of the Pre-W ehthtnzahon Ramer Incentive. Contra-ta Sd +;>se ____.. - _ _�._-.__. CUSTOMER INSTRUCTIONS Submit signed and comp) tedowes cr thisContractor gva laden Report and a copy of the paid Contractor Invoke to: Pula Weath r - r fl _ te t tri)' .}.-,r,tac EN Shavfiut No,Unti 2,Canton.MAO?021 Customer sy.a e. _ ._ _Y.. Date/O//7 /�M /6