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10B-078 50 WATER ST BP-2019-0472 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: l OB-078 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) CategoEy: INSULATION BUILDING PERMIT Permit# BP-2019-0472 Proiect# JS-2019-000755 Est.Cost: $1016.00 Fee: $55.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NORTHEAST HOME & ENERGY - JOHN PRUNIER 110804 Lot Size(sa.ft.): 11151.36 Owner: KILDUFF ELIZABETH J&KATHLEEN ANDERSON Zoning:URB(116)/WP(85) Applicant: NORTHEAST HOME & ENERGY - JOHN PRUNIER AT. 50 WATER ST Applicant Address: Phone: Insurance: 21 NORTH MAIN'ST (508) 839-7001 WC NORTH GRAFTONMA01536 ISSUED ON:10/18/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-AIR SEALING AND 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Deaartment 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 10/18/2018 0:00:00 $55.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner �c AIS v &,67-104/ City of Northampton .� Building Department t, 212 Main Street y" x•" Room 100 . "Y Northampton, MA 01060 ` { <!% phone 413-587-12 .. u APPLICATION TO CONSTRUCT,A TER REPAIR, RENOVATE OR DEM LISH A ONE OR TWO FAMILY DWELLING OCT1 5 2018 6 ,P_ I q- y 7� SECTION 1 -SITE INFORMATION DEPT.OF BUILDING INSPECTIONS hiS�S tion to be complete by office 1.1 Property Address: NORTHAMPTON,MA 01060 1(Jj]�/I/� 5D Wa� L �`� —'r"ma Lot 0 Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED W7 2.1 Owner of Record: Name(Print) Currgg�t r� cling d ss: `u� SIP-Ali 12_ Telephone Signature 2.2 Authorized am ent: �36hv) Num 2i N . mo,,`Ln .fit. N . d W Name(Print) Current Mailing Address: 5M 3M I'M SigniKure Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building O I 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 6. Total=0 +2+3+4+5) ck Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: ed lC7/a�� Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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 Lot Size ___ __....,...v ______._ __ L-------- Frontage _.. .Fronta a ...... ..._..... Setbacks Front ---_.._ € I Side Ll R:t _,_ z 1 1 Rear .. .. Building Height � ".___I x Bldg. Square Footage f Open Space Footage % (Lot area minus bldg&paved parking) #ofParking Spaces --' Fill: volume&Location 1___. ---... ._ ____.._ _._ ' _...._.. .. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW Q YES O _.. IF YES, date issued:1 i IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES O IF YES: enter Book Pagel and/or Document#l B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW © YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 , Date Issued , C. Do any signs exist on the property? YES © NO 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 O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor, '(� 1 , y�' Not Applicabllee/�❑ Name of License Holder: t I k V� 1 l�C- c I I Oou L License Number 21 N mo- M St . N , 0)"T4001 RCL , o IS36 12-9126 Address Expiration Date 41n- A y" S��q q l Sig ature Telephone 9.Reaistered Home'llmprovetnent Contractor; Not Applicable ❑ No fL4, " SA -ko)E Oku a• �o c�35� Company Name Registration Number ,21 N rn ,un st 'NQA-&&v)4 Pa . 6 lS 3( n la� aoc Addres Expiration Date (r Telephon U SECTION 10-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.......XNo...... ❑ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable► New House ❑ Addition ❑ Replacement Windows Alteration(s) QX Roofing ❑ Or Doors E] Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [0 Siding[0] Other[d] Brief Description of Proposed Rio, o, C�. _ I _ I, `e„`1 '. . r 2 o,4 ; Work: ]—�' ..]-�..(�.Ul, V�`iJl/��.X-, Alteration of existing bedroom Yes x No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.If New house and ow addition to existing housing, comalete 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? f. 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 1 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. Signature of Owner Date 1 (} K PI-LA,n I.( Y 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. ,To hn PrwV%►�v Print Name jj&!�a161,1111 % Signatu a of Owner/Agent Date City of Northampton A' Massachusetts wf i� DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 �s6�..... AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration,renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation � or LLC,that ed (L 0entity must be registered. Type of Work: I m I,liUl� `� kXaQ �t,6 Za - �lEst. Cost: I U I U Address of Work:V IA&UX a4- Date 4-Date of Permit Application: �o g I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): -Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 1 1 1 64Or-wv'`- Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton { Massachusetts DEPARTMENT OF BUILDING INSPECTIONS yt 212 Main Street • Municipal Building Northampton, MA 01060 ssYh , iso Massachusetts Residential Building Code Section 110.R5.1.2 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. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be 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. City of Northampton ` Massachusetts C DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building Northampton, MA 01060 1� Debris 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, as defined by MGL c 111, S 150A. The debris from construction work being performed at: no V st (Please print house number and street name) Is to be disposed of at: 0WV) 4A1,1�-CCL (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) 64VA a Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of Industrial Accidents - I Congress Street,Suite 100 a Boston,MA 02114-2017 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/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): I.L]1 am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]r 10❑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 are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑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.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 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 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: The.Commonwerxiih-iqf Massachusetty Depetrtnrent:or ndustridlAccidents I congress'stree05`U40,100 Bostoisr.MA 02..-R.4-;24x;.7 vwwrnass go.v/dia Workers'Compensation insuranceAf't7dar�it:B.tlilders%�itritru�to�es�(ir�t�i�ians/R�tr�iie s TO'B>g:Fix,LrD'4 , 'X'I'i��'ER1V�t"TI1�Cr?ACI�'�ifi1l�I"fX.; Name (Business/Organization/Individual):' 44n mi - Address: . 2- � City/.State/Zip: /V. 6P,&Ff6#t,fill 6L .Are you.an employer.."Checlt:tht Appropriate box: Typle'-a(project.(requ ire4): 1.%Camawgijayer�wlth � employees,0611 and/orpartAime),* 7. 0—New:Congtructitltl 2.01 am a sole,propriotor or,partoershipand'have'aio Wnploycts wotkin'g forme In 8, 0 Remodeling any capacity,(No.wor6rs'roinp.insurance,vequimaj 3Q 1 am a homeowner doing all woi�lt.�tnyuClf.`;[No tvorkbreYtamp::insutance.required; f' 9.. Q Demolition 4.❑tam a:homeowner and will beJi* coppmotors to eon..dnet oil an:a 14 0 tiAldit1'$'addition !3 nyptopodyi Cwill ensum that all'oonuyactors aidier.have wo&ars'compensation,Insurance-or-arosgle IiIG 91004cal[rop4irs of addit ono, proprietors with no omploycos 12:[]Plulntsitrg:rcpa;b;tar additions 5,E]I am a gYsr4elal a0utraatoratld'I'11aV0 hired the a4b-t7ontraCtetB'lieted;on.tllC'.:atte6lted 9hCCt Those sukontractorshave employees and haveworkers"comp;•►esurance;r 13:•:[3lioafrnpaii°s; . . . I .'��t�oG6we am acor ratin ofoxeupion Mligyt . .MLp, '152,f t(4),and we.baveno.employces.(No wockars'rornp..lnsumce•requirati)' *Any appltoant that cheeks box#.t must.atao fill ont the sociion below bhowtng their wotkbrs'�Itgrorteatton ptlltay iilfornt:itiori; t.Homeowncrrwho subiWtthis affidavitiodinatingtboygpdoingallworkanrr,then]itxopntsideegn aat4zs;imuytaexahmit'a.rtoeaat'tOWJ tIndiva'rir�g.suclta tcoritmators.diat4heckthis:box must attwhed anaddidoaai dheat-ahowingthanama of ihe.sul?-armtradtors,aod atpta whq;ber yr not thosgoptitfes have employees.Mtbe sub-contwors have of loyees,2 .:must rovidortheir�vorkers``,cam .policy nunibor, X area an errtpinyer haat Is pnovtrCing workers,"compertsatlon'in9ar.rxrrt a for !entplayees: Ifelr►�r:is:the pvltgy arad Jtrls safe lrtfnrrrratfart, ,,.,.JJ...-- cC�� Ittsuranee Company Na.tne: Policy#arSelf:ins.Lie.#, b—LLMq Eq,3 r Q 12 1 p _Expiration Date- i!� `7 J SiteAddrt;ss:50 Wa'bil, SJI LAI 1 A /n , b �3 Attach a cnpyofthe rvorkers,''coivipebse..tion.policydeclaratlon,pa[le`(sliowi>ng:the:policynumber and expiratitrn dltte), Failure to secure coverage,as.required.under,MGL-o 152*42'5A,.[s aIrim tial'�rt�iatit�r�plltlisf�i�lst�:by's ilrie•Up;td�1:;500.�0 4iid/or one-year imprisonment, . . Ma;-STOP.WOR- ADFR anda due ofup to 250.00 a arwrdci.tttha•( fivtestday:againstthGviotator,A copyof'this statettnt.'Inaybe oft eM for itlsuronco coverage velitioation.. �dukerebya -tlfyartder'the,palrrsar:dpertaltles•vfperjurytltat.:fheritof4:wutation., rovir d,4,0a'Yrerre,and-gowrlect Sianature.• >� i Q�c/alusa•arily. Dorto.twrr(ta:lizth�s'rtwcu;td'lie.avrrkpl�`etCby.cltyOr•tO.t�i!pt,vffifi:f+7�, City or Town: Per»lt/Liaense:lf :Issuing A,uthorlty(clrcle one): i 1.Board of Health 2:Building ilepartment`..1 City/Town:Clerk, .4.Electrical Inspector 5.Plumbingxnspector 1 6.Other i Contact Person: Phone#:. i' : Page t of4 CLEAResult'- CONTRACT CLEARosuft 50 Washington Street, Customer Name:ELIZABETH KILDUFF Westboroubh,MA,01581 Email:Not provided Phono:413.580.3812 Premise Address:50 Water St,Northampton,MA 01053 Project 0 3440731 Bate:July 21,2018 Applicable Customer Required Actions: Nates: • Storage Removal Customer is responsible for removing stored Items in the kneewall attic,,to allow access to Insulate the kneewall wall. Job Description Contractor will perform or cause to be performed the following work on these"Premises"In a pro-essional manner and In accordance with the terms of this Contract,Including the attached recommendations/work order describing the work in detail(the"Work")which are Incorporated herein by reference. M . 6.l1C ._t?a. c tf n. . . .. .. ....... ... ...•, .. ;;�°: ant •;Uri Total.Cost u� rn ..,.� . .. .... S.►gip. . : � ...... :. ..... .......... ...,.... ,:. r� {ty;=`;?i`<`:'::' (:' I Air Sealing at Estimated 62.5 CFM50 Per Hour 6 hr $555.48 $0.00 Door-2"Thermal Barrier Polyiso 2 each $180.88 $45.22 Exterior Door Weather Stripping(with AS hrs) 5 each $150.35 � � $0.00 Door Sweep(with AS hrs) 3 each $75.93 $0.00 Kneewall Wall-4"Dense Pack Cellulose 21 Sr $53,13 $13.28 Total: $1,015.77 Program Incentive: -$957.27 Customer Total: $58,50 Payment Customer agrees to pay Contractor for the Work,the Customer Share of the Contract Price as follows:Payment#1:$15.00 as a Deposit payable to CLEAResult upon signing the Contract(not to exceed 1/3 of the total retail costs).Mail check&contract to CLEAResult,50 Washington Street,,Westborough,MA,01581,Final Payment:$43,50 as the final payment for the Work shall be payable to the Home Performance Contractor(MPC)or Independent Installation Contractor(I10)upon satisfactory completion of the Page 2 of 4 Work.Customer understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of $957.27.Changes to individual line Itetns and/or previous incentives may increase or decrease tha size of the Utility Incentive Share. Dispute Resolution The IIC And Customer hereby mutually Agree in advance that in the event that the JIG has a dispute concerning this Contract,the IIC may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to submit to such arbitration as provided in M.G.L.c 142A. You may cancel this agreement if it has been signed by a party at a place other than an address of the seller,provided you notify tite seller In writing by ordinary+nail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signirtq. f this agreement.UO NOT SIGN THIS CONN�TRAC/T/IF THERE ARE ANY BLANK SPACES. CL SIOITIef' ignature V Elate Indicate your selected IIC here,if applicable Initial here if you want the Program to assign a Participating Contractor An 7/21/18 Noam Perlmutter CLEAResult Signature Date Name of CLEAResult Representative Permit Authorization Farm Site 117: 3440731 Customer: ELIZABETH K)LDUFF ); �►�,qrC-f E I 'z�t�.��- ,owner of the property located at: (Owner's Name,printed) 50 Water St Northampton, MA 01053 (Property Street Address) (City) _ hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform Insulation and/or weatherization work on my property, .._ Owner's Signature: .. 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 Name: CLEAResult• Phone: 800-480-7472 Email: For Offira Use 0nly Rev,102015 CERTIFICATE OF PLIABILITY INSURANCE FiATEIMMIDO"w) 1010112018 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: It the certificate holder is an ADDITIONAL INSURED,the policy(les)musk havi X561TIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions-of the policy,certain policies may require an ondoreemo t. A statement on this certificate does not confer rights to the certificate holder in lieu of such andomement e . PRODUCER Moynihan Insurance Agency,Inc. PN Nr! 8011 803.8080 SAS 803.8800 25 Surllcoat Street A 40, I miko mo nlhanins.com Worcester MA 01606 Nautilus Insurance Co. INSURED - INaURER s 1"ravelers Indomnl!y of Amerias NORTHEAST HOME&ENERGY INC. INDURER Q: 21 North Main Street North Grafton MA 01636 COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSURANCEAO C P ICY OL YEP LIMIT COMMERCIAL GENERAL LIABILITY 1 0Q Q00 A CLAIMS-MADE OCCUR AM ��(� S.100,000 Y NNO69469 10/04118 10/04119 41000 PERSONAL I V ItUUM ?00 000 cERL AGGREGATE LIMIT APTL S PER: 2 000 00 POLICY L_J J 1 LOC p p 2 QQQ ATQ 1< AUTOMOBILE LIABILITY MSI N L LIMIT S ANYAUTp BODILY INJURY(Par person) S OWNED SCHEDULED AUTO$ONLY AUTO$ a0011Y INJURY Po tscaldent) S HIRED NON-OWNED pp Dep= AMA0E g AUTO$ONLY AUTOS ONLY S UMBRELLA LIAB OCCUR p QMRRPNQE EXCESS LIARAggMg R AT -DED [Ranams WORKERS COMPENSATION 21AND EMPLOYERS,LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVEY C AC 1 NT 8 600,000 B OFFICERIMEMBER EXCLUDED? N NIA 6HUS9F43401.3.18 09/16/18 09!16!19 I E t16Q0,OQ0 (Mandatory In NH) IIa doacrilm under E.L DISEASE P2!,,ICX LIMIJ 600 000 DESCRIPTION OP OPERATIONS t LOCA-noNB t VENICLas (ACORD 101,Additional Remarks Schedule,may.be attached It more space is roqulrod) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEPORE THE EXPIRATION DATE THEREOP, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE elmim> (+019882016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD Massachua�tts /Department of Public Safety Board of BuNdIng Regulations and Standards License: CG-1-10804 Construction Sum. JOHN PRUNIER v 21 N MAIN STREET NORTH GRAFTON MA 01536 Expiration: CornMissfoner 06/28/2820 a Office of Consumer Affairs and Business Regulation 1000 Washington Street_-Sure 710 Boston, M usetts 02118 Home Improver ct©r Registration TVPm afio -4 NORTHEAST HOME&ENERGY,VC. !al_ � ftistrats= 106353 - 2� N.MAW STREET ��iorr_ 0712012020 N.GRAFTON,MA 01536 "update Address and ReWm Card. SCA1 v 20M,06H7 ofrae of ConsuinwAffabs&Business Regulation - HOME IMPROVEMENT�COWRACTOR Region valid for ftxrwiduai use only TYP before the expkaHen date. tt 1bund return to, eEckwon- Office of Consumer Affairs and Business Reguiabon 1 07/20/2020 1000 Washington Street-Suite 710 NORTHEAST �NC. Boston,MA 02118 RICHARD T.T.PRU 21 N.MAIN N.GRAF i'ON,MA 0' Undem=eMry Not valid without signature t s = - Thermal Protection 07 21 19 I • H01 DATA SNEET Foamed In Place Insulation 1.PRODUCT NAME HY Straw Foam-Item#4004621224 Touch'n Seale Quick Cure HY(High Yield 24 ounce 680 m Polyurethane Foam Sealant HY Foam Complete-Item#4004518100 Touch'n Seale Quick Cure RX(Reduced 10 pounds(4.54 kg) Expansion)Polyurethane Foam Sealant HY Foam Complete-Item#4004518160 2.MANUFACTURER 16 pounds(7.26 kg) t• Convenience Products •....;z; ,... ,,,.,, 866 Horan Dr.,Fenton,MO 63026 USA RX Foam Complete-Item#4004510950 (636)349-5855 10 pounds(4.54 kg) (800)325-6180 . ASTM D-1623 Tensile.Strength FAX (636)349-5335 RX Foam Complete-Item#4004516900 • ASTM D-6226 Closed Cell Content E-mail support@touch-n-seal.com 16 pounds(7.26 kg) . UL 1715 Fire Test Website; www.touch-n-seal.com 3.PRODUCT DESCRIPTION FeatureslBenedts ApprovelalCefifloatlonvUsNngs Multiple package sizes . ICC ES ESR-1926 Touch'n Seal Quick Cure foams are high . 'Easy to use • International Building Code performance,single component,moisture curing, . Class 1 fire retardant a Intematlonal Residential Code Class 1 fire retardant,expanding polyurethane a Provides a permanent seal against air, . BOCA National Building Code sealants.Quick Cure sealants are available In moisture and Insect Infiltration . 1999 Standard Building Code both straw dispensed aerosol cans and larger e Easier to use than caulk type penetration • California Bureau of Home Furnishings and cylinders with hoses and applicators. sealants insulation • Bonds to common building materials Including . Underwriters Laboratories Classified Caulking Quick Cure sealants are available In High Yield wood,concrete,Insulating foam boards,metal, &Sealants (HY)and Reduced Expansion(RX)formulations. plastics and shestrock Use Quick Cure HY when high expansion Is . •Available In bath straw and cylinder dispensing Shoff life needed to fill and seal larger gaps and cracks. systems 12 months in unopened container when stored Use Quick Cure RX when requiring controlled . Reduces energy loss between 60•-90•F(166-32°C),In a dry,well- dispensing rate and less post expansion.Both • No ozone depleting chemicals ventilated area. formulations are tack free In 30 minutes or less, • Does shrink can be trimmed d 1 hour and are fully cured d • Does not ire moisture,dust and allergens as Storage&Disposal about 24 hours,depending upon humidity and p � g temperature. does fiberglass Insulation Keep containers tightly closed In a cool,well- Expands to fill gaps and cracks,reducing air ventilated area.Ideal storage temperature is 60% Basic Use exchanges 90•F(16•-32°C).Storage above 90°F(32°C)will Use Quick Cure Polyurethane Foam Sealants to Reduces use of fossil fuels and Improves air reduce shelf life.Do not store at temperatures permanently air seal and insulate gaps and quality greater than 120•F(49•C).Avoid freezing.Do not cracks to block drafts,moisture and Insects while • Helps to reduce Greenhouse Gas Emissions . expose containers to conditions that may Improving comfort and reducing energy usage in •• Closed cell structure damage,puncture,or burst the containers. commercial,Industrial,agricultural and residential Dispose of leftover material/contalners In applications.Use to seal around plumbing, Limitations accordance with Federal,state and local ventilation outlets,electrical Junctions,between • Foam Is combustible.Do not expose-to regulations.See Material Safety Data Sheet for sill plates and concrete slabs,or anywhere you temperatures above 240°F(116•C),open more Information. need a fast,economical air-sealing moisture flames or sparks 5.INSTALLATION/APPLICATION barrier. a Not for exposure to ultraviolet light Always refer to local building codes prior to e Chemicals must be 50°-100°F(10°-38°C)prior application of Touch'n Seal foam sealants. For firebiock and sealing applications refer to to application ICC-ES ESR 1926 detail. a 'Do not store In temperatures above 120°F The Touch'n Seale Quick Cure one-component Quick cure foams provide permanent Insulating (49•C) expanding foam sealant can be applied to and p p g • Always refer to local building code regulations will adhere to almost any traditional construct and air sealing solutions to building component . Do not leave product exposed;cover with surfaces Including wood,masonry,insulating materials Including wood,masonry,Insulating approved facings foam boards,metal,plastics and sheetrock. foam boards,metal,wire Insulation,plastics and a Propellant In 12&24ounce straw foam is sheetrock. flammable;read MSDS and do not use near Surfaces to receive Touch'n Seal foam sealants Touch'n Seal Poly-Clean Foam Cleaner to high heat,sparks or open flame must be dry,dean and free of dust,dirt,grease Use Use wet Quick al o foams from hands,tools Not a fire stop material and other substances that may Inhibit properclea and foam applicator guns, adhesion.For best results apply Touch n Seale 4.TECHNICAL DATA Quick Cure expanding foam sealant when Applicable Standards surface and ambient temperatures are between Composition l Materials . ASTM E-84 Surface Burning Characteristics 60•-100•F(16°-38°C).Temperature of chemical compTouch'n Seal Quick Cure scala polyurethane one- • ASTM E-96 Water Vapor Transmission contents must be between 50°F-100°F(10°C- perma rent expanding foam sealants are . ASTM C-273 Shear Strength 38°C)before dispensing. permanent,hypoallergenic and dry within minutes of application.Quick Cure foams are non-toxic • ASTM C-273 Shear Strain and will not decompose with age. • ASTM C-518 R-Value Use all chemical contents within 30 days of initial • ASTM E-814 Modified for Fire Block dispensing. S/zas « ASTM C-1536 Yield HY Straw Foam-Item#4004521212 • ASTM D-1621 Compressive Strength Keep out of reach of children.Always wear 12 ounce(340 gm) • ASTM D-1622 Core Density proper personal protective equipment,Including Convenience Products 866 Horan Drive,Fenton,MO 63026 USA (800)325-6180,(636)349.6855 Tel. 64015.040213•TNS Thermal Protection 07 21 19 Foamed In Place Insulation ]�Ftr'dlll-DATA "mEET gloves,clothing and eyewear.Use In well- 7.WARRANTY and application training Is available by contacting ventilated area. Convenience Products warrants Its Touch'n Seal Convenience Products, products-to be free of defects In workmanship Please refer to manufacturer's Instructions or. and function. 10.FILING SYSTEMS request a faxed set of instructions from Additional Information Is available from the Convenience Products by calling Customer Convenience Products Is not liable for any manufacturer upon request. Service at 800-325-6180. Incidental,consequential or any other damages 6.AVAILABILITY&COST beyond the description herein,however,certain The Information contained herein was accurate at Availability states have specific laws regarding limitation on the time of publishing.Please refer to the Touch Touch'n Seal polyurethane foams are available Incidental or consequential damages,In which 'N Seal website for the latest information. throughout the U.S.,Canada,Mexico and the case,and you may have other legal rights. world.Contact Convenience Products Customer 8.MAINTENANCE Service at 800-325-6180 or FAX 636-349-1708 None for distributor Information. 9.TECHNICAL SERVICES Cost Technical assistance,Including more detailed Contact Convenience Products for local Information,product literature,test results, distributors who can provide cost and delivery assistance with preparing protect specifications Information. TYPICAL PROPERTIES OF TOUCH'N SEAL QUICK CURE POLYURETHANE CLASS 1 FOAM SEALANT Container Sizes 12&24 ounce 340&680 m Straw Foam 10&18 pound 4.54&7.26 k LC ander Foam Shelf Life 1 year,unopened container 1 year,unopened container Surface Dry Time/Surface Tack Free <30 minutes 72'F/50%R.H. <15 minutes Q 72'F/50%R.H. Time Full Cured 24 hours 72'F/50%R.H. 24 hours 72'F/50%R.H. Trimmable <1 hour 72'F/50%R.H. <1 hour 72'F/60%R.H. ASTM E-84 Surface Burning Characteristics Flame Spread 10 20 Smoke Development 15 25 ASTM E-98 Water Vapor Transmission 10 perm Inches 25mm 13 perm Inch ASTM C-273 Shear Strength N/A 18 psi1.27 k cm') ASTM C-273 Shear Strain N/A 57% ASTM C-518 R-Value 4-6 fin. 26 mm 4-5/In. 25 mm ASTM E-814 Modified for Fire Black Pass Pass 10 Ib HY 12 oz(340gm) %In.(6.4mm)dia.bead—15,300 ft.(4,863m) %In.(8.4mm)dia.bead—900 ft.(280m) 3/8 In. 9.5mm dia.bead.—6,800 ft.(2,072m) 3/8 In.(9.5mm)dia.bead—400 ft.(124m) 16 Ib HY %In.(6.4mm)dia.bead-24,400 ft.(7,437m) ASTM C-1536 Yield 3/8 In. 9.5mm dia.bead—10,900 ft.(3,322m) 10 Ib RX %In.(6.4mm)die.bead—14,700 ft.(4,480m) 24 oz(680gm) 3/8 In. 9.5mm dia,bead—6,600 ft.(1,981m %In.(6.4mm)die.bead—1,800 ft.(650m) 16 Ib RX 3/8 In.(9.5mm)dia.bead—800 ft.(249m) %In.(6.4mm)die.bead—24,080 ft.(7,340m) 3/8 in. 9.5mm dia.bead—10,600 ft.(3,200m) ASTM D-1621 Compressive Strength 11 psi 0.77 kg/cm ASTM D-1622 Core Density 1.75+/-.25 20.8+/1 4.0 k m 1.3 —1.8 20.8—28.8 k m ASTM D-1623 Tensile Strength 33 psi(0,02 kg/cm) Percent elongation at break N/A 10% UI.1715 Corner Room Fire Test N/A Pass-No thermal barter required In Type V construction ASTM D-6226 Closed Cell Content N/A 70% International Building Cade Conforms Conforms International Realdential Code Conforms Conforms BOCA National Bulldin Conforms Conforms 1999 Standard Building Code Conforms Conforms ICC-ES ESR-1926 ESR-1928 California Bureau of Home Furnishings Listed Listed and Insulation NPFA 30B Classification Aerosol Level 2 N/A Underwriters Laboratories Classified UL ULC R14176 Caulking&Sealants R14176 BLEZC.R14176 Convenience Products 866 Horan Drive,Fenton,MO 63026 USA (600)325-6180,(636)349.6855 Tel. 54015.040213-TNS ig�fw Nib FAe. T ►7HEET THIS IS GREENFIBEe LOOSE FILL, FORMULA INSULATION Application cove'r0ga Chad l��� 20 lbs (13.6 kg) Minimum Thitdtness Net Coverage Nat Coverage R-Value at (Inchon) (no ad)ustmenttor tramino) (al1Awict2"x8"harnhKtonITOR") 76°F Mean E aor minima Oabo0ox Hata pro aaoidn cebartum nate(aan aamponraaidn gars una eatruatum do Temp, (gri pWOadse) para d aangn 401 2"x a"on aemrr da i Volor do rnalotonaia Initial Settled Maodmum Mlmimum Minimum Maximum MlmImum mno tormloa Installed Thickness; Sq.Ft.per gag Bap$per wwo per Sq,Ft.per Beg Beg$per (valor R)a Thickness 1,000 Sq,PL 3 PL 1,000 S Ft, 7e F do t opeaor Mov" q' Mance q tomparatura Eapesor =10 Ctmdrodo Cartddad mkttma Paso 4ad�a Oanddad minlms media bNokl po dem 1,000 par pb�0 gip, aq doh"uuad PM 1:1 Instolodo p�boron pa R11 3.38 3,04 102.5 918 0.293 113,1 8,8 R 13 4,01 3,61 84.9 11,8 0.353 93,7 10.7 R19 5,88 5.29 55,2 18.1 0,544 60.5 1615 R 22 6,80 6112 46,6 21.5 0,644 50,4 1918 R 26 8.02 7,22 $8,4 28,1 0,782 41,0 24,4 R 30 9.22 8,30 32.4 30181 0,925 34.3 291 R 32 9,82 8.64 30.0 3313 0.999 31.7 313 R 38 11.60 10.44 24.4 40.9 1,23 25,6 3911 R 40 12.19 10,97 22,9 416 1131 24,0 41,7 R 44 13,36 12,03 20.4 49,0 1.47 21.2 47.1 R 48 14.63 13,07 18,3 54,6 1.64 1910 52.6 R 49 14,82 13,34 17,9 56.0 1.68 18,5 541 R 50 15,11 13,60 17,4 57.4 132 18.0 55.5 R 60 17.99 1 16.19 13,8 72,4 2,17 1 14,2 70,4 THE ABOVE COVERAGE CHART IS BASED ON A NOMINAL BAG WEIGHT OF 30 LBS USING A VOLUMATIC III,3rd GEAR AND r GATE,THE CHART IS BASED ON SETTLED THICKNESS AND 15 FOR ESTIMATING PURPOSES ONLY.00 NOT EXCEED MAXIMUM SQUARE FEET COVERAGE PERM.THE APPLICATOR MUST INSTALL BOTH THE MINIMUM NUMBER OF BAGS PER 1000$0,FT.AND THE MINIMUM INSTALLED THICKNESS TO INSURE THE STATED R•VALUE HAS BEEN REACHED.FAILURE TO MEET BOTH THESE REQUIREMENTS MAY PREVENT THE APPLICATION OF SMIFISD R-VALUE.THIS PRODUCT 18 INTENDED FOR DRY APPLICATION ONLY,JOB CONDITIONS, APPLICATION TECHNIQUES,EQUIPMENT,AND SETTING CAN INFLUENCE ACTUAL COVERAGE.00 NOT ADD WATER TO THIS PRODUCT,MINIMUM NET WEIGHT IS 20.6 LBS, a THIS COVERAGE CHART IS FOR DRY APPLICATIDNS ONLY AND 18 BASED ON THE Thermal Resistance Framing Installed Thickness Mlnlmum WL Maximum Coverage Par Ba Madmttm•Ctwarags Per Bap• KRENOL KS200,WITH MATERIAL APPLIED (R value) Ratruotura gnrdtas) Par Spuaro root (Pio Adlust r Framing4 tar Fram1 Rap DRY,FOR MAXIMUM COVERAGE PER BAG ROOM% 1p tarmlm 0apeaer bratalado ittrttQ �! (PulpadaA Peso mtnimo ppaorI� mAatwprw aero (0 a = e ) o ADJUSTED FOR FRAMING),THE FRAMING pbouedtadolgMi< an��pWaMaa (160 00) 24"00 FACTOR FOR 10"OC STUD SPACING IS 13 2x4 315 1,02 29,39 32,4 31.8 9,375%;FOR 2000 STUD SPACING THE 21 2x6 54 1.60 18,70 20.6 1919 FRAMING FACTOR IS 6,26%. READ THIS BEFORE YOU BUY What you should know about R-values This chart shows the RMvalue of this Insulation. R means resistance to heat flow. The higher the R.value, the greater the insulating power. Compare insulation R4values before you buy. There are other factors to Consider. The amount of the insulation you need depends on the Climate you live In. Also, your fuel savings from insulation will depend upon the climate, the type and size of your house, the amount of Insulation already in your house, and your fuel use patterns and family size. if you buy too much.Insulation, it will cost you more than what you'll save on fuel. To get the marked R-value, It is essential that this.insulation be installed properly. FOR MORE INFORMATION CONTACT: MANUFACTURING LOCATIONS: GreenFiber Corporate Office Albany, NY �4P•` ���tC� 5500 77 Center Chive, Suite 100 Belchertown,MA Charlotte,NC 28217 Delphos,OHr YIN(p)800,228,0024(f)704.379.0686 Norfolk, NE " (e)groonfiber.info@groonfiber.com Chandler,AZ greenfiber,com Salt Dake City,UT MADII INTHN Tampa,FL U S A Waco,TX Wilkes-Barre,PA PM-6,3-325 Rev D 0311