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17A-034 250 NORTH MAPLE ST BP-2020-0760 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-034 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 P E R M I T Permit# BP-2020-0760 Proiect# JS-2020-001310 Est.Cost: $3400.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group THE ENERGY STORE 106082 Lot Size(sq.ft.): 14766.84 Owner., YOUNG CHRISTINE E Zoning: RI(100)/URA(100)/WSP(100)/ Applicant. THE ENERGY STORE AT. 250 NORTH MAPLE ST Applicant Address: Phone: Insurance: 3 SIMM LANE NEWTONCT06470 ISSUED ON.1212612019 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATIONNVEATHERIZATION 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 12/26/2019 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner ' ?T?Y City of Nol th mpt Elm EI V ►'1 Dep Building Dep rtm t lJ Y, 3� '� 212 Main treet DEC2 6 �. 1 SULATION , Room 1b0 201 Northampton, A 0 0 Phone 413-587-1240ax $igt �� O THAMpT iNSPE TIONS ON,MA 01 60 APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INSULA TION PERMIT 1.1 Pr-o-,p�e�rty Address: Thiisssection to be completelby office "flap— 17/f Lot Unit {-" Zone Overlay District ) i Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 194'7 Name(Print) \n ) { urrent M 'I' Actress*-- s _ Telephone Signature �-- p 2.2 Authorized Agent• Name{Print) Current Malting Address: f i Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be com feted b permit applicant Official Use Only i. Building � (a)Building Permit Fee 2. Electrical T(b)Estimated Total Cost of Construction from 6 �3. Plumbing TBuilding Permit Fee 4. Mechanical(HVAC) 5. Fire Protection yY S. Total=(1 +2+3+4+5 ) �� `'� Check Number This Section For Official Use Only Building Permit Number: ra �� Date Issued: I Signature: Building Commissioner/Inspector of Buildings Date 1 E AIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) F ION 4-CONSTRUCTION SERVICES censed Construction Supervisor: Not Applicable ❑ Name of license Holder: r�] �____�/__L.�(. � t -- ense Number IS Atic7resS ��- > '^, Expiration Date Signature Telephone C�5 9.Registered Home Improvement Contractor' 1 Not Applicable ❑ Comp ny Name --�� ; `--- { Registration um er Address t r Expiratio Dat Teiephon SECTION 5-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. is affidavit will result in the denial of the issuance of the building permit. Failure to provide th Signed Af fdavit Attached Yes....... No...... ❑ Brief Description of Proposed Work )iAY,I5C'� tree as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application and belief, are true and accurate,to the best of my knowledge Signed fie{the pains and penalties of perjury. Print Narhrd l t Signature of er Agent Date I, property as Owner of the subject hereby authorize to act on my behalf, in al!matters relative to work authorized by this building permit application. Signature of Owner Date City of Northampton t Massachusetts �y DEPARTMENT OF DUXZDING INSPECTIONS a r ii -' 212 Main Street *Municipal Building u 1 Northampton, MA 02060 Debris Disposal Affz � dav1 t 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: (Please print house number�ndstre�etnam`e) �� Is to be disposed of at: LLC (Please pri it e and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) 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. DATE(MMDNYM 0412312019 DATE '"77 CERTIFICATE OF LIABILITY INSURANCE 0412319 TS UPON THE CERTIFICATE HOLDER.THIS THIS CERTIFICATE IS'ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS ED _ fq 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. ions or be endom"U. t ialivies!XIDII 7LINSUR D.the POIIC,)1,105)must have P01011 I ONAL INSURED provi- IMPOKIANT. If the Ceigiizire FZR'Cier is an 00— ons;of the policy,certain policies may require an endorsement A statement on If SUBROGATION IS WAIVED,subject to the terms and Condit! this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c NI-CT PRODUCER AIX No; Brown&awwr,.of New York,Inc. E-161AIL t certhcates(t_vDbinuny-C-n 1133 Westchester Avenue ADDRESS: 11 INSuReR(SJ AFFORDING COVERAGE NAIC# Suite,14-136 ny of New York 34462 I NY 10604 Homeland insurance ComPa White Plains NSURERS: Atlantic Pedia Company 27154 INSUREDINSURER C: t Insurance Company 40M StarNensu Energy PRZ LLC Dba The Energy Store Twin City Fire Insurance Company294.5:9 3 Simm Lane Suite 10 INSURER D: iNSUREF! Newtown CT 06470 INSURER F: CERTIFICATE NUMBER: 19-20 Renewed WC REA—'—" COVERAGES NAMED ABOVE FOR THE POLICY PF-RKJU THIS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS R INDM;,S 0 CERTIFY THATTHE POLICIES T-WITH RESPECT TO WHICH THIS I NOTWITHSTANDING ANY RECILItREMENT.TERM, OR CONDITION OF ANY CONTRACTOR OTHER DOCUMEN SUEUECTTOALLTHETERMS, IC TED. OTW POLICIES DESCRIBED HEREIN IS CERTIFICATE MAY BE ISSUED OR PERTAIN.7 HE INSURANCE AFFORDED BY THE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS LIMITS SHOWN MAY HAVE BF 01�3 AND CONDITIONS OF SUCH POLICIES.L FF P LIGY EXPUNITS DONY MWD .C415 POLICY NUMBER 'fw TYPE OF INSURANCIE INSID Vivo i EACH OCCURRENCE 1,000,000 COMMERCIAL GENERAL LIABILITY iAIAA100,000 r-7 PREMISES Ea '(rr!M2J— S I I/ OCCUR 10,000 CLAIMS-MADE I--N MED EXP(An One person) S Y 7930090810000 0312712019 0312712020 PeRSONAL&ADV INJURY 1,000,000 A I GENERALAGGREGATE 52,000,000 GFN'LAGGREGATE UMITAIIPLIES PERPRODUCTS-CONIPJOP AGG S 2,000,000 7] POLICY[5 PRC- JECT LOC — OTHER: coPm NED LIMB, S 1,000,000 i ---1 AUTOMOBILE LIABILD'y BODILY MURY ANY AUTO SCHEDULED 7930090820000 03/2712019 03127/2020 BoDILYIWURY(PersOciderd) OWN AUTOSED ONLY AUTOS PRCPERTY DAMAGE SPED NON-OWNED (PeracciderAl AUTOS ONLY AUTOS ONLY H OCCURRENCE S 5,00o'coo UMMEREL"LA LLAS X OCCUR 830000 03/27/2019 0312712020 AGGREGATE , 5,000,000 A EXCESS LIAR i CLAWAS-MADE 7930090 S DED RETEN`nCN S — PER OTH- WORKERS COMPENSATION STATUTE ER $ 1,000,000 AND EMPt.OYERS'LtABJUTY YIN E.L.EACH ACCIDENT I PRDPRfE`FCR!PARTNERIEXEC,MVE FN-1 MIA BNUWC0131379 0411512019 0411512020 000,000 oFmcEPIMEMBER EXCLUDED? I E.L.DISEASE-EA EMPLOYEE 11 000 (Mandatary in NMI LIMIT $ it yeu,aeswbe undw [E.L.DISEASE- gt:,SCMPTJON OF OPERATIONS teaks re I Poludon Liability 16SBAA62188 0312712019 0312712020 i Each Condition 1,000,000 .... LES(ACORO 101,Additional Remarks Schedule,may be attached it more SPNce is DESCRIPTION OF OPERATIONS!LOCATIONS!VE"'C reqlfired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES EIE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Proofofiasuranco AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. AGORD 25(201 61(33) The ACORD name and logo are registered marks of ACORD Permit Authorization ����� �^���N ������"�p °�w�.wr~= Form Site ID: 3911657 Customer: Christine Young |, Christine EYoung ,owner ofthe property located at: (mwne/sName,printed) 250 N Maple St Northampton, MA 01062 (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 onmnyproperty. Owner's Signature: Date: 11/26/19 FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date Narne: CLEAResu|L Phone: 800-480-7472 Email: Page 1ur/ For Office Use Only y s ' f ax, � E y z .iF w Row,- e j, goll 5 'Y 0,U =x r - � k. e w s�r✓ z i '� � 1 z d�. f� x h "a%»��" �` yc �'f a ^x��f � �r �� •�S� � y �Y �, /,� a / r f- to�t:< <� f�.a's ).r GF -� ' wra �f ,. �u..:, it ., ..�, �• v LL a 77 e E i a •�sz' fir w r 4�E•a r: SPECIFIED MEASURES AGREEMENT (SMA) 50 Washington St.Suite 3000 Westborough,MA 01581 Customer Name:Christine Young Email:cyoung1443@comcast.net Phone:413-563-4644 Premise Address:250 N Maple St,Northampton,MA 01062 Project lD:3941037 During your Home Energy Assessment the Energy Specialist specified areas of the residence that may be able to be insulated or further treated to increase the efficiency of your home.One or more of these areas have been determined to be unique requiring specific contractor capabilities to complete,and therefore will require pre-acceptance by a Participating Contractor and therefore will require a Mass Save®SMA selected Participating Contractor. Below you will see a list of the specified measures unique to your home, as determined by the Energy Specialist.By signing this form,you agree to have the Mass Save@ Contractor Services Team select an SMA contractor to review the weatherization work at your home.The contractor will determine if some or all of the work can be completed. If it is determined that partial upgrades can be completed due to site restrictions,the balance due will be adjusted.The total customer contribution will be due to the participating contractor upon completion of the work.Work can only be completed if there are no other health and safety roadblocks present in the residence.All pricing is standardized by the Mass Save@ Home Energy Services Program and you will not incur any price increase for the measures listed below. Photos or videos taken are for the explicit use of the Mass Save@ Home Energy Services Program and for the sole use of determining energy efficiency improvement eligibility.This Specified Measures Agreement form must be signed in order to receive contracts for weatherization. Specified Measures Detail Dirt-floored crawlspace requires vapor barrier, headroom is approximately 1 foot. Roadblocks Documented in the Home t ocatt% M rB D sCriptioti i "uro'Code Signature: Date: 11/26/19 Energy specialist:Noam Perlmutter Phone:800-480-7472 Email: Page 1 of 1 DocuSign Envelope ID:A965CF68-7DDE-4F4C-9DEB-OB4AC66036F1 CLEAResul ` CONTRACT CLEAResutt 50 Washington Street, Customer Name:Christine Young Westborough,MA,01581 Email:cyoung1443ga comcast.net Phone:413-563-4644 Premise Address:250 N Maple St,Northampton,MA 01062 Mailing Address:250 N Maple St,Northampton,MA 01062 Project ID:3941037 Date:Dec.9,2019 Applicable Customer Required Actions: Notes: • Storage Removal Homeowner is responsible for removing wood and storage boxes to allow access to rim joist,crawlspace, and kneewall attic. Job Description Contractor will perform or cause to be performed the following work on these"Premises"in a professional 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. iot1 Vin'`. onn Vapor Barrier-6 mil Polyethylene(with AS hrs) 176 SF $172.48 $0.00 Air Sealing at Estimated 62.5 CFM50 Per Hour 1 hr $92.58 $0.00 Rim Joist-6"Fiberglass Batting 130 SF $351.00 $87.75 Exterior Door Weather Stripping(with AS hrs) 2 each $60.14 $0.00 Door Sweep(with AS hrs) 2 each $50.62 $0.00 Kneewall Gable Wall-3"Fiberglass Batting 14 SF $26.74 $6.68 Kneewall Gable-2"Thermal Barrier Polyiso 14 SF $66.92 $16.73 Kneewall Slope-6"Fiberglass Batting 216 SF $460.08 $115.02 Kneewall Slope-2"Thermal Barrier Polyiso 216 SF $1,032.48 $258.12 Attic Slope-6"Dense Pack Cellulose 200 SF $564.00 $141.00 Transition Air sealing 27 LF $184.68 $0.00 Roof Vent-8" 4 each $437.20 $109.30 Total: $3,498.92 Program Incentive: -$2.764.32 Customer Total: $734.60 Page 1 of 4 DocuSign Envelope ID:A965CF68-7DDE-4F4C-9DEB-OB4AC66036F1 Payment Customer agrees to pay Contractor for the Work,the Customer Share of the Contract Price as follows:Payment#1:$0.00 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:$734.60 as the final payment for the Work shall be payable to the Home Performance Contractor(HPC)or Independent Installation Contractor(IIC)upon satisfactory completion of the Work.Customer understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of$2,764.32. Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. Dispute Resolution The 11C and Customer hereby mutually agree in advance that in the event that the IIC 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 the seller in writing by ordinary mail posted,by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. DocuSipned by: uAVlxll�tt (�bUtnl� 12/9/2019 111:31 AM PST -..—..-........... _..— 36F99642F3 3,4BE.. Customer Signa Date Indicate your selected IIC here, if applicable Initial here if you want the Program to assign a Participating Contractor 12/9/19 Thomas Bliss CLEAResult Signature Date Name of CLEAResult Representative Page 2 of 4 �A Office of Consumer Affairs and Business Regulation f 'r 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement GQntractor Registration T, Type: LLC __Jt Registration: 178392 �} ENERGY PRZ, LLC. �f Expiration: 04/09/2018 6 -, 31 Old Route 7 Brookfield, CT 06804 update Address and return card. Mark reason for change. SCA 1 0 20f,1-05,111 ❑ Address ❑ Renewal ❑Employment ❑ Lost Card a,,a Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: , t Beaistration �x 1{�ration Office of Consumer Affairs and Business Regulation to 10 Park Plaza-Suite 5170 178392 04/09/2018 Boston,MA 02118 ENERGY PRZ,LLC. ROBERT NEAL , 31 Old Route 7 - Brookfield,CT 06804 - Undersecretary Not valid without signature �oNsc;""k Displaying your six-digit HIC registration number on all advertisements, contracts OV �:` y�y'•,. and permits is required by the law. This includes but is not limited to business cards, ° websites,working trucks,signs and online advertising in any form. .kl s If you have any questions please contact the dedicated HIC line at(617)973-8788 �'? ss Or visit us at Mass.Gov/Homelmprovement