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23D-032 (6) 49 MILTON ST BP-2020-0871 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D-032 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. EeMA# BP-2020-0871 Project# JS-2020-001494 Est.Cost:$2700.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOMEWORKS ENERGY INC 103832 Lot Size(sg. ft.): 6403.32 Owner: WILSON JOANNA Zoning: URB(loo)/ Applicant: HOMEWORKS ENERGY INC AT. 49 MILTON ST Applicant Address: Phone: Insurance: 101 STATION LANDING (781) 205-2595 WC MEDFORDMA02155 ISSUED ON.1/31/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSULATION 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 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 Sil4nature: FeeType: Date Paid: Amount: Building 1/31/2020 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner De p City of Northampton;' "� / Building Department `jat? AAl 3 Q S ULATION 212 Main Street -• Room 100 T n� Northampton, MA 0106r' ^��n`'� r^iSF� phone 413-587-1240 Fax 413-587-1272 "_:? °^'s ONLY APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INS ULA TION PERMIT 1.1 Property Address This section to be completed by office 49 Milton Street Map 3n Lot 62 3'Z Unit Northampton, MA 01062 Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT ( Y13- 2.1 Owner of Record: Joanna Wilson 49 Milton Street Northampton, MA 01062 Name(Print) Current Mailing Address: 413-320-9913 -F^ 1 3_320-99 1 3 Telephone Signature 2.2 Authorized Agent: Gary Clement 101 Station Landing, Medford, MA 02155 Name(Print) Current Mailing Address. 781-205-2595 Signa t Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 2700.00 (a)Building Permit Fee 2. Electrical I (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) /� u 5. Fire Protection 6. Total=0 +2+3+4+5) Check Number This Section For Official Use Only 3V Date Building Permit Number: cry / Issued: Signature: UU a� Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 4-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:SCott Veggeberq CSSL-103832 License Number 8 Covington Street, #1 , Boston, MA 02127 10/13/2021 Address Expiration Date V��'� 781-205-2595 Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ HomeWorks Energy Inc. 181138 Company Name Registration Number _101 Station Landing, Medford, MA 02155 03/02/2021 Address Expiration Date Telephone 781-205-2595 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. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... V No...... ❑ Brief Description of Proposed Work Insulation and weatherization work (no structural changes) I Gary Clement 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. Gary Clement Print Name 01 /30/2020 Signatur f O Agent Date 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 City of Northampton Massachusetts 4- DEPARTMENT OF BUILDING INSPECTIONS �'• x 212 Main Street • Municipal Building O Northampton, MA 01060 1.3,:�<�`� 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 entity must be registered. Type of Work:Insulation and weatherization work(no structural changes) Est. Cost: 2700.00 Address of Work: 49 Milton Street Northampton, MA 01062 Date of Permit Application: 01/30/2020 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: 01 /30/2020 Gary Clement 181138 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 mow? '<< DEPARTMENT OF BUILDING INSPECTIONS �`• ,(z, 212 Main Street •Municipal Building Svc c� Northampton, MA 01060 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: (Please print house number and street name) Is to be disposed of at: McNamara Waste Services LLC, 24 E. Longmeadow Rd, Hampden, MA 01036 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) 01 /30/2020 natur f Permit Applicant or Owner Date LIP 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 k t=!2znUz==_J Department of Industrial Accidents am 1 Congress Street,Suite 100 Boston,MA 01114-2017 www mass gov/dia lVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant InforMation Please Print _140bly Name(Business/Organization/Individual): HomeWorks Energy Inc. Address: 101 Station Landing, Suite 110 City/State/Zip: Medford, MA 02155 Phone#: 781-305-3319 Are you an tmployer?Check the appropriate box: Type of project(required): 1.[51 am a employer with Sag employees(full and/or pari-time).` 7. ❑New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. [:]Remodeling any capacity.I No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeov%mer doing all work myself[No workers'comp,insurance required.j' 10 Building addition 4.n I am a homeowner and will he hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑I am a general contractor and t have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have wrorkers'comp.insurance.: �—} 6.r]We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[ other Insulation 152,§1(4),and ut have no employees.[No workers'comp.insurance required.] yAny applicant that checks box Wl must also fill out the section below showing their workers'compcnsation 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 addition-sheet showing the name of the sub-contractors and state whether or not those entities have ernployees. If the sub-contractors have employees,they must pmvide their workers'comp.policy number. I aur an employer that is providing workers'compensation insurance for ml,employees. Below is the policy and fob site information. Insurance Company Name: NH Employers Insurance Company Policy#or Self-ins.Li,,#: 4001017 Expiration Date: 01/01/2021 Job Site Address: 49 Milton Street cit /State/Zi : Northampton, MA 01062 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 tement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify ut ams nd p aaides of perjury t t the Information provided above is true and correct: Signature: Date: 01/30/2020 Phone#: 781-305-3319 Offlcial use only. Do not w to! this area,to be completed by city or town gf eial. City or Town: Permit/License# Issuing Authority(circle one): L11B30a,rd of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ert Person: Phone M HOMEENE-01 LLARIVIERE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ Y 12/19/22 0199 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). ME PRODUCER CONTACT Lisa Lariviere Foster Sullivan Insurance Group,LLC PHONE FAX 163 Main Street A/C,No,Ext):(978)686 2266 301 (A c,Ne;(978)686-6410 North Andover,MA 01845 E-MAIL .certificates@fostersuilivangroup.com INSURERS AFFORDING COVERAGE NAIC# _ INSURER A:Homeland Insurance Company NY 34452 INSURED INSURERB:Safety Indemnity Insurance Company 33618 Homeworks Energy Inc. -INSURER C:NIH Employers Insurance Company 13083 Homeworks IIC LLC 101 Station Landing Suite 110 INSURERD: Medford,MA 02155 INSURER E: INSURER F 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 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRI D /YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR 7930060650002 4/1/2019 4/1/2020 DAMAGE ro RENTED fEa occurrence)PRE ES $ 500,000 MED EXP(Any oneperson) 10,000 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICY 1:1 PEE 2'000'000 7 LOC PRODUCTS-COMP/OP AGG OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO 624437$ 4/1/2019 4/1/2020 BODILY INJURY Perperson) $ AAUT�O�S ONLY X ALTNOS�UyLNEEDp BODILY INJURY Per accident $ X AUTOS ONLY X AUOTO�ONLY PerOacEcltlent AMAGE A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE 7930060660002 4/1/2019 4/1/2020 AGGREGATE $ 2'000'000 DED X RETENTION$ 0 C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY T YIN ECC-600-4001017-2020A 1/1/2020 1/1/2021 1,000,000 ANY OFFICER/MEMBER EXCLUDED?ECUTIVE � N/A E.L.EACH ACCIDENT (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence Only I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Homeworks Ener Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9Y ACCORDANCE WITH THE POLICY PROVISIONS. 101 Station Landing Ste 110 Medford,MA 02155 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: HOME WORKS ENERGY,INC. 101 STATION LANDING STE 110 Expiration: 033!02/2/02/2 021 MEDFORD,MA 02155 Update Address and Return Card. SCA 1 0 20M-05/17 Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration Fxairatign Office of Consumer Affairs and Business Regulation 181138 03/02/2021 1000 Washington Street-Suite 710 HOME WORKS ENERGY,INC. Boston,MA 02118 GARY CLEMENT 1LCG�-- Git c 101 STATION LANDING STE 110 (� MEDFORD,MA 02155 Undersecretary of V id without signature f Iq Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards 14 Construction,'S oe'kAisor Specialty CSSL-103832spires: 10113/2021 SCOTT VEGGEBERG rX. 8 COVINGTON ST #1 BOSTON MA 02127 1`i'�` 1� Conn mi$sioner --- Insulation/Air Sealing Permit Authorization Specialist: Andrew Tacy Company: HomeWorks Energy Rn Email: And rew.Tacy@HomeWorks Energ- Address: 101 Station Landing HomeWorks Cell: (413)588-4336 Medford, Ma 02155 Phone: 781-305-3319 Customer: Joanna Wilson Address: 49 Milton St Email: 0 Northampton, MA 01062 Site ID: 422821 Phone: (413)320-9913 I, the owner of the property identified above hereby authorize HomeWorks Energy Inc., or their Partner to act on my behalf in obtaining any building permit that maybe required to perform insulation and/or Weatherization work on my property and all matters related to the work authorized by said permit if one is obtained. Any related permit application cost will come at no additional charge provided that the agreed Weatherization work is completed. Customer Signature: Joan WiDate: 12/16/2019 lson PLAN VIEW Name: Site ID: yaUf—?1 Finished Sq. Ft: /O Phone: 14113) 3.20-f Year of House: Electric Acct#: Address: y9 �`1//�n J% - #of Floors: Gas Acct#: 6,, Unit#: #Occupants: Housing Type?�P-r Ah DUCTWORK INSPECTION Ducts insulated?­I Duct Linear Ft. Duct Square Ft. (~/ Duct Air SealingHours Duct Insulation Duct Insulation Removal BASEMENT INSPECTION Existing Spec' Ln/S .Ft. Bsmt Wall AG Crawl Ceiling Crawl Rim Joist Bsmt R1 w/Sill Bsmt RJ NO Sill Vapor Barrier Bsmt Door Y N Blower Door? WALLS&GARAGE Drill Location? Siding Cell.Height Existing Spec'ing Sq. Ft. Framing Exterior Wall 1 x x Balloon/Platform Exterior Wall 2 / x x Balloon/Platform Overhang x x Garage Wall x Ballooln/Platform Garage Ceiling x x sP� 'Remo 7e7etp ScIft. ping: WORK SPEC'D BUT NOT CONTRACTED ROAD BLOCKS PRESENT?,MANDATORY) Attic Basement Crawls ace Other: K&T Y Moisture ly Combustion Sfty Y N Kneewall Overhan /Gars a I I Asbestos Y/IN11/N11Mold>100 sq.ft I Y/NCO Detector Missing Y Ductwork Exterior Walls Vermiculite Y/ Structl Concerns Y/ Other: Notes for Lead Vendor/Work Not Contracted: KW WALL AND KW FLOOR Blind Spec? - OR ► KW SLOPE AND GABLE END Blind Spec? u Why? i Why? FRAMING I FRAMING EXISTING SPEC'ING A SQ.FT. WALL X x SLOPE X X IN FLOOR X X GABLE X X ACCESS X TRANS X X TRANS X X ATTIC o ATTIC I SLOPE X X ; SLOPE x x EXISTING VENTING? EXISTING VENTING? EXISTING PIPES? Y/N KW Venting!' Vent BF BF Hose Damming Sheathing Access Temp Access KW Venting Vent BF Temp Access c 1 a S �u Oi ,U l.J J 1 q0 Insulated Wall X X Reed Light O�Ins.How BF Vent BF BFV Chim.CH Damming ----- 1Y Roo/V t 12RV Air Handler AH, Temp Access L' J Pull Down J Hatch F Wall Hatch H/ Door n/ a"RoOvent rsfty� ' VOI: ...0058 19(1 story) x x ATTIC 1 Blind Spec? `] x x ATTIC 2 Blind Spec? ] x rls.a(z a Existing Sp7ec'ing Sq ft Existing Spec'ing Sq ft ``13.6 tory) Unfloored n 5 rru-/ / / Trusses Cross Ba ng Floored Floored Mixed Insulation D rk >6"Loose No e Cath Sloe Cath Sloe e Walls Walls Access Access Venting Propavents Vent BF BF Hose Damming en ng ro avents Vent BF BF Hose Dammin m WHF Box r' Temp Access: CL 7w CL Sheathing Access: ._..4. to ' L Sq.Ft/300: •�J. (fit,NFA Wnting)_ i(Needed Ft/300= (1 NFA Vent) ad � NFA Venting) Roof Types )(��. � Existing Venting? RN NFA Venting) EXIS ' ntin HomeWorks Energy �Q 101 Station Landing,Medford,MA 02155 ��K"� 781-305-3319 FAX CONTRACT - AUDIT HQ�WQ._ Page 1 PROGRAM CMA-HPC CUSTOMER PHONE OATE CLIENT# WORK ORDER Joanna Wilson (413)585-9020 12/16/2019 422821 00004 SERVICE SIRE BILLINO STREEI PROPOSED Y: 49 Milton Street 49 Milton Street HomeWorks Energy SERVICE L STATE, Florence, MA 01062 Florence,MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL ATTIC DAMMING-R-38 FIBERGLASS 90 $184.50 $138.38 $46.12 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLAT- 11"OPEN R-40 CELLULOSE 1,068 $1,730.16 $1,297.62 $432.54 Provide labor and materials to install a 11"layer of R-40 Class I Cellulose to open attic space. SHEATHING ACCESS 1 $35.00 $26.25 $8.75 Provide labor and materials to make an access opening from one attic area to another by cutting a passage through sheathing. This access will be left open as it is between two common unheated non firewalled attic areas. VENTILATION CHUTES 58 $145.00 $108.75 $36.25 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. HomeWorks Energy �a n (� I I 1 101 Station Landing,Medford,MA 02155 CONTRACT - AUDIT HomeWoflcs 781-305-3319 FAX 0 VY Page 2 PROGRAM CMA-HPC CUSTOMER PHONE Joanna Wilson (413)585-9020 12/16/2019 422821 00004 SERVICE STREET BILLING STREET PROPOSED BY: 49 Milton Street 49 Milton Street HomeWorks Energy SERVICE CITY,STATE,ZIPBiLOW I Florence, MA 01062 Florence,MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL HOME AIR SEALING 6 $510.00 $510.00 Provide labor and materials to seal areas of your home against wasteful,excess 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.) A reduction in cubic feet per minute(cfm)of air infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door and/or combustion safety analysis will be conducted by the sub-contractor. Total: $2,604.66 Program Incentive: $2,081.00 Customer Total: $523.66 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF `**Five Hundred Twenty-Three&66/100 Dollars $523.66 -LDY,IPA1Pi'REPRESER7• NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE DAYS.