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23C-008 44 LANDY AVE BP-2021-0925 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23C-008 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-2021-0925 Project# JS-2021-001580 Est.Cost:$4900.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SEAN BRADSHAW 108517 Lot Size(sq. ft.): 6403.32 Owner: SCOTT RICHARD A Zoning: URB(100)/ Applicant: SEAN BRADSHAW AT: 44 LANDY AVE Applicant Address: Phone: Insurance: PO BOX 944 (413) 301-8010 WC CHICOPEEMA01021 ISSUED ON:2/26/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATE ATTIC FLAT 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. f . A . 'I . Certificate of Occupancy Signature: j i $ FeeType: Date Paid: Amount: Building 2/26/2021 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner I�a-T FF►(Muff C /J Z� / dotloop signature verification:dtlp.usNLMK-g820-ILKu r EH ` 2z z / �I ^ , The Commonwealth of Mits_sac is 19 Board of Building Regulations an s F R lictMassachusetts State Building Code, 0�/ IPALITY /),. ,, USE Building Permit Application To Construct,Repair,Renova Or,, lish R ised Mar 2011 One-or Two-Family Dwelling /q v7— /O This Section For Official Use Only t `Buildin Permit Number: 171—.)j,"‘Y�-u` Date Ap lied: Lv�� 4„ // � 7 2- 75-ZOZi Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pronertv Address: 1.2 Assessors(r+ Map&Parcel Numbers,' 44 Landy Avenue,Florence Ma 01062 l.la Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided N/A N/A N/A N/A N/A N/A 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Richard Scott Florence Ma 01062 Name(Print) City,State,ZIP 44 Landy Avenue 413-586-3008 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify:Insulation MassSave Brief Description of Proposed Work':Adding blown cellulose to attic flat to achieve an aggregate R-49.Please see attached work work order. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 4900 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ClStandard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fee /„ 4900 Check Not Check Amount:(,,fit Cash Amount: 6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: dotloop signature verification:dtlp.usNLMK-g820-ILKu SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-108517 12/10/2020 Sean Matthew Bailey Bradhsaw License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 246 Connecticut Ave No.and Street Type Description Springfield,MA,01104 U Unrestricted(Buildings up to 35,000 Cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-250-4746 Sean@BradshawEnterpisesLLC.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 194456 02/07/2021 Bradshaw Enterprises,LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name Sean Matthew Bailey Bradhsaw Sean@BradshawEnterpisesLLC.com No.and Street Email address 246 Connecticut Ave,Springfield,MA 01104 413-250-4746 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes 0 No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Bradshaw Enterprises,LLC to act on my behalf,in all matters relative to work authorized by this building permit application. Please see attached customer signature authorization form provided MassSave. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the lest of my lcnowledue and,tnderstandine .51ww,/03'RS 4,1a i t2,135p verified KDE0-21 S-0 8M EST Sean Bradshaw authorized Agent KDEOd&LS-0X8M-7(NN Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.it) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" dotloop signature verification: rya The Commonwealth of Massachusetts Department of Industrial Accidents • ,> 1 Congress Street,Suite 100 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 Name(Business/Organizational/Individual):Bradshaw Enterprises, LLC Address: 34 Front St Indian Orchard Mills Suite G60 City: Springfield State: MA Zip: 01051 Phone#: 413-250-4746 Are you an employer?Check the appropriate box: Type of project(required): 1. I am an employer with 11 employees(full and/or part time)* []7. New construction n2. I am a sole proprietor or partnership and have no employees working for me in any El8. Remodeling capacity.[No workers'comp.insurance required.] t 9. Demolition 3. I am a homeowner doing all work myself.[No workers'comp.insurance required]t n10. Building addition 4. I am a homeowner and will be hiring contractors to conduct all work on my property. 011. Electrical repairs or additions I will ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12. Plumbing repairs or additions n5. I am a general contractor and I have hired the sub-contractors listed on the attached n13. Roof Repairs sheet. 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. ✓ 14. Other c.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. tHomeowners 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 attach 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: Sentry Insurance (Agent - Phillips Insurance 413-594-5984) Policy#or Self-ins.Lic.#: AO 158300004 Expiration Date: 8/21/2021 Job Site Address: 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$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 7 ,do hereby certify under the pains and penalties of perjury that the information provided above is true and correct,and that clicking this checkbox and typing my name in the field below will act as my signature. Name: Sean Bradshaw Date: 9/29/20 Phone#: 413-250-4746 Email: sean@bradshawenterprisesllc.com dotloop signature verification:dtlp.usNLMK-g820-ILKu BRADENT-01 BROOK '4 TE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE DA9/2$/2020 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). - PRODUCERgCT Brooke Barre Phillips Insurance Agency,Inc. PHONE 413 594-5984 FAX 413 59248499 97 Center Street (A1C,No,Ext):( ) I(NC,No):( Chicopee,MA 01013 ADDRESS:brooke@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Middlesex Insurance Company INSURED INSURER B:Sentry Insurance 24988 Bradshaw Enterprises,LLC INSURERC: PO Box 944 INSURERD: Chicopee,MA 01021 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 LTR INSD WVp (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [X I OCCUR X A0158300 8/12/2020 8/12/2021 PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENTAGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY X JEC: LOC PRODUCTS-COMP/OP AGG $ 2,000,000 _ OTHER: $ A AUTOMOBILE LIABILITY (EO acccide SINGLE LIMIT $ 1,000,000 X ANY AUTO X A0158300003 8/12/2020 8/12/2021 BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOSRE ONLY AUTOS BODILY INJURYD (Per accident) $ AUTOS ONLY AUUTOS ONLY (PerR ardent)AGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LAB CLAIMS-MADE A0158300 8/12/2020 8/12/2021 AGGREGATE $ 2,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION X I STATUTE I ER OTH- AND EMPLOYERS'LABILITY ANYPROPRIETggOR/PARTNERIEXECUTIVE Y/N AO158300004 8/12/2020 8/12/2021 EL.EACH ACCIDENT $ 1,000,000 (Mandatory in NH)EXCLUDED? Y N/A EL.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below _ EL.DISEASE-POUCY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Thielsch Engineering,Inc.is listed as Additional Insured on a primary,non contributory basis with respect to General Liability and Auto Liability per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Thielsch Engineering,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 195 Frances Ave Cranston,RI 02910 - - — AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Knob & Tube Report Project Address 44 Landy Avenue, Florence Ma 01062 Year Built ]900 As the holder of Ma .License # CS-108517 Type CSL (CSL,Electrical) Sean Bradshaw under the pains of perjury as witnessed by my signature at the end of this document declare the following to be true in reference to the project address above. • No knob and tube wiring exists O Knob and Tube wiring exists and will be removed in a permitted manner O Knob and Tube exists and has been certified dead O Knob and tube appears active and those bays and areas in which it appears are noted in the diagram on the reverse of this document and those bays will not be insulated. (On the back of this form, when applicable, sketch a diagram starting with the street side as side A and continuing in a clockwise direction side B, C, etc. and note the bays affected dimensionally.) The undersigned, Having read and filled out this form and understanding the responsibility I am accepting do so freely of my own will. dotloop verified 0 /� a 779ELUX56-JTZB-NU7J 02/23/2021 Signature Date dotloop signature verification:dtlp.us/VLMK-g820-ILKu e///' C,('/I//1/l'///('(Yl// (/'. / i/•i.)(// i/'i(//) Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration T Type: LLC Registration: 194456 BRADSHAW ENTERPRISES,LLC s'_ • Expiration: 02/07/2021 246 CONNECTICUT AVE T - SPRINGFIELD,MA 01104 • .73 } Update Address and Return Card. SCA 1 0 20M•05/17 %/r yr,,,,,wniiiive,///r/. /�i7,44eie-AiiteM 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: Reaistration Expiration Office of Consumer Affairs and Business Regulation 194456 02/07/2021 1000 Washington Street-Suite 710 BRADSHAW ENTERPRISES,LLC Boston,MA 02118 SEAN M.BRADSHAW 34 FRONT STREET SPRINGFIELD,MA 01151 Undersecretary Not v.� without si• •ature � Commonwealth of Massachusetts Division of Professiona.Licensure Board of Building Regulations and Standards Constryt s,On(Supervisor CS-108517 • Wires: 12/10/2020 SEAN MATTHEW BMW' BRADSHAW- . ' 246 CONNECTICUT AVENUE �O SPRINGFIELD MA 01104}1l`l;- ' Commissioner l dotloop signature verification:dtlp.usNLMK-g820-ILKu DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of MGL c. 40, s.54,is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c.l 11, s.150A. ANY AND ALL DEBRIS PROUCED AS A RESULT OF WORK PERMITTED UNDER THE ATTACHED APPLICATION WILL BE DISPOSED OF IN: USA Waste Recycling Name of Licensed Solid Waste Disposal Business/Facility 15 Mullen Rd, Enfield CT 06082 Address of Licensed Solid Waste Disposal Business/Facility USA Waste Recycling Name of Hauler Sean Bradshaw 9/20/2020 Print Applicant Name Date ❑ I,Sean Bradshaw do hereby certify under the pains and penalties of perjury that the information provided above is true and correct, and that clicking this checkbox and typing my name in the field above will act as my signature. DocuSign Envelope ID:7CE8E09D-895F-4D9F-8841-455E5B7402E7 Federal ID*05-0405629 RISE Engineering RI Contractor Registration•8186 MA Contractor Registration 9120979 RISENRISE4t 60 Shawmut Unit 82,Canton,MA 02021 ENGINEERING CONTRACT - WZ (401)784-3700 FAX(401)784-3710 Page 1 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CMA-HES DESCREED BG AND ELOWME CUSTOMER FOR WORN AS CUSTOMER PHONE DATE CLIENT I WORK ORDER Richard Scott (413)586-3008 09/29/2020 296814 61902 SERVICE STREET BILLING STREET PROPOSED SY: 44 Landy Avenue 44 Landy Avenue Jeff Ledoux SERVICE CITY,STATE,ZIP BILLING CRY.STATE.ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 100%D 2020 For a limited time,Columbia Gas is offering an incentive of 100%on qualifying weatherization measures.This contract must be signed and returned within 20 days and the weatherization must be installed by November 30,2020.Eligible LED lightbulbs,programable thermostats,and hot water saving items are also incentivized at 100%.WiFi-enabled thermostat incentives vary by type of thermostat. UD CARBON MONOXIDE-HEATING SYSTEM Have your heating system tuned up and retested to be sure that the (initials) undiluted flue gasses do not exceed 100 parts per million(ppm)of carbon monoxide.Weatherization work cannot proceed until this is fixed. KNOB&TUBE WIRING(Northhampton) We have identified that your home might have Knob&Tube wiring 1 XS (initiate) I present.The following contract is not valid unless accompanied by the Pre-Weatherization Barrier Incentive form,signed by your licensed electrician.Work will not proceed with this work until we receive a copy of the form. STORAGE-ATTIC p-ua Homeowner is responsible for the removal of the stored items J gS (initials) I blocking the installation of weatherization work in the attic. Removal must occur prior to the scheduled work start. ATTIC DAMMING-R-38 FIBERGLASS 90 $184.50 $184.50 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLAT- 15"OPEN R-49 CELLULOSE 300 $558.00 $558.00 Provide labor and materials to install a 15"layer of R-49 Class I Cellulose to open attic space. ATTIC FLAT-4"FLOORED R-13 DENSE CELLULOSE 200 $338.00 $338.00 Provide labor and materials to install a 4"layer of R-13 Class I Cellulose to floored attic space. SLOPE-6"DENSE R-19 CELLULOSE 250 $487.50 $487.50 Provide labor and materials to install a 6"layer of R-19 Class I Cellulose to sloped ceiling area. ATTIC HATCH-SEAL& INSULATE 1 $60.00 $60.00 Provide labor and materials to insulate the back of an attic hatch with 2"rigid insulation board.Weatherstrip the perimeter. DocuSign Envelope ID:7CE8E09D-895F-4D9F-8B41-455E587402E7 Federal ID#0 5-04 0 56 29 RISE Engineering RI Contractor Registration#8186 MA Contractor Registration#120979 RISE 60 Shawmut Unit#2,Canton,MA 02021 CONTRACT YYZ ENGINEERING (401)784-3700 FAX(401)784-3710 Page 2 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CMA-HES DENGINEERING AND ESCRIBED BELOWTME CUSTOMER FOR WORK AS CUSTOMER PHONE DATE CLIENT WORK ORDER Richard Scott (413)586-3008 09/29/2020 296814 61902 SERVICE STREET BILLING STREET PROPOSED BY 44 Landy Avenue 44 Landy Avenue Jeff Ledoux SERVICE CITY.STATE.ZIP BILLING CITY.STATE ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL ATTIC DOOR- INSULATE&WS 1 S110.00 S110.00 Provide labor and materials to insulate the back of the attic door with 2"rigid insulation board and seal the door's edge with weatherstripping to restrict air leakage. VENTILATION CHUTES 82 $205.00 $205.00 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. HOME AIR SEALING 7 $595.00 $595.00 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.) WEATHERSTRIP AND ADD DOOR SWEEP 2 $160.00 $160.00 Provide labor and materials to install Q-lon weatherstripping and a doorsweep to door(s)to restrict air leakage. WALLS WOOD SIDED 675 $1,356.75 $1,356.75 Furnish and install blown in Class I Cellulose to shingle and/or clapboard exterior walls. The butt of the upper course of your wood siding is cut to drill holes into the wall sheathing behind.The holes are then plugged and the wood siding is reinstalled using exterior grade nails. Touch-up painting,if needed,will be the customer's responsibility. Homeowner has received a copy of the EPA's Renovate Right Lead-Safe information guide explaining the potential risk of the lead hazard exposure from the weathenzation work to be performed. Your signature is your acknowledgement of receipt and agreement to proceed. COMMON WALL R13 FIBERGLASS AND RIGID BOARD 70 $375.20 $375.20 Provide labor and materials to install R-13 unfaced fiberglass to a common wall. Then rigid board at R-10 or greater with required fire rating will be installed to a common wall area Seal all seams with FSK tape. BASEMENT SILLS RIGID BOARD INSULATION 100 $396.00 $396.00 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. DocuSign Envelope 10:7CE8E090-895F-409F-8841-455E587402E7 Federal ID#05-0405629 RISE Engineering RI Contractor Registration#8186 MA Contractor Registration#120979 IS60ShawmutUnit#2.Canton,MA02021 ENGINEERING CONTRACT - WZ (401)784-3700 FAX(401)784-3710 Page 3 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CMA-I-IES DENGINESCRIBEERING BELOW ANDTHE CUSTOMER FOR WORE AS ECUSTOMER PHONE DATE CLIENT X WORK ORDER Richard Scott (413)586-3008 09/29/2020 296814 61902 SERVICE STREET BILLING STREET PROPOSED BY. 44 Landy Avenue 44 Landy Avenue Jeff Ledoux SERVICE CITY.STATE.ZIP BILLING CITY.STATE ZIP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATE BULKHEAD DOOR 1 $110.00 $110.00 Provide labor and materials to insulate the back of the door to the basement's bulkhead with rigid board at R-10 or greater with the required fire rating and seal the door's edge with weatherstripping to restrict air leakage. Total: $4,935.95 Program Incentive: $4,935.95 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/Dollars $0.00 UPON RECEIPT OF YOUR RISE ENGINEERING INVOICE.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%%MIL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES.RIGHTS OF RECISION.SCHEDUUNG.AND CONTRACTOR REGISTRATION. DocuStned by. DDo�c/u�S}i�gn�1ed by:�,�frJ� J L<I�V K ciw SfGNA�RE" RI REBEMigivE ��� fi1USFfN)AHC974H1 841-1-1 7lUnFlVdFi NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE 10/7/2020 I 9:57 AM EDT SIGN DATE 30 DAYS ACCEPTANCE OF CONTRACT-THE ABOVE PRICES.SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO D0 THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTUNED ABOVE DocuSign Envelope ID:7CE8E09D-B95F-4D9F-8841-455E5B7402E7 RISES ENGINEERING OWNER AUTHORIZATION FORM Richard Scott (Owner's Name) owner of the property located at: 44 Landy Avenue (Property Address) Florence, MA 01062 (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. This form is only valid with a signed contract. The permit will be secured by the subcontractor, at no additional cost. It is the homeowner's responsibility to close out this permit by contacting their municipality at the completion of this work. c DocuSgned by. ,igt;,s�,�Aiwa ure 10/7/2020 I 9:57 AM EDT Date RISE Engineering,a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 I Canton, MA 02021 1339-502-6335 www.RlSEengineering.com ,_, .r (:fmrnonrreattII nt Massachusetts r "'r" ifilpiv icon of Proleaswnal Lrcensure ii e drd of Buildtnq R�x31rlatrnns and Standards Constriuetrnnl•t5pprvisor .. _ /! CS-I08S17 I lres_ 1210/2022 Orr 246 CONNFCITC I re•1►S��tdC�'I�� ' ' Commissioner , 0. h° �&» - -- 111 EVANSTON INSURANCE COMPANY MARI(EL® ENVIRONMENTAL COMMON POLICY DECLARATIONS THE COVERAGE PROVIDED BY ONE OR MORE COVERAGE FORMS OR INSURING AGREEMENTS INCLUDED IN THIS POLICY MAY BE WRITTEN AS CLAIMS-MADE AND REPORTED COVERAGE. CLAIMS-MADE AND REPORTED COVERAGE REQUIRES THAT A CLAIM BE FIRST MADE AGAINST YOU AND REPORTED TO US DURING THE POLICY PERIOD OR ANY APPLICABLE EXTENDED REPORTING PERIOD WE PROVIDE. POLICY NUMBER: CPLMOL105072 RENEWAL OF POLICY: NEW Named Insured and Mailing Address(No.,Street,Town or City,County,State,Zip Code) Bradshaw Enterprises LLC PO Box 944 Chicopee, MA 01021 Policy Period: From 01/01/2021 to 01/01/2022, at 12:01 A.M.Standard Time at your mailing address shown above. Form of Business: 0 Individual ❑ Partnership ❑Joint Venture ® Limited Liability Company ❑Organization, including Corporation (but not incl. Partnership,Joint Venture or LLC) IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Coverage is provided for the following only if indicated with an"X"in the checkbox(es)below: Claims-Made Occurrence Premium ❑ Commercial General Liability ❑ ❑ EXCLUDED ❑ Contractor's Pollution Liability ❑ ® INCLUDED ❑ Owners And Contractors Protective Liability Not applicable ❑ EXCLUDED (Monoline Coverage) ❑ Products-Completed Operations Liability ❑ ❑ EXCLUDED (Monoline Coverage) ❑ Professional Liability ❑ Not applicable EXCLUDED ❑ Site Pollution And Environmental ❑ Not applicable EXCLUDED ❑ Terrorism Risk Insurance Act(TRIA): EXCLUDED Advance And Deposit Premium: $1,358.00 Other Charge(see MDIL 1002): $154.32 Other Charge(Specify): $ Inspection Fee(100% Fully Earned): $ GRAND TOTAL(Including all charges and fees): $1,512.32 Producer Number, Name and Mailing Address 216041 Alternative Risk Company 605 SW US Highway 40#359 Blue Springs, MO 64014 MDEI 201411 17 Page 1 of 2 Combined General Aggregate Limit Of Insurance $250,000 The amount shown above is the most we will pay under all coverage parts attached to this policy Audit Period(Indicated by an"X" in the checkbox(es)below): ® Flat ❑Annual 0 Semi-Annual ❑ Quarterly 0 Monthly Endorsements Forms and Endorsements applying to this Coverage Form and made part of this policy at time of issue: SEE FORMS SCHEDULE MDIL 1001 ATTACHED These Declarations, together with the Common Policy Conditions, Supplemental Declaration(s), Coverage Form(s), and any Endorsements(s) complete the above numbered policy. cf-A,1 01/12/2021 Countersigned By Countersignature Date MDEI 201411 17 Page 2 of 2 dotloop signature verification:dtlp.usNLMK-g820-ILKu Bradshaw Enterprises, LLC PO. Box 944 Chicopee, MA 01021 Hello Building Department We are Bradshaw Enterprises, LLC located in Indian Orchard, MA. We are an Insulation / weatherization contractor for MASS SAVE. Enclosed in this packet is our Permit application and supporting documentation as follows: -Application -HIC Registration -Insurance Certificate -Signed customer Authorization form or copy of signed contract -Construction Supervisor License -Worker's Compensation Insurance Affidavit -Pre stamped return envelope We hope you find this packet intact and convenient. If you have any questions or concerns please call or email at 413-250-4746 Sean Bradshaw 413-301-8010 Office phone Email: Sean@BradshawEnterprisesLLC.com