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23C-007 (4) 40 LANDY AVE BP-2021-0983 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23C-007 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-2021-0983 Project# JS-2021-001684 Est.Cost: $4000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ENERGY PROTECTORS - JOSHUA DADA 101143 Lot Size(sci.ft.): 7492.32 Owner: YOUNG JAMES Zoning: URB(100)/ Applicant: ENERGY PROTECTORS - JOSHUA DADA AT: 40 LANDY AVE Applicant Address: Phone: Insurance: 64 PAXTON RD (774) 253-0277 WC SpencerMA01562 ISSUED ON:3/10/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATION/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. I Certificate of Occupancy Signaturi! • j , • • FeeType: Date Paid: Amount: Building 3/10/2021 0:00:00 $100.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner la--() V+-T ArAtprtArr iqt CE.IT -7.------tom. , La%:-('I 1!_^, IM II MAR - 5 2021 c�'�C71UNS The Commonwealth of MassacHast tt§'.' o'�rs r.IA n,060 FOR Board of Building Regulations and Standards`"---------. __ 4). Massachusetts State Building Code,780 CMR MUNICIPALITY USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 6 -1 0)) -' q g. Date lied: e_-t»>, 4275 �/ 3-10-zi Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address:, s: 1.2 Assessors Map&Parcel Numbers 0.7 1.1a Is(this an accepted street?yes no Map umber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq It) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 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 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Rec I�vrCS vuq Flae6cL ( MA- Gtoba_ Name(Print) City,State,ZIP Lto Lc/Vila Put 413-53c1_1(,0-) No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other CV<Pecify:a1 S(A( k.(A Brief Description of Proposed Work': `Z t1 4014. G t.%,f[,._k` to f -- 1" SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs_ Official Use Only (Labor and Materials) 1.Building $ LI i 6-0() 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (1-IVAC) $ List: 5.Mechanical (Fire $ Total All Fees:$ Suppression) (� ®�� Check No.31 00 ,Check Amount: t" Cash Amount: 6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) t O t l 4 { b( 2 2-- 0 Sh v 0\ \)Cl(I-\ License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description ' 'c e C Unrestricted(Buildings up to 35,000 cu.ft.) Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry '7 7L r as — 0 d--7 1 RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances c t&Cl 7 1no ��( Cc v^ I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) `?'� C,k(n( // t c1/ZZ pr U �'c �� HIC Registration Number Expiration Date HIC Crickny Na br HIC Registrant N No„,and Street Email address 3 VeileeC Lir\ ©csba �� aS -041) 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 Issuan of the building permit. Signed Affidavit Attached? Yes l3 No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize Ut h to act on my behalf,in all matters relative to work authorized by this building permit application. 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 best of my knowledge and understanding.p 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 find 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.ft.) 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" City of Northampton M `S si Massachusetts °'�S ce` w; v � '�.E �'.g DEFAMER?!FA ER?! OF BUILDINGINSPECTIONS y r. e: 212 Main Street • Municipal Building 0. fir;i, •. + Northampton, MA 01060 •...... CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: G �ck.x. 'A (LA sgthccr, Mh- u�5 6� The debris will be transported by: Name of Hauler: -C irk CC`#1N_S Signature of Applicant: 0 )04 Date: 3 ,2-1 2( g pp c—- i j �L AsPiii1111011.2106% PhasePrbt AMP= 64 .Pax-4 rid Spencer tM4- ®tom. : II,4 =1 S3 —0 21? impUreteklek This arrilieet Olean* =laargigerimillk I. ardlirremiwir 7_ Mime aemitedirm 101emesedspepdeelleeieseegteseurweilleis' ihrustir & Elltassiblig ae►—ilA treser.beeem e l a r11>enelirloa 31:11meseedeeeenee.inelmeeeerimity 4Qiessie ..nsaet a! ��rerQel ha IO QHiii�a3ii�ea ensisitillaminimilierimmtedanwslibmiassarearinsak t1OAiaricdt.iaareadioion sEll...°,.ert � t se a�ec 13.0 lbettispeirs illeiNaltedadmismoorgi Wrialmact 41:11111i� egesies.eeie � •r• a. su a "L V� an tabselartibasid s Yeatii.ti dieugtsearbaegalse �e �rapal rtiirariea f s.ek aiaenl youa fkrscpi.ie vie emp.pligruris. Imeasismeirieferiorispeeembligveerteatecempositemeisommatibrarapigem Mssidem*,a■uisie taeweeCo p rt e.e A CC Aline(It Rr1 ` iMPiCG+RCe— C.64 ft # L * {o S b)v6ob-1 6e30 n•ig -ct ! LI 21 . lobfailmAadeaag 14u LcAnal J T ii alishams Porenc. r h4 6 ice _), A$ kaaopafiremod&a ea yirde page iepeiie,�aneieraad eabj. Falhorkamemessege as nopdaiatiarltic1S;pSAitaeailimdve<ieleamil eiisbpaSesupbSI./N mwiesc,Hreaiietiiei6ateraSIMPWCIPImlRadi/aeatl ets=ma ilraliati ieleIsAmigy ettidedesumet ay letitemedediveisdim elikeedeedeeeselleenufirimmise cersograillkdieft latairdip asirtlitseheasipsobratelperiluy that a lialah aeiraeseadaeraet 2e.111t— -= 1 cel ne �I 2-1 2-4 Widener.*De wird&hi difteret,to beaampierrdIsr air',taajd Oar orThenc recelialeessei imire Antiwar(auk es* L deed•fie lge z 3.c�yrrh 4.Metrical :r S. pater DocuStgn Envelope ID:A8269890-F736-4581-9924-974E10740AE5 RISE FNGINF FRINC, OWNER AUTHORIZATION FORM I, James Young (Owner s Name) owner of the property located at: 40 Landy Avenue , (Property Address) Florence, MA 01062 (Property Address) hereby authorize SDL • (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. LtU os.yn.-d t, woer,s signarwe 10/16/2020 19:06 AM FDT Date RISE Engineering,a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 I Canton, MA 02021 1339-502-6335 www.RtSEengineering.com AC D� CERTIFICATE OF LIABILITY INSURANCE ��I ) �„, _ 06/31n0 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 temp 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). PRODUCER - Cindy Davis Coonan Insurance Agency,Inc. vi&P1410NE auk 506.887 7122 I(Aic.Not 508-867-1090 267 Main Street ApDREiss: cindyalCoonaninsurance.cam Oxford,MA 01540 INSURERS)AFPDRDING COVERAGE NAIL a INSURER A: Capital Specialty INSURED INSURER B: Safety Energy Protector,inc. INSURER C: Starstone 64 Paxton Road INSURER D Spencer,MA 01562 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.UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID pCLAIMS. MR TYPE OF INSURANCE POLICY NUMIIMA (1MN YYYYY) (�MrDpYYYLIMITS X COMMERCIAL GENERAL UM1LITY EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED CLAIMS-MADE Q OCCUR PREMISES(Ea occurrence) S 100,000 MED EXP(Any one person) S 6,000 A y CS18001320-06 08/31R0 08/31/21 PERSONAL aADV INJURY s 1,000,000 ,----- GENT AGGREGATE LIMIT APPLIES S PER: GENERAL AGGREGATE S 2,000,000 i POLICY El,IB CT I -)I LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: S AUTOMOBILE LABILITY CONNIVED( stacilL"uR s 1,000,000 ANY AUTO BODILY INJURY(Per person) S B AUTOS ONLY x AUTOS LED Y 8238618 12/23/19 12/23/20 BODILY INJURY(P.r aoeidant) S XHEED NON-0YVN� PROPERTY DAMAGE S AUTOS ONLY _ AUTOS ONLY (Per�^N) $ X UMiRELLA UM X OCCUR EACH OCCURRENCE s 3,000,000 —C EXCESS NAS CL IMS-MADE Y 89362T193AU 08/31/20 08/31/21 AGGREGATE s 3,000,000 DED I 1 RETENTIONS _ 3 WORKERS COMPENSATION STATUTE I PER 1 1 AND EMPLOYER$'LIABILITY Y/N ANY PROPRIETORIPARTNEER/EXECUTNE❑ N/A ' EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? ( ndeloyIn►m) EL DISEASE-EA EMPLOYEE S nPSt:R a OF below EL-DISEASE-POLICY UNIT -S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addltbnal Remarks Schedule,may be aAhebed M more space Is required) Workers Compensation insurance certificate to follow under seperate cover. emailed josh CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evidence of Coverage ACCORDANCE WITH THE POLICY PROVISION& AUTHORIZED REPRESENTATIVE I J4L'IX L èOoJt}io 61888.2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD AE r0 CERTIFICATE OF LIABILITY INSURANCE DATE" '°o") 08/31 THIS CERTIFICATE IS ISSUED AS A MATTER OF RIFORIIATION OILY 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 CERTFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING RISURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND TIE CERTIFICATE HOLDER. IMPORTANT: I Ste aerllRaat holder is an ADDITIONAL PISURED,the polcy(les)must be sndorred. If SUBROGATION IS WAIVED,subject to the tennis and a'mINons of U►e policy,canals policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endormnent(s). PRODUCER mumMolls DeCastro COONAN INSURANCE AGENCY , Ede (508)987-7122 Vic,Nei, ADOR>:ss: Nidtaacooraninsurence.com 267 MAIN ST INSURERS)AFFORDING COVERAGE NAIL OXFORD MA 01540 INSURER A: ACE AMERICAN INSURANCE CO , 22667 INSURED INSURER s ENERGY PROTECTOR INC INSURER C: INSURER D 64 PAXTON RD NSURI R E: SPENCER MA 01562 INSURER F: COVERAGES CERTIFICATE NUMBER 589858 REVISION MJIMBER 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,TIE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES.UNITS SHOAVN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE AND MAD POLICY WINNER I Yn LIB CONSIESICIALBEIIEtALL1ABR.RY EACH OCCURRENCEDAME TORENTED S CIAYASMADE [1 OCCUR PROMOS Re ooarrurar) , S LED DP(My err parson) S N/A PERSONAL&ADV AIJURY S GOO.AGGREGATE LAW APPLES PER GENERAL AGGREGATE S POLICY I col LAC PRODUCTS-0011INOP AGG S OTHER AUTOMOBILE LABILITYcowmen Ea accident) Le4T s ANY AUTO BOOt.Y INJURY(Pot perm) S SCHEDULED TOS NIA EDGI LYNJusY(Peraccide t) S AUTOS � NOS I. ED FROPERTY DAMAGE S ISSDRELL ALIAO OCCUR EACH OCCU S EXCESS LIAU r CLAWSMN:1E N/A AGGREGATE 4 DEN) RETENTION S �/ WORKERSCO ATION XI sTAIUTtc FOR AND SISPLOVERE LIANUTY ANYPAOPRIETORPARTIEREXECU11VE Y!N EL.EACH ACCIDENT s 500,000 A OFRCERAIELEERExCLUDE09 WA NA RNA 09/01/2020 09/01/2021 (yy__s _Yr_in NH) EL DISEASE-EAE EE MPLOY S 500,000 IDEaCIRPTION uriou OF OPERATIONS betoa, EL DISEASE-POLICY mar S 500,000 N/A O!'A RPT1ON OF OPEItATi01a!LOCATIONS 1 VEHICLES(ACORD 101,Additional Smarts selrdrdrs suer be rsaeeea V ee.space w,wed) Workers'Compensation benaAts wilt be pad to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B.no authorization is given to pay claims for banetls to employees in stales arisrthen Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificale al insurance shows the poicy in force on the date that this certificate vraS issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The MMus of this coverage can be monitored daily by accessag the Proof of Coverage-Coverage Verification Search tool at wwwmasSss bgebonSr. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W Enemy Protectpr Inc ACCORDANCE WITH THE POLICY PROVISIONS. 64 Paxton Rd Amman=REPRESENTAT1VE • Spencer MA 01562 Daniel M.Ovidjley,CPCU,Vice President Residual Market—WCRIBMA ®1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014A11) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Professional Licensure • • Board of Building Regulations and Standards ConstruCt4)htuporvisor CS 101143 • . Eiwires:08/1. 2022 , . JOSHUA 5 DADA . . 64 PAXTON RD SPENCER MA!SIMI. ' •, • COMmissiOIWK del4 Co col • Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation ENERGY PROTECTORS INC. Registration: 172980 Expiration: 08119/2022 84 PAXTON RD. SPENCER, MA 01562 Update Address and Return Card. OMlos of Consumer Affairs&Business Reettlatlon HOME IMPROVIMENT CONTRACTOR . Registration valid for Individual use only TYPO:Corporation before the sxplretlon date. If found return to: Reaistritign Walton Office of Consumer Affairs and Business Regulation 172900 08/194022 1000 Washington Street •Sults 710 ENERGY PROTECTORS INC. Boston, MA 02118 JOSHUA DADA 84 PAXTON RD. Not valid without signature SPENCER,MA 01502 Undersecretary City of Northampton ,o, ‘,S Si' 4,‘) .. 7, Massachusetts it „, k 4 '1**/° DEPARTMENT OF BUILDING INSPECTIONS 3 212 Main Street • Municipal Building ‘) - A.04 Northampton, MA 01060 3.4° ii,10. 4 Property Address: 1---/ 14-40i1 il< Contractor ,„-, i 4, 4, - ) Name: Y" ' '1 f-, .(. C.) Address: .... City, State: , Phone: 1-7 Li-7 S3-O.-) -ii I _ Property Owner 1- li Name: J ‘.-:;i4.45 iplevAil Address: 1 Li D 1., 1 re pc,—41 City, State: I, j -.),,L Oti 1-- (contractor)attest and affirm that the building I intend to insulate does not have any open air (knob and tube)wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. -- i 1 Contractor signature / / Date mass save 2020 weatherization baririer incentives 1 1 PA,Unit • 'olwrilbtaCi.1,1•••;,,•0—. 2%4: • •• • ,„, •. ,.. James Young 456770 40 Landy Avenue Florence mn 01062 413-539-7607 soxfaniim09.gmail.com • Cisstonter/Homeowner Signature: _ oat*: 1,1 tOt;),tn,,,con4rA,:;.tof tIrve,rt,Ot2tnt •t I • t, - •-``."- —e't' ,,E1 t - ;1.•_).; • t i(4. !) A Ctiicto s.gnature: Date: ti-4t) /s.go L.of tOn MOnO.tnits. • , • • ; ;. • ' Heating System Hot Water Heater Other: Contrncter Signature,