38A-080 BP-2021-2132
46 CHAPEL ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38A-080-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-2132 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION Contractor: License:
Est. Cost: 2147 POTENTIAL ENERGY LLC 106184
Const.Class: Exp.Date:04/27/2023
Use Group: Owner: BSS-3 PROPERTIES LLC
Lot Size (sq.ft.)
Zoning: URB Applicant: POTENTIAL ENERGY LLC
Applicant Address Phone: Insurance:
1 HARTFORD SQ BOX 2E (413)798-0273 O 9083282
NEW BRITAIN,CT 06052
ISSUED ON:11/03/2021
TO PERFORM THE FOLLO WING WORK:
INSULATION
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.
Signature: imAaiv1/4_,
•
Fees Paid: S65.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Buildine Commissioner
PAET1cETETT
The Commonwealth of Massac us s
Board of Building Regulations an Stan d NOV - 1
2021FOR
\ ' Massachusetts State Building Cod 780 MR CIPALITY
��ar of USE
Building Permit Application To Construct,Repa' ,Reno�r��'rN , soiorasRevi ed Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Buildin Permit Number: 81 � i—ak-b Date p 1EV113 II• Z-ZOZ)
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
46 Chapel Street 38A-080-001 38A-080-001
1.1 a Is this an accepted street?yes V no__ Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R Three Family 13068 N/A
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(f)
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 El Private 0 Zone: Outside Flood Zone? Municipal RI On site disposal system 0
Check if yesEl
SECTION 2: PROPERTY OWNERSHIP1
2.1 Owner'of Record:
BSS-3 PROPERTIES LLC FLORENCE,MA 01062
Name(Print) City,State,ZIP
41 CLOVERDALE ST 413-253-0285 kpm@kendrickmanagement.com
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply)
New Construction 0 Existing Building El Owner-Occupied 0 Repairs(s) 0 Alteration(s) El Addition 0
Demolition 0 Accessory Bldg. ❑ Number of Units Other El Specify:Insulation
Brief Description of Proposed Work2:DAMMING 12"layer of R-38 unfaced fiberglass batts to(58SF)
10"layer of R-37 Class I Cellulose added to(660)square feet,Insulate(1)attic hatch,Basement Sills(57)linear feet of rigid board,
Insulate basement door,Ventilation chutes(34),4"Bath exause hose
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $2,147.97 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fc. '"
Check No Lit�Check Amount rig cash Amount:
6.Total Project Cost: $2,147 97 0 Paid in Full 0 Outstanding Balance Due:
9
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CSFA-106184 4/27/23
Nicholas Meister License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) R
344 Andrews Street
No.and Street Type Description
Southington CT 06489 U Unrestricted(Buildings up to 35,000 Cu.ft.)
City/Town,State,ZIP R Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-798-0273 Info@potentialenergyus.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
192284 6/21/22
Potential Energy HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
1 Hartford Square,Door 65,Suite 216
Info@potentialenergyus.com
No.and Street Email address
New Britain,CT 06025 413-798-0273
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 El 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 Potential Energy
to act on my behalf,in all matters relative to work authorized by this building permit application.
4, 4 _ 10/27/21
Print Own`r s Name(El ronic 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.
•
NG�A.9 /� 10/27/21
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.) 2250 (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) 1980 Habitable room count 9
Number of fireplaces 0 Number of bedrooms 3
Number of bathrooms 3 Number of half/baths 0
Type of heating system GAS/WARM AIR Number of decks/porches 3
Type of cooling system Central Air Enclosed 0 Open 3
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
DocuSign Envelope ID: DC15F9E7-E6DA-4544-AAAB-770F66881489
Liocubign tnveiope lu: Ul.1 bl- t/-touA-4o4µ-w+FYC-/iur0000 Ivoa
Federal ID#05-0405629
RISE Engineering RI Contractor Registration#8186
MA Contractor Registration#120979
\Al
RISE 60 Shawmut,Canton,MA
ENGINEERING' CONTRACT YYZ
(401)784-3700 FAX(401)784-3710
Page 1
PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE
ENGINEERING AND THE CUSTOMER FOR WORK AS
CMA-HES DESCRIBED BELOW
CUSTOMER PHONE DATE CLIENT p WORK ORDER
Ashley Healy Xe1 �CkR \ly'1 (413)253-0285 07/09/2021 314993 38502
SERVICE STREET BILLING STREET PROPOSED BV:
46 Chapel Street#a 7e V6 Daniel Diaz
SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP
Northampton, MA 01060 Amherst, MA 0100/ y
DESCRIPTION QTY COST INCENTIVE TOTAL
INCENTIVE: RENTERS
For eligible measures,the Mass Save Program offers a renters
incentive of 100%off insulation and air sealing measures.To
participate in the Renter incentive, please submit a copy of the year-
round rental agreement.
To be eligible for the renter incentive, the utility bills must be in the
tenant's name and the home must be rented on a year-round basis.
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.)
ATTIC DAMMING-R-38 FIBERGLASS 58 $118.90 $118.90
Provide labor and materials to install a 12"layer of R-38 unfaced
fiberglass batts for damming purposes.
ATTIC FLAT- 10"OPEN R-37 CELLULOSE 660 $1,029.60 $1,029.60
Provide labor and materials to install a 10"layer of R-37 Class I
Cellulose to open attic space.
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.
BASEMENT SILLS RIGID BOARD INSULATION 57 $225.72 $225.72
Provide labor and materials to install rigid board insulation to the
perimeter of the basement ceiling at the house sill.
VENTILATION CHUTES 34 $85.00 $85.00
Provide labor and materials to install ventilation chutes in the rafter
bays to maintain air flow.
VENT BATH FAN THRU ROOF 4 INCH 1 $118.75 $118.75
Provide labor and materials to install an insulated 4"exhaust hose
with roof mounted flapper vent to exhaust existing bathroom fan(s).
DocuSign Envelope ID: DC15F9E7-E6DA-4544-AAAB-770F66881489
DocuSign Envelope ID: DC15F9E7-E6DA 4544-AAAB-770F66881489
Federal ID#05-0405629
RISE Engineering RI Contractor Registration#8186
MA Contractor Registration#120979
RISE 60 Shawmut,Canton,MA
ENGINEERING CONTRACT WZ
(401)784-3700 FAX(401)784-3710
Page 2
PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE
ENGINEERING AND THE CUSTOMER FOR WORK AS
CMA-HES DESCRIBED BELOW
CUSTOMER PHONE DATE CLIENT C WORK ORDER
Ashley Healy (413)253-0285 07/09/2021 314993 38502
SERVICE STREET BILLING STREET PROPOSED BY:
46 Chapel Street#a 437 Main Street Daniel Diaz
SERVICE CRY.STATE,TIP BILLING CITY.STATE.ZIP
Northampton, MA 01060 Amherst, MA 01002
DESCRIPTION QTY COST INCENTIVE TOTAL
INACCESSIBLE ATTIC AREA
•
We have identified an opportunity to insulate an attic area in your (Initials)
home that is not presently accessible.We are making our
recommendations based upon an educated understanding of your
home's construction, but upon gaining access to this space,your
home's work-scope might need to be modified. Your contractor and
our RISE inspector will guide these changes and discuss them with
you prior to proceeding.
Total: $2,147.97
Program Incentive: $2,147.97
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%WILL BE CHARGED MONTHLY ON ANY
UNPAID BALANCE AFTER 30 OATS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION.
(-DocuSlgned by'
p4J �t /�j `� ` Donna W. Golec
1 YSE 4i7444 471.96IVEPE USTOMER SIGNATURE owner,
//p� Kendrick Property Management
NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE 2/ 2.,/21
L/ION D///---���[[[II'E
ACCEPTANCE OF CONTRACT-THE ABOVE PRICES.SPECIFICATIONS AND CONDITIONS ARE
3Q DAYS. SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK
AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE
DocuSign Envelope ID: DC15F9E7-E6DA-4544-AAAB-770F66881489
DocuSign Envelope ID: DC15F9E7-E6DA-4544-AAAB-770F66881489
R ISE
ENGINEERING
OWNER AUTHORIZATION FORM
1, 1)1_, A»ct uc( rnc+ s.di
(O ner's F'p )ne)
owner of the property located at:
46 Chapel Street
(Property Address)
Northampton, MA 01060
(Property Address)
hereby authorize
Subcontractor(to be filled in by office)
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.
Donna W. Golec
Owner,
• ure Kendrick Property Management
ift)71Y1
Dat
RISE Engineering, a Division of Thielsch Engineering, Inc.
60 Shawmut Road Unit 2 I Canton, MA 02021 1339-502-6335
www.RISEengineering.corn
City of Northampton
r1r jr!/
Massachusetts/
ti DEPARTMENT OF BUILDING INSPECTIONSC
�� � 212 Main Street • Municipal Building
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: VAC), �ur � ers Q2cdc►, &5 '1 S rnc,;n
The debris will be transported by:
Name of Hauler: ¶ eAc.\ f�z ; t .L.
Signature of Applicant: Date: Ic,i r ;j 7_.�
•
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Construction. Whin 1 & 2 Family
CSFA-106184 Eipires:04/27/2023
• NICHOLAS ALEXANDER MEISTER
344 ANDREWS ST
SOUTHINGTON CT 06489
/ttiy,I.10.
Commissioner claia K. Y
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: LLC
Registration: 192284
POTENTIAL ENERGY LLC Expiration: op/21/2022
1 HARTFORD SQUARE BOX 2-E
NEW BRITAIN,CT 06052
Update Address and Return Card.
SCA 1 0 20M-05/17
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:
Registration Expiration Office of Consumer Affairs and Business Regulation
192284 06/21/2022 1000 Washington Street -Suite 710
POTENTIAL ENERGY LLC Boston,MA 02118
NICHOLAS MEISTER 44.
•
��
1 HARTFORD SQUARE DOOR 65 SUITE ram`""d t/ '
216 Not valid without signature
NEW BRITAIN,CT 06052 Undersecretary
•
The Commonwealth of Massachusetts
Department of Industrial Accidents
. Office of Investigations
G � � � 600 Washington Street
•
Boston,MA 02111
4,0 www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le.ib1v
Name(Business/Organization/Individual):
Address: \ \�Ca.- Stg� • e_ i :r "
City/State/Zip: Ne; , c,(c Phone #: y i3 St" -0.1
Are you an employer?Check the appropriate box: Type of project(required):
1.El I am a employer with \\ 4. I am a general contractor and I 6. New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub contractors have 8. C] Demolition
workingfor me in anycapacity. employees and have workers'
p 9. Building addition
[No worker§'comp.insurance comp.instrance.t
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' co right of exemption per MGL
Y comp. 12.0 oof repairs
insurance required.]t C. 152, §1(4),and we have no
employees.[No workers' 13. Other`k 4' r.n,r`
comp. insurance required.]*Any applicant applicant that checks box p I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who subnvt this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tCaniractors 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: 511•C f ui/ \n LV
Policy#or Self-ins. Lie.#: i�i �1 Cs 1;.g Expiration Date:
Job Site Address_ A cv,c±te_j s t City/State/Zip:llt 01o(j
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of
Investig tions of the DIA for insurance coverage verification.
I do hereby certify un they t 'es of perjury that the information provided above is true'and correct
Signature: — — Date:__ _012.i j
Phone#: `1 l 3 - 7e5;
J_
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#: