Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
23D-182 (4)
BP-2022-0280 14 NONOTUCK ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-182-001 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-2022-0280 PERMISSIONIS HEREBY GRANTED TO: Project# INSULATION Contractor: License: Est. Cost: 1300 ENERGY PROTECTORS INC 101143 Const.Class: Exp.Date:06/16/2022 JARRETT MATTHEW CURTIS& AMANDA K Use Group: Owner: HECHT Lot Size (sq.ft.) JARRETT MATTHEW CURTIS& AMANDA K Zoning: URB Applicant: HECHTENERGY PROTECTORS INC Applicant Address Phone: Insurance: 14 NONOTUCK ST FLORENCE, MA 01062 64 PAXTON RD (774)253-0277 6S62UB0G2982602 1 Spencer, MA 01562 ISSUED ON:03/22/2022 TO PERFORM THE FOLLOWING WORK: INSULATION/W EATH ERI ZATI ON 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: / „2 , • . Fees Paid: $65.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner I The Commonwealth of Massachusetts an,p 'iFOR tiBoard of Building Regulations and Standards A'I'i' 7 I -VAIUNICIPAiLITY Massachusetts State Building Code, 780 CMR _ USE! Building Permit Application To Construct,Repair, Renovate-Of 1,-p 9ed Mar 2011 .-i , ICJ;', rilCN,:3 One-of Two-Family Dwelling - r. lo- r //nn Thi• ction For Official Use Only Building Permit Number:.L�� 4.0 Date Applied: /4.-'t.)1 kZ 5- /, 3-ZZ-ZOZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers ►'- Na�1c'Address:_, S t- l.la Is this an accepted street?yes 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 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private CI Municipal_ Outside Flooyes Zone? Municipal CI On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of R cord: 1 PI o (o f e M `tok. 0 t 0 6 4. Name(Print) City, State,ZIP 04 JV o,nof vcc i SA- q1 3 --4CC_43c:),-3 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 131'S'pecity: Brief Description of Proposed Work': A\f` S t'C.1% v1 c.v\,. Ck c., k,c �h Sec >; AA \l t..._ k A-n_ V�'/ R . C . ca mac.vv.. snoC.kfan SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ I '. 0 (a 1. Building Permit Fee:$ indicate how fee is determined: 2.Electrical $ I - 0 Standard City/Town Application Fee . 0 Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Total All Fees:la Suppression) Check No.. ''{V Check Amount: Cash Amount: 6.Total Project Cost: $ t 3 0 ❑Paid in Full ❑Outstanding Balance Due: l SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-101143 6/16/22 Joshua Dada License Number _ Expiration Date Name of CSL Holder 64 Paxton Rd List CSL Type(see below) No.and Street — Type Description Spencer, MA 01562 U Unrestricted(Buildings up to 35,000 cu.13.) R Restricted 1&2 Family Dwelling City'Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding 774-253-0277 SF Solid Fuel Burning Appliances jdada79@hotmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 172960 8/19/22 _ pany Name or HIC Registrant NameEnergy Protectors Inc. HIC Com -- HIC Registration Number Expiration Date 64 Paxton Rd _ jdada79@hotmail.com No.and Street Email address Spencer,MA 01562 774-253-0277 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 Issuanc of the building permit. Signed Affidavit Attached? Yes l No O 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 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. 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 RA 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.rnass.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" The Commonwealth of Massachusetts Department of Industrial Accidents ,i-1, wet Congress Street,Suite 100 �_airBoston,MA 02114-2017 — .r www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Anopcant Information Please Print Legibly Name(Business/Organization Individual):Energy Protectors Inc Address:64 Paxton Rd City/State/Zip:Spencer,MA 01562 Phone#:774-253-0277 Are you an employer?Check the appropriate box: Type of project(required): 1.E)I am a employer with 11 employees(full and or part-time).* 7. [] New construction 2.0 I am a sole proprietor or partnership and have no employees working forme in 8. Remodeling any capacity.(No workers'comp.insurance required.) 9. ❑Demolition 30I am a homeowner doing all work myself.[No workers'comp,insurance required.]- l0[]Building addition 4.0I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions S.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ]3.QRoof repairs These sub-contractors have employees and have workers'comp.insurance.: 1.4.©OtherInsulation 6.0 We are a corporation and its officers have exercised their right of exemption per MGL 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 polio)information. 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 additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. lithe 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:Ace American Insurance Co Policy #or Self-ins.Lie.#:6S62UB0G29826021 Expiration Date:9/01/22 ll Job Site Address: t A J( O*"y C tc_ St City/State/Zip:Fk e AC MA- G t 06 d, 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. I do hereby certify under the pains aQndd penalties of perjury that the information provided above is true and correct Signature: ) �-`�— Date: Phone#: (� b-S "U a 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.Othe r Contact Person: Phone#: City of Northampton oa� M o `5 •. s,. �r.• Massachusetts ACV • °'c� • DEPARTMENT OF BUILDING INSPECTIONS le474r 212 Main Street • Municipal Building y oa 1 Northampton, MA 01060 NY sfOx* 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: C, X n act Location of Facility: 51 Y‘C Cr' M0 G c S A 4_ The debris will be transported by: �hc'r`ccy QcL-\-C.c 4 L c Name of Hauler: I6-tk_Signature of Applicant: Date: 1 t I �2 Rd' CERTIFICATE OF LIABILITY INSURANCE OAT!DMAIOWWY1r) 0s/sonl 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. IMPORTART: R the certificate holder Is an MOIT1OO1n(NOW the po1cy(is)must have ADDITIONAL INSUR!b provisions orb*endorsed. It 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 sndorsement(ej. PRODUCER 'ir►"0i Nina Arroyo Coonen Insurance Agency,Inc. LEM 60S-067.7122 suer. 806•a67.7162 267 Main Street t:�.. , Nineacoonaninsurancs.00m Oxford,MA 01540 aaulalRta)AFFORDING COVERAGE NAIC• INSURER A: AIX Specialty INSURED SOURER a: Safety Energy Protectors,Inc. sauna c: Century Surety insurance 64 Paxton Road INSURER 9: Spencer,MA 01862 INSURER E INSURER P: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THA 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 REDUC�ED[BYY PAID CLAIMS.��j flit TYPE or INSURANCE WSW P131 I�rY N(IMaER III�ICOI YI SWIM p� LIMITSCOMMERCALOS INRAl.LIABILITY EACHvCCU I -S 1,000,000 ht I CLAIMS•MADE a OCCUR PREMISES Se oeyr►encpl S 100,000 MP E(P LAM Oef WWI ,I 6,000 a — y L1N-H714$40-00 06131/21 06/31/22 PERSONAL{ADV*WRY $ 1,000,000 ...... AGGRI�ATE A .S PER. GENERAL AGGREGATE 8 2,000,000 IPOLICY�Q J T LOC PROt9UCTs•COMPKIP Age S 2,000,000,OTs+cn f AYTOMOe1LE LAMLITY C SiNOLE Ulnr '.$ 1,000,000 ANY AUTO (BODILY INJURY(Per person) S S TULEO Am.ONLY AUOSS y 8236510 12/23/20 12/23/21 BODILY INJURY(Per e cddem) f � LY' AU ONLY AUTOS ON PnAMADE $ I k INrsReS Aum �C OccuR EACH OCCURRENCE ,I 31000,000 o excess LAS CLAIMS.LIAoo y ccP1008740 08/31/21 08/31122 AcOREQATE ,I 3,000,000 WORSE L/Milar 4I ISTATUTE I I Zill. ,I AND EMPLOYIRIC U A*IU Y Y/N ANYA p/PARTNER/EXECUTIVE a ,E.L.EACH ACCIDENT , I , 1 FICr III I EXCLUDED? N I A IFyFIq IMI) EA.,DISEASE•EA E�MP{�QYF�I If 0.411D IP OPERATIONS below E.L,DISEASE•POLICY LIMIT,I , DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES IACORO 101,AddlMur l Remarks Schedule,May be eltecMd II nwn spore I.metered) Workers Compensation Insurance certificate to follow under*operate cover. Action Inc.and National Grid USA its direct and Indirect parents subsidiaries and afMllsts,shall be named as additional insured on Commercial General Liability and Automobile Liability policies CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL SE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Worcester Community Action Council AUTHORIZED REPRESENTATIVE 4E4 Mein St.ate.200 Worcester,MA 01608 I Lite10064-1111154r0 CO . All rights ACORD 28(2016/03) The ACORD name and logo ars registered marks of ACORD AC�Ca?De CERTIFICATE OF LIABILITY INSURANCE DATE(MINDDrYYYY) 08/31/2021 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 en ADDITIONAL INSURED,the pollcy(les) must be endorsed. If SUBROGATION 18 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). PRODUCER CONTACT _kw Nina Arroyo ....__ COONAN INSURANCE AGENCY piON ...,,: (508 9 1 7122 �,R-_-__..-.------- ._.___- _WC.ffsil ,A4DResa: Nina f cOOnan)nsurenCe.00m -, 267 MAIN ST NSSURFRISJAFFoRwNoc0YERAOE _pNc e OXFORD MA 01540 iseuRaRA; ACE AMERICAN INSURANCE CO 22887 INSURED INSURER a: ENERGY PROTECTOR INC INSURa%c: INSURER 0: . 64 PAXTON RD INSURER c SPENCER MA 01562 Munn COVERAGES CERTIFICATE NUMBER: 690758 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. IN R TYPE OF INSURANCE 1156C8018aJa - POLICY N2M441 /M LIMITS COMMERCIAL GENERAL LIAa1LTY EACH OCCURRENCE t S - -I C AIMS-MADE ..___ OCCUR .PREMA'SE$.1EESPANI n-keL__11.-........__..--._----.-..1 MdED EXP(Any one psrfon). _ NIA PERSONAL 6 ADV INJURY :S OEN•L AGGREGATE LICIT APPLIES PER. GENERAL AGGREGATE '$ t PRO• i PRODUCTS•COMPJOP AGG 8 POLICY t JECT LOC �S OTHER: l +COMENNEO SINGLE LIMIT s AUTOMDaa1LWSJTY Atas^tI_. , ANY AUTO I BODILY INJURY(Par sersonl..}.L-..._.__...._._.._.�.__-•- --"' ALL OWNED ; SCHEDULED N/A BODLY INJURY(Per acaCem.)-s AUT „-1 AUTOS . NON-OWNED �.P 1Per sIi5tot�NtaflfY ommdr-- 1i HIRED AU-OS �,_,.•AUTOS ': 1 UMMRELLA LIAS OCCUR - EACH OCCURRENCE 'S EXCESS LAS ~~ CLAIMS-MADE: N/A AGGREGATE `. S DEO 1 RETENTION S WORKERSCOMPENSATt0N f XIE _ !.E pP. AND EMPLOY$R$'Wa1LITY V N - ._._ ----___.. ._. _.---.• ANYPROPRIETORMARTNER EXECUTIVE E L EACH ACCIDENT "$ 500,000 A OFFICER/MEMBEREXCLUDED? NIA NIA 8S82UBOG29826021 09/01/2021 09/01f2022 - ---- (Mendatory M NIO Ex.DISEASE•EA EMPLOYEE S 500,000 'If YYes.descnS*wWN EL DISEASE•POUC�LIMB 1 s 500,000 DESCRIPTION OF OPERATIONS tslaw N/A DESCRIPTION OF OPERATIONS I LOCATION$I VEHICLES(ACORD 101,Addtsone Remarks ScMdut,may to attached If more epee*Is rewind) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees in states Other than Massachusetts if the Inured hires,or hes hired those employees Outside of Massachusetts. This certificate of insurance shows the policy In force On the date that this certificate was Issued(unless the expiration dale on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage•Coverage Vertficetion Search tool et www.mass.govfwd/workers•compensatominveslgations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE OESCRIBEO POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN Eversource National Grid ClearResult ACCORDANCE WITH THE POLICY PROVISIONS, • 120 Turnpike Rd Suite 200 AUTHORIZED REPRESENTATIVE Southborough MA 01772 Daniel M.Crowley.CPCU,Vice President-Residual Market-WCRIBMA 01988.2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I 1 III •1. e.t. A. 4 • . 11111. S A2 • of Consumer A Regulation 10oQ WeehIngism Stm.t« Sub 710 Boston, Meseadiusees ( 11S Home Impravemmit Contractor eglab Uon► • gran marir mammon ma, -: , ammo NOM MA 01* -r POO Mims and Mow Ord. oft, obassowinserarnraelmer OW=ge.117.1* MOM lelloWirtrd *WAIN PaaMoTORS Noe AS now ND. s' + wariouswiture DocuSign Envelope ID:El8E6CC2-44D2-4D36-B3A6-4612620389F5 RISES ENGINEERING OWNER AUTHORIZATION FORM Matthew Jarrett , (Owner's Name) owner of the property located at: 14 Nonotuck Street , (Property Address) Florence, MA 01062 , (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. DocuSigned by. Own 6Pg' t i6ftlre 3/10/2022 1 3: 34 PM EST Date RISE Engineering, a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 I Canton, MA 02021 1339-502-6335 www.RlSEengineering.com