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25C-109 (3) BP-2022-0313 36 GRANT AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25C-109-001 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-2022-0313 PERMISSIONIS HEREBY GRANTED TO: Project# 2022 WEATHERIZATION Contractor: License: Est. Cost: BRYAN HOBBS 83982 Const.Class: Exp.Date:05/02/2022 BROWN, CAMERON S. & SILVIA XIMENA CRUZ Use Group: Owner: DE BROWN Lot Size (sq.ft.) Zoning: URB Applicant: BRYAN HOBBS REMODELING LLC Applicant Address Phone: Insurance: PO BOX 1535 (413)775-9006 WC9057270 GREENFIELD, MA 01301 ISSUED ON:03/29/2022 TO PERFORM THE FOLLOWING WORK: WHOLE HOUSE 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: 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: 111 • ip CP 1 Fees Paid: $65.00 212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner sZ., The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Et Massachusetts State Building Code, 780 CMR MUNICIPALITY . USE w Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 (-. ` One-or Two-Family Dwelling cc This Section For Official Use Only s Bur4ing Pekmit um r: Bp--2,p22-D313 Date Applied: EUlti �5 �� 3-�9.Z6z7 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.�Property Address: 1.2 Assessors Map&Parcel Numbers J(p 6rt1v 1- i-P1vK.._ )..6-C'109' --da I 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Gl.R13 .292 acre 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 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Recor laMLrC c (riff �1 1 Name(Print) City,State,ZIP LD (. f4e,V Ate. 413-yy(o- ylly cs6dg„a21 e 4 e _ No.and Street Telephone Email Addres l SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other JSbo Specify:(*jeaANtti rjAk". Brief Description of Proposed Work2:ccaje 'ca., ,I. 5c itru L t' 041 s,,,, cicsle t I'i + 14 fcck CcIl<lvw alb( 4'1004 d nk- pea. skd .clis n I w .eykje _v• wc_llg, to ift.►1 ,r loam,/ Z (timjs,. cr . .,15fc,..— (...G.IIs, pixuv141, vcnL 1,414, rdi,, .s..17)i w-tt, rie1 uw)- SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ Io f a d?. 9 I 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire o� Suppression) $ Total All Fees: $ jpg Check No.25 Check Amount: t Cash Amount: 6.Total Project Cost: $Io 1 O S?, 9 1 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Y U�31F, 5)D buaD �P�S License Number Expiration Date Name of CSL Holder PYa 53 S� List CSL Type(see below) U No.and Street Type Description Gr (�` I ' �� Z U Unrestricted(Buildings up to 35,000 Cu.ft.) (,PJ�ct1 i o9 Q\3 O R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding ((11 1 SF Solid Fuel Burning Appliances qr -- 1 r Usk. inCilvs&Alc4olse G`` ati.ter.. I Insulation Telephone Email addreSS D Demolition 5.2 Registered 1Home Improvement Contractor(HIC) 1 Il �s� j'Yl� . LL° HIC Registration Number Ex iration Date C pany Name or HIC Registrant Name ^ 11 o.and S c 1531 I i1 gt►16v►iQ" pr Q / utt i r .it, arr¢r, � N a c '3c& Email address" 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 No .❑ 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. iCks 3)23 a z Pr wn rr''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. 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" DociSign Envelope ID D4859CB0-AC87-4565-8788-D30271EBA979 RISES ENGINEERING" OWNER AUTHORIZATION FORM l Cameron Brown (Owner's Name) owner of the property located at: 36 Grant Avenue (Property Address) Northampton, MA 01060 (Property Address) hereby authorize/\CvN_ ceSsrwdL _ Lax 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. DocuSigncd byLbUtIVOLA, brOWIA, Owne 'enilatUre 9/19/2021 I 9:22 PM 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 Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 • Home Improvement Contractor Registration Type: LLC BRYAN HOBBS REMODELING,LLC. Registration: 186045 P.O.BOX 1535 Expiration: 08/25/2023 GREENFIELD,MA 01302 Update Address and Return Card. Office of Consumer Affairs&Business Reoulatlon 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 196045 08125/2023 1000 Washington Street-Suite 710 BRYAN HOBBS REMODELING,LLC, Boston,MA 02118 BRYAN HOBBS 576 LEYDEN RD 4.ie • GREENFIELD,MA 01301 Undersecretary Not valid without signature Commonwealth of Massachusetts • Division of Professional Licensure Board of Building Regulations and Standards Co[1st-au:IorrD'anpands©c CS-083982 Expires:05/02/2022 BRYAN G HOBBS 26 OAK ST GILL MA 01354 f w r. Commissioner da.,,p� The Commonwealth Ads 16 ,�° of dw+scltusetts "�'� - q Department of last Aecider?ts li, _°ny '.ours. �(j�P: . ' . "- t•t •Office of Invatigations °' p10 Laf Venter EY°°`t' 7•:14, • 2Avenue de Leiftwafte, Boston,MA 02111-175t www.nu ogov/diaa I t .� {-L onipeniaiion Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Amite iltilit 1 . .." 1 New clides/Orgw on/lttdivldaat):Btyan Hobbs Remodeling, LLC Addle :`,7 y eyden Rd Po Box 183E cityistattajpi Greenfield,Me 01302 . Phone#'413 00d Ar,yivi ad, .player?Cheekhe appropriate box Type of protect(regain* 1.111 r sot vi-pioyer with 7 4. 0 I am a general contractor and I 6 0 Now constructionoy Mil and/or °* have hired the sub-contractor® 2.0 I ens a sole proprietor or partner- Hated on the attached sheet 7. 0 Remodeling ship and eve n►o employees These nub-contractors have 8. ❑Demolition working for me in any aapacty, employees and have workers' 9. ❑Building addition [No 'gyp.insurance comp.insurance.* requiredl 5. ® We are a coloration and its 10.0 Electrical repairs or additions 3.[31 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions • ray, / Vito workers' comp, right of exemption per MOL 12,❑Roof repairs inzatance re4uirei°)t c. 152.*1(4)°and we have Ito uwealthorl�OoYt employees. [No workers' all Other entauoe required.] •Any applicant that cheeks box*hunt also ffi&out the notion below showing their woakee eomponaation policy intimation. t ilomaeataters'aha inbuilt this affidavit hulleatieghay are doing all work and then hire outside contractors must submit a new affidavit indicating such. Motors that cheeps bbeummet asteebn4 m additional sheet showing the tune of the subcontractors and state whether et netting entities have emplosm NWsub oailstetsmins.employees,they must provide their workers°comp,policy number. ION ass oagrkj r the l'provMA q wosfiers'aamipenser/os Litanmate jibs my s mploysee Below la the policy ea*eke bIlinsetkis inns nos colvany Nemae:88i®o in illIBUttintia CdEIVaEfiy Policy#a ;@101 : . °MI 0:WCS367270 _ ._, Expiration Date:10/20/2022 • lob Ste A'.:y,2m....(,.(L.0 .l..CI, ..._.A. ., ... .... .. ,'malty/State Zipi K. 6, lei inn l Me 1 Attach a co.,,,, L, .`2' yorkere compensation ic1itty ceW a'ation page(showing the policy number and expiration date). Ftllera to secure covemge as mired trader B&.tlon 2SA of MOL c. 152 can lead to the imposition of criminal penalties of a fine up,to$1,500.00 esrdlor onefesr fmpelsosnnont,as mil as oivil penalties in the form of a STOP WORK ORDER and a fine of up to(260.00 a day most to yielder. Be advised that a tcpy of this statement may be forwarded to the Office of Inwnigai afthe DIA kr inseam mew verificcdon. ^ A' _ -. Ida hers*elite seeder Abe pakw sad perMiM a of gall9py AsA le 314foraraatiess provided above is bee and cornet • 3 Zb ,.:a. 41`1',VI r-- °� twits be lib suss,to its cow l�' y wows Odd City ne Tomtit ..,. _-..._� �....._.. Pert it/Manse CI Ia n Authority( oice)t taIrissaril tined* gDepatFtment 3'City/Town Clerk 4.❑Ves rte d hoe 'lumbing Inspector LLUOthers,_ _ A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDNYYY) 8/4/2021 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 an ADDITIONAL INSURED,the policy(ies)must 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). PRODUCER CONTACT Adina Edgett, CISR NAME: g Webber & Grinnell A 2.14L.Ext): (413)586-0111 FAX No): (413)see-e491 8 North King Street ADDRESS: aedgett@webberandgrinnell.com INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A:Selective Ins Co of S Carolina 19259 INSURED INSURER B:Selective Ins Co of America 12572 Bryan Hobbs Remodeling, LLC INsuRERc:Selective Ins Co of Southeast 39926 PO Box 1535 INSURER D:Evanston/ XS Brokers INSURER E: Greenfield MA 01302 INSURERF: COVERAGES CERTIFICATE NUMBER:Exp 08/22 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 EFF POLICY EXP W /Y LIMITS LTR INSR VD POLICY NUMBER (MM/DDYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE n OCCUR DAMAGE TO RENTED 500,000 PREMISES (Ea occurrence) $ S2289042 8/4/2021 8/4/2022 MED EXP(Any one person) $ 15,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY n P J O- f I PRO- ( I LOC , PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY $ 1,000,000 r_ (Ea accident) B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED A9105300 8/4/2021 • 8/4/2022 BODILY INJURY(Per accident) $ AUTOS - AUTOS PROPERTY DAMAGE (Per accident) $ X HIRED AUTOS X NOON-ON-OWNED AUTOS - Underinsured motorist BI split limit $ 20,000 X UMBRELLALIAB _ OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION $ S2289042 8/4/2021 8/4/2022 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N I A C (Mandatory in NH) WC9057270 10/20/2021 10/20/2022 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below Bryan Hobbs is Excluded E.L.DISEASE-POLICY LIMIT $ 1,000,000 • 1 D POLLUTION LIABILITY CpLMOL105179 1/19/2022 j 1/19/2023 PER OCCURRENCE $250,000 I AGGREGATE $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W Grinnell, C?CU, C_C P.(!(.._ r l('., ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) mass save- Weatherization barrier incentives Based on your Energy Specialist's recommendations,your home can benefit from program-eligible insulation and/or air sealing improvements.Before moving forward,please follow all the instructions below to remediate your weatherization barriers. CUSTOMER INSTRUCTIONS 1. Hire a qualified, licensed contractor to evaluate and/or remediate the weatherization barrier(s). 2.Submit signed and completed copies of this form and a copy of the paid contractor invoice(s)within 60 days of your Home Energy Assessment to: a Rd,l.!• . •`n,MA Ole' or email to ^.elnf¢.'a Rlr'- 3.The weatherization incentive will be deducted from the customer co-payment amount of the weatherization work.A rebate check will be issued in the event the amount exceeds the customer's co-payment amount. 4.Complete the recommended weatherization improvements. 5.The Mass Saves HEAT Loan offers interest-free financing opportunities that may be used to remediate eligible weatherization barriers. Learn more at masssave.com/en/saving/residential-rebates/heat-loan-program Customer Name: Cameron Brown Client Y or Site ID: 327302 Site Address: 36 Grant Avenue City: Northampton 7 State: MA ZIP: 01060 bore eeruce;s Ce. enr,nre.i Phone Number: 413-446-4114 Email: csbrown327@gmail.com Customer/Homeowner Signature: Date: • To determine if there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save' weatherization recommendations have been made: 1 Attic Floor Attic Wall Attic Slope p,Exterior Wall V Basement aril Other:Crawl space Other: esd oui by ine r-nerdy Sce:a:.: y'I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below. `/Attic Floor Attic Wall Attic Slope V Exterior Wall V Basement V'Other:Crawl space Other: !':.e001..i bV inn ?ASP.;'��Y..;'":i' rr Contractor Name: i\d77+tu41A �] Address: Jt0 i !C15d►ir )! City: +�Si 1�Icv�, Tvn q state: / /4 ZIP: Ur097 Company Name: (tii I/ 1=Xf'��I License Number: )V l / 9 Contractor Signature: -.6(-7Date: My signature confirms that I have performed my inspection of the electrical systems listed above and have corrected any barriers as indicated.My signature also confirms that I have read and agree to the Terms and Conditions outlined on the back of this form. SIM High Carbon Monoxide:Contractor is to service and re-evaluate the selected mechanical syster(s)and reduce the carbon monoxide level, as measured in the undiluted flue gas,to below 100 parts per million(ppm). Draft Failure:Contractor is to correct the draft in the selected flue(s).Refer to table on reverse for acceptable draft ranges. .. . Existing CO ppm: Revised CO ppm: Existing Draft Pa: Revised Draft Pa: LHeating System 168 Hot Water Heater — -- _ Other ._— — — - — • Spillage:Contractor is to correct the spillage of flue gases in the selected mechanical system(s).Must not spill after 60 seconds of operation. Heating System Hot Water Heater Other: 1/4�I 5Hd►rn i� f��-�rrl Cr�i ii, ?Iwrt,c& 1 n' S tr✓►ru4kC ott Contractor Name: �/ Address: Lj S(1,ttl, rt( I) S 1`d gl- city: h c:::cl oiviit 6 state:Mid' ZIP: e 1 U 3 Company Name: ilkieteril ter ✓ Cal 6 �Iu4 1N' cense Number: 1 c'i Contractor Signature: Date: I 6 - d My signature confirms that I have performed my inspection of the mechanical systems listed above and have corrected any barriers as indicated.My signature also confirms that I have read and agree to the Terms and Conditions outlined on the back of this form. N .T i = _. %I= t to. I..: -I . = 1�. , 4 lit ON i t ---4,1 T _ .. a ala iiiP r-ai sxce . I cii . M s*- U 111! g4 : J • • aft, we 18 0 E C-1.30 4X 4; U ,9, i is taN SO 411* AC 1 _, 4=2) AM 1,ia .'' .sue�. 1 Je --Sea ins' a a...pit a a = ,o via = , � _ " 40 4.*� - 0 xis j --4` 41 CIFa 4 �' F 4-2 a G a