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23C-064 (7) BP-P 022-0818 105 WILLOW ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23C-064-001 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-2022-0818 PERMISSION IS HEREBY GRANTE TO: Project# INSULATION Contractor: License: Est. Cost: 5000 ESE INC 072316 Const.Class: Exp.Date: 12/19/2023 Use Group: Owner: WESTOVER HARPER, MALCOLM M. JENAE M. Lot Size (sq.ft.) Zoning: WSP Applicant: ESE INC Applicant Address Phone: Insurance: 52 FITGERALD DR (603)532-6346 V9WC236415 JAFFREY, NH 03452 ISSUED ON:07/25/2022 TO PERFORM THE FOLLO WING WORK: INSULATION/WEATH 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: 7- , , Fees Paid: S65.00 212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner r"--"FR't-bs------' C ft.,L.E, .1/1`1 L 4'‘ ' .Z, IE. 1 2 e C mmonwealth of Massachusetts 2022Bo d of uilding Regulations and Standards �� aT Mas achu efts State Building Code,780 CMR . �r^', Nc431�i� lic ion To Construct,Repair,Renovate Or Demolish a 01p6p ne-or Two-Family Dwelling Rev. Sep 2014 This Sec n For Official Use Only Building Permit Number: 3 P— s — ' I d Date Applied: 1: ; f ; i. . b v,47 a0. Building Official(Print Name) Signature I to SECTION 1:SITE INFORMATION 1.1 Property Address' 1.2 Assessors Map&Parcel Number ci r L. l d0 A 7 1.1a Is this an accepted street?yes no Map Number Parcel Number 13 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❑ Private❑ Zone: Outside Flood Zone? Municipal❑ On site disposal syst¢m ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Recoojd-. �/14 CH-< N <6 n+ `/f4p.• Floim ucs , 4 "' MA O l'�L Name(Print) City,State,ZIP /0 GJ,'l l of J Sr 413 552 727? /Y1l41c001h►Awe(o eicaxeas r t C6 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 0 Demolition 0 Accessory Bldg.0 Number of Units Other ® Specify: Weatherization Brief Description of Proposed Work2: add insulation,air barriers,venting (no debris or demo) SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ IE 00ir 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 $ Suppression) Total All Fees:. 4 r Check No.?7 heck Amount: V Cash Amount: � 6.Total Project Cost: $ � D0 Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-072316 12/19/2023 Caleb Aho License Number Expiration Date Name of CSL Holder 52 Fitzgerald Dr List CSL Type(see below) No.and Street Type Description Jaffrey,NH 03452 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 603-532-6346 permits@esaverenabler.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 193253 09/30/2022 Caleb Aho dba ESE, Inc HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 52 Fitzgerald Dr., permits@esaverenabler.com No.and Street Email address Jaffrey,NH 03452 603-532-6346 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 Caleb Aho dba ESE, Inc to act on my behalf,in all matters relative to work authorized by this building permit application. A414 k l'/A/110141, Print Owner's Name(El tronic Signature) (authorization attached ) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT ECLARATION By entering my name below,I hereby attest der the pains and penalties of perjury that all of the information contained in this application is true and a •ate to the best of my knowledge and understanding. Caleb Aho dba ESE, Inc 2/7e9- Print Owner's or Authorized Agent's Name nic 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 riot have access to the arbitration program or guaranty fund under M.G.L.c. I 42A.Other important information on the HIC Program can be found at v����,w.t�tass.gov!ocn Information on the Construction Supervisor License can be found at vueve _i;lo:;;,:erd/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" CLEAResult CONTRACT CLEAResult 41 Brigham St., Customer Name:MALCOLM HARPER Marlborough,MA,01752 Email:malcolmharper@comcast.net Phone:413-552-7277 Premise Address:105 Willow St,Northampton,MA 01062 Mailing Address:105 WILLOW ST,Florence,MA 01062 Project ID:4505509 Date:May 23,2022 Job Description Contractor will perform or cause to be performed the following work on these"Premises"in a professional manner and in accordance with the terms of this Contract, including the attached recommendations/work order describing the work in detail(the"Work")which are incorporated herein by reference. Measure'_ ,_ Location Quantity Unit Total Cost Customer Cost Cut and Finish Access 1 each $124.53 $31.13 Attic Floor-13"Open Blow Cellulose 487 SF $1,032.44 $258.11 Attic Slope-6"Dense Pack Cellulose 306 SF $862.92 $215.73 Roof Vent-Turbine 2 each $332.12 $83.03 Walls-Clapboard-4"Dense Pack Cellulose 394 SF $985.00 $246.25 Walls-Wood Shingle-4"Dense Pack Cellulose 78 SF $185.64 $46.41 Damming 16 each $38.24 $9.56 Air Sealing at Estimated 62.5 CFM50 Per Hour 4 hr $370.32 $0.00 Exterior Door Weather Stripping (with AS hrs) 3 each $90.21 $0.00 Door Sweep(with AS hrs) 3 each $75.93 $0.00 Total: $4,097.35_,Z Program Incentive: -$3,207.13 Customer Total: $890.22 Payment Customer agrees to pay Contractor for the Work,the Customer Share of the Contract Price as follows: Payment#1:$0.00 as a Deposit payable to CLEAResult upon signing the Contract(not to exceed 1/3 of the total retail costs). Mail check&contract to CLEAResult,41 Brigham St., , Marlborough, MA,01752. Final Payment:$890.22 as the final payment for the Work shall be payable to the Home Performance Contractor(HPC)or Independent Installation Contractor(IIC) upon satisfactory completion of the Work. Customer Page 1 of 4 Document Ref I2O77-EHATF-YUAFF-DCIB3 Page 1 of 8 understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of$3,207.13. Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. Dispute Resolution The IIC and Customer hereby mutually agree in advance that in the event that the IIC has a dispute concerning this Contract,the IIC may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to submit to such arbitration as provided in M.G.L.c 142A. You may cancel this agreement if it has been signed by a party at a place other than an address of the seller, provided you notify the seller in writing by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the si g q�tt}l re a eLOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. /1 'rl7�f 06/24/2022 �7ii e Customer Signature Date Indicate your selected IIC here, if applicable Initial here if you want the Program to assign a •titi Colt/ Kevin Cote Participating •tAlk Contractor CLEAResult Signature Date Name of CLEAResult Representative Page 2 of 4 Document Ref 12077-EHATF-YUAFF-DCIB3 Page 2 of 8 MI MIL Fir . NCO►LANVIEW DIAGRAM .r.I,,,,,,' MCA Go\er t-kayix(Aeklra• Horne phone: ( t3 )- -��7 a t"Id�.J MOON�l l�� � , Work phone: ( - 1 r,wr, T•'�`L(� iV�(,1�, )4. cell Phone, ( )- - AIy LgNauA t r.A No,rtt I,/ wn L/ ib. VIA U yuq,,iu1,,nl.0 A.,.nra,a,. a:..•,....n.,,y,..10..fit i Ski I` Yro If yrs..,list,nln, Tito to 1.441 O qQ 'inertly ipoclallft; y S Reviewed by: C+�' ACESS, r I +�Ltg �•S . © Art 1 S' C' - ,-I 81 Lb • 9 a NSA err DP- 30(v • 3 Kres+stumps INSTAL.(. 2 - 12 II '[-al5INES 0QCL11PH° DP- 3Gy s 0 9AINrrLE N. zP- -1S Dili tniNG- 1(p CO t.1EW CAN ET 21 1 11 ALP A1P • AsL@7 3 ` to cs) ci 1 I t 1 Id D 0 AFL 1 ® 5i ASS O 1 FLAT lto ' itr,,,c)I ,, i iN pI.A CE lrurrape ff* 'hay • --_O ._ IInsert Radiators „1, Jd��aJwa ter Neighbor Proximity ( Pocket Doors --- S•Soffit G:Gable r .Vents Note inside Square R=Roof •Soffit L Conditions �� C$=continuous Soffit CDE=Continuous Drip Edge_ _ - f;y�MO*yrrnl -__--------Temp Unloss Noted •therwise r; c Ca C g111n(1 W Well S=Sheathing M•12"Mushroom for Accost WOO [�a M�rH hr,iiii ' inm it:leis p J3 Roof 5 s Soffit G•Gable _ �,�'/yrrf4JN�f�Pu7lrid►Y/Ib ` " 2200•IO-1/15 ' * TOT - • 1 . AFL Hi ' t .• kilo ' .kff 11 44 2) Li g 7 i i 53 ASL (41- (0) * (Li 2.- (0. ) Sti 4. Z 5 2 ' C t.f elk wait S IS+ le4Psitlik I 0 1 57 - 1 (h) 3(cti 2•0:410E) I g 1 (Pifj," ....- '5ct Lt 1 •I s :..& p to-, it. 20d G-4104 9y464._ 61111 .-- ___ c._..i doetykti- acce% 4 C h I(C g + Z I C4-r caki SS "Sett Acivr 5 __... Recommended rentitation CalCulation 1.1 r7 4 3,0 Z 1 q 5 /750 0 z Z - (C y sk , petommondscs ,/ /..." 44.,„. (....0-,41,e,,,r, Add 2 - .1V int 5 4-0 Thee4 i ' 1 S-0 4,'....A., r(.4 /PA?•-t<A, f...44C44,56611 WCAle He," 411100 0, .1; i', :e 4 16 (+2) A vii . tit, to,..0,,f, wil.'14*/, 14(Ji-ii(x) 1701-2000 ,T 2001-2300 Every 3002 Eitteptiefriel AFL 14,./t/rs Phenahly Gle,,forl AllteA c#4ksge,re,.cof 1.1:F N 1 4-4fuf Multiple Chimney/BF=2 Hours Prefab/Me/R/4e WAIrs 1/c,(-Newt/.9 4 kiwis Chimney=6 Hours Exceptional KW Pe," /'20 feet+ i liti,e/e '/,',,0••/.-40 ft s 2 Houm X>40 ft=4 Hours Rim Joist Only wAir,, P/'1"./i ft -1 049,if RJ>150 ft=2 Hours 13f4T Ceiling Only Hpure, 'Airing Are*" 'f//,1.,./11 *'--,•,.,- Ceiling Area>2,000 sq ft=2 Hours MOTE You MEW 154 fftWil1i#10 reit*itert~e,,folvov firi tviocif y P1 or EMIT Ceiling ONLY Air Sealing Hours*" .../....., pp cl Muitipliert, r ,11'Or/A* •t,,,,",-.•, , Cross Batt Insulation _ Ob. ,,,,4,,k904,t 1 /4-...044000 Truss Construction Fit Ottir E,1f:40(NO City of Northampton 0,H Mp\ 'i P,-,0' Massachusetts A. x_ ..ct` d i 1 �W.�. t DEPARTMENT OF BUILDING INSPECTIONS y, 1`--+ "�'. .• 212 Main Street • Municipal Building Jti.. Ct, i Northampton, MA 01060 *vs` j(‘`• 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. /0 ,,1L6 The debris will be disposed of in: Location of Facility: (.1 we / drri `1 /l///l.,ry iE J/1' i�t N 4 y l The debris will be transported by: Name of Hauler: E 5? /41<- Signature of Applicant: Date: 7/a-22.. The Commonwealth of Massachusetts _ h Department of Industrial Accidents __= ►= 1 Congress Street,Suite 100 = ��= Boston,MA 02114-2017-=_ 'r www mass.gov/dia V Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): Caleb Aho dba ESE, Inc. Address: 52 Fitzgerald Dr City/State/Zip: Jaffrey, NH 03452 Phone #: 603-532-6346 Are you an employer?Check the appropriate box: Type of project(require i): 1.'A I am a employer with 7 employees(full and/or part-time).* 7. ❑New construction 2.1:1 I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 9. El Demolition 10 El Building addition 4.01 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.❑Electrical repairs o, additions proprietors with no employees. 12.❑Plumbing repairs o additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0Other weatheriza ion 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. t 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. 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 andj b site information. Insurance Company Name: National Liability&Fire Ins Co Policy#or Self-ins.Lic.#: V9WC 382852(3a)MA&NH Expiration Date: 03/08/202V Job Site Address: /OE it.311/0Z1) r City/State/Zip: MA az Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirati n 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 in urance coverage verification. I do hereby certify under the pains penalties of perjury that the information provided above is true and corre Signature: /j — Date: -7/6/p�� Phone#: 603-532-6346 ' 444��� 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#: .aco CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDD/YYYY) 03/04/2022 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). PRODUCER CONTACT Lisa Nolan,CPCU NAME: FIAT/Cross insurance PHONE (603)669-3218 FAX (603)645-4331 ((EA/C,No,Est): (A/C,No): 1100 Elm Street ADDRESS: Manch.Certs@crossagency.com INSURER(S)AFFORDING COVERAGE _ NAIC# Manchester NH U3101 INSURER A: Ohio Security Ins Co 24082 INSURED INSURER B: Ohio Casualty Ins.Co. 24074 ESE,Inc. INSURER C: National Liability&Fire Ins Co 20052 52 Fitzgerald Drive INSURER D INSURER E: Jaffrey NH 03452 INSURER F COVERAGES CERTIFICATE NUMBER: 21-22 AII/22-23 WC 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD MD_ POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 15,000 A BKS55684497 07/31/2021 07/31/2022 PERSONAL&AD`✓INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY I 1 JPETT I I LOC PRODUCTS•COMP/OP AGG $ 2,000,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BA055684497 07/31/2021 07/31/2022 BODILY INJURY Per accident) $i AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $' AUTOS ONLY AUTOS ONLY (Per accident) X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE US055684497 07/31/2021 07/31/2022 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION _ AND EMPLOYERS'LIABILITY X STATUTE EERH ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 500,000 C OFFICERjMEMBER EXCLUDED? Y N IA V9WC382852(3a.)MA&NH 03/08/2022 03/08/2023 E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under _^DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 Caleb Aho is excluded from workers C compensation coverage DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Refer to policy for exclusionary endorsements and special provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN For Informational Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS. Informational Purposes Only AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD r0_,.??..menepea#A94y&o:44-ar%kme-4 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 � Home Improvement Contractor Registration Pt' 3�� 1444 Type: Corporation ESE INC Registration: 193253 Expiration: 09/30/3 52 FITZGERALD DRIVE Q29' 2d JAFFREY,NH 03452 Update Address and Return Card. SCA 1 CS 20M-05117 ./fr �iviui�ivui�rr��/%r/. /47Jirirlrel.^/4.% Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration I`wiration ,-• Office of Consumer Affairs and Business Regulation 193253 09/30l2�20~2 o% 1000 Washington Street-Suite 710 ESE INC Boston,MA 021 CALEB D.AHO - 52 FITZGERALD DRIVE JAFFREY,NH 03452 Undersecretary Not valid without signature Commonwealth of Massachusetts IA Division of Occupational Licensure Board of Building Regulations and Standards Const f1'7an[1 S ' yrvisor CS-072316 xpires: 12/19/2023 CALEB AHO 482 JARMAN"(HILL RD. SHARON NH13458 ` Commissioner dU fi. Uiunc-Lta_ Permit Authorization mass save Form SdnrinVs=try Er et ct oeoc Site ID: 4470995 Customer: MALCOLM HARPER Malcolm M. Harper , owner of the property located at: (Owner's Name,printed) 105 Willow St Northampton, MA 01062 (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Hal:'O u Rorer Owner's Signature: Date: 06 /24 /2022 FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: eatiz 440 0%3,@ ;N - 7/714 Participating Contractor Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 Fcr Office Use Cnly Document Ref:12O77-EHATF-YUAFF-DCIB3 Page 7 of 8 City of Northampton • B Massachusetts 3 DEPARTMENT OF BUILDING INSPECTIONS yJ 212 Main Street • Municipal Building s j Northampton, MA 01060 S'n• �� Property Address: LO iZLtia S Contractor //�� Name: (-At€43 4)40 ,per SSE Address: 5 2 r y&ai) C . City, State: 7/2i J) Adi 03/i Z- Phone: ' 532,63414 Property Owner / /Name: 6�DafriA Ape/L. Address: `0c Jl U o u) 77- City, State: M024-1-l/riwaivAJ1 /v 1- I, 1t isAtO P9.4 E52.IAA-- (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. Contractor signature Date 7/JQ/