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41-075 (7)
BP-2023-0226 31 LOUDVILLE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 41-075-001 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-2023-0226 PERMISSION IS HEREBY GRANTED TO: Project# basement reno 2023 Contractor: License: Est. Cost: 33180 ECO ENERGY SOLUTIONS LLC 94737 Const.Class: Exp.Date: 01/21/2024 Use Group: Owner: C SACKETT-TAYLOR HILLARY M &ANDREW Lot Size (sq.ft.) Zoning: RR Applicant: ECO ENERGY SOLUTIONS LLC Applicant Address ,Phone: Insurance: 800 PROSPECT HILL RD (860)219-0499 XWW57298427 WINDSOR. CT 06095 ISSUED ON: 02/27/2023 TO PERFORM THE FOLLOWING WORK: BASEMENT RENO 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 4 • ri/w.. .y2 55-1 Fees Paid: $214.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECE VL: . _� i I 6F E B 2 1• 2023 ,_, he Commonwealth of Massachusetts FOR �r of F3UILDING INSPECgtfat�of Building Regulations and Standards it NORTHAMt'?ON.MA 0 0 MUNICIPALITY -1-Massachusetts State Building Code, 780 CMR 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: 3A,2 3-• a3 6,_ Date Applied: r9' ► S . �; + , ).3 Building Building Official(Print Name) Signature I Dat SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 31 Loudville Road 1.1 a Is this an accepted street?yes x 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: Zone: _ Outside Flood Zone? Public 0 Private 0 Check if yes❑ Municipal 0 On site disposal system L] SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Hillary Sacket-Taylor Northampton,MA 01062 Name(Print) City,State,ZIP 31 Loudville Road 704-698-5532 hillary.sackett©gmail.com 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 0 Specify: Brief Description of Proposed Work2:TBF Perimeter Wall System,Decorative Post Surrounds,Finished Linen Drop Ceiling, 6-Panel Primed Door,Bi-Fold Door,Recessed Can Lights,Access Panel ( FiulEw 131161EMtn) SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: , 5. Mechanical (Fire Suppression) $ Total All Fees: ril A I 0 Check No.,9 1r heck Amount:54 Cash Amount: 6.Total Project Cost: $33,180.04 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-094737 01/21/2024 Dennis T Croughwell License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 545 Main Street No.and Street Type Description Dalton,MA 01226 U Unrestricted(Buildings up to 35,000 cu. IL) City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-212-1191 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 185329 05/25/2024 Eco Energy Solutions,LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 800 Prospect Hill Road-Suite E jodi©drenergysaverctma.com No.and Street Email address Windsor,CT 06095 860-219-0499 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 0 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 Eco Energy Solutions,LLC to act on my behalf,in all matters relative to work authorized by this building permit application. Hillary Sacket-Taylor Feb 17,2023 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. Jodi L.Fogarty Feb 17,2023 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.sov/dns 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 oaYH M o 5 S r [[ �` Massachusetts ��?S c'i` f I. • W;: * us. .( ' DEPARTMENT OF BUILDING INSPECTIONS P'•. j;; x 'r �, '� 212 Main Street • Municipal Building vb.,. '7 \ A Northampton, MA 01060 SSN •.3 ,,0 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: 800 Prospect Hill Road-Suite E,Windsor,CT 06095 The debris will be transported by: Name of Hauler: Eco Energy Solutions, LLC Signature of Applicant: VN Date: Feb 17, 2023 The Common wealth of:lfassachuselts cretzr.►� imum)eA Department of industrial Accidents =(pi 1 Congress Street,Suite 100 _;', Boston, MA 02114-2017 www rnass.got'/die 11 urkers'('ompensation Insurance:Affidavit:Buildersi('ontractors(ElectricianstfPlumber.. lt)111.f 11.1.0 411111 I HE PERMITTING Al rti()R1fl. knnlicaut Inforutatiun Please Print l.ettihl, Name(Husincs_t=Organtzationlnattiianat): Eco Energy Solutions, LLC Address: 800 Prospect Hill Road - Suite E City/State/Zip: Windsor. CT 06095 Phone#: 860-219-0499 Are yew an emplwer?('beck the apprupriaic but: Iti pe of project(required): 1.®1 eta a entpluyer xith 27 enrpluyccs(full and'ur part-titter 1-' 7. O New construction In I am a sole proprietor or partnership and have no entptoynes working for me in K. C3 Remodeling any capacay.[No workers'comp.insurance requiral l 9. 0 Demolition t I am a hurnouwner doing all work myself.[No Nude7s'comp.insurance required_)' 10 0 Building addition 4.0 I am a luneounn-r and will be hiring contractor.to conduct all week on my property. I will extsun that all contractors either have wader.`compensation insurance or are sole 11.]Electrical repairs or addition:, proprietor.N ith nu employees. 12.0 Plumbing repairs or addl[It°tty 50 1 am a general contractor and 1 have hind the sub-cunuacton listed un the attached sheet_ 1 Roof repairs These sub-contracture have employees and has c workers'comp.insurance.: 6.0 we area corporation and its officers have exercised their right of exemption per MC&c. 14.0 Other t5'_. 1441_and we have no certpluysees.[Nu*tickers'emnp.iasuraneereyuinri] *Any applicant that checks box=J mud a6u fill uut the section below showing their*takers'compensation policy utfucxnatiun. 'lksmeownen who submit this aftitktt it mdieatxng they are doing all work and then hire outside contractors mud submit a Ins attulav It indicating such. Contractors that check this boa must attached an additional sheet showing the name of the sub-ctmtracturs and state whither or not those rxrtities have .:utplovices. If the aub-contractors lts+c employees.Lire.;nu.o1 pre.itic their Luker,' .k!lrtp.MAW).niutiber. /am an.employer that is proridink►workers'compensation insurance for my etapk,ees. Below is tier policy and lob.site Information. Insuntnce Company Name: Liberty Mututal Insurance policy#or Self ins.Lic.#: XWW 57 29 84 27 _ Expiration Date: 04/27/2023 Job Site Address: 31 Loudville Road city,state!zip: Northampton, MA 01062 Attach a copy of the workers'compensation policy declaration page(showing thr policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a tine up to Sl 500.00 ante or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S2 i(1.OD a day against the violator.A copy of this statement may be forwarded to the Office of Investigations oldie DIA for insurance coterai s'ertticatiun. 1 do hereby cerof j.under tier Ixaas and penalties of perjury that the iruformalion provided above is true and correct. StYn:l(tile: 1),t. Feb 17, 2023 Phone r: 860- 19-0499 Official use only. Dr,nor write in tiei..urea,to he completed by city or town official. ('it, or Toss n: I'ertnitil.icensr k Issuing.luthurily Icircle muck: I. Board of Health 2. 13uildint;Department 3.City;To,sn Clerk 4.Electrical Inspector 5. I'lumbine. Inspector 6.Other Contact Person: Phone kt: Workers Compensation And Employers Liability Insurance Policy wU uu uu ui A Coverage Is Provided In: Policy Number: Liberty West American Insurance Company IXWW(23)57 29 84 271 r•-' Mutual. Prior Policy Number: INSURANCE IXWW(22)57 29 84 271 NCCI Co. No. 1115761 Risk ID 060703612 Workers Compensation and Employers Liability Insurance Policy Information Page ITEM 1:The Insured&Mailing Address Agent Mailing Address&Phone No. ECO ENERGY SOLUTIONS, LLC (860) 461-1441 DBA DR. ENERGY SAVER 1NSITE INSURANCE SERVICES 800 Prospect Hill Rd Ste E 433 S MAIN ST STE 107 Windsor, CT 06095 WEST HARTFORD, CT 06110-2812 Individual_ Partnership X Corporation or Limited Liability Company FEIN: 812377868 NAICS23831C Other workplaces not shown above: ITEM 2 The policy period is from 04/27/2022 to 04/27/2023 12:01 am Standard Time at the insured's mailing address. ITEM 3 A.Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: CT MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $1,000,000 each accident Bodily Injury by Disease $1,000,000 policy limit Bodily Injury by Disease $1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: See Extension of Information Page D.This policy includes these endorsements and schedules: See Policy Forms and Endorsements Summary ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Code Premium Basis-Total Rate per Estimated No. Estimated Annual $100 of Annual Remuneration Remuneration Premium Extension of Information Page(s) Total Estimated Annual Premium $48,623.00 Total Surcharges and Assessments $2,056.00 Minimum Premium $1,500.00 CT Total Estimated Cost $50,679.00 indicated below, interim adjustments of premiums shall be made. Deposit Premium $50,679.00 Countersigned by: Issue Date 05/17/22 report a claim, call your Agent or 1-844-325-2467 00 00 01 A (WC 3010F) © 1987 National Council on Compensation Insurance, Inc. ILL') e 4 SIN CI-ET •Thy uo1Z i qck O w e/ oh fi, i t 1 0 O O 4 14 ►A E. Cc)-) 'I� b 313 v L 0 3 i e0 4 Q .5_, ,, C c�ea ejs X 04, pt"c/ in u! i S C. h, c" •',c-old °s 13 A 111 91 3o 6g - --- -- - - - �, Po,nel ;I _ ----- L 1'111. 1(5, Nis• = `� -8 Door 5 ( ti i usuL1}1-ioU EX%S3ikiG (I aLL i&; +- I c`rc„i 9/4 6) p I, CA • o T c o 9, s t, c, as ,, 9, 9 I `., Cf 4, r W, ".` o r" G g 9� �� O ,. _ r1 f 0 r ; 2)5(V --. 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