The URL can be used to link to this page

32C-214 (11) BP-2023-0326 35 HOLYOKE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32C-214-001 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-2023-0326 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 3200 ENERGIA LLC 108421 Const.Class: Exp.Date: 02/19/2025 Use Group: Owner: WAGNER WARREN, JANET &ROBERT Lot Size (sq.ft.) Zoning: URC Applicant: ENERGIA LLC Applicant Address Phone: Insurance: 242 SUFFOLK ST (413)322-3111 WMZ-800-8008072-2022A HOLYOKE, MA 01040 ISSUED ON: 03/15/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/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: 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: �} II • Jr - , Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner i P d F s MAR 1 3 2023 1 I16u(c-r ig0J The Commonwealth of Massachusetts FOR Board of Building Regulations and Standards ,,.� E:ci 1 , 1 Massachusetts State Building Code, 780 CMR '': 'MUNICIPALITY '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 Buildingpermit Num� e•Amber: "3� )).& Date Applied: 11 (1�, 16-55 /42 .3- 11-1-ZOZ3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 35 HOLYOKE ST 1.1 a 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 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: ROBERT WAGNER NORTHAMPTON MA 01062 Name(Print) City, State,ZIP 35 HOLYOKE ST 413-626-1479 janettwarren126©gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) Cl Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other gl Specify:INSULATION Brief Description of Proposed Wdfi LATION-ATTIC FLOOR OPEN BLOW- FG DAMMING-ATTIC DOOR THERMAL BARRIER POLYISO SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $3200.00 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 (Fire6 $ Suppression) Total All F ((rr Check No.� `check Amount t)_Cash Amount: 6.Total Project Cost: $3200.00 0 Paid in Full ❑Outsta -ig Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 108421 2/19/25 BENJAMIN BORDEN/ENERGIA LLC License Number Expiration Date Name of CSL Holder List CSL Type(see below) u 242 SUFFOLK ST No.and Street Type Description HOLYOKE MA 01040 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 413 322 3111 ivelice@energiaus.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 165169 2/16/24 ENERGIA LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 242 SUFFOLK ST ivelice©energiaus.com No.and Street Email address HOLYOKE MA 01040 413-322-3111 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 ENERGIA LLC-BENJAMIN BORDEN to act on my behalf,in all matters relative to work authorized by this building permit application. SFF PFRMIT AIJTHO 3/10/23 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. BENJAMIN BORDEN/ENERGIA LLC 3/10/23 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.) (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 t? ,. ti. S•5 .r.. ,S'C' s -� Massachusetts �Q?'. .._ c� if- 'I t DEPARTMENT OF BUILDING INSPECTIONS Di yv ,,. `= " 212 Main Street • Municipal Building • Cam Northampton, MA 01060 ssy '�� jY 37 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: US A (A) AS : BO TO N RA., wie_sey of The debris will be transported by: Name of Hauler: utS it W ii' -1-- - Signature of Applicant: jg,,,(74,__ , Date: ta,Z? aY„Ap,y� City of Northampton _.. Ns "!a- , ES Massachusetts ' t DEPARTMENT OF BUILDING INSPECTIONS y, 4! 212 Main Street fa Municipal nici 01l6 Building <f0 � ,�pO Property Address: 35 HOLYOKE ST Contractor Name: ENERGIA LLC Address: 242 SUFFOLK ST City, State: HOLYOKE MA 01040 Phone: 413-322-3111 Property Owner Name: ROBERT WAGNER Address: 35 HOLYOKE ST City, State: NORTHAMPTON MA 01060 I, BENJAMIN BORDEN/ENERGIA LLC (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 5 -ayiurL Date 3/10/23 Permit Authorization mass save Form Site ID: 4237838 Customer: ROBERT WAGNER l� Robert Wagner , owner of the property located at: (Owner's Name,printed) 35 Holyoke St Northampton, MA 01060 (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. Owner's Signature: Rahn'.Waper Date: 02 / 08 /2023 N••••••••1•i••/•••i1•••••••••••••/•f•••i•••••1i••••••00001li11!!+, FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: 6062c2/k Participating Contractor Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 Fc,r Cffice Use Only Document Ref:DWVHY-UDLKF-HJJBJ-BL9VD Page 7 of 8 �....4, ENERLLC-01 JOCELYN ,4�oRa► CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYVY) 7/5/2022 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 Jocelyn M Douglas Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/C,No,Ext); (A/C,No); Chicopee,MA 01013 E-MAILDRESS;Jocelyn@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:State Automobile Mutual Ins Co INSURED INSURER B:A.I.M. Mutual Insurance Company Energia LLC INSURER C: 242 Suffolk Street INSURER D: Holyoke,MA 01040 ' INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD,WVD IMM/DD/YYYY) IMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PBP2870943 7/1/2022 7/1/2023 DAMAGETORENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT X LOC PRODUCTS-COMP/OP AGO $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO BAP2477206 7/1/2022 7/1/2023 ,BODILY INJURY(Per person)__ $ — OWNED SCHEDULED _ AUTOS ONLY AUTOS yy Ep BODILY INJURY(Per accident) $ AUT OS ONLY _ AUTOS ONNLY (Perr acc dent)AMAGE $ $ A X UMBRELLA LIAB X 'OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE PBP2870943 7/1/2022 7/1/2023 AGGREGATE $ 2,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE WMZ-800-8008072-2022A 7/1/2022 7/1/2023 1,000,000 OFFICER/MFM EXCLUDED? N N/A E.L.EACH ACCIDENT $ (Mandatory in IfIFH) j 1,000,000 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/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 Energia LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 242 Suffolk St. Holyoke,MA 1040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: ENERGIA LLC Address: 242 SUFFOLK ST. City/State/Zip: HOLYOKE, MA 01040 Phone #: 413-322-3111 Are you an employer? Check the appropriate box: Business Type(required): 1.❑■ I am a employer with 16 employees (full and/ 5. ❑ Retail or part-time).* 6. ❑ Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no 7. 0 Office and/or Sales(incl. real estate, auto,etc.) employees working for me in any capacity. 8. ❑Noo-profit [No workers' comp. insurance required] 3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment their right of exemption per c. 152, §1(4),and we have 10.0 Manufacturing no employees. [No workers' comp. insurance required]** 4.❑ We are a non-profit organization, staffed by volunteers, MO Health Care with no employees. [No workers' comp. insurance req.] 12.❑■ Other Insulation *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. **If the corporate officers have exempted themselves,but the corporation has other employees,a workers'compensation policy is required and such an organization should check box#1. I am an employer that is providing workers'compensation insurance.for my employees. Below is the policy information. Insurance Company Name: A.I.M. Mutual Insurance Insurer's Address:35 HOLYOKE ST City/State/Zip: NORTHAMPTON MA 01060 Policy#or Self-ins. Lic. #WMZ-800-8008072-2022A Expiration Date:7/01/2023 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under§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 Investigations of the DIA for insurance coverage verification. I do hereby certify, under the pains and penalties of perjury that the information provided above is true and correct. Signature: ' �9� Date: 3/10/23 Phone#: 413-322-3111 Ext 122 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 1.❑Board of Health 2.0 Building Department 3.0 City/Town Clerk 4.OLicensing Board 5.0 Selectmen's Office 6.❑Other Contact Person: Phone#: www.mass.gov/dia Licensee Details Demographic Information Full Name: BENJAMIN BORDEN Owner Name: License Address Information City: HOLYOKE State: MA Zipcode: 01040 Country: United States License Information License No: CS-108421 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 2/23/2023 Issue Date: 4/2/2015 Expiration Date: 2/19/2025 License Status: Active Today's Date: 2/23/2023 Secondary License Type: Doing Business As: ENERGIA LLC Status Chanoa_Beason: Li.Clnse Renewal Registration# 165169 Registrant ENERGIA LLC Name Benjamin Borden Address 242 SUFFOLK STREET City, State Zip HOLYOKE, MA 01040 Expiration Date 02/16/2024