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23D-004 (13) BP-2023-0546 15 NONOTUCK ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-004-001 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-2023-0546 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 1300 ENERGY PROTECTORS INC 101143 Const.Class: Exp.Date: 06/16/2024 Use Group: Owner: SCHATZ WALDRON BRIEN D&KELLY Lot Size (sq.ft.) Zoning: URB Applicant: ENERGY PROTECTORS INC Applicant Address Phone: Insurance: 64 PAXTON RD (774)253-0277 6S62UB0G29826021 Spencer,MA 01562 ISSUED ON: 05/01/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ERIZATION 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: 9-1 • 0 • >2 Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax' (413)587-1272 Office of the Building Commissioner I"Zi 3toir L -►4t��->, 5- 1-23 i'`'' '.:C E 7 .tguM-r 191O Z, The Commonwealth of Massachusetts APR 2 8 2023 ; FOR • Board of Building Regulations and Standards L.6) Massachusetts State Building Code,780 CMR MUNICIPALITY _ i USE Building Permit Application To Construct,Repair,Rtanovate`OI p.401. 1 1,i, NsP Iw1sedMar2011 ?r.,t: Mtn!n�1:.,..: F..4Mc,,o One-or Two-Family Dwelling This Se ton For Official Use Only Building Permit Number: 10 ' 3 �v Date Applied: et,,,,-u ri..-s as iiiz - 5-1-za23 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: S t 1.2 Assessors Map&Parcel Numbers 1 5 1uc3V1 Oi-uc_ 1.1a 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(It) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.I,c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Zone? — Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Re ord: 1.e111 S�hCi-z Foie c e. ,, \ A 01164 Name(Print) City,State,ZIP V5 JUowv +uc t, S t- ci 2 uI 13— 3 Ll 4°10 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) ❑ Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units O her 'D pecify: IV\Su I G..tt(.41 Brief Description of Proposed Work v"\ S A 4.4. A- �� b S c,N..e.k. i- 4 a c((ww1 cpcce SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ \ .3 c 0 1. Building Permit Fee:$ Indicate how fee is determined: 2. Electrical $ 7 0 Standard City/Town Application Fee 0 Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (11VAC) $ List: • 5.Mechanical (Fire $ - Suppression) Total All Fees:$ v v Check No.4161 Check Amount:" �` Cash Amount: 6. Total Project Cost: $ t ) 3 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-101143 ater24 Joshua Dada License N(imber Expiration Date Name of CSL Holder List CSL type(see below)u 64 Paxton Rd No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Spencer,MA 01582 R I Restricted 1&2 Family Dwelling City/Town,State,ZIP M ,_Masonry RC _ Roofing Covering WS Window and Siding _ SF Solid Fuel Burning Appliances 774-253-0277 /dada794]photmail.com I Insulation Telephone Email address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) It 1 2980 8/19/24 Energy Protectors Inc HIC Registration Number Expiration Date H1C Company Name or HIC Registrant Name 64 Paxton Rd Idada79&nhotmail.com No.and Street Email address Spencer,MA 01582 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 Issuance of the building permit. Signed Affidavit Attached? Yes '4;; No Cl 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 o perjury that all of the information contained in this application is true and accurate to the best of my knowledg and understanding. vsh ati y lZ3/ -2- 3 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.) Habitab e 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 '•i=—=';:ii-W. 'IDepartment of Industrial Accidents I-= 1 Congress Street, Suite 100 t. _?tl_ Boston, MA 02114-2017 ' ,= www.mass.gov/dia a s Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITI'ING AUTHORITY. Applicant 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: 1 Type of project(required): 10 I am a employer with1 1 employees(full and/or part-time)' 7, 0 New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] ] 9. 0 Demolition 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance require 10 Q Building addition 4.0 I 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 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance. 14.0✓ Other insulation 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#I must also till out the section below showing their workers'compensation policy information. r 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 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:National Liability& Fire Insurance Company Policy#or Self-ins.Lic.#:V9WC383933 Expiration Date:9/1/23 Job Site Address: i C KgO I v"t S - t+ City/State/Zip: r CC t 'M" 0 + V C''.)- 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 S 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 ains and penalties of perjury that the information provided above is true and correct. Signature: �C ��`) �`"`"' Bate: _I ( Z ( Z 3 Phone#:774-253-0277 Official use only. Do riot write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: City of Northampton 37:14Massachusetts (S" • C. c DEPARTMENT OF BUILDING INSPECTIONS y ' ,�� , •. 212 Main Street • Municipal Building ti " Northampton, MA 01060 PJa-fv .,,.�,ti1 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVA ON PROJECTS) In accordance of the provisions of MGL c 40, S54, a con ition 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: \o� t c c i -"')i- v c'(' 1— _ The debris will be transported by: Energy Protectors Inc 64 Paxton Rd Name of Hauler: Spencer, MA01562 Signature of Applicant: ) Date: Lit 1 3 I 3 ADORE. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/31/2022 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(les)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 NAME: Nina Arro O Coonan Insurance Agency, Inc. PHONE FAX 267 Main Street E-MAIL o.E 508- 7-7122 1A/C,No):808-987-7152 Oxford MA 01540 E OREss: nine@ aninsurance,com , URER(B)AFFORDING COVERAGE NM,/ —_— Ucense#;1782985 INSURER A:AIX S cialty Insurance CO INSURED ENERPRO-01 INSURER a:Safety Insurance Company Energy Protectors, Inc. 64 Paxton Road IN8URER C:Capitol SpciaIty Insurance Corporation Spencer MA 01562 INSURER D:National Liability&Fire Insurance Company INSURER E: Philade_phia Ins Companies INSURER F: COVERAGES CERTIFICATE NUMBER:2132532233 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 CONTRAC`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 --- --- 1 ------ V'E F POLICY EXP LTR TYPE OF INSURANCE________ gAD yyvo POLICY NUMBER IMMIDD/YYYY) IMM/DD/YYYYI LIARS A X COMMERCIAL GENERAL LIABILITY Y L1N-H714840-01 8/31/2022 8/31/2023 ' EACH OCCURRENCE $1.000,000 ENTED CLAIMS-MADE [ OCCUR _p1 EMIISMtE0 gG MITIMA __.$50.000 _ ------------- — MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 - GEN'L AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE S 2,000,000 X POLICY ,ECT LOC PRODUCTS-COIAPFOP AGO $1,000,000 OTHER: $ B AUTOMOBILE LIABILITY N 6236519 12/23/2021 12/23/2022 COMBINED SINGLE LIMIT s 1 000 000 (Ea aaidenU ANY AUTO BODILY INJURY(Per person) $ F-- OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _.AUTOS ONLY (Per accident) _ $ C X UMBRELLALIAB X OCCUR Y CCP1070516 ' 8/31/2022 8/31/2023 EACH OCCURRENCE $1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE _ _ DED X RETENTIONS infirm ^ $ D WORKERS COMPENSATION V9WC383933 9/1/2022 9/1/2023 X SS L_ FTH- AND EMPLOYERS'LIABILITY {ii ER -- ANYPROPRIETOR/PARTNER/EXECUE Y/N TIV E.L.EACH ACCIDENT 1500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 1500,000 If yes,describe under DESCRIPTION OF OPERATIONS below .E.L.DISEASE-POLICY LIMB 6500,000 E Pollution Liability PPK2386760 1/6/2022 1/6/2023 Each Occurence , 1,000,000 General Aggregate ; 2,000,000 Products-Completed 1 2,000,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY O THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE THE POLICY PROVISIONS. Eversource 247 Station Drive AUTHORIZED REPRESENTATIVE Westwood MA 02090 'LL'La. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD OWeafffi 1,1 Board n R°°0ctu of Massachusetts or Siding R ` trcensure • Co/lake/Aida;I fati ins and Standards 1 CS-101143il �rSor 64 PAXTON 06116/ ryes: 2024 itl3 SPENCER 01.,,b t0.ti4rV.pd??r,.a*...;,Y, : ^. ) '4 I/ C mtsssort 4, s THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington, Street- Suite 710 Boston, MassachusettsA118 Home Improvement Contrac •istration it'a ....--•ilt; -,�. Type: Corporation -- sir ,:.'_; -bon: 172960 INC. ENERGY PROTECTORS . '.�tion: 08/19/2024 64 PAXTON RD. - g SPENCER,MA 01562 _= ' es :1tir� iiiii ttl U Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for Individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:CO p;pration Office of Consumer Affairs and Business Regulation Registration Exsfiration 1000 Washington Street -Suite 710 172960 0811912024 Boston.MA 02118 ENERGY PROTECTORS INC. • JOSHUA DADA ^ 6 o 64 PAXTON RD. - ,,a..a'L,.,'alGx4 �'�n` C[ C SPENCER,MA 01562 Y -':-e % Undersecretary Nbt valid without signature WEATHERIZATION CONTRACT EVERSSURCE CUSTOMER PHONE DATE CLIENT II WORE ORDER Kelly Schatz (413)834-1010 02/16/2023 492410 10106 SERVICE STREET BILLING STREET PROPOSED BY: 15 Nonotuck Street 2 15 Nonotuck Street 2 Heather Lieber SERVICE CITY,STATE.ZIP BILLING CITY,STATE,ZIP Preprem Florence, MA 01062 Florence, MA 01062 EGMA-HES Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 75% For eligible weatherization measures, Eversource is offering an incentive of 75%for insulation measures and 100%for the air sealing measures, both with no limit.You are eligible to apply for the 0% Heat Loan to finance your co-pay, applications must be submitted before the weatherization work begins. EXTERIOR DOOR WEATHER STRIPPING 1 $31.81 $31.81 Provide labor and materials to install 0-Ion weatherstripping to door(s)to restrict air leakage. DOORSWEEP 2 $52.22 $52.22 Provide labor and materials to install a doorsweep to restrict air leakage. INSULATION REMOVAL 150 $186.00 $0.00 $186.00 Batt style insulation will be removed from the attic area and properly disposed,off site. DOOR:THERMAL BARRIER POLYISO 2" (ATTIC) 1 $90.61 $67.96 $22.65 Provide labor and materials to insulate the back of bulkhead door with 2"rigid insulation board. INSTALL 3.5" FIBERGLASS BATTING IN OPEN WALL 32 $63.04 $47.28 $15.76 Provide labor and materials to install R-13 faced fiberglass to a common wall. Insulation will be fastened in place. BASEMENT SILLS -RIGID BOARD INSULATION 57 $277.59 $208.19 $69.40 Provide labor and materials to install rigid board insulation to the perimeter of the basement ceiling at the house sill. INSULATE RIM JOIST WITH 6.25"FIBERGLASS BATTING 49 $131.81 $98.86 $32.95 Provide labor and materials to install R-19 unfaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. INSTALL 6"FG BATTING IN OPEN BASEMENT CEILING 16 $37.60 $28.20 $9.40 Provide labor and materials to install R-19 faced fiberglass batt �...77c (initials) insulation to the basement ceiling.This will be installed with the paper backing up against the floor above. The un-papered fiberglass side will be facing the basement,and these exposed fiberglass fibers will be the visible side when standing in the basement. Your initials are your agreement and understanding of this measure INSTALL 2"THERMAL BARRIER POLYISO OPEN CR CEILING 16 $78.24 $58.68 $19.56 Provide labor and materials to install 2"rigid board to the crawlspace ceiling. WEATHERIZATION CONTRACT EVERSeURCE CUSTOMER PHONE DATE CLIENT WORK ORDER Kelly Schatz (413)834-1010 02/16/2023 492410 10106 SERVICE STREET BILLING STREET PROPOSED BY: 15 Nonotuck Street 2 15 Nonotuck Street 2 Heather Lieber SERVICE CITY,STATE,ZIP BILLING CITY.STATE.ZIP Program Florence, MA 01062 Florence, MA 01062 EGMA-HES Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL CRAWLSPACE WALL-2" RIGID BOARD 69 $334.65 $250.99 $83.66 Provide labor and materials to install 2" rigid insulation board to the open wall. KNOB&TUBE WIRING-OK Because the weatherization recommendations are in readily accessible areas and your energy specialist verified they do not contain knob and tube wiring,your weatherization can proceed without an electrician's inspection. Total: $1,283.57 Program Incentive: $844.19 Client Total: $439.38 I.DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the above work at the Clients Address in a professional manner and in accordance with the terms of this Contract: II.PAYMENT Client agrees to pay the Contractor for the Work,the Client Share of the Contract Cost is payable to the Independent Installation Contractor IIIC)upon satisfactory completion of the Work,Client understands that they will not be required to pay the Program Incentive Share of the Contract cost.Changes to the individual line items and/or previous incentives may increase or decrease the size of the Program Incentive Share. RISE Representative Client Sign ure 5C%,� .. 3/25/23 Printed Name Date of Acceptance mass save Savings through energy efficiency PERMIT AUTHORIZATION FORM 1, Kelly Schatz owner of the property located at: (Owner's Name) 15 Nonotuck Street Florence (Property Street Address) (City) hereby authorize the Mass Save'5 Home Energy Services Program assigned Participating Contractor to act on my behalf and obtain a building permit to perform insulation and/or weatherization 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. MACL-5T- Ownegs Signature 3/25/23 Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: l� �t c` L.( )- 3 Participating Contractor Date City of Northampton , .„, . ,,t 'n Massachusetts !-- ,., DEPARTMENT OF BUILDING INSPECTIONS -,:., . •, , ''4,, • - ..;,;:. ,k ,,,,,, 212 Main Street • Municipal Building ^Ps, Northampton, MA 01060 , Property Address i/...., _.... Name: Contractor i 1 1 L6-(//r5'4.-f Ai7Y-1.2/5 ,--.. Address: 0-I ft.L.,41-), Pei City, State: ...)07, 6.4"i'' /1-1<, 0/66 7- 0 Phone: --774V -7 C7 7 Property Owner Name: 14,34./ C le "11Z . 7 , Irf. ..., .0 /I Address: 1 5- t121e/-vk/ ,---, City, State: I, - i-Al-9111- (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 cop of this affidavit. Contractor signature j Date i.,/• , V//41713