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17C-304 (2) BP-2023-0567 111 CHESTNUT ST COMMONWEALTH OF M SSACHUSETTS Map:Block:Lot: 17C-304-001 CITY OF NORTHA PTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0567 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 7300 PRECISION REMODELING INC 88742 Const.Class: Exp.Date: 01/16/2024 Use Group: Owner: FRONTIERO, VIRGINIA&LIBERMAN,AVERY Lot Size (sq.ft.) Zoning: URB Applicant: PRECISION REMODELING INC Applicant Address Phone: Insurance: 21 ROOSEVELT (413)575-1097 WC9083755 HOLYOKE, MA 01041 ISSUED ON: 05/04/2023 TO PERFORM THE FOLLOWING WORK: INSULATON/WEATHERI 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: i 3-1,� y�J Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:l(413)587-1272 Office of the Building Commissic{ner r -) eena 1 1 14. 60 ki-11) e-t adV Ir P 0 F of- A-pp RECEIVL- _,....._2_,T) 4301,, me The Commonwealth of Massachisi tts ------------. Board of Building Regulations and ta d rds MAY Massachusetts State Building Code, 8 MR Building Permit Application To Construct,Repair,Re fic.atecOr — 3 2023 UNIPALrry OR OSE evise?Mar 2011 NORTHAMP ' ECT1 NS ; One-or Two-Family Dwellink This Section For Official Use nly Building Permit Number: g a- 3- 60.2_ Date Applied: , 5 44. ZOZ5 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors'Map& Parcel Numbers 111 Chestnut St, Northampton.NIA_ 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage at) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M,G,L,c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 0 Private 0 --- Check if yes0 Municipal 0 On site disposal system 0 ... SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Northampton MA 01062 Avery Liberman Nam'(Print) City,State.ZIP i 111 Chestnut St. 301-455-6250 No,and Street .1,:leptione 1 Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units .Other 141 Specify:Weatheria7tion Brief Description of Proposed Work2: Mass Save sponsored air sealing & insualtion: 759 sf attic floor 100$Q fill cellulose R30: 293 sf kneewlIlrigid 2" insulation (Thermax) R12; install 56 propavents SECTION 4:ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) I.Building $ 4300 , I. Building Permit Fee: S Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ _ ....________ 0 Total Project Costa(Item 6)x multiplier x , 3. Plumbing S 2. Other Fees: $ 4. Mechanical (HVAC) $ List: ,—......., _......_ 5. Mechanical (Fire $ 43 Suppression) Total All Fees: $.......... I Check.1\1(6‘19_,C.leek Amoun . Cash Amount: 1 6.Total Project Cost: 1 $ 7300 0 Paid in Full 0 Outstanding Balance Due:_. L._ ...... r 1 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C 088742 01/16/2024 Robert Hunter Lice a Number Expiration Date Name of CSL Holder List SL Type(see below) U 21 Roosevelt Ave. No.and Street Tye Description Holyoke, MA 01040 I.. Unrestricted(Buildings up to 35,000 Cu.ft.) n Restricted I&2 Family Dwelling City/Town,State,ZIP ll, Masonry RC Roofing Covering WS Window and Siding _ SF Solid Fuel Burning Appliances 413-575-1097 pripremits©gmail.com I Insulation Telephone Email address D Demolition _ 5.2 Registered Home Improvement Contractor(HIC) t 152922 10/13/2024 Precision Remodeling, Inc. HIC Registration Number Expiration Date I-TIC Company Name or HIC Registrant Name 21 Roosevelt Ave „r pripremits@gmail.com No.and Street Email address Holyoke, MA 01040 413-575-1097 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 d No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize Robert Hunter to act on my behalf,in all matters relative to work authorized by till, building permit application. Please see attached Permit Authorization Form 5-2-2023 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER1 OR AUTHORIZED A ENT DECLARATION By entering my name below,I hereby attest under the pains and penaltie'of perjury that all of the information contained in this application is true and accurate to the best of my knowl,dge and understanding. Robert Hunter atov . 5-2-2023 Print Owner's or Authorized gen�me((Electronic Signature) Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or' 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 in ormation on the HIC Program can he found at .'w;w_mass;gov/oca Information on the Constriction Supervisor Lie- se can be found at www.mass;gtyidps 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.) Habit;ble room count Number of fireplaces Num•er of bedrooms Number of bathrooms Num,er of half/baths Type of heating system Num•er of decks/porches Type of cooling system Enclo ed Open _._..__r__ 3. "Total Project Square Footage"may be substituted for"Total Projec Cost" Permit Authorization mass save Form Site ID: 4752680 Customer: AVERY LIBERMAN Avery Liberman , owner of the property located at: (Owner's Name,printed) 111 Chestnut 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. Lt6roimae Owner's Signature: Date: 04 /25 /2023 FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Precision Remodeling, Inc 5-2-2023 Participating Contractor Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 For Office Use Only Document Ref:P659N-IMDAR-PFZY3-ZPMYR ,..( City of Northampton MassachusettsL DEPARTMENT OF BUILDING INSPECTIONS P 212 Main Street • Municipal Building %, �`' Northampton, MA 01060 'xYt7\°, 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. work site: 111 Chestnut St, Northampton MA The debris will be disposed of in: K&W Materials, 138 Palmer Rd, West Springfield MA Location of Facility: The debris will be transported by: Name of Hauler: Precision Remodeling, Inc. Robert Hunter 40 �' Signature of Applicant: Date: 5-2-2023 RCS PLANVIEW DIAGRAM ::: ....�_�C_..1Y _,__ �.,.._ Horne Phone: ( ♦_."-)©/' Work i�hone f 11. L i. rel _.. .__._., _.....y _ - t tom' I Town t" t0t%flf ..- ._._. __.._._ .... ._. Cell Phone. ( )- - Any bestattet for aect*s by WO MAI .. Ybd......._....... 3f yes,desert*:.....m._,......_........... ,„....................M.._.-..-___................._.........._.... ...,_. • 1 AM sr ,r+c dsrectub,tt crr r'+(lmar s fdcy, '[ Yes If yes,desert*,_,....._. ..._.... ._..._,__......_.._._, Site ID. ! e 68(1,2 Energy Specialist: CA--ice>_ zm p Reviewed by: ^ To CAN 2q M 6) 211 TISS it) etAihro n. • --1--,A. . A.S — y 2. 1 0 AMMING -( GCV *Minor moisture. CR cleared. Iz Cs A f :) L. 1ci ,' c c R --, AFL -- r\ G . i 2 i t o , 1 0\1 r=,.,o0 C�1.V CS For Office Use Only { Bushes Ladder 1 L Neighbor Proximity Pocket Doors Insert Radiators I Fence(s) _ _...._ _ _ _ ..........._ , ..___ ......_....... 1 Existing Conditions X=Access 0=Vents Note Inside Square R=Roo S=Soffit G=Gable RV=Ridge Vent CS=Continuous Soffit CDE= ontinuous Drip Edge T=Triangle install 0=New Access Note in Circle C-Ceiling W-Wail S=Sheathing Temp Unless Noted Otherwise p=Vents Note in Triangle R=8"Roof S=Soffit G=Gavle M=12"Mushroom For Access Rev 1/14 The Commonwealth of Massachusetts to 4 ' 'I Department of Industrial Accidents Si./I 1 Congress Street,Suite 100 �il i= -'� Boston, MA 02114-2017 's ,.+ ,;,•``` www.massgou/dia Workers'Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMII(INC AUTHORITY. Anfliicant Information Pleas rim( LeeIb y Name(Bust nadirs nizationitediwidual): Precision Remodeling, Inc. Address: 21 Roosevelt Ave City/State/Zip: Holyoke, MA 01040 Phone i#; 413-575-1097 Are you an employer?Check the appropriate box: Type of project(required)_ 1.aX I its a employer with 4 employees(full and/or put•time).• 7. 0 New construction 2.01 am a sots proprietor o r partnentip and have no employees working for me in 8. 0 Remodeling any capacity.[No worker/'comp.isusvaace requited.] 3.©1 am a homeowner doing an worst myself[No workers'comp,inataaner:required]+ 9. Demolition 4.0 I am a homeowner and will be Mesas ccouncion to conduct all work oo my property. 1 will if)©Building addition ensure that all contractors either have weekers'compensation insurance or are sok 11.❑Electrical repairs or additions proprietors with no employees. 5.Q t am a general=tractorand I have hired the sub-caotrarton listed onthe snatched sheet. 1 Plumbing repairs or additions These subcontraelon have employees and have workers'camp.Mumma.: 13.Q.Q hoof repairs 6.0 We a s corpontian and its officers h exercised their right of exemption per MGL C 14..:4 Other Wei3t. ri7afion are 152,I1(4),and we have so employees.(No workers'comp.insurance required] 'Any applicant that decks boar ill must also fill oat the section below showing ibis*Aitken'compensation policy information, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside crosnctan must subunit a crew sffidevit indicating such. 'Contractors that check this box most attached an sdditioaal sheet showing the manse of the suh-conuacton and sure whether or not those entities have employees. lithe aubcoatranon have employees,they must provide their workers'camp.policy number. l am an employer that is providing workers'compensation Insurance for my employees. Below is the polity and job site Information Insurance Company Name: Selective Insurance WC9083755 16 December 2023 Policy#or Self-ins.Lic.#: . _ Expiration Date: _. job site Address: 111 Chestnut St, city/state/zip; Northampton MA 01062 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 S250.00 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 pains and penalties of er/ury that the information provided above Ls true and correct Signature: Robert Hunter Diu: 5-2-2023 Phan,#: 413 575-1097 Official use only, Do not write In this area,to be completed by city or town officiaL City or Town: Permit/License# l 3 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Etkctricul Inspector 5.Plumbing Inspector 6.Other , Contact Person: Phone#: ,._ ir..a+ DATE(MM/DD/YVYY) LC.,.�R� CERTIFICATE OF LIABILITY INSURANCE 5/2/2023 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 The Dowd Agencies, LLC PHONE Debbie Mac Neal FAX 14 Bobala Road _WC-No.Ext:413-538-7444 i (A/c,No): Holyoke MA 01040 CRESS: dmacneal@dowd.com INSURER(S)AFFORDING COVERAGE _ NAIC 0 INSURER A:Selective Insurance of South Carolina 19259 INSURED PRERE INSURER B:Selective Insurance Company of the Southeast. 39926 Precision Remodeling, Inc. - 21 Roosevelt Ave INSURER C: -- - - , Holyoke MA 01040 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2028085676 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 LTR INSD WVD POLICY NUMBER (MM/DDIYYYY) (MMIDD/yvvY) LIMITS A X COMMERCIAL GENERAL LIABILITY S 2332110 12/3/20 2 12/3/2023 EACH OCCURRENCE $1,000,000 DBE TO RENTED -- CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $15,000 _ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ A AUTOMOBILE LIABILITY A 9107250 7/1/202I2 7/1/2023 (Ea BINEDtSINGLE LIMIT $1,000,000 I ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS 1 x HIRED X NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR S 2332110 12/3/2022 12/3/2023 EACH OCCURRENCE $1,000,000 _ EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 _ DED RETENTION$ $ B WORKERS COMPENSATION WC 9083755 12/16/2022 12/16/2023 X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N - ANYPROPRIETOR/PARTNERIEXECUTIVE N E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N/A - (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 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more ace is required)Y P 4 ) 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. Northampton, City of 210 Mai St Northampton MA 01060 AUTHORIZED REPRESENTATIVE (1)--...-4r-vt+a, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD r 9Commonwealth of Massachusetts D vision of Occupational Licensure Board of Building Re ulations and Standards 1�3i. onst itoni rvisor t S-083742 Comm: pares:01/16/2024 ROBERT R WINTER -;— 21 ROOSEVELT AVE. HOLYOKE MA 01040 ,i s , n Commissioner ; K, eed THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation Rt, isttatinn: 152922 PRECISION REMODELING,INC. ;, ' E4pitation: 10f13i2024 21 ROOSEVELT AVE. , HOLYOKE.MA 01040 Update Address and Return Card. THE COMMONWE ALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration lid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration dates. If found return to: TYPE:Cdr,cii ill WI Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 1520? '13,20?4 Boston,MA 02118 a PRECISION REMODELING.INC. ROBERT R.HUNTER R ita."&. 21 ROOSEVELT AVE. Yc�+�, K "'1i,,s21...ii_ HOLYOKE.MA 01040 Undersecretary N t valid without signature .r 1