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38B-102 (5) BP-2023-1380 148 SOUTH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38B-102-001 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-2023-1380 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est.Cost: 9012 THE ENERGY MONSTER 102765 Const.Class: Exp.Date: 07/22/2024 Use Group: Owner: BETTY ALLEN CHAPTER DAR Lot Size (sq.ft.) Zoning: URB Applicant: THE ENERGY MONSTER Applicant Address Phone: Insurance: 311 MAIN ST (508)796-5525 6S60UBSR71347322 WORCESTER, MA 01608 ISSUED ON: 10/10/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATH ER I Z ATI 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: (N Fees Paid: S65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner The Commonwealth of MassaAus= s I Q 2023 FOR r ° I Board of Building Regulations add St. dards Ilf I ICIPALITY \ y"`;: Massachusetts State Building Colie, 7g0�`!•(JAI bin USE vogi Building Permit Application To Construct,Repair,Renovate r_tift01440N. Rev sed Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building P rmit Number: •cr)•,— 0 90 Date Applied: id./0 -ZOZ Building Official(Print Name) ignature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 148 South Street, Northampton MA 01060 1.1 a Is this an accepted street?yes V 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❑ 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: Betty Allen Chapter Dar, Inc Northampton MA 01060 Name(Print) City,State,ZIP 148 South Street 413-320-7576 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:Insulation Brief Description of Proposed Work':Weatherization, Insulation,Air Sealing SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $9012.83 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $0.00 ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $0.00 2. Other Fees: $ 4.Mechanical (HVAC) $0.00 List: 5.Mechanical (Fire Suppression) $0.00 Total All Fee Check No. Check Amount:A .Cash Amount: 6.Total Project Cost: $ 9012.83 0 Paid in Fu 1 ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-102765 07/22/2024 Josh Leet License Number Expiration Date Name of CSL Holder List CSL Type(see below) I 311 Main Street No.and Street Type Description Worcester MA 01608 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 508-796-5525 hgibeault@myenergymonster.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 188796 09/04/2025 Josh Leet HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 311 Main Street hgibeault@myenergymonster.com No.and Street Email address Worcester MA 01608 508-796-5525 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 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 of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Josh Leet 09/22/2023 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.aov/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 SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE %,A City of Northampton Massachusetts �?•' d�. I E •,t• " DEPARTMENT OF BUILDING INSPECTIONS 71 \�..• 212 Main Street • Municipal Building y'-., CDC tom: Northampton, MA 01060 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. The debris will be disposed of in: Location of Facility: 100 Lamartine Street, Worcester MA, 01608 The debris will be transported by: Name of Hauler: Wattson Home Solutions INC Signature of Applicant: 5i.ee.i Lazt- Date: 09/22/2023 . The Commonwealth of Massachusetts Ilt, stiMM t Department of IndustrtalAccidents r�' I Congress Street,Suite 100 %'� , ` ' Boston,MA 02114-1017 Ia.h . ...L.,,,,:. v>> www.mass.gov/Ilia 11 takers'('ompensation Insurance Affidavit:BuilderslContractorsiEketricia.nsIPlumbers. 1'O BE FILED WITH THE PERMITTING AUTHORITY. Annlieant Information Please Print 1_eititth Name usincss/organization/1 lwi,dual):Wattson Home Solutions INC Address: 311 Main Street City/State/Zip:Worcester MA 01608 Ilion,: "- 508-796-5525 Arms MI ellePieli tr''Cbetii the appropriate IW t. Type of project(required): l,ra l arm a employer with 50 oval:yes-%(full;index part-time:• 7. 0 New construction 201 am a sole proprietor or partnership and have no employees wincing for me in $. 0 Remodeling any capacity.[No workers"coop.insim mee requirett.[ 9. 0 Demolition 3LI I am a homeowner doing all work myself.[No workers`conc.noura ce mimic&[' l0 0 Building addition 4.0 I am a homeowner and will be hiring norm-actors to conduct all work on any pruperty. I will ensure that all worm-tors either have wakes`ctrrrpertaatiun resonant or arc sole 11.l Electrical repairs or additions proprietors with no employers. 12.121 Plumbing repairs or additions Sin I am a general contractor and I have hunti the subcoutractora listed on the attached sheet. 130 Roof repairs Those subcontractors have employees and have worker.,'comp.insurance_ b.a Vie are a corporationand its utTtcene has e exercised their right of exenappsot per hiGL 14.®(solace I r1SUIatlOrl 152.3144).and we have no mtpluyyets.[Nu woxkets'cutup.insurance required.' *Any applicant that checks butt#1 mint also fill out the section below showing their workers'compensation policy enfunnution. 1`IL,mcawncrs who submit this affidavit indicating they medoina all work and then hire outside contractors nun!submit a new affidavit indicating such =Cnntractora that check this box must attached an aJditioaal beet ethow log the name of the sob-ccatractun and state whether or not those,cooties have onpltvxee.5. It the.sub-cis rsctors have canplu}MA:5,they mbar push.slide workers`coop-policy nuanlxr- I am an employer that is providing worLers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Hartford Underwriters INS CO Policy#or Self ins.Lie.#:6S60UB5R71347323 Expiration pate: 01/13/2024 Job Site Address. 148 South Street CityPState/Zip: Northampton MA 01060 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$1,500.00 and'or one-year imprisonment,as well as civil penalties in the form ofa 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 a rrrili•ancl/er the pains ur!/.ucnralties of perjury that the information provided above/s true and correct S gnatuuc. d� ._ C isles.. 09/22/2023 Phone#: 508-796-5525 Official use only. Do not write in this area,to be completed by city or town official ('its or I oss n: Permit/License# I„uiag authority icircle one): I Board of Health 2.Building Department 3.('it3,Tawn Clerk 4.Eketrical Inspector 5.Plumbing Inspector 4i t litter t intact Person: Phone*: City of Northampton •" Massachusetts 'f �: ''4 I it DEPARTMENT OF BUILDING INSPECTIONS k )1; wT 212 Main Street it Municipal Building C� ` c Northampton, MA 01060 444 x1''4 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born _ (insert month, day,year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of ,20_. (Signature) " AcoRL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 09/21/2023 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 Patricia Champagne NAME: SMITH BROTHERS INSURANCE LLC PHONE (508)499-5053 FAX JAIL,Na,EXt): _-- 1A/C,No): E-MAIL ADDRESS: pam ch a ne smithbrothersusa.com p g 68 NATIONAL DRIVE INSURER(S)AFFORDING COVERAGE NAIC# GLASTONBURY CT 06033 INSURERA: HARTFORD UNDERWRITERS INS CO 30104 INSURED INSURER B: _ ACCELERATED ENERGY INC& INSURERC: INSURER D: C 0 WATTSON HOME SOLUTIONS INC 311 MAIN ST 2ND FL INSURER E: WORCESTER MA 01608 INSURERF: COVERAGES CERTIFICATE NUMBER: 933226 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 LIMITS LTR /Y INSD�WVD POLICY NUMBER (MM/DDYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE RENED $ CLAIMS-MADE OCCUR PREM SESO(Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ �/ $ WORKERS COMPENSATION X STATUTE ER 0TH 'AND EMPLOYERS'LIABILITY A IOFFIC R/MEMBEREXCLUDED?ECUTIVE WA N/A N/A 6S60UB5R71347323 01/13/2023 01/13/2024 E.L EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B. no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires, or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage- Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 Daniel M.Cro I y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Energy Monster Home Performance Contractor mOnster 125 Blackstone River Rd,Worcester,MA CONTRACT - AUDIT 508-796-5525 FAX 508-720-3933 Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT B WORK ORDER Betty Allen Chapter Dar, Inc (413) 320-7576 07/25/2022 466734 00002 SERVICE STREET BILLING STREET PROPOSED BY: 148 South Street 148 South Street Energy Monster SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL HOME AIR SEALING 4 $377.32 $377.32 Provide labor and materials to seal areas of your home against wasteful, excess air leakage. Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics, basements, attached garages and other unheated areas(windows are not generally addressed.) ATTIC FLAT-9"OPEN R-33 CELLULOSE 300 $528.00 $396.00 $132.00 Provide labor and materials to install a 9" layer of R-33 Class Cellulose added to open attic space. ATTIC FLAT-4" FLOORED R-13 DENSE CELLULOSE 800 $1,512.00 $1,134.00 $378.00 Provide labor and materials to install a 4" layer of R-13 Class I Cellulose to floored attic space. ATTIC DOOR- INSULATE 1 $68.83 $51.62 $17.21 Provide labor and materials to insulate the back of the attic door with 2" rigid insulation board. WALLS-WOOD SIDED 2,624 $6,061.44 $4,546.08 $1,515.36 Furnish and install blown in Class I Cellulose to shingle and/or clapboard exterior walls.The butt of the upper course of your wood siding is cut to drill holes into the wall sheathing behind.The holes are then plugged and the wood siding is reinstalled using exterior grade nails. Touch-up painting, if needed,will be the customer's responsibility. Homeowner has received a copy of the EPA's Renovate Right Lead-Safe information guide explaining the potential risk of the lead hazard exposure from the weatherization work to be performed. Your signature is your acknowledgement of receipt and agreement to proceed. CRAWLSPACE- 10MIL GROUND COVER 192 $195.84 $146.88 $48.96 Provide labor and materials to install 10 ml polyethylene over open ground in designated crawlspace/earthen basement areas. VENTILATION CHUTES 60 $209.40 $157.05 $52.35 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. Dot I®:'5660d679831 Ut f34:92 ffi8ntbk321041£1"i Energy Monster m Orfester Home Performance Contractor 125 Blackstone River Rd,Worcester,MA CONTRACT - AUDIT 508-796-5525 FAX 508-720-3933 Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT N WORK ORDER Betty Allen Chapter Dar, Inc (413) 320-7576 07/25/2022 466734 00002 SERVICE STREET BILLING STREET PROPOSED BY', 148 South Street 148 South Street Energy Monster SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL INSULATED BATH EXHAUST HOSE 4 INCH 1 $60.00 $45.00 $15.00 Provide labor and materials to install an insulated 4"exhaust hose to existing bathroom fan(s). Total: $9,012.83 Program Incentive: $6,853.95 Customer Total: $2,158.88 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Two Thousand One Hundred Fifty-Eight & 88/100 Dollars $2,158.88 16// asairtPioa ,6a,,,1„,, Rru' COMPANY REPRESENTATIVE CUSTOMER SIGNATURE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE 08 / 19 / 2023 SIGN DATE DAYS, Doc tocith,aldate83176iid t t nsbkOzefAktIa a This Agreement is made by and among: e ne rg y m n ste r CUSTOMER(STATED ON PAGE 1.) and 311 Main Street V WORCESTER, MA 01608 I. DESCRIPTION OF WORK TO BE PERFORMED The Company will perform the following work on the address above in a professional manner and in accordance with the terms of the Contract, including the attached recommendations/work order/quote. II. PAYMENT Customer agrees to pay the Company for the Work as follows: The customer TOTAL less Incentives as listed on Previous Page(s), upon completion of the Work,due in full,payable by check,cash,or major credit card. III.LIMITED TIME OFFER The terms, prices,and incentive offered in this contract are valid until December 31sL of 2023. IV.COMMENCEMENT AND COMPLETION The COMPANY will not begin the work or order the materials before the signing of this Contract.Subject to the availability of subcontractors/materials and to delays attributable to the weather,the work will begin upon verbal agreement between the COMPANY and the CUSTOMER barring delay caused by circumstances beyond the COMPANY's control.The COMPANY reserves the right to advise the CUSTOMER of changes in the projected start and completion dates,based upon availability of materials and licensed contractors. Upon completion of the work,the COMPANY will leave the Premises in a neat and orderly condition but shall not be responsible to correct conditions outside the scope of its work. V.PERMITS The COMPANY agrees to be in compliance with any necessary permits for this project depending upon the judgment of local inspectors and certifies that the COMPANY will obtain any and all necessary work-related permits. VI.MODIFICATION This contract cannot be changed except by a writing signed by the COMPANY and the CUSTOMER. VII.CUSTOMER'S DUTY CUSTOMER must prepare the Premises for the work.Objects which obstruct areas of work must be moved before the work is to commence or CUSTOMER may be charged and agrees to pay the cost,time and labor incurring in moving such objects. VIII.NOTICE 1.All contractors and subcontractors must be registered by the director and any inquires about the contractor or subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration,One Ashburnham Place, Boston, Massachusetts 02108,617-727-8598. 2.The registration number of the COMPANY is 102761. 3.The COMPANY Warrants as follows: A. Materials and workmanship will meet or exceed the specifications in the COMPANY's materials and installation standards. B.The work and the materials furnished by the COMPANY will conform to the requirements of this Contract.If there be a defect in workmanship or materials,or any damage caused by its subcontractors or employees that is discovered within one year after completion of the work(including cleanup),the COMPANY will,at its own expense,at its option, remedy, repair,correct, replace or cause to be remedied,repaired,corrected or replaced of such defect or damage. 4.The CUSTOMER has the following rights under Chapter 142A. A. At the time of signing this Contract,the CUSTOMER shall be furnished with a copy of it. No work shall begin prior to signing the Contract. B. Any party may bring an action to enforce any provisions of M.G.L.c. 142A.or to seek damages or the CUSTOMER may request that dispute be decided under the terms of a private arbitration program approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations. 5.The COMPANY reserves its right,under Massachusetts law,to file a notice of contract,and to take all other steps provided by statute to perfect and to enforce by lawsuit a mechanic's and/or supplier's lien if the CUSTOMER fails to make payment as provide herein. °'^�'•cml..IcAi k 08 / 19 / 2023 Customer Signature Date ,ep/lcan. t Iaat�,sori 08 / 17 /2023 Energy Monster Date Doc ID:Ill6Ma306796813013 ngb90aef51135 a WATTHOM-01 LBOULAY ACORo CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) `•� 9/21/22112023 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 NAME: Smith Brothers Insurance,LLC PHONE FAX 300 Main Street (A/c,No,EA):(508)987-0333 (A/C,No►te60)652-3236 Oxford,MA 01540 gDpRl'kSS,generalmallbox@smlthbrothersusa.com INSURER(S)AFFORDING COVERAGE NAIC M INSURERA:EMC Property&Casualty Company ,25186 INSURED INSURER B: Wattson Home Solutions Inc INSURERC: 311 Main Street 2nd floor INSURER D: Worcester,MA 01608 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 rADDL SUBR POUCY NUMBER POUCY EFF POLICY EXP LIMITS LTR INSD WINDIMMIDD/YYYY1 IMMIDD/YYYYI. A X COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X I OCCUR 6D05384 6/1/2023 6/1/2024 DAMAGE TO RENTED 500,000 PREMISES1Eaoccurrence) S MED EXP(Any one person) $ 10,000 J PERSONAL 8 ADV INJURY $ 1,000,000 GENIIAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY[1 Fjpf LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ COMBINED A AUTOMOBILE LIABILITY Ea accidentSINGLE LIMIT S 1,000,000 X ANY AUTO 6Z05384 6/1/2023 6/1/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSRE� ONLY AUTOS BODILYp BODILY INJURYp (Per accident) S AUTOS ONLY AUTO'O Y (Perr accdent)AMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE 6J05384 6/1/2023 6/1/2024 AGGREGATE $ 5,000,000 DED X RETENTIONS 10,000 $ WORKERS COMPENSATION STATUTEPER ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S (AMandatory In NH)EXCLUDED? NIA E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ A General Liability 6D05384 6/1/2023 6/1/2024 Limited Site Poiluti 250,000 DESCRIPTION OF OPERATIONS I 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 Northampton CityHall THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE G� ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ��t�IJlSA d mass save energynster iG ',ta+.free- r,aa�K tllxr er<� ^fir" PERMIT AUTHORIZATION FORM I, , OWNER OF THE PROPERTY LOCATED AT: 148 South Street, North Hampton (PROPERTY STREET ADDRESS) (CITY/TOWN) HEREBY AUTHORIZE Energy Monster (PARTICIPATING CONTRACTOR) AN AUTHORIZED PARTICIPATING CONTRACTOR FOR THE MASS SAVE HOME ENERGY SERVICES PROGRAM UNDER THE DIRECTION OF ENERGY MONSTER,TO ACT ON MY BEHALF TO OBTAIN A BUILDING PERMIT AND TO PERFORM INSULATION AND/OR WEATHERIZATION WORK ON MY PROPERTY. AwJ., R 08 / 19 / 2023 OWNER'S SIGNATURE DATE Doc ID;�f5eia1,d8/980 161:14 IP S iMefAfil a THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingttreet-Suite 710 Boston„Massac uusetts 02118 Home Improvement Contractor Registration w +� i 1 Type: Corporation THE ENERGY MONSTER MA,INC. ro ( e• ation: 188796 311 MAIN STREET E j ation: 09/04/2025 WORCESTER,MA 01608 yeri pq yc; Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8 Business Regulation Registration valid for individual use only before the HOME IMPROVEMENTCONTRACTOR expiration date. If found return to: TYPE:.Corporation Office of Consumer Affairs and Business Regulation 1000 Washington Street -Suite 710 1 U Boston,MA 02118 THE ENERGY MONS JOSHUA D.LEET , Jt�J 311 MAIN STREET +. '.`l ��,,,,y�.� WORCESTER,MA 0160&iy ` Undersecretary Not valid without signature Constriicti n Supervisor Specialty Failwe iO Ixtssr"X a t inrritt rctthtul Gat ttit State BuikfuTt Code is fdttSC tot revttC.ation of For intortnatton about this license Call (617) 727 3200 or visit w**rttass goy OW Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction dpc1/ispr Specialty 'i CSSL-102765pires: JOSH LEET T f 311 MAIN STREET WORCESTER.�IA 01508 ;;*`,voisTot'l' # Q $ Commissioner diI g Vemabn., mesa Caewtww Main t&Awaaa tMprann HOME MIPROVIEMENTCONi11ACTOR Repistrauon vat,d for ind3viduat use only TTe'C.C.eaOaiYO't before t o sapa atbn date. it found ntuen to RUVADMTh itiettriciThMk*of Consumax Affair*acid Bus+rroas Rent 180100 000 Washington Street-Suit*710 .. . . MONBT ER MR 0•K 6oskon,HA 0211$ :OSI.UA O LEET 1 BLACXSTONE RNERRO •;,G,•.•e+ ! F-4++^ NCif CESTER ASA 01007 Uneerxecxeriary P'ot acid without signature A6Ik- mass save Weatherization barrier incentives Based on your Energy Specialist's recommendations,your home can benefit from program-eligible insulation and/or air sealing improvements.Before moving forward,please follow all the instructions below to remediate your weatherization barriers. CUSTOMER INSTRUCTIONS 1.Hire a qualified,licensed contractor to evaluate and/or remediate the weatherization barrier(s). 2.Submit signed and completed copies of this form and a copy of the paid contractor involce(s)within 60 days of your Home Energy Assessment to: 3.The weatherization incentive will be deducted from the customer co-payment amount of the weatherization work.A rebate check will be issued in the event the amount exceeds the customer's co-payment amount. 4.Complete the recommended weatherization improvements. 5.The Mass Save`HEAT Loan offers interest-free financing opportunities that may be used to remediate eligible weatherization barriers.(..earn more at masssave.com/en/saving/residential-rebates/heat-loan-program CUSTOMER iNFOPMATION Customer Name: Betty Allen Chapter Dar, Inc Client#or Site ID: 466734 Site Address: 148 South Street City; North Hampton State: MA ZIP: Phone Number: 41313 0,6,E Email: bettyallen1753@gmail.com Customer/Homeowner Signature: l i j? 94-xittiof ' Des. ,. 9 , ,Q 3 KNOB AND TUBE WIRING r.,:e t<. To determine If there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save weatherization recommendations have been made: �,,I Attic Floor (_)Attic Wall 0 Attic Slope ('Exterior Wail 0 Basement 0 Other; 0 Other: go I have performed my inspection arid determined there Is no active knob and tube wiring in the areas selected below. •Attic Floor op Attic Wall •Attic Slope •Exterior Wall •Basement go Other Cw'r e 0 Other: Contractor Name: 11e.I/t✓t K[el/6s/ -.S t . ) Address: Jo Fh;/` ,+tr"e / •/ City: Fiore..1c p0 State:MA A ZIP: >�IL) -r Company Name: t Jr-C d ec-//'c. License Number: t2c�S Oa-/� Contractor Signature: / - ' hate: t' /rr C/ 3 My signature nature confirms that I ha perform m nspection of the electrical systems listed above and have corrected any barriers as indicated.My signature also confirms that I have read and agree to the Terms and Conditions outlined on the back of this form. MECHANICAL SYSTEM BARPIEPS i iiktlout:r/V CI( _ . High Carbon Monoxide:Contractor is to service and re-evaluate the selected mechanical system(s)and reduce the carbon monoxide level, as measured in the undiluted flue gas,to below 100 parts per million(ppm). Draft Failure:Contractor into correct the draft in the selected flue(s).Refer to table on reverse for acceptable draft ranges. High Carbon Monoxide Draft Failure existing CO ppm: Revised CO PPrW Existing Draft Pe: Revised Draft Pa: _ HseEing System . --— Hot Water Heater , tither: Spillage:Contractor is to correct the spillage of flue gases in the selected mechanical system(s).Must not spill after 60 seconds of operation. 0 Heating System 0 Hot Water Heater 0 Other: Contractor Name: — Address:_,. City: State: ZIP: Company Name: License Number: Contractor Signature _. Date: My signature confirms that I have performed my inspection of the mechanical systems listed above and have corrected any barriers as indicated.My signature also confirms that I have read and agree to the Terms and Conditions outlined on the back of this form.