29-234 (4) BP-2023-1400
134 SPRUCE HILL AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-234-001 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-2023-1400 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 2700 ENERGIA LLC 108421
Const.Class: Exp.Date: 02/19/2025
Use Group: Owner: W HINDLE JAMES K&EMILY
Lot Size (sq.ft.)
Zoning: WSP Applicant: ENERGIA LLC
Applicant Address Phone: Insurance:
242 SUFFOLK ST (413)322-31 11 WMZ-800-8008072-2022A
HOLYOKE, MA 01040
ISSUED ON: 10/10/2023
TO PERFORM THE FOLLOWING WORK:
INSULATION/WEATH ERI ZATION
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: o QT
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• 1' . 4 11 .
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Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
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The Commonwealth of Mas .chw C'J.
,, Board of Building Regulations an. .1 .-: ds , FOR
ll' Massachusetts State Building Code, is.. ; 6' ICIPALITY
Building Permit Application To Construct,Repair,Reno,• ;a D emoliefi a 'evise' ar 2011
o One-or Two-Family Dwelling �' 7:'so
This Section For Official Use Only \ Tim
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Building Permit Number: � �' /�( Date A P lied:
4,, //45 / ID ,
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
134 SPRUCE HILL AVE
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 Et Zone: Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2. Owner'of Record.
AMES HINDL� NORTHAMPTON MA 01062
Name(Print) City,State,ZIP
134 SPRUCE HILL AVE 978-417-1232 EHINDLE@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) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other Specify:
Brief Description of Proposed Work2: Insulation - Attic Floor Open Blow Cellulose
fg Damming, rim joist
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $2700.00 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees
Check No�( Check Amount: Cash Amount:
6.Total Project Cost: $2700.00 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 108421 2/16/25
Benjamin Borden License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) "
242 Suffolk St.
No.and Street Type Description
Holyoke, MA 01040 U Unrestricted(Buildings up to 35,000 Cu.ft.)
y R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 165169
Energia, LLC HIC Registration Number Expiration Date
HIC Corn an Name or HIC Registrant Name
242 Suffolk St.
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 >Sd 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
to act on my behalf,in all matters relative to work authorized by this building permit application.
Please see permit autho - MA SAVE weatherization 10/3/23
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.
Sa -a.muiLgeoteirut. 10/3/23
Print 1044ner'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
spt HAMP �S`S.. , r'r'
w•y' Massachusetts , e,..
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„ .t +t,, , R` DEPARTMENT OF BUILDING INSPECTIONS �
'" � "'10 212 Main Street • Municipal Building yv,s CDC
r.. Northampton, MA 01060 s4.11' 317<\`�
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: Boston Rd Wilbraham MA
The debris will be transported by:
Name of Hauler: USA WASTE
Signature of Applicant: di€74--&ve -- Date: 10/3/23
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
Lafayette City Center
2 Avenue de Lafayette, Boston,MA 02111-1750
a 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. ❑ Office and/or Sales(incl. real estate, auto,etc.)
employees working for me in any capacity.
[No workers' comp. insurance required] 8. ❑Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑ Entertainment
their right of exemption per c. 152, §1(4),and we have 10.❑ Manufacturing
no employees. [No workers' comp. insurance required]** 11.0Health Care
4.❑ We are a non-profit organization, staffed by volunteers,
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: /3 V SP t2uCE H (L L k i 6—,
City/State/Zip: NO 27r NA w/J i d N /K .4 d00(s Z
Policy#or Self-ins. Lic. #WMZ-800-8008072-2023A Expiration Date:7/01/2024
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: 5�� q/19/2023
Date:
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.❑City/Town Clerk 4.❑Licensing Board
5.0 Selectmen's Office 6.['Other
Contact Person: Phone#:
www.mass.gov/dia
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
17 Commonwealth of Massachuse'ts
Division of Professiona' Licensure
Board of Building Regulations end Standards
Construction Supervisor
ENERGIA LLC
242 SUFFOLK STREET CS•108421 expires:02/19/202S
HOLYOKE,MA 01040 BENJAMIN BORDEN'
112 RYAN ROAD
FLORENCE MA 01062
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Ntiti 110
Commissioner 'ircr
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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:LLC Office of Consumer Affairs and Business Regulation
Registration Expiration 1000 Washington Street -Suite 710
165169 02/16/2024 Boston,MA 02118
ENERGIA LLC
BENJAMIN BORDEN •
242 SUFFOLK STREET
HOLYOKE,MA 01040
Undersecretary Not va id without signature
City of Northampton
Massachusetts �c
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f DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060I
Property Address: 134 SPRUCE HILL AVE
Contractor
Name: ENERGIA LLC
Address: 242 SUFFOLK ST
City, State: HOLYOKE MA 01040
Phone: 413-322-3111
Property Owner JAMES HINDLE
Name:
Address: 134 SPRUCE HILL AVE
City, State: NORTHAMPTON MA
I, BENJAMIN BORDEN (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
Date 10/3/23