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32A-193 (9)
BP-2023-1527 36 PHILLIPS PL COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-193-001 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-2023-1527 PERMISSION IS HEREBY GRANTED TO: INSULATION 2023 I Alts Project# Renovations Repair 106/13/2023 Contractor: License: Est. Cost: 3168 BRYAN HOBBS CS-083982 Const.Class: Exp.Date:05/02/2024 Use Group: Owner: WAECHTER MARIE Lot Size (sq.ft.) Zoning: URC Applicant: BRYAN HOBBS REMODELING LLC Applicant Address Phone: Insurance: PO BOX 1535 (413)775-9006 ECC6004001133 GREENFIELD, MA 01301 ISSUED ON: 10/30/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/W EATH 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: Q 3-41 � � I Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner , -----------60TRE E---0 acI A 2023 &IL 1- 1900 IZ, The Commonwealth of Massachuse is Board of Building Regulations and Stan'.rds c P c, rOR Massachusetts State Building Code, 780 MItEPL of sun p-o M� • ITY NORT►+AMP USE Building Permit Application To Construct,Repair, Renova e Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: M-d.3' J ,l7 D e A lied: ii KL ,i(ZS % ��1 )..ZdZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers ( AO ( 'bps 0 Ct.,.12 1.1a Is this an accepted street?yes no Map Number Pace'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 Lone•: Outside Flood Zone? Municipal 0 On site'disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 24 pwner'of Record: NIa Re, n,0 ilic►eC k, -e< ()MOO_ MA Name(Print) ity,State,ZIP ai9 Ph►1)10. elcu2 ({1-5-94k„.1-)0-7 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 Iliapecify: ��Q(,1L. QlltQ�lrl7 Brief Description of Proposed Work': Zit v PC. \(1� T % 1— ,ert -0- C.,fieG,lolseGcst_ C.cily , SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ Skit _t Sc---- 1. Building Permit Fee: $ Indicate how fee is determined: V� 0 Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) '�Total All Fees �, Check No. 1 Check Amount. Cash Amount: 6.Total Project Cost: $ 3\ 1 G k ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) oR 1 asS License Number Expiration Dateame of C�LTD•A1(1" Holder �? 6. 1S3r' List CSL Type(see below) No.and StreeR Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) & nh ) )--\(- cm)S - R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding 413 h(lS qb�� V ii SF Solid Fuel Burning Appliances . { !1 Q I Insulation Telephone E ail addres co, D Demolition 2 Registered e I rovement Contractor(HIC) 1 lo3LIC '-Q HIC Registration Number Ex iration Date Je C .6 any Name or HIC Registrant Name (tom . )5CEmail and St EmailEmail addre� t ief()vvn,State, , o i sa_ 413 Teip(9 ne 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 St_ 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. )11610, l'i•szipi )42.3)2_1 Owner's or Authorized Agent's Name(Electronic Signature) ate 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"maybe substituted for"Total Project Cost" • 4110Permit Authorization mass save Form Site ID: 4828885 Customer: MARIE WAECHTER I, Marie Waechter , owner of the property located at: (Owner's Name,printed) 36 Phillips PI 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: Mane Waec/fer Date: 05 / 02 / 2023 FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: 6\231 2_,3 I Participating Contractor f t Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 For Office Use Only Document Ref:7U2CO-YOU9K-SLD6O-SABXC Page 6 of 7 4ft 2019 WEATHERIZATION mass save BARRIER INCENTIVES Savrnys through encrov c ff-cii,nCS- 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 invoice(s) within 60 days of your Home Energy Assessment to: Pre-Wx Barrier Incentive, c/o CLEAResult, 50 Washington St. Suite 3000, Westborough, MA 01581 or email to: prewxoffer@clearesult.com 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. CUSTOMER INFORMATION Customer Name: MARIE WAECHTER Client#or Site ID: 4058308 Site Address: .___36 Phillips PI _ City: Northampton State: _MA _, zIP:01060 _ Phone Number: 413-246-3707 Email: mwaechter@wgby.orq Customer/Homeowner Signature: Date: KNOB AND TUBE WIRING 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: : Attic Floor LJ Attic Wall U Attic Slope U Exterior Wall J Basement J Other: _— __ ______U Other:._________ 'ave performed my inspection and determined there is no active knob and tube wiring in the areas selected below 11./araic Floor Lfic Wall Li-Attic Slope ffrExterior Wall basement JOther: UOther: shave read and agree to the Termsand Conditions o2t the back of this form. Contractor Name:i Bf'X " '�'� v7)47"° C/{�j L� Zo-n1 O Address: 6 / (G S I City: J -• O f` State:fv Company Name: C25 6g.o p 6- L -- License Number: ?!718- q Contractor Signature: �/� �� Date: ( -"((-" ZC9 MECHANICAL SYSTEM BARRIERS c ro lx f;acd o.rt by hccnt.ed,.ontrt,ctoc) 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 is to 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 ppm: Existing Draft Pa: Revised Draft Pa: Heating System Hot Water Heater Other: Spillage:Contractor is to correct the spillage of flue gases in the selected mechanical system(s).Must not spill after 60 seconds of operation. ❑ Heating System 0 Hot Water Heater 0 Other: 0 I have performed my inspection and have corrected the items noted in the areas selected above. ❑ I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: Address.,4-- __ City___..___.._...__.._._....___.__.__ _ State: ___ ZIP:_ Company Name: License Number: —�_- _.___._,_ Contractor Signature: Date: Page 1 of 2 Continued on back norm 1 of 7\ Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regulations and Standards g,?0,71I I' C,OnZkeT .NZ IIOTB i 3tttB' ;y. CS-083982 spires:05102/2024 BRYAN G Ht3BS A PO BOX 1631 GREENFIELIk')VIA 01302 .4 40. Commissioner fitt8 THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC BRYAN HOBBS REMODELING,LLC. — Registration: 166045 P.O.BOX 1535 Expiration: 06125l2025 GREENFIELD,MA 01302 • 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:LLC Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 196045 0612512025 Boston,MA 02118 BRYAN HOBBS REMODELING,LLC, BRYAN HOBBS 576 LEYDEN RD £o(e?. trlt' GREENFIELD,MA 01301 Undersecretary Not valid without signature . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center as ~' 2 Avenue de Lafayette, Boston,MA 02111-1750 wwx.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Bryan Hobbs Remodeling, LLC Address:576 Leyden Rd PO BOX 1535 City/State/Zip:Greenfield, Ma 01302 Phone#:413-775-9006 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 7 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. El Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no Weatherization employees. [No workers' 13.• Other comp. insurance required.] _ *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:AIM Mutual Policy#or Self-ins. Lic. #:ECC60040011332023A Expiration Date:10/20/2024 Job Site Address:3�o e\M;\\tPS Pin LQ City/State/Zip:Lkaloryleitr P Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 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 hereb certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: . Date: ) )7.3) Z 3 Phone#: �� ]�� — Ou4c, 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 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5EIPlumbing Inspector 6.0Other Contact Person: Phone#: AC REP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD YYW) kla.....----- 07/25/2023 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 Adina Edgett,CISR NAME: 9 Alera Group,Inc. PHONE (413)586-0111 FAX (413)586-6481 (A/C,No,Ext): (A/C,No): Webber&Grinnell Division E-MAILDSS: aedgett@webberandgrinnell.com 8 North King Street INSURER(S)AFFORDING COVERAGE NAIL# Northampton MA 01060 INSURER A: Selective Ins Co of S Carolina 19259 INSURED INSURER B: Selective Ins Co of America 12572 Bryan Hobbs Remodeling,LLC INSURER C: AIM Mutual PO Box 1535 Evanston/XS Brokers INSURER D: INSURER E: Greenfield MA 01302-1535 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 08/24 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. IPOLICY EFF LTRR ATYPE OF INSURANCE IN D L WVDSUHA M/DD/YYYY (POLICY NUMBER M POLICY EXP X COMMERCIAL GENERAL LIABILITY ) {MMIDD/YYYY) LIMITS 1 000,000 EACH OCCURRENCE $ CLAIMS-MADE X OCCUR DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Anyone person) $ 15,000 A S2289042 08/04/2023 08/04/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECTPRO- PRODUCTS-COMP/OPAGG $ PRO- LOC 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED A9105300 08/04/2023 08/04/2024 BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS X AU HIRTOSED ONLY /�X NON-TOOWNESONLDY PROPERTY DAMAGE (Per accident) $ AU Underinsured motorist BI $ 20,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE S2289042 08/04/2023 08/04/2024 AGGREGATE $ 2,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY YIN C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? Y NIA ECC60040011332023A 10/20/2023 10/20/2024 (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 Pollution Per Occurance $250,000 D CPLMOL115454 01/19/2023 01/19/2024 Aggregate $500,000 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 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1/,it �.�._,� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD City of Northampton ,/ \-1 Massachusetts ��? :%_ •!<<.. { t 7 DEPARTMENT OF BUILDING INSPECTIONS y; 212 Main Street • Municipal Building Jy �' ,Z71 Northampton, MA 01060 ssy14.•. ��oc 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: -4 l_asvhatM (- L._)cs-vhosy,pho. The debris will be transported by: Name of Hauler: I \..tn,, Signature of Applicant: Date: )c.4 23)23