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30A-012 BP-2023-1546 333 FLORENCE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30A-012-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1546 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2023 Contractor: License: Est. Cost: 16210 GREEN COLLAR LLC 108817 Const.Class: Exp.Date: 08/31/2024 Use Group: Owner: MCGUIRE ARDITH A Lot Size (sq.ft.) Zoning: WSP Applicant: GREEN COLLAR LLC Applicant Address Phone: Insurance: 570 NEWTON ST (413)532-1817 WMZ-800-8008323 SOUTH HADLEY, MA 01075 ISSUED ON: 11/02/2023 TO PERFORM THE FOLLOWING WORK: 23 REPLACEMENT WINDOWS 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 ; ► J s 1 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ..._ . usy, lflokote--clrioreb ce • _ae.....GE5v ,.....„ ,fto _ .. I 7_023 Wonwealth of Massac usett•0 ' Cf ' Boaing Regulations . • St. • :F . 0 Fa' shus is State Building Code, :I C nog I/SE LITY �nl`'�+1i1SPFG rN.n 0 �, c�7'T ion To Construct,Repair, Renovate .r,1r,: : ,, . Revis d Mar 2011 "= One-or Two-Family Dwelling .MA o,o nioy. This Section For Official Use Only Building Permit Number: 41 ) ,;.q4,9 Date Applied: 4,,�4 //fz ll-2-Zvz3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers :2133 1 r t 1 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use I Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public E l Private❑ Zone: _ Outside Flood Zone? Municipal$On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: (Mth map 1 U 6\N Name(Print) ity,State,ZIP 33 -loccJfx. . qoI. 5s-s-5 ; 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 W Specify: W eClaLUa5 Brief Description of Proposed Work2 V\ \\ fin eke. \ \c c re p\acemertt -a . ocAi5 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ /(9 / a/ O 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: &ash Check N 'Ir eck A mowll: rt Amount: 6.Total Project Cost: $ )co,a/D 0 Paid in Full ❑Outstanding Balance Due: • '‘' / ' / ) SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 8/23/2024 CS-108817 Robert Calhoun License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 390 Newton St. No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) South Hadley,MA 01075 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413 532 1817 Support@greencollarma.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 3/31/2025 Green Collar,LLC 181415 HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 570 Newton St Support@greencollarma.com No.and Street Email address South Hadley,MA 01075 413 532 1817 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 W 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 Green Collar,LLC to act on my behalf,in all matters relative to work authorized by this building permit application. SEE ATTACHED DOCUMENT Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER1 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. 0//(Z)03 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.) 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" The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations 1U! *,4 600 Washington Street Boston, MA 02111 '/.,; * www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Green Collar, LLC Address: 570 Newton St City/State/Zip: South Hadley, MA 01075 Phone #: 413 532 1817 Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with 15 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. n Remodeling ship and have no employees These sub-contractors have 8. n Demolition working for me in any capacity. employees and have workers' 9. n Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.1X Otherinsulation/Weatherization comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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: A.I.M Mutual Insurance Company — Policy#or Self-ins.Lic.#:W Z-800-8008323-2023A(1) Expiration Date:_9/23/24 Job Site Address: 3�3 FIB C +�(� - City/State/Zip: lUl'o'aJ /O0a Attach a copy of the workers' compensation policy declaration page(showi nd 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 fme 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: Date: /o/f Phone#: 413 532 1817 Official use only. Do not write in this area, to he completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: I Commonwealth of Massachusetts ® Division of Occupational Licensure Board of Building Re4ulations and Standards Cmist ldn SlitKtvisor CS-108817 F cpires:08/23/2024 ROBERT CArHHOUN 8 UPPER RIVER RD SOUTH HADLTY MA 01076 n 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 GREEN COLLAR LLC. Registration: 181415 570 NEWTON ST Expiration: 03/31/2025 SOUTH HADLEY,MA 01075 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 181415 03/31/2025 Boston,MA 02118 GREEN COLLAR LLC. ROBERT CALHOUN ) fRalV(t CalAttUtt 570 NEWTON ST T.�r!l/%l40,4 SOUTH HADLEY,MA 01075 Undersecretary Not valid without signature t GREE COLLA NR Permit Authorization Form Ardith Majkowski (Owner's Name) Owner of the property located at: 333 Florence Rd (Property Address) Florence, MA 01062 (Property Address) Here by authorize Green Collar, a certified Mass Save Independent Insulation Contractor, to act on my behalf to obtain a building permit and to perform work on my property. (Owner's Signature) 10/16/23 (Date) 351 Newton St. Unit B South Hadley,MA 01075 Phone:413.532. 1817 Email: support@greencollarma.com National Vinyl LLC. Customer 7 Coburn Street Phone: 413-420-0548 QUOTATION Chicopee, MA 01013 Fax: 413-420-0560 DATE CREATED SHIP TO: 10/25/2023 www.nvpwindows.com Green Collar LLC QUOTE EXPIRES BILL TO: 3110 14 Bridge Street Quote Not Green Collar LLC South Hadley MA 01075 - 570 Newton St. ShippingZonc CALL AHEAD 413-800-5007 Phone: 413-532-1817 Local Mobile413-800-5007 Daryl South Hadley MA 01075 Fax: Delivery Date dar I reencollarma.com 10/25/2023 Email: Y @9 Sales Person WMASS QUOTE# STATUS CUSTOMER PO# ORDER DATE 349727 None G-AMajkowski Quote Not Ordered QUOTED BY TERMS SHIP VIA PROJECT NAME dgauvin 2% 10 Net 30 Delivered on NVP Truck 333 Florence Rd. Lineltem# Description 100-1 Qty: 2 Green Collar LLC Make Size Northwind III, Double Hung, Double Hung, 19.5 x - 48.125 19.5"X 48.125" Frame Width = 19.5, Frame Height = 48.125, Sash Rough Opening Split = Even 19.75"X Flanker Frame Width = 48.625" Replacement, RO Deduction = -1/4" x -1/2", Thermal Comment/Room: Sash None Assigned Color = white °� Lock Options = Single Lock, Standard, White Sash Reinforcement = Lock and Keeper Rail Only, Composite Half Screen, Fiberglass Unit 1: Glazing Type = Triple Insul Dual Low E, Low 19.5' —' E Softcoat, Gas FIll = Argon po t9.75" Unit 1 Lower Glass, 1 Upper Glass: Glass Strength = Single Strength Clear Opening Width = 14.024, Clear Opening Height = 17.5625, Clear Opening Area = 1.710392 Unit 1: Unit CPD Number = NVP-K-14-00744-00001, Unit U-Factor = 0.2, Unit SHGC = 0.24, Unit VT = 0.39, Unit CR = 72, Air Infiltration Rating = < 0.3 cfm/ft2, Meets Energy Star = Yes Unit 1 Lower Glass, 1 Upper Glass: CPD Number = NVP-K-14-00744-00001, U-Factor = 0.2, CR = 72, SHGC = 0.24, VT = 0.39, AL = -1 Head Expander = Yes, 4 Sides Foam Wrap Page 1 Of 1