The URL can be used to link to this page

36-279 (7) BP-2023-1667 881 HURTS PIT RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 36-279-001 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-2023-1667 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 3400 BRADSHAW ENTERPRISES LLC 108517 Const.Class: Exp.Date: 12/10/2024 Use Group: Owner: GOLD SHAPIRO JODIE F&JOANNE Lot Size (sq.ft.) Zoning: SR Applicant: BRADSHAW ENTERPRISES LLC Applicant Address Phone: Insurance: 246 CONNECTICUT AVE 413-310-8010 A0158300004 SPRINGFIELD, MA 01104 ISSUED.ON:11/28/2023 TO PERFORM THE FOLLOWING WORK: INSUALTION/WEATHERIZATION 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 ' Q I2J11 Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner /91 fJUI t..T 199 it The Commonwealth of Massach efts �� • Board of Building Regulations an tand ds /(i FOR �� Massachusetts State Building Co e,78,Q MR OG c- IPALITY A� 9 — U 'Yp9T(-0 c0� R ised ar 2011 Building Permit Application To Construct,Repair,Reno * molisfi`a One-or Two-Family Dwelling ok%C ThisSection For Official Use Only M'107(f,r, / Building Permit Number: P,' ' /00 7 Date Applied:il ° S Vj ) lZs /7� 1I-z8-26z3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers _881 Burtis Pit Road,Florence MA 01062 NA 1.1a Is this an accepted street?yesYES no Parcel ID 1.3 Zoning Information: 1.4 Property Dimensions: NA NA NA NA 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 NA NA NA NA NA NA 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: J] Outside Flood Zone? Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Jodie Shapiro Florence,MA 01062 Name(Print) City,State,ZIP 881 Burtis Pit Road 413-250-3044 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ® Repairs(s) 0 Alteration(s) 0 Addition D Demolition 0 Accessory Bldg. 0 Number of Units_ Other ❑ Specify:_Insulation Brief Description of Proposed Work2Adding insulation to the attic and air sealing wall plates Work Order attached. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 3400 1. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: �,J 5.Mechanical (Fire $ Total All Fees: wr(6 Suppression) Check No.2A theck Amount: %, Cash Amount: 6.Total Project Cost: $ 3400 0 Paid in Full 0 Outstanding Balance Due: Treasurer's Approval: Board of Health DPW Conservation Comm Approval: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS 108517 12/10/2024 SEAN MATTHEW BAILEY BRADSHAW License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 246 CONNECTICUT AVENUE No.and Street Type Description SPRINGFIELD,MA 01104 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofmg Covering Signature WS Window and Siding SF Solid Fuel Burning Appliances 413-301-8010 SEAN@BRADSHAWENTERPRISESLLC.COM I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 194456 02/07/2025 BRADSHAW ENTERPRISES,LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name dodoop verified 246 CONNECTICUT AVENUE j $irmedad 11/20/23 10 12 AM EST Esu PSB2-NGGI31YZQ-HAG7 No.and Street Signature Email SPRINGFIELD,MA01104 413-301-8010 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 ■ 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. Jodie Shapiro Print Owner's Name 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 accura e to the hest of my knowledge and understanding. dotl��m.0 11/0/2 10: 2 AM EST erified SEAN BRADSHAW OGOR-GWUM ZQ 9-OMPG Print Owner's or Authorized Agent's Name 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 Official Webs;le of the Executive Office of EOFIED the Dvsion of Professional Licensure, and the Division of Standards VOW Public Safety • } • 441Mass.► Ma5 State Ges Licensee Details Demographic Information Full Name: SEAN Matthew Bailey BRADSHAW Owner Name: License Address Information City: South Hadley State: MA Zipcode: 01075 Country: United States License Information License No CS-108517 License Type: Construction Supervisor Profession Building Licenses Date of Last Renewal: 1/6/2023 Issue Date: 4/28/2015 Expiration Date. 12/10/2024 License Status: Active Today's Date. 1/9/2023 Secondary License Type: Doing Business As. Bradshaw Enterprises, LLC Status Change Reason: License Renewal Prerequisite Information No Prerequisite Information No Available Documents dose Window 0 2011 Commonwealth of Massachusetts Site Policies I Contact Us 0 0 0 e_ c O Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 194456 BRADSHAW ENTERPRISES, LLC Expiration: 02/071E1 246 CONNECTICUT AVE SPRINGFIELD, MA 01104 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 194456 02/07/2023 1000 Washington Street -Suite 710 BRADSHAW ENTERPRISES, LLC Boston,MA 02118 SEAN M.BRADSHAW 34 FRONT STREET t CG• '• SPRINGFIELD,MA 01151 Undersecretary Not valid without signature dodoop signature verification:::; ,,;,.K Cn3i • DEBRIS DISPOSAL AFFIDAVIT In accordance with the provisions of MGL c.40,s.54,is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c.111, s.150A. ANY AND ALL DEBRIS PROUCED AS A RRSULT OF WORK PERMIT I ED UNDER THE ATTACHED APPLICATION WILL BE DISPOSED OF IN: USA Waste Recycling Name of Licensed Solid Waste Disposal Business/Facility 15 Mullen Rd, Enfield CT 06082 Address of Licensed Solid Waste Disposal Business/Facility USA Waste Recycling Name of Hauler Sean Bradshaw 9/20/2020 Print Applicant Name Date ❑ I,Sean Bradshaw do hereby certify under the pains and penalties ofpedury that the information provided above is true and correct,and that clicking this checkbox and typing my name in the field above will as at my signature. ,/-- BRADENT-01 BROOKE Ac dsvRr)• DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/15/2023 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 Brooke Barre NAME: Phillips Insurance Agency, Inc. PHONE FAx 97 Center Street ((A/C,No,Ext): (413) 594-5984 (A/C,No):(413) 592-8499 Chicopee,MA 01013 EMAIL brooke hilli sinsurance.com ADDRESS: ( pP INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Middlesex Insurance Company 23434 INSURED INSURER B:Sentry Insurance 24988 Bradshaw Enterprises, LLC INSURER C: PO Box 944 INSURER 0: Chicopee,MA 01021 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. INBR ADDL SUBR POUCY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MWDOr'YYYY)I(MM/DD/YYYY) OMITS A X '�COMMERCIAL GENERAL LWBIUTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR A0158300 8/12/2023 8/12/2024 oAMAGE TO RENTED 5O0r000 X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ A AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO X A0158300003 8/12/2023 8/12/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident), $ H RREEfl� NON.pyiINED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE A0158300 8/12/2023 8/12/2024 AGGREGATE $ 2,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'UABIUTY Y/N i X_STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE A0158300004 8/12/2023 8/12/2024 1,000,000 OFFICER/MEMBER EXCLUDED? Y NIA EL EACH ACCIDENT (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Springfield Partners for Community Action,Inc: National Grid USA it's direct and indirect parent and subsidiaries and affilliates:G.L.C.A.C,Inc.;and Eversource Gas of MA shall be named as Additional Insureds on the Commercial General Liability and Automobile Liability policies where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Springfield Partners for CommunityAction THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 721 State Street Springfield, MA 01109 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD dotioop signature verification:dtip.us•IpFp.6GtK-CBat ,. The Commonwealth of Massachusetts • Department of Industrial Accidents 1 Congress Street,Suite 100 r��eyw_Y Boston,MA 021 1 4-201 7 ;�• www moss.govJdia • Workers'Compensation Insurance Affidavit:Bullders/C.ontractors/Electricians/Plumbers. TO BE FILED WrTN THE PERMITTING AUTHORITY. Applicant Information Name in; ness/Orgamrationai/Individual):Bradshaw Enterprises, LLC _. Address: 34 Front St Indian Orchard Mills Suite G60 city: Springfield State: MA ;p: 01051 Phone x: 413-250-4746 Are you an employer?Check the appropriate box: Type of paroled(required): am an employer with 11 employees(full and/or part timer [ 7. New construction 12. I am a sole proprietor or partnership and have no employees working for me in any —18. Remodeling capacity.(No workers'comp.insurance required.] F-1I9. Demolition 3. I am a homeowner doing all work myself.[No workers'comp.insurance requlred]t ' p0. Building addition []' 4. I am a homeowner and will be hiring contractors to conduct all work on my property. ' 11. Electrical repairs or additions 1 I will ensure that all contractors either have workers'compensation Insurance or are sole proprietors with no employees. r112. Plumbing repair,or additions U5. I am a general contractor and I have hired the sub-contractors fisted on the attached 13. Roof Repairs sheet. These sub-contractors have employees and have workers'comp.insurance# [16. We are a corporation and its officers have exercised their right of exemption per MGL. ,✓14. Other c.152,91(41,and we have no employees.(No workers'comp.insurance required.] "Any applicant that checks box a1 must also tilt out the section below showing their workers'compensation policy information. (Homeowners who submit this afheavrt indicating they are doing aft work and then hire outside contractors must submit a new affidavit indicating such. 2Coestractors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entitles have employees.It the subcontractors have employees,they must provide their workers'sump.policy number. l am an employer that Is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Sentry Insurance (Agent- Phillips Insurance 413-594-5984) Policy nor Self-Ins.11c.#: A0158300004 Expiration Date: 8/12/2024 Job Site Address: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGI..c.152,925A is a criminal violation punishable by a fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in me form of a 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. �v I do hereby ceniJy under the pains and penalties of perjury that the Information provided above Is true and correct,and that clicking this checkbar and typing my,mane to the field below will act os my signature. Name: Sean Bradshaw Date:.._ 9/29/20 Phone e: 413-250-4746 Email: seangbradshawenterprisesllc.com J� f Commonwealth of Massachusetts Division of Occupational L,icensure Board of Building Re ulations and Standards Cons ion thiporisor ,ils„: dfr --,‘ CS108517 ; , spires : 12/1O/2O24 SEAN MAMMA/ BAILEY `.� : w' • DSHAW . �r y� �F a v; commissio ner K. &e.yrt tie& WEATHERIZATION CONTRACT EVERS=URCE CUSTOMER PHONE DATE CLIENT# WORK ORDER Jodie Shapiro (413)250-3044 10/01/2023 549569 10302 SERVICE STREET BILLING STREET PROPOSED BY: 881 Burts Pit Road 881 Burts Pit Rd Ray Dickson SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Florence, MA 01062 Florence, Ma 01062 EGMA-HES Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 75% For eligible weatherization measures, Eversource is offering an incentive of 75%for insulation measures and 100%for the air sealing measures, both with no limit. You are eligible to apply for the 0%Heat Loan to finance your co-pay, applications must be submitted before the weatherization work begins. WEATHERSTRIP DOOR 1 $36.32 $36.32 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. WALLS-VINYL SIDED 6" 992 $3,382.72 $2,537.04 $845.68 Install blown in Class I Cellulose to vinyl-sided exterior walls. 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. Total: $3,419.04 Program Incentive: $2,573.36 Client Total: $845.68 I.DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the above work at the Client's Address in a professional manner and in accordance with the terms of this Contract: II.PAYMENT Client agrees to pay the Contractor for the Work,the Client Share of the Contract Cost is payable to the Independent Installation Contractor(IIC)upon satisfactory completion of the Work.Client understands that they will not be required to pay the Program Incentive Share of the Contract cost.Changes to the individual line items and/or previous incentives may increase or decrease the size of the Program Incentive Share. vve� RISE Representative Client Signature Ralean Dickson 10-12-2023 Printed Name Date of Acceptance Document Ref:M9JLS-HK88C-UM4E6-JAIW2 � � J� mass save Savings through energy efficiency PERMIT AUTHORIZATION FORM 1, Jodie Shapiro owner of the property located at: (Owner's Name) 881 Burts Pit Road Florence (Property Street Address) (City) hereby authorize the Mass Save® Home Energy Services Program assigned Participating Contractor to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. This form is only valid with a signed contract. The permit will be secured by the subcontractor, at no additional cost. �i��►�r�pur1- 10-12-2023 Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date Document Ref:M8JLS-HK88GUM4E8-,,lAtVY2 Page 1 or4Vt