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38A-122 (4) BP-2024-0014 63 OLANDER DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 38A-122-001 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-2024-0014 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est. Cost: 1200 ENERGIA LLC 108421 Const.Class: Exp.Date: 02/19/2025 Use Group: Owner: DARNELL, DONALD L.&DERRY, ROBBIN Lot Size (sq.ft.) Zoning: PV/SG a/SG b Applicant: ENERGIA LLC Applicant Address Phone: Insurance: 242 SUFFOLK ST (413)322-3111 WMZ-800-8008072-2022A HOLYOKE, MA 01040 ISSUED ON: 01/05/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/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: ( a >9 • I Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner zoo , ik„City of Northa P ton A F POR Building Dep me BAN ' 212 Main reet!_ ` Q %Oa4 f' . j � Rom f /IIdSULATION Northampton, MA 01O6f� '��` phone 413-587-1240 Fax 413-587427 ?pr-- As . OJIL Y •.„.. . APPLICATION FOR°INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INS ULA TION PERMIT 1.1 Property Address: This section to be completed by office (e43 Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: DONALD DARNNELL 63 OLANDER DR NORTHAMPTON MA Name(Print) Current Mailing Address: 413-341-0114 SEE PERMIT AUTHO FORM Telephone Signature 2.2 Authorized Agent: BENJAMIN BORDEN / ENERGIA LLC 242 SUFFOLK ST HOLYOKE MA 01040 Name(Print) Current Mailing Address'. 413-322-3111 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 1200.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) ti6 5. Fire Protection 6. Total=(1 +2+3+4+5) 1200.00 Check Number This Section For Official Use Only Building Permit Number: 6/4 Q?qI' /q sssuu ed: Signature: //€ I- S-ZOZ I Building Commissioner/Inspector of Buildings Date i��elice @energiaus.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 401‘i mass save Savings through energy efficiency PERMIT AUTHORIZATION FORM I, Donald Darnell owner of the property located at: (Owner's Name) 63 Olander Drive Northampton (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. Owner's Signature 11-30-2023 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 Commonwealth of Massachusetts �' Division of Occupational Licensure Board of Building Rei'gyu11lationsi and Standards VW'�1rjr StitaG%v CS-108421 rc.. _* ` f pires:02119/2025 BENJAMIN : '.• - .� y 242 SUFFOLIi 8 6 as . HOLYOKE Mt !i :> i l` Cammisstarter Z.,fcieril !,' ~';,L::,,., M yy Registration# 165169 Registrant ENERGIA LLC Name Benjamin Borden Address 242 SUFFOLK STREET City, State Zip HOLYOKE, MA 01040 Expiration Date 02/16/2024 i�...1 ENERLLC-01 ALYSSA ,4coRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ihm.....-•--- 6/20/2023 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 :NAME CT Alyssa Perusse Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (NC,No,Ext.): (A/C,No): Chicopee,MA 01013 I AESS:alyssa@phillipsInsurance.com INSURER(?)AFFORDING COVERAGE NAIC#� INSURER A:State Automobile Mutual Ins Co INSURED I INSURER B:A.I.M.Mutual Insurance Company 33758 Energia LLC ;INSURER c; 242 Suffolk Street INSURER D: Holyoke,MA 01040 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 ADDLfSUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR' INSD WVD • IMMIDDIYYYY1 (MMIDDIYYYYt A i X COMMERCIAL GENERAL LIABILITYI 1,000,000 EACH OCCURRENCE $ CLAIMS-MADE X I OCCUR PBP2870943 7/1/2023 7/1/2024 PRMTOERa EoNccTuErtD ncel $ 500,000 _ H- ___ _ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ! ! I— PRo ! 2,000,000 POLICY X JECT ' I LOG I PRODUCTS-COMP/OPAGG I$ I OTHER: $ A AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT 1,000,000 I(Ea accident) ,$ - X ANY AUTO BAP2477206 7/1/2023 7/1/2024 1 BODILY INJURY(Per person) $ OWNED I SCHEDULED (AUTOSONLY AUTOS Ep I BODILY INJURY(Per accident) $ AUTOS ONLY OS ONNLY •((Perr acEcnRTY tDAMAGE $ I i $ A X UMBRELLA LIAB 1 X;OCCUR 1 EACH OCCURRENCE $ 2,000,000 • EXCESSIJAB I 1 CLAIMS-MADE PBP2870943 I 7/1/2023 7/1/2024 !AGGREGATE $ 2,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION X I STATUTEi ERH AND EMPLOYERS'LIABILITY - --- ------ WMZ-800-8008072-2023A 7/1/2023 7/1/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT ,-$ __ OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE$ 1,000,000 If yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 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 Energia LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. 242 Suffolk St. Holyoke,MA 1040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD