Loading...
10B-017 (4) 48 RIVER RD BP-2021-0724 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 10B-017 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2021-0724 Project# JS-2021-001218 Est.Cost: $573.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: POTENTIAL ENERGY LLC 106184 Lot Size(sq.ft.): 17075.52 Owner: DOLLARD CATHERINE Zoning: URA(100)/ Applicant: POTENTIAL ENERGY LLC AT: 48 RIVER RD Applicant Address: Phone: Insurance: 1 HARTFORD SQ BOX 2E (413) 798-0273 () WC NEW BRITAINCT06052 ISSUED ON:3/3/2021 0:00:00 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UP N VIOLATION OF ANY OF ITS RULES AND REGULATIONS. i ` ,r • • + Certificate of Occupancy Signature:I FeeType: Date Paid: Amount: Building 3/3/2021 0:00:00 $65.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only ,�oti,µ.►;�o 2 ity of Northampton Status of Permit: b •:Iding Department Curb Cut/Driveway Permit I , .-kk` 1_ " C`sQFo�, 212 Main Street Sewer/Septic Availability «; o‘�,T" \P Room 100 Water/Well Availability \)\\PAD Northampton, MA 01060 Two Sets of Structural Plans `� ✓� '�� one 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office A% VEc Map �' ! Lot C ` Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: is o 7.r rA _ASC 1VL.v42 - Q—�•�•� hi G: eltsT-4n rnA- c_ 13 'I Name Print) � Current Mailing Address: f/0 Telephone ignature 2.2 Authorized Agent: Name(Print) J Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 5-)3 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee (/� 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 +2+ 3+4+ 5) 5-73 0 Check Number 497� � This Section For Official Use Only / . / Building Permit Numb r: d•LI Date Issued: Signature: '- /1-/'2(JZO Building Commissioner/Inspector of Buildings Date ((1 . � : 1 C h('N 1/ 1 . . C v i`N1 EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors l] Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [[] Siding[O] Other[4olf..04+; Brief Description of Proposed Work: (',C Ck Ll tscacO. Cp:.:V, c9 I i( ` 'Th O 1 `lkcn'Q-f �� nty j S Alteration of existing bedroom Yes No Adding new bedroom Yes / No Attached Narrative Renovating unfinished basement Yes ✓ No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other N b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, C 0.�hp�.s‘e.. .T)O\\C , as Owner of the subject properly hereby authorize ` C pA-ec \-i cA ?...np_cc‘ki , 1 tr to ac n my behalf, in all matters relative to wortkauthorized by this building permit application. J Sign ture of Owner Date j — I, TO .QANA-;G C Q t , as Owner/Authorized Agent hereby declare fhat`the stMtefment and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. C\nc,\c 3 Vnt:z SIt'P.! Print Name I0.-i-ZaZ;0 Signature of en Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage _ Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO (Y DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Regis of Deeds? NO Q DON'T KNOW YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Qf DONT KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained , Date Issued: C. Do any signs exist on the property? YES Q NO V IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO ®' IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,ex ation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: �bdHOLJ1 S' 'e73Tn ! . License Number 141-1 ,A116t .sS 53-c-eAZAr �c�-rn C iy t.q V 12 7 f�.1 Address J 7 Expiration Date /3 7980273 Sig r Telephone 9.Registered Home Improvement Contractor: Not Applicable 0 ` t'OTCNTIli-t-(i &-? * /9225 V Company Name Registration Number 11- rcoeo ortPc- KC. 26 ,04w 6KI/Ftw, e -060€- 6/20.2 Address / Expiratio Date />4;)$' Telephone /�2 O273 SECTION 10-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 111 No 0 City of Northampton Massachusetts l� ` G + DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building v� cs:b Northampton, MA 01060 rJlryyj��`� Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: c;' -er ct :s.:st (Please print house number and street name) Is to be disposed of at: kock- (Please print n me and locatio off ity) Or will be disposed of in a dumpster onsite rented or leased from: 9 (Company Name and Addres'sj Signature of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. City of Northampton 0.H M !C Massachusetts �'•-'t� ° L' DEPARTMENT OF BUILDING INSPECTIONS .11 .fir , J 212 Main Street • Municipal Building �J6 �'' Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered Type of Work: C ASQgc,,,2_ Est.Cost: SS 1340 Address of Work: 4 �, �L-oc_ j u o A rN 0 i o l":3 Date of Permit Application: r .—i I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): Job under$1,000.00 _Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: it-1--z 2f') 0 14-:0.\ ���� .Lce_— I 71 k1 Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature taPr City of Northampton ti z� c Massachusetts �� �`� 1s * G' ,i :it t Ad x t e'! DEPARTMENT OF BUILDING INSPECTIONS y; '' ti 212 Main Street • Municipal Building vI- ��'`� Northampton, MA 01060 Y Property Address: A% R:ae.c QLoad MocckiramoArr, O A C irss'3 Contractor Name: `/�c c*--ltd Cave 1 y, t_t_&_ Address: I 1-tCL n-et SGLAth..e— Sv. 'Zit,' ''a)�� CaS JVe L! ;+si:h,t i oc::Ms- City, State: f te.ci Sr,. \a:c‘ C. I o(n IDS- Phone: (.(1S - /CV - O2 71 Property Owner Name: (\.,cAka, _ -TNa\W Address: AY Ci4er Le,c(11 City, State: Afc„-A-1na,..011„ irt4. n t riS 3 I, kJ ,(r GALS rg.e;s-her 4f1kll 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 .// ,...„5:0!! ;›,_ Date I7---1-1z2Z Qom, C62042?/122042W-eaagdi Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC POTENTIAL ENERGY LLC Registration: 192284 1 HARTFORD SQUARE Expiration: 06/21/2022 BOX 2-E NEW BRITAIN,CT 06052 Update Address and Return Card. SCA 1 C 20M-05/17 '/4r ;,.in,Imnu'err///r/ llir.;.indii.:r>//: 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 192284> . 06/21/2022 1000 Washington Street -Suite 710 POTENTIAL ENERGY LLC Boston,MA 02118 NICHOLAS MEISTER 1 HARTFORD SQUARE nut 4. DOOR 65 SUITE 216 Undersecretary Not valid without signature NEW BRITAIN,CT 06052 Commonwealth of Massachusetts Division of Professional Licensure and Standards Board of Building Regulations ConstructionSuperVisor 1 & 2 Family CSFA-106184 Expires:04/27/2021 NICHOLAS ALEXARDETRI MEISTER; 344 ANDREWS ST SOUTHINGTOMI CT 06489 Commissioner q�.•« '��1 DocuSign Envelope ID:F6438592-DC20-43DE-8D9B-FB819247A076 Permit Authorization mass Save Form r .=a+ otwrgy Site ID: 4031017 Customer: CATHERINE DOLLARD Catherine Dollard ,owner of the property located at: (Owner's Name,printed) 48 River Rd Northampton, MA 01053 (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. DocuSigned by: Owner's Signatur : �krila t Uoa(4ri 72ADFC 1E8E614BB... Date:8/27/2020 14:21 PM EDT sassasswats!!•siasasass.sassassasassasassesasi#iliiii•slssasseasassess FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Potential Energy, LLC 12/7/2020 Participating Contractor Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 For Office Use Only Rev.102015 DocuSign Envelope ID:F6438592-DC20-43DE-8D9B-FB819247A076 CLEAResult" CONTRACT CLEAResult 50 Washington Street, Customer Name:CATHERINE DOLLARD Westborough,MA,01581 Email:cadollard@gmail.com Phone:413-588-1472 Premise Address:48 River Rd,Northampton.MA 01053 Mailing Address:48 RIVER RD,Leeds.MA 01053 Project ID:4031017 Date:July 20.2020 Applicable Customer Required Actions: Notes: • Other Customer must confirm no active knob&tube wiring in house and all vermiculite is being removed before insulation contract can be issued. Job Description Contractor will perform or cause to be performed the following work on these"Premises"in a professional manner and in accordance with the terms of this Contract, including the attached recommendations/work order describing the work in detail(the"Work")which are incorporated herein by reference. Measure Description Location Quantity Unit Total Cost Customer Cost Air Sealing at Estimated 62.5 CFM50 Per Hour 1 hr $92.58 $0.00 Door Sweep(with AS hrs) 2 each $50.62 $0.00 Exterior Door Weather Stripping(with AS hrs) 2 each $60.14 $0.00 Crawlspace Ceiling-2"Thermal Barrier Polyiso 120 SF $573.60 $0.00 Total: $776.94 Program Incentive: -$776.94 Weatherization Barrier Incentive: -$100.00 Customer Total: $-100.00 Payment Customer agrees to pay Contractor for the Work,the Customer Share of the Contract Price as follows: Payment#1:=I as a Deposit payable to CLEAResult upon signing the Contract(not to exceed 1/3 of the total retail costs). Mail check&contract to CLEAResult, 50 Washington Street, ,Westborough,MA,01581. Final Payment:_as the final payment for the Work shall be payable to the Home Performance Contractor(HPC)or Independent Installation Contractor(IIC)upon satisfactory completion of the Work. Customer Page 1 of 4 DocuSign Envelope ID:F6438592-DC20-43DE-8D9B-FB819247A076 understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of 11.1111.Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. Dispute Resolution The IIC and Customer hereby mutually agree in advance that in the event that the IIC has a dispute concerning this Contract,the IIC may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to submit to such arbitration as provided in M.G.L.c 142A. You may cancel this agreement if it has been signed by a party at a place other than an address of the seller,provided you notify the seller in writing by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. r—OocuSgned by: DS r y 8/27/2020 14:21 PM EDT `-tti§iftfrkirr6Slijnature Date Indicate your selected IIC here,if applicable Ini la ere if you want the Program to assign a Participating KtviG 9-4-2020 Kevi n Cote Contractor kv CLEAResult Signature Date Name of CLEAResult Representative Page 2 of 4 NI RCS PLANVIEW DIAGRAM Customer: k.04t6 e-Osc.I Home Phone. ( )- . Address Work Phone: ( )- �Yr " A�7 ut V v - t44 I, Qpcfy .Town: Cell Phone` ( 413 Any limitations for access by large truck, N�' •r+� yes if yes,describe_.___._-.._._ .,._..__....._._,.-..-- t -- Any spec f c directrons or landmarks? ra<. ��� yes il yes.describe _._ . -. . .... ...... tk Site ID: Energy Specialist Reviewed by. t: k-tv Lt fir,-.. _ 51155� - r c " t, L -- ?�u t Eva" -cr�6 u A POI ,S k-x j () �, 6 1 4 U \ a ra4- F 0 _`0 la Uz f 0 F-- cs —� --'--� & / \ ,t•P oc. 40 0 PS; ):3 iN) (k.,,) \ 02) / \ I t 0) orb For Office Use Only Bushes Ladder _ 4 1 Neighbor Proximity Pocket Doors insert Radiators Fence(s) Existing Conditions X=Access 0=Vents Note Inside Square R=Roof S=Soffit G=Gable RV=Ridge Vent CS=Continuous Soffit CDE=Continuous Drip Edge T=Triangle Install 0=New Access Note in Circle C=Ceiling W=Wall S=Sheathing Temp Unless Noted Otherwise A=Vents Note in Triangle R=8"Roof S=Soffit G=Gable M=12"Mushroom For Access 1-1t.9PP0HTttUG MATH A t a x�•L LiC�-,J V ( is.T is` , .d) - ( cots s r i7 (?rtd)J '` c'_vent $f . , r dvvv..eyNis roil � ate P�rc0CS /lay (ut�` -7Y r�' i7 _ - _ f ._ ___ . (act 7TIT * Hl i , aq_ck _✓ Recommended _ Ventilation Calculation Recommended ventilation Calculation r fo (300 - 6 , e l CSV Qn A '�.a, Jf,Dsp " Air Sealing Work Hour Calculation rA4 - (Qv Work Hours 4 i O 8 10 12 14 16 (+2) Attic Sq.Footage <500 f 501 -800 801 -1100 I 1101- 1400 1401- 1700 1 1701-2000 2001-2300 I Every 300' Exceptional AFL Hours Primarily Floored Attics ! Chimney or BF=1 Hour Multiple Chimney/BF=2 Hours Prefab/Modular Hours No Chimney=4 HoursT Chimney=6 Hours — Exceptional KW Hours X<20 feet=1 Hour T 20 ft<X<40 ft=2 Hours J X >40 ft=4 Hours Rim Joist Only Hours RJ< 150 ft= 1 Hour ____RJ_>150 ft=2 Hours E,,IT Ceiling Only Hours Ceiling Area<2,000 sq ft =1 Hour Ceiling Area>2.000 Sq ft=2 Hours "'NOTE:You MUST be INSULATINQ RJ or Basement Ceiling to specify RJ or BMT Ceiling ONLY Air Sealing Hours•" 0 >6"Loose Insulation Cross Batt Insulation Multipliers ---_.___—___._ �__.___. __ _ ._�.._..______ _-_�.—_ >_6"Mix Batt&Loose Insulation Truss Construction Ogre For Office Use Only r '�y The Commonwealth of Massachusetts Department of Industrial Accidents lit.=• Office of Investigations `r -7.�i600 Washington Street "1 = Boston,MA 02111 "'• www.mass.gov/dia Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Pluinbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ,`} Ace--ANCa.k Er,t� Address: �„t a St.,.,4-e....'l il� ' c tr 1� ;: �c ,,t�_Si u�t" City/State/Zip: , s3- c:e1, t c c c Phone.#: y t 3 - -7 C$ —i✓., Are you an employer?Cheek the appropriate bor: Type of project(required): 1.El I am a employer with_Ai 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 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' 9. ❑Building addition [No workers'comp.insurance comp.insurance. . repairs 5. ❑ We are a corporation and its 10❑Electrical or additions 3.❑ 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 employees.[No workers' 13.0 Other 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. lithe subcontractors have employees,they must provide their workers'tongs.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: rs; eti ei� `c t� 't;j1t Sec a; Policy#or Self-ins.Lic.#:. tat q�R � 3 Expiration Date: 8't'2'. I„c,c.. Job Site address:-48 River Road City/State/Zip: Northampton MA 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 Investi motions of the DIA for insurance coverage verification. Xdo hereby certify un thevp rr es of perjury that the information provided above is true'and correct Signature. _._ Date; 3/3/2021 _ es phone#: `'t i''3 --'?G Sk --C _y, Official use only. Da not write In this area,to be 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 S.Plumbing Inspector 6.Other Contact Person:,, Phone#: - t