Loading...
16B-025 (4) 109 FERN ST BP-2021-1455 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: I6B-025 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-2021-1455 Project# JS-2021-002416 Est. Cost: $5000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SEAN BRADSHAW 108517 Lot Size(sq. ft.): 5009.40 Owner: PREISSLER DONALD W Zoning: URB(100)/ Applicant: SEAN BRADSHAW AT: 109 FERN ST Applicant Address: Phone: Insurance: 2I4far CONNECTICUT AVE (413) 250-4746 O WC SPRINGFIELDMA01104 ISSUED ON:6/8/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATIONNVEATHERIZATION 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 UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. ` , +r , >2 . QT�, Certificate of Occupancy Signature: I �* I 0 FeeType: Date Paid: Amount: Building 6/8/2021 0:00:00 $65.00 2 I 2 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner . \\0\ dotloop signature verification: /' 1j *(C> The Commonwealth of Massachusetts'o "2 Board of Building Regulations and Standai'es� FOR Massachusetts State Building Code, 780 C1017,%, �c�2/ IUS ALITY Building Permit Application To Construct,Repair,Renovate Or Demon h a Revised Mar 2011 One-or Two Family Dwelling °'0`1% Th�� �? i�R �fi'p� I�,�o 'i3$e Qnly Building Permit Number: it/ >�lred; f Building Official(Print Name) Signature Date SECTION 1:SIT) INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 109 Fern Street, Florence Ma 01062 _ I Z 5' 1.1a Is tots an accepters street?yes x no Map Number Parcel 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 N/A N/A N/A N/A N/A N/A 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: _ Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yesCi 4C '21:, ?ROPERTY O t: 1TLPI 2.1 Owner'of Record: Florence, Ma 01062 Donald Preissler Name(Print) City,State,ZIP 109 Fern Street _ 978-460-1100 No.and Street Telephone Email Address SECTION 3 USCALPT1ON OF PROPOSED WORK'(chee(011'that apply) New Construction❑ Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other ® Specify:Insulation MassSave Brief Description of Proposed Work:Adding blown cellulose to attic flat to achieve an aggregate R-49.Please see attached work work order. SECTION 4':0� TED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 5000 I. Building Peru 1~ee:$ Tittlicate how fee is determined: 2.Electrical $ El Standard City toii/Town Applicat ee 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ . Other Fees: $ 4.Mechanical (I-1VAC) $ List: S.Mechanical (Fire $ .. Suppression) Total All F��elIes $ 5000 Check No,A .check Anidu'nt. Cash Amount: 6.Total Project Cost: $ ❑Paid-in.Full ❑Outstanding.Balance Due: dotloop signature verification:dtlp.us/4nEh-ABFb-ihhv • SEC ON 5: COSIS 'E .,_•®N SERVICES 5.1 Construction Supervisor License(CSL) C5-108517 12/10/2022 Sean Matthew Bailey Bradhsaw License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 246 Connecticut Ave No.and Street Type Desciptiori 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 Roofing Covering - --- WS Window and Siding SF Solid Fuel Burning Appliances 413-250-4746 Sean@BradshawEnterpisesLLC.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 194456 02/07/2021 Bradshaw Enterprises,LLC HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name Sean Matthew Bailey Bradhsaw Sean@BradshawEnterpisesLLC.com No.and Street Email address 246 Connecticut Ave,Springfield,MA 01104 413-250-4746 City/Town,State,ZIP Telephone 'SECTION 6:WORKERS'COMPENSATION INSURANCI Ai(FIDAVTT(M.G.L.c.1'S2 § C(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 0 No• U SI CTT01a.tiER rl<,�F 0>>li„IZATION TO BE COMPLE3 F U WHEN r..,..`,. . F> a AIFN Off': CTQ PLIES FOR$WLDING;;I'.ERMIT I,as Owner of the subject property,hereby authorize Bradshaw Enterprises,LLC — to act on my behalf,in all matters relative to work authorized by this building permit application. Please see attached customer signature authorization form provided MassSave. Print Owner's Name(Electronic Signature) Date 1f' E 0 .0 Lf0. . .. ?. m AGWAEG 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 1. et,s4 mx, dotloop verified Se a e ,,,,,,// 06/02/21 8:36 AM EDT 1� (/ YN9A-RU7E-HIIA-LOSJ Sean Bradshaw authorized Agent 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" dotloop signature verification:dtlp.us/4nEh-ABFb-iHhv The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/diaWorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Name(Business/Organizational/Individual}:Bradshaw Enterprises, LLC Address: 34 Front St Indian Orchard Mills Suite G60 City: Springfield State: MA Zip: 01051 Phone u: 413-250-4746 Are you an employer?Check the appropriate box: Type of project(required): ✓ 1. I am an employer with 1 1 employees(full and/or part time)* n 7. New construction 2. I am a sole proprietor or partnership and have no employees working for me in any 8. Remodeling capacity.[No workers'comp.insurance required.] n9. Demolition 3. I am a homeowner doing all work myself.[No workers'comp.insurance required]t 10. Building addition I�4. I am a homeowner and will be hiring contractors to conduct all work on my property. 11. Electrical repairs or additions I will ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. n12. Plumbing repairs or additions u5. I am a general contractor and I have hired the sub-contractors listed on the attached :H13. Roof Repairs • sheet. These sub-contractors have employees and have workers'comp.insurance.± t 'f I 16. We are a corporation and its officers have exercised their right of exemption per MGL. [�/ )14. Other c.152,§1(4),and we have no employees.[No workers'comp.insurance required.] ���••• ��� "Any 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 attach an additional sheet showing the name of the sub-contractors and state whether or not those entitles 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: Sentry Insurance (Agent - Phillips Insurance 413-594-5984) Policy#or Self-ins.Lic.#: A0158300004 Expiration Date: 8/21/2021 Job Site Address: Attach a copy of the workers'compensation policy dedaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL.c.152,§25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ✓ 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct,and that clicking this checkbox and typing my name in the field below will act as my signature. Name: Sean Bradshaw Date: 9/29/20 Phone#: 413-250-4746 Email: sean@bradshawenterprisesllc.com dotloop signature verification:dtlp.us/1aEh-ABFb-iHhv �__,... BRADENT-01 BROOKE " ICORCOa CERTIFICATE OF LIABILITY INSURANCE DATE(M_ `,'.�" 9128/2020 YYY) 202 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 WANED, 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 CONNTACT Brooke Barre ---- I ---... AX Phillips Insurance Agency,Inc. AA/C,PHONE E7t):(413)594-5984 I(A C,No 413)592-8499 97 Center Street j;� Chicopee,MA 01013 E-MAIL brooke@philtipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSuRERA=Middlesex Insurance Company INSURED V J INSURER B:Sentry Insurance 124988 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 SUCI I POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ICY EXP NSR TYPE OF INSURANCE 111450 Sy v I POUCY NUMBER IMMIDrti DY/YYYY) (M EFF DBLYX X.L UMIS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAMS-MADE X OCCUR X A0158300 8/12J2020 8/12/2021 PRE SES(Ea occunence) $ ^�500,000 MED EXP(Any one personl $ 10,000 PERSONAL&ADV INJURY _.$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE J 3,000,000 POLICY X JEC7 I 1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINEDDSINGLE LIMIT 1,000,000 X ANY AUTO )( A0158300003 8/12/2020 8/12/2021 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ __ PROPERTY DAMAGE HIRED NON-O NED j AUTOS ONLY AUTOS NLY i {per accfdentl A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 T EXCESS LIAR CLAIMS-MADE A0158300 8/12/2020 8/12/2021 AGGREGATE $ 2,000,000 OLD X RETENTIONS 0 $ B WORKERS COMPENSATION X PERTUTE 0T AND EMPLOYERS'LIABILITY A0158300004 8/12)2020 8/12/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE R Y r N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? Y N/A 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yea,describe tinder 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE.POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Thielsch Engineering,Inc.is listed as Additional Insured on a primary,non contributory basis with respect to General Liability and Auto Liability per written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Thielsch Engineering,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 g ACCORDANCE WITH THE POLICY PROVISIONS. 195 Frances Ave Cranston,RI 02910 AUTHORIZED R�EPRES ENTATI V E y I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD dotloop signature verification:dtlp.usi4nEh-ABFb-iHhv ' /tfi ..."(Viti/1/(Ye)/ortee'76(4 (/t. ,r..14 . ,_. /((f.,) .//re...' Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement C ntractor Registration `+ r= `";► Type: LLC °" -';•i„-- •:_.-am--•y ic, BRADSHAW ENTERPRISES,LLC ' ... .'• •` "-=` I Registration: 194456 - 4 \., Expiration: 02/07/2021 246 CONNECTICUT AVE Ft.o - --. ti-' SPRINGFIELD,MA 01104 "r-' .,-�" t'.i Y. Update Address and Return Card. SCA 1 0 2UM--05n ( .71, 7r!rJ,fy,,r,Y�r,//�I/- 7/,/,/rYilR%5rlJr/v 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 02/07/2021 1000 Washington Street-Suite 710 BRADSHAW ENTERPRISES,LLC Boston,MA 02118 SEAN M.BRADSHAW \* 1"-- _� ` 34 FRONT STREET L.J SPRINGFIELD,MA 01151 Undersecretary Not v-,'�without s+• •afore q t At' '� kf' „ 2 # A' .,� a i't ? " , § >sf �. t�- r f,� !�: ' CO`p 7ti .' ^✓.';k v'S . > r e . rze1rt ,..„j � i 1n'0}S .7 t ,,,,:3' , r W.4-Mi'1 4 , 1r ,y1 ¢ r ,� e :ram w+; .,n r n;. 4 - • �,, 4, G�„r y _��..1,' ' ,: !.t-,.� t -: ,a cc _"r ` -' r:•,-, . '.6✓Y� -.rti"w �' � },s.'a^'.ru' ,: sr '"� e` is• ,y r ,r ' r , , yYYY / }t c ,, N'w I... q 9n' jj Yy..$t ' t ' ' f.: b x t > s t • fi a? ts. 1r ' � o :ie r u ti1arreF z f> +�- f -t"y 6 • .f..4, ;r f,r, � 'r - A r5 "'+z , L i i 1 3 1aI a ,�*swi rs a itt t t a ty r Y n * , ' fita r Y1 u � c r p� L> . • 141 {'K�N.6u� f rt.' 6,h d44 t YY j' 1,04it.F !¢t n Wf. h +��,4 y ` t dotloop signature verification:ddp.us/4nEh-ABFb-iHhv 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.1 50A. ANY AND ALL DEBRIS PROUCED AS A RESULT OF WORK PERMITTED 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 of perjury that the information provided above is true and correct, and that clicking this checkbox and typing my name in the field above will act as my signature. Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC BRADSHAW ENTERPRISES, LLC Registration: 124456 246 CONNECTICUT AVE Exxpipi ration: 02/07/2023 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 f SPRINGFIELD, MA 01151 Undersecretary ( dwiout9natur e DocuSign Envelope ID:4742015E-3A90-45D7-A688-E4CC8991A472 Federal ID#05-0405629 RISE Engineering RI Contractor Registration#8186 MA Contractor Registration#120979 RISE 60 Shawmut Unit#2,Canton,MA 02021 ENGINEERING` CONTRACT RM1�1�'o A CT WZ (401)784-3700 FAX(401)7843710 Page 1 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS CMA-HES DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT 0 WORK ORDER Donald Preissler (978)460-1100 01/11/2021 297517 61903 SERVICE STREET BILLWG STREET PROPOSED BY: 109 Fern Street 109 Fern Street Jeff Ledoux SERVICE CITY,STATE,ZP BILLING CITY,STATE,ZP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 100%2020 For a limited time, Columbia Gas is offering an incentive of 100%on qualifying weatherization measures.This contract must be signed and returned within 30 days and the weatherization must be installed by June 30,2021. ATTIC DAMMING-R-38 FIBERGLASS 70 $143.50 $143.50 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLAT- 14"OPEN R-49 CELLULOSE 800 $1,440.00 $1,440.00 Provide labor and materials to install a 14"layer of R-49 Class I Cellulose to open attic space. ATTIC HATCH-SEAL& INSULATE 1 $60.00 $60.00 Provide labor and materials to insulate the back of an attic hatch with 2"rigid insulation board.Weatherstrip the perimeter. VENTILATION CHUTES 40 $100.00 $100.00 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. INSULATED BATH EXHAUST HOSE 4 INCH 1 $60.00 $60.00 Provide labor and materials to install an insulated 4"exhaust hose to existing bathroom fan(s). HOME AIR SEALING 8 $680.00 $680.00 Provide labor and materials to seal areas of your home against wasteful,excess air leakage.Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) WEATHERSTRIP AND ADD DOOR SWEEP 2 $160.00 $160.00 Provide labor and materials to install Q-lon weatherstripping and a doorsweep to door(s)to restrict air leakage. WALL THIN BATT 890 $2,153.80 $2,153.80 Furnish and install blown in Class I Cellulose to exterior walls. Existing walls have a thin batt insulation.Touch-up painting,if needed, will be the customer's responsibility. STORAGE-BASEMENT ups Homeowner is responsible for the removal of the stored items OP (initials) DocuSign Envelope ID:4742015E-3A90-45D7-A688-E4CC8991A472 Federal ID#05-0405629 RISE Engineering RI Contractor Registration#8186 MA Contractor Registration#120979 RISE60 Shawmut Unit#2,Canton,MA 02021 ENGINEERING" CONTRACT oL (401)7843700 FAX(401)7843710 Page 2 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS CMA-HES DESCRIBED BELOW CUSTOMER PHONE DATE CLENT WORK ORDER Donald Preissler (978)460-1100 01/11/2021 297517 61903 SERVICE STREET BILLING STREET PROPOSED BY: 109 Fern Street 109 Fern Street Jeff Ledoux SERVICE are,STATE,ZP BILLING CITY,STATE,ZP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL blocking the installation of weatherization work in the basement. Removal must occur prior to the scheduled work start. BASEMENT SILLS R19 FIBERGLASS BATT 120 $234.00 $234.00 Provide labor and materials to install R-19 unfaced fiberglass insulation to the perimeter of the basement ceiling at the house sill. Total: $5,031.30 Program Incentive: $5,031.30 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/Dollars $0.00 UPON RECEIPT OF YOUR RISE ENGINEERING INVOICE,CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF I%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. —DocuSgned by: r—DocuSigned by: J4 LtIo40c VouutU Prt-iSit 1/12/2021 1 8:39 AM EST NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US P NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE 30 DAYS. ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK AS SPECPED.PAYMENT WILL BE MADE AS OUTLINED ABOVE DocuSign Envelope ID:4742015E-3A90-45D7-A688-E4CC8991A472 RISE 7 ENGINEERING` OWNER AUTHORIZATION FORM Donald Preissler (Owner's Name) owner of the property located at: 109 Fern Street (Property Address) Florence, MA 01062 (Property Address) hereby authorize Subcontractor(to be filled in by office) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform 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. It is the homeowner's responsibility to close out this permit by contacting their municipality at the completion of this work. ,-DocuSigned by: VoL aL L Prt isst-r Okinesklfehgthre 1/12/2021 1 8:39 AM EST Date RISE Engineering, a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 I Canton, MA 02021 1339-502-6335 www.RlSEengineering.com dotloop signature verification:dilp.usianEh-ABFb-iHhv Bradshaw Enterprises, LLC P0. Box 944 Chicopee, MA 01021 Hello Building Department We are Bradshaw Enterprises, LLC located in Indian Orchard, MA. We are an Insulation / weatherization contractor for MASS SAVE. Enclosed in this packet is our Permit application and supporting documentation as follows: -Application -HIC Registration -Insurance Certificate -Signed customer Authorization form or copy of signed contract -Construction Supervisor License -Worker's Compensation Insurance Affidavit -Pre stamped return envelope We hope you find this packet intact and convenient. If you have any questions or concerns please call or email at 413-250-4746 Sean Bradshaw 413-301-8010 Office phone Email: Sean@BradshawEnterprisesLLC.com