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25C-173 (9) 125 NORTH ST BP-2022-0033 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:25C- 173, 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-2022-0033 Project# JS-2022-000057 Est.Cost:$4000.00 Fee,: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ENERGY PROTECTORS - JOSHUA DADA 101143 Lot Size(sq. ft.): 6098.40 Owner: TEMES KATIE Zoning: URC(100)/ Applicant: ENERGY PROTECTORS - JOSHUA DADA AT: 125 NORTH ST Applicant Address: Phone: Insurance: 64 PAXTON RD (774) 253-0277 WC SpencerMA01562 ISSUED ON:7/12/2021 0:00;00 TO PERFORM THE FOLLOWING WORK:INSULATE EXTERIOR WALLS 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. ` ;g • • Certificate of Occupancy Signature: l j FeeType: Date Paid: Amount: Building 7/12/2021 0:00:00 $65.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner f RECEI JUL 9 2021. IS, The Commonwealth of Massa,hus-. Board of Building Regulations • i i Stan 1 <<� BUILDING OR W Massachusetts State Building Code,7:t "', 'HAMpro INs o so CIPALITY n4AUSE Building Permit Application To Construct,Repair,Renovate Or Demolish a ' ,:•d Muir 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: ' '. Date___45,6,riiclmu Applt Building Ofiicial.(Print Name) Signature :,;SECTION--I:..Si"r'E INFORMATION ..Y. 1.1 Prope 'ddress: 1.2 Assessors Map&Parcel Numbers l a 11/4)01-+h Si- .zs e 7 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 Lot Area(sq ft) Frontage(ft) 13 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❑ Private❑ Zone:_ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ . ;.- SECTION:2 .PROPERTY OWNERSHIP' 2.1 Owner'of Record: 1-Z,a,-k-t C T e.v`.,t S ,K)of A-1tc,,s.n.0 t—Vwl t PIA- b 10 6 0 Name(Print) ►►""__ C City,State,ZIP 05-6 vis 1. No.and Street Telephone Email Address '' SECTION 3:`DESCRIPTION OF PROPOSED WORK'(check,all that apply) '' New Construction 0 Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition 0 AccessoryBldg.❑ Number of Units Other I j ecify: ' 5u V4. c" Brief Description of Proposed Work2: r,1n 5 V 1 c, F P K-4-2 i'"a r` c...-4.1 t, S' SECTION 4i ESTIMATED CONSTRUCTION;COSTS Item Estimated Costs: (Labor and Materials) OMeinl Use Only 1.Building $ L\r o 00 I :Building Permit Fee $ .Indicate how fee is determined: 2.Electrical $ 0 Standard�Ctty/Town Application:Fee -- 0•Total Project Costa(Item 6)x multiplier , .x 3.Plumbing $ 2. OtherFees $, 4.Mechanical (HVAC) $ Ltst 5.Mechanical (Fire $ Suppression) Total All Fees:$ O. CheckNo 3 eck Amount.:. Cash Amount. 6.Total Project Cost $ l '0 Paid in Full • ,0 OutstandingBalance Due: . r/ a C`� ,gl: "a jAYI - ,?'p;• ,}tea. Ai la. q 4 ii ir it 3 r om ,� N .J rlir. 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City of Northampton Massachusetts Ate'' DEEsimmarz OF BUILDING IASPSCTIOPSf,t ti o= ' ao'•SSA y y 212 Main Street • Municipal Building Jd b Y` Northampton, Mk 01060 swL o�/ , „ ag CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40,554,a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility,as defined by MGL c 111,S 150A. The debris will be disposed of in: Location of Facility: P6' act Spi.Art C-e-('ept A- o iSI The debris will be transported by: Name of Hauler: cr i P p Cr ' • Signature of Applicant: Date: 7!G c 2-( Decusign Envelope ID:13F6FA88-02BD-4DEE-8C0C-eA1230818A2F RISE ENGINEERING OWNER AUTHORIZATION FORM Katie Temes (Owner's Name) owner of the property located at: 125 North Street (Property Address) Northampton, MA 01060 (Property Address) hereby authorize ei4e111.1 Y .P 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 homeowners responsibility to close out this permit by contacting their municipality at the completion of this work. cDocaSioaed or. is Ow 's�` 9re 7/1/2021 l 12:56 PM EDT Date RISE Engineering,a Division of Thielsch Engineering,Inc. 60 Shawmut Road Unit 2 I Canton,MA 02021 1339-502.6335 www.RlSEengineering.com DATE Ata CERTIFICATE OF LIABILITY INSURANCE I ,� 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 ADDIRONAL 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 cT Cindy Davis PHONE Coonan Insurance Agency,Inc. mirk Esc: 508-987-7122 I Dia Nor 508-987-1090 267 rain Street cindy@Coonaninstuance.com INSURER(S)AFFORDINGCOVERAGE NAKCS INSURER A: Capital Specialty INSURED INSURER B: Safety Energy Protector,inc. INsuRER C: Starstone 64 Paxton Road INSURER Spencer,MA 01562 UISUREtE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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. NSR ''L:'.1. POLICY ErF POLICY DIP LIR TYPE OFINSURANCE MD VIVO POLICYNUMS j$TWOD(YYYY) IMMIDDIYYYY) IDRIS 1 cor um:N.Ga.ERALLA MM EACHOCCUIRRENCE $ 1,000,000 I RENTED CLA MADE 0 OCCUR RE ISEs IMS ) $ 100,000 MEDBP(Any one Pelson) $ 5.000 A y C516001320-05 08131120 08131121 PERSONAL&ADV IN URY $ 1,000,000 GENT. AGGREGATELTAFPLESPER GENERAL AGGREGATE $ 2,000,000 1^'POLICY inc PRODUCTS-COMP/OP AGG $ 2,000,000 OTtEit $ _ ���� COMBINED SINGLE umrr $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ —OWNED B Auros oNLY X SCHEDIJLED AUTOS y 6236519 12123119 12/23120 BODILY ItUURY(Pm=tided) $ X AUTOS ONLY X NONO ON DPROPERTY DAMAGE(Per accident) $ $ X p UMBRELLA X OCCUR EACH OCCURRENCE s 3,000,000 C —EXCESS LIAR CLAMS-MADE y 89362T193ALI 08r31r20 08131/21 AGGREGATE $ 3,000,000 DED I I RETENTION$ $ WORKERS CONPENSAMON AND BfPLOYERI'LIABRRY YIN IP TAATUTE I I i ANY PROPRIETORIPARTN RIEXECUTIVE❑ NfA EL EACH ACCIDENT S OFFICERII�EXCLUDED? (Uaiebeouy in NH) EL ruciPAQF_FAHAPLOYEE$ DEST�NOFFOOPERATIONSbelow EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be aged if more apace is required) Workers Compensation insurance certificate to follow under seperate cover. emailed josh CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE TIFF,NOTICE WILL BE DELIVERED IN Evidence of Coverage ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE vat..a..... LaaDaith.fri I Q 191)11.7n15 atn1Rn t`S1RPfRL71t1N All rFnhfc eacanrad AaR i CERTIFICATE OF LIABILITY INSURANCE DATE(DINDONTYVI 1/2920 THIS CERtlFICATE 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 een6 holder is an ADDITIONAL INSURED,the poticy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions ofthe policy,certain policies may require an endorsement. A statement on ads certificate does not confer rights to the certificate holder In Iles of such endersememt(s). PRODUCER mcomer em Hide DeCastro COONAN INSURANCE AGENCY PHONE waya (yes)687 71s2 I N,, hildia@cormaninsurance.com 267 MAIN ST ONSURERIs)APPoitnmccov6tAGE HMCO OXFORD MA 01540 I( A: ACE AMERICAN INSURANCE CO 22667 BRED INSURER El: ENERGY PROTECTOR INC mac: INSURER D: 64 PAXTON RD INSURER a: SPENCER MA 01562 USURER F: COVERAGES CERTIFICATE NUMBER: 569858 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 COMMON OF ANY CONTRACT OR OILIER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS CONDITIONS OF SUCH POLICIES.LIMNS SHOWN MAY HAVE BEEN REDUCE)BY PAID CLAIMS ULTRR TYPEOFUISVAANOE -ADUp Wen POIJCYNUYaER nisconnmrn munteravn LOWS COIu RaAl.GENSIAI.UAEUJTV EACH OCCURRENCE S PAIMSJMDE OCCUR P AMAGE TO RENTED I 1E8 towielneet S MED EMI(Area* ) S NIA PERSONALS,ADV INJURY S GEM AGGREGATE UMITAPPLIE.SPEit+ GENERAL AGGREGATE S POLICY D JEPR81 DLOC PRODUCTS-COUPRIPAGO S EM S AUTOMDBaauABodtY COMBINED SINGLE`I UTrozeklealt S — ANYAU=O BODILY INJURY(Per persan) S ALL OWNED =Mtn= AUTOS --AUTOS NIA GODLY INJURY(PermeateQ S NON-OWNED PROPERDALIAGE _ HIRED AUTOS A (Per td tt S uumast A GEGUR EACHOCtURRENCE S EXCESS EXCESSL1RB CLAIMS-MADE RWA AGGREGATE DED I I RETENTIONS S woRl�scouwommoN XI° UtT i I ER AND EMPLOYERS'LIABILITY ANYPROPRIETORIPAAT ip rlVE YIN El-EACH ACCIDENT S 500,000 A OFRCERAIEIMEREXCLUDED, LEN NIA NIA 6S62UB0G29828020 09/0112020 0910i/2021 MyCoengd,stomInNH) EL.DISEASE-EAEMPLOYEE.s MAW OES NDF0FERAIIONs tmlaa El-DISEASE-POUCYLOW S 500.000 N/A nescePTIDNOFOAERATIORBrL mAntererinsucLes(ADORDIOI.Pstainoodti a EtehedgMt.ersybs aUeduslifmorespaner ) Workers'Compensation benfIts will be patdtoMassachuseusernp!oyeas only Pursuant toEndoisemant WC2003069 aDa thw on Is giren to pay daims for benatils to employees instates other than MassechUsetts R uin Insured tires,or has It3red those employees outside of Massadmsetts. This certificate of insurance shlauS the policy Infarce(MUM date thatthiscertifimtewas Issued(antess the etrphadon date on the above pDrry precedes the issue dale of this cerEcate ofinsruance). Theestairrs alibis coverage can be daily by assessing the Proof ei{bverege_Coverage Ver+Eca ion Search tool at vivo mass. tionsl_ Sole proprietor has not elected fie. C)ncrtriCATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN Enerty Pfotec r Inc ACCORDANCEINUH THE POUCYPROVISIONS. 64 Paxton Rd AUntrute OREPRESerraram Spencer MA 01562 I QattTel M Ceaoy,CPCU,Vice President—Residual Market—WCRIBMA O 1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(20141101) The ACORD name and logo are registered marks of ACORD jetiOlecittuw°0 Avrip.tt9A t• magoode a:. ally('to Ge3 VIM,— evt,t01 SO :012 :.• • '" ;00.1100 ZZOZ 1.190 jo Pr3 00 041102 A MO* 74ttli 1°141'11 w sualteln ,0 00114 ; aaptioas 101010/014 0 " ttoall P% mow° cool so 0010 oismossootioutfi • Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 • Home Improvement.Contractor Registration, O Type: Corporation ENERGY PROTECTORS INC. Registration: 172960 64 PAXTON RD. Expiration: O8/'19/20?2 SPENCER, MA 01562 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR 4 Registration valid for Individual use only TYPE:Corporation before the expiration date. If found return to: Registration )rxpiratloq Office of Consumer Affairs and Business Regulation 172960 08/.19/2022 1000 Washington Street •Suite 710 ENERGY PROTECTORS INC, Boston,MA 02118 JOSHUA DADA B4 PAXTON RD . 1a, a' SPENCER,MA 01582 Not valid without signature Undersecretary