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36-393 (2) 1)1 —Ad v . —— EMERSON WAY COMMONWEALTH OF MASSACHUSETTS it 4,2 I •• 134 28 Map:Block:Lot: CITY OF NORTHAMPTON 3(�-3n3-001 Permit: New Build PERSONS CONTRACTING WITH ACCESSTO THE GUARANTY NREGISTERED CONTRACTORS DO NOT HAVEGUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2021-2208 PERMISSION'S HEREBY GRANTED TO: Project # NEW SINGLE FAMILY HOUSE Contractor: License:e0 250000 SHAUL PERRY Est. Cost: Exp.Date:06/2512022 Use Group:Class: Owner: SUNWOOD DEVELOPMENT CORPORA ION Use Lot Size (sq.ft.) Applicant: SUNWOOD BUILDERS zoning: SR Phone: Insurance: Applicant Address (41;)259 1000 WMZR0080056582021 A 84 POTWINE LN AMHERST. MA 01002 ISSUED ON:01/24/2022 TO PERFORM THE FOLLOWING WORK: SINGLE FAMILY HOUSE POST THIS CARD SO IT 1S VISIBLE FROM THE STREET Building Inspector Inspector of Plumbing Inspector of Wiring, D.P.W. €, P Underground: "" Service: Meter: Footings: 0 v.: oil p. g Rough: Rough: House # Foundation: A'" ,u/O-Ze". Final: -LI a Final: Rough Fr ame:Jl iL 3 31-z a Il•+? Fire DepartmentFire lace/Chimney: Rough: Driveway Final: P Insulation: � ill �• 6- 2 14 a Fin Oil: e"A0--?/Z �.j11( • Yf12T1A� IL f 112Z t `Z. 7,tSmoke: �� P—vv Final:/� THIS PE RMIT MAY BE REVOKE B1"EHE CITY OF NORTHAMPTON UPON VIO ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: . ) 4 k . a , .)f2 Fees Paid: $1,593.00 212 Main Street, Phone(413) 587-1240.Fax:(413)557-1272 Office of the Buildine, Commissioner OZ et-4 71 Z--/K/-c03- ilzg- vccrzre :r_t�t4 * The Commonwealth of Massachusetts City of Northampton $' Certificate of Occupancy In accordance with 780 CMR, (The Ninth Edition of the Massachusetts Residential Building Code) this Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified. Identify Name of Building of Space Within, Building Owner, or Permit Holder Certificate No. Issued to Sunwood Developement BP-2021 2231 Identify property address including street number, name, city or town and county Located at 134 Emerson Way HERS Rating Florence, Hampshire, Massachusetts 40 Use Group Classification(s) Single Family Dwelling Unit This Certificate of Occupancy is hereby issued by the undersigned to certif that the premise, .structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified below. It shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or. tampering with the contents of the certificate is strictly prohibited. Conditions of Use Single Family Dwelling Unit All fire protection and life safety systems must be maintained, and all means of egress must be kept clear Name of Municipal Date of Final Map/Plot: Building Official Kevin Ross Inspection 08/12/2022 Signature of Municipal %� Date of Building Official Issuance 08/12/2022 36-393 i'4r ,- The Commonwealth of Massachusetts Poj City of Northampton Temporary Certificate Certifcate of Occupancy In accordance with 780 CMR, (The Ninth Edition of the Massachusetts Residential Building Code) this Temporary Certificate of Occupancy is issued to the premise or structure or part thereof as herein identified. Identify Name of Building of Space Within, Building Owner, or Permit Holder Certificate No. Issued to Sunwood Developement BP-2021-2231 Identify property address including street number, name, city or town and county Located at 134 Emerson Way HERS Rating Florence, Hampshire, Massachusetts 40 Use Group Classification(s) Single Family Dwelling Unit This Temporary Certificate of Occupancy is hereby issued by the undersigned to certifj'that the premise, structure or portion thereof as herein specified has been inspected for general fire and life safety features. This certificate shall allow for the use as herein described and in conformance with any and all conditions as identified below. it shall be posted in a conspicuous place within the space as directed by the undersigned. Failure to post the certificate,failure to comply with conditions or.tampering with the contents of the certificate is strictly prohibited. Conditions of Use Single Family Dwelling Unit All fire protection and life safety systems must be maintained, and all means of egress must be kept clear Name of Municipal Date of Final Map/Plot: Building Official Kevin Ross Inspection 08/11/2022 Signature of Municipal /%"----Z Date of Building Official Issuance 08/11/2022 36-393 ........... Home Energy Rating Certificate Rating Date: 2022-08-03 HIS Final Report Registry ID: 575460313 HERS Ekotrope ID: BdNzKDcid HERS® Index Score: Annual Savings Hume: 134 Emerson Way Your home's HERS score is a relative $ 3 47 4 performance score.The lower the number, Northampton, MA 01060 the more energy efficient the home.To learn more,visit www.hersindex.com I Builder: *Relative to an average U.S.home Sunwood Builders Your Home's Estimated Energy Use: This home meets or exceeds the criteria of the following: Use IIVIBtul Annual Cost Heating 43,0 $580 2018 International Energy Conservation Code Cooling 0,6 $41 Hot Water 2.2 $142 Lights/Appliances 18.3 $984 Service Charges $264 Generation (e.g.Solar) 0.0 SO Total: 64.1 $2,011 HERS5 Index Home Feature Summary: Rating Completed by: Home type. Single family detached Model: N/A Energy Rater: Adin Maynard RESNET ID: 9463452 Community: N/A Home, k,o Conditioned Floor Area: 2,133 f( Rating Company: HIS&HERS Energy Efficiency .....4..... ),-, Number of Bedrooms: 3 57R Adams Rd.Williamsburg,MA 01039 Veffeetve Primary Heating System: Furnace•Natural Gas•96 AFUE 4136588784 Primary Cooling System: Air Conditioner•Electric•15 SEER Rating Provider: Energy Raters of Massachusetts ,, Primary Water Heating: Residential Water Heater•Electric•3.75 UEF 2 Woodlawn Street Amesbury,MA 01913 " • House Tightness: 529.2 CFM50(0.78 ACH50) 978-270-3911 ".. Ventilation: 56 CFM•32 Watts I —, Duct Leakage to Outside Forced Air Ductless ."--" ••-••• Alle . Above Grade Walls: R-28 , This Home 2,4) Ceiling: Attic,R-60 d7:,/-'‘,":4ZZ v, Window Type: U-Value:0 23,SHGC:0.21 Hnme I:1 Foundation Walls: R-15 Adin Maynard,Certified Energy Rater ._. -•-! ,t, Lest frawirw Framed Floor: N/A Digitally signed:8/4/22 at 2:35 PM . , , s 0 ekotrope Ekotrope RATER-Version:32.4.2963 The Energy Rating Disclosure for this home is available from the Approved Rating Provider. Energy savings calculated without modifications to the energy model.(As Modeled) This report does not constitute any warranty or guarantee. 2018 IECC R-406 RESNET Registered Energy Rating Index Report Property Organization Energy Rating index Information Buiider:Sunwood Builders Company:HIS& HERS Energy Efficiency RESNET Registered Rating Address: Phone:4136588784 Rating No:575460313 134 Emerson Way, Northampton, MA Rater:Adin Maynard Rater ID (RTIN):9463452 01060 Date Rated:2022-08-03 Estimated Annual Energy Consumption* Rated Home Calculated Energy Use Rated Home Cost(Styr) (MBtu) Heating 43.0 $580 Cooling 0.6 $41 Water Heating 2.2 $142 Lights &Appliances 18.3 $984 Photovoltaics 0.0 $0 Total 64.1 'Based o ssadowd ope-alard c.oldisons ERI with PV:47 ERI without PV:47 Annual Estimates k4kkt Electric(kWh):5,198.8 CO2 Emissions (Tons):6.0 Natural Gas(Therms):463.7 Maximum Energy Rating Index:61 This Home's Energy Rating index:47 PASS This home MEETS the Energy Rating Index Score requirement of 2018 ECG R-406 for Climate Zone 5. It MEETS all of the requirements verified by Ekotrope. Mandatory requirements are summarized on the 2nd page of this report, some of which are not verified by Ekotrope. Name: Adin Maynard Signature: Organization: HIS & HERS Energy Efficiency Digitally signed: 8/4/22 at 2:35 PM Rating Provider Data and Seal Company:Energy Raters of Massachusetts Address:2 Woodlawn Street Amesbury, MA 01913 Phone#:978-270-3911 1: -(00- /3.!, Fax#: 4--n• it• \ le; -"retresofo.e. To determine if a provider is properly accredited go to:www.resnetus/professionaltprogramsisearch_directory (Confirmed and tested) Climate Zone 5 Mandatory Requirements � Provision Number ' Topic Compliance0edwUon ' __ 1_ 2000 |ECCTab|e4O2�1 l' Building thonno|enve|ope minimum insulation levels and PASS � or4UZ.13 , maximum fenestration U-fuoVor and GHGC / R401,3 Post e permanent certificate listing the /eve| ofefficiencies Certificate required for CO � ' instu||eain the house R402.41�2 Envelope air leakage maximum leakage rate I PASS R402.4.1 /Tnb|o Comply with air sealing and insulation requirements in Table Checklist required for CO R402A11 R402.41�1 R402,44 Rooms containing fuel-burning appliances FASS^ R4O2.5 | Maximum fenestration U'taciorand SHGC (U'Faotor)RA,1 S (SHGC) RASS � R40312 Heat pump controls FY\SS^ | ! R4O �2 Ducts outside of conditioned space hoUe insulated maminimum PASS~ | ofR-G. R40332 / Duct sealing on all ducts PASS^ R4U3.3.3 | Duct testing for ducts in unconditioned space F9\SS^ R4O3�3�5 ' Building cavities not aodu�a. ' FY\SS` � � R40151 Heated v.,a0ar circulation and temperature maintenance systems PASS* comply ] � R403.5.3 Hot water pipe m»u|uteg to R-3 PASS ( F403.6 " Mechanical ventilation meeting the requirements of the |RCor PASS* U |K8C Outdoor air and exhaus\dampeoinotaUed | � / R4017 ACCA Manual J and S conducted for all heating and cooling ACCA forms r'quired for permit � oyn1nmm. ! � R403�8 Systems serving multiple dwelling units hn meet the mechanical PASS* requirements of IECC commercial code R4O3.9 Snow melt and ice system controls installed where applicable PASS' / R40310 Pools and permanent spa energy consumption meet PASS* requirements for heaters. time clocks and covers 11 1 High efficacy lights installed in 909/o of permanently installed fixtures �^ �� - ��^ ] PASS ^T�ean �emohave�eenOo��eh�od �y�e R�ec F�� |nopecw� CoUo |nopao�c m�uDUn� Ekotnopn RATER-Version 3.2,4.2963 /F-cczo,ucR/compliance**,/nco.c"/a'eu using E^nl npepmTsR'oe"e,g�and mme compliance m'o'~/,=. sxmmpe RATER m,nsomcT Accre*teu HERS Rating Too[ m/,r,"m are based or.data entered oys°"*~p,"s°,n c^m"=o disclaims ao liability for the information s",-)wnu"!his mpclt IECC 2018 Label 134 Emerson Way Ekotrope RATER-Version: 3.2.4.2963 HERS@ Index Score: 40 Ceiling: R-60 Above Grade Walls: R-28 Foundation Walls: R-15 Exposed Floor: N/A Slab: R-5 Infiltration: 529.2 CFM50(0.78 ACH50) Duct Insulation: N/A Duct Lkg to Outdoors: Forced Air Ductless 'U-Value: 0.23, SHGC:0.21 Door: R-5 Heating: Furnace • Natural Gas• 96 AFUE Cooling:Air Conditioner• Electric • 15 SEER Hot Water: Residential Water Heater• Electric • 3.75 UEF Average Mechanical Ventilation: 56 CFM Builderor Design Pro nab ,.. Signature: Air Leakage Report Property Organization Inspection Status IS 134 Emerson Way HIS & HERS Energy Effici, 2022-08-03 HERS Northampton, MA 01060 Adin Maynard Rater ID (RTIN): 9463452 4136588784 RESNET Registered 134EmersonWay (Confirmed) 134EmersonFnl Builder Sunwood Builders General Information Conditioned Floor Area [ft2] 2,133 Infiltration Volume VP] 40,707 Number of Bedrooms Air Leakage Measured Infiltration 529.2 CFM50 (0.78 ACH50) ACH50(Calculated) 0.78 ELA[sq. in.] (Calculated) 129.11 ELA per 100 s.f. Shell Area (Calculated) 0.332 CFM50 (Calculated) 529 CFM50 s.f. Shell Area (Calculated) 0.060 Duct Leakage Leakage to Outdoors Total Leakage Test Type Total Leakage[CFM @ 25 Pa) Total Leakage[CFM25/ 100 s.f.] Total Leakage[CFM25/CFA] Mechanical Ventilation Rate [CFM] 56 CFM Hours per day 24.0 Fan Power 32 Watts Recovery Efficiency% 81.0 Runs at least once every 3 hrs? true Average Rate[CFM] 56.0 CFM 2010 ASHRAE 62.2 Req. Cont.Ventilation 51.3 2013 ASHRAE 62.2 Req. Cont.Ventilation 80.4 Ekotrope RATER-Version 3.2.4.2963 Alt results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the information shown on this report Building Specification Summary IS Property Organization Inspection Status ERS 134 Emerson Way HIS & HERS Energy Effici. 2022-08-03 Northampton, MA 01060 Adin Maynard Rater ID (RTIN): 9463452 4136588784 RESNET Registered 134EmersonWay (Confirmed) 134Emerson_Fnl Builder Sunwood Builders Building Information Rating Conditioned Area [ft1 2,133.00 HERS Index 40 Conditioned Volume[ft3] 40,707.00 HERS Index w/o PV 40 Thermal Boundary Area[ft2] 8,765.60 Number Of Bedrooms 3 Housing Type Single family detached Building Shell Ceiling w/Attic I SO_R59,CE16",4-24; U-0.017 Windows(largest)I U-Value: 0.23, SHGC: 1.21 Vaulted Ceiling I None Window/Wall Ratio I 0.17 Above Grade Walls I Infiltration I 529.2 CFM50(0.78 Afh H50) Coho_vval116-16 cell + 1.25 ISO Cl (R7)_R26.5 nmnl; U-0.038 Duct Lkg to Outside I Forced Air Ductless Found. Walls I R151; R-15 Total Duct Leakage I Untested Framed Floors I None Slabs I R15 under, R5 edge_12'width; R-5 Mechanical Systems Heating Furnace•Natural Gas• 96 AFUE Cooling Air Conditioner•Electric• 15 SEER Water Heating Residential Water Heater• Electric• 3.75 UEF Programmable Thermostat Yes Ventilation System 56 CFM • 32 Watts Whole House Fan N/A Lights and Appliances Percent Interior LED 100% Clothes Dryer Fuel Natural Gas Percent Exterior LED 100% Clothes Dryer CEF 3.5 Refrigerator(kWh/yr) 570.0 Clothes Washer LER(kWh/yr) 105.0 Dishwasher Efficiency 269 kWh Clothes Washer Capacity 4.5 Ceiling Fan None Range/Oven Fuel Natu -I Gas Ekotrope RATER-Version 3.2.4.2963 All results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the information shown on this report. RESNET HOME ENERGY HIS RATING Standard Disclosure ERS For home(s) located at: 134 Emerson Way, Northampton, MA Check the applicable disclosure(s): W)1. The Rater or the Rater's employer is receiving a fee for providing the rating on this home. In addition to the rating, the Rater or the Rater's employer has also provided the following con-ulting services for this home: A. Mechanical system design B. Moisture control or indoor air quality consulting C. Performance testing and/or commissioning other than required for the rating itself D. Training for sales or construction personnel E. Other(specify) 3. The Rater or the Rater's employer is: A. The seller of this home or their agent B. The mortgagor for some portion of the financed payments on this home ILI C. An employee, contractor, or consultant of the electric and/or natural gas utility servi g this home 4. The Rater or Rater's employer is a supplier or installer of products, which may include: Products Installed in this home by OR is in the •usiness of HVAC systems 'Rater rjEmployer i Rater Employer Thermal insulation systems alRater DEmployer DRater I Employer Air sealing of envelope or duct systems Rater Employer Rater I Employer Energy efficient appliances ' Rater Employer —Rater 4Employer Construction (builder, developer, construction contractor, etc) Rater riEmployer Rater :Employer Other(specify): EiRater FlEmployer I- 'Rater Employer 5. This home has been verified under the provisions of Chapter 6, Section 603 "Technical Requi ements for Sampling"of the Mortgage Industry National Home Energy Rating Standard as set forth by the Res .ential Energy Services Network (RESNET). Rater Certification#: 9463452 Name: Adin Maynard Signature: Organization: HIS & HERS Energy Efficiency Digitally signed: 8/4/22 at 2: ;5 PM I attest that the above information is true and correct to the best of my knowledge.As a Ra r or Rating Provider I abide by the rating quality control provisions of the Mortgage Industry NationalHom Energy Rating Standard as set forth by the Residential Energy Services Network(RESNET). The national ating quality control provisions of the rating standard are contained in Chapter One 102.1.4.6 of the stan ard and are posted at https://standards.resnet.us The Home Energy Rating Standard Disclosure for this home is available from the rat ng provider. ^N��U ~��~� Credit��u~ o�� Property Organization Inspection Status 4ERS 134 Emerson Way HIS & HERS Energy Effio' 2022-08-03 Nodhmnnpbzn. yWA01060 AdinMaynard Rater ID (RTIN): 9463452 4136588704 RESNET Registered 134EmmrmonVVoy 134Emarmon_Fn| Builder SunwmodBwUdeno �� Confirmed om��o�o� n ��N�n�rmed Rating Normalized Modified End-Use Loads (KNBtu/ year) Category Category 2006 (ECC50% As Designed 90%Target Target Heating 32.1 24.1 Cooling Cooling 2.3 1�9 Total 34.4 26�O ! Building Features Cei|ingU: 0.017 Heating System: Furnace ^ Nmhma| Gas^ 8G VVaUU: 0.038 /\FUE Framed F|oorU: N/A Cooling System: Air Conditioner Bmctno ^ 15 S|ahFl� R-5 SEER Glazing Properties: U-Value: O.23. 8HGC: 0.21 Duct Leakage boOutside: Forced Air Duc'|ess This home meets the requirements for the residential energy efficiency tax credit under section 1332. mrmditfor Construction of New Energy Efficient Homes, of the Energy Policy Act pY30O5. Builder should verify th.;tthe 45LTax Credit is available for the year in which this home was built. The undersigned certifier verifies that: (1)The dwelling unit has a projected level of annual heating and cooling energy consumption that is at least 50 p.-rcent below the annual level of heating and cooling energy consumption of a reference dwellingunit in the same o|imad' zone; (2)Building envelope component improvements alone account for a level of annual heating and cooling energy consumption that iyo\least 1Opercent below the annual level of heating and cooling energy consumption of a re erence dwelling unit in the same climate zone;and (3)Heating and coolingenongyconoumpdonhavebeenoalou|atedmthemenno,prescdbedmoectmn2.O3ofthi' nudou. (4)Field inspections of the dwelling unit(or of other dwelling units under the ENERGY STAR0 for Homes Sampli g Protocol Guidelines)performed by the eligible certifier during and after the completion of construction have confi edthat all features of the home affecting such heating and cooling energy consumption comply with the design specifica 1ons provided 10 the eligible certifier. 'Under penalties of pejury, I declare that I have examined this certification, including accompanying documents, =ndtothe best of my knowledge and belief, the facts presented in support of this certification are true, correct,and complet ~�� ` Nmrne�� Adm ��aynarU Signature:� � �/� ^~~~~z�^ Organization: HIS & HERS Energy Efficiency Digitally signed: 8/4C22at2. '5PM / Ehotnope RATER'Version 3.24.2983 /mrev""s are based""data entered b*e"vtrope users,sx"m,"e disclaims all/kiN.ty for the information mm°=v"m.orepom 1 D rnt/r,1K-50)kI (Aitt ' . pp rr C,omnzonweanh o/I/labdacheudettd Official Use Only 1c _ q cx s Permit No. EP 7.0 Z .''DI h;Z- 1~ _;-A_: eparimenl 01 ire ewicee r_ -11=;. Occupancy and Fee Checked 9/ BOARD OF ARE PREVENTION REGULATIONS [Rev. 1/07] ""� 0 (leave blank) E c APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Al'work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE P 2- 2. 2 INIrVKOR TYPE ALL INFORM1�A""TIOI1) Date: Z.— 2 — City orfrown of: PO c-t of m TC,r1 To the Inspector of Wires: By this applicatio the undersigned gives notice ofhis or her intention to perform the electrical work described below. Location(Street&Number) 13 Li 'Erne iSo r) Imo,y Owner or Tenant ,Sv ii 1...'act'A bti i'tid e f 5 / Telephone No.LS •/O OG Owner's Address V`l CC7f'W/4 e Ll' Ain her 5 ,' . CJ/O d Z_ Is this permit in conjunction with a building permit? Yes IZI No n (Check Appropriate Box) Purpose of Building pc 4/ 14vt/5 C. Utility Authorization No. 305'17/© 3 G5' Existing Service Amps / Volts Overhead n Undgrd n No.of Meters New Service 2.0 G Amps (2v / 2-y0 Volts Overhead Undgrd EXt No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 111, ,1/4,u k V, - ,y i- 1 cp \_.;Aio(.-.. {h7v L -- Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 0 No.of Ceil.-Susp.(Paddle)Fans Z No.of Total 3 Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires '� Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets SO No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches () No.of Gas Burners No.of Detection and 3 Initiating Devices • No.of Ranges \ No.of Air Cond. Tans No.of AIerting Devices p Heat Pump Number Tons KW _ No.of Self-Contained 1 No.of Waste Disposers Totals: � Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection Other No.of Dryers \ Ileating Appliances KW Sec Systems:* No.urio bevices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ba!e - No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications EqWuivalent No.H 3' g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 3 22-ZZ. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) f certifj!,under the ains and penalties of erjury,that the in ormation on this application is true and completes FIRM NAME: lc Jr ec f 1 c LIC.NO.: 3 215 3� Licensee: Al rill n cal mti, f Signature LIC.NO.32 5-5,& (Ifapplicable.ent "exempt"in the license number line.) Bus.Tel.No.: Address: �j ,91'ic ti k.Mil 6i y Mingq"to MP) c/O3‘ Alt.Tel.No.:24 1 2-/1 *Per M.G.L.c_ 147,s. 57-61,security Niork requiresIDepartment of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FE $'?.-0 0 DATE(MM/DD/YYYY) AC o CERTIFICATE OF LIABILITY INSURANCE 04/09/2021 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 Christine Davenport Richard R.Green Insurance Agency,Inc. PHONE FAX 32 Somers Rd (A/C.No.�), (413)267-3495 ( No):(413)267 3496 Hampden,MA 01036 E-MAILDRSS: cdavenport@richardgreeninsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Mapfre Insurance Company 23876 INSURED Richard M.Smart,Jr. INSURER B: COMMERCE INS CO 34754 3 Isaac Bradway Rd Hampden,MA 01036 INSURER C: INSURER D: 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 ADDL-SUTYPE OF INSURANCE INSD WWIR POLICY NUMBER (MMIOO((YYYY1 (MMIDD(YYYY) UMITS POLICY EFF POUCY EXP VTR ,INSD WVD, A ✓ COMMERCIAL GENERAL LIABILITY 8008030014703 01/19/2021 01/19/2022 EACH OCCURRENCE S 1,000,000 DAMAGE TO CLAIMS-MADE OCCUR PREMISES(EaENTED occurrence) $ 100,000 MED EXP(Any one person) S 5,000 PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 VI POLICY JECT , LOC PRODUCTS-COMP/OP AGG S PRO. $ 2,000,000 OTHER: B AUTOMOBILE LIABIUTY BBQV28 11/14/2020 11/14/2021 COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ 100,000 — OWNED 7 SCHEDULED _ AUTOSONLY AUTOS BODILY INJURY(Peraccdent) $ 300,000 HIRED NON-OWNED PROPERTY DAMAGE S 25O,DOO _, AUTOS ONLY _ AUTOS ONLY (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION H AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A ' (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF ONS I VEHICLES(ACORD 1. " - ached if more space Is required 1 . , IV U ;- l3-32- ' )�Se!'"' �''' ors 6L 3-�'�?�. Qo�c�h — tr EX CO �C (r� 13�;�( 3 Ivy �� ZZ �, 7 F/ ' 2 3 2 3 , �o as �� - o�� QQ'� c,, I. - /f-4-it?p(�nN�( I o✓i J 3- a� rr�,, nro Q �._' By: Mt, V oX l;,tM,.^ -' 'I .,� .. 1S'- V- 3a cot a iv ;,4/ � '6/awl CERTIFICATE HOLDER CANCELLATION / SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ********FOR INFORMATIONAL PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE s _ 1 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD r _., MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM WORK r"-- /L f m n WI l�f 20 3 �,=s,�.— CITY MA DATE PERMIT# - ZSZ UOG -„.... ' JOB SITE ADDRESS )34 EmeGon 'Owl f OWNERS NAME 5VnW� ✓Jt\cW POWNER ADDRESS TEL FAX TYPE OR OCCUPAN Y TYPE COMMERCIAL ❑ EDUCATIONAL L I RESIDENTIAL PRINT CLEARLY NEW RENOVATION U REPLACEMENT PLANS SUBMITTED YES ❑ NO ❑ FIXTURES 1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB I _ _ CROSS CONNECTION DEVICE _ DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM _ _ ^ DEDICATED GREASE SYSTEM __ _ - . __. J DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM _ 1 DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK I - . LAVATORY ROOF DRAIN PL-UMDING & • : • -ECTUR - FORTHAUIP 9N- SHOWER STALL 1 _ _ AP P \!Fn NO APPROVED SERVICE/MOP SINK TOILET I a URINAL WASHING MACHINE CONNECTION I WATER HEATER ALL TYPES I WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES Uri NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ® OTHER TYPE OF INDEMNITY 0 BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 1,0 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: 0 NER El AGENT El SIGNATURE OF OWNER OR AGENT A I hereby certify that all of the details and information I have submitted or entered regarding this application ar.. accura ;-/the •, - my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in •r ^�. with . P- in- .rovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 01 PLUMBER'S NAME Phillip Hurteau LICENSE# 10963 j SI�NATUR t MP❑ JP El CORPORATION®# 2974 PARTNERSHIP❑# LLC El#_ ___ __. Phillip's Plumbing & Heating, Inc. 15 Arthur Street COMPANY NAME __ ____ ADDRESS ___ CITY _ Easthampton _. -_ STATE MA ZIP 01027 TEL 413-527- 340 FAX 413-527-2406 CELL 413-626-9725 EMAIL pphlSarthur@gmail.com AciiK 0 90/ C/ �,.av It 27-22 -7 ikt i«5 di 1, 5G1- as ilg O 7 Gk• l l 15/ °, =P _ M/AAS_S_A,CHUSETTS UNIFORM APPLICATION FO A P RMIT TO PERFORM WO/'R( s� M cm, o`1 i11r��l MA DATE OI 6 PERMIT XPVM"ZO1Z"OO f- T Tv►1 '' JOS SITE ADDRESS 134 E%InQf V,)o..y OWNERS NAME 50n oZkief$ " IV OWNER ADDRESS TEL FAX OCCUPANC PE COMMERCIAL l EDUCATIONAL 1 1 RESIDENTIAL T PRINT NEW RENOVATION 1 REPLACEMENT ❑ PLANS SUBMITTED YES 0 NO 0 C'ETEARLY ��,/ i � APPLIANCES 1 FLOORS—' BSM 1 2 3 4 5 ` ; a` �v - Q"� 1 , 13 14 BOILER BOOSTER _ � �� CONVERSION BURNER -A6;s �L( -ASS, COOKSTOVEl t Lost Gal/.J��DIRECT VENTENT HEATER DRYER I l' Ow $jr/a2 FIREPLACE 1 1:SB FRYOLATOR FURNACE GENERATOR GRILLE — I INFRARED HEATER j LABORATORY COCKS — MAKEUP AIR UNIT OVEN _ _ _ . POOL HEATER P IJJVI RING & (iAS INS'CTOR ^ ROOM/SPACE HEATER N O R T H A M PTO N ROOF TOP UNIT T - APPROVED NOT APPLVED TEST 7/T HEATER _ UNVENTED ROOM HEATER WATER HEATER OTHER ( I I I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES ® NO ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ® OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGE T 0 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are tru n c to to the f my nowledge and that all plumbing work and installations performed under the permit issued for this application will be in co i I Pertin t r visi e Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME Phillip G. Hurteau LICENSE# 10963 IGNA URE MP® MGF El JP❑ JGF❑ LPG!❑ CORPORATION a# 2974 PARTNERSHIP❑# LLC❑# COMPANY NAME Phillip's Plumbing&Heating, Inc. ADDRESS 15 Arthur Street CITY Easthampton STATE MA ZIP 01027 TEL 413-527-0340 FAX 413-527-2406 CELL 413-626-9725 EMAIL pphl5arthur@gmaiLcom y- Za �zz Atve, 3 G,a) n�rr Or►-.'O' /Vy