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17A-136 (6)
BP-2023-1503 237 CHESTNUT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-136-001 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-2023-1503 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2023 Contractor: License: Est. Cost: 2160 STEVEN COLLINS 106221 Const.Class: Exp.Date: 06/30/2025 Use Group: Owner: ROSTEN JULIE Lot Size (sq.ft.) Zoning: URA Applicant: J&L ENERGY INC Applicant Address Phone: Insurance: 42 SARGENT ST (617)259-4825 WC 9098987 WINTHROP, MA 02152 ISSUED ON:10/25/2023 TO PERFORM THE FOLLOWING WORK: INSULATION/W EATH ER I Z ATI ON 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: 14 i O Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner aki 2610 The Commonwealth of Massac setts/ O 'j \ j Board of Building Regulations anc�Sta1}41 ds FO• Massachusetts State Building Code, 780 Q, (70(,0M ICI.ALITY Building Permit Application To Construct, Repair, Renovd - ; .sh a evise' Mar 2011 n /y�o One-or Two-Family Dwelling This Section For Official Use Only '050oNs Building,Permit Number: €/ -4.1 ,- /5 3 Date Applied: /4 01l-z023 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 237 Chestnut St.Florence,MA 01062 1.1 a Is this an accepted 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 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 6 Private 0 Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Julie Rosten Florence,MA 01062 Name(Print) City,State,ZIP 237 Chestnut St. 413-575-6017 jnmir@comcast.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:Weatherization Brief Description of Proposed Work':Mass Save insulation and air sealing. No Structural Changes. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $2160.02 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost' (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Fees Check No.Wl1 Check Amount: h Amount: 6.Total Project Cost: $2160.02 ❑Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-106221 06/30/2025 Steven Collins License Number Expiration Date Name of CSL Holder List CSL Type(see below) I 42 Sargent Street No.and Street Type Description Winthrop,MA 02152 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 617-259-4825 permits.jandlenergy@gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 202555 07/13/2025 J&L Energy-Steven Collins HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 42 Sargent St permits.jandlenergy©gmail.com No.and Street Email address Winthrop,MA 02152 617-259-4825 City/Town,State,ZIP Telephone SECTION 6: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 0 No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize *CilIlios— J1 4-1 E pas TEAT to act on my b lf,' all matte ativ to work authorized by this building permit application. 10-17-2023 Print Owner Name(Electronic ignature) Date SECT ON 7b:OWNER' OR AUTHORIZED AGENT DECLARATION 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 best of my knowledge and understanding. 5if. (9I 10-17-2023 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" City of Northampton Nir rasrir \� Jj SAS,,....-..,sic Massachusetts �s' 4 fi, ; �ct. =L DEPARTMENT OF BUILDING INSPECTIONS l'dic 212 Main Street • Municipal Building JC Northampton, MA 01060 3',•.. ,.. CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, 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: 15 Marshall At.Ste. N,Canton.MA 02021 The debris will be transported by: Name of Hauler: J&L Energy Signature of Applicant: �t�'` C-81�'`14" Date: 10-17-2023 Construction Supervisor Specialty Restricted to: CSSL-IC-Insulation Contractor Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl Commonwealth of Massachusetts giDivision of Occupational Licensure Board of Building Regulations and Standards Vs Constructirupetr Specialty CSSL-106221 x spires:06/30/2025 STEVEN M CQLIJ p 42 SARGENTeST—RE7TiI WINTHROP NCO 021,0 • 'VOLLvt•t1JJ Commissioner dia a YErvatak. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration x rw yy - "" __ .. , Type: Corporation t wvJRegistration: 202555 J & L ENERGY INC. r^, .� Expiration: 07/13/2025 42 SARGENT STREET -= WINTHROP, MA 02152 - err 1,14 sve IMP Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE: Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 202555 i, 07/13/2025 Boston, MA 02118 J&L ENERGY INC. r t r.,..7.1111...L__.=___--- •-., STEVEN M.COLLINS '� h=c `t'�:.- '` �7 42 SARGENT STREET ._ - `4" ,,,,.�CG.,�aGh*6 WINTHROP. MA 02152 !+,1 - Undersecretary Not valid without signature AC R I:)® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/2/2023 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 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 NAME: McSweeney&Ricci Insurance Agency, Inc. PHONE 781-848-8600 (FAX ,No):781-843-8807 420 Washington Street (A/c.No.Ext) Braintree MA 02184 ADDRESS: mrireception@mcsweeneyricci.com INSURER(S)AFFORDING COVERAGE NAIC• INSURER A:Selective Insurance Group 12572 INSURED J&LENER-02 INSURER B:Westchester Fire Ins. 10030 J &L Energy, Inc. 42 Sargent Street INSURER C: Winthrop MA 02152 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1471965881 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 ADDL SUBR POLICY EFF POLICY EXP LIMBS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY),(MMIDDAYYYY) A GENERAL LIABILITY S 2516438 8/6/2023 8/6/2024 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $500,030 CLAIMS-MADE X_ OCCUR MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 POLICY PRO- 7 LOC $ A AUTOMOBILE LIABILITY A 9109411 8/6/2023 8/6/2024 COMBINED SINGLE LIMIT (Ea accident) $1.000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ ON-0WNED X HIRED AUTOS X N AUTOS (Per accident) A X UMBRELLA IJAB X OCCUR S 2516438 8/6/2023 8/6/2024 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$0 $ A WORKERS COMPENSATION WC 9098987 8/6/2023 8/6/2024 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Pollution Liability G7426962A 002 8/6/2023 8/6/2024 Each Occurance $1,000,000 Aggregate $1,000,000 Deductible $2,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Florence, MA AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents 0. Office of Investigations s � 5 ' Lafayette City Center �'!�' 2Avenue de Lafayette, Boston MA 2111-17 0 0 S - ww».mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): J and L Energy Inc Address:42 Sargent St City/State/Zip: Winthrop, MA 02152 Phone #: (617)259-4825 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 7 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 workingfor me in anycapacity. employees and have workers' P tY 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs 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 Weatherization employees. [No workers' 13.© 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. 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: Selective Insurance Policy#or Self-ins. Lic. #:WC9098987 Expiration Date:08/06/2024 Job Site Address: 237 Chestnut St. City/State/Zip:Florence, MA 01062 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 Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Steven Collins Digitally signed by Steven Collins 09/20/2023 Signature: Date:2023.04.10 18:41:06-04'00' Date: Phone#: (617) 259-4825 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 11=IBoard of Health 21:1 Building Department 31=ICity/Town Clerk 4.0 Electrical Inspector 5EIPlumbing Inspector 6.0Other Contact Person: Phone#: Client: Julie Rosten RISEut Address: 237 Chestnut Street AN EMPLOYEE OWNEDCOMPANY Florence, MA 01062 Energy Specialist: Aaron Rittlinger Phone: (413)- Program: EGMA-HES Client# 408609 Work Order# 10303 Work Scope DESCRIPTION Qty Notes 1 INOPERABLE HEATING SYSTEM 1 2 HOME AIR SEALING 4 3 ATTIC DAMMING 30 4 ATTIC FLAT-5"OPEN R-19 CELLULOSE 471 5 OK -SLOPES 1 6 OKAY- KW SLOPE 1 7 HATCH-INSULATE RIGID BOARD 1 8 OKAY-WALLS 1 9 COMMON WALL-2"RIGID BOARD 100 10 OKAY FLOOR 1 11 VENT BATH FAN TO ROOF OR OTHER 1 12 OKAY-VENTILATION 1 13 PREPARE YOUR HOME 1 Diagram 28 sloped ceiling Common Wall ISAttic space 50 \ sloped ceiling sloped ceiling 40ek mass save Savings through energy efficiency PERMIT AUTHORIZATION FORM I, Julie Rosten owner of the property located at: (Owner's Name) 237 Chestnut Street Florence (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. (Arlie le0sft Owner's Signature 09-15-2023 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 WEATHERIZATION CONTRACT EVERSeURCE CUSTOMER PHONE DATE CLIENT* WORK ORDER Julie Rosten (413) 09/13/2023 408609 10303 SERVICE STREET BILLING STREET PROPOSED BY: 237 Chestnut Street 237 Chestnut Street Aaron Rittlinger SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Florence, MA 01062 Florence, MA 01062 EGMA-HES Page 1 DESCRIPTION QTY COST INCENTIVE TOTAL INCENTIVE 75% For eligible weatherization measures, Eversource is offering an incentive of 75%for insulation measures and 100%for the air sealing measures, both with no limit.You are eligible to apply for the 0%Heat Loan to finance your co-pay,applications must be submitted before the weatherization work begins. INOPERABLE HEATING SYSTEM Your heating system was inoperable at the time of our inspection. We J.R. (initials) will need to perform a complete combustion safety test on your system before moving forward with any weatherization work. Once it is operable, please contact RISE to schedule the combustion safety test. Your signature acknowledges this required action. HOME AIR SEALING 4 $426.36 $426.36 Seal areas of your home against wasteful,excessive 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.) ATTIC DAMMING 30 $83.40 $62.55 $20.85 Provide labor and materials to install an approved damming material in the attic ATTIC FLAT-5"OPEN R-19 CELLULOSE 471 $880.77 $660.58 $220.19 Provide labor and materials to install a 5"layer of R-19 Class I Cellulose to open attic space. HATCH-INSULATE RIGID BOARD 1 $53.96 $40.47 $13.49 Provide labor and materials to insulate the back of an attic hatch with 2"rigid insulation board at R-10. COMMON WALL-2"RIGID BOARD 100 $549.00 $411.75 $137.25 Install 2"rigid board to a common wall area.All seams will be sealed with tape. VENT BATH FAN TO ROOF OR OTHER 1 $166.53 $124.90 $41.63 Install an insulated exhaust hose to a flapper vent to exhaust existing bathroom fan(s). Fan will be vented through the roof or an acceptable alternative if contractor cannot vent through the roof. WEATHERIZATION CONTRACT EVERS=URCE CUSTOMER PHONE DATE CLIENTA WORK ORDER Julie Rosten (413) 09/13/2023 408609 10303 SERVICE STREET BILLING STREET PROPOSED BY. 237 Chestnut Street 237 Chestnut Street Aaron Rittlinger SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Program Florence, MA 01062 Florence, MA 01062 EGMA-HES Page 2 DESCRIPTION QTY COST INCENTIVE TOTAL PREPARE YOUR HOME Homeowner is responsible for the removal of any items stored in the J.R. (initials) areas where the weatherization measures will be installed. The workers will need the space cleared to safely bring their tools and materials into these work areas. If you have any questions or specific concerns, please bring them to the attention of your subcontractor when they call to schedule your work. Total: $2,160.02 Program Incentive: $1,726.61 Client Total: $433.41 I.DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the above work at the Client's Address in a professional manner and in accordance with the terms of this Contract: II.PAYMENT Client agrees to pay the Contractor for the Work,the Client Share of the Contract Cost is payable to the Independent Installation Contractor(IIC)upon satisfactory completion of the Work.Client understands that they will not be required to pay the Program Incentive Share of the Contract cost.Changes to the individual line items and/or previous incentives may increase or decrease the size of the Program Incentive Share. "tarok add RaNtu RISE epresentative , Client Signature I/-QI V Rota. 09-15-2023 Printed Name Data of Acceptance