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22-017 (7) BP-2024-0924 35 SPRUCE HILL AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 22-017-001 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-2024-0924 PERMISSION IS HEREBY GRANTED TO: 2024 Project# INSULATION/WEATHERIZATION Contractor: License: Est. Cost: 4286.2 SCOTT MCCRAY 117322 Const.Class: Exp.Date: 04/14/2026 Use Group: Owner: NEAL-FOURHAWKS AMALIA E TRUSTEE Lot Size (sq.ft.) Zoning: WSP Applicant: PROSPECTIVE ENERGY SOLUTIONS INC Applicant Address Phone: Insurance: 14 PINEBROOK CIRCLE (413)424-3600 WC533SB23J7Q014 GRANBY, MA 01033 ISSUED ON: 07/23/2024 TO PERFORM THE FOLLOWING WORK: INSULATE ATTIC AND BASEMENT 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: 1/1.2.. Fees Paid: $75.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner DocuSigrifryerope ID:4E 697DD-FFAA-46E0-A684-B096A532B22A _4 lL5 / l N \ The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR Massachusetts State Building Code,780 CMR MUNICIPALITY I / USE Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Nuumbet&-24 J4-aq2 y Date Applied: 4%).1---) 7-4 /;2 -Z3-2021 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 35 Spruce Hill Ave, Florence Ma 01062 22-017-001 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: (n)$(2 •510 BtXe- 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: Public CI Private CI %one: Outside Flood Zone?Check ifyes❑ Municipal 0 On site disposal system CI SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Alton Neal Florence, Ma 01062 Name(Print) City,State,ZIP 35 Spruce Hill Ave _ 413-584-5800 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied O Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg.0 Number of Units Other C Specify:Insulation Brief Description of Proposed Work2: Blown cellulose insulation in attic (R-38), i n basement(R-19) and other various weatherization. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 4,286.20 1. Building Permit Fee:$ Indicate how fee is determined: 2. Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ vv Suppression) Total All Fees:$ /b Check No/pqi f Check Amoun 73 Cash Amount: 6.Total Project Cost: $ 4,286.20 0 Paid in Full 0 Outstanding Balance Due: DocuSign Envelope ID:4EF697DD-FFAA-46E0-A684-B096A532B22A SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-117322 02/17/2025 Scott McCray License Number Expiration Date Name of CSL Holder List CSI,Type(see below) Unrestricted 14 Pinebrook Circle No.and Street Type Description Granby, MA 01033 U Unrestricted(Buildings up to 35,000 cu.11.) —_ R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-219-1304 scott.mccray@prospectivenrg.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 207208 12/15/2024 Prospective Energy Solutions, Inc. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 14 Pinebrook Circle rachel.hall@prospectivenrg.com No.and Street Email address Granby, MA 01033 413-424-3600 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 El 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 Prospective Energy Solutions to act on my behalf,in all matters relative to work authorized by this building permit application. See attached permit authorization form. 6/15/2024t Print Owner's Name(Electronic Signature) Date SECTION 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. by � l 6/12/2024 ri ot er 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" DocuSign Envelope ID:4EF697DD-FFAA-46E0-A684-B096A532B22A I Massachusetts Department of Industrial Accidents _Mitt— Office of Investigations WPM eaLafayette City Center e, =my= z 2Avenue de Lafayette, Boston, MA 02111-1750 IMP www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Prospective Energy Solutions, Inc Address: 14 Pinebrook Circle City/State/Zip: Granby, MA 01033 Phone #:413-434-3600 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 5 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' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.: 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 11.1: 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 intdr►nation. 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: LM INS Corp Policy#or Self-ins. Lic. #:WC533SB23J7Q014 Expiration Date:02/17/2025 Job Site Address: 35 Spruce Hi 11 Ave 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature 6/12/2024 BF 1FIMtOIFA[HC5 Date: Phone#: 413-434-3600 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License # Issuing Authority(check one): 10Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector Sa lumbing Inspector 6.0Other Contact Person: Phone#: DocuSign Envelope ID:4EF697DD-FFAA-46E0-A684-B096A532B22A THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration th,„)rw _fIl _v. ':! r,l, Type: Corporation v =_$ 'egistration. 207208 PROSPECTIVE ENERGY SOLUTIONS, INC. P - E pitation: 12/15/2024 14 PINEBROOK CIRCLE GRANBY, MA 01033 a I SIEr ©/ E C.:, Imirommr 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 207208 12/15/2024 Boston, MA 02118 PROSPECTIVE ENERGY SOLUTIONS, INC. SCOTT MCCRAY t� p 14 PINEBROOK CIRCLE ,,,,.,ra.// GRANBY,MA 01033 Undersecretary of valid without signature DocuSign Envelope ID'. 4EF697DD-FFAA-46E0-A684-B096A532B22A Commonwealth of Massachusetts . Division of Occupational Licensure Board of Building Regulations and Standards ConstFttt:t bn ISlipervisor .y CS-117322 ' fires: 04/14/2026 SCOTT ANDWW MCCRAY 14 PINE BROOK CIRCLE' • 111L GRANBY MA11033 Commissioner YEmil, . Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. 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.govidpl City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste 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. Address of the work: 35 Spruce Hill Ave The debris will be transported by: Prospective Energy Solutions The debris will be received by: Valley Recycling Building permit number: TBD Name of Permit Applicant Rachel Hall, Prospective Energy Solutions 7/22/2024 Date Signature of Permit Applicant