38B-117 Date: Dec 15, 2010
Hi Linda,
We are not insulating over any knob and tube wiring at 19 East Street, Northampton Ma.
It is an unfinished attic with no knob and tube present in the area we are insulting. We are
dense packing some rafter slopes and an attic flat to finish off a third floor attic space.
If there are any more questions please let me know,
Sincerely,
Pan" 1 Sc� mi t
Co -op Power Inc.
Phone: 1- 413 -605 -5485 (cell)- best to call
1- 413 - 772 -8898 (office)
L 6£L9 £1.ti 1P!w4OS lncd a6£:L001. 91. °aa
'A CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDIYYYY)
11/23/201D
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 pollcy(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 J Deneault, CISR
NAME: _
Blackmer Insurance Agency Inc. ( ICC PHONE Ex(: (413) 625 -6527 FAX No): (413) 625 -8210
1147 Mohawk Trail ADDR @blacicmers.
PRODUCER 00003817
CUSTOMER ID #:
Shelburne MA 01370 -9707 INSURER(S) AFFORDING COVERAGE NAIC# —
INSURED IN5uRERA;Landmark American Ins Co
INSURER B :Commerce Insurance Co
Co -op Power, Inc INSURER CMax Specialty Insurance
324 Wells St INSURER D:Twin City Fire Insurance Co 29459
PO Box 68 B INSURER E : _
Greenfield MA 01301 INSURER F:
COVERAGES CERTIFICATE NUMBER :CL10 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.
1NSR TYPE OF INSURANCE A INSR S WVD POLICY NUMBER (MM DD (MM DDIIYYYY)
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED lOO 000
X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ ,
A CLAIMS -MADE I X I OCCUR X LBA086972 00 11/8/2010 11/8/2011 MED EXP (Any one person) $ 5, 000
PERSONAL &ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000
I POLICY PRO- LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO
B ALL OWNED AUTOS
LP5752 3/23/2010 3/23/2011 BOOILYINJURY(Perperson) $
BODILY INJURY (Per accident) $
X SCHEDULED AUTOS . E
PROPERTY DAMAGE $
X HIRED AUTOS (Per accident)
X NON -OWNED AUTOS $
$
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
EXCESS LIAB CLAIMS -MADE AGGREGATE $ 1,000,000
DEDUCTIBLE $
C RETENTION $
44X113100056487 6/2/2010 6/2/2011 $
D WORKERS COMPENSATION f WC STATU- 0TH -
AND EMPLOYERS' LIABILITY TORY LIMITS X ER
ANY PROPRIETOR/PARTNER/EXECUTIVE � N
(Mandatory in NN) E.L. EACH ACCIDENT $ 1,000,000
OFFICERIMEMBE EXCLUDED? t N i 08WSCLC6866 11/1/2010 11/1/2011 E.L. DISEASE - EA EMPLOYEE $ 1,000,000
if yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, tf more space Is required)
Operations usual to energy efficiency services - energy audits, air sealing, insulation, and solar hot water system
installation.
Certificate issued subject to the terms, conditions, exclusions, and endorsements attached thereto.
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.
Center for Ecologic Technology
112 Elm St.
Pittsfield, MA 01201 AUTHORIZED REPRESENTATIVE
ACORD 25(2009/09) ®1988-2009 ACORD CORPORATION. All rights reserved.
INS025 (2009091 The ACORD name and logo are registered marks of ACORD
The Commonwealth ofMassachusetts
- = DDepartment of Industrial Accidents
� Office of Investigations
n 710= !it 600 Washington Street
• Boston, MA 02111
=x www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organization/Individual): CO O 7° JpQ t e'r'
Address: 3 (Ai (_))J p
City /State /Zip: Cri /J , � ))17.4 Phone #: 1 1).3-771, 77Z f U °?
Are you an employer? Check the appropriate box: Type of project (required):
1 g I am a employer with l t) 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
working for me in any capacity. 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 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.0 Roof arcs
insurance required.] t c. 152, §1(4), and we have no ❑
employees. [No workers' I2Other Lnl )O4'
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: BO C Y e� T-✓VJ a
Policy # or Self-ins. Lic. #: 0 g w & C 1 C. i j ( -4 Expiration Date: l) ) y } V
Job Site Address: City /State /Zip:
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 $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I-do hereby certi der i )
ns and penalties of perjury that the information provided above is true and correct.
Signature: Cs�� Date: i i
Phone #: 1 '1)3-- ^ ( % V5 - t 31
Official use only. Do not write in this area, to be completed by city or town official
City or Town: PITTSFIELD Permit/License #
Issuing Authority: Building Department
Contact Person: Phone #: (413) 499 -9440
.J./te -6 , -- 1 1 f .
Office of Consumer Affairs and usiness Regulation
10 Park Plaza - Suite 5 170
� Boston, Massachusetts 02116 ' - -
Home Improvement Contractor Registration =_ -
- - - -- - _ - - Registration: 165217
-- - _ - - ' Type= Corporation
Expiration_ 1/21/2012 Tr4 292798
CO -OP POWER, INC_ T � s _ _ __
PAUL SCHMIDT = _ _
324 WELLS ST ° - • _ _ _
- -- .- GREENFIELI ,_MA 01301
- _ _ _ " Update Address and return card_ Mark reason for change..
` ..__
L Address Renewal Ei Employment [1 Lost Card
1 v 5om- ovo4- Gun215 ,_
eae - �o,�oazu R
Office of Consumer Affairs & Business Regulation License or registration valid for indwidul use only
before the expiration date.. If found return to:
WI HOME IMPROVEMENT ion:, 1652 CONTRACTOR Office of Consumer Affairs and Business Regulation
- - Registration:. ; = 155297
10 Park Plaza - Suite 5170
Expirafip v 12l!$D12 Tr# 292798 Boston, MA 02116
Type::,- `= 4riorafio :-_ -- -
;O-0P POWER;�IN ` -
'AUL SCHMIDT , -^ :,T_;'
124 WELLS ST — - - d ' •� P
3REENFIELD, MA0'130t` • Undersecretary Not valid without signature
;'Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor License
License: CS 103635
Restricted to 00
g !,; t
L y
PAUL SCHMIDT
24 CHESTNUT ST '
HATFIELD, MA 01038 `; t
- - % - y — Expiration: 5120/2013
('onunts Tr#: 103635
Yt-
ir,
,;TION 8 - CONSTRUCTION SERVICES
j.1 Licensed Construction Su rvisor: Not Applicable ❑
Name of License Holder : 01 S Cr 041 1 p ) 6 3 C75
Lie Number 51 1 )3
-- /j 4. 1 6 / UP/dr gr HAI Address Expiration Date
i l s '� ---� i (1) - — q7 -51 ' 9
Signa ,� - Telephone
9. Registered Home Improvement Contractor Not Applicable ❑
C O a °mf 190 ( i(_— I -6.5 z) `1
Comtsa Registration Number
3L ( ( l (.101.04' s f 74 a.-- A �: I �--- Z� t pp Expi on Date
'�L� �� L (Y) , Telephone ti J? 7 F
-
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
:i " ^ricers Compensation Insurance affidavit must be completed and submitted with this application_ Failure to provide this affidavit will result
the denial of the issuance of the building rrnit
Sgned Affidavit Attached Yes No El
11. - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner- o pl of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts.
as supervisor. CMR 780, Sixth Edition Section 108,3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two-year r eriocts #0011a> h2 considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be
responsillif for WI such work performed under the buildine permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 1$3 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, yow {thy be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State li iilding Code, City of
Northampton Ordinances, State and Lpcal Zoning Laws and State of Massachusetts General Lttws Annotated.
Homeowner Signature
•
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all aooiicable)
New House ❑ Addition ❑ Replacement Windows Alterations) Eg4 Roofing E
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks ED Siding [D] Otherjj jai L;?Fw
Brief Wok Description of Proposed R�G I f.1 t 1't ,Ntri l C L ff R24 A Cin _ �,i'�
Alteration of existing bedroom Yes LX No Adding new bedroom Yes No U NY �
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll - Sheet
, r i? ° :
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? _ Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, v
4 I f Gt a/1 6tA , as Owner of the subject
property QQ
hereby authorize ? rt.u� S t 41 I`,[
to act on my behalf, in all matters relative to work authorized by this Wilding permit application. a
/()
Signature of Owner � Date
f c ,� C O (g , as Owner /Authorized
Agent hefe6y declare that the staten{ents d information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the s a s penalti - of perjury.
4 / j /'mil
Print Name
_ I ?/ 7 ,I
Signature of Owne gent Date
City of Northampton 6
Building Department
212 Main Street
Room 100
Northampton, MA 01060 „
phone 413 - 587 -1240 Fax 413 - 587 -1272
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
Map Lot Unit
;65 Zone OyertarDistdet
Elm St. District GB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: (- t /u4
P i (i C C� (�td()T #i eii- 4 lya�' CAM j /1 KSN 04
Name (Print) Current Mailing Address:
L Telephone q
Signature (�/ j) 0 — ( 5
2.2 Authorized Agent: \
Sol , Cc — j ( (// Eft/V/77 fi t
Name (Print) Current Mailing Address:
i / 7
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building / jJ1 (a) Building Permit Fee
2. Electrical f , C J (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
- 6. Total = (1 + 2 + 3 + 4 + 5) Check Number / � 0-3
This Section For Official Use Only
Date
Building Permit Number. Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2011 -0541
APPLICANT /CONTACT PERSON PAUL SCHMIDT
ADDRESS/PHONE 24 CHESTNUT ST HATFIELD (413) 247 -5739
PROPERTY LOCATION 19 EAST ST
MAP 38B PARCEL 117 000 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �
Fee Paid /Oo `7 pr 5-5-
Typeof Construction: INSTALL INSULATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 103635
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission _ Permit DPW Storm Water Management
l.
Demoli ' t - lay
- / . —/// ; /
Signature of Build' g fficial Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
BP- 2011 -0541
GIS #: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2011 -0541
Project # JS- 2011- 000893
Est. Cost: $1650.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Groin PAUL SCHMIDT 103635
Lot Size(sq. ft.): Owner: GUIDOTTI ALICIA
Zoning: Applicant: PAUL SCHMIDT
AT: 19 EAST ST
Applicant Address: Phone: Insurance:
24 CHESTNUT ST (413) 247 -5739 WC
HATFIELDMA01038 ISSUED ON:12/16/2010 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL INSULATION
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.
Certificate of Occupancy Signature:
FeeTyp Date Paid: Amount:
Building 12/16/2010 0:00:00 $55.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner