31A-262 (3) ACC>R& CERTIFICATE 4F LIABILITY INSURANCE DATE(MMIDLttYYYY)
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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 cwWWAM holder 1s an ADDITIONAL INSURED,the poky(lee)must be sndors*d. H SUBROGATION IS WAIVED,subject to
the terra and condlgons of the policy,eertaln policies may require an endonament A statement on this csrtlfleats does not confer rights to the
cerdlfcalw hoWW in lieu of such s.
PRODUCER NAME: Mary Conroy
James J. Dowd and Sons Insurance Agency Inc. PHONE -^ �
14 Hoba1a Road No.CA 41 -�3 @.-Z�L44_ 1L�H 1413 3b _5?-212_
Holyoke MA 01040 ; -
mconroy@dowd_rom
4 sTDMrAiPF MORASHE O1 -_
NSURER IS)AFFORDING COVERAGE___ ! NA HC al
--- -_ ---------__..--
INSURED INSURER
Moran Sheet Metal Inc. INSURERS:
139 East Meadow Street -
INSURER C
Chicopee MA 01020
INSURER D'
H/SUREI E.
INSURER F .y.�.-
COVERAGES CERTIFICATE NUMBER:847223552 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 SUSJECT
TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Ita18R - r PZNJCY MA)
LTR TYPE OF INSURANCE POLICY NUMBER LIMITS
A GENERAL LABILITY CCI1203094 9/18/2014 9/18/2015 EACH OCCURRENCE �$1 000,000
_ �hTAi;EET�IiErJTE6 _ .
X COMMERCIAL GENERAL LIABtUTV PREM$.$L2_Qg9! l__ _5100 000
CLAIMS-MADE l-• I OCCUR MED EXP(Any one perswt)...... $5,000
PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
I GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S I 0 0,C 0 0
POLICY ¢ LOC $
A j AUTOMOBILE LIAORM CRA1203094 9/18/2014 9/1.8/201.5 COMBINED SINGLE LIMIT $ 0r 0,000
(Ea acxxbnt) _
ANY AUTO BODILY INJURY(Per Person) It
ALL OWNED AUTOS INJURY
BOD_ INJURE(Par eccaderd) $
X SCHEOULEDAUTOS -4 -_ E -
PROPERTY DRAHAGE i 3
HIRED ALIT i
(Per&code") ,
X NON-OWNED AUTOS -
is
- —-
p x UMBRELLALIAS X OCCUR CCU1203094 9/18/2014 9/18/2015 EACH OCCURRENCE $5,000,000
EXCESSUAB CIA DE AGGREGATE $ PC0,o00
-- f
DEDUCTIBLE ----- S
X RETENTION $10,000 S
A
WORKERS COMPEISATWN CWC1203094 9/18/2014 9/18/2015 �X'('Y,'C STAT^U-T— O'TH-
AND EMPLOYERS'LIASMJTY YIN _I TQRY lIN&L Ffi. -
ANYPROPRIETORRARTNER/EXECUTIVE❑ NIA E.L EACH ACCQ-ENT X11 000,0 0
OFFICERAIEMBER EXCLt1DEtY! -- _
INImmimryinNMI EL DISEASI"-FIAEMPLOti'£ $1 100,000 -
M yes,daaa"Radar
DESCRIPTION OPERATIONS goq!r I I E.L.DISEASE-POLICY LIMIT I $i,000,000
DESCRIPTION OF OPERATIONS I LOCATONS I VOWLES(Attwb ACORD 101,Add imW Remarks SahaAUM,H more specs is mgwrrad{
CERTIFICATE HOLDER CANCELLATION 3 0
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF,NOTICE MULL BE DELIVERED
IN ACCORDANCE NTH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
y Z 1988-2009 ACORD CORPORATION. All rights reservocd.
ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD
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INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes No❑
If you have checked Yes,indicate the type of coverage by checking the appropriate box below:
A liability insurance policy V Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box ,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation: YES NO
Progress Inspections
Date Comments
Final Inspection
Date Comments
Type of License:
BY Master
Title ❑ Master-Restricted � '�-'� �'"`
City/Town
❑Journeyperson Signature of Licensee
Permit#
❑Journeyperson-Restricted License Number: 1849
Fee$ ❑
Check at www.mass.gov/dpl
Inspector Signature of Permit Approval
� � ' Commonwealth of Massachusetts
�n - 9 NIS �J C
U l�
p"trIc Plumbing&Gas Inspections
Sheet Metal Permit
Northam ton,MA 01080
Permit#
�
Estimated Job Cost: $ \�O� o o Permit Fee: $ 0-D9,5
Plans ..
Plans Submitted: YES NO Plans Reviewed: YES NO
Business License# 638 Applicant License# 1849
Business Information: Property Owner/Job Location Information:
Name: Moran Sheet Metal, Inc. Name: Smith Colley-Paradise Rd. Hnusina
Street: 139 East Meadow Street Street: 69 Paradise Road
City/Town: Chicopee, MA 01013 City/Town: Northampton, MA
Telephone: 413-592-0031 Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES X NO
Staff Initial
J-1 /M-1-unrestricted license
J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less
Residential: 1-2 family Multi-family Condo/Townhouses Other
Commercial: Office Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detail ed description of work to be done:Ao't lvsk' &;�6 '/Z 4��L' /
File#SM-2015-0035
APPLICANT/CONTACT PERSON MORAN SHEETMETAL
ADDRESS/PHONE 139 EAST MEADOW ST (413)592-0031 Q
PROPERTY LOCATION 69 PARADISE RD
MAP 31 A PARCEL 262 001 ZONE EU(100VURC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid r = :
Building Permit Filled out J
Fee Paid
Typeof Construction: FABRICATION&INSTALLATION OF DUCTWORK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 1849
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF 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
fr m Elm ree ssion Permit DPW Storm Water Management
13- 4S
gnature of fruifding Official 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 the Office of
Planning&Development for more information.
69 PARADISE RD SM-2015-0035
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
IG1S#: X9470
Map. 31A
Block: ._ _ 262 \, IT
Lot - fool . SHEETMETAL PERM
Permit;_ S14EETMETAL
Category: SHEETMETAL
Permit# SM-2015=0035 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2014-001$29_
Est. Cosh $139,000.00 Contractor: License: Expires:
Fee Charged:$50.00 MORAN SHEETMETAL Sheetmetal- 1849 01/28/2016
Balance Due:$.00 Owner: SMITH COLLEGE OFFICE OF TREASURER
#of Fixtures Applicant: MORAN SHEETMETAL
[DigSafe# 1 _ __ AT: 69 PARADISE RD
!UseGroup
�ConstClass �� _
ISSUED ON. 13-Apr-2015 AMENDED ON: EXPIRES ON.
TO PERFORM THE FOLLOWING WORK.
FABRICATION&INSTALLATION OF DUCTWORK
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Sheetmetal REC-2015-003848 09-Mar-15 5085 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMSO 2015 Des Lauriers Municipal Solutions,Inc.