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32A-138 (112) iniajoh BP-2007-1015 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: EXTERIOR RENO BUILDING PERMIT Permit# BP-2007-1015 Project# JS-2007-001638 Est Cost: $8300.00 Fee:$50.00 - PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: use Group: ALLSTATE HOOD & DUCT INC 069654 9 Lot Size(so. ft.): 0.00 Owner: CARRERA MARTIN �k /At 9 Zoning:CB Applicant: ALLSTATE HOOD & DUCT INC AT: 31 MAIN ST Applicant Address: Phone: Insurance: 24 MAINLINE DR (413) 568-4663 WC W ESTFI ELDMA01085 ISSUED ON:5/1/2007 0:00:00 TO PERFORM THE FOLLOWING WORK:CONSTRUCT EXTERIOR 40 FT DUCT WORK FOR EXHAUST FAN 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: FeeType: Date Paid: Amount: Building 5/1/2007 0:00:00 $50.00365 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo • File p BP-2007-1015 APPLICANT/CONTACT PERSON ALLSTATE HOOD&DUCT INC ADDRESS/PHONE 24 MAINLINE DR WESTFIELD (413)568-4663 PROPERTY LOCATION 31 MAIN ST MAP 32A PARCEL 138 001 ZONE CB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONINC FORM FILED OUT Fee Paid Building Permit Filled out �+ Fee Paid ta7 D Tvoeof Construction: CONSTRUCT EXTERIOR 40 FT DUCT WORK FOR EXHAUST FAN New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 069654 3 sets of Plans/Plot Plan THE FO OWING 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 Variances Received&Recorded at Registry of Deeds Proof Enclosed J_,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 Com•lesion Siiir '/ ' 9 x. 09 Signa e of Building 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. s Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. e y Version!.?Commercial Buildm• Pennit Ma 15,2000 City of Northampton Building Department ^' aes._c.. ., X11 212 Maio Street �;. `libRoom'100 PAS Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 S � �� . -- _ _-r Ste. .;e. . . APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING - - -1:1�roneilY Add.., s -_ • $-' "` SSC hort gbe qg lE,Pnr4 _ bu. , ,;. L4 U<<q fv anq u �/ 4} I VA41.—y, rfa, iI ai O( 0 - �:' tes, _ ,' SECTION 2,.`PROPERTYOWNERSH1PAOTHORREDAGENT y _ 2.1 Owner of Record: % I ct'..II. Cw.trt -- I i at tet.., 5+- Name(Print) Currerrt ring Address: t! 9 (ct 5-fl- 7>b 1 _ KSignertTIgI Telephone 2.2 Authorized Anent: �� , 1 i 5A . .� Name(Print) Current Mating Address: S,e...... . Signa4ra --- ' Telephone SECTION 3•ESTIMATEO•CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be : , - OfficialUse0eilp- completed by pennif aPPiicaM 1. Building I �—. - I .(a)Building PermRFee' 1 2. Electrical SLYS (b Es6metad Total Costtof _t _ J Const iic onTiom(8) ) 3. Plumbing 1.__. I ,BwldinfPennittFee 4. Mechanical(HVAC) , 1Q`-'q I 5.Fire Protection i t1 /" ��JJ� .. 6. Total=(1 +2+3+4+5) Check:Number ,3& l(DJ6'J ThisSecSon Fa'rOfficiai Use Only Bui(dnagPefr;tlt FturnbE. W ;bate-' issued; Signature: Building CdnmissioneSAnspedfw.ot BeildTgs Versionl.7 Commercial Building Permit May 15,2000 9ECTIONEr.,9NSB }DN,SEBV10ESfQ%PR0.IEC.TS EBSTHAM35,088 4 1 CUBICTEETO!✓£NCLOSMOSI'.A.CE ' c, & 1L1mfA 4A1/01) Interior Alterations ❑ Existing Wall Signs O Demolition Repairs Additions ❑ Accessory Building❑ Exterior Alteration ❑ Existing Ground Sign 0 New Signs 0 Roofing/❑�� Change of Use❑ Othe\ Brief Description 'Enter a brief description here �'''l4 r'M ex;L ��+ Of ProPosed Work:i 4 , FA 4( fe,y44 64n4)-(6J . 49-.16) 4 to 1-1- 54d4 nom: q SECTIONS•USE-GROURAND3:ONS7RItGT1Qt$TYPE" ' . or 3,4? USE GROUP(Check as applicable) CONSTRUCTION TYPE ', A Assembly A-I ❑ A-2 0 A-3 0 1A I ❑ ❑ A-4 ❑ A-5 0 1B I ❑ B Business ❑ 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ - F-1 ❑ F-2 ❑ 2C 0 H High Hazard ❑ 3A ❑ I Institutional 0 I-t 0 1-2 0 13 ❑ 38 ❑ M Mercantile 0 4 ❑ R Residential ❑ R-1 0 R-2 ❑ R3 ❑ 5A ❑ s Storage ❑ S-1 ❑ S-2 ❑ 5B I ❑ U Utility ❑ Specify M Mixed Use ❑ Specify: S Spedal Use 0 Specify I COMPLETE,TF3raaanTFOXAF ISISTINGBUILCi1NGiUStOERGGIf_IGRENOVATIONS.ADDHIONSAND/ORCHANGE IN USE Y Existing Use Group: I Proposed Use Group: Existing Hazard Index 780 CMR 34):I I Proposed Hazard Index 780 CMR 34): SECTION-6BUNDINGIIES -4 BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION e '� v --" " Floor Area per Poor(sf) ,-= ^" 5- 1 r in i I NitTrt ` �,�" :-. -- 3b, 3" i 1 3 .�.= y , 41" 4 ��+yy 4°i I 1 Y >p ..1:2 3-*f' '� - -y Total Area(sf) j Total Proposed New Construction(sf) „mss:7' Total Height(ft) I Total Height ft 7.Water Supply(M.G.L c.40,§54) 7.1 Flood Zone Information: 7.3 Sewaggg Disposal System: Public'] Private 0 Zone'. Outside Flood Zone]] Municipal g7 On site disposal system V ersionl.7 Commercial Building Permit May IS,2000 x. *"'mow ,s t" Existing Proposed Required by Zoning This cola=to be filled in by Building Dewmnmt Lot Size I I — , r- Frontage -- Setbacks Front — r— a __. . -Building Height ] Bldg,Square Footage I _ L. ( — Open Space Footage % ..... v — (Lot area II ` king) ri tt of ParkSpaces nning - — Fill: _........ (volwif&Location) , A. Has a,Special Permit/Variance/Finding ever been issued for/on the site? NO 0. DONT KNOW © YES ( " IF YES, date issued: jj IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES O IF YES: enter Book j ''I Page and/or Document S B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW © YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained 0 , Date Issued: C. Do any signs exist on the property? YES yE„v NO IF YES, describe size, type and location: I1r,34r ?0{ - U-. .... 0, Are there any proposed changes to or additions of signs intended for the property? YES a NO IF YES, describe size, type and location: j I E. Will the construction activity disturb(cleating,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO il....y IF YES,then a Northampton Storm Water Management Permit from the DPW is required. • Vermont.7 Commercial Building Pemut May 15,2000 SECTION 9•PROFESSIONAL DESIGN ANO CONSTRUCTION SET.VICES-FORSVILDINGSaNDSSRUCTU{{F.SSUBJECTIO CONSTRUCT107i CONTROL.PURSUANT TO T80.CgR 118(CONTAINING NORC TNAN 3'S,fr99 C P.OF ENCI.OSEOSPACE( 9.1 Registered Architect Not Applicable 0 Name(Registrant). _ --- Registration Number Address - l Expiration Date Signature Telephone 92 Registered Professional Engineeris}: Name Area of Responsibility- Address Reg¢imtion Number Signature Telephone ...— Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Respas ity I Address Registration Number Signature Telephone EPi atiwr Dare 1 Name - Area of Responsibility Address Registration Number I Signature Telephone Expiration Date 92 General Contractor A1154-41, Y 77 I Not Applicable Company Name: I T p{1U4 j `0&inei- Responable In Charge of Construction 2 ', Ia ' Addre Signet ' Teleptone • Version1.7 Commercial Building Permit May 15,2000 fi SECTION 10.STRUCTURAL,PEERREIIiEW(BO.CMRi1T`11jx' „- .. ., Independent Structural Engineering Structural Peer Review Require Yes 0 No 0 $ECTIONlt-cWNERAt1TNORIZATION-TO BECOMPLEFE6:WEEEN OWNERS AGENT OR CONTRACTORAOPuESFOR BUI'L'DING?. ERM}T t, uut I v ..... _ - as Owner oof f the subject property ahereby authorize rS-F Alt rd, flab GI .—.. to act on my behalf,in a matters relative to work authorized by this building permit application_ Signature of Owner /' Date S//x4/07 (1.' ✓N. JtN CCC/ry .as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Shred under the .-ins and.=nalties of.=.'u, . _ Print Name 114141:17v• Gff K ,Gr4 /a�/J j/07 • Signature of OwnerlAgent Date tSECTfOttiz tONS.i Nutuyi07W.`SER1/JCE,R , t6.7 Licensed Construction Supervisor: {� Not Applicable 1:1 Name of License Holder. rcid i�J Lid t L='- License Number Address-d //JJ f,./.7;7#/: t._ Expiration Date `-113-Stel ' Signature Telephone SECTION 13-WORK RRS,.COMP_ENSATION1NSUIGGNGG A$tD VBt lin-L415Z§.25Cf6) 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 • The Commonwealth of Massachusetts Department of Industrial Accidents 1==4=9 Office ofInvestigations • 600 Washington Street Boston,MA 02111 'ear www.mass.gov/dia -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ] / Please Print Legibly Name(Bosutess/Organirvtioonninti—vidual): (4/1 -ie / Address: 744 / 4 c1 I ilIne 22 v€ City/State/Zip: COE ceff filtel 010E9 Phone R: Y13— S6f3- tf4,43 Are yqu an employer?Check the appropriate box: Type of project(required): I. II am a employer with (lea 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).' have hired the sub-contractors listed on the attached sheet 7. ❑ Remodeling 2.El I am a sole proprietor or partner- ship and have no employees These subcontractors have g, ❑Demolition workingfor me in anycapacity. employees and have workers' p tX 9. ❑Building addition [No workers' comp.insurance comp.insurance.[ required.] 5. 5 We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself [No workers'co right of exemption per MGL o 12.,❑../Roof repairs r insurance required.]t C. 152,§I(4),and we have no 13.2 Other 0 17,-cf/Fan employees. [No workers' comp.insurance required] .My applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they re doing all work and then hire outside contractors must submit a new affidavit indicating such. tConaactors that check this box most attached an additional sheet showing the name of the subconnacton and rate whether or not those entities have employees. If the subcontractors 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: SEctcN'1mu !t Shan t^P Policy#or Self-ins.Lic.#: n X 0-3 1Z Expiration Date:- //,.(S/Z4:643-] "j Joh Site Address: 1"1^41.0 SA- City/State/Zip: /2Calcei O)6Q' 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cervi nder the p s dppenalti of perjury that the information provided above is true and correct Signature: / � , Date: y/76'47 Phone#: LMS— &r,t21-- q 4, 3 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACORDW CERTIFICATE OF LIABILITY INSURANCE DATE IMMIOOmm el/17/200i PRODUCER 413-582-0332 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION MEYER AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FARM FAMILY INSURANCE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 15 BREWSTER COURT NORTHAMPTON, MA 01060 I INSURERS AFFORDING COVERAGE NAIL# INSURED j wsURERA: FARM FAMILY CASUALTY INSURANCE ALLSTATE HOOD AND DUCT IMAURER B: 24 MIAN LINE DR INSURER c: I WESTFIELD, MA 01065w INSURER P. • [INSURER!' COVERAGES 1 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED MOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. y POLICY NUMBER POLICYBFPECTNE POUCY EXPIRATION LiR MERtl 1WFOFINLO$ULU'C DATE IAMNOIYYI OAMEIMMNOTII LIMITS '. I GENERAL LIABILITY I EACH.OCCURRENCE S 1,000.000 X COMMERCIAL GENERAL LIABILITY ' POLICY# 11!15/2006 11/15/2007 v MISEsjFe ow=renug a- 50,000 I2007X0342 I MEDExPp.y me PFnen) F 5000_ CLAIMS MAGE X OCCUR i_. . • PERSONAL&ADVINJLRY S ..__ . ._ _ _ • 'GENERAL AGGREGATE S 2,000 000 GENT AGGREGATE LIMITAPPU3 PER y!xopucTS'COMP.POP AGO I E 2,0000`0_ ' X I POLICY I )JEL. f IC1C I IAUTOMOBILE LIABILITY COMBINEOSINGLE'JMIT I ANY AUTO 12001C48805A 11/15/2005 11/15/2007 (Ea avwaen0 Is ALL OWNED AUTOS &ICILY INJURY '. 1,000,000 X SCHEDULED AUTOS ''IPerpF+m) X i HIRED AUTOS EObILYIFULRv X I NINgwNEo.uaoe Iv«aFeM.ml s 1,000,000 PROPERTY CANAPE s 100.000 (PWvmleeM) I'I—GARI AGE LM&ILITf ', `UTO ONLY.EA ACCIDEN I9 _ .ANYAUTC •OTHER THAN EA ACC ig 'AUTO ONLY AGO 3 'EECESSNMSRELIA LSAINUY '. EACH OCCURRENCE s 2,000,000 T1 OCCUR 1_ CLAIMS MACE iPOLICY St 11115/2006 11/15/2007 I`GGREGATE S 2,000,000 '2007E1087 I ,DE000TIBLE - E 'RCTENTION S I I .S WORKERS COMPENSATION AND WC&TAT'b 911 EMPLOYERS LJANUTY 1 POLICY# 11/162006 11/15/2007 ' roR RALT3_--R ANY PROP IETORI ARTNE ExEcmlvE 1 2007W13251 Et EACH ACCIDENT $ 500,000 OFPCERmaxa.R EXCLUDED/ EL DISE �FAEMPlOVE�Ig SOO,000 Hidenyibp anal( ss, I E.L DISEASE,POLICY LIMIT "u 500,000 OTHER I DESCRIPTION°FOPERATIONS./LOCATIONS/VENICLESIERCLOSWNE AODEOBY ENDORSEMENT I SPECIAL PROVISIONS HOOD AND DUCT WORK CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPMATN)N DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 15 DAYS WRITTEN ALLSTATE HOOD AND DUCT NOTKE TO TNR CEPTIFICA a HOLDER NAMED TD THE LEFT,RUT nzuRE TO OO SO SHALL 24 MAINLINE DR RAMOSE NO OBLIGATION .R L . TY OF ANY RINOUIPON THE INSURER ITS AGENTS OR WESTFIELD, MA01085 REPRESENTATIVES. \ \ AUTNOROEOREPRESfleTATIYE ACORD 2512001/08) 'ACOR• RPO TI MIM .4 ALLSTATE HOOD & DUCT, INC. 24 MAINLINE DRIVE WESTFIELD, MA 01085 OFFICE:413-568-4663 FAX:413.568-4665 DATE: To Whom it May Concern, gni" / / I.Todd Duval, am allowing L'Snh C w, '/! To use my license, CS 69654 to pull a permit for the new ductwork going into S c (Acre ec c.1g located at: _(t74, n Please call with any questions or concerns. Thank You. Todd Duval 413-568-4663 Office 413-454-3080 Cell ;,.,,a',...a,&)„/// f. //oiwoi,,,o22 Board of Bu;Wing Regulations and Standards Construction Supervisor License License: CS 69e54 Birthdate: 12/29/1967 Expiration: 122912008 Fr# 7697 Restriction: 00 TODD At DUVAL 277SACKET RD WESTFIELO,MA 01085 Commissioner . .,. ,- Access Doors— High Temp Access Doors For Round and Fiat Duct Work Specifications • Tested to 20"w.g., with no leakage torted. ` • Available in 10x6 and 16x12. • Metal Thickness: 10x06 16 ga. Black iron t • 16x12 16 ga. Black iron • ceramic fiber rope (1,000° max) or ceramic fiber gasket(2,3000, Meets NEPA 96) ensures an air tight d :n seal • Zinc coated wing nuts are easily turned by hand t� s i l ;. • Self adhesive template is provided for easy . installation. • Zinc coated conical springs installed between the in- ner and outer door. } Packaging • Access Doors are sold as single units, Profile • Available sizes: 10x06 Fiat, 16x12 Flat 10x06x 6"through 30° 16x12x 18"through 60" Wing Nut Knob Ccmia4 SW* 1 Outer Dom Duct Work Dawes" Pau Work Ceramic Rope Cr et Installation Instructions 1. Adhere self adhesive template to ductwork. 2. Using a pair of sheet metal snips,cut our the tem- plate. 3. Unscrew knobs of door and insert into the opening C.L `VNIRD 4. Tighten knobs. & FAMILY INC. _ 1460 Delberts Drive Monongahela,PA 15063 TDTPL PM?