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23A-235 157 NONOTUCK ST BP-2020-0462 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23A-235 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2020-0462 Proiect# JS-2020-000782 Est.Cost: $4066.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO.- Const. O:Const.Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq.ft.): 13764.96 Owner: WHITE SARA Zoning: URB(100)/ Applicant: AMERICAN INSTALLATIONS LLC AT. 157 NONOTUCK ST Applicant Address: Phone: Insurance: 130 COLLEGE ST (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON:10/10/2019 0.00:00 TO PERFORM THE FOLLOWING WORK.-ATTIC AND BASEMENT INSULATION AND AIR SEALING THROUGHOUT 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: FeeTvpe: Date Paid: Amount: Building 10/10/2019 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 1 Louis Hasbrouck—Building Commissioner 619- ��u� I�I�3�► a ,�t Dep City of Northampton, ot? Building Department ' INSULATION 212 Main Street Room 100 Northampton, MA 01060 phone 413-587-1240 Fax 413-587-1272 PAYrX� APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY �—___ Vpn SECTION 1 -SITE INFORMATION INSULATION PE ; I TCT 1.1 Property Address: 02 3 d �� his section to be completed by office !T 1�FpT Map Lot It Ow n �_ ON rtAniP60 NS 157 Nonotuck Street Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Sara White 157 Nonotuck Street Name(Print) C Pnt;Miit�g See attached Telephone l Signature 2.2 Authorized Agent: American Installations 130 College Street Ste. 100, South Hadley, MA 01075 Name(Print) Current Mailing Address: Lk A24- CM A'taA (413) ssa-ozoo Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (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) 4066.00 Check Number Q This Section For Official Use Only Building Permit Number: Date Issued: Signature: 10 Building Commissioner/Inspector of Buildings Date production @ americaninstallations.com EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 4-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Wesley K. Couture 106178 License Number 130 College Street Ste. 100, South Hadley MA 01075 9/29/2021 Address Expiration Date _ C (413) 552-0200 t Signaure Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ American Installations 175982 Company Name Registration Number 130 College Street Ste. 100, South Hadley MA 01075 6/26/2021 Address Expiration Date Telephone (413) 552-0200 SECTION 5-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(li)) 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....... X No...... ❑ Brief Description of Proposed Work NO TE: INS ULA TION ONL Y Attic and basement insulation and air sealing throughout. t, American Installations - Wesley Couture 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. Signed under the pains and penalties of perjury. Wesley K. Couture Print Name 10/4/2019 Signature of Owne Agent Date I, , as Owner of the subject property hereby authorize American Installations to act on my behalf, in all matters relative to work authorized by this building permit application. See attached 10/4/2019 Signature of Owner Date - City of Northampton i a Massachusetts � - DEPARTMENT OF BUILDING INSPECTIONS ?` a 212 Main Street • Municipal Building Jd Cam Northampton, MA 01060 rTb —N'`���. AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation,repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation:or LLC, that entity must be registered Type of Work: Insulation Est. Cost: 4066.00 Address of Work: 157 Nonotuck Street Florence,MA 01062 Date of Permit Application: 10/4/2019 I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under S 1,000.00 Owner obtaining own permit(explain): Building not owner-occupied x Other(specify): Contractor pulling permit for homeowner OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: 10/4/2019 American Installations 175982 Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: 10/4/2019 1 �V�j I I K . Pei Date Owner Name)ind Signature City of Northampton ai! s Massachusetts L r N; M1 DEPARTMENT OF BUILDING INSPECTIONS \' 212 Main Street •Municipal Building Northampton, MA 01060 Debris 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. The debris from construction work being performed at: 1.j-7 Noiiotuck strect (Please print house number and street name) Is to be disposed of at: Waste Management of New England, Chicopee, MA 01020 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) a�w �- r—Nkvt, Signature of Pe mit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. City of Northampton Massachusetts z` DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building ,•,y`b- Northampton, MA 01060 MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: 157 Nonotuck Street Contractor Name: American Installations Address: 130 College Street Ste. 100 City, State: South Hadley MA Phone: (413) 552-0200 Property Owner Name: American Installations Address: 130 College Street Suite 100 City, State: South Hadley, MA 01075 1, Wesley K. Couture (contractor) attest and affirm that the building I intend to insulate does not have any open air (knob and tube) wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. Contractor signature f Date 10/4/2019 Federal ID#OS-0405626 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 CT Contractor Registration No620120 RISE60 Shawmut Road,Canton,MA 02021 CONTRACT - WZ ENGINEERING' 339-502-5335 X-7109 FAX 339.502.6345 Pago 1 PROGRAM tilt$CONTRACT IS ENTERED INTO BETWEEN RISE CMA-HES E TIDINEERINO AND THE CUSTOMER FOR WORN AS DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT F WORK ORMH Sara White (413)313-5750 07/24/2019 487555 23802 SERVICE STREET UILLINO STRLET 157 Nonotuck Street 157 Nonotuck Street SERVICE CITY.STATE.ZIP ISILLINO C11 I.STAM,210 Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL ASBESTOS HAZARD A blower door diagnostic test will not be conducted at your home.due to the possible presense of asbestos. ATTIC DAMMING-R-38 FIBERGLASS 54 5110.70 $83.03 527.67 Provide labor and materials to install a 12"layer of R-38 unfaced fiberglass batts for damming purposes. ATTIC FLAT-11"OPEN RAO CELLULOSE 632 S1,023.84 S767.88 $255.96 Provide labor and materials to install a 11"layer of R-40 Class I Cellulose to open attic space. ATTIC HATCH WEATHERSTRIP ONLY 1 S25.00 $18.75 56.25 Provide labor and materials to weatherstip the perimeter of an attic hatch with Q-Ion. VENTILATION CHUTES 27 S67.50 S50.63 516.87 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. INSULATED BATH EXHAUST HOSE 4 INCH 1 $60.00 $45.00 $15.00 Provide labor and materials to install an insulated exhaust hose to existing bathroom fan(s,. ROOF VENT 8 INCH 4 5348.60 $261.45 587.15 Provide labor and materials to install an 8"diameter roof vent(s)to increase ventilation in attic areas. The vent can be supplied in(circle color)black,brown,gray or mill finish. HOME AIR SEALING 8 $680.00 S680.00 Provide labor and materials to seal areas of your home against wasteful,excess 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.) A reduction in cubic feet per minute(cfm)of air infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the weatherization work,and at no additional cost to the homeowner, a final blower door and/or combustion safety analysis will be conducted by the sub-contractor. INSULATE BULKHEAD DOOR 1 $110.00 $82.50 $2750 Provide labor and materials to insulate the back of the door to the basement's bulkhead with rigid board at R-10 or greater with the Federal To 0 05-0405626 MSE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 � CT Contractor Registration No620120 RISE60 Shawmut Road,Canton,MA 02021 ENGINEERING 339.502-6335 X-7109 FAX 339-502.6345 CONTRACT — WZ Page 2 PROGRAM THIS CONTRACT IS ENIERED INTO BETWEEN RISE CMA-HES E!:OINEFRING AND THE CUSTOMER FOR WORK AS DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT• WORK ORDER Sara White (413)313-5750 07/24/2019 487555 23802 SERVICE STREET BILLING SINELT 157 Nonotuck Street 157 Nonotuck Street SERVICE CITY.SI ❑LING C41 Y.5 AI F.CTP Florence, MA 01062 Florence, MA 01062 DESCRIPTION QTY COST INCENTIVE TOTAL required fire rating and seal the doors edge with weatherstripping to restrict air leakage. CRAWLSPACE 10MIL GROUND COVER 396 $384.12 $288.09 $96.03 Provide labor and materials to install 10 ml polyethylene over open ground in designated crawlspace/earthen basement areas. CRAWLSPACE WALL R10 RIGID BOARD 310 S1,25550 S94163 5313.87 Provide labor and materials to install R-10 rigid Thermax insulation to the crawlspace perimeter wall up to the sill and against the band joist. I-INCENTIVE:75% For eligible measures,Columbia Gas of Massachusetts is offering an incentive of 75%,with no limit,and an incentive of 100%for the Air Sealing measures up to$1,020 Total: $4,065.26 Program Incentive: –$3,218.96 Customer Total: $846.30 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS,FOR THE SUM OF —Eight Hundred Forty-Six 81 30/100 Dollars $846.30 WON RECEIPT OF YOUR RIES ENGWEERMG CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTERES'Of t%WILL BE CHARGED MON1"LY ON AAV EARER bOAYM'B�EREVE IMPORTANT INFORMATION ON GUARANTEES.RIGHTS OF RECLUON.SCHEDULING,AND CONTRACTOR REOIE/MTION. NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE Or ACCEPTANCE 1'IFl 30 DAYS ACCEPT ANC!OF C014TRACI•.HE ABOVE PRICES.SPECIFICATIONS AND CONDITIONS ARE SATISFACT ONY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO T HE WORK AS SPECIFIED PAYMENT WILL BE MADE AS OUTLINED ABOVE The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 'y www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): American Installations, LLC Address: 130 College Street, Suite 100 City/State/Zip: South Hadley, MA 01075 Phone#: 413-552-0200 Are you an employer?Check the appropriate box: Type of project(required): 1.®I am a employer with 70 employees(full and/or part-tune).* 7. 0 New construction 2.f-1 1 am a sole proprietor or partnership and have no employees working for Inc in 8. E)Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.Q i am a homeowner doing all work myself.[No workers'comp,insurance required.]' 10 F-1 Building addition 4.Q lain a homeowner and will be hiring contractors to conduct all work on my property. [will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs _these sub-contractors have employees and have workers'comp.insurance.: 6.❑we are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other Insulation 152,§1(4),and we have no employees.[No workers'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 checkthis 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. /ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Berkshire Hathaway GUARD _ Policy#or Self-ins.LLic.#: AMWC0498775y n Expiration Date: 09/04/2020 Job Site Address: 1 }'4 lh—Lr.( City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiratio►date). Failure to secure.-overage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 per jure that the information provided above :s true and correct. Signature: Date: IV �� Phone* 413-552-00_00 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#: Commonwealth of Massachusetts Construction Supervisor Division of Professional Licensure Unrestricted -Buildings of any use group which contain Board of Building Regulations and Standards less than 35,000 cubic feet (991 cubic meters) of enclosed Construction Supervisor space. CS-106178 =xpires. 0912W2021 WESLEY COUTURE 139 PACKARDVILLE ROAD PELHAM MA 01002 .t4 Failure to possess a current edition of the Massachusetts r State Building Code is cause for revocation of this license. Commissioner y� -- For information about this license i' Call (617) 727-3200 or visit www.mass.gov/dpl Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC Registration: 175982 AMERICAN INSTALLATIONS,LLC, Expiration: 06/26/2021 130 COLLEGE STREET SUITE 100 SOUTH HADLEY, MA 01075 Update Address and Return Card. SCA t 8 20M4W17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 175982 06/26/2021 1000 Washington Street -Suite 710 AMERICAN INSTALLATIONS.LLC. Boston,MA 02118 2 WESLEY COUTURE /• ;% �— /Y 130 COLLEGE STREET SUITE 100 G ,r o% (�mG W1 SOUTH HADLEY,MA 01075 Undersecretary t valid without signature AC"I?"® D YYYY) CERTIFICATE OF LIABILITY INSURANCE DATE(MMID 1" 1 8/28/2019 THIS CERTIFICATE IS ISSUED ASA 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 Linda Powers NAME: Webber & Grinnell PHONEA/ No, o Ex (413)586-0111 (FAA/X,No (413)586-6481 8 North King Street E-MAIL 1 Owers@webberand rinnell.com ADDRESS: p g INSURERS AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A:Employers Mutual Casualty INSURED INSURERS:Berkshire Hathaway GUARD Ins. CO. American Installations, LLC INSURERC: Attn: Wes & Suzanne Couture INSURER D: 130 College Street, Suite 100 NSURERE: South Hadley MA 01075 INSURERF: COVERAGES CERTIFICATE NUMBER:Master Exp 9-2020 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 LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X CLAIMS-MADE ❑ PREMISESS Ea occurrence $ OCCUR DAMAGE (RENTED 500,000 PREMI SD3535217 9/4/2019 9/4/2020 MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JECT LOC PRODUCTS-COMP/OP AGG $POLICY F—] PRO- 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ccident $ 1,000,000 a ANYAUTO BODILY INJURY(Per person) $ F` ALL OWNED SCHEDULED SZ3535217 9/4/2019 9/4/2020 BODILY INJURY(Per accident) $ AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE X HIREDAUTOS X AUTOS Per accident $ X Coll$2,000 X comp$2,000 PIP-Basic $ 8,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB HCLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION $ 10,000 15J3535217 9/4/2019 9/4/2020 $ WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICE Ory in BER EXCLUDED? ❑ N I A B (Mandatory in BNH)ER AMWC994153 9/4/2019 9/4/2020 E .DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Business Personal Property 5A3535217 9/4/2019 9/4/2020 deductible$1,000 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W Grinnell, CPCU, CIC ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)