Loading...
31A-152 (4) 35 MAYNARD RD BP-2021-1316 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:31A- 152 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-2021-1316 Project# JS-2021-002179 Est.Cost: $3200.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(so.ft.): 7971.48 Owner: BRESLOW STEVEN H Zoning: URB(100)/ Applicant: AMERICAN INSTALLATIONS LLC AT: 35 MAYNARD RD Applicant Address: Phone: Insurance: 130 COLLEGE ST #100 (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON:5/11/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATIONNVEATHERIZATION 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. i0 • It • )2 . 32/61y Certificate of Occupancy Signature, FeeType: Date Paid: Amount: Building 5/11/2021 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner `sy'`sM`^�at6�k zP"x;. ep � rt.-� ; RT'`� 3§ •�NA� City of Northampton /� r ��, f �'1,k,, Building Departure `�q f 4NSULA TION 212 Main Street '')- 4,, 1O n :, ,i Room 100 ,`�� ,.,,:.,,,,,,:_I i; Northampton, MA 01060 n;f ��? phone 413-587-1240 Fax 413-587-FL ot'IL_ yauu . „0,,,, , 6 APPLICATION FOR INSULATION FOR A ONE OR TWO FAMLIDELLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT This section to be completed by office 1.1 Property Address: s N1 a n a rd load Map t /1' , Lot 1 )�' Unit Zone •.` Overlay District NiOrAam pforl, /V9 Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: SI-eYen, 8 Ce sitn J ,35 Ma /are] k'.d so , vbn Name(Print) Current Mailing Address: See attached 51/ -3ao -�ato i Telephone Signature 2.2 Authorized Agent: American Installations 130 College Street Ste. 100, South Hadley, MA 01075 Name(Print) Current Mailing Address: 6- 1 ‘------- (413)552-0200 Sii ure '4 Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 3 dQ� (a) Building Permit Fee 2. Electrical I (b) Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) Il.Y 5. Fire Protection 6. Total=(1 +2+3+4+5) �j 0-000 Check Number 7 t0(V J This Section For Official Use Only Building Permit Number: 01•/ .. /?j DateIssued: Signature: )// 5- 1i'2vZ1 9 Building Commissioner/Inspector of Buildings Date permits@AmericanInstallations.com @ EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 4-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 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 (413)552-0200 nature/ Telephone S.Registered Home Improvement Contractor: Not Applicable 0 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(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 IC No 0 Brief Description of Proposed Work NOTE: INSULATION ONL Y Attic and basement insulation and air sealing throughout. 1, 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 ,5-la-avao Signature of°• .•' Agent Date 1, ✓�1L 13 Ra ,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 Signature of Owner Date City of Northampton ..\ Massachusetts y: *„ t K DEPARTMENT OF BUILDING INSPECTIONS <, A fa ar• •` 212 Main Street • Municipal Building \ y r rT ° Northampton, MA 01060 j�1J 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: 3 RD 6 Address of Work: ;35 /44 Aar cl Rd , /��,r7'/1 Date of Permit Application: �S-,S-a/ I I hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): Job under$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: 5--all 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: Date Owner Name and Signature City of Northampton Massachusetts �. * c DEPARTMENT OF BUILDING INSPECTIONS y m 212 Main Street •Municipal Building J1 Northampton, MA 01060 Jbiy �� 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: 35 a n arch c� (Please print houInumber and street name) Is to be disposed of at: K b W Materials &Recycling, 138 Palmer Ave, West Springfield, MA 01089 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) 5-St Si ature of ermit 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 A. * c. 1" .i, ,. DEPARTMENT OF BUILDING INSPECTIONS 9'" ',. r 212 Main Street • Municipal Building ��s 0j�`�' Northampton, MA 01060 Y MANDATORY FOR HOUSES BUILT BEFORE 1945 Property Address: (15/I./ nflrid R ci /15c lass /) I Contractor Name: American Installations Address: 130 College Street Ste. 100 City, State: South Hadley MA Phone: (413)552-0200 Property Owner �I Name: 5-even c�re6l D LA) t yn ernu.&e Address: :35 / zt nG,rd, kJ_ City, State: �Q f#4_ / '/` O/d(c) 1, WesIey 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 / Date _ American Installations Home Performance Contractor 130 College Street,South Hadley,MA 01075 American Installations CONTRACT - VVZ 413-552-0200 FAX 413-552-0202 Page 1 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT# WORK ORDER Steven Breslow (413)320-6263 05/12/2020 452629 56206 SERVICE STREET BILLING STREET PROPOSED BY: 35 Maynard Road 35 Maynard Road American Installations SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL ATTIC FLAT-8"OPEN R-30 CELLULOSE 1,161 $1,671.84 $1,671.84 Provide labor and materials to install an 8"layer of R-30 Class I Cellulose to open attic space. ATTIC DOOR- INSULATE&WS 1 $110.00 $110.00 Provide labor and materials to insulate the back of the attic door with 2"rigid insulation board and seal the door's edge with weatherstripping to restrict air leakage. VENTILATION CHUTES 114 $285.00 $285.00 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. HOME AIR SEALING 8 $680.00 $680.00 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. WEATHERSTRIP DOOR 4 $232.00 $232.00 Provide labor and materials to install Q-Ion weatherstripping to door(s)to restrict air leakage. DOORSWEEP 4 $100.00 $100.00 Provide labor and materials to install a doorsweep to restrict air leakage. American Installations Home Performance Contractor American Installations 130 College Street,South Hadley,MA 01075 CONTRACT - YYZ 413-552-0200 FAX 413-552-0202 Page 2 PROGRAM CMA-HPC CUSTOMER PHONE DATE CLIENT# WORK ORDER Steven Breslow (413)320-6263 05/12/2020 452629 56206 SERVICE STREET BILLING STREET PROPOSED BY: 35 Maynard Road 35 Maynard Road American Installations SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Northampton, MA 01060 Northampton, MA 01060 DESCRIPTION QTY COST INCENTIVE TOTAL CRAWLSPACE WALL R10 RIGID BOARD 25 $104.00 $104.00 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. Total: $3,182.84 Program Incentive: $3,182.84 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***00/ Dollars $0.00 Caryn Brause Caryn Brause(May 12,2020) COMPANY REPRESENTATIVE CUSTOMER SIGNATURE May 12, 2020 NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE SIGN DATE DAYS. The Commonwealth of Massachusetts 3'"== 1. Department of Industrial Accidents v; l= 1 Congress Street,Suite 100 ';°x' Boston,MA 02114-2017 i_I www mass.gov/dia 1�orkers'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): I I am a employer with 41 employees(full and/or pan-tune).* 7. 0 New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. Ei Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.Q I am a homeowner doing all work myself[No workers'comp.insurance required.] 4.D I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 0 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.D We are a corporation and its officers have exercised their right of exemption per MGL c. 14.®Other Insulation 152,*1(4),and we have no employees.[No workers'comp insurance required.] *Any applicant that checks box#1 must also till out the section helm::showing their workers'compensation policy information. 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: Berkshire Hathaway GUARD Insurance Policy 4 or Self-ins.Lic.#: �/AM WC 187717 ,Q Expiration Date: 09/04/2021 /Job Site Address: 35 IV/lard / ?cl City/State/Zip: Of J6?1. Attach a copy of the workers'Lrompensation policy declaration page(showing the policy number and ex ration date). Q/061 2 Failure to secure coverage 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 perjury that the information provided above is true and correct. l I Signature: �{, (Q Date: S-5--Z,1 Phone#: 413-552-0200 dJ 1 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 IP 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. �C S-10617P Expires: 09129/2021 WESLEY COUTURE .._ 139 PACKARDVILLE ROAD PELHAM MA 01002 • Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner ,�.,.1 /• r` For information about this license Call (617) 727-3200 or visit www.mass.gov/dp1 p . P 6,vrwtzlfeeve-a �a ✓G r 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 1 0 2C11.4-06h 7 .7/7- w,,,,..2-i,,,,,; i/. /47.;.in i..evi. 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 WESLEY COUTURE / 130 COLLEGE STREET �.170/4adt' ! '� '^� SUITE 100 SOUTH HADLEY,MA 01075 Undersecretary Not valid without signature A oRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDYYYY) 09/21/2020 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 policy(ies)must have ADDITIONAL INSURED provisions or 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 Eichstaedt,CRIS NAME: Webber&Grinnell PAHONnE Ex21. (413)586-0111 {AIX,No): (413)586-6481 8 North King Street E-MAIL leichstaedt@webberandgrinnell.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURER A: Employers Mutual Casualty Company 21415 INSURED INSURER B: American Installations,LLC INSURER C: AMGUARD//BHGUARD 14702 Attn:Wes&Suzanne Couture INSURER D: 130 College Street,Suite 100 INSURER E: South Hadley MA 01 075 INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 9-2021 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 ADDL SUdR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN$D wVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE T $ 1,000,000 RENTED X CLAIMS-MADE OCCUR PREMISESO(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A 5D3535219 09/04/2020 09/04/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO 2,000,000 JECT LOC PRODUCTS $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED *is( SCHEDULED 5Z35352 09/04/2020 09/04/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /.. AUTOS ONLY (Per accident) X toll$2K X comp$2K PIP-Basic $ 8,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE 5J3535220 09/04/2020 09/04/2021 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION X ;MUTE EMPLOYERS'LIABILITY STATUTE ER Y/N 500,000 G ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A AMWC187717 09/04/2020 09/04/2021 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I 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 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD