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29-270 (6) 57 LONGVIEW DR COMMONWEALTH OF MASSACHUSETTS SM-2021-0062 Map:Block:Lot:29-270-001 Permit: Sheet Metal CITY OF NORTHAMPTON PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# SM-2021-0062 PERMISSION IS HEREBY GRANTED TO: Project# 2021 HEAT PUMPS Contractor: License: GENERAL MECHANICAL Est. Cost: 1000 CONTRACTORS INC Const.Class: Exp.Date: Use Group: Owner: KUMESKI ROBERT M Lot Size (sq.ft.) Zoning: WSP Applicant: GENERAL MECHANICAL CONTRACTORS INC Applicant Address Phone: Insurance: 29A SWORD ST (508)754-7366 MCC2002000427 AUBURN, MA 01501 ISSUED ON:09/28/2021 TO PERFORM THE FOLLOWING WORK: HVAC 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. Signature: I , O ' yd 'I . • Fees Paid: $50.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ULc7�� Commonwealth of Massachusetts Sheet Metal Permit Date: Q I aP I <j‘ ! RECEIVED Permit# cg�--�/ P6gce I ,5 CMG� # Y9c'3 Estimated Job Cost: $ 1 000.0 ermit Fee: $ EP 2 8 2021 Plans Submitted: YES 10 P ans eviewed: YES NO Business License# 146 DFPNT OF BUILDING iN )mot License# 1062 noTI IAMPTON.MA�f 060 Business Information: Property Owner/Job Location Information: Name: General Mechanical Contractors Name: Community Action Street: 29A Sword Street Street: 57 Longview Dr. City/Town: Auburn,MA 01501 City/Town: Northampton, MA Telephone: 508-754-7366 Telephone: 413-320-8073. Photo I.D.required/Copy of Photo I.D. attached: YES 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 X Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq.ft. X over 10,000 sq. ft. Number of Stories: 1 Sheet metal work to be completed: New Work: Renovation: HVAC X Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Install supply and r 'turn ductwork in the basement INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes x❑ No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy x❑ Other type of indemnity El Bond ❑ OWNER'S INSURANCE WAIVER:1 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 ' ❑x Master Title ❑Master-Restricted � City/Town ❑Joumeyperson Signature of Licensee Permit# ❑Joumeyperson-Restricted License Number. 1062 Fee$ Check at www.mass.gov/dpl fl\ieL (YA. lrispector Signature of Permit Approval t, COMMONWEALTH OF MASRACHUSETTi S DIVISION OF PROFESSIONAL LICENSURE BOARD OF SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE MASTER-UNRESTRICTED EMERSON W WHEELER III • `Q . 262 PLEASANT ST PAXTON,MA 01612-1408 W U_ 1062 02128/2022 792863 S ^ LICENS ?NUMBER EXPIRATION DATE SERIAL BE'' • CONTROL# ti i_ 1 3 9 9 5 6 IMPORTANT If your license is lost,damaged or destroyed;is inaccurate;or needs to be corrected,visit our web site at mass-gov/dpI for instructions to ensure the proper mailing of your Renewal Application and any other correspondence. This license is subject to Massachusetts General Laws and regulations.Your license is a privilege,and cannot be lent or • assigned to any person or entity under penalty of law.Keep this license on your person or posted as required by law and/or regulations. ACC DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/17/2021 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 Marsh&McLennan Agency LLC PHONE Cindy Carey FAX 100 Front St, Ste 800 (NC.No.Ext) 508-595-7934 (A/C.No):866-795-8016 Worcester MA 01608 ADDRESS: Cindy.Carey@marshmma.com INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:Massachusetts Employers Insurance Compa 12886 INSURED GENERMECHA2 INSURER B:Phoenix Insurance Com an 25623 General Mechanical Contractors, Inc. p — 29A Sword Street INSURER c:Travelers Indemnity Co of America _ 25666 Auburn MA 01501 INSURER D:Charter Oak Fire Insurance Company 25615 INSURER E:Travelers Property Casualty Co of Amer 25674 INSURER F: COVERAGES CERTIFICATE NUMBER:1302977375 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. ISPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS B X COMMERCIAL GENERAL I.IARII ITY DTCO9N787370PNX 10/3/2020 10/3/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE ' X I OCCUR PREMISES(Ea occurrence) $300,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 CFN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY LX_ j RE LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ C AUTOMOBILE LIABILITY 8109N7751981926G 10/3/2020 10/3/2021 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ E X ! UMBRELLA LIAR X OCCUR ZUP61 N24102 10/3/2020 10/3/2021 EACH OCCURRENCE $10,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$$1fLnnn $ A WORKERS COMPENSATION MCC2002000427 10/3/2020 10/3/2021 X AND EMPLOYERS'LIABILITY STATUTE ER Y ANYPROPRIETOR/PARTNER/EXECUTIVE N N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Installation Fltr QT6600P96760000F 10/3/2020 10/3/2021 Jobsite/Catastrophe $3,000,000 Property of Others Properly of Others $169,768 Equipment Floater Leased/Rented From $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE:Evidence of Insurance 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. City of Northampton 212 Main Street Northampton MA 01060 AUTHORIZED REPRESENTATIVE • ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD