Loading...
32C-058 Aaron Morin Sheet Metal 140 West Street Estimate West Hatfield, MA 01088 (413) 427 -1416 Cell# DATE ESTIMATE # (413) 247 -9924 Fax# 3/5/2010 171 BILL TO SHIP TO Bill McGloughlin PO Box 580 Williamsburg, MA 01096 DUE DATE P.O. NUMBER 5/5/2010 ITEM DESCRIPTION QTY RATE AMOUNT To supply and install a Life Breath 500 DCS heat recovery 12,994.00 ventilator. To install a supply and return weatherhood to outside of mechanical room. To install the necessary insulated duct work needed to bring constant fresh air to and from each of the 17rooms based on, and in coplaince with building and health codes. To remove existing insulation from hallway ceiling. Job: Northampton Lodging 195.00 Payment: 0.00 $5000.00 Due upon acceptance of proposal. $5000.00 Due upon completion of ductwork aril equiptment installation. / $3000.00 Due upon comple o • (s• •. d return .ill installation. Accepted B ; / 0.00 Date - -- /0 Date - - - •V' 7 7 Wiring not included Subtotal 13,189.00 0% Tax Total 13,189.00 • DATE (MM /DDIYYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 4/2/2010 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 pollcy(les) 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 endoraement(s). PRODUCER . _ NAM MEYER INSURANCE ((i N o, E xt } . (413) 2 0 3 - 518 0 F "' ( 1.86E Northampton St E - ( � C ' N °) Y^ ADDRESS: Easthampton, MA 01027 PRooLI ER — -- _UsTOMERJD $: ,,.. ..... IN5VR!Ria) AFFORDING COVERAGE NAICM INSURED Morin, Aaron INSURER A: Farm Family Casualty INSURER B : 140 West St INSURER W Hatfield, MA 01088 INSURER O INSURER E INSURER F : .R COVERAGES CERTIFICATE NUMBER: 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 TI-1 E POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INER T YPE OF I NSURANCE ADDL SURR �� °'� • • - - a LIMITS I,TR Runt wvt POLICY NUMBER (M IDD/1•YYY) (MWODlYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO REN7tU X COMMERCIAL GENERAL LIABILITY PREMISES (Ea oc°urraneN).$ 50,000 CLAIMS -MADE OCCUR MED EXP (Any one person) s 5, 0 00 2008X0180 01/19/10 01/19/17 PERSONAL a ADVINJURY $ GENERAL AGGREGATE s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/DP AGG $ 2, 000 , 000 X POLICYJ .Il fl LOC •.$'•-•— AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANYAUTO BODILY INJURY (Per Daman) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) NON-OWNED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS - MADE AGGREGATE S DEDUCTIBLE __ $ RETENTION $ wORKERS COMPENSATION WC STATU • AND EMPLOYERS' LIABILITY Q TORY LIMITS ER ANY PROPRICTOnmARTNER,EXECUTIV$ ryI NIA 2006W6194 03/22/10 03/22/11 E, L. EACH ACCIDENT s 500,000 OFFICER/MEMBER EXCLUDED? 5OO 000 (Mandatory In NH1 El, DISEASE - EA EMPLOYEES r If yea, describe undwr 560 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ r DESCRIPTION OF OPERATIONS r LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If morn spate Is required) Sheet Metal The Workers Compensation policy does not provide coverage for Aaron Morin CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W1TH THE POLICY PR SIONS, AUTHORIZED RE:PRE ENTATIV 1988 -20 b . C0" • - t.TIQN. A ri hts reserve ACORD25(2009/09) The ACORD name end logo are registered marks of ACORD A • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations '' 600 Washington Street Boston, MA 02111 www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders /Contractors/Electricians /Plumbers Applicant Information Please Print Legibly Name ( Business / Organization / Individual): "c /War, ( Address: /go (,./3r < €' City /State /Zip: Vest .Tip° (d , /i , � / - ©no's Phone #: 3- /4/1 (7 Are yo employer? Check the appropriate box: Type of project (required): 1. I am a employer with . 4. 0 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. ❑ I am a sole proprietor or partner- ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5- ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no q ] employees. [No workers' 13.[j�ther Ak✓ T//S'lgt comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below 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: c�.l i'h jl /►1 t l ' ��i -3 wz / -/?/ Policy # or Self -ins. Lic. #: 25r L6 6 / 9 1 Expiration Date: — •? —// Job Site Address: Of tie3S &r5 City /State /Zip: na—r 4 %L `6'ot 06© 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the pains and penalties of perjury that the information provided above is t correct. Signature: � /� Date: ( V Phone #: 9/ — ?7 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 #: . ` Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No O If 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, .. , as Owner of the subject property 0‘ r . hereby authorize ....�._ . a . _ _ _�. �__. ... _ . act on my behalf, in all matters relative to work authorized by this building permit application Signature of Owner Date I, ,!�� • " ." / b , �� � , _ l � as :s er /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the of my knowledge i and belief. ' Signed under t )a •s and enalties of .er u } ty Print Name \ Signa ure of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES sf'f c (, i MAW Not Applicable Name of License Holder : License Number Address Expiration Date 41(3 y7 -oSSd e t/ Telephone Signature e y <3 — ya SECTION 13 - 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 0 No 0 Version1.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUC ION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registere. Architect: .. _. _ ....... _.__..._ ...._._:._ _._..__..., _.____:.._._._ .,_. .. ,......_.____._ Not Applicable ❑ Name (Registrant): Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional En.'neer(s): Name Area of Res.= sibility s Address egistration Number Signature Telep • e Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telepho - Expiration Date Name Area of Responsibility Address • -gistration Number Signature Telephone _ Expiration Date 9.3 General Contractor Not Applicable ❑ Company Name: Responsible In Charge of Construc : ' Address Signature Telephone Versionl.7 Commercial Building Permit May 15, 2000 8. NORTHAMPTON ZONING Existing Proposed Required by Zoning This coluD be filled in by m B Department Lot Size Frontage . ............ .__ Setbacks Front Side L. R. Rear Building Height Bldg. Square Footage "- � -�� ��" _,_ _ .... Open Space Footag (Lot area minus bldg & paved parking) ..._.. a .,� „�d ......o....w ..� # of Parking Spaces Fill: _ .._..._... _._ ...._. .. (volume & Location) A. Hasa Special Permit /Variance /Finding ever been issued for /on the site? - NO 0 DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book Page, and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW (Si) YES 0 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 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Version1.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ ' Exterior Alteration ❑ Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description :Enter a brief description here. `3�b ,r -"lobo Lv i1 Of Proposed Work: j4SfA /I,7/ ' c t _ /h 5 ( 7 54CUr tO het5c Al ert 5 SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A -1 ❑ A -2 ❑ A -3 ❑ 1A 1 ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business ❑ ! 2A ❑ E Educational ❑ 2B r ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 38 ®. M Mercantile ❑ 4 ❑ R Residential ❑ R-1 Illik R -2 ❑ R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 ❑ 5B ❑ U Utility ❑ Specify M Mixed Use ❑ Specify. S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: - Prop• • e Group: _ .. _ ___.._____._ .__.___._ _...__,.. _ ._..._... Existing Hazard Index 780 CMR 34): Propose. Hazard Index 780 CMR 34): __ _ _ .,.... ____ _.. M __ SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) r 1 st 1 st 2 nd 2 3rd 3` 4 m a, Total Area (sf) Total Proposed New Construction (sf) Total Height (ft) .._ __..._._.. _ _ .__._ Total Height ft 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone information: 7.3 Sewage Disposal System: Public ❑ Private 0 Zone Outside Flood Zoneo Municipal ❑ On site disposal system Versionl.7 Commercial Buildin& Permit May 15, 2000 Departrpent rise only k �a ' City of Northampton zSta� aPet 4 fi Building Department E:urxCuffE3rtveway Perm XL 212 Main Street ,ewer /Sepfic�kuaiIaBrit '„ . ..� s . �� Rofam 100 Wat / JI AVa labilfty \ Northari pton, MA 01060 lwo` eCs of Strcctu�aC'l Cans k phone 413 - 587 -1240 Fax 413 - 587 -1272 Plomt/S�ite Mans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 29 e Sr (j„€ 6 Map Lot Unit iv Q ) AAP Zone Overlay District ... 4 __.....,_.,...�_ r • Elm St. District G CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED•AGENT 2.1 Owner of Record: if., tv. -Co..& t' I n sQ 9 2(tR1 Name (Print) Current Mailing Address: _. ____ . _ _.. _ Signature Telephone 24fer ct36 -00 2.2 Authorized Agent /9/9)(-, M r, • /4 s G✓ r� w Name (Print) Current Mailing Address ©/ 0 $l? _. ._...... _ „....... _ Signature Telephone SECTION 3 - ESTIIVIATED CONSTRUCTION COSTS • Rein 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 - � " o 2 ( 6. Total = (1 + 2 + 3 + 4 + 5) Check Number 7 This Section For Official Use Only Building Permit Number Date Issued Signature: Building Commissioner /Inspector of Buildings Date • File # BP- 2010 -0859 APPLICANT /CONTACT PERSON AARON MORIN ADDRESS/PHONE 140 WEST ST WEST HATFIELD (413) 247 -1416 PROPERTY LOCATION 129 PLEASANT ST MAP 32C PARCEL 058 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 9 (0)1° Fee Paid 0 Typeof Construction: INSTALL HRV SYSTEM FOR BASEMENT ROOMS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF, O 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 Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay fr Signature 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. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. ,,. 00 , BP- 2010 -0859 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: BUILDING PERMIT Permit # BP- 2010 -0859 Project # JS- 2010- 001279 Est. Cost: $13189.00 Fee: $78.60 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: AARON MORIN Lot Size(sq. ft.): 50529.60 Owner: BOWDITCH LLC Zoning: CB(100)/ Applicant: AARON MORIN AT: 129 PLEASANT ST Applicant Address: Phone: Insurance: 140 WEST ST (413) 247 -1416 WC WEST HATFIELDMA01088 ISSUED ON:4/8/2010 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL HRV SYSTEM FOR BASEMENT ROOMS 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 4/8/2010 0:00:00 $78.60 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo