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22-010 (2) 93 SPRUCE HILL AVE BP-2016-1299 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:22-010 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2016-1299 Project# JS-2016-002241 Est. Cost: $2827.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq. 1): 22738.32 Owner: BEAUDIN DAVID J&COLLEEN R Zoning: Applicant. AMERICAN INSTALLATIONS LLC AT. 93 SPRUCE HILL AVE Applicant Address: Phone: Insurance: 130 COLLEGE ST (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON.•5/10/2016 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL ATTIC/BASEMENT INSULATION 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: FeeT_ype: Date Paid: Amount: Building 5/10/2016 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2016-1299 APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEY01075(413)552-0200 PROPERTY LOCATION 93 SPRUCE HILL AVE MAP 22 PARCEL 010 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: INSTALL ATTIC/BASEMENT INSULATION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 106178 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQRMATION 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 of i De y Sig of Buy di ffic' 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. Departmaht'uso.only City of Northampton status of Permst: Building Department CUrb-CuygdVeway-Permit ,.6 212 Main Street Sewer/Septic Avallatitirty Nle RNs Room 100 Water/Well Availability N�3 a;n Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 P1otr3ite Plans OtIier Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 93 Sprice Hitt Ave Map Lot Unit. Florence, MA 01062 Zone Overlay District Elm SL District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Beaudin, David& Colleen 93 Sprice Hill Ave, Florence, iWA 01062 Name(Print) Current Mailing Address: 978-501-2757 See attached Telephone Signature 2.2 Authorized Accent: American Installations 130 College St., Ste 100 South Hadley, MA 01075 Name(Print) Current Malang Address: American Installations 413-552-0200 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $2527 (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) $2827 Check Number This Section For Official Use Only Da Building Permit Number: Issute ed: Signature: Budding Commisslonedlnspector of Buildings Date Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Ibis column to be filled in by Building Department Lot Size Frontage Setbacks Front I---- �� Side L:= R:= L:= R-.= Rear Building Height Bldg.Square Footage ' % ---, Open Space Footage (Lot arca minus bldg&paved j_ arkin ) #of Parking Spaces Fill: ---- — r ------------ (volume&Location) - A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O AYES O i IF YES: enter Book Pages and/or Document#1 B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES,has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: �^ C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O 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 md1l disturb over 1 acre? YES © NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Wesley K. Couture 106178 License Number 130 College St., Ste 100 South Hadley, MA 01075 9/29/17 Address Expiration Date �v 413-552-0200 Signature ' Telephone 9.Registered Home improvement Contractor: _. . Not Applicable ❑ Wesley Couture 175982 Company Name Registration Number American Installations 6127/17 Address Expiration Date 130 College St., Ste 100 South Hadley, MA 01075 Telephone 413-552-0200 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.952,§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.....,. IN No..... ❑ IL-0 Home Owner Exemption The current exemption for"homeowners"was extended to include Owner,-occupied dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Stath Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or fano structures.A person who constructs more than one homy in a two near period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shalt be responsible for all such work performed under the huilftg permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152("Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be Liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature The Commonwealth ofMassacfiusetts Department of Industrial Accidents Once oflnvestigafions 600 Washington Street Boston,Mass 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeaibIy Name(Basi rgastir individual):- /��7,M eci rmn „Ut Address: - 0 llecro '�1�-Q •.r Ciity/State/Zip:s&u4x �tl8A 01blor Are you an employer?Check the appropriate boat Type of project(repaired): 1 I am an employer witia `� 4.01 am a general contractor and I 6.D New construction emovees(fun and/or part time).* have hired the sub-contractors 2.0I tun a sole proprietor or partner- listed on the attached sheet. 7•D Remodating ship and have no employees These sub-canters have L D Demolition working for me In any capacity. employee$and have workers' 9.0 Building addition [No workers'comp,insurance comp.Insurance.t required] 5.0we are a corporation and its 10.D Electrical repairs or additions 3.0I am a homeowner doing all work officers have exercised iheir 11.D Plumbing repairs or additions myself[No workers'tromp, right of exemption perm MGL insurance required]t c.152,$1(4),and we have no 12.13 Roof repairs employees.[no workers' comp.Insurance required.] ,'Any applicant that checks boat fii moat also fill out the section below showlet their workers'compeandon polky haformatim tllameavratrs who submit Als at6dsvit lodieatias tbey are doing all work and Then hire outside tontracton must submit a new affidavit Indicating such. tContacton that eke*this box most attach an odditMnatskeet showing tba name of thesub•eoatracton and state whether or not tbonatlties have employees.if the sab•eoubselon haft$matures,they must tarovMe their worker'tom/►.Policy number. I ant an eatpioyer that is providing workers'compewadon lnsturartce for my employam Slow is the poft and job site Informdon. "V4 Insurance Company Ntmye:_ ��"'�y!(_� _ Policy#or Self-ins.Uc.#.-_ LA1 wC CPV-1 t 1�—t7 Expiration Date_q # {D Job Site Address: City/StateiZip: 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 152 can lead to the imposition of criminal penalties of a JIM up to$1,500.00 and/or one year imprisonment as well as civil penalties in the farm of a STOP WORK ORDER and a fine of $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby cert ffy under the pains and penalda of perjury that the Informadon provided above is true and correct. Date: Print Name re, Phone M 15 =Q2D a 10ffkJaluseonly Do not Trine In this area to be completed by city or town ofaTal City or Town: Permitlncense* Issuing Authority(circle one): 1.Board of Heath 2. Building Department 3.Citylrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: City of Northampton Massachusetts a�` 5 DEPARTMENT OF BUtZDING INSPECTIONS y; 212 Main Street • Municipal Building Jdftira Northampton, MA 01060 Property Address: r- Contractor Name: Address: City, State: A C IP 4 �, A n I0�'j Phone: Property Own! Name: Address: City, State: (,X b "ontractor)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. Contr ctorLignat � Z.-� Date :- www.Americaninstallations.com Ago BBB. Licensed&Insured �Ir► . MA CSL A 106178 - MA Registration#175982 American Installations 130 College Street Suite 100,South Hadley,MA 01075 •Office:(413)552-0200 Fax:1413)552-0202 •Email:wpport@Americanlnstallations.com Beaudin,David&Colleen 1/16/2016 vn) (F—I (Date) 93 Spruce Hill Avenue Florence MA 01062 (A&I—) (cay) (state) aIP) 1-413-297-4646 (Hnme) aeln IERI,In 428 013 16-0300 Isar ID) J.bpl Quantity Unit Unit Cost Total Air Sealing AIR SEALING 8 Iman hour 1 $ 85.00 $ 680.00 Total Air Sealing $ 680.00 Total Air Sealing Incentive $ 680.00 Weatherization INSULATE BULKHEAD DOOR 1 each $ 72.22 $ 72.22 DOOR WEATHERSTRIPPING W/SWEEP 2 each $ 75.00 $ 150.00 DAMMING R-38 80 linear ft $ 2.05 $ 164.00 VENTILATION CHUTES 8 each $ 2.00 $ 16.00 CRAWLSPACE WALL R10 RIGID INSL 120 Isqft $ 3.70 $ 444.00 FLAT-8"OPEN R-28 884 sgft $ 1.37 $ 1,211.08 REMOVE INSULATION 120 Isqft $ 0.75 $ 90.00 Total Incentivized Weatherization $ 2,057.30 Total Non-Incentivized Weatherization $ 90.00 Total Project $ 2,827.30 Total Utility Contribution $ 2,222.98 Total Customer ContributionF$ 604.33 WARRANTY:American Installations,LLC will provide the above stated homeowner with a 2 year workmanship warranty. American Installations,LLC hereby proposes to furnish all material and labor to complete the above scope of work in accordance with the above specifications and all local and state building regulations for the Total Contract Value as stated herein. ACCEPTANCE OF PROPOSAL:The above prices,specifications and TOTAL CONTRACT VALUE= $ 604.33 conditions are satisfactory and are hereby accepted.You are authorized to do work as specified.Payment will be 1/3 down prior to Down Payment= $ 201.00 ® 01/16/2016 start of work,and balance a upon Complex n. PAID Balance Due Upon Completion= $ 403.33 01/16/2016 Signature Date Beaudin, David&Colleen P.F-,--(Print) party Pxner 'gn) Date Lauren Harris 01/16/2016 B—novo(P—) RepeuntMve(sign) Date THIS AGREEMENT IS COMPOSED OF THIS PAGE AND THE REVERSE SIDE OF THIS PAGE AND SHALL BE CONSIDERED THE ENTIRE AGREEMENT BY THE PARTIES INVOLVED.THIS AGREEMENT IS BETWEEN AMERICAN INSTALLATIONS,LLC HEREINAFTER REFERRED TO AS"COMPANY AND TH E CUSTOMER(S)NAM ED ABOVE,HEREINAFTER REFERRE D TO AS-CLI ENT",AND WILL BE SUBJECT TO ALL APP ROPRIATE LAWS,REGULATIONS AND ORDINANCES OF TH E STATE OF MASSACHUSETTS OR CONNECTICUT RESPECTIVELY,AS WELL AS ALL LOCAL JURISDICTIONS.