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42-099 573 WESTHAMPTON RD BP-2017-0175 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:42-099 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-2017-0175 Project# JS-2017-000286 Est. Cost: $4100.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq. ft.): 27225.00 Owner: PHELAN MICHAEL&MELISSA Zoning: Applicant: AMERICAN INSTALLATIONS LLC AT: 573 WESTHAMPTON RD Applicant Address: Phone: Insurance: 130 COLLEGE ST (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON:8/11/2016 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 Sienature: FeeTvpe: Date Paid: Amount: Building 8/11/20160:00:00 $65.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0175 APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEYOI075(413)552-0200 PROPERTY LOCATION 573 WESTHAMPTON RD MAP 42 PARCEL 099 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT owe) �cr Fee Paid 7� Building Permit Filled out Fee Paid Tvneof 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 INFO ATION PRESENTED: AApproved 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 De i olition Dela . � 8 ///1 Signa • - 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. 0, of Northampton stave orPannk pavadme d'uea a+T %`15 's'ngDepartment Cmti�WOmepayTd�mg- .�,t, amara '12 Main Street seyrattsep&MtMm ,, Room 100 W�l6,IiNyel Avelabbly ex�`"a; Northampton, MA 01060kite" 44etti�efsmiayroEFIa,a sae phone 413-587-1240 Fax 413-587-1272 ,ply FS,a„ . ' APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY SMELLING SEC Wid 1-SITE DWORMATION 1.1 p.° Addreae; This section to be completed by office Map Lot Unit 573 Westhampton Road Florence,MA 01062 Zone Overlay District Etc SL Dbobt.... CB District , SECITON 2-PROPERTY NERSHIPIAU1NORIEED AGENT 2.1 Owner Record; Michael&Melissa Phelan 573 Westhampton Road Florence,MA 01062 Name WringtC n Malling 712-8320: See attached Telephone Signature 22 Authorised Anent American Installations 130 College St., Ste 100 South Hadley,MA 01075 tima{Ph- Comet Maty mama American Installations 413-552-0200 Signature Telephone SECTION 3-ESTIMATED CONS1RUCTNTN COSTS Den Emoted Cost Polars)to be ORiciat Use Onl Wmpieted by permit applaart 1. Building 4100.00 (a)Building Faring Fee 2. Eiectlml tat affimataa Tow Cost of Comte. an from(S) 3. Plumbing Building Perrin Fee 4. MechaNael(HVAC) 5.Fire PtutdULa, py 6. Totalc(1+2+3+4t5) 4100.00 Check member 'H' P Y This Section For Official Use OnlyDate r Building Permit Number: Must Signature: SuildaNConuntssionerilespector of8.&bgs Deb Section 4. ZONING All Nfomadon Must Be Cc.np(eted.Peimit Can Be Denied Due To Incomplete(formation Existing Proposed Required by Zoning Thin column to Wined in by Mugabe Dmmbnmt Lot Size Frontage k Setbacks Front Side L: l R:_ R II I II Building Height � Bldg.Square Footage 76 � Open Space Footage 7G ketoses minus bide&pined III oad®g) go Parking Spaces r—� I I Fill: _ �r — _-- (&oioa&taaedoo) _ I A. Has a Special PermitNariance/Finding ever been issued for/on the site? NO 0 DONT KNOW 0 YES 0 IF YES,date Isaed:1 IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES 0 IF YES: enter Book Pagel and/or Document EEL B. Does the site contain a brook,body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained O , Date Issued: C. Do any signs exist on the property? YES O 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,(e�x�vaUon or Wing)over 1 one or Is It part of a common plan that w®disturb overt we? YES 0 NO V IF YES,then a Northampton Storm Water Management Pennefrom the DEW is regudred. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addkfon 0 Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 0 Accessory Bldg. D Demolition ❑ New Signs fl Decks 10 Siding U7] OtherId41 Brief Work Athc and asement insulation and air sealing throughout Nteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement_Yes No Plans Attached Rag -Sheet .. _ .. _ nu se.If New house and or addltlon to eziednG'hriusinsi,complete the following a. Use of building:One Family Two Family Other b. Number of rooms in each family urYt Number of Bathrooms o. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heading? Fireplaces orWoodstaves Number of each g. Energy Conservation Compliance. Member* Energy Conpkance form attached? h. Type of construction L Is construction within 100 ft.of Wallands? Yes ^No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. W M building conform to the Building and Zoning regulations? Yes No. I. Septic Tank_ City Sewer_ Private wag_ City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Michael&Melissa Phelan as Owner tithe subject PraPenty hereby authorize American Installations to act on my behalf,In al matters relative to work authorized by this building permit application. See attached 8/2/2016 Signature of Owner Date I, American Installations as Owne M thO Red Agent hereby declare that the statements and Information on the foregoing application me hue and accurate,to the best of my knowledge mit belief. Signed under the pains and penalties of perjury. American Installations Print Name '� tin IL 1 8/2/2016 g� �ofw.wdMgent tits SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of Menge Romer; Wesley K. Couture 106178 teens,Number 130 College St, Ste 100 South Hadley,MA 01075 9/29/17Address FiSYmbn Cate UV N V 413-552-0200 Signature Telephone 9 !leakiered'Ilene 6mmovameiittotitrac(or•. Not Applicable 0 Wesley Couture 175982 Company Name Registration Number American Installations 6/27/17 Address Expiration Date 130 College St., Ste 100 South Hadley,MA 01075 Telephone 413-552-0200 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(11.G.L C.152,9 250(8)) 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 alts bidding permit. Signed Affidavit Attached Yes.-- fiNo.. 0 Il. -Home Dynan Ezemption The current exemption for"homeowners"was extended to include owner-ocawlsd Dwaine,of one(1) cc 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. Shah Edition Section 10833.1. peflaitlon of Homeowner Pan(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 almanacs accessoryto such me and/or farm structures.A person who constructs more than one home In a two-year paled shall not be considered a homeowner. Such'tomeowna^shall submit to the Building Official,on a form acceptable to the Building Official,thathetabe shall be resooadble for all such work performed soder the buidinenermtt. As actingfoustrpdion Supervisor your presence onthe job site will be regained from time to time,during and upon completion ofd&work for which this permit is issued. Also be advised that with reference to Chapter 152(Weaken'Compensation) and Chapter 153(Liability ofEmployers to Employees for injuries not resuling inDeath)of the Massachusetts Genal Laws Amotated,von maybe liable for persov(s) you hire to perform work far you under this permit, The undersigned'homeowner"certifies and assumes responsibility for compliance with the SicteBraiding Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature The Commonwealth of Massachusetts Department of Industrial Accidents =a l=5 Office of Investigations _ e_ 4 1 Congress Street,Suite 100 Boston,MA 02114-2017 • V`�� www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers 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): 1.1I I am a employer with 27 4. ❑ I am a general contractor and I employees(MI and/or part-time)." have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.I 9. ❑Building addition 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 employees. [No workers' 13.©Other Insulation comp.insurance required.] *Any applicant that checks box#t 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 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Guard Insurance Companies Policy#or Self-ins. Lic.#: J,UR,WC,6y0.9917/J,� Expiration Date: 09/04/2016 /�rh Job Site Address:S,2) ttiP,4"xu'fIGl7 IK1ALt City/State/Zip:Fin/P/U it d[Glyv 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 calunder the pains and penalties of perjury that the information provided above is true and correct. Si2natur'e�41/2t4L4L 9 en, .lt/lL_ Date: - - �VJ Phone#: Hi3-55A-OaROO 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#: City of Northampton ° 7rassachusetts osPIha1]®T OF BUILDING INSPECTIONS r 212 Iain Street • Municipal Snildinp MornLeeptcn, es 01060 Property Address: 573 Westhampton Road Florence,MA 01062 Contractor Name: American Installations Address: 130 College Street Ste. 100 City, State: South Hadley, MA Phone: 43-552-0200 Property Owner Name: Michael&Melissa Phelan Address: 573 Westhampton Road City, State: Florence,MA 01062 I,American Installations (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 , Lis Date V 8/2/2016 Ocensed&Insured I.. www.Anwrieanhtttailations.com M4C5a11:10E178 American Installations MA Registration W 175982 EficientHomeServices- 13eenllege Streit suite no,South Hadley,MA 007S• Office:(433)552-0200 Fax:0131552-0202•Emil:wpporl®Mnri amm6llatiom.com AIR SEALING PROPOSAL Michael Phelan 573 Westhampton Rd Northampton.MA 01062-9709 Site ID:S00(150209737 Project ID: P00050240430 Customer ID:000050211248 Contract UD:20160429 ASEAL Description Quantity Location Perform Air Sealaat Estimaled 82.5 CFM50 Per Maur a ,., Living Space $674.56_ Exterior 000r Weather Shipping 3 _.Y $8257 Door Sweep __. . 3..-_N/A $69_54 Sub Total: $026.01 Utility Incentive Share $826.87 Customer Contribution $0.00 WARRANTY:American Installations,LLC will provide the above stated homeowner with a 2 year workmanship warranty- American Installation.tLC hereby proposes tetum6b all material and abet to completetheabove scope of work lin accordance with the abovespec-Mations and ay-local and nate Wading regulatio ssfor the Total Contract Value as stated herein. ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions TOTAL CONTRACT VALUE r$ 0.00 are satisfactory and ale hereby accepted. You are authorized to do work as Down Payment=$ 0.00 specified.Payment will be 1/3 down prior to start of work,and balance due PAID upon Completion. Balance Due Upon Completion'.::s 0.00 Signature Date 6/29(2016 Phelan.Michael&Melina Property Owner(Prbe ;As°a. .. ' Date......_ Representative:(Print) Craig A.Dragovich (Sign) 2� Date_ 6/29/20116 0. 141 Licensed&Pored \• www.AmericanInstailations.com MAat°t "a American Installations MA Registration N 175982 -Efficient Hame Services- 341 NewtonaraSout Hada,MA 04915 • Offite:(613)532-0mo Fax:(4131 S5241202 S email:Stipp ttBAmerieanlVRbllatgre.wm WEATHERIZATION CONTRACT Mkhael Phelan 573 Wesihampron Rd Northampton.MA 01063-97$9 Site ID:SO0050209737 Project ID:P00050240430 Cuslena ID:C0005021(246 Contract ID:20160639 WORK Desallptlon Manny Location Insulate Rine Mg Wnb 2"Tbeonot Barnes Pafybn.__._...__._._.. 30 Ll*V Spate_._ .__.._.-. _......__£132.00 InstateRimRemoJoist x9m625't1pB�eas Bava9 52 WA Living Space $900_ Hatch130 hartaan Remove/ 52 Ta 55980_ ent TOnt Berner pdyiu,zrm(Amg 1 AUic ^jaiee __. 129.1.. Vent batho On roof tipper1 Lain „ ,- St5sz1_. Install 2' then61BwDeflate erOnt HC ..., e36__.Liati eceacia ..._ . .15880 lutea 2'lnnrmel Barrier Pdyiso Co Kre[.well 36 Lay gotta t158A0 DeaCuter 35 WM 126.65,... Cut atl FMSh Mass t NtA 555388„ 60 Instal 2 ym l Berner mW On Karma _,,..._. _tai___ _WLn Ss Hatch: Thermal Barnx Pattie 4lMr(Mlj tLIvIy t4i.ji Sheathing knees t WA 38l4 Pipe T u;. 10 NIA $21.90 kona 2TtlmaFarrier PNfso On Kneag36 _IMIgBp $1060 .._ .. _. .. . Stns 69_, Sub Total: $3,260.74 Utility Inactive Shea $2.000.00 Customer CeM4A+aion $4260.24 WARRANTY:American Installations,LIC will provide the above stated homeowner with a 2 year workmanship warranty. American Installations.LLC hereby proposes tetanal a material and labor to complete the above scope of work In accordance with the ahovespecifications and all local and state bW3ng regulations Mae Total Contract Value as stated herein. ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions TOTAL CONTRACT VALUE.$ 1260474 are satisfactory and are hereby accepted. You are authorized to do work as Down Payment m$ 420.00 specified Payment will be 1/3 down prior to start of work and balance due Poo upon Completion. Balance Out Upon completion-$ 640.24 a es Signature Date 6/29/2016 Property Owner tRrint) PhelanMelina (Sim) Date —/�/ ., Representative:[Print/ Craig A.Dragnvich Dia) J Date6/2912016 LLE xunxurzo-SEEPREn TO AS caapmf..uAM ayIwnAlMSEDMnv[WALL SE xmERRD TO AS'WEN-F.AND W LL BE SU PLrx[ouECT TO AILA'c.palm LAWS.v[6umn ONS AHD ORDINANCES O,THE