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22-013 (4) 67 SPRUCE HILL AVE BP-2017-0822 GIS#: COMMONWEALTH OF MASSACHUSETTS Mao:elock:22-013 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-2017-0822 Project# JS-2017-001376 Est.Cost: $2700.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq.ft.): 27007.20 Owner: MULLANE JEREMIAH 1 Zoning: Applicant: AMERICAN INSTALLATIONS LLC AT: 67 SPRUCE HILL AVE Applicant Address: Phone: Insurance: 130 COLLEGE ST (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON:12/30/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:ATTIC BASEMENT INSULATION AND AIR SEALING THROUGHOUT 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 12/30/20160:00:00 $65.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0822 APPLICANT/CONTACT PERSON AMERICAN INSTALLATIONS LLC ADDRESS/PHONE 130 COLLEGE ST SOUTH HADLEY (413)552-0200 PROPERTY LOCATION 67 SPRUCE HILL AVE MAP 22 PARCEL 013 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid �� Building Permit Filled out -" tl"` Fee Paid lypeot Construction„ ATTIC NT INSULATION AND AIR SEALING THROUGHOUT New Construction Non Structural interior renovations Addition to E,d ting Accessory Structure Building Plans Included: Owner/Statement or License 106178 3 sets of Pians/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO;XM-KFION PRESENTED; ki'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 DemoliC u Signa ure 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. ' Vii, Depadment Use o+kf EC g Wily of Northampton Naha of Permit: p "� Bltilding Department Cuff GutPwap Pairct 212 Main Street Sewer/SaphcAyalhblity Room 100 WaterlWehAvaftab ty Northampton, MA 01060 Two Sets of5vuctu alPlans phone 413-587-1240 Fax 413-587-1272 PIot7S1(e Plans . Olher Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH ACNE OR IWO FAMILY DWELLING SECTION 1-SITE INFORMATION 1.1 Property Address: This section to be completed by office 67 Spruce Hill Avenue Map Lot _Unit. Florence,MA 01062 Zone Overlay District Elm Si.District - CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2,1 Owner of Record: Jeremiah Mullane 67 Spruce Hill Avenue Florence,MA 01062 Name(Print) CunoMrymph�Address: (413) 584-2378 See attached - Telephone Signature 2.2 Authorized Anent American Installations 130 College St., Ste 100 South Hadley, MA 01075 Name(Petit) Current Mama Address: American Installations 413-552-0200 ST ie»{rtmno SECTION 3-ESTkBATED CONSTRUCTION COSTS hem Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Eagting 2700.00 (a)Building Perms Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fue Protection 1/ 6. Total Nu ,�,;f`� I=(i +2+3+4+5) 2700.00 Check!timber V if This Section For Official Use Only Date Building Permit Number. Issued' Signature: Building Commissioner/Inspector of Buildings pate Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size I Frontage Setbacks Front Side L: I R I I Rear Building Height I 7-1 Bldg Square Footage I--I I I % I I I I Open Space Footage (Littera minus bldg&pavd I L I I packing) #of Parking Spaces � I Fill: —_ .,.__ — ---__—_ —_— I (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES,date issued:! IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES 0 IF YES: enter Book I I Page I and/or Document#� B. Does the site contain a brook,body of water or wetlands? NO O DONT KNOW C) 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 Oiling)over i acre or is it part of a common plan that will disturb over l acre? YES 0 NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House f l Addition 0 Replacement Windows Alteration(s) Roofing 0 Or Doors D Arroseory Bldg. Q Demolition 0 New Signs [o) Decks ID Siding g31 teig Brief Description ofjproposed Worse Attic and basement insulation and air sealing throughout Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached s Rog -Sheet ddedrea Narrative Renovating unfinished basement Yes No A ea.If New house gad or adddion fo existing housing.,complete the following: a. Use of building:One Family Two Faintly Other b. Number of rooms N each famuy unit Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of newwrrs§uciion. Dimensions _ a. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each_„__ g. Energy Conservation Compliance. Masacheck Energy Compliance form attached? h. Type ofconstruden L Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No, I. Septic Tank City SewerPrivate well City water Supply_,,,_ SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENTAGOR CONTRACTOR APPLIES FOR BUILDING PERMIT Ic inh. MutICJ.CY�. __,as Owner of the subject M rty3ea hereby authorize American Installations to act on my behalf,in all matters relative to work authorized by this building permit application. See attached 12/24/16 Sfgnatn of Owner Date I, American Installations as Owner/Authorized Agent hereby declare that the statements and Information on the foregoing application are tine and accurate,to the best of my knowledge end belief. Signed under the pain and penalties of perjury. American Installations Print Name tV oi _ 12/24/2016 Signature of Owned Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of Ucense Nolder: Wesley K. Couture 106178 Ucense Number 130 College St, Ste 100 South Hadley,MA 01075 9/29117 Address Expiration Dale !,, , y dare - 3-552-0200 Signature r Telephone 9.Registered Home Improvement Contractor .. - 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(M.G.L e.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 pesnl0. Signed Affidavit Attached Yes._.... l No ❑ 11. -Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-oecupiedDwelings of one(1) or two(2)families and to allow such homeownerto engage an individual for him who does not possess a license,provided that the owner acts as saperybar.ChM DM, Sixth Eaton Section 1083.54. Definition of Homeowner:Person(s)who own a parcel of land on which be/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 home in a two-year period Shall not be considered a homeowner. Snell"homeowner shall submit to the Building Official,on a form acceptable to the Building Official that be/shc shall be responsible for all such work performed under the building 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 dancer 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,yell may beuabie for person(s) you hire to perfonB work for you ander this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Leval Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature City of Northampton / w a- Massachusetts IDENT OF BUILDING INSPECTIONS 212 Ma 212 Yarn Street • Nm,leipnl Beiidles Northampton, N6 01060 8611‘ Property Address: 67 Spruce Hill Avenue 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: leremiah Mullane Address: 67 Spruce Hill Avenue 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. Contraotf 1prs gnatu� &74t Date 12/24/2016 S i11. ears Amedarllmtalhtnnt[am 11 Licensed&Incur ed MA CSL 41:106178 Amarican Installations MA aaRlwmionol75982 140 College street Sulk 1W,Saudi Medley,MA 0107+Mice:143i 5574200 Fax:(4t3155242t2•Email:,Vppor.AmerkanlmVllaloevcom Muliane,leremiah 12/672016 1.0 Lima 67 Spruce Hill Ave. Florence MA 01062 551 EGE a.. 413584.2378 mWianejerryeyahoo.cOm 442768 Imp, Iwo 162039 NEE Quantity Unit Unit Cost 1`" Total Ak/Oud Seating AIR SEALING 8 man hour $ 85.00I$ 670-00 Air/Duct Sealing S 680.00 Air/Duct Sealing Incentive $ (680,00) Air/Duct Selaing WX Balance $ Weatherization _ CRAWLSPACE WALL R10 RIGID BOARD 93' CRAWLSPACE,R-19 rc BATT 24 sgft $ ISO $ 43.20 VENT BATH PAN THRU SOFFIT 1l each $ 118.75 $ 118.75 FINISHED CEILING ACCESS 1 each $ 135.00 $ 135.00 ATTIC DAMMING-R38 FIBERGLASS 72 sgft $ 2.05 $ 147.60 ATTIC FLAT 4"OPEN R-14 CELLULOSE 875 sgft $ 1.20 $ 1,050.00 REMOVE INSULATION 93 sgft $ 0.75 $ 69.75 Total Weatherization $ 1,940.95 Weatherizatlon Incentive $ 1,40340 Total Project $ 2,620.95 Total Utility Contribution $ 2,083.40 Total Customer Contribution $ 537.55 WAOMNrv. mmtin mulamm. ¢,bu providetheabove strvita.4 homeowrtv yatry a 2 year workmanship varrann. M1neaby popwa tafi,mnNM maevw Intl bbm mwmpiem teabow mot of won accordant*wrtbme above epeoftAens and a ll lom6"d 1Vu build" rea▪ ultt or tnMwlsGmrnt Values'slated Fneirt ACCEPTANCE Or PROPOSAL The awae wk6s.awclrraktallna TOTAL CONTRACT VALUE $ 537.55 condiiions are pansfactoy and are pYmb9 accepted You authnnzed to da work as IMnfied muscat will to U3 down prior to DOWil Payment= $ 179.00 25 12-6-2016 stare of work.and balance due upon Wmpklio. PA 16 •xxI Balance Due Upon Completion= $ 358.SS Mullane.Jeremiah � t/ `...� ]]76/2016 .wnzr.lnry Craig A.Dragovich / 12/6/2015 The Commonwealth of Massachusetts Ph —td Department of Industrial Accidents -==;+r t_I Office of Investigations ' _+R= i 600 Washington Street Boston, MA 02111 r vu'w.maSs.gov/dig \Yorkers' Compensation Insurance Affidavit:BuilderslContractors/ElectricianslPlumbers . .Applicant Information Please Print Legibly Name(Busineso'DremdrahioWIndividoap: American Installations,LLC Address: 130 College Street,Suite 100 City/State/Zip: South Hadley,MA 01075 Phone r: 413-552-0200 Are you an employer?Cheek the appropriate box: Type of project(required): i_ I am a employer with 31 4. 0 i am a general contractor and I 6. New construction employees(Poll and/or part-time).* have hired Ole sub-contractors 2.L1 t am a sole proprietor or partner- listed on the attached sheet,t 7. 0 Remodeling ship and have no employees These subcontractors have 8. 0 Demolition working for me in any capacity. workers'comp.insurance. 4. 0 Buildingt ddition [No workers'comp, insurance 5. 0 We are a have and its required.] officers have exercised their 10.� Electrical repairs or additions 3.0 lam a homeowner doing all work right of exemption per YMCA, 110 Plumbing repairs or additions myself.[No workers'cora C. 152, I(4 ,and we have no p. ) 12.0 Roof repairs insurance required.]' employees,[No workers' x comp.insurance required.] 13.t�Other Insulation ',any applicant that checks bon LI muse also LII out section below thawing dicie%sock s compensation policy information. `I nmc r.,tmts who snbmii thin:rnidavh indicating N Y are doing tit work and Item him ovoids cmumctom moo submit a new aiLduvit indicating such. :Contractors that check Ibis box must attached an additional shat showing the name of the subconincnor3 and that workers'comp.policy infonnonon. i not an employer that is providing workers'compensation insurance for cry enrployeer. Below is the policy and jab site information. Inmate Company Name: Guard Insurance Companies _ Policy II or Self-ins.((Lie..h: URWC609917� j� II C Expiration Date: 09/04/20179 1 a]l't ova 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 adt)I.c. 152 can load to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-yea imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and of up to 5250.00 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 ruder the pains and penalties of perjury that the information provided abase is true and correct. I $i9n32nre: Date:/2-27 -/62 Phone e: 413-552-0200 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License m Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical inspector 5.Plumbing Inspector 6.Other • Contact Person: Phone#: A CERTIFICATE OF LIABILITY INSURANCE ACORD 9/1/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does riot corder rights to the certificate holder in lieu of such endorsement(s). PRODUCER CNOMTACF Linda Powers • Webber & Grinnell MP * (413}506-0111 F.: ,:tul>Seb-64e1 8 North Ring Street AD'M^eRREy$.p. , W 1ppwera@webberandgrinnell.con DiSIMEa(5)ABFORDAG COVERAGE NMC Northampton IDL 01060 INSURER A EmplOYers Mutual Casualty INSURED INSURER B Berkshire Hathaway GUARD Ins. Co. American Installations, LLC INSURER C: Attn: Wee & Suzanne Couture INSURER D: 130 College Street, Suite 100 w$UReRE: South Hadley MA 01075 INsueee F: COVERAGES CERTIFICATE NUMBER3faster Exp 9-2017 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDHIONSOF SUCH POLICIES.LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAMS. INSR ASIrsORK- POD EFF POLICY EXP _ LIR TYPE OF INSURANCE INSD WVD POLICY NUMBER JM ( MIDDd 'fl UWTS COMMERCIAL GENERAL GAMLEN EACHOCCURRENCE 5 1,000,000 AMTIWNENTED A _ X CLAIMS-MADE L I OCCUR PREMISES As powered?)d?) 5 500,000 X_ Liquor Liability 503535217 9/4/2016 9/4/2017 MED$AP p,y orettmQ.Q 510,000 PERSONAL/3 ADV INJURY $ 1,000,000 GENL AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 X1 POLE ACT LOC PRODUCTS-COMWOPAGG 5 2,000,000 OTHER: $ AUTOMOBILE UMMIT• COAINNED SINGLE LAD 5 1,000,000 bietridat A ANY AUTO 90DILY INJURY(Per pew/ 5 AU,OWNED X $— AtIVOSDULED $7.3535217 9/4/2016 9/4/2017 BODILY INJURY(PersoMent S X HIRED AUTOS y- NONOVMED �DAMAGE 5 _ AUTOS IPS 000100 PIP.Nsc 5 8,000 X UMBRELLA tin ,OCCUR EACH OCCURRENCE 5 1,000,000 A EXCE$81JAB CLAIMS-MADE AGGREGATE $ 1,000,000 I'.CD X RETENTIONS 10,000 5.33535217 9/4/2015 9/4/2017 5 VIORNERS COMPENSATIONxI.$TATI nPER F Ig H. AND EMPLOYERS'LIABILITY ANY PRCeRIETORMATNEWEXECUTNE 'YININIA EL.EACHACCIDENT S 500,000 ARCEl (Mmi datoRIn NAA EXCLUDED? DRC609917 9/4/2015 9/4/2017 EL DISEASE.FA EMPLOYEE 5 500,000 pIR e4. SCRIPTN aeuIQer OOFF OPERATON$Wbv - EL DISEASE-POLICY LIMB S SCO,Q00 A Cormaercial Property E113535211 9/4/2016 9/4/2017 dedtjYMe51.0110 $20,000 sed eble51a00 $40,000 DESCRWPON OF OPERATORS ILOCATIONS/VEHICLES(ACORO 101,AadIMonal Remarks Sheduk,may be Mashed If mon space Ie required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF TM ABOVE DESCRIBED POLICIES BE CANCFI 1 FO BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Kevin Joyce/LMP ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014!01) The ACORD name and logo are registered marks of ACORD INSORS MUM, ItMassachusetts-Department of Public Safely URiestricted-Buildings of any use group which Board of Building Ragt1ladons and Standards I contain less than 35,000 cubic feet(991m)of Construction Srpenisor nieg= enclosed Soca License:CS-100_17/3ecrTTs eaq _ WESLEY COOT[Iwiei - 166NORffiM _ AMS • t SouthHedley M001 Villp - Failure to possess a ar,ent edition of the Massachusetts t-' 'r ss �rsu,va a` .'Mae Building Code Is Cause for revocatbn of this 8rense. 9. Commissioner Expiration Commissioner 09/29/2017 Far Des umuing intanwmn vide www.Mass.6ov/ovs 2.794 9 e W r • 10 /y I ,� , L l /440 4 ' 4 Office of Consumer Affairs and Busi- ss Reg-lation E lO Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Ciifrantor Registration =_ Registration: 175982 1 - T Type: LLC Ii' --i, Expiration: 6/27/2017 TO 265208 AMERICAN INSTALLATIONS, LLC. , 7,._. __,— w _ WESLEY COUTURE '_ =_-/ 130 COLLEGE STREET SUITE 100 �" / SOUTH HADLEY, MA 01075 _ --- b`' d vcc. ii Update Address and return tard.Mark reason for change. Scat 4 20M-05/11 -'-- 0 Address 0 Renewal 0 Employment 0 Lost Card Cee'nmomoee&h o/c'nyar/.ueef2 Office ofCousumer Attain&Business Regulation License or registration valid for individul use only ONE IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: >g75982 Type: Office of Consumer Affairs and Business Regulation ExpirMlon:_': IF0i3- LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 AMERICAN INSTAliKTION5S,#E'Kal-," ti f=. i3'. WESLEY COUTURE. rti 130 COLLEGE STREET' l7liE3ll�l ' r Ur/AT SOUTH HADLEY.MA 01075" Undersecretary N signature