23D-149 (9) 123 -125 HINCKLEY ST - BLD 3 SM-2017-0053
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
GIS#. 3305 "'"°*
Map 23D
Block: 49 2SHEETMETAL PERMIT
Lot: 001 -
Permit SHEETMETAL
mrv..=--e
_._ cw_
Category: SHEETMETAL
Fermin# SM-2017-0053 PERMISSION IS HEREBY GRANTED TO:
Project# IS-2017-000749
Contractor: License:
Est Cost: $4,000.00 Expires:
Fee Charged:$50.00 ALL SEASONS HEATING AIR Sheetmetal- 129
Balance Due:$.00 Owner: FRIEDDMAN THOMAS
#of Fixtures: Applicant ALL SEASONS HEATING AIR
DigSafe# AT: 123 -125 HINCKLEY ST-BLD 3
UseGroup
ConstClass
ISSUED ON: 20-Apr-2017 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
INSTALLATION OF DUCTED ERV-KITCHEN HOOD EXHAUST-DRYER EXHAUST
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Shectmetal REC-2017-005601 I8-Apr-17 2174 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Emailahasbrouckgnorthamptonma.gov
Geol MS4 2017 Des burners Municipal Solutions,Inc.
File#SM-2017-0053
APPLICANT/CONTACT PERSON ALL SEASONS HEATING AIR
ADDRESS/PHONE 93 ELM ST (413)247-9842
PROPERTY LOCATION 123 -125 HINCKLEY ST-BLD 3
MAP 23D PARCEL 149 001 ZONE URB(IQ,QE
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: INSTALLATION OF DUCTED ERV-KITCHEN HOOD EXHAUST-DRYER
EXHAIST
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner!Statement or License 129
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
pproved 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 r Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
I.. •t -et Commissi•nAge
Permit DPW Storm Water ManagementSign. - • i n din. Offd+. 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 the Office of
Planning& Development for more information.
1 1 Commonwealth of Massachusetts
r6' 7 ` City Of Northampton
Date: t\ \a-17 Sheet Metal Permit Permit#4917 -/7- 6 3
co
Estimated Job Cost: $ H o
Op . Ps. cA+siO Permit Fee: $ $O,,
Plans Submitted: YES NO X Plans Reviewed: YES NO
Business License# Applicant License # \aq
Business Information: Property Owner/Job Location Information:
Name: A\\ basoms \F aHtc Name: iltt;Ac5 g,`41v‘W2-WS-
Street: CAS EV-' Sfrnf Street:\ 3-\}c \-V \a 51 }
City/Town: \\ \I MA City/Town: Ps-tack,
Telephone: M -a97-q%9 Telephone: 4i3-Sgt.- %a%?
Photo I.D. required/Copy of Photo I.D. attached: YES NO
Staff Initial
J-1 nrestricted 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. )C over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC X Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed1description of
workTto be done:e (� 1
c A\` k O V C .Yo Stott Fav — 16‘4,434...; Arsoe2 1 bST-
Th 9C Evbn4t S�
Fees with Building Permit: $25.00 Residential, $50.00 Commercial.Fees for jobs without a Building Permit$6.00 per$1000
Minimum fees for jobs without Building Permit$50.00 Residential, $100.00 Commercial
INSURANCE COVERAGE: ,,,,,,tt
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes No❑
If you have checked Yea,Indicate the type of coverage by checking the appropriate box below:
A liability insurance policy Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee drn.not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit applicationtealvesthis requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box❑,I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and Installations performed under the permit Issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation: YES NO
prngrrcc Intpretinn%
ante Comments
FinaIlncprrenu
]late Comments
Type of License: �1
By 0 Master / f �
Title 0 Master-Restricted O-L�-/'///
City/Town ❑Journeyperson
Signature of Licensee
Permit#
❑Joumeyperson-Restricted `an.
License Number: l
Fee$ S
Check at Www nn‘‘Priv/dig
Inspector Signature of Permit Approval
ACO 0 CERTIFICATE OF LIABILITY INSURANCE f DATE
4/18/201]0
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 not confer rights to the
certificate holder in lieu Of such endorsement(s).
PRODUCER etan_CT Christina Barrett
Aguadro 6 Associates ..Px�E . (413)586-1373 :(FA
AIc No{a101 sea-assn
355 Bridge St. , P. 0. Box 357 EMAR*ss:a _ 1--
INSURER(S)
IRSURERISI AFFORDING COVERAGE NAC Y
Northampton NA 01061 _ INsuRERA:Travelers Indemnity Co of Amer 125666
INSURED INsuRERa national Grange Mutual Insurance : 14788
All Seasons Heating 6 Air Conditioning Inc. INSURER c:
93 Elm St INSURER 0:
INSURER E: i_ _ _—
Hatfield MA 01038 $NSURERF:
COVERAGES CERTIFICATE NUMBERCL1S81007832 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 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.IgLMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TLTA ...TYPE OF INSURANCE rIwan WVI D POLICT NUMBER. IPMYUOO�Y) IPMWDO )' Dens -. --�
,% COMMERCIAL GENERAL UABRUTY ( EEEAACH OCCURRENCE $ 1,000,000
A ('IAIMS-MADE X OCCUR ESE 0(Ea UPaC$ylrereal $ _300,000
I
I+REMIBE$
6e01c505649 7/10/2016
7/10/2017 MED E% {Any OMP Son) $ 5,000
PERSONAL SADV INJURY 1$ 1,000,000
_GEN L AGGREGATE LIMIT ADPL IE5 PER---- ' GENERAL AGGREGATE 1$ 2,000,000
'% Fatty .J CdT LCC PRODUCTS COMPOP AC$ 2,000,000
OTHER 1 JAIO I$
AUTOMOBILE LIABILITY 'COMBINED SINGLE LIMIT ''5 5,000,000
(E OehlI
_.
B _ANY AUTO --. BODILY INJURY(Pumrson) $
ALL OWNEOSCHEDULED --_
AUTOS 'C AUTOS : 1.11265293 7/10/2916 1/10/2019 &i0 JVNY(Mr ameeml $
X ED 'PROPERTY DAAMM
_HIREI AUTOS X AU1OS AUTOS (PmUffloent) $
i t EPWS $
1 UMBRELLA LIABI
OCCUR EACH OCCURRENCE i
EXCESS UAB 1 CLAIMS-MADE [ AGGREGATE $ _-- -- _-
0-ED j RETENTIONS :E
hOWORKERSMYER LI A LIABILITY
STATUTE _ERR µ
ANY EMPLOYERS' _. _...._.
PERJMEMSER/EXCLUDEExEf.UTIVE EL EACH AC('AOEM $ 1 000,000
E MEnNEXCL En? yip,
NIA
H Mandatory NH) Na6S2A4 1/10/'3016 ]/30/20ll E.L DISEASE-EA EMPLOYEE$ 1,000,000
DESCRIPTION OF OPERATIONS belays � ' .EL DISEASE-POLICY LIMIT $ 1.000,000
1
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Ramada Wade.may he a taatel Samna space 4 required)
CERTIFICATE HOLDER CANCELLATION
KCARSON@NORTHANPTONMA.GOV
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE CITY OF NORTHAMPTON THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
212 MAIN ST ACCORDANCE WITH THE POLICY PROVISIONS.
NORTHAMPTON, MA 01060 .
AUTI4ORiZEO REPRESENTATME
C Sullivan/CMSCa.niaM4L- H. STLtF1,4,' . ,-
C 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
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