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38B-213 (3)
18 FAIRVIEW AVE BP-2018-0763 GIS# COMMONWEALTH OF MASSACHUSETTS Map:Block:38B-213 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildino DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category, INSULATION BUILDING PERMIT Permit# BP-2016-0763 Proiect# JS-2018-001402 Est CosP$2900.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sa.ft.L 4486.68 Owner: FOELSTER MARK zoning URB(100y AI. AMERICAN INSTALLATIONS LLC AT. 18 FAIRVIEW AVE Aoolicant Address: Phone: Insurance: 130 COLLEGE ST (4131552-0200 WC SOUTH HADLEYMA01075 ISSUED ON.L2312018 0:00.00 TO PERFORM THE FOLLOWING WORK:ATTIC AND BASEMENT INSULATIN AND AIR SEALING THROUGHOUT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: TINS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signatory: FeeType• Date Paid: Amount: Building 12320180:00:00 565.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner ,YW 23 r. Department use only ity of Northampton Status of Pelmet: ng Department Curb Cu"veway Permit. or i, ',"tyy s Main Street Sewer/SepftcAvsilablldy _. Room 100 Water/Weft Availability. Northampton, MA 01060 Two Sets of Structural Plans phone 413587-1240 Fax 413587-1272 PbUSde Plans Othee$peufy. APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISHyAONE OR TWO FAMILY DWELLING SECTION 1 •SITE INFORMATION 1.1 Properly Address: This secbe completed bys m Map 3f6 Lot a/ Lta 18 Fairview Avenue Northampton,MA 01060 Zone Ovatay DlstrIc Eta SLDIsIn 0301a41C SECTION 2•PROPERTY OWNERSHIP/AUTHORRED AGENT 2.1 Owner of Record: Mark Foelster 18 Fairview Avenue Northampton MA 01060 Name(Plan Cumint ma3lpAdOnk fel S1R73-1452 See attached Telephone -- Signature 22 Ndlnrized AaerG American Installations 130 College St., Ste 100 South Hadley,MA 01075 Nane(Pirint) Curant MebgAAhaas: American Installations kAjWj,,. k . (nom. 413-S2-0200 Signaeas Tol" tere SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only cermideted bv count arsokent 1. Building 2,900.00 (a)Building Permit Fee 2 EleeVtcal (b)Estimated Total Costar Construction tram 3. Plumbelg Building Permit Fee 4. Mechanical(HVAC) S.Fere Protection 6. Total= 1 +2+3+4+6 2900.00 Check Number Title Section FotOlik®1 Use Only Date euld'olg Permit Number: Issued: Signature: Z / Bridng Commbsiwlwanspector c&idiigs Date SECTION b DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Aheration]s) Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs g7] Decks [0 SidinglO] Othef[JA Briet Oesuiptlon of Proposed work: Attic and basement insulation and air sealing throughout Alteration ofeldeRrg beloorn_Ym_No Addle rex bedroom Yes No Attached Narrative Renovating unfinished basement Yes _No Plans Attached Rall -Sheet 6a.If New house and or addition to existing housing. complete the following: a. Use d bufldmg :One Family Two Family Olher b. Number of rooms in each family unit Number of Bathrooms Q Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of healing? Fireplaces or Woodsloves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction I. Is construction within 100 R 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 Budding arta Zoning regulations? Yes No. I. Septic Tank_ City Sewer_ Pdvatewell_ Ckywater Supply_ SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Mark Foelster as Owner ofthe subject Property herebysuthorize AmericanlnstaUhtioss to act on my beha8,In al matters relative in wank authorized by this building peril application. See attached signuWeof poen Date I, American Installations as OwnedAuthonzed Agent hereby declare that the sib and lnformetion on the foregoing application ane We and accurate,to the best of my knowledge and belief. Signed urderthe pains and paultles of perjury. American Installations Pahl lime American Installations 1/16/2018 SignakwofOorwafil4gatOei City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 18 Fairview Avenue Northampton MA 01060 The debris will be transported by: American Installations The debris will be received by: Waste Management of NE - Chicopee Landfill Building permit number: Name of Permit Applicant American Installations 1/16/2018 A)LZA&nABL n_P Date Signature of Permit Applicant iY_Sf_ l� www Am,xmnl.,m bku em ELPIZ B®B G—i • y�,�ne alnsuree MA CSLk1f5 ArtA recan Installations Ma ReRlsmmnaysM9u 1ao Wve seen wbzp0.5ouN wakr,w,osazs.aslb:lsU1 ssxaxoo re:::lonlssxaxm.[maY:wnp=repAmerbnlnamLanmr.mm Foelrtep Mark 12/5/2017 18Fairyiew Ave Northampton MA 0206D ... 1215)873-1452 ^ mark.faelster@lm,il.com 457963 17-3261 wa Quantity Unit Unit Cost m. Total AM SaalbE AIR SEALING 9 man hour $ SSW $ 765"0 WEATHERSTRIP DOOR 1 each $ s8.00 $ 58.00 Air Sealing $ 82340 Air Sealing Incentive $ (823.00) Air SelaingM Balance $ - weatMNatlan BASEMENT SILLS-R19 FG BATT 86 Aft $ 1.951 16770 CRAWI$PACE-EMIL GROUND COVER 248 sqk $ 0.77 $ 19096 ATTICDOOR-INSUUTE&WS 1 each $ 110.00 $ 110.00 ATTIC FIAT-B"OPEN R-30 CELWLOSE 432 sqf $ 1.44 $ 622.08 COMMON WAIL-4"CELLULOSE 38 Aft $ 1.85 $ 70.30 COMMON WALL-2'RIGID BOARD 38 AN $ 3.85 $ 146.30 ATTIC PUT-8"FLOORED 1-25 DENSE CEUUTASE 38 Alt $ 1.93 5 73.34 8'ROOF VENT 4 each $ 87.15 $ 348.60 VENT BATH FAN THRU ROOF 1 each $ 116.75 $ 118.75 VEMIIATION CHUTES 24 each $ 2.50 $ 60"0 ATTIC RAMMING-R-38 FIBERGIA$5 74 Aft $ 205 $ 151.70 Total Weatherization $ 2,059.73 WeatlyaH.tion Incentive $ 1,544.80 Total Reject $ 2,882.n Tobi WINy CanMbutlon $ 2,315).80 Tobi Olsxomer CantribWan $ 514.93 wnwwnrc. ,ni"a.rmw.,nc.Inwea�e,�n<am„aaan m,,.a..,.wu.zw..ewm,nmiow,�,.y. n.rtnrwommwmm.:n an mmrui�ena,m,mwkmmexmmwown.onm,rrwrm.wnn rr.w.,wmnlmam,wawmwaw nm w:amr wa:�A".rw lm.aa„LLm.,attv,m,ximcea n.re". rnx¢of PnaPasu:rlw.em.Pneey,Palreellons a�a TOTALCDNII A VALUE= $ 514.93 2,an,nom,y..e...iwmey.,aePaee.youam authorueemeowon,,.Peamee.PaymentwNbloc—prom Down Payment= $ 571.00 ❑ ,hmolwmF.,ne bkns eueupan fnmrMlon. Puo Balance Due Upon Completion= $ 343.93 A 12/5/2017 F.Mer,Mark Cameron Berube Cia. Pzerr✓r m 12/5/2017 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 wlvnrm ssgov/dia Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Aaolicant Information Please Print Legiblv Name(Banness/0,lamieatiorAndividoa): American Installations,LLC Address: 130 College Street,Suite 100 City/Stale/Zip: South Hadley,MA 01075 Phone M: 413-552-0200 Aro you an employer?Cheek the appropriate box. Type of project(rMaired): L© I am a employer with 46 _ 4. ❑ 1 am a general contractor and 1 6. ❑New conalru tion employees(full and/or pan-time)' have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.t 7. ❑Remodeling ship and have no employees These sub-contractors have 9. ❑ Demolition working for me in any capacity. workers'comp. insurance. 9, ❑ Building addition [No workeri comp. insurance 5. ❑ We are a corporation and its officers have exercised their ME] Electrical repairs or additions required.l of 1.❑ 1 am a homeowner doing all work right of uenption per MGL 11.❑ Plumbing repairs or additions myself [No workers'comp. e. 152,§I(4),and we have no 12.❑ Roofrepons insurance required. t employees. [No workers' 13 N Other Insulation comp. insurance required.] I - J "Any appliram oto ckcis boa at mea also all W,Ne ceuion below show:og mea worker mm -svion polity infomuion `I lnmeowsn van submit nu aadavii utl�almg IM1cy on doing all wart ab raw M1im punter c va YM mull submit a rcw al uliok iadia�ing such. `Cunlm[mrs rbm.bve Ihrs tans marl onocbM nn Wdiliona sbml sbuwing tae mine of IM wb<onlmvwrs aM rM1rir waken'amp.polity infumiulmn. 1 am an enpbver thin is providing wwkm*comyen den insumrme forms ealployem Below is the policy and job site information Insurance Company Name: Guard Insurance Companies Policy a or Self-im.Lie.M: AMWC731485 Expiration Date: 09/04/2018 Job She Address: (rlAG.t �IlQ.11trC. City/State/Zip: I IONdta r' m l,\ D1Q'pO Attach a eaPry of the workers'compensation policy declaration page(sowing the policy number and expiration dale). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a line up to S 1.500.00 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this slacment may be forwarded W The Office of Investigations ofthe DIA for insurance coverage venrication. 1 do hereby ceyp_W�yunder the pains annd penald"ofpedu y raw fie inforenmion provided above h true and correct Sian. � Afd"a. �_ ( _ Dale: Phone k: 413-552'/0200 Oficial use only. Do not write in this area,in be coa idated by city or town oJfrcial Cit).,T ..: Permit/License k Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk A. Electrical Inspector 5. Plumbing Iaspecmr 6.Other Contact Person: Phoned: I Commonwealth of Massachusetts Construction Supervisor Division of Professional Ltensure Unrestricted!.Buildings of any use group viich cordain Board of Building Regulations aha Standards less then 86,000 Cubic(W(991 cubic meters)of enclosed Constriction Supervisor space. CS-106178 Expires:091292019 NIESLEY COUTORE 216 LATHROPSIZEr SOUTH RAOLLI'MA 01076 Pate Building possess a s curientause edition of me Massacnueeutts rse Stale BuiMinF Code is cause for finis tic n of this license. Q � For 7277200 or about Uis license Commissioner «s.� Call(6t])]2]3200 or visR www.mass.govldpl s;: Office of Consumer Affairs and Business Regulation r - 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type' LLC Registration: 175982 AMERICAN INSTALLATIONS,LLC. Exotration: OW26=19 130 COLLEGE STREET SURE 1D SOUTH HADLEY.MA 01075 Update Moran,and renrn Card. Mark reeann for Charge. MAI o za+os'n ^_ Add,— [I R-ane 11 FTN Oynnent I,]L gst C.rd gnHOMEIMPROVEMENT MPROMsnfi Bu4nep R7t011 on 1i ROME IMPROVEM :U CONTRAC]OR before tin expintl for Inddani duM found ret y TYPE:LLC betore thC.nusi atian flair a fornd return to: Reoktrenon ES91fB11911 Office Of Consumer Affairs arid Business Regula[Ion 1]5982 082&2019 10 Park Plaza-Buse 5170 AMERICAN INSTALLATIONS,LLC. Boefon,lAA 02116 WESLEY COUTURE �2c� 13oCOLLEGE STREET SUITE 100 J [valid wiNolrt signature SOUTH HADLEY.MA 01075 �, 9 ACO-R& MT/14/2017 Ll CERTIFICATE OF LIABILITY INSURANCE Bila/zo1T 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(SL AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcyp")must be endorsed. If SUBROGATION IS WAIVED,Subject to the roams and conditions of the policy,certain policies may require an eMorsemant. A stato nant on this certl8esle Gess not corder rights to the carti ic,me holder in lieu of such endomement(s). PaODULEa A Linda Poeera Hebber 6 Grinnell reoNE (413)586-0111INC 141315a6-Nn was AFFOIaftO GOVER.LOE WC0 Northampton ML 01060 s.a.aAmoplellpars Mutual Caanalt IxMmFO wsuaiatii rkmhirm Bathaea C21111m Ifre. Co. American Installations, LLC INSURERC: Attn: Nes S Suzanne Coatura Ix9URER 0: 130 College Street, Soite 100 Ixsumn E: Scuth Badley MIL 03075 INswER P: COVERAGES CERTIPICATENUMBERMaster 23SP 9-2018 REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE-TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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 CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. M YEFF UP Mia IYPEOFINSUMIICE POLCY NUMBER COMIE.Gesell ULeam Eµl1pCCURRENLE f 110001000 A i CAIM9M1 [-1 OCCUR R I f 500,000 W3535217 9/4/2017 9/4/2018 MEO E}➢INac,ep,Mnl L 10,000 PERE LLAOVINJUW 5 11000,000 C£NLAOWIEMTEgUMpTAFPIFA fFIt GENERAL AGCAEGATE f 2,000,000 i pOUGY❑,ID:A ❑AOL Pro000Ta-0]NPCPAW f 2.000.000 $ O ER: NIIOYOaaE gym, YI L 11000,000 ANY AUTO 80CILY INJUry(Pa PYL:NII t A NL ONNEO SLIFgAEO ASW i �0S Si353521T 9/4/2017 9/4/2018 a001LY I11X.RY ry.LaOMe L i RIRE0AUr08 i Auras 8,000 Z OMaR64 ULa 0«pR AGGEACH 3 1 000 000 A FSE9g yp8 CWMSMME REWTEOCCUmiExLE S 1 Opo Opo Z 10,001 Sa353521T 9/4/2017 9/4/2019 f shass"O CpIBryATCN i SND FWLOYEw iNa11Y YIN XY fPOR�lg9RARauERE7ENOYE ❑MIA ELOSEASECB EI 5 500 000 OfTCBll1@IEa FSLUCEOt OmICL09911 9/4/2017 tni. EL MSFAY.EA EM%QVE f 500 000 AE.I BSlSE PttICY OMIT f 500 000 A (' [ai43 Pzapazlg 5X3838211 9/4/41117 ea.?Y11Mn peSL7aF110N OF OPEAAl1U491LCCAlBN81 VFNClE3(AGGRO 1%.PEm'onn Renu,Y 8[eeEul4 mry W eb[MY M mort yub,lllmMl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EV1deROe Of Ina-rance THE EXpRUTON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REMESEMArr E Kevin Soyce/LNP ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD reme and logo are registered masks of ACORD INS025,mvnn