39-041 (5) 23 ATWOOD DR SM-2019-0006
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
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1ti4n39'n: 041 _ SHEETMETAL PERMIT
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PertDit: --- SHEE'I'METAL :—
Category: SHEETMETAL
Permit# ISM-2019.0006 _-JI PERMISSIONISHEREBYGRANTEDTO.
jeer# ' IS-2017-001642
st.Cost: $85,000.00 Contractor: License: Expires:
ee Charged:�$50.00RK SOLUTIONS Sheetmetal-508 09/28/2018
Balance Due:j$.00 !Owner.- ATWOODDRIVELLC
IfFixnrzesrir i— Applicant RK SOLUTIONS
DigSafe# 'AT: 23 ATWOOD DR
seGroup
ISSUED ON.- 02-Aug-2018 AMENDED ON: EXPIRES ON.•
TO PERFORM THE FOLLOWING WORK.
FABRICATE&INSTALL SUPPLY,RETURN AND EXHAUST DUCT SYSTEM
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Dale Peid: Check N. Amaun6
Sheendw RE&2019-000362 31-Jul-18 5183 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)589-1272,Email:lhasbrouckga noAhamptonma.go
Ge.TMS®2018 Des Laurie,Municipal Solation,,I.e.
File#SM-2019-0006
APPLICANT/CONTACT PERSON RK SOLUTIONS
ADDRESS/PHONE P O BOX 262 (413)374-8500
PROPERTY LOCATION 23 ATWOOD DR
MAP 39 PARCEL 041 001 ZONE GB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
D REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: FABRICATE&INSTALL PP TURN AND EXHAUST DUCT SYSTEM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 508
3 sets of Plans/Plot Plan
THE FO LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION 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 Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
:rout from Elm Street Commission Permit DPW Storm Water Management
Sigt uil ung t ' Dat /
Note:Issuance of a Zo ' g 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.
RECEIVED Commonwealth of Massachusetts
JUL 3 1 2018 City Of Northampton
Date July 30, .2 18 Sheet Metal Permit Permit#
DEPT OF BUILDING INSPECTIONS
NOaT 85000 .00 Permit Fee: $ 50.00
Plans Submitted: YES_ NO Plans Reviewed: YES_ NO
Business License# 508 Applicant License# 5644
Business Information: Property Owner/Job Location Information:
Name:RK Solutions Name: Northwood Development, LLC
Street PO Box 262 Sttmt_,3� Atwood Drive
City/Town:Agawam Citylrown: Northampton
Telephone: 413-374-8500 Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES NO_
Smart iniad
J-1 /M-1-unrestricted 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_ Multi-family— Condo/Townhouses— Other_
Commercial: Office X Retail_ Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. X Number of Stories:3
Sheet metal work to be completed: New Work: X Renovation:
HVAC X Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents_ Air Balancing_
Provide detailed description of work to be done:
Fabricate and install supply, return and exhaust duct systems.
Fees with Building Permit:$25.00 Residential,$50.00 Commercial.Fees forjobs without a Building Permit$6.00 per$1000
Minimum fees forjobs without Building Permit$50.00 Residential,$100.00 Commercial
INSURANCE COVERAGE
I have a current Rslaigh lnsu sena policy or its equivalent which assets the requlrannenta of M.G.L Ch.112 VpQ No❑
N 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 licenses doeamLhm the Insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on We perms applkatlonmushowdit requirement
Cheek One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By eheeking this boxEI,l taaaby certify Nalae of the deedte and Infmmaeon 1 haw wbasttted("enured) "a Ing this application aro nue and
accurate te the bee of my knowledge and Nal as almost meed work and Installations pwbmwd under the permit Issued fortha application will be
In cer siffmcs with all perik em provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Dud Inspection required prior to insulation installation:VES_NO_
Daze comments
avw.t�T..
Daze Cmm ••,•_
Type of License:
BY lff�mk.
p
Tme 0 Master-ResMcted
CKYIT n Qloumeyperson (-
Signature of Licensee
pe-k#- ❑.Iouaseypersorl-Restricted
License Number: '5-6 tf
pea S
Check at www mal.g..v�/.InI
Inspector Signature of permit Approval
RKSOL-1 OF ID:BR
ACRO' CERTIFICATE OF LIABILITY INSURANCE - -o
713012018
TMS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON WE 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: N the cerfi icate holler Is an ADDITIONAL INSURED,the pollcypes) must be andomed. N SUBROGATION 15 WAIVED,subject to
the terms and conditions of the policy,canain policies may require an endomem urn. A slabmenl on this certificate does not confer lights to the
Certificate holder in lieu of such endomeme s.
PMWCEa John Ea an
"BellLxvi ne a Deady rxoNE Ax
Insumn.yppency,Inc. .413-532-3291 xo:4134348982
837 G..Slnat I PO Be.59 B oxBu:
ChicopBB MA 01021-0059 - ---
JohnAOlKeefe INSURERIII AFFOfM0m CONERME NAKB
l w A:Arbella Protection Ins.Co. - - 41380
INSURE. R K Solutions of WestannMass. INNINERx:
Keith A.David,Sr. - - - -
PO BOX 282 Iasuant o'
Agawam, MA 01001 weDRw o: _
INSURBi E:
INSURmf'
COVERAGES CERTIFICATE NUMBER: 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 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 PND CLAIMS,
N RTYPE OF INSURANCE POLICY NUMBER
LTR Mal Us"
A X cDMMERCLLLaexERALUAMIm EACH DOCURRENCE s 1,0_00,0
CIAIMSMACE .00CUR 1B 0//20/2919 D1129T1019 PREMISES(Ea c¢M,e,m $ 380.9
MEO ExP IWIYaIe MSWe S 5,00
X EPL,addlinsd,a PENSONALSAWIwu" f 1.000.00
GENLAOGREWTEUMITAPPUESFER GENERAL RGGREGATE $ 2.000,00
POUCY F�]— 1:1 LOC PRODUCTS WMPMPMG f 2,000.00
OTHER: f
AWOMceneUMUTY Eeema.Nl L f 1,000,00
A ANYAUTO 1020000884 W1912018 0811912019 eoolLYIwU,Wne ) $
ALL OWNED X MOHEDULED aODILT IWURY IPr wNmli f
_ AUTOS AUTOS _.._
X HIRED NITOS X ,UTOWSGWNEO PP IMMME f
f
X UMBRELIAUAB X OCCUR EMH OCCURRENCE f
A E,TEM cos CwM WIDE 040120MBIB 0412012019 MGREGATE f 1,000,
CED X RETENTIONS 10,000 f
WOR NERSCOrRPEIrSATNx1 STATUTE E_R
.D EMPLOYERS WBIUTY -
A ANYPROPRETORPMTNERIE%ECVTNE TOxIA 0050288 02120/2%8 02121112019 EL EACH AccloEw S 1,000,00
CfFICERaIEMBER.CLUCEm 1000 g0
I.Nory FxHl EL DISEASE-EAFAP.OYE $
Hn Mc,..
CESCRIPTIONOFOPEMTIONSbW E1.DMODIE-PMICYUMIT B 1,000,00
pESCRIPTIOX OF OPEAAlNNl81 LOCATONS/VEMKIES(ACORa l%.MMlmel Rwwb BtMUN.my M MYeHM Hmw�pew N,ep11M)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EWIRATION DATE THEREOF. NOTKE WILL BE DEUVERED IN
RK Solutions ACCORDANCE WITH THE POLICY PROVISIONS.
AUTINIR®REPROSENTOWE
John A O'Keefe
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