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18-007 (12) 216 NORTH KING ST SM-2020-0023 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON GIS#: 8894 Map: 18 Block: 007 Lot: o01 - S H E E T M E TA L PERMIT Lot: , Permit: SHEETMETAL �" Category: Zoning Permit Permit# SM-2020-0023 PERMISSION IS HEREBY GRANTED TO: ..Project# JS-2020-000637 Est.Cost: $44,350.00 Contractor: License: Expires: Fee Charged:$50.00 M &E MECHANICAL CONTRACTSheetmetal-25311 01/28/2020 Balance Due:$.00 Owner: RANDALL GERALD F #of Fixtures:, Applicant: M& E MECHANICAL CONTRACTORS INC DigSafe# AT: 216 NORTH KING ST UseGroup ConstClass ISSUED ON: 10-Jan-2020 AMENDED ON: EXPIRES ON.- TO N:TO PERFORM THE FOLLOWING WORK: INSTALL DUCT DISTRIBUTION 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: Sheetmetal REC-2020-002230 10-Jan-20 7787 $50.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbroucknnorthamptonma.gov GeoTMS®2020 Des Lauriers Municipal Solutions,Inc. C r-*7 797 Commonwealth of Massachusetts City , � hampton Date: 1-I ZO Sheet Me It 'permit# U l JAN 0 Estimated Job Cost: $ y 5m �0 1g Permit Fee: $ E5 0 Plans Submitted: YES NO Pla s Reviewed: YES NO N, F �4�'%Ivs Business License# -a License # 2-15111 Business Information: Property Owner/Job Location Information: Name: L1�f_ KeCAs `tc,a,..\ Name: Li�L f v5e r (— Street: ` \�P_A rc. Street: 'Z1101- City/Town:7f�R a, tkPt City/Town: Telephone: 413-7%\-d0J Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO Staff Initial 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 Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft. 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 detailed description of work to be done: 1nsb:.,\k Ouc.+ '7. istr*,bu+kan ZnM (1) 1 iur- ke>.ri i v ton D'1S?erNnCA \f , 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, $100.00 Commercial INSURANCE COVERAGE: I have a current W-LbIL4 insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes❑ No ❑ i If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy 5k Other type of indemnity ❑ Bond ❑ OWNER'S INSUWkNCE WAIVER: I am aware that the licensee rinesnnt haves the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waive this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this boxI hereby certify that all of the details and information I have submitted (or entered)regarding this application are true and accurate to the best f my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Prn�1UrpeCt*0n-. Dat.0 C Final inc,�rtj,pu Date ( wnments Type of License: By §kMaster e� Title ❑ IMaster-Restricted City/Town ❑Journeyperson Signature of Licensee:; Permit# ❑Jou rneyperson-Restricted License Number: Fee$ ❑ Chuck at- mass g v/Tnl LolLi T'AL-md 0 IV 1C)/ao Inspector Signature of Permit Approval AME MECHANICAL CONTRACTORS INC. EAL.TH OF COMMONW MASSACHUSOF �$ SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE MASTER-UNRESTRICTED MICHAEL M EDWARDS 19 LONGVIEW DRIVEf SUFFIELD, CT 06078 W ' V 25311 � 01/28/2021 636404 C AJ+SETTS ,. DRIVER'S :. rte,. LICENSE , � " Ea' S NONE S4585802 Gi9B xn ocv mn t As s;=s dMPA98 si 'MICHAEL MATTHEW 49 APRICOT HILL RD W SPRINGFIELD,MA 01089.4481 DD O L 08 7075 Rev C7,iSA)^y 1 Allen Street • Springfield, MA01108 I T: (413) 781-0014 • F: (413) 781-0016 www.mandemechanical.com AME MECHANICAL CONTRACTORS INC. Sheet Metal Buisness License COMMONWEALTH ----------- _QF MASSACHUSETTS BOARD OF SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE ` BUSINESS MARK S EDWARDS M&E MECHANICAL CONTRACTORS INC 1 ALLEN STREET SPRINGFIELD, MA 01108 ° 323 04/07/2021 604522 1 Allen Street-Springfield, MA 01108 T: (413)781-0014 • F: (413) 781-0016 I AC:" CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDIYYYY) �. 10/02/2019 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 have ADDITIONAL INSURED provisions or 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 dots not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME CT David R Jerry Neill&Neill Insurance Agency Inc 662 Riverdale Street PHONE Ext,, 413-732-4137 a No): 413 731-6629 West Springfield, MA 01089 E-MAIL dj@neillandneill.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# ----___.INSURER A: SAFETY INSURANCE COMPANY 39454 INSURED M&E Mechanical Contractors INSURERS: Safety Ind Ins Co 33618 1 Allen Street Technology Springfield, MA 01108 INSURER C: Insurance Co 42376 INSURER 0: INSURER E: INSURER F: 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 PAID CLAIMS. INSR I TYPE OF INSURANCE ADDL SUBR —POLICY EFF POLICY EXP L POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY BMA0009180 08/31/2019 08/31/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE IVOCCUR DAMAGE TO RENTE PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JERCOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 1710518 04/21/2019 04/21/2020 —COMBINED SINGLE LIMIT $ 1,000,000 Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per cId $ S A UMBRELLA LIAB OCCUR CM00006018 10/31/2019 10/31/2020 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION WWC3374339 10/04/2019 10/04/2020 AND EMPLOYERS'LIABILITY YIN N STATUTE FRH ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? = N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE A13OVE DESCRIBED POLICIES BE CANCELLED BEFORE Mike Edwards THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 Allen Street ACCORDANCE WITH T =POLICY PROVISIONS, Springfield,MA 01108 AUTHORIZED REPRESENTA IVE a t ©1988-2015 ACORD CORFAOMATIGN. 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