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12C-012 (7) 97 MOUNTAIN ST BP-2020-0952 GIs#: COMMONWEALTH OF MASSACHUSETTS MV.-Block: 12C-012 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BASEMENT RENOVATION BUILDING PERMIT Permit# BP-2020-0952 Proiect# JS-2020-001623 Est.Cost: $60612.00 Fee: $397.00 PERMISSION IS HEREBY GRANTED TO.- Const. O.Const.Class: Contractor: License: Use Group: PETE MONAGHAN 047809 Lot Size(sq.ft.): 25787.52 Owner. BIENKOWSKI PETE Zoning: RI(100)/URA(100)/WSP(100Applicant: PETE MONAGHAN AT. 97 MOUNTAIN ST Applicant Address: Phone: Insurance: 60 SHAWMUT RD (781) 801-0744 WC CANTONMA02021 ISSUED ON:2/24/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-BASEMENT RENO ADD BATH 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: hough: 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 2/24/20200:00:00 $397.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner I Department use only City of Northampton Status of Permit: �.. Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Spe ify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address 1This section to be completed by office Map lot Lot 6 1C4- Unit 2/•( �a11,,,, �. .,4 Zone Overlay District Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: \ fZz�'2 3 c • �1av �ti �� Name(Print) Current Mailing ddres Signature Telephone e-11 2.2 Authorized Agent: /r dn�t''"S `ev?.vI—T ` �r Current Mailing Address: r" 0/ I gc J e y'` Signature Telephone SECTION 3- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by permit applicant 1. Building (a) Building Permit FeeI 3q7 — yG 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing h� Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =0 +2+3+4+ 5) c'' Z Check Number (� This Section For Official Use Only Building Permit Number: �j �0 ! 5�� Date Issued: Signature: 2- zy'zzo Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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 Frontage Setbacks Front Side L: R: L: R; Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW Q YES 0 IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO 0 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 ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors ID Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding [O] Other[O] Brief Description of Proposed Work: el,eki �6J4�2 c e.« s /j•�T4 1..� r Sr ck Alteration of existing bedroom Yes�,_No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. if New house and or addition to existing housing,complete the following: a. Use of building : One Family A Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. 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 Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, /r / �� as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, c �G� "T `- �� V � ��'` as Own �AuthorizeldAgent hereby declare that the s tements and information on the foregoing application are true and accurate, to the best oge and belief. Sign dun the pains and penalties of perjury. Pri t N e Signature ofb4uer/ARepe Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construct' ervisor: Not Applicable Name of License Holder: /�l�y r/fi'J el���9 751 License Number yet Expiration Date Signatu Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Gvk_ I L� SWI/ 7vN� �/J�7sS �G2rt , 'tj'w/�t{ l3'?—F93 Company Name Registration Number &� cpr#wr'-r vi 2 -a�, 2I Address Expiration Date rax/ /VJ4E ®ZdZ/ Telephone �' SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.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 permit. Signed Affidavit Attached Yes....... Ml-' No...... ❑ 1 City of Northampton r� Massachusetts �i'' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 j 1 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation,repair, modernization, conversion, improvement,removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered. Type of Work: t:ZCr �z` ��7 Est. Cost: fid' l Address of Work: avr Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent owner: 2-71-?e 6,K Qe-VoV4-116­� 1164 F.,Xt'3 y3 Date Contract6r Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature • l , - City of Northampton s /r Massachusetts ; DEPARTWNT OF BUILDING INSPECTIONS " 212 Main Street • Municipal Building Northampton, MA 01060 °° 1J Massachusetts Residential Building Code Section 110.R5.1.2 Homeowner: Person (s) who own a parcel of land on which he/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 farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work, then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official, that he/she 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 Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. JI City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building Northampton, MA 01060 ,✓���� Debris 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. The debris from construction work being performed at: (Please print house number and street name) Is to be disposed of at: rkp �vw�S7��S /yam, 4L),S7E M (Plea4e print name and location facility) Or will be disposed of in a dumpster onsite rented or leased from: mpany Name and Address) Signa ermit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts Department of Industrial Accidents a I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information n Please Print Leizibl Name(Business/Organization/Individual): c x � �,vvz'�•� ,Oz✓z9-✓S �.ft r•�.—� Address: �o ,yrs .moi ay, 0 City/State/Zip: <?40-4.v M A- 0202/ Phone#: Ms Are you an employer?Check the appropriate box: Type of project(required): I. am a employer with 2—U employees(full and/or part-time).* 7. []New construction ❑I am a sole proprietor or partnership and have no employees working for me in 8. [34kfffiodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]r 10 E] Building addition 4❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12.F-]Plumbing repairs or additions 5.r7 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Liic.#: 14 , Expiration Date: S, L �2 el- 2® Job Site Address: City/State/Zip: IC��r�►c�1�'��-�'�t w"� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covera ).cation. I dor ��ains�andpenaltze s�fe 'ury that the in ormation provided above is true and correct: Si nature: G (�C _l/ Date: Phone#: ' �01 'd wel Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia File No. IF-- ZONING PERMIT APPLICATION of o.2) Please type or print all information and return this form to the Building Inspector's Office with the X30 ftling fee (check or money order)payable to the City of Northampton �— /yff�rr 1,.4s✓ �Zr Qrc�c� �c✓2.�.J� 1. Name of Applicant: c ��%T/o�^✓S Address: (;5e S/4 ,4f`ii � Telephone: 2. Owner of Property: ��-YZ Address: 4?7 W041104 44"-) A2 > Telephone: y/3 -5-3 S- 3. Status of Applicant: ii Owners 1ff Contract Purchaser Lessee Other (explain) 4. Job Location: / T /yloG ^' /?>--3 Parcel Id: Zoning Map# Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): e sf '3474/?. S&gob s7z-eZSTL�S /,&"'d.l. ��✓�nr-�j l�eiz. -s �iu6, /is+✓�s w.w«s -�q Li' l 4�S�t�•P CeO 6'9" 11-te 7. Attached Plans: Sketch Plan ✓ Site Plan Engineered/Surveyed Plans 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO L'� DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document# 9.Does the site contain a brook, body of water or wetlands? NO 1--' DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained date issued: (Form Continues On Other Side) W:\Documents\FORMS\otiginal\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004 10. Do any signs exist on the property? YES NO IF YES, describe size, type and location: Are there any proposed changes to or additions of signs intended for the property? YES NO IF YES, describe size, type and location: 11. Will the construction activity disturb (clearing, grading, excavation, or filling) ov 1 acre or is it part of a common plan of development that will disturb over 1 acre? YES NO l7 )L � 6,-/C,2k IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION This column reserved for use by the Building Department EXISTING PROPOSED REQUIRED BY ZONING Lot Size Frontage Setbacks Front Side L: R: L: R: L: R: Rear Building Height Building Square Footage %Open Space: (lot area minus building Et paved parking #of Parking Spaces #of Loading Docks Fill: (volume Et location) 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: 2 -2L/- ZG Applicant's Signature NOTE:Issuance of a zoning permit does not relieve an applicant's burden to comply H-ith all zoning requirements and obtain all required permits from the Board of Health,Conservation Commission, Historic and Architectural Boards,Department of Public Works and other applicable permit granting authorities. W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004 CONTRACT Customer Name �1�iL Customer signature r . SKETCH Contract Date 451 Zo Sates Representative i'nature ATTACHMENT Customer Phone 913 5724- -2-6 1 � Contract Price .4 ( h • 7 • • 10 11 ., .],_.H IS 10:../, U ,Y 20 21 2 n N 25 2• A H >s >0 71 ,• P ,. ,o a n 9 U M a a Q a a ,C 51 „ b M ,• 91 A w ]. JA I �' 1_. �.. _ _.__�.._. i 1_. Bienkowski,Pete 1 r 97 Mountain St Northampton,MA 01062 (413)575-2845 { J 02 } fff/// 13 } a 00, - — - - -- —; - 6` t"- t� { 1 - _. _. j,• I � { 41 i f ._ 27 77V-7 21 30 1 31 33 b ' W IWO NOTES: 'P,AnQ. VaMc n .� irk. .va CS i`rSu 4P-rT I7 u iL— 11�WdwaloodVwA Ofth la9Anbm -,,ti 5 Q b> e.'l An) 1. d,Q &Y�ht rr/ 111.9 la e-_ Il�t ri dnMnMoir aN Io��Ya�s d ourMs,� \�h \% II'M°Mwy 00 Owens Corning Basement Finishing Systems of New England Bienkowski' Peter 97 Mountain St Contractor / Agent Authorization Fro Northampton, MA 01062 (413)575-2845 I, a orize Owens Corning Basement Finishing Systems of Boston to sign the building permit application my behalf,to perform the work at: Home Owners Signature: 'Z ' Date: a1 AU Project Manager Signature: `f Date: 60 Shawmut Road 9 Canton, MA 02021 9 Phone: 781-821-0060 • Fax: 781-821-8552 9 www.ocbostoncom BASEMENT INTERIOR & EXTERIOR WALL PANEL FINTSHING SYSTEM SUBMITTAL SHEET DESCRIPTION The Owers Comings Basernertt Finishing System'Un:trnrted(the system)is comprised of fightwreight fiber glass panels.PVC lineals (%+w: replace caw-tonal framir�i and foamed PVC trin moldings(which replace U'lim kimber).Trm components snap into the lineals, mating moldings and wall panels removable for access to a home's foundation walls and for adding additional wiring.Because traditional wood and paper-based building materials are replaced with fiber glass and PVC materials,the Basement Finishing System'Unlimited offers }N inherent resistance to mold and mildew*The ` system is covered by a lifetime limited war- ranty"covering man rfactunng defects x USES The Owens Coming®Basement Finishing System'Urdimited is an innovative system w designed to insulate and finish basement walls. h insulates,acoustically treats,and aesthetically a � - ..; -.�_ -•_-..-moi, finishes walls in a few simple steps.The sys- tem can be installed over exterior stud walls and interior partition walls built with either - wood or metal studs Panels can be painted to appeal to the homeowner's preference. AVAILABILITY ' w Trim Molding_ The panels are lightweight,fiberglass board PHYSICAL PROPERTIES laminated(using a water-based glue)with a Property Test Method Value specially formulated glass mat Edges are pro For Fiber Glass Board: tected with a resin hardener for durability Thermal Resistance ASTM C 518 R-4.16 94"x 48"x's/_'Wall Panels 1"Wall Lineals WaterVapor Sorption ASTM C 1 104 <2%by wt Q 120NF, Trim Molding 95%RH Cove Molding Compressive Strength ASTM C 165 min. D6cor Base Molding @10%deformation 25 psf Decor Crown Molding @25%deformation 90 psf Ca—g Normal Density ASTM C 303 7.0 PCF (AI trim componerns are available in white. For Fialshed Panel cherry or wood-grain in various profiles) Code Compliance: Nose Reduction Coefficient ASTM C 423 0.80 ICC-ES Evaluation Report No,ESR-1872 at (one coat of primer&one coat of paint) Type A Mount www.icc-es.org. Surface Burning Characteristics ASTM E 84+ Class A Flame Spread <25 mMeets Class A Bum Rating Smoke Developed<450 a e the` °�andwe*stern—dew tithe Owa>s�® Interior-Textile Finish Fire Classification NFPA-286 Meets Acceptance 88---h istn—Lk*rveed resist old and mldew the Systern—not pr--A or ni igne mold dthe Criteria condibons basernemneorury fcr add Famh od ewe e>mt"tO11 Mold Resistance ASTM C 1338 Pass "See acrd waTarty for ictal 4n tatiorx and restrictions ASTM G 21 Pass NowThe Basement Fnshng System—Unnraed Panel may +The surface-t-9 characteristics of the fin shed composite panel were detem>ined in accordance with ASTM E 84.This be rMilled aer wood 6'ame pwbon of wars dwags are --d—d...——d ri,e Prop—tics of materials,products or assemblies in response to heat and flame under tnwlateo to local code requirements including vapor barrier 1 SP-Diis mist{rmy be hist"t ac�I controlled laboratory conditions Data from ASTM E 84 testing cannot be used to describe a asses:the ere hazard or ere Constructed libuldabon wars or ote for wood or metal stud risk of materials,products or assemblies when considering all of the factors pertinent to an assessment of the fire hazard of co ed vQk a pwbcUw end use—Values are reported to the nearest 5 rating. FLOOR JOISTS 2'GYPSUM APPLIED UNDER JOISTS FROM SILL PLATE, ROCK WOOL BEYOND NEW FRAME FOR FIRE STOP ABOVE CEILING FIRESTOP SUSPENDED CEILING NOTE:PT 2 X 4 BEHIND STEEL STUDS EVERY 8'-0"FOR VERTICAL FIRE STOP CONCRETE R-15 BATT INSULATION BETWEEN STUDS. W COVERED W/OWENS CORNING PANEL=R-4 TOTAL R-19+ 0.¢1 O w STEEL STUDS/TOP&BOTTOM PLATES ARE STEEL STUDS/TOP&BOTTOM PLATES ARE STEEL 3$"PLACED ON CENTERS STEEL 3$"PLACED ON CENTERS w 1$"SPACE BETWEEN CONCRETE &STEEL SUDS TYPICAL FRAMING FOR BASEMENT SCALE:N.T.S DATE:12/12/19 DWG BY: GM SCALE:AS NOTED SHEET Rev Border is 24"X36" 0171 1 0 J/ e Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Ma�chusetts 02118 Home Improvem —C, tractor Registration Type: Supplement Card LUX RENOVATIONS,LLC. Registration: 137943 D/B/A OWENS CORNING BASEMENT FINISH I = Expiration: 02/04/2021 60 SHAWMUT RD CANTON,MA 02021 _,- SCA 1 b 20M-05/17 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:�SUoolement Card before the expiration date. If found return to: Reaistrat„®n 02/04/2021 Office of Consumer Affairs and Business Regulation _ 100 s ton Street-Suite 710 LUX RENOVATIOR Ston,M 02118 f. - DB/A OWENS C. N.... EMENT FINISHING SYSTEMS PETE MONAGHAN 60 SHAWMUT RD`t;; ;,., CANTON,MA 0202 `✓' Undersecretary Not valid Without Signature '.. GSTATE OF RHODEISLAND Commonwealth of Massachusetts �_-`� tIXIT�JJJ 4 RATIONDivision of Professional Licensure Board of Building Regulations and Standards AND LICENSING BOARD �! Constructio �@ 1 & 2 Family ,. ..,. N, REGISTRATIONCSFA-047809 N pires: 07/2212021 I PETER M MCPdA x r 136 RIDGE SE MILLIS MA 02A64 REPRESENTATIVE )� �0 •' 6Mn7SSg a0 DRIVERS , Commissioner HOME IMPRpNT CONTRACTOR ® BASEMENT 'i1iGSiT FINISHING SYSTEM' LU t 2�OVA ION__TLC 69 , C 410 i PETER MONAGHAN PROJECT MANAGER { Registration ccti Expiration 60 Shawmut road HIC.06 QUI /0 �t 11/30/2020 ®LU� canton,ma 02021 RANSTU mobile:781-801-0744 tSIGNED */ �!r RENOVATIONS, LLC e-mail:pmonaghan@ocboston.com LUXRENO-01 SCOOTS CERTIFICATE OF LIABILITY INSURANCE DAT9/3/2 D/YYYY) 9/3/2019 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 pol)cy(les)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 does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER C CT Stephanie Coots Gordon Atlantic Insurance PHONE FAX 306 Washington Street AIC,No,Ext): 781 659-2262 204 A/c,No; 781 659-4725 Norwell,MA 02061 .stephanie@gordonatianticinsurance.com INSURE S AFFORDING COVERAGE NAIC M INSURER A:American Fire and Casualty 24066 INSURED INSURER B:Safety Indemnity Insurance Company 33618 'Lux Renovations,LLC Dba Owens Corning Of New England INSURER c:The Ohio Casualty Insurance Company 24074 60 Shawmut Road INSURER D: Canton,MA 02021 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. ILTR NSR ADDLSTYPE OF INSURANCE J=A na POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADEa OCCUR BlCA57350449 9/512019 9/5/2020 DAMAGE TO RENTED 100,000 MED EXP(Any one arson $ 15,000 PERSONAL&ADV INJURY 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY D jr(Ff E]LOC PRODUCTS-COMP/OPAGG 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Eli IgGil,"t)ANY AUTO 5902260 4/4/2019 4/4/2020 BODILY INJURY Perperson) � UTOS ONLY X AUTOSULED REQ o �pyy� p BODILY INJURY(Per accident) X AUTOS ONLY X AUTOS ONJY P�Oa.ERTYt AMAGE $ C X UMBRELLA UAB X OCCUR EACH OCCURRENCE 1,000,000 EXCESS LIAB CLAIMS-MADE USO57350449 9/5/2019 915/2020 AGGREGATE $ 1,000,000 DED I X I RETENTIONS 10,000 C WORKERS COMPENSATION SPTEARTUTF OTH- ANDEMPLOYERS LlA&LITY X ANY PROPRIETORIPARTNER/EXECUTIVE ER Y/N XWO57350"9 5/24/2019 5/24/2020 1,000,000 �AFFICER/MEMgW)EXCLUDE09 �Y N/A E.L.EACH ACCIDENT 1,000,000 yyandatory In NH) E.L.DISEASE-EA EMPLOYE DESdR PdesTION OF OnderP RATIONS below 1,000,000 E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Addftlonal Remarks Schedule,may be attached it more space Is required) Home Improvement Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Insured's copy for proposals and/or permits THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Lux Renovations,LLC dba Owens Corning of New England ACCORDANCE WITH THE POLICY PROVISIONS. 60 Shawmut Rd Canton,MA 02Q21 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. 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