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24B-088 (7) SM- 022-0016 106INDUSTRIAL DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24B-088-001 CITY OF NORTHAMPTON Permit: Sheet Metal PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# SM-2022-0016 PERMISSION ISHEREBYGRANTE TO: Project# CLEAN ROOM Contractor: License: M& E MECHANICAL Est. Cost: 17000 CONTRACTORS INC Const.Class: Exp.Date: Use Group: Owner: HYTECH PARK PROPERTIES LLC Lot Size (sq.ft.) Zoning: GI Applicant: M& E MECHANICAL CONTRACTORS INC Applicant Address Phone: Insurance: • 1 ALLEN ST (413)781-0014 WWC3549578 SPRINGFIELD, MA 01 108 ISSUED ON:07/01/2022 TO PERFORM THE FOLLOWING WORK: duct work for clean room • 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: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: I 4: • + • . , • Fees Paid: $50.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RE Commonwealth of Massachusetts jut. - 1 2022 NORTHA n City Of Northampton Permit# ,r p GTIONS Sheet Metal Permit - /7� /� DEPT.OF E3 � Estimated Job Cost: $ 17,O 00. 60 Permit Fee: $ 50, Plans Submitted: YES NO i§ Plans Reviewed: YES NO . Business License# 32:-. Applicant License# '� .j\I Business Information: Property Owner/Job Location Information: Name: M e . MeG lcck) Co lame: l' -c -y OMe- Street: ` An er z Street: to 6 Tnd,Ln't oN "Ay4e_ City/Town: 'r c' �* NAn City/Town: 1 rn t Ni A Telephone: 116-TZA-o0 I L-/ Telephone: Lti3-32_0 - Photo I.D. required/Copy of Photo I.D. attached: YES /` NO Staff Initial J-1 OP 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 Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial K Educational Institutional Other Square Footage: under 10,000 sq. ft. 7\ over 10,000 sq. ft. Number of Stories: 1k Sheet metal work to be completed: New Work: V Renovation: HVAC 1 Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: Trr5-k\\ -0 0 a s-.\-1--;bu- or, 3rcr Mew Glec.txl -Room 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, $100.00 Commercial INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes l No❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ❑ Other type of indemnity El Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee finale nnt haw;the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waixesthis requirement. Check One Only Owner El Agent ❑ Signature of Owner or Owner's Agent By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO X Progrecc Incpectiovc Date Comments Final Increctinn nate Comments Typey of License: By r5Master Title ❑ Master-Restricted C City/Town OJourneyperson Signature of Licensee Permit# ❑Journeyperson-Restricted L 53�) License Number: Fee$ ❑ Check at www mast Qnv/dpl te 4,../Z3 7- ZcZ2 Inspector Signature of Permit Approval DATE(MM/DD/YYYY) ACORC® CERTIFICATE OF LIABILITY INSURANCE 10/25/2021 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(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 CONTACT David R Jarry Neill&Neill Insurance Agency Inc NAME: 662 Riverdale Street (Am,No.Ertl: (413)732-4137 FAX No):(413)731-6629 West Springfield, MA 01089 noDREss, dj@neillandneilt.com INSURER(8)AFFORDING COVERAGE NAIC 0 INSURER A: Safety Insurance Company 39454 INSURED M&E Mechanical Contractors INSURER a: WeSCO Insurance CO A0249 1 Allen Street INSURER C Springfield,MA 01108 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 ADDL.-SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN8D WVD POLICY NUMBER _(MM/DO/YYYY) (MM/DD/YYYY) UMITS A V COMMERCIAL GENERAL LIABILITY BMA0030374 08/31/2021 08/31/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 O- ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 11 POLICY OTHER: $ A AUTOMOBILE LIABILITY - 1710518 04/21/2021 04/21/2022 " COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED / SCHEDULED AUTOS ONLY V AUTOS BODILY INJURY(Per accident) S 7 HIRED - / NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY V AUTOS ONLY (Per accident) _ $ A IV UMBRELLALIAB V OCCUR CMU0006018 10/31/2021 10/31/2022 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE S 5,000,000 r DED RETENTION$ $ B AND EMPS WORKER LOYERS'LIABILITY COMPENSATION Y/N W WC3549578 10/04/2021 10/04/2022 STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) CERTIFICATE IS FOR PROOF OF INSURANCE PURPOSES ONLY CERTIFICATE HOLDER CANCELLATION M&E Mechanical Contractors SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 Allen Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Springfield,MA 01108 ACCORDANCE W THE POLICY PROVISIONS. AUTHORIZED REPRE ENT ±� • * t. e ©1988-2015 ACORD eV-PORATI m II rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD M&E Mechanical Permit Info 0, 2022 MECHANICAL CON t f C I ORS INC, v COMMO W . LTH OF MASSAC S TT COMMONWEALTH OF MASSA HUSETT DIVISION OF OCCUPATIONAL LICENSURE DIVISION OF PROFESSIONAL LICENSURE BOARD OF :OAR• •F SHEET METAL WORKERS SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE w ISSUES THE FOLLOWING LICENSE BUSINESS MASTER-UNRESTRICTED MARKS EDWARDS i z MARK S EDWARDS N w 49 ADRICOT HILL LN w M&E MECHANICAL CONTRACTORS INC W z 1 ALLEN STREET ��, U J W SPRINGFIELD, MA 01089 "1 SPRINGFIELD,MA 01108 J i \ \ 9099 03/.;/ ' • 323 04107/2023 999468 LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER 51 COMM• EALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE BOARD OF SHEET METAL WORKERS ISSUES THE FOLLOWING LICENSE Lu MASTER-UNRESTRICTED 10 MICHAEL M EDWARDS i'l i� 19 LONGVIEW DRIVE `) W SUFFIELD, CT 06078 z w U J 25311 01/28/2023 999766 LICENSE NUMBER EXPIRATION DATE SERIAL NUMBER 7'SSA( HIISE'1'TS DRIVER'S "9f » , LICENSE Connecticut DRIVER LICENSE limor •�.. .4n!SS 94 8N0 4d NUMBER 02-26-2016 NONE S90575881 h EXP , DOB >019743005 �'FSF NONE °- 1 03.10-2021 03-10-1959 0,.01105/1989 or, NONE F.CLASS REST , SEX M v HGT 6.02 A _.:;xn 01105/2025 hr D NONE �` rra '1 • 193 12/2712019 - ro, M y #;., ,EDWARDS '' aN17s6•04" r,rsBLU 2 MARKS i + 19122708202601M'e:� °"`.`a 4. EDWARDS je r 49 APRICOT HILL LANE MICHAEL MATTHE `/ W SPRINGFIELD,MA 01089.4461 Y `/�/�— 19 LONGVIEW DR DO 02.29-2016 Rev 0 7-15-2008 SUFFIELD,CT 06078-1222 1 Allen Street'Springfield, MA 01108 T. (413)781-0014 • F.(413) 781-0016