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31A-201 (4) SM-2024-0018 40 WASHINGTON AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-201-001 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-2024-0018 PERMISSION IS HEREBY GRANTED TO: Project# 2024 RENO Contractor: License: KEVIN PURINTON DBA ARNOLD C Est. Cost: 3500 PURINTON PLUMBING &HEATING Const.Class: Exp.Date: Use Group: Owner: GIRARD,WILLIAM M.&DOHERTY, BLAKE E. Lot Size (sq.ft.) KEVIN PURINTON DBA ARNOLD C PURINTON Zoning: URB Applicant: PLUMBING &HEATING Applicant Address Phone: Insurance: 4 CLESSON BROOK RD (413)625-8194 08WECAJ4PZZ BUCKLAND, MA 01338 ISSUED ON: 04/18/2024 TO PERFORM THE FOLLOWING WORK: HVAC FOR KITCHEN AND 2 BATH RENO 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. , Signature: 1'/ . Fees Paid: $25.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner Commonwealth of Massachusetts Sheet Metal Permit Pirmit S�- �`�-/ Date: Y/7/2y APR 1 7 2024 r C4 5 Estimated Job Cost: $ 3SoQ. a PerMit Fee: $ p, Nr,INSPt- Plans Submitted: YES NO 1✓ �",rd Mgp„IRemiewed: YES NO Business License# Applicant License# 77-7 3 (Yt- Business Information: Property Owner/Job Location Information: Name: (0116 , ?U i n1or P) 1�(o- KTG Name: Wi mar., G0:‘,J A. %I0 to !)o), er-l1 Street: CIIe5Son ��o a 1Zo Street: CID W nsh;6,5 -1.r. Aire City/Town: C ks ewt,o 4( /4/vi' D 433`f City/Town: 40 r!Al JY 1 A Telephone: 9/3- 't3LI-73,cr Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO Stall Initial J- 0124unrestricted 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. k over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC V-- Metal Watershed Roofing Kitchen Exhaust System �— Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: In 6410\l '1:* t.i c Loaf k -2 c l�. 11,r I f' or Zn`i w I Q- cnJ r4-51 of 5/3.rte Coe 2eMoc ( / ReV.J044:a g ) °:=1 INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes 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 ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ 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 a 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 Progress Inspections Date Comments Final Inspection Date Comments Type of License: By g Master Tile ❑Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: 7 77 3 Fee$ ❑ Check at www.mass.gov/dpl // 7 9.—ZOZII Inspector Signature of Permit Approval MASSACHUSETTS DRIVERS LICENSE s NUMBER 14l1512019 S70486714 DOB 1011712024 1011711962 END p S NONE NONE • KEVIN SCOTT • 4 ., 'p 4 CLESSON BROOK RD BUCKLAND,MA 01138.9704 EYES HAZ (y OD aMnat2019 a 01122'Alfi 1011 Aol Mail Search your mail or the web (11;/ * Home Keep y� F Back «1 <4 y as ,h, Move m Delete © Spam ••• ® P 0 0 New (No Subject) Aol/Old Mail Today on AOL Summer Travel Included mkitsimple@aol.com r_t Wed,Apr 17 at 7:32 AM Wanna get away® New Mail 49 From:mkitsimple@aol.com with low fares? Old Mail To:kevin Purinton From Hartford Starred one-way Ask „s Drafts Record 2022-003308-SM-MAR: $7 ► Sheet Metal Master Renewal Sent •Seatskayshnkts!mid;rear.,e:d.,& Record Status: Closed blkouts apply.21-day adv.porch. Book by 04R5. Spam inimm'm. Recently Deleted Southwest* _ Less Record Info Payments Education ViewsEZ !I' Contacts Premise Address ® Photos Documents e Subscriptions ftt Receipts Record Details ti Credits Licensed Professional: Travel KEVIN S PURITON M1 Folders Hide 4 Clesson Brook Rd + New Folder Charlemont,MA,01339-9722 United States Saved Mail 11 I Sheet Metal Master 7773 Archive ( More Details Notebook « �« ♦ ••• Notes SavedlMs sent emails Reply,Reply All or Forward t ► AC CERTIFICATE OF LIABILITY INSURANCE DATE`MM/°°"YYY) 04/17/2024 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 does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Betsy Wholey Osell NAME: Blackmer Insurance Agency PHONE (413)625-6527 FAX (413)625-8210 (A/C,No,Ext): (A/C,No): 1147 Mohawk Trail E-MAIL betsy@blackmers.com ADDRESS: y@ INSURER(S)AFFORDING COVERAGE NAIC# Shelburne MA 01370 INSURER A: MAPFRE Ins Co 23876 INSURED INSURER B: Twin City Fire Insurance Company 29459 Kevin Purinton INSURER C 4 Clesson Brook Road INSURER D: INSURER E: Charlemont MA 01339 INSURER F: COVERAGES CERTIFICATE NUMBER: 24-25 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 SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGES 0 REN fLD 300,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 A 8008030015878 03/05/2024 03/05/2025 PERSONAL Si ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY n n PRO- 2,000,000 JECT I I LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS ONLY _AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X STATUTE EOTH AND EMPLOYERS'LIABILITY Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE E .EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n .L N/A 08WECAJ4PZZ 01/11/2024 01/11/2025 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 10 ,00000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 131zaer � alga 1 ©1988-2015 ACORD CORPORATION. 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