31B-201 (2) D '�' _
DRIVER LICENSE
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NO 0- FED RAL IDENTIFICATION
9 Class D 12 Res ;B 9.Endors M
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3 DOB; 1 i ! 9 6 6 ,.E�:BRO
sb Expires;1 j 2018
> i'MOLIN "k .
2PETER 4 .,,
932 HARVARD DRR : °
EAST HARTFORD` TI)6108
I}"' a Issued:10-16.2012
Fold,Then;`le+,ach edeee All Perforrton,
COMMONWEALTH OF MASSACHUSETTS
DIVISION OF PROFESSIONALLICENSURE BOARD OF
BOARD SHEET METAL WORKERS
SM AS A MASTER-UNRESTRICTED
!SSIJES Thar eE3ov! LICENSE.To
TYPE PETER MOLIN
C
M1 13 BRITTON DR
DUCTCO LLC
BLOOMFIELD CT 06002-3616
93334 1521 11/28/13 93334
UMOEh1SE N L1ATE SERIAL NO
Fcld Then long Al P ere'it.ons
,
DUCTC-1 OP ID:MS
'` C—C:30 O' CERTIFICATE OF LIABILITY INSURANCE DATE(MhVDOlYYYY)
�...---/ 03!11113
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 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).
gems: Monica CONTACT
PRODUCER
860-953-6881 NAME Mo -The Kerin Agency Inc rl'�C
(THE KERN AGENCY,INC.
860-963-4059 P1i�NE f
'P.O.BOX 330910 .,,.e,,,. N,o_Eatt 860 953.6881 1 IArc,NVp,860-953 4053
WW.HARTFORD,CT 06133-0910 E-MAIL monica kerina nc .cot11
ADDRESS;.__ ._.y.,,,,,
}William A.Coscarelli
INSURERrst AFFORDING COVERAGE ),_,, NAIC If
INSURER A;CNA Insurance Co. _ .____. ......_
INSURED DUCTCO LLC INSURER 8: _
13 BRITTON DRIVE INSURER C: _... __
BLOOMFIELD,CT 06002-3616
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 ro ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ff ACO RI ._._.._..., .......iraC}CYF' POLICY'EXP _____.
S ILLR~��� TYPE OF INSURANCE , ;I , ,; POLICY NUMBER .t xtruno YYYYC IMMIDDITYYYI LIMITS
GENERAL LIABILITY EACH OCCURRENCE I$ 1,000,000
A X ;'COMMERCIAL GENERAL LIASILITV X X, 5090771310 12!31!12 } 12/31/13
4i*i3Ge"CD?LNt Eo
_ PREMJSE [aoei?ence S 500,000
l ,.»i CLAIMS-MADE X OCCUR MED EXP•An one person} 1,$ 5,000
� "PERSONAL&ADV INJURY $ 1,000,000
I ( GENERAL AGGREGATv $ 2,000,000
5;1 AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG I$ 2,000,000
1 I I POLICY}X I ';LCOT ,��;LOC I $
AUTOMOBILE LIABILITY I, COMBINED SIN LELI S 1 1,000,001
!Eat'entt_..... ._.__Ls
A 'X 1 ANY AUTO X X 5090771324 12131/12 12/31/13 BODILY INJURY(Per person) ($
ALL OWNED I SCHEDULED =RODtLY INJURY(Per accident)f$ --
AUTOS —I NON OWNED PROPERTY DAMAGE $
X HIRED AUTOS AUTOS 'Pet re der0.'t__ "-
I ' iS
I X i UMBRELLA LIAB X OCCUR I EACH OCCURRENCE i$ 5,000,000
A EXCESS LIAB I CLAIMS-MADF X X 15090771341 12/31/12 12131/13 !.AGGREGATE 5,000,000
DED I RETENTIONS 1. 'RETENTION I$. 10,000
WORKERS COMPENSATION X 4 WC STAN) I 0TH•
AND EMPLOYERS'LIABILITY ( _ ",Q IJf .1I
A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X 15090771338 - 12/31/12 12/31/13 E.L.EACH ACCIDENT $ 500,000
OFFICER/MEMBER EXCLUDED', 'N/A 1
(Mandatory in NH) E,L.DISEASE,EA EMPLOYEE($ 500,000
It yyes,describe under i 500,000
DESCRIPTION OF�OPERATIONS aebw i i E,L.DISEASE•POLICY LIMIT .$
A iPROPERTY COVERAGE ? (5090771310 12/31/12 I 12/31/13 BPP 1,000,000
A LEASED/RENTED EQUI i 090771310 12/31/12 12/31/13 leased 100,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required}
RE:PROJECT NUMBER:1113 PROJECT DESCRIPTION:CUTTER ZISKIND HOUSES
'CONSIGLI CONSTRUCTION,MJ MORAN INC AND SMITH COLLEGE ARE NAMED ADDITIONAL
!INSUREDS WHERE REQUIRED BY WRITTEN CONTRACT ON A PRIMARY AND
$NON-CONTRIBUTORY BASIS FOR WORK PERFORMED BY OR ON BEHALF OF THE NAMED
INSURED. (CONTINUED NEXT PAGE)
CERTIFICATE HOLDER CANCELLATION
MJMORAN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
M.J. MORAN INC ACCORDANCE WITH THE POLICY PROVISIONS.
4 SOUTH MAIN STREET
HAYDENVILLE,MA 01039 `AUTHORIZED REPRESENTATIVE
{ ,William A.Coscarelli
I
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes No❑
If you have checked Yes,indicate the type of coverage by checking the appropriate box below:
A liability insurance policy Er Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee rtnr+c not have the insurance coverage required by Chapter 112 of the
Massachusetts Gener I Laws, and that my signature on this permit application waivesthis requirement.
Check One Only
Owner Ef7. Agent ❑
Signature of Owner or Owner's Agent
By checking this boxrJ,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation:YES NO
Progress Tncrertions
Pate Comments
Final Tncrvrtinn
bate Fnmments
Type of License:
By ❑ Master
Title ❑ Master-Restricted
City/Town ❑Journeyperson
Signature of Licensee
Permit#
❑Journeyperson-Restricted
License Number:
Fee$ ❑
Check at www mace gnvlrlpt
Inspector Signature of Permit Approval
RECEIVED
APR - 8 2013 1 Commonwealth of Massachusetts
City Of Northampton
Date: y /3 Sheet Metal Permit Permit# 509 13 d
Estimated Job Cost: $ 6S7C/00 Permit Fee: $ r 3(p A5-0
Plans Submitted: YES / NO Plans Reviewed: YES NO
Business License# 001/0 2 30 S Applicant License # i 1/ /�2
Business Information: Property Owner/Job Location Information:
Name: u,t.i C0/ Name: 5,uo w Coo-(,l1roe-
Street: /3 611 'rr >Lt v Street: PA_-R I, E Rb
City/Town: 3'1-1.rivM> 1471,43/ C--- ' °C./2°z— City/Town: A/e/ 4AMp7t ', //AcS 01063
Telephone: 5100 2y3- 3S0 Telephone: W 3 Safi y— 700
Photo I.D. required/Copy of Photo I.D. attached: YES 6/ NO
Staff Initial
J-1 /glnrestricted 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 .7 C-0 776%,-7/2 sk'^'b
Institutional Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories: 3/
Sheet metal work to be completed: New Work: V Renovation: ✓
HVAC i/ Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
ffVA c- Aa. 611 TA 6(-0-0'-) T/l t:ot t& cia T /1k Sue ^r6
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
File#SM-2013-0050
APPLICANT/CONTACT PERSON DUCTCO LLC
ADDRESS/PHONE 13 BRITTON DR (860)243-0350
PROPERTY LOCATION 79 ELM ST-ZISKIND/CUTTER
MAP 31B PARCEL 201 001 ZONE EU(100)/URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid /
Typeof Construction: HVAC AIR DISTRIBUTION,KITCH VENTILATION SYS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 1521
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF911MATION PRESENTED:
Approved 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
Permit from Elm Street Co • 'ssion Permit DPW Storm Water Management
c� l /flit
Signature of Building Official Date
Note: Issuance of a Zoning 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.
79 ELM ST - ZISKIND/CUTTER SM-2013-0050
COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
�GIS#: 9529 !s"AM
Map: 31B t`-7,4414
Block: 201 ,- '
_ SHEETMETAL PERMIT
Lot: 001 �.
Permit: SHEETMETAL
Category: renovation
Permit# SM-2013-0050 PERMISSION IS HEREBY GRANTED TO:
Project# JS-2013-001320
Est.Cost: $557,000.00 Contractor: License: Expires:
Fee Charged:$50.00 DUCTCO LLC Sheetmetal- 1521 11/28/2013
Balance Due:S.00 Owner: Smith College
#of Fixtures: Applicant: DUCTCO LLC
DigSafe# AT: 79 ELM ST-ZISKIND/CUTTER
UseGroup
ConstClass
ISSUED ON: 11-Apr-2013 AMENDED ON: EXPIRES ON:
TO PERFORM THE FOLLOWING WORK:
HVAC AIR DISTRIBUTION,KITCH VENTILATION SYS
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-2013-005402 08-Apr-13 16136 $50.00
212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov
GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.