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32A-122 (3) A°IJ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 2!15120)3 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 ca l:Ideate holder Is an ADDITIONAL INSURED,the poficy(tasl must be endorsed. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may!squire an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER I'CONTACT NAME MEYER INSURANCE PHONE ��, t.4" 'Q3-5180 KAC 1 WC,NO) 186 Northampton St tss chadmever@charter.net Easthampton.MA 01027 1,1VII ..-ER CUSTOMER IQs esugeR(el AFFORDING COVERAGE t NAIL/ INSURED All State Hood and Duct Inc l I INSURER A Farm Family Casualty 'INSURER B 24 Mainline Dr j INSURER C Westfield_MA 01085-33lr1 ,INSURER D INSURER E IINSURER F I 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 POUCIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS_ TYPE OF INSURANCE F W I POLICY NUMBER 11N• ''I Lifts D+ r I I LIMITS GENERAL UAeIUTY Is t EACH OCCURRENCE 1 s 1,000,000 I I X I COMMERCIAL GENERAL LIABILITY I , I PREMISES(FakNacer►Onca) $ 50,000 CLAIMS'MADE l ,OCCUR I f MED EXP Any one person) S I A i I (2007X0371 ` I PERSONAL a ACV INJURY S 1 030,000 1'2/1012013 12110/2014 GENERAL AGGREGATE S 2,000,000 (''Govt.AGGREGATE LIMIT APPLIES PER I PRODUCTS-COMP/OP AGG S2.00 •000 I I POLICY j 1 JECT ` l LOC i t S •AUTOMOBILE UABIIITY 4 I COMBINED SINGLE LIMIT I S L. — I I (Ea accident) ANY AUTO I I I fff_ BODILY INJURY(Per person! I � _ ALL OWNED AUTOS BODILY INJURY(Per acuderr)_S SCHEDULED AUTOS I PROPERTY DAMAGE S I I HIRED AUTOS I I 4 I Y(P(Per aCC+ O) f l I S NON-DINNED AUTOS X I UMBRELLA LIAB I. OCCUR EACH OCCURRENCE S 2,000,000 EXCESS LIRE CLAMS MADE 12001E1113 12110/2013 02110/20141_AGGREGATE S 2,000.000 I A . I 1 DEDUCTIBLE 1 S I I RETENTION S I I WC STATU. I (OTH- I WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN TORY LIMITS I ER A ,ANY moantETOR/PARTNERIEXECuTTIVE 1� I 2001 W b5 I± �03110t?013 taZ/)012014 E L EACH ACCIDENT S 500,000 OFFICERAIENSER EXCLUDED, y rI,rA 500,000 (eendnoq,n KM E L.DISEASE-EA EMPLOYEE E I+yes demo nder 500,000 DES descrl N u Of OPERATIONS Detour ( El DISEASE-POLICY LIMIT S III I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 10I Addmonet Remarks Schea<de.If more space us,equated) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR TAT�tE c I M ,ik..,,) 01 Q09 ACORD COR 71ON. All nghts reserved_ 5(2009109) The ACORD name and logo are registered marks of ACORD • tom! Massachusetts -Department of Public Saiety Board of Building Regulations and Standards Construction Supervisor License: CS-06 9654 ,! • , TODD W DUVAL,` 24 MAINLINE WESTFIELD MR 01085 '1; �` )� 11t�� cX'piration Commissioner 12/29/2014 COMMONWEALTH OF- MASSACHHUSETTS DIVISION OF PROFESSIONAL LICENSURE-BOARD OF .AS EYP tR?ON-UN REST £TED ISSUES THE ABOVE LICENSE TO TODD W DUVAL r ,e 122 HILLSIDE RD APT .1 ``WEST€IELD MA 01085-4106 25011 12/28/13 141987 LICENSE NO. EXPIRATION DATE SERIAL NO. INSURANCE COVERAGE: �/ I have a current liahility insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes 4!I 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 rinac not havp the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waivesthis requirement. 1 Check One Only r e/ Owner ❑ Agent 'U�� Signature of Owner or Owner's Agent By checking this box0,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 Progrecs inspections nate rnmmPnts Final Incpertion T)atP Comments, Type of License: By ❑ Master Title ❑ Master-Restricted / Y City/Town VJourneyperson Signature of Licensee Permit# ❑Journeyperson Restricted License Number: 56:;) // Fee$ ❑ Check at www macc gnv/cipl Inspector Signature of Permit Approval f Commonwealth of Massachusetts ' ' Lu! City Of Northampton Electric. P u rr coons Nat i E ° Sheet Metal Permit Permit# 6g-/V-3y Estimated Job Cost: $ (p( 062 Permit Fee: $,R) q 5 Co 7 f Plans Submitted: YES J NO Plans Reviewed: YES NO Business License# Applicant License# Business Information: Property Owner//Job Location Information: Name: ts-k,k 46 c+ DCI C Name: -2 1-er Street:( / �(G '.� r4z fl Street: k.'45 (P- City/Town: bJe.s /6-e(cl 4- f Q/0$5 City/Town: /w!`-f4uvn104.4 ./77 Telephone: '/( S 6 3 Telephone: P oto I.D. required/Copy of Photo I.D. attached: YES ✓ NO Staff Initial J- 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 Metal Watershed Roofing Kitchen Exhaust System I/ Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: pe, C,-�.��cf4 � �c�� s6 s ri/ �— 4) (a-.� 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-2014-0034 APPLICANT/CONTACT PERSON ALLSTATE HOOD&DUCT INC ADDRESS/PHONE 24 MAINLINE DR (413)568-4663 PROPERTY LOCATION 65 KING ST-SUHER MEATS MAP 32A PARCEL 122 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid 3 <j/ 450 Building Permit Filled out �/�7(p Fee Paid Typeof Construction: TYPE II COMMERCIAL HOOD SYSTEM New Construction Non Structural interior renovations Addition to Existing_ Accessory Structure Building Plans Included: Owner/Statement or License 25011 3 sets of Plans/Plot Plan THE FOL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION 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 Pe i't fr.':.Elm eet Co 'ss� Permit DPW Storm Water Management / // / //fi ial Dat Signature of Building Official 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. 65 KING ST - SUHER MEATS SM-2014-0034 COMMONWEALTH OF MASSACHUSETTS 1GIS#: 19942 HAMp,.-, CITY OF NORTHAMPTON Map: 132A ,;` Block: 122 i , 1 � =,• � SHEETMETAL PERMIT Lot. 001 Permit: SHEETMETAL °��'��°� ERCENTE- [Category: SHEETMETAL Permit# SM-2014-0034 _-1 PERMISSION IS HEREBY GRANTED TO: Project# JS-2014-000932 Est. Cost: $6,000.00 Contractor: License: Expires: ALLSTATE HOOD&DUCT INC Sheetmetal-25011 Fee Charged:$50.00 12/28/2013 ,Balance Due:$.00 Owner: NORTHAMPTON CO-OPERATIVE BANK #of Fixtures: (Applicant: ALLSTATE HOOD&DUCT INC D1gSafe# AT: 65 KING ST-SUHER MEATS UseGroup ConstClass ISSUED ON: 21-Nov-2013 AMENDED ON: EXPIRES ON: TO PERFORM THE FOLLOWING WORK: TYPE II COMMERCIAL HOOD SYSTEM 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-2014-002293 21-Nov-13 3436 $50.00 212 Main Street,Phone:(413)587-1240,Fax:(413)587-1272,Email:lhasbrouck @northamptonma.gov GeoTMS®2013 Des Lauriers Municipal Solutions,Inc.