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23D-093 (2) 26 NUTTING AVE BP-2019-0908 GIS#: COMMONWEALTH OF MASSACHUSETTS MV-Block: 23D-093 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Catceorv' INSULATION BUILDING PERMIT Permit BP-2019-0908 Proiect# JS-2019-001516 Est Cost' 53562 00 Fee 565.00 PERMISSION IS HEREBY GRANTED TO: Cons[ Class: Contractor. License: Use Group: AMERICAN INSTALLATIONS LLC 106178 Lot Size(sq. ft.): 13808.52 Owner: SPENCER NORMAN A zoning_ URB(100)/ Applicant: AMERICAN INSTALLATIONS LLC AT: 26 NUTTING AVE Applicant Address: Phone: Insurance: 130 COLLEGE ST (413) 552-0200 WC SOUTH HADLEYMA01075 ISSUED ON.212212 01 9 0.00:00 TO PERFORM THE FOLLOWING WORK.-ATTIC INSULATION AND AIR SEALING THROUGHOUT 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: 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 2/22/2019 0:00:00 $65.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck--Building Commissioner • �N ��- Tial✓ C Departmerd use R= only r � City of Northampton Status of Permit. Building Department Curb Cut/Ddveway Pemdt FEB 7019 212 Main Street SaweNSeplicAvaOab9,ly Room 100 WatsdWell'Avallability N hempton, MA O1OS0 Two Sete of Structural Plans a 3-587-1240 Fax 41&587-1272 PIbUSIfe Plans- 41 .;� OtherSpecHy_. APPLICATION TO CONSTRUCT,ALTER,REPAIR RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1-SITE INFORMATION Jp-�i DD y 1.1 Property Address: This section to becompleted�byMce MaP�V_ Lot n'I /� 'J Umt 26 Nutting Avenue Florence, NIA 01062 Zone Overlay District Elm SL District-. CS Dlstkt SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Norman Spencer 26NUffingAvenue Name(PdnU C3S9M$e See attached Telephone Sigmaxe 2.2 Authorized Agent: American Installations 130 College St., Ste 100 South Hadley.iWA 01075 Name(PrW) Cwent MapNg Address: \ k= 413-552-0200 SmaaWre Telaplimm SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only tole elect by oermita titan 1. Bu3ding 3562.00 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Constructlan from 6 3. Plumbing Building Parrott Fee 4. Medwical(FiVAC) 5.Free Protection (/t 6. Thai=(1+2+3+4+5) 1 3562+00 Chack Number This Section For Official Use Only Date Building Permit Number. Issued; Slgnalure: ( 2- 2-)'Za14 Butding CommirsiorwrllnspeGor of BWldiNs Date 2/16/2019 Section 4. ZONING All Information Must Be Campieted.Penrdt Can Be Denied Due To Incomplete Infonnatson Eaisting Proposed Required by Zoning Ilia We.m be filled I.by Bugdmg Deperhae6 Lot Size Frontage Setbacks Front Side L:0 R= L= K= �J Rear Building Height ("— Bldg.Square Footage J % Open Sp uee Footage O J % o -J mmiva s bWg a:paved #of Parking Spaces Fill: volume&Lan6®) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES,date issued-1 IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document#F—' B. Does the site contain a brook,body of v ter or wetlands? NO O DONT KNOW O YES O IF YES,has a permit been or need to be obtained from the Comervation Commission? Needs to be obtained O Obtained O , Date Issued: C= C. Do any signs exist on the property? YES O NO O IF YES,describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES,describe size, type and location: i E. W0 the construction activity disturb(clearing,grading,excavation,or filling)over 1 ase or is It pan of a common plan that will disturb over 1 acre? YES O NO O IF YES,men a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicablel New House ❑ I Addition ❑ ReplacementWindows At Ionia) ❑ Roofing Or Doors O AccessoryBldg. ❑ Demolition ❑ New Signs [OI Decks [O Sldfng[0] Otherlft Brief Description of Proposed Work Attic insulation and air sealing throughout Alteration of existing bedroom_Yes_No Adding new bedroom Yes _No Attached Narrative Renovating unfinished basement Yes No PlansAttached Roll -Sheet se.If New house and or addition to ezistina housing,complete the following: a. Use of butiding:One Family Twa Family Other b. Number of rooms in each family unit Number of Bathmoma c. Is there a garage attached? d. Proposed Square footage of how consimWon. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance farm attached? h. Type of construction 1. Is wmtmction whhin lOO fL of wegends?_Yes —No. Is censbuction wMIn 100 yr. floodplain Yes_No j. Depth of basement or cater floor below finished grade k. Will building cenfarm to the Building and Zoning regulations? Yes No. I. Septic Tank_ Gly Sewer_ Private well_ City water Supply— SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMTT I, as Owner of the subject property herebyaulhorize American Installations to act on my behalf,in all matters relative to work authorized by this building permit application. See tied avenue of owner Dale 2/1612019 I, American Installations as Owner/AufhaRed Agehereby declare nt that the statements and Information on the foregoing application aka true and accurate,to gre best of my knowledge and belief. Signed under the pains and penalties of perjury. American Installations Prim Name o Oo � V, L'S-11 1inP SlgoaWed IAgem Dote 2/IW201 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ NomeotUmm NaideC Wesley K. Couture 106178 Uceme Number 130 Collie St., Ste 100 South Hadley, VIA 01075 91P9119 Address ExpWon Dale 413-552-0200 gerehlre Telephona 9 Renisiomd-ltomehnorovemeritComraoror. _ _ ` _ ` Not Applicable ❑ Wesley Couture 175982 Comnanv Name Registration Number American Installations 6126/19 Address Expiration Date 130 College St., Ste loo South Hadley,MA 01075 Tdephoce413-552-0200 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L e.152,ij 28C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Fallure to protide this affidavit WIN result In the denial of the Issuance of the building pem& Signed AffidevitAtlachad Yes....... W NO...... ❑ 11.-Home Owner Eaemnflon Thewmem exemptionfor"homeownerd'wasenmdedmitrelude Owneo-m vied DWdEnes afone(I) m two(2)fem0im and to allow such homcownerto engage an individual for hire who does set possess a license,provided that the owner acts as supervisor.CMR M. Stith Edition Section 108331. Definition of Homeowner:Person(s)who own a parcel of lead on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two fandty dwelling,attached or detached structures accessory to such use and/or funs structures.A Paton who c nsfra fs mom than one home in a two-year period shall not be considered a homes" Such"homeownet'shall submit to the Building OfficW,on a formacceptable to the Building Official thathe/she shall be resuoudble for all such work performed order the bundine perinlL As acting Conahvetian Supervisor yourptennec on the job she wgl be required from time to time,doting and upon complefiom of the work for which this permit is issued Also be advised that with tolerance to Chapter 152(Wmkets'Compensation) and Chapter 153(LiabilityofEmploymsto Employees for injuries notresulting in Death)of the Massachusetts General lavas Annotated,You may be gable fsrperson(s) you hire to perform we*for you under this permit. The undersigned"homeowner'cerfi5es and assumes responWbility for cemphance with the State Budding Code,City of Northampton Ordinances,State and Local Zoning laws and State of Massachusetts Generd Laws Annotated. Homeovmer Signature seeattached City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste 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. Address of the work: 26 Nutting Avenue The debris will be transported by: American Installations The debris will be received by: Waste Management of New England Building permit number: Name of Permit Applicant Wesley Couture 2/16/2019 �a)pV ,. k . 6FUL.t— Date Signature of Permit Applicant City of Northampton Massachusetta F "<� x UWAR22BSRT OF BDZLDZM ZaSF ZOBS 212 Wln ii:aut 0 Wnioipal BuilaW Northam n, W 01060 Property Address: 26 Nutting Avenue Florence, MA 01062 Contractor Name: American Installations Address: 130 College Street Ste. 100 City, State: South Hadley, MA Phone: 43-552-0200 Property Owner Name: Norman Spencer Address: 26 Nutting Avenue City, State: Florence, MA 01062 1, American Installations (contractor)attest and affirm that the building I intend to insulate does not have any open air(knob and tube)wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. Contractor yigynature L'CtiIZ—_ ��3� In t Date 2/16/2019 www.A.,epea.m..dale. .m Lme sea Bm...m \ MA CSL A IG6I I8 American Installations MAflmi4mfvn>ll5981 ]3p Ulle{e Sheeasultt Lp,SauN NNIry.MA 010)5•OMre.141315eEOZW ice.'. 4131553moi Enark supportaPmnloNm[allaXons.wm Spencer Norman 5/21/2018 26 Nutting Avenue w Florence MA 01062 TIT I (413)58)-0801 mspen@;uno.Com Le IT, 466 497 m.0 Xwe 19-0125 1'n•wl wn quantity unit unit Cost Total Alr Seell"a AIR SEALING 10 man hour $ 85.00 $ 850.00 Air Sealing $ 850.00 Air Sealing Incentive $ (850.00) Air Selaing WX Balance $ - Weathertzedon ATTICFIAT-6"OPEN R 22 CELLULOSE 1,560 sqk $ 1.32 $ 2,059.20 VENTIIATION CHUTES 46 each $ 250 $ 115.00 ATTICOAMMING-R-38FIBERGWS R 50k $ 2.05 $ 147.611 FLIP/SIASN EXISTING 1,560 El $ 0.25 $ 390.00 TOWIWeathetization $ 2,711.80 Weatherintion Incentive $ 1.741.35 Total Project $ 3,561.80 Total UtlliN Contribution It 2,591.35 Total Customer Contribuilon $ 97045 WARMINTY.Pmmnunlnanlallony LLC v'Nvmmtle,M1e ahwe.etMM1erteewnvwaM1e 2—rwre—vip+ananry. 6 bebyp —Ir I mnb all retire ana I,ill m}eu rbeamvu 11—d.—&—k m aeamn wX,nr veneepenharlem ma.111w1 Id Nrebwtllq ,.pa..I.re n,rwecam,eawiTi ...uha I—in eictPTANCEm PROPi Teancee Prei,eitlpean.....it TOTAL CONTRACT VALUE= $ 910.45 ..e.marcn[bhetayaM an nerebya.rep[ei.rpu art ruImemeo won a::pearleX.P>P.mt wulalla a.w.v.o,m Down Payment= $ 323.00 ❑ awark.antl balance Eue upon Campletbnp a NOi/NIINAt�dEHLEf' Balance Doe upon completion= $ 647.45 p p... , Spencer,Norman 5/21/2018 B.Zame, 5/21/2018 The Commonwealth of Massachusetts Department of Industrial Accidents Ogee of Investigations ul 600 Washington Street Boston,MA 02111 wtvw.mnss.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le '61v Name(Basimss/Orgam atim✓mdialduap; American Installations, LLC Address: 130 College Street,Suite 100 City/State/Zip: South Hadley,MA 01075 Phone#: 413-552-0200 Are you an employer?Check the appropriate box: Type of project(required): I.M 1 am o employer with 60 _ 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time)' have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.: 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity, workers'comp. insurance. 9. ❑ Building addition tNo workers'comp. insurance 5. ❑ We are a corporation and its required.) officers have exercised their I0.❑ Electrical repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MGL I I ❑ Plumbing repairs or additions myself. [No workers'comp. c. 152,11(4),and we have no 12.❑ Roof repairs insurance required.]I employees. [No workers' camp. insurance required.] I3.®Other lnsUla[10n 'Any nyplmin can checks boa al man also all out the xxtion hclaw ahowwe Ihcir waken'mmpnasruon polwy information. t I Ivni.00ea who.4`,il to.emde,f indicming amy am doing all work and Item hire am .&coniria.mal submil n new nlfida,u..dunning such. :Commetars Nm check din bon mal nwebed an adi ilwml shorn showwg the name or 0w.b onnrtars act Ihcir wm its'comp,policy information. I am an employer that is provlding workers'rompeecondon insurance for my employees Below u the policy and job sire inforn le- Insurance Company Name: Guard Insurance Companies Policy nor Self-irm Li,.N: URWy_C6�09917 Expiration Date: 09/04/2019 Job Site Address: LLQ MWl �(ILl AV U City/Stute/Zip: Nodhontt�V I`�I� OIVfY� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 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. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ceenify under the pains andm pah/ies of perjury that the information provided a(btru ]o is e and correct Signat r , JU2 111vta. Q a&tTA[J2rL— -- Dal: '2 –I Phone n: 413-552'/0200 Oficial use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License N Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone n Commonwea0h of Massachusetts Construction Supervisor ®; Division of Professional Licensure Unrestricted-BuNdings ofany use group whiffs contain Board of Building Regulations and Standards less thrr 36.000 cubiC feet rest Cubic eaters)ofe011osed Construetion Supervisor $Pam CS-106178 Expires: D9/282019 - 218THRO T SOUTH HADLEf`YMA 01075 8 • FaOve to possess a fewest r9Uwe of Ne MassachusettsWESLEYCOUTURE ' State Building Code b"use brrevocMlon of this w 0cen . (�Lg. nV Far inlmeeeRlon shadtlNs tlfanse Commissioner ✓"� /� Call(617)7D4200 or visit wwwmsegovldpl � n�/e ((�flllflylC1J"ffltP.lY���l Q�JC��J:1llf'�1ClS('� I Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home improvement Contractor Registration Type LLC AMERICAN INSTALLATIONS,I.I.C. Registration: 175882 130 COLLEGE STREET SUITE 100 E)Oration. 06/26/2019 SOUTH HADLEY,MA 01075 Update Adbess and ratum card. Mark reavan for/lunge. s Al 0 MIAa 11 n Addnzs [2 Ps.r•sl 0Empoyment 0loat Csrdl Onb awA Bullar Retulatlon HOME IMP0EMENT CONTRACTOR asses vs,,kdo.lad.. ItuelaeeNy r. TYPE:LLC belle of ntlair a dBus Mum e 9W75M Expiration OMcaof Consumer Affairs and Bullous Regulation 175982 (10/23/1019 10 Park Plaxa-Sues 5190 A61ERIOAN INSTALLATIONS,U.C. Baton,MA 02116 WESLEY COUTURE IM COL COLLEGE STREET SUITE 100 SOUTH HADLEY,MA 01075 Undersecretary t Valid wiMOut signature A &Il b' CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF NIFOFMATION ONLY AND CORFERS No RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATNELY 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 INSURISKSM AUfHONIED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER BAORTANT: H Me certBrye holler M an ADDITIONAL INSURED,the pDIIMIn)own be elXtcosee. N SUBROGATION 18 WANED.Su0(oct b MB terms coal 0olalltlem Of Me policy,certain policies may repulm an wJorawlent A mlemwR on dela mHIBcRa JOGS not spoke rlghM M the peDSOee holder In lieu of wM e. Hew Lust Poesom ■abbar E OrivvellNo, (413)556-0111 FA2 Immu-bN B tmrth xto,, Btr ELL .lpoeereeeebberaeJpriBBSll.cpm Xtlp "IIORpp°oYFexpe xAIC3 SbrthaRlpton YA 01060 NN/pB1A. 1 • 2mtiul Gaualt NOR® OOA10 Iv. CO. Ameslaen IveullatlOve, e.,n YRYRln Oe ATTsr Na A eoaeme Coutuze Names0, 130 C011e94, Straet, Suite 100 PRe: South BaJ1q to 01073 R. COVERAGES CERTIFICATE NUMBEROuster tm 9-2019 REVISION NURSER: THIS IS TO CERTIFY TMT THE POLICIES OF INSUiUNCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAKED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUREMEITT,TEAM OR OONOITION OF MY CONTRACT OR OTHER DOCUNENT WITH RESPECT TO WHICH THIS CERTIFICATE NAY BE ISSUED OR MAY PEWNN,THE INSURANCE AFFORDED BY THE POUC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TEAMS, EXCLUSIONS AND CONUITIONSOF SUCH POUOES.OMITS SHOV/N NAY HAVE SEEN REDUCED BY PND CWMB. TYKGNOpMXCe R Mow NY& Wit cosesep....WNNIY FIp1pC,CINIBIJE 3 1,000,000 A x gAIMBMADE ❑OOWR S 500,000 3033J3]D EIA/101t 9/U]Ol3 30D FI5 t 10,000 PBISCNNaAw wWv i 11000,000 oam- °R "p LIINWTAwIESPER: OEHtWLMORF9"TE f 2,000,000 Z PoIKv❑PM ❑= Nt)plCix.LpsgPApp t 2,000,000 f AvruoacuANuir f 1,000,ooa A A.A,m BglILY 1NXNY1PrtpxvO i I�.D Z 303)!]11 9/412010 0/4/2010 BbILY YUNYHMaJOxiO 1 X MxFDAVfO" Z .09HgPRRY D/NtlE i s u2].am x mrPsxum HP. 3 8,000 Z WBMW YAeQCUI1 ECH°CgemNOE 2 1,000,900 A ixOeB UAe gAYylNp! ADGfEpATE 3 1,000,000 Z RMHTIONS 10,000 W3333221 9/31.01" 9/N2019 se".0m WMMNAl10x ,1x031K0Y1M'NNMY O NIYMp SNWAeoR "DREWnYF r/x INWNWNANBIEx E%0.WE01 ❑X/A ELISEW-Owr 3 500000 5 Ixnb WIN pRxC60991T 9/312010 9/3/2019 EL p3FA3E-FwEWDYE 3 500.000 N MNuxxr OF I E.Lq 0w Is 500,000 A CaxYtdxl scope., 5NI335227 9/3nolt 9/312019 0binlltx iypp Ce9pORKN OF OPw1110x6/LOCATM11n/YINCL!!IACDM1N,be0vntllxeeb 90Maelnerb NYeMN,eeyu YxyNO/ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE xv117eilOe of Ise &=e THE EXPIRATION DATE THEREOF. NOTICE WILL BE DEINERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AVMORen)RBRAMAIN! �/, N Grinnell, CPLD, CIC 01989-2014 ACORD CORPORATION. All Hgfde feecoYW. ACORD 25(2W4AH) The ACORD name SM logo are roglcoeaJ marks M ACORD IN80251001aa1I