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.
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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.
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
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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
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